Search results for: survival rates

Authors: Praveen Adusumilli, Meher Lakshmi Konatam, Sadashivudu Gundeti, Stalin Bala

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The invention of trastuzumab has changed the treatment of breast cancer and lives of many patients all over the world. Despite many patients getting benefitted from the drug, it is out of reach for most of the patients. There is very limited real world data regarding the epidemiology and clinical outcome of Her2neu positive breast cancer patients. Materials and Methods: This is a retrospective analysis of breast cancer patients presenting to a tertiary care cancer centre in Southern India from 2007 to2013. All early and locally advanced breast cancer patients, who were Her2neu 3+ on IHC are included in the study and evaluated in terms of epidemiology, 3-year disease free survival (DFS)and 5-year overall survival(OS). Chemotherapy regimens used were-FAC 6 cycles or AC 4 cycles followed by 12 cycles of weekly paclitaxel . Trastuzumab was given after 6 cycles of FAC or weekly with paclitaxel followed by 3weekly maintenance until 1 year. Results: Over the period of this study there were 885 newly diagnosed cases of carcinoma breast, of which 242 (27%) were Her2neu positive, 360(40%) were hormone receptor positive, and 212(24%) were triple negative. A total of 71(8%) were Her2neu equivocal of which only 10 patients got FISH test done. Of the 212 newly diagnosed patients, only 74 (29%) opted to have standard of care therapy with trastuzumab at our centre, out of which 52(24%), 8(3%), received under insurance, paying basis respectively. 14(9%) patients received the care as part of clinical trial program (ALTTO trial). 7 (9.72%) patients developed decrease of ejection fraction by greater than 10%, requiring stoppage of trastuzumab out of which 5 were restarted in 2 months. Patients receiving trastuzumab along with chemotherapy had longer 3year DFS 92% vs. 60% (p value<0.0001) when compared to chemotherapy alone. 5 year OS was 87% vs 44% (p-value <0.0001) compared to chemotherapy alone. Conclusion: Trastuzumab with chemotherapy improves the DFS and OS in Her2neu positive patients. The biggest constraint is the cost of the treatment and absence of universal health security net to treat all patients with this diagnosis.

Keywords: breast cancer, Her 2 neu positive, real world data, Trastuzumab

Procedia PDF Downloads 146

Authors: Pouya Molana, Zeinab Alimohammadi

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Determining wind wave characteristics is essential for implementing projects related to Coastal and Marine engineering such as designing coastal and marine structures, estimating sediment transport rates and coastal erosion rates in order to predict significant wave height (H_s), this study applies the third generation spectral wave model, Mike 21 SW, along with CEM model. For SW model calibration and verification, two data sets of meteorology and wave spectroscopy are used. The model was exposed to time-varying wind power and the results showed that difference ratio mean, standard deviation of difference ratio and correlation coefficient in SW model for H_s parameter are 1.102, 0.279 and 0.983, respectively. Whereas, the difference ratio mean, standard deviation and correlation coefficient in The Choice Experiment Method (CEM) for the same parameter are 0.869, 1.317 and 0.8359, respectively. Comparing these expected results it is revealed that the Choice Experiment Method CEM has more errors in comparison to MIKE 21 SW third generation spectral wave model and higher correlation coefficient does not necessarily mean higher accuracy.

Keywords: MIKE 21 SW, CEM method, significant wave height, difference ratio

Procedia PDF Downloads 370

Authors: Ana Sofia Saldanha

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The globalization is changing the translation world day after day, year after year. The need to know more about new technologies, clients, companies and social networks is becoming more and more demanding and competitive. The recently graduated translators usually do not know where to go, what to do or even who to contact to start their careers in translation. It is well known that there are innumerous webinars, books, blogs, webpages and even Facebook pages indicating what to do, what not to do, rates, how your CV should look like, etc. but are these pieces of advice of real translators? Translators, who work daily with clients, who understand their demands, requests, questions? As far as today`s trends, the answer is NO. Most of these pieces of advice are just theoretical and far away from the real translation world. Therefore, mentoring is becoming a very important tool to help and guide new translators starting their career. An effective and well-oriented mentoring is a powerful way to orient these translators on how to create their CVs, where to send CVs, how to approach clients, how to answer emails and how to negotiate rates in an efficient way. Mentoring is crucial when properly delivered by professional and experienced translators, to help developing careers. The advice and orientation sessions are almost a 'weapon' to destroy the barriers created by opinions, by influences or even by universities. This new trend is the future path of new translators and is the future of the translation industry and professionals, however minds and spirits need to be opened and engaged in this new way of developing skills.

Keywords: mentoring, translation, translators, orientation, professional path

Procedia PDF Downloads 151

Authors: Mohammad Hossein Karimi Darvanjooghi, Sara Magdouli, Satinder Kaur Brar

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It has been reported that the microorganism’s attachment to the surfaces of ore samples is a key factor that influences the biooxidation in pretreatment for recovery of gold in sulfide-bearing ores. In this research, the implementation of D-(+)-Sucrose on the biooxidation of ore samples were studied in a semi-pilot experiment. The experiments were carried out in five separate jacketed columns (1 m height and 6 cm diameter) at a constant temperature of 37.5 ̊C and saturated humidity. The airflow rate and recycling solution flow rate were studied in the research and the optimum operating condition were reported. The ore sample (0.49 ppm gold grade) was obtained from the Hammond Reef mine site containing 15 wt.% of pyrite which included 98% of gold according to the results of micrograph images. The experiments were continued up to 100 days while air flow rates were chosen to be 0.5, 1, 1.5, 2, and 3 lit/min and the recycling solution (Containing 9K media and 0.4 wt.% D-(+)-Sucrose) flow rates were kept 5, 8, 15 ml/hr. The results indicated that the addition of D-(+)-Sucrose increased the bacterial activity due to the overproduction of extracellular polymeric substance (EPS) up to 95% and for the condition that the recycling solution and air flow rate were chosen to be 8 ml/hr and 2 lit/min, respectively, the maximum pyrite dissolution of 76% was obtained after 60 days. The results indicated that for the air flow rates of 0.5, 1, 1.5, 2, and 3 lit/min the ratio of daily pyrite dissolution per daily solution lost were found to be 0.025, 0.033, 0.031, 0.043, and 0.009 %-pyrite dissolution/ml-lost. The implementation of this microorganisms and the addition of D-(+)-Sucrose will enhance the efficiency of gold recovery through faster biooxidation process and leads to decrease in the time and energy of operation toward desired target; however, still other parameters including particle size distribution, agglomeration, aeration design, chemistry of recycling solution need to be controlled and monitored for reaching the optimum condition.

Keywords: column tests, biooxidation, gold recovery, Ferroplasma acidophilum, optimization

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Authors: F. Villaret, I. Jacot, Y. Shen, Z. Kong, T. XU, Y. Wang, D. Lu

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Wire Arc Additive Manufacturing (WAAM) allows the rapid production of large, homogeneous parts with complex geometry. However, in the nuclear field, parts can reach dimensions of ten to a hundred tons. In this case, the usual WAAM TIG or CMT processes do not have sufficient deposition rates to consider the manufacture of parts of such dimensions within a reasonable time. The submerged arc welding process (SAW, Submerged Arc Welding) allows much higher deposition rates. Although there are very few references to this process for additive manufacturing in the literature, it has been used for a long time for the welding and coating of nuclear power plant vessels, so this process is well-known and mastered as a welding process. This study proposes to evaluate the SAW process as an additive manufacturing technique by taking as an example a low-alloy steel of type 16MND5. In the first step, a parametric study allowed the evaluation of the effect of the different parameters and the deposition rate on the geometry of the beads and their microstructure. Larger parts were also fabricated and characterized by metallography and mechanical tests (tensile, impact, toughness). The effect of different heat treatments on the microstructure is also studied.

Keywords: WAAM, low alloy steel, submerged arc, caracterization

Procedia PDF Downloads 59

Authors: Benaissa Fatima, Alkama Rezak, Annesi-Maesano Isabella

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To assess the health impact of the air pollution on the population of Béjaia, we carried out a descriptive epidemiologic inquiry near the medical establishments of three areas. From the registers of hospital admissions, we collected data on the hospital mortality and admissions relating to the various cardiorespiratory pathologies generated by this type of pollution. In parallel, data on the automobile fleet of Bejaia and other measurements were exploited to show that the concentrations of the pollutants are strongly correlated with the concentration the urban traffic. This study revealed that the whole of the population is touched, but the sensitivity to pollution can show variations according to the age, the sex and the place of residence. So the under population of the town of Bejaia marked the most raised death and morbidity rates, followed that of Kherrata. Weak rates are recorded for under rural population of Feraoun. This approach enables us to conclude that the population of Béjaia could not escape the urban pollution generated by her old automobile fleet. To install a monitoring and measuring site of the air pollution in this city could provide a beneficial tool to protect its inhabitants by them informing on quality from the air that they breathe and measurements to follow to minimize the impacts on their health and by alerting the authorities during the critical situations.

Keywords: air, urban pollution, health, impacts

Procedia PDF Downloads 330

Authors: John Gichimu Mbaka, Jan Helmrich Martin von Baumbach, Celia Somlai, Denis Köpfer, Andreas Maeck, Andreas Lorke, Ralf Schäfer

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Leaf litter decomposition is an important process providing energy to biotic communities. Additionally, methane gas (CH4) has been identified as an important alternative source of carbon and energy in some freshwater food webs.Flow regulation and dams can strongly alter freshwater ecosystems, but little is known about the effect of small impoundments on leaf litter decomposition and methane derived carbon in streams. In this study, we tested the effect of small water storage impoundments on leaf litter decomposition rates and methane derived carbon. Leaf litter decomposition rates were assessed by comparing treatment sites located close to nine impoundments (Rheinland Pfalz state, Germany) and reference sites located far away from the impoundments.CH4 concentrations were measured in eleven impoundments and correlated with the δ13C values of two subfamilies of chironomid larvae (i.e. Chironomini and Tanypodinae). Leaf litter break down rates were significantly lower in study sites located immediately above the impoundments, especially associated with a reduction in the abundance of shredders. Chironomini larvae had the lower mean δ13C values (‒29.2 to ‒25.5 ‰), than Tanypodinae larvae (‒26.9 to ‒25.3 ‰).No significant relationships were established between CH4 concentrations and δ13C values of chironomids (p> 0.05).Mean δ13C values of chironomid larvae (mean: ‒26.8‰, range: ‒ 29.2‰ to ‒ 25.3‰) were similar to those of sedimentary organic matter (SOM) (mean: ‒28.4‰, range: ‒ 29.3‰ to ‒ 27.1‰) and tree leaf litter (mean: ‒29.8 ‰, range: ‒ 30.5‰ to ‒ 29.1‰). In conclusion, this study demonstrates that small impoundments may have a negative effect on leaf litter decomposition in forest streams and that CH4 has limited influence on the benthic food web in stream impoundments.

Keywords: river functioning, chironomids, Alder tree, stable isotopes, methane oxidation, shredder

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Authors: Lule Basha, Eralda Gjika

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The exchange rate is one of the most important economic variables, especially for a small, open economy such as Albania. Its effect is noticeable in one country's competitiveness, trade and current account, inflation, wages, domestic economic activity, and bank stability. This study investigates the fluctuation of Albania’s exchange rates using monthly average foreign currency, Euro (Eur) to Albanian Lek (ALL) exchange rate with a time span from January 2008 to June 2021, and the macroeconomic factors that have a significant effect on the exchange rate. Initially, the Random Forest Regression algorithm is constructed to understand the impact of economic variables on the behavior of monthly average foreign currencies exchange rates. Then the forecast of macro-economic indicators for 12 months was performed using time series models. The predicted values received are placed in the random forest model in order to obtain the average monthly forecast of the Euro to Albanian Lek (ALL) exchange rate for the period July 2021 to June 2022.

Keywords: exchange rate, random forest, time series, machine learning, prediction

Procedia PDF Downloads 78

Authors: Peter R. Alfieri

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The principal aim of this research and presentation is to give global and personal perspective of the migratory diaspora and how it is perceived by a substantial majority that relies on the media’s portrayal of migratory movements. Since its Greek origins the word “diaspora” has taken on several connotations, but none has surpassed its use in regard to the human element; because since before the dawn of history, man has had to struggle for survival. That survival was a struggle against the elements and other natural enemies, but none as tenacious and relentless as other men. Many have used the term diaspora to describe the spread of certain ethnic groups resulting in new generations in new places; but has the human diaspora been as haphazard as that of spores? The quest for survival has spawned migrations that are not quite that simple, even though it has several similarities to plant spores or dandelion seeds flying throughout the atmosphere. Man kind has constantly migrated in search of food, shelter, and safety. When they were able to find food and shelter, they would inform others who would venture to the new place. Information, whether through word of mouth, written material, or visual communications, has been a moving force in man’s life; and it spurred migrants in their quest for better environments. Today we pride ourselves in being able to communicate instantly with anyone anywhere in the world, and we are privileged to see most of what is happening in the world thanks to the highly developed modern media. Is Media a “wind/force” instrumental in propelling the diaspora throughout the world? The media has been the tool that has incentive many migratory, but unfortunately it is also the means responsible for many misconceptions regarding migrants and their hosts. Has the Media presented an unbiased view of the migrant or has it been the means that generated negative or prejudiced views of the migrant and, perhaps, the host environment? Some examples were easily seen in 19th century the United States where they advertised the following, “Help needed, Irish need not apply”. How do immigrants circumvent latent barriers that are not as obvious as the ones just mentioned? Some immigrants return home and have children that decide to emigrate. It is a perpetual cycle in the search for self-improvement. The stories that are brought back might be inspiration for the new generation of emigrants. Poverty, hunger, and political turmoil spur most migrations. The majority learn from others or through the media about certain destinations that will provide one or several opportunities to improve their existence. Many of those migrants suffer untold hardships to succeed. When they succeed, they provide a great incentive for their children to obtain an education or skill that will insure them a better life. Although the new environment may contribute greatly to a successful career, most immigrants do not forget their own struggle. They see the media’s portrayal of other migrants from all over the globe. Some try to communicate to others the true feelings of despair felt by immigrants, because they are all brothers and sisters in the perennial struggle for a better life. “HOPE” for a better life drives the immigrant toward the unknown and it has helped overcome the obstacles that present themselves challenging every newcomer. Hope and perseverance strengthen the resolve of the migrant in his struggle to survive.

Keywords: media, migration, heath, education, obstacles

Procedia PDF Downloads 350

Authors: Salma H. Abu Hafsa, A. Mendonca, B. Brehm-Stecher, A. A. Hassan, S. A. Ibrahim

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Enterococci are important inhabitants of the animal intestine and are widely used in probiotic products. A probiotic strain is expected to possess several desirable properties in order to exert beneficial effects. Therefore, the objective of this study was to isolate and characterize strains of Enterococcus sp. from chicken cecal and fecal samples to determine potential probiotic properties. Enterococci were isolated from thirty one chicken cecal and fecal samples collected from a local farm. In vitro studies were performed to assess antibacterial activity (using agar well diffusion and cell free supernatant broth technique against Salmonella enterica serotype Enteritidis), susceptibility to antibiotics (amoxycillin, cotrimoxazole, chloramphenicol, cefuroxime, ceftriaxone, ciprofloxacin, and nalidixic acid), survival in acidic conditions, resistance to bile salts, and their survival during simulated gastric juice conditions at pH 2.5. Isolates were identified using biochemical and molecular assays (API 50 CHL, and API ZYM kits followed by 16S rDNA gene sequence analysis). Two strains were identified, of which, Enteroccocus faecium was capable of inhibiting the growth of S. enteritidis and was susceptible to a wide range of antibiotics. In addition, the isolated strain exhibited significant resistance under highly acidic conditions (pH=2.5) for 8 hours and survived well in bile salt at 0.2% for 24 hours and showing ability to survive in the presence of simulated gastric juice at pH 2.5. Based on these results, the E. faecium isolate fulfills some of the criteria to be considered as a probiotic strain and therefore, could be used as a feed additive with good potential for controlling S. enteritidis in chickens. However, in vivo studies are needed to determine the safety of the strain.

Keywords: acid tolerance, antimicrobial activity, Enterococcus faecium, probiotic

Procedia PDF Downloads 379

Authors: Saeedeh Imani Moqadam, Ilya Bobrov, Jérémy Epp, Nils Ellendt, Lutz Mädler

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High entropy alloys (HEAs), having adjustable properties and enhanced stability compared with intermetallic compounds, are solid solution alloys that contain more than five principal elements with almost equal atomic percentage. The concept of producing such alloys pave the way for developing advanced materials with unique properties. However, the synthesis of such alloys may require advanced processes with high cooling rates depending on which alloy elements are used. In this study, the micro spheres of different diameters of HEAs were generated via a drop-on-demand droplet generator and subsequently solidified during free-fall in an argon atmosphere. Such droplet generators can generate individual droplets with high reproducibility regarding droplet diameter, trajectory and cooling while avoiding any interparticle momentum or thermal coupling. Metallography as well as X-ray diffraction investigations for each diameter of the generated metallic droplets where then carried out to obtain information about the microstructural state. To calculate the cooling rate of the droplets, a droplet cooling model was developed and validated using model alloys such as CuSn%6 and AlCu%4.5 for which a correlation of secondary dendrite arm spacing (SDAS) and cooling rate is well-known. Droplets were generated from these alloys and their SDAS was determined using quantitative metallography. The cooling rate was then determined from the SDAS and used to validate the cooling rates obtained from the droplet cooling model. The application of that model on the HEA then leads to the cooling rate dependency and hence to the identification of process windows for the synthesis of these alloys. These process windows were then compared with cooling rates obtained in processes such as powder production, spray forming, selective laser melting and casting to predict if a synthesis is possible with these processes.

Keywords: cooling rate, drop-on-demand, high entropy alloys, microstructure, single droplet generation, X-ray Diffractometry

Procedia PDF Downloads 187

Authors: Aliaa M. Issa, Mahmoud N. ElRouby, Sahar A. S. Ahmad, Mahmoud M. El-Merzabani

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Sider honey is a type of honey produced by bees feeding on the nectar of Sider tree, Ziziphus spina-christi (L) Desf . Honey is an effective agent for preventing, inhibiting and treating the growth of human and animal cancer cell lines in vitro and in vivo. The aim of the present study was to evaluate the impact of different dilutions from crude Sider honey and different duration times of exposure on the growth of six tumor cell lines (human cervical cancer cell line, HeLa; human hepatocellular carcinoma cell line, HepG-2; human larynx carcinoma cell line, Hep-2; brain tumor cell line, U251) as well as one animal cancerous cell line (Ehrlich ascites carcinoma cells line, EAC) and one normal cell line, Homo sapiens, human, (WISH) CCL-25. Different concentrations and treatment durations with Sider honey were tested on the growth of several cancer cell lines types. Histopathological changes in the tumor masses, animal survival, apoptosis and necrosis of the used cancer cell lines (using flow cytometry) were evaluated. Sider honey was administers either to the tumor mass itself by intratumoral injection or via drinking water. One-way ANOVA test was used for the analysis of (the means + standard error) of the optical density obtained from the Elisa reader and flow cytometry. The study revealed that different concentrations of Sider honey affected the growth patterns of all the studied cancer cell lines as well as their histopathological changes, and it depended on the cell line nature and the concentration of honey used. It is obvious that the relative animal survival percentage (bearing Ehrlich ascites carcinoma, EAC cells) was proportionally increased with the increase in the used honey concentrations. The study of apoptosis and necrosis using the flow cytometry technique emphasized the viability results. In conclusion, Sider honey was effective as antitumor agent, in the used concentrations.

Keywords: antitumor, honey, sider, tumor cell lines

Procedia PDF Downloads 496

Authors: Julius Steinkopf, Eric Rost, Aike Hessel, Sonia Lippke

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Objective: This study examined possible determinants of return to work (RTW) in individuals who participated in a medical rehabilitation program longitudinally over a time period of six months. Design/methodology/approach: N=1,044 rehabilitants were included in the baseline measurement in terms of completing a questionnaire during their medical rehabilitation. About 30% (n=350) have remained in the study in terms of participating in computer-assisted telephone interviewing (CATI) six months later. Frequency analyses and Regression analyses were run. Findings: About 70% of the rehabilitants returned to work six months after rehabilitation. Regression analyses revealed that the RTW rates were significantly predicted by gender (OR=0.12, men were more likely to return), perceived social support (OR=3.01) and current physical functioning (OR=1.25). Furthermore RTW motives, like expected monetary rewards (OR=25.2) and feelings of being needed (OR=0.18) same as motives for not returning to work (nRTW), like the wish to stop working in order to spend time with the spouse (OR=0.13) or a lack of enjoyment of work (OR=3.81), significantly predicted return to work rates. Life satisfaction, self-efficacy beliefs, mental health, current income, educational background or age did not significantly increase explained variance (all ps > .05). Practical implications: Taking theses predictors into account provides options to increase the effectiveness of interventions aiming at increasing RTW: Medical rehabilitations should not only aim at improving the physical functioning but also to enhance beneficial motives and social support as well as support women specifically in order to improve the effectiveness of medical rehabilitation and public health interventions. Originality/value: Illness-caused work absences are related to high financial costs and individual burden. Despite of the public health and societal implications, this is one of the very few studies investigating systematically fitness and health for the return to work.

Keywords: gender, fitness, health, physical functioning

Procedia PDF Downloads 217

Authors: Anil Kumar Kursenge

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In the State of united Andhra Pradesh, many Adivasi People live in areas rich in living and non-living resources, including forests that contain abundant biodiversity, water and minerals. Of united Andhra Pradesh 76.2m population, over five million are Adivasi population of forest landscape. They depend on forests for a substantial part of their livelihoods and close cultural affinity with forests. However, they are the most impoverished population of the State, and the high levels of poverty in Andhra Pradesh forest landscapes are largely an outcome of historically-rooted institutionalised marginalisation. As the State appropriated forests and forest land for itself, it deprived local people of their customary rights in the forest. The local realities of the forest rights deprivations are extremely complex, reflecting a century and a half of compounded processes. With growing population pressure and ever-increasing demands for natural and mineral resources, Adivasi Peoples' lands, which are often relatively rich in resources, become more and more attractive to 'developers.' The development projects and institutionalised marginalisation have been deprived Adivasi people's rights over natural resources has resulted in serious negative effects on Adivasi people and on their lands. Historically, the desire for development for such resources has resulted in the removal, decimation, or extermination of many tribal communities. These deprivations have led to highly conflictual relations between the State and the Adivasi people and forest areas in Andhra Pradesh. Today, the survival of the Adivasi Peoples requires recognition of their rights to the forest resources found in their lands and territories on which they depend for their economic, cultural, survival, spiritual and physical well-being. In this context, this paper attempts to discuss the issues of deprivation with regard to access to forest resources and development projects where many Adivasis in State uprooted from their homes and lands.

Keywords: tribal people, forest rights, livelihoods, deprivation, marginalisation, Andhra Pradesh

Procedia PDF Downloads 176

Authors: Arman Kishan, Mark Haft, Kiyanna Thomas, Duc Nguyen, Dawn Laporte

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Objective: Patients receiving anticoagulation therapy frequently experience increased rates of postoperative complications. Presently, limited data exist regarding the outcomes of patients undergoing carpal tunnel release surgery (CTR) while on anticoagulation. Our objective is to examine and compare the occurrence of complications in patients on anticoagulation who underwent either endoscopic CTR (ECTR) or open CTR (OCTR) for CTS. Methods: The Trinet X database was utilized to retrospectively identify patients who underwent OCTR or ECTR while concurrently on anticoagulation. Demographic data, medical comorbidities, and complication rates were analyzed. We used multivariable analysis to identify differences in postoperative complications, including wound infection within 90 days, wound dehiscence within 90 days, and intraoperative median nerve injury between the two surgical methods in patients on anticoagulation. Results: A total of 10,919 carpal tunnel syndrome patients on anticoagulation were included in the study, with 9082 and 1837 undergoing OCTR and ECTR, respectively. Among patients on anticoagulation, those undergoing ECTR exhibited a significantly lower occurrence of 90-day wound infection (p < 0.001) and nerve injury (p < 0.001) compared to those who underwent OCTR. However, there was no statistically significant difference in the risk of 90-day wound dehiscence between the two groups (p = 0.323). Conclusion:  In prior studies, ECTR demonstrated reduced rates of postoperative complications compared to OCTR in the general population. Our study demonstrates that among patients on anticoagulation, those undergoing ECTR experienced a significantly lower incidence of 90-day wound infection and nerve injury, with risk reductions of 35% and 40%, respectively. These findings support using ECTR as a preferred surgical method for patients with CTS who are on anticoagulation therapy.

Keywords: endoscopic treatment of carpal tunnel syndrome, open treatment of carpal tunnel syndrome, postoperative complications in patients on anticoagulation, carpal tunnel syndrome

Procedia PDF Downloads 43

Authors: Sigrid James

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Purpose and Background: Despite a global policy push for deinstitutionalization, residential care for children and youth remains a relevant and highly utilized out-of-home care option in many countries, fulfilling functions of care and accommodation as well as education and treatment. While many youths are placed in residential care programs temporarily or during times of transition, some still spend years in programs that range from small group homes to large institutions. How residential care is used and what function it plays in child welfare systems is influenced by a range of factors. Among them are sociocultural and historical developments, available resources for child welfare, cultural notions about family, a lack of family-based placement alternatives as well as a belief that residential care can be beneficial to children. As part of a larger study that examined differences in residential care across 16 countries along a range of dimensions, this paper reports findings on utilization rates of residential care, i.e., the proportion of out out-of-home care dedicated to residential care relative to forms of family-based foster care. Method: Using an embedded multiple-case design study approach where a country represents a case, residential care in 16 countries was studied and compared. The comparison was focused on countries with developed social welfare systems and included Spain, Denmark, Germany, Ireland, the Netherlands, England, Scotland, Australia, Italy, Israel, Argentina, Portugal, Finland, France, the United States and Canada. Experts from each country systematically collected data on residential care based on a common matrix developed by the author. A range of sources were accessed depending on the information sought, including administrative data, government reports, research studies, etc. Utilization rates were mostly drawn from administrative data or government reports. While denominators may slightly differ, available data allowed for meaningful comparisons. Beyond descriptive data on utilization rates, analysis allowed to also capture trends in utilization (increasing, decreasing, stable) as well as the rate change. Results: Results indicate high variability in the utilization of residential care, covering the entire spectrum from a low of 7% to a high of 97%, with most countries falling somewhere in between. Three utilization categories were identified: high-users of residential care (Portugal, Argentina and Israel), medium-users (Denmark, France, Italy, Finland, Spain, Netherlands, Germany), and low-users (England, Scotland, Ireland, Canada, Australia, the United States). A number of countries experienced drastic reductions in residential care during the past few years (e.g. US), while others have seen stable rates (e.g., Portugal) or even increasing rates (e.g., Spain). Conclusions: Multiple contextual factors have to be considered when interpreting findings. For instance, countries with low residential care rates have, in most cases, undergone recent legislative changes to drastically reduce residential care. In medium-utilization countries, residential care reforms seem to be primarily focused on improving standards and, thus, the quality of care. High utilization countries generally face serious obstacles to implementing alternative family-based forms of out-of-home care. Cultural acceptance of residential or foster care and notions of professionalism also appear to play an important role in explaining variability in utilization.

Keywords: residential youth care, child welfare, case study, cross-national comparative research

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Authors: F. S. Alavi, D. Mowla, F. Esmaeilzadeh

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In this paper, the Eclipse 300 simulator was used to perform compositional modeling of gas injection process for enhanced condensate recovery of a real gas condensate well in south of Iran here referred to as SA4. Some experimental data were used to tune the Peng-Robinson equation of state for this case. Different scenarios of gas injection at current reservoir pressure and at abandonment reservoir pressure had been considered with different gas compositions. Methane, carbon dioxide, nitrogen and two other gases with specified compositions were considered as potential gases for injection. According to the obtained results, nitrogen leads to highest pressure maintenance in the reservoir but methane results in highest condensate recovery among the selected injection gases. At low injection rates, condensate recovery percent is strongly affected by gas injection rate but this dependency shifts to zero at high injection rates. Condensate recovery is higher in all cases of injection at current reservoir pressure than injection at abandonment pressure. Using a constant injection rate, increasing the production well bottom hole pressure results in increasing the condensate recovery percent and time of gas breakthrough.

Keywords: gas-condensate reservoir, case-study, compositional modelling, enhanced condensate recovery, gas injection

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Authors: Jean C. G. Silva, Kaline N. Ferreira, Rennio F. Sena, Flavio L. H. Silva

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The Prosopis juliflora (called algaroba in Northeastern Region of Brazil) is a species of medium to large size that can reach 18 meters high, being typical of arid and semi-arid regions by to requirement less water to survive; this is a fundamental attribute from its adaptation. It's considered of multiple uses, because the trunk, the fruit, and the algaroba pods are utilized for several purposes, among them, the production of wood from lumber mill, charcoal, alcohol, animal and human consumption, being hence, a culture of economic and social value. The use of waste Prosopis juliflora can be carried out for like pyrolysis and gasification processes, in order to energy production in those regions where it is grown. Thus this study aims to characterize the residue of the algaroba pods and evaluate the kinetic parameters, activation energy (Ea) and pre-exponential factor (k0), the devolatilization process through the data obtained from TG/DTG curves with different levels of heating rates. At work was used the heating rates of 5 K.min-1, 10 K.min-1, 15 K.min-1, 20 K.min-1 and 30 K.min-1, in inert nitrogen atmosphere (99.997%) under a flow of 40 ml.min-1. The kinetic parameters were obtained using the methods of Friedman and Ozawa-Flynn-Wall.

Keywords: activation energy, devolatilization, kinetic parameters, waste

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Authors: G. Nampa, M. Ndlovu

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Mutualistic relationships amongst organisms drive diversity in terrestrial ecosystems. Yet, few mutual associations have been documented in the semi-arid savannas of Africa. The levels and benefits of association between Carissa bispinosa, a medium-sized evergreen thorny shrub, and Trinervitermes trinervoides, an ecosystem engineer termite species, were studied at a semi-arid savanna setting in Nylsvley nature reserve, South Africa. It was hypothesized that there would be a close plant-insect association since termite mounds provide nutrients for plant growth and, in return, the thorny shrubs protect mounds from predation and also provide a temperature buffer. Comparative plant and mounds measurements were taken from associated and isolated occurrences seasonally. Soil particle size, macro- and micronutrients were also evaluated from mounds and the adjacent topsoil matrix General Additive Mixed Models were used to assess internal mound temperatures in relation to prevailing ambient and plant shade temperatures. Findings revealed that plants growing on mounds were significantly taller with a wider canopy and remained greener in the dry season with more fruits. On the other hand, termite mounds under plants were less prone to be damaged by aardvarks and pangolins and had a significantly wider diameter than exposed mounds. All soil macronutrients except for calcium and phosphorous were enriched in mounds relative to the matrix. Only Manganese was enriched in mounds while the other micronutrients (Cu, Fe, Zn and B) were not. Termite mounds under plants maintained a better constant and higher mean internal temperature during winter compared to exposed mounds. To our best knowledge, the study has revealed a previously undocumented survival mechanism that termites use to escape extreme temperatures and predation in semi-arid savannas.

Keywords: mound, mutualism, soil nutrients, termites, thermoregulation

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Authors: Welawat Tienpratarn, Chaiyaporn Yuksen, Kasamon Aramvanitch, Karn Suttapanit, Yahya Mankong, Nussareen Yaemluksanalert, Sansanee Meesawad

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Introduction : Application of a rigid cervical collar may interfere with the laryngeal view, and potentially lead to failed endotracheal intubation (ETI). This study aimed to compare intubation success rates while performing inline stabilization with and without cervical hard collar. Methods : This randomized prospective comparative study included paramedics working in the Department of Emergency Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand to compare the success rates of endotracheal intubation on manikin using inline stabilization with and without cervical hard collar. Results : 125 participants were evaluated; 63 in the rigid cervical collar and 62 in the non-cervical hard collar group. The rate of successful intubation was significantly higher using manual stabilization without cervical hard collar (61 (96.8%) vs. 55 (88.7%); p=0.048). The time required to successfully perform intubation was also shorter, with manual stabilization only (14.1 ±20.9 vs. 18.9±29.0; p = 0.081). Conclusion : It seems that, removal of the rigid cervical collar during ETI in patients with suspected traumatic spine injury could increase the intubation success rate.

Keywords: ntubation, Intratracheal, Spinal Injuries, Multiple trauma

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Authors: A. S. Lourens, B. Du Plooy

Abstract:

Across the world, initiatives have been introduced to encourage women to enter into and remain in engineering fields. However, research has shown that many women leave engineering or suffer a loss of self-esteem and self-confidence compared to their male counterparts. To address this problem, a South African comprehensive university developed a self-leadership intervention pilot study in 2013, aimed at improving the self-efficacy of its female engineering students and increasing retention rates. This paper is a qualitative, descriptive and interpretive study of the rationale and operational aspects of the Women in Engineering Leadership Association’s (WELA) self-leadership workshop. The objectives of this paper are to provide a framework for the design of a self-leadership workshop and to provide insight into the process of developing such a workshop specifically for women engineering students at a South African university. Finally, the paper proposes an evaluation process for the pilot workshop, which also provides a framework to improve future workshops. It is anticipated that the self-leadership development framework will be applicable to other higher education institutions wishing to improve women engineering student’s feelings of self-efficacy and therefore retention rates of women in engineering.

Keywords: self-leadership, women in engineering, co-curricular interventions, self-efficacy

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Authors: Zhipeng Yan, Janice Wing-Tung Kwong, Ching-Lung Lai

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Background: Advanced melanoma accounts for the majority of skin cancer death due to its poor prognosis. Nivolumab and ipilimumab are monoclonal antibodies targeting programmed cell death protein 1 (PD-1) and cytotoxic T-lymphocytes antigen 4 (CTLA-4). Nivolumab and ipilimumab combination therapy has been proven to be effective for advanced melanoma. This systematic review and meta-analysis are to evaluate its clinical efficacy and adverse events. Method: A systematic search was done on databases (Pubmed, Embase, Medline, Cochrane) on 21 June 2020. Search keywords were nivolumab, ipilimumab, melanoma, and randomised controlled trials. Clinical trials fulfilling the inclusion criteria were selected to evaluate the efficacy of combination therapy in terms of prolongation of progression-free survival (PFS), overall survival (OS), and objective response rate (ORR). The odd ratios and distributions of grade 3 or above adverse events were documented. Subgroup analysis was performed based on PD-L1 expression-status and BRAF-mutation status. Results: Compared with nivolumab monotherapy, the hazard ratios of PFS, OS and odd ratio of ORR in combination therapy were 0.64 (95% CI, 0.48-0.85; p=0.002), 0.84 (95% CI, 0.74-0.95; p=0.007) and 1.76 (95% CI, 1.51-2.06; p < 0.001), respectively. Compared with ipilimumab monotherapy, the hazard ratios of PFS, OS and odd ratio of ORR were 0.46 (95% CI, 0.37-0.57; p < 0.001), 0.54 (95% CI, 0.48-0.61; p < 0.001) and 6.18 (95% CI, 5.19-7.36; p < 0.001), respectively. In combination therapy, the odds ratios of grade 3 or above adverse events were 4.71 (95% CI, 3.57-6.22; p < 0.001) compared with nivolumab monotherapy, and 3.44 (95% CI, 2.49-4.74; p < 0.001) compared with ipilimumab monotherapy, respectively. High PD-L1 expression level and BRAF mutation were associated with better clinical outcomes in patients receiving combination therapy. Conclusion: Combination therapy is effective for the treatment of advanced melanoma. Adverse events were common but manageable. Better clinical outcomes were observed in patients with high PD-L1 expression levels and positive BRAF-mutation.

Keywords: nivolumab, ipilimumab, advanced melanoma, systematic review, meta-analysis

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Authors: Amar Ranjan, Julieana Durai, Pranay Tanwar

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Background &Introduction: Ovarian cancer is one of the most common malignant tumor in the female. 70% of the cases of ovarian cancer are diagnosed at an advanced stage. The five-year survival rate associated with ovarian cancer is less than 30%. The early diagnosis of ovarian cancer becomes a key factor in improving the survival rate of patients. Presently, CAl25 (carbohydrate antigen125) is used for the diagnosis and therapeutic monitoring of ovarian cancer, but its sensitivity and specificity is not ideal. The introduction of HE4, human epididymis protein 4 has attracted much attention. HE4 has a sensitivity and specificity of 72.9% and 95% for differentiating between benign and malignant adnexal masses, which is better than CA125 detection.  Methods: Serum HE4 and CA -125 were estimated using the chemiluminescence method. Our cases were 40 epithelial ovarian cancer, 9 benign ovarian tumor, 29 benign gynaecological diseases and 13 healthy individuals. This group include healthy woman those who have undergoing family planning and menopause-related medical consultations and they are negative for ovarian mass. Optimal cut off values for HE4 and CA125 were 55.89pmol/L and 40.25U/L respectively (determined by statistical analysis). Results: The level of HE4 was raised in all ovarian cancer patients (n=40) whereas CA125 levels were normal in 6/40 ovarian cancer patients, which were the cases of OC confirmed by histopathology. There is a significant decrease in the level of HE4 with comparison to CA125 in benign ovarian tumor cases. Both the levels of HE4 and CA125 were raised in the nonovarian cancer group, which includes cancer of endometrium and cervix. In the healthy group, HE4 was normal in all patients except in one case of the rudimentary horn, and the reason for this raised HE4 level is due to the incomplete development of uterus whereas CA125 was raised in 3 cases. Conclusions: Findings showed that the serum level of HE4 is an important indicator in the diagnosis of ovarian cancer, and it also distinguishes between benign and malignant pelvic masses. However, a combination of HE4 and CA125 panel will be extremely valuable in improving the diagnostic efficiency of ovarian cancer. These findings of our study need to be validated in the larger cohort of patients.

Keywords: human epididymis protein 4, ovarian cancer, diagnosis, benign lesions

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Authors: Ali A. Bazzi, Ameer Hamza, Riley O’Hara, Kimberly Kado, Karen H. Hagglund, Lamia Fathallah, Robert T. Morris

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Introduction: Endometrial Cancer is a common gynecologic malignancy primarily treated with complete surgical staging, which may include complete pelvic and para-aortic lymphadenectomy. The role of lymphadenectomy is controversial, especially the intraoperative indications for the procedure. Three factors are important in decision to proceed with lymphadenectomy: Myometrial invasion, maximum tumor dimension, and histology. Many institutions incorporate these criteria in varying degrees in the decision to proceed with lymphadenectomy. This investigation assesses the use of intraoperatively measured MTD with and without pre-operative histologic grade. Methods: This study compared retrospectively EEC patients with intraoperatively measured MTD ≤2 cm to those with MTD >2 cm from January 1, 2002 to August 31, 2017. This assessment compared those with MTD ≤ 2cm with endometrial biopsy (EB) grade 1-2 to patients with MTD > 2cm with EB grade 3. Lymph node metastasis (LNM), recurrence, and survival were compared in these groups. Results: This study reviewed 222 patient cases. In tumors > 2 cm, LNM occurred in 20% cases while in tumors ≤ 2 cm, LNM was found in 6% cases (p=0.04). Recurrence and mean survival based on last follow up visit in these two groups were not statistically different (p=0.78 and 0.36 respectively). Data demonstrated a trend that when combined with preoperative EB International Federation of Gynecology and Obstetrics (FIGO) grade, a higher proportion of patients with EB FIGO Grade 3 and MTD > 2 cm had LNM compared to those with EB FIGO Grade 1-2 and MTD ≤ 2 cm (43% vs, 11%, p=0.06). LNM was found in 15% of cases in which lymphadenectomy was performed based on current practices, whereas if the criteria of EB FIGO 3 and MTD > 2 cm were used the incidence of LNM would have been 44% cases. However, using this criterion, two patients would not have had their nodal metastases detected. Compared to the current practice, the sensitivity and specificity of the proposed criteria would be 60% and 81%, respectively. The PPV and NPV would be 43% and 90%, respectively. Conclusion: The results indicate that MTD combined with EB FIGO grade can detect LNM in a higher proportion of cases when compared to current practice. MTD combined with EB FIGO grade may eliminate the need of frozen section sampling in a substantial number of cases.

Keywords: endometrial cancer, FIGO grade, lymphadenectomy, tumor size

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Authors: A. S. Lourens, B. Du Plooy

Abstract:

Across the world, initiatives have been introduced to encourage women to enter into and remain in engineering fields. However, research has shown that many women leave engineering or suffer a loss of self-esteem and self-confidence compared to their male counterparts. To address this problem, a South African comprehensive university developed a self-leadership intervention pilot study in 2013, aimed at improving the self-efficacy of its female engineering students and increasing retention rates. This paper is a qualitative, descriptive, and interpretive study of the rationale and operational aspects of the Women in Engineering Leadership Association’s (WELA) self-leadership workshop. The objectives of this paper are to provide a framework for the design of a self-leadership workshop and to provide insight into the process of developing such a workshop specifically for women engineering students at a South African university. Finally, the paper proposes an evaluation process for the pilot workshop, which also provides a framework to improve future workshops. It is anticipated that the self-leadership development framework will be applicable to other higher education institutions wishing to improve women engineering student’s feelings of self-efficacy and therefore retention rates of women in engineering.

Keywords: co-curricular interventions, self-efficacy, self-leadership, women in engineering

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Authors: Donna Erika E. De Jesus

Abstract:

Introduction: Cardiac arrest occurs when abrupt cessation of cardiac function results in loss of effective circulation and complete cardiovascular collapse. For every minute of cardiac arrest without early intervention (cardiopulmonary resuscitation [CPR], defibrillation), chances of survival drop by 7-10%. It is crucial that CPR be initiated within 4-6 minutes to avoid brain death. Most out-of-hospital cardiac arrests (OHCA) occur in a residential setting where access to trained personnel and equipment is not readily available, resulting in poor victim outcomes. Methods: This is a descriptive study done from August to November 2021 using a prospective cohort design. Participants of the study include adult patients aged 18 years and above brought to the emergency room who suffered from out-of-hospital cardiac arrest. Out of the total 102 cases of OHCA, 63 participants were included in the study. Descriptive statistics were used to summarize the demographic and clinical characteristics of the patients. Results: 43 were male patients, comprising the majority at 73.02%. Hypertension was identified as the top co-morbidity, followed by diabetes mellitus, heart failure, and chronic kidney disease (CKD). Medical causes of arrest were identified in 96.83% of the cases. 90.48% of cardiac arrests occurred at home. Only 26 patients (41.27%) received pre-hospital intervention prior to ER arrival, which comprised only hands-only CPR. Twenty-three of which were performed by individuals with background knowledge of CPR. 60.32% were brought via self-conduction, the remainder by ambulances, which were noted to have no available equipment necessary to provide proper resuscitation. The average travel time from dispatch to ER arrival is 20 minutes. Conclusion: Overall survival of OHCA in our local setting remains dismal, as a return of spontaneous circulation was not achieved in any of the patients. The small number of patients having pre-hospital CPR indicates the need for emphasis on training and community education.

Keywords: out-of-hospital cardiac arrest, cardiopulmonary resuscitation, basic life support, emergency medical services

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Authors: Tonga Agadi Danladi, Ajao Wasiu Bamidele, Terdue Dyeko

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Recent advancement in microwave communications technologies especially in telecommunications and broadcasting have resulted in congestion on the frequencies below 10GHz. This has forced microwave designers to look for high frequencies. Unfortunately for frequencies greater than 10GHz rain becomes one of the main factors of attenuation in signal strength. At frequencies from 10GHz upwards, rain drop sizes leads to outages that compromises the availability and quality of service this making it a critical factor in satellite link budget design. Rain rate and rain attenuation predictions are vital steps to be considered when designing microwave satellite communication link operating at Ku-band frequencies (112-18GHz). Unreliable rain rates data in the tropical regions of the world like Nigeria from radio communication group of the international Telecommunication Union (ITU-R) makes it difficult for microwave engineers to determine a realistic rain margin that needs to be accommodated in satellite link budget design in such region. This work presents an empirical tool for predicting the amount of signal due to rain on DBS signal operating at the Ku-band.

Keywords: attenuation, Ku-Band, microwave communication, rain rates

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Authors: Anderson Ngowa Chembe, John Olukuru

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Greenhouse emissions by human activities are known to irreversibly increase global temperatures through the greenhouse effect. This study seeks to propose a mortality model with sensitivity to heat-change effects as one of the underlying parameters in the model. As such, the study sought to establish the relationship between greenhouse emissions and mortality indices in five OECD countries (USA, UK, Japan, Canada & Germany). Upon the establishment of the relationship using correlation analysis, an additional parameter that accounts for the sensitivity of heat-changes to mortality rates was incorporated in the Lee-Carter model. Based on the proposed model, new parameter estimates were calculated using iterative algorithms for optimization. Finally, the goodness of fit for the original Lee-Carter model and the proposed model were compared using deviance comparison. The proposed model provides a better fit to mortality rates especially in USA, UK and Germany where the mortality indices have a strong positive correlation with the level of greenhouse emissions. The results of this study are of particular importance to actuaries, demographers and climate-risk experts who seek to use better mortality-modeling techniques in the wake of heat effects caused by increased greenhouse emissions.

Keywords: climate risk, greenhouse emissions, Lee-Carter model, OECD

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Authors: S. Studente, S. Ellis, S. F. Garivaldis

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We report upon a study introducing a chatbot to develop learning communities at a London University, with a largely international student base. The focus of the chatbot was twofold; to ease the transition for students into their first year of university study, and to increase study engagement. Four learning communities were created using the chatbot; level 3 foundation, level 4 undergraduate, level 6 undergraduate and level 7 post-graduate. Students and programme leaders were provided with access to the chat bot via mobile app prior to their study induction and throughout the autumn term of 2019. At the end of the term, data were collected via questionnaires and focus groups with students and teaching staff to allow for identification of benefits and challenges. Findings indicated a positive correlation between study engagement and engagement with peers. Students reported that the chatbot enabled them to obtain support and connect to their programme leader. Both staff and students also made recommendation on how engagement could be further enhanced using the bot in terms of; clearly specified purpose, integration with existing university systems, leading by example and connectivity. Extending upon these recommendations, a second pilot study is planned for September 2020, for which the focus will be upon improving attendance rates, student satisfaction and module pass rates.

Keywords: chatbot, e-learning, learning communities, student engagement

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Authors: Gimhani Madhushika Hewayalage, Thilini Ariyadasa, Sanja Gunawardena

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In Sri Lanka, the largest contribution for the industrial export earnings is governed by textile and apparel industry. However, this industry generates huge quantities of effluent consists of unfixed dyes which enhance the effluent colour and toxicity thereby leading towards environmental pollution. Therefore, the effluent should properly be treated prior to the release into the environment. The biological technique has now captured much attention as an environmental-friendly and cost-competitive effluent decolourization method due to the drawbacks of physical and chemical treatment techniques. The present study has focused on identifying dye decolourizing potential of several bacterial isolates obtained from the effluent of the local textile industry. Yellow EXF, Red EXF, Blue EXF, Nova Black WNN and Nylosan-Rhodamine-EB dyes have been selected for the study to represent different chromophore groups such as Azo and Xanthene. The rates of decolorization of each dye have been investigated by employing distinct bacterial isolates. Bacterial isolate which exhibited effective dye decolorizing potential was identified as Proteus mirabilis using 16S rRNA gene sequencing analysis. The high decolorizing rates of identified bacterial strain indicate its potential applicability in the treatment of dye-containing wastewaters.

Keywords: azo, bacterial, biological, decolourization, xanthene

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