Search results for: the double burden of malnutrition
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2179

Search results for: the double burden of malnutrition

1639 Socio-Political Crisis in the North West and South West Regions of Cameroon and the Emergence of New Cultures

Authors: Doreen Mekunda

Abstract:

This paper is built on the premise that the current socio-political crisis in the two restive regions of Cameroon, though enveloped with destructive and devastating trends (effects) on both property and human lives, is not without its strengths and merits. It is incontestable that many cultures, to a greater extent, are going to be destroyed as people forcibly move from war-stricken habitats to non-violent places. Many cultural potentials, traditional shrines, artifacts, art, and crafts, etc., are unknowingly or knowingly disfigured, and many other ugly things will, by the end of the crisis, affect the cultures of these two regions under siege and of the receiving population. A plethora of other problems like the persecution of Internally Displaced Persons (IDPs) for being displaced and blamed for increased crime rates and the existence of cultural and ethnic differences that produce both inter-tribal and interpersonal conflicts and conflicts between communities will abound. However, there is the emergence of rapid literature, and other forms of cultural productions, whether written or oral, is visible, thereby precipitating a rich cultural diversity due to the coming together of a variety of cultures of both the IDPs and the receiving populations, rapid urbanization, improvement of health-related issues, the rebirth of indigenous cultural practices, the development of social and lingua-cultural competences, dependence on alternative religions, faith and spirituality. Even financial and economic dependence, though a burden to others by IDPs, has its own merits as it improves the living standards of the IDPs. To be able to obtain plausible results, cultural materialism, which is a literary theory that hinges on the empirical study of socio-cultural systems within a materialist infrastructure-super-structure framework, is employed together with the postcolonial theory. Postcolonial theory because the study deals with postcolonial experiences/tenets of migration, hybridity, ethnicity, indignity, language, double consciousness, migration, center/margin binaries, and identity, amongst others. The study reveals that the involuntary movement of persons from their habitual homes brings about movement in cultures, thus, the emergence of new cultures. The movement of people who hold fast to their cultural heritage can only influence new forms of literature, the development of new communication competences, the rise of alternative religion, faith and spirituality, the re-emergence of customary and traditional legal systems that might have been abandoned for the new judicial systems, and above all the revitalization of traditional health care systems.

Keywords: alternative religion, emergence, socio-political crisis, spirituality, lingua-cultural competences

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1638 Emerging Issues of Non-Communicable Diseases among Older Persons in India

Authors: Dhananjay W. Bansod, Santosh Phad

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Non-Communicable Diseases (NCD) are major contributing factors to the disease burden in the world as well as in India. With a growing proportion of older persons in India gives rise to several challenges. With the advancement of age, elderly is exposed to various kinds of health problems more specifically NCDs. Therefore, an effort has been made to examine the prevalence of NCDs among older persons and its treatment-seeking behaviour, also it is tried to explore the association between the NCDs and its effect on the overall wellbeing of older persons. Data used from “Building Knowledge Base of Population Ageing Survey” conducted in 2011 in seven states of India. Six chronic diseases used (non-communicable diseases) namely Arthritis, Hypertension, Cataract, Diabetes, Asthma and Heart diseases to understand the issues related to NCDs. Also seen the effect of NCDs on the wellbeing of the elderly, the subjective well-being consists of nine questions from which SUBI score generated for mental health status, which ranges from 9 to 27. This Index indicates that lower the score better is the mental health status. Further, this index modified and generated three categories of Better (9-15), Average (16-20) and Worse (21-27). The reliability analysis is carried out with the coefficient (Cronbach’s alpha) of the scale was 0.8884. The result shows that Orthopedic / musculoskeletal ailments involving arthritis, rheumatism and osteoarthritis are the most common type of ailment followed by hypertension. Two-thirds of the elderly reported suffering from at least one chronic ailment. Most chronic illness conditions received some form of treatment and mainly depend on public health facilities. Financial insecurity is the primary obstruction in seeking treatment for most of the chronic ailments which typically require a longer duration of medication and repeated medical consultations, both having significant economic implications. According to SUBI index, only 15 per cent of the elderly are in Better mental health status, and one-third of the elderly are with the worse score. Elderly with the ailments like Cataract, Asthma and Arthritis have worse mental health. It depicts that the burden of disease is more among the elderly and it is directly affecting the overall wellbeing of older persons.

Keywords: NCD, well-being, older person, India

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1637 Thiopental-Fentanyl versus Midazolam-Fentanyl for Emergency Department Procedural Sedation and Analgesia in Patients with Shoulder Dislocation and Distal Radial Fracture-Dislocation: A Randomized Double-Blind Controlled Trial

Authors: D. Farsi, G. Dokhtvasi, S. Abbasi, S. Shafiee Ardestani, E. Payani

Abstract:

Background and aim:It has not been well studied whether fentanyl-thiopental (FT) is effective and safe for PSA in orthopedic procedures in Emergency Department (ED). The aim of this trial was to evaluate the effectiveness of intravenous FTversusfentanyl-midazolam (FM)in patients who suffered from shoulder dislocation or distal radial fracture-dislocation. Methods:In this randomized double-blinded study, Seventy-six eligible patients were entered the study and randomly received intravenous FT or FM. The success rate, onset of action and recovery time, pain score, physicians’ satisfaction and adverse events were assessed and recorded by treating emergency physicians. The statistical analysis was intention to treat. Results: The success rate after administrating loading dose in FT group was significantly higher than FM group (71.7% vs. 48.9%, p=0.04); however, the ultimate unsuccess rate after 3 doses of drugs in the FT group was higher than the FM group (3 to 1) but it did not reach to significant level (p=0.61). Despite near equal onset of action time in two study group (P=0.464), the recovery period in patients receiving FT was markedly shorter than FM group (P<0.001). The occurrence of adverse effects was low in both groups (p=0.31). Conclusion: PSA using FT is effective and appears to be safe for orthopedic procedures in the ED. Therefore, regarding the prompt onset of action, short recovery period of thiopental, it seems that this combination can be considered more for performing PSA in orthopedic procedures in ED.

Keywords: procedural sedation and analgesia, thiopental, fentanyl, midazolam, orthopedic procedure, emergency department, pain

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1636 The Addition of Opioids to Bupivacaine in Bilateral Infraorbital Nerve Block for Postoperative Pain Relief in Paediatric Patients for Cleft Lip Repair-Comparative Effects of Pethidine and Fentanyl: A Prospective Randomized Double Blind Study

Authors: Mrudula Kudtarkar, Rajesh Mane

Abstract:

Introduction: Cleft lip repair is one of the common surgeries performed in India and the usual method used for post-operative analgesia is perioperative opioids and NSAIDs. There has been an increase in use of regional techniques and Opioids are the common adjuvants but their efficacy and safety have not been studied extensively in children. Aim: A prospective, randomized, double-blind study was done to compare the efficacy, duration and safety of intraoral infraorbital nerve block on post-operative pain relief using bupivacaine alone or in combination with fentanyl or pethidine in paediatric cleft lip repair. Methodology: 45 children between the age group 5 – 60 months undergoing cleft lip surgery randomly allocated into 3 groups of 15 each received bilateral intraoral infraorbital nerve block with 0.75ml of solution. Group B received 0.25% bupivacaine; group P received 0.25% bupivacaine with 0.25mg/kg pethidine, group F received 0.25% bupivacaine with 0.25microgm/kg fentanyl. Sedation after recovery, post-operative pain intensity and duration of post-operative analgesia were assessed using Modified Hannallah Pain Score. Results: The mean duration of analgesia was 17.8 hrs in Group B, 23.53 hrs in Group F and 35.13 hrs in Group P. There was statistically significant difference between the means of the three groups- ANOVA (p < 0.05). Conclusion: Thus we conclude that addition of fentanyl or pethidine to bupivacaine for Bilateral Intraoral Infraorbital Nerve Block prolong the duration of analgesia with no complications and can be used safely in paediatric patients.

Keywords: cleft lip, infraorbital block, NSAIDS, Opiods

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1635 Addressing Undernourishment of Pupils in a Depressed Community through Feeding Program and Vitamin Supplementation

Authors: Alma M. Corpuz

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This study evaluated the supplemental feeding program for 59 undernourished pupils in an elementary school located in one of the depressed communities in Tarlac City, Philippines in SY 2013-2014. Pupils were fed for one month with heavy breakfast and afternoon snacks. They were also given vitamins daily. Findings revealed that most of the pupils regained normal Body Mass Indices (BMIs) during a routine weighing in the school opening. In addition, results revealed that the academic performance of the pupils in the 4th Quarter, after the feeding program, was higher compared to the 3rd Quarter period. The researchers recommended that school extension programs should prioritize activities to address malnutrition among pupils to help them perform well in academics. In addition, feeding programs must include heavy meal plans like what was implemented in this project. The feeding program must also include giving of milk and vitamins to ensure significant improvement in their nutrition. It is also important that feacalysis and deworming be performed before the feeding program and proper handwashing be integrated into the feeding activity.

Keywords: wasted, severely wasted, body mass index, supplemental feeding

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1634 Automation of Pneumatic Seed Planter for System of Rice Intensification

Authors: Tukur Daiyabu Abdulkadir, Wan Ishak Wan Ismail, Muhammad Saufi Mohd Kassim

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Seed singulation and accuracy in seed spacing are the major challenges associated with the adoption of mechanical seeder for system of rice intensification. In this research the metering system of a pneumatic planter was modified and automated for increase precision to meet the demand of system of rice intensification SRI. The chain and sprocket mechanism of a conventional vacuum planter were now replaced with an electro mechanical system made up of a set of servo motors, limit switch, micro controller and a wheel divided into 10 equal angles. The circumference of the planter wheel was determined based on which seed spacing was computed and mapped to the angles of the metering wheel. A program was then written and uploaded to arduino micro controller and it automatically turns the seed plates for seeding upon covering the required distance. The servo motor was calibrated with the aid of labVIEW. The machine was then calibrated using a grease belt and varying the servo rpm through voltage variation between 37 rpm to 47 rpm until an optimum value of 40 rpm was obtained with a forward speed of 5 kilometers per hour. A pressure of 1.5 kpa was found to be optimum under which no skip or double was recorded. Precision in spacing (coefficient of variation), miss index, multiple index, doubles and skips were investigated. No skip or double was recorded both at laboratory and field levels. The operational parameters under consideration were both evaluated at laboratory and field. Even though there was little variation between the laboratory and field values of precision in spacing, multiple index and miss index, the different is not significant as both laboratory and field values fall within the acceptable range.

Keywords: automation, calibration, pneumatic seed planter, system of rice intensification

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1633 Double Gaussian Distribution of Nonhomogeneous Barrier Height in Metal/n-type GaN Schottky Contacts

Authors: M. Mamor

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GaN-based compounds have attracted much interest in the fabrication of high-power, high speed and high-frequency electronic devices. Other examples of GaN-based applications are blue and ultraviolet (UV) light-emitting diodes (LEDs). All these devices require high-quality ohmic and Schottky contacts. Gaining an understanding of the electrical characteristics of metal/GaN contacts is of fundamental and technological importance for developing GaN-based devices. In this work, the barrier characteristics of Pt and Pd Schottky contacts on n-type GaN were studied using temperature-dependent forward current-voltage (I-V) measurements over a wide temperature range 80–400 K. Our results show that the barrier height and ideality factor, extracted from the forward I-V characteristics based on thermionic emission (TE) model, exhibit an abnormal dependence with temperature; i.e., by increasing temperature, the barrier height increases whereas the ideality factor decreases. This abnormal behavior has been explained based on the TE model by considering the presence of double Gaussian distribution (GD) of nonhomogeneous barrier height at the metal/GaN interface. However, in the high-temperature range (160-400 K), the extracted value for the effective Richardson constant A* based on the barrier inhomogeneity (BHi) model is found in fair agreement with the theoretically predicted value of about 26.9 A.cm-2 K-2 for n-type GaN. This result indicates that in this temperature range, the conduction current transport is dominated by the thermionic emission mode. On the other hand, in the lower temperature range (80-160 K), the corresponding effective Richardson constant value according to the BHi model is lower than the theoretical value, suggesting the presence of other current transport, such as tunneling-assisted mode at lower temperatures.

Keywords: Schottky diodes, inhomogeneous barrier height, GaN semiconductors, Schottky barrier heights

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1632 Impact of Revenue Reform on Vulnerable Communities

Authors: Pauliasi Tony Fakahau

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This paper provides an overview of the impact of the revenue reform programme on vulnerable communities in the Kingdom of Tonga. Economic turmoil and mismanagement during the late 1990s forced the government to seek technical and financial assistance from the Asian Development Bank to undertake a comprehensive Economic and Public Sector Reform (EPSR) programme. The EPSR is a Western model recommended by donor agencies as the solution to Tonga’s economic challenges. The EPSR programme included public sector reform, private sector growth, and revenue generation. Tax reform was the main tool for revenue generation, which set out to strengthen tax compliance and administration as well as implement a value-added consumption tax. The EPSR is based on Western values and ideology but failed to recognise that Tongan cultural values are important to the local community. Two participant groups were interviewed. Participant group one consisted of 51 people representing vulnerable communities. Participant group two consisted of six people from the government and business sector who were from the elite of Tongan society. The Kakala Research Methodology provided the framework for the research, and the Talanoa Research Method was used to conduct semi-structured interviews in the homes of the first group and in the workplaces of the second group. The research found a heavy burden of the consumption tax on the purchasing power of participant group one (vulnerable participants), having an impact on nearly every financial transaction they made. Participant group ones’ main financial priorities were kavenga fakalotu (obligations to the church), kavenga fakafāmili (obligations to the family) and kavenga fakafonua (obligations to cultural events for the village, nobility, and royalty). The findings identified inequalities of the revenue reform, especially from consumption tax, for vulnerable people and communities compared to the elite of society. The research concluded that government and donor agencies need ameliorating policies to reduce the burden of tax on vulnerable groups more susceptible to the impact of revenue reform.

Keywords: tax reform, tonga vulnerable community revenue, revenue reform, public sector reform

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1631 Biophysical Characterization of the Inhibition of cGAS-DNA Sensing by KicGAS, Kaposi's Sarcoma-Associated Herpesvirus Inhibitor of cGAS

Authors: D. Bhowmik, Y. Tian, Q. Yin, F. Zhu

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Cyclic GMP-AMP synthase (cGAS), recognises cytoplasmic double-stranded DNA (dsDNA), indicative of bacterial and viral infections, as well as the leakage of self DNA by cellular dysfunction and stresses, to elicit the host's immune responses. Viruses also have developed numerous strategies to antagonize the cGAS-STING pathway. Kaposi's sarcoma-associated herpesvirus (KSHV) is a human DNA tumor virus that is the causative agent of Kaposi’s sarcoma and several other malignancies. To persist in the host, consequently causing diseases, KSHV must overcome the host innate immune responses, including the cGAS-STING DNA sensing pathway. We already found that ORF52 or KicGAS (KSHV inhibitor of cGAS), an abundant and basic gamma herpesvirus-conserved tegument protein, directly inhibits cGAS enzymatic activity. To better understand the mechanism, we have performed the biochemical and structural characterization of full-length KicGAS and various mutants in regarding binding to DNA. We observed that KicGAS is capable of self-association and identified the critical residues involved in the oligomerization process. We also characterized the DNA-binding of KicGAS and found that KicGAS cooperatively oligomerizes along the length of the double stranded DNA, the highly conserved basic residues at the c-terminal disordered region are crucial for DNA recognition. Deficiency in oligomerization also affects DNA binding. Thus DNA binding by KicGAS sequesters DNA and prevents it from being detected by cGAS, consequently inhibiting cGAS activation. KicGAS homologues also inhibit cGAS efficiently, suggesting inhibition of cGAS is evolutionarily conserved mechanism among gamma herpesvirus. These results highlight the important viral strategy to evade this innate immune sensor.

Keywords: Kaposi's sarcoma-associated herpesvirus, KSHV, cGAS, DNA binding, inhibition

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1630 Effects of Different Fungicide In-Crop Treatments on Plant Health Status of Sunflower (Helianthus annuus L.)

Authors: F. Pal-Fam, S. Keszthelyi

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Phytosanitary condition of sunflower (Helianthus annuus L.) was endangered by several phytopathogenic agents, mainly microfungi, such as Sclerotinia sclerotiorum, Diaporthe helianthi, Plasmopara halstedtii, Macrophomina phaseolina and so on. There are more agrotechnical and chemical technologies against them, for instance, tolerant hybrids, crop rotations and eventually several in-crop chemical treatments. There are different fungicide treatment methods in sunflower in Hungarian agricultural practice in the quest of obtaining healthy and economic plant products. Besides, there are many choices of useable active ingredients in Hungarian sunflower protection. This study carried out into the examination of the effect of five different fungicide active substances (found on the market) and three different application modes (early; late; and early and late treatments) in a total number of 9 sample plots, 0.1 ha each other. Five successive vegetation periods have been investigated in long term, between 2013 and 2017. The treatments were: 1)untreated control; 2) boscalid and dimoxystrobin late treatment (July); 3) boscalid and dimoxystrobin early treatment (June); 4) picoxystrobin and cyproconazole early treatment; 5) picoxystrobin and cymoxanil and famoxadone early treatment; 6) picoxystrobin and cyproconazole early; cymoxanil and famoxadone late treatments; 7) picoxystrobin and cyproconazole early; picoxystrobin and cymoxanil and famoxadone late treatments; 8) trifloxystrobin and cyproconazole early treatment; and 9) trifloxystrobin and cyproconazole both early and late treatments. Due to the very different yearly weather conditions different phytopathogenic fungi were dominant in the particular years: Diaporthe and Alternaria in 2013; Alternaria and Sclerotinia in 2014 and 2015; Alternaria, Sclerotinia and Diaporthe in 2016; and Alternaria in 2017. As a result of treatments ‘infection frequency’ and ‘infestation rate’ showed a significant decrease compared to the control plot. There were no significant differences between the efficacies of the different fungicide mixes; all were almost the same effective against the phytopathogenic fungi. The most dangerous Sclerotinia infection was practically eliminated in all of the treatments. Among the single treatments, the late treatment realised in July was the less efficient, followed by the early treatments effectuated in June. The most efficient was the double treatments realised in both June and July, resulting 70-80% decrease of the infection frequency, respectively 75-90% decrease of the infestation rate, comparing with the control plot in the particular years. The lowest yield quantity was observed in the control plot, followed by the late single treatment. The yield of the early single treatments was higher, while the double treatments showed the highest yield quantities (18.3-22.5% higher than the control plot in particular years). In total, according to our five years investigation, the most effective application mode is the double in-crop treatment per vegetation time, which is reflected by the yield surplus.

Keywords: fungicides, treatments, phytopathogens, sunflower

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1629 Biophysical Study of the Interaction of Harmalol with Nucleic Acids of Different Motifs: Spectroscopic and Calorimetric Approaches

Authors: Kakali Bhadra

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Binding of small molecules to DNA and recently to RNA, continues to attract considerable attention for developing effective therapeutic agents for control of gene expression. This work focuses towards understanding interaction of harmalol, a dihydro beta-carboline alkaloid, with different nucleic acid motifs viz. double stranded CT DNA, single stranded A-form poly(A), double-stranded A-form of poly(C)·poly(G) and clover leaf tRNAphe by different spectroscopic, calorimetric and molecular modeling techniques. Results of this study converge to suggest that (i) binding constant varied in the order of CT DNA > poly(C)·poly(G) > tRNAphe > poly(A), (ii) non-cooperative binding of harmalol to poly(C)·poly(G) and poly(A) and cooperative binding with CT DNA and tRNAphe, (iii) significant structural changes of CT DNA, poly(C)·poly(G) and tRNAphe with concomitant induction of optical activity in the bound achiral alkaloid molecules, while with poly(A) no intrinsic CD perturbation was observed, (iv) the binding was predominantly exothermic, enthalpy driven, entropy favoured with CT DNA and poly(C)·poly(G) while it was entropy driven with tRNAphe and poly(A), (v) a hydrophobic contribution and comparatively large role of non-polyelectrolytic forces to Gibbs energy changes with CT DNA, poly(C)·poly(G) and tRNAphe, and (vi) intercalated state of harmalol with CT DNA and poly(C)·poly(G) structure as revealed from molecular docking and supported by the viscometric data. Furthermore, with competition dialysis assay it was shown that harmalol prefers hetero GC sequences. All these findings unequivocally pointed out that harmalol prefers binding with ds CT DNA followed by ds poly(C)·poly(G), clover leaf tRNAphe and least with ss poly(A). The results highlight the importance of structural elements in these natural beta-carboline alkaloids in stabilizing different DNA and RNA of various motifs for developing nucleic acid based better therapeutic agents.

Keywords: calorimetry, docking, DNA/RNA-alkaloid interaction, harmalol, spectroscopy

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1628 Performance Analysis of Modified Solar Water Heating System for Climatic Condition of Allahabad, India

Authors: Kirti Tewari, Rahul Dev

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Solar water heating is a thermodynamic process of heating water using sunlight with the help of solar water heater. Thus, solar water heater is a device used to harness solar energy. In this paper, a modified solar water heating system (MSWHS) has been proposed over flat plate collector (FPC) and Evacuated tube collector (ETC). The modifications include selection of materials other than glass, and glass wool which are conventionally used for fabricating FPC and ETC. Some modifications in design have also been proposed. Its collector is made of double layer of semi-cylindrical acrylic tubes and fibre reinforced plastic (FRP) insulation base. Water tank is made of double layer of acrylic sheet except base and north wall. FRP is used in base and north wall of the water tank. A concept of equivalent thickness has been utilised for calculating the dimensions of collector plate, acrylic tube and tank. A thermal model for the proposed design of MSWHS is developed and simulation is carried out on MATLAB for the capacity of 200L MSWHS having collector area of 1.6 m2, length of acrylic tubes of 2m at an inclination angle 25° which is taken nearly equal to the latitude of the given location. Latitude of Allahabad is 24.45° N. The results show that the maximum temperature of water in tank and tube has been found to be 71.2°C and 73.3°C at 17:00hr and 16:00hr respectively in March for the climatic data of Allahabad. Theoretical performance analysis has been carried out by varying number of tubes of collector, the tank capacity and climatic data for given months of winter and summer.

Keywords: acrylic, fibre reinforced plastic, solar water heating, thermal model, conventional water heaters

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1627 Conflict and Hunger Revisit: Evidences from Global Surveys, 1989-2020

Authors: Manasse Elusma, Thung-Hong Lin, Chun-yin Lee

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The relationship between hunger and war or conflict remains to be discussed. Do wars or conflicts cause hunger and food scarcity, or is the reverse relationship is true? As the world becomes more peaceful and wealthier, some countries are still suffered from hunger and food shortage. So, eradicating hunger calls for a more comprehensive understanding of the relationship between conflict and hunger. Several studies are carried out to detect the importance of conflict or war on food security. Most of these studies, however, perform only descriptive analysis and largely use food security indicators instead of the global hunger index. Few studies have employed cross-country panel data to explicitly analyze the association between conflict and chronic hunger, including hidden hunger. Herein, this study addresses this issue and the knowledge gap. We combine global datasets to build a new panel dataset including 143 countries from 1989 to 2020. This study examines the effect of conflict on hunger with fixed effect models, and the results show that the increase of conflict frequency deteriorates hunger. Peacebuilding efforts and war prevention initiative are required to eradicate global hunger.

Keywords: armed conflict, food scarcity, hidden hunger, hunger, malnutrition

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1626 Community Engagement: Experience from the SIREN Study in Sub-Saharan Africa

Authors: Arti Singh, Carolyn Jenkins, Oyedunni S. Arulogun, Mayowa O. Owolabi, Fred S. Sarfo, Bruce Ovbiagele, Enzinne Sylvia

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Background: Stroke, the leading cause of adult-onset disability and the second leading cause of death, is a major public health concern particularly pertinent in Sub-Saharan Africa (SSA), where nearly 80% of all global stroke mortalities occur. The Stroke Investigative Research and Education Network (SIREN) seeks to comprehensively characterize the genomic, sociocultural, economic, and behavioral risk factors for stroke and to build effective teams for research to address and decrease the burden of stroke and other non communicable diseases in SSA. One of the first steps to address this goal was to effectively engage the communities that suffer the high burden of disease in SSA. This study describes how the SIREN project engaged six sites in Ghana and Nigeria over the past three years, describing the community engagement activities that have arisen since inception. Aim: The aim of community engagement (CE) within SIREN is to elucidate information about knowledge, attitudes, beliefs, and practices (KABP) about stroke and its risk factors from individuals of African ancestry in SSA, and to educate the community about stroke and ways to decrease disabilities and deaths from stroke using socioculturally appropriate messaging and messengers. Methods: Community Advisory Board (CABs), Focus Group Discussions (FGDs) and community outreach programs. Results: 27 FGDs with 168 participants including community heads, religious leaders, health professionals and individuals with stroke among others, were conducted, and over 60 CE outreaches have been conducted within the SIREN performance sites. Over 5,900 individuals have received education on cardiovascular risk factors and about 5,000 have been screened for cardiovascular risk factors during the outreaches. FGDs and outreach programs indicate that knowledge of stroke, as well as risk factors and follow-up evidence-based care is limited and often late. Other findings include: 1) Most recognize hypertension as a major risk factor for stroke. 2) About 50% report that stroke is hereditary and about 20% do not know organs affected by stroke. 3) More than 95% willing to participate in genetic testing research and about 85% willing to pay for testing and recommend the test to others. 4) Almost all indicated that genetic testing could help health providers better treat stroke and help scientists better understand the causes of stroke. The CABs provided stakeholder input into SIREN activities and facilitated collaborations among investigators, community members and stakeholders. Conclusion: The CE core within SIREN is a first-of-its kind public outreach engagement initiative to evaluate and address perceptions about stroke and genomics by patients, caregivers, and local leaders in SSA and has implications as a model for assessment in other high-stroke risk populations. SIREN’s CE program uses best practices to build capacity for community-engaged research, accelerate integration of research findings into practice and strengthen dynamic community-academic partnerships within our communities. CE has had several major successes over the past three years including our multi-site collaboration examining the KABP about stroke (symptoms, risk factors, burden) and genetic testing across SSA.

Keywords: community advisory board, community engagement, focus groups, outreach, SSA, stroke

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1625 Improving the Uptake of Community-Based Multidrug-Resistant Tuberculosis Treatment Model in Nigeria

Authors: A. Abubakar, A. Parsa, S. Walker

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Despite advances made in the diagnosis and management of drug-sensitive tuberculosis (TB) over the past decades, treatment of multidrug-resistant tuberculosis (MDR-TB) remains challenging and complex particularly in high burden countries including Nigeria. Treatment of MDR-TB is cost-prohibitive with success rate generally lower compared to drug-sensitive TB and if care is not taken it may become the dominant form of TB in future with many treatment uncertainties and substantial morbidity and mortality. Addressing these challenges requires collaborative efforts thorough sustained researches to evaluate the current treatment guidelines, particularly in high burden countries and prevent progression of resistance. To our best knowledge, there has been no research exploring the acceptability, effectiveness, and cost-effectiveness of community-based-MDR-TB treatment model in Nigeria, which is among the high burden countries. The previous similar qualitative study looks at the home-based management of MDR-TB in rural Uganda. This research aimed to explore patient’s views and acceptability of community-based-MDR-TB treatment model and to evaluate and compare the effectiveness and cost-effectiveness of community-based versus hospital-based MDR-TB treatment model of care from the Nigerian perspective. Knowledge of patient’s views and acceptability of community-based-MDR-TB treatment approach would help in designing future treatment recommendations and in health policymaking. Accordingly, knowledge of effectiveness and cost-effectiveness are part of the evidence needed to inform a decision about whether and how to scale up MDR-TB treatment, particularly in a poor resource setting with limited knowledge of TB. Mixed methods using qualitative and quantitative approach were employed. Qualitative data were obtained using in-depth semi-structured interviews with 21 MDR-TB patients in Nigeria to explore their views and acceptability of community-based MDR-TB treatment model. Qualitative data collection followed an iterative process which allowed adaptation of topic guides until data saturation. In-depth interviews were analyzed using thematic analysis. Quantitative data on treatment outcomes were obtained from medical records of MDR-TB patients to determine the effectiveness and direct and indirect costs were obtained from the patients using validated questionnaire and health system costs from the donor agencies to determine the cost-effectiveness difference between community and hospital-based model from the Nigerian perspective. Findings: Some themes have emerged from the patient’s perspectives indicating preference and high acceptability of community-based-MDR-TB treatment model by the patients and mixed feelings about the risk of MDR-TB transmission within the community due to poor infection control. The result of the modeling from the quantitative data is still on course. Community-based MDR-TB care was seen as the acceptable and most preferred model of care by the majority of the participants because of its convenience which in turn enhanced recovery, enables social interaction and offer more psychosocial benefits as well as averted productivity loss. However, there is a need to strengthen this model of care thorough enhanced strategies that ensure guidelines compliance and infection control in order to prevent the progression of resistance and curtail community transmission.

Keywords: acceptability, cost-effectiveness, multidrug-resistant TB treatment, community and hospital approach

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1624 Stability Analysis of Hossack Suspension Systems in High Performance Motorcycles

Authors: Ciro Moreno-Ramirez, Maria Tomas-Rodriguez, Simos A. Evangelou

Abstract:

A motorcycle's front end links the front wheel to the motorcycle's chassis and has two main functions: the front wheel suspension and the vehicle steering. Up to this date, several suspension systems have been developed in order to achieve the best possible front end behavior, being the telescopic fork the most common one and already subjected to several years of study in terms of its kinematics, dynamics, stability and control. A motorcycle telescopic fork suspension model consists of a couple of outer tubes which contain the suspension components (coil springs and dampers) internally and two inner tubes which slide into the outer ones allowing the suspension travel. The outer tubes are attached to the frame through two triple trees which connect the front end to the main frame through the steering bearings and allow the front wheel to turn about the steering axis. This system keeps the front wheel's displacement in a straight line parallel to the steering axis. However, there exist alternative suspension designs that allow different trajectories of the front wheel with the suspension travel. In this contribution, the authors investigate an alternative front suspension system (Hossack suspension) and its influence on the motorcycle nonlinear dynamics to identify and reduce stability risks that a new suspension systems may introduce in the motorcycle dynamics. Based on an existing high-fidelity motorcycle mathematical model, the front end geometry is modified to accommodate a Hossack suspension system. It is characterized by a double wishbone design that varies the front end geometry on certain maneuverings and, consequently, the machine's behavior/response. It consists of a double wishbone structure directly attached to the chassis. In here, the kinematics of this system and its impact on the motorcycle performance/stability are analyzed and compared to the well known telescopic fork suspension system. The framework of this research is the mathematical modelling and numerical simulation. Full stability analyses are performed in order to understand how the motorcycle dynamics may be affected by the newly introduced front end design. This study is carried out by a combination of nonlinear dynamical simulation and root-loci methods. A modal analysis is performed in order to get a deeper understanding of the different modes of oscillation and how the Hossack suspension system affects them. The results show that different kinematic designs of a double wishbone suspension systems do not modify the general motorcycle's stability. The normal modes properties remain unaffected by the new geometrical configurations. However, these normal modes differ from one suspension system to the other. It is seen that the normal modes behaviour depends on various important dynamic parameters, such as the front frame flexibility, the steering damping coefficient and the centre of mass location.

Keywords: nonlinear mechanical systems, motorcycle dynamics, suspension systems, stability

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1623 Numerical Simulation of the Heat Transfer Process in a Double Pipe Heat Exchanger

Authors: J. I. Corcoles, J. D. Moya-Rico, A. Molina, J. F. Belmonte, J. A. Almendros-Ibanez

Abstract:

One of the most common heat exchangers technology in engineering processes is the use of double-pipe heat exchangers (DPHx), mainly in the food industry. To improve the heat transfer performance, several passive geometrical devices can be used, such as the wall corrugation of tubes, which increases the wet perimeter maintaining a constant cross-section area, increasing consequently the convective surface area. It contributes to enhance heat transfer in forced convection, promoting secondary recirculating flows. One of the most extended tools to analyse heat exchangers' efficiency is the use of computational fluid dynamic techniques (CFD), a complementary activity to the experimental studies as well as a previous step for the design of heat exchangers. In this study, a double pipe heat exchanger behaviour with two different inner tubes, smooth and spirally corrugated tube, have been analysed. Hence, experimental analysis and steady 3-D numerical simulations using the commercial code ANSYS Workbench v. 17.0 are carried out to analyse the influence of geometrical parameters for spirally corrugated tubes at turbulent flow. To validate the numerical results, an experimental setup has been used. To heat up or cool down the cold fluid as it passes through the heat exchanger, the installation includes heating and cooling loops served by an electric boiler with a heating capacity of 72 kW and a chiller, with a cooling capacity of 48 kW. Two tests have been carried out for the smooth tube and for the corrugated one. In all the tests, the hot fluid has a constant flowrate of 50 l/min and inlet temperature of 59.5°C. For the cold fluid, the flowrate range from 25 l/min (Test 1) and 30 l/min (Test 2) with an inlet temperature of 22.1°C. The heat exchanger is made of stainless steel, with an external diameter of 35 mm and wall thickness of 1.5 mm. Both inner tubes have an external diameter of 24 mm and 1 mm thickness of stainless steel with a length of 2.8 m. The corrugated tube has a corrugation height (H) of 1.1 mm and helical pitch (P) of 25 mm. It is characterized using three non-dimensional parameters, the ratio of the corrugation shape and the diameter (H/D), the helical pitch (P/D) and the severity index (SI = H²/P x D). The results showed good agreement between the numerical and the experimental results. Hence, the lowest differences were shown for the fluid temperatures. In all the analysed tests and for both analysed tubes, the temperature obtained numerically was slightly higher than the experimental results, with values ranged between 0.1% and 0.7%. Regarding the pressure drop, the maximum differences between the values obtained numerically, and the experimental values were close to 16%. Based on the experimental and the numerical results, for the corrugated tube, it can be highlighted that the temperature difference between the inlet and the outlet of the cold fluid is 42%, higher than the smooth tube.

Keywords: corrugated tube, heat exchanger, heat transfer, numerical simulation

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1622 Next Generation of Tunnel Field Effect Transistor: NCTFET

Authors: Naima Guenifi, Shiromani Balmukund Rahi, Amina Bechka

Abstract:

Tunnel FET is one of the most suitable alternatives FET devices for conventional CMOS technology for low-power electronics and applications. Due to its lower subthreshold swing (SS) value, it is a strong follower of low power applications. It is a quantum FET device that follows the band to band (B2B) tunneling transport phenomena of charge carriers. Due to band to band tunneling, tunnel FET is suffering from a lower switching current than conventional metal-oxide-semiconductor field-effect transistor (MOSFET). For improvement of device features and limitations, the newly invented negative capacitance concept of ferroelectric material is implemented in conventional Tunnel FET structure popularly known as NC TFET. The present research work has implemented the idea of high-k gate dielectric added with ferroelectric material on double gate Tunnel FET for implementation of negative capacitance. It has been observed that the idea of negative capacitance further improves device features like SS value. It helps to reduce power dissipation and switching energy. An extensive investigation for circularity uses for digital, analog/RF and linearity features of double gate NCTFET have been adopted here for research work. Several essential designs paraments for analog/RF and linearity parameters like transconductance(gm), transconductance generation factor (gm/IDS), its high-order derivatives (gm2, gm3), cut-off frequency (fT), gain-bandwidth product (GBW), transconductance generation factor (gm/IDS) has been investigated for low power RF applications. The VIP₂, VIP₃, IMD₃, IIP₃, distortion characteristics (HD2, HD3), 1-dB, the compression point, delay and power delay product performance have also been thoroughly studied.

Keywords: analog/digital, ferroelectric, linearity, negative capacitance, Tunnel FET, transconductance

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1621 Record Peak Current Density in AlN/GaN Double-Barrier Resonant Tunneling Diodes on Free-Standing Gan Substrates by Modulating Barrier Thickness

Authors: Fang Liu, Jia Jia Yao, Guan Lin Wu, Ren Jie Liu, Zhuang Guo

Abstract:

Leveraging plasma-assisted molecular beam epitaxy (PA-MBE) on c-plane free-standing GaN substrates, this work demonstrates high-performance AlN/GaN double-barrier resonant tunneling diodes (RTDs) featuring stable and repeatable negative differential resistance (NDR) characteristics at room temperature. By scaling down the barrier thickness of AlN and the lateral mesa size of collector, a record peak current density of 1551 kA/cm2 is achieved, accompanied by a peak-to-valley current ratio (PVCR) of 1.24. This can be attributed to the reduced resonant tunneling time under thinner AlN barrier and the suppressed external incoherent valley current by reducing the dislocation number contained in the RTD device with the smaller size of collector. Statistical analysis of the NDR performance of RTD devices with different AlN barrier thicknesses reveals that, as the AlN barrier thickness decreases from 1.5 nm to 1.25 nm, the average peak current density increases from 145.7 kA/cm2 to 1215.1 kA/cm2, while the average PVCR decreases from 1.45 to 1.1, and the peak voltage drops from 6.89 V to 5.49 V. The peak current density obtained in this work represents the highest value reported for nitride-based RTDs to date, while maintaining a high PVCR value simultaneously. This illustrates that an ultra-scaled RTD based on a vertical quantum-well structure and lateral collector size is a valuable approach for the development of nitride-based RTDs with excellent NDR characteristics, revealing their great potential applications in high-frequency oscillation sources and high-speed switch circuits.

Keywords: GaN resonant tunneling diode, peak current density, peak-to-valley current ratio, negative differential resistance

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1620 Food Insecurity and Its Implication for Poverty Alleviation in Nigeria

Authors: Peter Okpamen

Abstract:

Food security concentrates on the collective efforts of all nations to produce enough food to feed their people. Recently, though the emphasis shifted from food availability to accessibility constraints, which entails the difficulties undernourished people face in gaining access to food even when it is available. Broadly speaking, access to food depends on an individual’s access to resources, markets and food transfers. The opportunities to obtain food through these channels are entitlements, which when denied constitute food insecurity. Evidence shows that a significant percentage of Nigerians are undernourished with adverse implications for the fight against poverty. The greatest danger or consequence of food insecurity is malnutrition. Food insecurity as both an agent and consequence of poverty also increases the economic, political and social tensions in the country. The undernourished in Nigeria are marginalised in several ways to the extent that they are often ill; and because of illness, their work capacity is reduced with attendant reduction in their income. Without adequate income, they cannot save nor invest enough resources to take care of their basic needs. In this paper therefore, we used the political economy approach and statistical analysis to demonstrate that poverty alleviation in Nigeria would be a mirage if food security problems are not adequately resolved.

Keywords: alleviation, demographic, food insecurity, undernourished

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1619 Informal Carers in Telemonitoring of Users with Pacemakers: Characteristics, Time of Services Provided and Costs

Authors: Antonio Lopez-Villegas, Rafael Bautista-Mesa, Emilio Robles-Musso, Daniel Catalan-Matamoros, Cesar Leal-Costa

Abstract:

Objectives: The purpose of this trial was to evaluate the burden borne by and the costs to informal caregivers of users with telemonitoring of pacemakers. Methods: This is a controlled, non-randomised clinical trial, with data collected from informal caregivers, five years after implantation of pacemakers. The Spanish version of the Survey on Disabilities, Personal Autonomy, and Dependency Situations was used to get information on clinical and social characteristics, levels of professionalism, duration and types of care, difficulties in providing care, health status, economic and job aspects, impact on the family or leisure due to informal caregiving for patients with pacemakers. Results: After five years of follow-up, 55 users with pacemakers finished the study. Of which, 50 were helped by a caregiver, 18 were included in the telemonitoring group (TM) and 32 in the conventional follow-up group (HM). Overall, females represented 96.0% of the informal caregivers (88.89% in TM and 100.0% in HM group). The mean ages were 63.17 ± 15.92 and 63.13 ± 14.56 years, respectively (p = 0.83) in the groups. The majority (88.0%) of the caregivers declared that they had to provide their services between 6 and 7 days per week (83.33% in TM group versus 90.63% in HM group), without significant differences between both groups. The costs related to care provided by the informal caregivers were 47.04% higher in the conventional follow-up group than in the TM group. Conclusions: The results of this trial confirm that there were no significant differences between the informal caregivers regarding to baseline characteristics, workload and time worked in both groups of follow-up. The costs incurred by the informal caregivers providing care for users with pacemakers included in telemonitoring group are significantly lower than those in the conventional follow-up group. Trial registration: ClinicalTrials.gov NCT02234245. Funding: The PONIENTE study, has been funded by the General Secretariat for Research, Development and Innovation, Regional Government of Andalusia (Spain), project reference number PI/0256/2017, under the research call 'Development and Innovation Projects in the Field of Biomedicine and Health Sciences', 2017.

Keywords: costs, disease burden, informal caregiving, pacemaker follow-up, remote monitoring, telemedicine

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1618 Faith-Based Humanitarian Intervention: The Catholic Church and the Biafran Refugee Crisis during the Nigerian Civil War, 1967-1970

Authors: Edidiong Ekefre

Abstract:

The Nigerian civil war was one of the foremost postcolonial conflicts in West Africa that attracted a serious humanitarian problem due to an unprecedented refugee crisis that affected the Biafran region. Due to its geographical location, the Nigerian government used blockades and starvation as a weapon of war against the Biafran. Faced with strong opposition from the Nigerian government, most humanitarian organizations withdrew their support from Biafra, whose death toll was rapidly growing daily due to starvation, malnutrition, and chronic ailment. Thus, the Catholic Church, a major Christian denomination in Biafra, had to see it as its religious obligation to support the humanitarian needs of the Biafrans. Thus, applying oral history methods with archival research, this paper examines the humanitarian activities of the Catholic Church in the Nigerian civil war. It contends that the Catholic Church was a key player in the humanitarian aspect of the Nigerian civil war. The paper concludes that faith-based humanitarian intervention in the Biafran refugee crisis was essential for the survival of the Biafran war-stricken women and children.

Keywords: refugee crisis, humanitarian intervention, Caritas International, blockades, airlifts, starvation

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1617 Effectiveness of a Pasifika Women’s Diabetes Wellness Program (PWDWP) – Co-design With, by and for MāOri and Pasifika Women Living in Queensland

Authors: Heena Akbar, Winnie Niumata, Danielle Gallegos

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Type 2 diabetes is a significant public health problem for Māori and Pasifika communities in Queensland, who are experiencing a higher burden of morbidity and mortality from the condition. Despite this higher burden, there are few initiatives that are culturally tailored to improve prevention and management. Modification of personal behaviors through women’s wellness programs aimed at early intervention has been shown to reduce the risk of developing complications in established type 2 diabetes and may reduce hospitalization rates from preventable complications related to this disease. The 24-week Pasifika Women’s Diabetes Wellness Program (PWDWP) was culturally co-designed and co-developed with Māori and Pasifika women with type 2 diabetes through a community-academia partnership in Queensland. Underpinned by Social Cognitive Theory and the Indigenous Pacific Health frameworks to include family culture & spirituality and integrating a collectivist and whānau (family) centered approach to self-care, the program takes into consideration the cultural shame associated with acknowledging the disease and tailors the interventions using talanoa (storytelling or conversation in a relational context) as the key strategy to come to a shared meaning for behavior change. The pilot trial is a 12-week intervention followed by a 12-week follow-up period conducted with 50 women with type 2 diabetes, 25 women who will receive the intervention and 25 women who will receive usual care. The pilot program provides in-person and virtual access to culturally supported prevention and self-management of Māori and Pasifika women with type 2 diabetes with the aim to improve healthy lifestyles and reduce late hospital presentations from diabetes-related complications for better diabetes-related outcomes. This study will test and evaluate the effectiveness of the PWDWP pilot trial in partnership with Māori & Pasifika community organizations and key stakeholders for improved glycated hemoglobin (HbA1c) levels associated with poor management of type 2 diabetes.

Keywords: culturally co-designed intervention, Indigenous methodology, Māori and Pasifika communities, type 2 diabetes self-management

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1616 Dietary Diversification and Nutritional Education: A Strategy to Improve Child Food Security Status in the Rural Mozambique

Authors: Rodriguez Diego, Del Valle Martin, Hargreaves Matias, Riveros Jose Luis

Abstract:

Nutrient deficiencies due to a diet low in quantitative and qualitative terms, are prevalent throughout the developing world, especially in sub-Saharan Africa. Children and women of childbearing age are especially vulnerable. Limited availability, access and intake of animal foods at home and lack of knowledge about their value in the diet and the role they play in health, contribute to poor diet quality. Poor bioavailability of micronutrients in diets based on foods high in fiber and phytates, the low content of some micronutrients in these foods are further factors to consider. Goats are deeply embedded in almost every Sub-Saharan African rural culture, generally kept for their milk, meat, hair or leather. Goats have played an important role in African social life, especially in food security. Goat meat has good properties for human wellbeing, with a special role in lower income households. It has a high-quality protein (20 protein g/100 meat g) including all essential amino acids, good unsaturated/satured fatty acids relationship, and it is an important B-vitamin source with high micronutrients bioavailability. Mozambique has major food security problems, with poor food access and utilization, undiversified diets, chronic poverty and child malnutrition. Our objective was to design a nutritional intervention based on a dietary diversification, nutritional education, cultural beliefs and local resources, aimed to strengthen food security of children at Barrio Broma village (15°43'58.78"S; 32°46'7.27"E) in Chitima, Mozambique. Two surveys were conducted first of socio-productive local databases and then to 100 rural households about livelihoods, food diversity and anthropometric measurements in children under 5 years. Our results indicate that the main economic activity is goat production, based on a native breed with two deliveries per year in the absence of any management. Adult goats weighted 27.2±10.5 kg and raised a height of 63.5±3.8 cm. Data showed high levels of poverty, with a food diversity score of 2.3 (0-12 points), where only 30% of households consume protein and 13% iron, zinc, and B12 vitamin. The main constraints to food security were poor access to water and low income to buy food. Our dietary intervention was based on improving diet quality by increasing the access to dried goat meat, fresh vegetables, and legumes, and its utilization by a nutritional education program. This proposal was based on local culture and living conditions characterized by the absence of electricity power and drinkable water. The drying process proposed would secure the food maintenance under local conditions guaranteeing food safety for a longer period. Additionally, an ancient local drying technique was rescued and used. Moreover, this kind of dietary intervention would be the most efficient way to improve the infant nutrition by delivering macro and micronutrients on time to these vulnerable populations.

Keywords: child malnutrition, dietary diversification, food security, goat meat

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1615 Determinants of Child Anthropometric Indicators: A Case Study of Mali in 2015

Authors: Davod Ahmadigheidari

Abstract:

The main objective of this study was to explore prevalence of anthropometric indicators as well the factors associated with the anthropometric indications in Mali. Data on 2015, downloaded from the website of Unicef, were analyzed. A total of 16,467 women (ages 15-49 years) and 16,467 children (ages 0-59 months) were selected for the sample. Different statistical analyses, such as descriptive, crosstabs and binary logistic regression form the basis of this study. Child anthropometric indicators (i.e., wasting, stunting, underweight and BMI for age) were used as the dependent variables. SPSS Syntax from WHO was used to create anthropometric indicators. Different factors, such as child’s sex, child’s age groups, child’s diseases symptoms (i.e., diarrhea, cough and fever), maternal education, household wealth index and area of residence were used as independent variables. Results showed more than forty percent of Malian households were in nutritional crises (stunting (42%) and underweight (34%). Findings from logistic regression analyses indicated that low score of wealth index, low maternal education and experience of diarrhea in last two weeks increase the probability of child malnutrition.

Keywords: Mali, wasting, stunting, underweight, BMI for age and wealth index

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1614 Efficacy of Botulinum Toxin in Alleviating Pain Syndrome in Stroke Patients with Upper Limb Spasticity

Authors: Akulov M. A., Zaharov V. O., Jurishhev P. E., Tomskij A. A.

Abstract:

Introduction: Spasticity is a severe consequence of stroke, leading to profound disability, decreased quality of life and decrease of rehabilitation efficacy [4]. Spasticity is often associated with pain syndrome, arising from joint damage of paretic limbs (postural arthropathy) or painful spasm of paretic limb muscles. It is generally accepted that injection of botulinum toxin into a cramped muscle leads to decrease of muscle tone and improves motion range in paretic limb, which is accompanied by pain alleviation. Study aim: To evaluate the change in pain syndrome intensity after incections of botulinum toxin A (Xeomin) in stroke patients with upper limb spasticity. Patients and methods. 21 patients aged 47-74 years were evaluated. Inclusion criteria were: acute stroke 4-7 months before the inclusion into the study, leading to spasticity of wrist and/or finger flexors, elbow flexor or forearm pronator, associated with severe pain syndrome. Patients received Xeomin as monotherapy 90-300 U, according to spasticity pattern. Efficacy evaluation was performed using Ashworth scale, disability assessment scale (DAS), caregiver burden scale and global treatment benefit assessment on weeks 2, 4, 8 and 12. Efficacy criterion was the decrease of pain syndrome by week 4 on PQLS and VAS. Results: The study revealed a significant improvement of measured indices after 4 weeks of treatment, which persisted until the 12 week of treatment. Xeomin is effective in reducing muscle tone of flexors of wrist, fingers and elbow, forearm pronators. By the 4th week of treatment we observed a significant improvement on DAS (р < 0,05), Ashworth scale (1-2 points) in all patients (р < 0,05), caregiver burden scale (р < 0,05). A significant decrease of pain syndrome by the 4th week of treatment on PQLS (р < 0,05) и VAS (р < 0,05) was observed. No adverse effect were registered. Conclusion: Xeomin is an effective treatment of pain syndrome in postural upper limb spasticity after stroke. Xeomin treatment leads to a significant improvement on PQLS and VAS.

Keywords: botulinum toxin, pain syndrome, spasticity, stroke

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1613 Consideration of Uncertainty in Engineering

Authors: A. Mohammadi, M. Moghimi, S. Mohammadi

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Engineers need computational methods which could provide solutions less sensitive to the environmental effects, so the techniques should be used which take the uncertainty to account to control and minimize the risk associated with design and operation. In order to consider uncertainty in engineering problem, the optimization problem should be solved for a suitable range of the each uncertain input variable instead of just one estimated point. Using deterministic optimization problem, a large computational burden is required to consider every possible and probable combination of uncertain input variables. Several methods have been reported in the literature to deal with problems under uncertainty. In this paper, different methods presented and analyzed.

Keywords: uncertainty, Monte Carlo simulated, stochastic programming, scenario method

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1612 Prenatal Can Reduce the Burden of Preterm Birth and Low Birthweight from Maternal Sexually Transmitted Infections: US National Data

Authors: Anthony J. Kondracki, Bonzo I. Reddick, Jennifer L. Barkin

Abstract:

We sought to examine the association of maternal Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), and treponema pallidum (TP) (syphilis) infections with preterm birth (PTB) (<37 weeks gestation), low birth weight (LBW) (<2500 grams) and prenatal care (PNC) attendance. This cross-sectional study was based on data drawn from the 2020 United States National Center for Health Statistics (NCHS) Natality File. We estimated the prevalence of all births, early/late PTBs, moderately/very LBW, and the distribution of sexually transmitted infections (STIs) according to maternal characteristics in the sample. In multivariable logistic regression models, we examined adjusted odds ratios (aORs) and their corresponding 95% confidence intervals (CIs) of PTB and LBW subcategories in the association with maternal/infant characteristics, PNC status, and maternal CT, NG, and TP infections. In separate logistic regression models, we assessed the risk of these newborn outcomes stratified by PNC status. Adjustments were made for race/ethnicity, age, education, marital status, health insurance, liveborn parity, previous preterm birth, gestational hypertension, gestational diabetes, PNC status, smoking, and infant sex. Additionally, in a sensitivity analysis, we assessed the association with early, full, and late term births and the potential impact of unmeasured confounding using the E-value. CT (1.8%) was most prevalent STI in pregnancy, followed by NG (0.3%), and TP (0.1%). Non-Hispanic Black women, 20-24 years old, with a high school education, and on Medicaid had the highest rate of STIs. Around 96.6% of women reported receiving PNC and about 60.0% initiated PNC early in pregnancy. PTB and LBW were strongly associated with NG infection (12.2% and 12.1%, respectively) and late initiation/no PNC (8.5% and 7.6%, respectively), and ≤10 prenatal visits received (13.1% and 10.3%, respectively). The odds of PTB and LBW were 2.5- to 3-foldhigher for each STI among women who received ≤10 prenatal visits than >10 visits. Adequate prenatal care utilization and timely screening and treatment of maternal STIs can substantially reduce the burden of adverse newborn outcomes.

Keywords: low birthweight, prenatal care, preterm birth, sexually transmitted infections

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1611 Modeling of Bipolar Charge Transport through Nanocomposite Films for Energy Storage

Authors: Meng H. Lean, Wei-Ping L. Chu

Abstract:

The effects of ferroelectric nanofiller size, shape, loading, and polarization, on bipolar charge injection, transport, and recombination through amorphous and semicrystalline polymers are studied. A 3D particle-in-cell model extends the classical electrical double layer representation to treat ferroelectric nanoparticles. Metal-polymer charge injection assumes Schottky emission and Fowler-Nordheim tunneling, migration through field-dependent Poole-Frenkel mobility, and recombination with Monte Carlo selection based on collision probability. A boundary integral equation method is used for solution of the Poisson equation coupled with a second-order predictor-corrector scheme for robust time integration of the equations of motion. The stability criterion of the explicit algorithm conforms to the Courant-Friedrichs-Levy limit. Trajectories for charge that make it through the film are curvilinear paths that meander through the interspaces. Results indicate that charge transport behavior depends on nanoparticle polarization with anti-parallel orientation showing the highest leakage conduction and lowest level of charge trapping in the interaction zone. Simulation prediction of a size range of 80 to 100 nm to minimize attachment and maximize conduction is validated by theory. Attached charge fractions go from 2.2% to 97% as nanofiller size is decreased from 150 nm to 60 nm. Computed conductivity of 0.4 x 1014 S/cm is in agreement with published data for plastics. Charge attachment is increased with spheroids due to the increase in surface area, and especially so for oblate spheroids showing the influence of larger cross-sections. Charge attachment to nanofillers and nanocrystallites increase with vol.% loading or degree of crystallinity, and saturate at about 40 vol.%.

Keywords: nanocomposites, nanofillers, electrical double layer, bipolar charge transport

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1610 Consideration for a Policy Change to the South African Collective Bargaining Process: A Reflection on National Union of Metalworkers of South Africa v Trenstar (Pty) (2023) 44 ILJ 1189 (CC)

Authors: Carlos Joel Tchawouo Mbiada

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At the back of the apartheid era, South Africa embarked on a democratic drive of all its institution underpinned by a social justice perspective to eradicate past injustices. These democratic values based on fundamental human rights and equality informed all rights enshrined in the Constitution of the Republic of South Africa, 1996. This means that all rights are therefore infused by social justice perspective and labour rights are no exception. Labour law is therefore regulated to the extent that it is viewed as too rigid. Hence a call for more flexibility to enhance investment and boost job creation. This view articulated by the Free Market Foundation fell on deaf ears as the opponents believe in what is termed regulated flexibility which affords greater protection to vulnerable workers while promoting business opportunities and investment. The question that this paper seeks to examine is to what extent the regulation of labour law will go to protect employees. This question is prompted by the recent Constitutional Court’s judgment of National Union of Metalworkers of South Africa v Trenstar which barred the employer from employing labour replacement in response to the strike action by its employees. The question whether employers may use replacement labour and have recourse to lock-outs in response to strike action is considered in the context of the dichotomy between the Free market foundation and social justice perspectives which are at loggerheads in the South African collective bargaining process. With the current unemployment rate soaring constantly, the aftermath of the Covid 19 pandemic, the effects of the war in Ukraine and lately the financial burden of load shedding on companies to run their businesses, this paper argues for a policy shift toward deregulation or a lesser state and judiciary intervention. This initiative will relieve the burden on companies to run a viable business while at the same time protecting existing jobs.

Keywords: labour law, replacement labour, right to strike, free market foundation perspective, social justice perspective

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