Search results for: Peter Hubbard

Authors: Peter B. M. Vranas

Abstract:

An important question in moral philosophy is whether whatever is obligatory (i.e., morally required) is personally obligatory, namely obligatory for someone. A positive answer is uncontested in the literature: for example, if it is obligatory for you to keep your promises, it seems that it is obligatory for you you keep your promises. By using conceptual analysis, this paper defends a negative answer: some things are impersonally obligatory, namely obligatory, but not obligatory for anyone. For example, if each of us has promised to vote and thus has an obligation to vote, then it is obligatory that we all vote, but it is not obligatory for anyone that we all vote (because, for example, what is obligatory for you is that you vote, not that we all vote). The paper concludes that there is an important concept of impersonal obligatoriness irreducible to personal obligatoriness.

Keywords: impersonal obligatoriness, ought to be, ought to do, personal obligatoriness

Procedia PDF Downloads 97

Authors: Peter Amobi Chiamogu

Abstract:

Communication has subsisted as the basis for mass mobilization and political education through history with the media as a generic concept. Revolutions in ICTs have occasioned a limitless environment for the dissemination of information and ideas especially with the use of a seemingly pervasive access, penetration and use of the internet which has engendered a connected society. This study seeks to analyze the prospects and challenges for the adaptation of social media for free election and how this process can enhance public policy making, implementation and evaluation in a developing state.

Keywords: social media, e-participation, political mobilization, public policy, electioneering

Procedia PDF Downloads 352

Authors: Peter Balco, Miriam Filipova

Abstract:

The university education is generally concentrated on acquiring theoretical as well as professional knowledge. The right mix of these knowledges is key in creating innovative as well as inventive solutions. Despite the understanding of their importance by the professional community, these are promoted with problems and misunderstanding. The reason for the failure of many non-traditional, innovative approaches is the ignorance of Leadership in the process of their implementation, ie decision-making. In our paper, we focused on the role of Leadership in the educational process and how this knowledge can support decision-making, the selection of a suitable, optimal solution for practice.

Keywords: leadership, soft skills, innovation, invention, knowledge

Procedia PDF Downloads 187

Authors: Peter Krupa, Svetozár Malinarič

Abstract:

Transient plane source method has been used to measure the thermal diffusivity and thermal conductivity of a compact isostatic electro-ceramics at room temperature. The samples were fired at temperatures from 100 up to 1320 degrees Celsius in steps of 50. Bulk density and specific heat capacity were also measured with their corresponding standard uncertainties. The results were compared with further thermal analysis (dilatometry and thermogravimetry). Structural processes during firing were discussed.

Keywords: TPS method, thermal conductivity, thermal diffusivity, thermal analysis, electro-ceramics, firing

Procedia PDF Downloads 488

Authors: Peter W. Woodruff, Georgios Ponirakis, Reem Ibrahim, Amani Ahmed, Hoda Gad, Ioannis N. Petropoulos, Adnan Khan, Ahmed Elsotouhy, Surjith Vattoth, Mahmoud K. M. Alshawwaf, Mohamed Adil Shah Khoodoruth, Marwan Ramadan, Anjushri Bhagat, James Currie, Ziyad Mahfoud, Hanadi Al Hamad, Ahmed Own, Peter Haddad, Majid Alabdulla, Rayaz A. Malik

Abstract:

Introduction:- We aimed to test the hypothesis that, using corneal confocal microscopy (a non-invasive method for assessing corneal nerve fibre integrity), patients with schizophrenia would show neuronal abnormalities compared with healthy participants. Schizophrenia is a neurodevelopmental and progressive neurodegenerative disease, for which there are no validated biomarkers. Corneal confocal microscopy (CCM) is a non-invasive ophthalmic imaging biomarker that can be used to detect neuronal abnormalities in neuropsychiatric syndromes. Methods:- Patients with schizophrenia (DSM-V criteria) without other causes of peripheral neuropathy and healthy controls underwent CCM, vibration perception threshold (VPT) and sudomotor function testing. The diagnostic accuracy of CCM in distinguishing patients from controls was assessed using the area under the curve (AUC) of the Receiver Operating Characterstics (ROC) curve. Findings:- Participants with schizophrenia (n=17) and controls (n=38) with comparable age (35.7±8.5 vs 35.6±12.2, P=0.96) were recruited. Patients with schizophrenia had significantly higher body weight (93.9±25.5 vs 77.1±10.1, P=0.02), lower Low Density Lipoproteins (2.6±1.0 vs 3.4±0.7, P=0.02), but comparable systolic and diastolic blood pressure, HbA1c, total cholesterol, triglycerides and High Density Lipoproteins were comparable with control participants. Patients with schizophrenia had significantly lower corneal nerve fiber density (CNFD, fibers/mm2) (23.5±7.8 vs 35.6±6.5, p<0.0001), branch density (CNBD, branches/mm2) (34.4±26.9 vs 98.1±30.6, p<0.0001), and fiber length (CNFL, mm/mm2) (14.3±4.7 vs 24.2±3.9, p<0.0001) but no difference in VPT (6.1±3.1 vs 4.5±2.8, p=0.12) and electrochemical skin conductance (61.0±24.0 vs 68.9±12.3, p=0.23) compared with controls. The diagnostic accuracy of CNFD, CNBD and CNFL to distinguish patients with schizophrenia from healthy controls were, according to the AUC, (95% CI): 87.0% (76.8-98.2), 93.2% (84.2-102.3), 93.2% (84.4-102.1), respectively. Conclusion:- In conclusion, CCM can be used to help identify neuronal changes and has a high diagnostic accuracy to distinguish subjects with schizophrenia from healthy controls.

Keywords:

Procedia PDF Downloads 274

Authors: Reza Lotfalian, Sudarshan Martins, Peter Radziszewski

Abstract:

The effect of reliability on life-cycle cost, including initial and maintenance cost of a system is studied. The failure probability of a component is used to calculate the average maintenance cost during the operation cycle of the component. The standard deviation of the life-cycle cost is also calculated as an error measure for the average life-cycle cost. As a numerical example, the model is used to study the average life cycle cost of an electric motor.

Keywords: initial cost, life-cycle cost, maintenance cost, reliability

Procedia PDF Downloads 603

Authors: Hamada A. Ahmed, Kadry M. Sadek, Ayman E. Taha

Abstract:

The effects of basil and/or chamomile seed supplementation on the growth of Hubbard broiler chicks were evaluated. The antioxidant effects of these supplements were also assessed. One hundred and twenty 1-day-old broiler chicks were randomly divided into four equal groups. The control group (group 1) was fed a basal diet (BD) without supplementation. Groups 2, 3, and 4 were fed the BD supplemented with 10g basil, 10g chamomile, and 5g basil plus 5g chamomile per kg of food, respectively. Basil supplementation alone or in combination with chamomile non-significantly (P≥0.05) increased final body weight (3.2% and 0.3%, respectively) and weight gain (3.5% and 3.6%, respectively) over the experimental period. Chamomile supplementation alone non-significantly (P≥0.05) reduced final body weight and weight gain over the experimental period by 1.7% and 1.7%, respectively. In comparison to the control group, herbal seed supplementation reduced feed intake and improved the feed conversion and protein efficiency ratios. In general, basil seed supplementation stimulated chicken growth and improved the feed efficiency more effectively than chamomile seed supplementation. The antioxidant activities of basil and/or chamomile supplementation were examined in the thymus, bursa, and spleen. In chickens that received supplements, the level of malondialdehyde was significantly decreased, whereas the activities of glutathione, superoxide dismutase, and catalase were significantly increased (P<0.05). Supplementation of basil and/or chamomile did not affect blood protein levels, but had lipid-lowering effects as evidenced by reduced serum levels of total lipids, triglycerides, and cholesterol. In conclusion, supplementation of basil and/or chamomile improved growth parameters in broiler chicks and had antioxidant and blood lipid-lowering effects. These beneficial effects of basil and/or chamomile supplementation resulted in economically viable production of high-quality white meat containing no harmful residues.

Keywords: herbal additives, basil, chamomile, broiler, growth performance, antioxidant

Procedia PDF Downloads 542

Authors: Dávid Csercsik, Péter Kádár

Abstract:

In the case of the proposed method, the problem is parallelized by considering multiple possible mode of operation profiles, which determine the range in which the generators operate in each period. For each of these profiles, the optimization is carried out independently, and the best resulting dispatch is chosen. For each such profile, the resulting problem is a quadratic programming (QP) problem with a potentially negative definite Q quadratic term, and constraints depending on the actual operation profile. In this paper we analyze the performance of available MATLAB optimization methods and solvers for the corresponding QP.

Keywords: optimization, MATLAB, quadratic programming, economic dispatch

Procedia PDF Downloads 548

Authors: Nassim Dennouni, Yvan Peter, Luigi Lancieri, Zohra Slama

Abstract:

The objective of this article is to make a bibliographic study on the recommendation of mobile learning activities that are used as part of the field trip scenarios. Indeed, the recommendation systems are widely used in the context of mobility because they can be used to provide learning activities. These systems should take into account the history of visits and teacher pedagogy to provide adaptive learning according to the instantaneous position of the learner. To achieve this objective, we review the existing literature on field trip scenarios to recommend mobile learning activities.

Keywords: mobile learning, field trip, mobile learning activities, collaborative filtering, recommendation system, point of interest, ACO algorithm

Procedia PDF Downloads 445

Authors: Mohammad Shameel, Peter K. K. Loh, James H. Ng

Abstract:

Cybercrime is a new category of crime which poses a different challenge for crime investigators and incident responders. Attackers can mask their identities using a suite of tools and with the help of the deep web, which makes them difficult to track down. Scouring the deep web manually takes time and is inefficient. There is a growing need for a tool to scour the deep web to obtain useful evidence or intel automatically. In this paper, we will explain the background and motivation behind the research, present a survey of existing research on related tools, describe the design of our own crime/threat intelligence hunting tool prototype, demonstrate its capability with some test cases and lastly, conclude with proposals for future enhancements.

Keywords: cybercrime, deep web, threat intelligence, web crawler

Procedia PDF Downloads 172

Authors: Adekunle Kolawole Ojo, Idowu Peter Adebayo, Egwuche Sylvester O.

Abstract:

Chronic Kidney Disease (CKD) is a significant cause of morbidity and mortality across developed and developing nations and is associated with increased risk. There are no existing electronic means of capturing and monitoring CKD in Nigeria. The work is aimed at developing a spatial data model that can be used to implement renal registries required for tracking and monitoring the spatial distribution of renal diseases by public health officers and patients. In this study, we have developed a spatial data model for a functional renal registry.

Keywords: renal registry, health informatics, chronic kidney disease, interface

Procedia PDF Downloads 210

Authors: Jakub Kraus, Vladimír Plos, Peter Vittek

Abstract:

This article focuses on the issue of airport emergency plans, which are documents describing reactions to events with impact on aviation safety or aviation security. The article specifically focuses on the use and creation of emergency plans, where could be found a number of disagreements between different stakeholders, for which the airport emergency plan applies. Those are the friction surfaces of interfaces, which is necessary to identify and ensure them smooth process to avoid dangerous situations or delay.

Keywords: airport emergency plan, aviation safety, aviation security, comprehensive management system, friction surfaces of airport emergency plan, interfaces of processes

Procedia PDF Downloads 518

Authors: Peter P. K. Chiu

Abstract:

This paper reports a comparative study of new and old criteria for the professional accreditation of programme by the Hong Kong Institution of Engineers (HKIE). The major change in the criteria is the adoption of the outcome-based accreditation criteria and the use of measurement of attainment of outcomes which is very different from what academic did in the past. This has imposed a lot of difficulty for people in preparation for such exercise. Through this comparative study, the major difference between the two criteria is identified and a methodology is devised to help the academic to handle the issues due to the adoption of the new criteria. Thus it saves a lot of efforts.

Keywords: Hong Kong institution of engineers, outcome-based accreditation, Sydney accord, Washington accord

Procedia PDF Downloads 290

Authors: Peter Nave Shirga

Abstract:

Obadia Kehemen Orkor’s songs that focus on the predicament of the Tiv man in Taraba in North Central Nigeria handle themes such as poverty, social inequality, discrimination and tyranny perpetrated by Jukun against the Tiv. The major thrust of his focus in the songs is the overriding longing for mutual understanding between the Jukun and Tiv that would usher in love, equality, peace and harmonious co-existence for the two antagonistic ethnic groups. This paper examines Obadia’s hard-hitting lyrics that reveal the anger, frustration and boiling emotionalism of Tiv people in Taraba state of Nigeria.

Keywords: poet, crisis, emotionalism, frustration

Procedia PDF Downloads 308

Authors: Ipenyi Peter

Abstract:

Discipline is an issue that tends to undermine the provision of quality education in tertiary institutions in Nigeria. This is because the overall goals of tertiary institutions, as enunciated in the National Policy of Education, can hardly be achieved by all the stakeholders without strict conformity and adherence to the rules and regulations and the ideals of the entire society. The adherence is essential for the general welfare of the society. This paper critically X-rayed the causes of indiscipline in tertiary institutions in Nigeria. Such courses include laxity in home control and parental supervision, school, teacher and societal factors as well as government influence. The paper recommended among others such strategies as enculturation, acculturation as well as the acquisition of a certain number of generic skills for dealing with discipline and ethical issues in tertiary institutions in Nigeria.

Keywords: discipline, education, tertiary institutions, society

Procedia PDF Downloads 541

Authors: Thien X. Dinh, Peter Witt

Abstract:

A one-dimensional model for the simulation of condensation and solidification of a metallurgical vapor in the mixture of gas during supersonic expansion is presented. In the model, condensation is based on critical nucleation and drop-growth theory. When the temperature falls below the supercooling point, all the formed liquid droplets in the condensation phase are assumed to solidify at an infinite rate. The model was verified with a Computational Fluid Dynamics simulation of magnesium vapor condensation and solidification. The obtained results are in reasonable agreement with CFD data. Therefore, the model is a promising, efficient tool for use in the design process for supersonic nozzles applied in mineral processes since it is faster than the CFD counterpart by an order of magnitude.

Keywords: condensation, metallurgical flow, solidification, supersonic expansion

Procedia PDF Downloads 61

Authors: Tamas Jancso, Andrea Podor, Eva Nagyne Hajnal, Peter Udvardy, Gabor Nagy, Attila Varga, Meng Qingyan

Abstract:

The paper deals with the conditions and circumstances of integration of remotely sensed data for rural environmental monitoring purposes. The main task is to make decisions during the integration process when we have data sources with different resolution, location, spectral channels, and dimension. In order to have exact knowledge about the integration and data fusion possibilities, it is necessary to know the properties (metadata) that characterize the data. The paper explains the joining of these data sources using their attribute data through a sample project. The resulted product will be used for rural environmental analysis.

Keywords: remote sensing, GIS, metadata, integration, environmental analysis

Procedia PDF Downloads 119

Authors: Kausar Harun, Ahmad Azmin Mohamad

Abstract:

Zinc oxide (ZnO) has been extensively used in optoelectronic devices, with recent interest as photoanode material in dye-sensitize solar cell. Numerous methods employed to experimentally synthesized ZnO, while some are theoretically-modeled. Both approaches provide information on ZnO properties, but theoretical calculation proved to be more accurate and timely effective. Thus, integration between these two methods is essential to intimately resemble the properties of synthesized ZnO. In this study, experimentally-grown ZnO nanoparticles were prepared by sol-gel storage method with zinc acetate dihydrate and methanol as precursor and solvent. A 1 M sodium hydroxide (NaOH) solution was used as stabilizer. The optimum time to produce ZnO nanoparticles were recorded as 12 hours. Phase and structural analysis showed that single phase ZnO produced with wurtzite hexagonal structure. Further work on quantitative analysis was done via Rietveld-refinement method to obtain structural and crystallite parameter such as lattice dimensions, space group, and atomic coordination. The lattice dimensions were a=b=3.2498Å and c=5.2068Å which were later used as main input in first-principles calculations. By applying density-functional theory (DFT) embedded in CASTEP computer code, the structure of synthesized ZnO was built and optimized using several exchange-correlation functionals. The generalized-gradient approximation functional with Perdew-Burke-Ernzerhof and Hubbard U corrections (GGA-PBE+U) showed the structure with lowest energy and lattice deviations. In this study, emphasize also given to the modification of valence electron energy level to overcome the underestimation in DFT calculation. Both Zn and O valance energy were fixed at Ud=8.3 eV and Up=7.3 eV, respectively. Hence, the following electronic and optical properties of synthesized ZnO were calculated based on GGA-PBE+U functional within ultrasoft-pseudopotential method. In conclusion, the incorporation of Rietveld analysis into first-principles calculation was valid as the resulting properties were comparable with those reported in literature. The time taken to evaluate certain properties via physical testing was then eliminated as the simulation could be done through computational method.

Keywords: density functional theory, first-principles, Rietveld-refinement, ZnO nanoparticles

Procedia PDF Downloads 309

Authors: Gerhard Peter

Abstract:

In this paper, we present an integrated framework that governs the introduction of social media into enterprises and its evaluation. It is argued that the framework should address the following issues: (1) the contribution of social media for increasing efficiency and improving the quality of working life; (2) the level on which this contribution happens (i.e., individual, team, or organisation); (3) a description of the processes for implementing and evaluating social media; and the role of (4) organisational culture and (5) management. We also report the results of a case study where the framework has been employed to introduce a social networking platform at a German enterprise. This paper only considers the internal use of social media.

Keywords: case study, enterprise 2.0, framework, introducing and evaluating social media, social media

Procedia PDF Downloads 366

Authors: Peter Pfeifer, Julian Pfeifer, Niko Pfeifer

Abstract:

Information processing is the focus of brain and cognition research. This work has a different perspective; it starts with behaviors. The detailed analysis of behaviors leads to the discovery that a significant proportion of them are based on only five basic drives. These basic drives are combinable, and the combinations result in the diversity of human behavior and thinking. The key elements are drive memories. They collect memories of drive-related situations and feelings. They contain variations of basic drives in numerous areas of life and build combinations with different meanings depending on the area. Human thinking could be explained with variations on these nested combinations of basic drives.

Keywords: cognition, psycholinguistics, psychology, psychophysiology of cognition

Procedia PDF Downloads 160

Authors: Peter M. Maurer Maurer

Abstract:

DGL is a context free grammar-based tool for generating random data. Many types of simulator input data require some computation to be placed in the proper format. For example, it might be necessary to generate ordered triples in which the third element is the sum of the first two elements, or it might be necessary to generate random numbers in some sorted order. Although DGL is universal in computational power, generating these types of data is extremely difficult. To overcome this problem, we have enhanced DGL to include features that permit direct computation within the structure of a context free grammar. The features have been implemented as special types of productions, preserving the context free flavor of DGL specifications.

Keywords: DGL, Enhanced Context Free Grammars, Programming Constructs, Random Data Generation

Procedia PDF Downloads 146

Authors: Peter Unoh Bassey

Abstract:

The study is predicated on the current trend of the rate of dispositional loneliness experienced by the elderly in society today as a result of the breakdown in the family attachment patterns, loss of close associates, and interpersonal conflicts. The research adopted the ex-post facto research design through a survey data collected from a total of 500 elderly comprising of both retirees and community-based elders. Both the stratified and simple sampling techniques were used to select the sample. Based on the findings, it was recommended that the elderly should be trained in acquiring specific attachment styles as well as be trained in developing appropriate social skills to counter loneliness.

Keywords: dispositional loneliness, mental health, elderly, cross river state

Procedia PDF Downloads 152

Authors: Jo Rhodes, Peter Lok, Zahra Sadeghinejad

Abstract:

The aim of this study is to determine the impact of metacognition on top management team members and firm performance based on full team integration. A survey of 1500 small to medium enterprises (SMEs) was initiated and 140 firms were obtained in this study (with response rate of 9%). The result showed that different metacognitive abilities of managers [knowledge and experience] could enhance team decision-making and problem solving, resulting in greater firm performance. This is a significant finding for SMEs because these organisations have small teams with owner leadership and entrepreneurial orientation.

Keywords: metacognition, behavioural integration, top management team (TMT), performance

Procedia PDF Downloads 374

Authors: Mathias Marquardt, Peter Dünow, Sandra Baßler

Abstract:

The paper describes the use of subspace based identification methods for auto tuning of a state space control system. The plant is an unstable but self balancing transport robot. Because of the unstable character of the process it has to be identified from closed loop input-output data. Based on the identified model a state space controller combined with an observer is calculated. The subspace identification algorithm and the controller design procedure is combined to a auto tuning method. The capability of the approach was verified in a simulation experiments under different process conditions.

Keywords: auto tuning, balanced robot, closed loop identification, subspace identification

Procedia PDF Downloads 379

Authors: Achim Kampker, Peter Burggräf, Moritz Krunke, Hanno Voet

Abstract:

As a reaction to current challenges in factory planning, many companies think about introducing factory standards to lower planning times and decrease planning costs. If these factory standards are set-up with a high level of modularity, they are defined as modular factory systems. This paper deals with the main current problems in the application of modular factory systems in practice and presents a solution approach with its basic models. The methodology is based on methods from factory planning but also uses the tools of other disciplines like product development or technology management to deal with the high complexity, which the development of modular factory systems implies. The four basic models that such a methodology has to contain are introduced and pointed out.

Keywords: factory planning, modular factory systems, factory standards, cost-benefit analysis

Procedia PDF Downloads 593

Authors: Maximilian Winkens, Peter Nyhuis

Abstract:

Components with sensory properties such as gentelligent components developed at the Collaborative Research Center 653 offer a new angle on the full utilization of the remaining service life in case of a preventive maintenance. The developed methodology of component status driven maintenance analyses the stress data obtained during the component's useful life and on the basis of this knowledge assesses the type of maintenance called for in this case. The procedure is derived from the case-based reasoning method and will be elucidated in detail. The method's functionality is demonstrated with real-life data obtained during test runs of a racing car prototype.

Keywords: gentelligent component, preventive maintenance, case-based reasoning, sensory

Procedia PDF Downloads 362

Authors: Oluwole Opeyemi Dina, Saheed E. Elugoke, Peter Olutope Fayemi, Omolola E. Fayemi

Abstract:

This study presents the detection of epinephrine (EP) at Fe₃O₄ modified screen printed silver electrode (SPSE). The iron oxide (Fe₃O₄) nanoparticles were characterized with UV-visible spectroscopy, Fourier-Transform infrared spectroscopy (FT-IR) and Scanning electron microscopy (SEM) prior to the modification of the SPSE. The EP oxidation peak current (Iap) increased with an increase in the concentration of EP as well as the scan rate (from 25 - 400 mVs⁻¹). Using cyclic voltammetry (CV), the relationship between Iap and EP concentration was linear over a range of 3.8 -118.9 µM and 118.9-175 µM with a detection limit of 41.99 µM and 83.16 µM, respectively. Selective detection of EP in the presence of ascorbic acid was also achieved at this electrode.

Keywords: screenprint electrode, iron oxide nanoparticle, epinephrine, serum, cyclic voltametry

Procedia PDF Downloads 164

Authors: Johannes J. Schneider, Mathias S. Weyland, Peter Eggenberger Hotz, William D. Jamieson, Oliver Castell, Alessia Faggian, Rudolf M. Füchslin

Abstract:

Agglomerations of polydisperse systems of spherical particles are created in computer simulations using a simplified stochastic-hydrodynamic model: Particles sink to the bottom of the cylinder, taking into account gravity reduced by the buoyant force, the Stokes friction force, the added mass effect, and random velocity changes. Two types of particles are considered, with one of them being able to create connections to neighboring particles of the same type, thus forming a network within the agglomeration at the bottom of a cylinder. Decreasing the fraction of these particles, a percolation transition occurs. The critical regime is determined by investigating the maximum cluster size and the percolation susceptibility.

Keywords: binary system, maximum cluster size, percolation, polydisperse

Procedia PDF Downloads 59

Authors: Sanchayan Banerjee, Peter John

Abstract:

Nudge plus is a modification of the toolkit of behavioural public policy. It incorporates an element of reflection¾the plus¾into the delivery of a nudge, either blended in or made proximate. Nudge plus builds on recent work combining heuristics and deliberation. It may be used to design pro-social interventions that help preserve the autonomy of the agent. The argument turns on seminal work on dual systems, which presents a subtler relationship between fast and slow thinking than commonly assumed in the classic literature in behavioural public policy. We review classic and recent work on dual processes to show that a hybrid is more plausible than the default interventionist or parallel competitive framework. We define nudge plus, set out what reflection could entail, provide examples, outline causal mechanisms, and draw testable implications.

Keywords: nudge, nudge plus, think, dual process theory

Procedia PDF Downloads 191

Authors: Trenton Hubbard, Kenneth Soyemi, Emily Siffermann

Abstract:

Introduction: According to the American Academy of Pediatrics (AAP) there are different weight-based recommendations for the treatment of Chlamydia trachomatis (CT) in patients who are being evaluated for sexual assault. Current AAP Red Book guidelines recommend that uncomplicated C. trachomatis anogenital infection in prepubertal patients weighing less than =<45 kg be treated with oral erythromycin 50 mg/kg/day QID for 14 days with no alternative therapies, and for patients whose weight => 45 kg are Azithromycin 1 gm PO once. Our study objective was to determine the efficacy of single-dose Azithromycin therapy for the treatment of Chlamydia trachomatis in patients weighing less than 50 kg who were evaluated for child sexual abuse in an urban setting. Methods: We conducted a retrospective chart review of historical medical records (paper and electronic) patients weighing less than 50 kg who were evaluated for child sexual abuse and subsequently treated for C. trachomatis infection with Azithromycin (20 mg/kg PO once up to a maximum 1 gm) and received a Test of Cure (TOC) from 2006-2016. Qualitative variables were expressed as percentages. Quantitative variables were expressed as mean values (+/- standard deviation [SD]) if they followed a normal distribution or as median values (interquartile range[IQR]) if they did not. Wilcoxson two-sample test was used to compare means of Azithromycin Dose, mg/kg, and TOC timing between treatment responders and non-responders. Results: We reviewed records of 34 patients, average age (SD) was 5.4 (2.0) years, 33 (97%) were treated for CT and 1(3%) for both GC and CT. 25 (74%) were females. Urine PCR was the most commonly used test at evaluation and as TOC with 13 (38%) patients completing both tests. The average (SD) dose of Azithromycin at treatment was 470 (136) mg and average (SD) mg/kg dose of 20 (1.9) mg/kg for all patients. Median (IQR) timing for TOC testing was 19 (14-26) days. Of the 33 with complete data 25 (74%) had a negative TOC. When compared with treatment non-responders (TOC failures), treatment responders received higher doses (average dose (SD) received 495 (139) vs 401(110), P 0.06)); similar average (SD) weight base dosing received (20.8(2.0) vs 19.7 (1.5), P 0.15)), and earlier average (SD)TOC test timing (18.8 (5.6) vs 32 (28.6) P 0.02)). Conclusion: Azithromycin dosing appears to be efficacious in the treatment of CT post sexual assault as majority of patients responded. Although treatment responders and non-responders received similar weight based doses, there is need for additional studies to understand variances and predictors of response.

Keywords: child sexual abuse, chlmaydia trachmotis infection, single-dose azithromycin, weight less than or equal to 45 kilograms

Procedia PDF Downloads 292