Search results for: treatment outcomes

Authors: Gentiana Shegani

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Coagulation is a process that sanitizes leather effluents. It aims to reduce pollutants such as Chemical Oxygen Demand (COD), chloride, sulphate, chromium, suspended solids, and other dissolved solids. The current study aimed to evaluate coagulation efficiency of tannery wastewater by analysing the change in organic matter, odor, colour, ammonium ions, nutrients, chloride, H2S, sulphate, suspended solids, total dissolved solids, faecal pollution, and chromium hexavalent before and after treatment. Effluent samples were treated with coagulants Ca(OH)2 and FeSO4 .7H2O. The best advantages of this treatment included the removal of: COD (81.60%); ammonia ions (98.34%); nitrate ions (92%); chromium hexavalent (75.00%); phosphate (70.00%); chloride (69.20%); and H₂S (50%). Results also indicated a high level of efficiency in the reduction of fecal pollution indicators. Unfortunately, only a modest reduction of sulphate (19.00%) and TSS (13.00%) and an increase in TDS (15.60%) was observed.

Keywords: coagulation, effluent, tannery, treatment

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Authors: Abdullah Almatouq, Abdulla Abusam, Hussain Hussain, Mishari Khajah, Hussain Abdullah, Rashed Al-Yaseen, Mariam Al-Jumaa, Farah Al-Ajeel, Mohammad Aljassam

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Due to the high demand for energy from unsustainable resources in Kuwait, the Kuwaiti government has focused recently on using sustainable resources for energy, such as solar and wind energy. In addition, sludge which is generated as a by-product of physical, chemical, and biological processes during wastewater treatment, can be used as a substrate to generate energy through anaerobic digestion. Kuwait’s wastewater treatment plants produce more than 1.7 million m3 of sludge per year, and this volume is accumulated in the treatment plants without any treatment. Therefore, a pilot-scale (3 m3) two-stage anaerobic digester was constructed in one of the largest treatment plants in Kuwait. The reactor was operated in batch mode, and the hydraulic retention time varied between 14 – 27 days. The main of this study is to evaluate the technical feasibility of a two-stage anaerobic digester for sludge treatability and energy generation in Kuwait. The anaerobic digester achieved a total biogas production of 37 m3, and the highest value of daily biogas production was 0.4 m3/day. The methane content ranged between 50 % and 66 %, and the other gases were as follows: CO2 20 %, H2S 13 %, and 1 % O2. The generated biogas was used on-site for cooking and lighting. In some batches, low C/N was noticed, and that lead to maintaining the concentration of CH4 between 50%-55%. In conclusion, an anaerobic digester is an environmentally friendly technology that can be applied in Kuwait, and the obtained results support the scale-up of the process in all the treatment plants.

Keywords: wastewater, metahne, biogas production potential, anaerobic digestion

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Authors: Abiodun Ezekiel Adesina, Alice M. Olagunju

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This study determined the effects of Computer Assisted Instructions (CAI) and Academic Self-Concepts (ASC) on pre-service teachers’ achievement in AE concepts in CoE in Southwest, Nigeria. The study adopted pretest-posttest, control group, quasi-experimental design. Six CoE with e-library facilities were purposively selected. Two hundred and thirty-two intact 200 level Agricultural education students offering introduction to AE course across the six CoE were participants. The participants were assigned to three groups (D&PM, 77, TM, 73 and control, 82). Treatment lasted eight weeks. The AE achievement test (r=0.76), pre-service teachers’ ASC Scale (r=0.81); instructional guides for tutorial (r=0.76), drill and practice (r=0.81) and conventional lecture modes (r=0.83), and teacher performance assessment sheet were used for data collection. Data were analysed using analysis of covariance and Scheffe post-hoc at 0.05 level of significance. The participants were 55.6% female with mean age of 20.8 years. Treatment had significant main effects on pre-service teachers’ achievement (F(2,207)=60.52; η²=0.21; p < 0.05). Participants in D&PM (x̄ =27.83) had the best achievement compared to those in TM (x̄ =25.41) and control (x̄ =18.64) groups. ASC had significant main effect on pre-service teachers’ achievement (F(1,207)=22.011; η²=0.166; p < 0.05). Participants with high ASC (x̄ =27.52) had better achievement compared to those with low ASC (x̄ =22.37). The drill and practice and tutorial instructional modes enhanced students’ achievement in Agricultural Economics concepts. Therefore, the two instructional modes should be adopted for improved learning outcomes in agricultural economics concepts among pre-service teachers.

Keywords: achievement in agricultural economics concepts, colleges of education in southwestern Nigeria, computer-assisted instruction, drill and practice instructional mode, tutorial instructional mode

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Authors: Yogita Tulsian, R. S. Gupta, K. F. Laserson

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Background: Delays in the diagnosis and treatment of TB facilitates disease transmission in the community, so we conducted a study to evaluate the burden of and risk factors for delay in TB diagnosis and initiation of TB treatment among patients in the private and public sectors in Udaipur district, Rajasthan, India. Methods: A retrospective cohort study was conducted among 100 new sputum-positive TB. Patients were interviewed in the intensive phase of treatment September 2013-November 2013 Long total diagnosis delay (TDD) was defined as a time interval between first symptom to confirmed diagnosis > 30 days. Long health treatment delay (HTD) was defined as a time interval between confirmed diagnosis to treatment initiation > 7 days. Results: We observed a median TDD of 55 days (range: 7-136 days) in the public sector and of 92 days (11-380 days) in the private sector. Long TDD in the private sector was significantly associated with middle-higher socio-economic status (Risk Ratio (RR): 2;95% CI: 1.3-3). The reasons reported from the private sector for long TDD were suspect TB patients not advised for sputum examination (RR: 42; 95% CI:2.6-660), practise of self-medication (RR: 17.4; 95% CI: 1.1-267), or lack of awareness (RR: 9.7;95% CI: 0.6-145). The median HTD in the public sector was 3 days (range: 0-14 days), and in the private sector, 2 days (range: 0-11 days) (non-significant difference). Conclusions: Long TDD in private sector may be improved through sputum referral for all suspect TB cases and better education to all regarding TB.

Keywords: diagnosis delay, treatment delay, privatesector, public sector

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Authors: Garima Singh

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Objectives: Behavioral Crisis Center (BCC) is a community solution to a community problem. There has been an exponential increase in the incidence and prevalence of mental health crises around the world. The effects of the crisis negatively impact our patients and their families and strain the law enforcement and emergency room. The goal of the multi-disciplinary care model is to break the crisis cycle and provide 24-7 rapid access to an acre and crisis stabilization. We initiated our first BCC care center in 2020 in the midst of the COVID pandemic and have seen a remarkable improvement in patient ‘care and positive financial outcome. Background: Mental illnesses are common in the United States. Nearly one in five U.S. adults live with a mental illness (52.9 million in 2020). This number represented 21.0% of all U.S. adults. To address some of these challenges and help our community, In May 2020, we opened our first Behavioral crisis center (BCC). Since then, we have served more than 2500 patients and is the first southwest Missouri’s first 24/7 facility for crisis–level behavioral health and substance use needs. It has been proven to be a more effective place than emergency departments, jails, or local law enforcement. Methods: BCC was started in 2020 to serve the unmet need of the community and provide access to behavioral health and substance use services identified in the community. Funding was possible with significant investment from the county and Missouri Foundation for Health, with contributions from medical partners. It is a multi-disciplinary care center consisting of Physicians, nurse practitioners, nurses, behavioral technicians, peer support specialists, clinical intake specialists, and clinical coordinators and hospitality specialists. The center provides services including psychiatry care, outpatient therapy, community support services, primary care, peer support and engagement. It is connected to a residential treatment facility for substance use treatment for continuity of care and bridging the gap, which has resulted in the completion of treatment and better outcomes. Results: BCC has proven to be a great resource to the community and the Missouri Health Coalition is providing funding to replicate the model in other regions and work on a similar model for children and adolescents. Overall, 29% of the patients seen at BCC are stabilized and discharged with outpatient care. 50% needed acute stabilization in a hospital setting and 21% required long-term admission, mostly for substance use treatment. The local emergency room had a 42% reduction in behavioral health encounters compared to the previous 3 years. Also, by a quick transfer to BCC, the average stay in ER was reduced by 10 hours and time to follow up behavioral health assessment decreased by an average of 4 hours. Uninsured patients are also provided Medicaid application assistance which has benefited 55% of individuals receiving care at BCC. Conclusions: BCC is impacting community health and improving access to quality care and substance use treatment. It is a great investment for our patients and families.

Keywords: BCC, behvaioral health, community health care, addiction treatment

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Authors: M. Walmsley, S. Elmatarri, S. Mannion

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Introduction: Self-inflicted injury is a recognised cause of major trauma in adults and is an independent indicator of a reduced functional outcome compared to non-intentional major trauma. There is little literature available on the inpatient mental health (MH) management of this vulnerable group. A retrospective review was conducted of inpatient MH management of major trauma patients admitted to a UK regional Major Trauma Centre (MTC). Their outcomes were compared to all major trauma patients. This group of patients required multiple MH interventions whilst on the Major Trauma Ward (MTW) and a had worse functional outcome compared to non-intentional trauma. Method: The national TARN (Trauma Audit and Research Network) database was used to identify patients admitted to a regional MTC over a 2-year period from June 2018 to July 2020. Patients with an ISS (Injury Severity Score) of greater than 15 with a mechanism of either self-harm or high-risk behavior were included for further analysis. Inpatient medical notes were reviewed for MH interventions on the MTW. Further outcomes, including mortality, length of stay (LOS) and Glasgow Outcome Score (GOS) were compared with all major trauma patients for the same time period. Results: A total of 60 patients were identified in the time period and of those, 27 spent time on the MTW. A total of 23 (85%) had a prior MH diagnosis, with 11 (41%) under the care of secondary MH services. Adequate inpatient records for review were available for 24 patients. During their inpatient stay, 8 (33%) were reviewed on the ward by the inpatient MH team. There were 10 interventions required for 6 (25%) patients on the MTW including, sections under the Mental Health Act, transfer to specialist MH facility, pharmacological sedation and security being called to the MTW. When compared to all major trauma patients, those admitted due to self-harm or high-risk behavior had a statistically significantly higher ISS (31.43 vs 24.22, p=0.0001) and LOS (23.51d vs 16.06d, p=0.002). Functional outcomes using the GOS were reduced in this group of patients, GOS 5 (low disability) (51.66% vs. 61.01%) and they additionally had a higher level of mortality, GOS 1 (15.00% vs 11.67%). Discussion: Intentional self-harm is a recognised cause of major trauma in adults and this patient group sustains more severe injuries, requiring a longer hospital stay with worse outcomes compared to all major trauma patients. Inpatient MH interventions are required for a significant proportion of these patients and therefore, there needs to be a close relationship with MH services. There is limited available evidence for how this patient group is best managed as an inpatient to aid their recovery and further work is needed on how outcomes in this vulnerable group can be improved.

Keywords: adult major trauma, attempted suicide, self-inflicted major trauma, inpatient management

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Authors: Palak V. Patel, Jessica Pixley, Steven R. Feldman

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Introduction: Basal cell carcinoma (BCC) is the most common skin cancer worldwide and requires substantial resources to treat. When choosing between indicated therapies, providers consider their associated adverse effects, efficacy, cosmesis, and function preservation. The patient’s tumor burden, infiltrative risk, and risk of tumor recurrence are also considered. Treatment cost is often left out of these discussions. This can lead to financial toxicity, which describes the harm and quality of life reductions inflicted by high care costs. Methods: We studied the guidelines set forth by the American Academy of Dermatology for the treatment of BCC. A PubMed literature search was conducted to identify the costs of each recommended therapy. We discuss costs alongside treatment efficacy and side-effect profile. Results: Surgical treatment for BCC can be cost-effective if the appropriate treatment is selected for the presenting tumor. Curettage and electrodesiccation can be used in low-grade, low-recurrence tumors in aesthetically unimportant areas. The benefits of cost-conscious care are not likely to be outweighed by the risks of poor cosmesis or tumor return ($471 BCC of the cheek). When tumor burden is limited, MMS offers better cure rates and lower recurrence rates than surgical excision, and with comparable costs (MMS $1263; SE $949). Surgical excision with permanent sections may be indicated when tumor burden is more extensive or if molecular testing is necessary. The utility of surgical excision with frozen sections, which costs substantially more than MMS without comparable outcomes, is less clear (SE with frozen sections $2334-$3085). Less data exists on non-surgical treatments for BCC. These techniques cost less, but recurrence-risk is high. Side-effects of nonsurgical treatment are limited to local skin reactions, and cosmesis is good. Cryotherapy, 5-FU, and MAL-PDT are all more affordable than surgery, but high recurrence rates increase risk of secondary financial and psychosocial burden (recurrence rates 21-39%; cost $100-270). Radiation therapy offers better clearance rates than other nonsurgical treatments but is associated with similar recurrence rates and a significantly larger financial burden ($2591-$3460 BCC of the cheek). Treatments for advanced or metastatic BCC are extremely costly, but few patients require their use, and the societal cost burden remains low. Vismodegib and sonidegib have good response rates but substantial side effects, and therapy should be combined with multidisciplinary care and palliative measures. Expert-review has found sonidegib to be the less expensive and more efficacious option (vismodegib $128,358; sonidegib $122,579). Platinum therapy, while not FDA-approved, is also effective but expensive (~91,435). Immunotherapy offers a new line of treatment in patients intolerant of hedgehog inhibitors ($683,061). Conclusion: Dermatologists working within resource-compressed practices and with resource-limited patients must prudently manage the healthcare dollar. Surgical therapies for BCC offer the lowest risk of recurrence at the most reasonable cost. Non-surgical therapies are more affordable, but high recurrence rates increase the risk of secondary financial and psychosocial burdens. Treatments for advanced BCC are incredibly costly, but the low incidence means the overall cost to the system is low.

Keywords: nonmelanoma skin cancer, basal cell skin cancer, squamous cell skin cancer, cost of care

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Authors: Ma. Roxanne Fernandez, Josie Athens, Balsalobre-Fernandez, Masayoshi Kubo, Kim Hébert-Losier

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Objectives: The calf raise test (CRT) is used in rehabilitation and sports medicine to evaluate calf muscle function. For testing, individuals stand on one leg and go up on their toes and back down to volitional fatigue. The newly developed Calf Raise application (CRapp) for iOS uses computer-vision algorithms enabling objective measurement of CRT outcomes. We aimed to validate the CRapp by examining its concurrent validity and agreement levels against laboratory-based equipment and establishing its intra- and inter-rater reliability. Methods: CRT outcomes (i.e., repetitions, positive work, total height, peak height, fatigue index, and peak power) were assessed in thirteen healthy individuals (6 males, 7 females) on three occasions and both legs using the CRapp, 3D motion capture, and force plate technologies simultaneously. Data were extracted from two markers: one placed immediately below the lateral malleolus and another on the heel. Concurrent validity and agreement measures were determined using intraclass correlation coefficients (ICC₃,ₖ), typical errors expressed as coefficient of variations (CV), and Bland-Altman methods to assess biases and precision. Reliability was assessed using ICC3,1 and CV values. Results: Validity of CRapp outcomes was good to excellent across measures for both markers (mean ICC ≥0.878), with precision plots showing good agreement and precision. CV ranged from 0% (repetitions) to 33.3% (fatigue index) and were, on average better for the lateral malleolus marker. Additionally, inter- and intra-rater reliability were excellent (mean ICC ≥0.949, CV ≤5.6%). Conclusion: These results confirm the CRapp is valid and reliable within and between users for measuring CRT outcomes in healthy adults. The CRapp provides a tool to objectivise CRT outcomes in research and practice, aligning with recent advances in mobile technologies and their increased use in healthcare.

Keywords: calf raise test, mobile application, validity, reliability

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Authors: Jiyoung Kim, Chae Weon Chung

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Labor pain is one of the most common concerns of pregnant women, thus women are in need of possible options they could take to control the pain. So, this study aimed to explore maternal perception of epidural anesthesia and to compare the childbirth outcomes according to the use of epidural anesthesia. For this descriptive study, women who were over 36 weeks of pregnancy were recruited from an out-patient obstetric clinic in a public hospital in Seoul. Women were included in the study if agreed to participate, were pregnant singleton, without pregnancy complication, and expecting a natural birth. Data collection was done twice, the first one at the prenatal care visit and the second one at an in-patient ward on 2nd day postpartum. The instrument of the beliefs about epidural anesthesia, one item of asking intention to use epidural anesthesia, demographics, and obstetrical characteristics were incorporated into a questionnaire. One nurse researcher performed data collection with the structured questionnaire after the approval of the institutional review board. At the initial data collection 133 women were included, while 117 were retained at the second point after excluded 13 women due to the occurrence of complications. Analyses were done by chi-square, t-test, and ANOVA using the SPSS program. Women were aged 32.5 years old, 22.2% were over 35 years old. The average gestational age was 38.5 weeks, and 67.5% were nulliparous. Out of 38 multiparous women, 20 women (52.6%) had received epidural anesthesia in the previous delivery. At the initial interview, 62.6% (n=73) of women wanted to receive epidural anesthesia while 22.4% answered not decided and 15.4% did not want to take the procedure. However, there were changes in proportions between women’s intention to take it and actual procedures done, particularly, two-thirds of women (n=26) who had been undecided were found to receive epidural anesthesia during labor. There was a significant difference in the perception of epidural anesthesia measured before delivery between women who received and not received it (t=3.68, p < .001). Delivery outcomes were statistically different between the two groups in delivery mode (chi-square=8.64, p=.01), O₂ supply during labor (chi-square =5.01, p=.03), duration of 2nd stage of labor (t=3.70, p < .001), and arterial cord blood pH (t=2.64, p=.01). Interestingly, there was no difference in labor pain perceived between women with and without epidural anesthesia. Considering the preference and use of epidural anesthesia, health professionals need to assess coping ability of women undergoing delivery and to provide accurate information about pain control to support their decision making and eventually to enhance delivery outcomes for mothers and neonates.

Keywords: epidural anesthesia, delivery outcomes, labor pain, perception

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Authors: A. H. Dikko, D. N Tsado, M. S. T. Rita, D. S. Umar

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This study was conducted on eighteen (18) New Zealand and chinchilla breeds of rabbits were used. The rabbits were allotted to 3 treatments with each treatment having six (6) animals with two (2) replicates. T1 were castrated, which both testes was removed (Bilateral); T2 were castrated, which only one testes was removed (unilateral) and T3 were not castrated (control). In nutrient digestibility, T1 and T2 (p>0.05) has a higher rate than T3. There was no significant (p<0.05) difference in live weight and dressing weight among the treatment groups. There is a significant (p > 0.05) difference in visceral organs in the treatment groups.

Keywords: New Zealand, chinchilla, castration, bilateral, unilateral

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Authors: Mario Pérez-Won, Anais Palma-Acevedo, Luis González-Cavieres, Roberto Lemus-Mondaca, Gipsy Tabilo-Munizaga

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The Chilean abalone (Concholepas Concholepas) is a gastropod mollusk; it has a high commercial value due to the qualities of its meat, especially hardness, as a critical acceptance parameter. However, its main problem is its short shelf-life which is usually extended using traditional technologies with high energy consumption. Therefore, applying different technologies for the pre-treatment and drying process is necessary. In this research, pulsed electric field (PEF) was used as a pre-treatment for vacuum microwave drying (VMD), freeze-drying (FD), and hot-air drying (HAD). Drying conditions and characteristics were set according to previous experiments. The Drying samples were analyzed in terms of physical quality (color, texture, microstructure, and rehydration capacity), protein quality (degree of hydrolysis and computer protein efficiency ratio), and energy parameters. Regarding quality, the treatment that obtained lower harness was PEF+FD (195 N ± 10), the lowest change of color was for treatment PEF+VMD (ΔE: 17 ± 1.5), and the best rehydration capacity was for treatment PEF+VMD (1.2 h for equilibrium). For protein quality, the highest Computer-Protein Efficiency Ratio was the sample 2.0 kV/ cm of PEF (index of 4.18 ± 0.26 at the end of the digestion). Moreover, about energetic consumption, results show that VMD decreases the drying process by 97% whether PEF was used or not. Consequently, it is possible to conclude that using PEF as a pre-treatment for VMD and FD treatments has advantages that must be used following the consumer’s needs or preferences.

Keywords: chilean abalone, freeze-drying, proteins, pulsed electric fields

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Authors: D. Tohlob, E. Abo Hashem, N. Ghareeb, M. Ghanem, R. Elfarahaty, S. A. Roberts, P. Pemberton, L. Mohiyiddeen, W. G. Newman

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Gonadotropin stimulation is used in females undergoing assisted reproductive treatment for ovulation induction, but ovarian response is variable and unpredictable in these women. More effective protocols and individualization of treatment are needed to increase the success rate of IVF/ICSI cycles. We genotyped seven variants reported in previous studies to be associated with ovarian response (number of ova retrieved and total gonadotropin dose) in women undergoing IVF treatment including FSHR variants Asn 680 Ser (c.2039 A > G), Thr 307 Ala (c. 919 > A), -29 G > A, HRG c.610 C > T gene, BMP15 -9 C > G, AMH Ile 49 Ser (c.146 G > T), and AMHR -489A˃G in 118 Egyptian females attending Mansoura Integrated Fertility Center in Egypt, these females were undergoing their first cycle of controlled ovarian hyper stimulation for IVF/ICSI treatment. They were analyzed by TaqMan allelic discrimination assay in Manchester Center of Genomic Medicine. We found no evidence of any significant difference (p value < 0.05) in the number of eggs retrieved or the gonadotropin dose used between individuals in all genotypes except for HRG c.610 C > T gene polymorphism where regression analysis gives a p value of 0.04 with a fewer eggs number in TT genotyped females. These results indicate that these variants do not provide sufficient clinically relevant data to individualize the treatment protocols.

Keywords: controlled ovarian hyperstimulation, gene variants, ovarian response, assisted reproduction

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Authors: Lubomir Machuca, Vit Fara

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Ammonium nitrate (AN) is produced by the reaction of ammonia and nitric acid, and a waste condensate is obtained. The condensate contains pure AN in concentration up to 10g/L. The salt content in the condensate is too high to discharge immediately into the river thus it must be treated. This study is concerned with the treatment of condensates from an industrial AN production by combination of electrodialysis (ED) and electrodeionization (EDI). The condensate concentration was in range 1.9–2.5g/L of AN. A pilot ED module with 25 membrane pairs following by a laboratory EDI module with 10 membrane pairs operated continuously during 800 hours. Results confirmed that the combination of ED and EDI is suitable for the condensate treatment.

Keywords: desalination, electrodialysis, electrodeionization, fertilizer industry

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Authors: Danielle A. Walker, Kyle L. Johnson, Tara B. Thomas, Sandor Dorgo, Jacen S. Moore

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Approximately 37 million people worldwide are infected with the Human Immunodeficiency Virus (HIV), with the majority located in sub-Saharan Africa. The relationship existing between HIV incidence and socioeconomic inequity confirms the critical need for programs promoting HIV education, prevention and treatment access. This literature review analyzed 36 sources with a specific focus on the Democratic Republic of Congo, whose critically low socioeconomic status and education rate have resulted in a drastically high HIV rates. Relationships between HIV testing and treatment and barriers to care were explored. Cultural and religious considerations were found to be vital when creating and implementing HIV education and testing programs. Partnerships encouraging active support from community-based spiritual leaders to implement HIV educational programs were also key mechanisms to reach communities and individuals. Gender roles were highlighted as a key component for implementation of effective community trust-building and successful HIV education programs. The efficacy of added support by hospitals and clinics in rural areas to facilitate access to HIV testing and care for people living with HIV/AIDS (PLWHA) was discussed. This review highlighted the need for healthcare providers to provide a network of continued education for PLWHA in clinical settings during disclosure and throughout the course of treatment to increase retention in care and promote medication adherence for viral load suppression. Implementation of culturally sensitive models that rely on community familiarity with HIV educators such as ‘train-the-trainer’ were also proposed as efficacious tools for educating rural communities about HIV. Further research is needed to promote community partnerships for HIV education, understand the cultural context of gender roles as barriers to care, and empower local health care providers to be successful within the HIV Continuum of Care.

Keywords: cultural sensitivity, Democratic Republic of the Congo, education, HIV

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Authors: Irina Peterburgsky

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We have been working on finding internship positions for our math and computer science majors. Among many other positive outcomes of internship for students majoring in mathematics, there are: students see new applications of mathematics to real life and see new scientific problems; they learn new methods, tools, etc. that they have not seen in their classes; they appreciate the power of mathematics that increases their interest in learning mathematics; they make decisions to take more advanced math courses; students understand better what their potentials, strong points, and limitations are; learn what work ethic is; learn how to work as a member of a team at a workplace; understand better how to offer their help and how to ask for help; start building their professional relationship; build self-confidence as young professionals, and what is the most important - they get a better understanding of their goals in their future professional careers.

Keywords: internship, mathematics, positive outcoms for students, workplace

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Authors: Jedli Hedi, Hedfi Hachem, Abdessalem Jbara, Slimi Khalifa

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Natural and modified clay were used as an adsorbent for CO2 capture. Sample of clay was subjected to acid treatments to improve their textural properties, namely, its surface area and pore volume. The modifications were carried out by heating the clays at 120 °C and then by acid treatment with 3M sulphuric acid solution at boiling temperature for 10 h. The CO2 adsorption capacities of the acid-treated clay were performed out in a batch reactor. It was found that the clay sample treated with 3M H2SO4 exhibited the highest Brunauer–Emmett–Teller (BET) surface area (16.29–24.68 m2/g) and pore volume (0.056–0.064 cm3/g). After the acid treatment, the CO2 adsorption capacity of clay increased. The CO2 adsorption capacity of clay increased after the acid treatment. The CO2 adsorption by clay, were characterized by SEM, FTIR, ATD-ATG and BET method. For describing the phenomenon of CO2 adsorption for these materials, the adsorption isotherms were modeled using the Freundlich and Langmuir models. CO2 adsorption isotherm was found attributable to physical adsorption.

Keywords: clay, acid treatment, CO2 capture, adsorption mechanism

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Authors: Anirudh Sharma

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Introduction: The Covid-19 pandemic necessitated a change in the manner outpatient fracture clinics are conducted due to the need to reduce footfall in hospital. While studies regarding virtual fracture clinics have shown these to be useful and effective, they focus exclusively on remote consultations. However, our service was bespoke to the patient – either a face-to-face or telephone consultation depending on patient need – a ‘hybrid virtual clinic (HVC).’ We report patient satisfaction and outcomes with this novel service. Methods: Patients booked onto our fracture clinics during the first 2 weeks of national lockdown were retrospectively contacted to assess the mode of consultations (virtual, face-to-face, or hybrid), patient experience, and outcome. Patient experience was assessed using the net promoter (NPS), customer effort (CES) and customer satisfaction scores (CSS), and their likelihood of using the HVC in the absence of a pandemic. Patient outcomes were assessed using the components of the EQ5D score. Results: Of 269 possible patients, 140 patients responded to the questionnaire. Of these, 66.4% had ‘hybrid’ consultations, 27.1% had only virtual consultations, and 6.4% had only face-to-face consultations. The mean overall NPS, CES, and CSS (on a scale of 1-10) were 7.27, 7.25, and 7.37, respectively. The mean likelihood of patients using the HVC in the absence of a pandemic was 6.5/10. Patients who had ‘hybrid’ consultations showed better effort scores and greater overall satisfaction than those with virtual consultations only and also reported superior EQ5D outcomes (mean 79.27 vs. 72.7). Patients who did not require surgery reported increased satisfaction (mean 7.51 vs. 7.08) and were more likely to use the HVC in the absence of a pandemic. Conclusion: Our study indicates that a bespoke HVC has good overall patient satisfaction and outcomes and is a better format of fracture clinic service than virtual consultations alone. It may be the preferred mode for fracture clinics in similar situations in the future. Further analysis needs to be conducted in order to explore the impact on resources and clinician experience of HVC in order to appreciate this new paradigm shift.

Keywords: hybrid virtual clinic, coronavirus, COVID-19, fracture clinic, remote consultation

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Authors: Solomon Sisay, Belete Mengistu, Woldargay Erku, Desalegne Woldeyohannes

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Background: Tuberculosis is still the leading cause of illness in the world which accounted for 2.5% of the global burden of disease, and 25% of all avoidable deaths in developing countries. Objectives: The aim of study was to assess impact of DOTS strategy on tuberculosis case finding and treatment outcome in Gambella Regional State, Ethiopia from 2003 up to 2012 and from 2002 up to 2011, respectively. Methods: Health facility-based retrospective study was conducted. Data were collected and reported in quarterly basis using WHO reporting format for TB case finding and treatment outcome from all DOTS implementing health facilities in all zones of the region to Federal Ministry of Health. Results: A total of 10024 all form of TB cases had been registered between the periods from 2003 up to 2012. Of them, 4100 (40.9%) were smear-positive pulmonary TB, 3164 (31.6%) were smear-negative pulmonary TB and 2760 (27.5%) had extra-pulmonary TB. Case detection rate of smear-positive pulmonary TB had increased from 31.7% to 46.5% from the total TB cases and treatment success rate increased from 13% to 92% with average mean value of being 40.9% (SD= 0.1) and 55.7% (SD=0.28), respectively for the specified year periods. Moreover, the average values of treatment defaulter and treatment failure rates were 4.2% and 0.3%, respectively. Conclusion: It is possible to achieve the recommended WHO target which is 70% of CDR for smear-positive pulmonary TB, and 85% of TSR as it was already been fulfilled the targets for treatments more than 85% from 2009 up to 2011 in the region. However, it requires strong efforts to enhance case detection rate of 40.9% for smear-positive pulmonary TB through implementing alternative case finding strategies.

Keywords: Gambella Region, case detection rate, directly observed treatment short-course, treatment success rate, tuberculosis

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Authors: Haile F. Darge, Hsieh C. Tsai

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The tumor microenvironment affects the therapeutic outcomes of cancer disease. In a malignant tumor, overexpression of vascular endothelial growth factor (VEGF) provokes the production of pathologic vascular networks. This results in a hostile tumor environment that hinders anti-cancer drug activities and profoundly fuels tumor progression. In this study, we develop a strategy of sequential sustain release of the anti-angiogenic drug: Bevacizumab(BVZ), and anti-cancer drug: Doxorubicin(DOX) which had a synergistic effect on cancer treatment. Poly (D, L-Lactide)- Poly (ethylene glycol) –Poly (D, L-Lactide) (PDLLA-PEG-PDLLA) thermo-sensitive hydrogel was used as a vehicle for local delivery of drugs in a single platform. The in vitro release profiles of the drugs were investigated and confirmed a relatively rapid release of BVZ (73.56 ± 1.39%) followed by Dox (61.21 ± 0.62%) for a prolonged period. The cytotoxicity test revealed that the copolymer exhibited negligible cytotoxicity up to 2.5 mg ml-1 concentration on HaCaT and HeLa cells. The in vivo study on Hela xenograft nude mice verified that hydrogel co-loaded with BVZ and DOX displayed the highest tumor suppression efficacy for up to 36 days with pronounce anti-angiogenic effect of BVZ and with no noticeable damage on vital organs. Therefore, localized co-delivery of anti-angiogenic drug and anti-cancer drugs by the hydrogel system may be a promising approach for enhanced chemotherapeutic efficacy in cancer treatment.

Keywords: anti-angiogenesis, chemotherapy, controlled release, thermo-sensitive hydrogel

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Authors: Sarah E. Casey

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Epilepsy is the most common neurological disorder in children and approximately one-third of children with epilepsy have seizures that are uncontrolled on anticonvulsants alone. Cannabidiol is shown to be an effective treatment at reducing the amount of breakthrough seizures experienced by children with drug resistant epilepsy. Improvements in quality of life and overall condition were noted during cannabidiol treatment. Adverse side effects were experienced and were generally mild to moderate in nature. Additional double-blind, controlled studies with a more diverse sample population and standardized dosing are needed to ensure the efficacy and safety of cannabidiol use in children with drug resistant epilepsy.

Keywords: cannabis, drug resistant epilepsy, children, epilepsy

Procedia PDF Downloads 224

Authors: John Chau, Tzvi Aviv

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Cardiometabolic conditions (hypertension, diabetes, and hyperlipidemia) are major public health concerns. Analysis of all prescription records from about 10 million patients at the largest network of pharmacies in Canada reveals small year-over-year increases in the treatment prevalence of cardiometabolic diseases prior to the COVID-19 pandemic. Cardiometabolic treatment rates increase with age and are higher in males than females. Hypertension treatment rates were 24% in males and 19% in females in 2021. Diabetes treatment rates were 10% in males and 7% in females in 2021. Geospatial analysis using patient addresses reveals interesting differences among provinces and neighborhoods in Canada. Using digital surveys distributed among 8,504 Canadian adults, an increase in hypertension awareness with age and female gender was observed. However, 7% of seniors and 6% of middle-aged Canadians reported uncontrolled blood pressure (>140/90 mmHg). In addition, elevated blood pressure (130-139/80-89 mmHg) was reported by 20% of seniors and 14% of middle-aged Canadians.

Keywords: cardiometabolic conditions, diabetes, hypertension, precision public health

Procedia PDF Downloads 117

Authors: Flavio Araujo, Fabiolla Lima, Julio Lima, Paulo Scalize, Antonio Albuquerque, Heitor Reis

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One of the great environmental problems in the management of water treatment (WTP) is on the disposal of waste generated during the treatment process. The same occurs with the waste generated during rectification of porcelain tiles. Despite environmental laws in Brazil the residues does not have an ecologically balanced destination. Thus, with the purpose to identify an environmentally sustainable disposal, residues were used to replace part of the soil, for production soil-cement bricks. It was used the residues from WTP and coatings industry Cecrisa (Brazil). Consequently, a greater amount of fine aggregate in the two samples of residues was found. The residue affects the quality of bricks produced, compared to the sample without residues. However, the results of compression and water absorption tests were obtained values that meet the standards, respectively 2.0 MPa and 20% absorption.

Keywords: water treatment residue, porcelain tile residue, WTP, brick

Procedia PDF Downloads 486

Authors: Abhishek Singh, Rajlakshmi Barman, Tanmay Shah

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Coagulation is considered to be one of the predominant water treatment processes which improve the cost effectiveness of wastewater. The sole purpose of this experiment on thermal coagulation is to increase the efficiency and the rate of reaction. The process uses renewable sources of energy which comprises of improved and minimized time method in order to eradicate the water scarcity of the regions which are on the brink of depletion. This paper includes the various effects of temperature on the standard coagulation treatment of wastewater and their effect on water quality. In addition, the coagulation is done with the mix of bottom/fly-ash that will act as an adsorbent and removes most of the minor and macro particles by means of adsorption which not only helps to reduce the environmental burden of fly ash but also enhance economic benefit. Also, the method of sand filtration is amalgamated in the process. The sand filter is an environmentally-friendly wastewater treatment method, which is relatively simple and inexpensive. The existing parameters were satisfied with the experimental results obtained in this study and were found satisfactory. The initial turbidity of the wastewater is 162 NTU. The initial temperature of the wastewater is 27 C. The temperature variation of the entire process is 50 C-80 C. The concentration of alum in wastewater is 60mg/L-320mg/L. The turbidity range is 8.31-28.1 NTU after treatment. pH variation is 7.73-8.29. The effective time taken is 10 minutes for thermal mixing and sedimentation. The results indicate that the presence of thermal energy affects the coagulation treatment process. The influence of thermal energy on turbidity is assessed along with renewable energy sources and increase of the rate of reaction of the treatment process.

Keywords: adsorbent, sand filter, temperature, thermal coagulation

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Authors: Narges Solaymani

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Definition of Nurse: Nurse: A person who is educated and skilled in the field of scientific principles and professional skills of health care, treatment, and medical training of patients. Nursing is a very important profession in the societies of the world. Although in the past, all caregivers of the sick and disabled were called nurses, nowadays, a nurse is a person who has a university education in this field. There are nurses in bachelor's, master's, and doctoral degrees in nursing. New courses have been launched in the master's degree based on duty-oriented nurses. A nurse cannot have an independent treatment center but is a member of the treatment team in established treatment centers such as hospitals, clinics, or offices. Nurses can establish counseling centers and provide nursing services at home. According to the standards, the number of nurses should be three times the number of doctors or twice the number of hospital beds, or there should be three nurses for every thousand people. Also, international standards show that in the internal and surgical department, every 4 to 6 patients should have a nurse.

Keywords: nurse, intensive care, CPR, bandage

Procedia PDF Downloads 69

Authors: Mohammad Ali Oghabian, Reza Reiazi, Esmaeel Parsai, Mehdi Aghili, Ramin Jaberi

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In this project a new procedure has been introduced for utilizing digitally reconstructed radiograph from MRI images in Brachytherapy treatment planning. This procedure enables us to localize the tumor volume and delineate the extent of critical structures in vicinity of tumor volume. The aim of this project was to improve the accuracy of dose delivered to targets of interest in 2D treatment planning system.

Keywords: brachytherapy, cervix, digitally reconstructed radiographs, lymph node

Procedia PDF Downloads 532

Authors: Cecilia Moreira, Rita Paiva, Daniela Macedo, Leonor Ribeiro, Isabel Fernandes, Luis Costa

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Background: Head and neck paragangliomas are a rare group of tumors with a large spectrum of clinical manifestations. The approach to evaluate and treat these lesions has evolved over the last years. Surgery was the standard for the approach of these patients, but nowadays new techniques of imaging and radiation therapy changed that paradigm. Despite advances in treating, the growth potential and clinical outcome of individual cases remain largely unpredictable. Objectives: Characterization of our institutional experience with clinical management of these tumors. Methods: This was a cross-sectional study of patients followed in our institution between 01 January and 31 December 2017 with paragangliomas of the head and neck and cranial base. Data on tumor location, catecholamine levels, and specific imaging modalities employed in diagnostic workup, treatment modality, tumor control and recurrence, complications of treatment and hereditary status were collected and summarized. Results: A total of four female patients were followed between 01 January and 31 December 2017 in our institution. The mean age of our cohort was 53 (± 16.1) years. The primary locations were at the level of the tympanic jug (n=2, 50%) and carotid body (n=2, 50%), and only one of the tumors of the carotid body presented pulmonary metastasis at the time of diagnosis. None of the lesions were catecholamine-secreting. Two patients underwent genetic testing, with no mutations identified. The initial clinical presentation was variable highlighting the decrease of visual acuity and headache as symptoms present in all patients. In one of the cases, loss of all teeth of the lower jaw was the presenting symptomatology. Observation with serial imaging, surgical extirpation, radiation, and stereotactic radiosurgery were employed as treatment approaches according to anatomical location and resectability of lesions. As post-therapeutic sequels the persistence of tinnitus and disabling pain stands out, presenting one of the patients neuralgia of the glossopharyngeal. Currently, all patients are under regular surveillance with a median follow up of 10 months. Conclusion: Ultimately, clinical management of these tumors remains challenging owing to heterogeneity in clinical presentation, the existence of multiple treatment alternatives, and potential to cause serious detriment to critical functions and consequently interference with the quality of life of the patients.

Keywords: clinical outcomes, head and neck, management, paragangliomas

Procedia PDF Downloads 145

Authors: Jane E. Hill

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Quality of life is an important component for many. With that in mind, everyone will experience some type of loss within his or her lifetime. A person can experience loss due to break up, separation, divorce, estrangement, or death. An individual may experience loss of a job, loss of capacity, or loss caused by human or natural-caused disasters. An individual’s response to such a loss is unique to them, and not everyone will seek services to assist them with their grief due to loss. Counseling can promote positive outcomes for clients that are grieving by addressing the client’s personal loss and helping the client process their grief. However, a lack of understanding on the part of counselors of how people grieve may result in negative client outcomes such as poor health, psychological distress, or an increased risk of depression. Education and training in grief counseling can improve counselors’ problem recognition and skills in treatment planning. The purpose of this study was to examine whether the Council for Accreditation of Counseling and Related Educational Programs (CACREP) master’s degree counseling students view themselves as having been adequately trained in grief theories and skills. Many people deal with grief issues that prevent them from having joy or purpose in their lives and that leaves them unable to engage in positive opportunities or relationships. This study examined CACREP-accredited master’s counseling students’ self-reported competency, training, and education in providing grief counseling. The implications for positive social change arising from the research may be to incorporate and promote education and training in grief theories and skills in a majority of counseling programs and to provide motivation to incorporate professional standards for grief training and practice in the mental health counseling field. The theoretical foundation used was modern grief theory based on John Bowlby’s work on Attachment Theory. The overall research question was how competent do master’s-level counselors view themselves regarding the education or training they received in grief theories or counseling skills in their CACREP-accredited studies. The author used a non-experimental, one shot survey comparative quantitative research design. Cicchetti’s Grief Counseling Competency Scale (GCCS) was administered to CACREP master’s-level counseling students enrolled in their practicum or internship experience, which resulted in 153 participants. Using a MANCOVA, there was significance found for relationships between coursework taken and (a) perceived assessment skills (p = .029), (b) perceived treatment skills (p = .025), and (c) perceived conceptual skills and knowledge (p = .003). Results of this study provided insight for CACREP master’s-level counseling programs to explore and discuss curriculum coursework inclusion of education and training in grief theories and skills.

Keywords: counselor education and training, grief education and training, grief and loss, quality of life

Procedia PDF Downloads 192

Authors: Kubra Dogan, Fatih Tornuk

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Due to increasing consumer demand for the high-quality food products and awareness regarding the health benefits of different nutrients in food minimal processing becomes more popular in modern food preservation. To date, heat treatment is often used for inactivation of spoilage microorganisms in foods. However, it may cause significant changes in the quality and nutritional properties of food. In order to overcome the detrimental effects of heat treatment, several alternatives of non-thermal microbial inactivation processes have been investigated. Ultraviolet (UV) inactivation is a promising and feasible method for better quality and longer shelf life as an alternative to heat treatment, which aims to inhibit spoilage and pathogenic microorganisms and to inactivate the enzymes in vegetable juice production. UV-C is a sub-class of UV treatment which shows the highest microcidal effect between 250-270 nm. The wavelength of 254 nm is used for the surface disinfection of certain liquid food products such as vegetable juice. Effects of UV-C treatment on microbiological load and quality parameter of vegetable juice which is a mix of celery, carrot, lemon and orange was investigated. Our results showed that storing of UV-C applied vegetable juice for three months, reduced the count of TMAB by 3.5 log cfu/g and yeast-mold by 2 log cfu/g compared to control sample. Total phenolic content was found to be 514.3 ± 0.6 mg gallic acid equivalent/L, and there wasn’t a significant difference compared to control. The present work suggests that UV-C treatment is an alternative method for disinfection of vegetable juice since it enables adequate microbial inactivation, longer shelf life and has minimal effect on degradation of quality parameters of vegetable juice.

Keywords: heat treatment, phenolic content, shelf life, ultraviolet (UV-C), vegetable juice

Procedia PDF Downloads 210

Authors: Dylan Shiting Lu, Samson Okello, Anita Chunyan Wei, Daniel Xiao Li

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Mammotome vacuum-assisted breast biopsy (MVB) introduced in 1995 can be used for the removal of benign breast lesions. Whether or not MVB is a better option compared to conventional open surgery is inconclusive. We aim to compare the clinical and patient-related outcomes between MVB and open surgery to remove benign breast tumors less than 5 cm in women. We searched English and Chinese electronic databases with the keywords of Mammotome, clinical trial (CT), vacuum-assisted breast biopsy for studies comparing MVB and open surgery until May 2021. We performed a systematic review and random-effects meta-analysis to compare incision size, operation time, intraoperative blood loss, healing time, scar length, patient satisfaction, postoperative hematoma rate, wound infection rate, postoperative ecchymosis, and postoperative sunken skin among those who have Mammotome and those who have surgery. Our analysis included nine randomized CTs with 1155 total patients (575 Mammotome, 580 surgery) and mean age 40.32 years (standard deviation 3.69). We found statistically significant favorable outcomes for Mammotome including blood loss (ml) [standardized mean difference SMD -5.03, 95%CI (-7.30, -2.76)], incision size (cm) [SMD -12.22, 95%CI (-17.40, -7.04)], operation time (min) [SMD -6.66, 95%CI (-9.01, -4.31)], scar length (cm) [SMD -7.06, 95%CI (-10.76, -3.36)], healing time (days) [SMD -6.57, 95%CI (-10.18, -2.95)], and patient satisfaction [relative risk RR 0.38, 95%CI (0.13, 1.08)]. In conclusion, Mammotome vacuum-assisted breast biopsy compared to open surgery shows better clinical and patient-related outcomes. Further studies should be done on whether or not MVB is a better option for benign breast tumors excision.

Keywords: clinical and patient outcomes, open surgery, Mammotome vacuum-assisted breast biopsy, meta-analysis

Procedia PDF Downloads 217

Authors: Triana Fitriastuti, Pipiet Larasatie, Alex Vanderstraten

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Many scholars have demonstrated the negative impacts of the perception of organizational politics on organizational outcomes. The model proposed in this study analyzes the impact of the perception of organizational politics on job satisfaction. In the same way, ingratiation as a moderator variable is tested. We applied regression analysis to test the hypothesis. The findings of the current research, which was conducted with 240 employees in the public sector in Indonesia, show that the perception of organizational politics has a negative effect on job satisfaction. In contrast, ingratiation plays a role that fully moderates the relationship between organizational politics and organizational outcomes and changes the correlation between the perception of organizational politics on job satisfaction. Employees who use ingratiation as a coping mechanism tend to do so when they perceive a high degree of organizational politics.

Keywords: ingratiation, impression management, job satisfaction, perception of organizational politics

Procedia PDF Downloads 156