Search results for: directly observed treatment short course(DOTS)

Authors: Khachen Kongpakwattana, Nathorn Chaiyakunapruk

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Background: Decision-analytic models for Alzheimer’s disease (AD) have been advanced to discrete-event simulation (DES), in which individual-level modelling of disease progression across continuous severity spectra and incorporation of key parameters such as treatment persistence into the model become feasible. This study aimed to apply the DES to perform a cost-effectiveness analysis of treatment for AD in Thailand. Methods: A dataset of Thai patients with AD, representing unique demographic and clinical characteristics, was bootstrapped to generate a baseline cohort of patients. Each patient was cloned and assigned to donepezil, galantamine, rivastigmine, memantine or no treatment. Throughout the simulation period, the model randomly assigned each patient to discrete events including hospital visits, treatment discontinuation and death. Correlated changes in cognitive and behavioral status over time were developed using patient-level data. Treatment effects were obtained from the most recent network meta-analysis. Treatment persistence, mortality and predictive equations for functional status, costs (Thai baht (THB) in 2017) and quality-adjusted life year (QALY) were derived from country-specific real-world data. The time horizon was 10 years, with a discount rate of 3% per annum. Cost-effectiveness was evaluated based on the willingness-to-pay (WTP) threshold of 160,000 THB/QALY gained (4,994 US$/QALY gained) in Thailand. Results: Under a societal perspective, only was the prescription of donepezil to AD patients with all disease-severity levels found to be cost-effective. Compared to untreated patients, although the patients receiving donepezil incurred a discounted additional costs of 2,161 THB, they experienced a discounted gain in QALY of 0.021, resulting in an incremental cost-effectiveness ratio (ICER) of 138,524 THB/QALY (4,062 US$/QALY). Besides, providing early treatment with donepezil to mild AD patients further reduced the ICER to 61,652 THB/QALY (1,808 US$/QALY). However, the dominance of donepezil appeared to wane when delayed treatment was given to a subgroup of moderate and severe AD patients [ICER: 284,388 THB/QALY (8,340 US$/QALY)]. Introduction of a treatment stopping rule when the Mini-Mental State Exam (MMSE) score goes below 10 to a mild AD cohort did not deteriorate the cost-effectiveness of donepezil at the current treatment persistence level. On the other hand, none of the AD medications was cost-effective when being considered under a healthcare perspective. Conclusions: The DES greatly enhances real-world representativeness of decision-analytic models for AD. Under a societal perspective, treatment with donepezil improves patient’s quality of life and is considered cost-effective when used to treat AD patients with all disease-severity levels in Thailand. The optimal treatment benefits are observed when donepezil is prescribed since the early course of AD. With healthcare budget constraints in Thailand, the implementation of donepezil coverage may be most likely possible when being considered starting with mild AD patients, along with the stopping rule introduced.

Keywords: Alzheimer's disease, cost-effectiveness analysis, discrete event simulation, health technology assessment

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Authors: Jyoti Kumari, Pavuluri Srinivasa Rao

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Jackfruit (ArtocarpusheterophyllusL.) is an underutilized yet highly nutritious fruit with unique flavour, known for its therapeutic and culinary properties. Fresh jackfruit bulb has a very short shelf life due to high moisture and sugar content leading to microbial and enzymatic browning, hindering its consumer acceptability and marketability. An attempt has been made for the preservation of the ripe jackfruit bulbs, by the application of high pressure (HP) over a range of 200-500 MPa at ambient temperature for dwell times ranging from 5 to 20 min. The physicochemical properties of jackfruit bulbs such as the pH, TSS, and titrable acidity were not affected by the pressurization process. The ripening index of the fruit bulb also decreased following HP treatment. While the ascorbic acid and antioxidant activity of jackfruit bulb were well retained by high pressure processing (HPP), the total phenols and carotenoids showed a slight increase. The HPP significantly affected the colour and textural properties of jackfruit bulb. High pressure processing was highly effective in reducing the browning index of jackfruit bulbs in comparison to untreated bulbs. The firmness of the bulbs improved upon the pressure treatment with longer dwelling time. The polyphenol oxidase has been identified as the most prominent oxidative enzyme in the jackfruit bulb. The enzymatic activity of polyphenol oxidase and peroxidase were significantly reduced by up to 40% following treatment at 400 MPa/15 min. HPP of jackfruit bulbs at ambient temperatures is shown to be highly beneficial in improving the shelf stability, retaining its nutrient profile, color, and appearance while ensuring the maximum inactivation of the spoilage enzymes.

Keywords: antioxidant capacity, ascorbic acid, carotenoids, color, HPP-high pressure processing, jackfruit bulbs, polyphenol oxidase, peroxidase, total phenolic content

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Authors: Maria Barbano Acevedo-Gomez, Elena Sonsoles Rodriguez-Lopez, Sofia Olivia Calvo-Moreno, Angel Basas-Garcia, Cristophe Ramirez

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Introduction: Urinary incontinence (UI) is defined as the involuntary leakage of urine. In persons who practice sport, its prevalence is 36.1% (95% CI 26.5%-46.8%) and varies as it seems to depend on the intensity of exercise, movements, and impact on the ground. Such high impact sports are likely to generate higher intra-abdominal pressures and leading to pelvic floor muscle weakness. Even though the emphasis of this research is on female athletes, all women should perform pelvic floor muscle exercises as a part of their general physical exercise. Pelvic floor exercises are generally considered the first treatment against urinary incontinence. Objective: The main objective of the present study was to determine the knowledge of the pelvic floor and of the UI in elite athletes and know if they incorporate pelvic floor strengthening in their training. Methods: This was an observational study conducted on 754 elite athletes. After collecting questions about the pelvic floor, UI, and sport-related data, participants completed the questionnaire International Consultation on Incontinence Questionnaire-UI Short-Form (ICIQ-SF). Results: 57.3% of the athletes reflect not having knowledge of their pelvic floor, 48.3% do not know what strengthening exercises are, and around 90% have never practiced them. 78.1% (n=589) of all elite athletes do not include pelvic floor exercises in their training. Of the elite athletes surveyed, 33% had UI according to ICIQ-SF (mean age 23.75 ± 7.74 years). In response to the question 'Do you think you have or have had UI?', Only 9% of the 754 elite athletes admitted they presently had UI, and 13.3% indicated they had had UI at some time. However, 22.7% (n=171) reported they had experienced urine leakage while training. Of the athletes who indicated they did not have UI in the ICIQ-SF, 25.7% stated they did experience urine leakage during training (χ² [1] = 265.56; p < 0.001). Further, 12.3% of the athletes who considered they did not have UI and 60% of those who admitted they had had UI on some occasion stated they had suffered some urine leakage in the past 3 months (χ² [1] = 287.59; p < 0.001). Conclusions: There is a lack of knowledge about UI in sport. Through the use of validated questionnaires, we observed a UI prevalence of 33%, and 22.7% reported they experienced urine leakage while training. These figures contrast with only 9% of athletes who reported they had or had in the past had UI. This discrepancy could reflect the great lack of knowledge about UI in sports and that sometimes an athlete may consider that urine leakage is normal and a consequence of the demands of training. These data support the idea that coaches, physiotherapists, and other professionals involved in maximizing the performance of athletes should include pelvic floor muscle exercises in their training programs. Measures such as this could help to prevent UI during training and could be a starting point for future studies designed to develop adequate prevention and treatment strategies for this embarrassing problem affecting young athletes, both male and female.

Keywords: athletes, pelvic floor, performance, prevalence, sport, training, urinary incontinence

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Authors: Ayon Mukherjee

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Covariate-adjusted response-adaptive (CARA) designs use the available responses to skew the treatment allocation in a clinical trial in towards treatment found at an interim stage to be best for a given patient's covariate profile. Extensive research has been done on various aspects of CARA designs with the patient responses assumed to follow a parametric model. However, ranges of application for such designs are limited in real-life clinical trials where the responses infrequently fit a certain parametric form. On the other hand, robust estimates for the covariate-adjusted treatment effects are obtained from the parametric assumption. To balance these two requirements, designs are developed which are free from distributional assumptions about the survival responses, relying only on the assumption of proportional hazards for the two treatment arms. The proposed designs are developed by deriving two types of optimum allocation designs, and also by using a distribution function to link the past allocation, covariate and response histories to the present allocation. The optimal designs are based on biased coin procedures, with a bias towards the better treatment arm. These are the doubly-adaptive biased coin design (DBCD) and the efficient randomized adaptive design (ERADE). The treatment allocation proportions for these designs converge to the expected target values, which are functions of the Cox regression coefficients that are estimated sequentially. These expected target values are derived based on constrained optimization problems and are updated as information accrues with sequential arrival of patients. The design based on the link function is derived using the distribution function of a probit model whose parameters are adjusted based on the covariate profile of the incoming patient. To apply such designs, the treatment allocation probabilities are sequentially modified based on the treatment allocation history, response history, previous patients’ covariates and also the covariates of the incoming patient. Given these information, an expression is obtained for the conditional probability of a patient allocation to a treatment arm. Based on simulation studies, it is found that the ERADE is preferable to the DBCD when the main aim is to minimize the variance of the observed allocation proportion and to maximize the power of the Wald test for a treatment difference. However, the former procedure being discrete tends to be slower in converging towards the expected target allocation proportion. The link function based design achieves the highest skewness of patient allocation to the best treatment arm and thus ethically is the best design. Other comparative merits of the proposed designs have been highlighted and their preferred areas of application are discussed. It is concluded that the proposed CARA designs can be considered as suitable alternatives to the traditional balanced randomization designs in survival trials in terms of the power of the Wald test, provided that response data are available during the recruitment phase of the trial to enable adaptations to the designs. Moreover, the proposed designs enable more patients to get treated with the better treatment during the trial thus making the designs more ethically attractive to the patients. An existing clinical trial has been redesigned using these methods.

Keywords: censored response, Cox regression, efficiency, ethics, optimal allocation, power, variability

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Authors: Mohammed Fathima Shahanaaz, Shaik Fayazuddin, M. Uday Kiran

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Groundwater quality is deteriorating day by day in different parts of the world due to various reasons, toxic chemicals are being discharged without proper treatment into inland water bodies and land which in turn add pollutants to the groundwater. In this kind of situation, the rural communities which do not have municipal drinking water have to rely on groundwater though it is polluted for various uses. Tannery industry is one of the major industry which provides economy and employment to India. Since most of the developed countries stopped using chemicals which are toxic, the tanning industry which uses chromium as its major element are being shifted towards developing countries. Most of the tanning industries in India can be found in clusters concentrated mainly in states of Tamilnadu, West Bengal, Uttar Pradesh and limited places of Punjab. Limited work is present in the case of tanneries of Warangal. There exists 18 group of tanneries in Desaipet, Enamamula region of Warangal, out of which 4 are involved in dry process and are low responsible for groundwater pollution. These units of tanneries are discharging their effluents after treatment into Sai Cheruvu. Though the treatment effluents are being discharged, the Sai Cheruvu is turned in to Pink colour, with higher levels of BOD, COD, chromium, chlorides, total hardness, TDS and sulphates. An attempt was made to analyse the groundwater samples around this polluted Sai Cheruvu region since literature shows that a single tannery can pollute groundwater to a radius of 7-8 kms from the point of disposal. Sample are collected from 6 different locations around Sai Cheruvu. Analysis was performed for determining various constituents in groundwater such as pH, EC, TDS, TH, Ca+2, Mg+2, HCO3-, Na+, K+, Cl-, SO42-, NO3-, F and Cr+6. The analysis of these constitutes gave values greater than permissible limits. Even chromium is also present in groundwater samples which is exceeding permissible limits People in Paidepally and Sardharpeta villages already stopped the usage of groundwater. They are buying bottle water for drinking purpose. Though they are not using groundwater for drinking purpose complaints are made about using this water for washing also. So treatment process should be adopted for groundwater which should be simple and efficient. In this study rice husk silica (RHS) is used to treat pollutants in groundwater with varying dosages of RHS and contact time. Rice husk is treated, dried and place in a muffle furnace for 6 hours at 650°C. Reduction is observed in total hardness, chlorides and chromium levels are observed after the application RHS. Pollutants reached permissible limits for 27.5mg/l and 50 mg/l of dosage for a contact time of 130 min at constant pH and temperature.

Keywords: chromium, groundwater, rice husk silica, tanning industries

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Authors: Mokgophana Ramasobana

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Background: At the core of the demand to utilize evidence-based approaches in the policy-making cycle, prioritization of limited financial resources and results driven initiatives is the urgency to develop a cohort of competent Monitoring and Evaluation (M&E) practitioners and public servants. The ongoing strides in the evaluation capacity building (ECB) initiatives are a direct response to produce the highly-sought after M&E skills. Notwithstanding the rapid growth of M&E short courses, participants perceived value and expectation of M&E short courses as a panacea for ECB have not been empirically quantified or measured. The objective of this article is to explicitly illustrate the importance of measuring ECB interventions and understanding what works in ECB and why it works. Objectives: This article illustrates the importance of establishing empirical ECB measurement tools to evaluate ECB interventions in order to ascertain its contribution to the broader evaluation practice. Method: The study was primarily a desktop review of existing literature, juxtaposed by a survey of the participants across the African continent based on the 43 M&E short courses hosted by the Centre for Learning on Evaluation and Results Anglophone Africa (CLEAR-AA) in collaboration with the Department of Planning Monitoring and Evaluation (DPME) Results: The article established that participants perceive short course training as a panacea to improve their M&E practical skill critical to executing their organizational duties. In tandem, participants are likely to demand customized training as opposed to general topics in Evaluation. However, the organizational environments constrain the application of the newly acquired skills. Conclusion: This article aims to contribute to the 'how to' measure ECB interventions discourse and contribute towards the improvement to evaluate ECB interventions. The study finds that participants prefer training courses with longer duration to cover more topics. At the same time, whilst organizations call for customization of programmes, the study found that individual participants demand knowledge of generic and popular evaluation topics.

Keywords: evaluation capacity building, effectiveness and training, monitoring and evaluation (M&E) short course training, perceptions and expectations

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Authors: Ben Clapperton, Daniel Stahl, Kimberley Goldsmith, Trudie Chalder

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Chronic fatigue syndrome (CFS) is a condition characterised by chronic disabling fatigue and other symptoms that currently can't be explained by any underlying medical condition. Although clinical trials support the effectiveness of cognitive behaviour therapy (CBT), the success rate for individual patients is modest. Patients vary in their response and little is known which factors predict or moderate treatment outcomes. The aim of the project is to develop a prediction model from baseline characteristics of patients, such as demographics, clinical and psychological variables, which may predict likely treatment outcome and provide guidance for clinical decision making and help clinicians to recommend the best treatment. The project is aimed at identifying subgroups of patients with similar baseline characteristics that are predictive of treatment effects using modern cluster analyses and data mining machine learning algorithms. The characteristics of these groups will then be used to inform the types of individuals who benefit from a specific treatment. In addition, results will provide a better understanding of for whom the treatment works. The suitability of different clustering methods to identify subgroups and their response to different treatments of CFS patients is compared.

Keywords: chronic fatigue syndrome, latent class analysis, prediction modelling, self-organizing maps

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Authors: Marco Correa

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The increasing reduction of the volumes of surface water sources supplying most municipalities, as well as the rising demand for treated water, combined with the disposal of effluents from washing of decanters and filters of water treatment plants generates a continuous search for correct environmentally solutions to these problems. The effluents generated by the water treatment industry need to be suitably processed for return to the environment or re-use. This article shows alternatives for sludge dehydration from the water treatment plants (WTP) and eventual disposal of sludge drained. Using the simple design methodology, it is presented a case study for drainage in tanks geotextile, full-scale, which involve five sledge drainage tanks from WTP of the city of Rio Verde. Aiming to the reutilization of drained water from the sledge and enabling its reuse both at the beginning of the treatment process at the WTP and in less noble services as for watering the gardens of the local town hall. The sludge will be used to in the production of building materials.

Keywords: dehydration, effluent discharges, re-use, sludge, WTP sludge

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Authors: Bae Yu been, Choi Sung won, Lee Ju yeon, Yang Dan Bi

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The purpose of this study is to develop a self-help therapy program for bipolar disorder (BD). Psychosocial treatment is adjunct to pharmacotherapy for BD, however, it is limited and they demand high costs. Therefore, the objective of the study is to overcome these limitations by developing the self-treatment for BD. The study was examined the efficacy of the self-treatment program for BD. A randomized controlled trial compared the self-help therapy (ST) intervention with a treatment as usual (TAU) group. ST group has conducted the program for 8 weeks (16 sessions). Mood chart, Quality of Life in Bipolar Disorder Questionnaire, Attitudes toward seeking professional help Scale, BIS, CERQ, YMRS, MADRS were used by pre, post, and follow up. The efficacy of the self-help therapy was analyzed by using mixed ANOVAs. There were significant differences in the rate of occurrence of mania or depression between the two groups. ST group reported stable moods on mood chart, and reductions in mood symptoms and improvements in quality of life and treatment adherence. This study was confirmed applicable to BD to the self-help therapy for patients with BD conducted first in Korea.

Keywords: self help therapy, bipolar disorder, self help, self therapy

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Authors: Mike Wei, Nebu Koshy, Koen van Besien, Giorgio Inghirami, Steven M. Horwitz

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T-cell prolymphocytic leukemia (T-PLL) is a rare hematologic disease characterized by a T-cell phenotype, rapid progression, and poor prognosis with median survival of less than a year. Alemtuzumab-based chemotherapy has increased the rate of complete remissions but these are often short-lived, and allogeneic transplant is considered the only curative therapy. In recent studies, JAK3 activating mutations have been identified in T-cell cancers, with T-PLL having the highest rate of JAK3 mutations (30 – 42%). As such, T-PLL is a model disease for evaluating the utility of JAK3 inhibitors. We present a case of a 64-year-old man with relapsed-refractory T-PLL. He was initially treated with alemtuzumab and obtained complete response and was consolidated with matched unrelated donor stem cell transplant. His disease stayed in remission for approximately 1.5 years before relapse, which was then treated with a clinical trial of romidepsin-lenalidomide (partial responses then progression at 6 months) and later alemtuzumab. Due to complications of myelosuppression and CMV reactivation, his treatment was interrupted leading to disease progression. The doubling time of lymphocyte count was approximately 20 days and over a span of 60 days the lymphocyte count rose from 8 x 109/L to 68 x 109/L. Exon sequencing showed a JAK3 mutation. The patient consented to and was treated with FDA-approved tofacitinib (initially 5 mg BID, increased to 10 mg BID after 15 days of treatment). An initial decrease in lymphocyte count was followed by progression. In vitro treatment of the patient’s cells showed modest effects of tofacitinib and ruxolitinib as single agents, in the range of doxorubicin, but synergy between the agents. After 40 days of treatment with tofacitinib and with a lymphocyte count of 150 x 109/L, ruxolitinib (5mg BID) was added. Over the 60 days since dual inhibition was started, the lymphocyte count has stabilized. The patient has remained completely asymptomatic during treatment with tofacitinib and ruxolitinib. Neutrophil count has remained normal. Platelet count and hemoglobin have however declined from ~50 x109/L to ~30 x109/L and from 11 g/dL to 8.1 g/dL respectively, since the introduction of ruxolitinib. The stabilization in lymphocyte count confirms the clinical activity of JAK inhibitors in T-PLL as suggested by the presence of JAK3 mutations and by in-vitro assays. It also suggests clinical synergy between ruxolitinib and tofacitinib in this setting. Prospective studies of JAK inhibitors in PLL patients with formal dose-finding studies are needed.

Keywords: tofacitinib, ruxolitinib, T-cell prolymphocytic leukemia, JAK3

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Authors: Amin Mojiri, Hamidi Abdul Aziz

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Leachate is created while water penetrates through the waste in a landfill, carrying some forms of pollutants. In literature, for treatment of wastewater and leachate, different ways of biological treatment were used. Sequencing batch reactor (SBR) is a kind of biological treatment. This study investigated the co-treatment of landfill leachate and domestic waste water by SBR and powdered activated carbon augmented (PAC) SBR process. The response surface methodology (RSM) and central composite design (CCD) were employed. The independent variables were aeration rate (L/min), contact time (h), and the ratio of leachate to wastewater mixture (%; v/v)). To perform an adequate analysis of the aerobic process, three dependent parameters, i.e. COD, color, and ammonia-nitrogen (NH3-N or NH4-N) were measured as responses. The findings of the study indicated that the PAC-SBR showed a higher performance in elimination of certain pollutants, in comparison with SBR. With the optimal conditions of aeration rate (0.6 L/min), leachate to waste water ratio (20%), and contact time (10.8 h) for the PAC-SBR, the removal efficiencies for color, NH3-N, and COD were 72.8%, 98.5%, and 65.2%, respectively.

Keywords: co-treatment, landfill Leachate, wastewater, sequencing batch reactor, activate carbon

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Authors: Simon B.A. Egli, Katja Rost

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Literature on redistributive preferences has proliferated in past decades. A core assumption behind it is that variation in redistributive preferences can explain different levels of redistribution. In contrast, this paper considers the reverse. What if it is redistribution that changes redistributive preferences? The core assumption behind the argument is that if self-interest - which we label concrete preferences - and ideology - which we label abstract preferences - come into conflict, the former will prevail and lead to an adjustment of the latter. To test the hypothesis, data from a survey conducted in Switzerland during the first wave of the COVID-19 crisis is used. A significant portion of the workforce at the time unexpectedly received state money through the short-time working program. Short-time work was used as a proxy for self-interest and was tested (1) on the support given to hypothetical, ailing firms during the crisis and (2) on the prioritization of justice principles guiding state action. In a first step, several models using OLS-regressions on political orientation were estimated to test our hypothesis as well as to check for non-linear effects. We expected support for ailing firms to be the same regardless of ideology but only for people on short-time work. The results both confirm our hypothesis and suggest a non-linear effect. Far-right individuals on short-time work were disproportionally supportive compared to moderate ones. In a second step, ordered logit models were estimated to test the impact of short-time work and political orientation on the rankings of the distributive justice principles need, performance, entitlement, and equality. The results show that being on short-time work significantly alters the prioritization of justice principles. Right-wing individuals are much more likely to prioritize need and equality over performance and entitlement when they receive government assistance. No such effect is found among left-wing individuals. In conclusion, we provide moderate to strong evidence that unexpectedly finding oneself at the receiving end changes redistributive preferences if personal ideology is antithetical to redistribution. The implications of our findings on the study of populism, personal ideologies, and political change are discussed.

Keywords: COVID-19, ideology, redistribution, redistributive preferences, self-interest

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Authors: Margarita A. Belousova, Sergey N. Ermoliev, Nina K. Loginova

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The method of intraoral ultrasound densitometry developed to diagnose mineral density of alveolar bone jaws during retention period of orthodontic treatment (Patent of Russian Federation № 2541038). It was revealed significant decrease of the ultrasonic wave speed and bone mineral density in patients with relapses dentition anomalies during retention period of orthodontic treatment.

Keywords: intraoral ultrasonic densitometry, speed of sound, alveolar jaw bone, relapses of dentition anomalies, retention period of orthodontic treatment

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Authors: Ajayi Oluwasola Felix

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This paper examines how firm investments in technology-based employee monitoring impact both misconduct and productivity. We use unique and detailed theft and sales data from 392 restaurant locations from five firms that adopt a theft monitoring information technology (IT) product. We use difference-in-differences (DD) models with staggered adoption dates to estimate the treatment effect of IT monitoring on theft and productivity. We find significant treatment effects in reduced theft and improved productivity that appear to be primarily driven by changed worker behavior rather than worker turnover. We examine four mechanisms that may drive this productivity result: economic and cognitive multitasking, fairness-based motivation, and perceived increases of general oversight. The observed productivity results represent substantial financial benefits to both firms and the legitimate tip-based earnings of workers. Our results suggest that employee misconduct is not solely a function of individual differences in ethics or morality, but can also be influenced by managerial policies that can benefit both firms and employees.

Keywords: information technology, monitoring, misconduct, employee theft

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Authors: Gurmeet Singh Cheema, Navjotinder Singh, Gurjinder Singh, Amardeep Singh

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Aluminium and its alloys play have excellent corrosion resistant properties, ease of fabrication and high specific strength to weight ratio. In this investigation an attempt has been made to study the effect of different post weld heat treatment methods on the mechanical and metallurgical properties of TIG welded joints of the commercial aluminium alloy. Three different methods of post weld heat treatments are, solution heat treatment, artificial aged and combination of solution heat treatment and artificial aging are given to TIG welded aluminium joints. Mechanical and metallurgical properties of as welded and post weld treated joints of the aluminium alloys was examined.

Keywords: aluminium alloys, TIG welding, post weld heat treatment

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Authors: Shirin Jalili, Ramin Ghasemi Shayan

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Atrial fibrillation is the foremost common arrhythmia around the world, with expanding recurrence famous with age. Thromboembolic occasions and strokes are the number one cause of mortality and morbidity. For patients who don't react to restorative treatment for rate and beat control, the maze method offers an elective treatment mediation. pharmaco-medical treatment for atrial fibrillation is pointed at the control of rate or cadence, intrusive treatment for atrial fibrillation is pointed at cadence control. An obtrusive approach may comprise of percutaneous catheter treatment, surgery, or a crossover approach. Since the maze method is recognized as the foremost successful way to dispense with AF, combining the maze strategy amid major cardiac surgeries has been received in clinical hone. the maze strategy, moreover known as Cox¬maze iii or the ‘cut¬and¬sew’ method, involves making different incisions within the atria to make an arrangement of scars that dispose of each potential zone of re¬entry. The electrical drive is constrained through a maze of scars that coordinates the electrical drive from the sinus node to the av node. By settling the headstrong period between ranges of scar, re¬entry is disposed of. in this article, we evaluate the Maze surgery method that's the surgical method of choice for the treatment of restorative atrial fibrillation.

Keywords: atrial fibrillation, congenital heart disease, procedure, maze surgery, treatment

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Authors: Kun-Ping Cheng, Dong-Shang Chang, Rou-Wen Wang

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Pre-treatment of automobile paint-shop procedures are the preparation of warm water rinsing tank, hot water rinsing tank, degreasing tank, phosphate tank. The conventional boiler steam fuel is natural gas, producing steam to supply the heat exchange of each tank sink. In this study, the high-frequency soldering economizer is developed for recovering waste heat in the automotive paint-shop (RTO, Regenerative Thermal Oxidation). The heat recovery rate of the new economizer is 20% to 30% higher than the conventional embedded heat pipe. The adaptive control system responded to both RTO furnace exhaust gas and heat demands. In order to maintain the temperature range of the tanks, pre-treatment tanks are directly heated by waste heat recovery device (gas-to-water heat exchanger) through the hot water cycle of heat transfer. The performance of developed waste heat recovery system shows the annual recovery achieved to 1,226,411,483 Kcal of heat (137.8 thousand cubic meters of natural gas). Boiler can reduce fuel consumption by 20 to 30 percent compared to without waste heat recovery. In order to alleviate environmental impacts, the temperature at the end of the flue is further reduced from 160 to 110°C. The innovative waste heat recovery is helpful to energy savings and sustainable environment.

Keywords: waste heat recovery system, sustainability, RTO (Regenerative Thermal Oxidation), economizer, automotive industry

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Authors: M. Abuqebitah, H. Tanyildizi, N. Yeyin, I. Cavdar, M. Demir, L. Kabasakal

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Aim: Targeted radionuclide therapy (TRT) is an increasingly used treatment modality for wide range of cancers. Presently dosimetry is highly required either to plan treatment or to ascertain the absorbed dose delivered to critical organs during treatment. Methods and Materials: The study comprised 7 patients suffered from prostate cancer with progressive disease and candidate to undergo Lu-177-DOTA-617 therapy following to PSMA- PET/CT imaging for all patients. (5.2±0.3 mCi) was intravenously injected. To evaluate bone marrow absorbed dose 2 cc blood samples were withdrawn in short variable times (3, 15, 30, 60, 180 minutes) after injection. Furthermore, whole body scans were performed using scintillation gama camera in 4, 24, 48, and 120 hours after injection and in order to quantify the activity taken up in the body, kidneys , liver, right parotid, and left parotid the geometric mean of anterior and posterior counts were determined through ROI analysis, after that background subtraction and attenuation correction were applied using patients PSMA- PET/CT images taking in a consideration: organ thickness, body thickness, and Hounsfield unites from CT scan. OLINDA/EXM dosimetry program was used for curve fitting, residence time calculation, and absorbed dose calculations. Findings: Absorbed doses of bone marrow, left kidney, right kidney, liver, left parotid, right parotid, total body were 1.28±0.52, 32.36±16.36, 32.7±13.68, 10.35±3.45, 38.67±21.29, 37.55±19.77, 2.25±0.95 (mGy/mCi), respectively. Conclusion: Our first results clarify that Lu-177-DOTA-617 is safe and reliable therapy as there were no complications seen. In the other hand, the observable variation in the absorbed dose of the critical organs among the patients necessitate patient-specific dosimetry approach to save body organs and particularly highly exposed kidneys and parotid gland.

Keywords: Lu-177-PSMA, prostate cancer, radionuclide therapy

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Authors: Mehrdad Ebrahimi, Oliver Schmitz, Axel Schmidt, Peter Czermak

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“Produced water” (PW) is any fossil water that is brought to the surface along with crude oil or natural gas. By far, PW is the largest waste stream by volume associated with oil and gas production operations. Due to the increasing volume of waste all over the world in the current decade, the outcome and effect of discharging PW on the environment has lately become a significant issue of environmental concerns. Therefore, there is a need for new technologies for PW treatment due to increase focus on water conservation and environmental regulation. The use of membrane processes for treatment of PW has several advantages over many of the traditional separation techniques. In oilfield produced water treatment with ceramic membranes, process efficiency is characterized by the specific permeate flux and by the oil separation performance. Apart from the membrane properties, the permeate flux during filtration of oily wastewaters is known to be strongly dependent on the constituents of the feed solution, as well as on process conditions, e.g. trans-membrane pressure (TMP) and cross-flow velocity (CFV). The research project presented in these report describes the application of different ceramic membrane filtration technologies for the efficient treatment of oil-field produced water and different model oily solutions.

Keywords: ceramic membrane, membrane fouling, oil rejection, produced water treatment

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Authors: Ziya Esen, Özgür Duygulu, Nazlı S. Büyükatak

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This study investigates the effects of aging heat treatment on corrosion resistance and mechanical properties of WE43 Magnesium alloy. The heat treatment of alloys was conducted by solutionizing at 525oC for 16 h, followed by aging at 190, 210 and 230oC for up to 48 h. The type and the size of precipitates formed upon aging have influenced both the mechanical properties and corrosion behavior of the alloy. Solutionized alloy displayed the worst corrosion resistance in simulated body fluid, while peak hardness and the best corrosion resistance were observed in the alloy aged at 210oC for 24 h as a result of β’ precipitate formation. Longer aging duration at 210oC decreased the corrosion rate due to the coarsening of the precipitates and formation of precipitate-free zones. The increased corrosion resistance of the peak aged samples was attributed to the slowing down effect of the Mg(OH)₂/MgO corrosion layer by the pinning effect of β’-precipitates.

Keywords: WE43 magnesium alloy, simulated body fluid, corrosion, mechanical properties

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Authors: Fredrick O. Okumu, Mangaka C. Matoetoe

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Silver-platinum (Ag-Pt) bimetallic nanoparticles (NPs) with varying mole fractions (1:1, 1:3 and 3:1) were prepared by co-reduction of hexachloroplatinate and silver nitrate with sodium citrate. Upon successful formation of both monometallic and bimetallic (BM) core shell nanoparticles, cyclic voltammetry (CV) was used to characterize the NPs. The drop coated nanofilms on the GC substrate showed characteristic peaks of monometallic Ag NPs; Ag+/Ag0 redox couple as well as the Pt NPs; hydrogen adsorption and desorption peaks. These characteristic peaks were confirmed in the bimetallic NPs voltammograms. The following varying current trends were observed in the BM NPs ratios; GCE/Ag-Pt 1:3 > GCE/Ag-Pt 3:1 > GCE/Ag-Pt 1:1. Fundamental electrochemical properties which directly or indirectly affects the applicability of films such as; diffusion coefficient (D), electroactive surface coverage, electrochemical band gap, electron transfer coefficient (α) and charge (Q) were assessed using Randles - Sevcik plot and Laviron’s equations . High charge and surface coverage was observed in GCE/Ag-Pt 1:3 which supports its enhanced current. GCE/Ag-Pt 3:1 showed high diffusion coefficient while GCE/Ag-Pt 1:1 possessed high electron transfer coefficient that is facilitated by its high apparent heterogeneous rate constant relative to other BM NPs ratios. Surface redox reaction was determined as adsorption controlled in all modified GCEs. Surface coverage is inversely proportional to size; therefore the surface coverage data suggests that Ag-Pt 1:1 NPs have a small particle size. Generally, GCE/Ag-Pt 1:3 depicts the best electrochemical properties.

Keywords: characterization, core-shell, electrochemical, nanoparticles

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Authors: Cindy Woods

Abstract:

After years of implacable neoliberal globalization, multinational corporations have moved from the periphery to the center of the international legal agenda. Human rights advocates have long called for greater corporate accountability in the international arena. The creation of the Global Compact in 2000, while aimed at fostering greater corporate respect for human rights, did not silence these calls. After multiple unsuccessful attempts to adopt a set of norms relating to the human rights responsibilities of transnational corporations, the United Nations succeeded in 2008 with the Guiding Principles on Business and Human Rights (Guiding Principles). The Guiding Principles, praised by some within the international human rights community for their recognition of an individual corporate responsibility to respect human rights, have not escaped their share of criticism. Many view the Guiding Principles to be toothless, failing to directly impose obligations upon corporations, and call for binding international obligations on corporate entities. After decades of attempting to promulgate human rights obligations for multinational corporations, the existing legal frameworks in place fall short of protecting individuals from the human rights abuses of multinational corporations. The Global Compact and Guiding Principles are proof of the United Nations’ unwillingness to impose international legal obligations on corporate actors. In June 2014, the Human Rights Council adopted a resolution to draft international legally binding human rights norms for business entities; however, key players in the international arena have already announced they will not cooperate with such efforts. This Note, through an overview of the existing corporate accountability frameworks and a study of Newmont Mining’s Minas Conga project in Peru, argues that binding international human rights obligations on corporations are necessary to fully protect human rights. Where states refuse to or simply cannot uphold their duty to protect individuals from transnational businesses’ human rights transgressions, there must exist mechanisms to pursue justice directly against the multinational corporation.

Keywords: business and human rights, Latin America, international treaty on business and human rights, mining, human rights

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Authors: Farej Ahmed Emhmmed

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Fracture of duplex stainless steels (DSS) was investigated in air and in 3.5 wt % NaCl solution. Tow sets of fatigued specimens were heat treated at 475ºC for different times and pulled to failure either in air or after kept in 3.5% NaCl with polarization of -900 mV/ SCE. Fracture took place in general by ferrite cleavage and austenite ductile fracture in transgranular mode. Specimens measured stiffness (Ms) was affected by the aging time, with higher values measured for specimens aged for longer times. Microstructural features played a role in "blocking" the crack propagation process leading to lower the CTOD values specially for specimens aged for short times. Unbroken ligaments/ austenite were observed at the crack wake. These features may exerted a bridging stress, blocking effect, at the crack tip giving resistance to the crack propagation process i.e the crack mouth opening was reduced. Higher stress intensity factor Kıc values were observed with increased amounts of crack growth suggesting longer zone of unbroken ligaments in the crack wake. The bridging zone was typically several mm in length. Attempt to model the bridge stress was suggested to understand the role of ligaments/unbroken austenite in increasing the fracture toughness factor.

Keywords: stainless steels, fracture toughness, crack keying effect, ligaments

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Authors: P. Weerkamp Bartholomeus

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Autism treatment evaluation is crucial for monitoring the development of an intervention at an early stage. ‘ReAttach’ is a new intervention based on the principles of attachment and social cognitive training. Practical research suggests promising results on a variety of developmental areas. Five years after the first ReAttach sessions these findings can be extended with qualitative research by means of follow-up interviews. The potential impact of this treatment on daily life functioning and well-being of autistic persons becomes clear.

Keywords: autism, innovation, treatment, social cognitive training

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Authors: Altoumi Alndalusi

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The work examines the aqueous corrosion behavior of grades of stain less steel which are used as corrosion resistant castings for applications such as valve and pump bodies. The corrosion behavior of steels in the as-cast condition has been examined using potentiostatic studies to illustrate the need for correct thermal treatment. A metallurgical examination and chemical analysis were carried out to establish the morphology of the steel structure. Heat treatment was carried out in order to compare damage in relation to microstructure. Optical and scanning electron microscopy examinations confirmed that the austenitic steels suffers from severe localized inter-dendritic pitting attack, while non homogenized castings highly alloyed duplex steels gave inferior corrosion resistance. Through the heat treatment conditions a significant of phase transformation of the duplex steel C were occurred (from ferrite to austenite and sigma plus carbides) and were gave reduction resistance.

Keywords: cast, corrosion, duplex stainless, heat treatment, material, steel

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Authors: S. P. Gomes, D. C. Goncalves, E. Ribeiro, M. C. L. Seelaender

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Skin is susceptible to photo damage induced by exposure to sunlight, or ultraviolet (UV) radiation, which induces breakdown of extracellular matrix, DNA degradation, skin cell lesion and apoptosis, and development of cancer. Phytonutrients demonstrate protective effects against UV damage. The purpose of this study was evaluating the effect of an antioxidant juice (AJ) contaning Brazilian natural products upon skin damage. The juice was produced by Metabolics®. Male Wistar rats were divided in 4 groups: Animals receiving the antioxidant juice (AJ): orange, carrot, honey, tomato extract, avocado, ginger and camu-camu (Brazilian fruit, a major source of vitamin C) ad libitum for 21 days; or water (C), subdivided in groups exposed or not to UV radiation for 2 non consecutive days, during five hours each day, after 15 days of juice supplementation. On the 22nd day, rats were killed by decapitation and epithelium samples from the dorsal skin removed, fixed in bouin and embedded in paraffin. The sections were stained with hematoxylin and eosin or mallory and picrosirius red. Isolated DNA was submitted to electrophoresis (1.8% agarose gel, 0.5% ethidium bromide). UV radiation significantly induced sunburn of superficial epithelial cells of C, AJ treatment reduced this effect. Collagen changes were observed in UV groups, yet AJ treatment prevented collagen degradation. UV radiation induced significant DNA degradation, in C, which was prevented by AJ treatment. The antioxidant juice consumed chronically protected against acute skin damage.

Keywords: nutraceuticals, antioxidants, photoprotection, uv radiation

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Authors: Khalid Iqbal

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This work presents a comparison of an anthropomorphic PRESAGE® dosimeter and radiochromic film measurements with a commercial treatment planning system to determine the feasibility of PRESAGE® for 3D dosimetry in breast IMRT. An anthropomorphic PRESAGE® phantom was created in the shape of a breast phantom. A five-field IMRT plan was generated with a commercially available treatment planning system and delivered to the PRESAGE® phantom. The anthropomorphic PRESAGE® was scanned with the Duke midsized optical CT scanner (DMOS-RPC) and the OD distribution was converted to dose. Comparisons were performed between the dose distribution calculated with the Pinnacle3 treatment planning system, PRESAGE®, and EBT2 film measurements. DVHs, gamma maps, and line profiles were used to evaluate the agreement. Gamma map comparisons showed that Pinnacle3 agreed with PRESAGE® as greater than 95% of comparison points for the PTV passed a ± 3%/± 3 mm criterion when the outer 8 mm of phantom data were discluded. Edge artifacts were observed in the optical CT reconstruction, from the surface to approximately 8 mm depth. These artifacts resulted in dose differences between Pinnacle3 and PRESAGE® of up to 5% between the surface and a depth of 8 mm and decreased with increasing depth in the phantom. Line profile comparisons between all three independent measurements yielded a maximum difference of 2% within the central 80% of the field width. For the breast IMRT plan studied, the Pinnacle3 calculations agreed with PRESAGE® measurements to within the ±3%/± 3 mm gamma criterion. This work demonstrates the feasibility of the PRESAGE® to be fashioned into anthropomorphic shape, and establishes the accuracy of Pinnacle3 for breast IMRT. Furthermore, these data have established the groundwork for future investigations into 3D dosimetry with more complex anthropomorphic phantoms.

Keywords: 3D dosimetry, PRESAGE®, IMRT, QA, EBT2 GAFCHROMIC film

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Authors: Mthiyane Pretty, Mitsui Toshiake, Nagano Hirohiko, Aycan Murat

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Among the most significant greenhouse gases released from rice fields are methane and carbon dioxide. The primary focus of this research was to quantify CH₄ and CO₂ gas using different 4 rice cultivars, two water regimes, and a recording of soil moisture and temperature. In this study, we hypothesized that paddy field soils may directly affect soil enzymatic activities and physicochemical properties in the rhizosphere soil of paddy fields and subsequently indirectly affect the activity, abundance, diversity, and community composition of methanogens, ultimately affecting CH₄ flux. The experiment was laid out in the randomized block design with two treatments and three replications for each genotype. In two treatments, paddy fields and artificial soil were used. 35 days after planting (DAP), continuous flooding irrigation, Alternate wetting, and drying (AWD) were applied during the vegetative stage. The highest recorded measurements of soil and environmental parameters were soil moisture at 76%, soil temperature at 28.3℃, Bulk EC at 0.99 ds/m, and pore water EC at 1,25, using HydraGO portable soil sensor system. Gas samples were carried out once on a weekly basis at 09:00 am and 12: 00 pm to obtain the mean GHG flux. Gas Chromatography (GC, Shimadzu, GC-2010, Japan) was used for the analysis of CH4 and CO₂. The treatments with paddy field soil had a 1.3℃ higher temperature than artificial soil. The overall changes in Bulk EC were not significant across the treatment. The CH₄ emission patterns were observed in all rice genotypes, although they were less in treatments with AWD with artificial soil. This shows that AWD creates oxic conditions in the rice soil. CO₂ was also quantified, but it was in minute quantities, as rice plants were using CO₂ for photosynthesis. The highest tillering number was 7, and the lowest was 3 in cultivars grown. The rice varieties to be used for breeding are Norin 24, with showed a high number of tillers with less CH₄.

Keywords: greenhouse gases, methane, morphological characterization, alternating wetting and drying

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Authors: S. Vadivukkarasi, K. Karthi, M. Karthick, C. Dinesh, S. Santhosh, A. Yogaraj

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The appointment system was designed to minimize patient’s idle time overlooking patients waiting time in hospitals. This is no longer valid in today’s consumer oriented society. Long waiting times for treatment in the outpatient department followed by short consultations has long been a complaint. Nowadays, customers use waiting time as a decisive factor in choosing a service provider. Queuing theory constitutes a very powerful tool because queuing models require relatively little data and are simple and fast to use. Because of this simplicity and speed, modelers can be used to quickly evaluate and compare various alternatives for providing service. The application of queuing models in the analysis of health care systems is increasingly accepted by health care decision makers. Timely access to care is a key component of high-quality health care. However, patient delays are prevalent throughout health care systems, resulting in dissatisfaction and adverse clinical consequences for patients as well as potentially higher costs and wasted capacity for providers. Arguably, the most critical delays for health care are the ones associated with health care emergencies. The allocation of resources can be divided into three general areas: bed management, staff management, and room facility management. Effective and efficient patient flow is indicated by high patient throughput, low patient waiting times, a short length of stay at the hospital and overtime, while simultaneously maintaining adequate staff utilization rates and low patient’s idle times.

Keywords: appointment system, patient scheduling, bed management, queueing calculation, system analysis

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Authors: Tanveer Beg, Yasir H. Siddique, Gulshan Ara, Asfar S. Azmi, Mohammad Afzal

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Doxorubicin is a well-known DNA intercalating chemotherapy drug that is widely used for treatment of different cancers. Its clinical utility is limited due to the observed genotoxic side effects on healthy cells suggesting that newer combination and genoprotective regimens are urgently needed for the management of doxorubicin chemotherapy. Some dietary phytochemicals are well known for their protective mechanism of action and genistein from soy is recognized as an anti-oxidant with similar properties. Therefore, the present study investigates the effect of genistein against the genotoxic doses of doxorubicin by assessing chromosomal aberrations, sister chromatid exchanges, cell cycle kinetics, cell viability, apoptosis, and DNA damage markers in cultured human lymphocytes. Our results reveal that genistein treatment significantly suppresses genotoxic damage induced by doxorubicin. It is concluded that genistein has the potential to reduce the genotoxicity induced by anti-cancer drugs, thereby reducing the chances of developing secondary tumors during the therapy.

Keywords: apoptosis, DNA damage markers, doxorubicin, genistein, genotoxicity, human lymphocyte culture

Procedia PDF Downloads 359