Search results for: mortality rates
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3930

Search results for: mortality rates

3210 Exercise Intervention for Women After Treatment for Ovarian Cancer: Realist Evaluation of a Co-Designed Implementation Process

Authors: Deirdre Mc Grath, Joanne Reid

Abstract:

Background: Ovarian cancer is the leading cause of mortality among gynaecologic cancers in developed countries and the seventh most common cancer worldwide, with nearly 240,000 women diagnosed each year. Although it is recognized engaging in exercise results in positive health care outcomes, women with ovarian cancer are reluctant to participate. No evidence currently exists focusing on how to successfully implement an exercise intervention program for patients with ovarian cancer, using a realist approach. There is a requirement for the implementation of exercise programmes within the oncology health care setting as engagement in such interventions has positive health care outcomes for women with ovarian cancer both during and following treatment. Aim: To co-design the implementation of an exercise intervention for women following treatment for ovarian cancer. Methods: This study is a realist evaluation using quantitative and qualitative methods of data collection and analysis. Realist evaluation is well-established within the health and social care setting and has, in relation to this study, enabled a flexible approach to investigate how to optimise implementation of an exercise intervention for this patient population. This single centre study incorporates three stages in order to identify the underlying contexts and mechanisms which lead to the successful implementation of an exercise intervention for women who have had treatment for ovarian cancer. Stage 1 - A realist literature review. Stage 2 -Co-design of the implementation of an exercise intervention with women following treatment for ovarian cancer, their carer’s, and health care professionals. Stage 3 –Implementation of an exercise intervention with women following treatment for ovarian cancer. Evaluation of the implementation of the intervention from the perspectives of the women who participated in the intervention, their informal carers, and health care professionals. The underlying programme theory initially conceptualised before and during the realist review was developed further during the co-design stage. The evolving programme theory in relation to how to successfully implement an exercise for these women is currently been refined and tested during the final stage of this realist evaluation which is the implementation and evaluation stage. Results: This realist evaluation highlights key issues in relation to the implementation of an exercise intervention within this patient population. The underlying contexts and mechanisms which influence recruitment, adherence, and retention rates of participants are identified. Conclusions: This study will inform future research on the implementation of exercise interventions for this patient population. It is anticipated that this intervention will be implemented into practice as part of standard care for this group of patients.

Keywords: exercise, ovarian cancer, co-design, implementation

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3209 Risk Factors for Acute Respiratory Infection Among Children Under Five in Tanzania: A Systematic Review and Analysis of the 2015 Demographic and Health Survey for Tanzania

Authors: Ayesha Ali, Emilia Lindquist, Arif Jalal, Hannah Yusuf, Kayan Cheung, Rowan Eastabrook

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It is currently estimated that over a third of deaths in children under five in Tanzania are caused by acute respiratory infections (ARIs). However, despite being one of the leading causes of morbidity and mortality across the developing world, its risk factors are poorly understood. Therefore, a systematic review of the literature published between 2015 and 2020 was conducted, focusing on risk factors for ARI in Tanzanian children under the age of five. 2015 Demographic and Health Survey (DHS) for Tanzania was analysed to supplement these findings with national data. 2224 papers were retrieved from two databases and were analysed by three independent reviewers. Thirteen papers were eligible for inclusion, covering a wide range of risk factors among which comorbidities (n=6), malnutrition (n=5), lack of parental education (n=4), poor socio-economic status (n=3), and delay in seeking healthcare (n=3) were the most cited risk factors. The risk factors with the highest reported risk ratios/odds ratios were lack of parental education (RR=11.5-14.5), followed by enrolment in school (RR=4.4), delay in seeking healthcare (RR=3.8) and cooking indoors (aOR =1.8-RR=5.5). The DHS data provided local context to these risk factors. For instance, the number of children experiencing symptoms of ARI in both urban and rural areas ranged between 4.5-5% in the two weeks prior to the survey. However, 79% of symptomatic children in Zanzibar received antibiotics for treatment compared to just 34% of those in the Southern Highlands. As demonstrated by both the systematic review and the DHS analysis, risk factors for ARI are predominantly socially determined, with Tanzania’s poorer rural children possessing the highest risk for ARI and more adverse health outcomes. Therefore, the burden of ARIs in Tanzanian children may be alleviated through the provision of appropriate treatment and parental education in rural areas.

Keywords: acute respiratory infection, child, health education, morbidity, mortality, pneumonia, Tanzania

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3208 A Nonlinear Visco-Hyper Elastic Constitutive Model for Modelling Behavior of Polyurea at Large Deformations

Authors: Shank Kulkarni, Alireza Tabarraei

Abstract:

The fantastic properties of polyurea such as flexibility, durability, and chemical resistance have brought it a wide range of application in various industries. Effective prediction of the response of polyurea under different loading and environmental conditions necessitates the development of an accurate constitutive model. Similar to most polymers, the behavior of polyurea depends on both strain and strain rate. Therefore, the constitutive model should be able to capture both these effects on the response of polyurea. To achieve this objective, in this paper, a nonlinear hyper-viscoelastic constitutive model is developed by the superposition of a hyperelastic and a viscoelastic model. The proposed constitutive model can capture the behavior of polyurea under compressive loading conditions at various strain rates. Four parameter Ogden model and Mooney Rivlin model are used to modeling the hyperelastic behavior of polyurea. The viscoelastic behavior is modeled using both a three-parameter standard linear solid (SLS) model and a K-BKZ model. Comparison of the modeling results with experiments shows that Odgen and SLS model can more accurately predict the behavior of polyurea. The material parameters of the model are found by curve fitting of the proposed model to the uniaxial compression test data. The proposed model can closely reproduce the stress-strain behavior of polyurea for strain rates up to 6500 /s.

Keywords: constitutive modelling, ogden model, polyurea, SLS model, uniaxial compression test

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3207 Choosing the Green Energy Option: A Willingness to Pay Study of Metro Manila Residents for Solar Renewable Energy

Authors: Paolo Magnata

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The energy market in the Philippines remains to have one of the highest electricity rates in the region averaging at US$0.16/kWh (PHP6.89/kWh), excluding VAT, as opposed to the overall energy market average of US$0.13/kWh. The movement towards renewable energy, specifically solar energy, will pose as an expensive one with the country’s energy sector providing Feed-in-Tariff rates as high as US$0.17/kWh (PHP8.69/kWh) for solar energy power plants. Increasing the share of renewables at the current state of the energy regulatory background would yield a three-fold increase in residential electricity bills. The issue lies in the uniform charge that consumers bear regardless of where the electricity is sourced resulting in rates that only consider costs and not the consumers. But if they are given the option to choose where their electricity comes from, a number of consumers may potentially choose economically costlier sources of electricity due to higher levels of utility coupled with the willingness to pay of consuming environmentally-friendly sourced electricity. A contingent valuation survey was conducted to determine their willingness-to-pay for solar energy on a sample that was representative of Metro Manila to elicit their willingness-to-pay and a Single Bounded Dichotomous Choice and Double Bounded Dichotomous Choice analysis was used to estimate the amount they were willing to pay. The results showed that Metro Manila residents are willing to pay a premium on top of their current electricity bill amounting to US$5.71 (PHP268.42) – US$9.26 (PHP435.37) per month which is approximately 0.97% - 1.29% of their monthly household income. It was also discovered that besides higher income of households, a higher level of self-perceived knowledge on environmental awareness significantly affected the likelihood of a consumer to pay the premium. Shifting towards renewable energy is an expensive move not only for the government because of high capital investment but also to consumers; however, the Green Energy Option (a policy mechanism which gives consumers the option to decide where their electricity comes from) can potentially balance the shift of the economic burden by transitioning from a uniformly charged electricity rate to equitably charging consumers based on their willingness to pay for renewably sourced energy.

Keywords: contingent valuation, dichotomous choice, Philippines, solar energy

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3206 Sexual Health And Male Fertility: Improving Sperm Health With Focus On Technology

Authors: Diana Peninger

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Over 10% of couples in the U.S. have infertility problems, with roughly 40% traceable to the male partner. Yet, little attention has been given to improving men’s contribution to the conception process. One solution that is showing promise in increasing conception rates for IVF and other assisted reproductive technology treatments is a first-of-its-kind semen collection that has been engineered to mitigate sperm damage caused by traditional collection methods. Patients are able to collect semen at home and deliver to clinics within 48 hours for use in fertility analysis and treatment, with less stress and improved specimen viability. This abstract will share these findings along with expert insight and tips to help attendees understand the key role sperm collection plays in addressing and treating reproductive issues, while helping to improve patient outcomes and success. Our research was to determine if male reproductive outcomes can be increased by improving sperm specimen health with a focus on technology. We utilized a redesigned semen collection cup (patented as the Device for Improved Semen Collection/DISC—U.S. Patent 6864046 – known commercially as a ProteX) that met a series of physiological parameters. Previous research demonstrated significant improvement in semen perimeters (motility forward, progression, viability, and longevity) and overall sperm biochemistry when the DISC is used for collection. Animal studies have also shown dramatic increases in pregnancy rates. Our current study compares samples collected in the DISC, next-generation DISC (DISCng), and a standard specimen cup (SSC), dry, with the 1 mL measured amount of media and media in excess ( 5mL). Both human and animal testing will be included. With sperm counts declining at alarming rates due to environmental, lifestyle, and other health factors, accurate evaluations of sperm health are critical to understanding reproductive health, origins, and treatments of infertility. An increase in the health of the sperm as measured by extensive semen parameter analysis and improved semen parameters stable for 48 hours, expanding the processing time from 1 hour to 48 hours were also demonstrated.

Keywords: reprodutive, sperm, male, infertility

Procedia PDF Downloads 125
3205 Evaluation of Antibiotic Resistance and Extended-Spectrum β-Lactamases Production Rates of Gram Negative Rods in a University Research and Practice Hospital, 2012-2015

Authors: Recep Kesli, Cengiz Demir, Onur Turkyilmaz, Hayriye Tokay

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Objective: Gram-negative rods are a large group of bacteria, and include many families, genera, and species. Most clinical isolates belong to the family Enterobacteriaceae. Resistance due to the production of extended-spectrum β-lactamases (ESBLs) is a difficulty in the handling of Enterobacteriaceae infections, but other mechanisms of resistance are also emerging, leading to multidrug resistance and threatening to create panresistant species. We aimed in this study to evaluate resistance rates of Gram-negative rods bacteria isolated from clinical specimens in Microbiology Laboratory, Afyon Kocatepe University, ANS Research and Practice Hospital, between October 2012 and September 2015. Methods: The Gram-negative rods strains were identified by conventional methods and VITEK 2 automated identification system (bio-Mérieux, Marcy l’etoile, France). Antibiotic resistance tests were performed by both the Kirby-Bauer disk-diffusion and automated Antimicrobial Susceptibility Testing (AST, bio-Mérieux, Marcy l’etoile, France) methods. Disk diffusion results were evaluated according to the standards of Clinical and Laboratory Standards Institute (CLSI). Results: Of the totally isolated 1.701 Enterobacteriaceae strains 1434 (84,3%) were Klebsiella pneumoniae, 171 (10%) were Enterobacter spp., 96 (5.6%) were Proteus spp., and 639 Nonfermenting gram negatives, 477 (74.6%) were identified as Pseudomonas aeruginosa, 135 (21.1%) were Acinetobacter baumannii and 27 (4.3%) were Stenotrophomonas maltophilia. The ESBL positivity rate of the totally studied Enterobacteriaceae group were 30.4%. Antibiotic resistance rates for Klebsiella pneumoniae were as follows: amikacin 30.4%, gentamicin 40.1%, ampicillin-sulbactam 64.5%, cefepime 56.7%, cefoxitin 35.3%, ceftazidime 66.8%, ciprofloxacin 65.2%, ertapenem 22.8%, imipenem 20.5%, meropenem 20.5 %, and trimethoprim-sulfamethoxazole 50.1%, and for 114 Enterobacter spp were detected as; amikacin 26.3%, gentamicin 31.5%, cefepime 26.3%, ceftazidime 61.4%, ciprofloxacin 8.7%, ertapenem 8.7%, imipenem 12.2%, meropenem 12.2%, and trimethoprim-sulfamethoxazole 19.2 %. Resistance rates for Proteus spp. were: 24,3% meropenem, 26.2% imipenem, 20.2% amikacin 10.5% cefepim, 33.3% ciprofloxacin and levofloxacine, 31.6% ceftazidime, 20% ceftriaxone, 15.2% gentamicin, 26.6% amoxicillin-clavulanate, and 26.2% trimethoprim-sulfamethoxale. Resistance rates of P. aeruginosa was found as follows: Amikacin 32%, gentamicin 42 %, imipenem 43%, merpenem 43%, ciprofloxacin 50%, levofloxacin 52%, cefepim 38%, ceftazidim 63%, piperacillin/tacobactam 85%, for Acinetobacter baumannii; Amikacin 53.3%, gentamicin 56.6 %, imipenem 83%, merpenem 86%, ciprofloxacin 100%, ceftazidim 100%, piperacillin/tacobactam 85 %, colisitn 0 %, and for S. malthophilia; levofloxacin 66.6 % and trimethoprim/sulfamethoxozole 0 %. Conclusions: This study showed that resistance in Gram-negative rods was a serious clinical problem in our hospital and suggested the need to perform typification of the isolated bacteria with susceptibility testing regularly in the routine laboratory procedures. This application guided to empirical antibiotic treatment choices truly, as a consequence of the reality that each hospital shows different resistance profiles.

Keywords: antibiotic resistance, gram negative rods, ESBL, VITEK 2

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3204 Treatment of Septic Tank Effluent Using Moving Bed Biological Reactor

Authors: Fares Almomani, Majeda Khraisheh, Rahul Bhosale, Anand Kumar, Ujjal Gosh

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Septic tanks (STs) are very commonly used wastewater collection systems in the world especially in rural areas. In this study, the use of moving bed biological reactors (MBBR) for the treatment of septic tanks effluents (STE) was studied. The study was included treating septic tank effluent from one house hold using MBBRs. Significant ammonia removal rate was observed in all the reactors throughout the 180 days of operation suggesting that the MBBRs were successful in reducing the concentration of ammonia from septic tank effluent. The average ammonia removal rate at 25◦C for the reactor operated at hydraulic retention time of 5.7 hr (R1) was 0.540 kg-N/m3and for the reactor operated at hydraulic retention time of 13.3hr (R2) was 0.279 kg-N/m3. Ammonia removal rates were decreased to 0.3208 kg-N/m3 for R1 and 0.212 kg-N/m3 for R3 as the temperature of reactor was decreased to 8 ◦C. A strong correlation exists between theta model and the rates of ammonia removal for the reactors operated in continuous flow. The average ϴ values for the continuous flow reactors during the temperature change from 8°C to 20 °C were found to be 1.053±0.051. MBBR technology can be successfully used as a polishing treatment for septic tank effluent.

Keywords: septic tanks, wastewater treatment, morphology, moving biological reactors, nitrification

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3203 Modelling Causal Effects from Complex Longitudinal Data via Point Effects of Treatments

Authors: Xiaoqin Wang, Li Yin

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Background and purpose: In many practices, one estimates causal effects arising from a complex stochastic process, where a sequence of treatments are assigned to influence a certain outcome of interest, and there exist time-dependent covariates between treatments. When covariates are plentiful and/or continuous, statistical modeling is needed to reduce the huge dimensionality of the problem and allow for the estimation of causal effects. Recently, Wang and Yin (Annals of statistics, 2020) derived a new general formula, which expresses these causal effects in terms of the point effects of treatments in single-point causal inference. As a result, it is possible to conduct the modeling via point effects. The purpose of the work is to study the modeling of these causal effects via point effects. Challenges and solutions: The time-dependent covariates often have influences from earlier treatments as well as on subsequent treatments. Consequently, the standard parameters – i.e., the mean of the outcome given all treatments and covariates-- are essentially all different (null paradox). Furthermore, the dimension of the parameters is huge (curse of dimensionality). Therefore, it can be difficult to conduct the modeling in terms of standard parameters. Instead of standard parameters, we have use point effects of treatments to develop likelihood-based parametric approach to the modeling of these causal effects and are able to model the causal effects of a sequence of treatments by modeling a small number of point effects of individual treatment Achievements: We are able to conduct the modeling of the causal effects from a sequence of treatments in the familiar framework of single-point causal inference. The simulation shows that our method achieves not only an unbiased estimate for the causal effect but also the nominal level of type I error and a low level of type II error for the hypothesis testing. We have applied this method to a longitudinal study of COVID-19 mortality among Scandinavian countries and found that the Swedish approach performed far worse than the other countries' approach for COVID-19 mortality and the poor performance was largely due to its early measure during the initial period of the pandemic.

Keywords: causal effect, point effect, statistical modelling, sequential causal inference

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3202 The Impact of Heat Waves on Human Health: State of Art in Italy

Authors: Vito Telesca, Giuseppina A. Giorgio

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The earth system is subject to a wide range of human activities that have changed the ecosystem more rapidly and extensively in the last five decades. These global changes have a large impact on human health. The relationship between extreme weather events and mortality are widely documented in different studies. In particular, a number of studies have investigated the relationship between climatological variations and the cardiovascular and respiratory system. The researchers have become interested in the evaluation of the effect of environmental variations on the occurrence of different diseases (such as infarction, ischemic heart disease, asthma, respiratory problems, etc.) and mortality. Among changes in weather conditions, the heat waves have been used for investigating the association between weather conditions and cardiovascular events and cerebrovascular, using thermal indices, which combine air temperature, relative humidity, and wind speed. The effects of heat waves on human health are mainly found in the urban areas and they are aggravated by the presence of atmospheric pollution. The consequences of these changes for human health are of growing concern. In particular, meteorological conditions are one of the environmental aspects because cardiovascular diseases are more common among the elderly population, and such people are more sensitive to weather changes. In addition, heat waves, or extreme heat events, are predicted to increase in frequency, intensity, and duration with climate change. In this context, are very important public health and climate change connections increasingly being recognized by the medical research, because these might help in informing the public at large. Policy experts claim that a growing awareness of the relationships of public health and climate change could be a key in breaking through political logjams impeding action on mitigation and adaptation. The aims of this study are to investigate about the importance of interactions between weather variables and your effects on human health, focusing on Italy. Also highlighting the need to define strategies and practical actions of monitoring, adaptation and mitigation of the phenomenon.

Keywords: climate change, illness, Italy, temperature, weather

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3201 Knowledge Decision of Food Waste and Loss Reduction in Supply Chain System: A Case Study of Kingdom of Saudi Arabia

Authors: Nadia Adnan, Muhammad Mohsin Raza, Latha Ravindran

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Based on the principles above, the study presents an economic model of food waste for consumers, intermediaries, and producers. We discriminate between purchasing and selling, purchases versus customers consumption, and gross output versus sales for each intermediary. To compensate for waste at each level of the supply chain, agents must charge higher sales prices. The research model can produce more accurate predictions about how actions (public regulations or private efforts) to reduce food waste impact markets, including indirect (cascading) effects. With a formal model, researchers demonstrate the uniqueness of these interaction effects and simulate an empirical model calibrated to market characteristics and waste rates in Saudi Arabia. Researchers demonstrate that the effects of waste reduction differ per commodity, depending on supply and demand elasticities, degree of openness to international commerce, and the beginning rates of food loss and waste at each level of the value chain. Because of the consequential effects related to the supply chain, initiatives to minimize food waste will be strengthened in some circumstances and partially countered in others.

Keywords: food loss, food waste, supply chain management, Saudi Arabia, food supply

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3200 Evaluation of Neonicotinoids Against Sucking Insect Pests of Cotton in Laboratory and Field Conditions

Authors: Muhammad Sufyan, Muhammad D. Gogi, Muhammad Arshad, Ahmad Nawaz, Muhammad Usman

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Cotton (Gossypium hirsutum) universally known as silver fiber and is one of the most important cash crop of Pakistan. A wide array of pests constraints cotton production among which sucking insect pests cause serious losses. Mostly new chemistry insecticides used to control a wide variety of insect pests including sucking insect pests. In the present study efficacy of different neonicotinoids was evaluated against sucking insect pests of cotton in the field and in laboratory for red and dusky cotton bug. The experiment was conducted at Entomology Research Station, University of Agriculture Faisalabad, in a Randomized Complete Block Design (RCBD). Field trial was conducted to evaluate the efficacy of Confidence Ultra (Imidacloprid) 70% SL, Confidor (Imidacloprid) 20% SL, Kendo (Lambda cyhalothrin) 24.7 SC, Actara (Thiamethoxam) 25% WG, Forcast (Tebufenozide+ Emamectin benzoate) 8.8 EW and Timer (Emamectin benzoate) 1.9 EC at their recommended doses. The data was collected on per leaf basis of thrips, aphid, jassid and whitefly before 24 hours of spray. The post treatment data was recorded after 24, 48 and 72 hours. The fresh, non-infested and untreated cotton leaves was collected from the field and brought to the laboratory to assess the efficacy of neonicotinoids against red and dusky cotton bug. After data analysis all the insecticides were found effective against sucking pests. Confidence Ultra was highly effective against the aphid, jassid, and whitefly and gave maximum mortality, while showed non-significant results against thrips. In case of aphid plot which was treated with Kando 24.7 SC showed significant mortality after 72 hours of pesticide application. Similar trends were found in laboratory conditions with all these treatments by making different concentrations and had significant impact on dusky cotton bug and red cotton bug population after 24, 48 and 72 hours after application.

Keywords: cotton, laboratory and field conditions, neonicotinoids, sucking insect pests

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3199 The Mechanical Response of a Composite Propellant under Harsh Conditions

Authors: Xin Tong, Jin-sheng Xu, Xiong Chen, Ya Zheng

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The aim of this paper is to study the mechanical properties of HTPB (Hydroxyl-terminated polybutadiene) composite propellant under harsh conditions. It describes two tests involving uniaxial tensile tests of various strain rates (ranging from 0.0005 s-1 to 1.5 s-1), temperatures (ranging from 223 K to 343 K) and high-cycle fatigue tests under low-temperature (223 K, frequencies were set at 50, 100, 150 Hz) using DMA (Dynamic Mechanical Analyzer). To highlight the effect of small pre-strain on fatigue properties of HTPB propellant, quasi-static stretching was carried out before fatigue loading, and uniaxial tensile tests at constant strain rates were successively applied. The results reveal that flow stress of propellant increases with reduction in temperature and rise in strain rate, and the strain rate-temperature equivalence relationship could be described by TTSP (time-temperature superposition principle) incorporating a modified WLF equation. Moreover, the rate of performance degradations and damage accumulation of propellant during fatigue tests increased with increasing strain amplitude and loading frequencies, while initial quasi-static loading has a negative effect on fatigue properties by comparing stress-strain relations after fatigue tests.

Keywords: fatigue, HTPB propellant, tensile properties, time-temperature superposition principle

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3198 Bacterial Causes of Cerebral Abscess and Impact on Long Term Patient Outcomes

Authors: Umar Rehman, Holly Roy, K. T. Tsang, D. S. Jeyaretna, W Singleton, B. Fisher, P. A. Glew, J. Greig, Peter C. Whitfield

Abstract:

Introduction: A brain abscess is a life-threatening condition, carrying significant mortality. It requires rapid identification and treatment. Management involves a combination of antibiotics and surgery. The aim of the current study was to identify common bacteria responsible for cerebral abscesses as well as the long term functional and neurological outcomes of patients following treatment in a retrospective series at a single UK neurosurgical centre. Methodology: We analysed patients that had received a diagnosis of 'cerebral abscess' or 'subdural empyema' between June 2002 and June 2018. This was done in the form of a retrospective review. The search resulted in a total of 180 patients; with 37 patients being excluded (spinal abscess, below 18 or non-abscess related admissions). Data were collected from medical case notes including information about demographics, comorbidities, immunosuppression, presentation, size/location of lesions, pathogens, treatment, and outcomes. Results: In total, we analysed 143 patients between the ages of 18-90. Focal neurological deficit and headaches were seen in 84% and 68% of patients respectively. 108 positive brain cultures were seen; with the largest proportion, 59.2% being gram-positive cocci, with strep intermedius being the most common pathogen identified in 13.9% of patients. Of the patients with positive blood cultures (n=11), 72.7% showed the same organism both in the blood and on the brain cultures. Long term outcomes (n=72) revealed that 48% of patients seizure-free without requiring anti-epileptics, 51.3% of patients had full recovery of their neurological symptoms. There was a mortality rate of 13.9% in the series. Conclusion: In conclusion, the largest bacterial cause of abscess within our population was due to gram-positive cocci. The majority of the patient demonstrated full neurological recovery with close to half of patients not requiring anti-epileptics following discharge.

Keywords: bacteria, cerebral abscess, long term outcome, neurological deficit

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3197 Oncoplastic Augmentation Mastopexy: Aesthetic Revisional Surgery in Breast Conserving Therapy

Authors: Bar Y. Ainuz, Harry M. Salinas, Aleeza Ali, Eli B. Levitt, Austin J. Pourmoussa, Antoun Bouz, Miguel A. Medina

Abstract:

Introduction: Breast conservation therapy remains the mainstay surgical treatment for early breast cancer. Oncoplastic techniques, in conjunction with lumpectomy and adjuvant radiotherapy, have been demonstrated to achieve good aesthetic results without adversely affecting cancer outcomes in the treatment of patients with macromastia or significant ptosis. In our patient population, many women present for breast conservation with pre-existing cosmetic implants or with breast volumes too small for soft tissue, only oncoplastic techniques. Our study evaluated a consecutive series of patients presenting for breast conservation undergoing concomitant oncoplastic-augmentation-mastopexy (OAM) with a contralateral augmentation-mastopexy for symmetry. Methods: OAM surgical technique involves simultaneous lumpectomy with exchange or placement of implants, oncoplastic mastopexy, and concomitant contralateral augmentation mastopexy for symmetry. Patients undergoing lumpectomy for breast conservation as outpatients were identified via retrospective chart review at a high volume private academic affiliated community-based cancer center. Patients with ptosis and either pre-existing breast implants or insufficient breast volume undergoing oncoplastic implant placement (or exchange) and mastopexy were included in the study. Operative details, aesthetic outcomes, and complications were assessed. Results: Over a continuous three-year period, with a two-surgeon cohort, 30 consecutive patients (56 breasts, 4 unilateral procedures) were identified. Patients had an average age of 52.5 years and an average BMI of 27.5, with 40% smokers or former smokers. The average operative time was 2.5 hours, the average implant size removed was 352 cc, and the average implant size placed was 300 cc. All new implants were smooth silicone, with the majority (92%) placed in a retropectoral fashion. 40% of patients received chemotherapy, and 80% of patients received whole breast adjuvant photon radiotherapy with a total radiation dose of either 42.56 or 52.56 Gy. The average and median length of follow-up were both 8.2 months. Of the 24 patients that received radiotherapy, 21% had asymmetry due to capsular contracture. A total of 7 patients (29.2%) underwent revisions for either positive margins (12.5%), capsular contracture (8.3%), implant loss (4.2%), or cosmetic concerns (4.2%). One patient developed a pulmonary embolism in the acute postoperative period and was treated with anticoagulant therapy. Conclusion: Oncoplastic augmentation mastopexy is a safe technique with good aesthetic outcomes and acceptable complication rates for ptotic patients with breast cancer and a paucity of breast volume or pre-existing implants who wish to pursue breast-conserving therapy. The revision rates compare favorably with single-stage cosmetic augmentation procedures as well as other oncoplastic techniques described in the literature. The short-term capsular contracture rates seem lower than the rates in patients undergoing radiation after mastectomy and implant-based reconstruction. Long term capsular contractures and revision rates are too early to know in this cohort.

Keywords: breast conserving therapy, oncoplastic augmentation mastopexy, capsular contracture, breast reconstruction

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3196 Investigation of the Inhibition Effect of 2,3-Diaminopyridine on Mild Steel Corrosion in Solution Simulating Water of Pores Concrete in Absence and Presence of Chloride Ions

Authors: Fatiha Benghanem, Mokhtar Berarma, Saida Keraghel, Ali Ourari

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Corrosion is the result of the reaction between a material and its environment. Steel in concrete is protected from corrosion by a passive film promoted by concrete alkalinity. For the initiation of corrosion, this protective film must be destroyed and this can be mainly done in two ways: by the attack of chlorides on the steel or by carbonation of the cover concrete due the reaction with carbon dioxide, which causes reduction in the alkalinity of concrete. The literature reports several ways to decrease or to prevent reinforcement corrosion. Among them, the use of corrosion inhibitors has been an envisaged solution. Two approaches are generally used to evaluate the efficiency of inhibitors for concrete application; one uses simulated pore solution testing , and the other uses actual concrete or mortar specimens. Both methods are some times used in conjunction. The aim of this study is to investigate the use of 2,3-diaminopyridine as a corrosion inhibitors of steel in alkaline media which simulate the electrolyte in the concrete pores. The effectiveness of this compound as corrosion inhibitor was investigated by measuring the corrosion potentials, the polarization curves and the corrosion current densities of steel with and without chlorides. The study of corrosion inhibition by this compound led to the conclusion that he has low rates of inhibition in the absence of aggressive ions and high rates in their presence. This type of organic compounds are promoting for the protection of armatures in concrete.

Keywords: corrosion, inhibitors, mild steel, conjunction

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3195 Comparison of the Isolation Rates and Characteristics of Salmonella Isolated from Antibiotic-Free and Conventional Chicken Meat Samples

Authors: Jin-Hyeong Park, Hong-Seok Kim, Jin-Hyeok Yim, Young-Ji Kim, Dong-Hyeon Kim, Jung-Whan Chon, Kun-Ho Seo

Abstract:

Salmonella contamination in chicken samples can cause major health problems in humans. However, not only the effects of antibiotic treatment during growth but also the impacts of poultry slaughter line on the prevalence of Salmonella in final chicken meat sold to consumers are unknown. In this study, we compared the isolation rates and antimicrobial resistance of Salmonella between antibiotic-free, conventional, conventional Korean native retail chicken meat samples and clonal divergence of Salmonella isolates by multilocus sequence typing. In addition, the distribution of extended-spectrum β-lactamase (ESBL) genes in ESBL-producing Salmonella isolates was analyzed. A total of 72 retail chicken meat samples (n = 24 antibiotic-free broiler [AFB] chickens, n = 24 conventional broiler [CB] chickens, and n = 24 conventional Korean native [CK] chickens) were collected from local retail markets in Seoul, South Korea. The isolation rates of Salmonella were 66.6% in AFB chickens, 45.8% in CB chickens, and 25% in CK chickens. By analyzing the minimum inhibitory concentrations of β -lactam antibiotics with the disc-diffusion test, we found that 81.2% of Salmonella isolates from AFB chickens, 63.6% of isolates from CB chickens, and 50% of isolates from CK chickens were ESBL producers; all ESBL-positive isolates had the CTX-M-15 genotype. Interestingly, all ESBL-producing Salmonella were revealed as ST16 by multilocus sequence typing. In addition, all CTX-M-15-positive isolates had the genetic platform of blaCTX-M gene (IS26-ISEcp1-blaCTX-M-15-IS903), to the best of our knowledge, this is the first report in Salmonella around the world. The Salmonella ST33 strain (S. Hadar) isolated in this study has never been reported in South Korea. In conclusion, our findings showed that antibiotic-free retail chicken meat products were also largely contaminated with ESBL-producing Salmonella and that their ESBL genes and genetic platforms were the same as those isolated from conventional retail chicken meat products.

Keywords: antibiotic-free poultry, conventional poultry, multilocus sequence typing, extended-spectrum β-lactamase, antimicrobial resistance

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3194 New Challenges to the Conservation and Management of the Endangered Persian Follow Deer (Dama dama mesopotamica) in Ashk Island of Lake Uromiyeh National Park, Iran

Authors: Morteza Naderi

Abstract:

The Persian fallow deer was considered as a globally extinct species until 1956 when a small population was rediscovered from Dez Wildlife Refuge and Karkheh Wildlife Refuge in southwestern parts of Iran. After long species rehabilitation process, the species was transplanted to Dasht-e-Naz Wildlife Refuge in northern Iran, and from where, follow deer was introduced to the different selected habitats such as Ashk Island in Lake Uromiyeh National Park. During 12 years, (from 1978 to 1989) 58 individuals (25 males and 33 females) were transferred to Ask Island. The main threat to the established population was related to the freshwater shortage and existing just one single trough such as high mortality rate of adult males during rutting season, snake biting and dilutional hyponatremia. Desiccation of Lake Uromiyeh in recent years raised new challenges to the conservation process, as about 80 individuals, nearly one third of the population were died in 2011. Connection of Island to the mainland caused predators’ accessibility (such as wolf and Jackal) to the Ask Island and higher mortality because of follow deer attraction to the surrounding mainland farms. Conservation team faced such new challenges that may cause introduction plan to be probably failed. Investigations about habitat affinities and carrying capacity are the main basic researches in the management and conservation of the species. Logistic regression analysis showed that the presence of the different fresh water resources as well as Allium akaka and Pistacia atlantica are the main environmental variables affect Follow deer habitat selection. Habitat carrying capacity analysis both in summer and winter seasons indicated that Ashk Island can support 240±30 of Persian follow deer.

Keywords: carrying capacity, follow deer, lake Uromiyeh, microhabitat affinities, population oscillation, predation, sex ratio

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3193 Exploring the Impact of Tillage and Manure on Soil Water Retention and Van Genuchten

Authors: Azadeh Safadoust, Ali Akbar Mahboubi

Abstract:

A study was conducted to evaluate hydraulic properties of a sandy loam soil and corn (Zea mays L.) crop production under a short-term tillage and manure combinations field experiment carried out in west of Iran. Treatments included composted cattle manure application rates [0, 30, and 60 Mg (dry weight) ha-1] and tillage systems [no-tillage (NT), chisel plowing (CP), and moldboard plowing (MP)] arranged in a split-plot design. Soil water characteristic curve (SWCC) and saturated hydraulic conductivity (Ks) were significantly affected by manure and tillage treatments. At any matric suction, the soil water content was in the order of MP>CP>NT. At all matric suctions, the amount of water retained by the soil increased as manure application rate increased (i.e. 60>30>0 Mg ha-1). Similar to the tillage effects, at high suctions the differences of water retained due to manure addition were less than that at low suctions. The change of SWCC from tillage methods and manure applications may attribute to the change of pore size and aggregate size distributions. Soil Ks was in the order of CP>MP>NT for the first two layers and in the order of MP>CP and NT for the deeper soil layer. The Ks also increased with increasing rates of manure application (i.e. 60>30>0 Mg ha-1). This was due to the increase in the total pore size and continuity.

Keywords: corn, manure, saturated hydraulic conductivity, soil water characteristic curve, tillage

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3192 Modeling and Optimization of a Microfluidic Electrochemical Cell for the Electro-Reduction of CO₂ to CH₃OH

Authors: Barzin Rajabloo, Martin Desilets

Abstract:

First, an electrochemical model for the reduction of CO₂ into CH₃OH is developed in which mass and charge transfer, reactions at the surface of the electrodes and fluid flow of the electrolyte are considered. This mathematical model is developed in COMSOL Multiphysics® where both secondary and tertiary current distribution interfaces are coupled to consider concentrations and potentials inside different parts of the cell. Constant reaction rates are assumed as the fitted parameters to minimize the error between experimental data and modeling results. The model is validated through a comparison with experimental data in terms of faradaic efficiency for production of CH₃OH, the current density in different applied cathode potentials as well as current density in different electrolyte flow rates. The comparison between model outputs and experimental measurements shows a good agreement. The model indicates the higher hydrogen evolution in comparison with CH₃OH production as well as mass transfer limitation caused by CO₂ concentration, which are consistent with findings in the literature. After validating the model, in the second part of the study, some design parameters of the cell, such as cathode geometry and catholyte/anolyte channel widths, are modified to reach better performance and higher faradaic efficiency of methanol production.

Keywords: carbon dioxide, electrochemical reduction, methanol, modeling

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3191 Genotyping of Rotaviruses in Pediatric Patients with Gastroenteritis by Using Real-Time Reverse Transcription Polymerase Chain Reaction

Authors: Recep Kesli, Cengiz Demir, Riza Durmaz, Zekiye Bakkaloglu, Aysegul Bukulmez

Abstract:

Objective: Acute diarrhea disease in children is a major cause of morbidity worldwide and is a leading cause of mortality, and it is the most common agent responsible for acute gastroenteritis in developing countries. With hospitalized children suffering from acute enteric disease up to 50% of the analyzed specimen were positive for rotavirus. Further molecular surveillance could provide a sound basis for improving the response to epidemic gastroenteritis and could provide data needed for the introduction of vaccination programmes in the country. The aim of this study was to investigate the prevalence of viral etiology of the gastroenteritis in children aged 0-6 years with acute gastroenteritis and to determine predominant genotypes of rotaviruses in the province of Afyonkarahisar, Turkey. Methods: An epidemiological study on rotavirus was carried out during 2016. Fecal samples obtained from the 144 rotavirus positive children with 0-6 years of ages and applied to the Pediatric Diseases Outpatient of ANS Research and Practice Hospital, Afyon Kocatepe University with the complaint of diarrhea. Bacterial agents causing gastroenteritis were excluded by using bacteriological culture methods and finally, no growth observed. Rotavirus antigen was examined by both the immunochromatographic (One Step Rotavirus and Adenovirus Combo Test, China) and ELISA (Premier Rotaclone, USA) methods in stool samples. Rotavirus RNA was detected by using one step real-time reverse transcription-polymerase chain reaction (RT-PCR). G and P genotypes were determined using RT-PCR with consensus primers of VP7 and VP4 genes, followed by semi nested type-specific multiplex PCR. Results: Of the total 144 rotavirus antigen-positive samples with RT-PCR, 4 (2,8%) were rejected, 95 (66%) were examined, and 45 (31,2%) have not been examined for PCR yet. Ninety-one (95,8%) of the 95 examined samples were found to be rotavirus positive with RT-PCR. Rotavirus subgenotyping distributions in G, P and G/P genotype groups were determined as; G1:45%, G2:27%, G3:13%, G9:13%, G4:1% and G12:1% for G genotype, and P[4]:33%, P[8]:66%, P[10]:1% for P genotype, and G1P[8]:%37, G2P[4]:%21, G3P[8]:%10, G4P[8]:%1, G9P[8]:%8, G2P[8]:%3 for G/P genotype . Not common genotype combination were %20 in G/P genotype. Conclusions: This study subscribes to the global agreement of the molecular epidemiology of rotavirus which will be useful in guiding the alternative and application of rotavirus vaccines or effective control and interception. Determining the diversity and rates of rotavirus genotypes will definitely provide guidelines for developing the most suitable vaccine.

Keywords: gastroenteritis, genotyping, rotavirus, RT-PCR

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3190 Analysis and Study of Growth Rates of Indigenous Phytoplankton in Enriched Spent Oil Impacted Ecosystems in South Western Nigeria Coastal Waters

Authors: Lauretta Ighedo, Bukola Okunade, Monisade Okunade

Abstract:

In order to determine the effect of spent oil on the growth rates of indigenous phytoplankton in an aquaculture pond, a study was carried out on varying concentrations of samples using the bioassay procedure for a period of 14 days. Four divisions Cyanophyta, Chlorophyta, Euglenophyta and Bacillariophyta were observed in the water samples collected from the Aquaculture pond. The growth response was measured using a microprocessor photocolorimeter at optical density of 680nm. A general assessment of spent oil contaminated samples showed either a sharp rise or fall in growth rate from day 0 to day 2 followed by increased growth response for most higher concentration of pollutants up to Day 8, then fluctuations in the growth response pattern for the other days. There was no marked significant difference in the growth response of phytoplankton in the spent oil impacted water samples. The lowest and highest phytoplankton abundance was recorded in 10/90ml and 2.5/97.5ml spent oil impacted water sample respectively. Oscillatoria limosa, Chlorella sp., Microcystis aeruginosa, Nitzschia sp. and Navicula sp. showed high tolerance to oil pollution and these species used as bioindicators of an organic polluted environment increased abundantly and can therefore be employed in the cleanup and bioremediation process of an oil polluted freshwater body.

Keywords: phytoplankton, pollution, species abundance, environmental characteristics

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3189 An Analysis of Pick Travel Distances for Non-Traditional Unit Load Warehouses with Multiple P/D Points

Authors: Subir S. Rao

Abstract:

Existing warehouse configurations use non-traditional aisle designs with a central P/D point in their models, which is mathematically simple but less practical. Many warehouses use multiple P/D points to avoid congestion for pickers, and different warehouses have different flow policies and infrastructure for using the P/D points. Many warehouses use multiple P/D points with non-traditional aisle designs in their analytical models. Standard warehouse models introduce one-sided multiple P/D points in a flying-V warehouse and minimize pick distance for a one-way travel between an active P/D point and a pick location with P/D points, assuming uniform flow rates. A simulation of the mathematical model generally uses four fixed configurations of P/D points which are on two different sides of the warehouse. It can be easily proved that if the source and destination P/D points are both chosen randomly, in a uniform way, then minimizing the one-way travel is the same as minimizing the two-way travel. Another warehouse configuration analytically models the warehouse for multiple one-sided P/D points while keeping the angle of the cross-aisles and picking aisles as a decision variable. The minimization of the one-way pick travel distance from the P/D point to the pick location by finding the optimal position/angle of the cross-aisle and picking aisle for warehouses having different numbers of multiple P/D points with variable flow rates is also one of the objectives. Most models of warehouses with multiple P/D points are one-way travel models and we extend these analytical models to minimize the two-way pick travel distance wherein the destination P/D is chosen optimally for the return route, which is not similar to minimizing the one-way travel. In most warehouse models, the return P/D is chosen randomly, but in our research, the return route P/D point is chosen optimally. Such warehouses are common in practice, where the flow rates at the P/D points are flexible and depend totally on the position of the picks. A good warehouse management system is efficient in consolidating orders over multiple P/D points in warehouses where the P/D is flexible in function. In the latter arrangement, pickers and shrink-wrap processes are not assigned to particular P/D points, which ultimately makes the P/D points more flexible and easy to use interchangeably for picking and deposits. The number of P/D points considered in this research uniformly increases from a single-central one to a maximum of each aisle symmetrically having a P/D point below it.

Keywords: non-traditional warehouse, V cross-aisle, multiple P/D point, pick travel distance

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3188 Fuzzy Inference System for Diagnosis of Malaria

Authors: Purnima Pandit

Abstract:

Malaria remains one of the world’s most deadly infectious disease and arguably, the greatest menace to modern society in terms of morbidity and mortality. To choose the right treatment and to ensure a quality of life suitable for a specific patient condition, early and accurate diagnosis of malaria is essential. It reduces transmission of disease and prevents deaths. Our work focuses on designing an efficient, accurate fuzzy inference system for malaria diagnosis.

Keywords: fuzzy inference system, fuzzy logic, malaria disease, triangular fuzzy number

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3187 Animal Welfare through Stockmanship Competence and Its Relationship to Productivity and Economic Profitability: The Case of Backyard Goat Production in the Philippines

Authors: M. J. Alcedo, K. Ito, K. Maeda

Abstract:

A stockperson has a significant influence on the productivity and welfare of their animals. This influence may be good or bad depending on their stockmanship competence. In this study, stockmanship competence (SC) is defined as the capacity of the stockperson to ensure the welfare of their animals by providing their animal’s needs. The study was conducted to evaluate the stockmanship competence of backyard goat raisers and to examine its relationship to productivity and economic profitability. This was made possible by interviewing 101 backyard goat raisers who have undergone farmer livestock school on integrated goat management (FLS IGM) in Region I, Philippines on September 3-30, 2012 and March 4-17, 2013. Secondary data needed were gathered from the local government agencies involved. Data on stockmanship, goat productivity and farmer’s income before and after attending FLS-IGM were gathered through a semi-structured interview. Questions for stockamnship were based on the Philippine recommends on goat production, tips on goat raising and other scientific literature. Stockmanship competence index score (SCIS) was computed by summing the raw scores derived from each components of SC divided by the total number of components. Pearson correlation through SPSS was used to see the relationship between SC, productivity and income. Result showed that majority raised native and upgraded goats. The computed mean SCIS before and after undergoing FLS-IGM was 38.53% and 75.81%, respectively, an improvement of 49.17%. Both index scores resulted in significant differences in productivity and income. The median mature weight and mortality rate of goats before FLS-IGM, where SC was low, was 14 kg and 50% respectively. On the other hand, after stockmanship had improved, the median mature weight increased to 19 kgs and mortality rate decreased to 11.11%. Likewise, fewer goat diseases were observed by farmers as compared before. With regards to income, there was 127.34% difference on the median net income derived by farmers. Result implies that improved stockmanship competence can lead not only to increased productivity and income of backyard goat raisers but also welfare of the animal.

Keywords: stockmanship, backyard goat production, animal welfare, Philippines

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3186 A Study on Pattern of Acute Poisoning in Patients Admitted to Emergency Wards in a Tertiary Care Hospital

Authors: Sathvika Reddy, Devi Revathi

Abstract:

Background: In India, deliberate self-harm (DSH) with poisoning agents carries a significant impact on morbidity and mortality. Changes in the patterns of poisoning vary across various geographical locations. It is important to know the patterns in a given region in order to facilitate rapid clinical diagnosis, appropriate treatment to reduce associated morbidity and mortality. Aim and Objective: To study the patterns, treatment outcomes of acute poisoning in patients admitted to emergency wards in a tertiary care hospital and to provide poison information services. Materials and Methods: This study was conducted at M.S Ramaiah Memorial and Teaching Hospital from November 2016 to March 2017. The patient’s data was obtained from patient case sheet, interaction with health care professionals, interviewing patients and their caretakers (if possible), and were documented in a suitably designed form. Results: The study involved 131 patients with a mean age of 27.76 ± 15.5 years. Majority of the patients were in the age group 21-30 years, literates (n=53) dwelling in urban (n=113) areas belonging to upper middle class (n=50). Analgesics and antipyretics were commonly utilized in intentional drug overdosage (n=49). Envenomation constituted n=21(16.03%). Furthermore, a significant relationship was observed between marital status and self-poisoning (n=64) (P < 0.001) which commonly occurred through oral ingestion. The outcomes were correlated with the GCS and PSS system and n=85 recovered, n=17 were discharged against medical advice, and n=4 died, and n=4 were lost to follow up respectively. The poison information queries include drug overdose (n=29) and management related queries (n=22) provided majorly by residents (n=45) to update knowledge (n=11) and for better patient care (n=40). Conclusion: The trend in poisoning is dynamic. Medications were identified as the main cause of poisoning in urban areas of India. Educational programs with more emphasis on preventive measures are necessary to create awareness among the general public.

Keywords: poisoning, suicides, clinical pharmacist, envenomation, poison information services

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3185 Pharmacodynamic Enhancement of Repetitive rTMS Treatment Outcomes for Major Depressive Disorder

Authors: A. Mech

Abstract:

Repetitive transcranial magnetic stimulation has proven to be a valuable treatment option for patients who have failed to respond to multiple courses of antidepressant medication. In fact, the American Psychiatric Association recommends TMS after one failed treatment course of antidepressant medication. Genetic testing has proven valuable for pharmacokinetic variables, which, if understood, could lead to more efficient dosing of psychotropic medications to improve outcomes. Pharmacodynamic testing can identify biomarkers, which, if addressed, can improve patients' outcomes in antidepressant therapy. Monotherapy treatment of major depressive disorder with methylated B vitamin treatment has been shown to be safe and effective in patients with MTHFR polymorphisms without waiting for multiple trials of failed medication treatment for depression. Such treatment has demonstrated remission rates similar to antidepressant clinical trials. Combining pharmacodynamics testing with repetitive TMS treatment with NeuroStar has shown promising potential for enhancing remission rates and durability of treatment. In this study, a retrospective chart review (ongoing) of patients who obtained repetitive TMS treatment enhanced by dietary supplementation guided by Pharmacodynamic testing, displayed a greater remission rate (90%) than patients treated with only NeuroStar TMS (62%).

Keywords: improved remission rate, major depressive disorder, pharmacodynamic testing, rTMS outcomes

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3184 Mobility-Aware Relay Selection in Two Hop Unmanned Aerial Vehicles Network

Authors: Tayyaba Hussain, Sobia Jangsher, Saqib Ali, Saqib Ejaz

Abstract:

Unmanned Aerial vehicles (UAV’s) have gained great popularity due to their remoteness, ease of deployment and high maneuverability in different applications like real-time surveillance, image capturing, weather atmospheric studies, disaster site monitoring and mapping. These applications can involve a real-time communication with the ground station. However, altitude and mobility possess a few challenges for the communication. UAV’s at high altitude usually require more transmit power. One possible solution can be with the use of multi hops (UAV’s acting as relays) and exploiting the mobility pattern of the UAV’s. In this paper, we studied a relay (UAV’s acting as relays) selection for a reliable transmission to a destination UAV. We exploit the mobility information of the UAV’s to propose a Mobility-Aware Relay Selection (MARS) algorithm with the objective of giving improved data rates. The results are compared with Non Mobility-Aware relay selection scheme and optimal values. Numerical results show that our proposed MARS algorithm gives 6% better achievable data rates for the mobile UAV’s as compared with Non MobilityAware relay selection scheme. On average a decrease of 20.2% in data rate is achieved with MARS as compared with SDP solver in Yalmip.

Keywords: mobility aware, relay selection, time division multiple acess, unmanned aerial vehicle

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3183 Proposal of Optimality Evaluation for Quantum Secure Communication Protocols by Taking the Average of the Main Protocol Parameters: Efficiency, Security and Practicality

Authors: Georgi Bebrov, Rozalina Dimova

Abstract:

In the field of quantum secure communication, there is no evaluation that characterizes quantum secure communication (QSC) protocols in a complete, general manner. The current paper addresses the problem concerning the lack of such an evaluation for QSC protocols by introducing an optimality evaluation, which is expressed as the average over the three main parameters of QSC protocols: efficiency, security, and practicality. For the efficiency evaluation, the common expression of this parameter is used, which incorporates all the classical and quantum resources (bits and qubits) utilized for transferring a certain amount of information (bits) in a secure manner. By using criteria approach whether or not certain criteria are met, an expression for the practicality evaluation is presented, which accounts for the complexity of the QSC practical realization. Based on the error rates that the common quantum attacks (Measurement and resend, Intercept and resend, probe attack, and entanglement swapping attack) induce, the security evaluation for a QSC protocol is proposed as the minimum function taken over the error rates of the mentioned quantum attacks. For the sake of clarity, an example is presented in order to show how the optimality is calculated.

Keywords: quantum cryptography, quantum secure communcation, quantum secure direct communcation security, quantum secure direct communcation efficiency, quantum secure direct communcation practicality

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3182 Using a Train-the-Trainer Model to Deliver Post-Partum Haemorrhage Simulation in Rural Uganda

Authors: Michael Campbell, Malaz Elsaddig, Kevin Jones

Abstract:

Background: Despite encouraging progress, global maternal mortality has remained stubbornly high since the declaration of the Millennium development goals. Sub-Saharan Africa accounts for well over half of maternal deaths with Post-Partum Haemorrhage (PPH) being the lead cause. ‘In house’ simulation training delivered by local doctors may be a sustainable approach for improving emergency obstetric care. The aim of this study was to evaluate the use of a Train-the-Trainer (TtT) model in a rural Ugandan hospital to ascertain whether it can feasibly improve practitioners’ management of PPH. Methods: Three Ugandan doctors underwent a training course to enable them to design and deliver simulation training. These doctors used MamaNatalie® models to simulate PPH scenarios for midwives, nurses and medical students. The main outcome was improvement in participants’ knowledge and confidence, assessed using self-reported scores on a 10-point scale. Results: The TtT model produced significant improvements in the confidence and knowledge scores of the ten participants. The mean confidence score rose significantly (p=0.0005) from 6.4 to 8.6 following the simulation training. There was also a significant increase in the mean knowledge score from 7.2 to 9.0 (p=0.04). Medical students demonstrated the greatest overall increase in confidence scores whilst increases in knowledge scores were largest amongst nurses. Conclusions: This study demonstrates that a TtT model can be used in a low resource setting to improve healthcare professionals’ confidence and knowledge in managing obstetric emergencies. This Train-the-Trainer model represents a sustainable approach to addressing skill deficits in low resource settings. We believe that its expansion across healthcare institutions in Sub-Saharan Africa will help to reduce the region’s high maternal mortality rate and step closer to achieving the ambitions of the Millennium development goals.

Keywords: low resource setting, post-partum haemorrhage, simulation training, train the trainer

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3181 Correlation Analysis of Reactivity in the Oxidation of Para and Meta-Substituted Benzyl Alcohols by Benzimidazolium Dichromate in Non-Aqueous Media: A Kinetic and Mechanistic Aspects

Authors: Seema Kothari, Dinesh Panday

Abstract:

An observed correlation of the reaction rates with the changes in the nature of substituent present on one of the reactants often reveals the nature of transition state. Selective oxidation of organic compounds under non-aqueous media is an important transformation in synthetic organic chemistry. Inorganic chromates and dichromates being drastic oxidant and are generally insoluble in most organic solvents, a number of different chromium (VI) derivatives have been synthesized. Benzimidazolium dichromate (BIDC) is one of the recently reported Cr(VI) reagents which is neither hygroscopic nor light sensitive being, therefore, much stable. Not many reports on the kinetics of the oxidations by BIDC are seemed to be available in the literature. In the present investigation, the kinetics and mechanism of benzyl alcohol (BA) and a number of para- and meta-substituted benzyl alcohols by benzimidazolium dichromate (BIDC), in dimethyl sulphoxide, is reported. The reactions were followed spectrophotometrically at 364 nm by monitoring the decrease in [BIDC] for up to 85-90% reaction, the temperature being constant. The observed oxidation product is the corresponding benzaldehyde. The reactions were of first order with respect to each the alcohol and BIDC. The reactions are catalyzed by proton, and the dependence is of the form: kobs = a + b[H+]. The reactions thus follow both, an acid-dependent and acid-independent paths. The oxidation of [1,1 2H2]benzyl alcohol exhibited the presence of a substantial kinetic isotope effect ( kH/kD = 6.20 at 298 K ). This indicated the cleavage of a α-C-H bond in the rate-determining step. An analysis of the temperature dependence of the deuterium isotope effect showed that the loss of hydrogen proceeds through a concerted cyclic process. The rate of oxidation of BA was determined in 19 organic solvents. An analysis of the solvent effect by Swain’s equation indicated that though both the anion and cation-solvating powers of the solvent contribute to the observed solvent effect, the role of cation-solvation is major. The rates of the para and meta compounds, at 298 K, failed to exhibit a significant correlation in terms of Hammett or Brown's substituent constants. The rates were then subjected to analyses in terms of dual substituent parameter (DSP) equations. The rates of oxidation of the para-substituted benzyl alcohols show an excellent correlation with Taft's σI and σRBA values. However, the rates for the meta-substituted benzyl alcohols show an excellent correlation with σI and σR0. The polar reaction constants are negative indicating an electron-deficient transition state. Hence the overall mechanism is proposed to involve the formation of a chromate ester in a fast pre-equilibrium and then a decomposition of the ester in a subsequent slow step via a cyclic concerted symmetrical transition state, involving hydride-ion transfer, leading to the product. The first order dependence on alcohol may be accounted in terms of the small value of the formation constant of the ester intermediate. An another reaction mechanism accounting the acid-catalysis involve the formation of a protonated BIDC prior to formation of an ester intermediate which subsequently decomposes in a slow step leading to the product.

Keywords: benzimidazolium dichromate, benzyl alcohols, correlation analysis, kinetics, oxidation

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