Search results for: cost of care

Authors: Rahul Jain, Jagdish Chander, Anish Gupta

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Introduction: Laparoscopic common bile duct exploration (LCBDE) allows cholecystectomy and the removal of common bile duct (CBD) stones to be performed during the same sitting, thereby decreasing hospital stay. CBD exploration through choledochotomy can be closed primarily with an absorbable suture material, but can lead to biliary leakage postoperatively. In this study we tried to find a solution to further lower the incidence of bile leakage by using fibrin glue to reinforce the sutures put on choledochotomy suture line. It has haemostatic and sealing action, through strengthening the last step of the physiological coagulation and biostimulation, which favours the formation of new tissue matrix. Methodology: This study was conducted at a tertiary care teaching hospital in New Delhi, India, from 2011 to 2013. 20 patients with CBD stones documented on MRCP with CBD diameter of 9 mm or more were included in this study. Patients were randomized into two groups namely Group A in which choledochotomy was closed with polyglactin 4-0 suture and suture line reinforced with fibrin glue, and Group ‘B’ in which choledochotomy was closed with polyglactin 4-0 suture alone. Both the groups were evaluated and compared on clinical parameters such as operative time, drain content, drain output, no. of days drain was required, blood loss & transfusion requirements, length of postoperative hospital stay and conversion to open surgery. Results: The operative time for Group A ranged from 60 to 210 min (mean 131.50 min) and Group B 65 to 300 min (mean 140 minutes). The blood loss in group A ranged from 10 to 120 ml (mean 51.50 ml), in group B it ranged from 10 to 200 ml (mean 53.50 ml). In Group A, there was no case of bile leak but there was bile leak in 2 cases in Group B, minimum 0 and maximum 900 ml with a mean of 97 ml and p value of 0.147 with no statistically significant difference in bile leak in test and control groups. The minimum and maximum serous drainage in Group A was nil & 80 ml (mean 11 ml) and in Group B was nil & 270 ml (mean 72.50 ml). The p value came as 0.028 which is statistically significant. Thus serous leakage in Group A was significantly less than in Group B. The drains in Group A were removed from 2 to 4 days (mean: 3 days) while in Group B from 2 to 9 days (mean: 3.9 days). The patients in Group A stayed in hospital post operatively from 3 to 8 days (mean: 5.30) while in Group B it ranged from 3 to 10 days with a mean of 5 days. Conclusion: Fibrin glue application on CBD decreases bile leakage but in statistically insignificant manner. Fibrin glue application on CBD can significantly decrease post operative serous drainage after LCBDE. Fibrin glue application on CBD is safe and easy technique without any significant adverse effects and can help less experienced surgeons performing LCBDE.

Keywords: bile leak, fibrin glue, LCBDE, serous leak

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Authors: Irene Kretchy, Frances Owusu-Daaku, Samuel Danquah

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Hypertension is the leading risk factor for cardiovascular diseases, and a major cause of death and disability worldwide. This study examined whether psychosocial variables influenced patients’ perception and experience of side effects of their medicines, how they coped with these experiences and the impact on mental health and medication adherence to conventional hypertension therapies. Methods: A hospital-based mixed methods study, using quantitative and qualitative approaches was conducted on hypertensive patients. Participants were asked about side effects, medication adherence, common psychological symptoms, and coping mechanisms with the aid of standard questionnaires. Information from the quantitative phase was analyzed with the Statistical Package for Social Sciences (SPSS) version 20. The interviews from the qualitative study were audio-taped with a digital audio recorder, manually transcribed and analyzed using thematic content analysis. The themes originated from participant interviews a posteriori. Results: The experiences of side effects – such as palpitations, frequent urination, recurrent bouts of hunger, erectile dysfunction, dizziness, cough, physical exhaustion - were categorized as no/low (39.75%), moderate (53.0%) and high (7.25%). Significant relationships between depression (x 2 = 24.21, P < 0.0001), anxiety (x 2 = 42.33, P < 0.0001), stress (x 2 = 39.73, P < 0.0001) and side effects were observed. A logistic regression model using the adjusted results for this association are reported – depression [OR = 1.9 (1.03 – 3.57), p = 0.04], anxiety [OR = 1.5 (1.22 – 1.77), p = < 0.001], and stress [OR = 1.3 (1.02 – 1.71), p = 0.04]. Side effects significantly increased the probability of individuals to be non-adherent [OR = 4.84 (95% CI 1.07 – 1.85), p = 0.04] with social factors, media influences and attitudes of primary caregivers further explaining this relationship. The personal adoption of medication modifying strategies, espousing the use of complementary and alternative treatments, and interventions made by clinicians were the main forms of coping with side effects. Conclusions: Results from this study show that contrary to a biomedical approach, the experience of side effects has biological, social and psychological interrelations. The result offers more support for the need for a multi-disciplinary approach to healthcare where all forms of expertise are incorporated into health provision and patient care. Additionally, medication side effects should be considered as a possible cause of non-adherence among hypertensive patients, thus addressing this problem from a Biopsychosocial perspective in any intervention may improve adherence and invariably control blood pressure.

Keywords: biopsychosocial, hypertension, medication adherence, psychological disorders

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Authors: Phusit Phukamchanoad, Bua Srikos

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Research aimed to study the characteristics of a community in the social, economical and cultural context. This research used interviews and surveys members in Patthana Soi Ranongklang community, Dusit District, Bangkok. The results are as follows: In terms of overall conditions and characteristics, Patthana Soi Ranongklang community is located on the property of Treasury Department. 50 years ago the location of this community consisted of paddy fields with limited convenience in terms of transportation. Rama V Road was only a small narrow road with only three-wheelers and no buses. The majority of community members moved in from Makkhawan Rangsan Bridge. Thus, most community members were either workers or government officials as they were not the owners of the land. Therefore, there were no primary occupations within this 7 acres of the community. The development of the community started in 1981. At present, the community is continuously being developed and modernization is rapidly flowing in. One of the reasons was because main roads were amended, especially Rama V Road that allows more convenient transportation, leading to heightened citizens’ convenience. In terms of the economy and society, the research found out that the development and expansion of Rama V Road cause a change in the conditions of the area and buildings. Some building were improved and changed along the time, as well as the development of new facilities that cause the community members to continually become more materialistic. Jobs within the community started to appear, and areas were improved to allow for new building and housing businesses. The trend of jobs become more in variety, in terms of both jobs at home, such as workers, merchandizing, and small own businesses, and jobs outside the community, which became much more convenient as car drivers are used to the narrow roads inside the community. The location of the community next to Rama V Road also allows helo from government agencies to reach the community with ease. Moreover, the welfare of the community was well taken care of by the community committee. In terms of education, the research found that there are two schools: Wat Pracharabuedham School and Wat Noi Noppakun School, that are providing education within the community. The majority of the community received Bachelor degrees. In areas of culture, the research found that the culture, traditions, and beliefs of people in the community were mainly transferred from the old community, especially beliefs in Buddhism as the majority are Bhuddists. The main reason is because the old community was situated near Wat Makut Kasattriyaram. Therefore, the community members have always had Buddhist temples as the center of the community. In later years, more citizens moved in and bring along culture, traditions, and beliefs with them. The community members also took part in building a Dharma hall named Wat Duang Jai 72 Years Ranong Klang. Traditions that community members adhere to since the establishment of the community are the New Year merit making and Songkran Tradition.

Keywords: social capital, culture, Patthana Soi Ranongklang community, way of life

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Authors: Suveen Kumar

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Oral cancer (OC) is the sixth most death causing cancer in world which includes tumour of lips, floor of the mouth, tongue, palate, cheeks, sinuses, throat, etc. Conventionally, the techniques used for OC detection are toluidine blue staining, biopsy, liquid-based cytology, visual attachments, etc., however these are limited by their highly invasive nature, low sensitivity, time consumption, sophisticated instrument handling, sample processing and high cost. Therefore, we developed biosensing chips for non-invasive detection of OC via CYFRA-21-1 biomarker. CYFRA-21-1 (molecular weight: 40 kDa) is secreted in saliva of OC patients which is a non-invasive biological fluid with a cut-off value of 3.8 ng mL-1, above which the subjects will be suffering from oral cancer. Therefore, in first work, 3-aminopropyl triethoxy silane (APTES) functionalized zirconia (ZrO2) nanoparticles (APTES/nZrO2) were used to successfully detect CYFRA-21-1 in a linear detection range (LDR) of 2-16 ng mL-1 with sensitivity of 2.2 µA mL ng-1. Successively, APTES/nZrO2-RGO was employed to prevent agglomeration of ZrO2 by providing high surface area reduced graphene oxide (RGO) support and much wider LDR (2-22 ng mL-1) was obtained with remarkable limit of detection (LOD) as 0.12 ng mL-1. Further, APTES/nY2O3/ITO platform was used for oral cancer bioseneor development. The developed biosensor (BSA/anti-CYFRA-21-1/APTES/nY2O3/ITO) have wider LDR (0.01-50 ng mL-1) with remarkable limit of detection (LOD) as 0.01 ng mL-1. To improve the sensitivity of the biosensing platform, nanocomposite of yattria stabilized nanostructured zirconia-reduced graphene oxide (nYZR) based biosensor has been developed. The developed biosensing chip having ability to detect CYFRA-21-1 biomolecules in the range of 0.01-50 ng mL-1, LOD of 7.2 pg mL-1 with sensitivity of 200 µA mL ng-1. Further, the applicability of the fabricated biosensing chips were also checked through real sample (saliva) analysis of OC patients and the obtained results showed good correlation with the standard protein detection enzyme linked immunosorbent assay (ELISA) technique.

Keywords: non-invasive, oral cancer, nanomaterials, biosensor, biochip

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Authors: Rahul Ravindranathan, R. P. Gokul

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India, in its efforts towards economic and social development, is currently experiencing a heavy demand for energy. Due to the lack of sufficient domestic energy reserves, the country is highly dependent on energy imports which has increased rapidly at a rate of about 12 % per annum since 2005. Hence, India is currently focusing its efforts to manage this energy supply and demand gap and eventually achieve energy security. One of the most cost effective means to reduce this gap is by adopting Energy efficiency measures in the country. Initial assessments have shown that Energy efficiency measures have an energy conservation potential of about 23%. For an estimated investment potential of USD 8 Billion, the annual energy savings was estimated to be about 180 Billion Units per annum. In order to explore this huge energy conservation potential, many critical factors need to be considered to achieve practical energy savings. Financing options for these investments is one such major factor. Not only has India come out with various policy level as well as technology level drives to promote Energy efficiency but it has also developed various financing schemes to promote investment in Energy Efficiency projects. The Public sector has already come out with certain financing schemes such as the Partial Risk Guarantee Fund (PRGF), Venture Capital Fund (VCF), Partial Risk Sharing Fund (PRSF) etc., and various sectors are gradually utilizing these schemes to implement energy saving measures. However, additional financing options are required in order to explore the untouched energy conservation potential in the country. Hence, there is a need to develop some innovative financing options for India which would motivate the private sectors as well as financing institutions to invest in these energy saving measures. This paper shall review the existing financing schemes launched by the Government of India and highlight the key benefits as well as challenges with respect to these schemes. In addition to this, the paper would also review new and innovative financing schemes for India and how the same could be adopted in other parts of the globe especially in South and South East Asia. This review would provide an insight to the various Governments as well as Financial Institutions in coming out with new financing schemes for their country.

Keywords: energy, efficiency, financing, India

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Authors: W. Assaad, D. Wilmink, H. R. Pasaribu, H. J. M. Geijselaers

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Shell has developed a mono-diameter well concept for oil and gas wells as opposed to the traditional telescopic well design. A Mono-diameter well design allows well to have a single inner diameter from the surface all the way down to reservoir to increase production capacity, reduce material cost and reduce environmental footprint. This is achieved by expansion of liners (casing string) concerned using an expansion tool (e.g. a cone). Since the well is drilled in stages and liners are inserted to support the borehole, overlap sections between consecutive liners exist which should be expanded. At overlap, the previously inserted casing which can be expanded or unexpanded is called the host casing and the newly inserted casing is called the expandable casing. When the cone enters the overlap section, an expandable casing is expanded against a host casing, a cured cement layer and formation. In overlap expansion, ironing or lengthening may appear instead of shortening in the expandable casing when the pressure exerted by the host casing, cured cement layer and formation exceeds a certain limit. This pressure is related to cement strength, thickness of cement layer, host casing material mechanical properties, host casing thickness, formation type and formation strength. Ironing can cause implications that hinder the deployment of the technology. Therefore, the understanding of ironing becomes essential. A physical model is built in-house to calculate expansion forces, stresses, strains and post expansion casing dimensions under different conditions. In this study, only free casing and overlap expansion of two casings are addressed while the cement and formation will be incorporated in future study. Since the axial strain can be predicted by the physical model, the onset of ironing can be confirmed. In addition, this model helps in understanding ironing and the parameters influencing it. Finally, the physical model is validated with Finite Element (FE) simulations and small-scale experiments. The results of the study confirm that high pressure leads to ironing when the casing is expanded in tension mode.

Keywords: casing expansion, cement, formation, metal forming, plasticity, well design

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Authors: Ravi Kant, Banshi D. Gupta

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The unbridled application of insecticides to enhance agricultural yield has become a matter of grave concern to both the environment and the human health and, thus pose a potential threat to sustainable development. Fenitrothion is an extensively used organophosphate insecticide whose residues are reported to be extremely toxic for birds, humans and aquatic life. A sensitive, swift and accurate detection protocol for fenitrothion is, thus, highly demanded. In this work, we report an SPR based fiber optic sensor for the detection of fenitrothion, where a nanocomposite arrangement of Ta2O5 and reduced graphene oxide (rGO) (Ta₂O₅: rGO) decorated on silver coated unclad core region of an optical fiber forms the sensing channel. A nanocomposite arrangement synergistically integrates the properties of involved components and consequently furnishes a conducive framework for sensing applications. The modification of the dielectric function of the sensing layer on exposure to fenitrothion solutions of diverse concentration forms the sensing mechanism. This modification is reflected in terms of the shift in resonance wavelength. Experimental variables such as the concentration of rGO in the nanocomposite configuration, dip time of silver coated fiber optic probe for deposition of sensing layer and influence of pH on the performance of the sensor have been optimized to extract the best performance of the sensor. SPR studies on the optimized sensing probe reveal the high sensitivity, wide operating range and good reproducibility of the fabricated sensor, which unveil the promising utility of Ta₂O₅: rGO nanocomposite framework for developing an efficient detection methodology for fenitrothion. FOSPR approach in cooperation with nanomaterials projects the present work as a beneficial approach for fenitrothion detection by imparting numerous useful advantages such as sensitivity, selectivity, compactness and cost-effectiveness.

Keywords: surface plasmon resonance, optical fiber, sensor, fenitrothion

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Authors: Dina Jalalvand, Joshua A. Cleland

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This double-blind, randomized control trial with parallel groups aimed to examine the effectiveness of office-based occupational therapy for office workers with low back pain on the intensity of pain and range of motion. Seventy-two male office workers (age: 20-50 years) with chronic low back pain (more than three months with at least two symptoms of chronic low back pain) satisfied eligibility criteria and agreed to participate in this study. The absence of joint burst following magnetic resonance imagining (MRI) was considered as an important inclusion criterion as well. Subjects were randomly assigned to a control or experimental group. The experimental group received the modified package of exercise-based occupational therapy, which included 11 simple exercise movements (derived from Williams and McKenzie), and the control group just received the conventional therapy, which included their routine physiotherapy sessions. The subjects completed the exercises three times a week for a duration of six weeks. Each exercise session was 10-15 minutes. Pain intensity and range of motion were the primary outcomes and were measured at baseline, 6 weeks, and 12 weeks after the end of the intervention using the numerical rating scale (NRS) and goniometer accordingly. Repeated measure ANOVA was used for analyzing data. The results of this study showed that significant decreases in pain intensity (p ≤ 0.05) and an increase in range of motion (p ≤ 0.001) in the experimental group in comparison with the control group after 6 and 12 weeks of intervention (between-group comparisons). In addition, there was a significant decrease in intensity of the pain (p ≤ 0.05) and an increase (p ≤ 0.001) in range of motion in the intervention group in comparison with baseline after 6 and 12 weeks (within-group comparison). This showed a positive effect of exercise-based occupational therapy that could potentially be used with low cost among office workers who suffer from low back pain. In addition, it should be noted that the introduced package of exercise training is easy to do, and there is not a need for a specific introduction.

Keywords: public health, office workers, low back pain, occupational therapy

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Authors: P. Uma Devi, S. Sujith, K. Rahul, T. S. Dipu, V. Anil Kumar , Vidya Menon

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Introduction: Candida is an important cause of bloodstream infections (BSIs), causing significant mortality and morbidity. The epidemiology of Candida infection is also changing, mainly in relation to the number of episodes caused by species Candida non-albicans. However, in India, the true burden of candidemia is not clear. Thus, this study was conducted to evaluate the clinical characteristics, species distribution, antifungal susceptibility and outcome of candidemia at our hospital. Methodology: Between January 2012 and April 2014, adult patients with at least one positive blood culture for Candida species were identified through the microbiology laboratory database (for each patient only the first episode of candidemia was recorded). Patient data was collected by retrospective chart review of clinical characteristics including demographic data, risk factors; species distribution, resistance to antifungals and survival. Results: A total of 165 episodes of Candida BSI were identified, with 115 episodes occurring in adult patients. Most of the episodes occurred in males (69.6%). Nearly 82.6% patients were between 41 to 80 years and majority of the patients were in the intensive care unit (65.2%) at the time of diagnosis. On admission, 26.1% and 18.3% patients had pneumonia and urinary tract infection, respectively. Majority of the candidemia episodes were found in the general medicine department (23.5%) followed by gastrointestinal surgery (13.9%) and medical oncology & haematology (13%). Risk factors identified were prior hospitalization within one year (83.5%), antibiotic therapy within the last one month (64.3%), indwelling urinary catheter (63.5%), central venous catheter use (59.1%), diabetes mellitus (53%), severe sepsis (45.2%), mechanical ventilation (43.5%) and surgery (36.5%). C. tropicalis (30.4%) was the leading cause of infection followed by C. parapsilosis (28.7%) and C. albicans (13%). Other non-albicans species isolated included C. haemulonii (7.8%), C. glabrata (7%), C. famata (4.3%) and C. krusei (1.7%). Antifungal susceptibility to fluconazole was 87.9% (C. parapsilosis), 100% (C. tropicalis) and 93.3% (C. albicans). Mortality was noted in 51 patients (44.3%). Early mortality (within 7 days) was noted in 32 patients while late mortality (between 7 and 30 days) was noted in 19 patients. Conclusion: In recent years, candidemia has been flourishing in critically ill patients. Comparison of data from our own hospital from 2005 shows a doubling of the incidence. Rapid changes in the rate of infection, potential risk factors, and emergence of non-albicans Candida demand continued surveillance of this serious BSI. High index of suspicion and sensitive diagnostics are essential to improve outcomes in resource limited settings with emergence of non-albicans Candida.

Keywords: antifungal susceptibility, candida albicans, candidemia, non-albicans candida

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Authors: Agoston Restas

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Introduction: This paper describes many initiatives and shows also practical examples which happened recently using Unmanned Aerial Systems (UAS) to support disaster management. Since the operation of manned aircraft at disasters is usually not only expensive but often impossible to use as well, in many cases managers fail to use the aerial activity. UAS can be an alternative moreover cost-effective solution for supporting disaster management. Methods: This article uses thematic division of UAS applications; it is based on two key elements, one of them is the time flow of managing disasters, other is its tactical requirements. Logically UAS can be used like pre-disaster activity, activity immediately after the occurrence of a disaster and the activity after the primary disaster elimination. Paper faces different disasters, like dangerous material releases, floods, earthquakes, forest fires and human-induced disasters. Research used function analysis, practical experiments, mathematical formulas, economic analysis and also expert estimation. Author gathered international examples and used own experiences in this field as well. Results and discussion: An earthquake is a rapid escalating disaster, where, many times, there is no other way for a rapid damage assessment than aerial reconnaissance. For special rescue teams, the UAS application can help much in a rapid location selection, where enough place remained to survive for victims. Floods are typical for a slow onset disaster. In contrast, managing floods is a very complex and difficult task. It requires continuous monitoring of dykes, flooded and threatened areas. UAS can help managers largely keeping an area under observation. Forest fires are disasters, where the tactical application of UAS is already well developed. It can be used for fire detection, intervention monitoring and also for post-fire monitoring. In case of nuclear accident or hazardous material leakage, UAS is also a very effective or can be the only one tool for supporting disaster management. Paper shows some efforts using UAS to avoid human-induced disasters in low-income countries as part of health cooperation.

Keywords: disaster management, floods, forest fires, Unmanned Aerial Systems

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Authors: Steven G. Sclan

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Background: Since December 2019, the world has been afflicted by the spread of the Severe Acute Respiratory Syndrome-Corona Virus-2 (SARS-CoV-2), which is responsible for the condition referred to as Covid-19. The illness has had a cataclysmic impact on the political, social, economic, and overall well-being of the population of the entire globe. While Covid-19 has had a substantial universal fatality impact, it may have an even greater effect on the socioeconomic, medical well-being, and healthcare planning for remaining societies. Significance: As these numbers illustrate, many more persons survive the infection than die from it, and many of those patients have noted ongoing, persistent symptoms after successfully enduring the acute phase of the illness. Recognition and understanding of these symptoms are crucial for developing and arranging efficacious models of care for all patients (whether or not having been hospitalized) surviving acute covid illness and plagued by post-acute symptoms. Furthermore, regarding Covid infection in children (< 18 y/o), although it may be that Covid “+” children are not major vectors of infective transmission, it now appears that many more children than initially thought are carrying the virus without accompanying obvious symptomatic expression. It seems reasonable to wonder whether viral effects occur in children – those children who are Covid “+” and now asymptomatic – and if, over time, they might also experience similar symptoms. An even more significant question is whether Covid “+” asymptomatic children might manifest increased multiple health problems as they grow – i.e., developmental complications (e.g., physical/medical, metabolic, neurobehavioral, etc.) – in comparison to children who had been consistently Covid “ - ” during the pandemic. Topics Addressed and Theoretical Importance: This review is important because of the description of both quantitative and qualitative methods for clinical and biomedical research. Topics reviewed will consider the importance of well-designed, comprehensive (i.e., quantitative and qualitative methods) longitudinal studies of Post Covid-19 symptoms in both adults and children. Also reviewed will be general characteristics of longitudinal studies and a presentation of a model for a proposed study. Also discussed will be the benefit of longitudinal studies for the development of efficacious interventions and for the establishment of cogent, practical, and efficacious community healthcare service planning for post-acute covid patients. Conclusion: Results of multi-dimensional, longitudinal studies will have important theoretical implications. These studies will help to improve our understanding of the pathophysiology of long COVID and will aid in the identification of potential targets for treatment. Such studies can also provide valuable insights into the long-term impact of COVID-19 on public health and socioeconomics.

Keywords: COVID-19, post-COVID-19, long COVID, longitudinal research, quantitative research, qualitative research

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Authors: Aparecida De Fatima Dutra, Freddie Avant, Wilma Cordova

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People living with HIV/AIDS (PLWHA) have benefited from advances in treatment. Medical costs are a challenge for some, but the real challenge is the stigma and discrimination PLWHA continue to face, even though the disease has festered for the last four decades. Few studies regarding stigma and discrimination give voice to those affected by these practices. This study provides a voice to PLWHA in Brazil and in the US as to how they perceive stigma and discrimination, as well as services they access. The methodology of this study was designed based on phenomenological research, which is a research that aims to identify what individuals facing the same situation have to share about their experiences. Qualitative research using in- depth interviews was used in order to gather participants’ perceptions about services they access, and stigma and discrimination they experience as PLWHA (hypothesis). The target population was a minority group of 13 Afro-descendant men, mean age of 48.3, residents in East Texas, United States and Salvador, Brazil. Our findings indicate that in both countries, overall, participants have reasonable access to medication and qualified services, except for some specialties, such as dentistry. With regard to stigma and discrimination the majority of participants have not disclosed their diagnosis. They state they prefer not to disclose for fear of being ostracized and rejected. Participants who did reveal their status indicate that stigma and discrimination is a daily occurrence. These experiences tend to occur within their own families, neighborhoods, and in public health agencies where HIV/AIDS is not the focus. Participants who did offer suggestions for social change indicated they would have to reveal their status even if it means being stigmatized and discriminated against. Other factors contributing to this discrimination include skin color and poverty. This study concludes that even after decades since the spread of this epidemic, nothing has changed regarding stigma and discrimination towards PLWHA. Lack of awareness, empathy and education continue to be a major challenge, not only at a local level but across the globe. In conclusion, as documented in previous studies while stigma and discrimination towards this population prevail, negative attitudes will continue to jeopardize all individuals from receiving equal access to prevention, treatment and care. It is crucial to face stigma and discrimination not only as individual experiences, but as social practices that violate and restrict human rights and that as a result, reinforce inequality and social exclusion. Policies should be at the forefront to eliminate the stigma and discrimination PLWHA experience. Health professionals and societies must take a stand in order to promote mindfulness about the negative effect of oppression towards individuals living with HIV/AIDS and the potential global impact of these practices.

Keywords: discrimination, HIV/AIDS, human rights, stigma

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Authors: E. V. Fakhrutdinova, Y. S. Kolesnikova, E. A. Karasik, V. M. Zagidullina

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Poverty as the social and economic phenomenon exists in any society and represents a many-sided problem. In this sense it is universal and for many centuries serves as a research objects for scientists. Special attention to a problem of poverty in Russia is caused, first of all, by the critical growth of inequality and by scales of expansion of poverty, considerable decrease in the level and quality of life of the population, decrease in availability of education during the period of reforming. The expansion of poverty on the working members of society, youth, which has to provide reproduction of the population is alarming. As poverty is the reason of weakening of national security of the country, degradation of the population, decline in the quality of the human capital, complication of a demographic situation, strengthening of social contradictions in society, so far as the reduction of poverty, so, the increase in production. Poverty: the characteristic of an economic situation of the individual or social group at which they can't satisfy certain minimum requirements necessary for life, preservations of working capacity and reproduction. Poverty became one of the critical factors expelling people from the system of the institutional interactions reducing social space in which their relations were building breaking their social identity. Complication of the problem of poverty in modern society happened due to penetration of the related relations into many spheres of life. It is known that negative consequences of poverty display not only at the personal level of the poor person, but also at the level of interpersonal social interactions, decline in the quality and level of development of the human capital, and also at social and economic system in general. We conducted a research on the influence of education on the change of poverty level of the population. We consider education as a resource for an increase of the income and social mobility. Dependence of the income of the population on the level of education, availability of education (level of education and quality of education) on the level of income of families is found. Differentiation of quality and number of educational services for children depending on the level of the income of families is revealed. Influence of a factor of poverty on the availability of education is also studied. We consider expenses on education as the limiter of access to education. We consider education as a factor of fixation and aggravation of a property inequality. In the solution of problems of poverty the defining condition is the state regulation of social and economic development by means of creation of the effective institutional environment. The state has to develop measures for an increase of availability of various services to all categories of citizens, in particular services of health care and education, especially for poor citizens enters. The special attention regarding an increase of availability of education services has to be paid to creation of system of social elevators.

Keywords: poverty, education, human capital, quality of life

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Authors: Timine Suoware, Sylvester Edelugo, Charles Amgbari

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Natural fibre composites (NFC) are becoming very attractive especially for automotive interior and non-structural building applications because they are biodegradable, low cost, lightweight and environmentally friendly. NFC are known to release high combustible products during exposure to heat atmosphere and this behaviour has raised concerns to end users. To improve on their fire response, flame retardants (FR) such as aluminium tri-hydroxide (ATH) and ammonium polyphosphate (APP) are incorporated during processing to delay the start and spread of fire. In this paper, APP was modified with Gum Arabic powder (GAP) and synergized with carbon black (CB) to form new FR species. Four FR species at 0, 12, 15 and 18% loading ratio were added to oil palm fibre polyester composite (OPFC) panels as follows; OPFC12%APP-GAP, OPFC15%APP-GAP/CB, OPFC18%ATH/APP-GAP and OPFC18%ATH/APPGAP/CB. The panels were produced using hand lay-up compression moulding and cured at room temperature. Specimens were cut from the panels and these were tested for ignition time (Tig), peak heat released rate (HRRp), average heat release rate (HRRavg), peak mass loss rate (MLRp), residual mass (Rm) and average smoke production rate (SPRavg) using cone calorimeter apparatus as well as the available flame energy (ɸ) in driving the flame using radiant panel flame spread apparatus. From the ignitability data obtained at 50 kW/m2 heat flux (HF), it shows that the hybrid FR modified with APP that is OPFC18%ATH/APP-GAP exhibited superior flame retardancy and the improvement was based on comparison with those without FR which stood at Tig = 20 s, HRRp = 86.6 kW/m2, HRRavg = 55.8 kW/m2, MLRp =0.131 g/s, Rm = 54.6% and SPRavg = 0.05 m2/s representing respectively 17.6%, 67.4%, 62.8%, 50.9%, 565% and 62.5% improvements less than those without FR (OPFC0%). In terms of flame spread, the least flame energy (ɸ) of 0.49 kW2/s3 for OPFC18%ATH/APP-GAP caused early flame regression. This was less than 39.6 kW2/s3 compared to those without FR (OPFC0%). It can be concluded that hybrid FR modified with APP could be useful in the automotive and building industries to delay the start and spread of fire.

Keywords: flame retardant, flame regression, oil palm fibre, composite panel

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Authors: Philip T. Broughton, Mark P. Bettney, Isla L. Smail

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Effective treatment of ground instability is essential when managing the impacts associated with historic mining. A field trial was undertaken by the Coal Authority to investigate the geotechnical performance and potential use of composite materials comprising resin and fill or stone to safely treat surface collapses, such as crown-holes, associated with shallow mining. Test pits were loosely filled with various granular fill materials. The fill material was injected with commercially available silicate and polyurethane resin foam products. In situ and laboratory testing was undertaken to assess the geotechnical properties of the resultant composite materials. The test pits were subsequently excavated to assess resin permeation. Drilling and resin injection was easiest through clean limestone fill materials. Recycled building waste fill material proved difficult to inject with resin; this material is thus considered unsuitable for use in resin composites. Incomplete resin permeation in several of the test pits created irregular ‘blocks’ of composite. Injected resin foams significantly improve the stiffness and resistance (strength) of the un-compacted fill material. The stiffness of the treated fill material appears to be a function of the stone particle size, its associated compaction characteristics (under loose tipping) and the proportion of resin foam matrix. The type of fill material is more critical than the type of resin to the geotechnical properties of the composite materials. Resin composites can effectively support typical design imposed loads. Compared to other traditional treatment options, such as cement grouting, the use of resin composites is potentially less disruptive, particularly for sites with limited access, and thus likely to achieve significant reinstatement cost savings. The use of resin composites is considered a suitable option for the future treatment of shallow mining collapses.

Keywords: composite material, ground improvement, mining legacy, resin

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Authors: Robin Root

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A fundamental premise of medical anthropology is that clinical phenomena are simultaneously cultural, political, and economic: none more so than the linked acronyms HIV/AIDS. For the medical researcher, HIV/AIDS signals an epidemiological pandemic and a pathophysiology. For persons diagnosed with an HIV-related condition, the acronym often conjures dread, too often marking and marginalizing the afflicted irretrievably. Critical medical anthropology is uniquely equipped to theorize the linkages that bind individual and social wellbeing to global structural and culture-specific phenomena. This paper reports findings from an anthropological study of HIV/AIDS in Swaziland, site of the highest HIV prevalence in the world. The project, initiated in 2005, has documented experiences of HIV/AIDS, religiosity, and treatment and care as well as drought and famine. Drawing on interviews with Swazi religious and traditional leaders about their experiences of leadership amidst worsening economic conditions, environmental degradation, and an ongoing global health crisis, the paper provides uncommon insights for global health practitioners whose singular paradigm for designing and delivering interventions is biomedically-based. In contrast, this paper details the role of local leaders in mediating extreme social suffering and resilience in ways that medical science cannot model but which radically impact how sickness is experienced and health services are delivered and accessed. Two concepts help to organize the paper’s argument. First, a ‘moral economy of language’ is central to showing up the implicit ‘technologies of knowledge’ that inhere in scientific and religious discourses of HIV/AIDS; people draw upon these discourses strategically to navigate highly vulnerable conditions. Second, Paulo Freire’s ethnographic focus on a culture’s 'dangerous words' opens up for examination how ‘sex’ is dangerous for religion and ‘god’ is dangerous for science. The paper interrogates hegemonic and ‘lived’ discourses, both biomedical and religious, and contributes to an important literature on the moral economies of health, a framework of explication and, importantly, action appropriate to a wide-range of contemporary global health phenomena. The paper concludes by asserting that it is imperative that global health planners reflect upon and ‘check’ their hegemonic policy platforms by, one, collaborating with local authoritative agents of ‘what sickness means and how it is best treated,’ and, two, taking account of the structural barriers to achieving good health.

Keywords: Africa, biomedicine, HIV/AIDS, qualitative research , religion

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Authors: G. Melo, J. Felix, S. Maciel, C. Fernandes, W. Rodrigues

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In Brazilian public policy, the Centres of Reference for Social Assistance (CRAS in Portuguese) are part of the Unified Social Assistance System (SUAS in Portuguese). SUAS is responsible for addressing spontaneous or currently active cases that are brought forth from other services in the social assistance network. The following case was reviewed by CRAS’s team in Recife, Brazil, after a complaint of child abuse was filed against the mother of a 7-year-old girl by the girl’s aunt. The girl is the daughter of an incestuous relationship between her mother and her older brother. The complaint was registered by service staff and five interventions were subsequently carried out on behalf of the child. These interventions provided a secure place for dialogue with both the child and her family and allowed for an investigation of the abuse to proceed. They took place in the child’s school as well as her aunt’s residence. At school, the child (with her classmates) watched a video and listened to a song about the prevention of child abuse. This was followed up with a second intervention to determine any signs of Post-Traumatic Stress Disorder (PTSD), by having the child play with the mobile app ‘My Angela’. Books on the themes of family and fear were also read to the child on different occasions at her school – after every intervention she was asked to draw something related to fear and her concept of a family. After the interventions and discussing the case as a team, we reached several conclusions: 1) The child did not appear to show any symptoms of PTSD; 2) She normally fantasized about her future and life story; 3) She did not allow herself to be touched by strangers with whom she lacks a close relationship (such as classmates or her teacher); 4) Through her drawings, she reproduced the conversations she had had with the staff; 5) She habitually covered her drawings when asked questions about the abuse. In this particular clinical case, we want to highlight that the role of the Psychologist’s intervention at CRAS is to attempt to resolve the issue promptly (and not to develop a prolonged clinical study based on traditional methods), by making use of the available tools from the social assistance network, and by making referrals to the relevant authorities, such as the Public Ministry, so that final protective actions can be taken and enforced. In this case, the Guardian Council of the Brazilian Public Ministry was asked to transfer the custody of the child to her uncle. The mother of the child was sent to a CAPS (Centre for Psychosocial Care), having been diagnosed with psychopathology. The child would then participate in NGO programs that allow for a gradual reduction of social exposure to her mother before being transferred to her uncle’s custody in Sao Paulo.

Keywords: child abuse, intervention, social psychology, violence

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Authors: Deanne McArthur, Melinda Wall, Claire Hanlon, Dana Agnolin, Krista Davis, Melanie Dennis, Elizabeth Glidden, Anne Marie Smith, Claudette Thomson

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Background and significance: Patients with eating disorders have traditionally been an underserviced population within the publicly-funded Canadian healthcare system. This situation was worsened by the COVID-19 pandemic and accompanying public health measures, such as “lockdowns” which led to increased isolation, changes in routine, and other disruptions. Illness severity and prevalence rose significantly with corresponding increases in patient suffering and poor outcomes. In Ontario, Canada, the provincial government responded by increasing funding for the treatment of eating disorders, including the launch of a new day program at an intermediate, regional health centre that already housed an outpatient treatment service. The funding was received in March 2022. The care team sought to optimize this opportunity by designing a program that would fit well within the resource-constrained context in Ontario. Methods: This case study will detail how the team consulted the literature and sought patient and family input to design a program that optimizes patient outcomes and supports for patients and families while they await treatment. Early steps include a review of the literature, expert consultation and patient and family focus groups. Interprofessional consensus was sought at each step with the team adopting a shared leadership and patient-centered approach. Methods will include interviews, observations and document reviews to detail a rich description of the process undertaken to design the program, including evaluation measures adopted. Interim findings pertaining to the early stages of the program-building process will be detailed as well as early lessons and ongoing evolution of the program and design process. Program implementation and outcome evaluation will continue throughout 2022 and early 2023 with further publication and presentation of study results expected in the summer of 2023. The aim of this study is to contribute to the body of knowledge pertaining to the design and implementation of eating disorder treatment services that combine outpatient and day treatment services in a resource-constrained context.

Keywords: eating disorders, day program, interprofessional, outpatient, adolescents, transitional aged youth

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Authors: César Coelho, Nikolai Wiegand

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The advancement of nanosatellite technology has opened new avenues for cost-effective and faster space missions. The NanoSat MO Framework (NMF) from the European Space Agency (ESA) provides a modular and simpler approach to the development of flight software and operations of small satellites. This paper presents a methodology using the NMF together with Docker for simulating constellations of satellites. By leveraging Docker containers, the software environment of individual satellites can be easily replicated within a simulated constellation. This containerized approach allows for rapid deployment, isolation, and management of satellite instances, facilitating comprehensive testing and development in a controlled setting. By integrating the NMF lightweight simulator in the container, a comprehensive simulation environment was achieved. A significant advantage of using Docker containers is their inherent scalability, enabling the simulation of hundreds or even thousands of satellites with minimal overhead. Docker's lightweight nature ensures efficient resource utilization, allowing for deployment on a single host or across a cluster of hosts. This capability is crucial for large-scale simulations, such as in the case of mega-constellations, where multiple traditional virtual machines would be impractical due to their higher resource demands. This ability for easy horizontal scaling based on the number of simulated satellites provides tremendous flexibility to different mission scenarios. Our results demonstrate that leveraging Docker containers with the NanoSat MO Framework provides a highly efficient and scalable solution for simulating satellite constellations, offering not only significant benefits in terms of resource utilization and operational flexibility but also enabling testing and validation of ground software for constellations. The findings underscore the importance of taking advantage of already existing technologies in computer science to create new solutions for future satellite constellations in space.

Keywords: containerization, docker containers, NanoSat MO framework, satellite constellation simulation, scalability, small satellites

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Authors: Rahul Paul, Peter Mctaggart, Luke Skinner

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Maintaining public safety and network reliability are the core objectives of all electricity distributors globally. For many electricity distributors, managing vegetation clearances from their above ground assets (poles and conductors) is the most important and costly risk mitigation control employed to meet these objectives. Light Detection And Ranging (LiDAR) is widely used by utilities as a cost-effective method to inspect their spatially-distributed assets at scale, often captured using high powered LiDAR scanners attached to fixed wing or rotary aircraft. The resulting 3D point cloud model is used by these utilities to perform engineering grade measurements that guide the prioritisation of vegetation cutting programs. Advances in computer vision and machine-learning approaches are increasingly applied to increase automation and reduce inspection costs and time; however, real-world LiDAR capture variables (e.g., aircraft speed and height) create complexity, noise, and missing data, reducing the effectiveness of these approaches. This paper proposes a method for identifying each conductor from LiDAR data via clustering methods that can precisely reconstruct conductors in complex real-world configurations in the presence of high levels of noise. It proposes 3D catenary models for individual clusters fitted to the captured LiDAR data points using a least square method. An iterative learning process is used to identify potential conductor models between pole pairs. The proposed method identifies the optimum parameters of the catenary function and then fits the LiDAR points to reconstruct the conductors.

Keywords: point cloud, LİDAR data, machine learning, computer vision, catenary curve, vegetation management, utility industry

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Authors: Rupinder Bakshi, Geeta Walia, Anita Gupta

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Introduction: Urinary tract infections (UTI) are considered to be one of the most common bacterial infections with an estimated annual global incidence of 150 million. Antimicrobial drug resistance is one of the major threats due to widespread usage of uncontrolled antibiotics. Materials and Methods: A total number of 9149 urine samples were collected from R.H Patiala and processed in the Department of Microbiology G.M.C Patiala. Urine samples were inoculated on MacConkey’s and blood agar plates by using calibrated loop delivering 0.001 ml of sample and incubated at 37 °C for 24 hrs. The organisms were identified by colony characters, gram’s staining and biochemical reactions. Antimicrobial susceptibility of the isolates was determined against various antimicrobial agents (Hi – Media Mumbai India) by Kirby-Bauer disk diffusion method on Muller Hinton agar plates. Results: Maximum patients were in the age group of 21-30 yrs followed by 31-40 yrs. Males (34%) are less prone to urinary tract infections than females (66%). Out of 9149 urine sample, the culture was positive in 25% (2290) samples. Esch. coli was the most common isolate 60.3% (n = 1378) followed by Klebsiella pneumoniae 13.5% (n = 310), Proteus spp. 9% (n = 209), Staphylococcus aureus 7.6 % (n = 173), Pseudomonas aeruginosa 3.7% (n = 84), Citrobacter spp. 3.1 % (70), Staphylococcus saprophyticus 1.8 % (n = 142), Enterococcus faecalis 0.8%(n=19) and Acinetobacter spp. 0.2%(n=5). Gram negative isolates showed higher sensitivity towards, Piperacillin +Tazobactum (67%), Amikacin (80%), Nitrofurantoin (82%), Aztreonam (100%), Imipenem (100%) and Meropenam (100%) while gram positive showed good response towards Netilmicin (69%), Nitrofurantoin (79%), Linezolid (98%), Vancomycin (100%) and Teicoplanin (100%). 465 (23%) isolates were resistant to Penicillins, 1st generation and 2nd generation Cehalosporins which were further tested by double disk approximation test and combined disk method for ESBL production. Out of 465 isolates, 375 were ESBLs consisting of n 264 (70.6%) Esch.coli and 111 (29.4%) Klebsiella pneumoniae. Susceptibility of ESBL producers to Imipenem, Nitrofurantoin and Amikacin were found to be 100%, 76%, and 75% respectively. Conclusion: Uropathogens are increasingly showing resistance to many antibiotics making empiric management of outpatients UTIs challenging. Ampicillin, Cotrimoxazole, and Ciprofloxacin should not be used in empiric treatment. Nitrofurantoin could be used in lower urinary tract infection. Knowledge of uropathogens and their antimicrobial susceptibility pattern in a geographical region will help inappropriate and judicious antibiotic usage in a health care setup.

Keywords: Urinary Tract Infection, UTI, antibiotic susceptibility pattern, ESBL

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Authors: Abdul-Nasser El-Kassar, Walid Elgammal, Hisham Jawhar

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This paper studies the determinants of the dividends payout ratio. The factors affecting the dividends payout ratio are to be identified. The study focuses only on the cement and construction industry within the MENA region in an attempt to isolate any incoherent behavior. The factors under consideration are: sales growth, ROE, ROA, ROS, debt to equity ratio, firm size, and free cash flow. Data were collected from official stock exchange markets in addition to annual reports. The study considered all firms that paid dividend in each of the three consecutive years starting from 2010 till 2012. Out of the 123 listed firms that work in cement and construction industry in MENA region, only 19 paid dividends in the three consecutive years 2010-12. Our sample consists of the 19 firms (57 observations) which are selected according to purposive sampling. Moreover, the study uses the homogeneous subcategory within the purposive sampling since only similar firms in the construction industry had been examined. The outcome of the study provides a vital insight into the determinants of dividends payout ratio of companies in MENA region. The results showed that the dividend payout ratio has a strong and positive relationship with return on assets and strong but negative relationship with return on equity. On the other hand, the results detected weak relationships between dividend payout ratio and sale growth, debt to equity ratio, firm size, and free cash flow. The study suggests that board of directors tend to compensate shareholders and minimize the agency cost by distributing a high portion of profits in form of dividends whenever return on equity decreases. Also, when the performance of the firm improves, and hence return on assets increases, boards of directors are more generous in distributing profits.

Keywords: dividends payout ratio, profitability firm size, free cashflow, debt to equity ratio

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Authors: Merina Islam

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There are many environmental problems. Various counter measures have been taken for environmental problems. Philosophy is an important contributor to environmental studies as it takes deep interest in meaning analysis of the concept environment and other related concepts. The Buddhist frame, which is virtue ethical, remains a better alternative to the traditional environmental outlook. Granting the unique role of man in immoral deliberations, the Buddhist approach, however, maintains a holistic concept of ecological harmony. Buddhist environmental ethics is more concerned about the complete moral community, the total ecosystem, than any particular species within the community. The moral reorientation proposed here has resemblance to the concept of 'deep ecology. Given the present day prominence of virtue ethics, we need to explore further into the Buddhist virtue theory, so that a better framework to treat the natural world would be ensured. Environment has turned out to be one of the most widely discussed issues in the recent times. Buddhist concepts such as Pratityasamutpadavada, Samvrit Satya, Paramartha Satya, Shunyata, Sanghatvada, Bodhisattva, Santanvada and others deal with interdependence in terms of both internal as well external ecology. The internal ecology aims at mental well-being whereas external ecology deals with physical well-being. The fundamental Buddhist concepts for dealing with environmental Problems are where the environment has the same value as humans as from the two Buddhist doctrines of the Non-duality of Life and its Environment and the Origination in Dependence; and the inevitability of overcoming environmental problems through the practice of the way of the Bodhisattva, because environmental problems are evil for people and nature. Buddhism establishes that there is a relationship among all the constituents of the world. There is nothing in the world which is independent from any other thing. Everything is dependent on others. The realization that everything in the universe is mutually interdependent also shows that the man cannot keep itself unaffected from ecology. This paper would like to focus how the Buddhist’s identification of nature and the Dhamma can contribute toward transforming our understanding, attitudes, and actions regarding the care of the earth. Environmental Ethics in Buddhism presents a logical and thorough examination of the metaphysical and ethical dimensions of early Buddhist literature. From the Buddhist viewpoint, humans are not in a category that is distinct and separate from other sentient beings, nor are they intrinsically superior. All sentient beings are considered to have the Buddha-nature, that is, the potential to become fully enlightened. Buddhists do not believe in treating of non-human sentient beings as objects for human consumption. The significance of Buddhist theory of interdependence can be understood from the fact that it shows that one’s happiness or suffering originates from ones realization or non-realization respectively of the dependent nature of everything. It is obvious, even without emphasis, which in the context of deep ecological crisis of today there is a need to infuse the consciousness of interdependence.

Keywords: Buddhism, deep ecology, environmental problems, Pratityasamutpadavada

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Authors: Abdelhalim. N. Mohammed, Mohammed. Y. Esmail

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In the course of recent decades, medical imaging has been dominated by the use of costly film media for review and archival of medical investigation, however due to developments in networks technologies and common acceptance of a standard digital imaging and communication in medicine (DICOM) another approach in light of World Wide Web was produced. Web technologies successfully used in telemedicine applications, the combination of web technologies together with DICOM used to design a web-based and open source DICOM viewer. The Web server allowance to inquiry and recovery of images and the images viewed/manipulated inside a Web browser without need for any preinstalling software. The dynamic site page for medical images visualization and processing created by using JavaScript and HTML5 advancements. The XAMPP ‘apache server’ is used to create a local web server for testing and deployment of the dynamic site. The web-based viewer connected to multiples devices through local area network (LAN) to distribute the images inside healthcare facilities. The system offers a few focal points over ordinary picture archiving and communication systems (PACS): easy to introduce, maintain and independently platforms that allow images to display and manipulated efficiently, the system also user-friendly and easy to integrate with an existing system that have already been making use of web technologies. The wavelet-based image compression technique on which 2-D discrete wavelet transform used to decompose the image then wavelet coefficients are transmitted by entropy encoding after threshold to decrease transmission time, stockpiling cost and capacity. The performance of compression was estimated by using images quality metrics such as mean square error ‘MSE’, peak signal to noise ratio ‘PSNR’ and compression ratio ‘CR’ that achieved (83.86%) when ‘coif3’ wavelet filter is used.

Keywords: DICOM, discrete wavelet transform, PACS, HIS, LAN

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Authors: Navven Desai, Veena Soraganvi

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Heavy metals such as lead, cadmium and mercury do not have biological significance hence they are known to be extremely toxic heavy metals. Water contains various heavy metals like Cadmium (Cd), Chromium (Cr), Copper (Cu), Nickel (Ni), Arsenic (As), Lead (Pb), and Zinc (Zn) etc., when it gets polluted with industrial waste water. These heavy metals cause various health effects even at low concentration when consumed by humans. Most of the heavy metals are poisonous to living organisms. Heavy metals are non-degradable and are preserved in the environment through bioaccumulation. Therefore removal of heavy metals from water is necessary. In recent years, a great deal of attentions has been focused on to the application of nanosized metal oxides to treat heavy metals, especially titanium oxides, ferric oxides, manganese oxides, aluminium oxides and magnesium oxides as adsorbent and photocatalyst. TiO2 based photocatalysts have attracted continuously increasing attention because of the excellent properties such as high light -conversion efficiency, chemical stability, nontoxic nature, low cost. The catalyst displays high photocatalytic activity because of its large surface area. In this study, the photocatalytic degradation of Lead (Pb) from aqueous solution was investigated in natural sunlight by using TiO2 as Nanomaterial. This study was performed at laboratory scale. All the experiments were carried out in the batch process. The concentration of lead was constant (25mg/lit) in the experiment and effect of titanium dioxide dose and pH were varied to study the removal efficiency of the lead by adsorption. Further study was performed on the dependence of photocatalytic reaction on the reaction temperature. The aqueous solution was prepared by Lead metal powder. TiO2 photo catalyst nanopowder used was Sisco-74629 grade. The heavy metal is analyzed with VARIAN AA 240 atomic adsorption spectrophotometer. The study shows, with increasing TiO2 dose and pH the lead removal increases. According to study, it can be concluded that the utilization of titanium dioxide accounted for higher efficiency in the removal of lead from aqueous solution.

Keywords: adsorption, heavy metals, nanomaterial, photocatalysis

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Authors: Levicatus Mugenyi, Joaniter Nankabirwa, Emmanuel Arinaitwe, John Rek, Niel Hens, Moses Kamya, Grant Dorsey

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Background: Indoor residual spraying (IRS) reduces vector densities and malaria transmission, however, the most effective spraying intervals for IRS have not been well established. We aim to estimate the optimal timing interval for IRS using a modeling approach. Methods: We use a generalized additive model to estimate the optimal timing interval for IRS using the predicted malaria incidence. The model is applied to post IRS cohort clinical data from children aged 0.5–10 years in selected households in Tororo, historically a high malaria transmission setting in Uganda. Six rounds of IRS were implemented in Tororo during the study period (3 rounds with bendiocarb: December 2014 to December 2015, and 3 rounds with actellic: June 2016 to July 2018). Results: Monthly incidence of malaria from October 2014 to February 2019 decreased from 3.25 to 0.0 per person-years in the children under 5 years, and 1.57 to 0.0 for 5-10 year-olds. The optimal time interval for IRS differed between bendiocarb and actellic and by IRS round. It was estimated to be 17 and 40 weeks after the first round of bendiocarb and actellic, respectively. After the third round of actellic, 36 weeks was estimated to be optimal. However, we could not estimate from the data the optimal time after the second and third rounds of bendiocarb and after the second round of actellic. Conclusion: We conclude that to sustain the effect of IRS in a high-medium transmission setting, the second rounds of bendiocarb need to be applied roughly 17 weeks and actellic 40 weeks after the first round, and the timing differs for subsequent rounds. The amount of rainfall did not influence the trend in malaria incidence after IRS, as well as the IRS timing intervals. Our results suggest that shorter intervals for the IRS application can be more effective compared to the current practice, which is about 24 weeks for bendiocarb and 48 weeks for actellic. However, when considering our findings, one should account for the cost and drug resistance associated with IRS. We also recommend that the timing and incidence should be monitored in the future to improve these estimates.

Keywords: incidence, indoor residual spraying, generalized additive model, malaria

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Authors: Vasantha Gouri Prathapagiri

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Innovations in ICT sector facilitate qualitative life style for citizens across the globe. Countries that facilitate usage of new techniques in ICT, i.e., big data analytics find it easier to fulfil the needs of their citizens. Big data is characterised by its volume, variety, and speed. Analytics involves its processing in a cost effective way in order to draw conclusion for their useful application. Big data also involves into the field of machine learning, artificial intelligence all leading to accuracy in data presentation useful for public policy making. Hence using data analytics in public policy making is a proper way to march towards all round development of any country. The data driven insights can help the government to take important strategic decisions with regard to socio-economic development of her country. Developed nations like UK and USA are already far ahead on the path of digitization with the support of Big Data analytics. India is a huge country and is currently on the path of massive digitization being realised through Digital India Mission. Internet connection per household is on the rise every year. This transforms into a massive data set that has the potential to improvise the public services delivery system into an effective service mechanism for Indian citizens. In fact, when compared to developed nations, this capacity is being underutilized in India. This is particularly true for administrative system in rural areas. The present paper focuses on the need for big data analytics adaptation in Indian rural administration and its contribution towards development of the country on a faster pace. Results of the research focussed on the need for increasing awareness and serious capacity building of the government personnel working for rural development with regard to big data analytics and its utility for development of the country. Multiple public policies are framed and implemented for rural development yet the results are not as effective as they should be. Big data has a major role to play in this context as can assist in improving both policy making and implementation aiming at all round development of the country.

Keywords: Digital India Mission, public service delivery system, public policy, Indian administration

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Authors: Azad Hussain, Andrew Cobley

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The demand for lightweight parts with high mechanical strength(s) and integrity, in sectors such as the aerospace and automotive is ever increasing, motivated by the need for weight reduction in order to increase fuel efficiency with components usually manufactured using a high grade primary metal or alloy. For components manufactured using the squeeze casting process, this alloy is usually A356 aluminium (Al), it is one of the most versatile Al alloys; and is used extensively in castings for demanding environments. The A356 castings provide good strength to weight ratio making it an attractive option for components where strength has to be maintained, with the added advantage of weight reduction. In addition, the versatility in castabilitiy, weldability and corrosion resistance are other attributes that provide for the A356 cast alloy to be used in a large array of industrial applications. Conversely, it is rare to use remelted Al in these cases, due the nature of the applications of components in demanding environments, were material properties must be defined to meet certain specifications for example a known strength or ductility. However the use of remelted Al, especially primary grade Al such as A356, would offer significant cost and energy savings for manufacturers using primary alloys, provided that remelted aluminium can offer similar benefits in terms of material microstructure and mechanical properties. This study presents the results of the material microstructure and properties of 100% primary A356 Al and 100% remelt Al cast, manufactured via the direct squeeze cast method. The microstructures of the castings made from remelted A356 Al were then compared with the microstructures of primary A356 Al. The outcome of using remelting Al on the microstructure was examined via different analytical techniques, optical microscopy of polished and etched surfaces, and scanning electron microscopy. Microstructural analysis of the 100% remelted Al when compared with primary Al show similar α-Al phase, primary Al dendrites, particles and eutectic constituents. Mechanical testing of cast samples will elucidate further information as to the suitability of utilising 100% remelt for casting.

Keywords: A356, microstructure, remelt, squeeze casting

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Authors: Merfat Algethami, Anton Blencowe, Bryce Feltis, Stephen Best, Moshi Geso

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Nano-materials with high atomic number atoms have been demonstrated to enhance the effective radiation dose and thus potentially could improve therapeutic efficacy in radiotherapy. The optimal nanoparticulate agents require high X-ray absorption coefficients, low toxicity, and should be cost effective. The focus of our research is the development of a nanoparticle therapeutic agent that can be used in radiotherapy to provide optimal enhancement of the radiation effects on the target. In this study, we used bismuth (Bi) nanoparticles coated with starch and bismuth sulphide nanoparticles (Bi2S3) coated with polyvinylpyrrolidone (PVP). These NPs are of low toxicity and are one of the least expensive heavy metal-based nanoparticles. The aims of this study were to synthesise Bi2S3 and Bi NPs, and examine their cytotoxicity to human lung adenocarcinoma epithelial cells (A549). The dose enhancing effects of NPs on A549 cells were examined at both KV and MV energies. The preliminary results revealed that bismuth based nanoparticles show increased radio-sensitisation of cells, displaying dose enhancement with KV X-ray energies and to a lesser degree for the MV energies. We also observed that Bi NPs generated a greater dose enhancement effect than Bi2S3 NPs in irradiated A549 cells. The maximum Dose Enhancement Factor (DEF) was obtained at lower energy KV range when cells treated with Bi NPs (1.5) compared to the DEF of 1.2 when cells treated with Bi2S3NPs. Less radiation dose enhancement was observed when using high energy MV beam with higher DEF value of Bi NPs treatment (1.26) as compared to 1.06 DEF value with Bi2S3 NPs. The greater dose enhancement was achieved at KV energy range, due the effect of the photoelectric effect which is the dominant process of interaction of X-ray. The cytotoxic effect of Bi NPs on enhancing the X-ray dose was higher due to the higher amount of elemental Bismuth present in Bi NPs compared to Bi2S3 NPs. The results suggest that Bismuth based NPs can be considered as valuable dose enhancing agents when used in clinical applications.

Keywords: A549 lung cancer cells, Bi2S3 nanoparticles, dose enhancement effect, radio-sensitising agents

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Authors: Mohammad H. Yarmohammadian, Masoud Ferdosi, Abbas Haghshenas, Fatemeh Rezaei

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Surgical procedures aim at preserving human life and improving quality of their life. However, there are many potential risk sources that can cause serious harm to patients. For centuries, managers believed that technical competence of a surgeon is the only key to a successful surgery. But over the past decade, risks are considered in terms of process-based safety procedures, teamwork and inter departmental communication. Aims: This study aims to determine how the process- biased surgical risk management should be done in terms of project management tool named ABS (Activity Breakdown Structure). Settings and Design: This study was conducted in two stages. First, literature review and meeting with professors was done to determine principles and framework of surgical risk management. Next, responsible teams for surgical patient journey were involved in following meeting to develop the process- biased surgical risk management. Methods and Material: This study is a qualitative research in which focus groups with the inductive approach is used. Sampling was performed to achieve representativeness through intensity sampling biased on experience and seniority. Analysis Method used: context analysis of interviews and consensus themes extracted from FDG meetings discussion was the analysis tool. Results: we developed the patient journey process in 5 main phases, 24 activities and 108 tasks. Then, responsible teams, transposition and allocated places for performing determined. Some activities and tasks themes were repeated in each phases like patient identification and records review because of their importance. Conclusions: Risk management of surgical departments is significant as this facility is the hospital’s largest cost and revenue center. Good communication between surgical team and other clinical teams outside surgery department through process- biased perspective could improve safety of patient under this procedure.

Keywords: risk management, activity breakdown structure (ABS), surgical department, medical sciences

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