Search results for: high pressure reactor

Authors: Muhammad Rafiullah Khan, Vanee Chonhenchob

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The effect of sodium alginate (1%) based edible coating incorporated natural essential oils, thymol, carvone, and carvacrol as antimicrobial agents at different concentrations (0.1, 0.5, and 1.0%) on the quality changes of fresh-cut pineapple was investigated. Pineapple dipped in distilled water was served as control. After coating, the fruit was sealed in a modified atmosphere package (MAP) using high permeable film and stored at 5°C. Gas composition in package headspace, color values (L*, a*, b*, C*), TSS, pH, ethanol, browning, and microbial decay were monitored during storage. Oxygen concentration continuously decreased while carbon dioxide concentration inside all packages continuously increased over time. Color parameters (L*, b*, c*) decreased, and a* values increased during storage. All essential oils significantly (p ≤ 0.05) prevented microbial growth than control. A significantly higher (p ≤ 0.05) ethanol content was found in the control than in all other treatments. Visible microbial growth, high ethanol, and low color values limited the shelf life to 6 days in control as compared to 9 days in all other treatments. Among all essential oils, thymol at all concentrations maintained the overall quality of the pineapple and could potentially be used commercially in fresh fruit industries for longer storage.

Keywords: essential oils, antibrowning agents, antimicrobial agents, modified atmosphere packaging, microbial decay, pineapple

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Authors: Alina Rahim, Joanne Moffatt, Jessica Taylor, Joseph Hartland, Tamer Abdelrazik

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Background: In 2011, 15% of maternal deaths in Uganda were due to hypertensive disorders (pre-eclampsia and eclampsia). The majority of these deaths are avoidable with optimum antenatal care. The aim of the study was to evaluate how antenatal monitoring of pre-eclampsia was carried out in a low resource setting and to identify barriers to best practice as recommended by the World Health Organisation (WHO) as part of a 4th year medical student External Student Selected component field trip. Method: Women admitted to hospital with pre-eclampsia in rural Uganda (Villa Maria and Kitovu Hospitals) over a year-long period were identified using the maternity register and antenatal record book. It was not possible to obtain notes for all cases identified on the maternity register. Therefore a total of thirty sets of notes were reviewed. The management was recorded and compared to Ugandan National Guidelines and WHO recommendations. Additional qualitative information on routine practice was established by interviewing staff members from the obstetric and midwifery teams. Results: From the records available, all patients in this sample were managed according to WHO recommendations during labour. The rate of Caesarean section as a mode of delivery was noted to be high in this group of patients; 56% at Villa Maria and 46% at Kitovu. Antenatally two WHO recommendations were not routinely met: aspirin prophylaxis and calcium supplementation. This was due to lack of resources, and lack of attendance at antenatal clinic leading to poor detection of high-risk patients. Medical management of pre-eclampsia varied between individual patients, overall 93.3% complied with Ugandan national guidelines. Two patients were treated with diuretics, which is against WHO guidance. Discussion: Antenatal monitoring of pre-eclampsia is important in reducing severe morbidity, long-term disability and mortality amongst mothers and their babies 2 . Poor attendance at antenatal clinic is a barrier to healthcare in low-income countries. Increasing awareness of the importance of these visits for women should be encouraged. The majority of cases reviewed in this sample of women were treated according to Ugandan National Guidelines. It is recommended to commence the use of aspirin prophylaxis for women at high-risk of developing pre-eclampsia and the creation of detailed guidelines for Uganda which would allow for standardisation of care county-wide.

Keywords: antenatal monitoring, low resource setting, pre-eclampsia, Uganda

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Authors: Ali Shubbar, Hassnen M. Jafer, Anmar Dulaimi, William Atherton, Ali Al-Rifaie

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This research represents experimental work for investigation of the influence of utilising Ground Granulated Blast Furnace Slag (GGBS) and High Calcium Fly Ash (HCFA) as a partial replacement for Ordinary Portland Cement (OPC) and produce a low carbon cementitious material with comparable compressive strength to OPC. Firstly, GGBS was used as a partial replacement to OPC to produce a binary blended cementitious material (BBCM); the replacements were 0, 10, 15, 20, 25, 30, 35, 40, 45 and 50% by the dry mass of OPC. The optimum BBCM was mixed with HCFA to produce a ternary blended cementitious material (TBCM). The replacements were 0, 10, 15, 20, 25, 30, 35, 40, 45 and 50% by the dry mass of BBCM. The compressive strength at ages of 7 and 28 days was utilised for assessing the performance of the test specimens in comparison to the reference mixture using 100% OPC as a binder. The results showed that the optimum BBCM was the mix produced from 25% GGBS and 75% OPC with compressive strength of 32.2 MPa at the age of 28 days. In addition, the results of the TBCM have shown that the addition of 10, 15, 20 and 25% of HCFA to the optimum BBCM improved the compressive strength by 22.7, 11.3, 5.2 and 2.1% respectively at 28 days. However, the replacement of optimum BBCM with more than 25% HCFA have showed a gradual drop in the compressive strength in comparison to the control mix. TBCM with 25% HCFA was considered to be the optimum as it showed better compressive strength than the control mix and at the same time reduced the amount of cement to 56%. Reducing the cement content to 56% will contribute to decrease the cost of construction materials, provide better compressive strength and also reduce the CO₂ emissions into the atmosphere.

Keywords: cementitious material, compressive strength, GGBS, HCFA, OPC

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Authors: Abeer A. Aljohani

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COVID-19 virus spread has been one of the extreme pandemics across the globe. It is also referred to as coronavirus, which is a contagious disease that continuously mutates into numerous variants. Currently, the B.1.1.529 variant labeled as omicron is detected in South Africa. The huge spread of COVID-19 disease has affected several lives and has surged exceptional pressure on the healthcare systems worldwide. Also, everyday life and the global economy have been at stake. This research aims to predict COVID-19 disease in its initial stage to reduce the death count. Machine learning (ML) is nowadays used in almost every area. Numerous COVID-19 cases have produced a huge burden on the hospitals as well as health workers. To reduce this burden, this paper predicts COVID-19 disease is based on the symptoms and medical history of the patient. This research presents a unique architecture for COVID-19 detection using ML techniques integrated with feature dimensionality reduction. This paper uses a standard UCI dataset for predicting COVID-19 disease. This dataset comprises symptoms of 5434 patients. This paper also compares several supervised ML techniques to the presented architecture. The architecture has also utilized 10-fold cross validation process for generalization and the principal component analysis (PCA) technique for feature reduction. Standard parameters are used to evaluate the proposed architecture including F1-Score, precision, accuracy, recall, receiver operating characteristic (ROC), and area under curve (AUC). The results depict that decision tree, random forest, and neural networks outperform all other state-of-the-art ML techniques. This achieved result can help effectively in identifying COVID-19 infection cases.

Keywords: supervised machine learning, COVID-19 prediction, healthcare analytics, random forest, neural network

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Authors: Karthika Durairaj, Buvaneswari G., Gowdham M., Gilles M., Velmurugan G.

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Background: Hyperglycaemia is the primary cause of metabolic illness. Recently, researchers focused on the possibility that chemical exposure could promote metabolic disease. Hyperglycaemia causes a variety of metabolic diseases dependent on its etiologic conditions. According to animal and population-based research, individual chemical exposure causes health problems through alteration of endocrine function with the influence of microbial influence. We were intrigued by the function of gut microbiota variation in high fat and chemically induced hyperglycaemia. Methodology: C57/Bl6 mice were subjected to two different treatments to generate the etiologic-based diabetes model: I – a high-fat diet with a 45 kcal diet, and II - endocrine disrupting chemicals (EDCs) cocktail. The mice were monitored periodically for changes in body weight and fasting glucose. After 120 days of the experiment, blood anthropometry, faecal metagenomics and metabolomics were performed and analyzed through statistical analysis using one-way ANOVA and student’s t-test. Results: After 120 days of exposure, we found hyperglycaemic changes in both experimental models. The treatment groups also differed in terms of plasma lipid levels, creatinine, and hepatic markers. To determine the influence on glucose metabolism, microbial profiling and metabolite levels were significantly different between groups. The gene expression studies associated with glucose metabolism vary between hosts and their treatments. Conclusion: This research will result in the identification of biomarkers and molecular targets for better diabetes control and treatment.

Keywords: hyperglycaemia, endocrine-disrupting chemicals, gut microbiota, host metabolism

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Authors: Leonnel Mhuka

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Background: The field of photonics has witnessed substantial growth, with an increasing demand for miniaturized and high-performance optical components. Microstructured optical waveguides have gained significant attention due to their ability to confine and manipulate light at the subwavelength scale. Conventional fabrication methods, however, face limitations in achieving intricate and customizable waveguide structures. Two-photon polymerization (TPP) emerges as a promising additive manufacturing technique, enabling the fabrication of complex 3D microstructures with submicron resolution. Objectives: This experiment aimed to utilize two-photon polymerization to fabricate microstructured optical waveguides with precise control over geometry and dimensions. The objective was to demonstrate the feasibility of TPP as an additive manufacturing method for producing functional waveguide devices with enhanced performance. Methods: A femtosecond laser system operating at a wavelength of 800 nm was employed for two-photon polymerization. A custom-designed CAD model of the microstructured waveguide was converted into G-code, which guided the laser focus through a photosensitive polymer material. The waveguide structures were fabricated using a layer-by-layer approach, with each layer formed by localized polymerization induced by non-linear absorption of the laser light. Characterization of the fabricated waveguides included optical microscopy, scanning electron microscopy, and optical transmission measurements. The optical properties, such as mode confinement and propagation losses, were evaluated to assess the performance of the additive manufactured waveguides. Conclusion: The experiment successfully demonstrated the additive manufacturing of microstructured optical waveguides using two-photon polymerization. Optical microscopy and scanning electron microscopy revealed the intricate 3D structures with submicron resolution. The measured optical transmission indicated efficient light propagation through the fabricated waveguides. The waveguides exhibited well-defined mode confinement and relatively low propagation losses, showcasing the potential of TPP-based additive manufacturing for photonics applications. The experiment highlighted the advantages of TPP in achieving high-resolution, customized, and functional microstructured optical waveguides. Conclusion: his experiment substantiates the viability of two-photon polymerization as an innovative additive manufacturing technique for producing complex microstructured optical waveguides. The successful fabrication and characterization of these waveguides open doors to further advancements in the field of photonics, enabling the development of high-performance integrated optical devices for various applications

Keywords: Additive Manufacturing, Microstructured Optical Waveguides, Two-Photon Polymerization, Photonics Applications

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Authors: Regina R. Gunawan, Indwiani Astuti, H. Raden Danarto

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Cancer is the leading cause of death worldwide. Cancer is caused by mutations that alter the function of normal human genes and give rise to cancer genes. MicroRNA (miRNA) is a small non-coding RNA that regulates the gen through complementary bond towards mRNA target and cause mRNA degradation. miRNA works by either promoting or suppressing cell proliferation. miRNA level expression in cancer may offer another value of miRNA as a biomarker in cancer diagnostic. miRNA-21 is believed to have a role in carcinogenesis by enhancing proliferation, anti-apoptosis, cell cycle progression and invasion of tumor cells. Hsa-miR-21-5p marker has been identified in Prostate Cancer (PCa) and Benign Prostatic Hyperplasia (BPH) patient’s urine. This research planned to explore the diagnostic performance of miR-21 to differentiate PCa and BPH patients. In this study, urine samples were collected from 20 PCa patients and 20 BPH patients. miR-21 relative expression against the reference gene was analyzed and compared between the two. miRNA expression was analyzed using the comparative quantification method to find the fold change. miR-21 validity in identifying PCa patients was performed by quantifying the sensitivity and specificity with the contingency table. miR-21 relative expression against miR-16 in PCa patient and in BPH patient has 12,98 differences in fold change. From a contingency table of Cq expression of miR-21 in identifying PCa patients from BPH patient, Cq miR-21 has 100% sensitivity and 75% specificity. miR-21 relative expression can be used in discriminating PCa from BPH by using a urine sample. Furthermore, the expression of miR-21 has higher sensitivity compared to PSA (Prostate specific antigen), therefore miR-21 has a high potential to be analyzed and developed more.

Keywords: benign prostate hyperplasia, biomarker, miRNA-21, prostate cancer

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Authors: Glykeria A. Visvini, George N. Mathioudakis, Amaia Soto Beobide, Aris E. Giannakas, George A. Voyiatzis

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Polymeric nanocomposites have generated considerable interest in both academic research and industry because their properties can be tailored by adjusting the type & concentration of nano-inclusions, resulting in complementary and adaptable characteristics. The exceptional and/or unique properties of the nanocomposites, including the high mechanical strength and stiffness, the ease of processing, and their lightweight nature, are attributed to the high surface area, the electrical and/or thermal conductivity of the nano-fillers, which make them appealing materials for a wide range of engineering applications. Polymeric «breathable» membranes enabling water vapor permeability (WVP) can be designed either by using micro/nano-fillers with the ability to interrupt the continuity of the polymer phase generating micro/nano-porous structures or/and by creating micro/nano-pores into the composite material by uniaxial/biaxial stretching. Among the nanofillers, carbon nanotubes (CNTs) exhibit particular high WVP and for this reason, they have already been proposed for gas separation membranes. In a similar context, they could prove to be promising alternative/complementary filler nano-materials, for the development of "breathable" products. Polypropylene (PP) is a commonly utilized thermoplastic polymer matrix in the development of composite films, due to its easy processability and low price, combined with its good chemical & physical properties. PP is known to present several crystalline phases (α, β and γ), depending on the applied treatment process, which have a significant impact on its final properties, particularly in terms of WVP. Specifically, the development of the β-phase in PP in combination with stretching is anticipated to modify the crystalline behavior and extend the microporosity of the polymer matrix exhibiting enhanced WVP. The primary objective of this study is to develop breathable nano-carbon based (functionalized MWCNTs) PP composite membranes, potentially also avoiding the stretching process. This proposed alternative is expected to have a better performance/cost ratio over current stretched PP/CaCO3 composite benchmark membranes. The focus is to investigate the impact of both β-nucleator(s) and nano-carbon fillers on water vapor transmission rate properties of relevant PP nanocomposites.

Keywords: carbon nanotubes, nanocomposites, nucleating agents, polypropylene, water vapor permeability

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Authors: Martin Cai, Khadijah B. Hashim, Leng Leo, Edmund F. Tian

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Analysis of traditional Chinese medicinal (TCM) supplements has always been a laborious task, particularly in the case of multi‐ingredient formulations. Traditionally, herbal extracts are analysed using one or few markers compounds. In the recent years, however, pharmaceutical companies are introducing health supplements of TCM active ingredients to cater to the needs of consumers in the fast-paced society in this age. As such, new problems arise in the aspects of composition identification as well as quality analysis. In most cases of products or supplements formulated with multiple TCM herbs, the chemical composition, and nature of each raw material differs greatly from the others in the formulation. This results in a requirement for individual analytical processes in order to identify the marker compounds in the various botanicals. Thin-layer Chromatography (TLC) is a simple, cost effective, yet well-regarded method for the analysis of natural products, both as a Pharmacopeia-approved method for identification and authentication of herbs, and a great analytical tool for the discovery of chemical compositions in herbal extracts. Recent technical advances introduced High-Performance TLC (HPTLC) where, with the help of automated equipment and improvements on the chromatographic materials, both the quality and reproducibility are greatly improved, allowing for highly standardised analysis with greater details. Here we report an industrial consultancy project with ONI Global Pte Ltd for the analysis of LAC Liver Protector, a TCM formulation aimed at improving liver health. The aim of this study was to identify 4 key components of the supplement using HPTLC, following protocols derived from Chinese Pharmacopeia standards. By comparing the TLC profiles of the supplement to the extracts of the herbs reported in the label, this project proposes a simple and cost-effective analysis of the presence of the 4 marker compounds in the multi‐ingredient formulation by using 4 different HPTLC methods. With the increasing trend of small and medium-sized enterprises (SMEs) bringing natural products and health supplements into the market, it is crucial that the qualities of both raw materials and end products be well-assured for the protection of consumers. With the technology of HPTLC, science can be incorporated to help SMEs with their quality control, thereby ensuring product quality.

Keywords: traditional Chinese medicine supplement, high performance thin layer chromatography, active ingredients, product quality

Procedia PDF Downloads 262

Authors: Patricia Girrbach

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Currently, our society is facing a new and incremental upheaval technological revolution named digitalization. In order to face the relating challenges organizations have to be prepared. They need appropriate circumstances in order to cope with current issues concerning digital transformation processes. Nowadays digitalization emerged as top issues for companies and business leaders. In this context, it is a pressure on companies to have a positive, productive digital culture. And indeed, Organizations realize that they need to address this important issue. In this context 87 percent of organizations quote culture and engagement as one of their top challenges in terms of any change process, but especially in terms of the digital turn. Executives can give their company a competitive advantage and attract top talent by having a strong workplace culture that supports digitalization. Many current studies attest that fact. Digital-oriented companies can hire more easily, they have the lowest voluntary turnover rates, deliver better customer service, and are more profitable over the long run. Based on this background it is important to provide companies starting points and practical measurements how to reach this goal. The major findings are that firms need to make sense out of digitalization. In this context, they should focus on internal but also on external stakeholders. Furthermore, they should create certain working conditions and they should support the qualification of employees, e.g. by Virtual Reality. These measurements can create positive experiences in terms of digitalization in order to ensure the support of stuff in terms of the digital turn. Based on several current studies and literature research this paper provides concrete measurements for companies in order to enable the digital turn. Therefore, the aim of this paper is providing possible practical starting points which support both the education of employees by digitalization as well as the digital turn itself within the organization.

Keywords: digitalization, industry 4.0, education 4.0, virtual reality

Procedia PDF Downloads 143

Authors: Youssef R. Hassan, Mohamed S. Hasanin, Reda M. Abdelhameed

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Recently, innovations in packaging security features become more important to see the originality of packaging in industrial application. Luminescent 3d printing materials have been a promising property which can provides a unique opportunity for the design and application of 3D printing. Lack emission of terbium ions, as a source of green emission, in salt form prevent its uses in industrial applications, so searching about stable and highly emitter material become essential. Nowadays, metal organic frameworks (MOFs) play an important role in designing light emitter material. In this work, fluorescent high density polyethylene (FHDPE) composite filament with Tb-benzene 1,3,5-tricarboxylate (Tb-BTC) MOFs for 3D printing have been successfully developed.HDPE pellets were mixed with Tb-BTC and melting extrustion with single screw extruders. It was found that Tb-BTCuniformly dispersed in the HDPE matrix and significantly increased the crystallinity of PE, which not only maintained the good thermal property but also improved the mechanical properties of Tb-BTC@HDPE composites. Notably, the composite filaments emitted ultra-bright green light under UV lamp, and the fluorescence intensity increased as the content of Tb-BTC increased. Finally, several brightly luminescent exquisite articles could be manufactured by fused deposition modeling (FDM) 3D printer with these new fluorescent filaments. In this context, the development of novel fluorescent Tb-BTC@HDPE composites was combined with 3D printing technology to amplified the packaging Security Features.

Keywords: 3D printing, fluorescent, packaging, security

Procedia PDF Downloads 82

Authors: Vikas S. Minchekar

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The eyewitness is a crucial source of evidence in the criminal judicial system. However, rely on the reminiscence of an eyewitness especially intoxicated eyewitness is not always judicious. It might lead to some serious consequences. Day by day, alcohol-related crimes or the criminal incidences in bars, nightclubs, and restaurants are increasing rapidly. Tackling such cases is very complicated to any investigation officers. The people in that incidents are violated due to the alcohol consumption hence, their ability to identify the suspects or recall these phenomena is affected. The studies on the effects of alcohol consumption on motor activities such as driving and surgeries have received much attention. However, the effect of alcohol intoxication on memory has received little attention from the psychology, law, forensic and criminology scholars across the world. In the Indian context, the published articles on this issue are equal to none up to present day. This field experiment investigation aimed at to finding out the effect of alcohol consumption on identification accuracy in lineups. Forty adult, social drinkers, and twenty sober adults were randomly recruited for the study. The sober adults were assigned into 'placebo' beverage group while social drinkers were divided into two group e. g. 'low dose' of alcohol (0.2 g/kg) and 'high dose' of alcohol (0.8 g/kg). The social drinkers were divided in such a way that their level of blood-alcohol concentration (BAC) will become different. After administering the beverages for the placebo group and liquor to the social drinkers for 40 to 50 minutes of the period, the five-minute video clip of mock crime is shown to all in a group of four to five members. After the exposure of video, clip subjects were given 10 portraits and asked them to recognize whether they are involved in mock crime or not. Moreover, they were also asked to describe the incident. The subjects were given two opportunities to recognize the portraits and to describe the events; the first opportunity is given immediately after the video clip and the second was 24 hours later. The obtained data were analyzed by one-way ANOVA and Scheffe’s posthoc multiple comparison tests. The results indicated that the 'high dose' group is remarkably different from the 'placebo' and 'low dose' groups. But, the 'placebo' and 'low dose' groups are equally performed. The subjects in a 'high dose' group recognized only 20% faces correctly while the subjects in a 'placebo' and 'low dose' groups are recognized 90 %. This study implied that the intoxicated witnesses are less accurate to recognize the suspects and also less capable of describing the incidents where crime has taken place. Moreover, this study does not assert that intoxicated eyewitness is generally less trustworthy than their sober counterparts.

Keywords: intoxicated eyewitness, memory, social drinkers, lineups

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Authors: Mohammad Ansari, Ahmed Ismail, Satinder Mann

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Overcrowding in Emergency departments (ED) of United Kingdom has become a common problem. Urgent Care centres were developed nearly a decade ago to reduce pressure on EDs. Unfortunately, the development of Urgent Care centres has failed to produce the projected effects. It was thought that nearly 40% patients attending ED would go to Urgent Care centres and these would be staffed by Primary care Physicians. Data reveals that no more than 20% patients were seen by Primary Care Physicians even when the Urgent Care Centre was based in the ED. This study was carried out at the ED of George Eliot Hospital, Nuneaton, UK where the Urgent Care centre was based in the ED and employed Primary Care Physicians with special interest in trauma for nearly one year. This was then followed by a Primary Care Physician and Advanced Nurse Practitioner. We compared the number of patients seen during these periods and the cost-effectiveness of the service.We randomly selected a week of patients seen by Primary Care Physicians with special interest in Trauma and by Primary Care Physicians and the Advanced Nurse Practitioner. We compared the number and type of patients seen during these two periods. Nearly 38% patients were seen by Primary care Physician with special interest in Trauma, whilst only 14.3% patients were seen by the Primary care Physician and Advanced Nurse Practitioner. The Primary Care Physicians with special interest in trauma were paid less. Our study confirmed that unless Primary Care Physicians are able to treat minor trauma and interpret x-rays, the urgent care service is not going to be cost effective. Numerous previous studies have shown that 15 to 20% patients attending ED can be treated by Primary Care Physicians who do not require any investigations for their management. It is advantageous to have Urgent Care Centres within the ED because if the patient deteriorates they can be transferred to ED. We recommend that the Urgent care Centres should be a part of ED. Our study shows that Urgent care Centres in the ED can be helpful and cost effective if staffed by either senior Emergency Physicians or Primary Care Physicians with special interest and experience in the management of minor trauma.

Keywords: urgent care centres, primary care physician, advanced nurse practitioner, trauma

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Authors: Reham H. Soliman, Noha Noufal, Howayda AbdelAal

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Calcium/calmodulin-dependent serine protein kinase (CASK) belongs to the membrane-associated guanylate kinase (MAGUK) family and has been proposed as a mediator of cell-cell adhesion and proliferation, which can contribute to tumorogenesis. CASK has been linked as a good prognostic factor with some tumor subtypes, while considered as a poor prognostic marker in others. To our knowledge, no sufficient evidence of CASK role in colorectal cancer is available. The aim of this study is to evaluate the expression of Calcium/calmodulin-dependent serine protein kinase (CASK) in non-mucinous colorectal adenocarcinoma and adenomatous polyps as precursor lesions and assess its prognostic significance. The study included 42 cases of conventional colorectal adenocarcinoma and 15 biopsies of adenomatous polyps with variable degrees of dysplasia. They were reviewed for clinicopathological prognostic factors and stained by CASK; mouse, monoclonal antibody using heat-induced antigen retrieval immunohistochemical techniques. The results showed that CASK protein was significantly overexpressed (p <0.05) in CRC compared with adenoma samples. The CASK protein was overexpressed in the majority of CRC samples with 85.7% of cases showing moderate to strong expression, while 46.7% of adenomas were positive. CASK overexpression was significantly correlated with both TNM stage and grade of differentiation (p <0.05). There was a significantly higher expression in tumor samples with early stages (I/II) rather than advanced stage (III/IV) and with low grade (59.5%) rather than high grade (40.5%). Another interesting finding was found among the adenomas group, where the stronger intensity of staining was observed in samples with high grade dysplasia (33.3%) than those of lower grades (13.3%). In conclusion, this study shows that there is significant overexpression of CASK protein in CRC as well as in adenomas with high grade dysplasia. This indicates that CASK is involved in the process of carcinogenesis and functions as a potential trigger of the adenoma-carcinoma cascade. CASK was significantly overexpressed in early stage and low-grade tumors rather than tumors with advanced stage and higher histological grades. This suggests that CASK protein is a good prognostic factor. We suggest that CASK affects CRC in two different ways derived from its physiology. CASK as part of MAGUK family can stimulate proliferation and through its cell membrane localization and as a mediator of cell-cell adhesion might contribute in tumor confinement and localization.

Keywords: CASK, colorectal cancer, overexpression, prognosis

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Authors: Shannon Clayton

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In an effort to explore the potential transformation of North American postwar suburbs, this M.Arch thesis actively engages in the ongoing critique of modernism from the mid 20th century to the present. Contemporary urban design practice has emerged out of the reaction to orthodox modernism. Typically, new suburban development falls into one of two strategies; an attempt to replicate pre-war fabric that never existed, or a reliance on high-density to create instant urbanism. In both cases, the critical role of architecture has been grossly undervalued. Ironically, it is the denial of suburbia’s inherent modernity that has served to prevent genuine place-making. As history demonstrates, modernism is not antithetical to architecture and place. In the postwar years, a critical discussion emerged amongst architects, which sought to evolve modernism beyond functionalism. This was demonstrated through critical discussions on image, experience, and monumentality. As well as increased interest in civic space, and investigations into mat urbanism and the megastructure. The undercurrent within these explorations was a belief that the scale and complexity of modern development could become an opportunity to create urbanism, rather than squander it. This critical discourse has continued through architectural work in the Netherlands and Denmark since the early 1990s, where an emphasis on visual variety, human scale, and public interaction has been given high priority. This thesis applies principles from this ongoing dialogue, and identifies hidden potential within existing North American suburban networks. As a result, the project re-evaluates the legacy of the master plan from a contemporary perspective.

Keywords: urbanism, modernism, suburbia, place-making

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Authors: Elvira Lumi, Hans Jazxhi

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In the works of the writer Flutura Açka, the play with these questions is acute, and in almost each of them, the act of loneliness and isolation builds in a completely involuntary way unique and frequent conceptual spaces. Because the object of study is too broad to grasp all the works, this study lays out a rapid paradox of our access to three of the novels in the line of numerous authorial works. The novel "Woman Loneliness" (2001), also marked as the first work in prose by the author, declares in the title the paradigm of what she has decided to confess. The gender segregation proclaimed in the title will be revealed step by step in the work as conventional human segregation without gender. In this novel, the analysis of the state of "loneliness" will require a contemplation beyond man, when the role of the environment and the distance from the center of the narrative base will be extremely visible in the work. The novel "Cross of Oblivion" (2004) has another form of perception of loneliness, which, unlike the one built by the characters themselves in the novel "Woman Loneliness," is imposed and obligatory to live by the circumstances. Its characters are trapped in loneliness, as loneliness that comes from impossibility, from the past, from dependence on fate, from fear of change, and from the obligation to accept it. At the heart of the novel, the plot of the novel game is dictated by the Kanun and its rules and the loneliness of the basis of life in unbroken waves towards the periphery of the event, a periphery that has very large geography and is played in today's Europe. The novel "Where are you?" (2009) has a completely different form of constructing the concept of loneliness and isolation that comes under conditions of repression and political pressure. The loneliness in this novel takes the form of the protective element from the circumstances that actually require a social inclusion; it is personal loneliness that ensures relative mental health of the characters, up to a new trap created by the circumstances, thus building life fragmentary “healthy” in the order of a mentally ill and socially ill society.

Keywords: loneliness, existential, isolation, woman, prose

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Authors: Priscila Vitorino, Jeeziane Rezende, Edison Pereira, Adrielly Silva, Weimar Barroso

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Body composition insight during physical activity is relevant to follow up sports income since it can be important and actuate in velocity, resistance, potency, and has an effect on force and agility. The purpose of this study was to identify anthropometric profile, evaluate and correlate body mass index and bioimpedance behavior during the days of Caminhada Ecológica de Goiás - Brasil. A longitudinal study was performed with 25 male participants, with an average age of 45.6±9.1 years. All patients were actives. Body composition was evaluated by body mass index (BMI) measurement and bioimpedance procedures. Both were collected 20 days before walking beginning (A0) and in the four days along the same (A1, A2, A3 e A4). Data were collected in the end of each walking day at athletes accommodations. Final distance during walking route was 308 km in five days, with an average of 62km/day and 7,6 km/hour, and an average temperature of 30°C. Data are represented with mean and standard deviation. ANOVA (Bonferroni pos test) was used to compare frequent measurements between the days. Pearson's correlation test was used to correlate BMI with lean mass, fat mass, and water. BMI decreased from A0 to A1, A2 and A3 (p < 0,01) and increased on A4 (p < 0,01). No changes were observed concerning fat percentage (p=0,60), lean mass (p=0,10) and body water composition (p=0,09). A positive and moderate correlation between BMI and fat percentage was observed; an inverse and moderate correlation between BMI, lean mass and body water composition occurred. Total body mass increased during high intensity and long term walking distance. However, the values of body fat, lean mass and water were maintained.

Keywords: aerobic exercise, body composition, metabolism, sports

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Authors: Sawarni Hasibuan, Juliza Hidayati

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Competitiveness and sustainability issues not only put pressure on big companies, but also small and medium enterprises (SMEs). SMEs Batik Bogor is one of the local culture-based creative industries in Bogor city which is also dealing with the issue of sustainability. The purpose of this research is to develop framework of sustainability at SMEs Batik Indonesia case of SMEs Batik Bogor by integrating innovation of cleaner production in its supply chain. The approach used is desk study, field survey, in-depth interviews, and benchmarking best practices of SMEs sustainability. In-depth interviews involve stakeholders to identify the needs and standards of sustainability of SMEs Batik. Data analysis was done by benchmarking method, Multi Dimension Scaling (MDS) method, and Strength, Weakness, Opportunity, Threat (SWOT) analysis. The results recommend the framework of sustainability for SMEs Batik in Indonesia. The sustainability status of SMEs Batik Bogor is classified as Moderate Sustainable. Factors that support the sustainability of SMEs Batik Bogor such is a strong commitment of top management in adopting cleaner production innovation and creativity approach. Successful cleaner production innovations are implemented primarily in the substitution of dye materials from toxic to non-toxic, reducing the intensity of non-renewable energy use, as well as the reuse and recycle of solid waste. “Mosaic Batik” is one of the innovations of solid waste utilization of batik waste produced by company R&D center that gives benefit to three pillars of sustainability, that is financial benefit, environmental benefit, and social benefit. The sustainability of SMEs Batik Bogor cannot be separated from the support of Bogor City Government which proactively facilitates the promotion of sustainable innovation produced by SMEs Batik Bogor.

Keywords: cleaner production innovation, creativity, SMEs Batik, sustainability supply chain

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Authors: Ramkumar R., Gaurav Shinde, Pratik Shroff, Sachin Kumar Jain, Nagesh Walke

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Advancements in electric vehicles have significantly reduced the powertrain noise and moving components of vehicles. As a result, in-cab noises have become more noticeable to passengers inside the car. To ensure a comfortable ride for drivers and other passengers, it has become crucial to eliminate undesirable component noises during the development phase. Standard practices are followed to identify the severity of noises based on subjective ratings, but it can be a tedious process to identify the severity of each development sample and make changes to reduce it. Additionally, the severity rating can vary from jury to jury, making it challenging to arrive at a definitive conclusion. To address this, an automotive component was identified to evaluate squeak and rattle noise issue. Physical tests were carried out for random and sine excitation profiles. Aim was to subjectively assess the noise using jury rating method and objectively evaluate the same by measuring the noise. Suitable jury evaluation method was selected for the said activity, and recorded sounds were replayed for jury rating. Objective data sound quality metrics viz., loudness, sharpness, roughness, fluctuation strength and overall Sound Pressure Level (SPL) were measured. Based on this, correlation co-efficients was established to identify the most relevant sound quality metrics that are contributing to particular identified noise issue. Regression analysis was then performed to establish the correlation between subjective and objective data. Mathematical model was prepared using artificial intelligence and machine learning algorithm. The developed model was able to predict the subjective rating with good accuracy.

Keywords: BSR, noise, correlation, regression

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Authors: Eko Adhi Setiawan, Duli Asih Siregar, Aiman Setiawan

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Solar energy is abundant in nature, particularly in the tropics which have peak sun hour that can reach 8 hours per day. In the fabrication process, Photovoltaic’s (PV) performance are tested in standard test conditions (STC). It specifies a module temperature of 25°C, an irradiance of 1000 W/ m² with an air mass 1.5 (AM1.5) spectrum and zero wind speed. Thus, the results of the performance testing of PV at STC conditions cannot fully represent the performance of PV in the tropics. For example Indonesia, which has a temperature of 20-40°C. In this paper, the effect of temperature on the choice of the 5 kW AC inverter topology on the PV system such as the Central Inverter, String Inverter and AC-Module specifically for the tropics will be discussed. The proper inverter topology can be determined by analysis of the effect of temperature and irradiation on the PV panel. The effect of temperature and irradiation will be represented in the characteristics of I-V and P-V curves. PV’s characteristics on high temperature would be analyzed using Solar panel modeling through MATLAB Simulink based on mathematical equations that form Solar panel’s characteristic curve. Based on PV simulation, it is known then that temperature coefficients of short circuit current (ISC), open circuit voltage (VOC), and maximum output power (PMAX) consecutively as high as 0.56%/oC, -0.31%/oC and -0.4%/oC. Those coefficients can be used to calculate PV’s electrical parameters such as ISC, VOC, and PMAX in certain earth’s surface’s certain point. Then, from the parameters, the utility of the 5 kW AC inverter system can be determined. As the result, for tropical area, string inverter topology has the highest utility rates with 98, 80 %. On the other hand, central inverter and AC-Module Topology has utility rates of 92.69 % and 87.7 % eventually.

Keywords: Photovoltaic, PV-Inverter Configuration, PV Modeling, Solar Panel Characteristics.

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Authors: Shantanu Prakash, Suruchi Shukla, Amita Jain

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Introduction: The hepatitis C virus (HCV) is a major public health problem and a leading cause of chronic liver disease. Injection drug use and individuals receiving blood and blood products are the primary modes of HCV transmission. Our study aims to establish the prevalent genotypes/ subtypes of HCV circulating in Uttar Pradesh, North India, as reported from a tertiary care hospital. Methods: It is a retrospective observational analysis of consecutive 404 HCV RNA positive cases referred to our hospital during September 2014 to April 2017. The study was approved by an institutional ethics committee. Written informed consent was taken from each participant. Clinical and demographic details of these patients were recorded using predesigned questionnaires. All the laboratory testing was carried on stored serum sample of enrolled cases. Genotyping of all 404 strains was done by Sanger’s sequencing of the core region. The phylogenetic analysis of 179 HCV strains with high -quality sequencing data was performed. Results: The distribution of prevalent genotypes/ subtypes as noted in the present study was; Genotype (GT)1a [n-101(25%)], GT1b [n-12(2.9%)], GT1c [1(0.25%)], GT3a [275(68.07%)], GT3b [9(2.2%)], GT3g [2(0.49%)], GT3i [3(0.74%)], and GT4a [1(0.24%)]. HCV genotypes GT2, GT5 and GT6 were not detected from our region. Sequence analysis showed high genotypic variability in HCV GT3. Phylogenetic analysis showed that HCV GT3 and GT1 circulating in our region were related to Indian strains reported earlier. Conclusions: HCV genotypes 3a and 1a are commonest circulating genotypes in Uttar Pradesh (UP), India.

Keywords: Hepatitis C virus, genetic variation, bioinformatics, genotype, HCV

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Authors: M. L. Moyo

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Concerns about climate change, food productivity, and the ever-increasing cost of commercial fertilizer products is forcing have spurred interest in the production of alternatives or substitutes for commercial fertilizer products. In this study, the potential of pyrolytic tire char (PT-char) to improve soil productivity was investigated. The use of carbonized biomass, which is commonly termed biochar or biofertilizer and exhibits similar properties to PT-char in agriculture is not new, with historical evidence pointing to the use of charcoal for soil improvement by indigenous Amazon people for several centuries. Due to minimal market value or use of PT-char, huge quantities are currently stockpiled in South Africa. This successively reduces revenue and decreases investments in waste tire recycling efforts as PT-char constitutes 40 % weight of the total waste tire pyrolysis products. The physicochemical analysis results reported in this study showed that PT-char contains a low concentration of essential plant elements (P and K) and, therefore, cannot be used for increasing nutrient availability in soils. A low presence of heavy metals (Ni, Pb, and Cd), which may be harmful to the environment at high application rates was also observed. In addition, the results revealed that PT-char contains very high levels of Zn, a widely known phytotoxicity causing agents in plants. However, the study also illustrated that PT-char is made up of a highly aromatic and condensed carbon structure. PT-char is therefore highly stable, less prone to microbial degradation, and has a low chemical reactivity in soils. Considering these characteristics, PT-char meets the requirements for use as a carbon sequestration agent, which may be useful in mitigating climate change.

Keywords: agriculture, carbon sequestration, physicochemical analysis, pyrolytic tire char, soil amendment.

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Authors: Trunal Bhujangrao, Catherine Froustey, Fernando Veiga, Philippe Darnis, Franck Girot Mata

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The understanding of the material behavior under shear loading has great importance for a researcher in manufacturing processes like cutting, machining, milling, turning, friction stir welding, etc. where the material experiences large deformation at high temperature. For such material behavior analysis, hot shear tests provide a useful means to investigate the evolution of the microstructure at a wide range of temperature and to improve the material behavior model. Shear tests can be performed by direct shear loading (e.g. torsion of thin-walled tubular samples), or appropriate specimen design to convert a tensile or compressive load into shear (e.g. simple shear tests). The simple shear tests are straightforward and designed to obtained very large deformation. However, many of these shear tests are concerned only with the elastic response of the material. It is becoming increasingly important to capture a plastic response of the material. Plastic deformation is significantly more complex and is known to depend more heavily on the strain rate, temperature, deformation, etc. Besides, there is not enough work is done on high-temperature shear loading, because of geometrical instability occurred during the plastic deformation. The aim of this study is to design a new shear tensile specimen geometry to convert the tensile load into dominant shear loading under plastic deformation. Design of the specimen geometry is based on FEM. The material used in this paper is AA7075 alloy, tested quasi statically under elevated temperature. Finally, the microstructural changes taking place during

Keywords: AA7075 alloy, dynamic recrystallization, edge effect, large strain, shear tensile test

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Authors: Nnadi Ezekiel Oluwaseun Ejiofor

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The foundation of this study is the identification of risk variables and their implications on abandoned construction projects in Nigeria. The study's particular goals are to pinpoint the risk factors that lead to the abandonment of public building projects in Nigeria. This study used a hybrid research design that included case studies and descriptive survey research methods. Professionals who work directly in the built environment and are employed by Ministries and Departmental Agencies (MDAs), the public sector, or the private sector are the study's target demographic. This study used a descriptive survey and case study research design to gather data. Nigeria is experiencing a high rate of project abandonment due to housing deficit issues. Factors contributing to this include The study reveals factors contributing to public project abandonment in Abuja FCT include poor cashflow 4.96, inconsistent government policies 4.89, lack of accountability, high corruption, incompetent contractors, non-availability of building materials, lack of utilities, wrong materials, infrastructural facilities, poor planning, and undefined contracts. The study reveals that abandoned projects have a huge impact on the construction industry, such as wastage of resources with a mean value of 3.35, distrust of economic growth, 3.28, and so on. The study found a significant relationship between risk factors and public building construction in Abuja through a T-test value of 0.037, rejecting the null hypothesis and indicating a positive correlation.

Keywords: cost, tetfund, construction projects, public university

Procedia PDF Downloads 35

Authors: Gayatri Ghosh

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In this work, a flavour theory of a neutrino mass model based on A_4 symmetry is considered to explain the phenomenology of neutrino mixing. The spontaneous symmetry breaking of A_4 symmetry in this model leads to tribimaximal mixing in the neutrino sector at a leading order. We consider the effect of Z_2 × Z_2 invariant perturbations in neutrino sector and find the allowed region of correction terms in the perturbation matrix that is consistent with 3σ ranges of the experimental values of the mixing angles. We study the entanglement of this formalism on the other phenomenological observables, such as δ_CP phase, the neutrino oscillation probability P(νµ → νe), the effective Majorana mass |mee| and |meff νe |. A Z_2 × Z_2 invariant perturbations in this model is introduced in the neutrino sector which leads to testable predictions of θ_13 and CP violation. By changing the magnitudes of perturbations in neutrino sector, one can generate viable values of δ_CP and neutrino oscillation parameters. Next we investigate the feasibility of charged lepton flavour violation in type-I seesaw models with leptonic flavour symmetries at high energy that leads to tribimaximal neutrino mixing. We consider an effective theory with an A_4 × Z_2 × Z_2 symmetry, which after spontaneous symmetry breaking at high scale which is much higher than the electroweak scale leads to charged lepton flavour violation processes once the heavy Majorana neutrino mass degeneracy is lifted either by renormalization group effects or by a soft breaking of the A_4 symmetry. In this context the implications for charged lepton flavour violation processes like µ → eγ, τ → eγ, τ → µγ are discussed.

Keywords: Z2 × Z2 invariant perturbations, CLFV, delta CP phase, tribimaximal neutrino mixing

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Authors: Erfan Niazi, Marianne Fenech

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Red Blood Cells (RBCs) or erythrocytes tend to form chain-like aggregates under low shear rate called rouleaux. This is a reversible process and rouleaux disaggregate in high shear rates. Therefore, RBCs aggregation occurs in the microcirculation where low shear rates are present but does not occur under normal physiological conditions in large arteries. Numerical modeling of RBCs interactions is fundamental in analytical models of a blood flow in microcirculation. Population Balance Modeling (PBM) is particularly useful for studying problems where particles agglomerate and break in a two phase flow systems to find flow characteristics. In this method, the elementary particles lose their individual identity due to continuous destructions and recreations by break-up and agglomeration. The aim of this study is to find RBCs aggregation in a dynamic situation. Simplified PBM was used previously to find the aggregation rate on a static observation of the RBCs aggregation in a drop of blood under the microscope. To find aggregation rate in a dynamic situation we propose an experimental set up testing RBCs sedimentation. In this test, RBCs interact and aggregate to form rouleaux. In this configuration, disaggregation can be neglected due to low shear stress. A high-speed camera is used to acquire video-microscopic pictures of the process. The sizes of the aggregates and velocity of sedimentation are extracted using an image processing techniques. Based on the data collection from 5 healthy human blood samples, the aggregation rate was estimated as 2.7x10³(±0.3 x10³) 1/s.

Keywords: red blood cell, rouleaux, microfluidics, image processing, population balance modeling

Procedia PDF Downloads 341

Authors: Ala’a H. Al-Muhtaseb, Farrukh Jamil, Sandeep K. Saxena

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The fast growth rate of energy consumption along with world population expected to demand 50% more energy by 2030 than nowadays. At present, the energy demand is mostly provided by limited fossil fuel sources such as oil, natural gas, and coal that are resulting in dramatic increase in CO2 emissions from combustion of fossil fuels. The growth of the biodiesel industry over the last decade has resulted in a price drop because glycerol is obtained as a by-product during transesterification of vegetable oil or animal fats, which accounts for one tenth of every gallon of biodiesel produced. The production of oxygenates from glycerol gains much importance due to the excellent diesel-blending property of the oxygenates that not only improve the quality of the fuel but also increases the overall yield of the biodiesel in helping to meet the target for energy production from renewable sources for transport in the energy utilization directives. The reaction of bio-glycerol with bio-acetone was carried out in a magnetically stirred two necked round bottom flaskS. Condensation of bio-glycerol with acetone in the presence of various modified forms of beta zeolite has been done for synthesizing solketal (AB-2 modified with nitric acid, AB-3 modified with oxalic acid). Among all modified forms of beta zeolite, AB-2 showed the best performance for maximum glycerol conversion 94.26 % with 94.21 % solketal selectivity and minimum acetal formation 0.05 %. The physiochemical properties of parent beta zeolite and all its modified forms were analyzed by XRD, SEM, TEM, BET, FTIR and TPD. It has been revealed that AB-2 catalysts with high pore volume and surface area gave high glycerol conversion with maximum solketal selectivity. Despite this, the crystallinity of AB-3 was lower than AB-2 which helps to provide the shorter path length for reactants and product but due high pore volume AB-2 was preferred which gave maximum bio-glycerol conversion. Temperature does matter the glycerol conversion and selectivity of solketal, as it increases from 40 ºC to 60 ºC the conversion of glycerol rises from 80.04 % to 94.26 % and selectivity of solketal from 80.0 % to 94.21 % but further increase in temperature to 100 ºC glycerol conversion reduced to 93.06 % and solketal selectivity to 92.08 %. AB-2 was found to be highly stable as up to 4 repeated experimental runs there was less than 10% decrease in its activity. This process offers an attractive route for converting bio-glycerol, the main by-product of biodiesel to solketal with bio-acetone; a value-added green product with potential industrial applications as a valuable green fuel additive or combustion promoter for gasoline/diesel engines.

Keywords: beta-zeolite, bio-glycerol, catalyst, solketal

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Authors: Mohammed A. Al-Yafrsi, Fahed A. Al-Mana

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A study was conducted to evaluate the compaction-tolerance ability of some warm season turfgrasses under shade and sunlight conditions in Riyadh, Saudi Arabia. Hybrid bermudagrass (Cynodon dactylon): 'Tifway' and 'Tifsport', seashore paspalum (Paspalum vaginatum) and its cultivar 'Sea Isle 2000' were used. The study area was divided into two sections where one was exposed to sunlight and the other one was maintained under shade using green plastic grille (shade 70%). Turfgrasses were planted by sods in beds containing a mixture of sand, silt, and peat moss (4: 1: 1, v/v). The soil compaction was applied using a locally-made cylindrical roll (weighing 250 kg), passing four times over the growing turfgrasses for 3 days/week. The results revealed that compaction treatment led to a decrease in grass height, and it was the lowest (4.0 cm) for paspalum 'Sea Isle 2000' in February. At the shaded area, paspalum turfgrasses retained its high quality degree (4.0) in April, May, and June. In the sunlight area, the grass quality degree was the greatest (4.0) in 'Sea Isle 2000' and the lowest (3.0) in 'Tifsport'. Paspalum turfgrasses gave higher color degree (4) than bermuda grasses (2.5) in April, May, and June. The compaction also led to a decline in leaf area, fresh and dry weights of all grown turfgrasses. The grass density was high for paspalum turfgrasses indicating that their resistance to compaction was greater than bermudagrasses. It can be concluded that the best compaction and shade tolerant turfgrasses are 'Sea Isle 2000' and seashore paspalum.

Keywords: hybrid bermudagrass, seashore paspalum, soil compaction, shade area, sunlight condition

Procedia PDF Downloads 105

Authors: Mohammed Islam, Jungyong Wang, Dong Cheol Seo

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The Smoothed Particle Hydrodynamics (SPH) method is a novel, meshless, and Lagrangian technique based numerical method that has shown promises to accurately predict the hydrodynamics of water and structure interactions in violent flow conditions. The main goal of this study is to build confidence on the versatility of the Smoothed Particle Hydrodynamics (SPH) based tool, to use it as a complementary tool to the physical model testing capabilities and support research need for the performance evaluation of ships and offshore platforms exposed to an extreme and harsh environment. In the current endeavor, an open-sourced SPH-based tool was used and validated for modeling and predictions of the hydrodynamic interactions of a 6-DOF ship and bergy bits. The study involved the modeling of a modern generic drillship and simplified bergy bits in floating and towing scenarios and in regular and irregular wave conditions. The predictions were validated using the model-scale measurements on a moored ship towed at multiple oblique angles approaching a floating bergy bit in waves. Overall, this study results in a thorough comparison between the model scale measurements and the prediction outcomes from the SPH tool for performance and accuracy. The SPH predicted ship motions and forces were primarily within ±5% of the measurements. The velocity and pressure distribution and wave characteristics over the free surface depicts realistic interactions of the wave, ship, and the bergy bit. This work identifies and presents several challenges in preparing the input file, particularly while defining the mass properties of complex geometry, the computational requirements, and the post-processing of the outcomes.

Keywords: SPH, ship and bergy bit, hydrodynamic interactions, model validation, physical model testing

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Authors: A. Abubakar, A. Parsa, S. Walker

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Despite advances made in the diagnosis and management of drug-sensitive tuberculosis (TB) over the past decades, treatment of multidrug-resistant tuberculosis (MDR-TB) remains challenging and complex particularly in high burden countries including Nigeria. Treatment of MDR-TB is cost-prohibitive with success rate generally lower compared to drug-sensitive TB and if care is not taken it may become the dominant form of TB in future with many treatment uncertainties and substantial morbidity and mortality. Addressing these challenges requires collaborative efforts thorough sustained researches to evaluate the current treatment guidelines, particularly in high burden countries and prevent progression of resistance. To our best knowledge, there has been no research exploring the acceptability, effectiveness, and cost-effectiveness of community-based-MDR-TB treatment model in Nigeria, which is among the high burden countries. The previous similar qualitative study looks at the home-based management of MDR-TB in rural Uganda. This research aimed to explore patient’s views and acceptability of community-based-MDR-TB treatment model and to evaluate and compare the effectiveness and cost-effectiveness of community-based versus hospital-based MDR-TB treatment model of care from the Nigerian perspective. Knowledge of patient’s views and acceptability of community-based-MDR-TB treatment approach would help in designing future treatment recommendations and in health policymaking. Accordingly, knowledge of effectiveness and cost-effectiveness are part of the evidence needed to inform a decision about whether and how to scale up MDR-TB treatment, particularly in a poor resource setting with limited knowledge of TB. Mixed methods using qualitative and quantitative approach were employed. Qualitative data were obtained using in-depth semi-structured interviews with 21 MDR-TB patients in Nigeria to explore their views and acceptability of community-based MDR-TB treatment model. Qualitative data collection followed an iterative process which allowed adaptation of topic guides until data saturation. In-depth interviews were analyzed using thematic analysis. Quantitative data on treatment outcomes were obtained from medical records of MDR-TB patients to determine the effectiveness and direct and indirect costs were obtained from the patients using validated questionnaire and health system costs from the donor agencies to determine the cost-effectiveness difference between community and hospital-based model from the Nigerian perspective. Findings: Some themes have emerged from the patient’s perspectives indicating preference and high acceptability of community-based-MDR-TB treatment model by the patients and mixed feelings about the risk of MDR-TB transmission within the community due to poor infection control. The result of the modeling from the quantitative data is still on course. Community-based MDR-TB care was seen as the acceptable and most preferred model of care by the majority of the participants because of its convenience which in turn enhanced recovery, enables social interaction and offer more psychosocial benefits as well as averted productivity loss. However, there is a need to strengthen this model of care thorough enhanced strategies that ensure guidelines compliance and infection control in order to prevent the progression of resistance and curtail community transmission.

Keywords: acceptability, cost-effectiveness, multidrug-resistant TB treatment, community and hospital approach

Procedia PDF Downloads 111