Search results for: negative Poisson's ratio
Commenced in January 2007
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Paper Count: 8959

Search results for: negative Poisson's ratio

679 Comparative Vector Susceptibility for Dengue Virus and Their Co-Infection in A. aegypti and A. albopictus

Authors: Monika Soni, Chandra Bhattacharya, Siraj Ahmed Ahmed, Prafulla Dutta

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Dengue is now a globally important arboviral disease. Extensive vector surveillance has already established A.aegypti as a primary vector, but A.albopictus is now accelerating the situation through gradual adaptation to human surroundings. Global destabilization and gradual climatic shift with rising in temperature have significantly expanded the geographic range of these species These versatile vectors also host Chikungunya, Zika, and yellow fever virus. Biggest challenge faced by endemic countries now is upsurge in co-infection reported with multiple serotypes and virus co-circulation. To foster vector control interventions and mitigate disease burden, there is surge for knowledge on vector susceptibility and viral tolerance in response to multiple infections. To address our understanding on transmission dynamics and reproductive fitness, both the vectors were exposed to single and dual combinations of all four dengue serotypes by artificial feeding and followed up to third generation. Artificial feeding observed significant difference in feeding rate for both the species where A.albopictus was poor artificial feeder (35-50%) compared to A.aegypti (95-97%) Robust sequential screening of viral antigen in mosquitoes was followed by Dengue NS1 ELISA, RT-PCR and Quantitative PCR. To observe viral dissemination in different mosquito tissues Indirect immunofluorescence assay was performed. Result showed that both the vectors were infected initially with all dengue(1-4)serotypes and its co-infection (D1 and D2, D1 and D3, D1 and D4, D2 and D4) combinations. In case of DENV-2 there was significant difference in the peak titer observed at 16th day post infection. But when exposed to dual infections A.aegypti supported all combinations of virus where A.albopictus only continued single infections in successive days. There was a significant negative effect on the fecundity and fertility of both the vectors compared to control (PANOVA < 0.001). In case of dengue 2 infected mosquito, fecundity in parent generation was significantly higher (PBonferroni < 0.001) for A.albopicus compare to A.aegypti but there was a complete loss of fecundity from second to third generation for A.albopictus. It was observed that A.aegypti becomes infected with multiple serotypes frequently even at low viral titres compared to A.albopictus. Possible reason for this could be the presence of wolbachia infection in A.albopictus or mosquito innate immune response, small RNA interference etc. Based on the observations it could be anticipated that transovarial transmission may not be an important phenomenon for clinical disease outcome, due to the absence of viral positivity by third generation. Also, Dengue NS1 ELISA can be used for preliminary viral detection in mosquitoes as more than 90% of the samples were found positive compared to RT-PCR and viral load estimation.

Keywords: co-infection, dengue, reproductive fitness, viral quantification

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678 The Valuable Triad of Adipokine Indices to Differentiate Pediatric Obesity from Metabolic Syndrome: Chemerin, Progranulin, Vaspin

Authors: Mustafa M. Donma, Orkide Donma

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Obesity is associated with cardiovascular disease risk factors and metabolic syndrome (MetS). In this study, associations between adipokines and adipokine as well as obesity indices were evaluated. Plasma adipokine levels may exhibit variations according to body adipose tissue mass. Besides, upon consideration of obesity as an inflammatory disease, adipokines may play some roles in this process. The ratios of proinflammatory adipokines to adiponectin may act as highly sensitive indicators of body adipokine status. The aim of the study is to present some adipokine indices, which are thought to be helpful for the evaluation of childhood obesity and also to determine the best discriminators in the diagnosis of MetS. 80 prepubertal children (aged between 6-9.5 years) included in the study were divided into three groups; 30 children with normal weight (NW), 25 morbid obese (MO) children and 25 MO children with MetS. Physical examinations were performed. Written informed consent forms were obtained from the parents. The study protocol was approved by Ethics Committee of Namik Kemal University Medical Faculty. Anthropometric measurements, such as weight, height, waist circumference (C), hip C, head C, neck C were recorded. Values for body mass index (BMI), diagnostic obesity notation model assessment Index-II (D2 index) as well as waist-to-hip, head-to-neck ratios were calculated. Adiponectin, resistin, leptin, chemerin, vaspin, progranulin assays were performed by ELISA. Adipokine-to-adiponectin ratios were obtained. SPSS Version 20 was used for the evaluation of data. p values ≤ 0.05 were accepted as statistically significant. Values of BMI and D2 index, waist-to-hip, head-to-neck ratios did not differ between MO and MetS groups (p ≥ 0.05). Except progranulin (p ≤ 0.01), similar patterns were observed for plasma levels of each adipokine. There was not any difference in vaspin as well as resistin levels between NW and MO groups. Significantly increased leptin-to-adiponectin, chemerin-to-adiponectin and vaspin-to-adiponectin values were noted in MO in comparison with those of NW. The most valuable adipokine index was progranulin-to-adiponectin (p ≤ 0.01). This index was strongly correlated with vaspin-to-adiponectin ratio in all groups (p ≤ 0.05). There was no correlation between vaspin-to-adiponectin and chemerin-to--adiponectin in NW group. However, a correlation existed in MO group (r = 0.486; p ≤ 0.05). Much stronger correlation (r = 0.609; p ≤ 0.01) was observed in MetS group between these two adipokine indices. No correlations were detected between vaspin and progranulin as well as vaspin and chemerin levels. Correlation analyses showed a unique profile confined to MetS children. Adiponectin was found to be correlated with waist-to-hip (r = -0.435; p ≤ 0.05) as well as head-to-neck (r = 0.541; p ≤ 0.05) ratios only in MetS children. In this study, it has been investigated if adipokine indices have priority over adipokine levels. In conclusion, vaspin-to-adiponectin, progranulin-to-adiponectin, chemerin-to-adiponectin along with waist-to-hip and head-to-neck ratios were the optimal combinations. Adiponectin, waist-to-hip, head-to-neck, vaspin-to-adiponectin, chemerin-to-adiponectin ratios had appropriate discriminatory capability for MetS children.

Keywords: adipokine indices, metabolic syndrome, obesity indices, pediatric obesity

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677 The Neuropsychology of Obsessive Compulsion Disorder

Authors: Mia Bahar, Özlem Bozkurt

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Obsessive-compulsive disorder (OCD) is a typical, persistent, and long-lasting mental health condition in which a person experiences uncontrollable, recurrent thoughts (or "obsessions") and/or activities (or "compulsions") that they feel compelled to engage in repeatedly. Obsessive-compulsive disorder is both underdiagnosed and undertreated. It frequently manifests in a variety of medical settings and is persistent, expensive, and burdensome. Obsessive-compulsive neurosis was long believed to be a condition that offered valuable insight into the inner workings of the unconscious mind. Obsessive-compulsive disorder is now recognized as a prime example of a neuropsychiatric condition susceptible to particular pharmacotherapeutic and psychotherapy therapies and mediated by pathology in particular neural circuits. An obsessive-compulsive disorder which is called OCD, usually has two components, one cognitive and the other behavioral, although either can occur alone. Obsessions are often repetitive and intrusive thoughts that invade consciousness. These obsessions are incredibly hard to control or dismiss. People who have OCD often engage in rituals to reduce anxiety associated with intrusive thoughts. Once the ritual is formed, the person may feel extreme relief and be free from anxiety until the thoughts of contamination intrude once again. These thoughts are strengthened through a manifestation of negative reinforcement because they allow the person to avoid anxiety and obscurity. These thoughts are described as autogenous, meaning they most likely come from nowhere. These unwelcome thoughts are related to actions which we can describe as Thought Action Fusion. The thought becomes equated with an action, such as if they refuse to perform the ritual, something bad might happen, and so people perform the ritual to escape the intrusive thought. In almost all cases of OCD, the person's life gets extremely disturbed by compulsions and obsessions. Studies show OCD is an estimated 1.1% prevalence, making it a challenging issue with high co-morbidities with other issues like depressive episodes, panic disorders, and specific phobias. The first to reveal brain anomalies in OCD were numerous CT investigations, although the results were inconsistent. A few studies have focused on the orbitofrontal cortex (OFC), anterior cingulate gyrus (AC), and thalamus, structures also implicated in the pathophysiology of OCD by functional neuroimaging studies, but few have found consistent results. However, some studies have found abnormalities in the basal ganglion. There have also been some discussions that OCD might be genetic. OCD has been linked to families in studies of family aggregation, and findings from twin studies show that this relationship is somewhat influenced by genetic variables. Some Research has shown that OCD is a heritable, polygenic condition that can result from de novo harmful mutations as well as common and unusual variants. Numerous studies have also presented solid evidence in favor of a significant additive genetic component to OCD risk, with distinct OCD symptom dimensions showing both common and individual genetic risks.

Keywords: compulsions, obsessions, neuropsychiatric, genetic

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676 Blunt Abdominal Trauma Management in Adult Patients: An Investigation on Safety of Discharging Patients with Normal Initial Findings

Authors: Rahimi-Movaghar Vafa, Mansouri Pejman, Chardoli Mojtaba, Rezvani Samina

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Introduction: Blunt abdominal trauma is one of the leading causes of morbidity and mortality in all age groups, but diagnosis of serious intra-abdominal pathology is difficult and most of the damages are obscure in the initial investigation. There is still controversy about which patients should undergo abdomen/pelvis CT, which patients needs more observation and which patients can be discharged safely The aim of this study was to determine that is it safe to discharge patients with blunt abdominal trauma with normal initial findings. Methods: This non-randomized cross-sectional study was conducted from September 2013 to September 2014 at two levels I trauma centers, Sina hospital and Rasoul-e-Akram hospital (Tehran, Iran). Our inclusion criteria were all patients were admitted for suspicious BAT and our exclusion criteria were patients that have serious head and neck, chest, spine and limb injuries which need surgical intervention, those who have unstable vital signs, pregnant women with a gestational age over 3 months and homeless or without exact home address. 390 patients with blunt trauma abdomen examined and the necessary data, including demographic data, the abdominal examination, FAST result, patients’ lab test results (hematocrit, base deficit, urine analysis) on admission and at 6 and 12 hours after admission were recorded. Patients with normal physical examination, laboratory tests and FAST were discharged from the ED during 12 hours with the explanation of the alarm signs and were followed up after 24 hours and 1 week by a telephone call. Patients with abnormal findings in physical examination, laboratory tests, and FAST underwent abdomino-pelvic CT scan. Results: The study included 390 patients with blunt abdominal trauma between 12 and 80 years of age (mean age, 37.0 ± 13.7 years) and the mean duration of hospitalization in patients was 7.4 ± 4.1 hours. 88.6% of the patients were discharged from hospital before 12 hours. Odds ratio (OR) for having any symptoms for discharge after 6 hours was 0.160 and after 12 hours was 0.117 hours, which is statistically significant. Among the variables age, systolic and diastolic blood pressure, heart rate, respiratory rate, hematocrit and base deficit at admission, 6 hours and 12 hours after admission showed no significant statistical relationship with discharge time. From our 390 patients, 190 patients have normal initial physical examination, lab data and FAST findings that didn’t show any signs or symptoms in their next assessment and in their follow up by the phone call. Conclusion: It is recommended that patients with no symptoms at admission (completely normal physical examination, ultrasound, normal hematocrit and normal base deficit and lack of microscopic hematuria) and good family and social status can be safely discharged from the emergency department.

Keywords: blunt abdominal trauma, patient discharge, emergency department, FAST

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675 Synthesis of Methanol through Photocatalytic Conversion of CO₂: A Green Chemistry Approach

Authors: Sankha Chakrabortty, Biswajit Ruj, Parimal Pal

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Methanol is one of the most important chemical products and intermediates. It can be used as a solvent, intermediate or raw material for a number of higher valued products, fuels or additives. From the last one decay, the total global demand of methanol has increased drastically which forces the scientists to produce a large amount of methanol from a renewable source to meet the global demand with a sustainable way. Different types of non-renewable based raw materials have been used for the synthesis of methanol on a large scale which makes the process unsustainable. In this circumstances, photocatalytic conversion of CO₂ into methanol under solar/UV excitation becomes a viable approach to give a sustainable production approach which not only meets the environmental crisis by recycling CO₂ to fuels but also reduces CO₂ amount from the atmosphere. Development of such sustainable production approach for CO₂ conversion into methanol still remains a major challenge in the current research comparing with conventional energy expensive processes. In this backdrop, the development of environmentally friendly materials, like photocatalyst has taken a great perspective for methanol synthesis. Scientists in this field are always concerned about finding an improved photocatalyst to enhance the photocatalytic performance. Graphene-based hybrid and composite materials with improved properties could be a better nanomaterial for the selective conversion of CO₂ to methanol under visible light (solar energy) or UV light. The present invention relates to synthesis an improved heterogeneous graphene-based photocatalyst with improved catalytic activity and surface area. Graphene with enhanced surface area is used as coupled material of copper-loaded titanium oxide to improve the electron capture and transport properties which substantially increase the photoinduced charge transfer and extend the lifetime of photogenerated charge carriers. A fast reduction method through H₂ purging has been adopted to synthesis improved graphene whereas ultrasonication based sol-gel method has been applied for the preparation of graphene coupled copper loaded titanium oxide with some enhanced properties. Prepared photocatalysts were exhaustively characterized using different characterization techniques. Effects of catalyst dose, CO₂ flow rate, reaction temperature and stirring time on the efficacy of the system in terms of methanol yield and productivity have been studied in the present study. The study shown that the newly synthesized photocatalyst with an enhanced surface resulting in a sustained productivity and yield of methanol 0.14 g/Lh, and 0.04 g/gcat respectively, after 3 h of illumination under UV (250W) at an optimum catalyst dosage of 10 g/L having 1:2:3 (Graphene: TiO₂: Cu) weight ratio.

Keywords: renewable energy, CO₂ capture, photocatalytic conversion, methanol

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674 Acoustic Energy Harvesting Using Polyvinylidene Fluoride (PVDF) and PVDF-ZnO Piezoelectric Polymer

Authors: S. M. Giripunje, Mohit Kumar

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Acoustic energy that exists in our everyday life and environment have been overlooked as a green energy that can be extracted, generated, and consumed without any significant negative impact to the environment. The harvested energy can be used to enable new technology like wireless sensor networks. Technological developments in the realization of truly autonomous MEMS devices and energy storage systems have made acoustic energy harvesting (AEH) an increasingly viable technology. AEH is the process of converting high and continuous acoustic waves from the environment into electrical energy by using an acoustic transducer or resonator. AEH is not popular as other types of energy harvesting methods since sound waves have lower energy density and such energy can only be harvested in very noisy environment. However, the energy requirements for certain applications are also correspondingly low and also there is a necessity to observe the noise to reduce noise pollution. So the ability to reclaim acoustic energy and store it in a usable electrical form enables a novel means of supplying power to relatively low power devices. A quarter-wavelength straight-tube acoustic resonator as an acoustic energy harvester is introduced with polyvinylidene fluoride (PVDF) and PVDF doped with ZnO nanoparticles, piezoelectric cantilever beams placed inside the resonator. When the resonator is excited by an incident acoustic wave at its first acoustic eigen frequency, an amplified acoustic resonant standing wave is developed inside the resonator. The acoustic pressure gradient of the amplified standing wave then drives the vibration motion of the PVDF piezoelectric beams, generating electricity due to the direct piezoelectric effect. In order to maximize the amount of the harvested energy, each PVDF and PVDF-ZnO piezoelectric beam has been designed to have the same structural eigen frequency as the acoustic eigen frequency of the resonator. With a single PVDF beam placed inside the resonator, the harvested voltage and power become the maximum near the resonator tube open inlet where the largest acoustic pressure gradient vibrates the PVDF beam. As the beam is moved to the resonator tube closed end, the voltage and power gradually decrease due to the decreased acoustic pressure gradient. Multiple piezoelectric beams PVDF and PVDF-ZnO have been placed inside the resonator with two different configurations: the aligned and zigzag configurations. With the zigzag configuration which has the more open path for acoustic air particle motions, the significant increases in the harvested voltage and power have been observed. Due to the interruption of acoustic air particle motion caused by the beams, it is found that placing PVDF beams near the closed tube end is not beneficial. The total output voltage of the piezoelectric beams increases linearly as the incident sound pressure increases. This study therefore reveals that the proposed technique used to harvest sound wave energy has great potential of converting free energy into useful energy.

Keywords: acoustic energy, acoustic resonator, energy harvester, eigenfrequency, polyvinylidene fluoride (PVDF)

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673 Collaboration between Grower and Research Organisations as a Mechanism to Improve Water Efficiency in Irrigated Agriculture

Authors: Sarah J. C. Slabbert

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The uptake of research as part of the diffusion or adoption of innovation by practitioners, whether individuals or organisations, has been a popular topic in agricultural development studies for many decades. In the classical, linear model of innovation theory, the innovation originates from an expert source such as a state-supported research organisation or academic institution. The changing context of agriculture led to the development of the agricultural innovation systems model, which recognizes innovation as a complex interaction between individuals and organisations, which include private industry and collective action organisations. In terms of this model, an innovation can be developed and adopted without any input or intervention from a state or parastatal research organisation. This evolution in the diffusion of agricultural innovation has put forward new challenges for state or parastatal research organisations, which have to demonstrate the impact of their research to the legislature or a regulatory authority: Unless the organisation and the research it produces cross the knowledge paths of the intended audience, there will be no awareness, no uptake and certainly no impact. It is therefore critical for such a research organisation to base its communication strategy on a thorough understanding of the knowledge needs, information sources and knowledge networks of the intended target audience. In 2016, the South African Water Research Commission (WRC) commissioned a study to investigate the knowledge needs, information sources and knowledge networks of Water User Associations and commercial irrigators with the aim of improving uptake of its research on efficient water use in irrigation. The first phase of the study comprised face-to-face interviews with the CEOs and Board Chairs of four Water User Associations along the Orange River in South Africa, and 36 commercial irrigation farmers from the same four irrigation schemes. Intermediaries who act as knowledge conduits to the Water User Associations and the irrigators were identified and 20 of them were subsequently interviewed telephonically. The study found that irrigators interact regularly with grower organisations such as SATI (South African Table Grape Industry) and SAPPA (South African Pecan Nut Association) and that they perceive these organisations as credible, trustworthy and reliable, within their limitations. State and parastatal research institutions, on the other hand, are associated with a range of negative attributes. As a result, the awareness of, and interest in, the WRC and its research on water use efficiency in irrigated agriculture are low. The findings suggest that a communication strategy that involves collaboration with these grower organisations would empower the WRC to participate much more efficiently and with greater impact in agricultural innovation networks. The paper will elaborate on the findings and discuss partnering frameworks and opportunities to manage perceptions and uptake.

Keywords: agricultural innovation systems, communication strategy, diffusion of innovation, irrigated agriculture, knowledge paths, research organisations, target audiences, water use efficiency

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672 Commissioning, Test and Characterization of Low-Tar Biomass Gasifier for Rural Applications and Small-Scale Plant

Authors: M. Mashiur Rahman, Ulrik Birk Henriksen, Jesper Ahrenfeldt, Maria Puig Arnavat

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Using biomass gasification to make producer gas is one of the promising sustainable energy options available for small scale plant and rural applications for power and electricity. Tar content in producer gas is the main problem if it is used directly as a fuel. A low-tar biomass (LTB) gasifier of approximately 30 kW capacity has been developed to solve this. Moving bed gasifier with internal recirculation of pyrolysis gas has been the basic principle of the LTB gasifier. The gasifier focuses on the concept of mixing the pyrolysis gases with gasifying air and burning the mixture in separate combustion chamber. Five tests were carried out with the use of wood pellets and wood chips separately, with moisture content of 9-34%. The LTB gasifier offers excellent opportunities for handling extremely low-tar in the producer gas. The gasifiers producer gas had an extremely low tar content of 21.2 mg/Nm³ (avg.) and an average lower heating value (LHV) of 4.69 MJ/Nm³. Tar content found in different tests in the ranges of 10.6-29.8 mg/Nm³. This low tar content makes the producer gas suitable for direct use in internal combustion engine. Using mass and energy balances, the average gasifier capacity and cold gas efficiency (CGE) observed 23.1 kW and 82.7% for wood chips, and 33.1 kW and 60.5% for wood pellets, respectively. Average heat loss in term of higher heating value (HHV) observed 3.2% of thermal input for wood chips and 1% for wood pellets, where heat loss was found 1% of thermal input in term of enthalpy. Thus, the LTB gasifier performs better compared to typical gasifiers in term of heat loss. Equivalence ratio (ER) in the range of 0.29 to 0.41 gives better performance in terms of heating value and CGE. The specific gas production yields at the above ER range were in the range of 2.1-3.2 Nm³/kg. Heating value and CGE changes proportionally with the producer gas yield. The average gas compositions (H₂-19%, CO-19%, CO₂-10%, CH₄-0.7% and N₂-51%) obtained for wood chips are higher than the typical producer gas composition. Again, the temperature profile of the LTB gasifier observed relatively low temperature compared to typical moving bed gasifier. The average partial oxidation zone temperature of 970°C observed for wood chips. The use of separate combustor in the partial oxidation zone substantially lowers the bed temperature to 750°C. During the test, the engine was started and operated completely with the producer gas. The engine operated well on the produced gas, and no deposits were observed in the engine afterwards. Part of the producer gas flow was used for engine operation, and corresponding electrical power was found to be 1.5 kW continuously, and maximum power of 2.5 kW was also observed, while maximum generator capacity is 3 kW. A thermodynamic equilibrium model is good agreement with the experimental results and correctly predicts the equilibrium bed temperature, gas composition, LHV of the producer gas and ER with the experimental data, when the heat loss of 4% of the energy input is considered.

Keywords: biomass gasification, low-tar biomass gasifier, tar elimination, engine, deposits, condensate

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671 Agri-Tourism as a Sustainable Adaptation Option for Climate Change Impacts on Small Scale Agricultural Sector

Authors: Rohana Pandukabhya Mahaliyanaarachchi, Maheshwari Sangeetha Elapatha, Mohamed Esham, Banagala Chathurika Maduwanthi

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The global climate change has become one of the imperative issues for the smallholder dominated agricultural sector and nature based tourism sector in Sri Lanka. Thus addressing this issue is notably important. The main objective of this study was to investigate the potential of agri-tourism as a sustainable adaptation option to mitigate some of the negative impacts of climate change in small scale agricultural sector in Sri Lanka. The study was carried out in two different climatic zones in Sri Lanka namely Low Country Dry Zone and Up Country Wet Zone. A case study strategy followed by structured and unstructured interviewers through cross-sectional surveys were adapted to collect data. The study revealed that there had been a significant change in the climate in regard to the rainfall patterns in both climatic zones resulting unexpected rains during months and longer drought periods. This results the damages of agricultural production, low yields and subsequently low income. However, to mitigate these adverse effects, farmers have mainly focused on using strategies related to the crops and farming patterns rather than diversifying their business by adopting other entrepreneurial activities like agri-tourism. One of the major precursor for this was due to lesser awareness on the concept of agri-tourism within the farming community. The study revealed that the respondents of both climatic zones do have willingness and potential to adopt agri-tourism. One key important factor identified was that farming or agriculture was the main livelihood of the respondents, which is one of the vital precursor needed to start up an agri-tourism enterprise. Most of the farmers in the Up Country Wet Zone had an inclination to start a farm guest house or a farm home stay whereas the farmers in the Low Country Dry Zone wish to operate farm guest house, farm home stay or farm restaurant. They also have an interest to open up a road side farm product stall to facilitate the direct sales of the farm. Majority of the farmers in both climatic zones showed an interest to initiate an agri-tourism business as a complementary enterprise where they wished to give an equal share to both farming and agri-tourism. Thus this revealed that the farmers have identified agri-tourism as a vital concept and have given the equal importance as given to farming. This shows that most of the farmers have understood agri-tourism as an alternative income source that can mitigate the adverse effects of climatic change. This study emphasizes that agri-tourism as an alternative income source that can mitigate the adverse effects of climatic change on small scale agriculture sector.

Keywords: adaptation, agri-tourism, climate change, small scale agriculture

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670 Health Literacy: Collaboration between Clinician and Patient

Authors: Cathy Basterfield

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Issue: To engage in one’s own health care, health professionals need to be aware of an individual’s specific skills and abilities for best communication. One of the most discussed is health literacy. One of the assumed skills and abilities for adults is an individuals’ health literacy. Background: A review of publicly available health content appears to assume all adult readers will have a broad and full capacity to read at a high level of literacy, often at a post-school education level. Health information writers and clinicians need to recognise one critical area for why there may be little or no change in a person’s behaviour, or no-shows to appointments. Perhaps unintentionally, they are miscommunicating with the majority of the adult population. Health information contains many literacy domains. It usually includes technical medical terms or jargon. Many fact sheets and other information require scientific literacy with or without specific numerical literacy. It may include graphs, percentages, timing, distance, or weights. Each additional word or concept in these domains decreases the readers' ability to meaningfully read, understand and know what to do with the information. An attempt to begin to read the heading where long or unfamiliar words are used will reduce the readers' motivation to attempt to read. Critically people who have low literacy are overwhelmed when pages are covered with lots of words. People attending a health environment may be unwell or anxious about a diagnosis. These make it harder to read, understand and know what to do with the information. But access to health information must consider an even wider range of adults, including those with poor school attainment, migrants, and refugees. It is also homeless people, people with mental health illnesses, or people who are ageing. People with low literacy also may include people with lifelong disabilities, people with acquired disabilities, people who read English as a second (or third) language, people who are Deaf, or people who are vision impaired. Outcome: This paper will discuss Easy English, which is developed for adults. It uses the audiences’ everyday words, short sentences, short words, and no jargon. It uses concrete language and concrete, specific images to support the text. It has been developed in Australia since the mid-2000s. This paper will showcase various projects in the health domain which use Easy English to improve the understanding and functional use of written information for the large numbers of adults in our communities who do not have the health literacy to manage a range of day to day reading tasks. See examples from consent forms, fact sheets and choice options, instructions, and other functional documents, where Easy English has been developed. This paper will ask individuals to reflect on their own work practice and consider what written information must be available in Easy English. It does not matter how cutting-edge a new treatment is; when adults can not read or understand what it is about and the positive and negative outcomes, they are less likely to be engaged in their own health journey.

Keywords: health literacy, inclusion, Easy English, communication

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669 The Influence of Newest Generation Butyrate Combined with Acids, Medium Chain Fatty Acids and Plant Extract on the Performance and Physiological State of Laying Hens

Authors: Vilma Sasyte, Vilma Viliene, Asta Raceviciute-Stupeliene, Agila Dauksiene, Romas Gruzauskas, Virginijus Slausgalvis, Jamal Al-Saifi

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The aim of the present study was to investigate the effect of butyrate, acids, medium-chain fatty acids and plant extract mixture on performance, blood and gastrointestinal tract characteristics of laying hens’. For the period of 8 weeks, 24 Hisex Brown laying hens were randomly assigned to 2 dietary treatments: 1) control wheat-corn-soybean meal based diet (Control group), 2) control diet supplemented with the mixture of butyrate, acids, medium chain fatty acids and plant extract (Lumance®) at the level of 1.5 g/kg of feed (Experimental group). Hens were fed with a crumbled diet at 125 g per day. Housing and feeding conditions were the same for all groups and met the requirements of growth for laying hens of Hisex Brown strain. In the blood serum total protein, bilirubin, cholesterol, DTL- and MTL- cholesterol, triglycerides, glucose, GGT, GOT, GPT, alkaline phosphatase, alpha amylase, contents of c-reactive protein, uric acid, and lipase were analyzed. Development of intestines and internal organs (intestinal length, intestinal weight, the weight of glandular and muscular stomach, pancreas, heart, and liver) were determined. The concentration of short chain fatty acids in caecal content was measured using the method of HPLC. The results of the present study showed that 1.5 g/kg supplementation of feed additive affected egg production and feed conversion ratio for the production of 1 kg of egg mass. Dietary supplementation of analyzed additive in the diets increased the concentration of triglycerides, GOT, alkaline phosphatase and decreased uric acid content compared with the control group (P<0.05). No significant difference for others blood indices in comparison to the control was observed. The addition of feed additives in laying hens’ diets increased intestinal weight by 11% and liver weight by 14% compared with the control group (P<0.05). The short chain fatty acids (propionic, acetic and butyric acids) in the caecum of laying hens in experimental groups decreased compared with the control group. The supplementation of the mixture of butyrate, acids, medium-chain fatty acids and plant extract at the level of 1.5 g/kg in the laying hens’ diets had the effect on the performance, some gastrointestinal tract function and blood parameters of laying hens.

Keywords: acids, butyrate, laying hens, MCFA, performance, plant extract, psysiological state

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668 From Talk to Action-Tackling Africa’s Pollution and Climate Change Problem

Authors: Ngabirano Levis

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One of Africa’s major environmental challenges remains air pollution. In 2017, UNICEF estimated over 400,000 children in Africa died as a result of indoor pollution, while 350 million children remain exposed to the risks of indoor pollution due to the use of biomass and burning of wood for cooking. Over time, indeed, the major causes of mortality across Africa are shifting from the unsafe water, poor sanitation, and malnutrition to the ambient and household indoor pollution, and greenhouse gas (GHG) emissions remain a key factor in this. In addition, studies by the OECD estimated that the economic cost of premature deaths due to Ambient Particulate Matter Pollution (APMP) and Household Air Pollution across Africa in 2013 was about 215 Billion US Dollars and US 232 Billion US Dollars, respectively. This is not only a huge cost for a continent where over 41% of the Sub-Saharan population lives on less than 1.9 US Dollars a day but also makes the people extremely vulnerable to the negative climate change and environmental degradation effects. Such impacts have led to extended droughts, flooding, health complications, and reduced crop yields hence food insecurity. Climate change, therefore, poses a threat to global targets like poverty reduction, health, and famine. Despite efforts towards mitigation, air contributors like carbon dioxide emissions are on a generally upward trajectory across Africa. In Egypt, for instance, emission levels had increased by over 141% in 2010 from the 1990 baseline. Efforts like the climate change adaptation and mitigation financing have also hit obstacles on the continent. The International Community and developed nations stress that Africa still faces challenges of limited human, institutional and financial systems capable of attracting climate funding from these developed economies. By using the qualitative multi-case study method supplemented by interviews of key actors and comprehensive textual analysis of relevant literature, this paper dissects the key emissions and air pollutant sources, their impact on the well-being of the African people, and puts forward suggestions as well as a remedial mechanism to these challenges. The findings reveal that whereas climate change mitigation plans appear comprehensive and good on paper for many African countries like Uganda; the lingering political interference, limited research guided planning, lack of population engagement, irrational resource allocation, and limited system and personnel capacity has largely impeded the realization of the set targets. Recommendations have been put forward to address the above climate change impacts that threaten the food security, health, and livelihoods of the people on the continent.

Keywords: Africa, air pollution, climate change, mitigation, emissions, effective planning, institutional strengthening

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667 Healthcare Associated Infections in an Intensive Care Unit in Tunisia: Incidence and Risk Factors

Authors: Nabiha Bouafia, Asma Ben Cheikh, Asma Ammar, Olfa Ezzi, Mohamed Mahjoub, Khaoula Meddeb, Imed Chouchene, Hamadi Boussarsar, Mansour Njah

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Background: Hospital acquired infections (HAI) cause significant morbidity, mortality, length of stay and hospital costs, especially in the intensive care unit (ICU), because of the debilitated immune systems of their patients and exposure to invasive devices. The aims of this study were to determine the rate and the risk factors of HAI in an ICU of a university hospital in Tunisia. Materials/Methods: A prospective study was conducted in the 8-bed adult medical ICU of a University Hospital (Sousse Tunisia) during 14 months from September 15th, 2015 to November 15th, 2016. Patients admitted for more than 48h were included. Their surveillance was stopped after the discharge from ICU or death. HAIs were defined according to standard Centers for Disease Control and Prevention criteria. Risk factors were analyzed by conditional stepwise logistic regression. The p-value of < 0.05 was considered significant. Results: During the study, 192 patients had admitted for more than 48 hours. Their mean age was 59.3± 18.20 years and 57.1% were male. Acute respiratory failure was the main reason of admission (72%). The mean SAPS II score calculated at admission was 32.5 ± 14 (range: 6 - 78). The exposure to the mechanical ventilation (MV) and the central venous catheter were observed in 169 (88 %) and 144 (75 %) patients, respectively. Seventy-three patients (38.02%) developed 94 HAIs. The incidence density of HAIs was 41.53 per 1000 patient day. Mortality rate in patients with HAIs was 65.8 %( n= 48). Regarding the type of infection, Ventilator Associated Pneumoniae (VAP) and central venous catheter Associated Infections (CVC AI) were the most frequent with Incidence density: 14.88/1000 days of MV for VAP and 20.02/1000 CVC days for CVC AI. There were 5 Peripheral Venous Catheter Associated Infections, 2 urinary tract infections, and 21 other HAIs. Gram-negative bacteria were the most common germs identified in HAIs: Multidrug resistant Acinetobacter Baumanii (45%) and Klebsiella pneumoniae (10.96%) were the most frequently isolated. Univariate analysis showed that transfer from another hospital department (p= 0.001), intubation (p < 10-4), tracheostomy (p < 10-4), age (p=0.028), grade of acute respiratory failure (p=0.01), duration of sedation (p < 10-4), number of CVC (p < 10-4), length of mechanical ventilation (p < 10-4) and length of stay (p < 10-4), were associated to high risk of HAIS in ICU. Multivariate analysis reveals that independent risk factors for HAIs are: transfer from another hospital department: OR=13.44, IC 95% [3.9, 44.2], p < 10-4, duration of sedation: OR= 1.18, IC 95% [1.049, 1.325], p=0.006, high number of CVC: OR=2.78, IC 95% [1.73, 4.487], p < 10-4, and length of stay in ICU: OR= 1.14, IC 95% [1.066,1.22], p < 10-4. Conclusion: Prevention of nosocomial infections in ICUs is a priority of health care systems all around the world. Yet, their control requires an understanding of epidemiological data collected in these units.

Keywords: healthcare associated infections, incidence, intensive care unit, risk factors

Procedia PDF Downloads 356
666 Privacy Rights of Children in the Social Media Sphere: The Benefits and Challenges Under the EU and US Legislative Framework

Authors: Anna Citterbergova

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This study explores the safeguards and guarantees to children’s personal data protection under the current EU and US legislative framework, namely the GDPR (2018) and COPPA (2000). Considering that children are online for the majority of their free time, one cannot overlook the negative side effects that may be associated with online participation, which may put children’s wellbeing and their fundamental rights at risk. The question of whether the current relevant legislative framework in relation to the responsibilities of the internet service providers (ISPs) are adequate safeguards and guarantees to children’s personal data protection has been an evolving debate both in the US and in the EU. From a children’s rights perspective, processors of personal data have certain obligations that must meet the international human rights principles (e. g. the CRC, ECHR), which require taking into account the best interest of the child. Accordingly, the need to protect children’s privacy online remains strong and relevant with the expansion of the number and importance of social media platforms to human life. At the same time, the landscape of the internet is rapidly evolving, and commercial interests are taking a more targeted approach in seeking children’s data. Therefore, it is essential to constantly evaluate the ongoing and evolving newly adopted market policies of ISPs that may misuse the gap in the current letter of the law. Previous studies in the field have already pointed out that both GDPR and COPPA may theoretically not be sufficient in protecting children’s personal data. With the focus on social media platforms, this study uses the doctrinal-descriptive method to identifiy the mechanisms enshrined in the GDPR and COPPA designed to protect children’s personal data. In its second part, the study includes a data gathering phase by the national data protection authorities responsible for monitoring and supervision of the GDPR in relation to children’s personal data protection who monitor the enforcement of the data protection rules throughout the European Union an contribute to their consistent application. These gathered primary source of data will later be used to outline the series of benefits and challenges to children’s persona lata protection faced by these institutes and the analysis that aims to suggest if and/or how to hold ISPs accountable while striking a fair balance between the commercial rights and the right to protection of the personal data of children. The preliminary results can be divided into two categories. First, conclusions in the doctrinal-descriptive part of the study. Second, specific cases and situations from the practice of national data protection authorities. While for the first part, concrete conclusions can already be presented, the second part is currently still in the data gathering phase. The result of this research is a comprehensive analysis on the safeguards and guarantees to children’s personal data protection under the current EU and US legislative framework, based on doctrinal-descriptive approach and original empirical data.

Keywords: personal data of children, personal data protection, GDPR, COPPA, ISPs, social media

Procedia PDF Downloads 76
665 Jungle Justice on Emotional Health Challenges of Residents in Lagos Metropolis

Authors: Aaron Akinloye

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this research focuses on the impact of jungle justice on the emotional health challenges experienced by residents in the Lagos metropolitan city in Nigeria. Jungle justice refers to the practice of individuals taking the law into their own hands and administering punishment without proper legal procedures. The aim of this study is to investigate the influence of jungle justice on the emotional challenges faced by residents in Lagos. The specific objectives of the study are to examine the effects of jungle justice on trauma, pressure, fear, and depression among residents. The study adopts a descriptive survey research design and uses a questionnaire as the research instrument. The population of the study consisted of residents in the three senatorial districts that make up Lagos State. A simple random sampling technique was used to select two Local Government Areas (Yaba and Shomolu) from each of the three senatorial districts of Lagos State. Also, a simple random sampling technique was used to select fifty (50) residents from each of the chosen Local Government Areas to make three hundred (300) residents that formed the sample of the study. Accidental sampling technique is employed to select a sample of 300 residents. Data on the variables of interest is collected using a self-developed questionnaire. The research instrument undergoes validation through face, content, and construct validation processes. The reliability coefficient of the instrument is found to be 0.84. The study reveals that jungle justice significantly influences trauma, pressure, fear, and depression among residents in Lagos metropolitan city. The statistical analysis shows significant relationships between jungle justice and these emotional health challenges (df (298) t= 2.33, p< 0.05; df (298) t= 2.16, p< 0.05; df (298) t= 2.20, p< 0.05; df (298) t= 2.14, p< 0.05). This study contributes to the literature by highlighting the negative effects of jungle justice on the emotional well-being of residents. It emphasizes the importance of addressing this issue and implementing measures to prevent such vigilante actions. Data is collected through the administration of the self-developed questionnaire to the selected residents. The collected data is then analyzed using inferential statistics, specifically mean analysis, to examine the relationships between jungle justice and the emotional health challenges experienced by the residents. The main question addressed in this study is how jungle justice affects the emotional health challenges faced by residents in Lagos metropolitan city. Conclusion: The study concludes that jungle justice has a significant influence on trauma, pressure, fear, and depression among residents. To address this issue, recommendations are made, including the implementation of comprehensive awareness campaigns, improvement of law enforcement agencies, development of support systems for victims, and revision of the legal framework to effectively address jungle justice. Overall, this research contributes to the understanding of the consequences of jungle justice and provides recommendations for intervention to protect the emotional well-being of residents in Lagos metropolitan city.

Keywords: jungle justice, emotional health, depression, anger

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664 Impact of Emotional Intelligence and Cognitive Intelligence on Radio Presenter's Performance in All India Radio, Kolkata, India

Authors: Soumya Dutta

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This research paper aims at investigating the impact of emotional intelligence and cognitive intelligence on radio presenter’s performance in the All India Radio, Kolkata (India’s public service broadcaster). The ancient concept of productivity is the ratio of what is produced to what is required to produce it. But, father of modern management Peter F. Drucker (1909-2005) defined productivity of knowledge work and knowledge workers in a new form. In the other hand, the concept of Emotional Intelligence (EI) originated back in 1920’s when Thorndike (1920) for the first time proposed the emotional intelligence into three dimensions, i.e., abstract intelligence, mechanical intelligence, and social intelligence. The contribution of Salovey and Mayer (1990) is substantive, as they proposed a model for emotional intelligence by defining EI as part of the social intelligence, which takes measures the ability of an individual to regulate his/her personal and other’s emotions and feeling. Cognitive intelligence illustrates the specialization of general intelligence in the domain of cognition in ways that possess experience and learning about cognitive processes such as memory. The outcomes of past research on emotional intelligence show that emotional intelligence has a positive effect on social- mental factors of human resource; positive effects of emotional intelligence on leaders and followers in terms of performance, results, work, satisfaction; emotional intelligence has a positive and significant relationship with the teachers' job performance. In this paper, we made a conceptual framework based on theories of emotional intelligence proposed by Salovey and Mayer (1989-1990) and a compensatory model of emotional intelligence, cognitive intelligence, and job performance proposed by Stephen Cote and Christopher T. H. Miners (2006). For investigating the impact of emotional intelligence and cognitive intelligence on radio presenter’s performance, sample size consists 59 radio presenters (considering gender, academic qualification, instructional mood, age group, etc.) from All India Radio, Kolkata station. Questionnaires prepared based on cognitive (henceforth called C based and represented by C1, C2,.., C5) as well as emotional intelligence (henceforth called E based and represented by E1, E2,., E20). These were sent to around 59 respondents (Presenters) for getting their responses. Performance score was collected from the report of program executive of All India Radio, Kolkata. The linear regression has been carried out using all the E-based and C-based variables as the predictor variables. The possible problem of autocorrelation has been tested by having the Durbinson-Watson (DW) Statistic. Values of this statistic, almost within the range of 1.80-2.20, indicate the absence of any significant problem of autocorrelation. The possible problem of multicollinearity has been tested by having the Variable Inflation Factor (VIF) value. Values of this statistic, around within 2, indicates the absence of any significant problem of multicollinearity. It is inferred that the performance scores can be statistically regressed linearly on the E-based and C-based scores, which can explain 74.50% of the variations in the performance.

Keywords: cognitive intelligence, emotional intelligence, performance, productivity

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663 The Administration of Infection Diseases During the Pandemic COVID-19 and the Role of the Differential Diagnosis with Biomarkers VB10

Authors: Sofia Papadimitriou

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INTRODUCTION: The differential diagnosis between acute viral and bacterial infections is an important cost-effectiveness parameter at the stage of the treatment process in order to achieve the maximum benefits in therapeutic intervention by combining the minimum cost to ensure the proper use of antibiotics.The discovery of sensitive and robust molecular diagnostic tests in response to the role of the host in infections has enhanced the accurate diagnosis and differentiation of infections. METHOD: The study used a sample of six independent blood samples (total=756) which are associated with human proteins-proteins, each of which at the transcription stage expresses a different response in the host network between viral and bacterial infections.Τhe individual blood samples are subjected to a sequence of computer filters that identify a gene panel corresponding to an autonomous diagnostic score. The data set and the correspondence of the gene panel to the diagnostic patents a new Bangalore -Viral Bacterial (BL-VB). FINDING: We use a biomarker based on the blood of 10 genes(Panel-VB) that are an important prognostic value for the detection of viruses from bacterial infections with a weighted average AUROC of 0.97(95% CL:0.96-0.99) in eleven independent samples (sets n=898). We discovered a base with a patient score (VB 10 ) according to the table, which is a significant diagnostic value with a weighted average of AUROC 0.94(95% CL: 0.91-0.98) in 2996 patient samples from 56 public sets of data from 19 different countries. We also studied VB 10 in a new cohort of South India (BL-VB,n=56) and found 97% accuracy in confirmed cases of viral and bacterial infections. We found that VB 10 (a)accurately identifies the type of infection even in unspecified cases negative to the culture (b) shows its clinical condition recovery and (c) applies to all age groups, covering a wide range of acute bacterial and viral infectious, including non-specific pathogens. We applied our VB 10 rating to publicly available COVID 19 data and found that our rating diagnosed viral infection in patient samples. RESULTS: Τhe results of the study showed the diagnostic power of the biomarker VB 10 as a diagnostic test for the accurate diagnosis of acute infections in recovery conditions. We look forward to helping you make clinical decisions about prescribing antibiotics and integrating them into your policies management of antibiotic stewardship efforts. CONCLUSIONS: Overall, we are developing a new property of the RNA-based biomarker and a new blood test to differentiate between viral and bacterial infections to assist a physician in designing the optimal treatment regimen to contribute to the proper use of antibiotics and reduce the burden on antimicrobial resistance, AMR.

Keywords: acute infections, antimicrobial resistance, biomarker, blood transcriptome, systems biology, classifier diagnostic score

Procedia PDF Downloads 138
662 Slope Stability and Landslides Hazard Analysis, Limitations of Existing Approaches, and a New Direction

Authors: Alisawi Alaa T., Collins P. E. F.

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The analysis and evaluation of slope stability and landslide hazards are landslide hazards are critically important in civil engineering projects and broader considerations of safety. The level of slope stability risk should be identified due to its significant and direct financial and safety effects. Slope stability hazard analysis is performed considering static and/or dynamic loading circumstances. To reduce and/or prevent the failure hazard caused by landslides, a sophisticated and practical hazard analysis method using advanced constitutive modeling should be developed and linked to an effective solution that corresponds to the specific type of slope stability and landslides failure risk. Previous studies on slope stability analysis methods identify the failure mechanism and its corresponding solution. The commonly used approaches include used approaches include limit equilibrium methods, empirical approaches for rock slopes (e.g., slope mass rating and Q-slope), finite element or finite difference methods, and district element codes. This study presents an overview and evaluation of these analysis techniques. Contemporary source materials are used to examine these various methods on the basis of hypotheses, the factor of safety estimation, soil types, load conditions, and analysis conditions and limitations. Limit equilibrium methods play a key role in assessing the level of slope stability hazard. The slope stability safety level can be defined by identifying the equilibrium of the shear stress and shear strength. The slope is considered stable when the movement resistance forces are greater than those that drive the movement with a factor of safety (ratio of the resistance of the resistance of the driving forces) that is greater than 1.00. However, popular and practical methods, including limit equilibrium approaches, are not effective when the slope experiences complex failure mechanisms, such as progressive failure, liquefaction, internal deformation, or creep. The present study represents the first episode of an ongoing project that involves the identification of the types of landslides hazards, assessment of the level of slope stability hazard, development of a sophisticated and practical hazard analysis method, linkage of the failure type of specific landslides conditions to the appropriate solution and application of an advanced computational method for mapping the slope stability properties in the United Kingdom, and elsewhere through geographical information system (GIS) and inverse distance weighted spatial interpolation(IDW) technique. This study investigates and assesses the different assesses the different analysis and solution techniques to enhance the knowledge on the mechanism of slope stability and landslides hazard analysis and determine the available solutions for each potential landslide failure risk.

Keywords: slope stability, finite element analysis, hazard analysis, landslides hazard

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661 The Effects of Irregular Immigration Originating from Syria on Turkey's Security Issues

Authors: Muzaffer Topgul, Hasan Atac

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After the September 11 attacks, fight against terrorism has risen to higher levels in security concepts of the countries. The following reactions of some nation states have led to the formation of unstable areas in different parts of the World. Especially, in Iraq and Syria, the influences of radical groups have risen with the weakening of the central governments. Turkey (with the geographical proximity to the current crisis) has become a stop on the movement of people who were displaced because of terrorism. In the process, the policies of the Syrian regime resulted in a civil war which is still going on since 2011, and remain as an unresolved crisis. With the extension of the problem, changes occurred in foreign policies of the World Powers; moreover, the ongoing effects of the riots, conflicts of interests of foreign powers, conflicts in the region because of the activities of radical groups increased instability within the country. This case continues to affect the security of Turkey, particularly illegal immigration. It has exceeded the number of two million Syrians who took refuge in Turkey due to the civil war, while continuing uncertainty about the legal status of asylum seekers, besides the security problems of asylum-seekers themselves, there are problems in education, health and communication (language) as well. In this study, we will evaluate the term of immigration through the eyes of national and international law, place the disorganized and illegal immigration in security sphere, and define the elements/components of irregular migration within the changing security concept. Ultimately, this article will assess the effects of the Syrian refuges to Turkey’s short-term, mid-term, and long-term security in the light of the national and international data flows and solutions will be presented to the ongoing problem. While explaining the security problems the data and the donnees obtained from the nation and international corporations will be examined thorough the human security dimensions such as living conditions of the immigrants, the ratio of the genders, especially birth rate occasions, the education circumstances of the immigrant children, the effects of the illegal passing on the public order. In addition, the demographic change caused by the immigrants will be analyzed, the changing economical conditions where the immigrants mostly accumulate, and their participation in public life will be worked on and the economical obstacles sourcing due to irregular immigration will be clarified. By the entire datum gathered from the educational, cultural, social, economic, demographical extents, the regional factors affecting the migration and the role of irregular migration in Turkey’s future security will be revealed by implication to current knowledge sources.

Keywords: displaced people, human security, irregular migration, refugees

Procedia PDF Downloads 296
660 Pre-Cooling Strategies for the Refueling of Hydrogen Cylinders in Vehicular Transport

Authors: C. Hall, J. Ramos, V. Ramasamy

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Hydrocarbon-based fuel vehicles are a major contributor to air pollution due to harmful emissions produced, leading to a demand for cleaner fuel types. A leader in this pursuit is hydrogen, with its application in vehicles producing zero harmful emissions and the only by-product being water. To compete with the performance of conventional vehicles, hydrogen gas must be stored on-board of vehicles in cylinders at high pressures (35–70 MPa) and have a short refueling duration (approximately 3 mins). However, the fast-filling of hydrogen cylinders causes a significant rise in temperature due to the combination of the negative Joule-Thompson effect and the compression of the gas. This can lead to structural failure and therefore, a maximum allowable internal temperature of 85°C has been imposed by the International Standards Organization. The technological solution to tackle the issue of rapid temperature rise during the refueling process is to decrease the temperature of the gas entering the cylinder. Pre-cooling of the gas uses a heat exchanger and requires energy for its operation. Thus, it is imperative to determine the least amount of energy input that is required to lower the gas temperature for cost savings. A validated universal thermodynamic model is used to identify an energy-efficient pre-cooling strategy. The model requires negligible computational time and is applied to previously validated experimental cases to optimize pre-cooling requirements. The pre-cooling characteristics include the location within the refueling timeline and its duration. A constant pressure-ramp rate is imposed to eliminate the effects of rapid changes in mass flow rate. A pre-cooled gas temperature of -40°C is applied, which is the lowest allowable temperature. The heat exchanger is assumed to be ideal with no energy losses. The refueling of the cylinders is modeled with the pre-cooling split in ten percent time intervals. Furthermore, varying burst durations are applied in both the early and late stages of the refueling procedure. The model shows that pre-cooling in the later stages of the refuelling process is more energy-efficient than early pre-cooling. In addition, the efficiency of pre-cooling towards the end of the refueling process is independent of the pressure profile at the inlet. This leads to the hypothesis that pre-cooled gas should be applied as late as possible in the refueling timeline and at very low temperatures. The model had shown a 31% reduction in energy demand whilst achieving the same final gas temperature for a refueling scenario when pre-cooling was applied towards the end of the process. The identification of the most energy-efficient refueling approaches whilst adhering to the safety guidelines is imperative to reducing the operating cost of hydrogen refueling stations. Heat exchangers are energy-intensive and thus, reducing the energy requirement would lead to cost reduction. This investigation shows that pre-cooling should be applied as late as possible and for short durations.

Keywords: cylinder, hydrogen, pre-cooling, refueling, thermodynamic model

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659 Cultural Identity of Mainland Chinese, Hongkonger and Taiwanese: A Glimpse from Hollywood Film Title Translation

Authors: Ling Yu Debbie Tsoi

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After China has just exceeded the USA as the top Hollywood film market in 2018, Hollywood studios have been adapting the taste, preference, casting and even film title translation to resonate with the Chinese audience. Due to the huge foreign demands, Hollywood film directors are paying closer attention to the translation of their products, as film titles are entry gates to the film and serve advertising, informative, aesthetic functions. Other than film directors and studios, comments over quality film title translation also appear on various online clip viewing platforms, online media, and magazines. In particular, netizens in mainland China, Hong Kong, and Taiwan seems to defend film titles in their own region while despising the other two regions. In view of the endless debates and lack of systematic analysis on film title translation in Greater China, the study aims at investigating the translation of Hollywood film titles (from English to Chinese) across Greater China based on Venuti’s (1991; 1995; 1998; 2001) concept of domestication and foreignization. To offer a comparison over time, a mini-corpus was built comprised of the top 70 most popular Hollywood film titles in 1987- 1988, 1997- 1998, 2007- 2008 and 2017- 2018 of Greater China respectively. Altogether, 560 source texts and 1680 target texts of mainland China, Hong Kong, and Taiwan were compared against each other. The three regions are found to have a distinctive style and patterns of translation. For instance, a sizable number of film titles are foreignized in mainland China by adopting literal translation and transliteration, whereas Hong Kong and Taiwan prefer domestication. Hong Kong tends to adopt a more vulgar style by using colloquial Cantonese slangs and even swear words, associating characters with negative connotations. Also, English is used as a form of domestication in Hong Kong from 1987 till 2018. Use of English as a strategy of domestication was never found in mainland nor Taiwan. On the contrary, Taiwanese target texts tend to adopt a cute and child-like style by using repetitive words and positive connotations. Even if English was used, it was used as foreignization. As film titles represent cultural products of popular culture, it is suspected that Hongkongers would like to develop cultural identity via adopting style distinctive from mainland China by vulgarization and negativity. Hongkongers also identify themselves as international cosmopolitan, leading to their identification with English. It is also suspected that due to former colonial rule of Japan, Taiwan adopts a popular culture similar to Japan, with cute and childlike expressions.

Keywords: cultural identification, ethnic identification, Greater China, film title translation

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658 Development and Validation of a Turbidimetric Bioassay to Determine the Potency of Ertapenem Sodium

Authors: Tahisa M. Pedroso, Hérida R. N. Salgado

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The microbiological turbidimetric assay allows the determination of potency of the drug, by measuring the turbidity (absorbance), caused by inhibition of microorganisms by ertapenem sodium. Ertapenem sodium (ERTM), a synthetic antimicrobial agent of the class of carbapenems, shows action against Gram-negative, Gram-positive, aerobic and anaerobic microorganisms. Turbidimetric assays are described in the literature for some antibiotics, but this method is not described for ertapenem. The objective of the present study was to develop and validate a simple, sensitive, precise and accurate microbiological assay by turbidimetry to quantify ertapenem sodium injectable as an alternative to the physicochemical methods described in the literature. Several preliminary tests were performed to choose the following parameters: Staphylococcus aureus ATCC 25923, IAL 1851, 8 % of inoculum, BHI culture medium, and aqueous solution of ertapenem sodium. 10.0 mL of sterile BHI culture medium were distributed in 20 tubes. 0.2 mL of solutions (standard and test), were added in tube, respectively S1, S2 and S3, and T1, T2 and T3, 0.8 mL of culture medium inoculated were transferred to each tube, according parallel lines 3 x 3 test. The tubes were incubated in shaker Marconi MA 420 at a temperature of 35.0 °C ± 2.0 °C for 4 hours. After this period, the growth of microorganisms was inhibited by addition of 0.5 mL of 12% formaldehyde solution in each tube. The absorbance was determined in Quimis Q-798DRM spectrophotometer at a wavelength of 530 nm. An analytical curve was constructed to obtain the equation of the line by the least-squares method and the linearity and parallelism was detected by ANOVA. The specificity of the method was proven by comparing the response obtained for the standard and the finished product. The precision was checked by testing the determination of ertapenem sodium in three days. The accuracy was determined by recovery test. The robustness was determined by comparing the results obtained by varying wavelength, brand of culture medium and volume of culture medium in the tubes. Statistical analysis showed that there is no deviation from linearity in the analytical curves of standard and test samples. The correlation coefficients were 0.9996 and 0.9998 for the standard and test samples, respectively. The specificity was confirmed by comparing the absorbance of the reference substance and test samples. The values obtained for intraday, interday and between analyst precision were 1.25%; 0.26%, 0.15% respectively. The amount of ertapenem sodium present in the samples analyzed, 99.87%, is consistent. The accuracy was proven by the recovery test, with value of 98.20%. The parameters varied did not affect the analysis of ertapenem sodium, confirming the robustness of this method. The turbidimetric assay is more versatile, faster and easier to apply than agar diffusion assay. The method is simple, rapid and accurate and can be used in routine analysis of quality control of formulations containing ertapenem sodium.

Keywords: ertapenem sodium, turbidimetric assay, quality control, validation

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657 Development and Validation of a Rapid Turbidimetric Assay to Determine the Potency of Cefepime Hydrochloride in Powder Injectable Solution

Authors: Danilo F. Rodrigues, Hérida Regina N. Salgado

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Introduction: The emergence of resistant microorganisms to a large number of clinically approved antimicrobials has been increasing, which restrict the options for the treatment of bacterial infections. As a strategy, drugs with high antimicrobial activities are in evidence. Stands out a class of antimicrobial, the cephalosporins, having as fourth generation cefepime (CEF) a semi-synthetic product which has activity against various Gram-positive bacteria (e.g. oxacillin resistant Staphylococcus aureus) and Gram-negative (e.g. Pseudomonas aeruginosa) aerobic. There are few studies in the literature regarding the development of microbiological methodologies for the analysis of this antimicrobial, so researches in this area are highly relevant to optimize the analysis of this drug in the industry and ensure the quality of the marketed product. The development of microbiological methods for the analysis of antimicrobials has gained strength in recent years and has been highlighted in relation to physicochemical methods, especially because they make possible to determine the bioactivity of the drug against a microorganism. In this context, the aim of this work was the development and validation of a microbiological method for quantitative analysis of CEF in powder lyophilized for injectable solution by turbidimetric assay. Method: For performing the method, Staphylococcus aureus ATCC 6538 IAL 2082 was used as the test microorganism and the culture medium chosen was the Casoy broth. The test was performed using temperature control (35.0 °C ± 2.0 °C) and incubated for 4 hours in shaker. The readings of the results were made at a wavelength of 530 nm through a spectrophotometer. The turbidimetric microbiological method was validated by determining the following parameters: linearity, precision (repeatability and intermediate precision), accuracy and robustness, according to ICH guidelines. Results and discussion: Among the parameters evaluated for method validation, the linearity showed results suitable for both statistical analyses as the correlation coefficients (r) that went 0.9990 for CEF reference standard and 0.9997 for CEF sample. The precision presented the following values 1.86% (intraday), 0.84% (interday) and 0.71% (between analyst). The accuracy of the method has been proven through the recovery test where the mean value obtained was 99.92%. The robustness was verified by the parameters changing volume of culture medium, brand of culture medium, incubation time in shaker and wavelength. The potency of CEF present in the samples of lyophilized powder for injectable solution was 102.46%. Conclusion: The turbidimetric microbiological method proposed for quantification of CEF in lyophilized powder for solution for injectable showed being fast, linear, precise, accurate and robust, being in accordance with all the requirements, which can be used in routine analysis of quality control in the pharmaceutical industry as an option for microbiological analysis.

Keywords: cefepime hydrochloride, quality control, turbidimetric assay, validation

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656 Correlation Between Different Radiological Findings and Histopathological diagnosis of Breast Diseases: Retrospective Review Conducted Over Sixth Years in King Fahad University Hospital in Eastern Province, Saudi Arabia

Authors: Sadeem Aljamaan, Reem Hariri, Rahaf Alghamdi, Batool Alotaibi, Batool Alsenan, Lama Althunayyan, Areej Alnemer

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The aim of this study is to correlate between radiological findings and histopathological results in regard to the breast imaging-reporting and data system scores, size of breast masses, molecular subtypes and suspicious radiological features, as well as to assess the concordance rate in histological grade between core biopsy and surgical excision among breast cancer patients, followed by analyzing the change of concordance rate in relation to neoadjuvant chemotherapy in a Saudi population. A retrospective review was conducted over 6-year period (2017-2022) on all breast core biopsies of women preceded by radiological investigation. Chi-squared test (χ2) was performed on qualitative data, the Mann-Whitney test for quantitative non-parametric variables, and the Kappa test for grade agreement. A total of 641 cases were included. Ultrasound, mammography, and magnetic resonance imaging demonstrated diagnostic accuracies of 85%, 77.9% and 86.9%; respectively. magnetic resonance imaging manifested the highest sensitivity (72.2%), and the lowest was for ultrasound (61%). Concordance in tumor size with final excisions was best in magnetic resonance imaging, while mammography demonstrated a higher tendency of overestimation (41.9%), and ultrasound showed the highest underestimation (67.7%). The association between basal-like molecular subtypes and the breast imaging-reporting and data system score 5 classifications was statistically significant only for magnetic resonance imaging (p=0.04). Luminal subtypes demonstrated a significantly higher percentage of speculation in mammography. Breast imaging-reporting and data system score 4 manifested a substantial number of benign pathologies in all the 3 modalities. A fair concordance rate (k= 0.212 & 0.379) was demonstrated between excision and the preceding core biopsy grading with and without neoadjuvant therapy, respectively. The results demonstrated a down-grading in cases post-neoadjuvant therapy. In cases who did not receive neoadjuvant therapy, underestimation of tumor grade in biopsy was evident. In summary, magnetic resonance imaging had the highest sensitivity, specificity, positive predictive value and accuracy of both diagnosis and estimation of tumor size. Mammography demonstrated better sensitivity than ultrasound and had the highest negative predictive value, but ultrasound had better specificity, positive predictive value and accuracy. Therefore, the combination of different modalities is advantageous. The concordance rate of core biopsy grading with excision was not impacted by neoadjuvant therapy.

Keywords: breast cancer, mammography, MRI, neoadjuvant, pathology, US

Procedia PDF Downloads 70
655 Comparison of Microstructure, Mechanical Properties and Residual Stresses in Laser and Electron Beam Welded Ti–5Al–2.5Sn Titanium Alloy

Authors: M. N. Baig, F. N. Khan, M. Junaid

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Titanium alloys are widely employed in aerospace, medical, chemical, and marine applications. These alloys offer many advantages such as low specific weight, high strength to weight ratio, excellent corrosion resistance, high melting point and good fatigue behavior. These attractive properties make titanium alloys very unique and therefore they require special attention in all areas of processing, especially welding. In this work, 1.6 mm thick sheets of Ti-5Al-2,5Sn, an alpha titanium (α-Ti) alloy, were welded using electron beam (EBW) and laser beam (LBW) welding processes to achieve a full penetration Bead-on Plate (BoP) configuration. The weldments were studied using polarized optical microscope, SEM, EDS and XRD. Microhardness distribution across the weld zone and smooth and notch tensile strengths of the weldments were also recorded. Residual stresses using Hole-drill Strain Measurement (HDSM) method and deformation patterns of the weldments were measured for the purpose of comparison of the two welding processes. Fusion zone widths of both EBW and LBW weldments were found to be approximately equivalent owing to fairly similar high power densities of both the processes. Relatively less oxide content and consequently high joint quality were achieved in EBW weldment as compared to LBW due to vacuum environment and absence of any shielding gas. However, an increase in heat-affected zone width and partial ά-martensitic transformation infusion zone of EBW weldment were observed because of lesser cooling rates associated with EBW as compared with LBW. The microstructure infusion zone of EBW weldment comprised both acicular α and ά martensite within the prior β grains whereas complete ά martensitic transformation was observed within the fusion zone of LBW weldment. Hardness of the fusion zone in EBW weldment was found to be lower than the fusion zone of LBW weldment due to the observed microstructural differences. Notch tensile specimen of LBW exhibited higher load capacity, ductility, and absorbed energy as compared with EBW specimen due to the presence of high strength ά martensitic phase. It was observed that the sheet deformation and deformation angle in EBW weldment were more than LBW weldment due to relatively more heat retention in EBW which led to more thermal strains and hence higher deformations and deformation angle. The lowest residual stresses were found in LBW weldments which were tensile in nature. This was owing to high power density and higher cooling rates associated with LBW process. EBW weldment exhibited highest compressive residual stresses due to which the service life of EBW weldment is expected to improve.

Keywords: Laser and electron beam welding, Microstructure and mechanical properties, Residual stress and distortions, Titanium alloys

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654 Features of Fossil Fuels Generation from Bazhenov Formation Source Rocks by Hydropyrolysis

Authors: Anton G. Kalmykov, Andrew Yu. Bychkov, Georgy A. Kalmykov

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Nowadays, most oil reserves in Russia and all over the world are hard to recover. That is the reason oil companies are searching for new sources for hydrocarbon production. One of the sources might be high-carbon formations with unconventional reservoirs. Bazhenov formation is a huge source rock formation located in West Siberia, which contains unconventional reservoirs on some of the areas. These reservoirs are formed by secondary processes with low predicting ratio. Only one of five wells is drilled through unconventional reservoirs, in others kerogen has low thermal maturity, and they are of low petroliferous. Therefore, there was a request for tertiary methods for in-situ cracking of kerogen and production of oil. Laboratory experiments of Bazhenov formation rock hydrous pyrolysis were used to investigate features of the oil generation process. Experiments on Bazhenov rocks with a different mineral composition (silica concentration from 15 to 90 wt.%, clays – 5-50 wt.%, carbonates – 0-30 wt.%, kerogen – 1-25 wt.%) and thermal maturity (from immature to late oil window kerogen) were performed in a retort under reservoir conditions. Rock samples of 50 g weight were placed in retort, covered with water and heated to the different temperature varied from 250 to 400°C with the durability of the experiments from several hours to one week. After the experiments, the retort was cooled to room temperature; generated hydrocarbons were extracted with hexane, then separated from the solvent and weighted. The molecular composition of this synthesized oil was then investigated via GC-MS chromatography Characteristics of rock samples after the heating was measured via the Rock-Eval method. It was found, that the amount of synthesized oil and its composition depending on the experimental conditions and composition of rocks. The highest amount of oil was produced at a temperature of 350°C after 12 hours of heating and was up to 12 wt.% of initial organic matter content in the rocks. At the higher temperatures and within longer heating time secondary cracking of generated hydrocarbons occurs, the mass of produced oil is lowering, and the composition contains more hydrocarbons that need to be recovered by catalytical processes. If the temperature is lower than 300°C, the amount of produced oil is too low for the process to be economically effective. It was also found that silica and clay minerals work as catalysts. Selection of heating conditions allows producing synthesized oil with specified composition. Kerogen investigations after heating have shown that thermal maturity increases, but the yield is only up to 35% of the maximum amount of synthetic oil. This yield is the result of gaseous hydrocarbons formation due to secondary cracking and aromatization and coaling of kerogen. Future investigations will allow the increase in the yield of synthetic oil. The results are in a good agreement with theoretical data on kerogen maturation during oil production. Evaluated trends could be tooled up for in-situ oil generation by shale rocks thermal action.

Keywords: Bazhenov formation, fossil fuels, hydropyrolysis, synthetic oil

Procedia PDF Downloads 107
653 Monitoring and Evaluation of Web-Services Quality and Medium-Term Impact on E-Government Agencies' Efficiency

Authors: A. F. Huseynov, N. T. Mardanov, J. Y. Nakhchivanski

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This practical research is aimed to improve the management quality and efficiency of public administration agencies providing e-services. The monitoring system developed will provide continuous review of the websites compliance with the selected indicators, their evaluation based on the selected indicators and ranking of services according to the quality criteria. The responsible departments in the government agencies were surveyed; the questionnaire includes issues of management and feedback, e-services provided, and the application of information systems. By analyzing the main affecting factors and barriers, the recommendations will be given that lead to the relevant decisions to strengthen the state agencies competencies for the management and the provision of their services. Component 1. E-services monitoring system. Three separate monitoring activities are proposed to be executed in parallel: Continuous tracing of e-government sites using built-in web-monitoring program; this program generates several quantitative values which are basically related to the technical characteristics and the performance of websites. The expert assessment of e-government sites in accordance with the two general criteria. Criterion 1. Technical quality of the site. Criterion 2. Usability/accessibility (load, see, use). Each high-level criterion is in turn subdivided into several sub-criteria, such as: the fonts and the color of the background (Is it readable?), W3C coding standards, availability of the Robots.txt and the site map, the search engine, the feedback/contact and the security mechanisms. The on-line survey of the users/citizens – a small group of questions embedded in the e-service websites. The questionnaires comprise of the information concerning navigation, users’ experience with the website (whether it was positive or negative), etc. Automated monitoring of web-sites by its own could not capture the whole evaluation process, and should therefore be seen as a complement to expert’s manual web evaluations. All of the separate results were integrated to provide the complete evaluation picture. Component 2. Assessment of the agencies/departments efficiency in providing e-government services. - the relevant indicators to evaluate the efficiency and the effectiveness of e-services were identified; - the survey was conducted in all the governmental organizations (ministries, committees and agencies) that provide electronic services for the citizens or the businesses; - the quantitative and qualitative measures are covering the following sections of activities: e-governance, e-services, the feedback from the users, the information systems at the agencies’ disposal. Main results: 1. The software program and the set of indicators for internet sites evaluation has been developed and the results of pilot monitoring have been presented. 2. The evaluation of the (internal) efficiency of the e-government agencies based on the survey results with the practical recommendations related to the human potential, the information systems used and e-services provided.

Keywords: e-government, web-sites monitoring, survey, internal efficiency

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652 Protecting Human Health under International Investment Law

Authors: Qiang Ren

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In the past 20 years, under the high standard of international investment protection, there have been numerous cases of investors ignoring the host country's measures to protect human health. Examples include investment disputes triggered by the Argentine government's measures related to human health, quality, and price of drinking water under the North American Free Trade Agreement. Examples also include Philip Morris v. Australia, in which case the Australian government announced the passing of the Plain Packing of Cigarettes Act to address the threat of smoking to public health in 2010. In order to take advantage of the investment treaty protection between Hong Kong and Australia, Philip Morris Asia acquired Philip Morris Australia in February 2011 and initiated investment arbitration under the treaty before the passage of the Act in July 2011. Philip Morris claimed the Act constitutes indirect expropriation and violation of fair and equitable treatment and claimed 4.16 billion US dollars compensation. Fortunately, the case ended at the admissibility decision stage and did not enter the substantive stage. Generally, even if the host country raises a human health defense, most arbitral tribunals will rule that the host country revoke the corresponding policy and make huge compensation in accordance with the clauses in the bilateral investment treaty to protect the rights of investors. The significant imbalance in the rights and obligations of host states and investors in international investment treaties undermines the ability of host states to act in pursuit of human health and social interests beyond economic interests. This squeeze on the nation's public policy space and disregard for the human health costs of investors' activities raises the need to include human health in investment rulemaking. The current international investment law system that emphasizes investor protection fails to fully reflect the requirements of the host country for the healthy development of human beings and even often brings negative impacts to human health. At a critical moment in the reform of the international investment law system, in order to achieve mutual enhancement of investment returns and human health development, human health should play a greater role in influencing and shaping international investment rules. International investment agreements should not be limited to investment protection tools but should also be part of national development strategies to serve sustainable development and human health. In order to meet the requirements of the new sustainable development goals of the United Nations, human health should be emphasized in the formulation of international investment rules, and efforts should be made to shape a new generation of international investment rules that meet the requirements of human health and sustainable development.

Keywords: human health, international investment law, Philip Morris v. Australia, investor protection

Procedia PDF Downloads 158
651 Chemical Analysis of Particulate Matter (PM₂.₅) and Volatile Organic Compound Contaminants

Authors: S. Ebadzadsahraei, H. Kazemian

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The main objective of this research was to measure particulate matter (PM₂.₅) and Volatile Organic Compound (VOCs) as two classes of air pollutants, at Prince George (PG) neighborhood in warm and cold seasons. To fulfill this objective, analytical protocols were developed for accurate sampling and measurement of the targeted air pollutants. PM₂.₅ samples were analyzed for their chemical composition (i.e., toxic trace elements) in order to assess their potential source of emission. The City of Prince George, widely known as the capital of northern British Columbia (BC), Canada, has been dealing with air pollution challenges for a long time. The city has several local industries including pulp mills, a refinery, and a couple of asphalt plants that are the primary contributors of industrial VOCs. In this research project, which is the first study of this kind in this region it measures physical and chemical properties of particulate air pollutants (PM₂.₅) at the city neighborhood. Furthermore, this study quantifies the percentage of VOCs at the city air samples. One of the outcomes of this project is updated data about PM₂.₅ and VOCs inventory in the selected neighborhoods. For examining PM₂.₅ chemical composition, an elemental analysis methodology was developed to measure major trace elements including but not limited to mercury and lead. The toxicity of inhaled particulates depends on both their physical and chemical properties; thus, an understanding of aerosol properties is essential for the evaluation of such hazards, and the treatment of such respiratory and other related diseases. Mixed cellulose ester (MCE) filters were selected for this research as a suitable filter for PM₂.₅ air sampling. Chemical analyses were conducted using Inductively Coupled Plasma Mass Spectrometry (ICP-MS) for elemental analysis. VOCs measurement of the air samples was performed using a Gas Chromatography-Flame Ionization Detector (GC-FID) and Gas Chromatography-Mass Spectrometry (GC-MS) allowing for quantitative measurement of VOC molecules in sub-ppb levels. In this study, sorbent tube (Anasorb CSC, Coconut Charcoal), 6 x 70-mm size, 2 sections, 50/100 mg sorbent, 20/40 mesh was used for VOCs air sampling followed by using solvent extraction and solid-phase micro extraction (SPME) techniques to prepare samples for measuring by a GC-MS/FID instrument. Air sampling for both PM₂.₅ and VOC were conducted in summer and winter seasons for comparison. Average concentrations of PM₂.₅ are very different between wildfire and daily samples. At wildfire time average of concentration is 83.0 μg/m³ and daily samples are 23.7 μg/m³. Also, higher concentrations of iron, nickel and manganese found at all samples and mercury element is found in some samples. It is able to stay too high doses negative effects.

Keywords: air pollutants, chemical analysis, particulate matter (PM₂.₅), volatile organic compound, VOCs

Procedia PDF Downloads 127
650 Tuberculosis Outpatient Treatment in the Context of Reformation of the Health Care System

Authors: Danylo Brindak, Viktor Liashko, Olexander Chepurniy

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Despite considerable experience in implementation of the best international approaches and services within response to epidemy of multi-drug resistant tuberculosis, the results of situation analysis indicate the presence of faults in this area. In 2014, Ukraine (for the first time) was included in the world’s five countries with the highest level of drug-resistant tuberculosis. The effectiveness of its treatment constitutes only 35% in the country. In this context, the increase in allocation of funds to control the epidemic of multidrug-resistant tuberculosis does not produce perceptible positive results. During 2001-2016, only the Global Fund to fight AIDS, Tuberculosis, and Malaria allocated to Ukraine more than USD 521,3 million for programs of tuberculosis and HIV/AIDS control. However, current conditions in post-Semashko system create little motivation for rational use of resources or cost control at inpatient TB facilities. There is no motivation to reduce overdue hospitalization and to target resources to priority sectors of modern tuberculosis control, including a model of care focused on the patient. In the presence of a line-item budget at medical institutions, based on the input factors as the ratios of beds and staff, there is a passive disposal of budgetary funds by health care institutions and their employees who have no motivation to improve quality and efficiency of service provision. Outpatient treatment of tuberculosis is being implemented in Ukraine since 2011 and has many risks, namely creation of parallel systems, low consistency through dependence on funding for the project, reduced the role of the family doctor, the fragmentation of financing, etc. In terms of reforming approaches to health system financing, which began in Ukraine in late 2016, NGO Infection Control in Ukraine conducted piloting of a new, motivating method of remuneration of employees in primary health care. The innovative aspect of this funding mechanism is cost according to results of treatment. The existing method of payment on the basis of the standard per inhabitant (per capita ratio) was added with motivating costs according to results of work. The effectiveness of such treatment of TB patients at the outpatient stage is 90%, while in whole on the basis of a current system the effectiveness of treatment of newly diagnosed pulmonary TB with positive swab is around 60% in the country. Even though Ukraine has 5.24 TB beds per 10 000 citizens. Implemented pilot model of ambulatory treatment will be used for the creation of costs system according to results of activities, the integration of TB and primary health and social services and their focus on achieving results, the reduction of inpatient treatment of tuberculosis.

Keywords: health care reform, multi-drug resistant tuberculosis, outpatient treatment efficiency, tuberculosis

Procedia PDF Downloads 133