Search results for: delayed discharge

Authors: Syed Muzyan Shahzad, Liu Jianxin, Asim Shahzad, Muhammad Sharjeel Raza, Sun Ya, Fanidi Meryem

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Electrical resistivity investigation was conducted in vicinity of Tarbela Ghazi, in order to study the subsurface layer with a view of determining the depth to the aquifer and thickness of groundwater potential zones. Vertical Electrical Sounding (VES) using Schlumberger array was carried out at 16 VES stations. Well logging data at four tube wells have been used to mark the super saturated zones with great discharge rate. The present paper shows a geoelectrical identification of the lithology and an estimate of the relationship between the resistivity and Dar Zarrouk parameters (transverse unit resistance and longitudinal unit conductance). The VES results revealed both homogeneous and heterogeneous nature of the subsurface strata. Aquifer is unconfined to confine in nature, and at few locations though perched aquifer has been identified, groundwater potential zones are developed in unconsolidated deposits layers and more than seven geo-electric layers are observed at some VES locations. Saturated zones thickness ranges from 5 m to 150 m, whereas at few area aquifer is beyond 150 m thick. The average anisotropy, transvers resistance and longitudinal conductance values are 0.86 %, 35750.9821 Ω.m², 0.729 Siemens, respectively. The transverse unit resistance values fluctuate all over the aquifer system, whereas below at particular depth high values are observed, that significantly associated with the high transmissivity zones. The groundwater quality in all analyzed samples is below permissible limit according to World Health Standard (WHO).

Keywords: aquifer, Dar Zarrouk parameters, geoelectric layers, Tarbela Ghazi

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Authors: Rebeca V. Tholen, Elaine Bundy

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Background: Liver transplantation (LT) is considered the only curative treatment for end-stage liver disease Background: Liver transplantation (LT) is considered the only curative treatment for end-stage liver disease (ESLD). The effects of alcoholism can cause irreversible liver damage, cirrhosis and subsequent liver failure. Alcohol relapse after transplant occurs in 20-50% of patients and increases the risk for recurrent cirrhosis, organ rejection, and graft failure. Alcohol relapse after transplant has been identified as a problem among liver transplant recipients at a large urban academic transplant center in the United States. Transplantation will reverse the complications of ESLD, but it does not treat underlying alcoholism or reduce the risk of relapse after transplant. The purpose of this quality improvement project is to implement and evaluate the effectiveness of a High-Risk Alcoholism Relapse (HRAR) Scale to screen and identify patients at high-risk for alcohol relapse after receiving an LT. Methods: The HRAR Scale is a predictive tool designed to determine the severity of alcoholism and risk of relapse after transplant. The scale consists of three variables identified as having the highest predictive power for early relapse including, daily number of drinks, history of previous inpatient treatment for alcoholism, and the number of years of heavy drinking. All adult liver transplant recipients at a large urban transplant center were screened with the HRAR Scale prior to hospital discharge. A zero to two ordinal score is ranked for each variable, and the total score ranges from zero to six. High-risk scores are between three to six. Results: Descriptive statistics revealed 25 patients were newly transplanted and discharged from the hospital during an 8-week period. 40% of patients (n=10) were identified as being high-risk for relapse and 60% low-risk (n=15). The daily number of drinks were determined by alcohol content (1 drink = 15g of ethanol) and number of drinks per day. 60% of patients reported drinking 9-17 drinks per day, and 40% reported ≤ 9 drinks. 50% of high-risk patients reported drinking ≥ 25 years, 40% for 11-25 years, and 10% ≤ 11 years. For number of inpatient treatments for alcoholism, 50% received inpatient treatment one time, 20% ≥ 1, and 30% reported never receiving inpatient treatment. Findings reveal the importance and value of a validated screening tool as a more efficient method than other screening methods alone. Integration of a structured clinical tool will help guide the drinking history portion of the psychosocial assessment. Targeted interventions can be implemented for all high-risk patients. Conclusions: Our findings validate the effectiveness of utilizing the HRAR scale to screen and identify patients who are a high-risk for alcohol relapse post-LT. Recommendations to help maintain post-transplant sobriety include starting a transplant support group within the organization for all high-risk patients. (ESLD). The effects of alcoholism can cause irreversible liver damage, cirrhosis and subsequent liver failure. Alcohol relapse after transplant occurs in 20-50% of patients, and increases the risk for recurrent cirrhosis, organ rejection, and graft failure. Alcohol relapse after transplant has been identified as a problem among liver transplant recipients at a large urban academic transplant center in the United States. Transplantation will reverse the complications of ESLD, but it does not treat underlying alcoholism or reduce the risk of relapse after transplant. The purpose of this quality improvement project is to implement and evaluate the effectiveness of a High-Risk Alcoholism Relapse (HRAR) Scale to screen and identify patients at high-risk for alcohol relapse after receiving a LT. Methods: The HRAR Scale is a predictive tool designed to determine severity of alcoholism and risk of relapse after transplant. The scale consists of three variables identified as having the highest predictive power for early relapse including, daily number of drinks, history of previous inpatient treatment for alcoholism, and the number of years of heavy drinking. All adult liver transplant recipients at a large urban transplant center were screened with the HRAR Scale prior to hospital discharge. A zero to two ordinal score is ranked for each variable, and the total score ranges from zero to six. High-risk scores are between three to six. Results: Descriptive statistics revealed 25 patients were newly transplanted and discharged from the hospital during an 8-week period. 40% of patients (n=10) were identified as being high-risk for relapse and 60% low-risk (n=15). The daily number of drinks were determined by alcohol content (1 drink = 15g of ethanol) and number of drinks per day. 60% of patients reported drinking 9-17 drinks per day, and 40% reported ≤ 9 drinks. 50% of high-risk patients reported drinking ≥ 25 years, 40% for 11-25 years, and 10% ≤ 11 years. For number of inpatient treatments for alcoholism, 50% received inpatient treatment one time, 20% ≥ 1, and 30% reported never receiving inpatient treatment. Findings reveal the importance and value of a validated screening tool as a more efficient method than other screening methods alone. Integration of a structured clinical tool will help guide the drinking history portion of the psychosocial assessment. Targeted interventions can be implemented for all high-risk patients. Conclusions: Our findings validate the effectiveness of utilizing the HRAR scale to screen and identify patients who are a high-risk for alcohol relapse post-LT. Recommendations to help maintain post-transplant sobriety include starting a transplant support group within the organization for all high-risk patients.

Keywords: alcoholism, liver transplant, quality improvement, substance abuse

Procedia PDF Downloads 109

Authors: Zoran Herceg, Tomislava Vukušić, Anet Režek Jambrak, Višnja Stulić

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Today one of the greatest challenges are directed to the safety of food supply. If food pathogens are ingested they can cause human illnesses. Because of that new technologies that are effective in microbial reduction are developing to be used in food industries. One of such technology is cold gas phase plasma. Salmonella enterica was studied as one of the pathogenes that can be found in food. The aim of this work was to examine the inactivation rate and stress response of plasma treated cells of Salmonella enterica inoculated in apple juice. After the treatment cellular leakage, phenotypic changes in plasma treated cells-biofilm formation and degree of recovery were conducted. Sample volume was inoculated with 5 mL of pure culture of Salmonella enterica and 15 mL of apple juice. Statgraphics Centurion software (StatPoint Technologies, Inc., VA, USA) was used for experimental design and statistical analyses. Treatment time (1, 3, 5 min) and gas flow (40, 60, 80 L/min) were changed. Complete inactivation and 0 % of recovery after the 48 h was observed at these experimental treatments: 3 min; 40 L/min, 3 min; 80 L/min, 5 min; 40 L/min. Biofilm reduction was observed at all treated samples. Also, there was an increase in cellular leakage with a longer plasma treatment. Although there were a significant reduction and 0 % of recovery after the plasma treatments further investigation of the method is needed to clarify whether there are sensorial, physical and chemical changes in juices after the plasma treatment. Acknowledgments: The authors would like to acknowledge the support by Croatian Science Foundation and research project 'Application of electrical discharge plasma for the preservation of liquid foods'.

Keywords: salmonella enterica serotype typhimurium lt21, gas-phase plasma treatment, inactivation, stress response

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Authors: C. F. Glover, J. Marinaccio, A. Barnes, I. Mabbett, G. Williams

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The aim of the current study is to optimise formulations, in terms of charging efficiency, of a printed Ni(OH)2 precursor coating of a battery anode. Through the assessment of the current densities during charging, the efficiency of a range of formulations are compared. The Scanning vibrating electrode technique (SVET) is used extensively in the field of corrosion to measure area-averaged current densities of freely-corroding metal surfaces when fully immersed in electrolyte. Here, a Ni(OH)2 electrode is immersed in potassium hydroxide (30% w/v solution) electrolyte and charged using a range of applied currents. Samples are prepared whereby multiple coatings are applied to one substrate, separated by a non-conducting barrier, and charged using a constant current. With a known applied external current, electrode efficiencies can be calculated based on the current density outputs measured using SVET. When fully charged, a green Ni(OH)2 is oxidised to a black NiOOH surface. Distinct regions displaying high current density, and hence a faster oxidising reaction rate, are located using the SVET. This is confirmed by a darkening of the region upon transition to NiOOH. SVET is a highly effective tool for assessing homogeneity of electrodes during charge/discharge. This could prove particularly useful for electrodes where there are no visible surface appearance changes. Furthermore, a scanning Kelvin probe technique, traditionally used to assess underfilm delamination of organic coatings for the protection of metallic surfaces, is employed to study the change in phase of oxides, pre and post charging.

Keywords: battery, electrode, nickel hydroxide, SVET, printed

Procedia PDF Downloads 232

Authors: Debananda Mohapatra, Subramanya Badrayyana, Smrutiranjan Parida

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Recognizing the upcoming era of carbon nanostructures and their revolutionary applications, we investigated the formation and supercapacitor application of highly pure and hydrophilic carbon nano-onions (CNOs) by economical one-step flame-synthesis procedure. The facile and scalable method uses easily available organic carbon source such as clarified butter, restricting the use of any catalyst, sophisticated instrumentation, high vacuum and post processing purification procedure. The active material was conformally coated onto a locally available cotton wipe by “sonicating and drying” process to obtain novel, lightweight, inexpensive, flexible, binder-free electrodes with strong adhesion between nanoparticles and porous wipe. This interesting electrode with CNO as the active material delivers a specific capacitance of 102.16 F/g, the energy density of 14.18 Wh/kg and power density of 2448 W/kg which are the highest values reported so far in symmetrical two electrode cell configuration with 1M Na2SO4 as an electrolyte. Incorporation of CuO nanoparticles to these functionalized CNOs by one-step hydrothermal method add up to a significant specific capacitance of 420 F/g with deliverable energy and power density at 58.33 Wh/kg and 4228 W/kg, respectively. The free standing CNOs, as well as CNO-CuO composite electrode, showed an excellent cyclic performance and stability retaining 95 and 90% initial capacitance even after 5000 charge-discharge cycles at a current density of 5 A/g. This work presents a new platform for high performance supercapacitors for next generation wearable electronic devices.

Keywords: binder-free, flame synthesis, flexible, carbon nano-onion

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Authors: Asma Shaheen, Javed Iqbal

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The water resources are depleting due to an intrusion of industrial pollution. There are clusters of industries including leather tanning, textiles, batteries, and chemical causing contamination. These industries use bulk quantity of water and discharge it with toxic effluents. The penetration of heavy metals through irrigation from industrial effluent has toxic effect on soil and groundwater. There was strong positive significant correlation between all the heavy metals in three media of industrial effluent, soil and groundwater (P < 0.001). The metal to the metal association was supported by dendrograms using cluster analysis. The geospatial variability was assessed by using geographically weighted regression (GWR) and pollution model to identify the simulation of carcinogenic elements in soil and groundwater. The principal component analysis identified the metals source, 48.8% variation in factor 1 have significant loading for sodium (Na), calcium (Ca), magnesium (Mg), iron (Fe), chromium (Cr), nickel (Ni), lead (Pb) and zinc (Zn) of tannery effluent-based process. In soil and groundwater, the metals have significant loading in factor 1 representing more than half of the total variation with 51.3 % and 53.6 % respectively which showed that pollutants in soil and water were driven by industrial effluent. The cumulative eigen values for the three media were also found to be greater than 1 representing significant clustering of related heavy metals. The results showed that heavy metals from industrial processes are seeping up toxic trace metals in the soil and groundwater. The poisonous pollutants from heavy metals turned the fresh resources of groundwater into unusable water. The availability of fresh water for irrigation and domestic use is being alarming.

Keywords: groundwater, geostatistical, heavy metals, industrial effluent

Procedia PDF Downloads 225

Authors: Stephan Schiffer, Andreas Kain, Philipp Wilde, Maximilian Helbing, Bernard Bäker

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Automobile manufacturers progressively focus on a downsizing strategy to meet the EU's CO2 requirements concerning type-approval consumption cycles. The reduction in naturally aspirated engine power is compensated by increased levels of turbocharging. By downsizing conventional engines, CO2 emissions are reduced. However, it also implicates major challenges regarding longitudinal dynamic characteristics. An example of this circumstance is the delayed turbocharger-induced torque reaction which leads to a partially poor response behavior of the vehicle during acceleration operations. That is why it is important to focus conventional drive train design on real customer driving again. The currently considered dynamic maneuvers like the acceleration time 0-100 km/h discussed by journals and car manufacturers describe longitudinal dynamics experienced by a driver inadequately. For that reason we present the realization and evaluation of a comprehensive proband study. Subjects are provided with different vehicle concepts (electrified vehicles, vehicles with naturally aspired engines and vehicles with different concepts of turbochargers etc.) in order to find out which dynamic criteria are decisive for a subjectively strong acceleration and response behavior of a vehicle. Subsequently, realistic acceleration criteria are derived. By weighing the criteria an evaluation metric is developed to objectify customer-oriented transient dynamics. Fully-electrified vehicles are the benchmark in terms of customer-oriented longitudinal dynamics. The electric machine provides the desired torque almost without delay. This advantage compared to combustion engines is especially noticeable at low engine speeds. In conclusion, we will show the degree to which extent customer-relevant longitudinal dynamics of conventional vehicles can be approximated to electrified vehicle concepts. Therefore, various technical measures (turbocharger concepts, 48V electrical chargers etc.) and drive train designs (e.g. varying the final drive) are presented and evaluated in order to strengthen the vehicle’s customer-relevant transient dynamics. As a rating size the newly developed evaluation metric will be used.

Keywords: 48V, customer-oriented driving dynamics, electric charger, electrified vehicles, vehicle concepts

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Authors: Maria E. Laconi, Kyla D. Scherr, Mary A. Jamieson

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Human populations in urban environments have rapidly grown in recent decades. Consequently, the intensity of land-use and development has also increased in many urban and peri-urban environments. Some cities, such as Detroit, Michigan, USA, have embraced urban agriculture and local food production. Little is known, however, about how the local and landscape scale environmental factors influence crop productivity on urban farms. Our study aims to evaluate factors influencing the productivity of strawberries on community farms and gardens in the Detroit metropolitan area. Strawberries are one of few fruits that can provide an abundant harvest just after the first season of being planted, which is ideal for urban gardeners in developed areas. In the spring of 2016, we planted six different strawberry cultivars (three everbearing and three June bearing varieties) at five farm sites in Wayne and Oakland County (six replicate plants per cultivar per site). We surveyed flower and fruit phenology and production for everbearing varieties weekly (flowers for June bearing varieties were removed to enhance productivity in the coming growing season). Additionally, we conducted one initial 36hr pollinator survey in mid-September during peak fruit production and characterized local and landscape scale land-cover data. Preliminary results and observations from this first year of our study revealed that strawberry production varied significantly by site. Specifically, productivity at our most northern site appeared to suffer from delayed phenology and early frost damage to ripening strawberries. Bee abundance and diversity also differed among farms, though further surveys are needed to adequately inventory the pollinator community. Finally, strawberry cultivars demonstrated significant differences in the number and size of fruits produced. We plan to continue this study in the coming years, increasing the number of sites surveyed and number of pollinator sampling events. Our study aims to inform strategies for enhancing crop productivity on urban and peri-urban farms.

Keywords: insect pollination, strawberry productivity, sustainable agriculture, urban gardening

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Authors: Indu Bala Sethi, Meena Sewhag, Rakesh Kumar, Parveen Kumar

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Field experiment was conducted at Pulse Research Area of CCS Haryana Agricultural University, Hisar during rabi 2012-13 to study the economics of chickpea cultivars as influenced by sowing time and seed rate on sandy loam soils under irrigated conditions. The factorial experiment consisting of 24 treatment combinations with two sowing time (1st fortnight of November and 1st fortnight of December.) and four cultivars (H09-23, H08-18, C-235 and HC-1) kept in main plots while three seed rates viz. 40 kg ha-1, 50 kg ha-1 and 60 kg ha-1 was laid out in split plot design with three replications. The crop was sown with common row spacing of 30 cm as per the dates of sowing. The fertilizer was applied in the form of di- ammonium phosphate. The soil of the experimental site was deep sandy loam having pH of 7.9, EC of 0.13 dS/m and low in organic carbon (0.34%), low in available N status (193.36 kg ha-1), medium in available P2O5 (32.18 kg ha-1) and high in available K2O (249.67 kg ha-1). The crop was irrigated as and when required so as to maintain adequate soil moisture in the root zone The crop was sprayed with monocrotophos (1.25 l/ha) at initiation of flowering and at pod filling stage to protect the crop from pod borer attack. The yield was measured at the time of harvest. The cost of field preparation, sowing of seeds, thinning, weeding, plant protection, harvesting and cleaning contributed to fixed cost. The experiment was laid out in a split plot design with two sowing time (1st fortnight of November and 1st fortnight of December.) and four cultivars (H09-23, H08-18, C-235 and HC-1) kept in main plots while three seed rates viz. 40 kg ha-1, 50 kg ha-1 and 60 kg ha-1 were kept in subplots and replicated thrice. Results revealed that 1st fortnight of November sowing recorded significantly higher gross (Rs.1, 01,254 ha-1), net returns (Rs. 68,504 ha-1) and BC (3.09) ratio as compared to delayed crop of chickpea. Highest gross (Rs.91826 ha-1), net returns (Rs. 59076ha-1) and BC ratio (2.81) was recorded with H08-18. Higher value of cost of cultivation of chickpea was observed in higher seed rate than the lower ones. However no significant variation in net and gross returns was observed due to seed rates. Highest BC (2.72) ratio was recorded with 50 kg ha-1 which differs significantly from 60 kg ha-1 but was at par with 40 kg ha-1. This is because of higher grain yield obtained with 50 kg ha-1 seed rate. Net profit for farmers growing chickpea with seed rate of 50 kg ha-1 was higher than the farmers growing chickpea with seed rate of 40 and 60 kg ha.

Keywords: chickpea, cultivars, seed rate, sowing time

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Authors: Shouta Sora, Shizuki Kuriu, Radhika Mishra, Ariunbuyan Sukhbaatar, Maya Sakamoto, Shiro Mori, Tetsuya Kodama

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Lymph node (LN) metastasis accounts for 20 - 30 % of all deaths in patients with head and neck cancer. Therefore, the control of metastatic lymph nodes (MLNs) is necessary to improve the life prognosis of patients with cancer. In a classical metastatic theory, tumor cells are thought to metastasize hematogenously through a bead-like network of lymph nodes. Recently, a lymph node-mediated hematogenous metastasis theory has been proposed, in which sentinel LNs are regarded as a source of distant metastasis. Therefore, the treatment of MLNs at the early stage is essential to prevent distant metastasis. Radiation therapy is one of the primary therapeutic modalities in cancer treatment. In addition, total body irradiation (TBI) has been reported to act as activation of natural killer cells and increase of infiltration of CD4+ T-cells to tumor tissues. However, the treatment effect of TBI for MLNs remains unclear. This study evaluated the possibilities of low-dose total body irradiation (L-TBI) and middle-dose total body irradiation (M-TBI) for the treatment of MLNs. Mouse breast cancer FM3A-Luc cells were injected into subiliac lymph node (SiLN) of MXH10/Mo/LPR mice to induce the metastasis to the proper axillary lymph node (PALN) and lung. Mice were irradiated for the whole body on 4 days after tumor injection. The L-TBI and M-TBI were defined as irradiations to the whole body at 0.2 Gy and 1.0 Gy, respectively. Tumor growth was evaluated by in vivo bioluminescence imaging system. In the non-irradiated group, tumor activities on SiLN and PALN significantly increased over time, and the metastasis to the lung from LNs was confirmed 28 days after tumor injection. The L-TBI led to a tumor growth delay in PALN but did not control tumor growth in SiLN and metastasis to the lung. In contrast, it was found that the M-TBI significantly delayed the tumor growth of both SiLN and PALN and controlled the distant metastasis to the lung compared with non-irradiated and L-TBI groups. These results suggest that the M-TBI is an effective treatment method for MLNs in the early stage and distant metastasis from lymph nodes via blood vessels connected with LNs.

Keywords: metastatic lymph node, lung metastasis, radiation therapy, total body irradiation, lymphatic system

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Authors: Ji Jiazheng, Wang Jingrao, Jin Xin, Zhang Hong

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Diabetes mellitus is a metabolic disease characterized by high blood sugar. A long-standing hyperglycemic state can lead to various tissue damage. Diabetic retinopathy is the most common and widely studied ocular complication and has become the leading cause of blindness in my country. At the same time, diabetes has profound clinically relevant effects on the cornea, leading to keratopathy and vision-threatening. The cornea is an avascular tissue and is sensitive to hyperglycemia, Keratopathy caused by diabetes is usually chronic, they are called diabetic keratopathy or diabetic neurotrophic keratopathy, leading to several diabetic corneal complications including delayed epithelial wound healing, recurrent erosions, neuropathy, loss of sensitivity. Corneal stem cell dysfunction in diabetic patients as an important influencing factor of diabetic keratopathy. The consequences of this condition are often underestimated. The limbus is located between the cornea and the sclera tissue. The limbal stroma consists of a series of radial elevations with fibrovascular centers known as palisades of Vogt (POV). Previous studies have shown that palisades of Vogt (POV), as the main site of limbal stem cells, plays an important role in the homeostasis of the corneal epithelium. Therefore, POV plays a vital role in the healing of corneal epithelial surgery and postoperative evaluation. IVCM can observe the condition of the corneal epithelium at the cellular level. It has profound significance and guidance for the evaluation of limbal and limbal stem cells. We have previously observed structural changes in POV in HSK and HZO patients on IVCM. At present, there have been reports involving limbal stem cell dysfunction in diabetic patients, but the specific pathogenesis is still unclear. However, there are no studies on POV morphological changes in patients with DM. Therefore, we performed statistics and compared the correlation between POV morphological changes and corneal epithelial basal cell density, corneal nerves, and length of disease in DM patients and normal humans using IVCM studies. At the same time, fundoscopy was used to observe the correlation between the thickness of RNFL and the thickness of GCC and POV in diabetic patients. And to observe the correlation between SVD, DVD and POV for research.

Keywords: confocal microscopy, fundus, limbal stem cells, diabetes

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Authors: Namwinwelbere Dabire, Eugene C. Ezin, Adandedji M. Firmin

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The prediction of hydrological flows (rainfall-depth or rainfall-discharge) is becoming increasingly important in the management of hydrological risks such as floods. In this study, the Long Short-Term Memory (LSTM) network, a state-of-the-art algorithm dedicated to time series, is applied to predict the daily water level of Nokoue Lake in Benin. This paper aims to provide an effective and reliable method enable of reproducing the future daily water level of Nokoue Lake, which is influenced by a combination of two phenomena: rainfall and river flow (runoff from the Ouémé River, the Sô River, the Porto-Novo lagoon, and the Atlantic Ocean). Performance analysis based on the forecasting horizon indicates that LSTM can predict the water level of Nokoué Lake up to a forecast horizon of t+10 days. Performance metrics such as Root Mean Square Error (RMSE), coefficient of correlation (R²), Nash-Sutcliffe Efficiency (NSE), and Mean Absolute Error (MAE) agree on a forecast horizon of up to t+3 days. The values of these metrics remain stable for forecast horizons of t+1 days, t+2 days, and t+3 days. The values of R² and NSE are greater than 0.97 during the training and testing phases in the Nokoué Lake basin. Based on the evaluation indices used to assess the model's performance for the appropriate forecast horizon of water level in the Nokoué Lake basin, the forecast horizon of t+3 days is chosen for predicting future daily water levels.

Keywords: forecasting, long short-term memory cell, recurrent artificial neural network, Nokoué lake

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Authors: Hebah M. Musalem, Jeylan El-Mansoury, Lin M. Tuleimat, Selwa Alhazza, Abdul-Aziz A. Al Zoba

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Background: Amblyopia is a condition that affects the visual system triggering a decrease in visual acuity without a known underlying pathology. It is due to abnormal vision development in childhood or infancy. Most importantly, vision loss is preventable or reversible with the right kind of intervention in most of the cases. Strabismus, sensory defects, and anisometropia are all well-known causes of amblyopia. However, ocular misalignment in Strabismus is considered the most common form of amblyopia worldwide. The risk of developing amblyopia increases in premature children, developmentally delayed or children who had brain lesions affecting the visual pathway. The prevalence of amblyopia varies between 2 to 5 % in the world according to the literature. Objective: To determine the different causes of Amblyopia in pediatric patients seen in ophthalmology clinic of a tertiary care center, i.e. King Faisal Specialist Hospital and Research Center (KFSH&RC). Methods: This is a hospital based, random retrospective, based on reviewing patient’s files in the Ophthalmology Department of KFSH&RC in Riyadh city, Kingdom of Saudi Arabia. Inclusion criteria: amblyopic pediatric patients who attended the clinic from 2015 to 2016, who are between 6 months and 18 years old. Exclusion Criteria: patients above 18 years of age and any patient who is uncooperative to obtain an accurate vision or a proper refraction. Detailed ocular and medical history are recorded. The examination protocol includes a full ocular exam, full cycloplegic refraction, visual acuity measurement, ocular motility and strabismus evaluation. All data were organized in tables and graphs and analyzed by statistician. Results: Our preliminary results will be discussed on spot by our corresponding author. Conclusions: We focused on this study on utilizing various examination techniques which enhanced our results and highlighted a distinguished correlation between amblyopia and its’ causes. This paper recommendation emphasizes on critical testing protocols to be followed among amblyopic patient, especially in tertiary care centers.

Keywords: amblyopia, amblyopia causes, amblyopia diagnostic criterion, amblyopia prevalence, Saudi Arabia

Procedia PDF Downloads 152

Authors: Shun-Tong Chen, Wei-Ping Huang, Hong-Ye Yang, Ming-Chieh Yeh, Chih-Wei Du

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This study presents a novel versatile high-precision integrated micromachining system that combines contact and non-contact micromachining techniques to machine intricate micro-parts precisely. Two broad methods of micro fabrication-1) volume additive (micro co-deposition), and 2) volume subtractive (nanometric flycutting, ultrafine w-EDM (wire Electrical Discharge Machining), and micro honing) - are integrated in the developed micromachining system, and their effectiveness is verified. A multidirectional headstock that supports various machining orientations is designed to evaluate the feasibility of multifunctional micromachining. An exchangeable working-tank that allows for various machining mechanisms is also incorporated into the system. Hence, the micro tool and workpiece need not be unloaded or repositioned until all the planned tasks have been completed. By using the designed servo rotary mechanism, a nanometric flycutting approach with a concentric rotary accuracy of 5-nm is constructed and utilized with the system to machine a diffraction-grating element with a nano-metric scale V-groove array. To improve the wear resistance of the micro tool, the micro co-deposition function is used to provide a micro-abrasive coating by an electrochemical method. The construction of ultrafine w-EDM facilitates the fabrication of micro slots with a width of less than 20-µm on a hardened tool. The hardened tool can thus be employed as a micro honing-tool to hone a micro hole with an internal diameter of 200 µm on SKD-11 molded steel. Experimental results prove that intricate micro-parts can be in-situ manufactured with high-precision by the developed integrated micromachining system.

Keywords: integrated micromachining system, in-situ micromachining, nanometric flycutting, ultrafine w-EDM, micro honing

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Authors: Dalila Oulhaci, Mehdi Benlarbi, Mohammed Zahaf

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The irrigation method is fundamental for maintaining a wet bulb around the roots of the crop. This is the case with localized irrigation, where soil moisture can be maintained permanently around the root system between the two water content extremes. Also, one of the oldest methods used since Roman times throughout North Africa and the Near East is based on the frequent dumping of water into porous pottery vases buried in the ground. In this context, these two techniques have been combined by replacing the pottery vase with plastic bottles filled with sand that discharge water through their perforated walls into the surrounding soil. The first objective of this work is the theoretical determination using CLIMWAT and CROPWAT software of the irrigation doses of some crops (palm, wheat, and onion) and experimental by measuring the humidity of the soil before and after watering. The second objective is to determine the purifying power of the sand filter in the bottle. Based on the CROPWAT software results, the date palm needs 18.5 mm in the third decade of December, 57.2 mm in January, and 73.7 mm in February, whereas the doses received by experimentally determined by means of soil moisture before and after irrigation are 19.5 mm respectively, 79.66 mm and 95.66 mm. The onion needs 14.3 mm in the third decade of December of, 59.1 mm in January, and 80 mm in February, whereas the experimental dose received is 15.07 mm, respectively, 64.54 and 86.8 mm. The total requirements for the vegetative period are estimated at 1642.6 mm for date palms, 277.4 mm for wheat, and 193.5 mm for onions. The removal rate of the majority of pollutants from the bottle is 80%. This work covers, on the one hand, the context of water conservation, sustainable development, and protection of the environment, and on the other, the agricultural field.

Keywords: irrigation, sand, filter, humidity, bottle

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Authors: Resham Lal Phuldel

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This study based on a bilateral development cooperation project funded by the governments of Nepal and Finland. The first phase of the project has been completed in August 2012 and the phase II started in September 2013 and will end September 2018. The project strengthens the capacity of local governments in 14 districts to deliver services in water supply, sanitation and hygiene in Western development region and in Mid-Western development region of Nepal. In recent days, several spring sources have been dried out or slowly decreasing its yield across the country due to changing character of rainfall, increasing evaporative losses and some other manmade causes such as land use change, infrastructure development work etc. To sustain the hilly communities, the sources have to be able to provide sufficient water to serve the population, either on its own or in conjunction with other sources. Phase III have measured all water sources in Tanahu district in 2004 and sources were located with the GPS. Phase II has repeated the exercise to see changes in the district. 3320 water sources as identified in 2004 and altogether 4223 including new water sources were identified and measured in 2014. Between 2004 and 2014, 50% flow rate (yield) deduction of point sources’ average yield in 10 years is found. Similarly, 21.6% and 34% deductions of average yield were found in spring and stream water sources respectively. The rainfall from 2002 to 2013 shows erratic rainfalls in the district. The monsoon peak month is not consistent and the trend shows the decrease of annual rainfall 16.7 mm/year. Further, the temperature trend between 2002 and 2013 shows warming of + 0.0410C/year.

Keywords: climate change, rainfall, source discharge, water sources

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Authors: Susan Scott, Dina Hanna, Bassel Zebian, Gary Ruiz, Sreena Das

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Although the number of cases of TB in England has fallen over the last 4 years, it remains an important public health burden with 1 in 20 cases dying annually. The vast majority of cases present in non-UK born individuals with social risk factors. We present a case of non-pulmonary TB presenting in a healthy child born in the UK to professional parents. We present a case of a healthy 10 year old boy who developed acute back pain during school PE. Over the next 5 months, he was seen by various health and allied professionals with worsening back pain and kyphosis. He became increasing unsteady and for the 10 days prior to admission to our hospital, he developed fevers. He was admitted to his local hospital for tonsillitis where he suffered two falls on account of his leg weakness. A spinal X-ray revealed a pathological fracture and gibbus formation. He was transferred to our unit for further management. On arrival, the patient had lower motor neurone signs of his left leg. He underwent spinal fixture, laminectomy and decompression. Microbiology samples taken intra-operatively confirmed Mycobacterium Tuberculosis. He had a positive Mantoux and T-spot and treatment were commenced. There was no evidence of immune compromise. The patient was born in the UK, had a BCG scar and his only travel history had been two years prior to presentation when he travelled to the Phillipines for a short holiday. The patient continues to have issues around neuropathic pain, mobility, pill burden and mild liver side effects from treatment. Discussion: There is a paucity of case reports on spinal TB in paediatrics and diagnosis is often difficult due to the non-specific symptomatology. Although prognosis on treatment is good, a delayed diagnosis can have devastating consequences. This case highlights the continued need for higher index of suspicion and diagnosis in a world with changing patterns of migration and increase global travel. Surgical intervention is limited to the most serious cases to minimise further neurological damage and improve prognosis. There remains the need for a multi-disciplinary approach to deal with challenges of treatment and rehabilitation.

Keywords: tuberculosis, non-pulmonary TB, public health burden, diagnostic challenge

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Authors: Khaled Al-Badani, James Ren, Lisa Li, David Allanson

Abstract:

Droplet formation is an important process in many engineering systems and manufacturing procedures, which includes welding, biotechnologies, 3D printing, biochemical, biomedical fields and many more. The volume and the characteristics of droplet formation are generally depended on various material properties, microfluidics and fluid mechanics considerations. Hence, a detailed investigation of this process, with the aid of numerical computational tools, are essential for future design optimization and process controls of many engineering systems. This will also improve the understanding of changes in the properties and the structures of materials, during the formation of the droplet, which is important for new material developments to achieve different functions, pending the requirements of the application. For example, the shape of the formed droplet is critical for the function of some final products, such as the welding nugget during Capacitor Discharge Welding process, or PLA 3D printing, etc. Although, most academic journals on droplet formation, focused on issued with material transfer rate, surface tension and residual stresses, the general emphasis on the characteristics of droplet shape has been overlooked. The proposed work for this project will examine theoretical methodologies, experimental techniques, and numerical modelling, using ANSYS FLUENT, to critically analyse and highlight optimization methods regarding the formation of pendant droplet. The project will also compare results from published data with experimental and numerical work, concerning the effects of key material parameters on the droplet shape. These effects include changes in heating/cooling rates, solidification/melting progression and separation/break-up times. From these tests, a set of objectives is prepared, with an intention of improving quality, stability and productivity in modelling metal welding and 3D printing.

Keywords: computer modelling, droplet formation, material distortion, materials forming, welding

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Authors: Rowane May A. Fesalbon, Greyland C. Agno, Jodel L. Cuasay, Dindo A. Malonzo, Ma. Rosario Concepcion O. Ang

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The Department of Energy of the Republic of the Philippines estimates that the country’s energy reserves for 2015 are dwindling– observed in the rotating power outages in several localities. To aid in the energy crisis, a national hydropower resource assessment scheme is developed. Hydropower is a resource that is derived from flowing water and difference in elevation. It is a renewable energy resource that is deemed abundant in the Philippines – being an archipelagic country that is rich in bodies of water and water resources. The objectives of this study is to develop a methodology for a national hydropower resource assessment using hydrologic modeling and geospatial techniques in order to generate resource maps for future reference and use of the government and other stakeholders. The methodology developed for this purpose is focused on two models – the implementation of the Soil and Water Assessment Tool (SWAT) for the river discharge and the use of geospatial techniques to analyze the topography and obtain the head, and generate the theoretical hydropower potential sites. The methodology is highly coupled with Geographic Information Systems to maximize the use of geodatabases and the spatial significance of the determined sites. The hydrologic model used in this workflow is SWAT integrated in the GIS software ArcGIS. The head is determined by a developed algorithm that utilizes a Synthetic Aperture Radar (SAR)-derived digital elevation model (DEM) which has a resolution of 10-meters. The initial results of the developed workflow indicate hydropower potential in the river reaches ranging from pico (less than 5 kW) to mini (1-3 MW) theoretical potential.

Keywords: ArcSWAT, renewable energy, hydrologic model, hydropower, GIS

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Authors: Elizabeth B. Katana, Brenda N. Simbwa, Josephine Namayanja, Bob O. Amodan, Edirisa J. Nsubuga, Eva A. O. Laker

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Background: Understanding stakeholders’ perceptions towards the implementation of a mass vaccination campaign is important to ensure the design of better strategies to address challenges. We explored stakeholders’ perceptions of the implementation of a nationwide door-to-door mass vaccination campaign for the oral polio vaccine (nOPV2) in Uganda for the two rounds that occurred in January and November 2022. Methods: A qualitative study was conducted among stakeholders who participated in the campaign implementation from 8 districts in Uganda using random sampling. We conducted 46 In-depth interviews lasting 30 – 40 minutes with 6 national/central supervisors, 12 district, 14 sub-county, and 14 parish-level supervisors. Stakeholders were asked about their experiences in the campaign implementation, including challenges faced and their opinions of the campaign impact and use of the door-to-door strategy. Data were analyzed thematically in line with the major campaign activities. Results: Most of the stakeholders were primarily concerned about poor planning, inadequate training of vaccination teams, community resistance including schools, challenges with recruitment and teaming of vaccinators, poor and delayed payments, lack of logistics and motivation for vaccination teams, the timing of the activities and implementing amidst COVID-19 and Ebola. The stakeholders believed that the first round was not well planned and implemented, while the second round was leveraged in their previous experiences. On the other hand, some positive experiences were noted with regard to communication, advocacy and mobilization, vaccine delivery and distribution, district readiness assessments, and cold chain management. Conclusion: This study identified many challenges that were faced in the implementation of the door-to-door mass campaign for nOPV2 in Uganda. This study identified that more needs to be done to improve door-to-door mass campaigns with a focus on motivating the implementers. These findings highlight the need for conducting performance reviews, improved planning, especially routine updates and verification of target populations and training in microplanning, and adequate mapping of community resistance to inform the implementation of future mass campaigns.

Keywords: mass polio vaccination campaigns, door-to-door strategy, stakeholders' perceptions, implementation challenges

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Authors: Ramin Mansouri

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Due to the contrast of rivers discharge regime with water demands, one of the best ways to use water resources is to regulate the natural flow of the rivers and supplying water needs to construct dams. Optimal utilization of reservoirs, consideration of multiple important goals together at the same is of very high importance. To study about analyzing this method, statistical data of Bakhtiari and Roudbar dam over 46 years (1955 until 2001) is used. Initially an appropriate objective function was specified and using DE algorithm, the rule curve was developed. In continue, operation policy using rule curves was compared to standard comparative operation policy. The proposed method distributed the lack to the whole year and lowest damage was inflicted to the system. The standard deviation of monthly shortfall of each year with the proposed algorithm was less deviated than the other two methods. The Results show that median values for the coefficients of F and Cr provide the optimum situation and cause DE algorithm not to be trapped in local optimum. The most optimal answer for coefficients are 0.6 and 0.5 for F and Cr coefficients, respectively. After finding the best combination of coefficients values F and CR, algorithms for solving the independent populations were examined. For this purpose, the population of 4, 25, 50, 100, 500 and 1000 members were studied in two generations (G=50 and 100). result indicates that the generation number 200 is suitable for optimizing. The increase in time per the number of population has almost a linear trend, which indicates the effect of population in the runtime algorithm. Hence specifying suitable population to obtain an optimal results is very important. Standard operation policy had better reversibility percentage, but inflicts severe vulnerability to the system. The results obtained in years of low rainfall had very good results compared to other comparative methods.

Keywords: reservoirs, differential evolution, dam, Optimal operation

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Authors: Md. Kumruzzaman, Anutosh Das, Md. Mosharraf Hossain

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Historically, rapid urban growth activities are considered one of the main culprits behind urban floods or waterlogging. The increased unplanned urbanization of many areas of Dhaka has resulted in waterlogging, urban floods, and increasing groundwater depth. To determine potential groundwater recharge from precipitation, the study is being conducted to examine the changes in land use/land cover (LULC) and urban runoff extent based on the NRCS-CN from 2005–2021. Four kinds of land use are used to examine the LULC change: built-up, bare land, vegetation, and water body. These categories are used for the years 2005, 2010, 2015, and 2021. The built-up area is growing at a relatively fast rate: 7.43%, 17.4%, and 5.21%, respectively, between the years 2005 and 2010, 2010 and 2015, and 2015 and 2021. As the amount of impervious surface rose in Dhaka city, stormwater discharge increased from 2005 to 2021. In 2005, 2010, 2015, and 2021, heavy stormwater runoff regions made up around 24.873%, 32.616%, 49.118%, and 55.986% of the entire Dhaka city. Stormwater runoff accounted for around 53.738%, 55.092%, 63.472%, and 67.061% of the total rainfall in 2005, 2010, 2015, and 2021, respectively. Between 2005 and 2021, a significant portion of the natural land cover was altered because of the expanding impervious surface, which also harmed the natural drainage system. Due to careless growth, the potential for stormwater runoff and groundwater recharge in Dhaka city worsens every year. Concerning this situation, a sustainable urban drainage system (SUDS) can be the best possible solution for minimizing the stormwater runoff and groundwater recharge problem.

Keywords: LULC, impervious surface, stormwater runoff, groundwater recharge, SUDS

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Authors: Ali Kadivar, Kaveh Niayesh

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This report summarizes a simulation-based approach to estimate the current interruption behavior of a fuse element utilized in a DC network protecting battery banks under different stresses. Due to internal resistance of the battries, the short circuit current in very close to the nominal current, and it makes the fuse designation tricky. The base configuration considered in this report consists of five fuse units in parallel. The simulations are performed using a multi-physics software package, COMSOL® 5.6, and the necessary material parameters have been calculated using two other software packages.The first phase of the simulation starts with the heating of the fuse elements resulted from the current flow through the fusing element. In this phase, the heat transfer between the metallic strip and the adjacent materials results in melting and evaporation of the filler and housing before the aluminum strip is evaporated and the current flow in the evaporated strip is cut-off, or an arc is eventually initiated. The initiated arc starts to expand, so the entire metallic strip is ablated, and a long arc of around 20 mm is created within the first 3 milliseconds after arc initiation (v_elongation = 6.6 m/s. The final stage of the simulation is related to the arc simulation and its interaction with the external circuitry. Because of the strong ablation of the filler material and venting of the arc caused by the melting and evaporation of the filler and housing before an arc initiates, the arc is assumed to burn in almost pure ablated material. To be able to precisely model this arc, one more step related to the derivation of the transport coefficients of the plasma in ablated urethane was necessary. The results indicate that an arc current interruption, in this case, will not be achieved within the first tens of milliseconds. In a further study, considering two series elements, the arc was interrupted within few milliseconds. A very important aspect in this context is the potential impact of many broken strips parallel to the one where the arc occurs. The generated arcing voltage is also applied to the other broken strips connected in parallel with arcing path. As the gap between the other strips is very small, a large voltage of a few hundred volts generated during the current interruption may eventually lead to a breakdown of another gap. As two arcs in parallel are not stable, one of the arcs will extinguish, and the total current will be carried by one single arc again. This process may be repeated several times if the generated voltage is very large. The ultimate result would be that the current interruption may be delayed.

Keywords: DC network, high current / low SC fuses, FEM simulation, paralle fuses

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Authors: Manee Hasap, Mongkolchai Hasap, Tasanee Nasae

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The purpose of this study was to evaluate the primary caregivers’ knowledge and capabilities for providing quality care to be hospitalized post-hip fracture surgery elderly patients. The theoretical framework of the study was derived from the concepts of dependent care agency in Orem’s Self-Care theory, and family care provision for the elderly and chronically ill patients. 59 subjects were purposively selected. The subjects were primary caregivers of post-operated hip fracture elderly patients who had been admitted to the Orthopaedic Ward of Songklanagarind Hospital. Demographic data of the caregivers and patients were collected by non-participant observation using the evaluation and recording forms. The reliability of caregivers’ knowledge measurement (0.86) was obtained by KR-20 and that of caregivers’ capabilities for post-operative care evaluation form (0.97) obtained from 2 observers by interrater reliability. The data were analyzed using descriptive statistic, which were frequency, percentage, mean, and standard deviation. The result of this study indicated that elderly patients with post-hip fracture surgery had many pre-discharge self care limitations. Approximately, 75% of the caregivers had knowledge to respond to patient’s essential needs at a high level, while the rest (25%) had this knowledge a moderate level. For observation, 57.63% of the subjects had capabilities in care practice at a moderate level; 28.81% had capabilities in care practice at a high level, while 13.56% had at a low level. The result of this study can be used as basic information for patients and caregivers capabilities developing plan especially, providing patients’ activities, accident surveillance and complications prevention for a good life quality of elderly patients after hip surgery both hospitalization and rehabilitation at home.

Keywords: care givers’ knowledge, care givers’ capabilities, elderly hip fracture patients, patients

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Authors: Tahir Khaleeq, Patrick Lancaster, Keji Fakoya, Pedro Ferreira, Usman Ahmed

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Introduction: Virtual fracture clinics (VFC) have been shown to be a safe and cost-effective way of managing outpatient referrals to the orthopaedic department. During the coronavirus pandemic there has been a push to reduce unnecessary patient contact whilst maintaining patient safety. Materials and Methods: A protocol was developed by the clinical team in collaboration with Advanced Physiotherapy Practitioners (APP) on how to manage common musculoskeletal presentations to A&E prior to COVID as part of routine service development. Patients broadly triaged into 4 categories; discharge with advice, referral to VFC, referral to face to face clinic or discussion with on call team. The first 9 months of data were analysed to assess types of injury seen and outcomes. Results: In total 2489 patients were referred to VFC from internal and external sources. 734 patients were discharged without follow-up and 182 patients were discharged for physiotherapy review. Only 3 patients required admission. Regarding follow-ups, 431 patients had a virtual follow-up while 1036 of patients required further face to face follow up. 87 patients were triaged into subspecialty clinics. 37 patients were felt to have been referred inappropriately. Discussion: BOA guidelines suggest all patients need to be reviewed within 72 hours of their orthopaedic injury. Implementation of a VFC allows this target to be achieved and at the same time reduce patient contact. Almost half the patients were discharged following VFC review, the remaining patients were appropriately followed up. This is especially relevant in the current pandemic where reducing unnecessary trips to hospital will benefit the patient as well as make the most of the resources available.

Keywords: virtual fracture clinic, lockdown, trauma and orthopaedics, Covid- 19

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Authors: Barbara Farinon, Maurizio E. Picarella, Lorenzo Mancini, Andrea Mazzucato

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Italy is notoriously a secondary center of diversification for cultivated tomatoes (Solanum lycopersicum L.). The study of phenotypic and genetic diversity in landrace collections is important for germplasm conservation and biodiversity protection. Here, we set up to study the germplasm collected in the region of Lazio in Central Italy with a focus on the distinctiveness among landraces and the attribution of membership to unnamed accessions. Our regional collection included 30 accessions belonging to six different locally recognized landraces and 21 unnamed accessions. All accessions were gathered in Lazio and belonged to the collection held at the Regional Agency for the Development and Innovation of Agriculture in Lazio (ARSIAL, in the application of the Regional Act n. 15/2000, funded by Lazio Rural Development Plan 2014 – 2020 Agro-environmental Measure, Action 10.2.1) and at the University of Tuscia. We included 13 control genotypes as references. The collection showed wide phenotypic variability for several traits, such as fruit weight (range 14-277 g), locule number (2-12), shape index (0.54-2.65), yield (0.24-3.08 kg/plant), and soluble solids (3.4-7.5 °B). A few landraces showed uncommon phenotypes, such as potato leaf, colorless fruit epidermis, or delayed ripening. Multivariate analysis of 25 cardinal phenotypic variables grouped the named varieties and allowed to assign of some of the unnamed to recognized groups. A case study for distinctiveness is presented for the flattened-ribbed types that presented overlapping distribution according to the phenotypic data. Molecular markers retrieved by previous studies revealed differences compared to the phenotyping clustering, indicating that the named varieties “Scatolone di Bolsena” and “Pantano Romanesco” belong to the Marmande group, together with the reference landrace from Tuscany “Costoluto Fiorentino”. Differently, the landrace “Spagnoletta di Formia e Gaeta” was clearly distinct from the former at the molecular level. Therefore, a genotypic analysis of the analyzed collection appears needed to better define the molecular distinctiveness among the flattened-ribbed accessions, as well as to properly attribute the membership group of the unnamed accessions.

Keywords: distinctiveness, flattened-ribbed fruits, regional landraces, tomato

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Authors: Erol Kam, Z. U. Yümün

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Natural and artificial radionuclides cause radioactive contamination in environments, just as the other non-biodegradable pollutants (heavy metals, etc.) sink to the sea floor and accumulate in sediments. Especially the habitat of benthic foraminifera living on the surface of sediments or in sediments at the seafloor are affected by radioactive pollution in the marine environment. Thus, it is important for pollution analysis to determine the radionuclides. Radioactive pollution accumulates in the lowest level of the food chain and reaches humans at the highest level. The more the accumulation, the more the environment is endangered. This study used gamma spectrometry to investigate the natural and artificial radionuclide distribution of sediment samples taken from living benthic foraminifera habitats in the Western Marmara Sea. The radionuclides, K-40, Cs-137, Ra-226, Mn 54, Zr-95+ and Th-232, were identified in the sediment samples. For this purpose, 18 core samples were taken from depths of about 25-30 meters in the Marmara Sea in 2016. The locations of the core samples were specifically selected exclusively from discharge points for domestic and industrial areas, port locations, and so forth to represent pollution in the study area. Gamma spectrometric analysis was used to determine the radioactive properties of sediments. The radionuclide concentration activity values in the sediment samples obtained were Cs-137=0.9-9.4 Bq/kg, Th-232=18.9-86 Bq/kg, Ra-226=10-50 Bq/kg, K-40=24.4–670 Bq/kg, Mn 54=0.71–0.9 Bq/kg and Zr-95+=0.18–0.19 Bq/kg. These values were compared with the United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR) data, and an environmental analysis was carried out. The Ra-226 series, the Th-232 series, and the K-40 radionuclides accumulate naturally and are increasing every day due to anthropogenic pollution. Although the Ra-226 values obtained in the study areas remained within normal limits according to the UNSCEAR values, the K-40, and Th-232 series values were found to be high in almost all the locations.

Keywords: Ra-226, Th-232, K-40, Cs-137, Mn 54, Zr-95+, radionuclides, Western Marmara Sea

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Authors: Helga Martins, Idália Matias

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Background:Multiple sclerosis is a chronic inflammatory autoimmune demyelinating disease that affects young adults. Multiple sclerosis is a chronic disease in which the patient needs to self-manage the disease and the therapeutic regimen. Consequently, the promotion of health literacy assumes a relevant role for the accessibility, understanding, and use of information in order to promote and maintain the health of patients with multiple sclerosis. Aim: To determine the impact of lower health literacy in the self-management of patients with a multiple sclerosis. Methods: Literature review based on a search on the following electronic databases: CINAHLand MEDLINE; comprising all results published between September 2016 and September 2021. The search strategy was: (“Self-management [MeSH]” AND “Multiple sclerosis[MeSH]”AND “Health literacy[MeSH]”). The inclusion criteria were: original papers reporting about multiple sclerosis patients; participants with age above 18 years old, written in English, Spanish, French, or Portuguese. Two independent reviewers have done the screening and analysis of the results. 38 citations were identified, and after duplicates removal, a total of 25 results were screened; 14 were included after the application of the inclusion criteria. Results: The lower health literacy in the self-management of patients with a multiple sclerosis is related toless healthy choices, riskier health behavior, poor health outcomes, decreased of adhering to the therapeutic regimen after discharge, less self-management of chronic illness, and increased the time of hospitalization. Conclusion: Inadequate levels of health literacy contribute to poor health outcomes, unsuccessful self-management of chronic illness, and inadequate adherence to the therapeutic regimen. Therefore, health literacy is important for health policy and the healthcare services, as it can be understood as a mediator of self-management of multiple sclerosis disease.

Keywords: health literacy, multiple sclerosis, review, self-management

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Authors: Miguel Limbert Ramos, Joseph Amado Galvez

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Background: The nasal septal cartilage is an autologous graft that is widely used in different otolaryngologic procedures of the different subspecialties, such as in septorhinoplasty and ear rehabilitation procedures. The cartilage can be easily accessed and harvested to be utilized for such procedures. However, the dimension of the nasal septal cartilage differs, corresponding to race, gender, and age. Measurements can be done via direct measurement of harvested septal cartilage in cadavers or utilizing radiographic imaging studies giving baseline measurement of the nasal septal cartilage distinct to every race. A preliminary baseline measurement of the dimensions of Filipino nasal septal cartilage was previously established by measuring harvested nasal septal cartilage in Filipino Malay cadavers. This study intends to reinforce this baseline measurement by utilizing computed tomography (CT) scans of adult Filipinos in a tertiary government hospital in the City of Manila, Philippines, which will cover a larger sampling population. Methods: The unit of observation and analysis will be the computed tomography (CT) scans of patients ≥ 18years old who underwent cranial, facial, orbital, paranasal sinus, and temporal bone studies for the year 2019. The measurements will be done in a generated best midsagittal image (155 subjects) which is a view through the midline of the cerebrum that is simultaneously viewed with its coronal and axial views for proper orientation. The view should reveal important structures that will be used to plot the anatomic boundaries, which will be measured by a DICOM image viewing software (RadiAnt). The measured area of nasal septal cartilage will be compared by gender and age. Results: The total area of the nasal septal cartilage is larger in males compared to females, with a mean value of 6.52 cm² and 5.71 cm², respectively. The harvestable nasal septal cartilage area is also larger in males with a mean value of 3.57 cm² compared to females with only a measured mean value of 3.13 cm². The total and harvestable area of the nasal septal cartilage is largest in the 18-30 year-old age group with a mean value of 6.47 cm² and 3.60 cm² respectively and tends to decrease with the advancement of age, which can be attributed to continuous ossification changes. Conclusion: The best time to perform septorhinoplasty and other otolaryngologic procedures which utilize the nasal septal cartilage as graft material is during post-pubertal age, hence surgeries should be avoided or delayed to allow growth and maturation of the cartilage. A computed tomography scan is a cost-effective and non-invasive tool that can provide information on septal cartilage areas prior to these procedures.

Keywords: autologous graft, computed tomography, nasal septal cartilage, septorhinoplasty

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Authors: Thobela Conco, Sheena Kumari, Chika Nnadozie, Mahmoud Nasr, Thor A. Stenström, Mushal Ali, Arshad Ismail, Faizal Bux

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The discharge of antibiotics and its residues into the wastewater treatment plants (WWTP’s) create a conducive environment for the development of antibiotic resistant pathogens. This presents a risk of potential dissemination of antibiotic resistant pathogens and antibiotic resistance genes into the environment. It is, therefore, necessary to study the level of antibiotic resistance genes (ARG’s) among bacterial pathogens that proliferate in biological wastewater treatment systems. In the current study, metagenomic and meta-transcriptomic sequences of samples collected from the influents, secondary effluents and post chlorinated effluents of three wastewater treatment plants treating domestic and hospital effluents in Durban, South Africa, were analyzed for profiling of ARG’s among bacterial pathogens. Results show that a variety of ARG’s, mostly, aminoglycoside, β-lactamases, tetracycline and sulfonamide resistance genes were harbored by diverse bacterial genera found at different stages of treatment. A significant variation in diversity of pathogen and ARGs between the treatment plant was observed; however, treated final effluent samples from all three plants showed a significant reduction in bacterial pathogens and detected ARG’s. Both pre- and post-chlorinated samples showed the presence of mobile genetic elements (MGE’s), indicating the inefficiency of chlorination to remove of ARG’s integrated with MGE’s. In conclusion, the study showed the wastewater treatment plant efficiently caused the reduction and removal of certain ARG’s, even though the initial focus was the removal of biological nutrients.

Keywords: antibiotic resistance, mobile genetic elements, wastewater, wastewater treatment plants

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