Search results for: periprosthetic Joint infection

Authors: Duhania O. Mahara, Santi W. Purnami, Aulia N. Fitria, Merissa N. Z. Wirontono, Revina Musfiroh, Shofi Andari, Sagiran Sagiran, Estiana Khoirunnisa, Wahyudi Widada

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For assessing interventions in numerous disease areas, the use of multiple time-to-event outcomes is common. An individual might experience two different events called bivariate time-to-event data, the events may be correlated because it come from the same subject and also influenced by individual characteristics. The bivariate time-to-event case can be applied by copula-based bivariate Cox survival model, using the Clayton and Frank copulas to analyze the dependence structure of each event and also the covariates effect. By applying this method to modeling the recurrent event infection of hemodialysis insertion on chronic kidney disease (CKD) patients, from the AIC and BIC values we find that the Clayton copula model was the best model with Kendall’s Tau is (τ=0,02).

Keywords: bivariate cox, bivariate event, copula function, survival copula

Procedia PDF Downloads 82

Authors: Brandtner-Hafner Martin

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Adhesives have established themselves as an innovative joining technology in the industry. Their strengths lie in joining different materials, avoiding structural weakening as in welding or screwing, and enabling lightweight construction methods. Now there are a variety of ways to improve the efficiency and effectiveness of bonded joints. One way is to add fiber fillers. This leads to an improvement in adhesion and cohesion (structural integrity). In this study, the effectiveness of fiber-modified adhesives for bonding different construction materials is reviewed. A series of experimental tests were performed using the fracture analytical GF principle to study the adhesive bonding safety and performance of the joint. Three different structural adhesive systems based on epoxy, CA/A hybrid, and PUR were modified with different fiber materials on different substrates. The results show that significant performance improvements can be achieved and that bonding reliability can be sustainably increased.

Keywords: fiber-modified adhesives, bonding safety, GF-principle, fracture analysis

Procedia PDF Downloads 173

Authors: Yaping Zhao

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In the present study, the exact solutions for the steady response of quasi-linear systems under non-white wide-band random excitation are considered by means of the stochastic averaging method. The non linearity of the systems contains the power-law damping and the cross-product term of the power-law damping and displacement. The drift and diffusion coefficients of the Fokker-Planck-Kolmogorov (FPK) equation after averaging are obtained by a succinct approach. After solving the averaged FPK equation, the joint probability density function and the marginal probability density function in steady state are attained. In the process of resolving, the eigenvalue problem of ordinary differential equation is handled by integral equation method. Some new results are acquired and the novel method to deal with the problems in nonlinear random vibration is proposed.

Keywords: random vibration, stochastic averaging method, FPK equation, transition probability density

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Authors: M. A. Peribanez, G. Illan, I. De Blas, A. Muniesa, I. Ruiz-Zarzuela

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Intensive aquaculture is commonly associated with increased incidence of parasites. However, in Spain, the recent intensification of cyprinid production has not led to knowledge of the parasites that develop in the aquaculture facilities, the factors that affect their development and spread and the transmission between wild and cultivated fish species. The present study focuses on the knowledge of environmental factors, as well as host dependent factors, and their possible influence as risk factors in the incidence and intensity of parasitic infections. This work was conducted in the Duero River Basin, NW Spain. A total of 114 tenches (Tinca tinca) were caught in a fish farm and 667 specimens belonging to six species of cyprinid, not tench, in five rivers. An exhaustive search and microscopic identification of protozoa on skin and gills were carried out. Physical, chemical, and biological parameters of water samples from the capture points were determined. Only two ectoprotozoa were identified, Ichthyophthirius multifiliis and Tripartiella sp. In I. multifiliis, a high intensity of infection (more than 40 parasites on the body surface and more than 80 on gills) was determined in farmed tench (14%) and in Iberian barbel (Luciobarbus bocagei) (91%) and Duero nase (Pseudochondrostoma duriense) (71%) of middle stretches of rivers. The prevalence was similar between farmed tenches and cyprinids of middle courses. Tripartiella sp. was only found in barbels (prevalence in middle stretches, 0.7%) and in farmed tenches (63%), this species resulting in a high risk factor (odds ratio, OR= 1143) in the presence of the ciliate. There were no differences between the two species relative to the intensity of parasitization. Some of the physical, chemical and microbiological water quality parameters appear to be risk factors in the presence of I. multifiliis, with maximum OR of 8. Nevertheless, in Tripartiella sp., the risk is multiplied by 720 when the pH value exceeds 8.4, if we consider the total of the data, and it is increased more than 500 times if we only consider the values recorded in the fish farm (529 by nitrates > 3 mg/l; 530 by total coliforms > 100 CFU/100 ml). However, the high prevalence and risk of infection by I. multifiliis and Tripartiella sp. in fish farms should be related to environmental factors that dependent upon sampling point rather than in direct influence of the physical-chemical and biological parameters of the water. The high pH value recorded in the fish farm (9.62 ± 0.76) is the only parameter that we consider may have a substantial direct influence. Chronic exposure to alkaline pH levels can be a chronic stress generator, predisposing to parasitization by Tripartiella sp. In conclusion, often minor changes in ecosystem conditions, both natural and man-made, can modify the host-parasite relationship, resulting in an increase in the prevalence and intensity of parasitic infections in populations of cyprinids, sometimes causing disease outbreaks.

Keywords: cyprinids, fish, parasites, protozoa, risk factors

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Authors: Thomas Giansetto, Olivier Broux, Géraldine Bolen, Stéphanie Claeys

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Objective: To describe a modified preputial urethrostomy in four dogs. Study design: Short case series. Animals: Four male dogs were treated by the modified preputial urethrostomy, three because of urethral stenosis, and one because of severe complications following perineal urethrostomy. Methods: Four dogs were presented for dysuria and urinary obstruction. secondary to urethral stenosis or tear. Obstruction was treated with a modified preputial urethrostomy. Results: Four dogs had resolution of dysuria with a modified preputial urethrostomy without penile amputation. None of the dogs presented signs of dysuria, urinary tract infection, or dermatitis postoperatively. Two dogs showed signs of urinary incontinence 15 days and one month postoperatively. Conclusion: The modified preputial urethrostomy resulted in a favorable prognosis and may be an alternative to prepubic urethrostomy in male dogs.

Keywords: urethrostomy, preputial, technique, urogenital

Procedia PDF Downloads 168

Authors: Alireza Moghtaderi, Negin Khakpour

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Hallux Valgus is a kind of Toes aberration where the Metatarsophalangeal joint that connects the big toe to the foot, leading to the inner side and a protrusion on the inner surface of toe arise. This study aimed to determine the effect of botulinum toxin A injection to reduce pain and deviation angle of the thumb in Hallux Valgus and to increase outcomes of treatment as an adjuvant therapy. Randomized clinical study was performed on 18 patients at the Clinic of Physical Medicine and Rehabilitation, Isfahan University of Medical Sciences. In this study the Halgvs valgus angle (HVA) between the metatarsals (IMA) and cartilage distal metatarsal angle (DMAA) and pain were assessed before and after injection. Average of Hallux Valgus angle before and after Botox injections were 28/89 ± 10/21 and 21/56 ± 8/22 degrees and the angle deviation in the 6 months after treatment was significantly improved (p <0.001). Injection of botulinum toxin A is a suitable and acceptable method to reform the skeleton deformities and also to reduce the pain in patients with Hallux valgus.

Keywords: metatasal, hallux valgus, pain, botulinum toxuin

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Authors: Ramya Rathan, Miral N. F. Salama

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The variations in the arteries have been drawing attention of anatomists for a long time because of their clinical significance. The brachial artery is the principal artery of the arm which is the continuation of the axillary artery from the lower border of the Teres Major. It terminates into the radial and ulnar arteries below the elbow joint at the neck radius. The present study aims at exploring the clinical significance of the high termination of the brachial artery. During the routine cadaveric dissection of the arm, for the undergraduate students of medicine at our university, we observed a high bifurcation of the radial and the ulnar artery at the midshaft of the humerus. The median nerve was seen passing between these two junctions. Further, the course and the relations of this artery were studied. The accurate knowledge regarding these kinds of variation in the blood vessels is mandatory for planning of designing. General physicians, surgeons and radiologists should keep in mind the variations in the branching pattern of the arteries in their daily medical, diagnostic and therapeutic procedures to avoid complications in diagnostic and surgical procedures.

Keywords: brachial artery, high termination, radial artery, ulnar artery

Procedia PDF Downloads 167

Authors: Kishen Prathivadi

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The Sewer Authority Mid-Coastside (SAM) is a Joint Powers Authority formed in 1976 and provides secondary wastewater treatment to an average flow of 2.0 million gallons per day. SAM owns and operates a Wastewater Treatment Plant (WWTP) and a sanitary sewage collection system that collects sewage from its three member agencies: the City of Half Moon Bay, the Granada Community Services District and Montara Water and Sanitary District. The Sewer Authority Mid-Coastside (SAM) partnered with Pacific Gas & Electric, and its contractor GEL America, to review and replace all inefficient lighting fixtures and bulbs at the SAM treatment plant and administrative office. The project focused on replacing old and inefficient lighting fixtures and bulbs, reducing annual operating and maintenance costs, and reducing SAM’s carbon footprint. The project resulted in a 55% overall energy reduction, higher light quality and acuity, and a total operational savings of $495,000 over ten years.

Keywords: energy savings, LED, lighting, electrical

Procedia PDF Downloads 139

Authors: Jack Wippell

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This paper explores the role of social relations in explaining far-right actors' decisions over whether to travel down the process of radicalization and terrorism alone or in a group. To this end, a joint comparative method of difference and agreement is applied to four case studies across key temporal points on the radicalization and terrorism pathway to generate a theory of why individuals decide to radicalize and/or act alone or within a group. While social relations are identified as playing some moderate role in explaining why certain individuals radicalize alone versus within a group, this paper argues they play a significant role in affecting decisions over whether to act alone versus in a group. These findings suggest new avenues of distinction and understanding of far-right actors' processes of radicalization and terrorism, in turn, offering potential new avenues for counter-terrorism policy and important areas for future research.

Keywords: far-right, lone-actor, terrorism, United States, radicalization

Procedia PDF Downloads 91

Authors: Ahbdelfattah M. Khourshid, T. Elabeidi

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Friction Stir Welding (FSW), a solid state joining technique, is widely being used for joining Al alloys for aerospace, marine automotive and many other applications of commercial importance. FSW were carried out using a vertical milling machine on Al 5083 alloy pipe. These pipe sections are relatively small in diameter, 5mm, and relatively thin walled, 2mm. In this study, 5083 aluminum alloy pipe were welded as similar alloy joints using (FSW) process in order to investigate mechanical and microstructural properties .rotation speed 1400 r.p.m and weld speed 10,40,70 mm/min. In order to investigate the effect of welding speeds on mechanical properties, metallographic and mechanical tests were carried out on the welded areas. Vickers hardness profile and tensile tests of the joints as a metallurgical investigation, Optic Microscopy and Scanning Electron Microscopy (SEM) were used for base and weld zones.

Keywords: friction stir welding (FSW), Al alloys, mechanical properties, microstructure

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Authors: Emmanuel Ogundimu, Esther Akinlabi, Mutiu Erinosho

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The aim of this paper is to study the effect of welding current on the microstructure and the mechanical properties. Material characterizations were conducted on a 6 mm thick plates of type-304 austenite stainless steel, welded by TIG welding process at two different welding currents of 150 A (Sample F3) and 170 A (Sample F4). The tensile strength and the elongation obtained from sample F4 weld were approximately 584 MPa and 19.3 %; which were higher than sample F3 weld. The average microhardness value of sample F4 weld was found to be 235.7 HV, while that of sample F3 weld was 233.4 HV respectively. Homogenous distribution of iron (Fe), chromium (Cr) and nickel (Ni) were observed at the welded joint of the two samples. The energy dispersive spectroscopy (EDS) analysis revealed that Fe, Cr, and Ni made up the composition formed in the weld zone. The optimum welding current of 170 A for TIG welding of type-304 austenite stainless steel can be recommended for high-tech industrial applications.

Keywords: microhardness, microstructure, tensile, MIG welding, process, tensile, shear stress TIG welding, TIG-MIG welding

Procedia PDF Downloads 195

Authors: Fatima Zohra Bissaad, Farid Bounaceur, Nassima Behidj, Nadjiba Chebouti, Fatma Halouane, Bahia Doumandji-Mitiche

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Effect of Beauveria bassiana and Metarhizium anisopliae var. acridum on the 5^th instar nymphs of Schistocerca gregaria was studied in the laboratory. Infection by these both entomopathogenic fungi caused reduction in the hemolymph total protein. The average amounts of total proteins were 2.3, 2.07, 2.09 µg/100 ml of haemolymph in the control and M. anisopliae var. acridum, and B. bassiana based-treatments, respectively. Three types of haemocytes were recognized and identified as prohaemocytes, plasmatocytes and granulocytes. The treatment caused significant reduction in the total haemocyte count and in each haemocyte type on the 9^th day after its application.

Keywords: Beauveria bassiana, haemolymph picture, haemolymph protein, Metarhizium anisopliae var. acridum, Schistocerca gregaria

Procedia PDF Downloads 479

Authors: Paul Feyi Waboso

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This case report presents a 57-year-old female patient with a history of colon cancer, colostomy, and immunocompromise, who presented with an unusual bilateral vulval abscess, more prominent on the left side. Due to the atypical presentation, an MRI was performed, revealing a pelvic collection and a fistulous connection between the pelvis and vulva. This finding prompted an urgent surgical intervention. This case highlights the diagnostic and therapeutic challenges of managing complex abscesses and fistulas in immunocompromised patients. Introduction: Vulval abscesses in immunocompromised individuals can present with atypical features and may be associated with complex pathologies. Patients with a history of cancer, colostomy, and immunocompromise are particularly prone to infections and may present with unusual manifestations. This report discusses a case of a large bilateral vulval abscess with an underlying pelvic fistula, emphasizing the importance of advanced imaging in cases with atypical presentations. Case Presentation: A 57-year-old female with a known history of colon cancer, treated with colostomy, presented with severe pain and swelling in the vulval area. Physical examination revealed bilateral vulval swelling, with the abscess on the left side appearing larger and more pronounced than on the right. Given her immunocompromised status and the unusual nature of the presentation, we requested an MRI of the pelvis, suspecting an underlying pathology beyond a typical abscess. Investigations: MRI imaging revealed a significant pelvic collection and identified a fistulous tract between the pelvis and the vulva. This confirmed that the vulval abscess was connected to a deeper pelvic infection, necessitating urgent intervention. Management: After consultation with the multidisciplinary team (MDT), it was agreed that the patient required surgical intervention, having had 48 hours of antibiotics. The patient underwent evacuation of the left-sided vulval abscess under spinal anesthesia. During surgery, the pelvic collection was drained of 200 ml of pus. Outcome and Follow-Up: Postoperative recovery was closely monitored due to the patient’s immunocompromised state. Follow-up imaging and clinical evaluation showed improvement in symptoms, with gradual resolution of infection. The patient was scheduled for regular follow-up visits to monitor for recurrence or further complications. Discussion: Bilateral vulval abscesses are uncommon and, in an immunocompromised patient, warrant thorough investigation to rule out deeper infectious or fistulous connections. This case underscores the utility of MRI in identifying complex fistulous tracts and highlights the importance of a multidisciplinary approach in managing such high-risk patients. Conclusion: This case illustrates a rare presentation of bilateral vulval abscess with an associated pelvic fistula.

Keywords: vulval abscess, MDT team, colon cancer with pelvic fistula, vulval skin condition

Procedia PDF Downloads 18

Authors: R. Ranjith Kumar

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Computer modeling and simulation of human movement is playing an important role in sports and rehabilitation. Accurate modeling and analysis of human knee join is more complex because of complicated structure whose geometry is not easily to represent by a solid model. As part of this project, from the number of CT scan images of human knee join surface reconstruction is carried out using 3D slicer software, an open source software. From this surface reconstruction model, using mesh lab (another open source software) triangular meshes are created on reconstructed surface. This final triangular mesh model is imported to Solid Works, 3D mechanical CAD modeling software. Finally this CAD model is imported to ABAQUS, finite element analysis software for analyzing the knee joints. The results obtained are encouraging and provides an accurate way of modeling and analysis of biological parts without human intervention.

Keywords: solid works, CATIA, Pro-e, CAD

Procedia PDF Downloads 124

Authors: Alaa Al-Mosawe, Riadh Al-Mahaidi

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Carbon fiber reinforced polymers have been wildly used to strengthen steel structural elements. Those structural elements are normally subjected to static, dynamic, fatigue loadings during their life time. CFRP laminate is one of the common methods to strengthen these structures under the subjected loads. A number of researches have been focused on the bond characteristics of CFRP sheets to steel members under static, dynamic and fatigue loadings. There is a lack in understanding the behavior of the CFRP laminates under impact loading. This paper is showing the effect of high load rate on this bond. CFRP laminate CFK 150/2000 was used to strengthen steel joint by using Araldite 420 epoxy. The results showed that applying high load rate has a significant effect on the bond strength while a little influence on the effective bond length.

Keywords: adhesively bonded joints, bond strength, CFRP laminate, impact tensile loading

Procedia PDF Downloads 361

Authors: Hyungoo Kang, Minsung Kim, Jinkoo Kim

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This study investigates the performance of a 2D and 3D steel moment frame subjected to vehicle collision at a first story column using LS-DYNA. The finite element models of vehicles provided by the National Crash Analysis Center (NCAC) are used for numerical analysis. Nonlinear dynamic time history analysis of the 2D and 3D model structures are carried out based on the arbitrary column removal scenario, and the vertical displacement of the damaged structures are compared with that obtained from collision analysis. The analysis results show that the model structure remains stable when the speed of the vehicle is 40km/h. However, at the speed of 80 and 120km/h both the 2D and 3D structures collapse by progressive collapse. The vertical displacement of the damaged joint obtained from collision analysis is significantly larger than the displacement computed based on the arbitrary column removal scenario.

Keywords: vehicle collision, progressive collapse, FEM, LS-DYNA

Procedia PDF Downloads 342

Authors: Yousif M. Yousif Abdallah, Mohamed E. Gar-Elnabi, Abdoelrahman H. A. Bakary, Alaa M. H. Eltoum, Abdelazeem K. M. Ali

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The study was established to measure the amount of radiation outside the treatment field in external beam radiation therapy using day method of dose calculation, the data was collected from 89 patients of cervical carcinoma in order to determine if the dose outside side the irradiation treatment field for spleen, liver, both kidneys, small bowel, large colon, skin within the acceptable limit or not. The cervical field included mainly 4 organs which are bladder, rectum part of small bowel and hip joint these organ received mean dose of (4781.987±281.321), (4736.91±331.8), (4647.64±387.1) and (4745.91±321.11) respectively. The mean dose received by outfield organs was (77.69±15.24cGy) to large colon, (93.079±12.31cGy) to right kidney (80.688±12.644cGy) to skin, (155.86±17.69cGy) to small bowel. This was more significant value noted.

Keywords: radiation dose, cervical carcinoma, day’s methods, radiation medicine

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Authors: Emna Abid, Linda Chebbi, Yosra Mabrouk, Amel Labidi, Lamia Mansour

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Werner syndrome (WS) is a rare genetic disorder inherited in an autosomal recessive pattern characterized by accelerated aging. While extensive research has been conducted on its systemic manifestations, the specific dental implications of WS remain poorly understood. The medical history and the oral health status of two patients diagnosed with WS were detailed. Our findings revealed a high prevalence of dental problems in both patients, including periodontitis, xerostomia, and temporomandibular joint disorders. This article aims to investigate the dental challenges faced by individuals with WS as well as the prosthetic options envisaged through two clinical cases contributing to a deeper understanding of the dental implications of WS and to choose the appropriate prosthetic solution in this population. Future research should focus on larger scale studies and clinical trials to validate these proposed strategies.

Keywords: adult progeria, clinical symptoms, oral manifestations, dental care, prosthetic management

Procedia PDF Downloads 51

Authors: S. A. Bhat, Ahmad Arif, Muneeb U. Rehman, Manzoor R Mir, S. Bilal, Ishraq Hussain, H. M Khan, S. Shanaz, M. I Mir, Sabhiya Majid

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Background: Geologically Climatic conditions of the state range from sub-tropical (Jammu), temperate (Kashmir) to cold artic (Ladakh) zones, which exerts significant influence on its agro-climatic conditions. Gastrointestinal parasitism is a major problem in sheep production worldwide. Materials and Methods: The present study was to evaluate the resistance status of sheep breeds reared in Kashmir Valley for natural resistance against Haemonchus contortus by natural pasture challenge infection. Ten microsatellite markers were used in the study for evaluation of association of Ovar-MHC with parasitic resistance in association with biochemical and parasitological parameters. Following deworming, 500 animals were subjected to selected contaminated pastures in a vicinity of the livestock farms of SKUAST-K and Sheep Husbandry Kashmir. For each animal about 10-15 ml blood was collected aseptically for molecular and biochemical analysis. Weekly fecal samples (3g) were taken, directly from the rectum of all experimental animals and examined for Fecal egg count (FEC) with modified McMaster technique. Packed cell volume (PCV) was determined within 2-5 h of blood collection, all the biochemical parameters were determined in serum by semi automated analyzer. DNA was extracted from all the blood samples with phenol-chloroform method. Microsatellite analysis was done by denaturing sequencing gel electrophoresis Results: Overall sheep from Bakerwal breed followed by Corriediale breed performed relatively better in the trial; however difference between breeds remained low. Both significant (P<0.05) and non-significant differences with respect to resistance against haemonchosis were noted at different intervals in all the parameters.. All the animals were typed for the microsatellites INRA132, OarCP73, DRB1 (U0022), OLA-DQA2, BM1818, TFAP2A, HH56, BM1815, IL-3 and BM-1258. An association study including the effect of FEC, PCV, TSP, SA, LW, and the number of alleles within each marker was done. All microsatellite markers showed degree of heterozygosity of 0.72, 0.72, 0.75, 0.62, 0.84, 0.69, 0.66, 0.65, 0.73 and 0.68 respectively. Significant association between alleles and the parameters measured were only found for the OarCP73, OLA-DQA2 and BM1815 microsatellite marker. Standard alleles of the above markers showed significant effect on the TP, SA and body weight. The three sheep breeds included in the study responded differently to the nematode infection, which may be attributed to their differences in their natural resistance against nematodes. Conclusion: Our data confirms that some markers (OarCP73, OLA-DQA2 and BM1815) within Ovar-MHC are associated with phenotypic parameters of resistance and suggest superiority of Bakerwal sheep breed in natural resistance against Haemonchus contortus.

Keywords: Ovar-Mhc, ovine leukocyte antigen (OLA), sheep, parasitic resistance, Haemonchus contortus, phenotypic & genotypic markers

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Authors: Mikhail Bouniaev

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The paper reviews design and implementation of a Calculus Course required for the Biomedical Competency Based Program developed as a joint project between The University of Texas Rio Grande Valley, and the University of Texas’ Institute for Transformational Learning, from the theoretical perspective as presented in scholarly work on active learning, formative assessment, and on-line teaching. Following a four stage curriculum development process (objective, content, delivery, and assessment), and theoretical recommendations that guarantee effectiveness and efficiency of assessment in active learning, we discuss the practical recommendations on how to incorporate a strong formative assessment component to address disciplines’ needs, and students’ major needs. In design and implementation of this project, we used Constructivism and Stage-by-Stage Development of Mental Actions Theory recommendations.

Keywords: active learning, assessment, calculus, cognitive demand, mathematics, stage-by-stage development of mental action theory

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Authors: E. Omanya, E. Mueni, G. Makau, M. Kariuki

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HIV infection is the strongest risk factor for a person to develop TB. Isoniazid preventive therapy (IPT) for People Living with HIV (PLWHIV) not only reduces the individual patients’ risk of developing active TB but mitigates cross infection. In Kenya, IPT for six months was recommended through the National TB, Leprosy and Lung Disease Program to treat latent TB. In spite of this recommendation by the national government, uptake of IPT among PLHIV remained low in Kenya by the end of 2015. The USAID/Kenya and East Africa Afya Jijini project, which supports 42 TBHIV health facilities in Nairobi County, began addressing low uptake of IPT through Quality Improvement (QI) teams set up at the facility level. Quality is characterized by WHO as one of the four main connectors between health systems building blocks and health systems outputs. Afya Jijini implements the Kenya Quality Model for Health, which involves QI teams being formed at the county, sub-county and facility levels. The teams review facility performance to identify gaps in service delivery and use QI tools to monitor and improve performance. Afya Jijini supported the formation of these teams in 42 facilities and built the teams’ capacity to review data and use QI principles to identify and address performance gaps. When the QI teams began working on improving IPT uptake among PLHIV, uptake was at 31.8%. The teams first conducted a root cause analysis using cause and effect diagrams, which help the teams to brainstorm on and to identify barriers to IPT uptake among PLHIV at the facility level. This is a participatory process where program staff provides technical support to the QI teams in problem identification and problem-solving. The gaps identified were inadequate knowledge and skills on the use of IPT among health care workers, lack of awareness of IPT by patients, inadequate monitoring and evaluation tools, and poor quantification and forecasting of IPT commodities. In response, Afya Jijini trained over 300 health care workers on the administration of IPT, supported patient education, supported quantification and forecasting of IPT commodities, and provided IPT data collection tools to help facilities monitor their performance. The facility QI teams conducted monthly meetings to monitor progress on implementation of IPT and took corrective action when necessary. IPT uptake improved from 31.8% to 61.2% during the second year of the Afya Jijini project and improved to 80.1% during the third year of the project’s support. Use of QI teams and root cause analysis to identify and address service delivery gaps, in addition to targeted program interventions and continual performance reviews, can be successful in increasing TB related service delivery uptake at health facilities.

Keywords: isoniazid, quality, health care workers, people leaving with HIV

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Authors: Naragain Phumchusri, Krisada Roekdethawesab, Manoj Lohatepanont

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Overbooking is an approach of selling more goods or services than available capacities because sellers anticipate that some buyers will not show-up or may cancel their bookings. At present, many airlines deploy overbooking strategy in order to deal with the uncertainty of their customers. Particularly, some airlines sell more cargo capacity than what they have available to freight forwarders with beliefs that some of them will cancel later. In this paper, we propose methods to find the optimal overbooking level of volume and weight for air cargo in order to minimize the total cost, containing cost of spoilage and cost of offloaded. Cancellations of volume and weight are jointly random variables with a known joint distribution. Heuristic approaches applying the idea of weight and volume independency is considered to find an appropriate answer to the full problem. Computational experiments are used to explore the performance of approaches presented in this paper, as compared to a naïve method under different scenarios.

Keywords: air cargo overbooking, offloading capacity, optimal overbooking level, revenue management, spoilage capacity

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Authors: Kariem Elhelow

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The task of optimizing teeth surface relations remains perplexing for many dental practitioners. The well-being of teeth, periodontium, and the musculoskeletal system is closely associated with occlusal stability. Dental occlusion is rather far beyond the simple contact of the occlusal surfaces of the opposite jaws, a fact that turned the word “Occlusion” into one of the most complicated puzzles in dentistry. The literature describing the pathological approaches made the practice of occlusion even more intimidating. Understanding the biomechanics of teeth and jaw movements makes the goals of occlusal rehabilitation very lively and simple to practice. The purpose of this article is to establish a path for understanding and practicing the fundamental occlusal principles in a simple yet in depth way. Relying of the evidence based core would deliver a context for showing that occlusion is not as complicated as literatures might reflect. Conclusion: Maintaining a well-defined picture of what a healthy occlusion should be like is very gratifying to both the operator and the patient, with added worth of predictability, esthetics, and function to the whole treatment.

Keywords: occlusal, temporomandibular joint, prosthetic, dentition

Procedia PDF Downloads 129

Authors: Sun Tao, Lou Liang, Tan Xing Haw Marvin, Gu Yuandong Alex

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Patients with blood clots in their brains can experience problems with their vision or speech, seizures and general weakness. To treat blood clots, clinicians presently have two options. The first involves drug therapy to thin the blood and thus reduce the clot. The second choice is to invasively remove the clot using a plastic tube called a catheter. Both approaches carry a high risk of bleeding, and invasive procedures, such as catheter intervention, can also damage the blood vessel wall and cause infection. Ultrasonic treatment as a potential alternative therapy to break down clots is attracting growing interests due to the reduced adverse effects. To demonstrate the concept, in this investigation a microfabricated ultrasonic device was electrically packaged with printed circuit board to treat healthy human blood. The red blood cells could be broken down after 3-hour ultrasonic treatment.

Keywords: microfabrication, blood clot, ultrasonic thrombolysis device, ultrasonic device

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Authors: F. Ghasim-akbari, A. M. Hadian, A. M. Aminazad

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Fluid transmission pipes made of aluminum are widely use in petrochemical industries. For many applications they have to be brazed to each other. The brazed joints, in many cases, are encountered with corrosive medias. This paper reports a part of a work to investigate the corrosion behavior of brazed Al6061 using Al4047 as filler metal with and without the use of flux to discover the effect of different brazing atmospheres. The samples brazed under air, vacuum, argon, and hydrogen atmospheres. The interfacial area of the joints was examined to ensure being free of any defects. The sides of each test piece were covered with insulator and the surface of the joint was encountered to polarization test. The results revealed a significant difference of corrosion resistance. The samples that brazed under argon and hydrogen atmospheres had better corrosion resistance than other samples. Microstructure of the corroded joints revealed that the amount of the filler metal is a critical parameter on corrosion resistance of the joints.

Keywords: brazing, corrosion behavior, Al6061, polarization

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Authors: Amine Alaoui Sanae, Tagjdid Reda, Loutfi Chafiqa, Melloul Merouane, Laloui Aziz, Touil Nadia, El Fahim, E. Mostafa

Abstract:

Background: Rotavirus group A (RVA) strains with G8P[14] specificities are usually detected in calves and goats. However, these strains have been reported globally in humans and have often been characterized as originating from zoonotic transmissions, particularly in area where ruminants and humans live side-by-side. Whether human P[14] genotypes are two-way and can be transmitted to animal species remains to be established. Here we describe VP4 deduced amino-acid relationships of three Moroccan P[14] genotypes originating from different species and the receptiveness of an alpine goat to a human G8P[14] through an experimental infection. Material/methods: the human MA31 RVA strain was originally identified in a four years old girl presenting an acute gastroenteritis hospitalized at the pediatric care unit in Rabat Hospital in 2011. The virus was isolated and propagated in MA104 cells in the presence of trypsin. Ch_10S and 8045_S animal RVA strains were identified in fecal samples of a 2-week-old native goat and 3-week-old calf with diarrhea in 2011 in Bouaarfa and My Bousselham respectively. Genomic RNAs of all strains were subjected to a two-step RT-PCR and sequenced using the consensus primers VP4. The phylogenetic tree for MA31, Ch_10S and 8045_S VP4 and a set of published P[14] genotypes was constructed using MEGA6 software. The receptivity of MA31 strain by an eight month-old alpine goat was assayed. The animal was orally and intraperitonally inoculated with a dose of 8.5 TCID50 of virus stock at passage level 3. The shedding of the virus was tested by a real time RT-PCR assay. Results: The phylogenetic tree showed that the three Moroccan strains MA31, Ch_10S and 8045_S VP4 were highly related to each other (100% similar at the nucleotide level). They were clustered together with the B10925, Sp813, PA77 and P169 strains isolated in Belgium, Spain and Italy respectively. The Belgian strain B10925 was the most closely related to the Moroccan strains. In contrast, the 8045_S and Ch_10S strains were clustered distantly from the Tunisian calf strain B137 and the goat strain cap455 isolated in South Africa respectively. The human MA31 RVA strain was able to induce bloody diarrhea at 2 days post infection (dpi) in the alpine goat kid. RVA virus shedding started by 2 dpi (Ct value of 28) and continued until 5 dpi (Ct value of 25) with a concomitant elevation in the body temperature. Conclusions: Our study while limited to one animal, is the first study proving experimentally that a human P[14] genotype causes diarrhea and virus shedding in the goat. This result reinforce the potential role of inter- species transmission in generating novel and rare rotavirus strains such G8P[14] which infect humans.

Keywords: interspecies transmission, rotavirus, goat, human

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Authors: Muhammad Ilyas, Awais Khan, Syed Ali Raza Shah

Abstract:

DC motors are widely used in industries to provide mechanical power in speed and torque. The position and speed control of DC motors is getting the interest of the scientific community in robotics, especially in the robotic arm, a flexible joint manipulator. The current research work is based on position control of DC motors using experimental investigations in LabVIEW. The linear control strategy is applied to track the position and speed of the DC motor with comparative analysis in the LabVIEW platform and simulation analysis in MATLAB. The tracking error in hardware setup based on LabVIEW programming is slightly greater than simulation analysis in MATLAB due to the inertial load of the motor during steady-state conditions. The controller output shows the input voltage applied to the dc motor varies between 0-8V to ensure minimal steady error while tracking the position and speed of the DC motor.

Keywords: DC motor, labview, proportional integral derivative control, position tracking, speed tracking

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Authors: Bacha Zakaria

Abstract:

This study aimed to investigate the reality of humane treatment and work environment problems for nurses in public hospitals and their repercussions on the patients arriving there. In this curve, our field study was based on a sample of nurses in Algiers hospitals estimated at 100 nurses. The questionnaire prepared by the two researchers was applied face to face with the nurses, and after obtaining and analyzing the data, we concluded the most important results: The presence of many problems in the work environment, such as work pressures, lack of appreciation, verbal and physical violence, risk of infection, poor salary and incentives, working during fatigue, administrative problems etc. And accordingly, The embodiment of humane dealing with patients requires providing a humane work environment for nurses and dealing with them humanely so that they embody positive behaviors while dealing with patients.

Keywords: nursing, future, family-focused care, health equity

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Authors: Wissem Abdaoui, Ilhem Mokhtari, Adel Gouri, Benouareth Djamel Eddine

Abstract:

Contracted in a health facility, hospital-acquired infections are a major public health problem in recent years. The increase of nosocomial infections is partly related to diagnostic and therapeutic advances in medicine. The aim of our study was to isolate and diagnose some types of bacteria that are circulating in the hospital by performing different samples at two medical services: Pulmonary and Infectious Diseases. The antibiotic susceptibility tests were performed for bacterial isolates. The results have shown that there is a predominance of enterobacteria followed by the staphylococcus with its two species epidermidis ans saprophyticus. The study of the antibiogramme identified that some of these bacteria have a resistant profile against all the tested antibiotics. The fight against nosocomial infections is difficult because it must act on several factors: quality of care, safety of the hospital environment, hygiene, wearing gloves etc. are all areas that should be of heightened vigilance and preventive measures.

Keywords: nosocomial infection, isolation, identification, sensitivity and resistance to antibiotics

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Authors: B. B. S. Pereira, M. O. Souza, L. P. Zanetti, L. C. S. Oliveira, J. R. P. Moreno, M. P. Souza, V. R. Colturato, C. M. Machado

Abstract:

Background: The introduction of prophylactic or preemptive therapies has effectively decreased the CMV mortality rates after hematopoietic stem cell transplantation (HSCT). CMV antigenemia (pp65) or quantitative PCR are methods currently approved for CMV surveillance in pre-emptive strategies. Commercial assays are preferred as cut-off levels defined by in-house assays may vary among different protocols and in general show low reproducibility. Moreover, comparison of published data among different centers is only possible if international standards of quantification are included in the assays. Recently, the World Health Organization (WHO) established the first international standard for CMV detection. The real time PCR COBAS Ampliprep/ CobasTaqMan (CAP/CTM) (Roche®) was developed using the WHO standard for CMV quantification. However, the cut-off for the introduction of antiviral has not been determined yet. Methods: We conducted a retrospective study to determine: 1) the sensitivity and specificity of the new CMV CAP/CTM test in comparison with pp65 antigenemia to detect episodes of CMV infection/reactivation, and 2) the cut-off of viral load for introduction of ganciclovir (GCV). Pp65 antigenemia was performed and the corresponding plasma samples were stored at -20°C for further CMV detection by CAP/CTM. Comparison of tests was performed by kappa index. The appearance of positive antigenemia was considered the state variable to determine the cut-off of CMV viral load by ROC curve. Statistical analysis was performed using SPSS software version 19 (SPSS, Chicago, IL, USA.). Results: Thirty-eight patients were included and followed from August 2014 through May 2015. The antigenemia test detected 53 episodes of CMV infection in 34 patients (89.5%), while CAP/CTM detected 37 episodes in 33 patients (86.8%). AG and PCR results were compared in 431 samples and Kappa index was 30.9%. The median time for first AG detection was 42 (28-140) days, while CAP/CTM detected at a median of 7 days earlier (34 days, ranging from 7 to 110 days). The optimum cut-off value of CMV DNA was 34.25 IU/mL to detect positive antigenemia with 88.2% of sensibility, 100% of specificity and AUC of 0.91. This cut-off value is below the limit of detection and quantification of the equipment which is 56 IU/mL. According to CMV recurrence definition, 16 episodes of CMV recurrence were detected by antigenemia (47.1%) and 4 (12.1%) by CAP/CTM. The duration of viremia as detected by antigenemia was shorter (60.5% of the episodes lasted ≤ 7 days) in comparison to CAP/CTM (57.9% of the episodes lasting 15 days or more). This data suggests that the use of antigenemia to define the duration of GCV therapy might prompt early interruption of antiviral, which may favor CMV reactivation. The CAP/CTM PCR could possibly provide a safer information concerning the duration of GCV therapy. As prolonged treatment may increase the risk of toxicity, this hypothesis should be confirmed in prospective trials. Conclusions: Even though CAP/CTM by ROCHE showed great qualitative correlation with the antigenemia technique, the fully automated CAP/CTM did not demonstrate increased sensitivity. The cut-off value below the limit of detection and quantification may result in delayed introduction of pre-emptive therapy.

Keywords: antigenemia, CMV COBAS/TAQMAN, cytomegalovirus, antiviral cut-off

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