Search results for: AIC (Active Interaction Control Device)
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 17980

Search results for: AIC (Active Interaction Control Device)

5830 Automated System: Managing the Production and Distribution of Radiopharmaceuticals

Authors: Shayma Mohammed, Adel Trabelsi

Abstract:

Radiopharmacy is the art of preparing high-quality, radioactive, medicinal products for use in diagnosis and therapy. Radiopharmaceuticals unlike normal medicines, this dual aspect (radioactive, medical) makes their management highly critical. One of the most convincing applications of modern technologies is the ability to delegate the execution of repetitive tasks to programming scripts. Automation has found its way to the most skilled jobs, to improve the company's overall performance by allowing human workers to focus on more important tasks than document filling. This project aims to contribute to implement a comprehensive system to insure rigorous management of radiopharmaceuticals through the use of a platform that links the Nuclear Medicine Service Management System to the Nuclear Radio-pharmacy Management System in accordance with the recommendations of World Health Organization (WHO) and International Atomic Energy Agency (IAEA). In this project we attempt to build a web application that targets radiopharmacies, the platform is built atop the inherently compatible web stack which allows it to work in virtually any environment. Different technologies are used in this project (PHP, Symfony, MySQL Workbench, Bootstrap, Angular 7, Visual Studio Code and TypeScript). The operating principle of the platform is mainly based on two parts: Radiopharmaceutical Backoffice for the Radiopharmacian, who is responsible for the realization of radiopharmaceutical preparations and their delivery and Medical Backoffice for the Doctor, who holds the authorization for the possession and use of radionuclides and he/she is responsible for ordering radioactive products. The application consists of sven modules: Production, Quality Control/Quality Assurance, Release, General Management, References, Transport and Stock Management. It allows 8 classes of users: The Production Manager (PM), Quality Control Manager (QCM), Stock Manager (SM), General Manager (GM), Client (Doctor), Parking and Transport Manager (PTM), Qualified Person (QP) and Technical and Production Staff. Digital platform bringing together all players involved in the use of radiopharmaceuticals and integrating the stages of preparation, production and distribution, Web technologies, in particular, promise to offer all the benefits of automation while requiring no more than a web browser to act as a user client, which is a strength because the web stack is by nature multi-platform. This platform will provide a traceability system for radiopharmaceuticals products to ensure the safety and radioprotection of actors and of patients. The new integrated platform is an alternative to write all the boilerplate paperwork manually, which is a tedious and error-prone task. It would minimize manual human manipulation, which has proven to be the main source of error in nuclear medicine. A codified electronic transfer of information from radiopharmaceutical preparation to delivery will further reduce the risk of maladministration.

Keywords: automated system, management, radiopharmacy, technical papers

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5829 Acute Phase Proteins as Biomarkers of Urinary Tract Infection (UTI) in Dairy Cattle

Authors: Wael El-Deeb

Abstract:

The present study aimed to investigate the diagnostic importance of acute phase proteins in urinary tract infection (UTI) in cattle. We describe the clinical, bacteriological and biochemical findings in 99 lactating cows. Blood and urine samples from diseased (n=84) and control healthy cows (n=15) were submitted to laboratory investigations. The urine analysis revealed hematuria and pyuria in UTI group. The isolated bacteria were E.coli (43/84) Corynebacterium spp, (31/84), Proteus spp. (6/84) and Streptococcus spp (4/84). The concentrations of Haptoglobin (Hp), serum amyloid A (SAA), α1-Acid glycoprotein (AGP), fibrinogen (Fb), total protein, albumen, and globulin were higher in cows with UTI when compared to healthy ones. Fifty-one of 84 cows with UTI were successfully treated. The levels of Hp, SAA, AGP, total protein, and globulin were associated with the odds of treatment failure. Conclusively, acute phase proteins could be used as diagnostic and prognostic biomarkers in cows with UTI.

Keywords: cows, urinary, infections, haptoglobin, serum Amyloid A

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5828 Drug Design Modelling and Molecular Virtual Simulation of an Optimized BSA-Based Nanoparticle Formulation Loaded with Di-Berberine Sulfate Acid Salt

Authors: Eman M. Sarhan, Doaa A. Ghareeb, Gabriella Ortore, Amr A. Amara, Mohamed M. El-Sayed

Abstract:

Drug salting and nanoparticle-based drug delivery formulations are considered to be an effective means for rendering the hydrophobic drugs’ nano-scale dispersion in aqueous media, and thus circumventing the pitfalls of their poor solubility as well as enhancing their membrane permeability. The current study aims to increase the bioavailability of quaternary ammonium berberine through acid salting and biodegradable bovine serum albumin (BSA)-based nanoparticulate drug formulation. Berberine hydroxide (BBR-OH) that was chemically synthesized by alkalization of the commercially available berberine hydrochloride (BBR-HCl) was then acidified to get Di-berberine sulfate (BBR)₂SO₄. The purified crystals were spectrally characterized. The desolvation technique was optimized for the preparation of size-controlled BSA-BBR-HCl, BSA-BBR-OH, and BSA-(BBR)₂SO₄ nanoparticles. Particle size, zeta potential, drug release, encapsulation efficiency, Fourier transform infrared spectroscopy (FTIR), tandem MS-MS spectroscopy, energy-dispersive X-ray spectroscopy (EDX), scanning and transmitting electron microscopic examination (SEM, TEM), in vitro bioactivity, and in silico drug-polymer interaction were determined. BSA (PDB ID; 4OR0) protonation state at different pH values was predicted using Amber12 molecular dynamic simulation. Then blind docking was performed using Lamarkian genetic algorithm (LGA) through AutoDock4.2 software. Results proved the purity and the size-controlled synthesis of berberine-BSA-nanoparticles. The possible binding poses, hydrophobic and hydrophilic interactions of berberine on BSA at different pH values were predicted. Antioxidant, anti-hemolytic, and cell differentiated ability of tested drugs and their nano-formulations were evaluated. Thus, drug salting and the potentially effective albumin berberine nanoparticle formulations can be successfully developed using a well-optimized desolvation technique and exhibiting better in vitro cellular bioavailability.

Keywords: berberine, BSA, BBR-OH, BBR-HCl, BSA-BBR-HCl, BSA-BBR-OH, (BBR)₂SO₄, BSA-(BBR)₂SO₄, FTIR, AutoDock4.2 Software, Lamarkian genetic algorithm, SEM, TEM, EDX

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5827 Challenging the Standard 24 Equal Quarter Tones Theory in Arab Music: A Case Study of Tetrachords Bayyātī and ḤIjāz

Authors: Nabil Shair

Abstract:

Arab music maqām (Arab modal framework) is founded, among other main characteristics, on microtonal intervals. Notwithstanding the importance and multifaceted nature of intonation in Arab music, there is a paucity of studies examining this subject based on scientific and quantitative approaches. The present-day theory concerning the Arab tone system is largely based on the pioneering treatise of Mīkhā’īl Mashāqah (1840), which proposes the theoretical division of the octave into 24 equal quarter tones. This kind of equal-tempered division is incompatible with the performance practice of Arab music, as many professional Arab musicians conceptualize additional pitches beyond the standard 24 notes per octave. In this paper, we refute the standard theory presenting the scale of well-tempered quarter tones by implementing a quantitative analysis of the performed intonation of two prominent tetrachords in Arab music, namely bayyātī and ḥijāz. This analysis was conducted with the help of advanced computer programs, such as Sonic Visualiser and Tony, by which we were able to obtain precise frequency data (Hz) of each tone every 0.01 second. As a result, the value (in cents) of all three intervals of each tetrachord was measured and accordingly compared to the theoretical intervals. As a result, a specific distribution of a range of deviation from the equal-tempered division of the octave was detected, especially the detection of a diminished first interval of bayyātí and diminished second interval of ḥijāz. These types of intonation entail a considerable amount of flexibility, mainly influenced by surrounding tones, direction and function of the measured tone, ornaments, text, personal style of the performer and interaction with the audience. This paper seeks to contribute to the existing literature dealing with intonation in Arab music, as it is a vital part of the performance practice of this musical tradition. In addition, the insights offered by this paper and its novel methodology might also contribute to the broadening of the existing pedagogic methods used to teach Arab music.

Keywords: Arab music, intonation, performance practice, music theory, oral music, octave division, tetrachords, music of the middle east, music history, musical intervals

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5826 Torsional Design Method of Asymmetric and Irregular Building under Horizontal Earthquake Action

Authors: Radhwane Boudjelthia

Abstract:

Based upon elaborate analysis on torsional design methods of asymmetric and irregular structure under horizontal earthquake action, it points out that the main design principles of an asymmetric building subjected to horizontal earthquake are: the torsion of vertical members induced by the torsion angle of the floor (rigid diaphragm) cannot exceed the allowable value, the inter-story displacement at outermost frame or shear wall should be less than that required by design code, stresses in plane of the slab should be controlled within acceptable extent under different intensity earthquakes. That current seismic design code only utilizes the torsion displacement ratio to control the floor torsion, which seems not reasonable enough since its connotation is the multiple of the floor torsion angle and the distance of floor mass center to the edge frame or shear wall.

Keywords: earthquake, building, seismic forces, displacement, resonance, response

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5825 An Earth Mover’s Distance Algorithm Based DDoS Detection Mechanism in SDN

Authors: Yang Zhou, Kangfeng Zheng, Wei Ni, Ren Ping Liu

Abstract:

Software-defined networking (SDN) provides a solution for scalable network framework with decoupled control and data plane. However, this architecture also induces a particular distributed denial-of-service (DDoS) attack that can affect or even overwhelm the SDN network. DDoS attack detection problem has to date been mostly researched as entropy comparison problem. However, this problem lacks the utilization of SDN, and the results are not accurate. In this paper, we propose a DDoS attack detection method, which interprets DDoS detection as a signature matching problem and is formulated as Earth Mover’s Distance (EMD) model. Considering the feasibility and accuracy, we further propose to define the cost function of EMD to be a generalized Kullback-Leibler divergence. Simulation results show that our proposed method can detect DDoS attacks by comparing EMD values with the ones computed in the case without attacks. Moreover, our method can significantly increase the true positive rate of detection.

Keywords: DDoS detection, EMD, relative entropy, SDN

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5824 Development of a Novel Ankle-Foot Orthotic Using a User Centered Approach for Improved Satisfaction

Authors: Ahlad Neti, Elisa Arch, Martha Hall

Abstract:

Studies have shown that individuals who use Ankle-Foot-Orthoses (AFOs) have a high level of dissatisfaction regarding their current AFOs. Studies point to the focus on technical design with little attention given to the user perspective as a source of AFO designs that leave users dissatisfied. To design a new AFO that satisfies users and thereby improves their quality of life, the reasons for their dissatisfaction and their wants and needs for an improved AFO design must be identified. There has been little research into the user perspective on AFO use and desired improvements, so the relationship between AFO design and satisfaction in daily use must be assessed to develop appropriate metrics and constraints prior to designing a novel AFO. To assess the user perspective on AFO design, structured interviews were conducted with 7 individuals (average age of 64.29±8.81 years) who use AFOs. All interviews were transcribed and coded to identify common themes using Grounded Theory Method in NVivo 12. Qualitative analysis of these results identified sources of user dissatisfaction such as heaviness, bulk, and uncomfortable material and overall needs and wants for an AFO. Beyond the user perspective, certain objective factors must be considered in the construction of metrics and constraints to ensure that the AFO fulfills its medical purpose. These more objective metrics are rooted in a common medical device market and technical standards. Given the large body of research concerning these standards, these objective metrics and constraints were derived through a literature review. Through these two methods, a comprehensive list of metrics and constraints accounting for both the user perspective on AFO design and the AFO’s medical purpose was compiled. These metrics and constraints will establish the framework for designing a new AFO that carries out its medical purpose while also improving the user experience. The metrics can be categorized into several overarching areas for AFO improvement. Categories of user perspective related metrics include comfort, discreteness, aesthetics, ease of use, and compatibility with clothing. Categories of medical purpose related metrics include biomechanical functionality, durability, and affordability. These metrics were used to guide an iterative prototyping process. Six concepts were ideated and compared using system-level analysis. From these six concepts, two concepts – the piano wire model and the segmented model – were selected to move forward into prototyping. Evaluation of non-functional prototypes of the piano wire and segmented models determined that the piano wire model better fulfilled the metrics by offering increased stability, longer durability, fewer points for failure, and a strong enough core component to allow a sock to cover over the AFO while maintaining the overall structure. As such, the piano wire AFO has moved forward into the functional prototyping phase, and healthy subject testing is being designed and recruited to conduct design validation and verification.

Keywords: ankle-foot orthotic, assistive technology, human centered design, medical devices

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5823 Update on Epithelial Ovarian Cancer (EOC), Types, Origin, Molecular Pathogenesis, and Biomarkers

Authors: Salina Yahya Saddick

Abstract:

Ovarian cancer remains the most lethal gynecological malignancy due to the lack of highly sensitive and specific screening tools for detection of early-stage disease. The OSE provides the progenitor cells for 90% of human ovarian cancers. Recent morphologic, immunohistochemical and molecular genetic studies have led to the development of a new paradigm for the pathogenesis and origin of epithelial ovarian cancer (EOC) based on a ualistic model of carcinogenesis that divides EOC into two broad categories designated Types I and II which are characterized by specific mutations, including KRAS, BRAF, ERBB2, CTNNB1, PTEN PIK3CA, ARID1A, and PPPR1A, which target specific cell signaling pathways. Type 1 tumors rarely harbor TP53. type I tumors are relatively genetically stable and typically display a variety of somatic sequence mutations that include KRAS, BRAF, PTEN, PIK3CA CTNNB1 (the gene encoding beta catenin), ARID1A and PPP2R1A but very rarely TP53 . The cancer stem cell (CSC) hypothesis postulates that the tumorigenic potential of CSCs is confined to a very small subset of tumor cells and is defined by their ability to self-renew and differentiate leading to the formation of a tumor mass. Potential protein biomarker miRNA, are promising biomarkers as they are remarkably stable to allow isolation and analysis from tissues and from blood in which they can be found as free circulating nucleic acids and in mononuclear cells. Recently, genomic anaylsis have identified biomarkers and potential therapeutic targets for ovarian cancer namely, FGF18 which plays an active role in controlling migration, invasion, and tumorigenicity of ovarian cancer cells through NF-κB activation, which increased the production of oncogenic cytokines and chemokines. This review summarizes update information on epithelial ovarian cancers and point out to the most recent ongoing research.

Keywords: epithelial ovarian cancers, somatic sequence mutations, cancer stem cell (CSC), potential protein, biomarker, genomic analysis, FGF18 biomarker

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5822 Numerical Investigation of Indoor Environmental Quality in a Room Heated with Impinging Jet Ventilation

Authors: Mathias Cehlin, Arman Ameen, Ulf Larsson, Taghi Karimipanah

Abstract:

The indoor environmental quality (IEQ) is increasingly recognized as a significant factor influencing the overall level of building occupants’ health, comfort and productivity. An air-conditioning and ventilation system is normally used to create and maintain good thermal comfort and indoor air quality. Providing occupant thermal comfort and well-being with minimized use of energy is the main purpose of heating, ventilating and air conditioning system. Among different types of ventilation systems, the most widely known and used ventilation systems are mixing ventilation (MV) and displacement ventilation (DV). Impinging jet ventilation (IJV) is a promising ventilation strategy developed in the beginning of 2000s. IJV has the advantage of supplying air downwards close to the floor with high momentum and thereby delivering fresh air further out in the room compare to DV. Operating in cooling mode, IJV systems can have higher ventilation effectiveness and heat removal effectiveness compared to MV, and therefore a higher energy efficiency. However, how is the performance of IJV when operating in heating mode? This paper presents the function of IJV in a typical office room for winter conditions (heating mode). In this paper, a validated CFD model, which uses the v2-f model is used for the prediction of air flow pattern, thermal comfort and air change effectiveness. The office room under consideration has the dimensions 4.2×3.6×2.5m, which can be designed like a single-person or two-person office. A number of important factors influencing in the room with IJV are studied. The considered parameters are: heating demand, number of occupants and supplied air conditions. A total of 6 simulation cases are carried out to investigate the effects of the considered parameters. Heat load in the room is contributed by occupants, computer and lighting. The model consists of one external wall including a window. The interaction effects of heat sources, supply air flow and down draught from the window result in a complex flow phenomenon. Preliminary results indicate that IJV can be used for heating of a typical office room. The IEQ seems to be suitable in the occupied region for the studied cases.

Keywords: computation fluid dynamics, impinging jet ventilation, indoor environmental quality, ventilation strategy

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5821 Material Handling Equipment Selection Using Fuzzy AHP Approach

Authors: Priyanka Verma, Vijaya Dixit, Rishabh Bajpai

Abstract:

This research paper is aimed at selecting appropriate material handling equipment among the given choices so that the automation level in material handling can be enhanced. This work is a practical case scenario of material handling systems in consumer electronic appliances manufacturing organization. The choices of material handling equipment among which the decision has to be made are Automated Guided Vehicle’s (AGV), Autonomous Mobile Robots (AMR), Overhead Conveyer’s (OC) and Battery Operated Trucks/Vehicle’s (BOT). There is a need of attaining a certain level of automation in order to reduce human interventions in the organization. This requirement of achieving certain degree of automation can be attained by material handling equipment’s mentioned above. The main motive for selecting above equipment’s for study was solely based on corporate financial strategy of investment and return obtained through that investment made in stipulated time framework. Since the low cost automation with respect to material handling devices has to be achieved hence these equipment’s were selected. Investment to be done on each unit of this equipment is less than 20 lakh rupees (INR) and the recovery period is less than that of five years. Fuzzy analytic hierarchic process (FAHP) is applied here for selecting equipment where the four choices are evaluated on basis of four major criteria’s and 13 sub criteria’s, and are prioritized on the basis of weight obtained. The FAHP used here make use of triangular fuzzy numbers (TFN). The inability of the traditional AHP in order to deal with the subjectiveness and impreciseness in the pair-wise comparison process has been improved in the FAHP. The range of values for general rating purposes for all decision making parameters is kept between 0 and 1 on the basis of expert opinions captured on shop floor. These experts were familiar with operating environment and shop floor activity control. Instead of generating exact value the FAHP generates the ranges of values to accommodate the uncertainty in decision-making process. The four major criteria’s selected for the evaluation of choices of material handling equipment’s available are materials, technical capabilities, cost and other features. The thirteen sub criteria’s listed under these following four major criteria’s are weighing capacity, load per hour, material compatibility, capital cost, operating cost and maintenance cost, speed, distance moved, space required, frequency of trips, control required, safety and reliability issues. The key finding shows that among the four major criteria selected, cost is emerged as the most important criteria and is one of the key decision making aspect on the basis of which material equipment selection is based on. While further evaluating the choices of equipment available for each sub criteria it is found that AGV scores the highest weight in most of the sub-criteria’s. On carrying out complete analysis the research shows that AGV is the best material handling equipment suiting all decision criteria’s selected in FAHP and therefore it is beneficial for the organization to carry out automated material handling in the facility using AGV’s.

Keywords: fuzzy analytic hierarchy process (FAHP), material handling equipment, subjectiveness, triangular fuzzy number (TFN)

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5820 The Constraints of Modern Islamic Boarding School's Strategy in Addressing Physical Violence: A Case Study in Indonesia

Authors: Syauqi Asfiya R.

Abstract:

This study examines the constraints faced by Islamic boarding school (Pesantren) in Indonesia in effectively addressing physical violence within their educational institutions. The vulnerability to violence in the education sector remains pervasive, including in Pesantren, primarily due to the residential nature of the boarding school system, which necessitates round-the-clock interaction among students from diverse backgrounds. Additionally, environmental factors, parenting styles, individual characteristics, and media influences further complicate the conditions within Pesantren. Numerous cases of physical violence have been reported, underscoring the need to identify the constraints of violence prevention strategies implemented by Pesantren. Adopting a case study approach, this research focuses on a Modern Pesantren in Tangerang and utilizes interviews conducted with 20 victims of violence to explore the aspects of Pesantren's violence prevention strategies that may have been overlooked. The findings indicate that many students face a dilemma when reporting the violence they experience, as the imposed sanctions often prove excessively severe and carry the risk of exacerbating the violence perpetrated by the offenders. Consequently, numerous victims choose to remain silent, thereby enabling the perpetuation of violence. Moreover, senior students (mudabbir) are prohibited from giving punishment, but there are still many who punish other students based on their personal moods. Furthermore, violence is also perpetrated by religious teachers (ustadz), despite their responsibility for addressing such issues. The evaluation process often follows a unidirectional approach wherein the santri have limited freedom compared to the Mudabbir or ustadz when it comes to providing feedback. Additionally, sentiment within specific student generations is reinforced due to the segregation of dormitories based on cohorts. Lastly, the absence of psychologists to address the trauma experienced by victims further exacerbates the situation. This research sheds light on the constraints faced by Pesantren in effectively preventing physical violence and emphasizes the importance of implementing comprehensive measures to create safer and nurturing learning environments within these institutions.

Keywords: physical violence, islam, boarding school, constraint

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5819 Hydrogen Production By Photoreforming Of n-Butanol And Structural Isomers Over Pt Doped Titanate Catalyst

Authors: Hristina Šalipur, Jasmina Dostanić, Davor Lončarević, Matej Huš

Abstract:

Photocatalytic water splitting/alcohol photoreforming has been used for the conversion of sunlight energy in the process of hydrogen production due to its sustainability, environmental safety, effectiveness and simplicity. Titanate nanotubes are frequently studied materials since they combine the properties of photo-active semiconductors with the properties of layered titanates, such as the ion-exchange ability. Platinum (Pt) doping into titanate structure has been considered an effective strategy in better separation efficiency of electron-hole pairs and lowering the overpotential for hydrogen production, which results in higher photocatalytic activity. In our work, Pt doped titanate catalysts were synthesized via simple alkaline hydrothermal treatment, incipient wetness impregnation method and temperature-programmed reduction. The structural, morphological and optical properties of the prepared catalysts were investigated using various characterization techniques such as X-ray diffraction (XRD), scanning electron microscopy (SEM), N2 physisorption, and diffuse reflectance spectroscopy (DRS). The activities of the prepared Pt-doped titanate photocatalysts were tested for hydrogen production via photocatalytic water splitting/alcohol photoreforming process under simulated solar light irradiation. Characterization of synthesized Pt doped titanate catalysts showed crystalline anatase phase, preserved nanotubular structure and high specific surface area. The result showed enhancement of activity in photocatalytic water splitting/alcohol photoreforming in the following order 2-butanol>1-butanol>tert-butanol, with obtained maximal hydrogen production rate of 7.5, 5.3 and 2 mmol g-1 h-1, respectively. Different possible factors influencing the hole scavenging ability, such as hole scavenger redox potential and diffusivity, adsorption and desorption rate of the hole scavenger on the surface and stability of the alcohol radical species generated via hole scavenging, were investigated. The theoretical evaluation using density functional theory (DFT) further elucidated the reaction kinetics and detailed mechanism of photocatalytic water splitting/alcohol photoreforming.

Keywords: hydrogen production, platinum, semiconductor, water splitting, density functional theory

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5818 Immunostimulant from Biodiversity to Enhance Shrimp Survival against Vibriosis

Authors: Frank Alexis, Jenny Antonia Rodriguez Leon, Cristobal Leonardo Dominguez Borbor, Mery Rosario Ramirez Munoz

Abstract:

The shrimp industry has increased in the last years to the point of becoming one of the most dynamic industries. However, the appearance of diseases that significantly affect the production of shrimps has been an obstacle for the shrimp industry. We hypothesized that natural fibers from biodiversity can stimulate the immune system to prevent shrimp diseases like vibriosis. In this project, we extracted the fibers from vegetal sources in Ecuador and characterized them using common techniques like XRD, SEM, and then we tested the effect of fibers as immunostimulants for shrimps in-vitro and in-vivo using small aquarium and large pools. Our results demonstrate that vegetal fibers can significantly increase the survival of shrimps. Moreover, the production of shrimps in a large pool was significantly increased. Lastly, the test of color and taste successfully surpass the control group of shrimps not treated with fiber food supplements.

Keywords: fibers, immunostimulant, shrimp, vibriosis

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5817 Free and Encapsulated (TiO2)2 Dimers into Carbon Nanotubes

Authors: S. Dargouthi, S. Boughdiri, B. Tangour

Abstract:

This work invoked two complementary parts. In the first, we performed a theoretical study of various dimers of molecular of titanium dioxide. Five structures were examined. Three among them, the (T), (C) and (T/P) isomers, may be considered as stable compounds because they represent absolute minima on their potential energy surfaces. (T) and (C) may coexist because they are separted by only 6.5 kcal mol-1 but (T/P) dimer is in a metastable state from an energetic point of view. Non bonded dimer (P) transforms into its homologue (O) which has been considered as transitory specie with low lifetime which evolves to (T) structure. In the second part, we highlight the possible stabilization of (T), (C) and (P) dimers by encapsulation in carbon nanotubes. This indicates the probable role that plays this transitory specie the polymerization process of molecular TiO2. Confinement is suitable to control the fast evolution process and could towards the synthesis of new titanium dioxide nanostructured materials. An alternative description of TiO2 polymorphs (Rutie, anatase et Brookite) is proposed from (T), (C) and (T/P) dimmers motifs.

Keywords: titanium dioxide, carbon nanotube, confinement. encapsulation, transitory specie

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5816 Orchestra Course Outcomes in Terms of Values Education

Authors: Z. Kurtaslan, H. Hakan Okay, E. Can Dönmez, I. Kuçukdoğan

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Music education aims to bring up individuals most appropriately and to advanced levels as a balanced whole physically, cognitively, affectively, and kinesthetically while making a major contribution to the physical and spiritual development of the individual. The most crucial aim of music education, an influential education medium per se, is to make music be loved; yet, among its educational aims are concepts such as affinity, friendship, goodness, philanthropy, responsibility, and respect all extremely crucial bringing up individuals as a balanced whole. One of the most essential assets of the music education is the training of making music together, solidifying musical knowledge and enabling the acquisition of cooperation. This habit requires internalization of values like responsibility, patience, cooperativeness, respect, self-control, friendship, and fairness. If musicians lack these values, the ensemble will become after some certain time a cacophony. In this qualitative research, the attitudes of music teacher candidates in orchestra/chamber music classes will be examined in terms of values.

Keywords: education, music, orchestra/chamber music, values

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5815 Carriage of 675 4G/5G Polymorphism in PAI-1 Gene and Its Association with Early Pregnancy Losses in Patients with Polycystic Ovary Syndrome

Authors: R. Komsa-Penkova, G. Golemanov, G. Georgieva, K. Popovski, N. Slavov, P. Ivanov, K. Kovacheva, S. Rathee, E. Konova, A. Blajev

Abstract:

Leptin and PAI-1 are important cytokines and may play a role in the regulation of PCOS development. PCOS is frequently associated with obesity, high BMI index and consequently with increased risk of metabolic disorders. The aim of the present study was to evaluate PAI-1 levels, genetic influence of the carriage of 675 4G/5G polymorphism in PAI-1 gene and leptin as a marker of obesity in the development of PCOS. Methods: Genotyping in 84 patients with PCOS and PCO and 100 healthy control subjects to detect single nucleotide deletion 675 G in the promoter of PAI-1 gene. The present study provides evidence that SNP 4G in the PAI-1 gene is associated with early pregnancy losses in patients with polycystosis. Further to this, there is a correlation between leptin levels, PAI-1 levels and BMI in the patients with PCOS, which confirms the role of obesity as a risk factor for PCOS.

Keywords: carriage of 675 4G/5G polymorphism, PCOS, early pregnancy losses, PAI-1 gene

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5814 Radiological Hazard Assessments and Control of Radionuclides Emitted from Building Materials in Kuwait Using Expert Systems

Authors: Abdulla Almulla, Wafaa Mahdi

Abstract:

Building materials can make a significant contribution to the level of natural radioactivity in closed dwelling areas. Therefore, developing an expert system for monitoring the activity concentrations (ACs) of naturally occurring radioactive materials (NORMs) existing in building materials is useful for limiting the population’s exposure to gamma radiation emitted from those materials. The present work not only is aimed at examining the indoor radon concentration emitted by the building materials that are originated from various countries but are commercially available in Kuwait, but also is aimed at developing an expert system for monitoring the radiation emitted from these materials and classifying it as normal (acceptable) or dangerous (unacceptable). This system makes it possible to always monitor any radiological risks to human health. When detecting high doses of radiation, the system gives warning messages.

Keywords: building materials, NORMs, HNBRA, radionuclides, activity concentrations, expert systems

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5813 Prevalence and Antimicrobial Resistance of Salmonella spp. Isolated from Pigs at Slaughterhouses in Northeast of Thailand

Authors: Sunpetch Angkititrakul, Seree Klaengair, Dusadee Phongaran, Arunee Ritthipanun

Abstract:

The objective of this study is to determine the prevalence and antimicrobial resistance pattern of Salmonella spp. isolated from pigs at slaughterhouses in the northeast of Thailand. During 2015-2016, all samples were isolated and identified by ISO 6579:2002. A total of 699 samples of rectal swab were collected and isolated for the presence of Salmonella. Salmonella was detected in 275 of 699 (39.34%) samples. 24 serovars were identified in the 275 isolates. The most prevalent serovars were rissen (36.97%), S. enterica ser.4,5,12:i: (25.35%) and typhimurium (21.33%). In this study, 76.30% of the isolates were resistant to at least one antimicrobial drug and 38.39% were multidrug resistant. The highest resistances were found in ampicillin (69.20%), tetracycline (66.35%), sulfamethoxazole/trimethoprim (35.55%) and chloramphenicol (9.00%) The results showed high prevalence of Salmonella spp. in pigs and high antimicrobial resistance among the isolates, and indicated the need for monitoring program to control Salmonella contamination and reduce the dissemination of antimicrobial resistance in pig supply chain.

Keywords: prevalence, antimicrobial resistance, Salmonella spp., pig

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5812 A Study of Anthropometric Correlation between Upper and Lower Limb Dimensions in Sudanese Population

Authors: Altayeb Abdalla Ahmed

Abstract:

Skeletal phenotype is a product of a balanced interaction between genetics and environmental factors throughout different life stages. Therefore, interlimb proportions are variable between populations. Although interlimb proportion indices have been used in anthropology in assessing the influence of various environmental factors on limbs, an extensive literature review revealed that there is a paucity of published research assessing interlimb part correlations and possibility of reconstruction. Hence, this study aims to assess the relationships between upper and lower limb parts and develop regression formulae to reconstruct the parts from one another. The left upper arm length, ulnar length, wrist breadth, hand length, hand breadth, tibial length, bimalleolar breadth, foot length, and foot breadth of 376 right-handed subjects, comprising 187 males and 189 females (aged 25-35 years), were measured. Initially, the data were analyzed using basic univariate analysis and independent t-tests; then sex-specific simple and multiple linear regression models were used to estimate upper limb parts from lower limb parts and vice-versa. The results of this study indicated significant sexual dimorphism for all variables. The results indicated a significant correlation between the upper and lower limbs parts (p < 0.01). Linear and multiple (stepwise) regression equations were developed to reconstruct the limb parts in the presence of a single or multiple dimension(s) from the other limb. Multiple stepwise regression equations generated better reconstructions than simple equations. These results are significant in forensics as it can aid in identification of multiple isolated limb parts particularly during mass disasters and criminal dismemberment. Although a DNA analysis is the most reliable tool for identification, its usage has multiple limitations in undeveloped countries, e.g., cost, facility availability, and trained personnel. Furthermore, it has important implication in plastic and orthopedic reconstructive surgeries. This study is the only reported study assessing the correlation and prediction capabilities between many of the upper and lower dimensions. The present study demonstrates a significant correlation between the interlimb parts in both sexes, which indicates a possibility to reconstruction using regression equations.

Keywords: anthropometry, correlation, limb, Sudanese

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5811 Private and Public Health Sector Difference on Client Satisfaction: Results from Secondary Data Analysis in Sindh, Pakistan

Authors: Wajiha Javed, Arsalan Jabbar, Nelofer Mehboob, Muhammad Tafseer, Zahid Memon

Abstract:

Introduction: Researchers globally have strived to explore diverse factors that augment the continuation and uptake of family planning methods. Clients’ satisfaction is one of the core determinants facilitating continuation of family planning methods. There is a major debate yet scanty evidence to contrast public and private sectors with respect to client satisfaction. The objective of this study is to compare quality-of-care provided by public and private sectors of Pakistan through a client satisfaction lens. Methods: We used Pakistan Demographic Heath Survey 2012-13 dataset (Sindh province) on a total of 3133 Married Women of Reproductive Age (MWRA) aged 15-49 years. Source of family planning (public/private sector) was the main exposure variable. Outcome variable was client satisfaction judged by ten different dimensions of client satisfaction. Means and standard deviations were calculated for continuous variable while for categorical variable frequencies and percentages were computed. For univariate analysis, Chi-square/Fisher Exact test was used to find an association between clients’ satisfaction in public and private sectors. Ten different multivariate models were made. Variables were checked for multi-collinearity, confounding, and interaction, and then advanced logistic regression was used to explore the relationship between client satisfaction and dependent outcome after adjusting for all known confounding factors and results are presented as OR and AOR (95% CI). Results: Multivariate analyses showed that clients were less satisfied in contraceptive provision from private sector as compared to public sector (AOR 0.92,95% CI 0.63-1.68) even though the result was not statistically significant. Clients were more satisfied from private sector as compared to the public sector with respect to other determinants of quality-of-care (follow-up care (AOR 3.29, 95% CI 1.95-5.55), infection prevention (AOR 2.41, 95% CI 1.60-3.62), counseling services (AOR 2.01, 95% CI 1.27-3.18, timely treatment (AOR 3.37, 95% CI 2.20-5.15), attitude of staff (AOR 2.23, 95% CI 1.50-3.33), punctuality of staff (AOR 2.28, 95% CI 1.92-4.13), timely referring (AOR 2.34, 95% CI 1.63-3.35), staff cooperation (AOR 1.75, 95% CI 1.22-2.51) and complications handling (AOR 2.27, 95% CI 1.56-3.29).

Keywords: client satisfaction, family planning, public private partnership, quality of care

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5810 The Outcome of the Discontinuation of Cheques on Bank Reconciliation

Authors: Estelle Abrahams, Tania Pretorius

Abstract:

A joint media statement by the South African Reserve Bank, the Banking Association of South Africa, the Financial Sector Conduct Authority, and the Payments Association of South Africa was recently published, stating that the receipt or acceptance of cheques will terminate effectively on 31 December 2020. All stakeholders are urged to cease accepting or issuing cheques as a payment method. The purpose of the study is to examine the effect that the discontinuation of the usage of cheques has on bank reconciliations for the subject: economic and management sciences. A literature study was performed to gain insight into the bank reconciliation process to be able to draw conclusions on the outcome of the discontinuation of cheques on the bank reconciliation. The study found that the teaching of the bank reconciliation process will change to introduce new replacement source documents for digital payments, and this impacts the teaching of reconciling differences.

Keywords: bank reconciliation, internal control, accounting education, source documents

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5809 Siderophore Receptor Protein from Klebsiella pneumoniae as a Promising Immunogen for Serotype-Independent Therapeutic Lead Development

Authors: Sweta Pandey, Samridhi Dhyani, Susmita Chaudhuri

Abstract:

Klebsiella pneumoniae causes a wide range of infections, including urinary tract infections, sepsis, bacteremia, pneumonia, and liver abscesses. The emergence of multi-drug resistance in this bacterium led to a major setback for clinical management. WHO also endorsed a need for finding alternative therapy to antibiotics for the treatment of these infections. Development of vaccines and passive antibody therapy has been proven as a potent alternative to antibiotics in the case of MDR, XDR, and PDR Klebsiella infections. Siderophore receptors have been demonstrated to be overexpressed for the internalization of iron siderophore complexes during infections in most Gram-negative bacteria. For the present study, immune response to siderophore receptors to establish this protein as a potential immunogen for the development of therapeutic leads was explored. Clinical strains of Klebsiella pneumoniae were grown in iron-deficient conditions, and the iron-regulated outer membrane proteins were extracted and characterized through mass spectrometry for specific identification. The gene for identified protein was cloned in pET- 28a vector and expressed in E. coli. The native protein and the recombinant protein were isolated and purified and used as antigens for the generation of immune response in BALB/c mice. The native protein of Klebsiella pneumoniae grown in iron-deficient conditions was identified as FepA (Ferrienterobactin receptor) and other siderophore receptors. This 80 kDa protein generated an immune response in BALB/c mice. The antiserum from mice after subsequent booster doses was collected and showed binding with FepA protein in western blot and phagocytic uptake of the K. pneumoniae in the presence antiserum from immunized mice also observed from the animal studies after bacterial challenge post immunisation in mice have shown bacterial clearance. The antiserum from mice showed binding and clearance of the Klebsiella pneumoniae bacteria in vitro and in vivo. These antigens used for generating an active immune response in mice can further be used for therapeutic monoclonal antibody development against Klebsiella pneumoniae infections.

Keywords: antiserum, FepA, Klebsiella pneumoniae, multi drug resistance, siderophore receptor

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5808 Incineration of Sludge in a Fluidized-Bed Combustor

Authors: Chien-Song Chyang, Yu-Chi Wang

Abstract:

For sludge disposal, incineration is considered to be better than direct burial because of regulations and space limitations in Taiwan. Additionally, burial after incineration can effectively prolong the lifespan of a landfill. Therefore, it is the most satisfactory method for treating sludge at present. Of the various incineration technologies, the fluidized bed incinerator is a suitable choice due to its fuel flexibility. In this work, sludge generated from industrial plants was treated in a pilot-scale vortexing fluidized bed. The moisture content of the sludge was 48.53%, and its LHV was 454.6 kcal/kg. Primary gas and secondary gas were fixed at 3 Nm3/min and 1 Nm3/min, respectively. Diesel burners with on-off controllers were used to control the temperature; the bed temperature was set to 750±20 °C, and the freeboard temperature was 850±20 °C. The experimental data show that the NO emission increased with bed temperature. The maximum NO emission is 139 ppm, which is in agreement with the regulation. The CO emission is low than 100 ppm through the operation period. The mean particle size of fly ash collected from baghouse decreased with operating time. The ration of bottom ash to fly ash is about 3. Compared with bottom ash, the potassium in the fly ash is much higher. It implied that the potassium content is not the key factor for aggregation of bottom ash.

Keywords: bottom ash, fluidized-bed combustion, incineration, sludge

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5807 A Comparative and Mixed Methods Study of Possible Selves of Adolescent Boys in an Observation Home and a Children's Home in India

Authors: Apurva Sapra

Abstract:

The aim of this research was to study and compare the nature of expected, feared and hoped-for selves in institutionalized adolescent boys in two residential settings – an observation home with children in conflict with the law, and a children’s home with children in need of care and protection. The study uses a concurrent mixed methods design, in which eight adolescent boys from each group, aged 13-17, were asked to respond to a questionnaire, followed by an in-depth interview. The questionnaire looked into the total scores on current, probable and hoped-for/feared positive and negative self-descriptors. Possible selves of both groups were found to be influenced by their unique histories, such as with their experience of violence, interaction with the police and emphasis given on education. Expected selves and hoped-for selves were similar within the two groups. However, they were more concrete and attainable in the observation home and more ambitious in the children’s home. Quantitative results showed that on the positive self-descriptors, the participants in the observation home had a slightly lower total score on the current parameter as on the probable and hoped-for parameters. The participants in the children’s home showed similar results on current and probable positive self-descriptors, with higher scores on the hoped-for parameter. For most of the negative self-descriptors, the current score for the observation home group was lower than the expected score, and for the children’s home group, they were feared slightly more than they were expected. Along with the nature of possible selves, the study also looked into threats and support to desired and feared possible selves, as well as strategies to attain the desired possible selves and avoid feared possible selves. While threats to possible selves were identified as external and internal in both groups, the participants in the children’s home tended to identify threats as external. The categories of support were similar across the two groups, although the nature of support provided differed. Strategies adopted by participants in the observation home could be clearly divided as past, present and future strategies, while those adopted by participants in the children’s home had an overlap with past and future strategies. The institution was perceived as having a negative influence for the future in the observation home group, but positive in the children’s home group. Limitations of the study and recommendations for future research, policy setting and the counselling profession are discussed.

Keywords: adolescents, expected self, feared self, hoped-for self, institutions, possible selves

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5806 Comparative Analysis of Fused Deposition Modeling and Binding-Jet 3D Printing Technologies

Authors: Mohd Javaid, Shahbaz Khan, Abid Haleem

Abstract:

Purpose: Large numbers of 3D printing technologies are now available for sophisticated applications in different fields. Additive manufacturing has established its dominance in design, development, and customisation of the product. In the era of developing technologies, there is a need to identify the appropriate technology for different application. In order to fulfil this need, two widely used printing technologies such as Fused Deposition Modeling (FDM), and Binding-Jet 3D Printing are compared for effective utilisation in the current scenario for different applications. Methodology: Systematic literature review conducted for both technologies with applications and associated factors enabling for the same. Appropriate MCDM tool is used to compare critical factors for both the technologies. Findings: Both technologies have their potential and capabilities to provide better direction to the industry. Additionally, this paper is helpful to develop a decision support system for the proper selection of technologies according to their continuum of applications and associated research and development capability. The vital issue is raw materials, and research-based material development is key to the sustainability of the developed technologies. FDM is a low-cost technology which provides high strength product as compared to binding jet technology. Researcher and companies can take benefits of this study to achieve the required applications in lesser resources. Limitations: Study has undertaken the comparison with the opinion of experts, which may not always be free from bias, and some own limitations of each technology. Originality: Comparison between these technologies will help to identify best-suited technology as per the customer requirements. It also provides development in this different field as per their extensive capability where these technologies can be successfully adopted. Conclusion: FDM and binding jet technology play an active role in industrial development. These help to assist the customisation and production of personalised parts cost-effectively. So, there is a need to understand how these technologies can provide these developments rapidly. These technologies help in easy changes or in making revised versions of the product, which is not easily possible in the conventional manufacturing system. High machine cost, the requirement of skilled human resources, low surface finish, and mechanical strength of product and material changing option is the main limitation of this technology. However, these limitations vary from technology to technology. In the future, these technologies are to be commercially viable for efficient usage in direct manufacturing of varied parts.

Keywords: 3D printing, comparison, fused deposition modeling, FDM, binding jet technology

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5805 Vancomycin Resistance Enterococcus and Implications to Trauma and Orthopaedic Care

Authors: O. Davies, K. Veravalli, P. Panwalkar, M. Tofighi, P. Butterick, B. Healy, A. Mofidi

Abstract:

Vancomycin resistant enterococcus infection is a condition that usually impacts ICUs, transplant, dialysis, and cancer units, often as a nosocomial infection. After an outbreak in the acute trauma and orthopaedic unit in Morriston hospital, we aimed to access the conditions that predispose VRE infections in our unit. Thirteen cases of VRE infection and five cases of VRE colonisations were identified in patients who were treated for orthopaedic care between 1/1/2020 and 1/11/2021. Cases were reviewed to identify predisposing factors, specifically looking at age, presenting condition and treatment, presence of infection and antibiotic care, active haemo-oncological condition, long term renal dialysis, previous hospitalisation, VRE predisposition, and clearance (PREVENT) scores, and outcome of care. The presenting condition, treatment, presence of postoperative infection, VRE scores, age was compared between colonised and the infected cohort. VRE type in both colonised and infection group was Enterococcus Faecium in all but one patient. The colonised group had the same age (T=0.6 P>0.05) and sex (2=0.115, p=0.74), presenting condition and treatment which consisted of peri-femoral fixation or arthroplasty in all patients. The infected group had one case of myelodysplasia and four cases of chronic renal failure requiring dialysis. All of the infected patient had sustained an infected complication of their fracture fixation or arthroplasty requiring reoperation and antibiotics. The infected group had an average VRE predisposition score of 8.5 versus the score of 3 in the colonised group (F=36, p<0.001). PREVENT score was 7 in the infected group and 2 in the colonised group(F=153, p<0.001). Six patients(55%) succumbed to their infection, and one VRE infection resulted in limb loss. In the orthopaedic cohort, VRE infection is a nosocomial condition that has peri-femoral predilection and is seen in association with immunosuppression or renal failure. The VRE infection cohort has been treated for infective complication of original surgery weeks prior to VRE infection. Based on our findings, we advise avoidance of infective complications, change of practice in use of antibiotics and use radical surgery and surveillance for VRE infections beyond infective precautions. PREVENT score shows that the infected group are unlikely to clear their VRE in the future but not the colonised group.

Keywords: surgical site infection, enterococcus, orthopaedic surgery, vancomycin resistance

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5804 Design of a Human-in-the-Loop Aircraft Taxiing Optimisation System Using Autonomous Tow Trucks

Authors: Stefano Zaninotto, Geoffrey Farrugia, Johan Debattista, Jason Gauci

Abstract:

The need to reduce fuel and noise during taxi operations in the airports with a scenario of constantly increasing air traffic has resulted in an effort by the aerospace industry to move towards electric taxiing. In fact, this is one of the problems that is currently being addressed by SESAR JU and two main solutions are being proposed. With the first solution, electric motors are installed in the main (or nose) landing gear of the aircraft. With the second solution, manned or unmanned electric tow trucks are used to tow aircraft from the gate to the runway (or vice-versa). The presence of the tow trucks results in an increase in vehicle traffic inside the airport. Therefore, it is important to design the system in a way that the workload of Air Traffic Control (ATC) is not increased and the system assists ATC in managing all ground operations. The aim of this work is to develop an electric taxiing system, based on the use of autonomous tow trucks, which optimizes aircraft ground operations while keeping ATC in the loop. This system will consist of two components: an optimization tool and a Graphical User Interface (GUI). The optimization tool will be responsible for determining the optimal path for arriving and departing aircraft; allocating a tow truck to each taxiing aircraft; detecting conflicts between aircraft and/or tow trucks; and proposing solutions to resolve any conflicts. There are two main optimization strategies proposed in the literature. With centralized optimization, a central authority coordinates and makes the decision for all ground movements, in order to find a global optimum. With the second strategy, called decentralized optimization or multi-agent system, the decision authority is distributed among several agents. These agents could be the aircraft, the tow trucks, and taxiway or runway intersections. This approach finds local optima; however, it scales better with the number of ground movements and is more robust to external disturbances (such as taxi delays or unscheduled events). The strategy proposed in this work is a hybrid system combining aspects of these two approaches. The GUI will provide information on the movement and status of each aircraft and tow truck, and alert ATC about any impending conflicts. It will also enable ATC to give taxi clearances and to modify the routes proposed by the system. The complete system will be tested via computer simulation of various taxi scenarios at multiple airports, including Malta International Airport, a major international airport, and a fictitious airport. These tests will involve actual Air Traffic Controllers in order to evaluate the GUI and assess the impact of the system on ATC workload and situation awareness. It is expected that the proposed system will increase the efficiency of taxi operations while reducing their environmental impact. Furthermore, it is envisaged that the system will facilitate various controller tasks and improve ATC situation awareness.

Keywords: air traffic control, electric taxiing, autonomous tow trucks, graphical user interface, ground operations, multi-agent, route optimization

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5803 Neighborhood of Dwelling with Historical Architectural Elements – Case Study: Khorasgan' Stream of Isfahan

Authors: M.J. Seddighi, A. Moradchelleh, M. Keyvan

Abstract:

The ultimate goal in building a city is to provide pleasant, comfortable and nurturing environment as a context of public life. City environment establishes strong connection with people and their surrounding habitant, acting as relevance in social interactions between citizens itself. Urban environment and appropriate municipal facilities are the only way for proper communication between city and citizens and also citizens themselves. There is a need for complement elements between buildings and constructions to settling city life through which the move, comfort, reactions and anxiety will adjust and reflect the spirit to the city. In the surging development of society, urban’ spaces are encountered evolution, sometimes causing the symbols to fade and waste, and as a result, leading to destroy belongs among humans and their physical liquidate. Houses and living spaces exhibit materialistic reflection of life style. In other words, way of life makes the symbolic essence of living spaces. In addition, it is of sociocultural factor of lifestyle, consisting the concepts and culture, morality, worldview, and national character. Culture is responsible for some crucial meaningful needs which can be wide because they depend on various causes such as perception and interpretation of believes, philosophy of life, interaction with neighbors and protection against climate and enemies. The bilateral relationship between human and nature is the main factor that needs to be properly addressed. It is because of the fact that the approach which is taken against landscape and nature has a pertinent influence on creation and shaping the structure of a house. The first response of human in tackling the environment is to build a “shelter” and place as dwelling. This has been a crucial factor in all time periods. In the proposed study, dwelling in Khorasgan’ Stream, as an area located in one of the important historical city of Iran, has been studied. Khorasgan’ Stream is the basic constituent elements of the present architectural form of Isfahan. The influence of Islamic spiritual culture and neighborhood with the historical elements on the dwelling of the selected location, subsequently on other regions of the town are presented.

Keywords: historical architectural elements, dwelling' neighborhood, Khorasgan’ Stream of Isfahan, architecture

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5802 Performance Evaluation of Al Jame’s Roundabout Using SIDRA

Authors: D. Muley, H. S. Al-Mandhari

Abstract:

This paper evaluates the performance of a multi-lane four-legged modern roundabout operating in Muscat using SIDRA model. The performance measures include Degree of Saturation (DOS), average delay, and queue lengths. The geometric and traffic data were used for model preparation. Gap acceptance parameters, critical gap, and follow-up headway were used for calibration of SIDRA model. The results from the analysis showed that currently the roundabout is experiencing delays up to 610 seconds with DOS 1.67 during peak hour. Further, sensitivity analysis for general and roundabout parameters was performed, amongst lane width, cruise speed, inscribed diameter, entry radius, and entry angle showed that inscribed diameter is the most crucial factor affecting delay and DOS. Upgradation of the roundabout to the fully signalized junction was found as the suitable solution which will serve for future years with LOS C for design year having DOS of 0.9 with average control delay of 51.9 seconds per vehicle.

Keywords: performance analysis, roundabout, sensitivity analysis, SIDRA

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5801 Fastidious Enteric Pathogens in HIV

Authors: S. Pathak, R. Lazarus

Abstract:

A 25-year-old male HIV patient (CD4 cells 20/µL and HIV viral load 14200000 copies/ml) with a past medical history of duodenal ulcer, pneumocystis carinii pneumonia, oesophageal candidiasis presented with fever and a seizure to hospital. The only recent travel had been a religious pilgrimage from Singapore to Malaysia 5 days prior; during the trip he sustained skin abrasions. The patient had recently started highly active antiretroviral therapy 2 months prior. Clinical examination was unremarkable other than a temperature of 38.8°C and perianal warts. Laboratory tests showed a leukocyte count 12.5x109 cells/L, haemoglobin 9.4 g/dL, normal biochemistry and a C-reactive protein 121 mg/L. CT head and MRI head were unremarkable and cerebrospinal fluid analysis performed after a delay (due to technical difficulties) of 11 days was unremarkable. Blood cultures (three sets) taken on admission showed Gram-negative rods in the anaerobic bottles only at the end of incubation with culture result confirmed by molecular sequencing showing Helicobacter cinaedi. The patient was treated empirically with ceftriaxone for seven days and this was converted to oral co-amoxiclav for a further seven days after the blood cultures became positive. A Transthoracic echocardiogram was unremarkable. The patient made a full recovery. Helicobacter cinaedi is a gram-negative anaerobic fastidious organism affecting patients with comorbidity. Infection may manifest as cellulitius, colitis or as in this case as bloodstream infection – the latter is often attributed to faeco-oral infection. Laboratory identification requires prolonged culture. Therapeutic options may be limited by resistance to macrolides and fluoroquinolones. The likely pathogen inoculation routes in the case described include gastrointestinal translocation due to proctitis at the site of perianal warts, or breach of the skin via abrasions occurring during the pilgrimage. Such organisms are increasing in prevalence as our patient population ages and patients have multiple comorbidities including HIV. It may be necessary in patients with unexplained fever to prolong incubation of sterile sites including blood in order to identify this unusual fastidious organism.

Keywords: fastidious, Helicobacter cinaedi, HIV, immunocompromised

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