Search results for: treatment response

Authors: Saeed Ghali

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Designed martensitic stainless steel was produced in a 30 kg induction furnace. The molten metal was cast into a refractory sand mold at 1600 °C. The produced ingots were recharged into the reheating furnace. Martensitic stainless steel was held for 1 hour at a temperature of 1150°C. The forging process starts and finishes at 1150 °C and 900 °C, respectively. A chemical analysis was carried out. Microstructure was studied. Heat treatment for martensitic stainless steel was carried out at 300 oC, 400 oC, 500 oC, 600 oC and 700 oC for 5 min, 20 min, 45 min, 120 min and 240 min. Hardness was measured after each heat treatment. The contribution influence of each time and temperature on hardness was investigated using factorial design for tempering temperature range (500 oC – 700 oC) for time up to 240 min. It was found that the microstructure is mainly a martensitic phase, and it conforms to the Schaeffler diagram. The results showed that time, temperature and their interaction combination have a negative effect on hardness in the temperature range ( 500 oC – 700 oC) with time range (5 min – 240 min). The model was built up in the form of coded variables and in actual variables. The predicted values – from coded and actual variables - of hardness are compatible with the experimental values. Factorial design is a useful technique to predict the effect and contribution effect of both time and temperature on the hardness of 7Cr-0.93Mo-2.27W martensitic stainless steel.

Keywords: steel, factorial design, hardness, heat treatment, temperature

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Authors: Avigail Moor

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Rape and sexual assault have been widely linked to severe psychological sequelae, the recovery from which often requires professional help. Thanks to the current shift in societal attitudes towards sexual violence, the victim's perspective is increasingly being heard. The present study is yet another step in that direction. Through the investigation of what recovered survivors of sexual assault identify as the therapeutic interventions that most assisted them in overcoming their trauma, guidelines for optimal sexual assault treatment are established. These receive further support from a comparison with expert therapists as to what they view as being most conducive to recovery from rape. In-depth semi-structured interviews were conducted with 15 survivors who have experienced a successful course of therapy and 15 therapists with extensive expertise in the field. The results document considerable agreement between the two perspectives, which share much in common. First, irrespective of the specific techniques involved, both survivors and therapists placed the greatest importance on a respectful and validating therapeutic relationship, that operates to counter the dehumanization and degradation entailed in the assault. In addition, specific interventions were identified, which include the reprocessing of all rape-specific peri-traumatic reactions coupled with the intentional countering of their consequences within the therapeutic relationship. Together, these reports provide a detailed account of post-rape treatment needs and the interventions required for their effective resolution.

Keywords: sexual assault, rape, treatment efficacy, survivors

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Authors: Alyaa Abdlwahab

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Cutaneous leishmaniasis represents a serious health problem in Syria; this problem has become noticeably aggravated after the civil war in the country. Leishmania tropica parasite is the main cause of cutaneous leishmaniasis in Syria. In order to control the disease, we need an effective vaccine against leishmania parasite. DNA vaccination remains one of the favorable approaches that have been used to face cutaneous leishmaniasis. Ribosomal protein S4 is responsible for important roles in Leishmania parasite life. DNA vaccine based on S4 gene has been used against infections by many species of Leishmania parasite but leishmania tropica parasite, so this gene represents a good candidate for DNA vaccine construction. After proving the existence of ribosomal protein S4 gene in a Syrian strain of Leishmania tropica (LCED Syrian 01), sequencing it and cloning it into pCI plasmid, BALB/C mice were inoculated with pCI-S4 DNA vaccine. The immune response was determined by monitoring the lesion progression in inoculated BALB/C mice for six weeks after challenging mice with Leishmania tropica (LCED Syrian 01) parasites. IL-12, IFN-γ, and IL-4 were quantified in draining lymph nodes (DLNa) of the immunized BALB/C mice by using the RT-qPCR technique. The parasite burden was calculated in the final week for the footpad lesion and the DLNs of the mice. This study proved the existence and the expression of the ribosomal protein S4 gene in Leishmania tropica (LCED Syrian 01) promastigotes. The sequence of ribosomal protein cDNA S4 gene was determined and published in Genbank; the gene size was 822 bp. Expression was also demonstrated at the level of cDNA. Also, this study revealed that pCI-S4 DNA vaccine induces TH1\TH2 response in immunized mice; this response prevents partially developing a dermal lesion of Leishmania.

Keywords: ribosomal protein S4, DNA vaccine, Leishmania tropica, BALB\c

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Authors: Mohammad Ali Rajaeifar, Oliver Heidrich

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Nowadays, Li-ion batteries are vastly disseminated and the battery market is expected to experience a huge growth during next decade especially in terms of traction batteries. As the automotive industry moving towards the electrification of the powertrain, more raw/critical materials and energy are extracted while on the other hand, concerns are made regarding the scarcity of the materials as well as environmental issues regarding the destiny of the spent batteries. In this regards, recycling could play a vital role in the supply chain, leading reutilization of key battery materials and also reducing environmental burden related to the use of batteries. The aim of this paper is to review the previous and state-of-the-art treatments for recycling of Li-ion batteries. All the treatments method from mechanical, mild-thermal, pyrometallurgical and hydrometallurgical as well as combined methods for recycling of Li-ion batteries were considered in the study. There are various treatment methods that are economical, but they are not environmentally friendly or vice versa. This is due to the fact that the benefits of the Li-ion batteries recycling could be affected by different factors such as the amount of spent batteries available, the quality of the recovered material, the energy and material consumption by the process itself and environmental burdens caused by required logistics. Finally, a preliminary work sheet of possible route for recycling of spent Li-ion batteries was presented through the course of this study. Overall, it is worth quoting that recycling processes generally consumes a great deal of energy and auxiliary materials. Moreover, the collection of spent products from waste streams represents additional environmental efforts. Therefore, developing and optimizing efficient collection and separation technologies is essential to achieve sustainability goals.

Keywords: hydrometallurgical treatment, Li-ion batteries, mild-thermal treatment, mechanical treatment, recycling, pyrometallurgical treatment

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Authors: T. Hojageldiyev, Y. Bolmammedov, S. Gurbanaliyev

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It is known that drugs used in the treatment of tuberculosis show toxic effect to organism especially to liver besides its therapeutic effect. Because of ineffectiveness of drugs used in the treatment regimen of tuberculosis against multidrug resistance (MDR) and extensively drug-resistance (XDR) tuberculosis requires the development of new treatment methods and new, novel drugs. Considering the usage of Artemisia absinthium in traditional medicine in treatment of wounds which suggests its antibacterial activity it seems that, also it may have significant antimycobacterial activity. The objective of present study was to evaluate antibacterial activity of ethanolic extract of A. absinthium against M. tuberculosis. In this study, the effect of ethanolic extract of A. absinthium was tested against tuberculosis and pharmaco-toxicological properties evaluated on laboratory animals. The 20%, 40%, 70% and 96% ethanolic extracts of A. absinthium prepared then its bacteriostatic and bactericidal activities were evaluated by validated methods. Data were analyzed by GraphPad Prism 7.0 at the level P < 0.05. Results showed that ethanolic extracts of A. absinthium show no toxicological properties with having high LD50. All concentrations of extract show high bacteriostatic activity on M. tuberculosis. 96% ethanolic extract has highest bactericidal effect among other concentrations. By conducting further studies, as a result of our study, antimycobacterial drug can be prepared from A. absinthium.

Keywords: Artemisia absinthium, antimycobacterial, ethanolic extract, Mycobacteria tuberculosis

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Authors: Priya Kedia, Kiranmoy Das

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There is a rich literature on variable selection in regression setting. However, most of these methods assume normality for the response variable under consideration for implementing the methodology and establishing the statistical properties of the estimates. In many real applications, the distribution for the response variable may be non-Gaussian, and one might be interested in finding the best subset of covariates at some predetermined quantile level. We develop dynamic Bayesian approach for variable selection in quantile regression framework. We use a zero-inflated mixture prior for the regression coefficients, and consider the asymmetric Laplace distribution for the response variable for modeling different quantiles of its distribution. An efficient Gibbs sampler is developed for our computation. Our proposed approach is assessed through extensive simulation studies, and real application of the proposed approach is also illustrated. We consider the data from health and retirement study conducted by the University of Michigan, and select the important predictors when the outcome of interest is out-of-pocket medical cost, which is considered as an important measure for financial risk. Our analysis finds important predictors at different quantiles of the outcome, and thus enhance our understanding on the effects of different predictors on the out-of-pocket medical cost.

Keywords: variable selection, quantile regression, Gibbs sampler, asymmetric Laplace distribution

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Authors: Sina Moradi, Christopher W. K. Chow, John Van Leeuwen, David Cook, Mary Drikas, Patrick Hayde, Rose Amal

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Chloramine is commonly used as a disinfectant in drinking water distribution systems (DWDSs), particularly in Australia and the USA. Maintaining a chloramine residual throughout the DWDS is important in ensuring microbiologically safe water is supplied at the customer’s tap. In order to simulate how chloramine behaves when it moves through the distribution system, a water quality network model (WQNM) can be applied. In this work, the WQNM was based on mono-chloramine decomposition reactions, which enabled prediction of mono-chloramine residual at different locations through a DWDS in Australia, using the Bentley commercial hydraulic package (Water GEMS). The accuracy of WQNM predictions is influenced by a number of water quality parameters. Optimization of these parameters in order to obtain the closest results in comparison with actual measured data in a real DWDS would result in both cost reduction as well as reduction in consumption of valuable resources such as energy and materials. In this work, the optimum operating conditions of water quality parameters (i.e. temperature, pH, and initial mono-chloramine concentration) to maximize the accuracy of mono-chloramine residual predictions for two water supply scenarios in an entire network were determined using response surface methodology (RSM). To obtain feasible and economical water quality parameters for highest model predictability, Design Expert 8.0 software (Stat-Ease, Inc.) was applied to conduct the optimization of three independent water quality parameters. High and low levels of the water quality parameters were considered, inevitably, as explicit constraints, in order to avoid extrapolation. The independent variables were pH, temperature and initial mono-chloramine concentration. The lower and upper limits of each variable for two water supply scenarios were defined and the experimental levels for each variable were selected based on the actual conditions in studied DWDS. It was found that at pH of 7.75, temperature of 34.16 ºC, and initial mono-chloramine concentration of 3.89 (mg/L) during peak water supply patterns, root mean square error (RMSE) of WQNM for the whole network would be minimized to 0.189, and the optimum conditions for averaged water supply occurred at pH of 7.71, temperature of 18.12 ºC, and initial mono-chloramine concentration of 4.60 (mg/L). The proposed methodology to predict mono-chloramine residual can have a great potential for water treatment plant operators in accurately estimating the mono-chloramine residual through a water distribution network. Additional studies from other water distribution systems are warranted to confirm the applicability of the proposed methodology for other water samples.

Keywords: chloramine decay, modelling, response surface methodology, water quality parameters

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Authors: Samkeliso S. Ndzimandze, Welldone Moyo, Oranso T. Mahlangu, Adolph A. Muleja, Alex T. Kuvarega, Thabo T. I. Nkambule

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The high cost of precursor materials has hindered the commercialization of ceramic membrane technology in water treatment. In this work, a ceramic membrane disc (approximately 50 mm in diameter and 4 mm thick) was prepared from low-cost starting materials, kaolin, and fly ash by pressing at 200 bar and calcining at 900 °C. The fabricated membrane was characterized for various physicochemical properties, natural organic matter (NOM) removal as well as fouling propensity using several techniques. Further, the ceramic membrane was tested on samples collected from four drinking water treatment plants in KwaZulu-Natal, South Africa (named plants 1-4). The membrane achieved 48.6%, 54.6%, 57.4%, and 76.4% bulk UV254 reduction for raw water at plants 1, 2, 3, and 4, respectively. These removal rates were comparable to UV254 reduction achieved by coagulation/flocculation steps at the respective plants. Further, the membrane outperformed sand filtration steps in plants 1-4 in removing disinfection by-product precursors (8%-32%) through size exclusion. Fluorescence excitation-emission matrices (FEEM) studies showed the removal of fluorescent NOM fractions present in the water samples by the membrane. The membrane was fabricated using an up-scalable facile method, and it has the potential for application as a polishing step to complement conventional processes in water treatment for drinking purposes.

Keywords: crossflow filtration, drinking water treatment plants, fluorescence excitation-emission matrices, ultraviolet 254 (UV₂₅₄)

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Authors: Anusha Atmakuri, R. D. Tyagi, Patrick Drogui

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Landfilling is the most familiar and easy way to dispose solid waste. Landfill is generally received via wastes from municipal near to a landfill. The waste collected is from commercial, industrial, and residential areas and many more. Landfill leachate (LFL) is formed when rainwater passes through the waste placed in landfills and consists of several dissolved organic materials, for instance, aquatic humic substances (AHS), volatile fatty acids (VFAs), heavy metals, inorganic macro components, and xenobiotic organic matters, highly toxic to the environment. These components of LFL put a load on it, hence it necessitates the treatment of LFL prior to its discharge into the environment. Various methods have been used to treat LFL over the years, such as physical, chemical, biological, physicochemical, electrical, and advanced oxidation methods. This study focuses on the combination of biological and electrochemical methods- extracellular polymeric substances and electrocoagulation(EC). The coupling of electro-coagulation process with extracellular polymeric substances (EPS) (as flocculant) as pre and\or post treatment strategy provides efficient and economical process for the decontamination of landfill leachate contaminated with suspended matter, metals (e.g., Fe, Mn) and ammonical nitrogen. Electro-coagulation and EPS mediated coagulation approach could be an economically viable for the treatment of landfill leachate, along with possessing several other advantages over several other methods. This study utilised waste substrates such as activated sludge, crude glycerol and waste cooking oil for the production of EPS using fermentation technology. A comparison of different scenarios for the treatment of landfill leachate is presented- such as using EPS alone as bioflocculant, EPS and EC with EPS being the 1st stage, and EPS and EC with EC being the 1st stage. The work establishes the use of crude EPS as a bioflocculant for the treatment of landfill leachate and wastewater from a site near a landfill, along with EC being successful in removal of some major pollutants such as COD, turbidity, total suspended solids. A combination of these two methods is to be explored more for the complete removal of all pollutants from landfill leachate.

Keywords: landfill leachate, extracellular polymeric substances, electrocoagulation, bioflocculant.

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Authors: Shangerganesh Lingeshwaran

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In this presentation, we have performed numerical simulations for a reaction-diffusion equation with various nonlinear density-dependent diffusion operators and proliferation functions. The mathematical model represented by parabolic partial differential equation is considered to study the invasion of gliomas (the most common type of brain tumors) and to describe the growth of cancer cells and response to their treatment. The unknown quantity of the given reaction-diffusion equation is the density of cancer cells and the mathematical model based on the proliferation and migration of glioma cells. A standard Galerkin finite element method is used to perform the numerical simulations of the given model. Finally, important observations on the each of nonlinear diffusion functions and proliferation functions are presented with the help of computational results.

Keywords: glioma invasion, nonlinear diffusion, reaction-diffusion, finite eleament method

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Authors: Christo Nicholls

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The National Electricity Grid (NEG) in South Africa has been under strain for the last five years. This overburden of the NEG led Eskom (the State-Owned Entity responsible for the NEG) to implement a blunt methodology to assist them in reducing the maximum demand (MD) on the NEG, when required, called Loadshedding. The challenge of this methodology is that not only does it lead to immense technical issues with the distribution network equipment, e.g., transformers, due to the frequent abrupt off and on switching, it also has a broader negative fiscal impact on the distributors, as their key consumers (commercial & industrial) are now grid defecting due to the lack of Electricity Security Provision (ESP). This paper provides a pragmatic alternative methodology utilizing specific functionalities embedded within direct-connect single and three-phase Advanced Meter Infrastructure (AMI) Solutions deployed within the distribution network, in conjunction with a Multi-Agent Systems Based AI implementation focused on Automated Negotiation Peer-2-Peer trading. The results of this research clearly illustrate, not only does methodology provide a factual percentage contribution towards the NEG MD at the point of consideration, it also allows the distributor to leverage the real-time MD data from key consumers to activate complex, yet impact-measurable Demand Response (DR) programs.

Keywords: AI, AMI, demand response, multi-agent

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Authors: Trevor Sabiston, Mohsen Mohammadi, Mohammed Cherkaoui, Kaan Inal

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A new micromechanics framework is developed for long fibre reinforced composites using a single fibre surrounded by a functionally graded interphase and matrix as a representative unit cell. The unit cell is formulated to represent any number of aligned fibres by a single fibre. Using this model the elastic response of long fibre composites is predicted in all directions. The model is calibrated to experimental results and shows very good agreement in the elastic regime. The differences between the proposed model and existing models are discussed.

Keywords: computational mechanics, functionally graded interphase, long fibre composites, micromechanics

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Authors: Linda Blümel, Bettina Bert, Jan Brosda, Heidrun Fink, Melanie Hamann

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Age-related cognitive decline can eventually lead to dementia, the most common mental illness in elderly people and an immense challenge for patients, their families and caregivers. Cholinesterase inhibitors constitute the most commonly used antidementia prescription medication. The standardized Ginkgo biloba leaf extract EGb 761® is approved for treating age-associated cognitive impairment and has been shown to improve the quality of life in patients suffering from mild dementia. A clinical trial with 96 Alzheimer´s disease patients indicated that the combined treatment with donepezil and EGb 761® had fewer side effects than donepezil alone. In an animal model of cognitive aging, we compared the effect of combined treatment with EGb 761® or donepezil monotherapy and vehicle. We compared the effect of chronic treatment (15 days of pretreatment) with donepezil (1.5 mg/kg p. o.), EGb 761® (100 mg/kg p. o.), or the combination of the two drugs, or vehicle in 18 – 20 month old male OFA rats. Learning and memory performance were assessed by Morris water maze testing, motor behavior in an open field paradigm. In addition to chronic treatment, the substances were administered orally 30 minutes before testing. Compared to the first day and to the control group, only the combination group showed a significant reduction in latency to reach the hidden platform on the second day of testing. Moreover, from the second day of testing onwards, the donepezil, the EGb 761® and the combination group required less time to reach the hidden platform compared to the first day. The control group did not reach the same latency reduction until day three. There were no effects on motor behavior. These results suggest a superiority of the combined treatment of donepezil with EGb 761® compared to monotherapy.

Keywords: age-related cognitive decline, dementia, ginkgo biloba leaf extract EGb 761®, learning and memory, old rats

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Authors: Keerthi Katam, Abhinav B. Tirunaghari, Vinod Vadithya, Toshiyuki Shimizu, Satoshi Soda, Debraj Bhattacharyya

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Researchers worldwide are increasingly focusing on the removal of carbon and nutrient from wastewater using algal-bacterial hybrid systems. Algae produce oxygen during photosynthesis, which is taken up by heterotrophic bacteria for mineralizing organic carbon to carbon dioxide. This phenomenon reduces the net mechanical aeration requirement of aerobic biological wastewater treatment processes. Consequently, the treatment cost is also reduced. Microalgae also participate in the treatment process by taking up nutrient (N, P) from wastewater. Algal biomass, if harvested, can generate value-added by-products. The aim of the present study was to compare the performance of two systems - System A (mixed microalgae and bacteria) and System B (diatoms and bacteria) in treating kitchen wastewater (KWW). The test reactors were operated at five different solid retention times (SRTs) -2, 4, 6, 8, and 10-days in draw-and-fill mode. The KWW was collected daily from the dining hall-kitchen area of the Indian Institute of Technology Hyderabad. The influent and effluent samples were analyzed for total organic carbon (TOC), total nitrogen (TN) using TOC-L analyzer. A colorimetric method was used to analyze anionic surfactant. Phosphorus (P) and chlorophyll were measured by following standard methods. The TOC, TN, and P of KWW were in the range of 113.5 to 740 mg/L, 2 to 22.8 mg/L, and 1 to 4.5 mg/L, respectively. Both the systems gave similar results with 85% of TOC removal and 60% of TN removal at 10-d SRT. However, the anionic surfactant removal in System A was 99% and 60% in System B. The chlorophyll concentration increased with an increase in SRT in both the systems. At 2-d SRT, no chlorophyll was observed in System B, whereas 0.5 mg/L was observed in System A. At 10-d SRT, the chlorophyll concentration in System A was 7.5 mg/L, whereas it was 4.5 mg/L in System B. Although both the systems showed similar performance in treatment, the increase in chlorophyll concentration suggests that System A demonstrated a better algal-bacterial symbiotic relationship in treating KWW than System B.

Keywords: diatoms, microalgae, retention time, wastewater treatment

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Authors: Ş. Çiftcioğlu, E. Efe

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In recent years, cancer has been at the top of diseases that cause death in children. Adequate and balanced nutrition plays an important role in the treatment of cancer. Cancer and cancer treatment is affecting food intake, absorption and metabolism, causing nutritional disorders. Appropriate nutrition is very important for the cancerous child to feel well before, during and after the treatment. There are various difficulties in feeding children with cancer. These are the cancer-related factors. Other factors are environmental and behavioral. As health professionals who spend more time with children in the hospital, nurses should be able to support the children on nutrition and help them to have balanced nutrition. This study aimed to evaluate the importance of nursing approaches in the nutrition of children with cancer. This article is planned as a review article by searching the literature on this field. Anorexia may develop due to psychogenic causes or chemotherapeutic agents or accompanying infections and nutrient uptake may be reduced.  In addition, stomatitis, mucositis, taste and odor changes in the mouth, the feeling of nausea, vomiting and diarrhea can also reduce oral intake and result in significant losses in the energy deficit. In assessing the nutritional status of children with cancer, determining weight loss and good nutrition is essential anamnesis of a child.  Some anthropometric measurements and biochemical tests should be used to evaluate the nutrition of the child. The nutritional status of pediatric cancer patients has been studied for a long time and malnutrition, in particular under nutrition, in this population has long been recognized. Yet, its management remains variable with many malnourished children going unrecognized and consequently untreated. Nutritional support is important to pediatric cancer patients and should be integrated into the overall treatment of these children.

Keywords: cancer treatment, children, complication, nutrition, nursing approaches

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Authors: Awol Seid Ebrie

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HIV results as an incurable disease, AIDS. After a person is infected with virus, the virus gradually destroys all the infection fighting cells called CD4 cells and makes the individual susceptible to opportunistic infections which cause severe or fatal health problems. Several studies show that the CD4 cells count is the most determinant indicator of the effectiveness of the treatment or progression of the disease. The objective of this paper is to investigate the progression of the disease over time among patient under HAART treatment. Two main approaches of the generalized multilevel ordinal models; namely the proportional odds model and the nonproportional odds model have been applied to the HAART data. Also, the multilevel part of both models includes random intercepts and random coefficients. In general, four models are explored in the analysis and then the models are compared using the deviance information criteria. Of these models, the random coefficients nonproportional odds model is selected as the best model for the HAART data used as it has the smallest DIC value. The selected model shows that the progression of the disease increases as the time under the treatment increases. In addition, it reveals that gender, baseline clinical stage and functional status of the patient have a significant association with the progression of the disease.

Keywords: nonproportional odds model, proportional odds model, random coefficients model, random intercepts model

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Authors: Burak Bal

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Mechanical characterization tests might come with a remarkable cost of time and money for both companies and academics. The inquiry to transform laboratory experiments to the computational media is getting a trend; accordingly, the literature supplies many analytical ways to explain the mechanics of deformation. In our work, we focused on the crystal plasticity finite element modeling (CPFEM) analysis on various materials in various crystal structures to predict the stress-strain curve without tensile tests. For FEM analysis, which we used in this study was ABAQUS, a standard user-defined material subroutine (UMAT) was prepared. The geometry of a specimen was created via DREAM 3D software with the inputs of Euler angles taken by Electron Back-Scattered Diffraction (EBSD) technique as orientation, or misorientation angles. The synthetic crystal created with DREAM 3D is also meshed in a way the grains inside the crystal meshed separately, and the computer can realize interaction of inter, and intra grain structures. The mechanical deformation parameters obtained from the literature put into the Fortran based UMAT code to describe how material will response to the load applied from specific direction. The mechanical response of a synthetic crystal created with DREAM 3D agrees well with the material response in the literature.

Keywords: crystal plasticity finite element modeling, ABAQUS, Dream.3D, microstructure

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Authors: Awais Ali, Hesham Ali

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The absence of teeth through either premature loss or developmental absence is a common condition with potentially severe impact on affected individuals. Management of these cases presents a clinical challenge which may be difficult to resolve given the effects of tooth loss or hypodontia over the course of a patient’s lifetime. Treatment of such cases is often best provided by a multi-disciplinary team, where the patient’s expectations and care delivery can be optimally managed. Orthodontic treatment is often used to prepare the dentition in advance of restorative replacement of missing teeth. Conversely, the placement of implants may precede the delivery of orthodontic treatment and indeed may function as an adjunctive orthodontic procedure. We discuss the use of both approaches here and illustrate their clinical implementation with two case reports. The first case demonstrates the use of fixed appliances to prepare the mouth for an opposing implant-retained complete denture. A second case demonstrates the use of implant-retained crowns to provide orthodontic anchorage in a partially dentate patient. We propose that complex cases such as these should always be planned and treated by a multi-disciplinary team in order to optimise the delivery of care, patient experience, and treatment outcome. The presented cases add to the body of evidence in this area.

Keywords: orthodontics, dental implantology, hypodontia, multi-disciplinary

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Authors: Leonore Robieux, Franck Zenasni, Marc Pocard, Clarisse Eveno

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Empirical data in health psychology studies show the necessity to consider the doctor-patient communication and its positive impact on outcomes such as patients’ satisfaction, treatment adherence, physical and psychological wellbeing. In this line, the present research aims to define the role and determinants of an effective doctor–patient communication during the treatment of patients with serious illness (peritoneal carcinomatosis). We carried out a prospective longitudinal study including patients treated for peritoneal carcinomatosis of various origins. From November 2016, to date, data were collected using validated questionnaires at two times of evaluation: one month before the surgery (T0) and one month after (T1). Thus, patients reported their (a) anxiety and depression levels, (b) standardized and individualized quality of life and (c) how they perceived communication, attitude and empathy of the surgeon. 105 volunteer patients (Mean age = 58.18 years, SD = 10.24, 62.2% female) participated to the study. PC arose from rare diseases (14%), colorectal (38%), eso-gastric (24%) and ovarian (8%) cancer. Three groups are defined according to the severity of their pathology and the treatment offered to them: (1) important surgical treatment with the goal of healing (53%), (2) repeated palliative surgical treatment (17%), and (3) the patients recused for surgical treatment, only palliative approach (30%). Results are presented according to Baron and Kenny recommendations. The regressions analyses show that only depression and anxiety are sensitive to the communication and empathy of surgeon. The main results show that a good communication and high level of empathy at T0 and T1 limit depression and anxiety of the patients in T1. Results also indicate that the severity of the disease modulates this positive impact of communication: better is the communication the less are the level of depression and anxiety of the patients. This effect is higher for patients treated for the more severe disease. These results confirm that, even in the case severe disease a good communication between patient and physician remains a significant factor in promoting the well-being of patients. More specific training need to be developed to promote empathic care.

Keywords: clinical empathy, determinants, healthcare, psychological wellbeing

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Authors: Mohd Raish Ansari, Tauheed Alam Khan

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This research paper is a comparative study of the belt truss in the Regular RC frame structure at the different positions of the floor. The method used in this research is the response spectrum method with the help of the ETABS Software, there are six models in this paper with belt truss. The Indian standard code used in this work are IS 456:2000, IS 800:2007, IS 875 part-1, IS 875 part-1, and IS 1893 Part-1:2016. The cross-section of the belt truss is the I-section, a grade of steel that is made up of Mild Steel. The basic model in this research paper is the same, only position of the belt truss is going to change, and the dimension of the belt truss is remain constant for all models. The plan area of all models is 24.5 meters x 28 meters, and the model has G+20, where the height of the ground floor is 3.5 meters, and all floor height is 3.0 meters remains constant. This comparative research work selected some important seismic parameters to check the stability of all models, the parameters are base shear, fundamental period, storey overturning moment, and maximum storey displacement.

Keywords: belt truss, RC frames structure, ETABS, response spectrum analysis, special moment resisting frame

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Authors: Fares Almomani, Majeda Khraisheh, Rahul Bhosale, Anand Kumar, Ujjal Gosh

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Septic tanks (STs) are very commonly used wastewater collection systems in the world especially in rural areas. In this study, the use of moving bed biological reactors (MBBR) for the treatment of septic tanks effluents (STE) was studied. The study was included treating septic tank effluent from one house hold using MBBRs. Significant ammonia removal rate was observed in all the reactors throughout the 180 days of operation suggesting that the MBBRs were successful in reducing the concentration of ammonia from septic tank effluent. The average ammonia removal rate at 25◦C for the reactor operated at hydraulic retention time of 5.7 hr (R1) was 0.540 kg-N/m3and for the reactor operated at hydraulic retention time of 13.3hr (R2) was 0.279 kg-N/m3. Ammonia removal rates were decreased to 0.3208 kg-N/m3 for R1 and 0.212 kg-N/m3 for R3 as the temperature of reactor was decreased to 8 ◦C. A strong correlation exists between theta model and the rates of ammonia removal for the reactors operated in continuous flow. The average ϴ values for the continuous flow reactors during the temperature change from 8°C to 20 °C were found to be 1.053±0.051. MBBR technology can be successfully used as a polishing treatment for septic tank effluent.

Keywords: septic tanks, wastewater treatment, morphology, moving biological reactors, nitrification

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Authors: Amirah Azzeri, Fatiha H. Shabaruddin, Scott A. McDonald, Rosmawati Mohamed, Maznah Dahlui

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Objective: A scaled-up treatment cascade with direct-acting antiviral (DAA) therapy is necessary to achieve global WHO targets for hepatitis C virus (HCV) elimination in Malaysia. Recently, limited access to Sofosbuvir/Daclatasvir (SOF/DAC) is available through compulsory licensing, with future access to Sofosbuvir/Velpatasvir (SOF/VEL) expected through voluntary licensing due to recent agreements. SOF/VEL has superior clinical outcomes, particularly for cirrhotic stages, but has higher drug acquisition costs compared to SOF/DAC. It has been proposed that a stratified treatment cascade might be the most cost-efficient approach for Malaysia whereby all HCV patients are treated with SOF/DAC except for patients with cirrhosis who are treated with SOF/VEL. This study aimed to conduct a five-year budget impact analysis from the provider perspective of the proposed stratified treatment cascade for HCV treatment in Malaysia. Method: A disease progression model that was developed based on model-predicted HCV epidemiology data in Malaysia was used for the analysis, where all HCV patients in scenario A were treated with SOF/DAC for all disease stages while in scenario B, SOF/DAC was used only for non-cirrhotic patients and SOF/VEL was used for the cirrhotic patients. The model projections estimated the annual numbers of patients in care and the numbers of patients to be initiated on DAA treatment nationally. Healthcare costs associated with DAA therapy and disease stage monitoring was included to estimate the downstream cost implications. For scenario B, the estimated treatment uptake of SOF/VEL for cirrhotic patients were 25%, 50%, 75%, 100% and 100% for 2018, 2019, 2020, 2021 and 2022 respectively. Healthcare costs were estimated based on standard clinical pathways for DAA treatment described in recent guidelines. All costs were reported in US dollars (conversion rate US$1=RM4.09, the price year 2018). Scenario analysis was conducted for 5% and 10% reduction of SOF/VEL acquisition cost anticipated from the competitive market pricing of generic DAA in Malaysia. Results: The stratified treatment cascade with SOF/VEL in Scenario B was found to be cost-saving compared to Scenario A. A substantial portion of the cost reduction was due to the costs associated with DAA therapy which resulted in USD 40 thousand (year 1) to USD 443 thousand (year 5) savings annually, with cumulative savings of USD 1.1 million after 5 years. Cost reductions for disease stage monitoring were seen in year three onwards which resulted in cumulative savings of USD 1.1 thousand. Scenario analysis estimated cumulative savings of USD 1.24 to USD 1.35 million when the acquisition cost of SOF/VEL was reduced. Conclusion: A stratified treatment cascade with SOF/VEL was expected to be cost-saving and can results in a budget impact reduction in overall healthcare expenditure in Malaysia compared to treatment with SOF/DAC. The better clinical efficacy with SOF/VEL is expected to halt patients’ HCV disease progression and may reduce downstream costs of treating advanced disease stages. The findings of this analysis may be useful to inform healthcare policies for HCV treatment in Malaysia.

Keywords: Malaysia, direct acting antiviral, compulsory licensing, voluntary licensing

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Authors: Helen Johnson-Egemba

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This paper will discuss the current effectiveness of music therapy for a range of conditions, such as depression and anxiety. Indeed, traditional forms of therapy have often been effective in treating various mental and physical health conditions. However, they are not with their limitations. Music therapy, on the other hand, is a non-invasive and cost-effective alternative that can produce similar or even better results. Music therapy can produce longer-lasting results. The research also highlights the underlying mechanisms of traditional music therapy, such as its complementary treatment. A systematic review of existing literature was conducted to gather relevant studies and establish a comprehensive understanding of the topic. Various research methods, including experimental studies, qualitative research, surveys, were utilized to explore the therapeutic potential of traditional music interventions. The findings reveal that traditional music therapy shows promise in managing anxiety and depression symptoms, with positive outcomes impacting brain activity, emotions, and stress regulation. The outcomes of this study contribute to evidence-based practice, providing insights for clinicians and therapists to incorporate traditional music therapy into their treatment approaches. Furthermore, the research promotes awareness and acceptance of traditional music as a legitimate and effective therapeutic intervention for anxiety and depression, potentially enhancing access to alternative and complementary treatment options. Overall, this study demonstrates the potential benefits of traditional music therapy in addressing anxiety and depression, offering valuable implications for mental health care and improving the well-being of individuals struggling with these conditions.

Keywords: anxiety, effectiveness, depression, traditional music, therapy, treatment

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Authors: Manjinder Bajwa, Mahipal Singh, Ashish Tulli

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In the research, the effect of varying cutting parameters, design parameters and heat treatment processes were studied on the cutting performance (Tool life) of a PVD coated tool. Thus, in a quest for these phenomenon comparison, a single coated tool and a multicoated tool were analyzed after suitable heat treatment process. TNMG shaped insert with single coating of TiCN and multi-coating of TiAlN/TiN were developed on tungsten carbide substrate. These coated inserts were then successfully annealed and normalized for a temperature of 350°C for 30 minutes and their cutting performance was evaluated as per the flank wear obtained after turning of mild steel. The results showed that heat treatment had a suitable impact on the tool life of the coated insert and also led to increase in the micro-hardness of the tool coatings and decrease in the wear rate.

Keywords: PVD coatings, flank wear, micro-hardness, annealing, normalizing

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Authors: Meng Koon Lee, Mohammad Hosseini Fouladi, Satesh Narayana Namasivayam

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Research is focused on the response of soundboards of Classical guitars at frequencies up to 5 kHz as the soundboard is a major contributor to acoustic radiation at high frequencies when compared to the bridge and sound hole. A thin rectangular plate of variable thickness that is simply-supported on all sides is used as an analytical model of the research. This model is used to study the response of the guitar soundboard as the latter can be considered as a modified form of a rectangular plate. Homotopy Perturbation Method (HPM) is selected as a mathematical method to obtain an analytical solution of the 4th-order parabolic partial differential equation of motion of the rectangular plate of constant thickness viewed as a linear problem. This procedure is generalized to the nonlinear problem of the rectangular plate with variable thickness and an analytical solution can also be obtained. Sound power is used as a parameter to investigate the acoustic radiation of soundboards made from spruce using various bracing patterns. The sound power of soundboards made from Malaysian softwood such as damar minyak, sempilor or podo are investigated to determine the viability of replacing spruce as future materials for soundboards of Classical guitars.

Keywords: rectangular plates, analytical solution, homotopy perturbation, natural frequencies

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Authors: Tolulope Allo, Mofoluwake P. Ajayi, Adenike E. Idowu, Emmanuel O. Amoo, Fadeke Esther Olu-Owolabi

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Breast cancer which was more prevalent in Europe and America in the past is gradually being mirrored across the world today with greater economic burden on low and middle income countries (LMCs). Breast cancer is the most common cancer among women globally and current studies have shown that a woman dies with the diagnosis of breast cancer every thirteen minutes. The economic cost of breast cancer is overwhelming particularly for developing economies. While it causes billion of dollar in losses of national income, it pushes millions of people below poverty line. This study examined the economic burden of breast cancer on Nigerian women, its impacts on their standard of living and its effects on Nigeria’s socio economic development. The study adopts a qualitative research approach using the in-depth interview technique to elicit valuable information from respondents with cancer experience from the Southern part of Nigeria. Respondents constituted women in their reproductive age (15-49 years) that have experienced and survived cancer and also those that are currently receiving treatment. Excerpts from the interviews revealed that the cost of treatment is one of the major factors contributing to the late presentation of breast cancer incidences among women as many of them could not afford to pay for their own treatment. The study also revealed that many women prefer to explore other options such as herbal treatments and spiritual consultations which is less expensive and affordable. The study therefore concludes that breast cancer diagnosis and treatment should be subsidized by the government in order to facilitate easy access and affordability thereby promoting early detection and reducing the economic burden of treatment on women.

Keywords: breast cancer, development, economic burden, women

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Authors: Beenish Saba, Ann D. Christy

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Modern day municipal solid waste landfills are operated and controlled to protect the environment from contaminants during the biological stabilization and degradation of the solid waste. They are equipped with liners, caps, gas and leachate collection systems. Landfill gas is passively or actively collected and can be used as bio fuel after necessary purification, but leachate treatment is the more difficult challenge. Leachate, if not recirculated in a bioreactor landfill system, is typically transported to a local wastewater treatment plant for treatment. These plants are designed for sewage treatment, and often charge additional fees for higher strength wastewaters such as leachate if they accept them at all. Different biological, chemical, physical and integrated techniques can be used to treat the leachate. Treating that leachate with simultaneous power production using microbial fuel cells (MFC) technology has been a recent innovation, reported its application in its earliest starting phase. High chemical oxygen demand (COD), ionic strength and salt concentration are some of the characteristics which make leachate an excellent substrate for power production in MFCs. Different materials of electrodes, microbial communities, carbon co-substrates and temperature conditions are some factors that can be optimized to achieve simultaneous power production and treatment. The advantage of the MFC is its dual functionality but lower power production and high costs are the hurdles in its commercialization and more widespread application. The studies so far suggest that landfill leachate MFCs can produce 1.8 mW/m2 with 79% COD removal, while amendment with food leachate or domestic wastewater can increase performance up to 18W/m3 with 90% COD removal. The columbic efficiency is reported to vary between 2-60%. However efforts towards biofilm optimization, efficient electron transport system studies and use of genetic tools can increase the efficiency of the MFC and can determine its future potential in treating landfill leachate.

Keywords: microbial fuel cell, landfill leachate, power generation, MFC

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Authors: Ciro Cursio, Giulia Cursio, Pio Luigi Cursio, Luigi Cursio

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Communication between practitioner and patient is of the utmost importance in aesthetic medicine: as of today, images of previous treatments are the most common tool used by doctors to describe and anticipate future results for their patients. However, using photos of other people often reduces the engagement of the prospective patient and is further limited by the number and quality of pictures available to the practitioner. Pre-existing work solves this issue in two ways: 3D scanning of the area with manual editing of the 3D model by the doctor or automatic prediction of the treatment by warping the image with hand-written parameters. The first approach requires the manual intervention of the doctor, while the second approach always generates results that aren’t always realistic. Thus, in one case, there is significant manual work required by the doctor, and in the other case, the prediction looks artificial. We propose an AI-based algorithm that autonomously generates a realistic prediction of treatment results. For the purpose of this study, we focus on hyaluronic acid treatments in the facial area. Our approach takes into account the individual characteristics of each face, and furthermore, the prediction system allows the patient to decide which area of the face she wants to modify. We show that the predictions generated by our system are realistic: first, the quality of the generated images is on par with real images; second, the prediction matches the actual results obtained after the treatment is completed. In conclusion, the proposed approach provides a valid tool for doctors to show patients what they will look like before deciding on the treatment.

Keywords: prediction, hyaluronic acid, treatment, artificial intelligence

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Authors: Melissa Nelson, Simran Jandu, Hana Jalal, Mia Ingram, Chrysi Stefanidou

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There is a significant overlap between autism spectrum disorder (ASD) and obsessive compulsive disorder (OCD), with up to 90% of young people diagnosed with ASD having this co-morbidity. Distinguishing between the symptoms of the two leads to issues with accurate treatment, yet this is paramount in benefitting the young person. There are two distinct methods of treatment, psychological or pharmacological, with clinicians tending to choose one or the other, potentially due to the lack of research available. This report reviews the efficacy of psychological and pharmacological treatments for young people diagnosed with ASD and co-morbid OCD. A literature review was performed on papers from the last fifteen years, including “ASD,” “OCD,” and individuals under the age of 18. Eleven papers were selected as relevant. The report looks at the comparison between more traditional methods, such as selective serotonin reuptake inhibitors (SSRI) and cognitive behavior therapy (CBT), and newer therapies, such as modified or intensive ASD-focused psychotherapies and the use of other medication classes. On reviewing the data, it was identified that there was a distinct lack of information on this important topic. The most widely used treatment was medication such as Fluoxetine, an SSRI, which rarely showed an improvement in symptoms or outcomes. This is in contrast to modified forms of CBT, which often reduces symptoms or even results in OCD remission. With increased research into the non-traditional management of these co-morbid conditions, it is clear there is scope that modified CBT may become the future treatment of choice for OCD in young people with ASD.

Keywords: autism spectrum disorder, intensive or adapted cognitive behavioral therapy, obsessive compulsive disorder, pharmacological management

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Authors: Kartika Marta Budiana

Abstract:

Low competence in speaking for the students of Non English native speakers have been crucial so far for the teachers in language teaching in Indonesia. This study attempts to explore the effect of video using in teaching speaking onstudents of non-native English speakers at STIE Perbanas Surabaya. This includes investigate the students` attitudes toward the video used in classroom. This is a quantitative research that is an experimental one based on analyses derived the concepts of from teaching speaking and the use of video. There are two classes observed, the experimental and the control one. The experimental consist of 28 students and the control class consists of 25 students. Before the treatment given, both of the group is given the pre-test to check their ability level. Then, after the treatment is given, the post-test is given to the both groups. Then, the students were given treatment how to conduct a meeting that they learnt from a video of business English. The post test was held after they undergone a treatment. The instruments to get the data are the oral test and questionnaire. The data of this study is students` score and from the tests` score it can be seen there is a positive significant difference in the experimental group. The t-test to test hypothesize also shows that it is accepted which said that there is an improvement on the students` speaking competence achievement. In conclusion, the video effects on the significant difference on the students speaking competence achievement.

Keywords: video, teaching, speaking, Indonesia

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