Search results for: outpatient treatment efficiency

Authors: Mousaab Alrhmoun, Magali Casellas, Michel Baudu, Christophe Dagot

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The aim of the study is to improve removal of trace organic contaminants dissolved in activated sludge by the process of filtration with membrane bioreactor combined with modified activated carbon, for a maximum removal of organic compounds characterized by low molecular weight. Special treatment was conducted in laboratory on activated carbon. Tow reaction parameters: The pH of aqueous middle and the type of granular activated carbon were very important to improve the removal and to motivate the electrostatic Interactions of organic compounds with modified activated carbon in addition to physical adsorption, ligand exchange or complexation on the surface activated carbon. The results indicate that modified activated carbon has a strong impact in removal 21 of organic contaminants and in percentage of 100% of the process.

Keywords: activated carbon, organic micropolluants, membrane bioreactor, carbon

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Authors: Andreas Aceranti, Sergio Romanò, Simonetta Vernocchi, Silvia Arnaboldi, Emilio Mazza

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As a result of the Sars-Cov2 pandemic, the incidence of thymism disorders has significantly increased and, often, patients are reluctant to want to take drugs aimed at stabilizing mood. In order to provide an alternative approach to drug therapies, we have prepared a study in order to evaluate the possibility of improving the quality of life of these subjects through osteopathic treatment. Patients were divided into visceral and fascial manual treatment with the aim of increasing serotonin levels and stimulating the vagus nerve through validated techniques. The results were evaluated through the administration of targeted questionnaires in order to assess quality of life, mood, sleep and intestinal functioning. At a first endpoint we found, in patients undergoing fascial treatment, an increase in quality of life and sleep: in fact, they report a decrease in the number of nocturnal awakenings; a reduction in falling asleep times and greater rest upon waking. In contrast, patients undergoing visceral treatment, as well as those included in the control group, did not show significant improvements. Patients in the fascial group have, in fact, reported an improvement in thymism and subjective quality of life with a generalized improvement in function. Although the study is still ongoing, based on the results of the first endpoint we can hypothesize that fascial stimulation of the vagus nerve with manual and osteopathic techniques may be a valid alternative to pharmacological treatments in mood and sleep disorders.

Keywords: ostheopathy, insomnia, noctural awakening, thymism

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Authors: Ashley R. Logsdon, Becky F. Antle, Cynthia M. Kamer

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This study examines the cost and benefits of a family treatment drug court in an urban county in a southeastern state. Additionally, this cost analysis will provide a detailed description of the type and cost of activities to produce the services provided to child welfare families. This study utilized return-on-investment analysis, which uses child welfare practices, disaggregates them into separate activities and estimates costs for these activities including child-level placement data for total cost of care for the child. Direct and indirect costs were considered as well as saving calculations what costs would be associated with child welfare outcomes both short and long term. The costs included were general program costs (salaries, drug screens, transportation, childcare, parent education, program evaluation, visitation, incentives) or personnel costs for other team members (judges, court administrators, child welfare workers, child welfare supervisors, and community mental health provider). The savings that were used in the study were length of time in out of home care, Medicaid costs, substance exposed births, emergency room utilization and jail/probation costs. This study documents an overall savings of between $168,993.30 and $837,993.30. The total savings per family divided by the 40 families who have participated in the program was between $4,224.83 to $20,949.83 per family. The results of this cost benefit analysis are consistent with prior research documenting savings associated with out of home care and jail/probation; however, there are also unique contributions of this study to the literature on cost effectiveness of family treatment drug courts. We will present recommendations for further utilization of family treatment drug courts and how to expand the current model.

Keywords: child welfare, cost analysis, family drug court, family treatment drug court

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Authors: Shamim Akhtar

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The purpose of the present research was to analyse the performance level of district administrators and school heads teachers at secondary school level. The sample of the study was head teachers and teachers of secondary schools. In survey three scales were used, two scales were for the head teachers, one five point scale was for analysing the working efficiency of educational administrators and other seven points scale was for head teachers for analysing their own performance and one another seven point rating scale similar to head teacher was for the teachers for analysing the working performance of their head teachers. The results of the head teachers’ responses revealed that the performance of their District Educational Administrators was average and for the performance efficiency of the head teachers, researcher constructed the rating scales on seven parameters of management likely academic management, personnel management, financial management, infra-structure management, linkage and interface, student’s services, and managerial excellence. Results of percentages, means, and graphical presentation on different parameters of management showed that there was an obvious difference in head teachers and teachers’ responses and head teachers probably were overestimating their efficiency; but teachers evaluated that they were performing averagely on majority statements. Results of t-test showed that there was no significance difference in the responses of rural and urban teachers but significant difference in male and female teachers’ responses showed that female head teachers were performing their responsibilities better than male head teachers in public sector schools. When efficiency of the head teachers on different parameters of management were analysed it was concluded that their efficiency on academic and personnel management was average and on financial management and on managerial excellence was highly above of average level but on others parameters like infra-structure management, linkage and interface and on students services was above of average level on most statements but highly above of average on some statements. Hence there is need to improve the working efficiency in academic management and personnel management.

Keywords: educational administration, educational management, parameters of management, education

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Authors: Samuel Oludayo Alamu, Seong Lee

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The need for generating energy from biomass in an efficient way as well as maximizing the yield of total energy from the thermal conversion process has been a major concern for researchers. A holistic approach which involves the combination of First law of thermodynamics (FLT) and the second law of thermodynamics (SLT) is required for conducting an effective assessment of an energy plant since FLT analysis alone fails to identify the quality of the dissipated energy and how much work potential is available. The overall purpose of this study is to investigate the exergy analysis of direct combustion of poultry waste being converted to energy with a handful of environmental assessment of the conversion processes in order to maximize thermal efficiency. The exergy analysis around the shell and tube heat exchanger (STHE) was investigated primarily by varying the operating parameters for different tube shapes and flow direction, and an exergy model was obtained from estimations of the higher heating value and standard entropy of poultry waste from the elemental compositions. The STHE was designed and fabricated by Lee Research Group at Morgan State University. The analysis conducted on theSTHE using the flue gas temperature entering and exiting show that only about one-third of the energy input to the STHE was available to do work with an overall efficiency of 13.8%, while a huge amount was lost to the surrounding. By recirculating the flue gas, the exergy efficiency of the combustion system can be maximized with a greater reduction in the amount of exergy loss.

Keywords: exergy analysis, shell and tube heat exchanger, thermodynamics, combustion system, thermal efficiency

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Authors: Lintle Mohase, Ninikoe Lebusa, Mpho Stephen Mafa

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Wheat is an economically important cereal crop. However, the changing climatic conditions that intensify drought in production areas, and additional pest infestation, such as the Russian wheat aphid (RWA, Diuraphis noxia), severely hamper its production. Drought and pest management require an additional water supply through irrigation and applying inorganic nutrients (including silicon) as alternative strategies to mitigate the stress effects. Therefore, other approaches are needed to enhance wheat productivity during drought stress and aphid abundance. Two wheat cultivars were raised under greenhouse conditions, exposed to drought stress, and treated with silicon before infestation with the South African RWA biotype 2 (RWASA2). The morphological evaluations showed that severe drought or a combination of drought and infestation significantly reduced the plant height of wheat cultivars. Silicon treatment did not alleviate the growth reduction. The biochemical responses were measured using spectrophotometric assays with specific substrates. An evaluation of the enzyme activities associated with oxidative stress and defence responses indicated that drought stress increased NADPH oxidase activity, while silicon treatment significantly reduced it in drought-stressed and infested plants. At 48 and 72 hours sampling periods, a combination of silicon, drought and infestation treatment significantly increased peroxidase activity compared to drought and infestation treatment. The treatment also increased β-1,3-glucanase activity 72 hours after infestation. In addition, silicon and drought treatment increased glucose but reduced sucrose accumulation. Furthermore, silicon, drought, and infestation treatment combinations reduced the sucrose content. Finally, silicon significantly increased the trehalose content under severe drought and infestation, evident at 48 and 72-hour sampling periods. Our findings shed light on silicon’s ability to induce protective biochemical responses during drought and aphid infestation.

Keywords: drought, enzyme activity, silicon, soluble sugars, Russian wheat aphid, wheat

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Authors: Idil Kanter Otcu

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Nowadays, due to the growing problems of energy supply and the drastic reduction of natural non-renewable resources, the development of new applications in the energy sector and steps towards greater efficiency in energy consumption are required. Since buildings account for a large share of energy consumption, increasing the structural density of buildings causes an increase in energy consumption. This increase in energy consumption means that energy efficiency approaches to building design and the integration of new systems using emerging technologies become necessary in order to curb this consumption. As new systems for productive usage of generated energy are developed, buildings that require less energy to operate, with rational use of resources, need to be developed. One solution for reducing the energy requirements of buildings is through landscape planning, design and application. Requirements such as heating, cooling and lighting can be met with lower energy consumption through planting design, which can help to achieve more efficient and rational use of resources. Within this context, rather than a planting design which considers only the ecological and aesthetic features of plants, these considerations should also extend to spatial organization whereby the relationship between the site and open spaces in the context of climatic elements and planting designs are taken into account. In this way, the planting design can serve an additional purpose. In this study, a landscape design which takes into consideration location, local climate morphology and solar angle will be illustrated on a sample building project.

Keywords: energy efficiency, landscape design, plant design, xeriscape landscape

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Authors: Yonas Lamore, Abebe Beyene, Samuel Fekadu, Moa Megersa

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Unaffordable construction cost of conventional water treatment plant and distribution system in most developing countries makes difficult to provide safe and adequate water for all households, especially for the rural setup. Water treatment at the source can be the best alternative. Solar disinfection is one alternative among point of use treatments. In this study, aqua lens, photovoltaic box and glass bottle were used subsequent to plant coagulants to evaluate microbial reduction potentials. Laboratory- and field-based experiments were conducted from May to August 2016. The Escherichia coli, total coliforms and heterotrophic plate counts were used as indicator organisms. The result indicated that aqua lens (AL), photovoltaic box (PV) and glass bottle (GB) have high inactivation rate subsequently almost for all indicator organisms in short solar exposure time. Total coliforms were inactivated in AL (SD = 15.8 °C, R2 = 0.92) followed by PV inactivation temperature associa- tion (SD = 11.6 C, R2 = 0.90), and the GB concentrator was inactivated (SD = 10.9 °C, R2 = 0.70) at turbidity level of 3.41 NTU. As the study indicated, aqua lens coupled with Moringa oleifera coagulant can be an effective with minimum cost for household water treatment system. The study also concludes heterotrophic bacteria were more resistant than other types of bacteria in SODIS with similar exposure time.

Keywords: acrylic glass, aqua lens, moringa olifera, photovoltaic box, solar disinfection, water treatment

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Authors: A. D. Zikiryahodjaev, L. V. Bolotina, A. S. Sukhotko

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Purpose. To evaluate the expediency and timeliness of performance of surgical treatment as a component of multi-therapy treatment of patients with stage IV breast cancers. Materials and Methods. This investigation comparatively analyzed the results of complex treatment with or without surgery in patients with metastatic breast cancer. We analyzed retrospectively treatment experience of 196 patients with generalized breast cancer in the department of oncology and breast reconstructive surgery of P.A. Herzen Moscow Cancer Research Institute from 2000 to 2012. The average age was (58±1,1) years. Invasive ductul carcinoma was verified in128 patients (65,3%), invasive lobular carcinoma-33 (16,8%), complex form - 19 (9,7%). Complex palliative care involving drug and radiation therapies was performed in two patient groups. The first group includes 124 patients who underwent surgical intervention as complex treatment, the second group includes 72 patients with only medical therapy. Standard systemic therapy was given to all patients. Results. Overall, 3-and 5-year survival in fist group was 43,8 and 21%, in second - 15,1 and 9,3% respectively [p=0,00002 log-rank]. Median survival in patients with surgical treatment composed 32 months, in patients with only systemic therapy-21. The factors having influencing an influence on the prognosis and the quality of life outcomes for of patients with generalized breast cancer were are also studied: hormone-dependent tumor, Her2/neu hyper-expression, reproductive function status (age, menopause existence). Conclusion.Removing primary breast tumor in patients with generalized breast cancer improve long-term outcomes. Three- and five-year survival increased by 28,7 and 16,3% respectively, and median survival–for 11 months. These patients may benefit from resection of the breast tumor. One explanation for the effect of this resection is that reducing the tumor load influences metastatic growth.

Keywords: breast cancer, combination therapy, factors of prognosis, primary tumor

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Authors: Tudor Deaconescu, Andrea Deaconescu

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The utilization of pneumatic muscles in the actuation of industrial systems is still in its early stages, hence studies on the constructive solutions which include an assessment of their functional performance with a focus on one of the most important characteristics-energy efficiency are required. A quality indicator that adequately reflects the energy efficiency of an actuator is the energy-to-mass ratio. This ratio is computed in the paper for various types and sizes of pneumatic muscles manufactured by Festo, and is subsequently compared to the similar ratios determined for two categories of pneumatic cylinders.

Keywords: pneumatic cylinders, pneumatic muscles, energy-to-mass ratio, muscle stroke

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Authors: K. Ighilahriz, M. Taleb Ahmed, R. Maachi

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Oil industries are responsible for most cases of contamination of our ecosystem by oil and heavy metals. They are toxic and considered carcinogenic and dangerous even when they exist in trace amounts. At Algiers refinery, production, transportation, and refining of crude oil generate considerable waste in storage tanks; these residues result from the gravitational settling. The composition of these residues is essentially a mixture of hydrocarbon and lead. We propose in this work the application of electrooxidation treatment for the leachate of the leaden sludge. The effect of pH, current density and the electrolysis time were studied, the effectiveness of the processes is evaluated by measuring the chemical oxygen demand (COD). The dissolution is the best way to mobilize pollutants from leaden mud, so we conducted leaching before starting the electrochemical treatment. The process was carried out in batch mode using graphite anode and a stainless steel cathode. The results clearly demonstrate the compatibility of the technique used with the type of pollution studied. In fact, it allowed COD removal about 80%.

Keywords: electrooxidation, leaching, leaden sludge, oil industry

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Authors: Tina Vuko, Marija Maretić, Marko Čular

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The aim of this study is to analyze the role and effectiveness of internal mechanism (audit committee) of corporate governance on credit institutions performance in Croatia. Based on research objective, sample of 78 credit institutions listed on Zagreb Stock Exchange, from 2007 to 2012, has been collected and efficiency index of audit committee (EIAC) has been created. Based on the sample and created EIAC, conclusions are as follows: audit committees of credit institutions have medium efficiency, based on EIAC measurement; there is a significant difference in audit committee effectiveness, in observed period; there is no positive relationship between audit committee effectiveness and credit institution performance; there is a significant difference between level of audit committee effectiveness and audit firm type. Future research should contain increased number of elements in EIAC creation and increased sample, for all obligators who need to establish audit committee.

Keywords: corporate governance, audit committee, financial institutions, efficiency index of audit committee

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Authors: Woosuk Lee

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We controlled the electron injection rate in inverted quantum dot light-emitting diode (QLED) by inserting PEIE layer between ZnO electron transport layer(ETL) and quantum dots(QDs) layer and successfully demonstrated high efficiency of QLEDs. The inverted QLED has the layer structure of ITO(cathode)/ ZnO NPs/PEIE/QDs/PEIE/P-TPD/MoO3/Al(anode). The PEIE between poly-TPD hole transport layer (HTL) and quantum dot emitting layer protects QD EML during HTL coating process and improves the surface morphology. In addition, the hole injection barrier is reduced by upshifting the valence band maximum (VBM) of QDs. An additional layer of PEIE was introduced between ZnO and QD to balance charge within QD emissive layer in device, which serves as an effective electron blocking layer without changing device operating condition such as turn-on voltage and emissive spectra. As a result, the optimized QLED with 5nm PEIE shows a ~36% improved current efficiency and external quantum efficiency (EQE) compared to the QLED without PEIE.(maximum current efficiency, and EQE are achieved 70cd/A and 17.3%, respectively). In particular, the maximum brightness of the optimized QLED dramatically improved by a factor of 2.3 relative to the QLED without PEIE. The main reasons for these QLED performance improvement are due to the suppressing the leakage current across the device and well confined exciton by inserting PEIE layers.

Keywords: quantum dot light-emitting diodes, interfacial layer, charge-injection balance, suppressing QD charging

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Authors: Naglaa A. Abd Elkader, Haithem A. Farghali

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The present study carried out on fifteen clinical cases of different species of dogs which admitted to surgical clinic of veterinary medicine with different symptoms (Acute vomiting, hematemesis and anorexia). There was diagnostic march which including plain radiograph and endoscopic examination. Treatment was including surgical interference and endoscopic retrieval followed by medicinal treatment. This study was aimed the detection of different foreign bodies by the most suitable method according to the type of the foreign bodies.

Keywords: stomach, endoscopy, foreign bodies, dogs

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Authors: Yanuarti Retnaningrum, Cendrawasih A. Farmasyanti, Kuswahyuning

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Orthodontists find challenges in treating patients who have cases of macroglossia and multiple tooth agenesis because difficulties in determining the causes, formulating a diagnosis and the potential for relapse after treatment. Definition of macroglossia is a tongue enlargement due to muscle hypertrophy, tumor or an endocrine disturbance. Macroglossia may cause many problems such as anterior proclination of upper and lower incisors, development of general diastema and anterior and/ or posterior open bite. Treatment for such patients with multiple tooth agenesis and macroglossia can be complex and must consider orthodontic and/or surgical interventions. This article discusses an orthodontic non surgical approach to a patient with a general diastema in both maxilla and mandible associated with multiple tooth agenesis and macroglossia. Fixed orthodontic therapy with straightwire appliance was used for space closure in anterior region of maxilla and mandible, also to create a space suitable for future prosthetic restoration. After 12 months treatment, stable and functional occlusal relationships was achieved, although still have edentulous area in both maxilla and mandible. At the end of the orthodontic treatment was obtained with correct overbite and overjet values. After removal of the brackets, a maxillary and mandibular removable retainer combine with artificial tooth were placed for retention.

Keywords: general diastema, macroglossia, space closure, tooth agenesis

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Authors: S. Abdourraziq, M. A. Abdourraziq

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One of the most famous and important applications of solar energy systems is water pumping. It is often used for irrigation or to supply water in countryside or private firm. However, the cost and the efficiency are still a concern, especially with a continued variation of solar radiation and temperature throughout the day. Then, the improvement of the efficiency of the system components is one of the different solutions to reducing the cost. In this paper, we will present a detailed definition of each element of a PV pumping system, and we will present the different MPPT algorithm used in the literature. Our system consists of a PV panel, a boost converter, a motor-pump set, and a storage tank.

Keywords: PV cell, converter, MPPT, MPP, PV pumping system

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Authors: Denise Ben-Porath, Tracy Masterson

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In the past, individuals who struggled with and sought treatment for mental health difficulties were stigmatized. However, the current generation holds more open attitudes around mental health issues. Indeed, public figures such as Demi Lovato, Naomi Osaka, and Simone Biles have taken to social media to break the silence around mental health, discussing their own struggles and the benefits of treatment. Thus, there is considerable reason to believe that this generation would hold fewer stigmatizing attitudes toward mental health difficulties and treatment compared to previous ones. In this study, we explored possible changes in stigma on mental health diagnosis and treatment seeking behavior between two generations: Gen Z, the current generation, and Gen X, those born between 1965-1980. It was hypothesized that Gen Z would hold less stigmatizing views on mental illness than Gen X. To examine possible changes in stigma attitudes between these two generations, we conducted a cross-generational cohort design by using the same methodology employed 20 years ago from the Ben-Porath (2002) study. Thus, participants were randomly assigned to read one of the following four case vignettes employed in the Ben-Porath (2002) study: (a) “Tom” who has received psychotherapy due to depression (b) “Tom” who has been depressed but received no psychological help, (c) “Tom” who has received medical treatment due to a back pain, or (d) “Tom” who had a back pain but did not receive medical attention. After reading the vignette, participants rated “Tom” on various personality dimensions using the IFQ Questionnaire and answered questions about their frequency of social media use and willingness to seek mental health treatment on a scale from 1-10. Identical to the results 20 years prior, a significant main effect was found for diagnosis with “Tom” being viewed in more negative terms when he was described as having depression vs. a medical condition (back pain) [F (1, 376) = 126.53, p < .001]. However, in the study conducted 20 years earlier, a significant interaction was found between diagnosis and help-seeking behavior [F (1, 376) = 8.28, p < .005]. Specifically, “Tom” was viewed in the most negative terms when described as depressed and seeking treatment. Alternatively, the current study failed to find a significant interaction between depression and help seeking behavior. These findings suggest that while individuals who hold a mental health diagnosis may still be stigmatized as they were 20 years prior, seeking treatment for mental health issues may be less so. Findings are discussed in the context of social media use and its impact on destigmatization.

Keywords: stigma, mental illness, help-seeking, social media

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Authors: A. Abubakar, A. Parsa, S. Walker

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Despite advances made in the diagnosis and management of drug-sensitive tuberculosis (TB) over the past decades, treatment of multidrug-resistant tuberculosis (MDR-TB) remains challenging and complex particularly in high burden countries including Nigeria. Treatment of MDR-TB is cost-prohibitive with success rate generally lower compared to drug-sensitive TB and if care is not taken it may become the dominant form of TB in future with many treatment uncertainties and substantial morbidity and mortality. Addressing these challenges requires collaborative efforts thorough sustained researches to evaluate the current treatment guidelines, particularly in high burden countries and prevent progression of resistance. To our best knowledge, there has been no research exploring the acceptability, effectiveness, and cost-effectiveness of community-based-MDR-TB treatment model in Nigeria, which is among the high burden countries. The previous similar qualitative study looks at the home-based management of MDR-TB in rural Uganda. This research aimed to explore patient’s views and acceptability of community-based-MDR-TB treatment model and to evaluate and compare the effectiveness and cost-effectiveness of community-based versus hospital-based MDR-TB treatment model of care from the Nigerian perspective. Knowledge of patient’s views and acceptability of community-based-MDR-TB treatment approach would help in designing future treatment recommendations and in health policymaking. Accordingly, knowledge of effectiveness and cost-effectiveness are part of the evidence needed to inform a decision about whether and how to scale up MDR-TB treatment, particularly in a poor resource setting with limited knowledge of TB. Mixed methods using qualitative and quantitative approach were employed. Qualitative data were obtained using in-depth semi-structured interviews with 21 MDR-TB patients in Nigeria to explore their views and acceptability of community-based MDR-TB treatment model. Qualitative data collection followed an iterative process which allowed adaptation of topic guides until data saturation. In-depth interviews were analyzed using thematic analysis. Quantitative data on treatment outcomes were obtained from medical records of MDR-TB patients to determine the effectiveness and direct and indirect costs were obtained from the patients using validated questionnaire and health system costs from the donor agencies to determine the cost-effectiveness difference between community and hospital-based model from the Nigerian perspective. Findings: Some themes have emerged from the patient’s perspectives indicating preference and high acceptability of community-based-MDR-TB treatment model by the patients and mixed feelings about the risk of MDR-TB transmission within the community due to poor infection control. The result of the modeling from the quantitative data is still on course. Community-based MDR-TB care was seen as the acceptable and most preferred model of care by the majority of the participants because of its convenience which in turn enhanced recovery, enables social interaction and offer more psychosocial benefits as well as averted productivity loss. However, there is a need to strengthen this model of care thorough enhanced strategies that ensure guidelines compliance and infection control in order to prevent the progression of resistance and curtail community transmission.

Keywords: acceptability, cost-effectiveness, multidrug-resistant TB treatment, community and hospital approach

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Authors: Zainab A. Alaghbri, Labiba A., Esam A.

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Tuberculosis (TB) is the fourth leading cause of death in Yemen and is considered a major priority by the Ministry of Public Health. The war in Yemen has led to the emergence of one of the worst humanitarian crises in the world. These circumstances may lead to exacerbate the situation of tuberculosis. This study aims to describe the trend and incidence of TB in north and east governorates, Yemen 2019-2021 and provide recommendations for interventions. A descriptive analysis was conducted during July to September 2022. Data of TB cases were obtained from the national tuberculosis program as soft copy. The Data included the TB case collected and diagnosed during 2019-2021. The data contains the following variables: Sex, age, governorates, smear-positive cases, extra-pulmonary cases, and treatment outcomes. 16791 TB cases were notified for an overall case notification rate 65.5/100000 for all forms (smear positive and Extra-pulmonary), There was a slightly declined in 2020 and 2021 by 1%. Both the pulmonary smear positive and Extra pulmonary rates were slightly decreased from 8.8 to 7.7 and 13.5 to 12.8 / 100, 000 populations respectively. For Tuberculosis cases by type of patient, the incidence of extra-pulmonary was the highest (12,9, 11.3 and 12,2/100000) over the three years. However, the incidence of pulmonary failure was the lowest. The majority of cases were in the age group 25-34. The overall treatment success rate for smear-positive patients was 88%. Of the 627 patients with documented unsuccessful outcomes (e.g., failure, death, and default), 165 (23%) died, 52 (8.3%) failed treatment, and 410 (65%) defaulted. Overall, the magnitude of tuberculosis decreased over the periods reviewed. The proportion of Extra-pulmonary TB was the highest. The success rate achieved after treatment was below the levels established by the WHO End Tuberculosis Strategy (90%). Failure to complete treatment may be responsible for the low success rate. Monitoring and addressing the risk factors that were associated with treatment outcomes and duration may help improve the likelihood of achieving favorable outcomes among cases of smear-positive pulmonary TB.

Keywords: tuberculosis, trend, incidence, yemen

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Authors: Bin Su

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The draft Auckland Unitary Plan outlines the future land used for new housing and businesses with Auckland population growth over the next thirty years. According to Auckland Unitary Plan, over the next 30 years, the population of Auckland is projected to increase by one million, and up to 70% of total new dwellings occur within the existing urban area. Intensification will not only increase the number of median or higher density houses such as terrace house, apartment building, etc. within the existing urban area but also change mean housing design data that can impact building thermal performance under the local climate. Based on mean energy consumption and building design data, and their relationships of a number of Auckland sample houses, this study is to estimate the future mean housing energy consumption associated with the change of mean housing design data and evaluate housing energy efficiency with the Auckland Unitary Plan.

Keywords: Auckland Unitary Plan, building thermal design, housing design, housing energy efficiency

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Authors: Aline Alves Bandeira, Luís Pedro Lima, Maria Cecília de Paula Silva, Paulo Henrique de Viveiros Tavares

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Nowadays, the study of public policies regarding management efficiency is essential. Public policies are about what governments do or do not do, being an area that has grown worldwide, contributing through the knowledge of technologies and methodologies that monitor and evaluate the performance of public administrators. The information published on official government websites needs to provide for transparency and responsiveness of managers. Thus, transparency is a primordial factor for the execution of Accountability, providing, in this way, services to the citizen with the expansion of transparent, efficient, democratic information and that value administrative eco-efficiency. The ecologically balanced management of a Smart City must optimize environmental education, building a fairer society, which brings about equality in the use of quality environmental resources. Smart Cities add value in the construction of public management, enabling interaction between people, enhancing environmental education and the practical applicability of administrative eco-efficiency, fostering economic development and improving the quality of life.

Keywords: accountability, environmental education, new public administration, smart cities

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Authors: Aldan A. Sapargaliyev, Yerbol A. Sapargaliyev

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Since the invention, the electric machine (EM) can be defined as oEM – one-vector electric machine, as it works due to one-vector inductive coupling with use of one-vector electromagnet. The disadvantages of oEM are large size and limited efficiency at low and medium power applications. This paper describes multi-vector electric machine (mEM) based on multi-vector inductive coupling, which is characterized by the increased surface area of ​​the inductive coupling per EM volume, with a reduced share of inefficient and energy-consuming part of the winding, in comparison with oEM’s. Particularly, it is considered, calculated and compared the performance of three different electrical motors and their power at the same volumes and rotor frequencies. It is also presented the result of calculation of correlation between power density and volume for oEM and mEM. The method of multi-vector inductive coupling enables mEM to possess 1.5-4.0 greater density of power per volume and significantly higher efficiency, in comparison with today’s oEM, especially in low and medium power applications. mEM has distinct advantages, when used in transport vehicles such as electric cars and aircrafts.

Keywords: electric machine, electric motor, electromagnet, efficiency of electric motor

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Authors: Lakmali Anthony, Madeline Gillies

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Purpose: Long-term survivorship in colorectal cancer (CRC) is increasing as mortality decreases, leading to increased focus on patient-reported outcomes such as quality of life (QoL). CRC patients often have decreased QoL even after treatment is complete. This systematic review of the literature aims to identify psychosocial factors associated with decreased QoL in post-treatment CRC patients. Methodology: This systematic review was performed in accordance with the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations. The search was conducted in MEDLINE, EMBASE, and PsychINFO using MeSH headings. The two authors screened studies for relevance and extracted data. Results: Seventeen studies were identified, including 6,272 total participants (mean = 392, 58% male) with a mean age of 60.6 years. The European Organisation for Research and Treatment of Cancer QLQ-C30 was the most common measure of QoL (n=14, 82.3%). Most studies (n=15, 88.2%) found that emotional distress correlated with poor global QoL. This was most commonly measured with the Hospital Anxiety & Depression Scale (n=11, 64.7%). Other psychosocial factors associated with QoL were lack of social support, body image, and financial difficulties. Clinicopathologic determinants included presence of stoma and metastasis. Conclusion: This systematic review provides a summary of the psychosocial determinants of poor QoL in post-treatment CRC patients, as well as the most commonly reported measures of these. An understanding of these potentially modifiable determinants of poor outcome is pivotal to the provision of quality, patient-centred care in surgical oncology.

Keywords: colorectal cancer, cancer surgery, quality of life, oncology, social determinants

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Authors: Nurhayati Br Tarigan, Rizkita Rachmi Esyanti

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Stevia (Stevia rebaudiana Bertoni) has a great potential to be used as a natural sweetener because it contains steviol glycoside, which is approximately 100 - 300 times sweeter than sucrose, yet low calories. Vegetative and generative propagation of S. rebaudiana is inefficient to produce stevia biomass and stevioside. One of alternative for stevia propagation is in vitro shoot culture. This research was conducted to optimize the best medium for shoot growth and to compare the bioconversion efficiency and stevioside production of S. rebaudiana shoot culture cultivated in thin layer culture (TLC), recipient for automated temporary immersion system (TIS RITA®) bioreactor, and bubble column bioreactor. The result showed that 1 ppm of Kinetin produced a healthy shoot and the highest number of leaves compared to BAP. Shoots were then cultivated in TLC, TIS RITA® bioreactor, and bubble column bioreactor. Growth medium efficiency was determined by yield and productivity. TLC produced the highest growth medium efficiency of S. rebaudiana, the yield was 0.471 ± 0.117 gbiomass.gsubstrate-1, and the productivity was 0.599 ± 0.122 gbiomass.Lmedium-1.day-1. While TIS RITA® bioreactor produced the lowest yield and productivity, 0.182 ± 0.024 gbiomass.gsubstrate-1 and 0.041 ± 0.0002 gbiomass.Lmedium-1.day-1 respectively. The yield of bubble column bioreactor was 0.354 ± 0.204 gbiomass.gsubstrate-1 and the productivity was 0,099 ± 0,009 gbiomass.Lmedium-1.day-1. The stevioside content from the highest to the lowest was obtained from stevia shoot which was cultivated on TLC, TIS RITA® bioreactor, and bubble column bioreactor; the content was 93,44 μg/g, 42,57 μg/g, and 23,03 μg/g respectively. All three systems could be used to produce stevia shoot biomass, but optimization on the number of nutrition and oxygen intake was required in each system.

Keywords: bubble column, growth medium efficiency, Stevia rebaudiana, stevioside, TIS RITA®, TLC

Procedia PDF Downloads 264

Authors: Piyanud Chompookard

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This research aims to study the effect of self-compassion techniques for individuals with depression (A pilot study). A quasi-experimental research with pretest-posttest is used to design this work. The research includes 30 participants, divided into the experimental group (ten samples) and the control group (twenty samples). The experimental group received a self-compassion techniques with an appropriate treatment for a total six times. The control group received an appropriate treatment. The measurement of this study using the Hamilton Rating Scale for Depression (Thai version). There are significant differences in levels of depression after received a self-compassion techniques with an appropriate treatment (p<.01). And there are significant differences in levels of depression between the experimental group and the control group (p<.01).

Keywords: depression, self compassion techniques, psychotherapy, pilot study

Procedia PDF Downloads 136

Authors: Ashit Syngle, Nidhi Garg, Pawan Krishan

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Objective: Bone marrow derived stem cells, endothelial progenitor cells (EPCs), protect against atherosclerotic vascular damage. However, EPCs are depleted in AS and contribute to the enhanced cardiovascular risk. Statins have a protective effect in CAD and diabetes by enhancing the proliferation, migration and survival of EPCs. Therapeutic potential of augmenting EPCs to treat the heightened cardiovascular risk of AS has not yet been exploited. We aimed to investigate the effect of rosuvastatin on EPCs population and inflammation in AS. Methods: 30 AS patients were randomized to receive 6 months of treatment with rosuvastatin (10 mg/day, n=15) and placebo (n=15) as an adjunct to existing stable anti-rheumatic drugs. EPCs (CD34+/CD133+) were quantified by Flow Cytometry. Inflammatory measures (BASDAI, BASFI, CRP and ESR), pro-inflammatory cytokines (TNF-α, IL-6 and IL-1) and lipids were measured at baseline and after treatment. Results: At baseline, inflammatory measures and pro-inflammatory cytokines were elevated and EPCs depleted among both groups. EPCs increased significantly (p < 0.01) after treatment with rosuvastatin. At 6 months, BASDAI, BASFI, ESR, CRP, TNF-α, and IL-6 improved significantly in rosuvastatin group. Significant negative correlation was observed between EPCs and BASDAI, CRP and IL-6 after rosuvastatin treatment. Conclusion: First study to show that rosuvastatin augments EPCs population in AS. This defines a novel mechanism of rosuvastatin treatment in AS: the augmentation of EPCs with improvement in proinflammatory cytokines and inflammatory disease activity. The augmentation of EPCs by rosuvastatin may provide a novel strategy to prevent cardiovascular events in AS.

Keywords: ankylosing spondylitis, Endothelial Progenitor Cells, inflammation, pro-inflammatory cytokines, rosuvastatin

Procedia PDF Downloads 350

Authors: Stefan Bradu, Daniel Siegel, Jameson Loyal, Andrea Leaf, Alana Kurtti, Usha Alapati, Jared Jagdeo

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Compared with all other variants of nodular melanoma, patients with polypoid nodular melanoma have the lowest 5-year survival rate. The pathophysiology and management of polypoid melanoma are scarcely reported in the literature. Although surgical excision is the cornerstone of melanoma management, treatment of polypoid melanoma is complicated by several negative prognostic factors, including early metastasis. This report demonstrates the successful treatment of a rapidly developing red nodular polypoid melanoma with metastasis using surgery and adjuvant nivolumab in a SARS-CoV-2-positive patient who delayed seeking care due to the COVID-19 pandemic. In addition to detailing the successful treatment approach, the immunosuppressive effects of SARS-2-CoV and its possible contribution to the rapid progression of polypoid melanoma are discussed. This case highlights the complex challenges of melanoma diagnosis and management during the COVID-19 pandemic.

Keywords: covid-19, dermatology, immunotherapy, melanoma, nivolumab

Procedia PDF Downloads 205

Authors: Krytskyy T.

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Introduction: The role of androgen deficiency in men as a factor in the pathogenesis of many somatic diseases is unmistakable. The interaction of thyroid and sex hormones with hypothyroidism in men is still the subject of discussions. The purpose of the study is to assess the androgen status of men with primary hypothyroidism, depending on its duration and the state of compensation. Materials and methods: 45 men with primary hypothyroidism aged 35 to 60 years, as well as 25 healthy men, who formed a control group, were under supervision. A selection of men for examination was conducted in the process of outpatient and in-patient treatment at the endocrinology department of the University Hospital in Ternopil. The functional state of the pituitary-gonadal system was evaluated in order to characterize the androgen status of patients. The concentration of follicle stimulating hormone, luteinizing hormone, prolactin, thyroid-stimulating hormone was determined in blood with the help of enzyme-linked method. Also, the content of hormones: total testosterone, linking sex hormones globulin were determined. Results: Reduced total testosterone (TT) content was found in 42.2% of patients with hypothyroidism. Herewith in 17.8% of patients, blood TT levels were lower than 8.0 nmol / L, and in 11 (24.4%) men, the rate was in the range of 8.0 to 12.0 nmol / L. Based on the results of the determination of the content of free testosterone (FT), the frequency of laboratory hypogonadism in men with hypothyroidism was higher than the results of the determination of TT. The degree of compensation of hypothyroidism probably did not affect the average levels of gonadotropic and sex hormones. Conclusions: Reduced total testosterone content was found in 42.2% of patients with primary hypothyroidism. Herewith, in 17.8% of patients blood TT levels were lower than 8.0 nmol / L, which is a sign of absolute deficiency of testosterone, and in 24.4% of men the rate ranged from 8.0 to 12.0 nmol / l , indicating partial androgen deficiency. Linking sex hormones globulin levels were believed to be lower in 46.7% of patients with hypothyroidism compared to control group. The average levels of E2 in the examined patients did not significantly differ from the mean of control group. FSH, LH, and prolactin levels in men with hypothyroidism were within the normal age limits and probably did not differ from those of control group. The degree of compensation of hypothyroidism probably did not affect the average levels of gonadotropic and sex hormones. The mean LH content in the blood was significantly increased in men with a duration of hypothyroidism up to 5 years and did not differ from that of the control group and in men with a duration of hypothyroidism over 5 years. In men with hypothyroidism, a probable reduction in T / LH coefficient is found. The obtained data may indicate a combined lesion of the central and peripheral parts of the pituitary-gonadal system in men with hypothyroidism.

Keywords: androgenic status, hypothyroidism, testosterone, linking sex hormones globulin

Procedia PDF Downloads 189

Authors: Md Azizul Islam

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Seam is the line of joining two separate fabric layers for functional or aesthetic purposes. Different kinds of seams are used for assembling the different areas or parts of the garment to increase serviceability. To empirically support the importance of seam efficiency on serviceability of garments, this study is focused on choosing the right type of seams for particular sewing parts of the garments based on the seam efficiency to ensure better serviceability. Seam efficiency is the ratio of seam strength and fabric strength. Single jersey knitted finished fabrics of four different GSMs (gram per square meter) were used to make the test garments T-shirt. Three distinct types of the seam: superimposed, lapped and flat seam was applied to the side seams of T-shirt and sewn by lockstitch (stitch class- 301) in a flat-bed plain sewing machine (maximum sewing speed: 5000 rpm) to make (3x4) 12 T-shirts. For experimental purposes, needle thread count (50/3 Ne), bobbin thread count (50/2 Ne) and the stitch density (stitch per inch: 8-9), Needle size (16 in singer system), stitch length (31 cm), and seam allowance (2.5cm) were kept same for all specimens. The grab test (ASTM D5034-08) was done in the Universal tensile tester to measure the seam strength and fabric strength. The produced T-shirts were given to 12 soccer players who wore the shirts for 20 soccer matches (each match of 90 minutes duration). Serviceability of the shirt were measured by visual inspection of a 5 points scale based on the seam conditions. The study found that T-shirts produced with lapped seam show better serviceability and T-shirts made of flat seams perform the lowest score in serviceability score. From the calculated seam efficiency (seam strength/ fabric strength), it was obvious that the performance (in terms of strength) of the lapped and bound seam is higher than that of the superimposed seam and the performance of superimposed seam is far better than that of the flat seam. So it can be predicted that to get a garment of high serviceability, lapped seams could be used instead of superimposed or other types of the seam. In addition, less stressed garments can be assembled by others seems like superimposed seams or flat seams.

Keywords: seam, seam efficiency, serviceability, T-shirt

Procedia PDF Downloads 197

Authors: F. Arıkan, Z. Karakus

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Cancer is a widespread disease in the world and is the third reason of deaths among the chronic diseases. Educating patients and caregivers has a vital role for empowering them in managing disease and treatment's symptoms. Informing of the patients about their disease and treatment process decreases patient's distress and decisional conflicts, improves wellbeing of them, increase success of the treatment and survival. In this era, technological education methods are used for patients that have different chronic disease. Many studies indicated that especially web based patient education such as chronic obstructive lung disease; heart failure is more effective than printed materials. Web based education provide easiness to patients while they are reaching health services. It also has more advantages because of it decreases health cost and requirement of staff. It is thought that web based education may be beneficial method for cancer patient's empowerment in coping with the disease's symptoms. The aim of the study is evaluate the effectiveness of web based education for cancer patients' clinical outcomes.

Keywords: cancer patients, e-learning, nursing, web based education

Procedia PDF Downloads 423