Search results for: primary wastewater treatment

Authors: Heba Esaily, Rawhia Eledl, Daila Aboelela, Rasha Noreldin

Abstract:

Objective: Assess serum level of Transforming growth factor beta 2 (TGF-β2) and Matrilin-3 (MATN3) SNP6 polymorphism in osteoarthritic patients Background: Osteoarthritis (OA) is a musculoskeletal disease characterized by pain and joint stiffness. TGF-β 2 is involved in chondrogenesis and osteogenesis, It has found that MATN3 gene and protein expression was correlated with the extent of tissue damage in OA. Findings suggest that regulation of MATN3 expression is essential for maintenance of the cartilage extracellular matrix microenvironment Subjects and Methods: 72 cases of primary OA (56 with knee OA and 16 with generalized OA were compared with that of 18 healthy controls. Radiographs were scored with the Kellgren-Lawrence scale. Serum TGF-β2 was measured by using (ELISA), levels of marker were correlated to radiographic grading of disease and MATN3 SNP6 polymorphism was determined by (PCR-RFLP). Results: MATN3 SNP6 polymorphism and serum level of TGF-β2 were higher in OA compared with controls. Genotype, NN and N allele frequency were higher in patients with OA compared with controls. NN genotype and N allele frequency were higher in knee osteoarthritis than generalized OA. Significant positive correlation between level of TGFβ2 and radiographic grading in group with knee OA, but no correlation between serum level of TGFβ2 and radiographic grading in generalized OA. Conclusion: MATN3 SNP6 polymorphism and TGF-β2 implicated in the pathogenesis of osteoarthritis. Association of N/N genotype with primary osteoarthritis emphasizes on the need for prospective study include larger sample size to confirm the results of the present study.

Keywords: Matrilin-3, transforming growth factor beta 2, primary osteoarthritis, knee osteoarthritis

Procedia PDF Downloads 259

Authors: Heiko Jessen, Laura Tanus, Slobodan Ruzicic

Abstract:

Objectives: The efficacy of Stribild®, an integrase strand transfer inhibitor (INSTI) -based STR, has been evaluated in randomized clinical trials and it has demonstrated durable capability in terms of achieving sustained suppression of HIV-1 RNA-levels. However, differences in monitoring frequency, existing selection bias and profile of patients enrolled in the trials, may all result in divergent efficacy of this regimen in routine clinical settings. The aim of this study was to assess the virologic outcomes, safety and tolerability profile of Stribild® in a routine clinical setting. Methods: This was a retrospective monocentric analysis on HIV-1-infected patients, who started with or were switched to Stribild®. Virological failure (VF) was defined as confirmed HIV-RNA>50 copies/ml. The minimum time of follow-up was 24 weeks. The percentage of patients remaining free of therapeutic failure was estimated using the time-to-loss-of-virologic-response (TLOVR) algorithm, by intent-to-treat analysis. Results: We analyzed the data of 197 patients (56 ART-naïve and 141 treatment-experienced patients), who fulfilled the inclusion criteria. Majority (95.9%) of patients were male. The median time of HIV-infection at baseline was 2 months in treatment-naïve and 70 months in treatment-experienced patients. Median time [IQR] under ART in treatment-experienced patients was 37 months. Among the treatment-experienced patients 27.0% had already been treated with a regimen consisting of two NRTIs and one INSTI, whereas 18.4% of them experienced a VF. The median time [IQR] of virological suppression prior to therapy with Stribild® in the treatment-experienced patients was 10 months [0-27]. At the end of follow-up (median 33 months), 87.3% (95% CI, 83.5-91.2) of treatment-naïve and 80.3% (95% CI, 75.8-84.8) of treatment-experienced patients remained free of therapeutic failure. Considering only treatment-experienced patients with baseline VL<50 copies/ml, 83.0% (95% CI, 78.5-87.5) remained free of therapeutic failure. A total of 17 patients stopped treatment with Stribild®, 5.4% (3/56) of them were treatment-naïve and 9.9% (14/141) were treatment-experienced patients. The Stribild® therapy was discontinued in 2 (1.0%) because of VF, loss to follow-up in 4 (2.0%), and drug-drug interactions in 2 (1.0%) patients. Adverse events were in 7 (3.6%) patients the reason to switch from therapy with Stribild® and further 2 (1.0%) patients decided personally to switch. The most frequently observed adverse events were gastrointestinal side effects (20.0%), headache (8%), rash events (7%) and dizziness (6%). In two patients we observed an emergence of novel resistances in integrase-gene. The N155H evolved in one patient and resulted in VF. In another patient S119R evolved either during or shortly upon switch from therapy with Stribild®. In one further patient with VF two novel mutations in the RT-gene were observed when compared to historical genotypic test result (V106I/M and M184V), whereby it is not clear whether they evolved during or already before the switch to Stribild®. Conclusions: Effectiveness of Stribild® for treatment-naïve patients was consistent with data obtained in clinical trials. The safety and tolerability profile as well as resistance development confirmed clinical efficacy of Stribild® in a daily practice setting.

Keywords: ART, HIV, integrase inhibitor, stribild

Procedia PDF Downloads 275

Authors: Mitsuo Yoshida

Abstract:

A significant mercury contamination of soil/sediment was unveiled by an environmental monitoring program in a wetland along La Plata River, west to Montevideo City, Uruguay. The mercury contamination was caused by industrial wastewater discharged from a chlor-alkali plant using a mercury-cell process. The contamination level is above 60 mg/kg in soil/sediment. Most of mercury (Hg) in the environment is inorganic, but some fractions are converted by bacteria to methylmercury (MeHg), a toxic organic compound. MeHg biologically accumulates through a food-chain and become serious public health risk. In order to clarify the contaminated part for countermeasure operation, an intervention value of mercury contamination of sediment/soil was defined as 15 mg/kg (total Hg) by the authority. According to the intervention value, mercury contaminated area in the La Plata site is approximately 48,280 m² and estimated total volume of contaminated sediments/soils was around 18,750 m³. The countermeasures to contaminated zone were proposed in two stages; (i) mitigation of risks for public health and (ii) site remediation. The first stage is an installation of fens and net around the contamination zone, for mitigating risks of exposure, inhalation, and intake. The food chain among wetland-river ecosystem was also interrupted by the installation of net and fens. The state of mercury contamination in La Plata site and plan of countermeasure was disclosed to local people and the public, and consensus on setting off-limit area was successfully achieved. Mass media also contribute to share the information on the contamination site. The cost for countermeasures was borne by the industry under the polluter-pay-principle.

Keywords: chlor-alkali plant, mercury contamination, polluter pay principle, Uruguay, wetland

Procedia PDF Downloads 118

Authors: Chanida Tangjai Benchalak Muangmeesri, Dechrit Maneetham

Abstract:

Collection of marine garbage in the modern world, where technology is vital to existence. Consequently, technology can assist in reducing the duplicate labor in the subject of collecting trash in the water that must be done the same way repeatedly owing to the consequence of suffering an emerging disease or COVID-19. This is due to the rapid advancement of technology. As a result, solid trash and plastic garbage are increasing. Agricultural gardens, canals, ponds, and water basins are all sources of water. Building boat-like instruments for rubbish collection in the water will be done this time. It has two control options, boat control via remote control and boat control via an Internet of Things system. A solar panel with a power output of 40 watts powers the system being able to store so accurate and precise waste collection, allowing for thorough water cleaning. The primary goals are to keep the water's surface clean and assess its quality to support the aquatic ecology.

Keywords: automatic boat, water treatment, cleaning machine, iot

Procedia PDF Downloads 80

Authors: Mohamed Salaheldien Mohamed Alayat, Ahmed Mohamed Elsoudany, Roaa Abdulghani Sroge, Bayan Muteb Aldhahwani

Abstract:

Background: Neck pain is a common illness that could affect individual’s daily activities. Class IV laser with longer wavelength can stimulate tissues and penetrate more than the classic low-level laser therapy. Objectives: The aim of the study was to investigate the efficacy of class IV diode laser in the treatment of patients with chronic neck pain (CNP). Methods: Fifty-two patients participated and completed the study. Their mean age (SD) was 50.7 (6.2). Patients were randomized into two groups and treated with laser plus exercise (laser + EX) group and placebo laser plus exercise (PL+EX) group. Treatment was performed by Class IV laser in two phases; scanning and trigger point phases. Scanning to the posterior neck and shoulder girdle region with 4 J/cm2 with a total energy of 300 J applied to 75 cm2 in 4 minutes and 16 seconds. Eight trigger points on the posterior neck area were treated by 4 J/cm2 and the time of application was in 30 seconds. Both groups received exercise two times per week for 4 weeks. Exercises included range of motion, isometric, stretching, isotonic resisted exercises to the cervical extensors, lateral bending and rotators muscles with postural correction exercises. The measured variables were pain level using visual analogue scale (VAS), and neck functional activity using neck disability index (NDI) score. Measurements were taken at baseline and after 4 weeks of treatment. The level of statistical significance was set as p < 0.05. Results: There were significant decreases in post-treatment VAS and NDI in both groups as compared to baseline values. Laser + EX effectively decreased VAS (mean difference -6.5, p = 0.01) and NDI scores after (mean difference -41.3, p = 0.01) 4 weeks of treatment compared to PL + EX. Conclusion: Class IV laser combined with exercise is effective treatment for patients with CNP as compared to PL + EX therapy. The combination of laser + EX effectively increased functional activity and reduced pain after 4 weeks of treatment.

Keywords: chronic neck pain, class IV laser, exercises, neck disability index, visual analogue scale

Procedia PDF Downloads 295

Authors: R. Suresh, C. B. Singh, A. K. Sarda

Abstract:

Background: Over the decades, several surgical techniques have been developed to treat anal fistulas with variable success rates and complications. Large amount of work has been done in radiofrequency excision of the fistula for several years but no work has been done for ablating the tract. Therefore one can consider for obliteration ofanal fistula by Radiofrequency ablation (RFA). Material and Methods: A randomized controlled clinical trial was conducted at Lok Nayak Hospital, where a total of 40 patients were enrolled in the study and they were randomly assigned to Group I (fistulectomy)(n=20) and Group II (RFA) (n=20). Aim of the study was to compare the efficacy of RFA of fistula versus fistulectomy in the treatment of a low anal fistula and to evaluate RFA as an effective alternative to fistulectomy with respect to time taken for wound healing as primary outcome and post-operative pain, time taken to return to work as secondary outcomes. Patients with simple low anal fistulas, single internal and external opening, not more than two secondary tracts were included. Patients with high complex fistula, fistulas communicating with cavity, fistula due to condition like tuberculosis, Crohn's, malignancy were excluded from the study. Results: Both groups were comparable with respect to age, sex ratio, type of fistula. Themean healing time was significantly shorter in group II (41.02 days) than in group I(62.68 days).The mean operative time was significantly shorter in groupII (21.40 min) than in group I(28.50 min). The mean time taken to return to work was significantly shorter in group II(8.30 days)than in group I(12.01 days).There was no significant difference in the post operative hospital stay, mean postoperative pain score, wound infection and recurrence between the two groups. Conclusion: The patients who underwent RFA of fistula had shorter wound healing time, operative time and time taken to return to work when compared to those who underwent fistulectomy and therefore RFA shows outcome comparable to fistulectomy in the treatment of low anal fistula.

Keywords: fistulectomy, low anal fistula, radio frequency ablation, wound healing

Procedia PDF Downloads 334

Authors: Erfan Ghasemi, Mohammadreza Khani, Hamidreza Mahmoudi, Mohammad Ali Nilforoushzadeh, Babak Shokri, Pouria Akbartehrani

Abstract:

Given the global significance of treating infectious wounds, the goal of this study is to use spark plasma as a new treatment for infectious wounds. To generate spark plasma, a high-voltage (7 kV) and high-frequency (75 kHz) source was used. Infectious wounds in the peritoneum of mice were divided into control and plasma-treated groups at random. The plasma-treated animals received plasma radiation every 4 days for 12 days, for 60 seconds each time. On the 15th day after the first session, the wound in the plasma-treated group had completely healed. The spectra of spark plasma emission and tissue properties were studied. The mechanical resistance of the wound healed in the plasma treatment group was considerably higher than in the control group (p<0.05), according to the findings. Furthermore, histological evidence suggests that wound re-epithelialization is faster in comparison to controls. Angiogenesis and fibrosis (collagen production) were also dramatically boosted in the plasma-treated group, whereas the stage of wound healing inflammation was significantly reduced. Plasma therapy accelerated wound healing by causing considerable wound constriction. The results of this investigation show that spark plasma has an influence on the treatment of infectious wounds.

Keywords: infectious wounds, mice, spark plasma, treatment

Procedia PDF Downloads 283

Authors: H. Mohit

Abstract:

In automotive air conditioning system, two heat exchangers are used as evaporator and condenser which are placed inside the bonnet of a car in a compact manner. The dust particles from outside and moisture content produced during the process leads to formation of impure particles on the surface of evaporator coil. But in condenser coil, the impure particles are settling down due to dust from atmosphere. The major problem of the heat exchanger used in automotive air conditioning is leakage of refrigerant due to corrosion. This effect of corrosion will lead to damage on the surface of heat exchanger and leakage of refrigerant from the system. To protect from corrosion, coatings are applied on its surfaces. Nowadays, to improve the corrosion resistance of these heat exchangers, hydrophilic coatings are used, which is very expensive. Cryogenic treatment is one method which involves the treatment of materials below -150 °C using the cryogenic fluid such as liquid nitrogen. In this project work, a study of improvement in corrosion resistance of materials of aluminium alloys of various grades as AA 1100, AA 6061, AA 6063 and AA 2024 that are mainly used for fin and tube heat exchangers in automotive air conditioning system is made. In total, five different processes are selected for these grades of aluminium alloy and various parameters like corrosion rate, dimensional stability, hardness and microstructure are measured. The improvements were observed in these parameters while comparing it with conventional heat treatment process.

Keywords: cryogenic treatment, corrosion resistance, dimensional stability, materials science

Procedia PDF Downloads 245

Authors: Štěpán Hýsek, Milan Podlena, Miloš Pavelek, Matěj Hodoušek, Martin Böhm, Petra Gajdačová

Abstract:

Particle boards have being used in the civil engineering as a decking for load bearing and non-load bearing vertical walls and horizontal panels (e. g. floors, ceiling, roofs) in a large scale. When the straw is used as non-wood material for manufacturing of lignocellulosic panels, problems with wax layer on the surface of the material can occur. Higher percentage of silica and wax cause the problems with the adhesion of the adhesive and this is the reason why it is necessary to break the surface layer for the better bonding effect. Surface treatment of the particles cause better mechanical properties, physical properties and the overall better results of the composite material are reached. Plasma application is one possibility how to modify the surface layer. The aim of this research is to modify the surface of straw particles by using cold plasma treatment. Surface properties of lignocellulosic materials were observed before and after cold plasma treatment. Cold plasma does not cause any structural changes deeply in the material. There are only changes in surface layers, which are required. Results proved that the plasma application influenced the properties of surface layers and the properties of composite material.

Keywords: composite, lignocellulosic materials, straw, cold plasma, surface treatment

Procedia PDF Downloads 316

Authors: Ilirian Laçi, Alketa Spahiu

Abstract:

Modality of treatment in hepatocellular carcinoma (HCC) patients depends on the stage of the disease. The Barcelona Clinic Liver Cancer Classification (BCLC) is the preferred staging system. There are many patients initially present with intermediate-stage disease. For these patients, transarterial chemoembolization (TACE) is the treatment of choice. The differences in individual factors that are not captured by the BCLC framework, such as the tumor growth pattern, degree of hypervascularity, and vascular supply, complicate further evaluation of these patients. Because of these differences, not all patients benefit equally from TACE. Several tools have been devised to aid the decision-making process, which have shown promising initial results but have failed external evaluation and have not been translated to the clinic aspects. Criteria for treatment decisions in daily clinical practice are needed in all stages of the disease.

Keywords: hepatocellular carcinoma, transarterial chemoembolization, TACE, liver

Procedia PDF Downloads 80

Authors: A. Bello-Olusoji, M. O. Sodamola, Y. A. Adejola, D. D Akinbola

Abstract:

An eight (8) weeks study was carried out on Four hundred and five (405) African catfish (Clarias gariepinus) juveniles to examine the effect of graded levels of egg shell on their growth performance and survival rates. They were acclimatized for two (2) weeks after which they were weighed and allotted into five dietary treatments of three (3) replicates each and 27 fishes per replicate making a total number of eighty-one (81) fishes per treatment. The dietary treatments contained 0, 25, 50, 75 and 100(%) egg shell inclusion from treatment one to treatment five respectively. Parameter on daily feed intake, weekly weight gain, and daily mortalities were recorded. The result of the experiment indicated that treatment four (4) with 75% inclusion of egg shell was the best in terms of weight gain and survival rates and was significantly different (P<0.05) when compared with the other treatments. For Catfish farming to remain viable in the nearest future, lower feed cost and increased profit are required; it is therefore recommended that diets of African catfish (Clarias gariepinus) be supplemented with well processed egg shell at 75% level of inclusion to achieve this.

Keywords: African catfish, egg shell, performance, performance, survival rate, weight gain

Procedia PDF Downloads 372

Authors: S. Jaikeaw, S. Chavadej

Abstract:

The objective of this study was to determine the effects of COD loading rate on hydrogen and methane production and micronutrient transportation using a two-stage upflow anaerobic sludge blanket (UASB) system under mesophilic temperature (37°C) with a constant recycle ratio of 1:1 (final effluent flow rate: feed flow rate). The first (hydrogen) UASB unit having 4 L liquid holding volume was controlled at pH 5.5 but the second (methane) UASB unit having 24 L liquid holding volume had no pH control. The two-stage UASB system operated at different COD loading rates from 8 to 20 kg/m³d based on total UASB working volume. The results showed that, at the optimum COD loading rate of 13 kg/m³d, the produced gas from the hydrogen UASB unit contained 1.5% H₂, 16.5% CH₄, and 82% CO₂ with H₂S of 252 ppm and also provided a hydrogen yield of 1.66 mL/g COD removed (or 0.56 mL/g COD applied) and a specific hydrogen production rate of 156.85 ml H₂/LRd (or 5.12 ml H₂/g MLVSS d). Under the optimum COD loading rate, the produced gas from the methane UASB unit mainly contained methane and carbon dioxide without hydrogen of 74 and 26%, respectively with hydrogen sulfide of 287 ppm and the system also provided a maximum methane yield of 407.00 mL/g COD removed (or 263.23 mL/g COD applied) and a specific methane production rate of 2081.44 ml CH₄/LRd (or 99.75 ml CH₄/g MLVSS d). Under the optimum COD loading rate, all micronutrients markedly dropped by the sulfide precipitation reactions. The reduction of micronutrients mostly appeared in the methane UASB unit. Under the studied conditions, both Co and Ni were found to be greatly precipitated out, causing the deficiency to microbial activity. It is hypothesized that an addition of both Co and Ni can improve the methanogenic activity.

Keywords: hydrogen and methane production, ethanol wastewater, a two-stage upflow anaerobic blanket (UASB) system, mesophillic temperature, microbial concentration (MLVSS), micronutrients

Procedia PDF Downloads 278

Authors: K. Domagala, D. Kata, T. Graule

Abstract:

Diseases caused by contaminated drinking water are the worldwide problem, which leads to the death and severe illnesses for hundreds of millions million people each year. There is an urgent need for efficient water treatment techniques for virus pathogens removal. The aim of the research was to develop safe and economic solution, which help with the water treatment. In this study, the synthesis of copper-based multi-walled carbon nanotube composites is described. Proposed solution utilize combination of a low-cost material with a high active surface area and copper antiviral properties. Removal of viruses from water was possible by adsorption based on electrostatic interactions of negatively charged virus with a positively charged filter material.

Keywords: multi walled carbon nanotubes, water purification, virus removal, water treatment

Procedia PDF Downloads 119

Authors: Bhagwant Singh, Sikander Singh Cheema

Abstract:

This paper examines firewall mechanisms routinely implemented for network security in depth. A firewall can't protect you against all the hazards of unauthorized networks. Consequently, many kinds of infrastructure are employed to establish a secure network. Firewall strategies have already been the subject of significant analysis. This study's primary purpose is to avoid unnecessary connections by combining the capability of the firewall with the use of additional firewall mechanisms, which include packet filtering and NAT, VPNs, and backdoor solutions. There are insufficient studies on firewall potential and combined approaches, but there aren't many. The research team's goal is to build a safe network by integrating firewall strength and firewall methods. The study's findings indicate that the recommended concept can form a reliable network. This study examines the characteristics of network security and the primary danger, synthesizes existing domestic and foreign firewall technologies, and discusses the theories, benefits, and disadvantages of different firewalls. Through synthesis and comparison of various techniques, as well as an in-depth examination of the primary factors that affect firewall effectiveness, this study investigated firewall technology's current application in computer network security, then introduced a new technique named "tight coupling firewall." Eventually, the article discusses the current state of firewall technology as well as the direction in which it is developing.

Keywords: firewall strategies, firewall potential, packet filtering, NAT, VPN, proxy services, firewall techniques

Procedia PDF Downloads 88

Authors: Mahdi Akhbardeh

Abstract:

St John's wort plant can help to treat depression disease through decreasing this disease symptom, due to having some similar features of Prozac (Fluoxetine Hcl) pill. People suffering from slight depression who have fear of using antidepressants side effects can use St John's wort drops under doctor observation. This method of treatment is proposed specially to those women who are spending menopause or depression resulted from this period. St John's wort plant have proposed traditional and plant medicine as newest researches in treating mood disorders compared to Prozac (Fluoxetine Hcl) drug in treating depression disease which is being administrated in clinic research center of Washington. Objective: the aim of this study is to find an alternative treatment method in people suffering from depression which are treated with Prozac (Fluoxetine Hcl). Almost 70 percent of treatment failures with Prozac (Fluoxetine Hcl) drug in patients suffering from slight to normal depression is due to intensive side effects including: decrease in blood pressure, reduce in sexual desire and 30 percent of it is due to this drug affectless in treatment procedure which leads to leaving treatment. Results of Hypercuim plant function are exactly similar to antidepressants. Increase in serotonin amount in brain synopsis terminal end causes increase in existence time of this material in this part. In fact these two drugs have similar function. Though side effects of Hypercuim plant(St John's wort) including headache and slight nausea tolerable. Results: St John's wort plant can be used lonely in slight to normal depressions in which patients are avoiding Prozac (Fluoxetine Hcl) drug due to it's side effects. In intensive depressions through which general patients don’t indicate positive response to drug, it is probably expected relative or even complete treatment through combining antidepressants drugs with this plant. This treatment method has been investigated and confirmed in clinical tests and researches.

Keywords: depression, St John's wort, Prozac, antidepressant

Procedia PDF Downloads 469

Authors: Titir Bhattacharya, Tanika Chakraborty, Prabal K. De

Abstract:

Maternal and child health continue to be a significant policy focus in developing countries, including India. An emerging model in health care is the creation of public and private partnerships. Since the construction of physical infrastructure is costly, governments at various levels have tried to implement social health insurance schemes where a trust calculates insurance premiums and medical payments. Typically, qualifying families get full subsidization of the premium and get access to private hospitals, in addition to low cost public hospitals, for their tertiary care needs. We analyze one such pioneering social insurance scheme in the Indian state of Andhra Pradesh (AP). The Rajiv Aarogyasri program (RA) was introduced by the Government of AP on a pilot basis in 2007 and implemented in 2008. In this paper, we first examine the extent to which access to reproductive health care changed. For example, the RA scheme reimburses hospital deliveries leading us to expect an increase in institutional deliveries, particularly in private hospitals. Second, we expect an increase in institutional deliveries to also improve child health outcomes. Hence, we estimate if the program improved infant and child mortality. We use District Level Health Survey data to create annual birth cohorts from 2000-2015. Since AP was the only state in which such a state insurance program was implemented, the neighboring states constituted a plausible control group. Combined with the policy timing, and the year of birth, we employ a difference-indifference strategy to identify the effects of RA on the residents of AP. We perform several checks against threats to identification, including testing for pre-treatment trends between the treatment and control states. We find that the policy significantly lowered infant and child mortality in AP. We also find that deliveries in private hospitals increased, and government hospitals decreased, showing a substitution effect of the relative price change. Finally, as expected, out-of-pocket costs declined for the treatment group. However, we do not find any significant effects for usual preventive care such as vaccination, showing that benefits of insurance schemes targeted at the tertiary level may not trickle down to the primary care level.

Keywords: public health insurance, maternal and child health, public-private choice

Procedia PDF Downloads 68

Authors: Derick Shi-Chen Ou, Liang-Yu Chen

Abstract:

Background: Acupuncture, a potential alternative, and complementary therapy revealed insufficient evidence in depression treatment. The efficacy of acupuncture treatment was still uncertainty. To evaluate the effect of acupuncture in treating depression, the randomized controlled trials (RCTs) were examined. Methods: RCTs of the acupuncture therapy in treating major depression were searched from MEDLINE from 2007 to 2017. Keywords used for searching strategy included acupuncture, acupoint, and major depressive disorder. Results: Among the nine RCTs, four studies demonstrated great improvement in acupuncture treatment and five studies revealed the effectiveness of acupuncture intervention in medication. General trends suggest that acupuncture treatment is as effective as antidepressants with minimal side effects. Conclusion: Despite the promising results from the RCTs, there are still a variety of limitations, including small sample size, imprecise enrollment criteria, difficulties with blinding, randomization, short duration of study and lack of longitudinal follow-up. Therefore, the evidence that acupuncture as an alternative therapy for depression is inconclusive. More rigorously designed RCTs should be conducted in the future.

Keywords: acupuncture, major depressive disorders, randomized clinical trials, antidepressants

Procedia PDF Downloads 223

Authors: Bilal Ahmed

Abstract:

Rehabilitation of congenital and acquired maxillofacial defects is always a challenging clinical scenario. These defects pose major physiological and psychological threat not only to the patient but to the entire family. There has been an enormous scientific development in maxillofacial rehabilitation with the advent of CAD CAM, 3-D scanning, Osseo-integrated implants and improved restorative materials. There are also specialized centers with latest diagnostic and treatment facilities in the developed countries. However, in certain clinical case scenarios, conventional prosthodontic principles are still the gold standards. Similarly in a less developed world, financial and technical constraints are factors affecting treatment planning and final outcomes. However, we can do a lot of benefits to the affected human beings, even with use of simple and cost-effective conventional prosthodontic techniques and materials. These treatment strategies may sometimes be considered as intermediate or temporary options, but with regular follow-up maintenance these can be used on a definitive basis.

Keywords: maxillofacial defects, obturators, prosthodontics, medical and health sciences

Procedia PDF Downloads 329

Authors: Trenton Hubbard, Kenneth Soyemi, Emily Siffermann

Abstract:

Introduction: According to the American Academy of Pediatrics (AAP) there are different weight-based recommendations for the treatment of Chlamydia trachomatis (CT) in patients who are being evaluated for sexual assault. Current AAP Red Book guidelines recommend that uncomplicated C. trachomatis anogenital infection in prepubertal patients weighing less than =<45 kg be treated with oral erythromycin 50 mg/kg/day QID for 14 days with no alternative therapies, and for patients whose weight => 45 kg are Azithromycin 1 gm PO once. Our study objective was to determine the efficacy of single-dose Azithromycin therapy for the treatment of Chlamydia trachomatis in patients weighing less than 50 kg who were evaluated for child sexual abuse in an urban setting. Methods: We conducted a retrospective chart review of historical medical records (paper and electronic) patients weighing less than 50 kg who were evaluated for child sexual abuse and subsequently treated for C. trachomatis infection with Azithromycin (20 mg/kg PO once up to a maximum 1 gm) and received a Test of Cure (TOC) from 2006-2016. Qualitative variables were expressed as percentages. Quantitative variables were expressed as mean values (+/- standard deviation [SD]) if they followed a normal distribution or as median values (interquartile range[IQR]) if they did not. Wilcoxson two-sample test was used to compare means of Azithromycin Dose, mg/kg, and TOC timing between treatment responders and non-responders. Results: We reviewed records of 34 patients, average age (SD) was 5.4 (2.0) years, 33 (97%) were treated for CT and 1(3%) for both GC and CT. 25 (74%) were females. Urine PCR was the most commonly used test at evaluation and as TOC with 13 (38%) patients completing both tests. The average (SD) dose of Azithromycin at treatment was 470 (136) mg and average (SD) mg/kg dose of 20 (1.9) mg/kg for all patients. Median (IQR) timing for TOC testing was 19 (14-26) days. Of the 33 with complete data 25 (74%) had a negative TOC. When compared with treatment non-responders (TOC failures), treatment responders received higher doses (average dose (SD) received 495 (139) vs 401(110), P 0.06)); similar average (SD) weight base dosing received (20.8(2.0) vs 19.7 (1.5), P 0.15)), and earlier average (SD)TOC test timing (18.8 (5.6) vs 32 (28.6) P 0.02)). Conclusion: Azithromycin dosing appears to be efficacious in the treatment of CT post sexual assault as majority of patients responded. Although treatment responders and non-responders received similar weight based doses, there is need for additional studies to understand variances and predictors of response.

Keywords: child sexual abuse, chlmaydia trachmotis infection, single-dose azithromycin, weight less than or equal to 45 kilograms

Procedia PDF Downloads 277

Authors: M. Farhaoui, M. Derraz

Abstract:

Problem statement: In the water treatment processes, the coagulation and flocculation processes produce sludge according to the level of the water turbidity. The aluminum sulfate is the most common coagulant used in water treatment plants of Morocco as well as many countries. It is difficult to manage the sludge produced by the treatment plant. However, it can be used in the process to improve the quality of the treated water and reduce the aluminum sulfate dose. Approach: In this study, the effectiveness of sludge was evaluated at different turbidity levels (low, medium, and high turbidity) and coagulant dosage to find optimal operational conditions. The influence of settling time was also studied. A set of jar test experiments was conducted to find the sludge and aluminum sulfate dosages in order to improve the produced water quality for different turbidity levels. Results: Results demonstrated that using sludge produced by the treatment plant can improve the quality of the produced water and reduce the aluminum sulfate using. The aluminum sulfate dosage can be reduced from 40 to 50% according to the turbidity level (10, 20 and 40 NTU). Conclusions/Recommendations: Results show that sludge can be used in order to reduce the aluminum sulfate dosage and improve the quality of treated water. The highest turbidity removal efficiency is observed within 6 mg/l of aluminum sulfate and 35 mg/l of sludge in low turbidity, 20 mg/l of aluminum sulfate and 50 mg/l of sludge in medium turbidity and 20 mg/l of aluminum sulfate and 60 mg/l of sludge in high turbidity. The turbidity removal efficiency is 97.56%, 98.96% and 99.47% respectively for low, medium and high turbidity levels.

Keywords: coagulation process, coagulant dose, sludge, turbidity removal

Procedia PDF Downloads 316

Authors: Christine Ysabelle G. Roman, Pauline Torres

Abstract:

Background: Hypertrophic cardiomyopathy is a disease of marked heterogeneity. It is a genetically determined heart disease characterized by significant myocardium hypertrophy that results in diastolic dysfunction, left ventricular outflow tract obstruction, and an increased risk of arrhythmias. The primary treatment in patients with such conditions is negative inotropic drugs, such as beta-blockers, calcium channel antagonists, and disopyramide. However, for those who remain symptomatic and need septal reduction therapy, surgical septal myectomy or alcohol septal ablation are options. Case Summary: A 19 – year old female presented in the authors’ institution with easy fatigability. The consult was done a year prior, and 2D echocardiography was requested which showed concentric left ventricular hypertrophy, asymmetrically hypertrophied interventricular septum (IVS) with the largest diameter of 3.3cm & subaortic dynamic obstruction with a maximum gradient of 47 mmHg. A repeat echo a year later showed asymmetric septal hypertrophy (IVS measuring at 3cm) with the systolic anterior motion of anterior mitral valve leaflet and left ventricular outflow tract obstruction (peak gradient of 50mmHg). The patient then underwent alcohol septal ablation and was discharged stable after four days of admission. Conclusion: Hypertrophic obstructive cardiomyopathy, a cardiovascular genetic disease, results in various patterns of left ventricular hypertrophy and abnormality of mitral valve apparatus. The patient is managed medically initially. However, despite optimal drug therapy and significant left ventricular outflow tract obstruction, significant heart failure symptoms or syncope require invasive treatment.

Keywords: hypertrophic obstructive cardiomyopathy, left ventricular outflow tract obstruction, alcohol septal ablation, alcohol

Procedia PDF Downloads 64

Authors: Sila Akhan, Muge Toygar, Murat Sayan, Simge Fidan

Abstract:

Chronic viral hepatitis B, C, and D can cause hepatocellular carcinoma (HCC), cirrhosis and death. The proper treatment reduce the risk of development of HCC importantly, but not to zero point. Materials and Methods: We analysed retrospectively our chronic viral hepatitis B, C and D patients who attended to our Infectious Diseases policlinic between 2004-2018. From 589 biopsy-proven chronic hepatitis patients 3 have hepatocellular carcinoma on our follow up. First case is 74 years old patient. His HCV infection diagnosis was made 8 years ago. First treatment was pegylated interferon plus ribavirin only 28 weeks, because of HCV RNA breakthrough under treatment. In 2013 he was retreated with telaprevir, pegylated interferon plus ribavirin 24 weeks. But at the end of the therapy HCV RNA was found 1.290.000 IU/mL. He has abdominal ultrasonography (US) controls and alpha-fetoprotein (AFP) at 6 months intervals. All seemed normal until 2015 then he has an abdominal magnetic resonance imaging (MRI) and found HCC by chance. His treatment began in Oncology Clinic after verified with biopsy of HCC. And then sofosbuvir/ledipasvir was given to him for HCV 24 weeks. Sustained virologic response (SVR) was obtained. He is on cure for HCV infection and under control of Oncology for HCC. Second patient is 36 years old man. He knows his HBV infection since 2008. HBsAg and HBeAg positive; HDV RNA negative. Liver biopsy revealed grade:4, stage 3-4 according modified Knodell scoring system. In 2010 tenofovir treatment was began. His abdominal US and AFP were normal. His controls took place at 6 months intervals and HBV DNA negative, US, and AFP were normal until 2016 continuously. AFP found 37 above the normal range and then HCC was found in MRI. Third patient is 57 years old man. As hepatitis B infection was first diagnosed; he has cirrhosis and was began tenofovir as treatment. In short time he has HCC despite normal AFP values. Conclusion: In Mediterranian countries including Turkey naturally occurring pre-S/S variants are more than 75% of all chronic hepatitis B patients. This variants may contribute to the development of progressive liver damage and hepatocarcinogenesis. HCV-induced development of HCC is a gradual process and is affected by the duration of disease and viral genotype. All the chronic viral hepatitis patients should be followed up in 6 months intervals not only with US and AFP for HCC. Despite they have proper treatment there is always the risk development of HCC. Chronic hepatitis patients cannot be dropped from follow up even treated well.

Keywords: HCC, HCV, HBV, DAA

Procedia PDF Downloads 123

Authors: Bezzi Nacer

Abstract:

The study focused on the qualitative and quantitative study of Trace elements contained in the natural phosphate ore of Djebel Onk layer and their behaviour to the various mineralurgic modes of treatment. The main objective is to locate the importance of these contents according to granulometry and their association with the existing mineralogical species and to define how the most appropriate treatment. The raw ore is in first submitted to a prior mechanical treatment consisting of homogenization operations, of grinding and of sifting, in order to separate it into three particle-size classes: fine <100 µm (F); medium 100-500 µm (I) and coarse > 500 µm (G), and then treated by calcination, washing and floatation. The identification of the different mineralogical phases, the chemical composition and the thermal behaviour of these samples were realized by various techniques: MEB, DRX, ATG-ATD, etc. The study of Trace elements, carried out by ICP-MS, identified thirty items, consisting mainly of rare earths and of transition metals. A close relation between trace elements and various minerals phases (apatite, dolomite and silicates), through operations of substitution. These elements are distributed between several mineralogical phases, in particular apatite (strontium, uranium, chrome, barium, cadmium) and silicates (strontium, sodium, nickel, zinc and copper).

Keywords: valorization of natural phosphate ore, heavy metals, qualitative and quantitative analysis, various mineralurgic

Procedia PDF Downloads 326

Authors: Kim Eunha

Abstract:

This study examined a group-based intervention for alcohol use disorders based on the principles of acceptance and commitment therapy (ACT) in patients (N=22; 63.7% female; M = 38.2 years old; 100% South Korean) in a residential alcohol addiction treatment program. Patients were randomly assigned to either ACT group (receiving the ACT intervention) or control group (receiving treatment as usual). The ACT intervention consisted of four 2-hr group sessions scheduled during two weeks. The first session focused on the negative effects of suppression and avoidance, and a rationale for defusion and acceptance using several of the well-known ACT metaphors (e.g., Two Scales Metaphor, Man in the Hole). The second session taught defusion and acceptance skills through such exercises as mindfulness, cutting a sour fruit, naming one’s thoughts, and physicalizing. The third session included another mindfulness exercise and encouraged the participants to identify their values and set up life goals. The last session included more discussion on values and life goals, especially related to family and intimacy. The effects of the interventions were assessed using intent-to-treat analyses. The ACT interventions resulted in smaller immediate gains in motivation to stay sober and reductions in depression, anxiety, and experiential avoidance. In addition, at a 2-month follow up, those who attended the ACT group reported a lower average level of alcohol consumption and higher treatment attendance compared to the control group. These preliminary findings suggest that additional treatment and testing of ACT for alcohol use disorders will be crucial.

Keywords: acceptance and commitment therapy, alcohol use disorders, defusion, values

Procedia PDF Downloads 205

Authors: Mohammad Hassan Heidari, Amir Hossein Goodarzi, Majid Azarniush

Abstract:

Radiation doses to tissues and organs were measured using the anthropomorphic phantom as an equivalent to the human body. When high-energy X-rays are externally applied to treat laryngeal cancer, the absorbed dose at the laryngeal lumen is lower than given dose because of air space which it should pass through before reaching the lesion. Specially in case of high-energy X-rays, the loss of dose is considerable. Three-dimensional absorbed dose distributions have been computed for high-energy photon radiation therapy of laryngeal and hypo pharyngeal cancers, using a coaxial pair of opposing lateral beams in fixed positions. Treatment plans obtained under various conditions of irradiation.

Keywords: 3D treatment planning, anthropomorphic phantom, larynx cancer, radiotherapy

Procedia PDF Downloads 533

Authors: Klaus Froehlich-Gildhoff, Ullrich Boettinger, Katharina Rauh, Angela Schickler

Abstract:

The Prevention Network Ortenaukreis, PNO, funded by the German Ministry of Education and Research, aims to promote physical and mental health as well as the social inclusion of 3 to 10 years old children and their families in the Ortenau district. Within a period of four years starting 11/2014 a community network will be established. One regional and five local prevention representatives are building networks with stakeholders of the prevention and health promotion field bridging the health care, educational and youth welfare system in a multidisciplinary approach. The regional prevention representative implements regularly convening prevention and health conferences. On a local level, the 5 local prevention representatives implement round tables in each area as a platform for networking. In the setting approach, educational institutions are playing a vital role when gaining access to children and their families. Thus the project will offer 18 month long organizational development processes with specially trained coaches to 25 kindergarten and 25 primary schools. The process is based on a curriculum of prevention and health promotion which is adapted to the specific needs of the institutions. Also to ensure that the entire region is reached demand oriented advanced education courses are implemented at participating day care centers, kindergartens and schools. Evaluation method: The project is accompanied by an extensive research design to evaluate the outcomes of different project components such as interview data from community prevention agents, interviews and network analysis with families at risk on their support structures, data on community network development and monitoring, as well as data from kindergarten and primary schools. The latter features a waiting-list control group evaluation in kindergarten and primary schools with a mixed methods design using questionnaires and interviews with pedagogues, teachers, parents, and children. Results: By the time of the conference pre and post test data from the kindergarten samples (treatment and control group) will be presented, as well as data from the first project phase, such as qualitative interviews with the prevention coordinators as well as mixed methods data from the community needs assessment. In supporting this project, the Federal Ministry aims to gain insight into efficient components of community prevention and health promotion networks as it is implemented and evaluated. The district will serve as a model region, so that successful components can be transferred to other regions throughout Germany. Accordingly, the transferability to other regions is of high interest in this project.

Keywords: childhood research, health promotion, physical health, prevention network, psychological well-being, social inclusion

Procedia PDF Downloads 207

Authors: Panadda Rojpibulstit, Suthathip Kittisenachai, Songchan Puthong, Sirikul Manochantr, Pornpen Gamnarai, Sasichai Kangsadalampai, Sittiruk Roytrakul

Abstract:

Hepatocellular carcinoma (HCC) is the most primary hepatic cancer worldwide. Nowadays a targeted therapy via monoclonal antibodies (mAbs) specific to tumor-associated antigen is continually developed in HCC treatment. In this regard, after establishing and consequently exploring Hep88 mAb’s tumoricidal effect on hepatocellular carcinoma cell line (HepG2 cell line), the Hep88 mAb’s specific Ag from both membrane and cytoplasmic fractions of HepG2 cell line was identified by 2-D gel electrophoresis and western blot analysis. After in-gel digestion and subsequent analysis by liquid chromatography-mass spectrometry (LC-MS), mortalin (HSPA9) and alpha-enolase were identified. The recombinant proteins specific to Hep88 mAb were cloned and expressed in E.coli BL21 (DE3). Moreover, alteration of HepG2 and Chang liver cell line after being induced by Hep88 mAb for 1-3 days was investigated using a transmission electron microscope. The result demonstrated that Hep88 mAb can bind to the recombinant mortalin (HSPA9) andalpha-enolase. In addition, gradual appearance of mitochondria vacuolization and endoplasmic reticulum dilatation were observed. Taken together, paraptosis-like programmed cell death (PCD) of HepG2 is induced by binding of mortalin (HSPA9) and alpha-enolase to Hep88 mAb. Mortalin depletion by formation of Hep88 mAb-mortalin (HSPA9) complex might initiate transcription-independent of p53-mediated apoptosis. Additionally, Hep88 mAb-alpha-enolase complex might initiate HepG2 cells energy exhaustion by glycolysis pathway obstruction. These results imply that Hep88 mAb might be a promising tool for development of an effective treatment of HCC in the next decade.

Keywords: Hepatocellular carcinoma, Monoclonal antibody, Paraptosis-like program cell death, Transmission electron microscopy, mortalin (HSPA9), alpha-enolase

Procedia PDF Downloads 348

Authors: A. S. Strait, J. A. Bryk-Lucy, L. M. Ritchie

Abstract:

Thrush is a common disease of ungulates primarily affecting the frog and sulci, caused by the anaerobic bacteria Fusobacterium necrophorum. Thrush accounts for approximately 45.0% of hoof disorders in horses. Prevention and treatment of thrush are essential to prevent horses from developing severe infections and becoming lame. Proper knowledge of hoof care and thrush treatments is crucial to avoid financial costs, unsoundness and lost training time. Research on the effectiveness of numerous commercial and homemade thrush treatments is limited in the equine industry. The objective of this study was to compare the effectiveness of three common thrush treatments for horses: weekly application of Thrush Buster, daily dilute bleach solution spray, or Metronidazole pastes every other day. Cases of thrush diagnosed by a veterinarian or veterinarian-trained researcher were given a score, from 0 to 4, based on the severity of the thrush in each hoof (n=59) and randomly assigned a treatment. Cases were rescored each week of the three-week treatment, and the final and initial scores were compared to determine effectiveness. The thrush treatments were compared with Thrush Buster as the reference at a significance level of α=.05. Binomial Logistic Regression Modeling was performed, finding that the odds of a hoof treated with Metronidazole to be thrush-free was 6.1 times greater than a hoof treated with Thrush Buster (p=0.001), while the odds of a hoof that was treated with bleach to be thrush-free was only 0.97 times greater than a hoof treated with Thrush Buster (p=0.970), after adjustment for treatment week. Of the three treatments utilized in this study, Metronidazole paste applied to the affected areas every other day was the most effective treatment for thrush in horses. There are many other thrush remedies available, and further research is warranted to determine the efficacy of additional treatment options.

Keywords: fusobacterium necrophorum, thrush, equine, horse, lameness

Procedia PDF Downloads 136

Authors: Rashedul Islam

Abstract:

A firmly-validated aim of teaching science is to support student enthusiasm for science learning with an outspread interest in scientific issues in future life. This is in keeping with the recent development in Gifted and Talented Education statement which instructs that gifted students have a renewed interest and natural aptitude in science. Yet, the practice of science teaching leaves many students with the feeling that science is difficult and compared to other school subjects, students interest in science is declining at the final years of the primary school. As a curriculum guides the teaching-learning activities in school, where significant consequences may result from the context of the curricula and syllabi, are a major feature of certain educational jurisdictions in NSW, Australia. The purpose of this study was an exploration of the curriculum sets the context to identify how science education is practiced through primary schools in Sydney, Australia. This phenomenon was explored through document review from two publicly available documents namely: the NSW Science Syllabus K-6, and Australian Curriculum: Foundation - 10 Science. To analyse the data, this qualitative study applied themed content analysis at three different levels, i.e., first cycle coding, second cycle coding- pattern codes, and thematic analysis. Preliminary analysis revealed the phenomenon of teaching-learning practices drawn from eight themes under three phenomena aligned with teachers’ practices and gifted student’s learning characteristics based on Gagné’s Differentiated Model of Gifted and Talent (DMGT). From the results, it appears that, overall, the two documents are relatively well-placed in terms of identifying the context of teaching and learning primary science to gifted students. However, educators need to make themselves aware of the ways in which the curriculum needs to be adapted to meet gifted students learning needs in science. It explores the important phenomena of teaching-learning context to provide gifted students with optimal educational practices including inquiry-based learning, problem-solving, open-ended tasks, creativity in science, higher order thinking, integration, and challenges. The significance of such a study lies in its potential to schools and further research in the field of gifted education.

Keywords: teaching primary science, gifted student learning, curriculum context, science syllabi, Australia

Procedia PDF Downloads 409

Authors: Marsudi, Noor Hidayat, Ratno Bagus Edy Wibowo

Abstract:

This paper considers a deterministic model for the transmission dynamics of HIV/AIDS in which condom campaign and treatment are both important for the disease management. In modelling of the spread of AIDS, the population is divided into six subpopulations, namely susceptible population, susceptible population who change their behavior due to education condom campaign, infected population, pre-AIDS population, treated population and full-blown AIDS population. We calculate the effective reproduction number using the next generation matrix method and investigate the existence and stability of the equilibrium points. A sensitivity analysis discovers parameters that have a high impact on effective reproduction number and should be targeted by intervention strategies. Numerical simulations are given to illustrate and verify our analytic results.

Keywords: HIV/AIDS, condom campaign, antiretroviral treatment, effective reproduction number, stability and sensitivity analysis

Procedia PDF Downloads 245