Search results for: mortality rate
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 8925

Search results for: mortality rate

7305 Pharmacovigilance in Hospitals: Retrospective Study at the Pharmacovigilance Service of UHE-Oran, Algeria

Authors: Nadjet Mekaouche, Hanane Zitouni, Fatma Boudia, Habiba Fetati, A. Saleh, A. Lardjam, H. Geniaux, A. Coubret, H. Toumi

Abstract:

Medicines have undeniably played a major role in prolonging shelf life and improving quality. The absolute efficacy of the drug remains a lever for innovation, its benefit/risk balance is not always assured and it does not always have the expected effects. Prior to marketing, knowledge about adverse drug reactions is incomplete. Once on the market, phase IV drug studies begin. For years, the drug was prescribed with less care to a large number of very heterogeneous patients and often in combination with other drugs. It is at this point that previously unknown adverse effects may appear, hence the need for the implementation of a pharmacovigilance system. Pharmacovigilance represents all methods for detecting, evaluating, informing and preventing the risks of adverse drug reactions. The most severe adverse events occur frequently in hospital and that a significant proportion of adverse events result in hospitalizations. In addition, the consequences of hospital adverse events in terms of length of stay, mortality and costs are considerable. It, therefore, appears necessary to develop ‘hospital pharmacovigilance’ aimed at reducing the incidence of adverse reactions in hospitals. The most widely used monitoring method in pharmacovigilance is spontaneous notification. However, underreporting of adverse drug reactions is common in many countries and is a major obstacle to pharmacovigilance assessment. It is in this context that this study aims to describe the experience of the pharmacovigilance service at the University Hospital of Oran (EHUO). This is a retrospective study extending from 2011 to 2017, carried out on archived records of declarations collected at the level of the EHUO Pharmacovigilance Department. Reporting was collected by two methods: ‘spontaneous notification’ and ‘active pharmacovigilance’ targeting certain clinical services. We counted 217 statements. It involved 56% female patients and 46% male patients. Age ranged from 5 to 78 years with an average of 46 years. The most common adverse reaction was drug toxidermy. For the drugs in question, they were essentially according to the ATC classification of anti-infectives followed by anticancer drugs. As regards the evolution of declarations by year, a low rate of notification was noted in 2011. That is why we decided to set up an active approach at the level of some services where a resident of reference attended the staffs every week. This has resulted in an increase in the number of reports. The declarations came essentially from the services where the active approach was installed. This highlights the need for ongoing communication between all relevant health actors to stimulate reporting and secure drug treatments.

Keywords: adverse drug reactions, hospital, pharmacovigilance, spontaneous notification

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7304 Co-Factors of Hypertension and Decomposition of Inequalities in Its Prevalence in India: Evidence from NFHS-4

Authors: Ayantika Biswas

Abstract:

Hypertension still remains one of the most important preventable contributors to adult mortality and morbidity and a major public health challenge worldwide. Studying regional and rural-urban differences in prevalence and assessment of the contributions of different indicators is essential in determining the drivers of this condition. The 2015-16 National Family Health Survey data has been used for the study. Bivariate analysis, multinomial regression analysis, concentration indices and decomposition of concentration indices assessing contribution of factors has been undertaken in the present study. An overall concentration index of 0.003 has been found for hypertensive population, which shows its concentration among the richer wealth quintiles. The contribution of factors like age 45 to 49 years, years of schooling between 5 to 9 years are factors that are important contributors to inequality in hypertension occurrence. Studies should be conducted to find approaches to prevent or delay the onset of the condition.

Keywords: hypertension, decomposition, inequalities, India

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7303 Predictors for Success in Methadone Maintenance Treatment Clinic: 24 Years of Experience

Authors: Einat E. Peles, Shaul Schreiber, Miriam Adelson

Abstract:

Background: Since established more than 50 years ago, methadone maintenance treatment (MMT) is the most effective treatment for opioid addiction, a chronic relapsing brain disorder that became an epidemic in western societies. Treatment includes daily individual optimal medication methadone dose (a long acting mu opioid receptor full agonist), accompanied with psychosocial therapy. It is well established that the longer retention in treatment the better outcome and survival occur. It reduces the likelihood to infectious diseases and overdose death that associated with drug injecting, enhanced social rehabilitation and eliminate criminal activity, and lead to healthy productive life. Aim: To evaluate predictors for long term retention in treatment we analyzed our prospective follow up of a major MMT clinic affiliated to a big tertiary medical center. Population Methods: Between June 25, 1993, and June 24, 2016, all 889 patients ( ≥ 18y) who ever admitted to the clinic were prospectively followed-up until May 2017. Duration in treatment from the first admission until the patient quit treatment or until the end of follow-up (24 years) was taken for calculating cumulative retention in treatment using survival analyses (Kaplan Meier) with log-rank and Cox regression for multivariate analyses. Results: Of the 889 patients, 25.2% were females who admitted to treatment at younger age (35.0 ± 7.9 vs. 40.6 ± 9.8, p < .0005), but started opioid usage at same age (22.3 ± 6.9). In addition to opioid use, on admission to MMT 58.5% had positive urine for benzodiazepines, 25% to cocaine, 12.4% to cannabis and 6.9% to amphetamines. Hepatitis C antibody tested positive in 55%, and HIV in 7.8% of the patients and 40%. Of all patients, 75.7% stayed at least one year in treatment, and of them, 67.7% stopped opioid usage (based on urine tests), and a net reduction observed in all other substance abuse (proportion of those who stopped minus proportion of those who have started). Long term retention up to 24 years was 8.0 years (95% Confidence Interval (CI) 7.4-8.6). Predictors for longer retention in treatment (Cox regression) were being older on admission ( ≥ 30y) Odds Ratio (OR) =1.4 (CI 1.1-1.8), not abusing opioids after one year OR=1.8 (CI 1.5-2.1), not abusing benzodiazepine after one year OR=1.7 (CI 1.4-2.1) and treating with methadone dose ≥ 100mg/day OR =1.8 (CI 1.5-2.3). Conclusions: Treating and following patients over 24 years indicate success of two main outcomes, high rate of retention after one year (75.7%) and high proportion of opiate abuse cessation (67.7%). As expected, longer cumulative retention was associated with patients treated with high adequate methadone dose that successfully result in opioid cessation. Based on these findings, in order to reduce morbidity and mortality, we find the establishment of more MMT clinics within a general hospital, a most urgent necessity.

Keywords: methadone maintenance treatment, epidemic, opioids, retention

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7302 Study to Understand the Social Implications of Sexually Transmitted Infections in Patients Belonging to Low Socio-Economic Status

Authors: Rudraksh Kesharwani, Ritika Agarkar

Abstract:

Sexually transmitted diseases are a major public health concern affecting both the mortality and the morbidity of a population. It is among the most serious causes of the diseases affecting the quality of life of a individual leading to a significant decrease in their health. In India, STIs have been a significant public health concern due to various reasons, including a large population, limited access to healthcare in certain areas, stigma around discussing sexual health, and insufficient sex education. Some common STIs in India include HIV/AIDS, syphilis, gonorrhea, chlamydia, and herpes. This research report aims to determine the percentage of people infected with sexually transmitted infections (STI) worrying about it’s impact on their day to day activity, specifically focusing on it’s impact on the mentaland sexual health of the patient infected along with his/her partner.

Keywords: sexual health, mental health, sexually transmitted disease, sexual taboos

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7301 Effect of Non-Fat Solid Ratio on Bloom Formation in Untempered Chocolate

Authors: Huanhuan Zhao, Bryony J. James

Abstract:

The relationship between the non-fat solid ratio and bloom formation in untempered chocolate was investigated using two types of chocolate: model chocolate made of varying cocoa powder ratios (46, 49.5 and 53%) and cocoa butter, and commercial Lindt chocolate with varying cocoa content (70, 85 and 90%). X-ray diffraction and colour measurement techniques were used to examine the polymorphism of cocoa butter and the surface whiteness index (WI), respectively. The polymorphic transformation of cocoa butter was highly correlated with the changes of WI during 30 days of storage since it led to the redistribution of fat within the chocolate matrix and resulted in a bloomed surface. The change in WI indicated a similar bloom rate in the chocolates, but the model chocolates with a higher cocoa powder ratio had more pronounced total bloom. This is due to a higher ratio of non-fat solid particles on the surface resulting in microscopic changes in morphology. The ratio of non-fat solids is an important factor in determining the extent of bloom but not the bloom rate.

Keywords: untempered chocolate, microstructure of bloom, polymorphic transformation, surface whiteness

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7300 Time-Dependent Analysis of Composite Steel-Concrete Beams Subjected to Shrinkage

Authors: Rahal Nacer, Beghdad Houda, Tehami Mohamed, Souici Abdelaziz

Abstract:

Although the shrinkage of the concrete causes undesirable parasitic effects to the structure, it can then harm the resistance and the good appearance of the structure. Long term behaviourmodelling of steel-concrete composite beams requires the use of the time variable and the taking into account of all the sustained stress history of the concrete slab constituting the cross section. The work introduced in this article is a theoretical study of the behaviour of composite beams with respect to the phenomenon of concrete shrinkage. While using the theory of the linear viscoelasticity of the concrete, and on the basis of the rate of creep method, in proposing an analytical model, made up by a system of two linear differential equations, emphasizing the effects caused by shrinkage on the resistance of a steel-concrete composite beams. Results obtained from the application of the suggested model to a steel-concrete composite beam are satisfactory.

Keywords: composite beams, shrinkage, time, rate of creep method, viscoelasticity theory

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7299 Understanding Retail Benefits Trade-offs of Dynamic Expiration Dates (DED) Associated with Food Waste

Authors: Junzhang Wu, Yifeng Zou, Alessandro Manzardo, Antonio Scipioni

Abstract:

Dynamic expiration dates (DEDs) play an essential role in reducing food waste in the context of the sustainable cold chain and food system. However, it is unknown for the trades-off in retail benefits when setting an expiration date on fresh food products. This study aims to develop a multi-dimensional decision-making model that integrates DEDs with food waste based on wireless sensor network technology. The model considers the initial quality of fresh food and the change rate of food quality with the storage temperature as cross-independent variables to identify the potential impacts of food waste in retail by applying s DEDs system. The results show that retail benefits from the DEDs system depend on each scenario despite its advanced technology. In the DEDs, the storage temperature of the retail shelf leads to the food waste rate, followed by the change rate of food quality and the initial quality of food products. We found that the DEDs system could reduce food waste when food products are stored at lower temperature areas. Besides, the potential of food savings in an extended replenishment cycle is significantly more advantageous than the fixed expiration dates (FEDs). On the other hand, the information-sharing approach of the DEDs system is relatively limited in improving sustainable assessment performance of food waste in retail and even misleads consumers’ choices. The research provides a comprehensive understanding to support the techno-economic choice of the DEDs associated with food waste in retail.

Keywords: dynamic expiry dates (DEDs), food waste, retail benefits, fixed expiration dates (FEDs)

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7298 Classical and Bayesian Inference of the Generalized Log-Logistic Distribution with Applications to Survival Data

Authors: Abdisalam Hassan Muse, Samuel Mwalili, Oscar Ngesa

Abstract:

A generalized log-logistic distribution with variable shapes of the hazard rate was introduced and studied, extending the log-logistic distribution by adding an extra parameter to the classical distribution, leading to greater flexibility in analysing and modeling various data types. The proposed distribution has a large number of well-known lifetime special sub-models such as; Weibull, log-logistic, exponential, and Burr XII distributions. Its basic mathematical and statistical properties were derived. The method of maximum likelihood was adopted for estimating the unknown parameters of the proposed distribution, and a Monte Carlo simulation study is carried out to assess the behavior of the estimators. The importance of this distribution is that its tendency to model both monotone (increasing and decreasing) and non-monotone (unimodal and bathtub shape) or reversed “bathtub” shape hazard rate functions which are quite common in survival and reliability data analysis. Furthermore, the flexibility and usefulness of the proposed distribution are illustrated in a real-life data set and compared to its sub-models; Weibull, log-logistic, and BurrXII distributions and other parametric survival distributions with 3-parmaeters; like the exponentiated Weibull distribution, the 3-parameter lognormal distribution, the 3- parameter gamma distribution, the 3-parameter Weibull distribution, and the 3-parameter log-logistic (also known as shifted log-logistic) distribution. The proposed distribution provided a better fit than all of the competitive distributions based on the goodness-of-fit tests, the log-likelihood, and information criterion values. Finally, Bayesian analysis and performance of Gibbs sampling for the data set are also carried out.

Keywords: hazard rate function, log-logistic distribution, maximum likelihood estimation, generalized log-logistic distribution, survival data, Monte Carlo simulation

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7297 Channel Estimation/Equalization with Adaptive Modulation and Coding over Multipath Faded Channels for WiMAX

Authors: B. Siva Kumar Reddy, B. Lakshmi

Abstract:

WiMAX has adopted an Adaptive Modulation and Coding (AMC) in OFDM to endure higher data rates and error free transmission. AMC schemes employ the Channel State Information (CSI) to efficiently utilize the channel and maximize the throughput and for better spectral efficiency. This CSI has given to the transmitter by the channel estimators. In this paper, LSE (Least Square Error) and MMSE (Minimum Mean square Error) estimators are suggested and BER (Bit Error Rate) performance has been analyzed. Channel equalization is also integrated with with AMC-OFDM system and presented with Constant Modulus Algorithm (CMA) and Least Mean Square (LMS) algorithms with convergence rates analysis. Simulation results proved that increment in modulation scheme size causes to improvement in throughput along with BER value. There is a trade-off among modulation size, throughput, BER value and spectral efficiency. Results also reported the requirement of channel estimation and equalization in high data rate systems.

Keywords: AMC, CSI, CMA, OFDM, OFDMA, WiMAX

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7296 Impact of a Novel Technique of S-Shaped Tracheostoma in Pediatric Tracheostomy in Intensive Care Unit on Success and Procedure Related Complications

Authors: Devendra Gupta, Sushilk K. Agarwal, Amit Kesari, P. K. Singh

Abstract:

Objectives: Pediatric patients often may experience persistent respiratory failure that requires tracheostomy placement in Pediatric ICU. We have designed a technique of tracheostomy in pediatric patients with S-shaped incision on the tracheal wall with higher success rate and lower complication rate. Technique: Following general anesthesia and positioning of the patient, the trachea was exposed in midline by a vertical skin incision. In order to make S-shaped tracheostoma, second tracheal ring was identified. The conventional vertical incision was made in second tracheal ring and then extended at both its ends laterally in the inter-cartilaginous space parallel to the tracheal cartilage in the opposite direction to make the incision S-shaped. The trachea was dilated with tracheal dilator and appropriate size of tracheostomy tube was then placed into the trachea. Results: S-shaped tracheostomy was performed in 20 children with mean age of 6.25 years (age range is 2-7) requiring tracheostomy placement. The tracheostomy tubes were successfully placed in all the patients in single attempt. There was no incidence of significant intra-operative bleeding, subcutaneous emphysema, vocal cord palsy or pneumothorax. Two patients developed pneumonia and expired within a year. However, there was no incidence of tracheo-esophageal fistula, suprastomal collapse or difficulty in decannulation on one year of follow up related to our technique. One patient developed late trachietis managed conservatively. Conclusion: S-shaped tracheoplasty was associated with high success rate, reduced risk of the early and late complications in pediatric patients requiring tracheostomy.

Keywords: peatrics, tracheostomy, ICU, tracheostoma

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7295 The Colorectal Cancer in Patients of Eastern Algeria

Authors: S. Tebibel, C. Mechati, S. Messaoudi

Abstract:

Algeria is currently experiencing the same rate of cancer progression as that registered these last years in the western countries. Colorectal cancer, constituting increasingly a major public health problem, is the most common form of cancer after breast and Neck-womb cancer at the woman and prostate cancer at the man. Our work is based on a retrospective study to determine the cases of colorectal cancer through eastern Algeria. Our goal is to carry out an epidemiological, histological and immune- histochemical study to investigate different techniques for the diagnosis of colorectal cancer and their interests and specific in detecting the disease. The study includes 110 patients (aged between 20 to 87 years) with colorectal cancer where the inclusions and exclusions criteria were established. In our study, colorectal cancer, expresses a male predominance, with a sex ratio of 1, 99 and the most affected age group is between 50 and 59 years. We noted that the colon cancer rate is higher than rectal cancer rate, whose frequencies are respectively 60,91 % and 39,09 %. In the series of colon cancer, the ADK lieberkunien is histological the most represented type, or 85,07 % of all cases. In contrast, the proportion of ADK mucinous (colloid mucous) is only 1,49% only. Well-differentiated ADKS, are very significant in our series, they represent 83,58 % of cases. Adenocarcinoma moderately and poorly differentiated, whose proportions are respectively 2,99 % and 0.05 %. For histological varieties of rectal ADK, we see in our workforce that ADK lieberkunien represent the most common histological form, or 76,74%, while the mucosal colloid is 13,95 %. Research of the mutation on the gene encoding K-ras, a major step in the targeted therapy of colorectal cancers, is underway in our study. Colorectal cancer is the subject of much promising research concern: the evaluation of new therapies (antiangiogenic monoclonal antibodies), the search for predictors of sensitivity to chemotherapy and new prognostic markers using techniques of molecular biology and proteomics.

Keywords: adenocarcinoma, age, colorectal cancer, epidemiology, histological section, sex

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7294 Analysis of the Effects of Institutions on the Sub-National Distribution of Aid Using Geo-Referenced AidData

Authors: Savas Yildiz

Abstract:

The article assesses the performance of international aid donors to determine the sub-national distribution of their aid projects dependent on recipient countries’ governance. The present paper extends the scope from a cross-country perspective to a more detailed analysis by looking at the effects of institutional qualities on the sub-national distribution of foreign aid. The analysis examines geo-referenced aid project in 37 countries and 404 regions at the first administrative division level in Sub-Saharan Africa from the World Bank (WB) and the African Development Bank (ADB) that were approved between the years 2000 and 2011. To measure the influence of institutional qualities on the distribution of aid the following measures are used: control of corruption, government effectiveness, regulatory quality and rule of law from the World Governance Indicators (WGI) and the corruption perception index from Transparency International. Furthermore, to assess the importance of ethnic heterogeneity on the sub-national distribution of aid projects, the study also includes interaction terms measuring ethnic fragmentation. The regression results indicate a general skew of aid projects towards regions which hold capital cities, however, being incumbent presidents’ birth region does not increase the allocation of aid projects significantly. Nevertheless, with increasing quality of institutions aid projects are less skewed towards capital regions and the previously estimated coefficients loose significance in most cases. Higher ethnic fragmentation also seems to impede the possibility to allocate aid projects mainly in capital city regions and presidents’ birth places. Additionally, to assess the performance of the WB based on its own proclaimed goal to aim the poor in a country, the study also includes sub-national wealth data from the Demographic and Health Surveys (DSH), and finds that, even with better institutional qualities, regions with a larger share from the richest quintile receive significantly more aid than regions with a larger share of poor people. With increasing ethnic diversity, the allocation of aid projects towards regions where the richest citizens reside diminishes, but still remains high and significant. However, regions with a larger share of poor people still do not receive significantly more aid. This might imply that the sub-national distribution of aid projects increases in general with higher ethnic fragmentation, independent of the diverse regional needs. The results provide evidence that institutional qualities matter to undermine the influence of incumbent presidents on the allocation of aid projects towards their birth regions and capital regions. Moreover, even for countries with better institutional qualities the WB and the ADB do not seem to be able to aim the poor in a country with their aid projects. Even, if one considers need-based variables, such as infant mortality and child mortality rates, aid projects do not seem to be allocated in districts with a larger share of people in need. Therefore, the study provides further evidence using more detailed information on the sub-national distribution of aid projects that aid is not being allocated effectively towards regions with a larger share of poor people to alleviate poverty in recipient countries directly. Institutions do not have any significant influence on the sub-national distribution of aid towards the poor.

Keywords: aid allocation, georeferenced data, institutions, spatial analysis

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7293 Effect of Migrant Influx toward Betterment of Aging and Low Fertility Rate: Statistical Analyses in Japan

Authors: Sari K. Ishii

Abstract:

This study considers a wider viewpoint to connect migration studies with questions about financial capitalism, which seeks cheap, disposable labour transnationally. This study offers insight into whether the current state of immigration acceptance contributes to stabilizing the aging society of the nation in the long term or merely fulfills the ephemeral requirements of industries. The analyses in this study focused on three aspects. First, it examined how many migrants in Japan joined the labour market. Second, it analyzed the number of migrants that are aging. Third, it determined the number of dependent migrants accepted through labour migrants. The study findings raise further questions for future empirical studies to verify the schema of financial capitalism through the lens of migration. The scheme of seeking cheap, disposable labour transnationally may result in the descendants of both locals and mobilized labour becoming more unstable than the prior generations.

Keywords: migration, aging society, low fertility rate, Japan

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7292 Corrosion Behavior of Fe-Ni-Cr and Zr Alloys in Supercritical Water Reactors

Authors: Igor Svishchev, Kashif Choudhry

Abstract:

Progress in advanced energy technologies is not feasible without understanding how engineering materials perform under extreme environmental conditions. The corrosion behaviour of Fe-Ni-Cr and Zr alloys has been systematically examined under high-temperature and supercritical water flow conditions. The changes in elemental release rate and dissolved gas concentration provide valuable insights into the mechanism of passivation by forming oxide films. A non-intrusive method for monitoring the extent of surface oxidation based on hydrogen release rate has been developed. This approach can be used for the on-line monitoring corrosion behavior of reactor materials without the need to interrupt the flow and remove corrosion coupons. Surface catalysed thermochemical reactions may generate sufficient hydrogen to have an effect on the accumulation of oxidizing species generated by radiolytic processes in the heat transport systems of the supercritical water cooled nuclear reactor.

Keywords: high-temperature corrosion, non-intrusive monitoring, reactor materials, supercritical water

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7291 Seroprevalence of Cytomegalovirus among Pregnant Women in Islamabad, Pakistan

Authors: Hassan Waseem

Abstract:

Cytomegalovirus (CMV) is ubiquitously distributed viral agent responsible for different clinical manifestations that may vary according to the immunologic status of the patient. CMV can cause morbidity and mortality among fetuses and patients with compromised immune system. A cross-sectional study was carried out in Islamabad to investigate the prevalence and risk factors associated with CMV infection among pregnant women. Blood samples of 172 pregnant women visiting Mother and Child Healthcare, Pakistan Institute of Medical Sciences (PIMS) Islamabad were taken. In present study, serum samples of the women were checked for CMV-specific IgG and IgM antibodies by enzyme linked immunosorbent assay (ELISA). Clinical, obstetrical and socio-demographical characteristics of the women were collected by using structured questionnaires. Out of 172 pregnant women included in the study, 171 (99.4%) were CMV specific IgG positive and 30 (17.4%) were found positive for CMV-IgM antibodies. The CMV has taken an endemic form in Pakistan so, routine screening of CMV among pregnant women is recommended.

Keywords: Cytomegalovirus, blood transfusion, ELISA, seroprevalence

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7290 Occupational Stress in Nurses of a Maternity Ward in Lubango, Angola

Authors: Lídia Chienda, Tchilissila A. Simoes

Abstract:

Angola is known for the low quality of maternal health services, registering one of the highest maternal and child mortality of Africa. Working in these health facilities may be of great challenge for health professionals. In this study, we aimed to identify the presence of occupational stress in 76 nurses working in a maternity ward in Lubango, Southern Angola. The participants completed the Health Professional Stress Questionnaire and reported a moderate and high level of stress. To these individuals, 'receiving a low salary,' 'inadequate/insufficient salary,' 'overwork or very demanding work' and 'working long hours in a row' seemed to be the main indicators of occupational stress. Moreover, there was an influence of the work overload, the remuneration earned, the career, and family conflicts in the occupational stress index. These results contributed to a better understanding of the difficulties Angolan nurses are facing and the need to implement policies that envisage the wellbeing of this population.

Keywords: Africa, maternity wards, nursing, occupational stress

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7289 Contributions of Search and Rescue to the World Peace

Authors: Dursun Kalebaşi

Abstract:

When we examine the history of mankind (from the past up to the present), we see that millions of people died because of the wars. Especially, since the beginning of 19th century, the increase of the human death rate is caused mostly by the regional conflicts and natural disasters rather than the wars. From that point of view, the biggest threat humanity face today is temperature increase and climate change that started to emerge in recent years. When we take into account the natural disasters on one hand and refuges that flee from regional conflicts on the other, it stands out as a dramatic situation because of the huge human losses. In this context, most of the countries started to give more importance to Search and Rescue (SAR) operations to stop the loss of lives or decrease the death rate. This article will tell about the SAR activities in Turkey since 2000 and discuss the Turkey’s contributions to Rescue Missions after the natural disasters in different parts of the world. Moreover, there will be some new highlights to a more habitable and more peaceful world through the SAR missions.

Keywords: search and rescue, natural disasters, migration and world peace, Turkish army forces

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7288 Association between G2677T/A MDR1 Polymorphism with the Clinical Response to Disease Modifying Anti-Rheumatic Drugs in Rheumatoid Arthritis

Authors: Alan Ruiz-Padilla, Brando Villalobos-Villalobos, Yeniley Ruiz-Noa, Claudia Mendoza-Macías, Claudia Palafox-Sánchez, Miguel Marín-Rosales, Álvaro Cruz, Rubén Rangel-Salazar

Abstract:

Introduction: In patients with rheumatoid arthritis, resistance or poor response to disease modifying antirheumatic drugs (DMARD) may be a reflection of the increase in g-P. The expression of g-P may be important in mediating the effluence of DMARD from the cell. In addition, P-glycoprotein is involved in the transport of cytokines, IL-1, IL-2 and IL-4, from normal lymphocytes activated to the surrounding extracellular matrix, thus influencing the activity of RA. The involvement of P-glycoprotein in the transmembrane transport of cytokines can serve as a modulator of the efficacy of DMARD. It was shown that a number of lymphocytes with glycoprotein P activity is increased in patients with RA; therefore, P-glycoprotein expression could be related to the activity of RA and could be a predictor of poor response to therapy. Objective: To evaluate in RA patients, if the G2677T/A MDR1 polymorphisms is associated with differences in the rate of therapeutic response to disease-modifying antirheumatic agents in patients with rheumatoid arthritis. Material and Methods: A prospective cohort study was conducted. Fifty seven patients with RA were included. They had an active disease according to DAS-28 (score >3.2). We excluded patients receiving biological agents. All the patients were followed during 6 months in order to identify the rate of therapeutic response according to the American College of Rheumatology (ACR) criteria. At the baseline peripheral blood samples were taken in order to identify the G2677T/A MDR1 polymorphisms using PCR- Specific allele. The fragment was identified by electrophoresis in polyacrylamide gels stained with ethidium bromide. For statistical analysis, the genotypic and allelic frequencies of MDR1 gene polymorphism between responders and non-responders were determined. Chi-square tests as well as, relative risks with 95% confidence intervals (95%CI) were computed to identify differences in the risk for achieving therapeutic response. Results: RA patients had a mean age of 47.33 ± 12.52 years, 87.7% were women with a mean for DAS-28 score of 6.45 ± 1.12. At the 6 months, the rate of therapeutic response was 68.7 %. The observed genotype frequencies were: for G/G 40%, T/T 32%, A/A 19%, G/T 7% and for A/A genotype 2%. Patients with G allele developed at 6 months of treatment, higher rate for therapeutic response assessed by ACR20 compared to patients with others alleles (p=0.039). Conclusions: Patients with G allele of the - G2677T/A MDR1 polymorphisms had a higher rate of therapeutic response at 6 months with DMARD. These preliminary data support the requirement for a deep evaluation of these and other genotypes as factors that may influence the therapeutic response in RA.

Keywords: pharmacogenetics, MDR1, P-glycoprotein, therapeutic response, rheumatoid arthritis

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7287 Factors Associated with Self-Rated Health among Persons with Disabilities: A Korean National Survey

Authors: Won-Seok Kim, Hyung-Ik Shin

Abstract:

Self-rated health (SRH) is a subjective assessment of individual health and has been identified as a strong predictor for mortality and morbidity. However few studies have been directed to the factors associated with SRH in persons with disabilities (PWD). We used data of 7th Korean national survey for 5307 PWD in 2008. Multiple logistic regression analysis was performed to find out independent risk factors for poor SRH in PWD. As a result, indicators of physical condition (poor instrumental ADL), socioeconomic disadvantages (poor education, economically inactive, low self-rated social class, medicaid in health insurance, presence of unmet need for hospital use) and social participation and networks (no use of internet service) were selected as independent risk factors for poor SRH in final model. Findings in the present study would be helpful in making a program to promote the health and narrow the gap of health status between the PWD.

Keywords: disabilities, risk factors, self-rated health, socioeconomic disadvantages, social networks

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7286 Effect of Segregation on the Reaction Rate of Sewage Sludge Pyrolysis in a Bubbling Fluidized Bed

Authors: A. Soria-Verdugo, A. Morato-Godino, L. M. García-Gutiérrez, N. García-Hernando

Abstract:

The evolution of the pyrolysis of sewage sludge in a fixed and a fluidized bed was analyzed using a novel measuring technique. This original measuring technique consists of installing the whole reactor over a precision scale, capable of measuring the mass of the complete reactor with enough precision to detect the mass released by the sewage sludge sample during its pyrolysis. The inert conditions required for the pyrolysis process were obtained supplying the bed with a nitrogen flowrate, and the bed temperature was adjusted to either 500 ºC or 600 ºC using a group of three electric resistors. The sewage sludge sample was supplied through the top of the bed in a batch of 10 g. The measurement of the mass released by the sewage sludge sample was employed to determine the evolution of the reaction rate during the pyrolysis, the total amount of volatile matter released, and the pyrolysis time. The pyrolysis tests of sewage sludge in the fluidized bed were conducted using two different bed materials of the same size but different densities: silica sand and sepiolite particles. The higher density of silica sand particles induces a flotsam behavior for the sewage sludge particles which move close to the bed surface. In contrast, the lower density of sepiolite produces a neutrally-buoyant behavior for the sewage sludge particles, which shows a proper circulation throughout the whole bed in this case. The analysis of the evolution of the pyrolysis process in both fluidized beds show that the pyrolysis is faster when buoyancy effects are negligible, i.e. in the bed conformed by sepiolite particles. Moreover, sepiolite was found to show an absorbent capability for the volatile matter released during the pyrolysis of sewage sludge.

Keywords: bubbling fluidized bed, pyrolysis, reaction rate, segregation effects, sewage sludge

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7285 Effectiveness Factor for Non-Catalytic Gas-Solid Pyrolysis Reaction for Biomass Pellet Under Power Law Kinetics

Authors: Haseen Siddiqui, Sanjay M. Mahajani

Abstract:

Various important reactions in chemical and metallurgical industries fall in the category of gas-solid reactions. These reactions can be categorized as catalytic and non-catalytic gas-solid reactions. In gas-solid reaction systems, heat and mass transfer limitations put an appreciable influence on the rate of the reaction. The consequences can be unavoidable for overlooking such effects while collecting the reaction rate data for the design of the reactor. Pyrolysis reaction comes in this category that involves the production of gases due to the interaction of heat and solid substance. Pyrolysis is also an important step in the gasification process and therefore, the gasification reactivity majorly influenced by the pyrolysis process that produces the char, as a feed for the gasification process. Therefore, in the present study, a non-isothermal transient 1-D model is developed for a single biomass pellet to investigate the effect of heat and mass transfer limitations on the rate of pyrolysis reaction. The obtained set of partial differential equations are firstly discretized using the concept of ‘method of lines’ to obtain a set of ordinary differential equation with respect to time. These equations are solved, then, using MATLAB ode solver ode15s. The model is capable of incorporating structural changes, porosity variation, variation in various thermal properties and various pellet shapes. The model is used to analyze the effectiveness factor for different values of Lewis number and heat of reaction (G factor). Lewis number includes the effect of thermal conductivity of the solid pellet. Higher the Lewis number, the higher will be the thermal conductivity of the solid. The effectiveness factor was found to be decreasing with decreasing Lewis number due to the fact that smaller Lewis numbers retard the rate of heat transfer inside the pellet owing to a lower rate of pyrolysis reaction. G factor includes the effect of the heat of reaction. Since the pyrolysis reaction is endothermic in nature, the G factor takes negative values. The more the negative value higher will be endothermic nature of the pyrolysis reaction. The effectiveness factor was found to be decreasing with more negative values of the G factor. This behavior can be attributed to the fact that more negative value of G factor would result in more energy consumption by the reaction owing to a larger temperature gradient inside the pellet. Further, the analytical expressions are also derived for gas and solid concentrations and effectiveness factor for two limiting cases of the general model developed. The two limiting cases of the model are categorized as the homogeneous model and unreacted shrinking core model.

Keywords: effectiveness factor, G-factor, homogeneous model, lewis number, non-catalytic, shrinking core model

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7284 A Comparative Study of the Impact of the Total Fertility Rate (TFR) on Trends in the Second Demographic Transition in Rwanda

Authors: Etienne Gatera

Abstract:

Many studies have been conducted on SDT. Most of them focus on developed countries because of influencing factors such as; education, health, labor force, female labor force participation, industrialization, urbanization and migration. However, this thesis project paper aims to assess the impact of the total fertility rate (TFR) on the trends of the SDR in Rwanda. We will mainly be based in Rwanda after the 1994 genocide. Rwanda is located in East Africa, with approximately 13 million inhabitants. Thus, after the 1994 Tutsi genocide. The population growth rate exploded out of control with 6.17 children per woman in 1995. However, it's declined to 4.2 in 2014-2015 and declining to 4.1% in 2019-2020. Respectively with 3.4 children per woman in urban areas and 4.3 in rural areas. According to the National Institute of Statistics of Rwanda. Rwanda's population is expected to continue to grow for the rest of the century and reach 33.35 million people in 2099, with 2.1 children per woman in 2050. However, this project document aims to demonstrate the impact of the TFR on SDT trends in Rwanda. Thus, the decline in the TFR in Rwanda began with the introduction of family planning practices, which now account for 47.5% in 2019. Childbearing with three children for rural women compared to two children in the city, the increase in Divorce and separation caused by the behavior called "Kuza n'ijoro" or "coming at night" similar to cohabitation in developed countries. The decline in remarriage is caused by single mothers behavior who prefer to raise their children rather than remarry. Therefore, the study used probability sampling with (Stratified random sampling) method with a survey questionnaire of 1067 respondents in the 5 Districts (3 in rural areas and two in urban areas), with the target group of women Age between 15-49. The study demonstrated that the age of marriage in rural areas is two years higher than in urban areas. Divorce is more common in urban is with 6.2% with 5.2% in rural areas. However, separation is more common in rural areas than in urban areas, with a lower rate of 3%, due to the higher system called "Kuza n'ijoro" or "come at night", similar to cohabitation in developed countries. The study revealed that more than 85% of divorced people prefer to remain single, which confirms the low remarriage rate. Childbearing has started to decrease, especially for young singles in urban areas, due to the economic situation, with national statistics showing that unemployment in the youth community is still 16% higher. Therefore, the study concluded by confirming the hypothesis based on the results of the TFR indicators such as marriage, remarriage, divorce, separation, divorce, Kuza n'ijoro, childbearing] and abortion. The study consists of four sections, an introduction and background, a review of the literature, a description of the data and methodology, an analysis of the data, discussion results and a conclusion.

Keywords: Kuza n'ijoro, Rwanda, second demographic transition (SDT), total fertility rate (TFR)

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7283 Nutrients Removal Control via an Intermittently Aerated Membrane Bioreactor

Authors: Junior B. N. Adohinzin, Ling Xu

Abstract:

Nitrogen is among the main nutrients encouraging the growth of organic matter and algae which cause eutrophication in water bodies. Therefore, its removal from wastewater has become a worldwide emerging concern. In this research, an innovative Membrane Bioreactor (MBR) system named “moving bed membrane bioreactor (MBMBR)” was developed and investigated under intermittently-aerated mode for simultaneous removal of organic carbon and nitrogen. Results indicated that the variation of the intermittently aerated duration did not have an apparent impact on COD and NH4+–N removal rate, yielding the effluent with average COD and NH4+–N removal efficiency of more than 92 and 91% respectively. However, in the intermittently aerated cycle of (continuously aeration/0s mix), (aeration 90s/mix 90s) and (aeration 90s/mix 180s); the average TN removal efficiency was 67.6%, 69.5% and 87.8% respectively. At the same time, their nitrite accumulation rate was 4.5%, 49.1% and 79.4% respectively. These results indicate that the intermittently aerated mode is an efficient way to controlling the nitrification to stop at nitrition; and also the length of anoxic duration is a key factor in improving TN removal.

Keywords: membrane bioreactor (MBR), moving bed biofilm reactor (MBBR), nutrients removal, simultaneous nitrification and denitrification

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7282 Factors Associated with Recruitment and Adherence for Virtual Mindfulness Interventions in Youths

Authors: Kimberly Belfry, Shavon Stafford, Fariha Chowdhury, Jennifer Crawford, Soyeon Kim

Abstract:

Intervention programs are mostly delivered online during the pandemic. Screen fatigue has become a significant deterrent for virtually-deliveredinterventions, and thus, we aimed to examine factors associated with recruitment and adherence toan online mindfulness program for youths. Our preliminary analysis indicated that 40% of interested youths enrolled in the program. No difference in gender and age was found for those enrolled in the program. Adherence rate was approximately 25%, which warrants further examination. Grounding on the preliminary findings, we will conduct a binary logistic regression analysis to identify elements associated with recruitment and adherence. The model will include predictors such as age, sex, recruiter, mental health status, time of the year. Odds ratios and 95% CI will be reported. Our preliminary analysis showed low recruitment and adherence rate. By identifying elements associated with recruitment and adherence, our study provides transferrable information that can improve recruitment and adherence of online-delivered interventions offered during the pandemic.

Keywords: virtual interventions, recruitment, youth, mindfulness

Procedia PDF Downloads 149
7281 Estimating Interdependence of Social Statuses in a Cooperative Breeding Birds through Mathematical Modelling

Authors: Sinchan Ghosh, Fahad Al Basir, Santanu Ray, Sabyasachi Bhattacharya

Abstract:

The cooperatively breeding birds have two major ranks for the sexually mature birds. The breeders mate and produce offspring while the non-breeding helpers increase the chick production rate through help in mate-finding and allo-parenting. However, the chicks also cooperate to raise their younger siblings through warming, defending and food sharing. Although, the existing literatures describes the evolution of allo-parenting in birds but do not differentiate the significance of allo-parenting in sexually immature and mature helpers separately. This study addresses the significance of both immature and mature helpers’ contribution to the total sustainable bird population in a breeding site using Blue-tailed bee-eater as a test-bed species. To serve this purpose, a mathematical model has been built considering each social status and chicks as separate but interactive compartments. Also, to observe the dynamics of each social status with changing prey abundance, a prey population has been introduced as an additional compartment. The model was analyzed for stability condition and was validated using field-data. A simulation experiment was then performed to observe the change in equilibria with a varying helping rate from both the helpers. The result from the simulation experiment suggest that the cooperative breeding population changes its population sizes significantly with a change in helping rate from the sexually immature helpers. On the other hand, the mature helpers do not contribute to the stability of the population equilibrium as much as the immature helpers.

Keywords: Blue-tailed bee eater, Altruism, Mathematical Ethology, Behavioural modelling

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7280 Low-Cost Embedded Biometric System Based on Fingervein Modality

Authors: Randa Boukhris, Alima Damak, Dorra Sellami

Abstract:

Fingervein biometric authentication is one of the most popular and accurate technologies. However, low cost embedded solution is still an open problem. In this paper, a real-time implementation of fingervein recognition process embedded in Raspberry-Pi has been proposed. The use of Raspberry-Pi reduces overall system cost and size while allowing an easy user interface. Implementation of a target technology has guided to opt some specific parallel and simple processing algorithms. In the proposed system, we use four structural directional kernel elements for filtering finger vein images. Then, a Top-Hat and Bottom-Hat kernel filters are used to enhance the visibility and the appearance of venous images. For feature extraction step, a simple Local Directional Code (LDC) descriptor is applied. The proposed system presents an Error Equal Rate (EER) and Identification Rate (IR), respectively, equal to 0.02 and 98%. Furthermore, experimental results show that real-time operations have good performance.

Keywords: biometric, Bottom-Hat, Fingervein, LDC, Rasberry-Pi, ROI, Top-Hat

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7279 Muscle and Cerebral Regional Oxygenation in Preterm Infants with Shock Using Near-Infrared Spectroscopy

Authors: Virany Diana, Martono Tri Utomo, Risa Etika

Abstract:

Background: Shock is one severe condition that can be a major cause of morbidity and mortality in the Neonatal Intensive Care Unit. Preterm infants are very susceptible to shock caused by many complications such as asphyxia, patent ductus arteriosus, intra ventricle haemorrhage, necrotizing enterocolitis, persistent pulmonal hypertension of the newborn, and septicaemia. Limited hemodynamic monitoring for early detection of shock causes delayed intervention and comprises the outcomes. Clinical parameters still used in neonatal shock detection, such as Capillary Refill Time, heart rate, cold extremity, and urine production. Blood pressure is most frequently used to evaluate preterm's circulation, but hypotension indicates uncompensated shock. Near-infrared spectroscopy (NIRS) is known as a noninvasive tool for monitoring and detecting the state of inadequate tissue perfusion. Muscle oxygen saturation shows decreased cardiac output earlier than systemic parameters of tissue oxygenation when cerebral regional oxygen saturation is still stabilized by autoregulation. However, to our best knowledge, until now, no study has analyzed the decrease of muscle oxygen regional saturation (mRSO₂) and the ratio of muscle and cerebral oxygen regional saturation (mRSO₂/cRSO₂) by NIRS in preterm with shock. Purpose: The purpose of this study is to analyze the decrease of mRSO₂ and ratio of muscle to cerebral oxygen regional saturation (mRSO₂/cRSO₂) by NIRS in preterm with shock. Patients and Methods: This cross-sectional study was conducted on preterm infants with 28-34 weeks gestational age, admitted to the NICU of Dr. Soetomo Hospital from November to January 2022. Patients were classified into two groups: shock and non-shock. The diagnosis of shock is based on clinical criteria (tachycardia, prolonged CRT, cold extremity, decreased urine production, and MAP Blood Pressure less than GA in weeks). Measurement of mRSO₂ and cRSO₂ by NIRS was performed by the doctor in charge when the patient came to NICU. Results: We enrolled 40 preterm infants. The initial conventional hemodynamic parameter as the basic diagnosis of shock showed significant differences in all variables. Preterm with shock had higher mean HR (186.45±1.5), lower MAP (29.8±2.1), and lower SBP (45.1±4.28) than non-shock children, and most had a prolonged CRT. The patients’ outcome was not a significant difference between shock and non-shock patients. The mean mRSO₂ in the shock and non-shock groups were 33,65 ± 11,32 vs. 69,15 ± 3,96 (p=0.001), and the mean ratio mRSO₂/cRSO₂ 0,45 ± 0,12 vs. 0,84 ± 0,43 (p=0,001), were significantly different. The mean cRSO₂ in the shock and non-shock groups were 71,60 ± 4,90 vs. 81,85 ± 7,85 (p 0.082), not significantly different. Conclusion: The decrease of mRSO₂ and ratio of mRSO₂/cRSO₂ can differentiate between shock and non-shock in the preterm infant when cRSO₂ is still normal.

Keywords: preterm infant, regional muscle oxygen saturation, regional cerebral oxygen saturation, NIRS, shock

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7278 Microbiological Profile and Surgical Outcomes of Microbial Keratitis Associated Endophthalmitis

Authors: Prachi Abhishek Dave, Manisha Singh

Abstract:

Purpose: The purpose is to study the microbiological profile, prognostic factors, and outcomes of surgery for microbial keratitis (MK) associated endophthalmitis. Methods: It is a retrospective analysis of 39 MK associated endophthalmitis cases which underwent combined PKP with VR surgery. Results: The majority (84.6%) of patients had a history of previous ocular surgery, cataract surgery being the most common (51.2%). Six patients had a history of trauma and 8 patients had corneal graft infection. The culture positivity rate was 92.3%. Organisms isolated were Streptococcal sp (20.5%), Pseudomonas (15.3%), Staphylococcal sp (12.8%) and Fungus (35.8%). Final visual acuities ranged from NPL to 20/120. Poor anatomic success was seen in 15(38.46%) eyes (9-phthisis, 6-eviscerated). Fungal cases had a poor success rate (P-0.02). Conclusion: MK associated endophthalmitis is a sight threatening ocular condition. Fungal etiology carries a poorer prognosis. Timely surgical intervention can achieve favourable anatomical and functional results.

Keywords: endophthalmitis, microbial keratitis, penetrating keratoplasty, vitreo retinal surgery

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7277 Hydrology and Hydraulics Analysis of Aremenie Earthen Dam, Ethiopia

Authors: Azazhu Wassie

Abstract:

This study tried to analyze the impact of the hydrologic and hydraulic parameters (catchment area, rainfall intensity, and runoff coefficient) on the referenced study area. The study was conducted in June 2023. The Aremenie River Dam has 30 years of record, which is reasonably sufficient data. It is a matter of common experience that, due to the failure of an instrument or the absence of a gauged river, the rainfall record at quite a number of stations is incomplete. From the analysis, the 50-year return period design flood is 62.685 m³/s at 1.2 hr peak time. This implies that for this watershed, the peak flood rate per km² area of the watershed is about this value, which ensures that high rainfall in the area can generate a higher rate of runoff per km² of the generating catchment. The Aremenie Rivers carry a large amount of sediment along with water. These sediments are deposited in the reservoir upstream of the dam because of the reduction in velocity. Sediment reduces the available capacity of the reservoir with continuous sedimentation; the useful life of the reservoir goes on decreasing.

Keywords: dam design, peak flood, rainfall, reservoir capacity, runoff

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7276 Using the Micro Computed Tomography to Study the Corrosion Behavior of Magnesium Alloy at Different pH Values

Authors: Chia-Jung Chang, Sheng-Che Chen, Ming-Long Yeh, Chih-Wei Wang, Chih-Han Chang

Abstract:

Introduction and Motivation: In recent years, magnesium alloy is used to be a kind of medical biodegradable materials. Magnesium is an essential element in the body and is efficiently excreted by the kidneys. Furthermore, the mechanical properties of magnesium alloy is closest to human bone. However, in some cases magnesium alloy corrodes so quickly that it would release hydrogen on surface of implant. The other product is hydroxide ion, it can significantly increase the local pH value. The above situations may have adverse effects on local cell functions. On the other hand, nowadays magnesium alloy corrode too fast to maintain the function of implant until the healing of tissue. Therefore, much recent research about magnesium alloy has focused on controlling the corrosion rate. The in vitro corrosion behavior of magnesium alloys is affected by many factors, and pH value is one of factors. In this study, we will study on the influence of pH value on the corrosion behavior of magnesium alloy by the Micro-CT (micro computed tomography) and other instruments.Material and methods: In the first step, we make some guiding plates for specimens of magnesium alloy AZ91 by Rapid Prototyping. The guiding plates are able to be a standard for the degradation of specimen, so that we can use it to make sure the position of specimens in the CT image. We can also simplify the conditions of degradation by the guiding plates.In the next step, we prepare the solution with different pH value. And then we put the specimens into the solution to start the corrosion test. The CT image, surface photographs and weigh are measured on every twelve hours. Results: In the primary results of the test, we make sure that CT image can be a way to quantify the corrosion behavior of magnesium alloy. Moreover we can observe the phenomenon that corrosion always start from some erosion point. It’s possibly based on some defect like dislocations and the voids with high strain energy in the materials. We will deal with the raw data into Mass Loss (ML) and corrosion rate by CT image, surface photographs and weigh in the near future. Having a simple prediction, the pH value and degradation rate will be negatively correlated. And we want to find out the equation of the pH value and corrosion rate. We also have a simple test to simulate the change of the pH value in the local region. In this test the pH value will rise to 10 in a short time. Conclusion: As a biodegradable implant for the area with stagnating body fluid flow in the human body, magnesium alloy can cause the increase of local pH values and release the hydrogen. Those may damage the human cell. The purpose of this study is finding out the equation of the pH value and corrosion rate. After that we will try to find the ways to overcome the limitations of medical magnesium alloy.

Keywords: magnesium alloy, biodegradable materials, corrosion, micro-CT

Procedia PDF Downloads 457