Search results for: Negative Poisson’s Ratio

Authors: Helen S. Ghali, Engy Serag, A. Samer Ezeldin

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In many countries, the construction industry relies heavily on outsourcing models in executing their projects and expanding their businesses to fit in the diverse market. Such extensive integration of subcontractors is becoming an influential factor in contractor’s cash flow management. Accordingly, subcontractors’ financial terms are important phenomena and pivotal components for the well-being of the contractor’s cash flow. The aim of this research is to study the contractor’s cash flow with respect to the owner and subcontractor’s payment management plans, considering variable advance payment, payment frequency, and lag and retention policies. The model is developed to provide contractors with a decision support tool that can assist in selecting the optimum subcontracting plan to minimize the contractor’s financing limits and optimize the profit values. The model is built using Microsoft Excel VBA coding, and the genetic algorithm is utilized as the optimization tool. Three objective functions are investigated, which are minimizing the highest negative overdraft value, minimizing the net present worth of overdraft, and maximizing the project net profit. The model is validated on a full-scale project which includes both self-performed and subcontracted work packages. The results show potential outputs in optimizing the contractor’s negative cash flow values and, in the meantime, assisting contractors in selecting suitable subcontractors to achieve the objective function.

Keywords: cash flow optimization, payment plan, procurement management, subcontracting plan

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Authors: Hee-Chang Lim

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The study aims to understand the surface pressure distribution around the bodies such as the suction pressure in the leading edge on the top and side-face when the aspect ratio of bodies and the wind direction are changed, respectively. We carried out the wind tunnel measurement and numerical simulation around a series of rectangular bodies (40^d×80^w×80^h, 80^d×80^w×80^h, 160^d×80^w×80^h, 80^d×40^w×80^h and 80^d×160^w×80^h in mm³) placed in a deep turbulent boundary layer. Based on a modern numerical platform, the Navier-Stokes equation with the typical 2-equation (k-ε model) and the DES (Detached Eddy Simulation) turbulence model has been calculated, and they are both compared with the measurement data. Regarding the turbulence model, the DES model makes a better prediction comparing with the k-ε model, especially when calculating the separated turbulent flow around a bluff body with sharp edged corner. In order to observe the effect of wind direction on the pressure variation around the cube (e.g., 80^d×80^w×80^h in mm), it rotates at 0º, 10º, 20º, 30º, and 45º, which stands for the salient wind directions in the tunnel. The result shows that the surface pressure variation is highly dependent upon the approaching wind direction, especially on the top and the side-face of the cube. In addition, the transverse width has a substantial effect on the variation of surface pressure around the bodies, while the longitudinal length has little or no influence.

Keywords: rectangular bodies, wind direction, aspect ratio, surface pressure distribution, wind-tunnel measurement, k-ε model, DES model, CFD

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Authors: Yao Song, Danni Cheng, Jianjun Ren

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Objectives: We aimed to explore the prognostic effects of absolute values and dynamic changes of common hematological indices on oropharynx squamous cell carcinoma (OPSCC) patients treated with radiation. Methods and materials: The absolute values of white blood cell (WBC), absolute neutrophil count (ANC), absolute lymphocyte count (ALC), hemoglobin (Hb), platelet (Plt), albumin (Alb), neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) at baseline (within 45 days before radiation), 1-, 3-, 6- and 12-months after the start of radiotherapy were retrospectively collected. Locally-estimated smoothing scatterplots were used to describe the smooth trajectory of each index. A mixed-effect model with a random slope was fitted to describe the changing rate and trend of indices over time. Cox proportional hazard analysis was conducted to assess the correlation between hematological indices and treatment outcomes. Results: Of the enrolled 85 OPSCC patients, inflammatory indices, such as WBC and ALC, dropped rapidly during acute treatment and gradually recovered, while NLR and PLR increased at first three months and subsequently declined within 3-12 months. Higher absolute value or increasing trend of nutritional indices (Alb and Hb) was associated with better prognosis (all p<0.05). In contrast, patients with higher absolute value or upward trend of inflammatory indices (WBC, ANC, Plt, PLR and NLR) had worse survival (all p<0.05). Conclusions: The absolute values and dynamic changes of hematological indices were valuable prognostic factors for OPSCC patients who underwent radiotherapy.

Keywords: hematological indices, oropharyngeal cancer, radiotherapy, NLR, PLR

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Authors: Bashar Tarawneh, Yasser Hakam

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Rapid Impact Compaction (RIC) is a modern dynamic compaction device mainly used to compact sandy soils, where silt and clay contents are low. The device uses the piling hammer technology to increase the bearing capacity of soils through controlled impacts. The RIC device uses "controlled impact compaction" of the ground using a 9-ton hammer dropped from the height between 0.3 m to 1.2 m onto a 1.5 m diameter steel patent foot. The delivered energy is about 26,487 to 105,948 Joules per drop. To evaluate the performance of this technique, three project sites in the United Arab Emirates were improved using RIC. In those sites, a loose to very loose fine to medium sand was encountered at a depth ranging from 1.0m to 4.0m below the ground level. To evaluate the performance of the RIC, Cone Penetration Tests (CPT) were carried out before and after improvement. Also, load tests were carried out post-RIC work to assess the settlements and bearing capacity. The soil was improved to a depth of about 5.0m below the ground level depending on the CPT friction ratio (the ratio between sleeve friction and tip resistance). CPT tip resistance was significantly increased post ground improvement work. Load tests showed enhancement in the soil bearing capacity and reduction in the potential settlements. This study demonstrates the successful application of the RIC for middle-deep improvement and compaction of the ground. Foundation design criteria were achieved in all site post-RIC work.

Keywords: compaction, RIC, ground improvement, CPT

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Authors: Vijay Reena Durai, Krithica Srinivasan

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Introduction: The two fundamental skills involved in the growth and wellbeing of any child can be categorized into visual motor and perceptual skills. Visual stress is a disorder which is characterized by visual discomfort, blurred vision, misspelling words, skipping lines, letters bunching together. There is a need to understand the deficits in perceptual skills among children with visual stress. Aim: To estimate the association between visual stress and visual perceptual skills Objective: To compare visual perceptual skills of children with and without visual stress Methodology: Children between 8 to 15 years of age participated in this cross-sectional study. All children with monocular visual acuity better than or equal to 6/6 were included. Visual perceptual skills were measured using test for visual perceptual skills (TVPS) tool. Reading speed was measured with the chosen colored overlay using Wilkins reading chart and pattern glare score was estimated using a 3cpd gratings. Visual stress was defined as change in reading speed of greater than or equal to 10% and a pattern glare score of greater than or equal to 4. Results: 252 children participated in this study and the male: female ratio of 3:2. Majority of the children preferred Magenta (28%) and Yellow (25%) colored overlay for reading. There was a significant difference between the two groups (MD=1.24±0.6) (p<0.04, 95% CI 0.01-2.43) only in the sequential memory skills. The prevalence of visual stress in this group was found to be 31% (n=78). Binary logistic regression showed that odds ratio of having poor visual perceptual skills was OR: 2.85 (95% CI 1.08-7.49) among children with visual stress. Conclusion: Children with visual stress are found to have three times poorer visual perceptual skills than children without visual stress.

Keywords: visual stress, visual perceptual skills, colored overlay, pattern glare

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Authors: Maryam Beiranvand

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Multi-drug resistance in various microorganisms has increased globally in many healthcare facilities. Less effective antimicrobial activity of drug therapies for infection control becomes trouble. Since 1980, no new type of antimicrobial drug has been identified, even though combinations of antibiotic drugs have been discovered almost every decade. Between 1981 and 2006, over 70% of novel pharmaceuticals and chemical agents came from natural sources. Microorganisms have yielded almost 22,000 natural compounds. The identification of antimicrobial components from endophytes bacteria could help overcome the threat posed by multi-drug resistant strains. The project aims to analyze and identify antimicrobial peptides isolated from entophytic bacteria and their activity against multidrug-resistant Gram-negative bacteria in South Korea. Endophytic Paenibacillus polymyxa. 4G3 isolated from the plant, Gynura procumbery exhibited considerable antimicrobial activity against Methicillin-resistant Staphylococcus aureus, and Escherichia coli. The Rapid Annotations using Subsystems Technology showed that the total size of the draft genome was 5,739,603bp, containing 5178 genes with 45.8% G+C content. Genome annotation using antiSMASH version 6.0.0 was performed, which predicted the most common types of non-ribosomal peptide synthetase (NRPS) and polyketide synthase (PKS). In this study, diethyl aminoethyl cellulose (DEAEC) resin was used as the first step in purifying for unknown peptides, and then the target protein was identified using hydrophilic and hydrophobic solutions, optimal pH, and step-by-step tests for antimicrobial activity. This crude was subjected to C18 chromatography and elution with 0, 10%, 20%, 30%, 40%, 50%, 60%, 70%, 80%, 90%, and 100% methanol, respectively. Only the fraction eluted with 20% -60% methanol demonstrated good antimicrobial activity against MDR E. coli. The concentration of the active fragment was measured by the Brad-ford test, and Protein A280 - Thermo Fisher Scientific at the end by examining the SDS PAGE Resolving Gel, 10% Acrylamide and purity were confirmed. Our study showed that, based on the combined results of the analysis and purification. P polymyxa. 4G3 has a high potential exists for producing novel functions of polymyxin E and bacitracin against bacterial pathogens.

Keywords: endophytic bacteria, antimicrobial activity, antimicrobial peptide, whole genome sequencing analysis, multi -drug resistance gram negative bacteria

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Authors: S. Abd Rahim, F. A. Rahman, E. M. Nasir, N. A. Ramle

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Co-crystal is believed to improve the solubility and dissolution rates and thus, enhanced the bioavailability of poor water soluble drugs particularly during the oral route of administration. With the existing of poorly soluble drugs in pharmaceutical industry, the screening of co-crystal formation using carbamazepine (CBZ) as a model drug compound with dicarboxylic acids co-crystal formers (CCF) namely fumaric (FA) and succinic (SA) acids in ethanol has been studied. The co-crystal formations were studied by varying the mol ratio values of CCF to CBZ to access the effect of CCF concentration on the formation of the co-crystal. Solvent evaporation, slurry, and cooling crystallisations which representing the solution based method co-crystal screening were used. The product crystal from the screening was characterized using X-ray powder diffraction (XRPD). The XRPD pattern profile analysis has shown that the CBZ co-crystals with FA and SA were successfully formed for all ratios studied. The findings revealed that CBZ-FA co-crystal were formed in two different polymorphs. It was found that CBZ-FA form A and form B were formed from evaporation and slurry crystallisation methods respectively. On the other hand, in cooling crystallisation method, CBZ-FA form A was formed at lower mol ratio of CCF to CBZ and vice versa. This study disclosed that different methods and mol ratios during the co-crystal screening can affect the outcome of co-crystal produced such as polymorphic forms of co-crystal and thereof. Thus, it was suggested that careful attentions is needed during the screening since the co-crystal formation is currently one of the promising approach to be considered in research and development for pharmaceutical industry to improve the poorly soluble drugs.

Keywords: co-crystal, dicarboxylic acid, carbamazepine, industry

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Authors: Swati Srivastava, Ashish Kumar Upadhyay

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Haemophilus influenzae Type B (Hib) cause infections of pneumonia, meningitis, epiglottises and other invasive disease exclusively among children under age five. Occurrence of these infections may impair child growth by causing micronutrient deficiency. Using longitudinal data from first and second waves of Young Lives Study conducted in India during 2002 and 2006-07 respectively and multivariable logistic regression models (using generalised estimation equation to take into account the cluster nature of sample), this study aims to examine the impact of Hib vaccination on child anthropometric outcomes (stunting, underweight and wasting) in India. Bivariate result shows that, a higher percent of children were stunted and underweight among those who were not vaccinated against Hib (39% & 48% respectively) as compare to those who were vaccinated (31% and 39% respectively).The risk of childhood stunting and underweight was significantly lower among children who were vaccinated against Hib (odds ratio: 0.77, 95% CI: 0.62-0.96 and odds ratio: 0.79, 95% C.I: 0.64-0.98 respectively) as compare to the unvaccinated children. No significant association was found between vaccination status against Hib and childhood wasting. Moreover, in the statistical models, about 13% of stunting and 12% of underweight could be attributable to lack of vaccination against Hib in India. Study concludes that vaccination against Hib- in addition to being a major intervention for reducing childhood infectious disease and mortality- can be consider as a potential tool for reducing the burden of undernutrition in India. Therefore, the Government of India must include the vaccine against Hib into the Universal Immunization Programme in India.

Keywords: Haemophilus influenzae Type-B, Stunting, Underweight, Wasting, Young Lives Study (YLS), India

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Authors: Shinji Sato, M. M. A. Alam, Manabu Takao

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In recent, investigation of an unsteady flow inside the resonance tube have become a strongly motivated research field for their potential application as high-frequency actuators. By generating a shock wave inside the resonance tube, a high temperature and pressure can be achieved inside the tube, and this high temperature can also be used to ignite a jet engine. In the present research, a computational fluid dynamics (CFD) analysis was carried out to investigate the flow inside the resonance tube. The density-based solver of rhoCentralFoam in OpenFOAM was used to numerically simulate the flow. The supersonic jet that was driven by a cylindrical nozzle with a nominal exit diameter of φd = 20.3 mm impinged onto the resonance tube. The jet pressure ratio was varied between 2.6 and 7.8. The gap s between the nozzle exit and tube entrance was changed between 1.5d and 3.0d. The diameter and length of the tube were taken as D = 1.25d and L=3.0D, respectively. As a result, when a supersonic jet has impinged onto the resonance tube, a compression wave was found generating inside the tube and propagating towards the tube end wall. This wave train resulted in a rise in the end wall gas temperature and pressure. While, in an outflow phase, the gas near tube enwall was found cooling back isentropically to its initial temperature. Thus, the compression waves repeated a reciprocating motion in the tube like a piston, and a fluctuation in the end wall pressures and temperatures were observed. A significant change was found in the end wall pressures and temperatures with a change of jet flow conditions. In this study, the highest temperature was confirmed at a jet pressure ratio of 4.2 and a gap of s=2.0d

Keywords: compressible flow, OpenFOAM, oscillations, a resonance tube, shockwave

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Authors: Michal Alon-Tirosh, Dorit Hadar-Shoval

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Social Psychology theories, such as the intergroup contact theory, content that bringing members of different social groups into contact is a promising approach for improving intergroup relations. The heterogeneous nature of the nursing profession generates encounters between members of different social groups .The social relations that nursing students develop with their peers during their years of study, and the meanings they ascribe to these contacts, may affect the success of their nursing careers. Jewish-Arab relations in Israel are the product of an ongoing conflict and are characterized by stereotyped negative perceptions and mutual suspicions. Nursing education is often the first situation in which Jewish and Arab nursing students have direct and long-term contact with people from the other group. These encounters present a significant challenge. The current study explores whether this contact between Jewish and Arab nursing students during their academic studies improves their perception of their intergroup relationship. The study explores the students' perceptions of the social relations between the two groups. We examine attribution of stereotypes (positive and negative) and willingness to engage in social interactions with individuals from the other group. The study hypothesis is that academic seniority (beginning students, advanced students) will be related to perceptions of the relations between the two groups, as manifested in attributions of positive and negative stereotypes and willingness to reduce the social distance between the two groups. Method: One hundred and eighty Jewish and Arab nursing students (111 Jewish and 69 Arab) completed questionnaires examining their perceptions of the social relations between the two groups. The questionnaires were administered at two different points in their studies (beginning students and those at more advanced stages Results: No differences were found between beginning students and advanced students with respect to stereotypes. However, advanced students expressed greater willingness to reduce social distance than did beginning students. Conclusions: The findings indicate that bringing members of different social groups into contact may improve some aspects of intergroup relations. The findings suggest that different aspects of perceptions of social relations are influenced by different contexts: the students' specific context (joint studies and joint work in the future) and the broader general context of relations between the groups. Accordingly, it is recommended that programs aimed at improving relations in a between social groups will focus on willingness to cooperate and reduce social distance rather than on attempts to eliminate stereotypes.

Keywords: nursing education, perceived social relations, social distance, stereotypes

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Authors: Tzu-Jung Tseng, Pei-Hsuen Han, Tsung-Hsueh Lu

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Background: Choropleth mortality map is commonly used to identify areas with higher mortality risk. However, the use of choropleth map alone might result in the misinterpretation of differences in mortality rates between areas. Two areas with different color shades might not actually have a significant difference in mortality rates. The mortality rates estimated for an area with a small population would be less stable. We suggest of bringing the 95% confidence intervals (CI) into the choropleth mortality map to help users interpret the areal mortality rate difference more properly. Method: In the first choropleth mortality map, we used only three color to indicate standardized mortality ratio (SMR) for each district in Tainan, Taiwan. The red color denotes that the SMR of that district was significantly higher than the Tainan average; on the contrary, the green color suggests that the SMR of that district was significantly lower than the Tainan average. The yellow color indicates that the SMR of that district was not statistically significantly different from the Tainan average. In the second choropleth mortality map, we used traditional sequential color scheme (color ramp) for different SMR in 37 districts in Tainan City with bar chart of each SMR with 95% CI in which the users could examine if the line of 95% CI of SMR of two districts overlapped (nonsignificant difference). Results: The all-causes SMR of each district in Tainan for 2008 to 2013 ranged from 0.77 (95% CI 0.75 to 0.80) in East District to 1.39 Beimen (95% CI 1.25 to 1.52). In the first choropleth mortality map, only 16 of 37 districts had red color and 8 districts had green color. For different causes of death, the number of districts with red color differed. In the first choropleth mortality map we added a bar chart with line of 95% CI of SMR in each district, in which the users could visualize the SMR differences between districts. Conclusion: Through the use of 95% CI the users could interpret the aral mortality differences more properly.

Keywords: choropleth map, small area variation, standardized mortality ratio (SMR), Taiwan

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Authors: Kerem Can Dizdar, Semih Ateş, Ozan Güler, Gökhan Basman, Derya Dışpınar, Cevat Fahir Arısoy

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Grain refinement and obtaining homogeneous microstructure is the key parameter in casting of aluminum alloys. Ti has been traditionally used as grain refiner, however, inconsistency and heterogeneous dendrite arms, as well as fading efficiency, have been the drawbacks of Ti. Alternatively, Nb (Niobium) has gained attention. In this work, the effect of Nb was investigated in case of both as cast and T6 heat treated conditions. Different ratios of Nb (0.0, 0.03, 0.05, 0.07, 0.1 weight%) were added to AlSi11 alloy, mechanical properties were examined statistically, and relationship was established between microstructure and mechanical properties by examining the grain size and dendrite characteristics before and after heat treatment. Results indicate that in the case of as cast state; with the increasing addition of Nb has no significant effect on yield strength, however, it increases the tensile strength and elongation starting with 0.05wt% ratio, and it remains constant up to 0.1wt%. For the heat-treated condition; Nb addition provides increment at yield strength and tensile strength up to 0.05wt%, but it leads to decrementfrom 0.05 to 0.1wt%. The opposite is valid for the elongation; It decreases in between 0-0.05wt% then rises in range of 0.05-0.1wt%. Highest yield strength and ultimate tensile strength were found T6 heat treated 0.05wt% Nb addition. 0.05wt% was found as critical Nbaddition ratio for mechanical properties of Al-11Si alloys. Grain refinement and obtaining homogeneous microstructure is the key parameter in casting of aluminum alloys. Ti has been traditionally used as grain refiner, however, inconsistency and heterogeneous dendrite arms, as well as fading efficiency, have been the drawbacks of Ti. Alternatively, Nb (Niobium) has gained attention. In this work, the effect of Nb was investigated in case of both as cast and T6 heat treated conditions. Different ratios of Nb (0.0, 0.03, 0.05, 0.07, 0.1 weight%) were added to AlSi11 alloy, mechanical properties were examined statistically, and relationship was established between microstructure and mechanical properties by examining the grain size and dendrite characteristics before and after heat treatment. Results indicate that in the case of as cast state; with the increasing addition of Nb has no significant effect on yield strength, however, it increases the tensile strength and elongation starting with 0.05wt% ratio, and it remains constant up to 0.1wt%. For the heat-treated condition; Nb addition provides increment at yield strength and tensile strength up to 0.05wt%, but it leads to decrement from 0.05 to 0.1wt%. The opposite is valid for the elongation; It decreases in between 0-0.05wt% then rises in range of 0.05-0.1wt%. Highest yield strength and ultimate tensile strength were found T6 heat treated 0.05wt% Nb addition. 0.05wt% was found as critical Nbaddition ratio for mechanical properties of Al-11Si alloys.

Keywords: al-si alloy, grain refinement, heat treatment, mechanical properties, microstructure, niobium, sand casting

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Authors: Debalkie Demissie Addisu, Ejigu Alemu Abebe, Tsegay Tensay Assefa

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This study examines the indirect effect of servant leadership on organizational citizenship behavior through perceptions of organizational politics moderated by political skill. This study reports the responses of 321 respondents from six federal public service organizations in Ethiopia. A multi-stage random sampling procedure was employed to select the sampled federal public service organizations. To test hypotheses, the study employed structural equation modeling using AMOS version-26 software. The result revealed that all direct effects have a significant effect. Specifically, servant leadership has a positive effect on organizational citizenship behavior. Likewise, servant leadership has a negative effect on perceptions of organizational politics. Also, a perception of organizational politics has a negative effect on organizational citizenship behavior. Moreover, perceptions of organizational politics competitively mediated the effect of servant leadership on organizational citizenship behavior. As well, political skill moderated the effect of perceptions of organizational politics on organizational citizenship behavior but not the indirect effect. To the best of our knowledge, no one else employs perceptions of organizational politics as a mediating effect between servant leadership and organizational citizenship behavior. Furthermore, we are not aware of anyone else employing political skill as a moderating role in the indirect effect of servant leadership on organizational citizenship behavior through perceptions of organizational politics.

Keywords: servant leadership, organizational citizenship behavior, perceptions of organizational politics, political skill, public service organization, Ethiopia

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Authors: Rebecca M. Dagger, Katy Hadgraft, Matthew Teggart, Peter Angell

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Background: There is a growing body of evidence that demonstrates the association between sedentary behaviour, cardiometabolic risk and all-cause mortality. Since full time working adults spend approximately 8 hours per day in the workplace, interventions to reduce sedentary behaviour at work may alleviate some of the negative health outcomes associated with sedentary behaviour. The aims of this pilot study were to assess the impacts of using a Sit-Stand workstation on markers of cardiometabolic health in a cohort of desk workers. Methods: Twenty eight participants were recruited and randomly assigned to a control (n=5 males, 9 females, mean age 37 years ± 9.4 years) or intervention group (n= 5 males, 9 females, mean age 42 years ± 12.7 years). All participants attended the labs on 2 occasion’s pre and post intervention, following baseline measurements the intervention participants had the Sit Stand Workstations (Ergotron, USA) installed for a 10 week intervention period. The Sit Stand workstations allow participants to stand or sit at their usual workstation and participants were encouraged to the use the desk in a standing position at regular intervals throughout the working day. Cardiometabolic risk markers assessed were body mass, body composition (using bio impedance analysis; Tanita, Tokyo), fasting blood Total Cholesterol (TC), lipid profiles (HDL-C, LDL-C, TC: HDL-C ratio), triglycerides and fasting glucose (Cholestech LDX), resting systolic and diastolic blood pressure and resting heart rate. ANCOVA controlling for baseline values was used to assess the group difference in changes in risk markers between pre and post intervention. Results: The 10 week intervention was associated with significant reductions in some cardiometabolic risk factors. There were significant group effects on change in body mass (F (1,25)=5.915, p<0.05), total body fat percentage (F(1,25)=12.615, p<0.01), total fat mass (F (1,25)=6.954, p<0.05), and systolic blood pressure (F (1,25)=5.012, p<0.05). There were no other significant group effects on changes in other cardiometabolic risk markers. Conclusion: This pilot study highlights the importance of reducing sedentary behaviour in the workplace for reduction in cardiometabolic risk markers. Further research is required to support these findings.

Keywords: sedentary behaviour, caridometabolic risk, evidence, risk makers

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Authors: Wiem Daoud Ben Amor, Luis Martínez López, Hela Moalla Frikha

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Most of the multi-criteria group decision making (MCGDM) problems dealing with qualitative criteria require consideration of the large background of expert information. It is common that experts have different degrees of knowledge for giving their alternative assessments according to criteria. So, it seems logical that they use different evaluation scales to express their judgment, i.e., multi granular linguistic scales. In this context, we propose the extension of the classical additive ratio assessment (ARAS) method to the case of a hierarchical linguistics term for managing multi granular linguistic scales in uncertain contexts where uncertainty is modeled by means in linguistic information. The proposed approach is called the extended hierarchical linguistics-ARAS method (ARAS-ELH). Within the ARAS-ELH approach, the DM can diagnose the results (the ranking of the alternatives) in a decomposed style, i.e., not only at one level of the hierarchy but also at the intermediate ones. Also, the developed approach allows a feedback transformation i.e the collective final results of all experts able to be transformed at any level of the extended linguistic hierarchy that each expert has previously used. Therefore, the ARAS-ELH technique makes it easier for decision-makers to understand the results. Finally, An MCGDM case study is given to illustrate the proposed approach.

Keywords: additive ratio assessment, extended hierarchical linguistic, multi-criteria group decision making problems, multi granular linguistic contexts

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Authors: Shuwen Hu, Yuancheng Lou, Dongxu Ji

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Photovoltaic (PV) power generation, as one of the most commercialized methods to utilize solar power, can only convert a limited range of solar spectrum into electricity, whereas the majority of the solar energy is dissipated as heat. To address this problem, thermoelectric (TE) module is often integrated with the concentrated PV module for waste heat recovery and regeneration. In this research, a feasibility analysis is conducted for the tandem concentrated photovoltaic-thermoelectric (CPV-TE) hybrid system considering various operational parameters as well as TE material properties. Furthermore, the power output density of the CPV-TE hybrid system is maximized by selecting the optimal TE material with application of a systematic assessment methodology. In the feasibility analysis, CPV-TE is found to be more advantageous than sole CPV system except under high optical concentration ratio with low cold side convective coefficient. It is also shown that the effects of the TE material properties, including Seebeck coefficient, thermal conductivity, and electrical resistivity, on the feasibility of CPV-TE are interacted with each other and might have opposite effect on the system performance under different operational conditions. In addition, the optimal TE material selected by the proposed assessment methodology can improve the system power output density by 227 W/m2 under highly concentrated solar irradiance hence broaden the feasible range of CPV-TE considering optical concentration ratio.

Keywords: feasibility analysis, material assessment methodology, photovoltaic waste heat recovery, tandem photovoltaic-thermoelectric

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Authors: Chuchai Sujivorakul

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This research focused on the study of various parameters of fiber itself affecting on the flexure of hooked steel fiber reinforced concrete (HSFRC). The size of HSFRC beams was 150x150 mm in cross section and 550 mm in length, and the flexural test was carried out in accordance with EN-14651 standard. The test result was the relationship between centre-point load and crack-mount opening displacement (CMOD) at the centre notch. Controlled concrete had a compressive strength of 42 MPa. The investigated variables related to the hooked fiber itself were: (a) 3 levels of aspect ratio of fibers (65, 80 and 100); (b) 2 different fiber lengths (35 mm and 60 mm); (c) 2 different tensile strength of fibers (1100 MPa and 1500 MPa); and (d) 3 different fiber-end geometries (3D 4D and 5D fibers). The 3D hooked fibers have two plastic hinges at both ends, while the 4D and 5D hooked fibers are the newly developed steel fibers by Bekaert, and they have three and four plastic hinges at both ends, respectively. The hooked steel fibers were used in concrete with three different fiber contents, i.e., 20 30 and 40 kg/m³. From the study, it was found that all variables did not seem to affect the flexural strength at limit of proportionality (LOP) of HSFRC. However, they affected the residual flexural tensile strength (fR,j). It was observed that an increase in fiber lengths and the tensile strength the fibers would significantly increase in the fR,j of HSFRC, while the aspect ratio of the fiber would slightly effect the fR,j of HSFRC. Moreover, it was found that using 5D fibers would better enhance the fR,j and flexural behavior of HSFRC than 3D and 4D fibers, because they gave highest mechanical anchorage effect created by their hooked-end geometry.

Keywords: hooked steel fibers, fiber reinforced concrete, EN-14651, flexural test

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Authors: Mrunal Phatak

Abstract:

Introduction: Thyroid hormone is important for the normal function of the auditory system. Hearing impairment can occur insidiously in subclinical hypothyroidism. The present study was undertaken with the aim of evaluating audiological tests like tuning fork tests, pure tone audiometry, brainstem evoked auditory potentials (BAEPs), and auditory reaction time (ART) in hypothyroid women and in age and sex-matched controls to evaluate the effect of thyroid hormone on hearing. The objective of the study was to investigate hearing status by the audiological profile in hypothyroidism (group 1) and healthy controls (group 2) to compare the audiological profile between these groups and find the correlation of levels of TSH, T3 and T4 with the above parameters. Material and methods: A total sample size of 124 women in the age group of 30 to 50 years was recruited and divided into the Cases group comprising 62 newly diagnosed hypothyroid women and a Control group having 62 women with normal thyroid profiles. Otoscopic examination, tuning fork tests, Pure tone audiometry tests (PTA). Brain Stem Auditory Evoked Potential (BAEP) and Auditory Reaction Time (ART) were done in both ears, i.e., a total of 248 ears of all subjects. Results: By BAEPs, hearing impairment was detected in a total of 64 years (51.61%). A significant increase was seen in Wave V latency, IPL I-V and IPL III-V, and the decrease was seen in the amplitude of Wave I and V in both the ears cases. A positive correlation of Wave V latency of the Right and Left ears is seen with TSH levels (p < 0.001) and a negative correlation with T3 (>0.05) and with T4 (p < 0.01). The negative correlation of wave V amplitude of the Right and Left ears is seen with TSH levels (p < 0.001), and a significant positive correlation is seen with T3 and T4. Pure tone audiometry parameters showed hearing impairment of conductive (31.29%), sensorineural (36.29%), as well as mixed type (15.32%). Hearing loss was mild in 65.32% of ears and moderate in 17.74% of ears. Pure tone averages (PTA) were significantly increased in cases than in controls in both ears. A significant positive correlation of PTA of Right and Left ears is seen with TSH levels (p<0.05). A negative correlation between T3 and T4 is seen. A significant increase in HF ART and LF ART is seen in cases as compared to controls. A positive correlation between ART of high frequency and low frequency is seen with TSH levels and a negative correlation with T3 and T4 (p > 0.05). Conclusion: The abnormal BAEPs in hypothyroid women suggest an impaired central auditory pathway. BAEP abnormalities are indicative of a nonspecific injury in the bulbo-ponto-mesencephalic centers. The results of auditory investigations suggest a causal relationship between hypothyroidism and hearing loss. The site of lesion in the auditory pathway is probably at several levels, namely, in the middle ear and at cochlear and retrocochlear sites. Prolonged ART also suggests an impairment in central processing mechanisms. The results of the present study conclude that the probable reason for hearing impairment in hypothyroidism may be delayed impulse conduction in the acoustic nerve up to the level of the midbrain (IPL I-V, III-V), particularly the inferior colliculus (wave V). There is also impairment in central processing mechanisms, as shown by prolonged ART.

Keywords: hypothyroidism, deafness, pure tone audiometry, brain stem auditory evoked potential

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Authors: Juan A. Ferriz-Papi, Simon Thomas

Abstract:

The construction industry generates large amounts of waste, usually mixed, which can be composed of different origin materials, most of them catalogued as non-hazardous. The European Union targets for this waste for 2020 have been already achieved by the UK, but it is mainly developed in downcycling processes (backfilling) whereas upcycling (such as recycle in new concrete batches) still keeps at a low percentage. The aim of this paper is to explore further in the use of recycled aggregates from construction and demolition waste (CDW) in concrete mixes so as to improve upcycling. A review of most recent research and legislation applied in the UK is developed regarding the production of concrete blocks. As a case study, initial tests were developed with a CDW recycled aggregate sample from a CDW plant in Swansea. Composition by visual inspection and sieving tests of two samples were developed and compared to original aggregates. More than 70% was formed by soil waste from excavation, and the rest was a mix of waste from mortar, concrete, and ceramics with small traces of plaster, glass and organic matter. Two concrete mixes were made with 80% replacement of recycled aggregates and different water/cement ratio. Tests were carried out for slump, absorption, density and compression strength. The results were compared to a reference sample and showed a substantial reduction of quality in both mixes. Despite that, the discussion brings to identify different aspects to solve, such as heterogeneity or composition, and analyze them for the successful use of these recycled aggregates in the production of concrete blocks. The conclusions obtained can help increase upcycling processes ratio with mixed CDW as recycled aggregates in concrete mixes.

Keywords: aggregates, concrete, concrete block, construction and demolition waste, recycling

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Authors: Asep Sukohar, Ramadhan Triyandi, Muhammad Iqbal, Sahidin, Suharyani

Abstract:

Introduction: Resveratrol is a class of bioactive chemicals found in melinjo, which has a wide range of biological actions. The purpose of this study is to determine the linarin content of the melinjo fraksi by using preparative-high-performance liquid chromatography (prep-HPLC). Method: Extraction used the soxhletation method with 96% ethanol solvent. Fractionation used ethyl acetate and ethanol in a ratio of 1:1. Tracing of linarin compound used prep-HPLC with a mobile phase ratio of distilled water: methanol (55: 45, v/v). The presence of linarin was detected using a wavelength of 215 nm. Fourier Transform Infrared (FTIR) was used to identify the functional groups of compound. Result: The retention time required to elute the ethyl acetate fraction was 2.601 minutes. Compound separation identification using Fourier Transform Infrared Spectroscopy - Quest Attenuated Total Reflectance (FTIR - QATR) has a similarity value range with standards from 0 to 1000. The elution results of the ethyl acetate fraction have similar values with the standard compounds linarin (668), resveratrol (578), and catechin (455). Conclusion: Tracing for active compound in the ethyl acetate fraction of Gnetum Gnemon L. using prep-HPLC showed a strong suspicion of the presence of linarin compound.

Keywords: Gnetum gnemon L., linarin, prep-HPLC, fraction ethyl acetate

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Authors: Giorgi Sulashvili, Vladimer Kekenadze, Olga Khutsishvili, Bela Khotenashvili, Tsiuri Phkhakadze, Besarion Tsikhelashvili

Abstract:

The article dealt with the South Caucasus is a complex economic policy, which consists of strands: The process of deepening economic integration in the South Caucasus region; deepening economic integration with the EU in the framework of "Neighbourhood policy with Europe" and in line with the Maastricht criteria; the development of bilateral trade and economic relations with many countries of the world community; the development of sufficient conditions for the integration of the South Caucasus region in the world to enter the market. According to the author, to determine the place of Georgia in the regional policy of the South Caucasus, it is necessary to consider two views about Georgia: The first is the view of Georgia, as a part of global economic and political processes and the second look at Georgia, as a country located in the geo-economic and geopolitical space of the South Caucasus. Such approaches reveal the place of Georgia in two dimensions; in the global and regional economies. In the countries of South Caucasus, the tourism has been developing fast and has a great social and economic importance. Tourism influences deeply on the social and economic growth of the regions of the country. Tourism development formulates thousand new jobs, fixes the positions of small and middle businesses, ensures the development of the education and culture of the population. In the countries of South Caucasus, the Tourist Industry can be specified as the intersectoral complex, which consists of travel transport and it’s technical service network, tourist enterprises which are specialized in various types, wide network services. Tourists have a chance to enjoy all of these services. At the transitional stage of shifting to the market economy, tourism is among the priorities in the development of the national economy of our country. It is true that the Georgian tourism faces a range of problems at present, but its recognition and the necessity for its development may be considered as a fact. Besides, we would underline that the revitalization of the Georgian tourism is not only the question of time. This area can bring a lot of benefits as to private firms, as to specific countries. It also has many negative effects were conducted fundamental research and studies to consider both, positive and negative impacts of tourism. In the future such decisions will be taken that will bring, the maximum benefit at minimum cost, in order for tourism to take its place in Georgia it is necessary to understand the role of the tourism sector in the economic structure.

Keywords: transitional stage, national economy, Georgian tourism, positive and negative impacts

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Authors: Hanna Schübel, Ivo Wallimann-Helmer

Abstract:

In order to reach the goal of the Paris Agreement to not overshoot 1.5°C of warming above pre-industrial levels, various countries including the UK and Switzerland have committed themselves to net zero emissions by 2050. The employment of negative emission technologies (NETs) is very likely going to be necessary for meeting these national objectives as well as other internationally agreed climate targets. NETs are methods of removing carbon from the atmosphere and are thus a means for addressing climate change. They range from afforestation to technological measures such as direct air capture and carbon storage (DACCS), where CO2 is captured from the air and stored underground. As all so-called geoengineering technologies, the development and deployment of NETs are often subject to moral hazard arguments. As these technologies could be perceived as an alternative to mitigation efforts, so the argument goes, they are potentially a dangerous distraction from the main target of mitigating emissions. We think that this is a dangerous argument to make as it may hinder the development of NETs which are an essential element of net zero emission targets. In this paper we argue that the moral hazard argument is only problematic if we do not reflect upon which levels of emissions are at stake in order to meet net zero emissions. In response to the moral hazard argument we develop an account of which levels of emissions in given societies should be mitigated and not be the target of NETs and which levels of emissions can legitimately be a target of NETs. For this purpose, we define four different levels of emissions: the current level of individual emissions, the level individuals emit in order to appear in public without shame, the level of a fair share of individual emissions in the global budget, and finally the baseline of net zero emissions. At each level of emissions there are different subjects to be assigned responsibilities if societies and/or individuals are committed to the target of net zero emissions. We argue that all emissions within one’s fair share do not demand individual mitigation efforts. The same holds with regard to individuals and the baseline level of emissions necessary to appear in public in their societies without shame. Individuals are only under duty to reduce their emissions if they exceed this baseline level. This is different for whole societies. Societies demanding more emissions to appear in public without shame than the individual fair share are under duty to foster emission reductions and are not legitimate to reduce by introducing NETs. NETs are legitimate for reducing emissions only below the level of fair shares and for reaching net zero emissions. Since access to NETs to achieve net zero emissions demands technology not affordable to individuals there are also no full individual responsibilities to achieve net zero emissions. This is mainly a responsibility of societies as a whole.

Keywords: climate change, mitigation, moral hazard, negative emission technologies, responsibility

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Authors: F. O. Oboite, P. G. Comeau

Abstract:

Advance regeneration is present in many lodgepole pine stands in Alberta. When the overstory pine canopy is killed by Mountain Pine Beetle (MPB) the growth of this advance is likely to increase. Understanding the growth response of these understory tree species is needed to improve mid-term timber supply projections and management decisions. To quantify the growth (diameter, height, height/diameter ratio) responses of black spruce and white spruce to lodgepole pine mortality, sample trees of black and white spruce advance regeneration were selected from 7 lodgepole pine dominated stands (5 attacked; 2 control) in the Foothills Region of western Alberta. Measurements were collected 7-8 years after MPB attack across a wide range of spruce height and stand densities. Analysis was done using mixed model linear regression. Result indicates that there was an increase in both diameter and height growth after MPB attack; however, this increase in growth was delayed for about four years. Both spruce species had similar height response and their height/diameter ratio decreased after release, partly as a result of increased understory light associated with loss of needles in the pine canopy. In addition, the diameter and height growth responses of both spruce species were strongly related to density, prerelease growth and initial size.

Keywords: mountain pine beetle, forest regeneration, lodgepole pine, growth response

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Authors: Shima Behkami, Nor Shahirul Umirah Idris, Sharifuddin Md. Zain, Kah Hin Low, Mehrdad Gholami, Nima A. Behkami, Ahmad Firdaus Kamaruddin

Abstract:

In this work, Inductively Coupled Plasma Mass Spectrometry (ICP-MS), Isotopic Ratio Mass Spectrometry (IRMS) and Ultrasound Milko Tester were used to study milk samples obtained from various geographical locations in Malaysia. ICP-MS was used to determine the concentration of trace elements in milk, water and soil samples obtained from seven dairy farms at different geographical locations in peninsular Malaysia. IRMS was used to analyze the milk samples for isotopic ratios of δ13C, 15N and 18O. Nutritional parameters in the milk samples were determined using an ultrasound milko tester. Data obtained from these measurements were evaluated by Principal Component Analysis (PCA) and Hierarchical Analysis (HA) as a preliminary step in determining geographical origin of these milk samples. It is observed that the isotopic ratios and a number of the nutritional parameters are responsible for the discrimination of the samples. It was also observed that it is possible to determine the geographical origin of these milk samples solely by the isotopic ratios of δ13C, 15N and 18O. The accuracy of the geographical discrimination is demonstrated when several milk samples from a milk factory taken from one of the regions under study were appropriately assigned to the correct PCA cluster.

Keywords: inductively coupled plasma mass spectroscopy ICP-MS, isotope ratio mass spectroscopy IRMS, ultrasound, principal component analysis, hierarchical analysis, geographical origin, milk

Procedia PDF Downloads 362

Authors: Yang-Ho Jang, Soon-Ok Jee, Hae-Chul Park, Jeong-Woo Kang, Byung-Jae So, Sung-Shik Shin, Kyu-Sung Ahn, Kwang-Jick Lee

Abstract:

Introduction: Antibiotics have been used as feed additives for the growth promotion and performance in food-producing animals. However, the possibility of selection of antimicrobial resistance and the concerns of residue in animal products led to ban the use of antibiotics in farm animals at 2011 in Korea. This strategy is also adjusted to anticoccidial drugs soon but these are still allowed for the time being to use in a diet for the treatment and control for the enteric necrosis in poultry. Therefore substantial focus has been given to find alternatives to antimicrobial agents. Several phytogenic materials have been reported to have positive effects on coccidiosis. This study was to evaluate the effects on anti-coccidial effect of oregano oil based herb mixture on Eimeria spp. in poultry. Materials and Methods: A total of one day-old boiler chickens divided into six groups (each group=30 chkckens) were used in this study. The herbal mixture was fed with water freely as follows: two groups, one infected with Eimeria spp. and the other group served as controls without herbal mixture respectively; 0.2ml/L of oregano oil; 0.2ml/L of oregano oil and Sanguisorbae radix; 0.2ml/L of Sanguisorbae radix; last group was fed with dichlazuril diet as positive control. Sporulated Eimeria spp. was infected at 14 day-old. Following infection, survival rate, bloody diarrhea, OPG (oocyst per gram) and feed conversion ratios were determined. The experimental period was lasted for 4 weeks. Results: Herbal mixture feeding groups (Group 3,4,5) showed low feed conversion ratio comparing with negative control. Oregano oil group and positive control group recorded the highest survival rate. The grade of bloody diarrhea was scored 0 to 5. Herbal mixture feeding groups showed 2, 3 and 1 score respectively however, group 2 (infection and no-treatment) showed 4. OPG results in herbal mixture feeding group were 3 to 4 times higher than diclazuril diet feeding group. Conclusions: These results showed that oregano oil and Sanguisorbae radix mixture may have an anti-coccidial effect and also affect chick performance.

Keywords: anticoccidial effects, oregano oil based herb mixture, herbal mixture, antibiotics

Procedia PDF Downloads 550

Authors: Mrunal Phatak, Suvarna Raut

Abstract:

Introduction: Thyroid hormone is important for the normal function of the auditory system. Hearing impairment can occur insidiously in subclinical hypothyroidism. The present study was undertaken with the aims of evaluating audiological tests like tuning fork tests, pure tone audiometry, brainstem evoked auditory potentials (BAEPs), and auditory reaction time (ART) in hypothyroid women and in age and sex matched controls so as to evaluate the effect of thyroid hormone on hearing. The objective of the study was to investigate hearing status by the audiological profile in hypothyroidism (group 1) and healthy controls ( group 2) to compare the audiological profile between these groups and find the correlation of levels of TSH, T3, and T4 with the above parameters. Material and methods: A total sample size of 124 women in the age group of 30 to 50 years was recruited and divided into the Cases group comprising of 62 newly diagnosed hypothyroid women and the Control group having 62 women with normal thyroid profile. Otoscopic examination, tuning fork tests, Pure tone audiometry tests (PTA). Brain Stem Auditory Evoked Potential (BAEP) and Auditory Reaction Time (ART) were done in both ears, i.e. total 248 ears of all subjects. Results: By BAEPs, hearing impairment was detected in total 64 ears (51.61%). A significant increase was seen in Wave V latency, IPL I-V, and IPL III-V, and the decrease was seen in the amplitude of Wave I and V in both the ears in cases. Positive correlation of Wave V latency of Right and Left ears is seen with TSH levels (p < 0.001) and a negative correlation with T3 (>0.05) and with T4 (p < 0.01). Negative correlation of wave V amplitude of Right and Left ears is seen with TSH levels (p < 0.001), and a significant positive correlation is seen with T3 and T4. Pure tone audiometry parameters showed hearing impairment of conductive (31.29%), sensorineural (36.29%), as well as the mixed type (15.32%). Hearing loss was mild in 65.32% of ears and moderate in 17.74% of ears. Pure tone averages (PTA) were significantly increased in cases than in controls in both the ears. Significant positive correlation of PTA of Right and Left ears is seen with TSH levels (p<0.05). Negative correlation with T3 and T4 is seen. A significant increase in HF ART and LF ART is seen in cases as compared to controls. Positive correlation of ART of high frequency and low frequency is seen with TSH levels and a negative correlation with T3 and T4 (p > 0.05). Conclusion: The abnormal BAEPs in hypothyroid women suggest an impaired central auditory pathway. BAEP abnormalities are indicative of a nonspecific injury in the bulbo-ponto-mesencephalic centres. The results of auditory investigations suggest a causal relationship between hypothyroidism and hearing loss. The site of lesion in the auditory pathway is probably at several levels, namely, in the middle ear and at cochlear and retrocochlear sites. Prolonged ART also suggests the impairment in central processing mechanisms. The results of the present study conclude that the probable reason for hearing impairment in hypothyroidism may be delayed impulse conduction in acoustic nerve up to the level of the midbrain (IPL I-V, III-V), particularly inferior colliculus (wave V). There is also impairment in central processing mechanisms, as shown by prolonged ART.

Keywords: deafness, pure tone audiometry, brain stem auditory evoked potential, hyopothyroidism

Procedia PDF Downloads 124

Authors: Chen-Yu Tsai, Wen-Te Liu, Chen-Chen Lo, Kang Lo, Yin-Tzu Lin

Abstract:

Background: Driving drowsiness related to insufficient or disordered sleep accounts for a major percentage of vehicular accidents. Sleep deprivation is the primary reason related to low sleep efficiency. Nevertheless, the mechanism of sleep deprivation induces driving fatigue to remain unclear. Objective: The objective of this study is to associate the relationship between insufficient sleep efficiency and driving fatigue. Methodologies: The physical condition while driving was obtained from the questionnaires to classify the state of driving fatigue. Sleep efficiency was quantified as the polysomnography (PSG), and the sleep stages were sentenced by the reregistered Technologist during examination in a hospital in New Taipei City (Taiwan). The independent T-test was used to investigate the correlation between sleep efficiency, sleep stages ratio, and driving drowsiness. Results: There were 880 subjects recruited in this study, who had been done polysomnography for evaluating severity for obstructive sleep apnea syndrome (OSAS) as well as completed the driver condition questionnaire. Four-hundred-eighty-four subjects (55%) were classified as fatigue group, and 396 subjects (45%) were served as the control group. The ratio of stage three sleep (N3) (0.032 ± 0.056) in fatigue group were significantly lower than the control group (p < 0.01). The significantly higher value of snoring index (242.14 ± 205.51 /hours) was observed in the fatigue group (p < 0.01). Conclusion: We observe the considerable correlation between deep sleep reduce and driving drowsiness. To avoid drowsy driving, the sleep deprivation, and the snoring events during the sleeping time should be monitored and alleviated.

Keywords: driving drowsiness, sleep deprivation, stage three sleep, snoring index

Procedia PDF Downloads 139

Authors: Oladipo Oluwaseun Peter

Abstract:

Daily consumption of crude oil is alarming as a result of increasing demand for energy. Waste generation tends to rise with the level of economic advancement of a nation. Hence, this project work researches how wastes which could pose toxic if left unattended to can be processed through biodigestion in order to generate biofuel which could serve as a good substitute for petroleum, a non renewable energy source, so as to reduce over-dependence on petroleum and to prevent environmental pollution. Anaerobic digestion was carried out on organic wastes comprising brewery spent grains, rice husks and poultry droppings in a plastic biodigester of 1000 liters volume using the poultry droppings as a natural inoculums source. The feed composition in ratio 5:3:2, spent grain, rice husks and poultry droppings were mixed with water in the ratio 1:6. Thus, 600 Kg of water was used to prepare the slurry with 100 Kg of feed materials. A plastic biodigester was successfully constructed, and the problem of corrosion and rusting were completely overcome as a result of the use of non-corroding materials of construction. A reasonable quantity of biogas, 33.63m3, was generated over a period of 60 days of biodigestion. The bioslurry was processed through two different process routes; evaporation and filteration. Evaporation process of analysis shows high values of 0.64%, 2.11% and 0.034% for nitrogen, phosphorous and potassium respectively, while filteration process gives 00.61%, 1.93% and 0.026% for nitrogen, phosphorous and potassium respectively.

Keywords: biodigestion, biofuel, digestion, slurry, biogas

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Authors: Ravinder Singh, Pratima Syal

Abstract:

Background: The rising prevalence and incidence of Acute Pancreatitis (AP) and its associated metabolic variables known as metabolic syndrome (MetS) are common medical conditions with catastrophic consequences and substantial treatment costs. The correlation between MetS and AP, as well as their impact on Health Related Quality of Life (HRQoL) is uncertain, and because there are so few published studies, further research is needed. As a result, we planned this study to determine the relationship between MetS components impact on HRQoL in AP patients. Patients and Methods: A prospective, observational study involving the recruitment of patients with AP with and without MetS was carried out in tertiary care hospital of North India. Patients were classified with AP if they were diagnosed with two or more components of the following criteria, abdominal pain, serum amylase and lipase levels two or more times normal, imaging trans-abdominal ultrasound, computed tomography, or magnetic resonance. The National Cholesterol Education Program–Adult Treatment Panel III (NCEP-ATP III) criterion was used to diagnose the MetS. The various socio-demographic variables were also taken into consideration for the calculation of statistical significance (P≤.05) in AP patients. Finally, the correlation between AP and MetS, along with their impact on HRQoL was assessed using Student's t test, Pearson Correlation Coefficient, and Short Form-36 (SF-36). Results: AP with MetS (n = 100) and AP without MetS (n = 100) patients were divided into two groups. Gender, Age, Educational Status, Tobacco use, Body Mass Index (B.M.I), and Waist Hip Ratio (W.H.R) were the socio-demographic parameters found to be statistically significant (P≤.05) in AP patients with MetS. Also, all the metabolic variables were also found to statistically significant (P≤.05) and found to be increased in patients with AP with MetS as compared to AP without MetS except HDL levels. Using the SF-36 form, a greater significant decline was observed in physical component summary (PCS) and mental component summary (MCS) in patients with AP with MetS as compared to patients without MetS (P≤.05). Furthermore, a negative association between all metabolic variables with the exception of HDL, and AP was found to be producing deterioration in PCS and MCS. Conclusion: The study demonstrated that patients with AP with MetS had a worse overall HRQOL than patients with AP without MetS due to number of socio-demographic and metabolic variables having direct correlation impacting physical and mental health of patients.

Keywords: metabolic disorers, QOL, cost effectiveness, pancreatitis

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Authors: Megan L. Srinivas

Abstract:

Individuals with underlying rheumatologic diseases such as dermatomyositis may not adequately respond to tuberculin (PPD) skin tests, creating false negative results. These illnesses are frequently treated with immunosuppressive therapy making proper identification of TB infection imperative. A 59-year-old Filipino man was diagnosed with dermatomyositis on the basis of rash, electromyography, and muscle biopsy. He was initially treated with IVIG infusions and transitioned to oral prednisone and mycophenolate. The patient’s symptoms improved on this regimen. Six months after starting mycophenolate, the patient began having fevers, night sweats, and productive cough without hemoptysis. He moved from the Philippines 5 years prior to dermatomyositis diagnosis, denied sick contacts, and was PPD negative both at immigration and immediately prior to starting mycophenolate treatment. A third PPD was negative following the onset of these new symptoms. He was treated for community-acquired pneumonia, but symptoms worsened over 10 days and he developed watery diarrhea and a growing non-tender, non-mobile mass on the left side of his neck. A chest x-ray demonstrated a cavitary lesion in right upper lobe suspicious for TB that had not been present one month earlier. Chest CT corroborated this finding also exhibiting necrotic hilar and paratracheal lymphadenopathy. Neck CT demonstrated the left-sided mass as cervical chain lymphadenopathy. Expectorated sputum and stool samples contained acid-fast bacilli (AFB), cultures showing TB bacteria. Fine-needle biopsy of the neck mass (scrofula) also exhibited AFB. An MRI brain showed nodular enhancement suspected to be a tuberculoma. Mycophenolate was discontinued and dermatomyositis treatment was switched to oral prednisone with a 3-day course of IVIG. The patient’s infection showed sensitivity to standard RIPE (rifampin, isoniazid, pyrazinamide, and ethambutol) treatment. Within a week of starting RIPE, the patient’s diarrhea subsided, scrofula diminished, and symptoms significantly improved. By the end of treatment week 3, the patient’s sputum no longer contained AFB; he was removed from isolation, and was discharged to continue RIPE at home. He was discharged on oral prednisone, which effectively addressed his dermatomyositis. This case illustrates the unreliability of PPD tests in patients with long-term inflammatory diseases such as dermatomyositis. Other immunosuppressive therapies (adalimumab, etanercept, and infliximab) have been affiliated with conversion of latent TB to disseminated TB. Mycophenolate is another immunosuppressive agent with similar mechanistic properties. Thus, it is imperative that patients with long-term inflammatory diseases and high-risk TB factors initiating immunosuppressive therapy receive a TB blood test (such as a quantiferon gold assay) prior to the initiation of therapy to ensure that latent TB is unmasked before it can evolve into a disseminated form of the disease.

Keywords: dermatomyositis, immunosuppressant medications, mycophenolate, disseminated tuberculosis

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