Search results for: total floating time (TFT)
Commenced in January 2007
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Edition: International
Paper Count: 24688

Search results for: total floating time (TFT)

22828 The Association Between CYP2C19 Gene Distribution and Medical Cannabis Treatment

Authors: Vichayada Laohapiboolkul

Abstract:

Introduction: As the legal use of cannabis is being widely accepted throughout the world, medical cannabis has been explored in order to become an alternative cure for patients. Tetrahydrocannabinol (THC) and Cannabidiol (CBD) are natural cannabinoids found in the Cannabis plant which is proved to have positive treatment for various diseases and symptoms such as chronic pain, neuropathic pain, spasticity resulting from multiple sclerosis, reduce cancer-associated pain, autism spectrum disorders (ASD), dementia, cannabis and opioid dependence, psychoses/schizophrenia, general social anxiety, posttraumatic stress disorder, anorexia nervosa, attention-deficit hyperactivity disorder, and Tourette's disorder. Regardless of all the medical benefits, THC, if not metabolized, can lead to mild up to severe adverse drug reactions (ADR). The enzyme CYP2C19 was found to be one of the metabolizers of THC. However, the suballele CYP2C19*2 manifests as a poor metabolizer which could lead to higher levels of THC than usual, possibly leading to various ADRs. Objective: The aim of this study was to investigate the distribution of CYP2C19, specifically CYP2C19*2, genes in Thai patients treated with medical cannabis along with adverse drug reactions. Materials and Methods: Clinical data and EDTA whole blood for DNA extraction and genotyping were collected from patients for this study. CYP2C19*2 (681G>A, rs4244285) genotyping was conducted using the Real-time PCR (ABI, Foster City, CA, USA). Results: There were 42 medical cannabis-induced ADRs cases and 18 medical cannabis tolerance controls who were included in this study. A total of 60 patients were observed where 38 (63.3%) patients were female and 22 (36.7%) were male, with a range of age approximately 19 - 87 years. The most apparent ADRs for medical cannabis treatment were dry mouth/dry throat (76.7%), followed by tachycardia (70%), nausea (30%) and a few arrhythmias (10%). In the total of 27 cases, we found a frequency of 18 CYP2C19*1/*1 alleles (normal metabolizers, 66.7%), 8 CYP2C19*1/*2 alleles (intermediate metabolizers, 29.6%) and 1 CYP2C19*2/*2 alleles (poor metabolizers, 3.7%). Meanwhile, 63.6% of CYP2C19*1/*1, 36.3% and 0% of CYP2C19*1/*2 and *2/*2 in the tolerance controls group, respectively. Conclusions: This is the first study to confirm the distribution of CYP2C19*2 allele and the prevalence of poor metabolizer genes in Thai patients who received medical cannabis for treatment. Thus, CYP2C19 allele might serve as a pharmacogenetics marker for screening before initiating treatment.

Keywords: medical cannabis, adverse drug reactions, CYP2C19, tetrahydrocannabinol, poor metabolizer

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22827 Improving Functionality of Radiotherapy Department Through: Systemic Periodic Clinical Audits

Authors: Kamal Kaushik, Trisha, Dandapni, Sambit Nanda, A. Mukherjee, S. Pradhan

Abstract:

INTRODUCTION: As complexity in radiotherapy practice and processes are increasing, there is a need to assure quality control to a greater extent. At present, no international literature available with regards to the optimal quality control indicators for radiotherapy; moreover, few clinical audits have been conducted in the field of radiotherapy. The primary aim is to improve the processes that directly impact clinical outcomes for patients in terms of patient safety and quality of care. PROCEDURE: A team of an Oncologist, a Medical Physicist and a Radiation Therapist was formed for weekly clinical audits of patient’s undergoing radiotherapy audits The stages for audits include Pre planning audits, Simulation, Planning, Daily QA, Implementation and Execution (with image guidance). Errors in all the parts of the chain were evaluated and recorded for the development of further departmental protocols for radiotherapy. EVALUATION: The errors at various stages of radiotherapy chain were evaluated and recorded for comparison before starting the clinical audits in the department of radiotherapy and after starting the audits. It was also evaluated to find the stage in which maximum errors were recorded. The clinical audits were used to structure standard protocols (in the form of checklist) in department of Radiotherapy, which may lead to further reduce the occurrences of clinical errors in the chain of radiotherapy. RESULTS: The aim of this study is to perform a comparison between number of errors in different part of RT chain in two groups (A- Before Audit and B-After Audit). Group A: 94 pts. (48 males,46 female), Total no. of errors in RT chain:19 (9 needed Resimulation) Group B: 94 pts. (61 males,33 females), Total no. of errors in RT chain: 8 (4 needed Resimulation) CONCLUSION: After systematic periodic clinical audits percentage of error in radiotherapy process reduced more than 50% within 2 months. There is a great need in improving quality control in radiotherapy, and the role of clinical audits can only grow. Although clinical audits are time-consuming and complex undertakings, the potential benefits in terms of identifying and rectifying errors in quality control procedures are potentially enormous. Radiotherapy being a chain of various process. There is always a probability of occurrence of error in any part of the chain which may further propagate in the chain till execution of treatment. Structuring departmental protocols and policies helps in reducing, if not completely eradicating occurrence of such incidents.

Keywords: audit, clinical, radiotherapy, improving functionality

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22826 Bi-Criteria Objective Network Design Model for Multi Period Multi Product Green Supply Chain

Authors: Shahul Hamid Khan, S. Santhosh, Abhinav Kumar Sharma

Abstract:

Environmental performance along with social performance is becoming vital factors for industries to achieve global standards. With a good environmental policy global industries are differentiating them from their competitors. This paper concentrates on multi stage, multi product and multi period manufacturing network. Bi-objective mathematical models for total cost and total emission for the entire forward supply chain are considered. Here five different problems are considered by varying the number of suppliers, manufacturers, and environmental levels, for illustrating the taken mathematical model. GA, and Random search are used for finding the optimal solution. The input parameters of the optimal solution are used to find the tradeoff between the initial investment by the industry and the long term benefit of the environment.

Keywords: closed loop supply chain, genetic algorithm, random search, green supply chain

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22825 Travel Time Estimation of Public Transport Networks Based on Commercial Incidence Areas in Quito Historic Center

Authors: M. Fernanda Salgado, Alfonso Tierra, David S. Sandoval, Wilbert G. Aguilar

Abstract:

Public transportation buses usually vary the speed depending on the places with the number of passengers. They require having efficient travel planning, a plan that will help them choose the fast route. Initially, an estimation tool is necessary to determine the travel time of each route, clearly establishing the possibilities. In this work, we give a practical solution that makes use of a concept that defines as areas of commercial incidence. These areas are based on the hypothesis that in the commercial places there is a greater flow of people and therefore the buses remain more time in the stops. The areas have one or more segments of routes, which have an incidence factor that allows to estimate the times. In addition, initial results are presented that verify the hypotheses and that promise adequately the travel times. In a future work, we take this approach to make an efficient travel planning system.

Keywords: commercial incidence, planning, public transport, speed travel, travel time

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22824 Donoho-Stark’s and Hardy’s Uncertainty Principles for the Short-Time Quaternion Offset Linear Canonical Transform

Authors: Mohammad Younus Bhat

Abstract:

The quaternion offset linear canonical transform (QOLCT), which isa time-shifted and frequency-modulated version of the quaternion linear canonical transform (QLCT), provides a more general framework of most existing signal processing tools. For the generalized QOLCT, the classical Heisenberg’s and Lieb’s uncertainty principles have been studied recently. In this paper, we first define the short-time quaternion offset linear canonical transform (ST-QOLCT) and drive its relationship with the quaternion Fourier transform (QFT). The crux of the paper lies in the generalization of several well-known uncertainty principles for the ST-QOLCT, including Donoho-Stark’s uncertainty principle, Hardy’s uncertainty principle, Beurling’s uncertainty principle, and the logarithmic uncertainty principle.

Keywords: Quaternion Fourier transform, Quaternion offset linear canonical transform, short-time quaternion offset linear canonical transform, uncertainty principle

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22823 Education and Learning in Indonesia to Refer to the Democratic and Humanistic Learning System in Finland

Authors: Nur Sofi Hidayah, Ratih Tri Purwatiningsih

Abstract:

Learning is a process attempts person to obtain a new behavior changes as a whole, as a result of his own experience in the interaction with the environment. Learning involves our brain to think, while the ability of the brain to each student's performance is different. To obtain optimal learning results then need time to learn the exact hour that the brain's performance is not too heavy. Referring to the learning system in Finland which apply 45 minutes to learn and a 15-minute break is expected to be the brain work better, with the rest of the brain, the brain will be more focused and lessons can be absorbed well. It can be concluded that learning in this way students learn with brain always fresh and the best possible use of the time, but it can make students not saturated in a lesson.

Keywords: learning, working hours brain, time efficient learning, working hours in the brain receive stimulus.

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22822 Balloon Analogue Risk Task (BART) Performance Indicators Help Predict Outcomes of Matched Savings Program

Authors: Carlos M. Parra, Matthew Sutherland, Ranjita Poudel

Abstract:

Reduced mental-bandwidth related to low socioeconomic status (low-SES) might lead to impulsivity and risk-taking behavior, which poses as a major hurdle towards asset building (savings) behavior. Understanding the relationship between risk-related personality metrics as well as laboratory risk behavior and real-life savings behavior can help facilitate the development of effective asset building programs, which are vital for mitigating financial vulnerability and income inequality. As such, this study explored the relationship between personality metrics, laboratory behavior in a risky decision-making task and real-life asset building (savings) behaviors among individuals with low-SES from Miami, Florida (FL). Study participants (12 male, 15 female) included racially and ethnically diverse adults (mean age 41.22 ± 12.65 years), with incomplete higher education (18% had High School Diploma, 30% Associates, and 52% Some College), and low annual income (mean $13,872 ± $8020.43). Participants completed eight self-report surveys and played a widely used risky decision-making paradigm called the Balloon Analogue Risk Task (BART). Specifically, participants played three runs of BART (20 trials in each run; total 60 trials). In addition, asset building behavior data was collected for 24 participants who opened and used savings accounts and completed a 6-month savings program that involved monthly matches, and a final reward for completing the savings program without any interim withdrawals. Each participant’s total savings at the end of this program was the main asset building indicator considered. In addition, a new effective use of average pump bet (EUAPB) indicator was developed to characterize each participant’s ability to place winning bets. This indicator takes the ratio of each participant’s total BART earnings to average pump bet (APB) in all 60 trials. Our findings indicated that EUAPB explained more than a third of the variation in total savings among participants. Moreover, participants who managed to obtain BART earnings of at least 30 cents out of their APB, also tended to exhibit better asset building (savings) behavior. In particular, using this criterion to separate participants into high and low EUAPB groups, the nine participants with high EUAPB (mean BART earnings of 35.64 cents per APB) ended up with higher mean total savings ($255.11), while the 15 participants with low EUAPB (mean BART earnings of 22.50 cents per APB) obtained lower mean total savings ($40.01). All mean differences are statistically significant (2-tailed p  .0001) indicating that the relation between higher EUAPB and higher total savings is robust. Overall, these findings can help refine asset building interventions implemented by policy makers and practitioners interested in reducing financial vulnerability among low-SES population. Specifically, by helping identify individuals who are likely to readily take advantage of savings opportunities (such as matched savings programs) and avoiding the stipulation of unnecessary and expensive financial coaching programs to these individuals. This study was funded by J.P. Morgan Chase (JPMC) and carried out by scientists from Florida International University (FIU) in partnership with Catalyst Miami.

Keywords: balloon analogue risk task (BART), matched savings programs, asset building capability, low-SES participants

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22821 Life in the Time of Lockdown: An Analysis of the Lockdown Imposed during the First Wave of the Novel Corona Virus Pandemic and the Resultant Stress and Anxiety It Caused

Authors: Charu Kriti

Abstract:

The year 2020 will be remembered in history as the year when everything changed suddenly. As the world is engrossed in fighting a pandemic, individual life has taken a hit. The sudden imposition of lockdown, the perpetual fear of testing positive for the COVID virus, and rescheduling one’s entire life around this one global phenomenon have created unprecedented stress among all cadres. This paper aims to highlight the level of stress that students face during the shift of the classroom from the physical setup to the virtual one. The paper takes into account the day-to-day hassles that a student faces during online classes. The paper also attempts to analyse these from the other perspective of the students’ lives and the difficulties faced by them on all fronts. This is an empirical research paper that takes into account responses from a total of 4,241 students. The responses have been collected via the online survey, which is being assessed and inferred for the purposes of this paper. The final results show the extent of stress that online classes have induced upon the students.

Keywords: anxiety, COVID, stress, anxiety disorder

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22820 Prospective Cohort Study on Sequential Use of Catheter with Misoprostol vs Misoprostol Alone for Second Trimester Medical Abortion

Authors: Hanna Teklu Gebregziabher

Abstract:

Background: A variety of techniques for medical termination of second-trimester pregnancy can be used, but there is no consensus about which is the best. Even though most evidence suggests the combined use of intracervical Foley catheter and vaginal misoprostol is safe, effective, and acceptable method for termination of second-trimester pregnancy, which is comparable to mifepristone-misoprostol combination regimen with lower cost and no additional maternal risks. The use of mifepristone and misoprostol alone with no other procedure is still the most common procedure in different institutions for 2nd-trimester pregnancy. Methods: A cross-sectional comparative prospective study design is employed on women who were admitted for 2nd-trimester medical abortion and medical abortion failed or if there was no change in cervical status after 24 hours of 1st dose of misoprostol. The study was conducted at St. Paulose Hospital Millennium Medical College. A sample of 44 participants in each arm was necessary to give a two-tailed test, a type 1 error of 5%, 80% statistical power, and a 1:1 ratio among groups. Thus, a total of 94 cases, 47 from each arm, were recruited. Data was entered and cleaned by using Epi-info and analyzed using SPSS version 29.0 statistical software and was presented in descriptive and tabular forms. Different variables were cross-tabulated and compared for significant differences and statistical analysis using the chi-square test and independent t-test, to conclude. Result: There was a significant difference between the two groups on induction to expulsion time and number of doses used. The mean ± SD of induction to expulsion time for those used misoprostol alone was 48.09 ± 11.86 and those who used trans-cervical catheter sequentially with misoprostol were 36.7 ±6.772. Conclusion: The use of a trans-cervical Foley catheter in conjunction with misoprostol in a sequential manner is a more effective, safe, and easily accessible procedure. In addition, the cost of utilizing the catheter is less compared to the cost of misoprostol and is readily available. As a good substitute, we advised using Trans-cervical Catether even for medical abortions performed in the second trimester.

Keywords: second trimester, medical abortion, catheter, misoprostol

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22819 Development of a Decision Model to Optimize Total Cost in Food Supply Chain

Authors: Henry Lau, Dilupa Nakandala, Li Zhao

Abstract:

All along the length of the supply chain, fresh food firms face the challenge of managing both product quality, due to the perishable nature of the products, and product cost. This paper develops a method to assist logistics managers upstream in the fresh food supply chain in making cost optimized decisions regarding transportation, with the objective of minimizing the total cost while maintaining the quality of food products above acceptable levels. Considering the case of multiple fresh food products collected from multiple farms being transported to a warehouse or a retailer, this study develops a total cost model that includes various costs incurred during transportation. The practical application of the model is illustrated by using several computational intelligence approaches including Genetic Algorithms (GA), Fuzzy Genetic Algorithms (FGA) as well as an improved Simulated Annealing (SA) procedure applied with a repair mechanism for efficiency benchmarking. We demonstrate the practical viability of these approaches by using a simulation study based on pertinent data and evaluate the simulation outcomes. The application of the proposed total cost model was demonstrated using three approaches of GA, FGA and SA with a repair mechanism. All three approaches are adoptable; however, based on the performance evaluation, it was evident that the FGA is more likely to produce a better performance than the other two approaches of GA and SA. This study provides a pragmatic approach for supporting logistics and supply chain practitioners in fresh food industry in making important decisions on the arrangements and procedures related to the transportation of multiple fresh food products to a warehouse from multiple farms in a cost-effective way without compromising product quality. This study extends the literature on cold supply chain management by investigating cost and quality optimization in a multi-product scenario from farms to a retailer and, minimizing cost by managing the quality above expected quality levels at delivery. The scalability of the proposed generic function enables the application to alternative situations in practice such as different storage environments and transportation conditions.

Keywords: cost optimization, food supply chain, fuzzy sets, genetic algorithms, product quality, transportation

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22818 Effects of Live Webcast-Assisted Teaching on Physical Assessment Technique Learning of Young Nursing Majors

Authors: Huey-Yeu Yan, Ching-Ying Lee, Hung-Ru Lin

Abstract:

Background: Physical assessment is a vital clinical nursing competence. The gap between conventional teaching method and the way e-generation students’ preferred could be bridged owing to the support of Internet technology, i.e. interacting with online media to manage learning works. Nursing instructors in the wake of new learning pattern of the e-generation students are challenged to actively adjust and make teaching contents and methods more versatile. Objective: The objective of this research is to explore the effects on teaching and learning with live webcast-assisted on a specific topic, Physical Assessment technique, on a designated group of young nursing majors. It’s hoped that, with a way of nursing instructing, more versatile learning resources may be provided to facilitate self-directed learning. Design: This research adopts a cross-sectional descriptive survey. The instructor demonstrated physical assessment techniques and operation procedures via live webcast broadcasted online to all students. It increased both the off-time interaction between teacher and students concerning teaching materials. Methods: A convenient sampling was used to recruit a total of 52 nursing-majors at a certain university. The nursing majors took two-hour classes of Physical Assessment per week for 18 weeks (36 hrs. in total). The instruction covered four units with live webcasting and then conducted an online anonymous survey of learning outcomes by questionnaire. The research instrument was the online questionnaire, covering three major domains—online media used, learning outcome evaluation and evaluation result. The data analysis was conducted via IBM SPSS Statistics Version 2.0. The descriptive statistics was undertaken to describe the analysis of basic data and learning outcomes. Statistical methods such as descriptive statistics, t-test, ANOVA, and Pearson’s correlation were employed in verification. Results: Results indicated the following five major findings. (1) learning motivation, about four fifth of the participants agreed the online instruction resources are very helpful in improving learning motivation and raising the learning interest. (2) learning needs, about four fifth of participants agreed it was helpful to plan self-directed practice after the instruction, and meet their needs of repetitive learning and/or practice at their leisure time. (3) learning effectiveness, about two third agreed it was helpful to reduce pre-exam anxiety, and improve their test scores. (4) course objects, about three fourth agreed that it was helpful to achieve the goal of ‘executing the complete Physical Assessment procedures with proper skills’. (5) finally, learning reflection, about all of participants agreed this experience of online instructing, learning, and practicing is beneficial to them, they recommend instructor to share with other nursing majors, and they will recommend it to fellow students too. Conclusions: Live webcasting is a low-cost, convenient, efficient and interactive resource to facilitate nursing majors’ motivation of learning, need of self-directed learning and practice, outcome of learning. When live webcasting is integrated into nursing teaching, it provides an opportunity of self-directed learning to promote learning effectiveness, as such to fulfill the teaching objective.

Keywords: innovative teaching, learning effectiveness, live webcasting, physical assessment technique

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22817 Improvement of Microscopic Detection of Acid-Fast Bacilli for Tuberculosis by Artificial Intelligence-Assisted Microscopic Platform and Medical Image Recognition System

Authors: Hsiao-Chuan Huang, King-Lung Kuo, Mei-Hsin Lo, Hsiao-Yun Chou, Yusen Lin

Abstract:

The most robust and economical method for laboratory diagnosis of TB is to identify mycobacterial bacilli (AFB) under acid-fast staining despite its disadvantages of low sensitivity and labor-intensive. Though digital pathology becomes popular in medicine, an automated microscopic system for microbiology is still not available. A new AI-assisted automated microscopic system, consisting of a microscopic scanner and recognition program powered by big data and deep learning, may significantly increase the sensitivity of TB smear microscopy. Thus, the objective is to evaluate such an automatic system for the identification of AFB. A total of 5,930 smears was enrolled for this study. An intelligent microscope system (TB-Scan, Wellgen Medical, Taiwan) was used for microscopic image scanning and AFB detection. 272 AFB smears were used for transfer learning to increase the accuracy. Referee medical technicians were used as Gold Standard for result discrepancy. Results showed that, under a total of 1726 AFB smears, the automated system's accuracy, sensitivity and specificity were 95.6% (1,650/1,726), 87.7% (57/65), and 95.9% (1,593/1,661), respectively. Compared to culture, the sensitivity for human technicians was only 33.8% (38/142); however, the automated system can achieve 74.6% (106/142), which is significantly higher than human technicians, and this is the first of such an automated microscope system for TB smear testing in a controlled trial. This automated system could achieve higher TB smear sensitivity and laboratory efficiency and may complement molecular methods (eg. GeneXpert) to reduce the total cost for TB control. Furthermore, such an automated system is capable of remote access by the internet and can be deployed in the area with limited medical resources.

Keywords: TB smears, automated microscope, artificial intelligence, medical imaging

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22816 Combat Capability Improvement Using Sleep Analysis

Authors: Gabriela Kloudova, Miloslav Stehlik, Peter Sos

Abstract:

The quality of sleep can affect combat performance where the vigilance, accuracy and reaction time are a decisive factor. In the present study, airborne and special units are measured on duty using actigraphy fingerprint scoring algorithm and QEEG (quantitative EEG). Actigraphic variables of interest will be: mean nightly sleep duration, mean napping duration, mean 24-h sleep duration, mean sleep latency, mean sleep maintenance efficiency, mean sleep fragmentation index, mean sleep onset time, mean sleep offset time and mean midpoint time. In an attempt to determine the individual somnotype of each subject, the data like sleep pattern, chronotype (morning and evening lateness), biological need for sleep (daytime and anytime sleepability) and trototype (daytime and anytime wakeability) will be extracted. Subsequently, a series of recommendations will be included in the training plan based on daily routine, timing of the day and night activities, duration of sleep and the number of sleeping blocks in a defined time. The aim of these modifications in the training plan is to reduce day-time sleepiness, improve vigilance, attention, accuracy, speed of the conducted tasks and to optimize energy supplies. Regular improvement of the training supposed to have long-term neurobiological consequences including neuronal activity changes measured by QEEG. Subsequently, that should enhance cognitive functioning in subjects assessed by the digital cognitive test batteries and improve their overall performance.

Keywords: sleep quality, combat performance, actigraph, somnotype

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22815 Analysis and Study of Phytoplankton and the Environmental Characteristics of Tarkwa Bay, Lagos, South-Western, Nigeria

Authors: Bukola Dawodu, Charles Onyema

Abstract:

The phytoplankton and environmental characteristics of Tarkwa Bay, Lagos in South-western Nigeria were investigated from January to June 2012. Environmental characteristics within the Bay were largely determined by floodwater inflow in the wet months (April – June) and increased tidal marine conditions in the dry months (January – March). Similarly, rainfall distribution and possibly tidal seawater inflow were the key factors that govern the variation in phytoplankton distribution, species diversity, chlorophyll a concentration and environmental characteristics of the bay. Values for physico-chemical parameters were indicative of high levels of fluctuations inwards from the East mole towards Tarkwa Bay (e.g. T.S.S > 11mg/L, T.D.S > 33541.0mg/L, D.O. < 5.4). Chlorophyll A values did not show any discernable pattern and correlated negatively with total dissolved solids and total suspended solids (r = -0.27 and -0.04) as both were inconsistent throughout the study period. Four phytoplankton divisions were observed throughout the sampling period with the Bacillariophyta (diatoms) being the dominant group followed by Dinophyta (dinoflagellates), Cyanophyta (the blue-green algae) and Chlorophyta (the green algae). A total of twenty-one species from nine genera were recorded during the period of study. Diatoms formed the most abundant group making fifteen species from five genera. The centric forms dominated over the pennates in the diatom group with Skeletonema sp. Chaetoceros spp. and Coscinodiscus spp. being the dominant centric diatoms while Navicula spp. was the more dominant pennate form. The Dinoflagellates were represented by six species from one genus, the blue-green algae with five species from two genera while the green algae had one species from one genus. Comparatively, total biomass was more in the dry months (Jan. - Mar.) and decreased in the 'wet months' (Apr. – Jun.). Species diversity (S), Shannon Wiener index (Hs), Margalef Index (d) and Equitability Index (j) values were higher during the dry months while reduced value marked the wet months possibly as a result of dilution of rain effects. Outcomes of bio-indices variations were reflections of the degree of occurrence and abundance of species linked to seasons operating in the study site.

Keywords: coastal waters, phytoplankton, species abundance, ecosystems

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22814 Experimental Investigation of Boundary Layer Instability and Transition on a Rotating Parabola in Axial Flow

Authors: Ali Kargar, Kamyar Mansour

Abstract:

In this paper the boundary layer instability and transition on a rotating parabola which is sheathed shape on a rotating 30 degrees total apex angle cone have been study by smoke visualization. The rotating cone especially 30 degrees total apex angle is a well-established subject in some previous novel works and also in our previous works. But in this paper a stabilizing effect is detected by the bluntness of nose and also surface curvature. A parabola model which is satisfying those conditions (sheathed parabola of the 30 degrees cone) has been built and studied in the wind tunnel. The results are shown that the boundary layer transition occurs at higher rotational Reynolds number in comparison by the cone. The results are shown in the visualization pictures and also are compared graphically.

Keywords: transitional Reynolds number, wind tunnel, smoke visualization, rotating parabola

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22813 Ultrafiltration Process Intensification for Municipal Wastewater Reuse: Water Quality, Optimization of Operating Conditions and Fouling Management

Authors: J. Yang, M. Monnot, T. Eljaddi, L. Simonian, L. Ercolei, P. Moulin

Abstract:

The application of membrane technology to wastewater treatment has expanded rapidly under increasing stringent legislation and environmental protection requirements. At the same time, the water resource is becoming precious, and water reuse has gained popularity. Particularly, ultrafiltration (UF) is a very promising technology for water reuse as it can retain organic matters, suspended solids, colloids, and microorganisms. Nevertheless, few studies dealing with operating optimization of UF as a tertiary treatment for water reuse on a semi-industrial scale appear in the literature. Therefore, this study aims to explore the permeate water quality and to optimize operating parameters (maximizing productivity and minimizing irreversible fouling) through the operation of a UF pilot plant under real conditions. The fully automatic semi-industrial UF pilot plant with periodic classic backwashes (CB) and air backwashes (AB) was set up to filtrate the secondary effluent of an urban wastewater treatment plant (WWTP) in France. In this plant, the secondary treatment consists of a conventional activated sludge process followed by a sedimentation tank. The UF process was thus defined as a tertiary treatment and was operated under constant flux. It is important to note that a combination of CB and chlorinated AB was used for better fouling management. The 200 kDa hollow fiber membrane was used in the UF module, with an initial permeability (for WWTP outlet water) of 600 L·m-2·h⁻¹·bar⁻¹ and a total filtration surface of 9 m². Fifteen filtration conditions with different fluxes, filtration times, and air backwash frequencies were operated for more than 40 hours of each to observe their hydraulic filtration performances. Through comparison, the best sustainable condition was flux at 60 L·h⁻¹·m⁻², filtration time at 60 min, and backwash frequency of 1 AB every 3 CBs. The optimized condition stands out from the others with > 92% water recovery rates, better irreversible fouling control, stable permeability variation, efficient backwash reversibility (80% for CB and 150% for AB), and no chemical washing occurrence in 40h’s filtration. For all tested conditions, the permeate water quality met the water reuse guidelines of the World Health Organization (WHO), French standards, and the regulation of the European Parliament adopted in May 2020, setting minimum requirements for water reuse in agriculture. In permeate: the total suspended solids, biochemical oxygen demand, and turbidity were decreased to < 2 mg·L-1, ≤ 10 mg·L⁻¹, < 0.5 NTU respectively; the Escherichia coli and Enterococci were > 5 log removal reduction, the other required microorganisms’ analysis were below the detection limits. Additionally, because of the COVID-19 pandemic, coronavirus SARS-CoV-2 was measured in raw wastewater of WWTP, UF feed, and UF permeate in November 2020. As a result, the raw wastewater was tested positive above the detection limit but below the quantification limit. Interestingly, the UF feed and UF permeate were tested negative to SARS-CoV-2 by these PCR assays. In summary, this work confirms the great interest in UF as intensified tertiary treatment for water reuse and gives operational indications for future industrial-scale production of reclaimed water.

Keywords: semi-industrial UF pilot plant, water reuse, fouling management, coronavirus

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22812 Dynamics Pattern of Land Use and Land Cover Change and Its Driving Factors Based on a Cellular Automata Markov Model: A Case Study at Ibb Governorate, Yemen

Authors: Abdulkarem Qasem Dammag, Basema Qasim Dammag, Jian Dai

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Change in Land use and Land cover (LU/LC) has a profound impact on the area's natural, economic, and ecological development, and the search for drivers of land cover change is one of the fundamental issues of LU/LC change. The study aimed to assess the temporal and Spatio-temporal dynamics of LU/LC in the past and to predict the future using Landsat images by exploring the characteristics of different LU/LC types. Spatio-temporal patterns of LU/LC change in Ibb Governorate, Yemen, were analyzed based on RS and GIS from 1990, 2005, and 2020. A socioeconomic survey and key informant interviews were used to assess potential drivers of LU/LC. The results showed that from 1990 to 2020, the total area of vegetation land decreased by 5.3%, while the area of barren land, grassland, built-up area, and waterbody increased by 2.7%, 1.6%, 1.04%, and 0.06%, respectively. Based on socio-economic surveys and key informant interviews, natural factors had a significant and long-term impact on land change. In contrast, site construction and socio-economic factors were the main driving forces affecting land change in a short time scale. The analysis results have been linked to the CA-Markov Land Use simulation and forecasting model for the years 2035 and 2050. The simulation results revealed from the period 2020 to 2050, the trend of dynamic changes in land use, where the total area of barren land decreased by 7.0% and grassland by 0.2%, while the vegetation land, built-up area, and waterbody increased by 4.6%, 2.6%, and 0.1 %, respectively. Overall, these findings provide LULC's past and future trends and identify drivers, which can play an important role in sustainable land use planning and management by balancing and coordinating urban growth and land use and can also be used at the regional level in different levels to provide as a reference. In addition, the results provide scientific guidance to government departments and local decision-makers in future land-use planning through dynamic monitoring of LU/LC change.

Keywords: LU/LC change, CA-Markov model, driving forces, change detection, LU/LC change simulation

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22811 Theoretical Calculation of Wingtip Devices for Agricultural Aircraft

Authors: Hashim Bashir

Abstract:

The Vortex generated at the edges of the wing of an Aircraft are called the Wing Tip Vortex. The Wing Tip Vortices are associated with induced drag. The induced drag is responsible for nearly 50% of aircraft total drag and can be reduced through modifications to the wing tip. Some models displace wingtips vortices outwards diminishing the induced drag. Concerning agricultural aircrafts, wing tip vortex position is really important, while spreading products over a plantation. In this work, theoretical calculations were made in order to study the influence in aerodynamic characteristics and vortex position, over Sudanese agricultural aircraft, by the following types of wing tips: delta tip, winglet and down curved. The down curved tip was better for total drag reduction, but not good referring to vortex position. The delta tip gave moderate improvement on aerodynamic characteristic and on vortex position. The winglet had a better vortex position and lift increment, but caused an undesirable result referring to the wing root bending moment. However, winglet showed better development potential for agricultural aircraft.

Keywords: wing tip device, wing tip vortice, agricultural aircaft, winglet

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22810 Evaluation of the Predatory Mites' Manner against Root-Knot Nematode Using Water Agar Technique

Authors: Abdelrady K. Nasr, Ezzat M. A. Noweer, Mahmoud M. Ramadan

Abstract:

The root-knot nematode, Meloidogyne incognita Kofoid and White (Tylenchida: Heteroderidae), is one of the most important plant-parasitic nematodes attacking large numbers of vegetable and fruit plants in Egypt. Moreover, the soil predatory mites (Protogamasellopsisdenticus (Nasr), Gaeolaelaps longus (Hafez, El-Badry and Nasr) and Cosmolaelapskeni(Hafez, El-Badry and Nasr) are one of the excellent agents for biocontrol, this study was designed to evaluate the predation of the root-knot nematode (M. incognita) using water agar technique. The water agar medium was used as an experimental medium to rear both the mentioned mites and egg masses; these media allowed observe the development and predacious manner. The present study revealed that the predatory mites successfully developed and reproduced their egg masses. The mean life cycle of the tested mites P. denticus, G. longus, and C.keni were 10.33, 12.00, and 9.77 days, respectively. The mean total life span of the female of P. denticus, G. longus, and C. keni on egg-mases of M. incognita were obtained 63.44, 77.55 and 70.11 days, respectively, and the mean total fecundity of predatory mites, P. denticus, G.longus, and C. keni on egg-mases nematode were observed 62.66, 31.61 and 11.83 eggs, respectively. The mean total number of eggs laid by female P. denticus was significantly higher than other predatory mites, G. longus and C. keni. According to the obtained results, the tested predacious mites can be applied to combat the spreading of M. incognita in the agriculture field as a safe and effective biological control.

Keywords: biological control, plant-parasitic nematodes, predaceous mites, water agar

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22809 Transformative Measures in Chemical and Petrochemical Industry Through Agile Principles and Industry 4.0 Technologies

Authors: Bahman Ghorashi

Abstract:

The immense awareness of the global climate change has compelled traditional fossil fuel companies to develop strategies to reduce their carbon footprint and simultaneously consider the production of various sources of clean energy in order to mitigate the environmental impact of their operations. Similarly, supply chain issues, the scarcity of certain raw materials, energy costs as well as market needs, and changing consumer expectations have forced the traditional chemical industry to reexamine their time-honored modes of operation. This study examines how such transformative change might occur through the applications of agile principles as well as industry 4.0 technologies. Clearly, such a transformation is complex, costly, and requires a total commitment on the part of the top leadership and the entire management structure. Factors that need to be considered include organizational speed of change, a restructuring that would lend itself toward collaboration and the selling of solutions to customers’ problems, rather than just products, integrating ‘along’ as well as ‘across’ value chains, mastering change and uncertainty as well as a recognition of the importance of concept-to-cash time, i.e., the velocity of introducing new products to market, and the leveraging of people and information. At the same time, parallel to implementing such major shifts in the ethos, and the fabric of the organization, the change leaders should remain mindful of the companies’ DNA while incorporating the necessary DNA defying shifts. Furthermore, such strategic maneuvers should inevitably incorporate the managing of the upstream and downstream operations, harnessing future opportunities, preparing and training the workforce, implementing faster decision making and quick adaptation to change, managing accelerated response times, as well as forming autonomous and cross-functional teams. Moreover, the leaders should establish the balance between high-value solutions versus high-margin products, fully implement digitization of operations and, when appropriate, incorporate the latest relevant technologies, such as: AI, IIoT, ML, and immersive technologies. This study presents a summary of the agile principles and the relevant technologies and draws lessons from some of the best practices that are already implemented within the chemical industry in order to establish a roadmap to agility. Finally, the critical role of educational institutions in preparing the future workforce for Industry 4.0 is addressed.

Keywords: agile principles, immersive technologies, industry 4.0, workforce preparation

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22808 Influence of the Non-Uniform Distribution of Filler Porosity on the Thermal Performance of Sensible Heat Thermocline Storage Tanks

Authors: Yuchao Hua, Lingai Luo

Abstract:

Thermal energy storage is of critical importance for the highly-efficient utilization of renewable energy sources. Over the past decades, single-tank thermocline technology has attracted much attention owing to its high cost-effectiveness. In the present work, we investigate the influence of the filler porosity’s non-uniform distribution on the thermal performance of the packed-bed sensible heat thermocline storage tanks on the basis of the analytical model obtained by the Laplace transform. It is found that when the total amount of filler materials (i.e., the integration of porosity) is fixed, the different porosity distributions can result in the significantly-different behaviors of outlet temperature and thus the varied charging and discharging efficiencies. Our results indicate that a non-uniform distribution of the fillers with the proper design can improve the heat storage performance without changing the total amount of the filling materials.

Keywords: energy storage, heat thermocline storage tank, packed bed, transient thermal analysis

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22807 Study on Sharp V-Notch Problem under Dynamic Loading Condition Using Symplectic Analytical Singular Element

Authors: Xiaofei Hu, Zhiyu Cai, Weian Yao

Abstract:

V-notch problem under dynamic loading condition is considered in this paper. In the time domain, the precise time domain expanding algorithm is employed, in which a self-adaptive technique is carried out to improve computing accuracy. By expanding variables in each time interval, the recursive finite element formulas are derived. In the space domain, a Symplectic Analytical Singular Element (SASE) for V-notch problem is constructed addressing the stress singularity of the notch tip. Combining with the conventional finite elements, the proposed SASE can be used to solve the dynamic stress intensity factors (DSIFs) in a simple way. Numerical results show that the proposed SASE for V-notch problem subjected to dynamic loading condition is effective and efficient.

Keywords: V-notch, dynamic stress intensity factor, finite element method, precise time domain expanding algorithm

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22806 Postoperative Radiotherapy in Cancers of the Larynx: Experience of the Emir Abdelkader Cancer Center of Oran, about 89 Cases

Authors: Taleb Lotfi, Benarbia Maheidine, Allam Hamza, Boutira Fatima, Boukerche Abdelbaki

Abstract:

Introduction and purpose of the study: This is a retrospective single-center study with an analytical aim to determine the prognostic factors for relapse in patients treated with radiotherapy after total laryngectomy with lymph node dissection for laryngeal cancer at the Emir Abdelkader cancer center in Oran (Algeria). Material and methods: During the study period from January 2014 to December 2018, eighty-nine patients (n=89) with squamous cell carcinoma of the larynx were treated with postoperative radiotherapy. Relapse-free survival was studied in the univariate analysis according to pre-treatment criteria using Kaplan-Meier survival curves. We performed a univariate analysis to identify relapse factors. Statistically significant factors have been studied in the multifactorial analysis according to the Cox model. Results and statistical analysis: The average age was 62.7 years (40-86 years). It was a squamous cell carcinoma in all cases. Postoperatively, the tumor was classified as pT3 and pT4 in 93.3% of patients. Histological lymph node involvement was found in 36 cases (40.4%), with capsule rupture in 39% of cases, while the limits of surgical excision were microscopically infiltrated in 11 patients (12.3%). Chemotherapy concomitant with radiotherapy was used in 67.4% of patients. With a median follow-up of 57 months (23 to 104 months), the probabilities of relapse-free survival and five-year overall survival are 71.2% and 72.4%, respectively. The factors correlated with a high risk of relapse were locally advanced tumor stage pT4 (p=0.001), tumor site in case of subglottic extension (p=0.0003), infiltrated surgical limits R1 (p=0.001), l lymph node involvement (p=0.002), particularly in the event of lymph node capsular rupture (p=0.0003) as well as the time between surgery and adjuvant radiotherapy (p=0.001). However, in the subgroup analysis, the major prognostic factors for disease-free survival were subglottic tumor extension (p=0.001) and time from surgery to adjuvant radiotherapy (p=0.005). Conclusion: Combined surgery and postoperative radiation therapy are effective treatment modalities in the management of laryngeal cancer. Close cooperation of the entire cervicofacial oncology team is essential, expressed during a multidisciplinary consultation meeting, with the need to respect the time between surgery and radiotherapy.

Keywords: laryngeal cancer, laryngectomy, postoperative radiotherapy, survival

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22805 Extent of Knowledge, Preparedness and Perception on Telemedicine among Family Medicine Resident Physicians in Different Training Institutions in Cebu City, PH during COVID-19 Pandemic

Authors: Kristine Joy Y. Sumanga, Clarissa Mae D. Derecho

Abstract:

Telemedicine is providing health care services using electronic means at a distance, including the diagnosis, treatment, and prevention of diseases as well as the research and evaluation and education of health care providers. The role of telemedicine in this time of the COVID-19 pandemic is vital, especially in the practice of medicine. General Objective: To determine the extent of knowledge, preparedness and perception of telemedicine among Family Medicine Resident Physicians in different training institutions in Cebu City during the Coronavirus Disease 19 pandemic. Methods: A descriptive, cross-sectional survey research study was conducted in four hospital training institutions in Cebu City. A total of 41 respondents gave their consent and were given the online survey questionnaire pertaining to the extent of knowledge, preparedness and perceptions on telemedicine, including respondents’ demographic data and problems encountered in Telemedicine. Results: Out of the 41 respondents, 56.10% were young adults (26 to 30 years old), mostly females (70.73%), single (68.29%), first-year residents (43.90%), employed at a government hospital (70.73%) and are in the traditional residency pathway (82.93%). On relevant experience, 82.93% experienced telemedicine during residency, with 100% on follow-up consultations, and 95% were consulted due to infections. Respondents’ extent of knowledge was average, while the extent of preparedness and perception were great. Problems with low connectivity (80.48%) were noted by most of the respondents. Conclusion: Resident physicians moderately understood the information about telemedicine but with a great extent of preparedness and perception. They are always prepared for telemedicine modality because they are fully aware of its existence and need in the delivery of health care services among their patients at the time of the pandemic. Challenges to low connectivity and handling patients’ data privacy were the major concerns met by the resident physicians in the use of telemedicine.

Keywords: telemedicine, knowledge, preparedness, perception, family medicine, residents, COVID 19

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22804 In vitro Effects of Viscum album on the Functionality of Rabbit Spermatozoa

Authors: Marek Halenár, Eva Tvrdá, Simona Baldovská, Ľubomír Ondruška, Peter Massányi, Adriana Kolesárová

Abstract:

This study aimed to assess the in vitro effects of different concentrations of the Viscum album extract on the motility, viability, and reactive oxygen species (ROS) production by rabbit spermatozoa during different time periods (0, 2, and 8h). Spermatozoa motility was assessed by using the CASA (Computer aided sperm analysis) system. Cell viability was evaluated by using the metabolic activity MTT assay, and the luminol-based luminometry was applied to quantify the ROS formation. The CASA analysis revealed that low Viscum concentrations were able to prevent a rapid decline of spermatozoa motility, especially in the case of concentrations ranging between 1 and 5 µg/mL (P<0.05 with respect to time 8h). At the same time, concentrations ranging between 1 and 100 µg/mL of the extract led to a significant preservation of the cell viability (P<0.05 in case of 5, 50 and 100 µg/mL; P<0.01 with respect to 1 and 10 µg/mL, time 8h). 1 and 5 µg/mL of the extract exhibited antioxidant characteristics, translated into a significant reduction of the ROS production, particularly notable at time 8h (P<0.01). The results indicate that the Viscum extract is capable of delaying the damage inflicted to the spermatozoon by the in vitro environment.

Keywords: CASA, mistletoe, mitochondrial activity, motility, reactive oxygen species, rabbits, spermatozoa, Viscum album

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22803 Minimally Invasive versus Conventional Sternotomy for Aortic Valve Replacement: A Systematic Review and Meta-Analysis

Authors: Ahmed Shaboub, Yusuf Jasim Althawadi, Shadi Alaa Abdelaal, Mohamed Hussein Abdalla, Hatem Amr Elzahaby, Mohamed Mohamed, Hazem S. Ghaith, Ahmed Negida

Abstract:

Objectives: We aimed to compare the safety and outcomes of the minimally invasive approaches versus conventional sternotomy procedures for aortic valve replacement. Methods: We conducted a PRISMA-compliant systematic review and meta-analysis. We ran an electronic search of PubMed, Cochrane CENTRAL, Scopus, and Web of Science to identify the relevant published studies. Data were extracted and pooled as standardized mean difference (SMD) or risk ratio (RR) using StataMP version 17 for macOS. Results: Forty-one studies with a total of 15,065 patients were included in this meta-analysis (minimally invasive approaches n=7231 vs. conventional sternotomy n=7834). The pooled effect size showed that minimally invasive approaches had lower mortality rate (RR 0.76, 95%CI [0.59 to 0.99]), intensive care unit and hospital stays (SMD -0.16 and -0.31, respectively), ventilation time (SMD -0.26, 95%CI [-0.38 to -0.15]), 24-h chest tube drainage (SMD -1.03, 95%CI [-1.53 to -0.53]), RBCs transfusion (RR 0.81, 95%CI [0.70 to 0.93]), wound infection (RR 0.66, 95%CI [0.47 to 0.92]) and acute renal failure (RR 0.65, 95%CI [0.46 to 0.93]). However, minimally invasive approaches had longer operative time, cross-clamp, and bypass times (SMD 0.47, 95%CI [0.22 to 0.72], SMD 0.27, 95%CI [0.07 to 0.48], and SMD 0.37, 95%CI [0.20 to 0.45], respectively). There were no differences between the two groups in blood loss, endocarditis, cardiac tamponade, stroke, arrhythmias, pneumonia, pneumothorax, bleeding reoperation, tracheostomy, hemodialysis, or myocardial infarction (all P>0.05). Conclusion: Current evidence showed higher safety and better operative outcomes with minimally invasive aortic valve replacement compared to the conventional approach. Future RCTs with long-term follow-ups are recommended.

Keywords: aortic replacement, minimally invasive, sternotomy, mini-sternotomy, aortic valve, meta analysis

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22802 Experimental Study on the Preparation of Pelletizing of the Panzhihua's Fine Ilmenite Concentrate

Authors: Han Kexi, Lv Xuewei, Song Bing

Abstract:

This paper focuses on the preparation of pelletizing with the Panzhihua ilmenite concentrate to satisfy the requirement of smelting titania slag. The effects of the moisture content, mixing time of raw materials, pressure of pellet, roller rotating speed of roller, drying temperature and time on the pelletizing yield and compressive strength were investigated. The experimental results show that the moister content was controlled at 2.0%~2.5%, mixing time at 20 min, the pressure of the ball forming machine at 13~15 mpa, the pelletizing yield can reach up 85%. When the roller rotating speed is 6~8 r/min while the drying temperature and time respectively is 350 ℃ and 40~60 min, the compressive strength of pelletizing more than 1500 N. The preparation of pelletizing can meet the requirement of smelting titania slag.

Keywords: Panzhihua fine ilmenite concentrate, pelletizing, pelletizing yield, compressive strength, drying

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22801 Investigation of the Variables Affecting the Use of Charcoal to Delay Fermentation in Wet Beans Slurry Using Chemical and Physical Analysis

Authors: Anuoluwapo O. Adewole

Abstract:

Fermentation is the conversion of monomeric sugars into ethanol and carbondioxide in the presence of microorganisms under anaerobic conditions. In line with the aim and objective of this research project, which is to investigate into the variables affecting the use of charcoal to delay fermentation in wet beans slurry, some physical and chemical analysis were carried out on the wet beans slurry using a PH meter in which a thermometer is incorporated in it, and a measuring cylinder was used for the foam level test. About 250 grams of the ground beans slurry was divided into two portions for testing. The sample with charcoal was labeled sample 'A' while the second sample without charcoal was labeled sample 'B' subsequently. The experiment lasted for a period of 41.15 hours (i.e., forty-one hours and nine minutes). During the fourth process, both samples could not be tested as the laboratory had been saturated with foul odor and both samples were packed and sealed in polythene bag for disposal in the trash can. It was generally observed that the sample with the charcoal lasted for a longer time before that without charcoal before total spoilage occurred.

Keywords: fermentation, monomeric sugars, beans slurry, charcoal, anaerobic conditions

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22800 Impact of Long Term Application of Municipal Solid Waste on Physicochemical and Microbial Parameters and Heavy Metal Distribution in Soils in Accordance to Its Agricultural Uses

Authors: Rinku Dhanker, Suman Chaudhary, Tanvi Bhatia, Sneh Goyal

Abstract:

Municipal Solid Waste (MSW), being a rich source of organic materials, can be used for agricultural applications as an important source of nutrients for soil and plants. This is also an alternative beneficial management practice for MSW generated in developing countries. In the present study, MSW treated soil samples from last four to six years at farmer’s field in Rohtak and Gurgaon states (Haryana, India) were collected. The samples were analyzed for all-important agricultural parameters and compared with the control untreated soil samples. The treated soil at farmer’s field showed increase in total N by 48 to 68%, P by 45.7 to 51.3%, and K by 60 to 67% compared to untreated soil samples. Application of sewage sludge at different sites led to increase in microbial biomass C by 60 to 68% compared to untreated soil. There was significant increase in total Cu, Cr, Ni, Fe, Pb, and Zn in all sewage sludge amended soil samples; however, concentration of all the metals were still below the current permitted (EU) limits. To study the adverse effect of heavy metals accumulation on various soil microbial activities, the sewage sludge samples (from wastewater treatment plant at Gurgaon) were artificially contaminated with heavy metal concentration above the EU limits. They were then applied to soil samples with different rates (0.5 to 4.0%) and incubated for 90 days under laboratory conditions. The samples were drawn at different intervals and analyzed for various parameters like pH, EC, total N, P, K, microbial biomass C, carbon mineralization, and diethylenetriaminepentaacetic acid (DTPA) exactable heavy metals. The results were compared to the uncontaminated sewage sludge. The increasing level of sewage sludge from 0.5 to 4% led to build of organic C and total N, P and K content at the early stages of incubation. But, organic C was decreased after 90 days because of decomposition of organic matter. Biomass production was significantly increased in both contaminated and uncontaminated sewage soil samples, but also led to slight increases in metal accumulation and their bioavailability in soil. The maximum metal concentrations were found in treatment with 4% of contaminated sewage sludge amendment.

Keywords: heavy metal, municipal sewage sludge, sustainable agriculture, soil fertility and quality

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22799 Prevalence of Chlamydia Trachomatis Infection in Multiple Anatomical Sites among Patients at Stis Center, Thailand

Authors: Siwimol Phoomniyom, Pathom Karaipoom, Rossaphorn Kittyaowaman

Abstract:

Background: C. trachomatis is the most common bacterial sexually transmitted infections. Although infection with C. trachomatis can be treated with antibiotic, it is frequently asymptomatic, especially in extragenital sites. Hence, if screening tests are not performed, undetected and untreated is a crucial problem for C. trachomatis infection, especially in Thailand, which is less well studied. We sought to assess the prevalence of C. trachomatis infection in multiple anatomical sites among patients attending Bangrak STIs Center. Methods: We examined laboratory results of all patients at baseline visit from 3 January 2018 to 27 December 2019. These results were tested by a validated in-house real time PCR specify for the cryptic plasmid gene of C. trachomatis. The prevalence of C. trachomatis was analyzed by anatomical sites, sexes, and ages. Urogenital samples were obtained from urethral swab of men and cervical swab of women. The median ages of the patients were 32 years (range 13-89 years). Chi-square test by IBM SPSS statistic version 20 was used to assess difference in the distribution of variables between groups. Results: Among 3,789 patients, the prevalence for C. trachomatis infection was the highest in rectal (16.1%), followed by urogenital (11.2%) and pharyngeal (3.5%) sites. Rectal and urogenital infection in men was higher than in women, with the highest prevalence of 16.6% in rectal site. Both rectal and urogenital sites also showed statistically significant differences between sexes (P<0.001). Meanwhile, pharyngeal C. trachomatis infection rate was higher in women than men. Interestingly, the chlamydia prevalence was the highest in age 13-19 years of all three sites (18.5%, urogenital; 17.7%, rectal; 6.5%, pharyngeal), with statistically significant difference between age groups (P<0.001). Total of 45 C. trachomatis infections, 20.0%, 51.1%, and 6.7% were isolated from urogenital, rectal, and pharyngeal sites. In total, 75.6%, 26.7%, and 80.0% of chlamydia infections would have been missed, if only urogenital, rectal, or pharyngeal screening was performed. Conclusions: The highest source of C. trachomatis infection was the rectal site. While, the highest prevalence in men was at rectal site, that in women was at urogenital site. The highest chlamydia prevalence was found in adolescent age group, indicating that the pediatric population was a high-risk group. This finding also elucidated that a high proportion of C. trachomatis infection would be missed, if only single anatomical site screening was performed, especially in extragenital sites. Hence, extragenital screening is also required for the extensive C. trachomatis detection.

Keywords: chlamydia trachomatis, anatomical sites, sexes, ages

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