Search results for: poor outcome of delayed breast cancer treatment

Authors: Amir Hajiali, Gevorg P. Pirumyan

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In this research, removal of Non-Organic Suspended Solids and Non-Organic Solved Solids with and without sediment in treatment of an industrial wastewater system before and after ozonation was studied and compared. The most hazardous part of these substances is monomers of chlorophenolic combinations which in biological reactors in a liquid phase could be absorbed much easier and with a high velocity. These monomers and particularly monomers with high molecular weights are seen a lot in such wastewater treatment systems. After the treatment, the measured non-organic solved and suspended solids contents in the cyclic ozonation-biotreatment system compared to the non-organic solved and suspended solids values in the treatment method without ozonation. Sedimentation was the other factor which was considered in this experiment.The solids removals were measured with and without sediments. The comparison revealed that the remarkable efficiency of the cyclic ozonation-biotreatment system in removing the non-organic solids both with and without sediments is extremely considerable. Results of the experiments showed that ozone can be dramatically effective for solving most organic materials in activated sludge in such a wastewater or for making them mineral. Moreover, bio dissolubility increase related to the solved materials was reported.

Keywords: non-organic solids, ozonation, sediment, wastewater treatment

Procedia PDF Downloads 179

Authors: Mohadeseh Shojaei Shahrokhabadi, Ding-Geng (Din) Chen

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Positive continuous outcomes with a substantial number of zero values and incomplete longitudinal follow-up are quite common in medical cost data. To jointly model semi-continuous longitudinal cost data and survival data and to provide marginalized covariate effect estimates, a marginalized two-part joint model (MTJM) has been developed for outcome variables with lognormal distributions. In this paper, we propose MTJM models for outcome variables from a generalized gamma (GG) family of distributions. The GG distribution constitutes a general family that includes approximately all of the most frequently used distributions like the Gamma, Exponential, Weibull, and Log Normal. In the proposed MTJM-GG model, the conditional mean from a conventional two-part model with a three-parameter GG distribution is parameterized to provide the marginal interpretation for regression coefficients. In addition, MTJM-gamma and MTJM-Weibull are developed as special cases of MTJM-GG. To illustrate the applicability of the MTJM-GG, we applied the model to a set of real electronic health record data recently collected in Iran, and we provided SAS code for application. The simulation results showed that when the outcome distribution is unknown or misspecified, which is usually the case in real data sets, the MTJM-GG consistently outperforms other models. The GG family of distribution facilitates estimating a model with improved fit over the MTJM-gamma, standard Weibull, or Log-Normal distributions.

Keywords: marginalized two-part model, zero-inflated, right-skewed, semi-continuous, generalized gamma

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Authors: Michael Zaidman, Naum Simanovsky

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Introduction. Symptomatic tarsal coalition with rigid flat foot often demands operative solution. An isolated coalition resection does not guarantee pain relief; correction of co-existing foot deformity may be required. The objective of the study was to analyze the results of combination of tarsal coalition resection and arthroereisis. Patients and methods. We retrospectively reviewed medical records and radiographs of children operatively treated in our institution for symptomatic calcaneonavicular or talocalcaneal coalition between the years 2019 and 2022. Eight patients (twelve feet), 4 boys and 4 girls with mean age 11.2 years, were included in the study. In six patients (10 feet) calcaneonavicular coalition was diagnosed, two patients (two feet) sustained talonavicular coalition. To quantify degrees of foot deformity, we used calcaneal pitch angle, lateral talar-first metatarsal (Meary's) angle, and talonavicular coverage angle. The clinical results were assessed using the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle Hindfoot Score. Results. The mean follow-up was 28 month. The preoperative mean talonavicular coverage angle was 17,75º as compared with postoperative mean angle of 5.4º. The calcaneal pitch angle improved from mean 6,8º to 16,4º. The mean preoperative Meary’s angle of -11.3º improved to mean 2.8º. The preoperative mean AOFAS score improved from 54.7 to 93.1 points post-operatively. In nine of twelve feet, overall clinical outcome judged by AOFAS scale was excellent (90-100 points), in three feet was good (80-90 points). Six patients (ten feet) obviously improved their subtalar range of motion. Conclusion. For symptomatic stiff or rigid flat feet associated with tarsal coalition, the combination of coalition resection and arthroereisis leads to normalization of radiographic parameters, clinical and functional improvement with good patient’s satisfaction and likely to be more effective than the isolated procedures.

Keywords: rigid flat foot, tarsal coalition resection, arthroereisis, outcome

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Authors: Averill Reindle T. Camilo, Veena Jaye B. Cosme, Hazel Kaye a Mabborang, Johannah a Magayam, Julie May D. Magguiya, Trisha Irish W. Maique, Klein Van M. Maloc, Jaydee B. Masadao, Yvonne Mae P. Ματεο

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The City of Tabuk had the highest number of registered births in the province of Kalinga, indicating the need to study birth spacing trends in Tabuk City further. The study investigates women's experiences with poor birth spacing in Bulanao, Tabuk City, Kalinga, focusing on their views, practices, challenges, and strategies to cope with these issues. A qualitative research approach was used, specifically the Descriptive Phenomenological Research Design with eight (8) participants from Bulanao, Tabuk City, Kalinga. The study found that women's views on poor birth spacing, including intense desire, wanting to have more children, and their perception of children as blessings and helpers, are prevalent and including side effects of contraceptives. The challenges faced by women due to poor birth spacing include financial constraints, sickness, lack of support, and time constraints. These issues can lead to increased living costs for stay-at-home parents, including food, clothing, transportation, medical care, housing, childcare, and budget modifications. The participants also face difficulties in handling sick children and adjusting to uneven birth spacing. To cope, they focus on earning money, patience, andcontraception, while seeking family support fromin-laws andmothers.

Keywords: birth spacing, contraception, coping strategies, maternal health, women experiences

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Authors: Majd Megheirkouni

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The aim of this study is to identify empirical studies that explore and investigate ethical leadership in order to assess and synthesize its impacts and outcomes. This study seeks to provide an evidence-informed answer to a set of questions on ethical leadership definition in the field of tourism and hospitality, its investigation, and examination, and its outcome. A systematic literature review, using medical science-based methodology, was conducted to synthesize research by reliable means. Four themes were identified from the analysis. These themes are: Ethical leaders’ characteristics, healthy work environment, ethical leadership effectiveness, and the application of ethical leadership across cultures. This study provides the potential to move hospitality and tourism leadership forward and encourage researchers to investigate new research topics. To the best of the author’s knowledge, this is the first systematic review focusing on ethical leadership in tourism and hospitality settings.

Keywords: ethical leadership, approach, outcome, tourism, hospitality, systematic review

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Authors: Ayedun Hassan, Ayadi Odunayo Peter

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The ancient city of Abeokuta has been supplied with pipe borne water since 1911, yet, a continuous increase in population and unplanned city expansion makes water a very precious and scarce commodity. The government reserved areas (GRA’s) are well planned, and public water supply is available; however, the sub-urban areas consist of scattered structures with individuals trying to source water by digging wells and boreholes. The geology of the city consists of basement rock which makes digging wells and boreholes very difficult. The present study was conducted to assess the risk arising from the consumption of toxic elements in the groundwater of Abeokuta, Ogun State, Nigeria. Forty-five groundwater samples were collected from nine different areas of Abeokuta and analyzed for physicochemical parameters and toxic elements. The physicochemical parameters were determined using standard methods, while the toxic elements were determined using Inductively Coupled Plasma-Mass Spectrometer (ICP/MS). Ninety-six percent (96%) of the water sample has pH < 6.5, and 11% has conductivity > 250 µSCm⁻¹ limits in drinking water as recommended by WHO. Seven percent (7%) of the samples have Pb concentration >10 µgL⁻¹ while 75% have Al concentration >200 µgL⁻¹ recommended by WHO. The order for risk of cancer from different area of Abeokuta are Cd²⁺ > As³⁺ > Pb²⁺ > Cr⁶⁺ for Funaab, Camp and Obantoko; As³⁺ > Cd²⁺ > Pb²⁺ > Cr⁶⁺ for Ita Osin, Isale Igbein, Ake and Itoku; Cd²⁺ >As > Cr⁶⁺ > Pb²⁺ for Totoro; Pb²⁺ > Cd²⁺ > As³⁺ > Cr⁶⁺ for Idiaba. The order of non-cancer hazard index (HI) calculated for groundwater of Abeokuta City are Cd²⁺ > As³⁺ > Mn²⁺ > Pb²⁺ > Ni²⁺ and were all greater than one, which implies susceptibility to other illnesses. The sources of these elements are the rock and inappropriate waste disposal method, which leached the elements into the groundwater. A combination of sources from food will accumulate these elements in the human body system. Treatment to remove Al and Pb is necessary, while the method of water distribution should be reviewed to ensure access to potable water by the residents.

Keywords: Abeokuta, groundwater, Nigeria, risk

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Authors: Arezoo Fallahi, Fateme Aslibigi, Parvaneh Taymoori, Babak Nematshahrbabaki

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Background and Aims: Cancer of the cervix, one of cancer-related death, is the second most common cancer in women worldwide. It develops over time but it is one of the most preventable types of cancer and there is the available proper screening program for its preventing. Since Pap smear test is vital to prevent and control of disease but women do not accomplish it regularly. Therefore, this study was aimed to explore women's needs referring to health care centers for doing Pap smear test. Material and methods: In this study, an inductive qualitative method with content analysis approach was used. This survey was done in varamin city (is located capital of Iran) in year 2014. Through the purposive sampling 15 women's view of point referring to health care centers of for doing Pap smear test was surveyed. Inclusion criteria were: 20-50 years old married women, having experience Pap smear test and attendance to participate in the Study. Recorded semi- structured interviews were typed and analyzed through of content analysis method. To obtain trustworthiness and rigor of the data, the criteria of credibility, dependability, confirmability and transferability was used. Results: During the data analysis, four main categories of “role of health care team”, “role of organizations”, “social support” and “policies and administration system” were developed. The participants emphasized on making motivational rules and coordination among organizations to do behaviors related to women health. Conclusion: The findings of study showed that doing Pap smear test are attributed to appropriate and intimate interactions with health professionals, family support, encouraging legislation and policies and coordination and notification of organizations. Therefore, designers and stockholders of policies and health system should more consider to growth and involve other organizations toward women's health.

Keywords: qualitative approach, pap smear test, women, health care centers

Procedia PDF Downloads 492

Authors: Fitsumbrhan Tajebe, Fadil Murad, Mitikie Tigabie, Mareye Abebaw, Tadele Alemu, Sefanit Abate, Rezika Mohammedw, Arega Yeshanew, Elias Shiferaw

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Background: Visceral leshimaniasis is a parasitic disease characterized by a systemic infection of phagocytic cells. Hematological parameters of these patients may be affected by the progress of the disease or treatment. Thus, the current study aimed to assess the hematological profiles of visceral leishmaniasis patients before and after treatment. Method: An institutional based retrospective cohort study was conducted among visceral leishmaniasis patients at University of Gondar Comprehensive Specialized Referral Hospital Leishmaniasis Research and Treatment Center from 2013 to 2018. Hematological profiles before initiation and after completion of treatment were extracted from registration book. Descriptive statics was presented using frequency and percentage. Paired t-test and Wilcoxon Signed rank test were used for comparing mean difference for normally and non- normally distributed data, respectively. Spearman and Pearson correlation analysis was used to describe the correlation of hematological parameters with different variables. P value < 0.05 was considered as statistically significant. Result: Except absolute nerutrophil count, post treatment hematological parameters show a significant increment compared to pretreatment one. The prevalence of anemia, leucopenia and thrombocytopenia was 85.5%, 83.4% and 75.8% prior to treatment and it was 58.3%, 38.2% and 19.2% after treatment, respectively. Moreover, parasite load of the disease showed statistically significant negative correlation with hematological profiles mainly with white blood cell and red blood cell. Conclusion: Majority of hematological profiles of patients with active VL have been restored after treatment, which might be associated with treatment effect on parasite proliferation and concentration of parasite in visceral organ, which directly affect hematological profiles.

Keywords: visceral leshimaniasis, hematological profile, anti-leshimanial drug, Gondar

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Authors: Abbas Hadj Abbas, Hacini Massaoud, Aiad Lahcen

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In Hassi-Messoud’s oil industry, the systems which are water based (WBM) are generally used for drilling in the first phase. For the rest of the well, the oil mud systems are employed (OBM). In the field of oil exploration, panoply of chemical products is employed in the drilling fluids formulation. These components of different natures and whose toxicity and biodegradability are of ill-defined parameters are; however, thrown into nature. In addition to the hydrocarbon (HC, such as diesel) which is a major constituent of oil based mud, we also can notice spills as well as a variety of other products and additives on the drilling sites. These wastes are usually stored in places called (crud wastes). These may cause major problems to the ecosystem. To treat these wastes, we have considered two methods which are: solidification/ stabilization (chemical) and thermal. So that we can evaluate the techniques of treatment, a series of analyses are performed on dozens of specimens of wastes before treatment. After that, and on the basis of our analyses of wastes, we opted for diagnostic treatments of pollution before and after solidification and stabilization. Finally, we have done some analyses before and after the thermal treatment to check the efficiency of the methods followed in the study.

Keywords: wastes treatment, the oil pollution, the norms, wastes drilling

Procedia PDF Downloads 287

Authors: S. P. Chintan, A. M. Khoja, M. Modi, R. K. Chopra, S. Garde, D. Jain, O. Kajale

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Pulmonary Hypertension is a rare but debilitating disease that affects individuals of all ages and walks of life. As recent as 15 years ago, a patient diagnosed with PH was given an average survival rate of 2.8 years. Recent advances in treatment options have allowed patients to improve quality o and quantity of life. Initial screening for PH is through echocardiography with final diagnosis confirmed through right heart catheterization. PH is now considered to have five major classifications with subgroups among each. The mild to moderate PH is common in chronic lung diseases like Chronic obstructive pulmonary diseases and Interstitial lung disease. But very severe PH is noted in few cases. In COPD patients, PH is associated with an increased risk of severe exacerbations and a reduced life expectancy. Similarly, in patients with ILD, the presence of PH correlates with a poor prognosis. Early diagnosis is essential to slow disease progression. We report here five cases of severe PH (Out of Proportion) of which four cases were of COPD and another one of IPF (UIP pattern). There echocardiography showed gross RA/RV dilatation, interventricular septum bulging to the left and mPAP of more than 100 mmHg in all the five cases. These patients were put on LTOT, pulmonary rehabilitation, combination pharmacotherapy of vasodilators and diuretics in continuation to the treatment of underlying disease. As these patients have grave prognosis close monitoring and follow up is required. Physicians associated with respiratory care and treating chronic lung disease should have knowledge in the diagnosis and management of patients with PH.

Keywords: COPD, pulmonary hypertension, chronic lung disease, India

Procedia PDF Downloads 354

Authors: Ghada Esheba, Ghadeer Aldoobi, Salwa Almalk, Abrar Alshareef, Eman Al-khairi, Eman Yaseen

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Background: In Saudi Arabia, ovarian cancer ranked seventh among female population and is the most common female genital tract malignancy after endometrial cancer. A slight increase in the incidence of ovarian cancer was observed from 2001–2008. Makkah, Riyadh, and the eastern region of Saudi Arabia had the highest incidence rate ratio for the number of ovarian cancer cases (1). Differentiating metastatic adenocarcinomas from primary ovarian carcinomas, especially those of endometrioid and mucinous type is clinically significant and a challenge for clinicians and pathologists, yet the distinction has important therapeutic and prognostic implications. Aim: To clarify the most important histopathological criteria to differentiate between primary ovarian surface epithelial tumors especially mucinous and endometrioid subtypes, and metastatic adenocarcinoma and to evaluate the value of a panel of antibodies consisting of CK7, CK20, and CDX-2 in the distinction between primary ovarian surface epithelial tumors and metastatic adenocarcinoma. Material and methods: This study was carried out on 26 cases of primary ovarian surface epithelial neoplasms and 14 cases of metastatic ovarian adenocarcinoma. All cases were studied immunohistochemically using CK7, CK20, and CDX-2. Results: All cases of primary ovarian adenocarcinoma were positive for CK7. 25% and 58% of mucinous borderline mucinous tumor and mucinous carcinoma respectively were positive for CK20. Only 42% of mucinous carcinoma were positive for CDX-2. All cases of endometrioid carcinomas were negative for both CK20 and CDX-2. All cases of metastatic adenocarcinoma from the colon were negative for CK7 and positive for CK20 and CDX-2. Conclusions: CK7 is an important positive marker for primary ovarian tumors, while CK20 and CDX-2 are useful markers for colorectal carcinoma metastatic to the ovary. Caution should be taken as primary ovarian mucinous tumors may stain positive for CK20, CDX-2, or both, however, they usually exhibit a focal pattern of reactivity.

Keywords: adenoma, endometrioid, malignancy, ovarian

Procedia PDF Downloads 226

Authors: Deniz Sahin

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This study provides a literature review of the special issue on wastewater treatment technologies, especially membrane technologies. Currently, wastewater is a serious and increasing worldwide problem with an adverse effect on the environment and living organisms. For this reason, many technologies have been developed to treat wastewater before discharging it to water bodies. We have been discussed membrane technologies to remove contaminants from wastewater such as heavy metals, dyes, pesticides, etc., which represent the main pollutants in wastewater. All the properties of these technologies including performance, economics, simplicity, and operability are also compared with other wastewater treatment technologies. The conventional water treatment technologies have the disadvantages of low separation efficiency, high energy consumption, and strict operating temperature. To overcome these difficulties, membrane technologies have been developed and used in wastewater treatment. Membrane technology uses a selectively permeable membrane to remove suspended and dissolved solids from water. This membrane is a very thin film of synthetic organic or inorganic materials, that can allow a very selective separation between a mixture and its components. Examples of membrane technologies include microfiltration (MF), ultrafiltration (UF), nanofiltration (NF), reverse osmosis (RO), electrodialysis (ED), gas separation, etc. Most of these technologies have been used extensively for the treatment of heavy metal wastewater. For instance, wastewater that contains Cu²⁺, Cd²⁺, Pb²⁺, Zn²⁺ was treated by ultrafiltration technology. It was shown that complete removal of metal ions could be achieved.

Keywords: industrial pollution, membrane technologies, metal ions, wastewater

Procedia PDF Downloads 189

Authors: Maatouk Mohamed, Nouira Mariem, Hamdi Kbir Gh, Mahjoubi M. F., Ben Moussa M.

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Background and aim: Preoperative biliary drainage (PBD) has been introduced to lower bilirubin levels and to control the negative effects of obstructive jaundice in patients with malignant obstructive jaundice undergoing pancreaticoduodenectomy (PD). The optimal time interval between PBD and PD is still not clear. Delaying surgery by 4 to 6 weeks is the commonly accepted practice. However, delayed PD has been shown to decrease the rate of resection and adversely affect the tumor grading and prognosis. Thus, the purpose of our systematic review and meta-analysis was to evaluate the optimal period for PBD prior to PD: short or prolonged in terms of postoperative morbidity and survival outcomes. Methods: Trials were searched in PubMed, Science Direct, Google Scholar, and Cochrane Library until November 2022. Studies using PBD in patients with malignant obstructive jaundice that compared short duration group (SDG) (surgery performed within 3-4 weeks) with prolonged duration group (PDG) (at least 3-4 weeks after PBD) were included in this study. The risk of bias was assessed using the Rob v2 and Robins-I tools. The priori protocol was published in PROSPERO (ID: CRD42022381405). Results: Seven studies comprising 1625 patients (SDG 870, PDG 882) were included. All studies were non-randomized, and only one was prospective. No significant differences were observed between the SDG and PDG in mortality (OR= 0.59; 95% CI [0.30, 1.17], p=0.13), major morbidity (Chi² = 30.28, p <0.00001; I² = 87%), pancreatic fistula (Chi² = 6.61, p = 0.25); I² = 24%), post pancreatectomy haemorrhage (OR= 1.16; 95% CI [0.67, 2.01], p=0.59), positive drainage culture (OR= 0.36; 95% CI [0.10, 1.32], p=0.12), septic complications (OR= 0.78; 95% CI [0.23, 2.72], p=0.70), wound infection (OR= 0.08, p=0.07), operative time (MD= 0.21; p=0.21). Conclusion: Early surgery within 3 or 4 weeks after biliary drainage is both safe and effective. Thus, it is reasonable to suggest early surgery following PBD for patients having resectable periampullary cancers.

Keywords: preoperative biliary drainage, pancreatic cancer, pancreatic surgery, complication

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Authors: Rajnish Gourh, Nitesh Sharma, Nikhil Patil

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Introduction: Adequate nutrition is essential for improving pregnancy and its outcomes. Failure to comply with the required daily intake of nutrition can lead to complications threatening both mother and child survival. Objectives: To provide access to nutritious diet to mothers in antenatal and post-natal stage for supporting a healthy progressive pregnancy, positive delivery outcome, and lactation and to promote regular consumption of the foods by the mothers and help overcome the dietary gap by nutrition education during pregnancy time. Methodology: Total of 95 ANC mothers were identified from Malvada PHC area, in Palghar district of Maharashtra. This short-term cohort intended for the proposed supplementation and education was targeted for follow-up until birth and six-months of post-natal period. In month of May 2016 to June 2017. Results: Average weight of women was observed 40.01kg, (SD- 5.024) at registered for ANC at Centre in the first month. In same month, average Haemoglobin level of women was observed 9.13gm/dl. Average increase in weight of women during pregnancy in month October 2016 was 48.83kg. Birth weight of 14 babies was less than 2 kgs. 13 babies with birth weight in range of 2.1kgs to 2.4kgs. 68 babies with birth weight in range of 2.5kg to 3kg and above. Conclusion: Importance of consumption of food, improving levels of nutrient intake and outcome of delivery was excellent.

Keywords: delivery status, nutrition, pregnancy, education

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Authors: Syed Asif Ali Naqvi, Muhammad Azeem Tufail

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Inadequate sanitation causes direct costs of treating illnesses and loss of income through reduced productivity. This study estimated the economic cost of health (ECH) due to poor sanitation and factors determining the lack of access to latrine for the rural, backward hamlets and slums of district Faisalabad, Pakistan. Cross sectional data were collected and analyzed for the study. As the population under study was homogenous in nature, it is why a simple random sampling technique was used for the collection of data. Data of 440 households from 4 tehsils were gathered. The ordinary least square (OLS) model was used for health cost analysis, and the Probit regression model was employed for determining the factors responsible for inaccess to toilets. The results of the study showed that condition of toilets, situation of sewerage system, access to adequate sanitation, Cholera, diarrhea and dysentery, Water and Sanitation Agency (WASA) maintenance, source of medical treatment can plausibly have a significant connection with the dependent variable. Outcomes of the second model showed that the variables of education, family system, age, and type of dwelling have positive and significant sway with the dependent variable. Variable of age depicted an insignificant association with access to toilets. Variable of monetary expenses would negatively influence the dependent variable. Findings revealed the fact, health risks are often exacerbated by inadequate sanitation, and ultimately, the cost on health also surges. Public and community toilets for youths and social campaigning are suggested for public policy.

Keywords: sanitation, toilet, economic cost of health, water, Punjab

Procedia PDF Downloads 118

Authors: Noor Shafifiyaz Mohd Yazid, Najihah Mohd Hashim, Hapipah Mohd Ali, Syam Mohan, Rosea Go

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Artocarpus kemando is a plant species from Moraceae family. This plant is used as household utensil by the local and the fruits are edible. The plants’ bark was used for the extraction process and yielded the chloroform crude extract which was used to screen for anticancer potential. The cytotoxic effect of the extract on CAOV-3 and WRL 68 cell lines were determined using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide or MTT assays. Qualitative AO/PI assay was performed to confirm the apoptosis and necrosis process. Meanwhile, the measurement of cell loss, nuclear morphology, DNA content, cell membrane permeability, mitochondrial membrane potential changes and cytochrome c release from mitochondria were detected through cytotoxicity 3 assay. In MTT assay, A. kemando inhibited 50% growth of CAOV-3 cells at 27.9 ± 0:03, 20.1± 0:03, 18.21± 0:04 µg/mL after 24, 48 and 72 hour, respectively. The morphology changes can be seen on CAOV-3 with a production of cell membrane blebbing, cromatin condensation and apoptotic bodies. Evaluation of cytotoxicity 3 on CAOV-3 cells after treated with extract resulting loss of mitochondrial membrane potential and release of cytochrome c from mitochondria. The results demonstrated A. kemando has potentially anticancer agent, particularly on human ovarian cancer.

Keywords: anticancer, Artocarpus kemando, ovarian cancer, cytotoxicity

Procedia PDF Downloads 545

Authors: Franklin Chu Buh, Irene Ule Ngole Sumbele, Andrew I. R. Maas, Mathieu Motah, Jogi V. Pattisapu, Eric Youm, Basil Kum Meh, Firas H. Kobeissy, Kevin W. Wang, Peter J. A. Hutchinson, Germain Sotoing Taiwe

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Introduction: Studying TBI characteristics and their relation to outcomes can identify initiatives to improve TBI prevention and care. The objective of this study was to define the features and outcomes of TBI patients seen over a 1-year period in a level-I trauma center in Cameroon. Methods: Data on demographics, causes, injury mechanisms, clinical aspects, and discharge status were prospectively collected over a period of 12 months. The Glasgow Outcome Scale-Extended (GOSE) and the Quality of Life Questionnaire after Brain Injury (QoLIBRI) were used to evaluate outcomes 6-months after TBI. Categorical variables were described as frequencies and percentages. Comparisons between 2 categorical variables were done using Pearson's Chi-square test or Fisher's exact test. Results: A total of 160 TBI patients participated in the study. The age group 15-45 years (78%; 125) was most represented. Males were more affected (90%; 144). Low educational level was recorded in 122 (76%) cases. Road traffic incidents (RTI) were the main cause of TBI (85%), with professional bike riders being frequently involved (27%, 43/160). Assaults (7.5%) and falls (2.5%) represent the second and third most common causes of TBI in Cameroon, respectively. Only 15 patients were transported to the hospital by ambulance, and 14 of these were from a referring hospital. CT-imaging was performed in 78% (125/160) of cases intracranial traumatic abnormality was identified in 77/125 (64%) cases. Financial constraints were the main reason for not performing a CT scan on 35 patients. A total of 46 (33%) patients were discharged against medical advice (DAMA) due to financial constraints. Mortality was 14% (22/160) but disproportionately high in patients with severe TBI (46%). DAMA had poor outcomes with QoLIBRI. Only 4 patients received post-injury physiotherapy services. Conclusion: TBI in Cameroon mainly results from RTIs and commonly affects young adult males, and low educational or socioeconomic status and commercial bike riding appear to be predisposing factors. Lack of pre-hospital care, financial constraints limiting both CT-scanning and medical care, and lack of acute physiotherapy services likely influenced care and outcomes adversely.

Keywords: characteristics, traumatic brain injury, outcome, disparities in care, prospective study

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Authors: Mehmet Bulent Topkaya, Mustafa Yildirim

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Wastewater treatment systems are designed and used to minimize adverse impacts of the wastewater on the environment before discharging. Various treatment options for wastewater treatment have been developed, and each of them has different performance characteristics and environmental impacts (e.g. material and land usage, energy consumption, greenhouse gas emission, water and soil emission) during construction, operation or maintenance phases. Assessing the environmental impacts during these phases are essential for the overall evaluation of the treatment systems. In this study, wastewater treatment options, such as vegetated land treatment, constructed wetland, rotating biological contactor, conventional activated sludge treatment, membrane bioreactor, extended aeration and stabilization pond are evaluated. The comparison of the environmental impacts is conducted under the assumption that the effluents will be discharged to sensitive and less sensitive areas respectively. The environmental impacts of each alternative are evaluated by life cycle assessment (LCA) approach. For this purpose, data related to energy usage, land requirement, raw material consumption, and released emissions from the life phases were collected with inventory studies based on field studies and literature. The environmental impacts were assessed by using SimaPro 7.1 LCA software. As the scale of the LCA results is global, an MS-Excel based decision support tool that includes the LCA result is developed in order to meet also the local demands. Using this tool, it is possible to assign weight factors on the LCA results according to local conditions by using Analytical Hierarchy Process and finally the most environmentally appropriate treatment option can be selected.

Keywords: analytical hierarchy process, decision support system, life cycle assessment, wastewater treatment

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Authors: Tugba Yilmaz Aydin, Ergun Guntekin, Murat Aydin

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Effects of heat treatment on the elastic constants of cedar wood (Cedrus libani) were investigated. Specimens were exposed to heat under atmospheric pressure at four different temperatures (120, 150, 180, 210 °C) and three different time levels (2, 5, 8 hours). Three Young’s modulus (EL, ER, ET) and six Poisson ratios (μLR, μLT, μRL, μRT, μTL, μTR) were determined from compression test using bi-axial extensometer at constant moisture content (12 %). Three shear modulus were determined using ultrasound. Six shear wave velocities propagating along the principal axes of anisotropy were measured using EPOCH 650 ultrasonic flaw detector with 1 MHz transverse transducers. The properties of the samples tested were significantly affected by heat treatment by different degree. As a result, softer treatments yielded some amount of increase in Young modulus and shear modulus values, but increase of time and temperature resulted in significant decrease for both values. Poisson ratios seemed insensitive to heat treatment.

Keywords: cedar wood, elastic constants, heat treatment, ultrasound

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Authors: Ken Ninez Nurpramesti Prinindya, Yuli Setiyorini

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Crown enclosure high temperature flares damaged and reduced dimensions crown. Generally crown on EHTF could have a life time up to twenty years. Therefore, this study aims to increase the value of thermal resistance with the effect post treatment on NiCr coated arc spray method. The variation of post treatment temperature, was at 650°C, 750°C, and 850°C. Morphology on the surface and the adhesion strength was analyzed by SEM-EDX, Surface Roughness and Pull - off test. XRD testing was conducted to determine the contained in NiCr coated. Thermal stability of NiCr coated was tested by DSC-TGA. The most optimal results was owned by NiCr coating with post treated at 850°C. It has good thermal stability until 1000°C because of Cr2O3 formation in coated specimen. The higher temperature of post treatment coating was showed better result on porosity and roughness surface value.

Keywords: Arc spray process, NiCr wire, post-treatment coating, high temperature-corrosion resistance

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Authors: Babak Nematshahrbabaki, Fallahi Arezoo

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Objective: The aim of this study was to describe teenagers’ decisions to undergo orthodontic treatment through a qualitative study. Materials and methods: Twenty-three patients (12 girls), aged 12–18 years, at a dental clinic in Sanandaj the western part of Iran participated. Face-to-face and semi-structured interviews and two focus group discussions were held to gather data. Data analyzed by the grounded theory method. Results: ‘Decision-making’ was the core category. During the data analysis four main themes were developed: ‘being like everyone else’, ‘being diagnosed’, ‘maintaining the mouth’ and ‘cultural-social and environmental factors’. Conclusions: cultural- social and environmental factors have crucial role in decision-making to undergo orthodontic treatment. The teenagers were not fully conscious of these external influences. They thought their decision to undergo orthodontic treatment is independent while it is related to cultural- social and environmental factors.

Keywords: decision-making, qualitative study, teenager, orthodontic treatment

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Authors: Dyah Larasati, Karishma Alize Huda, Sri Kusumastuti Rahayu, Martin Daniel Siyaranamual

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Indonesia continues to reform its social protection system to provide the needed protection for its citizen. Indonesia Social Protection consisted of social assistance programs (non-contributory/tax-financed) specifically targeted for the poor and at-risk and social security/insurance program (contributory system). The social assistance programs have mostly been implemented since 1998. The national health insurance has been implemented since 2014 and the employment social insurance since 2015. One major reform implemented has been improving the targeting performance of its major social assistance portfolios including (1) Food Assistance for the poor families (Rastra and BPNT/noncash foods assistance); (2) Education Assistance for poor children; (3) Conditional Cash Transfer for poor families (PKH); and (4) Subsidized beneficiaries of National Health Insurance (JKN-PBI) for the poor and at-risk individuals. For the Social Insurance (through BPJS Employment program), several initiatives have been implemented to expand the program contributing members, although it mostly benefits the formal sector workers. However, major gaps still exist especially for the emerging middle-income groups who typically work at the informal sectors. They have yet to get the protection needed to sustain their social and economic growth. Since 2017, TNP2K (the National Team for Poverty Reduction) under the Vice President office has led the social protection discourse as the government understands the need to address vulnerabilities across the lifecycle and prioritize support to the most at-risk population particularly the elderly, young children and people with disabilities. Discussion and advocacy to recommend for more investment is continuing in order for the government to establish a comprehensive social protection system in the near future (2020-2024) that protects children through an inclusive child benefit program; build a system to benefit more working-age adults (including individuals with disabilities) and a three-tier elderly protection as they reach 65 years.

Keywords: poverty reduction, social assistance, social insurance, social protection

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Authors: Priyanka Ghosh, Priti Kumar Roy

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Every year a considerable number of people die due to methyl alcohol poisoning, in which most of them die even before proper treatment. This work gives a simple and cheap first aid to those affected individuals by the administration of activated charcoal. In this article, we emphasise on the adsorption capability of activated charcoal for the treatment of poisoning and use an impulsive differential equation to study the effect of activated charcoal during adsorption. We also investigate the effects of various parameters on the adsorption which are incorporated in the model system.

Keywords: activated charcoal, adsorption, impulsive differential equation, methanol poisoning

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Authors: Gabriel Malgaresi, Sara Borazjani, Hadi Madani, Pavel Bedrikovetsky

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Suspension-Colloidal flow in porous media occurs in numerous engineering fields, such as industrial water treatment, the disposal of industrial wastes into aquifers with the propagation of contaminants and low salinity water injection into petroleum reservoirs. The main effects are particle mobilization and captured by the porous rock, which can cause pore plugging and permeability reduction which is known as formation damage. Various factors such as fluid salinity, pH, temperature, and rock properties affect particle detachment. Formation damage is unfavorable specifically near injection and production wells. One way to control formation damage is pre-treatment of the rock with nanoparticles. Adsorption of nanoparticles on fines and rock surfaces alters zeta-potential of the surfaces and enhances the attachment force between the rock and fine particles. The main objective of this study is to develop a two-stage mathematical model for (1) flow and adsorption of nanoparticles on the rock in the pre-treatment stage and (2) fines migration and permeability reduction during the water production after the pre-treatment. The model accounts for adsorption and desorption of nanoparticles, fines migration, and kinetics of particle capture. The system of equations allows for the exact solution. The non-self-similar wave-interaction problem was solved by the Method of Characteristics. The analytical model is new in two ways: First, it accounts for the specific boundary and initial condition describing the injection of nanoparticle and production from the pre-treated porous media; second, it contains the effect of nanoparticle sorption hysteresis. The derived analytical model contains explicit formulae for the concentration fronts along with pressure drop. The solution is used to determine the optimal injection concentration of nanoparticle to avoid formation damage. The mathematical model was validated via an innovative laboratory program. The laboratory study includes two sets of core-flood experiments: (1) production of water without nanoparticle pre-treatment; (2) pre-treatment of a similar core with nanoparticles followed by water production. Positively-charged Alumina nanoparticles with the average particle size of 100 nm were used for the rock pre-treatment. The core was saturated with the nanoparticles and then flushed with low salinity water; pressure drop across the core and the outlet fine concentration was monitored and used for model validation. The results of the analytical modeling showed a significant reduction in the fine outlet concentration and formation damage. This observation was in great agreement with the results of core-flood data. The exact solution accurately describes fines particle breakthroughs and evaluates the positive effect of nanoparticles in formation damage. We show that the adsorbed concentration of nanoparticle highly affects the permeability of the porous media. For the laboratory case presented, the reduction of permeability after 1 PVI production in the pre-treated scenario is 50% lower than the reference case. The main outcome of this study is to provide a validated mathematical model to evaluate the effect of nanoparticles on formation damage.

Keywords: nano-particles, formation damage, permeability, fines migration

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Authors: Tri Murti, Muhammad Hanafiah Juni, Hejar Abdul Rahman, Salmiah Binti Said

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The diarrhoeal disease continues to be a leading cause of childhood mortality in countries such as Indonesia, where it is estimated to be responsible for 300,000 deaths annually in children under the age of years. Morbidity survey the Ministry of Health of Indonesia from 2000 to 2010 showed incidence diarrhoea remains a leading cause of infant mortality. Causes of death from diarrhoea is related to poor governance both at home and in health facilities. Despite the improvement of health facilities and government effort to reduce the occurrence of diarrhoea among children and death from diarrhoea, the incidence of diarrhoea among children area still high.

Keywords: management diarrheal disease, practices mother, treatment, diarrhoea among children

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Authors: L. Mallesha, P. Mallu, B. Veeresh

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In the present study, 2, 6-diflurobenzohydrazide and 4-fluorophenylisothiocyanate were used as the starting materials to synthesize 5-phenyl-N3-(4-fluorophenyl)-4H-1, 2, 4-triazole-3, 4-diamine. Further, compound 5-phenyl-N3-(4-fluorophenyl)-4H-1, 2, 4-triazole-3,4-diamine reacted with fluoro substituted benzaldehydes to yield a series of Schiff bases. All the final compounds were characterized using IR, 1H NMR, 13C NMR, MS and elemental analyses. New compounds were evaluated for their antiproliferative effect using the MTT assay method against four human cancer cell lines (K562, COLO-205, MDA-MB231, and IMR-32) for the time period of 24 h. Among the series, few compounds showed good activity on all cell lines, whereas the other compounds in the series exhibited moderate activity.

Keywords: Schiff bases, MTT assay, antiproliferative activity, human cancer cell lines, 1, 2, 4-triazoles

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Authors: Salim Ahmed

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The aim of this study was to recover a natural residue in the form of activated carbon prepared from Moroccan "argan pits and date pits" plant waste. After preparing the raw material for manufacture, the carbon was carbonised at 300°C and chemically activated with phosphoric acid of purity 85. The various characterisation results (moisture and ash content, specific surface area, pore volume, etc.) showed that the carbons obtained are comparable to those manufactured industrially and could therefore be tested, for example, in water treatment processes and especially for the depollution of effluents used in the agri-food and textile industries.

Keywords: activated carbon, water treatment, adsorption, argan

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Authors: Amandeep Thakur, Yi-Hsuan Chu, Chun-Hsu Pan, Kunal Nepali

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The transfer of ADP-ribose residues onto target substrates from nicotinamide adenine dinucleotide (NAD) (PARylation) is catalyzed by Poly (ADP-ribose) polymerases (PARPs). Amongst the PARP family members, the DNA damage response in cancer is majorly regulated by PARP1 and PARP2. The blockade of DNA repair by PARP inhibitors leads to the progression of DNA single-strand breaks (induced by some triggering factors) to double-strand breaks. Notably, PARP inhibitors are remarkably effective in cancers with defective homologous recombination repair (HRR). In particular, cancer cells with BRCA mutations are responsive to therapy with PARP inhibitors. The aforementioned requirement for PARP inhibitors to be effective confers a narrow activity spectrum to PARP inhibitors, which hinders their clinical applicability. Thus, the quest to expand the application horizons of PARP inhibitors beyond BRCA mutations is the need of the hour. Literature precedents reveal that HDAC inhibition induces BRCAness in cancer cells and can broaden the therapeutic scope of PARP inhibitors. Driven by such disclosures, dual inhibitors targeting both PARP and HDAC enzymes were designed by our research group to extend the efficacy of PARP inhibitors beyond BRCA-mutated cancers to cancers with induced BRCAness. The design strategy involved the installation of Veliparib, an investigational PARP inhibitor, as a surface recognition part in the HDAC inhibitor pharmacophore model. The chemical architecture of veliparib was deemed appropriate as a starting point for the generation of dual inhibitors by virtue of its size and structural flexibility. A validatory docking study was conducted at the outset to predict the binding mode of the designed dual modulatory chemical architectures. Subsequently, the designed chemical architectures were synthesized via a multistep synthetic route and evaluated for antitumor efficacy. Delightfully, one compound manifested impressive anti-leukemic effects (HL-60 cell lines) mediated via dual inhibition of PARP and class I HDACs. The outcome of the western blot analysis revealed that the compound could downregulate the expression levels of PARP1 and PARP2 and the HDAC isoforms (HDAC1, 2, and 3). Also, the dual PARP-HDAC inhibitor upregulated the protein expression of the acetyl histone H3, confirming its abrogation potential for class I HDACs. In addition, the dual modulator could arrest the cell cycle at the G0/G1 phase and induce autophagy. Further, polymer-based nanoformulation of the dual inhibitor was furnished to afford targeted delivery of the dual inhibitor at the cancer site. Transmission electron microscopy (TEM) results indicate that the nanoparticles were monodispersed and spherical. Moreover, the polymeric nanoformulation exhibited an appropriate particle size. Delightfully, pH-sensitive behavior was manifested by the polymeric nanoformulation that led to selective antitumor effects towards the HL-60 cell lines. In light of the magnificent anti-leukemic profile of the identified dual PARP-HDAC inhibitor, in-vivo studies (pharmacokinetics and pharmacodynamics) are currently being conducted. Notably, the optimistic findings of the aforementioned study have spurred our research group to initiate several medicinal chemistry campaigns to create bifunctional small molecule inhibitors addressing PARP as the primary target.

Keywords: PARP inhibitors, HDAC inhibitors, BRCA mutations, leukemia

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Authors: Yong Ho Jeon, Youn Mi Lee, Yong Yoon Lee

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Effects of cold plasma treatment on various plant seed germination were studied. The seeds of hot pepper, cucumber, tomato and arabidopsis were exposed to plasma and the plasma was generated in various devices. The germination speed was evaluated compared to an unexposed control. A positive effect on germination speed was observed in all tested seeds but the effects strongly depended on the type of the used plasma device (Argon-DBD, surface-DBD or MARX generator), time of exposure (6s~10min or 1~10shots) and kind of seeds. The SEM images showed that arrays of gold particles along the cell wall were observed on the surface of cucumber seeds showed a germination-accelerating effect by plasma treatment, which was the same as untreated. However, when treated with the high dose plasma, gold particles were not arrayed at the seed surface, it seems that due to the surface etching. This may suggest that the germination is not promoted by etching or damage of surface caused by the plasma treatment. Seedling growth improvement was also observed by indirect plasma treatment. These lead to an important conclusion that the effect of charged particles on plasma play the essential role in plant germination and indirect plasma treatment offers new perspectives for large scale application.

Keywords: cold plasma, cucumber, germination, SEM

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Authors: Ayu Nabila Kusuma Pradana, Aprinaldi Jasa Mantau, Tomohiko Akahoshi

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The incidence of Disseminated intravascular coagulation (DIC) following gastrointestinal surgery has a poor prognosis. Therefore, it is important to determine the factors that can predict the prognosis of DIC. This study will investigate the factors that may influence the outcome of DIC in patients after gastrointestinal surgery. Eighty-one patients were admitted to the intensive care unit after gastrointestinal surgery in Kyushu University Hospital from 2003 to 2021. Acute DIC scores were estimated using the new Japanese Association for Acute Medicine (JAAM) score from before and after surgery from day 1, day 3, and day 7. Acute DIC scores will be compared with The Sequential Organ Failure Assessment (SOFA) score, platelet count, lactate level, and a variety of biochemical parameters. This study applied machine learning algorithms to predict the prognosis of DIC after gastrointestinal surgery. The results of this study are expected to be used as an indicator for evaluating patient prognosis so that it can increase life expectancy and reduce mortality from cases of DIC patients after gastrointestinal surgery.

Keywords: the survival rate, gastrointestinal surgery, JAAM score, neural network, machine learning, disseminated intravascular coagulation (DIC)

Procedia PDF Downloads 251