Search results for: intensity modulated radiation therapy

Authors: Maha Salah Abdullah Ismail, Manal S. Ismail, Amir M. Saleh

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Reflexology treatment is a method for enhancing body relaxation. It is a widely recognized as an alternative therapy, effective for many health conditions. This study aimed to evaluate the effect of reflexology treatment on arterial blood gases among mechanically ventilated patients. A quasi-experimental (pre and post-test) research design was used. Research hypothesis was mechanically ventilated patients who will receive the reflexology treatment will have improvement in their arterial blood gases than those who will not. The current study was carried out in different Intensive Care Units at the Cairo University Hospitals. A purposeful sample of 100 adults’ mechanically ventilated patients was recruited over a period of three months of data collection. The participants were divided into two equally matched groups; (1) The study group who has received the routine care, in addition, two reflexology sessions on the feet, (2) The control group who has received only the routine care. One tool was utilized to collect data pertinent to the study; mechanically ventilated patients' data sheet that consists of demographic and medical data. Result: Majority (58% of the study group and 82% of the control group) were males, with mean age of 50.9 years in both groups. Patients who received the reflexology treatment significantly increase in the oxygen saturation pre second session (t=5.15, p=.000), immediate post sessions (t=4.4, p=.000) and post two hours (t= 4.7, p= .000). The study group was more likely to have lower PaO2 (F=5.025, p=.015), PaCo2 (F=4.952, p=.025) and higher HCo3 (F=15.211, p=.000) than the control group. Conclusion: This study results support the positive effect of reflexology treatment in improving some arterial blood gases among mechanically ventilated patients’ with the conventional therapy as in the study group there was increase in the oxygen saturation. In differences between groups there decrease PaO2, PaCo2 and increase HCo3 in the study group. Recommendation: Nurses should be trained how to demonstrate the foot reflexology among mechanically ventilated patients.

Keywords: arterial blood gases, foot, mechanical ventilated patient, reflexology

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Authors: Radoslav Stojchevski, Leonid Poretsky, Dimiter Avtanski

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Proinflammatory cytokines play an important role in cancer initiation and progression by mediating the intracellular communication between the cancer cells and tumor microenvironment. Increased tumor growth causing reduced oxygen concentration and oxygen pressure commonly result in hypoxia. Mechanistically, hypoxia is characterized by stabilization and nuclear translocation of hypoxia-inducible factor 1 alpha (HIF-1α) followed by propagation of molecular pathway cascade involving multiple downstream targets. Cobalt(II) chloride (CoCl₂) is commonly used to mimic hypoxia in experimental conditions since it directly induces the expression of HIF-1α. The aim of the present study was to investigate the in vitro effects and the molecular mechanisms by which hypoxia regulates the cytokine secretory profile of breast cancer cells. As a model for this study, we used several breast cancer cell lines bearing various molecular characteristics and metastatic potential (MDA-MB-231 (clauding low, ER-/PR-/HER²⁻), MCF-7 (luminal A, ER⁺/PR⁺/HER²⁻), and BT-474 (liminal B, ER⁺/PR⁺/HER²⁺)). We demonstrated that breast cancer cells secrete numerous cytokines and cytokine ligands, including interleukins, chemokines, and growth factors. Treatment with CoCl₂significantly modulated the breast cancer cells' cytokine expression in a concentration- and time-dependent manner. These effects were mediated via activation of several signaling pathways (JNK/SAPK1, NF-κB, STAT5A/B, and Erk/MAPK1/2). Taken together, the present data define some of the molecular mechanisms by which hypoxia affects the breast cancer cells' cytokine secretory profile, thus contributing to the development of novel therapies for metastatic breast cancer.

Keywords: breast cancer, cytokines, cobalt(II) chloride (CoCl₂), hypoxia

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Authors: Edvard Kokanyan, Narine Babajanyan, Ninel Kokanyan, Marco Bazzan

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Lithium niobate (LN) crystals, renowned for their exceptional nonlinear optical, electro-optical, piezoelectric, and photorefractive properties, stand as foundational materials in diverse fields of study and application. While they have long been utilized in frequency converters of laser radiation, electro-optical modulators, and holographic information recording media, LN crystals doped with rare earth ions represent a compelling frontier for modern compact devices. These materials exhibit immense potential as key components in infrared lasers, optical sensors, self-cooling systems, and radiation balanced laser setups. In this study, we present the successful synthesis of Ho-doped lithium niobate (LN:Ho) thin films on sapphire substrates employing the Sol-Gel technique. The films exhibit a strong crystallographic orientation along the perpendicular direction to the substrate surface, with X-ray diffraction analysis confirming the predominant alignment of the film's "c" axis, notably evidenced by the intense (006) reflection peak. Further characterization through Raman spectroscopy, employing a confocal Raman microscope (LabRAM HR Evolution) with exciting wavelengths of 532 nm and 785 nm, unraveled intriguing insights. Under excitation with a 785 nm laser, Raman scattering obeyed selection rules, while employing a 532 nm laser unveiled additional forbidden lines reminiscent of behaviors observed in bulk LN:Ho crystals. These supplementary lines were attributed to luminescence induced by excitation at 532 nm. Leveraging data from anti-Stokes Raman lines facilitated the disentanglement of luminescence spectra from the investigated samples. Surface scanning affirmed the uniformity of both structure and luminescence across the thin films. Notably, despite the robust orientation of the "c" axis perpendicular to the substrate surface, Raman signals indicated a stochastic distribution of "a" and "b" axes, validating the mosaic structure of the films along the mentioned axis. This study offers valuable insights into the structural properties of Ho-doped lithium niobate thin films, with the observed luminescence behavior holding significant promise for potential applications in optoelectronic devices.

Keywords: lithium niobate, Sol-Gel, luminescence, Raman spectroscopy

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Authors: Çağla Aras, Kübra Bi̇nay, Aysberg Şamil önlü, Mine Baydan Aran, Dicle Aras

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The purpose of the present research was to investigate the acute effects of 30-min hatha yoga and 30-min resistance-based aerobic exercise (RBAE) on computerized dynamic posturography (CDP) and functional head impulse test (fHIT) scores in adult female yoga practitioners. To reach this aim, ten participants executed CDP and fHIT three times in total: at rest, after yoga, and after RBAE. The yoga practice lasted a total of 30 minutes, including 25 min of asanas and 5 minutes of savasana. RBAE lasted a total of 30 minutes with an intensity of 70-75% of the heart rate reserve method. When the results were examined, no change was observed in any parameters of the fHIT scores due to resting or exercise implementation. On the contrary, some changes were observed in CDP test results depending on the type of exercise. The post-RBAE somatosensory and visual systems values were higher than resting (p<0.05). The composite balance score derived after RBAE was found to be improved when compared to post-yoga and resting values (p<0.01). Lastly, the post-RBAE vestibular system score was found to be statistically significantly higher than the post-Yoga values. In addition, it was observed that body composition parameters, especially decreasing BW, LBM, PBF, MBF and TBW, were associated with improved postural stability values. According to the results, it can be stated that neither hatha yoga nor resistance-based aerobic exercise has an acute effect on functional vestibulo-ocular reflex. In addition, although there was no change in balance level after yoga, it was observed that RBAE performed at 70-75% of the heart rate reserve and for 30 minutes had positive acute effects on postural stability and balance.

Keywords: hatha yoga, resistance training, aerobic training, high intensity training, computerized dynamic posturography, functional head impulse test

Procedia PDF Downloads 60

Authors: M. Nita-Lazar, E. Manea, C. Bumbac, A. Banciu, C. Stoica

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The population and economic growth have generated a significant new number of pollutant compounds which have to be degraded before reaching the environment. The wastewater treatment plants (WWTPs) have been the last barrier between the domestic and/or industrial wastewaters and the environment. At present, the conventional WWTPs have very high operational costs, most of them linked to the aeration process (60-65% from total energy costs related to wastewater treatment). In addition, they have had a low efficiency in pollutants removal such as pharmaceutical and other resilient anthropogenic compounds. In our study, we have been focused on new wastewater treatment strategies to enhance the efficiency of pollutants removal and decrease the wastewater treatment operational costs. The usage of mixed microalgae-bacteria granules technology generated high efficiency and low costs by a better harvesting and less expensive aeration. The intertrophic relationships between microalgae and bacteria have been characterized by the structure of the population community to their metabolic relationships. The results, obtained by microscopic studies, showed well-organized and stratified microalgae-bacteria granules where bacteria have been enveloped in the microalgal structures. Moreover, their population community structure has been modulated as well as their nitrification, denitrification processes (analysis based on qPCR genes expression) by the type of the pollutant compounds and amounts. In conclusion, the understanding and modulation of intertrophic relationships between microalgae and bacteria could be an economical and technological viable alternative to the conventional wastewater treatment. Acknowledgements: This research was supported by grant PN-III-P4-ID-PCE-2016-0865 from the Romanian National Authority for Scientific Research and Innovation CNCS/CCCDI-UEFISCDI.

Keywords: activated sludge, bacteria, granules, microalgae

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Authors: Lekshmi Vijayan, K. Shreekrishna Kumar

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We demonstrated an organic field effect transistor based photodetector using phthalocyanine as the active material that exhibited high photosensitivity under varying light wavelengths. The thermally grown SiO₂ layer on silicon wafer act as a substrate. The critical parameters, such as photosensitivity, responsivity and detectivity, are comparatively high and were 3.09, 0.98AW⁻¹ and 4.86 × 10¹⁰ Jones, respectively, under a bias of 5 V and a monochromatic illumination intensity of 4mW cm⁻². The photodetector has a linear I-V curve with a low dark current. On comparing photoresponse of copper phthalocyanine at four different wavelengths, 560 nm shows better photoresponse and the highest value of photosensitivity is also obtained.

Keywords: photodetector, responsivity, photosensitivity, detectivity

Procedia PDF Downloads 180

Authors: Sophia Cyril Vincent

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Background: As per the Indian Census 2011, there is nearly 104 million elderly population aged above 60 years (53 million females and 51 males), and the count is expected to be 173 million by the end of 2026. Nearly 5.5% of women and 1.5% of men are living alone.1 In India, even though it is the moral duty of the children to take care of aged parents, many elders are landing in old age homes due to the social transformation factors like mushrooming of nuclear families, migration of children, cultural echoes, differences in mindset and values. Nearly 728 old age homes are seen across the country, out of which 78 old age homes with approximately 3000 inmates are seen only in Bangalore2. The existing literature shows that elderly women residing in old age homes experience the challenges like- loneliness, health issues, rejection from children, grief, death anxiety, etc, which leads to mental and physical wellbeing in numerous and tangible ways3. Hence the best and cost-effective way to improve the meaning and quality of life among elderly females is logotherapy, a type of psychotherapeutic analysis and treatment, motivating and driving force4 within the human experience to lead a decent life. Aim: The current research is aimed at studying the effectiveness of a logotherapy intervention on meaning and quality of life among elderly women of old age homes. Samples:200 women aged < 60 years and staying in the old age home for more than 1 year were randomly allocated to the control group and experimental group. Methodology: Using the Meaning in life questionnaire (MLQ)and the World health organization quality of life (WHOQOL) questionnaire, meaning and quality of life were assessed among both groups' women. Intensive Logotherapy and meaning in life program for five days were provided for the experimental group and the control group, with no treatment. Result: Under analysis. Conclusion: It is the right of the elderly woman to lead a happy and peaceful life till her death irrespective of the residing place. Hence, continuous monitoring and effective management are necessary for elderly women.

Keywords: quality of life, meaning of life, logo therapy, old age home

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Authors: A. Mezzidi, H. Hamli Benzahar

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The present study evaluates the stress and stress intensity factor during the propagation of a crack at presence of a dislocation near of crack tip. The problem is formulated using a glass material having an equivalent elasticity modulus and a Poisson ratio. In this research work, the proposed material is a plate form with a main crack in one of these ends and a dislocation near this crack, subjected to tensile stresses according to the mode 1 opening. For each distance between the two cracks, we can determine these stresses. This study is treated by finite elements method by using the software (ABAQUS) rate. It is shown here in that obtained results agreed with those determined by other researchers

Keywords: crack, dislocation, finite element, glass

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Authors: Albana Hasimi, Edlira Tako, Elvin Çomo, Partizan Malkaj, Blerina Papajani, Ledjan Malaj, Mirela Ndrita

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Many endeavors have been exerted during the last years for developing new artificial polymeric membranes which fulfill the demanded conditions for biomedical uses. One of the most tested polymers is Poly(vinyl alcohol) [PVA]. Ours groups, is based on the possibility of using PVA for personal protective equipment against covid. In them, we explore the possibility of modifying the properties of the polymer by adding Montmorillonite [MMT]. Heat-treatment above the glass transition temperature are used to improve mechanical properties mainly by increasing the crystallinity of the polymer, which acts as a physical network. Temperature-Modulated Differential Scanning Calorimetry (TMDSC) measurements indicated that the presence of 0.5% MMT in PVA causes a higher Tg value and shaped peak of crystallinity. Decomposition is observed at two of the melting points of the crystals during heating 25-240oC and overlap of the recrystallization ridges during cooling 240-25oC. This is indicative of the presence of two types (quality or structure ) of polymer crystals. On the other hand, some indication of improvement of the quality of the crystals by heat-treatment is given by the distinct non-reversing contribution to melting. Data on sorption and transport of water in polyvinyl alcohol films: PVA pure and PVA/MMT matrix, modified by thermal treatment, are presented. The thermal treatment has aftereffect the films become more rigid, and because of this, the water uptake is significantly lower in membranes. That is indicates by analysis of the resulting water uptake kinetics. The presence 0.5% w/w of MMT has no significant impact on the properties of PVA membranes. Water uptake kinetics deviates from Fick’s law due to slow relaxation of glassy polymer matrix for all membranes category.

Keywords: crystallinity, montmorillonite, nanocomposite, poly (vinyl alcohol)

Procedia PDF Downloads 130

Authors: Hannah Bigelow, Marcus D. Gottlieb, Michelle Ogrodnik, Jeffrey, D. Graham, Barbara Fenesi

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Attention Deficit Hyperactivity Disorder (ADHD) is one of the most common neurodevelopmental disorders affecting approximately 6% of children worldwide. ADHD is characterized by a combination of persistent deficits including impaired inhibitory control, working memory and task-switching. Many children with ADHD also have comorbid mental health issues such as anxiety and depression. There are several treatment options to manage ADHD impairments, including drug and behavioural management therapy, but they all have drawbacks, such as worsening mood disturbances or being inaccessible to certain demographics. Both physical exercise and mindfulness meditation serve as alternative options to potentially help mitigate ADHD symptoms. Although there is extensive support for the benefits of long-term physical exercise or mindfulness meditation programs, there is insufficient research investigating how acute bouts (i.e., single, short bouts) can help children with ADHD. Thus, the current study aimed to understand how single, short bouts of exercise and mindfulness meditation impacts executive functioning and psycho-emotional well-being in children with ADHD, as well as to directly compare the efficacy of these two interventions. The study used a a pre- post-test, within-subjects design to assess the effects of a 10-minute bout of moderate intensity exercise versus a 10-minute bout of mindfulness meditation (versus 10 minutes of a reading control) on the executive functioning and psycho-emotional well-being of 16 children and youth with ADHD aged 10-14 (male=11; White=80%). Participants completed all three interventions: 10 minutes of exercise, 10 minutes of mindfulness meditation, and 10 minutes of reading (control). Executive functioning (inhibitory control, working memory, task-switching) and psycho-emotional well-being (mood, self-efficacy) were assessed before and after each intervention. Mindfulness meditation promoted executive functioning, while exercise enhanced positive mood and self-efficacy. Critically, this work demonstrates that a single, short bout of mindfulness meditation session can promote inhibitory control among children with ADHD. This is especially important for children with ADHD as inhibitory control deficits are among the most pervasive challenges that they face. Furthermore, the current study provides preliminary evidence for the benefit of acute exercise for promoting positive mood and general self-efficacy for children and youth with ADHD. These results may increase the accessibility of acute exercise for children with ADHD, providing guardians and teachers a feasible option to incorporate just 10 minutes of exercise to assist children emotionally. In summary, this research supports the use of acute exercise and mindfulness meditation on varying aspects of executive functioning and psycho-emotional well-being in children and youth with ADHD. This work offers important insight into how behavioural interventions could be personalized according to a child’s needs.

Keywords: attention-deficit hyperactivity disorder (ADHD), acute exercise, mindfulness meditation, executive functioning, psycho-emotional well-being

Procedia PDF Downloads 138

Authors: Kuo-Teng Tsai, You-Min Huang

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In this study, the problem of a spiral fin with a period base temperature is analyzed by using the Adomian decomposition method. The Adomian decomposition method is a useful and practice method to solve the nonlinear energy equation which are associated with the heat radiation. The period base temperature is around a mean value. The results including the temperature distribution and the heat flux from the spiral fin base can be calculated directly. The results also discussed the effects of the dimensionless variables for the temperature variations and the total energy transferred from the spiral fin base.

Keywords: spiral fin, period, adomian decomposition method, nonlinear

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Authors: Shawna Staud, Mary Kaye Scaramucci

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Objective: Rubber cup polishing has been a traditional method of preventative therapy in dental hygiene treatment. Newer methods such as air polishing have changed the way dental hygiene care is provided, yet this technique has not been embraced by students in the program nor by practitioners in the workforce. Students entering the workforce tend to follow office protocol and are limited in confidence to introduce technologies learned in the curriculum. This project was designed to help students gain confidence in newer skills and encourage private practice settings to adopt newer technologies for patient care. Our program recently introduced air polishing earlier in the program before the rubber cup technique to determine if students would embrace the technology to become leading-edge professionals when they enter the marketplace. Methods: The class of 2022 was taught the traditional method of polishing in the first-year curriculum and air polishing in the second-year curriculum. The class of 2023 will be taught the air polishing method in the first-year curriculum and the traditional method of polishing in the second-year curriculum. Pre- and post-graduation survey data will be collected from both cohorts. Descriptive statistics and pre and post-paired t-tests with alpha set at .05 to compare pre and post-survey results will be used to assess data. Results: This study is currently in progress, with a completion date of October 2023. The class of 2022 completed the pre-graduation survey in the spring of 2022. The post-gradation survey will be sent out in October 2022. The class of 2023 cohort will be surveyed in the spring of 2023 and October 2023. Conclusion: Our hypothesis is students who are taught air polishing first will be more inclined to adopt that skill in private practice, thereby embracing newer technology and improving oral health care.

Keywords: luggage handling system at world’s largest pilgrimage center

Procedia PDF Downloads 106

Authors: Maria Del Carmen Millan-Linares, Ana Lemus Conejo, Rocio Toscano, Alvaro Villanueva, Francisco Millan, Justo Pedroche, Sergio Montserrat-De La Paz

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GPETAFLR (Glycine-Proline-Glutamine-Threonine-Alanine-Phenylalanine-Leucine-Arginine) is a peptide isolated from Lupinus angustifolius L. protein hydrolysate (LPH). Herein, the effect of this peptide was investigated in two different models of neuroinflammation: in the immortalized murine microglia cell line BV-2 and in a high-fat-diet-induced obesity mouse model. Methods and Results: Effects of GPETAFLR on neuroinflammation were evaluated by RT-qPCR, flow cytometry, and ELISA techniques. In BV-2 microglial cells, Lipopolysaccharides (LPS) enhanced the release of pro-inflammatory cytokines (TNF-α, IL-1β, and IL-6) whereas GPETAFLR decreased pro-inflammatory cytokine levels and increased the release of the anti-inflammatory cytokine IL-10 in BV2 microglial cells. M1 (CCR7 and iNOS) and M2 (Arg-1 and Ym-1) polarization markers results showed how the GPETAFLR octapeptide was able to decrease M1 polarization marker expression and increase the M2 polarization marker expression compared to LPS. Animal model results indicate that GPETAFLR has an immunomodulatory capacity, both decreasing pro-inflammatory cytokine IL-6 and increasing the anti-inflammatory cytokine IL-10 in brain tissue. Polarization markers in the brain tissue were also modulated by GPETAFLR that decreased the pro-inflammatory expression (M1) and increased the anti-inflammatory expression (M2). Conclusion: Our results suggest that GPETAFLR isolated from LPH has significant potential for management of neuroinflammatory conditions and offer benefits derived from the consumption of Lupinus angustifolius L. in the prevention of neuroinflammatory-related diseases.

Keywords: GPETAFLR peptide, BV-2 cell line, neuroinflammation, cytokines, high-fat-diet

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Authors: Adedayo Adeleke, Dineo Pule

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The ongoing load-shedding in most parts of South Africa, combined with climate change causing severe drought conditions in Cape Town, has left electricity consumers seeking alternative sources of power and water. Solar energy, which is abundant in most parts of South Africa and is regarded as a clean and renewable source of energy, allows for the generation of electricity via solar photovoltaic systems. Rainwater harvesting is the collection and storage of rainwater from building rooftops, allowing people without access to water to collect it. The lack of dependable energy and water source must be addressed by shifting to solar energy via solar photovoltaic systems and rainwater harvesting. Before this can be done, the potential of building rooftops must be assessed to determine whether solar energy and rainwater harvesting will be able to meet or significantly contribute to Atlantis industrial areas' electricity and water demands. This research project presents methods and approaches for automatically extracting building rooftops in Atlantis industrial areas and evaluating their potential for solar photovoltaics and rainwater harvesting systems using Light Detection and Ranging (LiDAR) data and aerial imagery. The four objectives were to: (1) identify an optimal method of extracting building rooftops from aerial imagery and LiDAR data; (2) identify a suitable solar radiation model that can provide a global solar radiation estimate of the study area; (3) estimate solar photovoltaic potential overbuilding rooftop; and (4) estimate the amount of rainwater that can be harvested from the building rooftop in the study area. Mapflow, a plugin found in Quantum Geographic Information System(GIS) was used to automatically extract building rooftops using aerial imagery. The mean annual rainfall in Cape Town was obtained from a 29-year rainfall period (1991- 2020) and used to calculate the amount of rainwater that can be harvested from building rooftops. The potential for rainwater harvesting and solar photovoltaic systems was assessed, and it can be concluded that there is potential for these systems but only to supplement the existing resource supply and offer relief in times of drought and load-shedding.

Keywords: roof potential, rainwater harvesting, urban plan, roof extraction

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Authors: Pushpavathi M., Kavya V., Akshatha V.

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Introduction: Cleft lip and palate (CLP) is a congenital condition which hinders effectual communication due to associated speech and language difficulties. Expressive language delay (ELD) is a feature seen in this population which is influenced by factors such as type and severity of CLP, age at surgical and linguistic intervention and also the type and intensity of speech and language therapy (SLT). Since CLP is the most common congenital abnormality seen in Indian children, early intervention is a necessity which plays a critical role in enhancing their speech and language skills. The interaction between the timing of intervention and factors which contribute to effective intervention by caregivers is an area which needs to be explored. Objectives: The present study attempts to determine the effect of timing of intervention on the contributing maternal factors for effective linguistic intervention in toddlers with repaired CLP with respect to the awareness, home training patterns, speech and non-speech behaviors of the mothers. Participants: Thirty six toddlers in the age range of 1 to 4 years diagnosed as ELD secondary to repaired CLP, along with their mothers served as participants. Group I (Early Intervention Group, EIG) included 19 mother-child pairs who came to seek SLT soon after corrective surgery and group II (Delayed Intervention Group, DIG) included 16 mother-child pairs who received SLT after the age of 3 years. Further, the groups were divided into group A, and group B. Group ‘A’ received SLT for 60 sessions by Speech Language Pathologist (SLP), while Group B received SLT for 30 sessions by SLP and 30 sessions only by mother without supervision of SLP. Method: The mothers were enrolled for the Early Language Intervention Program and following this, their awareness about CLP was assessed through the Parental awareness questionnaire. The quality of home training was assessed through Mohite’s Inventory. Subsequently, the speech and non-speech behaviors of the mothers were assessed using a Mother’s behavioral checklist. Detailed counseling and orientation was done to the mothers, and SLT was initiated for toddlers. After 60 sessions of intensive SLT, the questionnaire and checklists were re-administered to find out the changes in scores between the pre- and posttest measurements. Results: The scores obtained under different domains in the awareness questionnaire, Mohite’s inventory and Mothers behavior checklist were tabulated and subjected to statistical analysis. Since the data did not follow normal distribution (i.e. p > 0.05), Mann-Whitney U test was conducted which revealed that there was no significant difference between groups I and II as well as groups A and B. Further, Wilcoxon Signed Rank test revealed that mothers had better awareness regarding issues related to CLP and improved home-training abilities post-orientation (p ≤ 0.05). A statistically significant difference was also noted for speech and non-speech behaviors of the mothers (p ≤ 0.05). Conclusions: Extensive orientation and counseling helped mothers of both EI and DI groups to improve their knowledge about CLP. Intensive SLT using focused stimulation and a parent-implemented approach enabled them to carry out the intervention in an effectual manner.

Keywords: awareness, cleft lip and palate, early language intervention program, home training, orientation, timing of intervention

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Authors: K. Orozović, B. Balon

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In this paper, we take a different approach to de Broglie wavelength, as we relate it to relativistic physics. The quantum energy of the photon radiated by a body with de Broglie wavelength, as it moves with velocity v, can be defined within relativistic physics by rest energy E₀. In this way, we can show the connection between the quantum of radiation energy of the body and the rest of energy E₀ and thus combine what has been incompatible so far, namely relativistic and quantum physics. So, here we discuss the unification of relativistic and quantum physics by introducing the factor k that is analog to the Lorentz factor in Einstein's theory of relativity.

Keywords: de Brogli wavelength, relativistic physics, rest energy, quantum physics

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Authors: Meless Gebrie Bore, Lin Perry, Xiaoyue Xu, Andargachew Kassa, Marilyn Cruickshank

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Background: Adolescents living with HIV (ALHIV) in Ethiopia face significant health challenges, particularly related to nutrition, which is essential for optimizing antiretroviral therapy (ART) outcomes. This population is vulnerable to nutritional deficiencies due to increased energy demands and the adverse effects of HIV, alongside rapid growth and low socio-economic status. Despite advances in ART, research on nutritional care for ALHIV in Ethiopia is limited. Integrated nutritional interventions are critical for improving health outcomes, yet comprehensive guidance is lacking. This study aimed to evaluate healthcare workers' practices in ART clinics, assess the nutritional status of ALHIV, and provide recommendations for enhancing nutritional care. Method: Cross-sectional surveys were conducted, recruiting 44 healthcare professionals and 384 ALHIV across ten public hospitals in Addis Ababa and Oromia regions. Participants were selected using purposive sampling for healthcare workers and proportionate random sampling for ALHIV engaged in ART services. Data was collected using a pre-tested structured questionnaire with quantitative and qualitative components facilitated by trained healthcare workers through the Kobo Toolbox program. Results: Findings revealed that while most healthcare workers conducted basic nutritional assessments, more sensitive methods were rarely used. Only 36.4% assessed dietary intake and 27.3% evaluated food security. Nutrition counseling was limited, with only 38.6% providing such services regularly. Health Care worker participants expressed dissatisfaction with the integration of nutrition services due to a lack of training and resources. Nutritional assessments revealed that 24.2% of ALHIV were classified as thin, 21.7% as stunted, and 34.9% as malnourished based on mid-upper arm circumference, with 19.4% experiencing severe acute malnutrition. These results highlight the urgent need and opportunities to improve nutritional support tailored to ALHIV-specific needs. Conclusion and Recommendations: Study findings identified evidence of substantial nutritional deficits and critical gaps in nutritional care for ALHIV in Ethiopian ART clinics. While basic assessment and counseling were generally practiced, limited use of more sensitive methods and inadequate integration of nutrition services hindered care effectiveness. To improve health outcomes, it is essential to enhance training for healthcare workers, develop standardized nutrition guidelines, and allocate resources effectively. Conducting further research with large, diverse samples and integrating comprehensive nutritional care alongside ART services will enable better matching of the nutritional needs of this vulnerable population.

Keywords: adolescents living with HIV(ALHIV), antiretroviral therapy (ART), HIV, Ethiopia, malnutrition, nutritional support, stunting, thinness

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Authors: Fleura Shkëmbi, Sevim Mustafa, Naim Fanaj

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Hypnosis, often known as cognitive therapy, is a sort of mind-body psychotherapy. A professional and certified hypnotist or hypnotherapist guides the patient into this extreme level of focus and relaxation during the session by utilizing verbal cues, repetition, and imagery. In recent years, hypnotherapy has gained popularity in the treatment of a variety of disorders, including anxiety and particular phobias. The term "phobia" is commonly used to define fear of a certain trigger. When faced with potentially hazardous situations, the brain naturally experiences dread. While a little dread here and there may keep us safe, phobias can drastically reduce our quality of life. In summary, persons who suffer from anxiety are considered to see particular environmental situations as dangerous, but those who do not suffer from anxiety do not. Hypnosis is essential in the treatment of anxiety disorders. Hypnosis can help patients minimize their anxiety symptoms. This broad concept has aided in the development of models and therapies for anxiety disorders such as generalized anxiety disorder, panic attacks, hypochondria, and obsessional disorders. Hypnosis techniques are supposed to be attentive and mental pictures, which is conceivable; this is why they're associated with improved working memory and visuospatial abilities. In this sense, the purpose of this study is to determine how effectively specific therapeutic methods perform in treating persons with anxiety and phobias. In addition to cognitive-behavioral therapy and other therapies, the approaches emphasized the use of therapeutic hypnosis. This study looks at the use of hypnosis and related psychotherapy procedures in the treatment of anxiety disorders. Following a discussion of the evolution of hypnosis as a therapeutic tool, neurobiological research is used to demonstrate the influence of hypnosis on the change of perception in the brain. The use of hypnosis in the treatment of phobias, stressful situations, and posttraumatic stress disorder is examined, as well as similarities between the hypnotic state and dissociative reactions to trauma. Through an extensive literature evaluation, this study will introduce hypnotherapy procedures that result in more successful anxiety and phobia treatment.

Keywords: anxiety, hypnosis, hypnotherapy, phobia, technique, state

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Authors: Modi Alsubaie, Chris Dickens, Barnaby Dunn, Andy Gibson, Obioha Ukoumunned, Alison Evans, Rachael Vicary, Manish Gandhi, Willem Kuyken

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Background: Depression co-occurs in 20% of people with cardiovascular disorders, can persist for years and predicts worse physical health outcomes. While psychosocial treatments have been shown to effectively treat acute depression in those with comorbid cardiovascular disorders, to date there has been no evaluation of approaches aiming to prevent relapse and treat residual depression symptoms in this group. Therefore, the current study aimed to examine the feasibility and acceptability of a randomised controlled trial design evaluating an adapted version of mindfulness-based cognitive therapy (MBCT) designed specifically for people with co-morbid depression and cardiovascular disorders. Methods: A 3-arm feasibility randomised controlled trial was conducted, comparing MBCT adapted for people with cardiovascular disorders plus treatment as usual (TAU), mindfulness-based stress reduction (MBSR) plus TAU, and TAU alone. Participants completed a set of self-report measures of depression severity, anxiety, quality of life, illness perceptions, mindfulness, self-compassion and affect and had their blood pressure taken immediately before, immediately after, and three months following the intervention. Those in the adapted-MBCT arm additionally underwent a qualitative interview to gather their views about the adapted intervention. Results: 3400 potentially eligible participants were approached when attending an outpatient appointment at a cardiology clinic or via a GP letter following a case note search. 242 (7.1%) were interested in taking part, 59 (1.7%) were screened as being suitable, and 33 (<1%) were eventually randomised to the three groups. The sample was heterogeneous in terms of whether they reported current depression or had a history of depression and the time since the onset of cardiovascular disease (one to 25 years). Of 11 participants randomised to adapted MBCT seven completed the full course, levels of home mindfulness practice were high, and positive qualitative feedback about the intervention was given. Twenty-nine out of 33 participants randomised completed all the assessment measures at all three-time points. With regards to the primary outcome (depression), five out of the seven people who completed the adapted MBCT and three out of five under MBSR showed significant clinical change, while in TAU no one showed any clinical change at the three-month follow-up. Conclusions: The adapted MBCT intervention was feasible and acceptable to participants. However, aspects of the trial design were not feasible. In particular, low recruitment rates were achieved, and there was a high withdrawal rate between screening and randomisation. Moreover, the heterogeneity in the sample was high meaning the adapted intervention was unlikely to be well tailored to all participants needs. This suggests that if the decision is made to move to a definitive trial, study recruitment procedures will need to be revised to more successfully recruit a target sample that optimally matches the adapted intervention.

Keywords: mindfulness-based cognitive therapy (MBCT), depression, cardiovascular disorders, feasibility, acceptability

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Authors: Bijit Kalita, K. V. N. Surendra

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The pulley works under both compressive loading due to contacting belt in tension and central torque due to cause rotation. In a power transmission system, the belt pulley assemblies offer a contact problem in the form of two mating cylindrical parts. In this work, we modeled a pulley as a heavy two-dimensional circular disk. Stress analysis due to contact loading in the pulley mechanism is performed. Finite element analysis (FEA) is conducted for a pulley to investigate the stresses experienced on its inner and outer periphery. In most of the heavy-duty applications, most frequently used mechanisms to transmit power in applications such as automotive engines, industrial machines, etc. is Belt Drive. Usually, very heavy circular disks are used as pulleys. A pulley could be entitled as a drum and may have a groove between two flanges around the circumference. A rope, belt, cable or chain can be the driving element of a pulley system that runs over the pulley inside the groove. A pulley is experienced by normal and shear tractions on its contact region in the process of motion transmission. The region may be belt-pulley contact surface or pulley-shaft contact surface. In 1895, Hertz solved the elastic contact problem for point contact and line contact of an ideal smooth object. Afterward, this hypothesis is generally utilized for computing the actual contact zone. Detailed stress analysis in such contact region of such pulleys is quite necessary to prevent early failure. In this paper, the results of the finite element analyses carried out on the compressed disk of a belt pulley arrangement using fracture mechanics concepts are shown. Based on the literature on contact stress problem induced in the wide field of applications, generated stress distribution on the shaft-pulley and belt-pulley interfaces due to the application of high-tension and torque was evaluated in this study using FEA concepts. Finally, the results obtained from ANSYS (APDL) were compared with the Hertzian contact theory. The study is mainly focused on the fatigue life estimation of a rotating part as a component of an engine assembly using the most famous Paris equation. Digital Image Correlation (DIC) analyses have been performed using the open-source software. From the displacement computed using the images acquired at a minimum and maximum force, displacement field amplitude is computed. From these fields, the crack path is defined and stress intensity factors and crack tip position are extracted. A non-linear least-squares projection is used for the purpose of the estimation of fatigue crack growth. Further study will be extended for the various application of rotating machinery such as rotating flywheel disk, jet engine, compressor disk, roller disk cutter etc., where Stress Intensity Factor (SIF) calculation plays a significant role on the accuracy and reliability of a safe design. Additionally, this study will be progressed to predict crack propagation in the pulley using maximum tangential stress (MTS) criteria for mixed mode fracture.

Keywords: crack-tip deformations, contact stress, stress concentration, stress intensity factor

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Authors: Ludovic Fabre, Paola Melani, Patrick Lemaire

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The goal of this study was to test whether and how emotions influence drone operators in estimation skills. The empirical study was run in the context of numerical estimation. Participants saw a two-digit number together with a collection of cars. They had to indicate whether the stimuli collection was larger or smaller than the number. The two-digit numbers ranged from 12 to 27, and collections included 3-36 cars. The presentation of the collections was dynamic (each car moved 30 deg. per second on the right). Half the collections were smaller collections (including fewer than 20 cars), and the other collections were larger collections (i.e., more than 20 cars). Splits between the number of cars in a collection and the two-digit number were either small (± 1 or 2 units; e.g., the collection included 17 cars and the two-digit number was 19) or larger (± 8 or 9 units; e.g., 17 cars and '9'). Half the collections included more items (and half fewer items) than the number indicated by the two-digit number. Before and after each trial, participants saw an image inducing negative emotions (e.g., mutilations) or neutral emotions (e.g., candle) selected from International Affective Picture System (IAPS). At the end of each trial, participants had to say if the second picture was the same as or different from the first. Results showed different effects of emotions on RTs and percent errors. Participants’ performance was modulated by emotions. They were slower on negative trials compared to the neutral trials, especially on the most difficult items. They errored more on small-split than on large-split problems. Moreover, participants highly overestimated the number of cars when in a negative emotional state. These findings suggest that emotions influence numerical estimation, that effects of emotion in estimation interact with stimuli characteristics. They have important implications for understanding the role of emotions on estimation skills, and more generally, on how emotions influence cognition.

Keywords: drone operators, emotion, numerical estimation, arithmetic

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Authors: Zellagui Redouane, Bellaouar Ahmed, Lachi Mohammed

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The railway axles are the essential parts in the bogie of train, and its failure creates a big problem in the railway transport; during the work of this parts we noticed a premature deterioration. The aim has been presented a predictive model allowing the identification of the probable causes that are the cause of these premature deterioration. The results are employed for predicting fatigue crack growth in the railway axle, Also we want to present the variation value of stress intensity factor in different positions of elliptical crack tip. The modeling of axle in performed by the SOLID WORKS software and imported into ANSYS.

Keywords: crack growth, static load, railway axle, lifetime

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Authors: Yen-Hao Su, Wan-Chun Tang, Ya-Wen Cheng, Peik Sia, Chi-Chen Huang, Yi-Chao Lee, Hsin-Yi Jiang, Ming-Heng Wu, I-Lu Lai, Jun-Wei Lee, Kuen-Haur Lee

Abstract:

There is a wide range of drugs and combinations under investigation and/or approved over the last decade to treat colorectal cancer (CRC), but the 5-year survival rate remains poor at stages II–IV. Therefore, new, more efficient drugs still need to be developed that will hopefully be included in first-line therapy or overcome resistance when it appears, as part of second- or third-line treatments in the near future. In this study, we revealed that heat shock protein 90 (Hsp90) inhibitors have high therapeutic potential in CRC according to combinative analysis of NCBI's Gene Expression Omnibus (GEO) repository and chemical genomic database of Connectivity Map (CMap). We found that second generation Hsp90 inhibitor, NVP-AUY922, significantly down regulated the activities of a broad spectrum of kinases involved in regulating cell growth arrest and death of NVPAUY922-sensitive CRC cells. To overcome NVP-AUY922-induced upregulation of survivin expression which causes drug insensitivity, we found that combining berberine (BBR), a herbal medicine with potency in inhibiting survivin expression, with NVP-AUY922 resulted in synergistic antiproliferative effects for NVP-AUY922-sensitive and -insensitive CRC cells. Furthermore, we demonstrated that treatment of NVP-AUY922-insensitive CRC cells with the combination of NVP-AUY922 and BBR caused cell growth arrest through inhibiting CDK4 expression and induction of microRNA-296-5p (miR-296-5p)-mediated suppression of Pin1–β-catenin–cyclin D1 signaling pathway. Finally, we found that the expression level of Hsp90 in tumor tissues of CRC was positively correlated with CDK4 and Pin1 expression levels. Taken together, these results indicate that combination of NVP-AUY922 and BBR therapy can inhibit multiple oncogenic signaling pathways of CRC.

Keywords: berberine, colorectal cancer, connectivity map, heat shock protein 90 inhibitor

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Authors: Adel Dalilottojari, Bahman Delalat, Frances J. Harding, Michaelia P. Cockshell, Claudine S. Bonder, Nicolas H. Voelcker

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Endothelial Progenitor Cell (EPC) based therapies continue to be of interest to treat ischemic events based on their proven role to promote blood vessel formation and thus tissue re-vascularisation. Current strategies for the production of clinical-grade EPCs requires the in vitro isolation of EPCs from peripheral blood followed by cell expansion to provide sufficient quantities EPCs for cell therapy. This study aims to examine the use of different biomolecules to significantly improve the current strategy of EPC capture and expansion on collagen type I (Col I). In this study, four different biomolecules were immobilised on a surface and then investigated for their capacity to support EPC capture and proliferation. First, a cell microarray platform was fabricated by coating a glass surface with epoxy functional allyl glycidyl ether plasma polymer (AGEpp) to mediate biomolecule binding. The four candidate biomolecules tested were Col I, collagen type II (Col II), collagen type IV (Col IV) and vascular endothelial growth factor A (VEGF-A), which were arrayed on the epoxy-functionalised surface using a non-contact printer. The surrounding area between the printed biomolecules was passivated with polyethylene glycol-bisamine (A-PEG) to prevent non-specific cell attachment. EPCs were seeded onto the microarray platform and cell numbers quantified after 1 h (to determine capture) and 72 h (to determine proliferation). All of the extracellular matrix (ECM) biomolecules printed demonstrated an ability to capture EPCs within 1 h of cell seeding with Col II exhibiting the highest level of attachment when compared to the other biomolecules. Interestingly, Col IV exhibited the highest increase in EPC expansion after 72 h when compared to Col I, Col II and VEGF-A. These results provide information for significant improvement in the capture and expansion of human EPC for further application.

Keywords: biomolecules, cell microarray platform, cell therapy, endothelial progenitor cells, high throughput screening

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Authors: Hussain Bunyan, Wesam Ali

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In this paper we will study the performance of a Silicon Photovoltaic (PV) system with different tilt angle arrangement in Kuwait (latitude 30˚ N). In this study the PV system is installed facing south, collecting maximum solar radiation at noon, and their angles are from 00 to 900 respectively, during full year at the Solstice and Equinox periods and aiming for a higher angle than 300 with competitive output power. The results show that the performance and the output power of the PV system with 50˚ tilt angle, is equivalent to the latitude tilt angle (30˚) during a full year.

Keywords: photovoltaic model, tilt angle, solar collector, PV system performance, State of Kuwait

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Authors: Celine Shi Ying Lee, Jong Jian Lee

Abstract:

Background: Infectious keratitis is one of the leading causes of blindness worldwide. Prompt treatment with effective medication will control the infection early, preventing corneal scarring and visual loss. fluoroquinolones ophthalmic medication is used because of its broad-spectrum properties, potency, good intraocular penetration, and low toxicity. The study aims to evaluate the treatment outcome of corneal ulcers using Levofloxacin 1.5% ophthalmic solution (LVFX) with adjuvant oral ciprofloxacin when indicated and apply this treatment strategy in primary health care as first-line treatment. Methods: Patients with infective corneal ulcer treated in an eye center were recruited. Inclusion criteria includes Corneal infection consistent with bacterial keratitis, single or multiple small corneal ulcers. Treatment regime: LVFX hourly for the first 2 days, 2 hourly from the 3rd day, and 3 hourly on the 5th day of review. Adjuvant oral ciprofloxacin 500mg BD was administered for 5 days if there were multiple corneal ulcers or when the location of the cornea ulcer was central or paracentral. Results: 47 subjects were recruited. There were 16 (34%) males and 31 (66%) females. 40 subjects (85%) were contact lens (CL) related to corneal ulcer, and 7 subjects (15%) were non-contact lens related. 42 subjects (89%) presented with one ulcer, of which 20 of them (48%) needed adjuvant therapy. 5 subjects presented with 2 or 3 ulcers, of which 3 needed adjuvant therapy. A total of 23 subjects (49%) was given adjuvant therapy (oral ciprofloxacin 500mg BD for 5 days).21 of them (91%) were CL related. All subjects recovered fully, and the average duration of treatment was 3.7 days, with 49% of the subjects resolved on the 3rd day, 38% on the 5thday of and 13% on the 7thday. All subjects showed symptoms of relief of pain, light-sensitivity, and redness on the 3rd day with full visual recovery post-treatment. No adverse drug reactions were recorded. Conclusion: Our treatment regime demonstrated good clinical outcome as first-line treatment for corneal ulcers. A corneal ulcer is a common eye condition in Singapore, mainly due to CL wear. Pseudomonas aeruginosa is the most frequent and potentially sight-threatening pathogen involved in CL related corneal ulcer. Coagulase-negative Staphylococci, Staphylococcus aureus, and Streptococcus Pneumoniae were seen in non-CL users. All these bacteria exhibit good sensitivity rates to ciprofloxacin and levofloxacin. It is therefore logical in our study to use LVFX Eyedrops and adjuvant ciprofloxacin oral antibiotics when indicated as first line treatment for most corneal ulcers. Our study of patients, both CL related and non-CL related, have shown good clinical response and full recovery using the above treatment strategy. There was also a full restoration of visual acuity in all the patients. Eye-trained primary Healthcare practitioners can consider adopting this treatment strategy as first line treatment in patients with corneal ulcers. This is relevant during the COVID pandemic, where hospitals are overwhelmed with patients and in regions with limited access to specialist eye care. This strategy would enable early treatment with better clinical outcome.

Keywords: corneal ulcer, levofloxacin hydrate, treatment strategy, ciprofloxacin

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Authors: Anita Bajpai, Sarah Duan, Ashlee Erskine, Shehzein Khan, Raymond Kramer

Abstract:

Introduction: This research focuses on exploring the beneficial effects if any, of Vitamin-D in reducing the need for supplemental oxygen among hospitalized COVID-19 patients. Two questions are investigated – Q1)Doeshaving a healthy level of baselineVitamin-D 25-OH (≥ 30ng/ml) help,andQ2) does administering Vitamin-D therapy after-the-factduring inpatient hospitalization help? Methods/Study Design: This is a comprehensive, retrospective, observational study of all inpatients at RUHS from March through December 2020 who tested positive for COVID-19 based on real-time reverse transcriptase–polymerase chain reaction assay of nasal and pharyngeal swabs and rapid assay antigen test. To address Q1, we looked atall N1=182 patients whose baseline plasma Vitamin-D 25-OH was known and who needed supplemental oxygen. Of this, a total of 121 patients had a healthy Vitamin-D level of ≥30 ng/mlwhile the remaining 61 patients had low or borderline (≤ 29.9ng/ml)level. Similarly, for Q2, we looked at a total of N2=893 patients who were given supplemental oxygen, of which713 were not given Vitamin-D and 180 were given Vitamin-D therapy. The numerical value of the maximum amount of oxygen flow rate(dependent variable) administered was recorded for each patient. The mean values and associated standard deviations for each group were calculated. Thesetwo sets of independent data served as the basis for independent, two-sample t-Test statistical analysis. To be accommodative of any reasonable benefitof Vitamin-D, ap-value of 0.10(α< 10%) was set as the cutoff point for statistical significance. Results: Given the large sample sizes, the calculated statistical power for both our studies exceeded the customary norm of 80% or better (β< 0.2). For Q1, the mean value for maximumoxygen flow rate for the group with healthybaseline level of Vitamin-D was 8.6 L/min vs.12.6L/min for those with low or borderline levels, yielding a p-value of 0.07 (p < 0.10) with the conclusion that those with a healthy level of baseline Vitamin-D needed statistically significant lower levels of supplemental oxygen. ForQ2, the mean value for a maximum oxygen flow rate for those not administered Vitamin-Dwas 12.5 L/min vs.12.8L/min for those given Vitamin-D, yielding a p-valueof 0.87 (p > 0.10). We thereforeconcludedthat there was no statistically significant difference in the use of oxygen therapy between those who were or were not administered Vitamin-D after-the-fact in the hospital. Discussion/Conclusion: We found that patients who had healthy levels of Vitamin-D at baseline needed statistically significant lower levels of supplemental oxygen. Vitamin-D is well documented, including in a recent article in the Lancet, for its anti-inflammatory role as an adjuvant in the regulation of cytokines and immune cells. Interestingly, we found no statistically significant advantage for giving Vitamin-D to hospitalized patients. It may be a case of “too little too late”. A randomized clinical trial reported in JAMA also did not find any reduction in hospital stay of patients given Vitamin-D. Such conclusions come with a caveat that any delayed marginal benefits may not have materialized promptly in the presence of a significant inflammatory condition. Since Vitamin-D is a low-cost, low-risk option, it may still be useful on an inpatient basis until more definitive findings are established.

Keywords: COVID-19, vitamin-D, supplemental oxygen, vitamin-D in primary care

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Authors: Hussain Bunyan, Wesam Ali

Abstract:

In this paper we will study the performance of a Silicon Photovoltaic (PV) system with different tilt angle arrangement in Kuwait (latitude 30˚ N). In the study the PV system is installed facing South, collecting maximum solar radiation at noon, and their angles are from 00 to 900 respectively, during full year at the Solstice and Equinox periods, aiming for a higher angle than 300 with competitive output power. The results show that the performance and the output power of the PV system with 50˚ tilt angle, is equivalent to the latitude tilt angle (30˚) during a full year.

Keywords: photovoltaic model, tilt angle, solar collector, PV system performance, State of Kuwait

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Authors: István Fekete, Imre Berki, Áron Béni, Katalin Juhos, Marianna Makádi, Zsolt Kotroczó

Abstract:

The average annual precipitation significantly influences the moisture content of the soils and, through this, the decomposition of the organic substances in the soils, the leaching of nutrients from the soils, and the pH of the soils. Climate change, together with the lengthening of the vegetation period and the increasing CO₂ level, can increase the amount of biomass that is formed. Degradation processes, which accelerate as the temperature increases and slow down due to the drying climate, and the change in the degree of leaching can cancel out or strengthen each other's effects. In the course of our research, we looked for oak forests with climate-zonal soils where the geological, geographical and ecological background conditions are as similar as possible, apart from the different annual precipitation averages and the differences that can arise from them. We examined 5 dry and 5 humid Hungarian oak soils. Climate change affects the soils of drier and wetter forests differently. The aim of our research was to compare the content of carbon, nitrogen and some other nutrients, as well as the pH of the soils of humid and dry forests. Showing the effects of the drier climate on the tested soil parameters. In the case of the examined forest soils, we found a significant difference between the soils of dry and humid forests: in the case of the annual average precipitation values (p≥ 0.0001, for dry forest soils: 564±5.2 mm; for humid forest soils: 716±3.8 mm) for pH (p= 0.0004, for dry forest soils: 5.49±0.16; for wet forest soils: 5.36±0.21); for C content (p= 0.0054, for dry forest soils: 6.92%±0.59; for humid forest soils 3.09%±0.24), for N content (p= 0.0022, dry forest in the case of soils: 0.44%±0.047; in the case of humid forest soils: 0.23%±0.013), for the K content (p=0.0017, in the case of dry forest soils: 5684±732 (mg/kg); in the case of humid forest soils 2169±196 (mg/kg)), for the Ca content (p= 0.0096, for dry forest soils: 8207±2118 (mg/kg); for wet forest soils 957±320 (mg/kg)). No significant difference was found in the case of Mg. In a wetter environment, especially if the moisture content of the soil is also optimal for the decomposing organisms during the growing season, the decomposition of organic residues accelerates, and the processes of leaching from the soil are also intensified. The different intensity of the leaching processes is also well reflected in the quantitative differences of Ca and K, and in connection with these, it is also reflected in the difference in pH values. The differences in the C and N content can be explained by differences in the intensity of the decomposition processes. In addition to warming, drying is expected in a significant part of Hungary due to climate change. Thus, the comparison of the soils of dry and humid forests allows us to predict the subsequent changes in the case of the examined parameters.

Keywords: soil nutrients, precipitation difference, climate change, organic matter decomposition, leaching

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Authors: Amirah Azzeri, Fatiha H. Shabaruddin, Scott A. McDonald, Rosmawati Mohamed, Maznah Dahlui

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Objective: A scaled-up treatment cascade with direct-acting antiviral (DAA) therapy is necessary to achieve global WHO targets for hepatitis C virus (HCV) elimination in Malaysia. Recently, limited access to Sofosbuvir/Daclatasvir (SOF/DAC) is available through compulsory licensing, with future access to Sofosbuvir/Velpatasvir (SOF/VEL) expected through voluntary licensing due to recent agreements. SOF/VEL has superior clinical outcomes, particularly for cirrhotic stages, but has higher drug acquisition costs compared to SOF/DAC. It has been proposed that a stratified treatment cascade might be the most cost-efficient approach for Malaysia whereby all HCV patients are treated with SOF/DAC except for patients with cirrhosis who are treated with SOF/VEL. This study aimed to conduct a five-year budget impact analysis from the provider perspective of the proposed stratified treatment cascade for HCV treatment in Malaysia. Method: A disease progression model that was developed based on model-predicted HCV epidemiology data in Malaysia was used for the analysis, where all HCV patients in scenario A were treated with SOF/DAC for all disease stages while in scenario B, SOF/DAC was used only for non-cirrhotic patients and SOF/VEL was used for the cirrhotic patients. The model projections estimated the annual numbers of patients in care and the numbers of patients to be initiated on DAA treatment nationally. Healthcare costs associated with DAA therapy and disease stage monitoring was included to estimate the downstream cost implications. For scenario B, the estimated treatment uptake of SOF/VEL for cirrhotic patients were 25%, 50%, 75%, 100% and 100% for 2018, 2019, 2020, 2021 and 2022 respectively. Healthcare costs were estimated based on standard clinical pathways for DAA treatment described in recent guidelines. All costs were reported in US dollars (conversion rate US$1=RM4.09, the price year 2018). Scenario analysis was conducted for 5% and 10% reduction of SOF/VEL acquisition cost anticipated from the competitive market pricing of generic DAA in Malaysia. Results: The stratified treatment cascade with SOF/VEL in Scenario B was found to be cost-saving compared to Scenario A. A substantial portion of the cost reduction was due to the costs associated with DAA therapy which resulted in USD 40 thousand (year 1) to USD 443 thousand (year 5) savings annually, with cumulative savings of USD 1.1 million after 5 years. Cost reductions for disease stage monitoring were seen in year three onwards which resulted in cumulative savings of USD 1.1 thousand. Scenario analysis estimated cumulative savings of USD 1.24 to USD 1.35 million when the acquisition cost of SOF/VEL was reduced. Conclusion: A stratified treatment cascade with SOF/VEL was expected to be cost-saving and can results in a budget impact reduction in overall healthcare expenditure in Malaysia compared to treatment with SOF/DAC. The better clinical efficacy with SOF/VEL is expected to halt patients’ HCV disease progression and may reduce downstream costs of treating advanced disease stages. The findings of this analysis may be useful to inform healthcare policies for HCV treatment in Malaysia.

Keywords: Malaysia, direct acting antiviral, compulsory licensing, voluntary licensing

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