Search results for: conception rate

Authors: Huseyin Arasli, Maryam Abdullahi, Tugrul Gunay

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One of the prominence elements used by the destination marketing organization (DMO) as a marketing strategy is the application of Social media tools. During the current spread of coronavirus disease (COVID-19), travel restriction was placed in most countries of the world, leading to the closure of borders movement. It should be noted that most tourism travelers depend on social media to obtain and exchange different kinds of information about COVID-19 in an unprecedented scale. The situational information people received is valued, which calls for the response of the tourism industry on the epidemic. Therefore, it is highly important to recognize such situational information and to understand how people spread this propaganda on social media platforms so that suitable information that relates the COVID-19 epidemic is available in a manner that will not tarnish the marketing strategies, festival planners. Data for this research study was collected from the desk review, which is a secondary source data, online blogs, and interview through social media chat. The results of this research show that the widespread of COVID-19 pandemics led to rapid lockdown in states and cities all over Nigeria, causing declining demands in hotels, airlines, recreation, and tourism centers. Additionally, billions of dollars lost has been recorded in the high increase of hotels and travel bookings cancellations which caused hundreds and thousands of job loss in the country. The result of this research also revealed that COVID-19 is causing more havoc on the unemployment rate indices of the country. Similarly, the over-dependence of government on petroleum has further caused considerable revenue loss, thereby raising a high poverty rate among less privileged Nigerians. Based on this result, the study suggested that there is an urgent need for the government to diversify its economy by looking at other different sectors such as tourism and agricultural farm produce to harmonize other commercial trades sectors in the country.

Keywords: social media, destination marketing organizations, DMOs, cultural COVID-19, coronavirus, hospitality, travel tour, tourism

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Authors: Juan Pablo Bertuzzi, Mauro Chiarella

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Employing a communication studies perspective and a socio-technological approach, this paper introduces a theoretical framework for understanding the concept of hybrid world; the avatarization phenomena; and the communicational archetype of co-hybridization. This analysis intends to make a contribution to future design of virtual reality experimental applications. Ultimately, this paper presents an ongoing research project that proposes the study of human-avatar interactions in digital educational environments, as well as an innovative reflection on inner digital communication. The aforementioned project presents the analysis of human-avatar interactions, through the development of an interactive experience in virtual reality. The goal is to generate an innovative communicational dimension that could reinforce the hypotheses presented throughout this paper. Being thought for its initial application in educational environments, the analysis and results of this research are dependent and have been prepared in regard of a meticulous planning of: the conception of a 3D digital platform; the interactive game objects; the AI or computer avatars; the human representation as hybrid avatars; and lastly, the potential of immersion, ergonomics and control diversity that can provide the virtual reality system and the game engine that were chosen. The project is divided in two main axes: The first part is the structural one, as it is mandatory for the construction of an original prototype. The 3D model is inspired by the physical space that belongs to an academic institution. The incorporation of smart objects, avatars, game mechanics, game objects, and a dialogue system will be part of the prototype. These elements have all the objective of gamifying the educational environment. To generate a continuous participation and a large amount of interactions, the digital world will be navigable both, in a conventional device and in a virtual reality system. This decision is made, practically, to facilitate the communication between students and teachers; and strategically, because it will help to a faster population of the digital environment. The second part is concentrated to content production and further data analysis. The challenge is to offer a scenario’s diversity that compels users to interact and to question their digital embodiment. The multipath narrative content that is being applied is focused on the subjects covered in this paper. Furthermore, the experience with virtual reality devices proposes users to experiment in a mixture of a seemingly infinite digital world and a small physical area of movement. This combination will lead the narrative content and it will be crucial in order to restrict user’s interactions. The main point is to stimulate and to grow in the user the need of his hybrid avatar’s help. By building an inner communication between user’s physicality and user’s digital extension, the interactions will serve as a self-guide through the gameworld. This is the first attempt to make explicit the avatarization phenomena and to further analyze the communicational archetype of co-hybridization. The challenge of the upcoming years will be to take advantage from these forms of generalized avatarization, in order to create awareness and establish innovative forms of hybridization.

Keywords: avatar, hybrid worlds, socio-technology, virtual reality

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Authors: Ahmed E. Hodaib, Muhammed A. Hashem

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High-speed transportation has become a growing concern. To increase high-speed efficiencies and minimize power consumption of a vehicle, we need to eliminate the friction with the ground and minimize the aerodynamic drag acting on the vehicle. Due to the complexity and high power requirements of electromagnetic levitation, we make use of the air in front of the capsule, that produces the majority of the drag, to compress it in two phases and inject a proportion of it through small nozzles to make a high-pressure air cushion to levitate the capsule. The tube is partially-evacuated so that the air pressure is optimized for maximum compressor effectiveness, optimum tube size, and minimum vacuum pump power consumption. The total relative mass flow rate of the tube air is divided into two fractions. One is by-passed to flow over the capsule body, ensuring that no chocked flow takes place. The other fraction is sucked by the compressor where it is diffused to decrease the Mach number (around 0.8) to be suitable for the compressor inlet. The air is then compressed and intercooled, then split. One fraction is expanded through a tail nozzle to contribute to generating thrust. The other is compressed again. Bleed from the two compressors is used to maintain a constant air pressure in an air tank. The air tank is used to supply air for levitation. Dividing the total mass flow rate increases the achievable speed (Kantrowitz limit), and compressing it decreases the blockage of the capsule. As a result, the aerodynamic drag on the capsule decreases. As the tube pressure decreases, the drag decreases and the capsule power requirements decrease, however, the vacuum pump consumes more power. That’s why Design optimization techniques are to be used to get the optimum values for all the design variables given specific design inputs. Aerodynamic shape optimization, Capsule and tube sizing, compressor design, diffuser and nozzle expander design and the effect of the air bearing on the aerodynamics of the capsule are to be considered. The variations of the variables are to be studied for the change of the capsule velocity and air pressure.

Keywords: tube-capsule, hyperloop, aerodynamic design optimization, air compressor, air bearing

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Authors: Chompunut Jantarasorn, Chutima Prommak

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This paper presents an intensive measurement studying of the network performance analysis when IEEE 802.11g Wireless Local Area Networks (WLAN) coexisting with IEEE 802.15.4 Wireless Personal Area Network (WPAN). The measurement results show that the coexistence between both networks could increase the Frame Error Rate (FER) of the IEEE 802.15.4 networks up to 60% and it could decrease the throughputs of the IEEE 802.11g networks up to 55%.

Keywords: wireless performance analysis, coexistence analysis, IEEE 802.11g, IEEE 802.15.4

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Authors: A. Bajek, J. Skopinska-Wisniewska, A. Rynkiewicz, A. Jundzill, M. Bodnar, A. Marszalek, T. Drewa

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Traumatic injury and age-related degenerative diseases associated with cartilage are major health problems worldwide. The articular cartilage is comprised of a relatively small number of cells, which have a relatively slow rate of turnover. Therefore, damaged articular cartilage has a limited capacity for self-repair. New clinical methods have been designed to achieve better repair of injured cartilage. However, there is no treatment that enables full restoration of it. The aim of this study was to evaluate how collagen gel with bone marrow mesenchymal stem cells (MSCs) and collagen gel alone will influence on the hip cartilage repair after injury. Collagen type I was isolated from rats’ tails and cross-linked with N-hydroxysuccinimide in 24-hour process. MSCs were isolated from rats’ bone marrow. The experiments were conducted according to the guidelines for animal experiments of Ethics Committee. Fifteen 8-week-old Wistar rats were used in this study. All animals received hip joint surgery with a total of 30 created cartilage defects. Then, animals were randomly divided into three groups and filled, respectively, with collagen gel (group 1), collagen gel cultured with MSCs (group II) or left untreated as a control (control group). Immunohistochemy and radiological evaluation was carried out 11 weeks post implantation. It has been proved that the surface of the matrix is non-toxic, and its porosity promotes cell adhesion and growth. However, the in vivo regeneration process was poor. We observed the low integration rate of biomaterial. Immunohistochemical evaluation of cartilage after 11 weeks of treatment showed low II and high X collagen expression in two tested groups in comparison to the control one, in which we observed the high II collagen expression. What is more, after radiological analysis, we observed the best regeneration process in control group. The biomaterial construct and mesenchymal stem cells, as well as the use of the biomaterial itself was not sufficient to regenerate the hip cartilage surfaces. These results suggest that the collagen gel based biomaterials, even with MSCs, are not satisfactory in repar of hip cartilage defect. However, additional evaluation is needed to confirm these results.

Keywords: collafen gel, MSCs, cartilage repair, hip cartilage

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Authors: Wanbao Chen, Qianqian Yao, Zhenming Zhou

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Whole grains with intact pericarp are largely resistant to digestion by ruminants because entire kernels are not conducive to bacterial attachment. But processing methods makes the starch more accessible to microbes, and increases the rate and extent of starch degradation in the rumen. To estimate the feasibility of applying a steam-flaking as the processing technique of grains for ruminants, cereal grains (maize, wheat, barley and sorghum) were processed by steam-flaking (steam temperature 105°C, heating time, 45 min). And chemical analysis, in vitro gas production, volatile fatty acid concentrations, and energetic values were adopted to evaluate the effects of steam-flaking. In vitro cultivation was conducted for 48h with the rumen fluid collected from steers fed a total mixed ration consisted of 40% hay and 60% concentrates. The results showed that steam-flaking processing had a significant effect on the contents of neutral detergent fiber and acid detergent fiber (P < 0.01). The concentration of starch gelatinization degree in all grains was also great improved in steam-flaking grains, as steam-flaking processing disintegrates the crystal structure of cereal starch, which may subsequently facilitate absorption of moisture and swelling. Theoretical maximum gas production after steam-flaking processing showed no great difference. However, compared with intact grains, total gas production at 48 h and the rate of gas production were significantly (P < 0.01) increased in all types of grain. Furthermore, there was no effect of steam-flaking processing on total volatile fatty acid, but a decrease in the ratio between acetate and propionate was observed in the current in vitro fermentation. The present study also found that steam-flaking processing increased (P < 0.05) organic matter digestibility and energy concentration of the grains. The collective findings of the present study suggest that steam-flaking processing of grains could improve their rumen fermentation and energy utilization by ruminants. In conclusion, the utilization of steam-flaking would be practical to improve the quality of common cereal grains.

Keywords: cereal grains, gas production, in vitro rumen fermentation, steam-flaking processing

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Authors: Teklay Gebrecherkos

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Background: Serological testing for SARS-CoV-2 plays an important role in epidemiological studies, in aiding the diagnosis of COVID-19 and assess vaccine responses. Little is known about the dynamics of SARS-CoV-2 serology in African settings. Here, we aimed to characterize the longitudinal antibody response profile to SARS-CoV-2 in Ethiopia. Methods: In this prospective study, a total of 102 PCR-confirmed COVID-19 patients were enrolled. We obtained 802 plasma samples collected serially. SARS-CoV-2 antibodies were determined using four lateral flow immune assays (LFIAs) and an electrochemiluminescent immunoassay. We determined longitudinal antibody response to SARS-CoV-2 as well as seroconversion dynamics. Results: Serological positivity rate ranged between 12%-91%, depending on timing after symptom onset. There was no difference in the positivity rate between severe and non-severe COVID-19 cases. The specificity ranged between 90%-97%. Agreement between different assays ranged between 84%-92%. The estimated positive predictive value (PPV) for IgM or IgG in a scenario with seroprevalence at 5% varies from 33% to 58%. Nonetheless, when the population seroprevalence increases to 25% and 50%, there is a corresponding increase in the estimated PPVs. The estimated negative-predictive value (NPV) in a low seroprevalence scenario (5%) is high (>99%). However, the estimated NPV in a high seroprevalence scenario (50%) for IgM or IgG is reduced significantly from 80% to 85%. Overall, 28/102 (27.5%) seroconverted by one or more assays tested within a median time of 11 (IQR: 9–15) days post symptom onset. The median seroconversion time among symptomatic cases tended to be shorter when compared to asymptomatic patients [9 (IQR: 6–11) vs. 15 (IQR: 13–21) days; p = 0.002]. Overall, seroconversion reached 100% 5.5 weeks after the onset of symptoms. Notably, of the remaining 74 COVID-19 patients included in the cohort, 64 (62.8%) were positive for antibodies at the time of enrollment, and 10 (9.8%) patients failed to mount a detectable antibody response by any of the assays tested during follow-up. Conclusions: Longitudinal assessment of antibody response in African COVID-19 patients revealed heterogeneous responses. This underscores the need for a comprehensive evaluation of serum assays before implementation. Factors associated with failure to seroconvert need further research.

Keywords: COVID-19, antibody, rapid diagnostic tests, ethiopia

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Authors: Antoifi Abdoulhalik, Ashraf Ahmed

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Saltwater intrusion (SWI) in coastal aquifers has become a growing threat for many countries around the world. While various control measures have been suggested to mitigate SWI, the construction of subsurface physical barriers remains one of the most effective solutions for this problem. In this work, we used laboratory experiments and numerical simulations to investigate the effectiveness of subsurface dams in heterogeneous layered coastal aquifer with different layering patterns. Four different cases were investigated, including a homogeneous (case H), and three heterogeneous cases in which a low permeability (K) layer was set in the top part of the system (case LH), in the middle part of the system (case HLH) and the bottom part of the system (case HL). Automated image analysis technique was implemented to quantify the main SWI parameters under high spatial and temporal resolution. The method also provides transient salt concentration maps, allowing for the first time clear visualization of the spillage of saline water over the dam (advancing wedge condition) as well as the flushing of residual saline water from the freshwater area (receding wedge condition). The SEAWAT code was adopted for the numerical simulations. The results show that the presence of an overlying layer of low permeability enhanced the ability of the dam to retain the saline water. In such conditions, the rate of saline water spillage and inland extension may considerably be reduced. Conversely, the presence of an underlying low K layer led to a faster increase of saltwater volume on the seaward side of the wall, therefore considerably facilitating the spillage. The results showed that a complete removal of the residual saline water eventually occurred in all the investigated scenarios, with a rate of removal strongly affected by the hydraulic conductivity of the lower part of the aquifer. The data showed that the addition of the underlying low K layer in case HL caused the complete flushing to be almost twice longer than in the homogeneous scenario.

Keywords: heterogeneous coastal aquifers, laboratory experiments, physical barriers, seawater intrusion control

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Authors: Dativa Maria Aliddeki, Fred Monje, Godfrey Nsereko, Benon Kwesiga, Daniel Kadobera, Alex Riolexus Ario

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Background: Cholera is a severe gastrointestinal disease caused by Vibrio cholera. It has caused several pandemics. On 26 February 2018, a suspected cholera outbreak, with one death, occurred in School X in Hoima Municipality, western Uganda. We investigated to identify the scope and mode of transmission of the outbreak, and recommend evidence-based control measures. Methods: We defined a suspected case as onset of diarrhea, vomiting, or abdominal pain in a student or staff of School X or their family members during 14 February–10 March. A confirmed case was a suspected case with V. cholerae cultured from stool. We reviewed medical records at Hoima Hospital and searched for cases at School X. We conducted descriptive epidemiologic analysis and hypothesis-generating interviews of 15 case-patients. In a retrospective cohort study, we compared attack rates between exposed and unexposed persons. Results: We identified 15 cases among 75 students and staff of School X and their family members (attack rate=20%), with onset from 25-28 February. One patient died (case-fatality rate=6.6%). The epidemic curve indicated a point-source exposure. On 24 February, a student brought fried fish from her home in a fishing village, where a cholera outbreak was ongoing. Of the 21 persons who ate the fish, 57% developed cholera, compared with 5.6% of 54 persons who did not eat (RR=10; 95% CI=3.2-33). None of 4 persons who recooked the fish before eating, compared with 71% of 17 who did not recook it, developed cholera (RR=0.0, 95%CIFisher exact=0.0-0.95). Of 12 stool specimens cultured, 6 yielded V. cholerae. Conclusion: This cholera outbreak was caused by eating fried fish, which might have been contaminated with V. cholerae in a village with an ongoing outbreak. Lack of thorough cooking of the fish might have facilitated the outbreak. We recommended thoroughly cooking fish before consumption.

Keywords: cholera, disease outbreak, foodborne, global health security, Uganda

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Authors: A. Guemache, M. Omari

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Oxides with formula Ca1-xSrx MnO3(0≤x≤0.2) were synthesized using co precipitation method. The identification of the obtained phase was carried out using infrared spectroscopy and x-ray diffraction. Thermogravimetric and differential analysis was permitted to characterize different transformations of precursors which take place during one heating cycle. The study of electrochemical behavior was carried out by cyclic voltammetry and impedance spectroscopy. The obtained results show that apparent catalytic activity improved when increasing the concentration of strontium. Anodic current densities varies from 1.3 to 5.9 mA/cm2 at the rate scan of 20 mV.s-1 and a potential 0.8 V for oxides with composition x=0 to 0.2.

Keywords: oxide, co-precipitation, thermal analysis, electrochemical properties

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Authors: E. M. H. Maggie, M. N. A. Nazmey, M. A. Abdel-Sattar, S. A. Saied

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A successful trial of transplanting cotton is reported. Seeds grown in trays for 4-5 weeks in an easily prepared supporting medium such as peat moss or similar plant waste are tried. Careful transplanting of seedlings, with root system as intact as possible, is being made in the permanent field. The practice reduced damping-off incidence rate and allowed full winter crop revenues. Further work is needed to evaluate certain parameters such as growth curve, flowering curve, and yield at economic bases.

Keywords: cotton, transplanting cotton, damping-off diseases, environment sciences

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Authors: Nicky Wilson, Graeme Ralph

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Legacy aerostructure assembly is defined by large components, low build rates, and manual assembly methods. With an increasing demand for commercial aircraft and emerging markets such as the eVTOL (electric vertical take-off and landing) market, current methods of manufacturing are not capable of efficiently hitting these higher-rate demands. This project will look at how legacy manufacturing processes can be rate enabled by taking a holistic view of data usage, focusing on how data can be collected to enable fully integrated digital factories and supply chains. The study will focus on how data is flowed both up and down the supply chain to create a digital thread specific to each part and assembly while enabling machine learning through real-time, closed-loop feedback systems. The study will also develop a bespoke architecture to enable connectivity both within the factory and the wider PLM (product lifecycle management) system, moving away from traditional point-to-point systems used to connect IO devices to a hub and spoke architecture that will exploit report-by-exception principles. This paper outlines the key issues facing legacy aircraft manufacturers, focusing on what future manufacturing will look like from adopting Industry 4 principles. The research also defines the data architecture of a PLM system to enable the transfer and control of a digital thread within the supply chain and proposes a standardised communications protocol to enable a scalable solution to connect IO devices within a production environment. This research comes at a critical time for aerospace manufacturers, who are seeing a shift towards the integration of digital technologies within legacy production environments, while also seeing build rates continue to grow. It is vital that manufacturing processes become more efficient in order to meet these demands while also securing future work for many manufacturers.

Keywords: Industry 4, digital transformation, IoT, PLM, automated assembly, connected factories

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Authors: M. Aeysha Parvin, J. Asha, J. Jenifer

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This letter presents a novel frequency-shift keying(FSK) receiver using PLL-based FSK demodulator, thereby achieving high sensitivity and low power consumption. The proposed receiver comprises a power amplifier, mixer, 3-stage ring oscillator, PLL based demodulator. Moreover, the proposed receiver is fabricated using 0.12µm CMOS process and consumes 0.7Mw. Measurement results demonstrate that the proposed receiver has a sensitivity of -93dbm with 1Mbps data rate in receiving a 2.4 GHz FSK signal.

Keywords: CMOS FSK receiver, phase locked loop (PLL), 3-stage ring oscillator, FSK signal

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Authors: Jiachen Wang, Dongxu Ji

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Geothermal power generation is a mature technology with zero carbon emission and stable power output, which could play a vital role as an optimum substitution of base load technology in China’s future decarbonization society. However, the development of geothermal power plants in China is stagnated for a decade due to the underestimation of geothermal energy and insufficient favoring policy. Lack of understanding of the potential value of base-load technology and environmental benefits is the critical reason for disappointed policy support. This paper proposed a different energy-economic model to uncover the potential benefit of developing a geothermal power plant in Puer, including the value of base-load power generation, and environmental and economic benefits. Optimization of the Organic Rankine Cycle (ORC) for maximum power output and minimum Levelized cost of electricity was first conducted. This process aimed at finding the optimum working fluid, turbine inlet pressure, pinch point temperature difference and superheat degrees. Then the optimal ORC model was sent to the energy-economic model to simulate the potential economic and environmental benefits. Impact of geothermal power plants based on the scenarios of implementing carbon trade market, the direct subsidy per electricity generation and nothing was tested. In addition, a requirement of geothermal reservoirs, including geothermal temperature and mass flow rate for a competitive power generation technology with other renewables, was listed. The result indicated that the ORC power plant has a significant economic and environmental benefit over other renewable power generation technologies when implementing carbon trading market and subsidy support. At the same time, developers must locate the geothermal reservoirs with minimum temperature and mass flow rate of 130 degrees and 50 m/s to guarantee a profitable project under nothing scenarios.

Keywords: geothermal power generation, optimization, energy model, thermodynamics

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Authors: Wenjie Wu, Peng Cheng, Zehua Zhang, Fei Luo, Feng Wu, Min Zhong, Jianzhong Xu

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Background: There has been limited research into the therapeutic efficacy of rapid diagnosis of spinal tuberculosis complicated with pulmonary tuberculosis. We attempted to discover whether the utilization of a DNA microarray assay to detect multidrug-resistant spinal tuberculosis complicated with pulmonary tuberculosis can improve clinical outcomes. Methods: A prospective study was conducted from February 2006 to September 2015. One hundred and forty-three consecutive culture–confirmed, clinically and imaging diagnosed MDR-TB patients with spinal tuberculosis complicated by pulmonary tuberculosis were enrolled into the study. The initial time to treatment for MDR-TB, the method of infection control, radiological indicators of spinal tubercular infectious foci, culture conversion, and adverse drug reactions were compared with the standard culture methods. Results: Of the total of 143 MDR-TB patients, 68 (47.6%) were diagnosed by conventional culture methods and 75 (52.4%) following the implementation of detection using the DNA microarray. Patients in the microarray group began rational use of the second-line drugs schedule more speedily than sufferers in the culture group (17.3 vs. 74.1 days). Among patients were admitted to a general tuberculosis ward, those from the microarray group spent less time in the ward than those from the culture group (7.8 vs. 49.2 days). In those patients with six months follow-up (n=134), patients in the microarray group had a higher rate of sputum negativity conversion at six months (89% vs. 73%). In the microarray group, the rate of drug adverse reactions was significantly lower (22.2% vs. 67.7%). At the same time, they had a more obvious reduction of the area with spinal tuberculous lesions in radiological examinations (77% vs. 108%). Conclusions: The application of the CapitalBio™ DNA Microarray assay caused noteworthy clinical advances including an earlier time to begin MDR-TB treatment, increased sputum culture conversion, improved infection control measures and better radiographical results

Keywords: tuberculosis, multidrug-resistant, tuberculous spondylitis, DNA microarray, clinical outcomes

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Authors: Rowshan Mamtaz, Shuvo Ahmed, Imran Noor, Sumaiya Rahman, Prithvi Shams, Fahmida Gulshan

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Last few decades have witnessed a phenomenal rise in the use of electrical and electronic equipment globally in our everyday life. As these items reach the end of their lifecycle, they turn into e-wastes and contribute to the waste stream. Bangladesh, in conformity with the global trend and due to its ongoing rapid growth, is also using electronics-based appliances and equipment at an increasing rate. This has caused a corresponding increase in the generation of e-wastes. Bangladesh is a developing country; its overall waste management system, is not yet efficient, nor is it environmentally sustainable. Most of its solid wastes are disposed of in a crude way at dumping sites. Addition of e-wastes, which often contain toxic heavy metals, into its waste stream has made the situation more difficult and challenging. Assessment of generation of e-wastes is an important step towards addressing the challenges posed by e-wastes, setting targets, and identifying the best practices for their management. Understanding and proper management of e-wastes is a stated item of the Sustainable Development Goals (SDG) campaign, and Bangladesh is committed to fulfilling it. A better understanding and availability of reliable baseline data on e-wastes will help in preventing illegal dumping, promote recycling, and create jobs in the recycling sectors and thus facilitate sustainable e-waste management. With this objective in mind, the present study has attempted to estimate the amount of e-wastes and its future generation trend in Bangladesh. To achieve this, sales data on eight selected electrical and electronic products (TV, Refrigerator, Fan, Mobile phone, Computer, IT equipment, CFL (Compact Fluorescent Lamp) bulbs, and Air Conditioner) have been collected from different sources. Primary and secondary data on the collection, recycling, and disposal of the e-wastes have also been gathered by questionnaire survey, field visits, interviews, and formal and informal meetings with the stakeholders. Material Flow Analysis (MFA) method has been applied, and mathematical models have been developed in the present study to estimate e-waste amounts and their future trends up to the year 2035 for the eight selected electrical and electronic equipment. End of life (EOL) method is adopted in the estimation. Model inputs are products’ annual sale/import data, past and future sales data, and average life span. From the model outputs, it is estimated that the generation of e-wastes in Bangladesh in 2018 is 0.40 million tons and by 2035 the amount will be 4.62 million tons with an average annual growth rate of 20%. Among the eight selected products, the number of e-wastes generated from seven products are increasing whereas only one product, CFL bulb, showed a decreasing trend of waste generation. The average growth rate of e-waste from TV sets is the highest (28%) while those from Fans and IT equipment are the lowest (11%). Field surveys conducted in the e-waste recycling sector also revealed that every year around 0.0133 million tons of e-wastes enter into the recycling business in Bangladesh which may increase in the near future.

Keywords: Bangladesh, end of life, e-waste, material flow analysis

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Authors: Ifeoma Anozie, Teka Apalata, Dominic Abaver

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Introduction: Despite use of Anti-retroviral therapy to reduce the incidence of opportunistic infections among HIV/AIDS patients, rapid episodes of re-infection after deworming are still common occurrences because pharmaceutical intervention alone does not prevent reinfection. Unsafe water and inadequate personal hygiene and parasitic infections are widely expected to accelerate the progression of HIV infection. This is because the chronic immunosuppression of HIV infection encourages susceptibility to opportunistic (including parasitic) infections which is linked to CD4+ cell count of <200 cells/μl. Intestinal parasites such as G. intestinalis and Entamoeba spp are ubiquitous protozoa that remain infectious over a long time in an environment and show resistance to standard disinfection. To control re-infection, the social factors that underpin the prevention need to be controlled. This study aims at prevention of intestinal parasites in people living with HIV/AIDS by using a treatment, hygiene education and sanitation (THEdS) bundle approach. Methods: This study was conducted in four clinics (Ngangelizwe health centre, Tsolo gateway clinic, Idutywa health centre and Nqamakwe health centre) across the seven districts in Eastern cape, South Africa. The four clinics were divided in two: experimental and control, for the purpose of intervention. Data was collected from March 2019 to February 2020. Six hundred participants were screened for intestinal parasitic infections. Stool samples were collected and analysed twice: before (Pre-test infection screening) and after (Post-test re-infection) THEdS bundle intervention. The experimental clinics received full intervention package, which include therapeutic treatment, health education on personal hygiene and sanitation training, while the control clinics received only therapeutic treatment for those found with intestinal parasitic infections. Results: Baseline prevalence of Intestinal Parasites isolated shows 12 intestinal parasites with overall frequency of 65, with Ascaris lumbricoides having most frequency (44.6%). The intervention had a cure rate of 60%, with odd ratio of 1.42, which indicates that the intervention group is 1.42 times more likely of parasite clearing as compared to the control group. The relative risk ratio of 1.17 signifies that there is 1.17 times more likelihood to clear intestinal parasite if there no intervention. Discussion and conclusion: Infection with multiple parasites can cause health defects, especially among HIV/AIDS patients. Efficiency of some HIV vaccines in HIV/AIDS patients is affected because treatment of re-infection amplifies drug resistance, affects the efficacy of the front-line drugs, and still permits transmission. In South Africa, treatment of intestinal parasites is usually offered to clinic attending HIV/AIDS patients upon suspicion but not as a mandate for patients being initiated into Antiretroviral (ART) program. The effectiveness of THEdS bundle advocates for inclusiveness of mandatory screening for intestinal parasitic infections among attendees of HIV/Aids clinics on regular basis.

Keywords: cure rate, , HIV/AIDS patients, intestinal parasites, intervention studies, reinfection rate

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Authors: Dong Seop Lee, Byung Sik Kim

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In the 4th Industrial Revolution, various intelligent technologies have been developed in many fields. These artificial intelligence technologies are applied in various services, including disaster management. Disaster information management does not just support disaster work, but it is also the foundation of smart disaster management. Furthermore, it gets historical disaster information using artificial intelligence technology. Disaster information is one of important elements of entire disaster cycle. Disaster information management refers to the act of managing and processing electronic data about disaster cycle from its’ occurrence to progress, response, and plan. However, information about status control, response, recovery from natural and social disaster events, etc. is mainly managed in the structured and unstructured form of reports. Those exist as handouts or hard-copies of reports. Such unstructured form of data is often lost or destroyed due to inefficient management. It is necessary to manage unstructured data for disaster information. In this paper, the Optical Character Recognition approach is used to convert handout, hard-copies, images or reports, which is printed or generated by scanners, etc. into electronic documents. Following that, the converted disaster data is organized into the disaster code system as disaster information. Those data are stored in the disaster database system. Gathering and creating disaster information based on Optical Character Recognition for unstructured data is important element as realm of the smart disaster management. In this paper, Korean characters were improved to over 90% character recognition rate by using upgraded OCR. In the case of character recognition, the recognition rate depends on the fonts, size, and special symbols of character. We improved it through the machine learning algorithm. These converted structured data is managed in a standardized disaster information form connected with the disaster code system. The disaster code system is covered that the structured information is stored and retrieve on entire disaster cycle such as historical disaster progress, damages, response, and recovery. The expected effect of this research will be able to apply it to smart disaster management and decision making by combining artificial intelligence technologies and historical big data.

Keywords: disaster information management, unstructured data, optical character recognition, machine learning

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Authors: Debashree Ghosh, Preethi Sridhar, Shloka Atul Dhavle

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The judicious and economic consumption of energy for sustainable growth and development is nowadays a thing of primary importance; Phase Change Materials (PCM) provide an ingenious option of storing energy in the form of Latent Heat. Energy storing mechanism incorporating phase change material increases the efficiency of the process by minimizing the difference between supply and demand; PCM heat exchangers are used to storing the heat or non-convectional energy within the PCM as the heat of fusion. The experimental study evaluates the effect of thermo-physical properties, variation in inlet temperature, and flow rate on charging period of a coiled heat exchanger. Secondly, a numerical study is performed on a PCM double pipe heat exchanger packed with two different PCMs, namely, RT50 and Fatty Acid, in the annular region. In this work, the simulation of charging of paraffin wax (RT50) using water as high-temperature fluid (HTF) is performed. Commercial software Ansys-Fluent 15 is used for simulation, and hence charging of PCM is studied. In the Enthalpy-porosity model, a single momentum equation is applicable to describe the motion of both solid and liquid phases. The details of the progress of phase change with time are presented through the contours of melt-fraction, temperature. The velocity contour is shown to describe the motion of the liquid phase. The experimental study revealed that paraffin wax melts with almost the same temperature variation at the two Intermediate positions. Fatty acid, on the other hand, melts faster owing to greater thermal conductivity and low melting temperature. It was also observed that an increase in flow rate leads to a reduction in the charging period. The numerical study also supports some of the observations found in the experimental study like the significant dependence of driving force on the process of melting. The numerical study also clarifies the melting pattern of the PCM, which cannot be observed in the experimental study.

Keywords: latent heat storage, charging period, discharging period, coiled heat exchanger

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Authors: Anupam Chanda

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Presently Packaging plays a significant role for drug discoveries. The process of selecting materials and the type of packaging also offers an opportunity for the Packaging scientist to look for biological delivery choices. Most injectable protein products were supplied in some sort of glass vial, prefilled syringe, cartridge. Those product having high Ph content there is a chance of “delamination “from inner surface of glass vial. With protein-based drugs, the biggest issue is the effect of packaging derivatives on the protein’s threedimensional and surface structure. These are any effects that relate to denaturation or aggregation of the protein due to oxidation or interactions from contaminants or impurities in the preparation. The potential for these effects needs to be carefully considered in choosing the container and the container closure system to avoid putting patients in jeopardy. Cause of Delamination : -Formulations with a high pH include phosphate and citrate buffers increase the risk of glass delamination. -High alkali content in glass could accelerate erosion. -High temperature during the vial-forming process increase the risk of glass delamination. -Terminal sterilization (irradiated at 20-40 kGy for 150 min) also is a risk factor for specific products(veterinary parenteral administration),could cause delamination. -High product-storage temperatures and long exposure times can increase the rate and severity of glass delamination. How to prevent Delamination -Treating the surface of the glass vials with materials, such as ammonium sulfate or siliconization can reduce the rate of glass erosion. -Consider alternative sterilization methods only in rare cases. -The correct specification for the glass to ensure its suitability for the pH of the product. -Use Cyclic olefin copolymer(COC)/Cyclic olefin Polymer(COP) Adsorption of protein and Solutions: Option#1 Coat with linear methoxylated polyglycerol and hyperbranchedmethoxylated polyglycerol. Option#2 Thehyperbranched non-methoxylated coating performed best. Option#3 Coat with hyperbranched polyglycerol Option#4 Right selection of Sterilization of glass vial/syringe.

Keywords: delamination of glass, ptrotien adoptions inside the glass surface, extractable & leachable solutions, injectable designs for new drugs

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Authors: Ming-Jyh Chen, Wen-Ming Huang, Yi-Chu Liu, Li-Hui Yang

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Introduction: Social responsibility is the key to sustainable organizational development. Under the ground Green Health Hospital Declaration signed by our superintendent, we have launched comprehensive energy conservation management in medical services, the community, and the staff’s life. To execute environment-friendly promotion with robust strategies, we build up a low-carbon medical system and community with smart green public construction promotion as well as intensifying energy conservation education and communication. Purpose/Methods: With the support of the board and the superintendent, we construct an energy management team, commencing with an environment-friendly system, management, education, and ISO 50001 energy management system; we have ameliorated energy performance and energy efficiency and continuing. Results: In the year 2021, we have achieved multiple goals. The energy management system efficiently controls diesel, natural gas, and electricity usage. About 5% of the consumption is saved when compared to the numbers from 2018 and 2021. Our company develops intelligent services and promotes various paperless electronic operations to provide people with a vibrant and environmentally friendly lifestyle. The goal is to save 68.6% on printing and photocopying by reducing 35.15 million sheets of paper yearly. We strengthen the concept of environmental protection classification among colleagues. In the past two years, the amount of resource recycling has reached more than 650 tons, and the resource recycling rate has reached 70%. The annual growth rate of waste recycling is about 28 metric tons. Conclusions: To build a green medical system with “high efficacy, high value, low carbon, low reliance,” energy stewardship, economic prosperity, and social responsibility are our principles when it comes to formulation of energy conservation management strategies, converting limited sources to efficient usage, developing clean energy, and continuing with sustainable energy.

Keywords: energy efficiency, environmental education, green hospital, sustainable development

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Authors: Fumiya Sugino, Naohiro Nakamura, Yuji Miyazu

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In earthquake resistant design of buildings, evaluation of vibration characteristics is important. In recent years, due to the increment of super high-rise buildings, the evaluation of response is important for not only the first mode but also higher modes. The knowledge of vibration characteristics in buildings is mostly limited to the first mode and the knowledge of higher modes is still insufficient. In this paper, using earthquake observation records of a SRC building by applying frequency filter to ARX model, characteristics of first and second modes were studied. First, we studied the change of the eigen frequency and the damping ratio during the 3.11 earthquake. The eigen frequency gradually decreases from the time of earthquake occurrence, and it is almost stable after about 150 seconds have passed. At this time, the decreasing rates of the 1st and 2nd eigen frequencies are both about 0.7. Although the damping ratio has more large error than the eigen frequency, both the 1st and 2nd damping ratio are 3 to 5%. Also, there is a strong correlation between the 1st and 2nd eigen frequency, and the regression line is y=3.17x. In the damping ratio, the regression line is y=0.90x. Therefore 1st and 2nd damping ratios are approximately the same degree. Next, we study the eigen frequency and damping ratio from 1998 after 3.11 earthquakes, the final year is 2014. In all the considered earthquakes, they are connected in order of occurrence respectively. The eigen frequency slowly declined from immediately after completion, and tend to stabilize after several years. Although it has declined greatly after the 3.11 earthquake. Both the decresing rate of the 1st and 2nd eigen frequencies until about 7 years later are about 0.8. For the damping ratio, both the 1st and 2nd are about 1 to 6%. After the 3.11 earthquake, the 1st increases by about 1% and the 2nd increases by less than 1%. For the eigen frequency, there is a strong correlation between the 1st and 2nd, and the regression line is y=3.17x. For the damping ratio, the regression line is y=1.01x. Therefore, it can be said that the 1st and 2nd damping ratio is approximately the same degree. Based on the above results, changes in eigen frequency and damping ratio are summarized as follows. In the long-term study of the eigen frequency, both the 1st and 2nd gradually declined from immediately after completion, and tended to stabilize after a few years. Further it declined after the 3.11 earthquake. In addition, there is a strong correlation between the 1st and 2nd, and the declining time and the decreasing rate are the same degree. In the long-term study of the damping ratio, both the 1st and 2nd are about 1 to 6%. After the 3.11 earthquake, the 1st increases by about 1%, the 2nd increases by less than 1%. Also, the 1st and 2nd are approximately the same degree.

Keywords: eigenfrequency, damping ratio, ARX model, earthquake observation records

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Authors: Parveen Kumar

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The cope the rapid change of technology and to control the ephemeral rate of information generation, librarians along with their professional colleagues need to equip themselves as per the requirement of the electronic information society. E-learning is purely based on computer and communication technologies. The terminologies like computer based learning. It is the delivery of content via all electronic media through internet, internet, Extranets television broadcast, CD-Rom documents, etc. E-learning poses lot of issues in the transformation of literature or knowledge from the conventional medium to ICT based format and web based services.

Keywords: e-learning, digital libraries, online learning, electronic information society

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Authors: Boris Bajer, Andrea Havranova, Miroslav Vlcek, Richard Imrich, Adela Penesova

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Lifestyle interventions can prevent the deterioration of impaired glucose tolerance to manifest type 2 diabetes, and also prevent cardiovascular diseases, as it showed many studies (the Finnish Diabetes Prevention Study, Diabetes Prevention Program (DPP), . the China Da Qing Diabetes Prevention Study, etc.) Therefore the aim of our study was to compare the effect of intensified lifestyle intervention on cardiometabolic parameters. Methods: It is an ongoing randomized interventional clinical study (NCT02325804) focused on the reduction of body weight/fat. Intervention: hypocaloric diet (30% restriction of calories) and physical activity 150 minutes/week. Before and after 8 weeks of intervention all patients underwent complete medical examination (measurement of physical fitness, resting metabolic rate (RMR), body composition analysis, oral glucose tolerance test, parameters of lipid metabolism, and other cardiometabolic risk factors. Results: So far 39 patients finished the intervention. The average reduction of body weight was 6,8 + 4,9 kg (0-15 kg; p=0,0006), accompanied with significant reduction of body fat percentage (p ≤ 0,0001), amount of fat mass (p=0,03), waist circumference (p=0.02). Amount of lean mass and RMR remained unchanged. Heart rate (p=0,02), systolic and diastolic blood pressure was reduced (p=0,01 p=0,02 resp.) as well as insulin sensitivity was improved. Lipid parameters also changed - cholesterol, LDL decreased (p=0,05, p=0,04 resp.), while triglycerides showed tendency to decrease (p=0,055). Liver function improved, alanine aminotrasnferase (ALT) were reduced (p=0,01). Physical fitness significantly improved (as measure VO2 max (p=0,02). Conclusion: Results of our study are in line with previous results about the beneficial effect of intensive lifestyle changes on the reduction of cardiometabolic risk factors and improvement of liver function. Supported by grants APVV 15-0228; VEGA 2/0161/16

Keywords: obesity, weight loss, diet lipids, blood pressure, liver enzymes

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Authors: Alkaben Patel

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The proposed RP-HPLC method is easy, rapid, economical, precise and accurate stability indicating RP-HPLC method for simultaneous estimation of Astorvastatin and Methylcobalamine in their combined dosage form has been developed.The separation was achieved by LC-20 AT C18(250mm*4.6mm*2.6mm)Colum and water (pH 3.5): methanol 70:30 as mobile phase, at a flow rate of 1ml/min. wavelength of this dosage form is 215nm.The drug is related to stress condition of hydrolysis, oxidation, photolysis and thermal degradation.

Keywords: RP- HPLC, atorvastatin, methylcobalamine, method, development, validation

Procedia PDF Downloads 336

Authors: Wei-Chou Hsu, Ching-Sung Lee, Han-Yin Liu

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This work uses H2O2 oxidation technique to improve the pH sensitivity of the AlGaN/GaN-based ion-sensitive field-effect transistors (ISFETs). 10-nm-thick Al2O3 was grown on the surface of the AlGaN. It was found that the pH sensitivity was improved from 41.6 mV/pH to 55.2 mV/pH. Since the H2O2-grown Al2O3 was served as a passivation layer and the problem of Fermi-level pinning was suppressed for the ISFET with the H2O2 oxidation process. Hysteresis effect in the ISFET with the H2O2 treatment also became insignificant. The hysteresis effect was observed by dipping the ISFETs into different pH value solutions and comparing the voltage difference between the initial and final conditions. The hysteresis voltage (Vhys) of the ISFET with the H2O2 oxidation process was improved from 8.7 mV to 4.8 mV. The hysteresis effect is related to the buried binding sites which are related to the material defects like threading dislocations in the AlGaN/GaN heterostructure which was grown by the hetero-epitaxy technique. The H2O2-grown Al2O3 passivate these material defects and the Al2O3 has less material defects. The long-term stability of the ISFET is estimated by the drift effect measurement. The drift measurement was conducted by dipping the ISFETs into a specific pH value solution for 12 hours and the ISFETs were operating at a specific quiescent point. The drift rate is estimated by the drift voltage divided by the total measuring time. It was found that the drift rate of the ISFET was improved from 10.1 mV/hour to 1.91 mV/hour in the pH 7 solution, from 14.06 mV/hour to 6.38 mV/pH in the pH 2 solution, and from 12.8 mV/hour to 5.48 mV/hour in the pH 12 solution. The drift effect results from the capacitance variation in the electric double layer. The H2O2-grown Al2O3 provides an additional capacitance connection in series with the electric double layer. Therefore, the capacitance variation of the electric double layer became insignificant. Generally, the H2O2 oxidation process is a simple, fast, and cost-effective method for the AlGaN/GaN-based ISFET. Furthermore, the performance of the AlGaN/GaN ISFET was improved effectively and the non-ideal effects were suppressed.

Keywords: AlGaN/GaN, Al2O3, hysteresis effect, drift effect, reliability, passivation, pH sensors

Procedia PDF Downloads 325

Authors: Abdullah Nurus Salam Khan, Farhana Karim, Mohiuddin Ahsanul Kabir Chowdhury, S. Masum Billah, Nabila Zaka, Alexander Manu, Shams El Arifeen

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Globally, pre-eclampsia (PE) and ante-partum haemorrhage (APH) are two major causes of maternal mortality. Prompt identification and management of these conditions depend on competency of the birth attendants. Since these conditions are infrequent to be observed, clinical vignette based assessment could identify the extent of health worker’s competence in managing emergency obstetric care (EmOC). During June-August 2016, competence of 39 medical officers (MO) and 95 nurses working in obstetric ward of 15 government health facilities (3 district hospital, 12 sub-district hospital) was measured using clinical vignettes on PE and APH. The vignettes resulted in three outcome measures: total vignette scores, scores for diagnosis component, and scores for management component. T-test was conducted to compare mean vignette scores and linear regression was conducted to measure the strength and association of vignette scores with different cadres of health workers, facility’s readiness for EmOC and average annual utilization of normal deliveries after adjusting for type of health facility, health workers’ work experience, training status on managing maternal complication. For each of the seven component of EmOC items (administration of injectable antibiotics, oxytocic and anticonvulsant; manual removal of retained placenta, retained products of conception; blood transfusion and caesarean delivery), if any was practised in the facility within last 6 months, a point was added and cumulative EmOC readiness score (range: 0-7) was generated for each facility. The yearly utilization of delivery cases were identified by taking the average of all normal deliveries conducted during three years (2013-2015) preceding the survey. About 31% of MO and all nurses were female. Mean ( ± sd) age of the nurses were higher than the MO (40.0 ± 6.9 vs. 32.2 ± 6.1 years) and also longer mean( ± sd) working experience (8.9 ± 7.9 vs. 1.9 ± 3.9 years). About 80% health workers received any training on managing maternal complication, however, only 7% received any refresher’s training within last 12 months. The overall vignette score was 8.8 (range: 0-19), which was significantly higher among MO than nurses (10.7 vs. 8.1, p < 0.001) and the score was not associated with health facility types, training status and years of experience of the providers. Vignette score for management component (range: 0-9) increased with higher annual average number of deliveries in their respective working facility (adjusted β-coefficient 0.16, CI 0.03-0.28, p=0.01) and increased with each unit increase in EmOC readiness score (adjusted β-coefficient 0.44, CI 0.04-0.8, p=0.03). The diagnosis component of vignette score was not associated with any of the factors except it was higher among the MO than the nurses (adjusted β-coefficient 1.2, CI 0.13-2.18, p=0.03). Lack of competence in diagnosing and managing obstetric complication by the nurses than the MO is of concern especially when majority of normal deliveries are conducted by the nurses. Better EmOC preparedness of the facility and higher utilization of normal deliveries resulted in higher vignette score for the management component; implying the impact of experiential learning through higher case management. Focus should be given on improving the facility readiness for EmOC and providing the health workers periodic refresher’s training to make them more competent in managing obstetric cases.

Keywords: Bangladesh, emergency obstetric care, clinical vignette, competence of health workers

Procedia PDF Downloads 191

Authors: Phill-Seung Jung, Dae-Yeon Kim

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Objectives: In young, especially nulliparous women, it is not easy to decide on excisional therapy for cervical intraepithelial neoplasia (CIN). We aimed to evaluate how effective topical imiquimod is in the treatment of high-grade CIN so that excisional therapy can be avoided in young women. Methods: Patients with CIN were allocated to this pilot study. They did not want excisional therapy and agreed with topical imiquimod therapy, which required once-a-week hospital visit for 8 weeks for the application of imiquimod to the cervix by a gynecologic oncologist. If the lesion got worse during treatment, it was decided to convert imiquimod therapy to excisional therapy. Results: A total of 36 patients with a median age of 29 years (range, 22–41 years) agreed to receive topical imiquimod therapy. Of these, 32 patients (88.9%) were positive for high-risk human papillomavirus (HR HPV). Twenty-five patients (69.4%) had low-grade squamous intraepithelial lesion (LSIL), and 11 (30.6%) had high-grade squamous intraepithelial lesion (HSIL) on their initial LBC. Twenty-eight patients underwent punch biopsy, which showed CIN 1 in 7 (19.4%), CIN 2 in 11 (30.6%), and CIN 3 in 10 (27.8%) patients. Twenty patients finished the 8-week imiquimod therapy. Among them, 14 patients had CIN 2 or 3, and 6 patients had CIN 1. HR HPV was positive in 12 patients. On the last examination, 14 patients (70.0%) had negative intraepithelial lesions, 3 (15.0%) had atypical squamous cells of undetermined significance, and 1 (5.0%) had LSIL. Two patients had persistent HSIL: 1 patient underwent loop electrosurgical excision procedure, resulting in CIN 3 with positive resection margin, and the other patient underwent punch biopsy, resulting in intermediate cells and restarted imiquimod therapy. Only 7 patients were negative for HR HPV. Conclusions: This study showed that topical imiquimod therapy was effective for the treatment of high-grade CIN, with a histologic regression rate of 85.7% (14/20) and HPV eradication rate of 25.0% (8/32). Based on our findings, topical imiquimod therapy might have a successful therapeutic effect in young women with CIN 2-3 so that they can avoid excisional therapy. In addition, it could be a more reassuring treatment option for CIN 1 than just follow-up after few months. To confirm its efficacy, a phase II study with larger cohort would be needed.

Keywords: Imiquimod, Cervical Intraepthelial Neoplasia, Cervical Dysplasia, Human Papillomavirus

Procedia PDF Downloads 251

Authors: Jatinder Pal Singh, Harpreet Singh, Gagandeep Singh Digra, Mandeep Kaur Sidhu, Pawan Kumar

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Introduction: Ganglion cyst is a benign condition in which there is a cystic lesion in relation to a joint or a tendon sheath arising from myxoid degeneration of fibrous connective tissue. These can be unilocular or multilocular. In rare cases, there may be multiple ganglion cysts, known as cystic ganglionosis. They can occur at any age but are commonly seen in adults. Clinically they may be asymptomatic or present as swelling or mass effect in adjacent structures. These are common in extremities such as hands and feet. Case Presentation: 11-year-old female child presented with slowly progressive painless swelling of her right hand since the age of 4. Antenatal and perinatal history was unremarkable. Her family history was negative. She denies fever, malaise, morning stiffness, weight loss, fatigue, restriction of joint movements, or any sensory and motor deficit. Lab parameters were negative for inflammatory or infectious etiology. No other joint or extremity involvement was present. On physical examination, the swelling was present on the dorsum and palmer aspect of the right hand and wrist. They were non-tender on palpation without any motor or sensory deficit. MRI hand revealed multiple well-defined fluid signal intensity cystic appearing lesions in periarticular/intraarticular locations in relation to distal radio-ulnar, radio-carpal, intercarpal, carpometacarpal, metacarpophalangeal and interphalangeal joints as well as peritendinous location around flexor tendons more so in the region of wrist, palm, 1st and 5th digit and along extensor tendons in the region of wrist, largest one noted along flexor pollicis longus tendon in thenar region and along 1st digit measuring approx. 4.6 x 1.2 x 1.2 centimeter. Pressure erosions and bone remodelling were noted in the bases of the 2nd to 5th metacarpals, capitate, trapezoid, the distal shaft of 1st metacarpal, and proximal phalanx of 1st digit. Marrow edema was noted in the base and proximal shaft of the 4th metacarpal and proximal shaft of the 3rd metacarpal – likely stress or pressure related. The patient was advised of aspiration, but the family refused the procedure. Therefore the patient was kept on conservative treatment. Conclusion: Cystic ganglionosis is a rare condition with very few cases reported in the medical literature. Its prevalence and association are not known because of the rarity of this condition. It should be considered as an important differential in patients presenting with soft tissue swelling in extremities. Treatment option includes conservative management, aspiration, and surgery. Aspiration has a high recurrence rate. Although surgery has a low recurrence rate, it carries a high rate of complications. Imaging with MRI is essential for confirmation of the cystic nature of lesions and their relation with the joint capsules or tendons. This helps in differentiating from other soft tissue lesions and presurgical planning.

Keywords: radiology, rare, cystic ganglionosis, child

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Authors: Rafiqul Hasan, A. S. M. Tanim Anwar, Mohammad Azizul Hakim

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Background: Chronic kidney disease (CKD) is a major public health problem that continues to increase in prevalence globally. The prevalence of chronic kidney disease is increasing day by day in low to middle income countries (LMICs). People living in LMICs have the highest need for renal replacement therapy (RRT) despite they have lowest access to various modalities of treatment. As continuous ambulatory peritoneal dialysis (CAPD) does not require advanced technologies, very much infrastructure, dialysis staff support, it should be an ideal form of RRT in LMICs, particularly for those living in remote areas. To authors knowledge there was scarcity of data regarding CAPD performance in remote area of Bangladesh. This study was aimed to report the characteristics and outcomes of CAPD in ESRD patients lived in least developed area of Bangladesh. Methods: This prospective study was conducted in Cox’sbazar Medical College Hospital, Cox’sbazar and Parkview hospital Ltd, Chattogram, Bangladesh. Data were collected by questionnaire from the patients of any age with end-stage renal disease (ESRD) who underwent CAPD in 2018–2021. The baseline characteristics, PD-related complication as well as patient and technique survivals were analyzed. Results: Out of 31 patients who underwent CAPD, 18 (58%) were male on the age range of 15–79 years. The mean follow-up duration was 18 months. Mortality was inversely related with the EF of echocardiography. The peritonitis rate was 0.48 episodes per patient per year. The 1, 3 and 4-year patient survival rates were 64.34% (95% CI = 52.5–81.5), 23.79% (95% CI = 17.9 – 57.4) and 3.22% (95% CI = 31.2–77.5) respectively. Conclusions: In this study, CAPD performance was poorer than usual reference. Cardiac compromised patient and inappropriate dwell might be the main contributing factors behind this scenario. The peritonitis rate was nearly similar to that of developed countries. CAPD was cost effective than HD in remote area. Some accessible measures may be taken to make CAPD a more acceptable RRT modality with improved outcomes in poor socioeconomic backgrounds.

Keywords: dialysis cost, peritoneal dialysis, peritonitis, CAPD, least developed area, remote area, Bangladesh

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