Search results for: recommended summary plan for emergency care and treatment
Commenced in January 2007
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Edition: International
Paper Count: 15414

Search results for: recommended summary plan for emergency care and treatment

12744 Preventing Discharge to No Fixed Address-Youth (NFA-Y)

Authors: Cheryl Forchuk, Sandra Fisman, Steve Cordes, Dan Catunto, Katherine Krakowski, Melissa Jeffrey, John D’Oria

Abstract:

The discharge of youth aged 16-25 from hospital into homelessness is a prevalent issue despite research indicating social, safety, health and economic detriments on both the individual and community. Lack of stable housing for youth discharged into homelessness results in long-term consequences, including exacerbation of health problems and costly health care service use and hospital readmission. People experiencing homelessness are four times more likely to be readmitted within one month of discharge and hospitals must spend $2,559 more per client. Finding safe housing for these individuals is imperative to their recovery and transition back to the community. People discharged from hospital to homelessness experience challenges, including poor health outcomes and increased hospital readmissions. Youth are the fastest-growing subgroup of people experiencing homelessness in Canada. The needs of youth are unique and include supports related to education, employment opportunities, and age-related service barriers. This study aims to identify the needs of youth at risk of homelessness by evaluating the efficacy of the “Preventing Discharge to No Fixed Address – Youth” (NFA-Y) program, which aims to prevent youth from being discharged from hospital into homelessness. The program connects youth aged 16-25 who are inpatients at London Health Sciences Centre and St. Joseph’s Health Care London to housing and financial support. Supports are offered through collaboration with community partners: Youth Opportunities Unlimited, Canadian Mental Health Association Elgin Middlesex, City of London Coordinated Access, Ontario Works, and Salvation Army’s Housing Stability Bank. This study was reviewed and approved by Western University’s Research Ethics Board. A series of interviews are being conducted with approximately ninety-three youth participants at three time points: baseline (pre-discharge), six, and twelve months post-discharge. Focus groups with participants, health care providers, and community partners are being conducted at three-time points. In addition, administrative data from service providers will be collected and analyzed. Since homelessness has a detrimental effect on recovery, client and community safety, and healthcare expenditure, locating safe housing for psychiatric patients has had a positive impact on treatment, rehabilitation, and the system as a whole. If successful, the findings of this project will offer safe policy alternatives for the prevention of homelessness for at-risk youth, help set them up for success in their future years, and mitigate the rise of the homeless youth population in Canada.

Keywords: youth homelessness, no-fixed address, mental health, homelessness prevention, hospital discharge

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12743 Landfill Leachate Wastewater Treatment by Fenton Process

Authors: Rewadee Anuwattana, Pattamaphorn Phuangngamphan, Narumon Soparatana, Supinya Sutthima, Worapong Pattayawan, Saroj Klangkongsub, Songkiat Roddang, Pluek Wongpanich

Abstract:

The leachate wastewater is high contaminant water; hence it needs to be treated. The objective of this research was to determine the Chemical Oxygen Demand (COD) concentration, Phosphate (PO₄³⁻), Ammonia (NH₃) and color in leachate wastewater in the landfill area. The experiments were carried out in the optimum condition by pH, the Fenton reagent dosage (concentration of dosing Fe²⁺ and H₂O₂). The optimum pH is 3, the optimum [Fe²⁺]/[COD] and [H₂O₂]/[COD₀] = 0.03 and 0.03, respectively. The Biochemical Oxygen Demand (BOD₅)/Chemical Oxygen Demand (COD) ratio can be adjusted to 1 for landfill leachate wastewater (BOD₅/COD = 0.11). From the results, the Fenton process shall be investigated further to achieve the removal of phosphates in addition to COD and color.

Keywords: landfill leachate treatment, open dumpsite, Fenton process, wastewater treatment

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12742 Sun-Driven Evaporation Enhanced Forward Osmosis Process for Application in Wastewater Treatment and Pure Water Regeneration

Authors: Dina Magdy Abdo, Ayat N. El-Shazly, Hamdy Maamoun Abdel-Ghafar, E. A. Abdel-Aal

Abstract:

Forward osmosis (FO) is one of the important processes during the wastewater treatment system for environmental remediation and fresh water regeneration. Both Egypt and China are troubled by over millions of tons of wastewater every year, including domestic and industrial wastewater. However, traditional FO process in wastewater treatment usually suffers low efficiency and high energy consumption because of the continuously diluted draw solution. An additional concentration process is necessary to keep running of FO separation, causing energy waste. Based on the previous study on photothermal membrane, a sun-driven evaporation process is integrated into the draw solution side of FO system. During the sun-driven evaporation, not only the draw solution can be concentrated to maintain a stable and sustainable FO system, but fresh water can be directly separated for regeneration. Solar energy is the ultimate energy source of everything we have on Earth and is, without any doubt, the most renewable and sustainable energy source available to us. Additionally, the FO membrane process is rationally designed to limit the concentration polarization and fouling. The FO membrane’s structure and surface property will be further optimized by the adjustment of the doping ratio of controllable nano-materials, membrane formation conditions, and selection of functional groups. A novel kind of nano-composite functional separation membrane with bi-interception layers and high hydrophilicity will be developed for the application in wastewater treatment. So, herein we aim to design a new wastewater treatment system include forward osmosis with high-efficiency energy recovery via the integration of photothermal membrane.

Keywords: forword, membrane, solar, water treatment

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12741 Effect of Manual Progressive Ischemic Pressure versus Post Isometric Facilitation in the Treatment of Latent Myofascial Trigger Points in Mechanical Neck Pain

Authors: Mohamed M. Diab, Fahmy E. Mohamed, Alaa Balbaa

Abstract:

Background: Myofascial pain syndrome a common type of non-articular musculoskeletal pain, is a condition associated with regional pain and muscle tenderness characterized by the presence of hypersensitive nodules. Objectives: the purpose of this study is to compare between the effects of manual progressive ischemic pressure versus the effect of post isometric facilitation in the treatment of Rhomboid latent myofascial trigger points. Methods: six patients had participated in this study. Patients divided into two groups. Group A treated by manual progressive ischemic pressure and traditional physical therapy program. Group B treated by post isometric facilitation and traditional physical therapy program. Treatment program was for 6 sessions over two week’s period. Result: Statistical analysis revealed that there is no significant difference in post treatment from pretreatment in pain severity (VAS) in myofascial trigger points with Rhomboid muscles) and Pain pressure threshold (PPT) for tenderness at both groups (A,B). Conclusion: ischemic pressure technique appear to be no more effective than post isometric facilitation in treatment of rhomboids latent myofacial trigger point.

Keywords: Rhmoiboid trigger point, myofacila trigger point, ischemic pressure, post isometric facilitation

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12740 Immigration and Gender Equality – An Analysis of the Labor Market Characteristics of Turkish Migrants Living in Germany

Authors: C. Asarkaya, S. Z. Siretioglu Girgin

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Turkish migrants constitute the largest group among people with migration background living in Germany. Turkish women’s labor market participation is of significant importance for their social and economic integration to the German society. This paper thus aims to investigate their labor market positions. Turkish migrant women participate less in the labor market compared to men, and are responsible for most of the housework, child care, and elderly care. This is due to their traditional roles in the family, educational level, insufficient knowledge of German language, and insufficient professional experience. We strongly recommend that wide-reaching integration policies for women are formulated, so as to encourage participation of not only migrant women but also their husbands, fathers and/or brothers, and natives.

Keywords: empowerment, Germany, labor market, migration, Turkish, women

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12739 Rapid Strategic Consensus Building in Land Readjustment in Kabul

Authors: Nangialai Yousufzai, Eysosiyas Etana, Ikuo Sugiyama

Abstract:

Kabul population has been growing continually since 2001 and reaching six million in 2025 due to the rapid inflow from the neighboring countries. As a result of the population growth, lack of living facilities supported by infrastructure services is becoming serious in social and economic aspects. However, about 70% of the city is still occupied illegally and the government has little information on the infrastructure demands. To improve this situation, land readjustment is one of the powerful development tools, because land readjustment does not need a high governmental budget of itself. Instead, the method needs cooperation between stakeholders such as landowners, developers and a local government. So it is becoming crucial for both government and citizens to implement land readjustment for providing tidy urban areas with enough public services to realize more livable city as a whole. On the contrary, the traditional land readjustment tends to spend a long time until now to get consensus on the new plan between stakeholders. One of the reasons is that individual land area (land parcel) is decreased due to the contribution to public such as roads/parks/squares for improving the urban environment. The second reason is that the new plan is difficult for dwellers to imagine new life after the readjustment. Because the paper-based plan is made by an authority not for dwellers but for specialists to precede the project. This paper aims to shorten the time to realize quick consensus between stakeholders. The first improvement is utilizing questionnaire(s) to assess the demand and preference of the landowners. The second one is utilizing 3D model for dwellers to visualize the new environment easily after the readjustment. In additions, the 3D model is reflecting the demand and preference of the resident so that they could select a land parcel according to their sense value of life. The above-mentioned two improvements are carried out after evaluating total land prices of the new plans to select for maximizing the project value. The land price forecasting formula is derived from the current market ones in Kabul. Finally, it is stressed that the rapid consensus-building of land readjustment utilizing ICT and open data analysis is essential to redevelop slums and illegal occupied areas in Kabul.

Keywords: land readjustment, consensus building, land price formula, 3D simulation

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12738 Numerical Investigation of Supertall Buildings and Using Aerodynamic Characteristics to Create New Wind Power Sources

Authors: Mohammad A. Masoumi, Mohammad Zare, Soroush Sabouki

Abstract:

This study investigates the aerodynamic characteristics of supertall buildings to evaluate wind turbine installation at high altitudes. Most recent studies have investigated supertall buildings at a horizontal plane, while a vertical plan could be as important, especially to install wind turbines. A typical square-plan building with a height of 500 m is investigated numerically at horizontal and vertical plans to evaluate wind power generation potentials. The results show good agreement with experimental data and past studies. Then four new geometries are proposed to improvise regions at high altitudes to install wind turbines. Evaluating the simulations shows two regions with high power density, which have the possibility to install wind turbines. Results show that improvised regions to install wind turbines at high altitudes contain significant power density while higher power density is found behind buildings in a far distance. In addition, power density fluctuations behind buildings are investigated, which show decreasing fluctuations by reaching 50 m altitude while altitudes lower than 20 m have the most fluctuations.

Keywords: wind power, supertall building, power density, aerodynamic characteristics, wind turbine mobile, quality assurance, testing, applications

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12737 Poster for Sickle Cell Disease and Barriers to Care in South Yorkshire from 2017 to 2023

Authors: Amardass Dhami, Clare Samuelson

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Background: Sickle cell disease (SCD) is a complex, multisystem condition that significantly impacts patients' quality of life, characterized by acute illness episodes, progressive organ damage, and reduced life expectancy. In the UK, over 13,000 individuals are affected, with South Yorkshire having the fifth highest prevalence, including approximately 800 patients. Retinal complications in SCD can manifest as either proliferative or non-proliferative disease, with proliferative changes being more prevalent. These retinal issues can cause significant morbidity, including visual loss and increased care requirements, underscoring the need for regular monitoring. An integrated approach was applied to ensure timely interventions, ultimately enhancing patient outcomes and reduce ‘did not attend’ rates. Aim: To assess the factors which may influence attendance to Haematology and Ophthalmology Clinics with attention towards levels of deprivation towards non-attendance. Method : A retrospective study on 84 eligible patients, from the regional tertiary Centre for Sickle Cell Care (Sheffield Teaching Hospital) from 2017 to 2023. The study focused on the incidence of sickle cell eye disease, specifically examining the outcomes of patients who attended the combined haematology and ophthalmology clinics. Patients who did not attend either clinic were excluded from the analysis to ensure a clear understanding of the combined clinic's impact. This data was then compared with the United Kingdom’s Index of Multiple Deprivation (IMD) datasets to assess if inequalities of care affected this population. Results: The study concluded that the effectiveness of combining haematology and ophthalmology clinics was reduced following the intervention. The DNA rates increased to 40% for the haematology clinic. Additionally, a significant proportion of the cohort was classified as residing in areas of deprivation, suggesting a possible link between socioeconomic factors and non-attendance rates Conclusion: These findings underscore the challenges of integrating care for SCD patients, particularly in relation to socioeconomic barriers. Despite the intent to streamline care and improve patient outcomes, the increase in DNA rates points to the need for further investigation into the underlying causes of non-attendance. Addressing these issues, especially in deprived areas, could enhance the effectiveness of combined clinics and ensure that patients receive the necessary monitoring and interventions for their eye health and overall well-being. Future strategies may need to focus on improving accessibility, outreach, and support for patients to mitigate the impact of socioeconomic factors on healthcare attendance.

Keywords: south yorkshire, sickle cell anemia, deprivation, factors, haematology

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12736 Identifying the Barriers to Institutionalizing a One Health Concept in Responding to Zoonotic Diseases in South Asia

Authors: Rojan Dahal

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One Health refers to a collaborative effort between multiple disciplines - locally, nationally, and globally - to attain optimal health. Although there were unprecedented intersectoral alliances between the animal and human health sectors during the avian influenza outbreak, there are different views and perceptions concerning institutionalizing One Health in South Asia. It is likely a structural barrier between the relevant professionals working in different entities or ministries when it comes to collaborating on One Health actions regarding zoonotic diseases. Politicians and the public will likely need to invest large amounts of money, demonstrate political will, and understand how One Health works to overcome these barriers. One Health might be hard to invest in South Asian countries, where the benefits are based primarily on models and projections and where numerous issues related to development and health need urgent attention. The other potential barrier to enabling the One Health concept in responding to zoonotic diseases is a failure to represent One Health in zoonotic disease control and prevention measures in the national health policy, which is a critical component of institutionalizing the One Health concept. One Health cannot be institutionalized without acknowledging the linkages between animal, human, and environmental sectors in dealing with zoonotic diseases. Efforts have been made in the past to prepare a preparedness plan for One Health implementation, but little has been done to establish a policy environment to institutionalize One Health. It is often assumed that health policy refers specifically to medical care issues and health care services. When drafting, reviewing, and redrafting the policy, it is important to engage a wide range of stakeholders. One Health institutionalization may also be hindered by the interplay between One Health professionals and bureaucratic inertia in defining the priorities of diseases due to competing interests on limited budgets. There is a possibility that policymakers do not recognize the importance of veterinary professionals in preventing human diseases originating in animals. Compared to veterinary medicine, the human health sector has produced most of the investment and research outputs related to zoonotic diseases. The public health profession may consider itself superior to the veterinary profession. Zoonotic diseases might not be recognized as threats to human health, impeding integrated policies. The effort of One Health institutionalization remained only among the donor agencies and multi-sectoral organizations. There is a need for strong political will and state capacity to overcome the existing institutional, financial, and professional barriers for its effective implementation. There is a need to assess the structural challenges, policy challenges, and the attitude of the professional working in the multiple disciplines related to One Health. Limited research has been conducted to identify the reasons behind the barriers to institutionalizing the One Health concept in South Asia. Institutionalizing One Health in responding to zoonotic diseases breaks down silos and integrates animals, humans, and the environment.

Keywords: one health, institutionalization, South Asia, institutionalizations

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12735 Effectiveness, Safety, and Tolerability Profile of Stribild® in HIV-1-infected Patients in the Clinical Setting

Authors: Heiko Jessen, Laura Tanus, Slobodan Ruzicic

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Objectives: The efficacy of Stribild®, an integrase strand transfer inhibitor (INSTI) -based STR, has been evaluated in randomized clinical trials and it has demonstrated durable capability in terms of achieving sustained suppression of HIV-1 RNA-levels. However, differences in monitoring frequency, existing selection bias and profile of patients enrolled in the trials, may all result in divergent efficacy of this regimen in routine clinical settings. The aim of this study was to assess the virologic outcomes, safety and tolerability profile of Stribild® in a routine clinical setting. Methods: This was a retrospective monocentric analysis on HIV-1-infected patients, who started with or were switched to Stribild®. Virological failure (VF) was defined as confirmed HIV-RNA>50 copies/ml. The minimum time of follow-up was 24 weeks. The percentage of patients remaining free of therapeutic failure was estimated using the time-to-loss-of-virologic-response (TLOVR) algorithm, by intent-to-treat analysis. Results: We analyzed the data of 197 patients (56 ART-naïve and 141 treatment-experienced patients), who fulfilled the inclusion criteria. Majority (95.9%) of patients were male. The median time of HIV-infection at baseline was 2 months in treatment-naïve and 70 months in treatment-experienced patients. Median time [IQR] under ART in treatment-experienced patients was 37 months. Among the treatment-experienced patients 27.0% had already been treated with a regimen consisting of two NRTIs and one INSTI, whereas 18.4% of them experienced a VF. The median time [IQR] of virological suppression prior to therapy with Stribild® in the treatment-experienced patients was 10 months [0-27]. At the end of follow-up (median 33 months), 87.3% (95% CI, 83.5-91.2) of treatment-naïve and 80.3% (95% CI, 75.8-84.8) of treatment-experienced patients remained free of therapeutic failure. Considering only treatment-experienced patients with baseline VL<50 copies/ml, 83.0% (95% CI, 78.5-87.5) remained free of therapeutic failure. A total of 17 patients stopped treatment with Stribild®, 5.4% (3/56) of them were treatment-naïve and 9.9% (14/141) were treatment-experienced patients. The Stribild® therapy was discontinued in 2 (1.0%) because of VF, loss to follow-up in 4 (2.0%), and drug-drug interactions in 2 (1.0%) patients. Adverse events were in 7 (3.6%) patients the reason to switch from therapy with Stribild® and further 2 (1.0%) patients decided personally to switch. The most frequently observed adverse events were gastrointestinal side effects (20.0%), headache (8%), rash events (7%) and dizziness (6%). In two patients we observed an emergence of novel resistances in integrase-gene. The N155H evolved in one patient and resulted in VF. In another patient S119R evolved either during or shortly upon switch from therapy with Stribild®. In one further patient with VF two novel mutations in the RT-gene were observed when compared to historical genotypic test result (V106I/M and M184V), whereby it is not clear whether they evolved during or already before the switch to Stribild®. Conclusions: Effectiveness of Stribild® for treatment-naïve patients was consistent with data obtained in clinical trials. The safety and tolerability profile as well as resistance development confirmed clinical efficacy of Stribild® in a daily practice setting.

Keywords: ART, HIV, integrase inhibitor, stribild

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12734 Computed Tomography Differential Diagnose of Intraventicular Masses in the Emergency Departemen

Authors: Angelis P. Barlampas

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Purpose: A 29 years old woman presented in the emergency department with psychiatric symptoms. The psychiatrist ordered a computed tomography scan as part of a general examination. Material and methods: The CT showed bilateral enlarged choroid plexus structures mimicking papillomata and situated in the trigones of the lateral ventricles. The left choroid plexus was heavily calcified, but the right one has no any obvious calcifications. Results: It is well kown that any brain mass can present with behavioral changes and even psychiatric symptomatology. Papillomata of the ventricular system have been described to cause psychotic episodes. According to literature, choroid plexus papillomas are seldom neuroepithelial intraventricular tumors, which are benign and categorized as WHO grade 1 tumors. They are more common in the pediatric population, but they can occur in the adults, too1. In addition, the distinction between choroid plexus papilloma and carcinoma is very difficult and impossible by imagine alone. It can only be implied with more advanced imaging, such as arterial spin labeling and MRI. The final diagnosis is, of course, after surgical excision. The usual location in adults is the fourth ventricle, but in children, it is the lateral ventricles. Their imaging appearance is that of a solid vascular tumor, which enhances intensely after the intravenous administration of contrast material. One out of fourth tumors presents speckled calcifications1. In our case, there are symmetrically sized masses at the trigones, and there are no calcifications in one of them, whereas the other one is grossly calcified. Also, there is no obvious hydrocephalus or any other evidence of increased intracranial pressure. General conclusions: When there is a new psychiatric patient, someone must undergo any possible examination, and of course, a brain CT study should be done to exclude any rare organic causes that may be responsible for the disease.

Keywords: phycosis, intraventricular masses, CT, brain calcifications

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12733 A Combined Activated Sludge-Filtration-Ozonation Process for Abattoir Wastewater Treatment

Authors: Pello Alfonso-Muniozguren, Madeleine Bussemaker, Ralph Chadeesingh, Caryn Jones, David Oakley, Judy Lee, Devendra Saroj

Abstract:

Current industrialized livestock agriculture is growing every year leading to an increase in the generation of wastewater that varies considerably in terms of organic content and microbial population. Therefore, suitable wastewater treatment methods are required to ensure the wastewater quality meet regulations before discharge. In the present study, a combined lab scale activated sludge-filtration-ozonation system was used to treat a pre-treated abattoir wastewater. A hydraulic retention time of 24 hours and a solid retention time of 13 days were used for the activated sludge process, followed by a filtration step (4-7 µm) and using ozone as tertiary treatment. An average reduction of 93% and 98% was achieved for Chemical Oxygen Demand (COD) and Biological Oxygen Demand (BOD), respectively, obtaining final values of 128 mg/L COD and 12 mg/L BOD. For the Total Suspended Solids (TSS), the average reduction increased to 99% in the same system, reducing the final value down to 3 mg/L. Additionally, 98% reduction in Phosphorus (P) and a complete inactivation of Total Coliforms (TC) was obtained after 17 min ozonation time. For Total Viable Counts (TVC), a drastic reduction was observed with 30 min ozonation time (6 log inactivation) at an ozone dose of 71 mg O3/L. Overall, the combined process was sufficient to meet discharge requirements without further treatment for the measured parameters (COD, BOD, TSS, P, TC, and TVC).

Keywords: abattoir waste water, activated sludge, ozone, waste water treatment

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12732 The Efficacy of Class IV Diode Laser in the Treatment of Patients with Chronic Neck Pain: A Randomized Controlled Trial

Authors: Mohamed Salaheldien Mohamed Alayat, Ahmed Mohamed Elsoudany, Roaa Abdulghani Sroge, Bayan Muteb Aldhahwani

Abstract:

Background: Neck pain is a common illness that could affect individual’s daily activities. Class IV laser with longer wavelength can stimulate tissues and penetrate more than the classic low-level laser therapy. Objectives: The aim of the study was to investigate the efficacy of class IV diode laser in the treatment of patients with chronic neck pain (CNP). Methods: Fifty-two patients participated and completed the study. Their mean age (SD) was 50.7 (6.2). Patients were randomized into two groups and treated with laser plus exercise (laser + EX) group and placebo laser plus exercise (PL+EX) group. Treatment was performed by Class IV laser in two phases; scanning and trigger point phases. Scanning to the posterior neck and shoulder girdle region with 4 J/cm2 with a total energy of 300 J applied to 75 cm2 in 4 minutes and 16 seconds. Eight trigger points on the posterior neck area were treated by 4 J/cm2 and the time of application was in 30 seconds. Both groups received exercise two times per week for 4 weeks. Exercises included range of motion, isometric, stretching, isotonic resisted exercises to the cervical extensors, lateral bending and rotators muscles with postural correction exercises. The measured variables were pain level using visual analogue scale (VAS), and neck functional activity using neck disability index (NDI) score. Measurements were taken at baseline and after 4 weeks of treatment. The level of statistical significance was set as p < 0.05. Results: There were significant decreases in post-treatment VAS and NDI in both groups as compared to baseline values. Laser + EX effectively decreased VAS (mean difference -6.5, p = 0.01) and NDI scores after (mean difference -41.3, p = 0.01) 4 weeks of treatment compared to PL + EX. Conclusion: Class IV laser combined with exercise is effective treatment for patients with CNP as compared to PL + EX therapy. The combination of laser + EX effectively increased functional activity and reduced pain after 4 weeks of treatment.

Keywords: chronic neck pain, class IV laser, exercises, neck disability index, visual analogue scale

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12731 Method for Improving Antidepressants Adherence in Patients with Depressive Disorder: Systemic Review and Meta-Analysis

Authors: Juntip Kanjanasilp, Ratree Sawangjit, Kanokporn Meelap, Kwanchanok Kruthakool

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Depression is a common mental health disorder. Antidepressants are effective pharmacological treatments, but most patients have low medication adherence. This study aims to systematic review and meta-analysis what method increase the antidepressants adherence efficiently and improve clinical outcome. Systematic review of articles of randomized controlled trials obtained by a computerized literature search of The Cochrane, Library, Pubmed, Embase, PsycINFO, CINAHL, Education search, Web of Science and ThaiLIS (28 December 2017). Twenty-three studies were included and assessed the quality of research by ROB 2.0. The results reported that printing media improved in number of people who had medication adherence statistical significantly (p= 0.018), but education, phone call, and program utilization were no different (p=0.172, p=0.127, p=0.659). There was no significant difference in pharmacist’s group, health care team’s group and physician’s group (p=0.329, p=0.070, p=0.040). Times of intervention at 1 month and 6 months improved medication adherence significantly (p= 0.0001, p=0.013). There was significantly improved adherence in single intervention (p=0.027) but no different in multiple interventions (p=0.154). When we analyzed medication adherence with the mean score, no improved adherence was found, not relevant with who gives the intervention and times to intervention. However, the multiple interventions group was statistically significant improved medication adherence (p=0.040). Phone call and the physician’s group were statistically significant improved clinical outcomes in number of improved patients (0.025 and 0.020, respectively). But in the pharmacist’s group and physician’s group were not found difference in the mean score of clinical outcomes (p=0.993, p=0.120, respectively). Times to intervention and number of intervention were not significant difference than usual care. The overall intervention can increase antidepressant adherence, especially the printing media, and the appropriate timing of the intervention is at least 6 months. For effective treatment, the provider should have experience and expert in caring for patients with depressive disorders, such as a psychiatrist. Medical personnel should have knowledge in caring for these patients also.

Keywords: depression, medication adherence, clinical outcomes, systematic review, meta-analysis

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12730 The Effects of Spark Plasma on Infectious Wound Healing

Authors: Erfan Ghasemi, Mohammadreza Khani, Hamidreza Mahmoudi, Mohammad Ali Nilforoushzadeh, Babak Shokri, Pouria Akbartehrani

Abstract:

Given the global significance of treating infectious wounds, the goal of this study is to use spark plasma as a new treatment for infectious wounds. To generate spark plasma, a high-voltage (7 kV) and high-frequency (75 kHz) source was used. Infectious wounds in the peritoneum of mice were divided into control and plasma-treated groups at random. The plasma-treated animals received plasma radiation every 4 days for 12 days, for 60 seconds each time. On the 15th day after the first session, the wound in the plasma-treated group had completely healed. The spectra of spark plasma emission and tissue properties were studied. The mechanical resistance of the wound healed in the plasma treatment group was considerably higher than in the control group (p<0.05), according to the findings. Furthermore, histological evidence suggests that wound re-epithelialization is faster in comparison to controls. Angiogenesis and fibrosis (collagen production) were also dramatically boosted in the plasma-treated group, whereas the stage of wound healing inflammation was significantly reduced. Plasma therapy accelerated wound healing by causing considerable wound constriction. The results of this investigation show that spark plasma has an influence on the treatment of infectious wounds.

Keywords: infectious wounds, mice, spark plasma, treatment

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12729 Effect of Deep Cryogenic Treatment on Aluminium Alloy Used for Making Heat Exchangers in Automotive HVAC System

Authors: H. Mohit

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In automotive air conditioning system, two heat exchangers are used as evaporator and condenser which are placed inside the bonnet of a car in a compact manner. The dust particles from outside and moisture content produced during the process leads to formation of impure particles on the surface of evaporator coil. But in condenser coil, the impure particles are settling down due to dust from atmosphere. The major problem of the heat exchanger used in automotive air conditioning is leakage of refrigerant due to corrosion. This effect of corrosion will lead to damage on the surface of heat exchanger and leakage of refrigerant from the system. To protect from corrosion, coatings are applied on its surfaces. Nowadays, to improve the corrosion resistance of these heat exchangers, hydrophilic coatings are used, which is very expensive. Cryogenic treatment is one method which involves the treatment of materials below -150 °C using the cryogenic fluid such as liquid nitrogen. In this project work, a study of improvement in corrosion resistance of materials of aluminium alloys of various grades as AA 1100, AA 6061, AA 6063 and AA 2024 that are mainly used for fin and tube heat exchangers in automotive air conditioning system is made. In total, five different processes are selected for these grades of aluminium alloy and various parameters like corrosion rate, dimensional stability, hardness and microstructure are measured. The improvements were observed in these parameters while comparing it with conventional heat treatment process.

Keywords: cryogenic treatment, corrosion resistance, dimensional stability, materials science

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12728 Survey of Personality Characteristics in Adolescents under the Care of Tehran Juvenile Detention Center

Authors: Jamal Shokrzadehmadiyeh, Kambiz Kamkari, Shohreh Shokrzadeh

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According to the research topic, the purpose of the current paper is to research personality characteristics in adolescents under the care of the Tehran Juvenile Detention Centre, and a survey research method has been used. In this regard, through systematic random sampling, 120 people from the research population were selected as a sample, who were referred to Tehran Juvenile Detention Centre after the decision was reached by the court. Data collection was carried out by separate examination using NEO-PI-III personality inventory, and statistical analysis was done using a one-sample t-test. Finally, the results of the research revealed that the level of neuroticism is higher than the average level, the level of conscientiousness is lower than the average level, and the level of extraversion, agreeableness, and openness are at the average level.

Keywords: personality characteristics, adolescents, Juvenile Detention Center, Tehran city

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12727 Effects of Different Sowing Dates on Oil Yield of Castor (Ricinus communis L.)

Authors: Özden Öztürk, Gözde Pınar Gerem, Ayça Yenici, Burcu Haspolat

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Castor (Ricinus communis L.) is one of the important non-edible oilseed crops having immense industrial and medicinal value. Oil yield per unit area is the ultimate target in growing oilseed plants and sowing date is one of the important factors which have a clear role in the production of active substances particularly in oilseeds. This study was conducted to evaluate the effect of sowing date on the seed and oil yield of castor in Central Anatolia in Turkey in 2011. The field experiment was set up in a completely randomized block design with three replication. Black Diamond-2 castor cultivar was used as plant material. The treatment was four sowing dates of May 10, May 25, June 10, June 25. In this research; seed yield, oil content and oil yield were investigated. Results showed that the effect of different sowing dates was significant on all of the characteristics. In general; delayed sowing dates, resulted in decreased seed yield, oil content and oil yield. The highest value of seed yield, oil content and oil yield (respectively, 2523.7 kg ha-1, 51.18% and 1292.2 kg ha-1) were obtained from the first sowing date (May 10) while the lowest seed yield, oil content and oil yield (respectively, 1550 kg ha-1, 43.67%, 677.3 kg ha-1) were recorded from the latest sowing date (June 25). Therefore, it can be concluded that early May could be recommended as an appropriate sowing date in the studied location and similar climates for achieved high oil yield of castor.

Keywords: castor bean, Ricinus communis L., sowing date, seed yield, oil content

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12726 Particleboard Production from Atmospheric Plasma Treated Wheat Straw Particles

Authors: Štěpán Hýsek, Milan Podlena, Miloš Pavelek, Matěj Hodoušek, Martin Böhm, Petra Gajdačová

Abstract:

Particle boards have being used in the civil engineering as a decking for load bearing and non-load bearing vertical walls and horizontal panels (e. g. floors, ceiling, roofs) in a large scale. When the straw is used as non-wood material for manufacturing of lignocellulosic panels, problems with wax layer on the surface of the material can occur. Higher percentage of silica and wax cause the problems with the adhesion of the adhesive and this is the reason why it is necessary to break the surface layer for the better bonding effect. Surface treatment of the particles cause better mechanical properties, physical properties and the overall better results of the composite material are reached. Plasma application is one possibility how to modify the surface layer. The aim of this research is to modify the surface of straw particles by using cold plasma treatment. Surface properties of lignocellulosic materials were observed before and after cold plasma treatment. Cold plasma does not cause any structural changes deeply in the material. There are only changes in surface layers, which are required. Results proved that the plasma application influenced the properties of surface layers and the properties of composite material.

Keywords: composite, lignocellulosic materials, straw, cold plasma, surface treatment

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12725 Transarterial Chemoembolization (TACE) in Hepatocellular Carcinoma (HCC)

Authors: Ilirian Laçi, Alketa Spahiu

Abstract:

Modality of treatment in hepatocellular carcinoma (HCC) patients depends on the stage of the disease. The Barcelona Clinic Liver Cancer Classification (BCLC) is the preferred staging system. There are many patients initially present with intermediate-stage disease. For these patients, transarterial chemoembolization (TACE) is the treatment of choice. The differences in individual factors that are not captured by the BCLC framework, such as the tumor growth pattern, degree of hypervascularity, and vascular supply, complicate further evaluation of these patients. Because of these differences, not all patients benefit equally from TACE. Several tools have been devised to aid the decision-making process, which have shown promising initial results but have failed external evaluation and have not been translated to the clinic aspects. Criteria for treatment decisions in daily clinical practice are needed in all stages of the disease.

Keywords: hepatocellular carcinoma, transarterial chemoembolization, TACE, liver

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12724 The Effectiveness of Psychodrama on Self-esteem Enhancement in Adolescent Boys

Authors: Saeed Dehnavi, Zahra Dehnavi

Abstract:

Background: Psychodrama, as a form of art therapy, helps people to enact and use role-plays for a specific problem, rather than just talking about it, in an effort to review the problem, gain feedback from group members, find appropriate solutions, and practice them for their life. This paper evaluated the effectiveness of psychodrama on enhancing self-esteem of young adolescent boys. Methodology: This is aquasi-experimental research study, using a pre-post testing plan with control group.From four secondary schools in Kermanshah – Iran, 210 adolescent boys (aged 13 and 14 years) were asked to complete Koper Smith's self-esteem measure scale. Given the low self-esteem scores (less than the cut-off of 23), a number of 20 individuals were selected and randomly placed into two control and experimental groups. The experimental group participated in a twelve-session psychodrama therapy plan for 6 weeks, while the control group received no intervention. Data analysis was carried out by the analysis of covariance (ANCOVA). Results: The results of ANCOVA analysis showed an increase in the post-test scores for self-esteem, and such increase was statistically significant. Conclusion: The findings indicated the effectiveness of psychodrama on self-esteem enhancement of young boys. During psychodrama sessions, the adolescents learned to take the initiative, communicate with others in an excited state, and improve their self-esteem with positive and constructive experiences.

Keywords: psychodrama, self-esteem, young adolescents, boys

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12723 Switchable Lipids: From a Molecular Switch to a pH-Sensitive System for the Drug and Gene Delivery

Authors: Jeanne Leblond, Warren Viricel, Amira Mbarek

Abstract:

Although several products have reached the market, gene therapeutics are still in their first stages and require optimization. It is possible to improve their lacking efficiency by the use of carefully engineered vectors, able to carry the genetic material through each of the biological barriers they need to cross. In particular, getting inside the cell is a major challenge, because these hydrophilic nucleic acids have to cross the lipid-rich plasmatic and/or endosomal membrane, before being degraded into lysosomes. It takes less than one hour for newly endocytosed liposomes to reach highly acidic lysosomes, meaning that the degradation of the carried gene occurs rapidly, thus limiting the transfection efficiency. We propose to use a new pH-sensitive lipid able to change its conformation upon protonation at endosomal pH values, leading to the disruption of the lipidic bilayer and thus to the fast release of the nucleic acids into the cytosol. It is expected that this new pH-sensitive mechanism promote endosomal escape of the gene, thereby its transfection efficiency. The main challenge of this work was to design a preparation presenting fast-responding lipidic bilayer destabilization properties at endosomal pH 5 while remaining stable at blood pH value and during storage. A series of pH-sensitive lipids able to perform a conformational switch upon acidification were designed and synthesized. Liposomes containing these switchable lipids, as well as co-lipids were prepared and characterized. The liposomes were stable at 4°C and pH 7.4 for several months. Incubation with siRNA led to the full entrapment of nucleic acids as soon as the positive/negative charge ratio was superior to 2. The best liposomal formulation demonstrated a silencing efficiency up to 10% on HeLa cells, very similar to a commercial agent, with a lowest toxicity than the commercial agent. Using flow cytometry and microscopy assays, we demonstrated that drop of pH was required for the transfection efficiency, since bafilomycin blocked the transfection efficiency. Additional evidence was brought by the synthesis of a negative control lipid, which was unable to switch its conformation, and consequently exhibited no transfection ability. Mechanistic studies revealed that the uptake was mediated through endocytosis, by clathrin and caveolae pathways, as reported for previous lipid nanoparticle systems. This potent system was used for the treatment of hypercholesterolemia. The switchable lipids were able to knockdown PCSK9 expression on human hepatocytes (Huh-7). Its efficiency is currently evaluated on in vivo mice model of PCSK9 KO mice. In summary, we designed and optimized a new cationic pH-sensitive lipid for gene delivery. Its transfection efficiency is similar to the best available commercial agent, without the usually associated toxicity. The promising results lead to its use for the treatment of hypercholesterolemia on a mice model. Anticancer applications and pulmonary chronic disease are also currently investigated.

Keywords: liposomes, siRNA, pH-sensitive, molecular switch

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12722 Mycophenolate Versus Methotrexate in Non-Infectious Ocular Inflammatory Disease: A Systematic Review and Meta-Analysis

Authors: Mohammad Karam, Abdulmalik Alsaif, Abdulrahman Al-Naseem, Amrit Hayre, Abdurrahman Al Jabbouri, Ahmad Aldubaikhi, Narvair Kahlar, Salem Al-Mutairi

Abstract:

Purpose: To compare the outcomes of mycophenolate mofetil (MMF) versus methotrexate (MTX) in non-infectious ocular inflammatory disease (NIOID). Methods: A systematic review and meta-analysis were performed as per the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) Guidelines and an electronic search was conducted to identify all comparative studies of MMF versus MTX in NIOID. Treatment results and side effects were primary outcome measures. Secondary outcome measures included visual acuity and resolution of macular oedema. Fixed and random-effects models were used for the analysis. Results: Four studies enrolling 905 patients were identified. There was no significant difference between MMF and MTX groups in overall treatment success (Odds Ratio [OR] = 0.97, P = 0.96) and failure (OR = 0.86, P = 0.85) of NIOID. Although treatment success of uveitis showed no significant difference for anterior and intermediate uveitis cases (OR = 2.33, P = 0.14), MTX showed a significantly improved effect in cases involving posterior uveitis and panuveitis (OR = 0.41, P = 0.003). However, the median dose required for treatment success was lower for MTX whereas MMF was associated with a faster median time to treatment success. Further to this, MMF showed a reduced rate of side effects when compared to MTX, but MTX failed to reach statistical significance, most notably for liver enzyme elevation (OR = 0.65, P = 0.16), fatigue (OR = 0.84, P = 0.49) and headache (OR = 0.81, P = 0.37). For secondary outcomes, no significant difference was noted in visual acuity and resolution of macular edema. Conclusions: MMF is comparable to MTX in the treatment of NIOID as there was no significant difference in the outcome of treatment success and side effect profiles.

Keywords: Mycophenolate mofetil, methotrexate, non-infectious ocular inflammation, uveitis, scleritis

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12721 Chromium Adsorption by Modified Wood

Authors: I. Domingos, B. Esteves, A. Figueirinha, Luísa P. Cruz-Lopes, J. Ferreira, H. Pereira

Abstract:

Chromium is one of the most common heavy metals which exist in very high concentrations in wastewater. The removal is very expensive due to the high cost of normal adsorbents. Lignocellulosic materials and mainly treated materials have proven to be a good solution for this problem. Adsorption tests were performed at different pH, different times and with varying concentrations. Results show that is at pH 3 that treated wood absorbs more chromium ranging from 70% (2h treatment) to almost 100% (12 h treatment) much more than untreated wood with less than 40%. Most of the adsorption is made in the first 2-3 hours for untreated and heat treated wood. Modified wood adsorbs more chromium throughout the time. For all the samples, adsorption fitted relatively well the Langmuir model with correlation coefficient ranging from 0.85 to 0.97. The results show that heat treated wood is a good adsorbent ant that this might be a good utilization for sawdust from treating companies.

Keywords: adsorption, chromium, heat treatment, wood modification

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12720 Development of a Mechanical Ventilator Using A Manual Artificial Respiration Unit

Authors: Isomar Lima da Silva, Alcilene Batalha Pontes, Aristeu Jonatas Leite de Oliveira, Roberto Maia Augusto

Abstract:

Context: Mechanical ventilators are medical devices that help provide oxygen and ventilation to patients with respiratory difficulties. This equipment consists of a manual breathing unit that can be operated by a doctor or nurse and a mechanical ventilator that controls the airflow and pressure in the patient's respiratory system. This type of ventilator is commonly used in emergencies and intensive care units where it is necessary to provide breathing support to critically ill or injured patients. Objective: In this context, this work aims to develop a reliable and low-cost mechanical ventilator to meet the demand of hospitals in treating people affected by Covid-19 and other severe respiratory diseases, offering a chance of treatment as an alternative to mechanical ventilators currently available in the market. Method: The project presents the development of a low-cost auxiliary ventilator with a controlled ventilatory system assisted by integrated hardware and firmware for respiratory cycle control in non-invasive mechanical ventilation treatments using a manual artificial respiration unit. The hardware includes pressure sensors capable of identifying positive expiratory pressure, peak inspiratory flow, and injected air volume. The embedded system controls the data sent by the sensors. It ensures efficient patient breathing through the operation of the sensors, microcontroller, and actuator, providing patient data information to the healthcare professional (system operator) through the graphical interface and enabling clinical parameter adjustments as needed. Results: The test data of the developed mechanical ventilator presented satisfactory results in terms of performance and reliability, showing that the equipment developed can be a viable alternative to commercial mechanical ventilators currently available, offering a low-cost solution to meet the increasing demand for respiratory support equipment.

Keywords: mechanical fans, breathing, medical equipment, COVID-19, intensive care units

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12719 Weeds Density Affects Yield and Quality of Wheat Crop under Different Crop Densities

Authors: Ijaz Ahmad

Abstract:

Weed competition is one of the major biotic constraints in wheat crop productivity. Avena fatua L. and Silybum marianum (L.) Gaertn. are among the worst weeds of wheat, greatly deteriorating wheat quality subsequently reducing its market value. In this connection, two-year experiments were conducted in 2018 & 2019. Different seeding rate wheat viz; 80, 100, 120 and 140 kg ha-1 and different weeds ratio (A. fatua: S. marianum ) sown at the rate 1:8, 2:7, 3:6, 4:5, 5:4, 6:3, 7:2, 8:1 and 0:0 respectively. The weeds ratio and wheat densities are indirectly proportional. However, the wheat seed at the rate of 140 kg ha-1 has minimal weeds interference. Yield losses were 17.5% at weeds density 1:8 while 7.2% at 8:1. However, in wheat density, the highest percent losses were computed on 80 kg ha-1 while the lowest was recorded on 140 kg ha-1. Since due to the large leaf canopy of S. marianum other species can't sustain their growth. Hence, it has been concluded that S. marianum is the hotspot that causes reduction to the yield-related parameters, followed by A. fatua and the other weeds. Due to the morphological mimicry of A. fatua with wheat crop during the vegetative growth stage, it cannot be easily distinguished. Therefore, managing A. fatua and S. marianum before seed setting is recommended for reducing the future weed problem. Based on current studies, it is suggested that sowing wheat seed at the rate of 140 kg ha-1 is recommended to better compete with all the field weeds.

Keywords: fat content, holly thistle, protein content, weed competition, wheat, wild oat

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12718 Multi-Walled Carbon Nanotube Based Water Filter for Virus Pathogen Removal

Authors: K. Domagala, D. Kata, T. Graule

Abstract:

Diseases caused by contaminated drinking water are the worldwide problem, which leads to the death and severe illnesses for hundreds of millions million people each year. There is an urgent need for efficient water treatment techniques for virus pathogens removal. The aim of the research was to develop safe and economic solution, which help with the water treatment. In this study, the synthesis of copper-based multi-walled carbon nanotube composites is described. Proposed solution utilize combination of a low-cost material with a high active surface area and copper antiviral properties. Removal of viruses from water was possible by adsorption based on electrostatic interactions of negatively charged virus with a positively charged filter material.

Keywords: multi walled carbon nanotubes, water purification, virus removal, water treatment

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12717 A Hybrid Energy Storage Module for the Emergency Energy System of the Community Shelter in Yucatán, México

Authors: María Reveles-Miranda, Daniella Pacheco-Catalán

Abstract:

Sierra Papacal commissary is located north of Merida, Yucatan, México, where the indigenous Maya population predominates. Due to its location, the region has an elevation of fewer than 4.5 meters above sea level, with a high risk of flooding associated with storms and hurricanes and a high vulnerability of infrastructure and housing in the presence of strong gusts of wind. In environmental contingencies, the challenge is providing an autonomous electrical supply using renewable energy sources that cover vulnerable populations' health, food, and water pumping needs. To address this challenge, a hybrid energy storage module is proposed for the emergency photovoltaic (PV) system of the community shelter in Sierra Papacal, Yucatán, which combines high-energy-density batteries and high-power-density supercapacitors (SC) in a single module, providing a quick response to energy demand, reducing the thermal stress on batteries and extending their useful life. Incorporating SC in energy storage modules can provide fast response times to power variations and balanced energy extraction, ensuring a more extended period of electrical supply to vulnerable populations during contingencies. The implemented control strategy increases the module's overall performance by ensuring the optimal use of devices and balanced energy exploitation. The operation of the module with the control algorithm is validated with MATLAB/Simulink® and experimental tests.

Keywords: batteries, community shelter, environmental contingencies, hybrid energy storage, isolated photovoltaic system, supercapacitors

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12716 The Role of Uterine Artery Embolization in the Management of Postpartum Hemorrhage

Authors: Chee Wai Ku, Pui See Chin

Abstract:

As an emerging alternative to hysterectomy, uterine artery embolization (UAE) has been widely used in the management of fibroids and in controlling postpartum hemorrhage (PPH) unresponsive to other therapies. Research has shown UAE to be a safe, minimally invasive procedure with few complications and minimal effects on future fertility. We present two cases highlighting the use of UAE in preventing PPH in a patient with a large fibroid at the time of cesarean section and in the treatment of secondary PPH refractory to other therapies in another patient. We present a 36-year primiparous woman who booked at 18+6 weeks gestation with a 13.7 cm subserosal fibroid at the lower anterior wall of the uterus near the cervix and a 10.8 cm subserosal fibroid in the left wall. Prophylactic internal iliac artery occlusion balloons were placed prior to the planned classical midline cesarean section. The balloons were inflated once the baby was delivered. Bilateral uterine arteries were embolized subsequently. The estimated blood loss (EBL) was 400 mls and hemoglobin (Hb) remained stable at 10 g/DL. Ultrasound scan 2 years postnatally showed stable uterine fibroids 10.4 and 7.1 cm, which was significantly smaller than before. We present the second case of a 40-year-old G2P1 with a previous cesarean section for failure to progress. There were no antenatal problems, and the placenta was not previa. She presented with term labour and underwent an emergency cesarean section for failed vaginal birth after cesarean. Intraoperatively extensive adhesions were noted with bladder drawn high, and EBL was 300 mls. Postpartum recovery was uneventful. She presented with secondary PPH 3 weeks later complicated by hypovolemic shock. She underwent an emergency examination under anesthesia and evacuation of the uterus, with EBL 2500mls. Histology showed decidua with chronic inflammation. She was discharged well with no further PPH. She subsequently returned one week later for secondary PPH. Bedside ultrasound showed that the endometrium was thin with no evidence of retained products of conception. Uterotonics were administered, and examination under anesthesia was performed, with uterine Bakri balloon and vaginal pack insertion after. EBL was 1000 mls. There was no definite cause of PPH with no uterine atony or products of conception. To evaluate a potential cause, pelvic angiogram and super selective left uterine arteriogram was performed which showed profuse contrast extravasation and acute bleeding from the left uterine artery. Superselective embolization of the left uterine artery was performed. No gross contrast extravasation from the right uterine artery was seen. These two cases demonstrated the superior efficacy of UAE. Firstly, the prophylactic use of intra-arterial balloon catheters in pregnant patients with large fibroids, and secondly, in the diagnosis and management of secondary PPH refractory to uterotonics and uterine tamponade. In both cases, the need for laparotomy hysterectomy was avoided, resulting in the preservation of future fertility. UAE should be a consideration for hemodynamically stable patients in centres with access to interventional radiology.

Keywords: fertility preservation, secondary postpartum hemorrhage, uterine embolization, uterine fibroids

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12715 Use of Recycled Aggregates in Current Concretes

Authors: K. Krizova, R. Hela

Abstract:

The paper a summary of the results of concretes with partial substitution of natural aggregates with recycled concrete is solved. Design formulas of the concretes were characterised with 20, 40 and 60% substitution of natural 8-16 mm fraction aggregates with a selected recycled concrete of analogous coarse fractions. With the product samples an evaluation of coarse fraction aggregates influence on fresh concrete consistency and concrete strength in time was carried out. The results of concretes with aggregates substitution will be compared to reference formula containing only the fractions of natural aggregates.

Keywords: recycled concrete, natural aggregates, fresh concrete, properties of concrete

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