Search results for: J. Joel Bright
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 218

Search results for: J. Joel Bright

98 Synthesis and Gas Transport Properties of Polynorbornene Dicarboximides Bearing Trifluoromethyl Isomer Moieties

Authors: Jorge A. Cruz-Morales, Joel Vargas, Arlette A. Santiago, Mikhail A. Tlenkopatchev

Abstract:

In industrial processes such as oil extraction and refining, products are handled or generated in the gas phase, which represents a challenge in terms of treatment and purification. During the past three decades, new scientific findings and technological advances in separation based on the use of membranes have led to simpler and more efficient gas separation processes, optimizing the use of energy and generating less pollution. This work reports the synthesis and ring-opening metathesis polymerization (ROMP) of new structural isomers based on norbornene dicarboximides bearing trifluoromethyl moieties, specifically N-2-trifluoromethylphenyl-exo,endo-norbornene-5,6-dicarboximide (2a) and N-3-trifluoromethylphenyl-exo,endo-norbornene-5,6-dicarboximide (2b), using tricyclohexylphosphine [1,3-bis(2,4,6-trimethylphenyl)-4,5-dihydroimidazol-2-ylidene][benzylidene] ruthenium dichloride (I), bis(tricyclohexylphosphine) benzylidene ruthenium (IV) dichloride (II), and bis(tricyclohexylphosphine) p-fluorophenylvinylidene ruthenium (II) dichloride (III). It was observed that the -CF3 moiety attached at the ortho position of the aromatic ring increases thermal and mechanical properties of the polymer, whereas meta substitution has the opposite effect. A comparative study of gas transportation in membranes, based on these fluorinated polynorbornenes, showed that -CF3 ortho substitution increases permeability of the polymer membrane as a consequence of the increase in both gas solubility and gas diffusion. In contrast, gas permeability coefficients of the meta-substituted polymer membrane are rather similar to those of that which is non-fluorinated; this can be attributed to a lower fractional free volume. The meta-substituted polymer membrane, besides showing the largest permselectivity coefficients of all the isomers studied here, was also found to have one of the largest permselectivity coefficients for separating H2/C3H6 into glassy polynorbornene dicarboximides.

Keywords: gas transport membranes, polynorbornene dicarboximide, ROMP, structural isomers

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97 An Empirical Enquiry on Cultural Influence and Purchase Decision for Durable Goods in Nigeria

Authors: Bright C. Opara, Gideon C. Uboegbulam

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This study can be appreciated from the significant role culture exert in purchase decision of durable goods the world over. This study is motivated by cultural diversity in Nigeria and socio-economic changes that have taken place in the recent times. These call for the validation of similarly studies in order to formulate informed marketing strategies that will enhance purchase behaviour. This study therefore, is set out to examine the cultural influence in family purchase decision-making for durable goods in the three major ethnic groups in Nigeria (Hausa, Ibo, and Yoruba). The primary data was sourced using structured and semi-structured research questionnaire, while the secondary information was generated from existing / available relevant literature journals / periodicals. A judgmental sampling technique was used to determine the sample size of 300 households. The Analysis of Variance (ANOVA) statistical tool was used to test the hypotheses, with the aid of Statistical Packages for Social Sciences (SPSS) version 17.0. The finding showed that cultural influence on the family Purchase Decision of Durable Goods does not significantly differ in three ethnic groups, and that family Purchase Decision Making for Durable Goods does not significantly differ in the three ethnic groups. We therefore, conclude that culture do not really impact significantly on the purchase behaviour of the three ethnic groups in the Nigeria as it does in some others. However, there is need for marketers and marketing decision makers not to generalise the findings of this study. This is because of the significant role culture play in purchase behaviour which differs from one culture or country to another.

Keywords: cultural, durable goods, influence, purchase decision

Procedia PDF Downloads 366
96 Self-Action of Pyroelectric Spatial Soliton in Undoped Lithium Niobate Samples with Pyroelectric Mechanism of Nonlinear Response

Authors: Anton S. Perin, Vladimir M. Shandarov

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Compensation for the nonlinear diffraction of narrow laser beams with wavelength of 532 and the formation of photonic waveguides and waveguide circuits due to the contribution of pyroelectric effect to the nonlinear response of lithium niobate crystal have been experimentally demonstrated. Complete compensation for the linear and nonlinear diffraction broadening of light beams is obtained upon uniform heating of an undoped sample from room temperature to 55 degrees Celsius. An analysis of the light-field distribution patterns and the corresponding intensity distribution profiles allowed us to estimate the spacing for the channel waveguides. The observed behavior of bright soliton beams may be caused by their coherent interaction, which manifests itself in repulsion for anti-phase light fields and in attraction for in-phase light fields. The experimental results of this study showed a fundamental possibility of forming optically complex waveguide structures in lithium niobate crystals with pyroelectric mechanism of nonlinear response. The topology of these structures is determined by the light field distribution on the input face of crystalline sample. The optical induction of channel waveguide elements by interacting spatial solitons makes it possible to design optical systems with a more complex topology and a possibility of their dynamic reconfiguration.

Keywords: self-action, soliton, lithium niobate, piroliton, photorefractive effect, pyroelectric effect

Procedia PDF Downloads 137
95 Hot Cracking Susceptibility Evaluation of the Advanced UNS S31035 Austenitic Stainless Steel by Varestraint Weldability Testing

Authors: Mikael M. Johansson, Peter Stenvall, Leif Karlsson, Joel Andersson

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Sandvik Sanicro 25, UNS S31035, is an advanced high temperature austenitic stainless steel that potentially can be used in super-heaters and reheaters in the next generation of advanced ultra-super critical power plants. The material possesses both high creep strength and good corrosion resistance at temperatures up to 700°C. Its high temperature properties are positioned between other commercially available high temperature austenitic stainless steels and nickel-based alloys. It is, however, well known that an austenitic solidification mode combined with a fully austenitic microstructure exacerbate susceptibility towards hot cracking. The problem increases even more for thick walled material in multipass welding and could compromise the integrity of the welded component. Varestraint weldability testing is commonly used to evaluate susceptibility towards hot cracking of materials. In this paper, Varestraint test results are evaluated for base material of both UNS S31035 steel and are compared to those of the well-known and well-characterized UNS S31008 grade. The more creep resistant alloy, UNS S31035, is metallurgically more complicated than the UNS S31008 grade and has additions of several alloying elements to improve its high temperature properties. It benefits from both solid solution hardening as well as precipitation hardening. This investigation therefore attempts, based on the Varestraint weldability test, to understand if there are any differences in cracking mechanisms between these two grades due to the additional alloying elements used in UNS S31035. Results from Varestraint testing and crack type investigations will be presented and discussed in some detail. It is shown that hot cracking susceptibility of the UNS S31035 steel is only slightly higher than that of UNS S31008 despite the more complicated metallurgy. Weldability of the two alloys is therefore judged to be comparable making the newer alloy well suited also for critical applications.

Keywords: austenitic stainless steel, hot cracking susceptibility, UNS S31035, UNS S31008, varestraint weldability testing

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94 Quality and Qualitative Education for All, Panacea for Insecurity and Political Unrest in Nigeria

Authors: Babatunde Joel Todowede

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It is a public knowledge that lack of quality and qualitative education breeds problems besetting Nigeria as a nation today. This paper entitled “Quality and Qualitative Education for all, panacea for insecurity and political unrest in Nigeria” seeks to explore how quality and qualitative education for all will tends to put an end to insecurity and political unrest in Nigeria as a Nation. It may be pertinent to note at this juncture that the development of any modern society or nation is primarily hinged on the functionality of its educational system. There is no developed nation in the world today, which does not owe its advancement to quality and qualitative education. In other words, Education is a vital instrument in the nation’s economic competitiveness, in its people, and in its communities. Hence, Education is not luxury to be cut in difficult economic times – it is an essential element of growth. In fact, education is the bedrock of any society that hopes to be numbered among the developed economies in the world. Nigeria, as a nation, has made continual efforts to assume its rightful place in education on the African continent, but has not been quite lucky. Interestingly however, Quality and Qualitative Education for all will come about if all stakeholders in the Education Sector perform their roles with skill and efficiency. Education is a very sensitive area, hence, needs to be passionate about education, and focused on building a future for the sector.” Quality and qualitative education instill significant core values in every student, which shape them into mature, caring and independent individuals. These values include commitment, collaboration, integrity, responsibility and respect. By imbibing these values in every aspect of their life, they are able to contribute their skills and talents while supporting each other in attaining their lifelong goals. This paper identified lack of proper education as the bane of insecurity and political unrest in the Country and urged the government to review the policy in a way that there will be quality and standard to check insurgency in the Country. More so, until the fallen standard of education in Nigeria is fixed to engage out of school children, the incessant attack on innocent Nigerians, particularly in the North East may get worse.

Keywords: quality and qualitative education, panacea, insecurity, political unrest

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93 Strategies for Medium Sized Construction Firms to Survive the Current Economic Conditions That Is Compounded by the Most Recent COVID-19 Pandemic in Nigeria

Authors: Aloysius Colman Chukwuemeka Ezeabasili, Chibuike Patrick Ezeabasili

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Medium Sized Construction Companies in Nigeria are those employing 50-250 workers that are mostly involved in roads, Commercial and domestic building Construction, among others. These companies are in the majority and contribute immensely to infrastructural development in Nigeria. Despite the last eight years of economic downturn and the past years of COVID-19 pandemic, signs of these Companies recovering from the economic recession and pandemic seem bright. Nigeria has recorded 213,000 confirmed cases 3968 deaths from COVID-19 as at now. These medium sized companies are currently trying to explore various opportunities to grow their businesses to achieve competitive advantages over others by studying and improving on their bidding efficiency, Strategies for selecting businesses, bidding markup Strategies, and cash flow. These strategies were studied through the recruitment of construction experts and professionals. Many of them have acquired new technologies that have impacted positively on their strategies. The impact of these technologies like the BIM, e-tendering, conditions of contract, and claim management strategies are advantages to them and has given them good advantages over their peers. Monte Carlo solution, Swot analysis, and average bid methods have also clearly added advantages to bidding practices. New and existing strategies are Scrutinized, and training of young Nigerians in advanced countries to acquire knowledge in best practices have elevated some of these companies. The Covid-19 has not been very harsh to Nigeria, and the country is surely not as devastated as the advanced countries. Nigeria has therefore been able to cope with the combination of the downturn and the pandemic.

Keywords: medium sized construction companies, competitive advantage, new bidding technologies, Nigeria

Procedia PDF Downloads 107
92 4D Modelling of Low Visibility Underwater Archaeological Excavations Using Multi-Source Photogrammetry in the Bulgarian Black Sea

Authors: Rodrigo Pacheco-Ruiz, Jonathan Adams, Felix Pedrotti

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This paper introduces the applicability of underwater photogrammetric survey within challenging conditions as the main tool to enhance and enrich the process of documenting archaeological excavation through the creation of 4D models. Photogrammetry was being attempted on underwater archaeological sites at least as early as the 1970s’ and today the production of traditional 3D models is becoming a common practice within the discipline. Photogrammetry underwater is more often implemented to record exposed underwater archaeological remains and less so as a dynamic interpretative tool.  Therefore, it tends to be applied in bright environments and when underwater visibility is > 1m, reducing its implementation on most submerged archaeological sites in more turbid conditions. Recent years have seen significant development of better digital photographic sensors and the improvement of optical technology, ideal for darker environments. Such developments, in tandem with powerful processing computing systems, have allowed underwater photogrammetry to be used by this research as a standard recording and interpretative tool. Using multi-source photogrammetry (5, GoPro5 Hero Black cameras) this paper presents the accumulation of daily (4D) underwater surveys carried out in the Early Bronze Age (3,300 BC) to Late Ottoman (17th Century AD) archaeological site of Ropotamo in the Bulgarian Black Sea under challenging conditions (< 0.5m visibility). It proves that underwater photogrammetry can and should be used as one of the main recording methods even in low light and poor underwater conditions as a way to better understand the complexity of the underwater archaeological record.

Keywords: 4D modelling, Black Sea Maritime Archaeology Project, multi-source photogrammetry, low visibility underwater survey

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91 Synthesis of Zeolites from Bauxite and Kaolin: Effect of Synthesis Parameters on Competing Phases

Authors: Bright Kwakye-Awuah, Elizabeth Von-Kiti, Isaac Nkrumah, Baah Sefa-Ntiri, Craig D. Williams

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Bauxite and kaolin from Ghana Bauxite Company mine site were used to synthesize zeolites. Bauxite served as the alumina source and kaolin the silica source. Synthesis variations include variation of aging time at constant crystallization time and variation of crystallization times at constant aging time. Characterization techniques such as X-ray diffraction (XRD), scanning electron microscopy (SEM), energy dispersive x-ray analysis (EDX) and Fourier transform infrared spectroscopy (FTIR) were employed in the characterization of the raw samples as well as the synthesized samples. The results obtained showed that the transformations that occurred and the phase of the resulting products were coordinated by the aging time, crystallization time, alkaline concentration and Si/Al ratio of the system. Zeolites A, X, Y, analcime, Sodalite, and ZK-14 were some of the phases achieved. Zeolite LTA was achieved with short crystallization times of 3, 5, 18 and 24 hours and a maximum aging of 24 hours. Zeolite LSX was synthesized with 24 hr aging followed with 24 hr hydrothermal treatment whilst zeolite Y crystallized after 48 hr of aging and 24 hr crystallization. Prolonged crystallization time produced a mixed phased product. Prolonged aging times, on the other hand, did not yield any zeolite as the sample was amorphous. Increasing the alkaline content of the reaction mixture above 5M introduced sodalite phase in the final product. The properties of the final products were comparable to zeolites synthesized from pure chemical reagents.

Keywords: bauxite, kaolin, aging, crystallization, zeolites

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90 Nature-based Solutions for Mitigating the Impact of Climate Change on Plants: Utilizing Encapsulated Plant Growth Regulators and Associative Microorganisms

Authors: Raana Babadi Fathipour

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Over the past decades, the climatic CO2 concentration and worldwide normal temperature have been expanding, and this drift is anticipated to before long gotten to be more extreme. This situation of climate alter escalate abiotic stretch components (such as dry spell, flooding, saltiness, and bright radiation) that debilitate timberland and related environments as well as trim generation. These variables can contrarily influence plant development and advancement with a ensuing lessening in plant biomass aggregation and surrender, in expansion to expanding plant defenselessness to biotic stresses. As of late, biostimulants have ended up a hotspot as an viable and economical elective to reduce the negative impacts of stresses on plants. In any case, the larger part of biostimulants has destitute solidness beneath natural conditions, which leads to untimely debasement, shortening their organic movement. To unravel these bottlenecks, small scale- and nano-based definitions containing biostimulant atoms and/or microorganisms are picking up consideration as they illustrate a few points of interest over their routine details. In this survey, we center on the embodiment of plant development controllers and plant acquainted microorganisms as a technique to boost their application for plant assurance against abiotic stresses. We moreover address the potential restrictions and challenges confronted for the execution of this innovation, as well as conceivable outcomes with respect to future inquire about.

Keywords: bio stimulants, Seed priming, nano biotechnology, plant growth-promoting, rhizobacteria, plant growth regulators, microencapsulation

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89 Investigation of Resistive Switching in CsPbCl₃ / Cs₄PbCl₆ Core-Shell Nanocrystals Using Scanning Tunneling Spectroscopy: A Step Towards High Density Memory-based Applications

Authors: Arpan Bera, Rini Ganguly, Raja Chakraborty, Amlan J. Pal

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To deal with the increasing demands for the high-density non-volatile memory devices, we need nano-sites with efficient and stable charge storage capabilities. We prepared nanocrystals (NCs) of inorganic perovskite, CsPbCl₃ coated with Cs₄PbCl₆, by colloidal synthesis. Due to the type-I band alignment at the junction, this core-shell composite is expected to behave as a charge trapping site. Using Scanning Tunneling Spectroscopy (STS), we investigated voltage-controlled resistive switching in this heterostructure by tracking the change in its current-voltage (I-V) characteristics. By applying voltage pulse of appropriate magnitude on the NCs through this non-invasive method, different resistive states of this system were systematically accessed. For suitable pulse-magnitude, the response jumped to a branch with enhanced current indicating a high-resistance state (HRS) to low-resistance state (LRS) switching in the core-shell NCs. We could reverse this process by using a pulse of opposite polarity. These two distinct resistive states can be considered as two logic states, 0 and 1, which are accessible by varying voltage magnitude and polarity. STS being a local probe in space enabled us to capture this switching at individual NC site. Hence, we claim a bright prospect of these core-shell NCs made of inorganic halide perovskites in future high density memory application.

Keywords: Core-shell perovskite, CsPbCl₃-Cs₄PbCl₆, resistive switching, Scanning Tunneling Spectroscopy

Procedia PDF Downloads 64
88 Performance Optimization on Waiting Time Using Queuing Theory in an Advanced Manufacturing Environment: Robotics to Enhance Productivity

Authors: Ganiyat Soliu, Glen Bright, Chiemela Onunka

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Performance optimization plays a key role in controlling the waiting time during manufacturing in an advanced manufacturing environment to improve productivity. Queuing mathematical modeling theory was used to examine the performance of the multi-stage production line. Robotics as a disruptive technology was implemented into a virtual manufacturing scenario during the packaging process to study the effect of waiting time on productivity. The queuing mathematical model was used to determine the optimum service rate required by robots during the packaging stage of manufacturing to yield an optimum production cost. Different rates of production were assumed in a virtual manufacturing environment, cost of packaging was estimated with optimum production cost. An equation was generated using queuing mathematical modeling theory and the theorem adopted for analysis of the scenario is the Newton Raphson theorem. Queuing theory presented here provides an adequate analysis of the number of robots required to regulate waiting time in order to increase the number of output. Arrival rate of the product was fast which shows that queuing mathematical model was effective in minimizing service cost and the waiting time during manufacturing. At a reduced waiting time, there was an improvement in the number of products obtained per hour. The overall productivity was improved based on the assumptions used in the queuing modeling theory implemented in the virtual manufacturing scenario.

Keywords: performance optimization, productivity, queuing theory, robotics

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87 Novel Fluorescent High Density Polyethylene Composites for Fused Deposition Modeling 3D Printing in Packaging Security Features

Authors: Youssef R. Hassan, Mohamed S. Hasanin, Reda M. Abdelhameed

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Recently, innovations in packaging security features become more important to see the originality of packaging in industrial application. Luminescent 3d printing materials have been a promising property which can provides a unique opportunity for the design and application of 3D printing. Lack emission of terbium ions, as a source of green emission, in salt form prevent its uses in industrial applications, so searching about stable and highly emitter material become essential. Nowadays, metal organic frameworks (MOFs) play an important role in designing light emitter material. In this work, fluorescent high density polyethylene (FHDPE) composite filament with Tb-benzene 1,3,5-tricarboxylate (Tb-BTC) MOFs for 3D printing have been successfully developed.HDPE pellets were mixed with Tb-BTC and melting extrustion with single screw extruders. It was found that Tb-BTCuniformly dispersed in the HDPE matrix and significantly increased the crystallinity of PE, which not only maintained the good thermal property but also improved the mechanical properties of Tb-BTC@HDPE composites. Notably, the composite filaments emitted ultra-bright green light under UV lamp, and the fluorescence intensity increased as the content of Tb-BTC increased. Finally, several brightly luminescent exquisite articles could be manufactured by fused deposition modeling (FDM) 3D printer with these new fluorescent filaments. In this context, the development of novel fluorescent Tb-BTC@HDPE composites was combined with 3D printing technology to amplified the packaging Security Features.

Keywords: 3D printing, fluorescent, packaging, security

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86 Evaluation of Goji By-Product as a Value-Added Ingredient for the Functional Food Industry

Authors: Sanaa Ragaee, Paragyani Bora, Wee Teng Tan, Xin Hu

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Goji berry (Lycium barbarum) is a member of the family Solanaceae which is grown widely in China, Tibet, and other parts of Asia. Its fruits are 1–2 cm-long, bright orange-red ellipsoid berries and it has a long tradition as a food and medicinal plant. Goji berries are believed to boost immune system properties. The berries are considered an excellent source of macronutrients, micronutrients, vitamins, minerals and several bioactive components. Studies have shown effects of goji fruit on aging, neuroprotection, general well-being, fatigue/endurance, metabolism/energy expenditure, glucose control in diabetics and glaucoma, antioxidant properties, immunomodulation and anti-tumor activity. Goji berries are being used to prepare Goji beverage, and the remaining solid material is considered as by-product. The by-product is currently unused and disposed as waste despite its potential as a value-added food ingredient. Therefore, this study is intended to evaluate nutritional properties of Goji by-product and its potential applications in the baking industry. The Goji by-product was freeze dried and ground to pass through 1 mm screen prior to evaluation and food use. The Goji by-product was found to be a rich source of fiber (54%) and free phenolic components (1,307 µg/g), protein (13.6%), ash (3.3%) and fat (10%). Incorporation of the Goji by-product in muffins and cookies at various levels (10-40%) significantly improved the nutritional quality of the baked products. The baked products were generally accepted and highly rated by panelists at 20% replacement level. The results indicate the potential of Goji by-product as a value-added ingredient in particular as a source of dietary fiber and protein.

Keywords: Goji, by-product, phenolics, fibers, baked products

Procedia PDF Downloads 280
85 Healthcare Workers’ Knowledge and Attitude Toward Telemedicine During the COVID-19 Pandemic: A Global Survey

Authors: Saman Naqvi

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Introduction: Telemedicine is the practise of providing remote healthcare to patients via the utilisation of communication technologies. Its application has become increasingly important since the Coronavirus Disease 2019 (COVID-19) pandemic. It is essential to determine the knowledge and attitudes of healthcare professionals concerning its use in order to maximise its application. Purpose: We aim to examine and evaluate the current understanding and perceptions of medical staff toward the use of telemedicine. Methods: In this cross-sectional study, we surveyed 1091 healthcare professionals worldwide. Following an extensive review of the literature, data were gathered using a questionnaire. To depict the participant profile, frequency, percentages, and cumulative percentages were determined. Results: The majority of respondents had either heard of (90.9%), seen (65.3%), or were familiar with (74.6%) how telemedicine is implemented in practice. 72.2% of people were familiar with the tools that could be applied to this technology. Those with a medical degree and experience of under five years were found to be more familiar with telemedicine. Additionally, opinions on providing healthcare remotely were largely favorable, with 80% of respondents stating that it reduced staff burden and 80.6% thinking that it eliminated unnecessary transportation costs. Furthermore, 83% expressed that it saves clinicians' time. However, 20% of participants believed telemedicine adds to staff workload and 40% of healthcare professionals felt it compromises patient privacy and information confidentiality. Conclusion: Despite being a new and developing practice in many countries, telemedicine appears to have a bright future. This is crucial during a pandemic as it provides effective healthcare while maintaining social isolation measures. Moreover, the majority of the participants in this study demonstrated a good understanding and a favorable attitude toward telemedicine.

Keywords: healthcare system, global survey, knowledge, attitude, covid 19, telemedicine

Procedia PDF Downloads 55
84 Airborne SAR Data Analysis for Impact of Doppler Centroid on Image Quality and Registration Accuracy

Authors: Chhabi Nigam, S. Ramakrishnan

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This paper brings out the analysis of the airborne Synthetic Aperture Radar (SAR) data to study the impact of Doppler centroid on Image quality and geocoding accuracy from the perspective of Stripmap mode of data acquisition. Although in Stripmap mode of data acquisition radar beam points at 90 degrees broad side (side looking), shift in the Doppler centroid is invariable due to platform motion. In-accurate estimation of Doppler centroid leads to poor image quality and image miss-registration. The effect of Doppler centroid is analyzed in this paper using multiple sets of data collected from airborne platform. Occurrences of ghost (ambiguous) targets and their power levels have been analyzed that impacts appropriate choice of PRF. Effect of aircraft attitudes (roll, pitch and yaw) on the Doppler centroid is also analyzed with the collected data sets. Various stages of the RDA (Range Doppler Algorithm) algorithm used for image formation in Stripmap mode, range compression, Doppler centroid estimation, azimuth compression, range cell migration correction are analyzed to find the performance limits and the dependence of the imaging geometry on the final image. The ability of Doppler centroid estimation to enhance the imaging accuracy for registration are also illustrated in this paper. The paper also tries to bring out the processing of low squint SAR data, the challenges and the performance limits imposed by the imaging geometry and the platform dynamics on the final image quality metrics. Finally, the effect on various terrain types, including land, water and bright scatters is also presented.

Keywords: ambiguous target, Doppler Centroid, image registration, Airborne SAR

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83 Life Cycle Assessment of Biogas Energy Production from a Small-Scale Wastewater Treatment Plant in Central Mexico

Authors: Joel Bonales, Venecia Solorzano, Carlos Garcia

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A great percentage of the wastewater generated in developing countries don’t receive any treatment, which leads to numerous environmental impacts. In response to this, a paradigm change in the current wastewater treatment model based on large scale plants towards a small and medium scale based model has been proposed. Nevertheless, small scale wastewater treatment (SS-WTTP) with novel technologies such as anaerobic digesters, as well as the utilization of derivative co-products such as biogas, still presents diverse environmental impacts which must be assessed. This study consisted in a Life Cycle Assessment (LCA) performed to a SS-WWTP which treats wastewater from a small commercial block in the city of Morelia, Mexico. The treatment performed in the SS-WWTP consists in anaerobic and aerobic digesters with a daily capacity of 5,040 L. Two different scenarios were analyzed: the current plant conditions and a hypothetical energy use of biogas obtained in situ. Furthermore, two different allocation criteria were applied: full impact allocation to the system’s main product (treated water) and substitution credits for replacing Mexican grid electricity (biogas) and clean water pumping (treated water). The results showed that the analyzed plant had bigger impacts than what has been reported in the bibliography in the basis of wastewater volume treated, which may imply that this plant is currently operating inefficiently. The evaluated impacts appeared to be focused in the aerobic digestion and electric generation phases due to the plant’s particular configuration. Additional findings prove that the allocation criteria applied is crucial for the interpretation of impacts and that that the energy use of the biogas obtained in this plant can help mitigate associated climate change impacts. It is concluded that SS-WTTP is a environmentally sound alternative for wastewater treatment from a systemic perspective. However, this type of studies must be careful in the selection of the allocation criteria and replaced products, since these factors have a great influence in the results of the assessment.

Keywords: biogas, life cycle assessment, small scale treatment, wastewater treatment

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82 Effect of Dimensional Reinforcement Probability on Discrimination of Visual Compound Stimuli by Pigeons

Authors: O. V. Vyazovska

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Behavioral efficiency is one of the main principles to be successful in nature. Accuracy of visual discrimination is determined by the attention, learning experience, and memory. In the experimental condition, pigeons’ responses to visual stimuli presented on the screen of the monitor are behaviorally manifested by pecking or not pecking the stimulus, by the number of pecking, reaction time, etc. The higher the probability of rewarding is, the more likely pigeons will respond to the stimulus. We trained 8 pigeons (Columba livia) on a stagewise go/no-go visual discrimination task.16 visual stimuli were created from all possible combinations of four binary dimensions: brightness (dark/bright), size (large/small), line orientation (vertical/horizontal), and shape (circle/square). In the first stage, we presented S+ and 4 S-stimuli: the first that differed in all 4-dimensional values from S+, the second with brightness dimension sharing with S+, the third sharing brightness and orientation with S+, the fourth sharing brightness, orientation and size. Then all 16 stimuli were added. Pigeons rejected correctly 6-8 of 11 new added S-stimuli at the beginning of the second stage. The results revealed that pigeons’ behavior at the beginning of the second stage was controlled by probabilities of rewarding for 4 dimensions learned in the first stage. More or fewer mistakes with dimension discrimination at the beginning of the second stage depended on the number S- stimuli sharing the dimension with S+ in the first stage. A significant inverse correlation between the number of S- stimuli sharing dimension values with S+ in the first stage and the dimensional learning rate at the beginning of the second stage was found. Pigeons were more confident in discrimination of shape and size dimensions. They made mistakes at the beginning of the second stage, which were not associated with these dimensions. Thus, the received results help elucidate the principles of dimensional stimulus control during learning compound multidimensional visual stimuli.

Keywords: visual go/no go discrimination, selective attention, dimensional stimulus control, pigeon

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81 Defect Correlation of Computed Tomography and Serial Sectioning in Additively Manufactured Ti-6Al-4V

Authors: Bryce R. Jolley, Michael Uchic

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This study presents initial results toward the correlative characterization of inherent defects of Ti-6Al-4V additive manufacture (AM). X-Ray Computed Tomography (CT) defect data are compared and correlated with microscopic photographs obtained via automated serial sectioning. The metal AM specimen was manufactured out of Ti-6Al-4V virgin powder to specified dimensions. A post-contour was applied during the fabrication process with a speed of 1050 mm/s, power of 260 W, and a width of 140 µm. The specimen was stress relief heat-treated at 16°F for 3 hours. Microfocus CT imaging was accomplished on the specimen within a predetermined region of the build. Microfocus CT imaging was conducted with parameters optimized for Ti-6Al-4V additive manufacture. After CT imaging, a modified RoboMet. 3D version 2 was employed for serial sectioning and optical microscopy characterization of the same predetermined region. Automated montage capture with sub-micron resolution, bright-field reflection, 12-bit monochrome optical images were performed in an automated fashion. These optical images were post-processed to produce 2D and 3D data sets. This processing included thresholding and segmentation to improve visualization of defect features. The defects observed from optical imaging were compared and correlated with the defects observed from CT imaging over the same predetermined region of the specimen. Quantitative results of area fraction and equivalent pore diameters obtained via each method are presented for this correlation. It is shown that Microfocus CT imaging does not capture all inherent defects within this Ti-6Al-4V AM sample. Best practices for this correlative effort are also presented as well as the future direction of research resultant from this current study.

Keywords: additive manufacture, automated serial sectioning, computed tomography, nondestructive evaluation

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80 Extraction of Dye from Coconut Husk and Its Application on Wool and Silk

Authors: Deepali Rastogi

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Natural dyes are considered to be eco-friendly as they cause no pollution and are safe to use. With the growing interest in natural dyes, new sources of natural dyes are being explored. Coconut (Cocos nucifera) is native to tropical eastern region. It is abundantly available in Asia, Africa and South America. While coconut has tremendous commercial value in food, oil, pharmaceutical and cosmetic industry, the most important use of coconut husk has been as coir which is used for making mats, ropes, etc. In the present study an attempt has been made to extract dye from the coconut husk and study its application on wool and silk. Dye was extracted from coconut husk in an aqueous medium at three different pH. The coconut husk fibres were boiled in water at different pH of 4, 7 and 9 for one hour. On visual inspection of the extracted dye solution, maximum colour was found to be extracted at pH 9. The solution was obtained in neutral medium whereas, no dye was extracted in acidic medium. Therefore, alkaline medium at pH 9 was selected for the extraction of dye from coconut husk. The extracted dye was applied on wool and silk at three different pH, viz., 4, 7 and 9. The effect of pre- and post- mordanting with alum and ferrous sulphate on the colour value of coconut husk dye was also studied. The L*a*b*/L*c*h* values were measured to see the effect of the mordants on the colour values of all the dyed and mordanted samples. Bright golden brown to dark brown colours were obtained at pH 4 on both wool and silk. The colour yield was not very good at pH 7 and 9. Mordanting with alum resulted in darker and brighter shades of brown, whereas mordanting with ferrous sulphate resulted in darker and duller shades. All the samples were tested for colourfastness to light, rubbing, washing and perspiration. Both wool and silk dyed with dye extracted from coconut husk exhibited good to excellent wash, rub and perspiration fastness. Fastness to light was moderate to good.

Keywords: coconut husk, wool, silk, natural dye, mordants

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79 An Industrial Steady State Sequence Disorder Model for Flow Controlled Multi-Input Single-Output Queues in Manufacturing Systems

Authors: Anthony John Walker, Glen Bright

Abstract:

The challenge faced by manufactures, when producing custom products, is that each product needs exact components. This can cause work-in-process instability due to component matching constraints imposed on assembly cells. Clearing type flow control policies have been used extensively in mediating server access between multiple arrival processes. Although the stability and performance of clearing policies has been well formulated and studied in the literature, the growth in arrival to departure sequence disorder for each arriving job, across a serving resource, is still an area for further analysis. In this paper, a closed form industrial model has been formulated that characterizes arrival-to-departure sequence disorder through stable manufacturing systems under clearing type flow control policy. Specifically addressed are the effects of sequence disorder imposed on a downstream assembly cell in terms of work-in-process instability induced through component matching constraints. Results from a simulated manufacturing system show that steady state average sequence disorder in parallel upstream processing cells can be balanced in order to decrease downstream assembly system instability. Simulation results also show that the closed form model accurately describes the growth and limiting behavior of average sequence disorder between parts arriving and departing from a manufacturing system flow controlled via clearing policy.

Keywords: assembly system constraint, custom products, discrete sequence disorder, flow control

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78 All-Optical Gamma-Rays and Positrons Source by Ultra-Intense Laser Irradiating an Al Cone

Authors: T. P. Yu, J. J. Liu, X. L. Zhu, Y. Yin, W. Q. Wang, J. M. Ouyang, F. Q. Shao

Abstract:

A strong electromagnetic field with E>1015V/m can be supplied by an intense laser such as ELI and HiPER in the near future. Exposing in such a strong laser field, laser-matter interaction enters into the near quantum electrodynamics (QED) regime and highly non-linear physics may occur during the laser-matter interaction. Recently, the multi-photon Breit-Wheeler (BW) process attracts increasing attention because it is capable to produce abundant positrons and it enhances the positron generation efficiency significantly. Here, we propose an all-optical scheme for bright gamma rays and dense positrons generation by irradiating a 1022 W/cm2 laser pulse onto an Al cone filled with near-critical-density plasmas. Two-dimensional (2D) QED particle-in-cell (PIC) simulations show that, the radiation damping force becomes large enough to compensate for the Lorentz force in the cone, causing radiation-reaction trapping of a dense electron bunch in the laser field. The trapped electrons oscillate in the laser electric field and emits high-energy gamma photons in two ways: (1) nonlinear Compton scattering due to the oscillation of electrons in the laser fields, and (2) Compton backwardscattering resulting from the bunch colliding with the reflected laser by the cone tip. The multi-photon Breit-Wheeler process is thus initiated and abundant electron-positron pairs are generated with a positron density ~1027m-3. The scheme is finally demonstrated by full 3D PIC simulations, which indicate the positron flux is up to 109. This compact gamma ray and positron source may have promising applications in future.

Keywords: BW process, electron-positron pairs, gamma rays emission, ultra-intense laser

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77 Assessment of Knowledge, Awareness about Hemorrhoids Causes and Stages among the General Public of Saudi Arabia

Authors: Asaiel Mubark Al Hadi

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Background: A frequent anorectal condition known as hemorrhoids, sometimes known as piles, is characterized by a weakening of the anal cushion and the supporting tissue as well as spasms of the internal sphincter. Hemorrhoids are most frequently identified by painless bright red bleeding, prolapse, annoying grape-like tissue prolapse, itching, or a combination of symptoms. digital rectal examination (DRE) and anoscope are used to diagnose it. Constipation, a low-fiber diet, a high body- mass index (BMI), pregnancy, and a reduced physical activity are among the factors that are typically thought to increase the risk of hemorrhoids. Golighers is the most commonly used hemorrhoid classification scheme It is 4 degrees, which determines the degree of the event. The purpose of this study is to assess knowledge and awareness level of the causes and stages of Hemorrhoids in the public of Saudi Arabia. Method: This cross-sectional study was conducted in the Saudi Arabia between Oct 2022- Dec 2022. The study group included at least 384 aged above 18 years. The outcomes of this study were analyzed using the SPSS program using a pre-tested questionnaire. Results: The study included 1410 participants, 69.9% of them were females and 30.1% were males. 53.7% of participants aged 20- 30 years old. 17% of participants had hemorrhoids and 42% had a relative who had hemorrhoids. 42.8% of participants could identify stage 1 of hemorrhoids correctly, 44.7% identified stage 2 correctly, 46.7% identified stage 3 correctly and 58.1% identified stage 4 correctly. Only 28.9% of participants had high level of knowledge about hemorrhoids, 62.7% had moderate knowledge and 8.4% had low knowledge. Conclusion: In conclusion, Saudi general population has poor knowledge of hemorrhoids, their causes and their management approach. There was a significant association between knowledge scores of hemorrhoids with age, gender, residence area and employment.

Keywords: hemorrhoids, external hemorrhoid, internal hemorrhoid, anal fissure, hemorrhoid stages, prolapse, rectal bleeding

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76 Consideration for a Policy Change to the South African Collective Bargaining Process: A Reflection on National Union of Metalworkers of South Africa v Trenstar (Pty) (2023) 44 ILJ 1189 (CC)

Authors: Carlos Joel Tchawouo Mbiada

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At the back of the apartheid era, South Africa embarked on a democratic drive of all its institution underpinned by a social justice perspective to eradicate past injustices. These democratic values based on fundamental human rights and equality informed all rights enshrined in the Constitution of the Republic of South Africa, 1996. This means that all rights are therefore infused by social justice perspective and labour rights are no exception. Labour law is therefore regulated to the extent that it is viewed as too rigid. Hence a call for more flexibility to enhance investment and boost job creation. This view articulated by the Free Market Foundation fell on deaf ears as the opponents believe in what is termed regulated flexibility which affords greater protection to vulnerable workers while promoting business opportunities and investment. The question that this paper seeks to examine is to what extent the regulation of labour law will go to protect employees. This question is prompted by the recent Constitutional Court’s judgment of National Union of Metalworkers of South Africa v Trenstar which barred the employer from employing labour replacement in response to the strike action by its employees. The question whether employers may use replacement labour and have recourse to lock-outs in response to strike action is considered in the context of the dichotomy between the Free market foundation and social justice perspectives which are at loggerheads in the South African collective bargaining process. With the current unemployment rate soaring constantly, the aftermath of the Covid 19 pandemic, the effects of the war in Ukraine and lately the financial burden of load shedding on companies to run their businesses, this paper argues for a policy shift toward deregulation or a lesser state and judiciary intervention. This initiative will relieve the burden on companies to run a viable business while at the same time protecting existing jobs.

Keywords: labour law, replacement labour, right to strike, free market foundation perspective, social justice perspective

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75 Queerness and Gender Representation Through the Lens of Five Ghanaian Artists

Authors: Sela Adjei

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This research delves into the nuanced representations of queerness in Ghana, presented through photographs, illustrations, film and music videos on social media and streaming platforms. The study focuses on the works of five Ghanaian artists (Va-Bene Elikem Fiatsi, Angel Maxine, Josephine Kuuire, Bright Ackwerh and Philip Nee Whang) within the context of Ghana's evolving media landscape. Of primary concern is a need to uncover the various aspects of queerness captured within the distinct artistic expressions of these five creatives. This study adopts a qualitative approach by analyzing artistic expressions of queerness in Ghana’s digital media spaces. Content analysis and visual semiotics served as the guiding tools to discuss and decipher the nuanced messages embedded in their works, considering both the visual and narrative aspects. This dual approach takes into account both the visual aesthetics and narrative elements, enhancing our understanding of the complex interplay between queerness and gender representation in the media. This study's contribution is twofold. First, it enriches the discourse surrounding queerness as portrayed by artists within Ghana's vibrant media landscape and situates their works within the broader discourse of global gender identities. Secondly, analyzing the creative output of these five Ghanaian artists broadens our understanding of gender minorities and the various challenges they face in Ghana (currently debating in parliament to pass an anti-LGBTQ+ bill that criminalizes activities related to gender minority groups). While focusing on the intersection of queerness, art, and gender identities, the reflections in this study challenge existing narratives and offer fresh insights into how these artists navigate and challenge societal norms through their creative expressions.

Keywords: queer, film, representation, streaming, media, gender

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74 Optimization of Sodium Lauryl Surfactant Concentration for Nanoparticle Production

Authors: Oluwatoyin Joseph Gbadeyan, Sarp Adali, Bright Glen, Bruce Sithole

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Sodium lauryl surfactant concentration optimization, for nanoparticle production, provided the platform for advanced research studies. Different concentrations (0.05 %, 0.1 %, and 0.2 %) of sodium lauryl surfactant was added to snail shells powder during milling processes for producing CaCO3 at smaller particle size. Epoxy nanocomposites prepared at filler content 2 wt.% synthesized with different volumes of sodium lauryl surfactant were fabricated using a conventional resin casting method. Mechanical properties such as tensile strength, stiffness, and hardness of prepared nanocomposites was investigated to determine the effect of sodium lauryl surfactant concentration on nanocomposite properties. It was observed that the loading of the synthesized nano-calcium carbonate improved the mechanical properties of neat epoxy at lower concentrations of sodium lauryl surfactant 0.05 %. Meaningfully, loading of achatina fulica snail shell nanoparticles manufactures, with small concentrations of sodium lauryl surfactant 0.05 %, increased the neat epoxy tensile strength by 26%, stiffness by 55%, and hardness by 38%. Homogeneous dispersion facilitated, by the addition of sodium lauryl surfactant during milling processes, improved mechanical properties. Research evidence suggests that nano-CaCO3, synthesized from achatina fulica snail shell, possesses suitable reinforcement properties that can be used for nanocomposite fabrication. The evidence showed that adding small concentrations of sodium lauryl surfactant 0.05 %, improved dispersion of nanoparticles in polymetrix material that provided mechanical properties improvement.

Keywords: sodium lauryl surfactant, mechanical properties , achatina fulica snail shel, calcium carbonate nanopowder

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73 A Case of Mantle Cell Lymphoma Presenting With GI Symptoms and Noted to Have Extranodal Involvement of the Stomach and Colon on Presentation

Authors: Saba Amreen Syeda, Summaiah Asim, Syeda, Hafsa, Essam Quraishi

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Mantle Cell Lymphoma (MCL) is a relatively uncommon type of lymphoma that comprises approximately 7 percent of non hodgkin's lymphomas (NHL), Classic MCL presents mostly in lymph nodes and occasionally in extranodal sites. About 26 % of MCL is present primarily in the Gastrointestinal tract. While both the upper GI tract and the lower GI tract could be involved, it is rare to present with concurrent upper and lower GI involvement with MCL. We present the case of a 51-year-old Asian Indian male that presented to our clinic with complaints of chronic diarrhea for the last one year, progressively worsening over the past three months. The Patient also reported black stool as well as bright red blood per rectum. Patient reported severe fatigue on minimal exertion. On a physical exam, the patient was noted to have matted lymphadenopathy in the neck. Patient was noted to be anemic with a hemoglobin to be 8 g/dl. Esophagogastroduodenoscopy and colonoscopy was performed. EGD showed a large 4 cm ulcer in the gastric antrum with thick heaped up edges. There was bleeding on contact. Colonoscopy showed a large 35 mm multilobulated polyp in the ascending colon, which was biopsied. The patient was also noted to have nodular proctitis in the mid rectum. This was localized and extended to about 5 cm. This area was biopsied as well. Biopsies from the stomach, colon, as well as the rectum, returned with findings of mantle cell lymphoma on pathology. Lymphoid cells in the biopsy were stained strongly positive for CD 20, cyclin D1, and CD 5. There was the absence of stain for CD 3 and CD 10. The IHC stain for CD 23 was negative. Biopsies from neck LAD were obtained and were also positive for MCL. The patient was referred to oncology for staging and treatment.

Keywords: mantle cell lymphoma, GI bleed, diarrhea, gastric ulcer, colon polyp

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72 Green Initiative and Marketing Approach: Developing a Better Marketing Approach of Green Initiatives by an Apparel Brand

Authors: Vaishali Joshi, Pallav Joshi

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Environment concern has become an important topic and continues to acquire more popularity in the coming scenario. We all are exposed to messages daily, which encourage us to involve in green behavior. Factors such as Global Warming, Climate change are creating a big buzz amongst the people. Realizing this, many firms/companies are adopting the bright way of making profit along with creating a brand image, by going green. These firms/companies persuade consumers to use purchase eco-friendly products for the benefit of the environment and the society. In such scenario, it becomes very essential for such firms/companies to approach the customers in a better way. In other words, we can say that marketing approach plays a crucial role for such firm/companies. Hence in this research study, we have tried to create a marketing approach for the firms/companies for selling the eco-friendly apparels. We have studied the hypothetical apparel brand who has taken a green initiative of making their products eco-friendly. We have named this hypothetical brand as “Go-Green”. By taking this hypothetical brand we have studied about how this brand can achieve better marketing approach. In particular, we have studied the four types of print advertisements of this brand as follows :(i) print advertisement showing only eco-friendly apparel (ii) print advertisement showing eco-friendly apparel labeled with eco-label (iii) print advertisement showing eco-friendly apparel along with information about the benefit of the featured apparel and (iv) print advertisement showing eco-friendly apparel with both eco-label and information about the benefit of the featured apparel. The conclusion of this research suggest that respondents more positively evaluate the print advertisement of eco-friendly apparel labeled with eco-labels and information about the benefit of the featured apparel, compared by other three print advertisement. Moreover, in this research study, we have studied environment knowledge, as the moderating factor affecting the consumer green purchase behavior.

Keywords: eco-friendly apparel, print advertisement, eco-label, environment knowledge

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71 Luminescent Functionalized Graphene Oxide Based Sensitive Detection of Deadly Explosive TNP

Authors: Diptiman Dinda, Shyamal Kumar Saha

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In the 21st century, sensitive and selective detection of trace amounts of explosives has become a serious problem. Generally, nitro compound and its derivatives are being used worldwide to prepare different explosives. Recently, TNP (2, 4, 6 trinitrophenol) is the most commonly used constituent to prepare powerful explosives all over the world. It is even powerful than TNT or RDX. As explosives are electron deficient in nature, it is very difficult to detect one separately from a mixture. Again, due to its tremendous water solubility, detection of TNP in presence of other explosives from water is very challenging. Simple instrumentation, cost-effective, fast and high sensitivity make fluorescence based optical sensing a grand success compared to other techniques. Graphene oxide (GO), with large no of epoxy grps, incorporate localized nonradiative electron-hole centres on its surface to give very weak fluorescence. In this work, GO is functionalized with 2, 6-diamino pyridine to remove those epoxy grps. through SN2 reaction. This makes GO into a bright blue luminescent fluorophore (DAP/rGO) which shows an intense PL spectrum at ∼384 nm when excited at 309 nm wavelength. We have also characterized the material by FTIR, XPS, UV, XRD and Raman measurements. Using this as fluorophore, a large fluorescence quenching (96%) is observed after addition of only 200 µL of 1 mM TNP in water solution. Other nitro explosives give very moderate PL quenching compared to TNP. Such high selectivity is related to the operation of FRET mechanism from fluorophore to TNP during this PL quenching experiment. TCSPC measurement also reveals that the lifetime of DAP/rGO drastically decreases from 3.7 to 1.9 ns after addition of TNP. Our material is also quite sensitive to 125 ppb level of TNP. Finally, we believe that this graphene based luminescent material will emerge a new class of sensing materials to detect trace amounts of explosives from aqueous solution.

Keywords: graphene, functionalization, fluorescence quenching, FRET, nitroexplosive detection

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70 Scientific Investigation for an Ancient Egyptian Polychrome Wooden Stele

Authors: Ahmed Abdrabou, Medhat Abdalla

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The studied stele dates back to Third Intermediate Period (1075-664) B.C in an ancient Egypt. It is made of wood and covered with painted gesso layers. This study aims to use a combination of multi spectral imaging {visible, infrared (IR), Visible-induced infrared luminescence (VIL), Visible-induced ultraviolet luminescence (UVL) and ultraviolet reflected (UVR)}, along with portable x-ray fluorescence in order to map and identify the pigments as well as to provide a deeper understanding of the painting techniques. Moreover; the authors were significantly interested in the identification of wood species. Multispectral imaging acquired in 3 spectral bands, ultraviolet (360-400 nm), visible (400-780 nm) and infrared (780-1100 nm) using (UV Ultraviolet-induced luminescence (UVL), UV Reflected (UVR), Visible (VIS), Visible-induced infrared luminescence (VIL) and Infrared photography. False color images are made by digitally editing the VIS with IR or UV images using Adobe Photoshop. Optical Microscopy (OM), potable X-ray fluorescence spectroscopy (p-XRF) and Fourier Transform Infrared Spectroscopy (FTIR) were used in this study. Mapping and imaging techniques provided useful information about the spatial distribution of pigments, in particular visible-induced luminescence (VIL) which allowed the spatial distribution of Egyptian blue pigment to be mapped and every region containing Egyptian blue, even down to single crystals in some instances, is clearly visible as a bright white area; however complete characterization of the pigments requires the use of p. XRF spectroscopy. Based on the elemental analysis found by P.XRF, we conclude that the artists used mixtures of the basic mineral pigments to achieve a wider palette of hues. Identification of wood species Microscopic identification indicated that the wood used was Sycamore Fig (Ficus sycomorus L.) which is recorded as being native to Egypt and was used to make wooden artifacts since at least the Fifth Dynasty.

Keywords: polychrome wooden stele, multispectral imaging, IR luminescence, Wood identification, Sycamore Fig, p-XRF

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69 Factors Associated with Death during Tuberculosis Treatment of Patients Co-Infected with HIV at a Tertiary Care Setting in Cameroon: An 8-Year Hospital-Based Retrospective Cohort Study (2006-2013)

Authors: A. A. Agbor, Jean Joel R. Bigna, Serges Clotaire Billong, Mathurin Cyrille Tejiokem, Gabriel L. Ekali, Claudia S. Plottel, Jean Jacques N. Noubiap, Hortence Abessolo, Roselyne Toby, Sinata Koulla-Shiro

Abstract:

Background: Contributors to fatal outcomes in patients undergoing tuberculosis (TB) treatment in the setting of HIV co-infection are poorly characterized, especially in sub-Saharan Africa. Our study’s aim was to assess factors associated with death in TB/HIV co-infected patients during the first 6 months their TB treatment. Methods: We conducted a tertiary-care hospital-based retrospective cohort study from January 2006 to December 2013 at the Yaoundé Central Hospital, Cameroon. We reviewed medical records to identify hospitalized co-infected TB/HIV patients aged 15 years and older. Death was defined as any death occurring during TB treatment, as per the World Health Organization’s recommendations. Logistic regression analysis identified factors associated with death. Magnitudes of associations were expressed by adjusted odds ratio (aOR) with 95% confidence interval. A p value < 0.05 was considered statistically significant. Results: The 337 patients enrolled had a mean age of 39.3 (+/- 10.3) years and more (54.3%) were women. TB treatment outcomes included: treatment success in 60.8% (n=205), death in 29.4% (n=99), not evaluated in 5.3% (n=18), loss to follow-up in 5.3% (n=14), and failure in 0.3% (n=1) . After exclusion of patients lost to follow-up and not evaluated, death in TB/HIV co-infected patients during TB treatment was associated with: a TB diagnosis made before national implementation of guidelines regarding initiation of antiretroviral therapy (aOR = 2.50 [1.31-4.78]; p = 0.006), the presence of other AIDS-defining infections (aOR = 2.73 [1.27-5.86]; p = 0.010), non-AIDS comorbidities (aOR = 3.35 [1.37-8.21]; p = 0.008), not receiving co-trimoxazole prophylaxis (aOR = 3.61 [1.71-7.63]; p = 0.001), not receiving antiretroviral therapy (aOR = 2.45 [1.18-5.08]; p = 0.016), and CD4 cell counts < 50 cells/mm3 (aOR = 16.43 [1.05-258.04]; p = 0.047). Conclusions: The success rate of anti-tuberculosis treatment among hospitalized TB/HIV co-infected patients in our setting is low. Mortality in the first 6 months of treatment was high and strongly associated with specific clinical factors including states of greater immunosuppression, highlighting the urgent need for targeted interventions, including provision of anti-retroviral therapy and co-trimoxazole prophylaxis in order to enhance patient outcomes.

Keywords: TB/HIV co-infection, death, treatment outcomes, factors

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