Search results for: evidence weight

Authors: Aishwarya Venkat, Anastasia Marshak, Ryan B. Simpson, Elena N. Naumova

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Livestock ownership is simultaneously linked to improved nutritional status through increased availability of animal-source protein, and increased risk of enteric infections through higher exposure to contaminated water sources. Agrarian and agro-pastoral households, especially those with cattle, goats, and sheep, are highly dependent on seasonally various environmental conditions, which directly impact nutrition and health. This study explores global spatiotemporally explicit evidence regarding the relationship between livestock ownership, enteric infections, and malnutrition. Seasonal and cyclical fluctuations, as well as mediating effects, are further examined to elucidate health and nutrition outcomes of individual and communal livestock ownership. The US Agency for International Development’s Demographic and Health Surveys (DHS) and the United Nations International Children's Emergency Fund’s Multi-Indicator Cluster Surveys (MICS) provide valuable sources of household-level information on anthropometry, asset ownership, and disease outcomes. These data are especially important in data-sparse regions, where surveys may only be conducted in the aftermath of emergencies. Child-level disease history, anthropometry, and household-level asset ownership information have been collected since DHS-V (2003-present) and MICS-III (2005-present). This analysis combines over 15 years of survey data from DHS and MICS to study 2,466,257 children under age five from 82 countries. Subnational (administrative level 1) measures of diarrhea prevalence, mean livestock ownership by type, mean and median anthropometric measures (height for age, weight for age, and weight for height) were investigated. Effects of several environmental, market, community, and household-level determinants were studied. Such covariates included precipitation, temperature, vegetation, the market price of staple cereals and animal source proteins, conflict events, livelihood zones, wealth indices and access to water, sanitation, hygiene, and public health services. Children aged 0 – 6 months, 6 months – 2 years, and 2 – 5 years of age were compared separately. All observations were standardized to interview day of year, and administrative units were harmonized for consistent comparisons over time. Geographically weighted regressions were constructed for each outcome and subnational unit. Preliminary results demonstrate the importance of accounting for seasonality in concurrent assessments of malnutrition and enteric infections. Household assets, including livestock, often determine the intensity of these outcomes. In many regions, livestock ownership affects seasonal fluxes in malnutrition and enteric infections, which are also directly affected by environmental and local factors. Regression analysis demonstrates the spatiotemporal variability in nutrition outcomes due to a variety of causal factors. This analysis presents a synthesis of evidence from global survey data on the interrelationship between enteric infections, malnutrition, and livestock. These results provide a starting point for locally appropriate interventions designed to address this nexus in a timely manner and simultaneously improve health, nutrition, and livelihoods.

Keywords: diarrhea, enteric infections, households, livestock, malnutrition, seasonality

Procedia PDF Downloads 98

Authors: Balwinder Singh, Veerpaul Kaur Mann

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A composite material is formed by the combination of two or more phases or materials. Natural minerals-derived Basalt fiber is a kind of fiber being introduced in the polymer composite industry due to its good mechanical properties similar to synthetic fibers and low cost, environment friendly. Also, there is a rising trend towards the use of industrial wastes as fillers in polymer composites with the aim of improving the properties of the composites. The mechanical properties of the fiber-reinforced polymer composites are influenced by various factors like fiber length, fiber weight %, filler weight %, filler size, etc. Thus, a detailed study has been done on the characterization of short-chopped Basalt fiber-reinforced polymer matrix composites using fly ash as filler. Taguchi’s L9 orthogonal array has been used to develop the composites by considering fiber length (6, 9 and 12 mm), fiber weight % (25, 30 and 35 %) and filler weight % (0, 5 and 10%) as input parameters with their respective levels and a thorough analysis on the mechanical characteristics (tensile strength and impact strength) has been done using ANOVA analysis with the help of MINITAB14 software. The investigation revealed that fiber weight is the most significant parameter affecting tensile strength, followed by fiber length and fiber weight %, respectively, while impact characterization showed that fiber length is the most significant factor, followed by fly ash weight, respectively. Introduction of fly ash proved to be beneficial in both the characterization with enhanced values upto 5% fly ash weight. The present study on the natural fibres reinforced epoxy composites using fly ash as filler material to study the effect of input parameters on the tensile strength in order to maximize tensile strength of the composites. Fabrication of composites based on Taguchi L9 orthogonal array design of experiments by using three factors fibre type, fibre weight % and fly ash % with three levels of each factor. The Optimization of composition of natural fibre reinforces composites using ANOVA for obtaining maximum tensile strength on fabricated composites revealed that the natural fibres along with fly ash can be successfully used with epoxy resin to prepare polymer matrix composites with good mechanical properties. Paddy- Paddy fibre gives high elasticity to the fibre composite due to presence of approximately hexagonal structure of cellulose present in paddy fibre. Coir- Coir fibre gives less tensile strength than paddy fibre as Coir fibre is brittle in nature when it pulls breakage occurs showing less tensile strength. Banana- Banana fibre has the least tensile strength in comparison to the paddy & coir fibre due to less cellulose content. Higher fibre weight leads to reduction in tensile strength due to increased nuclei of air pockets. Increasing fly ash content reduces tensile strength due to nonbonding of fly ash particles with natural fibre. Fly ash is also not very strong as compared to the epoxy resin leading to reduction in tensile strength.

Keywords: tensile strength and epoxy resin. basalt Fiber, taguchi, polymer matrix, natural fiber

Procedia PDF Downloads 18

Authors: Amir Doustgani

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Melt electrospinning is a safe and simple technique for the production of micro and nanofibers which can be an alternative to conventional solvent electrospinning. The effects of various melt-electrospinning parameters, including molecular weight, electric field strength, flow rate and temperature on the morphology and fiber diameter of polylactic acid were studied. It was shown that molecular weight was the predominant factor in determining the obtainable fiber diameter of the collected fibers. An orthogonal design was used to examine process parameters. Results showed that molecular weight is the most effective parameter on the average fiber diameter of melt electrospun PLA nanofibers and the flow rate has the less important impact. Mean fiber diameter increased by increasing MW and flow rate, but decreased by increasing electric field strength and temperature. MFD of optimized fibers was below 100 nm and the result of software was in good agreement with the experimental condition.

Keywords: fiber formation, processing, spinning, melt blowing

Procedia PDF Downloads 414

Authors: C. C. Okafor, T. M. Ezeh

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The effect of addition of sweet potato leaves in replacement of wheat offal in the production of broiler chicks feed was studied. 72 day-old marshal strain chicks were used and brooded for two weeks with a normal commercial feed in Nigeria called top feed and weighed separately at the end of the two weeks, complete randomized design (CRD) was used. The weighed broiler chicks were randomly allocated to four dietary treatments. Each treatment was replicated to twice with eighteen birds per replicate. The four dietary treatment identified as T1, T2, T3 and T4. T1 served as control diet with 21% crude protein content, while T2 was prepared with Enzyme and in T3 and T4, wheat offal was replaced with sweet potato leaves and in T4 with inclusion of enzyme. Growth performance was studied using the following daily feed intake, daily weight gain and feed efficiency. The result in daily weight gain showed that chicks fed with T2 feed had the highest weight gain (93.75) while chicks fed with T3 had the least weight gain of (34.5 gm). In daily feed intake chicks fed with T4 fed more (53.06 gm) than chicks fed with T2 (51.08 gm). In feed efficiency T3 had the highest value of 30% while the T2 had the least efficiency of 22%. There was no significant difference (P≥ 0.05) in all the three parameter tested. Sweet potato leaves can replace wheat offal in broiler feed production without any adverse effect on the growth performance.

Keywords: broiler, diet, dietary, potato leaves, wheat offal

Procedia PDF Downloads 475

Authors: K. N. Ashna

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Lightweight fills are a viable alternative where weak soils such as soft clay, peat, and loose silt are encountered. Materials such as Expanded Polystyrene (EPS) geo-foam, plastics, tire wastes, rubber wastes have been used along with soil in order to obtain a lightweight fill. Out of these, Expanded Polystyrene (EPS) geo-foam has gained wide popularity in civil engineering over the past years due to its wide variety of applications. It is extremely lightweight, durable and is available in various densities to meet the strength requirements. It can be used as backfill behind retaining walls to reduce lateral load, as a fill over soft clay or weak soils to prevent the excessive settlements and to reduce seismic forces. Geo-foam is available in block form as well as beads form. In this project Expanded Polystyrene (EPS) beads of various diameters and varying densities were mixed along with sand to study their lightweight as well as strength properties. Four types of EPS beads were used 1mm, 2mm, 3-7 mm and a mix of 1-7 mm. In this project, EPS beads were varied at .25%, .5%, .75% and 1% by weight of sand. A water content of 10% by weight of sand was added to prevent segregation of the mixture. Unconsolidated Unconfined (UU) tri-axial test was conducted at 100kPa, 200 kPa and 300 kPa and angle of internal friction, and cohesion was obtained. Unit weight of the mix was obtained for a relative density of 65%. The results showed that by increasing the EPS content by weight, maximum deviator stress, unit weight, angle of internal friction and initial elastic modulus decreased. An optimum EPS bead content was arrived at by considering the strength as well as the unit weight. The stress-strain behaviour of the mix was found to be dependent on type of bead, bead content and density of the beads. Finally, regression equations were developed to predict the initial elastic modulus of the mix.

Keywords: expanded polystyrene beads, geofoam, lightweight fills, stress-strain behavior, triaxial test

Procedia PDF Downloads 233

Authors: Daria Druzhinenko- Silhan, Patrick Schmoll

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Childhood obesity is one of the important problem in domain of health care. During two recent decades we are observing a real epidemic of this noninfectious illness. Its consequences are hard: cardio-vascular disease; diabetes; arthrosis etc. (OMS, 2012) Keep Healthy Kids  » study aims to create a new system of accompanying of childhood obesity based on new technologies as mobile applications or serious video-games. We realize a support-study which aims to understand motivations, psychological dynamite and family's impact on weight-loss process in childhood. Sample: 65 children from 7 to 10 years old accompanied by special Care Center in France. Methodology: we proceed by an innovative approach that bases on quantitative and qualitative methods of data collection. We focus our proposal on data collected from medical files. We are also realizing individual assessment (still ongoing) that aims to understand psychological profiles of obese children and their family dynamic. Results: Only 16,9% of children asked for medical accompanying of obesity. We noted that the most important reason to come to the care Center was the fact of mates' scoffs (46,2%°), the second one was the appearance or look (40 %). We found out that the self-image of these children in self-evaluation questionnaire was described mostly as rather good (46,2) or good (28,2%); the most part of children evaluated their well-being as rather good (29,7%) or good (51,4%). In interviews children had tendency to not recall why they came to the Care Center. Discussion : These results permit us to make a hypothesis that children suffering of overweight or obesity are not clearly aware why they must loose weight. It was rather the peer environment that pointed out the problem of overweight for them. So the motivation to loose weight is mostly supported by environment. We suppose that it is a « weak-point » of their motivation and it can be over-come using serious video-games supporting physical activity that can make deviate the motivation from « to loose weight for be looked better by the others » into « have fun and feeling me better ».

Keywords: childhood obesity, motivation, weight-loss, serious video-game

Procedia PDF Downloads 282

Authors: Amina Bouzitouna, Kheireddine Ouali, Sandra Amri, Houria Rahmoun, Mourad Bensouilah

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Aim of this study: To evaluate the effect of Cisthanche tinctoria treatment on maternal-fetal outcome and antioxidant systems of streptozotocin-induced diabetic rats. Materials and methods: Virgin female Wistar rats were injected with 50 mg/kg streptozotocin before mating. Oral administration of an methanolic extract of Cistanche tinctoria was given to non-diabetic and diabetic pregnant rats at doses of 200 mg/kg from 0 to 19th day of pregnancy. At day 20 of pregnancy the rats were killed and a maternal blood sample was collected for the determination Vitamin C (Vit C) and malonaldehyde (MDA). The gravid uterus was weighed with its contents and fetuses were analyzed. Results and conclusion: The data showed that the diabetic dams presented an increased glycemic level, resorption, placental weight, placental index, and fetal anomalies, and reduced VIT C and MDA determinations, live fetuses, maternal weight gain, gravid uterine weight, and fetal weight. It was also verified that Cisthanche tictoria treatment had no hypoglycemic effect, did not improve maternal outcomes in diabetic rats, but it contributed to maintain GSH concentration similarly to non-diabetic groups, suggesting relation with the decreased incidence of visceral anomalies.

Keywords: cistanche tinctoria, diabetes, pregnancy, reproductive outcome, anomaly, orobanchacées

Procedia PDF Downloads 421

Authors: A. O Amosu, A. M Hammed, G. W. Maneveldt, D. V. Robertson-Andersson

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In aquaculture, feed utilization is an important factor affecting growth of the target species, and thus the success of the aquaculture operation. Growth of C. gariepinus fingerlings (weight 1.60 ± 0.05 g; length 4.50 ± 0.07cm) was monitored in a closed door hatchery for a period of 21 days in an experiment consisting of 4 treatments stocked at 20 fish/10 litre tanks, fed in triplicate twice daily (08:30, 17:30) at 4% body weight with weight changes recorded every 3 days. Treatments were: 1) FeedX; 2) 35% crude protein diet + non enriched Ulva spp (11.18% crude protein) (CD + NEU); 3) 35% crude protein diet + enriched Ulva spp (11.98% crude protein)(CD +EU) and 4) control diet of 35% crude protein (CD). The production of Ulva spp. biomass was cultivated for a period of 3 months. The result shows that the fish fed macroalgal enriched diet had good growth, though no significant difference (p > 0.05) was recorded amongst the weight gain, %weight gain, specific growth rates and nitrogen metabolism of diets CD + NEU, CD + EU and CD. Significant differences (p < 0.05), were, however, found in the food conversion ratio (FCR) and gross food conversion ratio (gFCR) among the fingerlings across all the different experimental diets. The best FCRs were recorded for control diet (0.79 ± 2.39) and the Ulva enriched (1.75 ± 1.34) diets. The results suggest that the fingerlings were able to utilize Ulva supplemented with control diet better than the FeedX. We have shown that Ulva supplemented diets are good substitutes for formulated and commercial feeds, with potential to be successful fish feed in aquaculture systems.

Keywords: aquaculture, clarias gariepinus, growth, macroalgae, nutrient, ulva

Procedia PDF Downloads 669

Authors: Mohamed Radwan

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Introduction: Polycystic ovary syndrome is becoming very common among girls from ages 14 to 21 years old, alongside women in their childbearing period. A combination of menstrual irregularities, overweight or obesity, insulin resistance (type 2 diabetes), and symptoms of virilization are characteristics of these cases. Background: A multidisciplinary team should be involved in managing these cases and may consist of A gynecologist, endocrinologist, nutritionist, and psychologist. The role of nutritionists is crucial in these cases in weight reduction and nutritional management. It is mandatory to present some questions that may help in expanding further our understanding of the nutritional management of this syndrome, such as it is not an easy process to reduce the weight of PCO patients (2) we need to know what suitable nutritional plans for these cases are. Methodology: It is not successful to use one diet plan for all patients or a specific plan, but we need to give tailored plans for each patient. We will summarize the medical, nutritional therapy and weight management in polycystic ovary patients and highlight the best eating plan and dietary composition in the treatment of these women. We will also discuss the role of dieticians in treating polycystic ovary cases and overcoming the challenges these women face. Conclusion: All diet plans would decrease the weight of Polycystic ovary cases as low calory diet, low glycemic index diet, high protein diet, as well as Dash diet, but the most suitable diet plan to improve hormones and lead to spontaneous pregnancy is the Mediterranean diet.

Keywords: obesity, PCO mediteranian diet, dash diet, high protein diet

Procedia PDF Downloads 36

Authors: Eduardo Remirez, Luis Moreno

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The rapid growth of the private satellite launchers sector is leading the space race. Hence, with the privatization of the sector, all the companies are racing for a more efficient and reliant way to set satellites in orbit. Having detected the current needs for power management in the launcher vehicle industry, the Modular Power Bus is proposed as a technology to revolutionize power management in current and future Launcher Vehicles. The MPBus Project is committed to develop a new power bus architecture combining ejectable batteries with the main bus through intelligent nodes. These nodes are able to communicate between them and a battery controller using an improved, data over DC line technology, expected to reduce the total weight in two main areas: improving the use of the batteries and reducing the total weight due to harness. This would result in less weight for each launch stage increasing the operational satellite payload and reducing cost. These features make the system suitable for a number of launchers.

Keywords: modular power bus, Launcher vehicles, ejectable batteries, intelligent nodes

Procedia PDF Downloads 445

Authors: Thomas P. Jones

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Overview: Drowning is an important cause of accidental death, particularly in children and young people. Although many survive drowning incidents, it is a relatively rare presenting complaint in Emergency Departments. When cases do present, they can be complex and unpredictable. For patients to receive the best care, it is important that their management is standardized and evidence based, however this can be difficult in a topic area with limited studies and inconsistencies in case reporting. Objectives: To review recent cases to assess the performance of Manchester Royal Infirmary Emergency Department in the management of near drowning. To produce evidence based guideline on the management of drowning victims in the ED. Methods: Emergency department records were searched for patients with the diagnosis of ‘fatal drowning’ or ‘nearly drowning’ and two relevant case notes reviewed. To produce the guideline a literature review was conducted and a series of structured short cut systematic reviews known as Best BETs carried out. This information was used to produce a clear treatment pathway. Results: The case studies emphasized the variety in presentation of drowning victims whilst highlighting inconsistencies in management and documentation. An evidence-based guideline is presented as a flowchart, which illustrates the relevant investigations and treatment that victims of a drowning incident should receive, based on the best available evidence. Conclusion: It is hoped that when put into practice, the guideline will improve and standardize patient care in cases of near drowning. An audit is recommended to assess its effectiveness.

Keywords: drowning, near drowning, non fatal drowning, fatal drowning

Procedia PDF Downloads 184

Authors: T. Arkle, D. Pournaras, S. Lam, B. Kumar

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Introduction: Fundoplication is widely recognised as the best surgical option for gastro-oesophageal reflux disease (GORD) in the general population. However, there is controversy surrounding the use of conventional fundoplication in obese patients. Whilst the intra-operative failure of fundoplication, including wrap disruption, is reportedly higher in obese individuals, the more significant issue surrounds symptom recurrence post-surgery. Could a bariatric procedure be considered in obese patients for weight management, to treat the GORD, and to also reduce the risk of recurrence? Roux-en-Y gastric bypass, a widely performed bariatric procedure, has been shown to be highly successful both in controlling GORD symptoms and in weight management in obese patients. Furthermore, NICE has published clear guidelines on eligibility for bariatric surgery, with the main criteria being type 3 obesity or type 2 obesity with the presence of significant co-morbidities that would improve with weight loss. This study aims to identify the proportion of patients who undergo conventional fundoplication for GORD and/or hiatus hernia, which would have been eligible for bariatric surgery referral according to NICE guidelines. Methods: All patients who underwent fundoplication procedures for GORD and/or hiatus hernia repair at a single NHS foundation trust over a 10-year period will be identified using the Trust’s health records database. Pre-operative patient records will be used to find BMI and the presence of significant co-morbidities at the time of consideration for surgery. This information will be compared to NICE guidelines to determine potential eligibility for the bariatric surgical referral at the time of initial surgical intervention. Results: A total of 321 patients underwent fundoplication procedures between January 2011 and December 2020; 133 (41.4%) had available data for BMI or to allow BMI to be estimated. Of those 133, 40 patients (30%) had a BMI greater than 30kg/m², and 7 (5.3%) had BMI >35kg/m². One patient (0.75%) had a BMI >40 and would therefore be automatically eligible according to NICE guidelines. 4 further patients had significant co-morbidities, such as hypertension and osteoarthritis, which likely be improved by weight management surgery and therefore also indicated eligibility for referral. Overall, 3.75% (5/133) of patients undergoing conventional fundoplication procedures would have been eligible for bariatric surgical referral, these patients were all female, and the average age was 60.4 years. Conclusions: Based on this Trust’s experience, around 4% of obese patients undergoing fundoplication would have been eligible for bariatric surgical intervention. Based on current evidence, in class 2/3 obese patients, there is likely to have been a notable proportion with recurrent disease, potentially requiring further intervention. These patient’s may have benefitted more through undergoing bariatric surgery, for example a Roux-en-Y gastric bypass, addressing both their obesity and GORD. Use of patient written notes to obtain BMI data for the 188 patients with missing BMI data and further analysis to determine outcomes following fundoplication in all patients, assessing for incidence of recurrent disease, will be undertaken to strengthen conclusions.

Keywords: bariatric surgery, GORD, Nissen fundoplication, nice guidelines

Procedia PDF Downloads 37

Authors: Yu Zhang, Kohei Inoue, Kiichi Urahama

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We propose a simplified bilateral filter with binarized coefficients for accelerating it. Its computational cost is further decreased by sampling pixels. This computationally low cost filter is useful for smoothing or denoising images by using mobile devices with limited computational power.

Keywords: bilateral filter, binarized-weight bilateral filter, image smoothing, image denoising, pixel sampling

Procedia PDF Downloads 447

Authors: Farhad Farahvash, Parya Mobaseri

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Weeds control based on their critical period leads to less production costs and risks of wide chemical application of weeds control methods. The present study considered effect of weeds control time (weeds interference after 20, 40 and 60 days, weeds full control, weeds interference and weeds control after 20, 40 and 60 days) on growth and yield of forage maize 454. The experiment based on full-randomized blocks design with three replications was conducted at research farm of Islamic Azad University of Tabriz located at 15th km of East Tabriz in 2013. According to the results, weeds interference after 40 and 60 days as well as weeds control after 20 days prevented from decrease of maize biomass resulted from weeds presence while weeds interference after 20 days, weeds interference and weeds control after 40 and 60 days led respectively to 41.2%, 35%, 25% and 32.5% decrease of forage maize biomass. The weeds-influenced decrease was manifested at different parts of the plant depending on presence period of weeds. Decrease of fresh weight of ear and fresh weight of leaf and stem was observed due to weeds interference after 20 days and weeds interference. If weeds are controlled after 60 days, decrease of ear weight and fresh weight of stem will lead to biomass decrease. Also, if weeds are controlled after 40 days, decrease of fresh weight of maize stems will result in biomass decrease. Ear traits were affected by weeds control treatment. Being affected by treatments of weeds interference after 20 days, weeds non-interference, weeds control after 40 and 60 days, ear length was shortened 29.9 %, 41.4 %, 27.6 % and 37.2 %, respectively. The stem diameter demonstrated a significant decrease although it was only affected by treatments of weeds interference and weeds control after 60 days. Considering results of the present study, generally, it is suggested to control weeds during initial 20-60 days of maize growth in order to prevent undesirable effect of weeds on growth, production and production biomass of maize and decrease of production costs.

Keywords: maize, competition, weed, biomass

Procedia PDF Downloads 334

Authors: Maria L. G. Lourenço, Keylla H. N. P. Pereira, Viviane Y. Hibaru, Fabiana F. Souza, Joao C. P. Ferreira, Simone B. Chiacchio, Luiz H. A. Machado

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Anasarca is generalized congenital edema that is often lethal. The condition is transmitted hereditarily and is autosomal dominant, with a racial predisposition in French Bulldogs and English Bulldogs. This study aims at reporting a case of anasarca treatment in neonates. The fetuses of a one year and six months old, primiparous English Bulldog mother were diagnosed with anasarca during an ultrasound examination performed at the 55th day of pregnancy and, therefore, an elective cesarean section was scheduled to prevent fetal dystocia. At birth, all puppies presented anasarca, and one of the six was stillborn. The newborns presented cyanosis, dyspnea, bradycardia, absent reflexes, low vitality scores (3/10), and hypothermia ( < 32ºC). The weight of the puppies at the time of birth varied between 347 and 373 grams, about 100 grams above the average weight estimated for the breed. Immediate neonatal care was applied with oxygen therapy via a mask, aminophylline (0.2 ml/100 g/PV/sublingual), and slow heating. After 10 minutes, there was a significant improvement in the neonatal parameters. The anasarca was treated with the drug furosemide, administered subcutaneously, at a dose of 0.2 mg per 100 grams of weight, every three hours. The stimulation for urination of newborns was performed every 30 minutes, and weight loss was monitored every 30 minutes. Five grams of potassium chloride were administered orally for every 30 grams of weight loss to counterbalance the loss of potassium caused by the diuretic medication. After 15 hours, the neonates reached the ideal weight for the breed, around 209 to 230 grams. In total, four neonates received five doses of furosemide, while one received six doses. The puppies are currently ten months old, healthy and neutered. Anasarca should not be ignored and is considered potentially lethal and an indication for euthanasia in all cases. Early intervention is of utmost importance for the survival of these patients.

Keywords: Walrus syndrome, congenital edema, water puppy syndrome, puppies

Procedia PDF Downloads 144

Authors: Victor U. Odoemelam, Ihemdirim C. Unamba-Opara, Martins C. Anyanwuocha

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Antibiotics used as growth promoters in animal feeds have been criticized and banned in many nations due to possible development of both drug resistance, cross resistance and multiple resistances by consumers. Numerous additives are now being used or proposed as alternatives. A study to compare the effects of Ocimum gratissimum (Scent leaf) and antibiotic growth promoter (Oxytetracycline HCl) on growth performance and intestinal morphology of starter broiler birds was conducted using ninety six (96) days old broiler birds. The birds were randomly assigned to four treatments with each treatment comprising 24 birds replicated three times with 8 birds per replicate in a completely randomized design experiment. Four diets (T1 control diet without Oxytetracycline HCl and Ocimum gratissimum; T2 had Oxytetracycline HCl; T3 had 1% Ocimum gratissimum; T4 had 1.5% Ocimum gratissimum) were formulated and offered ad libitum to the respective birds. Data was collected on feed intake, body weight gain and feed conversion ratio (FCR) also Jejenal sections of the intestine were collected for examination of Villi length and Crypt depth at the end of starter phase. Results show that there were no significant difference (P>0.05) observed in feed intake and final body weight. However, feed conversion ratio (FCR) and daily weight gain significantly differed (P<0.05). T1, T2, and T4 were similar, however T2 differed (P<0.05) from T3. FCR followed the same pattern. Dietary treatment significantly (P<0.05) affected Villi length, Crypt depth and Villi length/crypt depth ratio. Birds fed OG containing diets, had significantly higher (P<0.05) villi length/crypt depth ratio. However, this did not translate to a significantly higher body weight gain or feed conversion ratio. It can be concluded that O. gratissimum can replace antibiotic growth promoter (Oxytetracycline HCl) since their effect on performance were similar.

Keywords: antibiotics, body weight, feed additives, intestinal morphology, phytogenics

Procedia PDF Downloads 511

Authors: Claire B. Salvedia, Enrico P. Supangco, Francisco B. Eligado, Renato Sa Vega, Antonio A. Rayos

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The study was conducted to evaluate the effect of probiotic feeding on weight gain, blood biochemical and hematological indices of crossbred dairy goat kids. Sixteen (16) crossbred Anglo-Nubian x Saanen dairy goat kids, 3 to 4 months old, ranging from 19 to 23kg were randomly assigned into four treatments fed with 5x109 cfu/ml probiotic supplements; Treatment 1 – control; Treatment 2 – lactic acid bacteria (L. plantarum BS and P. acidilactici 3G3); treatment 3 – S. cerevisiae 2030; Treatment 4 – multi-strain probiotics (L. plantarum BS, P. acidilactici 3G3, and S.cerevisiae 2030). Feed ration provided daily for each of the experimental animals were composed of 1kg mixed concentrate feed ((Leucaena leucocephala dried leaves and pollard), and 4 kg fresh Pennisetum purpureum and Gliciridia sepium leaves (50:50). The experimental feeding trial lasted for 9 weeks. Result revealed that treatments fed with probiotics had significantly (P≤0.05) higher weight gain compared to the control. Significant effect on plasma urea nitrogen (PUN) and triglyceride were noted during 30th and 60th day of probiotic feeding. White blood cell counts were significantly affected by probiotic feeding during the 60th day. Concentrations of glucose and cholesterol remained unchanged throughout the experimental period. The findings suggests, under the condition of the experiment, that live probiotic feeding could have a significant role in improving weight gain and metabolism of crossbred dairy goat kids.

Keywords: probiotics, weight gain, blood biochemical indices, crossbred dairy goat kids

Procedia PDF Downloads 451

Authors: Nurzaki Ikhsan, Ahmad Saifizul Abdullah, Rahizar Ramli

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One of the functions of the commercial heavy vehicle is to safely and efficiently transport goods and people. Due to its size and carrying capacity, it is important to study the vehicle dynamic stability during cornering. Study has shown that there are a number of overloaded heavy vehicles or permissible gross vehicle weight (GVW) violations recorded at selected areas in Malaysia assigned by its type and category. Thus, the objective of this study is to investigate the correlation and effect of the GVW on heavy vehicle stability during cornering event using simulation. Various selected heavy vehicle types and category are simulated using IPG/Truck Maker® with different GVW and road condition (coefficient of friction of road surface), while the speed, driver characteristic, center of gravity of load and road geometry are constant. Based on the analysis, the relationship between GVW and lateral acceleration were established. As expected, on the same value of coefficient of friction, the maximum lateral acceleration would be increased as the GVW increases.

Keywords: heavy vehicle, road safety, vehicle stability, lateral acceleration, gross vehicle weight

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Authors: S. Fazelifar, M. Ghasemi

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Aim: Recent studies on cardiovascular risk factors have been focused on the new markers of inflammatory diseases such as C-reactive protein (CRP). Research evidence shows that physical activity along with other factors such as reduced smoking, controlling blood pressure, control blood lipids TC, LDL-c, HDL-c and having a healthy weight can reduce the risk of chronic heart disease (CHD) .Therefore, the aim of this study was to determine the effect of twelve weeks aerobic exercise and consumption of apple vinegar on cardiovascular risk factor in older women. Methodology: 28 inactive women (mean body weight 72.13 ± 8.6 kg, height 157 ± 7.4cm, age 48.06 ± 5.18 years and BMI 28.2 ± 3.2 kg/m2) by recall and notice of investigation, among of the eligible voters recruited and randomly divided in 4 groups: control, apple vinegar, exercise, exercise + apple vinegar. The training program includes a 20-minute warm-up and stretching, running for 15 minutes in the first session with an intensity of 80% of maximum heart rate and an increase in one-minute run time in next training session. Also, subjects in experimental groups received daily specified amount of 50 ml apple vinegar. Blood samples were collected from the brachial vein in before and after training to measure CRP and blood lipids (cholesterol, HDL, VLDL, LDL). The levels of CRP were measured by ELISA way. K-S test to determine the normality of the data and analysis of variance for repeated measures was used to analyze the data. A significant difference in the p < 0/05 accepted. Results: The results indicated that individual characteristics including height, weight, age, and body mass index were not significantly different among the four groups. The results showed that levels of CRP and LDL cholesterol were significantly reduced in all groups at post-test compared to the pre-test. The HDL levels increased significantly in all groups in post-test compared to the pre-test. Analysis of the data indicates that levels of CRP, TC, and LDL were significantly reduced in all groups compared to the control group, while the changes in the other groups were not significant relative to each other. Conclusion: Results of this study showed that twelve weeks of aerobic exercise with apple vinegar cause a significant decrease in CRP, cholesterol, LDL, and significantly increased HDL levels. According to the results of this study, it is possible that aerobic exercise with apple vinegar can inhibit CRP and undesirable fats. Considering the strong association between the inflammatory indices and the prevalence of cardiovascular diseases, every factor that decreases these indices can reduce the cardiovascular complications.

Keywords: aerobic exercise, apple vinegar, CRP, older women

Procedia PDF Downloads 424

Authors: Armin Najipour, A. M. Fattahi

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The aim of this research was to investigate the effect of the addition of multi walled carbon nanotubes on the mechanical properties of polyethylene/carbon nanotube nanocomposites. To do so, polyethylene and carbon nanotube were mixed in different weight percentages containing 0, 0.5, 1, and 1.5% carbon nanotube in two screw extruder apparatus by fusion. Then the nanocomposite samples were molded in injection apparatus according to ASTM:D638 standard. The effects of carbon nanotube addition in 4 different levels on the tensile strength, elastic modulus and elongation of the nanocomposite samples were investigated. The results showed that the addition of carbon nanotube had a significant effect on improving tensile strength of the nanocomposite samples such that by adding 1% w/w carbon nanotube, the tensile strength 23.4%,elastic modulus 60.4%and elongation 29.7% of the samples improved. Also, according to the results, Manera approximation model at percentages about 0.5% weight and modified Halpin-Tsai at percentages about 1% weight lead to favorite and reliable results.

Keywords: carbon nanotube, injection molding, Mechanical properties, Nanocomposite, polyethylene

Procedia PDF Downloads 234

Authors: Fentie Bishaw Wagayie

Abstract:

This study was carried out with the objective of studying the response of Farta sheep in feed intake and live weight change when fed on hay supplemented with noug seed cake (NSC), wheat bran (WB), and their mixtures. The digestibility trial of 7 days and 90 days of feeding trial was conducted using 25 intact male Farta sheep with a mean initial live weight of 16.83 ± 0.169 kg. The experimental animals were arranged randomly into five blocks based on the initial live weight, and the five treatments were assigned randomly to each animal in a block. Five dietary treatments used in the experiment comprised of grass hay fed ad libitum (T1), grass hay ad libitum + 300 g DM WB (T2), grass hay ad libitum + 300 g DM (67% WB: 33% NSC mixture) (T3), grass hay ad libitum + 300 g DM (67% NSC: 33% WB) (T4) and 300 g DM/ head/day NSC (T5). Common salt and water were offered ad libitum. The supplements were offered twice daily at 0800 and 1600 hours. The experimental sheep were kept in individual pens. Supplementation of NSC, WB, and their mixtures significantly increased (p < 0.01) the total dry matter (DM) (665.84-788 g/head/day) and (p < 0.001) crude protein (CP) intake. Unsupplemented sheep consumed significantly higher (p < 0.01) grass hay DM (540.5g/head/day) as compared to the supplemented treatments (365.8-488 g/h/d), except T2. Among supplemented sheep, T5 had significantly higher (p < 0.001) CP intake (99.98 g/head/day) than the others (85.52-90.2 g/head/day). Supplementation significantly improved (p < 0.001) the digestibility of CP (66.61-78.9%), but there was no significant effect (p > 0.05) on DM, OM, NDF, and ADF digestibility between supplemented and control treatments. Very low CP digestibility (11.55%) observed in the basal diet (grass hay) used in this study indicated that feeding sole grass hay could not provide nutrients even for the maintenance requirement of growing sheep. Significant final and daily live weight gain (p < 0.001) in the range of 70.11-82.44 g/head/day was observed in supplemented Farta sheep, but unsupplemented sheep lost weight by 9.11g/head/day. Numerically, among the supplemented treatments, sheep supplemented with a higher proportion of NSC in T4 (201 NSC + 99 g WB) gained more weight than the rest, though not statistically significant (p > 0.05). The absence of statistical difference in daily body weight gain between all supplemented sheep indicated that the supplementation of NSC, WB, and their mixtures had similar potential to provide nutrients. Generally, supplementation of NSC, WB, and their mixtures to the basal grass hay diet improved feed conversion ratio, total DM intake, CP intake, and CP digestibility, and it also improved the growth performance with a similar trend for all supplemented Farta sheep over the control group. Therefore, from a biological point of view, to attain the required level of slaughter body weight within a short period of the growing program, sheep producer can use all the supplement types depending upon their local availability, but in the order of priority, T4, T5, T3, and T2, respectively. However, based on partial budget analysis, supplementation of 300 g DM/head /day NSC (T5) could be recommended as profitable for producers with no capital limitation, whereas T4 supplementation (201 g NSC + 99 WB DM/day) is recommended when there is capital scarcity.

Keywords: weight gain, supplement, Farta sheep, hay as basal diet

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Authors: Hisham Arab Alkabeya, A. M. Hughes, J. Adams

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Background: People with Rheumatoid Arthritis (RA) continue to experience problems with hand function despite new drug advances and targeted medical treatment. Consequently, it is important to identify the factors that influence the impact of RA disease on hand function. This systematic review identified observational studies that reported factors that influenced the impact of RA on hand function. Methods: MEDLINE, EMBASE, CINAL, AMED, PsychINFO, and Web of Science database were searched from January 1990 up to March 2017. Full-text articles published in English that described factors related to hand functional disability in people with RA were selected following predetermined inclusion and exclusion criteria. Pertinent data were thoroughly extracted and documented using a pre-designed data extraction form by the lead author, and cross-checked by the review team for completion and accuracy. Factors related to hand function were classified under the domains of the International Classification of Functioning, Disability, and Health (ICF) framework and health-related factors. Three reviewers independently assessed the methodological quality of the included articles using the quality of cross-sectional studies (AXIS) tool. Factors related to hand function that was investigated in two or more studies were explored using a best-evidence synthesis. Results: Twenty articles form 19 studies met the inclusion criteria from 1,271 citations; all presented cross-sectional data (five high quality and 15 low quality studies), resulting in at best limited evidence in the best-evidence synthesis. For the factors classified under the ICF domains, the best-evidence synthesis indicates that there was a range of body structure and function factors that were related with hand functional disability. However, key factors were hand strength, disease activity, and pain intensity. Low functional status (physical, emotional and social) level was found to be related with limited hand function. For personal factors, there is limited evidence that gender is not related with hand function; whereas, conflicting evidence was found regarding the relationship between age and hand function. In the domain of environmental factors, there was limited evidence that work activity was not related with hand function. Regarding health-related factors, there was limited evidence that the level of the rheumatoid factor (RF) was not related to hand function. Finally, conflicting evidence was found regarding the relationship between hand function and disease duration and general health status. Conclusion: Studies focused on body structure and function factors, highlighting a lack of investigation into personal and environmental factors when considering the impact of RA on hand function. The level of evidence which exists was limited, but identified that modifiable factors such as grip or pinch strength, disease activity and pain are the most influential factors on hand function in people with RA. The review findings suggest that important personal and environmental factors that impact on hand function in people with RA are not yet considered or reported in clinical research. Well-designed longitudinal, preferably cohort, studies are now needed to better understand the causality between personal and environmental factors and hand functional disability in people with RA.

Keywords: factors, hand function, rheumatoid arthritis, systematic review

Procedia PDF Downloads 121

Authors: N. Choobkar, M. Rezaeimanesh, A. M. Emami Rad, M. Ghaeni, H. Norouzi, S. Pahlavani, M. S. Tamasoki, E. Nezafatian

Abstract:

Antibiotics are used to increase the immune and wound healing in many animals . But due to the residual effects of a drug , researchers sought to replace them with natural materials such as Plant extracts. Falcaria vulgaris is the most attractive sources of the new drugs. Falcaria vulgaris (locally named Ghazzyaghi/Poghazeh) is a member of Umbelliferae family which grows near farmlands and is consumed as a vegetable in some regions of Iran. In the West of the country, in the wound healing and irregularities in the digestive system is also used. There were no scientific reports available in literature in support of the traditional claims of F. vulgaris in fish. The present study is therefore an attempt to assess the efficacy of this indigenous herb for its healing effect in common carp (Cyprinus carpio). Falcaria vulgaris at concentrations of 0, 2 and 10 % with Lophag foods used on wound healing of common carp and immune response, and weight grow and survival during periods of 21 days with feeding 2 times per day on the basis of body weight. The results showed that, compared with the control group, using of concentration 10 % F. vulgaris have significant effect on wound healing and stimulates the immune system by increasing white blood cells (WBC) and weight grow and survival of carp. The herb can used in wound healing, increased resistance to disease and weight grow in fish and the beneficial effects of this combination goes back to man.

Keywords: common carp, falcaria vulgaris, immune response, wound healing

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Authors: Pranjali Sharma, Swati Neogi

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Composite pressure vessels are low weight structures mainly used in a variety of applications such as automobiles, aeronautics and chemical engineering. Fiber reinforced polymer (FRP) composite materials offer the simplicity of design and use, high fuel storage capacity, rapid refueling capability, excellent shelf life, minimal infrastructure impact, high safety due to the inherent strength of the pressure vessel, and little to no development risk. Apart from these preliminary merits, the subsidized weight of composite vessels over metallic cylinders act as the biggest asset to the automotive industry, increasing the fuel efficiency. The result is a lightweight, flexible, non-explosive, and non-fragmenting pressure vessel that can be tailor-made to attune with specific applications. The winding pattern of the composite over-wrap is a primary focus while designing a pressure vessel. The critical stresses in the system depend on the thickness, angle and sequence of the composite layers. The composite over-wrap is wound over a plastic liner, whose geometry can be varied for the ease of winding. In the present study, we aim to optimize the FRP vessel geometry that provides an ease in winding and also aids in weight reduction for enhancing the vessel performance. Finite element analysis is used to study the effect of dome geometry, yielding a design with maximum value of burst pressure and least value of vessel weight. The stress and strain analysis of different dome ends along with the cylindrical portion is carried out in ANSYS 19.2. The failure is predicted using different failure theories like Tsai-Wu theory, Tsai-Hill theory and Maximum stress theory. Corresponding to a given winding sequence, the optimum dome geometry is determined for a fixed internal pressure to identify the theoretical value of burst pressure. Finally, this geometry is used to decrease the number of layers to reach the set value of safety in accordance with the available safety standards. This results in decrease in the weight of the composite over-wrap and manufacturing cost of the pressure vessel. An improvement in the overall weight performance of the pressure vessel gives higher fuel efficiency for its use in automobile applications.

Keywords: Compressed Gas Storage, Dome geometry, Theoretical Analysis, Type-4 Composite Pressure Vessel, Improvement in Vessel Weight Performance

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Authors: Saleh Alagla, Murya Habbash

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The paper investigates whether the board of directors plays a monitoring role or not in CEO compensation for the UK firms during the eve of the recent financial crisis, 2004-2008. The use of heteroscedastic and autocorrelated error consistent estimation of the panel data shows, surprisingly, that four board characteristics variables are found to play a significant role in increasing the level of CEO compensation. This insightful result would suggest evidence of the managerial power theory in general and the cronyism hypothesis in particular. Moreover, the interesting evidence supporting managerial power perspective is that CEO-Chair duality reduces long-term compensation while increasing short-term compensation, thus suggesting that CEOs are risk averse who prefer short-term compensation to long-term compensation. Finally, consistent with the agency perspective board size is found to increase all compensation variables as expected.

Keywords: corporate governance, CEO compensation, board of directors, internal governance mechanisms, agency theory, managerial power theory, cronyism hypothesis

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Authors: Orkide Donma, Mustafa M. Donma

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Chronologic age (CA) of individuals is closely related to obesity and generally affects the magnitude of obesity parameters. On the other hand, close association between basal metabolic rate (BMR) and metabolic age (MA) is also a matter of concern. It is suggested that MA higher than CA is the indicator of the need to improve the metabolic rate. In this study, the aim was to assess some commonly used obesity parameters, such as obesity degree, visceral adiposity, BMR, BMR-to-weight ratio, in several groups with varying differences between MA and CA values. The study comprises adults, whose ages vary between 18 and 79 years. Four groups were constituted. Group 1, 2, 3 and 4 were composed of 55, 33, 76 and 47 adults, respectively. The individuals exhibiting -1, 0 and +1 for their MA-CA values were involved in Group 1, which was considered as the control group. Those, whose MA-CA values varying between -5 and -10 participated in Group 2. Those, whose MAs above their real ages were divided into two groups [Group 3 (MA-CA; from +5 to + 10) and Group 4 (MA-CA; from +11 to + 12)]. Body mass index (BMI) values were calculated. TANITA body composition monitor using bioelectrical impedance analysis technology was used to obtain values for obesity degree, visceral adiposity, BMR and BMR-to-weight ratio. The compiled data were evaluated statistically using a statistical package program; SPSS. Mean ± SD values were determined. Correlation analyses were performed. The statistical significance degree was accepted as p < 0.05. The increase in BMR was positively correlated with obesity degree. MAs and CAs of the groups were 39.9 ± 16.8 vs 39.9 ± 16.7 years for Group 1, 45.0 ± 15.3 vs 51.4 ± 15.7 years for Group 2, 47.2 ± 12.7 vs 40.0 ± 12.7 years for Group 3, and 53.6 ± 14.8 vs 42 ± 14.8 years for Group 4. BMI values of the groups were 24.3 ± 3.6 kg/m², 23.2 ± 1.7 kg/m², 30.3 ± 3.8 kg/m², and 40.1 ± 5.1 kg/m² for Group 1, 2, 3 and 4, respectively. Values obtained for BMR were 1599 ± 328 kcal in Group 1, 1463 ± 198 kcal in Group 2, 1652 ± 350 kcal in Group 3, and 1890 ± 360 kcal in Group 4. A correlation was observed between BMR and MA-CA values in Group 1. No correlation was detected in other groups. On the other hand, statistically significant correlations between MA-CA values and obesity degree, BMI as well as BMR/weight were found in Group 3 and in Group 4. It was concluded that upon consideration of these findings in terms of MA-CA values, BMR-to-weight ratio was found to be much more useful indicator of the severe increase in obesity development than BMR. Also, the lack of associations between MA and BMR as well as BMR-to-weight ratio emphasize the importance of consideration of MA-CA values rather than MA.

Keywords: basal metabolic rate, basal metabolic rate-to-weight-ratio, chronologic age, metabolic age, obesity degree

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Authors: Ting Shen

Abstract:

Whether resource matters to school has been a topic of intense debate since 1960s. Educational researchers and policy makers have been particularly interested in knowing the return or payoff of Per-Pupil Expenditure (PPE) on improving students’ achievement. However, the evidence on the effect of PPE has been mixed and the size of the effect is also unknown. With regard to the methods, it is well-known that meta-analysis study is superior to individual study and it is also preferred to vote counting method in terms of scientifically weighting the evidence by the sample size. This meta-analysis study aims to provide a synthesized evidence on the correlation between PPE and student academic achievement using recent study data from 1990s to 2010s. Meta-analytical approach of fixed- and random-effects models will be utilized in addition to a meta regression with predictors of year, location, region and school type. A preliminary result indicates that by and large there is no statistically significant relationship between per pupil expenditure and student achievement, but location seems to have a mediating effect.

Keywords: per pupil expenditure, student academic achievement, multilevel model, meta-analysis

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Authors: Abbas Al-Refaie

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This paper aims at improving the performance of the tableting process using statistical quality control and fuzzy goal programming. The tableting process was studied. Statistical control tools were used to characterize the existing process for three critical responses including the averages of a tablet’s weight, hardness, and thickness. At initial process factor settings, the estimated process capability index values for the tablet’s averages of weight, hardness, and thickness were 0.58, 3.36, and 0.88, respectively. The L₉ array was utilized to provide experimentation design. Fuzzy goal programming was then employed to find the combination of optimal factor settings. Optimization results showed that the process capability index values for a tablet’s averages of weight, hardness, and thickness were improved to 1.03, 4.42, and 1.42, respectively. Such improvements resulted in significant savings in quality and production costs.

Keywords: fuzzy goal programming, control charts, process capability, tablet optimization

Procedia PDF Downloads 239

Authors: Sohail Ahmed, Ahmad Raza

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Physical properties of maize grains were correlated with levels of the life history of Sitotroga cerealella (Oliv.) (Gelechiidae: Lepidoptera) in no choice test to find out relative resistance in different varieties. Eight maize varieties /lines (EV-6089, Sahiwal-2002, Golden, 34N43, EV-1098, Sultan, China-1, EV-20) including seven yellow and one white were obtained from Maize and Millet Research Institute, Yousaf Wala, Sahiwal, Punjab, Pakistan. Freshly laid eggs (one day old) of S. cerealella were obtained and cultured on a susceptible maize variety for two generations for later on shifting to test varieties. Results showed that maximum moth emergence (10.33), fecundity (35.66), hatching (87.66%), moth weight (5.05 mg), development time (36.0 days) damage (93.35%) and grain weight loss (38.84%) was found in varieties, 34N43 and Golden, Sultan, Sahiwal 2002, 34N43, EV-6089, 34N43 and EV-1089, respectively. Varieties had significant difference with other varieties in these parameters (P<0.05). The varieties had positive as well as negative correlation between hardness index, grain weight and bulk density with the biological parameters of S. cerealella, percent grain damage and weight loss. Possible involvement of these grain properties in the resistance of maize grains towards S. cerealella is discussed.

Keywords: sitotroga cerealella, hardness index, grain damage, maize, varieties

Procedia PDF Downloads 347

Authors: Alan S. Weber

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This contribution reviews the current biomedical and qualitative arts research on arts-in-health interventions to improve both individual and population health outcomes. Arts therapies–for example, music therapy with roots in Aristoxenus’s Ἁρμονικὰ στοιχεῖα and the Pythagorean sect–have long been employed in therapeutic contexts. However, the 20th century witnessed the increasing use of the visual and plastic arts (drawing, painting, sculpting), performing arts (drama and dance), and other expressive arts modalities into occupational therapy, well-being medicine, and psychological and psychiatric counselling, diagnosis, and treatment. A significant body of peer-reviewed evidence in the medical and neurological sciences on the role of arts-in-health has developed, and specifically, research on music and art therapy has led to their inclusion within the current biomedical paradigm of evidence-based practice. The arts cannot only aid in public and population health promotion (promoting healthy behaviors and lifestyles, preventing disease onset) but also in addressing psychological issues (regulation of emotion; stress, anxiety, and depression reduction), behavioural issues (basic life skills, coping), and physiological response (immune system function, hormonal regulation, homeostatis). Working as a cross-disciplinary researcher in the arts in an American medical college, the author has developed several successful arts-in-health programs at the national and international level.

Keywords: arts-in-health, evidence based medicine, arts for health, expressive arts therapies

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