Search results for: infant formula shortage

Authors: Claudia Carbajal, Jija Dutt, Smriti Pahwa, Sumukhi Vaid, Karishma Vats

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ASER Centre, the research and assessment arm of Pratham Education Foundation sees measurement as the first stage of action. ASER uses primary research to push and give empirical foundations to policy discussions at a multitude of levels. At a household level, common citizens use a simple assessment (a floor-level test) to measure learning across rural India. This paper presents the evidence on the applicability of an ASER approach to the health sector. A citizen-led assessment was designed and executed that collected information from young mothers with children up to a year of age. The pilot assessments were rolled-out in two different models: Paid surveyors and student volunteers. The survey covered three geographic areas: 1,239 children in the Jaipur District of Rajasthan, 2,086 in the Rae Bareli District of Uttar Pradesh, and 593 children in the Bhuj Block in Gujarat. The survey tool was designed to study knowledge of health-related issues, daily practices followed by young mothers and access to relevant services and programs. It provides insights on behaviors related to infant and young child feeding practices, child and maternal nutrition and supplementation, water and sanitation, and health services. Moreover, the survey studies the reasons behind behaviors giving policy-makers actionable pathways to improve implementation of social sector programs. Although data on health outcomes are available, this approach could provide a rapid annual assessment of health issues with indicators that are easy to understand and act upon so that measurements do not become an exclusive domain of experts. The results give many insights into early childhood health behaviors and challenges. Around 98% of children are breastfed, and approximately half are not exclusively breastfed (for the first 6 months). Government established diet diversity guidelines are met for less than 1 out of 10 children. Although most households are satisfied with the quality of drinking water, most tested households had contaminated water.

Keywords: citizen-led assessment, rapid health assessment, Infant and Young Children Feeding, water and sanitation, maternal nutrition, supplementation

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Authors: Aid Abdelkrim

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A method of fatigue damage accumulation based upon application of energy parameters of the fatigue process is proposed in the paper. Using this model is simple, it has no parameter to be determined, it requires only the knowledge of the curve W–N (W: strain energy density N: number of cycles at failure) determined from the experimental Wöhler curve. To examine the performance of nonlinear models proposed in the estimation of fatigue damage and fatigue life of components under random loading, a batch of specimens made of 6082 T 6 aluminium alloy has been studied and some of the results are reported in the present paper. The paper describes an algorithm and suggests a fatigue cumulative damage model, especially when random loading is considered. This work contains the results of uni-axial random load fatigue tests with different mean and amplitude values performed on 6082T6 aluminium alloy specimens. The proposed model has been formulated to take into account the damage evolution at different load levels and it allows the effect of the loading sequence to be included by means of a recurrence formula derived for multilevel loading, considering complex load sequences. It is concluded that a ‘damaged stress interaction damage rule’ proposed here allows a better fatigue damage prediction than the widely used Palmgren–Miner rule, and a formula derived in random fatigue could be used to predict the fatigue damage and fatigue lifetime very easily. The results obtained by the model are compared with the experimental results and those calculated by the most fatigue damage model used in fatigue (Miner’s model). The comparison shows that the proposed model, presents a good estimation of the experimental results. Moreover, the error is minimized in comparison to the Miner’s model.

Keywords: damage accumulation, energy model, damage indicator, variable loading, random loading

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Authors: N. Piwpuan, J. Tosalee, N. Phonkerd

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Malachite green (MG), a synthetic dye, is used in industries and aquaculture and also disposed in the effluent. Use of wastewater in irrigation increases due to water shortage. However, wastewater containing dyes, MG, are toxic to biological systems. Therefore, effects of MG on growth of vegetables were evaluated in order to utilize dye-contaminated wastewater for irrigation. In this study, Pak choy (Brassica chinensis) and Chinese convolvulus (Ipomoea aquatica) were grown in growing material (mixture of soil, coconut fiber, and compost) for four weeks and afterward kept watering with 200 ml of tap water containing MG at the concentrations of 0 (control), 1, 2, 10, and 20 mg/L. At harvest, number of leaf and shoot and root dry weight of the treated plants were measured and compared with control. For both species, their biomass values were similar among treatments and did not differ from the control plants (dry weight were 0.6-1.0 and 1.1-1.7 g/plant for B. chinensis and I. aquatica, respectively). B. chinensis treated with 2, 10, and 20 mg/L of MG produced lower number of new leaf and had smaller and shorter leaf compared to control and treatment of 1 mg/L. These results indicate the different responses between plant species, which B. chinensis is more sensitive to contaminant compared to I. aquatica. There was no sign of MG and leucomalachite green (LMG) detected in root and shoot tissues of plants treated with MG at 20 mg/L, tested by thin layer chromatography. After plant harvest, toxicity of the growing material from all treatments was tested on mung beans. Percent germination (83-97%), seedling fresh weight (0.3-0.5 g/plant), and shoot length (11-12.5 cm) were similar to the control. These indicated that contaminant in growing material did not pose detrimental effect on mung beans. Based on these results, the water contaminated with low concentration of MG, such as discharge from aquaculture, may serve as ferti-irrigation water to compensate water shortage.

Keywords: ferti-irrigation, soil toxicity, triphenylmethane dye, wastewater reuse

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Authors: Thanooja Naushad, Meena Natarajan, Tushar Vasant Kulkarni

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Background: The Lacey Assessment of Preterm Infants (LAPI) is used in clinical practice to identify premature babies at risk of neuromotor impairments, especially cerebral palsy. This study attempted to find the validity of the Lacey assessment of preterm infants to predict neuromotor outcomes of premature babies at 12 months corrected age and to compare its predictive ability with the brain ultrasound. Methods: This prospective cohort study included 89 preterm infants (45 females and 44 males) born below 35 weeks gestation who were admitted to the neonatal intensive care unit of a government hospital in Dubai. Initial assessment was done using the Lacey assessment after the babies reached 33 weeks postmenstrual age. Follow up assessment on neuromotor outcomes was done at 12 months (± 1 week) corrected age using two standardized outcome measures, i.e., infant neurological international battery and Alberta infant motor scale. Brain ultrasound data were collected retrospectively. Data were statistically analyzed, and the diagnostic accuracy of the Lacey assessment of preterm infants (LAPI) was calculated -when used alone and in combination with the brain ultrasound. Results: On comparison with brain ultrasound, the Lacey assessment showed superior specificity (96% vs. 77%), higher positive predictive value (57% vs. 22%), and higher positive likelihood ratio (18 vs. 3) to predict neuromotor outcomes at one year of age. The sensitivity of Lacey assessment was lower than brain ultrasound (66% vs. 83%), whereas specificity was similar (97% vs. 98%). A combination of Lacey assessment and brain ultrasound results showed higher sensitivity (80%), positive (66%), and negative (98%) predictive values, positive likelihood ratio (24), and test accuracy (95%) than Lacey assessment alone in predicting neurological outcomes. The negative predictive value of the Lacey assessment was similar to that of its combination with brain ultrasound (96%). Conclusion: Results of this study suggest that the Lacey assessment of preterm infants can be used as a supplementary assessment tool for premature babies in the neonatal intensive care unit. Due to its high specificity, Lacey assessment can be used to identify those babies at low risk of abnormal neuromotor outcomes at a later age. When used along with the findings of the brain ultrasound, Lacey assessment has better sensitivity to identify preterm babies at particular risk. These findings have applications in identifying premature babies who may benefit from early intervention services.

Keywords: brain ultrasound, lacey assessment of preterm infants, neuromotor outcomes, preterm

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Authors: Cuiyang Feng, Xu Tang, Yi Jin

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Coal is the most important primary energy source in China, which exerts a significant influence on the rapid economic growth. However, it makes the water resources to be a constraint on coal industry development, on account of the reverse geographical distribution between coal and water. To ease the pressure on water shortage, the ‘3 Red Lines’ water policies were announced by the Chinese government, and then ‘water for coal’ plan was added to that policies in 2013. This study utilized a structural path analysis (SPA) based on the multi-regional input-output table to quantify the virtual water flows caused by coal consumption in different stages. Results showed that the direct water input (the first stage) was the highest amount in all stages of coal consumption, accounting for approximately 30% of total virtual water content. Regional analysis demonstrated that virtual water trade alleviated the pressure on water use for coal consumption in water shortage areas, but the import of virtual water was not from the areas which are rich in water. Sectoral analysis indicated that the direct inputs from the sectors of ‘production and distribution of electric power and heat power’ and ‘Smelting and pressing of metals’ took up the major virtual water flows, while the sectors of ‘chemical industry’ and ‘manufacture of non-metallic mineral products’ importantly but indirectly consumed the water. With the population and economic growth in China, the water demand-and-supply gap in coal consumption would be more remarkable. In additional to water efficiency improvement measures, the central government should adjust the strategies of the virtual water trade to address local water scarcity issues. Water resource as the main constraints should be highly considered in coal policy to promote the sustainable development of the coal industry.

Keywords: coal consumption, multi-regional input-output model, structural path analysis, virtual water

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Authors: Ghada El-Husseiny, Dina Yousri, Christian Richter

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Social services are often characterized by market failures, which justifies government intervention in the provision of these services. It is widely acknowledged that government intervention breeds corruption since resources are being transferred from one party to another. However, what is still being extensively studied is the magnitude of the negative impact of corruption on publicly provided services and development outcomes. Corruption has the power to hinder development and cripple our march towards the Sustainable Development Goals. Corruption diminishes the efficiency and effectiveness of public health and education spending and directly impacts the outcomes of these sectors. This paper empirically examines the impact of Institutional Failure on public sector services provision, with the sole purpose of studying the impact of corruption on SDG3 and 4; Good health and wellbeing and Quality education, respectively. The paper explores the effect of corruption on these goals from various perspectives and extends the analysis by examining if the impact of corruption on these goals differed when it accounted for the current corruption state. Using Pooled OLS(Ordinary Least Square) and Fixed effects panel estimation on 22 corrupt and 22 clean countries between 2000 and 2017. Results show that corruption in both corrupt and clean countries has a more severe impact on Health than the Education sector. In almost all specifications, corruption has an insignificant effect on School Enrollment rates but a significant effect on Infant Mortality rates. Results further indicate that, on average, a 1 point increase in the CPI(Consumer Price Index) can increase health expenditures by 0.116% in corrupt and clean countries. However, the fixed effects model indicates that the way Health and Education expenditures are determined in clean and corrupt countries are completely country-specific, in which corruption plays a minimal role. Moreover, the findings show that School Enrollment rates and Infant Mortality rates depend, to a large extent, on public spending. The most astounding results-driven is that corrupt countries, on average, have more effective and efficient healthcare expenditures. While some insights are provided as to why these results prevail, they should be further researched. All in all, corruption impedes development outcomes, and any Anti-corrupt policies taken will bring forth immense improvements and speed up the march towards sustainability.

Keywords: corruption, education, health, public spending, sustainable development

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Authors: Farhad Abbas Gandomkar, Mona Danesh

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This paper aims to determine Fundamental Natural Frequency (FNF) of a structural composite floor system known as Chromite. To achieve this purpose, FNFs of studied panels are determined by development of Finite Element Models (FEMs) in ABAQUS program. American Institute of Steel Construction (AISC) code in Steel Design Guide Series 11, presents a fundamental formula to calculate FNF of a steel framed floor system. This formula has been used to verify results of the FEMs. The variability in the FNF of the studied system under various parameters such as dimensions of floor, boundary conditions, rigidity of main and secondary beams around the floor, thickness of concrete slab, height of composite joists, distance between composite joists, thickness of top and bottom flanges of the open web steel joists, and adding tie beam perpendicular on the composite joists, is determined. The results show that changing in dimensions of the system, its boundary conditions, rigidity of main beam, and also adding tie beam, significant changes the FNF of the system up to 452.9%, 50.8%, -52.2%, %52.6%, respectively. In addition, increasing thickness of concrete slab increases the FNF of the system up to 10.8%. Furthermore, the results demonstrate that variation in rigidity of secondary beam, height of composite joist, and distance between composite joists, and thickness of top and bottom flanges of open web steel joists insignificant changes the FNF of the studied system up to -0.02%, -3%, -6.1%, and 0.96%, respectively. Finally, the results of this study help designer predict occurrence of resonance, comfortableness, and design criteria of the studied system.

Keywords: Fundamental Natural Frequency, Chromite Composite Floor System, Finite Element Method, low and high frequency floors, Comfortableness, resonance.

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Authors: Maryam Tabrizi, Shahrzad Aarup

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Objectives- Understanding the close association between oral health and overall health for older adults at the right time and right place, a person, focus treatment through Project ECHO telementoring. Methodology- Data from monthly ECHO telementoring sessions were provided for three years. Sessions including case presentations, overall health conditions, considering medications, organ functions limitations, including the level of cognition. Contributions- Providing the specialist level of providing care to all elderly regardless of their location and other health conditions and decreasing oral health inequity by increasing workforce via Project ECHO telementoring program worldwide. By 2030, the number of adults in the USA over the age of 65 will increase more than 60% (approx.46 million) and over 22 million (30%) of 74 million older Americans will need specialized geriatrician care. In 2025, a national shortage of medical geriatricians will be close to 27,000. Most individuals 65 and older do not receive oral health care due to lack of access, availability, or affordability. One of the main reasons is a significant shortage of Oral Health (OH) education and resources for the elderly, particularly in rural areas. Poor OH is a social stigma, a thread to quality and safety of overall health of the elderly with physical and cognitive decline. Poor OH conditions may be costly and sometimes life-threatening. Non-traumatic dental-related emergency department use in Texas alone was over $250 M in 2016. Most elderly over the age of 65 present with at least one or multiple chronic diseases such as arthritis, diabetes, heart diseases, and chronic obstructive pulmonary disease (COPD) are at higher risk to develop gum (periodontal) disease, yet they are less likely to get dental care. In addition, most older adults take both prescription and over-the-counter drugs; according to scientific studies, many of these medications cause dry mouth. Reduced saliva flow due to aging and medications may increase the risk of cavities and other oral conditions. Most dental schools have already increased geriatrics OH in their educational curriculums, but the aging population growth worldwide is faster than growing geriatrics dentists. However, without the use of advanced technology and creating a network between specialists and primary care providers, it is impossible to increase the workforce, provide equitable oral health to the elderly. Project ECHO is a guided practice model that revolutionizes health education and increases the workforce to provide best-practice specialty care and reduce health disparities. Training oral health providers for utilizing the Project ECHO model is a logical response to the shortage and increases oral health access to the elderly. Project ECHO trains general dentists & hygienists to provide specialty care services. This means more elderly can get the care they need, in the right place, at the right time, with better treatment outcomes and reduces costs.

Keywords: geriatric, oral health, project echo, chronic disease, oral health

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Authors: Liang Ming Zhong, Yu Zhong, Wen Zhong, Fei Fei Yin

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Trinary affinity is a description of existence: every object exists as it is known and spoken of, in a system of 2 differences (denoted dif1, dif₂) and 1 similarity (Sim), equivalently expressed as dif₁ / Sim / dif₂ and kn / 0 / tkn (kn = the known, tkn = the 'to be known', 0 = the zero point of knowing). They are mathematically verified and illustrated in this paper by the arrangement of all integers onto 3 columns, where each number exists as a difference in relation to another number as another difference, and the 2 difs as arbitrated by a third number as the Sim, resulting in a trinary affinity or trinity of 3 numbers, of which one is the known, the other the 'to be known', and the third the zero (0) from which both the kn and tkn are measured and specified. Consequently, any number is horizontally specified either as 3n, or as '3n – 1' or '3n + 1', and vertically as 'Cn + c', so that any number seems to occur at the intersection of its X and Y axes and represented by its X and Y coordinates, as any point on Earth’s surface by its latitude and longitude. Technically, i) primes are viewed and treated as progenitors, and composites as descending from them, forming families of composites, each capable of being measured and specified from its own zero called in this paper the realistic zero (denoted 0r, as contrasted to the mathematic zero, 0m), which corresponds to the constant c, and the nature of which separates the composite and prime numbers, and ii) any number is considered as having a magnitude as well as a position, so that a number is verified as a prime first by referring to its descriptive formula and then by making sure that no composite number can possibly occur on its position, by dividing it with factors provided by the composite number formulas. The paper consists of 3 parts: 1) a brief explanation of the trinary affinity of things, 2) the 8 formulas that represent ALL the primes, and 3) families of composite numbers, each represented by a formula. A composite number family is described as 3n + f₁‧f₂. Since there are an infinitely large number of composite number families, to verify the primality of a great probable prime, we have to have it divided with several or many a f₁ from a range of composite number formulas, a procedure that is as laborious as it is the surest way to verifying a great number’s primality. (So, it is possible to substitute planned division for trial division.)

Keywords: trinary affinity, difference, similarity, realistic zero

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Authors: Mohamed Moheyeldin Mahmoud

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Egypt suffers from a severe shortage of data and charts concerning the physical dimensions, measurements, qualities and consumer behavior. The shortage of needed information and appropriate methods has forced the Egyptian designer to use any other foreign standard when designing a product for the Egyptian consumer which has led to many problems. The urgently needed database concerning the physical specifications, measurements of the Egyptian consumers, as well as the need to support the Ergonomics given courses in many colleges and institutes with the latest technologies, is stated as the research problem. Descriptive analytical method relying on the compiling, comparing and analyzing of information and facts in order to get acceptable perceptions, ideas and considerations is the used methodology by the researcher. The research concludes that: 1. Good interaction relationship between users and products shows the success of that product. 2. An integration linkage between the most prominent fields of science specially Ergonomics, Interaction Design and Ethnography should be encouraged to provide an ultimately updated database concerning the nature, specifications and environment of the Egyptian consumer, in order to achieve a higher benefit for both user and product. 3. Chinese economic policy based on the study of market requirements long before any market activities should be emulated. 4. Using Ethnography supports the design activities creating new products or updating existent ones through measuring the compatibility of products with their environment and user expectations, While contracting a joint cooperation between military colleges, sports education institutes from one side, and design institutes from the other side to provide an ultimately updated (annually updated) database concerning some specifications about students of both sexes applying in those institutes (height, weight, etc.) to provide the Industrial designer with the needed information when creating a new product or updating an existing one concerning that category is recommended by the researcher.

Keywords: adapt, ergonomics, ethnography, interaction design

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Authors: Michael Zhang, Nicholas Marriage, Valerie Astle, Marie-Louise Ratican, Jonathan Ash, Haddijatou Hughes

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Objective: Young infants are often brought to the Emergency Department (ED) with a variety of complaints, some of them are non-specific and present as a diagnostic challenge to the attending clinician. Whilst invasive investigations such as blood tests and lumbar puncture are necessary in some cases to exclude serious infections, some basic clinical tools in additional to thorough clinical history can be useful to assess the risks of serious conditions in these young infants. This study aimed to examine the utilization of one of clinical tools in this regard. Methods: This retrospective observational study examined the medical records of infants under 6 months presenting to a mixed urban ED between January 2013 and December 2014. The infants deemed to have non-specific complaints or diagnoses by the emergency clinicians were selected for analysis. The ones with clear systemic diagnoses were excluded. Among all relevant clinical information and investigation results, utilization of Standard Paediatric Observation Chart (SPOC) was particularly scrutinized in these medical records. This specific chart was developed by the expert clinicians in local health department. It categorizes important clinical signs into some color-coded zones as a visual cue for serious implication of some abnormalities. An infant is regarded as SPOC positive when fulfills 1 red zone or 2 yellow zones criteria, and the attending clinician would be prompted to investigate and treat for potential serious conditions accordingly. Results: Eight hundred and thirty-five infants met the inclusion criteria for this project. The ones admitted to the hospital for further management were more likely to have SPOC positive criteria than the discharged infants (Odds ratio: 12.26, 95% CI: 8.04 – 18.69). Similarly, Sepsis alert criteria on SPOC were positive in a higher percentage of patients with serious infections (56.52%) in comparison to those with mild conditions (15.89%) (p < 0.001). The SPOC sepsis criteria had a sensitivity of 56.5% (95% CI: 47.0% - 65.7%) and a moderate specificity of 84.1% (95% CI: 80.8% - 87.0%) to identify serious infections. Applying to this infant population, with a 17.4% prevalence of serious infection, the positive predictive value was only 42.8% (95% CI: 36.9% - 49.0%). However, the negative predictive value was high at 90.2% (95% CI: 88.1% - 91.9%). Conclusions: Standard Paediatric Observation Chart has been applied as a useful clinical tool in the clinical practice to help identify and manage young sick infants in ED effectively.

Keywords: clinical tool, infants, non-specific complaints, Standard Paediatric Observation Chart

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Authors: Leila Batmany

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This research studies the relationship between the feeling of distributive justice and national identity of the youth. The present analysis intends to experimentally investigate the various dimensions of the justice feeling and its effect on the national identity components. The study has taken justice into consideration from four different points of view on the basis of availability of valuable social sources such as power, wealth, knowledge and status in the political, economic, and cultural and status justice respectively. Furthermore, the national identity has been considered as the feeling of honour, attachment and commitment towards national society and its seven components i.e. history, language, culture, political system, religion, geographical territory and society. The 'field study' has been used as the method for the research with the individual as unit, taking 368 young between the age of 18 and 29 living in Tehran, chosen randomly according to Cochran formula. The individual samples have been randomly chosen among five districts in north, south, west, east, and centre of Tehran, based on the multistage cluster sampling. The data collection has been performed with the use of questionnaire and interview. The most important results are as follows: i) The feeling of economic justice is the weakest one among the youth. ii) The strongest and the weakest dimensions of the national identity are, respectively, the historical and the social dimension. iii) There is a positive and meaningful relationship between the feeling political and statues justice and then national identity, whereas no meaningful relationship exists between the economic and cultural justice and the national identity. iv) There is a positive and meaningful relationship between the feeling of justice in all dimensions and legitimacy of the political system. There is also such a relationship between the legitimacy of the political system and national identity. v) Generally, there is a positive and meaningful relationship between the feeling of distributive justice and national identity among the youth. vi) It is through the legitimacy of the political system that justice feeling can have an influence on the national identity.

Keywords: distributive justice, national identity, legitimacy of political system, Cochran formula, multistage cluster sampling

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Authors: Mustafa M. Donma, Orkide Donma

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Metabolic syndrome (MetS) is a severe health problem which is common among obese individuals. The components of MetS are rather stable in adults compared to the components discussed for children. Due to the ambiguity in this group of the population, how to diagnose MetS in morbid obese (MO) children still constitutes a matter of discussion. For this purpose, a formula, which facilitates the diagnosis of MetS in MO children, was investigated. The aim of this study was to develop a formula which was capable of discriminating MO children with and without MetS findings. Study population comprised MO children. Age and sex-dependent body mass index (BMI) percentiles of the children were above 99. Metabolic syndrome components were also determined. Elevated systolic and diastolic blood pressures (SBP and DBP), elevated fasting blood glucose (FBG), elevated triglycerides (TRG), and/or depressed high density lipoprotein cholesterol (HDL-C) in addition to central obesity were listed as MetS components for each child. Presence of at least two of these components confirmed that the case was MetS. Two groups were constituted. In the first group, there were forty-two MO children without MetS components. Second group was composed of forty-four MO children with at least two MetS components. Anthropometric measurements, including weight, height, waist, and hip circumferences, were performed following physical examination. Body mass index and homeostatic model assessment of insulin resistance values were calculated. Informed consent forms were obtained from the parents of the children. Institutional Non-Interventional Ethics Committee approved the study design. Blood pressure values were recorded. Routine biochemical analysis, including FBG, insulin (INS), TRG, HDL-C were performed. The performance and the clinical utility of the Diagnostic Obesity Notation Model Assessment Metabolic Syndrome Index (DONMA MetS index) [(INS/FBG)/(HDL-C/TRG)*100] was tested. Appropriate statistical tests were applied to the study data. p value smaller than 0.05 was defined as significant. Metabolic syndrome index values were 41.6±5.1 in MO group and 104.4±12.8 in MetS group. Corresponding values for HDL-C values were 54.5±13.2 mg/dl and 44.2±11.5 mg/dl. There were statistically significant differences between the groups (p<0.001). Upon evaluation of the correlations between MetS index and HDL-C values, a much stronger negative correlation was found in MetS group (r=-0.515; p=0.001) in comparison with the correlation detected in MO group (r=-0.371; p=0.016). From these findings, it was concluded that the statistical significance degree of the difference between MO and MetS groups was highly acceptable for this recently introduced MetS index as expected. This was due to the involvement of all of the biochemically defined MetS components into the index. This is particularly important because each of these four parameters used in the formula is cardiac risk factor. Aside from discriminating MO children with and without MetS findings, MetS index introduced in this study is important from the cardiovascular risk point of view in MetS group of children.

Keywords: children, fasting blood glucose, high density lipoprotein cholesterol, index, insulin, metabolic syndrome, morbid obesity, triglycerides.

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Authors: Apoorva D. R.

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INTRODUCTION: Hemophagocytic lymphohistiocytosis (HLH) is a severe, potentially fatal syndrome in which there is excessive immune activation. The disease is seen in children and people of all ages, but infants from birth to 18 months are most frequently affected. HLH is a sporadic or familial condition that can be triggered by various events that disturb immunological homeostasis. In cases with a genetic predisposition and sporadic occurrences, infection is a frequent trigger. Because of the rarity of this disease, the diverse clinical presentation, and the lack of specificity in the clinical and laboratory results, prompt treatment is essential, but the biggest obstacle to a favorable outcome is frequently a delay in identification. CASE REPORT: Here we report a case of a 6-month-old male infant who presented to the dermatology outpatient with disseminated skin lesions present over the face, abdomen, scalp, and bilateral upper and lower limbs for the past month. The lesions were insidious in onset, initially started over the abdomen, and gradually progressed to involve other body parts. The patient also had a history of fever which was moderate in grade, on and off in nature for 1 month. There were no significant complaints in the past, family, or drug history. There was no history of feeding difficulties in the baby. Parents gave a history of developmental milestones appropriate for age. Examination findings include multiple well-defined monomorphic erythematous papules with a central crater present over bilateral cheeks. Few lichenoid shiny papules present over bilateral arms, legs, and abdomen. Ultrasound of the abdomen and pelvis showed mild degree hepatosplenomegaly, intraabdominal lymphadenopathy, and bilateral inguinal lymphadenopathy. Routine blood investigations showed anemia and lymphopenia. Multiple X-rays of the skull, chest, and bilateral upper and lower limbs were done and were normal. Histopathology features were suggestive of non-Langerhans cell cutaneous histiocytosis. CONCLUSION: HLH is a fatal and rare disease. A high level of suspicion and an interdisciplinary approach among experienced clinicians, pathologists, and microbiologists to define the diagnosis and causative disease are key to diagnosing this case. Early detection and treatment can reduce patient morbidity and mortality.

Keywords: histiocytosis, non langerhans cell, case report, fatal, rare

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Authors: Titir Bhattacharya, Tanika Chakraborty, Prabal K. De

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Maternal and child health continue to be a significant policy focus in developing countries, including India. An emerging model in health care is the creation of public and private partnerships. Since the construction of physical infrastructure is costly, governments at various levels have tried to implement social health insurance schemes where a trust calculates insurance premiums and medical payments. Typically, qualifying families get full subsidization of the premium and get access to private hospitals, in addition to low cost public hospitals, for their tertiary care needs. We analyze one such pioneering social insurance scheme in the Indian state of Andhra Pradesh (AP). The Rajiv Aarogyasri program (RA) was introduced by the Government of AP on a pilot basis in 2007 and implemented in 2008. In this paper, we first examine the extent to which access to reproductive health care changed. For example, the RA scheme reimburses hospital deliveries leading us to expect an increase in institutional deliveries, particularly in private hospitals. Second, we expect an increase in institutional deliveries to also improve child health outcomes. Hence, we estimate if the program improved infant and child mortality. We use District Level Health Survey data to create annual birth cohorts from 2000-2015. Since AP was the only state in which such a state insurance program was implemented, the neighboring states constituted a plausible control group. Combined with the policy timing, and the year of birth, we employ a difference-indifference strategy to identify the effects of RA on the residents of AP. We perform several checks against threats to identification, including testing for pre-treatment trends between the treatment and control states. We find that the policy significantly lowered infant and child mortality in AP. We also find that deliveries in private hospitals increased, and government hospitals decreased, showing a substitution effect of the relative price change. Finally, as expected, out-of-pocket costs declined for the treatment group. However, we do not find any significant effects for usual preventive care such as vaccination, showing that benefits of insurance schemes targeted at the tertiary level may not trickle down to the primary care level.

Keywords: public health insurance, maternal and child health, public-private choice

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Authors: J. L. Chukwuneke, C. H. Achebe, S. N. Omenyi

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This research work presents the surface thermodynamics approach to M-TB/HIV-Human sputum interactions. This involved the use of the Hamaker coefficient concept as a surface energetics tool in determining the interaction processes, with the surface interfacial energies explained using van der Waals concept of particle interactions. The Lifshitz derivation for van der Waals forces was applied as an alternative to the contact angle approach which has been widely used in other biological systems. The methodology involved taking sputum samples from twenty infected persons and from twenty uninfected persons for absorbance measurement using a digital Ultraviolet visible Spectrophotometer. The variables required for the computations with the Lifshitz formula were derived from the absorbance data. The Matlab software tools were used in the mathematical analysis of the data produced from the experiments (absorbance values). The Hamaker constants and the combined Hamaker coefficients were obtained using the values of the dielectric constant together with the Lifshitz equation. The absolute combined Hamaker coefficients A132abs and A131abs on both infected and uninfected sputum samples gave the values of A132abs = 0.21631x10-21Joule for M-TB infected sputum and Ã132abs = 0.18825x10-21Joule for M-TB/HIV infected sputum. The significance of this result is the positive value of the absolute combined Hamaker coefficient which suggests the existence of net positive van der waals forces demonstrating an attraction between the bacteria and the macrophage. This however, implies that infection can occur. It was also shown that in the presence of HIV, the interaction energy is reduced by 13% conforming adverse effects observed in HIV patients suffering from tuberculosis.

Keywords: absorbance, dielectric constant, hamaker coefficient, lifshitz formula, macrophage, mycobacterium tuberculosis, van der waals forces

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Authors: Ghada A. Abdelbary, Maha M. Amin, Mostafa Abdelmoteleb

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Zaleplon (ZP) is a non-benzodiazepine poorly soluble hypnotic drug indicated for the short term treatment of insomnia having a bioavailability of about 30%. The aim of the present study is to enhance the solubility and consequently the bioavailability of ZP using hydrotropic agents (HA). Phase solubility diagrams of ZP in presence of different molar concentrations of HA (Sodium benzoate, Urea, Ascorbic acid, Resorcinol, Nicotinamide, and Piperazine) were constructed. ZP/Sodium benzoate and Resorcinol microparticles were prepared adopting melt, solvent evaporation and melt-evaporation techniques followed by XRD. Directly compressed mixed hydrotropic ZP tablets of Sodium benzoate and Resorcinol in different weight ratios were prepared and evaluated compared to the commercially available tablets (Sleep aid® 5 mg). The effect of shelf and accelerated stability storage (40°C ± 2°C/75%RH ± 5%RH) on the optimum tablet formula (F5) for six months were studied. The enhancement of ZP solubility follows the order of: Resorcinol > Sodium benzoate > Ascorbic acid > Piperazine > Urea > Nicotinamide with about 350 and 2000 fold increase using 1M of Sodium benzoate and Resorcinol respectively. ZP/HA microparticles exhibit the order of: Solvent evaporation > melt-solvent evaporation > melt > physical mixture which was further confirmed by the complete conversion of ZP into amorphous form. Mixed hydrotropic tablet formula (F5) composed of ZP/(Resorcinol: Sodium benzoate 4:1w/w) microparticles prepared by solvent evaporation exhibits in-vitro dissolution of 31.7±0.11% after five minutes (Q5min) compared to 10.0±0.10% for Sleep aid® (5 mg) respectively. F5 showed significantly higher GABA concentration of 122.5±5.5mg/mL in plasma compared to 118±1.00 and 27.8±1.5 mg/mL in case of Sleep aid® (5 mg) and control taking only saline respectively suggesting a higher neuropharmacological effect of ZP following hydrotropic solubilization.

Keywords: zaleplon, hydrotropic solubilization, plasma GABA level, mixed hydrotropy

Procedia PDF Downloads 417

Authors: Gherbi Khadidja

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In the Mediterranean region, water resources are limited and very unevenly distributed in space and time. The main objective of this project is the development of a wireless network for the management of water resources in northern Algeria, the Mitidja plain, which helps farmers to irrigate in the most optimized way and solve the problem of water shortage in the region. Therefore, we will develop an aid tool that can modernize and replace some traditional techniques, according to the real needs of the crops and according to the soil conditions as well as the climatic conditions (soil moisture, precipitation, characteristics of the unsaturated zone), These data are collected in real-time by sensors and analyzed by an algorithm and displayed on a mobile application and the website. The results are essential information and alerts with recommendations for action to farmers to ensure the sustainability of the agricultural sector under water shortage conditions. In the first part: We want to set up a wireless sensor network, for precise management of water resources, by presenting another type of equipment that allows us to measure the water content of the soil, such as the Watermark probe connected to the sensor via the acquisition card and an Arduino Uno, which allows collecting the captured data and then program them transmitted via a GSM module that will send these data to a web site and store them in a database for a later study. In a second part: We want to display the results on a website or a mobile application using the database to remotely manage our smart irrigation system, which allows the farmer to use this technology and offers the possibility to the growers to access remotely via wireless communication to see the field conditions and the irrigation operation, at home or at the office. The tool to be developed will be based on satellite imagery as regards land use and soil moisture. These tools will make it possible to follow the evolution of the needs of the cultures in time, but also to time, and also to predict the impact on water resources. According to the references consulted, if such a tool is used, it can reduce irrigation volumes by up to up to 40%, which represents more than 100 million m3 of savings per year for the Mitidja. This volume is equivalent to a medium-size dam.

Keywords: optimal irrigation, soil moisture, smart irrigation, water management

Procedia PDF Downloads 82

Authors: Fawad Zaidi

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This paper discusses a variety of challenges and solutions involved with creating computer games and the issues faced by the software engineers working in this field. This review further investigates the articles coverage of project scope and the problem of feature creep that appears to be inherent with game development. The paper tries to answer the following question: Is this a problem caused by a shortage, or bad software engineering practices, or is this outside the control of the software engineering component of the game production process?

Keywords: software engineering, computer games, software applications, development

Procedia PDF Downloads 451

Authors: Simplejit Kaur Dhanoa, Manmohan Singh

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This study was done with the primary objective to evaluate the motor and mental developmental delays among children having neonatal Jaundice. A total sample of 300 neonates were collected; out of them, 150 were preterm neonates, and 150 were full term neonates from the hospital setting and follow up study was done with the help of the Developmental Assessment scale of the Indian Infant. The registered samples were assessed up to 2.6 years with a gap of 6 months. The outcomes of this study reveal that developmental delays were present among children who had preterm neonatal jaundice as compare to full term normal babies. Further, It was reported that both motor and mental development is affected due to neonatal hyperbilirubinemia in addition to preterm birth.

Keywords: hyperbinirubinemia, preterm neonates, developmental delays, preterm

Procedia PDF Downloads 134

Authors: Tamer M. Shehata

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Objective: Currently, mucoadhesive microparticles acquired a high interest in both research and pharmaceutical technology fields. Recently, BÜCHI lunched its latest fourth generation nano spray dryer B-90 used for nanoparticle production. B-90 offers an elegant technology combined particle engineering and drying in one step. In our laboratory, we successfully developed a new formulation for metformin hydrochloride, mucoadhesive microparticles utilizing B-90 technology for treatment of type 2-diabetis. Method: Gelatin or sodium alginate, natural occurring polymers with mucoadhesive properties, solely or in combination was used in our formulation trials. Preformulation studies (atomization head mesh size, flow rate, head temperature, polymer solution viscosity and surface tension) and postformulation characters (particle size, flowability, surface scan and dissolution profile) were evaluated. Finally, hypoglycemic effect of the selected formula was evaluated in streptozotocin-induced diabetic rats. Spray head with 7 µm hole, flow rate of 3.5 mL/min and head temperature 120 ºC were selected. Polymer viscosity was less than 11.5 cP with surface tension less than 70.1 dyne/cm. Result: Discrete, non aggregated particles and free flowing powders with particle size was less than 2000 nm were obtained. Gelatin and sodium alginate combination in ratio 1:3 were successfully sustained the in vitro release profile of the drug. Hypoglycemic evaluation of the previous formula, showed a significant reduction of blood glucose level over 24 h. Conclusion: B-90 technology can open a new era of , mucoadhesive microparticles preparation offering convenient dosage form that can enhance compliance of type 2 diabetic patients.

Keywords: mucoadhesive, microparticles, technology, diabetis

Procedia PDF Downloads 266

Authors: Chaitanya H. Acharya, Pavan Kumar P., Gopalakrishna Narayana

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In the realm of aerodynamics, numerous vehicles incorporate moving components to enhance their performance. For instance, airliners deploy hydraulically operated flaps and ailerons during take-off and landing, while Formula 1 racing cars utilize hydraulic tubes and actuators for various components, including the Drag Reduction System (DRS). The DRS, consisting of a rear wing and adjustable flaps, plays a crucial role in overtaking manoeuvres. The DRS has two positions: the default position with the flaps down, providing high downforce, and the lifted position, which reduces drag, allowing for increased speed and aiding in overtaking. Swift deployment of the DRS during races is essential for overtaking competitors. The fluid flow over the rear wing flap becomes intricate during deployment, involving flow reversal and operational changes, leading to unsteady flow physics that significantly influence aerodynamic characteristics. Understanding the drag and downforce during DRS deployment is crucial for determining race outcomes. While experiments can yield accurate aerodynamic data, they can be expensive and challenging to conduct across varying speeds. Computational Fluid Dynamics (CFD) emerges as a cost-effective solution to predict drag and downforce across a range of speeds, especially with the rapid deployment of the DRS. This study employs the finite volume-based solver Ansys Fluent, incorporating dynamic mesh motions and a turbulent model to capture the complex flow phenomena associated with the moving rear wing flap. A dedicated section for the rare wing-flap is considered in the present simulations, and the aerodynamics of these sections closely resemble S1223 aerofoils. Before delving into the simulations of the rare wing-flap aerofoil, numerical results undergo validation using experimental data from an NLR flap aerofoil case, encompassing different flap angles at two distinct angles of attack was carried out. The increase in flap angle as increase in lift and drag is observed for a given angle of attack. The simulation methodology for the rare-wing-flap aerofoil case involves specific time durations before lifting the flap. During this period, drag and downforce values are determined as 330 N and 1800N, respectively. Following the flap lift, a noteworthy reduction in drag to 55 % and a decrease in downforce to 17 % are observed. This understanding is critical for making instantaneous decisions regarding the deployment of the Drag Reduction System (DRS) at specific speeds, thereby influencing the overall performance of the Formula 1 racing car. Hence, this work emphasizes the utilization of dynamic mesh motion methodology to predict the aerodynamic characteristics during the deployment of the DRS in a Formula 1 racing car.

Keywords: DRS, CFD, drag, downforce, dynamics mesh motion

Procedia PDF Downloads 63

Authors: Shan-Hong Ying, Ying-Fang Wang

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A surrogate approach was deployed for assessing exposures of multiple chemicals at the selected working area of coating processes and applied to assess the exposure concentration of similar exposed groups using the same chemicals but different formula ratios. For the selected area, 6 to 12 portable photoionization detector (PID) were placed uniformly in its workplace to measure its total VOCs concentrations (CT-VOCs) for 6 randomly selected workshifts. Simultaneously, one sampling strain was placed beside one of these portable PIDs, and the collected air sample was analyzed for individual concentration (CVOCi) of 5 VOCs (xylene, butanone, toluene, butyl acetate, and dimethylformamide). Predictive models were established by relating the CT-VOCs to CVOCi of each individual compound via simple regression analysis. The established predictive models were employed to predict each CVOCi based on the measured CT-VOC for each the similar working area using the same portable PID. Results show that predictive models obtained from simple linear regression analyses were found with an R2 = 0.83~0.99 indicating that CT-VOCs were adequate for predicting CVOCi. In order to verify the validity of the exposure prediction model, the sampling analysis of the above chemical substances was further carried out and the correlation between the measured value (Cm) and the predicted value (Cp) was analyzed. It was found that there is a good correction between the predicted value and measured value of each measured chemical substance (R2=0.83~0.98). Therefore, the surrogate approach could be assessed the exposure concentration of similar exposed groups using the same chemicals but different formula ratios. However, it is recommended to establish the prediction model between the chemical substances belonging to each coater and the direct-reading PID, which is more representative of reality exposure situation and more accurately to estimate the long-term exposure concentration of operators.

Keywords: exposure assessment, exposure prediction model, surrogate approach, TVOC

Procedia PDF Downloads 118

Authors: Tamer Shehata

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Recently, nanotechnology acquired a great interest in the field of pharmaceutical production. Several pharmaceutical equipment were introduced into the research field for production of nanoparticles, among them, BÜCHI’ fourth generation nano-spray dryer B-90. B-90 is specialized with single step of production and drying of nano and microparticles. Currently, our research group is investigating several pharmaceutical formulations utilizing BÜCHI Nano-Spray Dryer B-90 technology. One of our projects is the formulation and evaluation of metformin hydrochloride mucoadhesive microparticles for treatment of type 2-diabetis. Several polymers were investigated, among them, gelatin and sodium alginate. The previous polymers are natural polymers with mucoadhesive properties. Preformulation studies such as atomization head mesh size, flow rate, head temperature, polymer solution viscosity and surface tension were performed. Postformulation characters such as particle size, flowability, surface scan and dissolution profile were evaluated. Finally, the pharmacological activity of certain selected formula was evaluated in streptozotocin-induced diabetic rats. B-90’spray head was 7 µm hole heated to 120 with air flow rate 3.5 mL/min. The viscosity of the solution was less than 11.5 cP with surface tension less than 70.1 dyne/cm. Successfully, discrete, non-aggregated particles and free flowing powders with particle size was less than 2000 nm were obtained. Gelatin and Sodium alginate combination in ratio 1:3 were successfully sustained the in vitro release profile of the drug. Hypoglycemic evaluation of the previous formula showed a significant reduction of blood glucose level over 24 h. In conclusion, mucoadhesive metformin hydrochloride microparticles obtained from B-90 could offer a convenient dosage form with enhanced hypoglycemic activity.

Keywords: mucoadhesive, microparticles, metformin hydrochloride, nano-spray dryer

Procedia PDF Downloads 284

Authors: Tri Murti, Muhammad Hanafiah Juni, Hejar Abdul Rahman, Salmiah Binti Said

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The diarrhoeal disease continues to be a leading cause of childhood mortality in countries such as Indonesia, where it is estimated to be responsible for 300,000 deaths annually in children under the age of years. Morbidity survey the Ministry of Health of Indonesia from 2000 to 2010 showed incidence diarrhoea remains a leading cause of infant mortality. Causes of death from diarrhoea is related to poor governance both at home and in health facilities. Despite the improvement of health facilities and government effort to reduce the occurrence of diarrhoea among children and death from diarrhoea, the incidence of diarrhoea among children area still high.

Keywords: management diarrheal disease, practices mother, treatment, diarrhoea among children

Procedia PDF Downloads 382

Authors: R. Ziaie Moayed, S. Taghvamanesh

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So far several methods by different researchers have been developed in order to calculate the bearing capacity factors of foundations and retaining walls. In this paper, the bearing capacity factor Ny (shape factor) for different types of foundation have been investigated. The formula for bearing capacity on c–φ–γ soil can still be expressed by Terzaghi’s equation except that the bearing capacity factor Ny depends on the surcharge ratio, and friction angle φ. Many empirical definitions have been used for measurement of the bearing capacity factors N

Keywords: bearing capacity, bearing capacity factor Nγ, irregular foundations, shape factor

Procedia PDF Downloads 114

Authors: Nancy Wilson

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In utero, fetal drug exposure is prevalent amongst birthing facilities. Assessment tools for neonatal abstinence syndrome (NAS) are often cumbersome and ill-fitting, harboring immense subjectivity. This paradox often leads the clinical assessor to be hypervigilant when assessing the newborn for subtle symptoms of NAS, often mistaken for normal newborn behaviors. As a quality improvement initiative, this project led to a more adaptable NAS tool termed eat, sleep, console (ESC). This function-based NAS assessment scores the infant based on the ability to accomplish three basic newborn necessities- to sleep, to eat, and to be consoled. Literature supports that ESC methodology improves patient and family outcomes while providing more cost-effective care.

Keywords: neonatal abstinence syndrome, neonatal opioid withdrawal, maternal substance abuse, pregnancy, and addiction, Finnegan neonatal abstinence syndrome tool, eat, sleep, console

Procedia PDF Downloads 114

Authors: Stoyanka Vladeva, Elena Kirilova, Nikola Kirilov

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Background: The creatinine clearance is a widely used value to estimate the GFR. Increased creatinine clearance is often called hyperfiltration and is usually seen during pregnancy, patients with diabetes mellitus preceding the diabetic nephropathy. It may also occur with large dietary protein intake or with plasma volume expansion. Renal injury in lupus nephritis is known to affect the glomerular, tubulointerstitial, and vascular compartment. However high creatinine clearance has not been found in patients with SLE, Target: Follow-up of creatinine clearance values in patients with systemic lupus erythematosus without history of kidney injury. Material and methods: We observed the creatinine, creatinine clearance, GFR and dipstick protein values of 7 women (with a mean age of 42.71 years) with systemic lupus erythematosus. Patients with active lupus have been monthly tested in the period of 13 months. Creatinine clearance has been estimated by Cockcroft-Gault Equation formula in ml/sec. GFR has been estimated by MDRD formula (The Modification of Diet in renal Disease) in ml/min/1.73 m2. Proteinuria has been defined as present when dipstick protein > 1+.Results: In all patients without history of kidney injury we found elevated creatinine clearance levels, but GFRremained within the reference range. Two of the patients were in remission while the other five patients had clinically and immunologically active Lupus. Three of the patients had a permanent presence of high creatinine clearance levels and proteinuria. Two of the patients had periodically elevated creatinine clearance without proteinuria. These results show that kidney disturbances may be caused by the vascular changes typical for SLE. Glomerular hyperfiltration can be result of focal segmental glomerulosclerosis caused by a reduction in renal mass. Probably lupus nephropathy is preceded not only by glomerular vascular changes, but also by tubular vascular changes. Using only the GFR is not a sufficient method to detect these primary functional disturbances. Conclusion: For early detection of kidney injury in patients with SLE we determined that the follow up of creatinine clearance values could be helpful.

Keywords: systemic Lupus erythematosus, kidney injury, elevated creatinine clearance level, normal glomerular filtration rate

Procedia PDF Downloads 245

Authors: Mustafa Metin Donma

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Obesity increases the risk of elevated blood pressure, which is a metabolic syndrome (MetS) component. Waist circumference (WC) is accepted as an indispensable parameter for the evaluation of these health problems. The close relationship of height with blood pressure values revealed the necessity of including height in tense indices. The association of tense indices with WC has also become an increasingly important topic. The purpose of this study was to develop a tense index that could contribute to differential diagnosis of MetS more than the indices previously introduced. One hundred and ninety-four children, aged 06-11 years, were considered to constitute four groups. The study was performed on normal weight (Group 1), overweight+obese (Group 2), morbid obese [without (Group 3) and with (Group 4) MetS findings] children. Children were included in the groups according to the recommendations of World Health Organization based on age- and gender dependent body mass index percentiles. For MetS group, MetS components well-established before were considered. Anthropometric measurements, as well as blood pressure values were taken. Tense indices were computed. The formula for the first tense index was (SP+DP)/2. The second index was Advanced Donma Tense Index (ADTI). The formula for this index was [(SP+DP)/2] * Height. Statistical calculations were performed. 0.05 was accepted as the p value indicating statistical significance. There were no statistically significant differences between the groups for pulse pressure, systolic-to-diastolic pressure ratio and tense index. Increasing values were observed from Group 1 to Group 4 in terms of mean arterial blood pressure and advanced Donma tense index (ADTI), which was highly correlated with WC in all groups except Group 1. Both tense index and ADTI exhibited significant correlations with WC in Group 3. However, in Group 4, ADTI, which includes height parameter in the equation, was unique in establishing a strong correlation with WC. In conclusion, ADTI was suggested as a tense index while investigating children with MetS.

Keywords: blood pressure, child, height, metabolic syndrome, waist circumference

Procedia PDF Downloads 31

Authors: Jianlin Wang, Jiajia Zhao

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This paper applies the theory and empirical method to examine the relationship between electricity price and coal price, as well as electricity and industry output, for China during Jan 1999-Dec 2012. Our results indicate that there is no any causality between coal price and electricity price under other factors are controlled. However, we found a bi-directional causality between electricity consumption and industry output. Overall, the electricity price set by China’s NDRC is inefficient, which lead to the electricity supply shortage after 2004. It is time to reform electricity price system for China’s reformers.

Keywords: electricity price, coal price, power supply, China

Procedia PDF Downloads 442