Search results for: standard treatment

Authors: Amirah Azzeri, Fatiha H. Shabaruddin, Scott A. McDonald, Rosmawati Mohamed, Maznah Dahlui

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Objective: A scaled-up treatment cascade with direct-acting antiviral (DAA) therapy is necessary to achieve global WHO targets for hepatitis C virus (HCV) elimination in Malaysia. Recently, limited access to Sofosbuvir/Daclatasvir (SOF/DAC) is available through compulsory licensing, with future access to Sofosbuvir/Velpatasvir (SOF/VEL) expected through voluntary licensing due to recent agreements. SOF/VEL has superior clinical outcomes, particularly for cirrhotic stages, but has higher drug acquisition costs compared to SOF/DAC. It has been proposed that a stratified treatment cascade might be the most cost-efficient approach for Malaysia whereby all HCV patients are treated with SOF/DAC except for patients with cirrhosis who are treated with SOF/VEL. This study aimed to conduct a five-year budget impact analysis from the provider perspective of the proposed stratified treatment cascade for HCV treatment in Malaysia. Method: A disease progression model that was developed based on model-predicted HCV epidemiology data in Malaysia was used for the analysis, where all HCV patients in scenario A were treated with SOF/DAC for all disease stages while in scenario B, SOF/DAC was used only for non-cirrhotic patients and SOF/VEL was used for the cirrhotic patients. The model projections estimated the annual numbers of patients in care and the numbers of patients to be initiated on DAA treatment nationally. Healthcare costs associated with DAA therapy and disease stage monitoring was included to estimate the downstream cost implications. For scenario B, the estimated treatment uptake of SOF/VEL for cirrhotic patients were 25%, 50%, 75%, 100% and 100% for 2018, 2019, 2020, 2021 and 2022 respectively. Healthcare costs were estimated based on standard clinical pathways for DAA treatment described in recent guidelines. All costs were reported in US dollars (conversion rate US$1=RM4.09, the price year 2018). Scenario analysis was conducted for 5% and 10% reduction of SOF/VEL acquisition cost anticipated from the competitive market pricing of generic DAA in Malaysia. Results: The stratified treatment cascade with SOF/VEL in Scenario B was found to be cost-saving compared to Scenario A. A substantial portion of the cost reduction was due to the costs associated with DAA therapy which resulted in USD 40 thousand (year 1) to USD 443 thousand (year 5) savings annually, with cumulative savings of USD 1.1 million after 5 years. Cost reductions for disease stage monitoring were seen in year three onwards which resulted in cumulative savings of USD 1.1 thousand. Scenario analysis estimated cumulative savings of USD 1.24 to USD 1.35 million when the acquisition cost of SOF/VEL was reduced. Conclusion: A stratified treatment cascade with SOF/VEL was expected to be cost-saving and can results in a budget impact reduction in overall healthcare expenditure in Malaysia compared to treatment with SOF/DAC. The better clinical efficacy with SOF/VEL is expected to halt patients’ HCV disease progression and may reduce downstream costs of treating advanced disease stages. The findings of this analysis may be useful to inform healthcare policies for HCV treatment in Malaysia.

Keywords: Malaysia, direct acting antiviral, compulsory licensing, voluntary licensing

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Authors: Kaisa M. Herne, Hanna E. Björkstedt

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Comparisons of online and laboratory environments are important for assessing whether the environment influences behavioral results. Trust game behavior was examined in three environments: 1) The standard laboratory setting with physically present participants (laboratory), 2) An online environment with an online meeting before playing the trust game (online plus a meeting); and 3) An online environment without a meeting (online without a meeting). In laboratory, participants were present in a classroom and played the trust game anonymously via computers. Online plus a meeting mimicked the laboratory in that participants could see each other in an online meeting before sessions started, whereas online without a meeting was a standard online experiment in which participants did not see each other at any stages of the experiment. Participants were recruited through pools of student subjects at two universities. The trust game was identical in all conditions; it was played with the same software, anonymously, and with stranger matching. There were no statistically significant differences between the treatment conditions regarding trust or trustworthiness. Results suggest that conducting trust game experiments online will yield similar results to experiments implemented in a laboratory.

Keywords: laboratory vs. online experiment, trust behavior, trust game, trustworthiness behavior

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Authors: M. Hadji, A. Haddad, Y. Hadji

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The effects of boronizing treatment on the friction coefficient and wear behavior of Ti2AlC were investigated. In order to modify the surface properties of Ti2AlC, boronizing treatment was carried out through powder pack cementation in the 1150-1350 °C temperature range. After boronizing treatment, one mixture layer, composed of TiB2 and SiC, forms on the surface of Ti2AlC. The growth of the coating is processed by inward diffusion of Boron and obeys a linear rule. The Boronizing treatment increases the hardness of Ti2AlC from 6 GPa to 13GPa. In the pin-on-disc test, it was found that the material undergoes a steady-state coefficient of friction of around 0.8 and 0.45 in case of Ti2AlC/Al2O3 tribocouple under 7N load for the non treated and the boronized samples, respectively. The wear resistance of Ti2AlC under Al2O3 ball sliding has been significantly improved, which indicated that the boronizing treatment is a promising surface modification way of Ti2AlC.

Keywords: MAX phase, wear, hardness, boronizing

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Authors: Mohamed Ben Amar, Henda Barhoumi, Hokia Siala, Foued Elhalouani

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The present contribution consists of a purely experimental investigation on the effect of Squeeze casting on the micro structural and mechanical propriety of Al-Si alloys destined to automotive industry. Accordingly, we have proceeding, by ourselves, to all the thermal treatment consisting of solution treatment at 540°C for 8h and aging at 160°C for 4h. The various thermal treatment, have been carried out in order to monitor the processes of formation and dissolution accompanying the solid state phase transformations as well as the resulting changes in the mechanical proprieties. The examination of the micrographs of the aluminum alloys reveals the dominant presence of dendrite. Concerning the mechanical characteristic the Vickers micro-hardness curve an increase as a function of the pressure. As well as the heat treatment increase mechanical propriety such that pressure and micro hardness. The curves have been explained in terms of structural hardening resulting from the various compounds formation.

Keywords: squeeze casting, process parameters, heat treatment, ductility, microstructure

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Authors: Nejib Turki, Karima Kouki Khalfallah

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The effect of six treatments of organic amendments were evaluated on a sandy soil in the region of Soukra in Tunisia. T1: cattle manure 55 t.ha-1, T2: commercial compost from Germany to 1 t.ha-1, T3: a mixture of 27.5 t.ha-1 of T1 with 0.5 t. ha-1 of T2, T4: commercial compost from France 2 t.ha-1, T5: a Tunisian commercial compost to 10 t.ha-1 and T0: control without treatment. The nitrogen in the soil increase to 0.029 g.kg-1 of soil treatment for the T1 and 0.021 g. kg-1 of soil treatment for the T3. The highest content of P2O5 has been registered by the T3 treatment that 0.44 g kg-1 soil with respect to the control (T0), which shows a content of 0.36 g.kg-1 soil. The soil was initially characterized by a potassium content of 0.8 g kg-1 soil, K2O exchangeable rate varied between 0.63 g.Kg-1 and 0.71 g.kg-1 soil respectively T2 and T1.

Keywords: compost, organic amendement, Ntot, P2O5, K2O

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Authors: Hen Friman

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Various categories of aqueous solutions are discharged within residential, institutional, commercial, and industrial structures. To safeguard public health and preserve the environment, it is imperative to subject wastewater to treatment processes that eliminate pathogens (such as bacteria and viruses), nutrients (such as nitrogen and phosphorus), and other compounds. Failure to address untreated sewage accumulation can result in an array of adverse consequences. Israel exemplifies a special case in wastewater management. Appropriate wastewater treatment significantly benefits sectors such as agriculture, tourism, horticulture, and industry. Nevertheless, untreated sewage in settlements lacking proper sewage collection or transportation networks remains an ongoing and substantial threat. Notably, the process of wastewater treatment entails substantial energy consumption. Consequently, this study explores the integration of solar energy as a renewable power source within the wastewater treatment framework. By incorporating renewable energy sources into the process, costs can be minimized, and decentralized facilities can be established even in areas lacking adequate infrastructure for traditional treatment methods.

Keywords: renewable energy, solar energy, innovative, wastewater treatment

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Authors: Shirajul Islam Khan, Muhammad Ashraful Alam Bhuiyan, Syeda Tania Begum

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Introduction: Acne vulgaris is one of the most common dermatologic conditions and affects the vast majority of people at some point during their lifetime, so effective treatment is of major importance. The failure of usual treatment modalities, teratogenic effects with some severe side effects, and resistance to P.Acne by Retinoides have been focusing on new therapeutic options for the treatment of acne. More recently, pulsed dye laser therapy has been reported to reduce acne lesion counts. The negligible morbidity of these treatment modalities and some other benefits of subsequent acne scar management lead this therapy more attractive. Objective: The objective of this study is to assess the efficacy and safety of pulsed dye laser therapy in the treatment of inflammatory acne vulgaris. Materials and Methods: A prospective clinical trial was done in the Department of Dermatology and Venereology, Combined Military Hospital (CMH), Dhaka, to find out the role of pulse dye laser in the treatment of inflammatory acne vulgaris. The study was carried out with 60 patients with mild to moderate acne vulgaris, and those were treated with pulsed dye laser therapy at baseline and after 4, 8, and 12 weeks. Results: Among 60 patients with inflammatory acne, 42(70%) were in the age group of less than 20 years, and 36(60%) were female. Regarding the number of inflammatory lesions, the baseline mean number (± SD) was 12.77 ± 4.01; after 4 weeks of treatment of inflammatory acne by pulsed dye laser was 7.80 ± 4.11; after 8 weeks of treatment, 6.10 ± 4.03 and after 12 weeks of treatment was 4.17 ± 4.02. After 4 weeks of treatment by pulse dye laser, the level of improvement was excellent at 3.3%, good at 10%, fair at 60%, and poor at 26.7%; after 8 weeks of treatment, excellent was 13.3%, good was 46.7%, the fair was 30% and poor 10% and after 12 weeks of treatment, excellent was 56.7%, good 13.3%, fair 23.3% and poor 6.7%. Regarding safety level, out of 60 patients of inflammatory acne vulgaris treated by pulsed dye laser, about 52(86.7%) patients did not observe any side effects. Conclusions: On the basis of the study results, it can be concluded that pulsed-dye laser is highly effective and well tolerated by patients in the treatment of inflammatory acne.

Keywords: pulsed-dye laser, inflammatory acne, acne vulgaris, retinoids

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Authors: Jasper Kevin C. Dionisio, Denise Mae M. Unsay

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In a manufacturing firm, controlling the process ensures that optimum efficiency, productivity, and quality in an organization are achieved. An operation with no standardized procedure yields a poor productivity, inefficiency, and an out of control process. This study focuses on controlling the small intestine processing of a chicken dressing plant through the use of Statistical Process Control (SPC). Since the operation does not employ a standard procedure and does not have an established standard time, the process through the assessment of the observed time of the overall operation of small intestine processing, through the use of X-Bar R Control Chart, is found to be out of control. In the solution of this problem, the researchers conduct a motion and time study aiming to establish a standard procedure for the operation. The normal operator was picked through the use of Westinghouse Rating System. Instead of utilizing the traditional motion and time study, the researchers used the X-Bar R Control Chart in determining the process average of the process that is used for establishing the standard time. The observed time of the normal operator was noted and plotted to the X-Bar R Control Chart. Out of control points that are due to assignable cause were removed and the process average, or the average time the normal operator conducted the process, which was already in control and free form any outliers, was obtained. The process average was then used in determining the standard time of small intestine processing. As a recommendation, the researchers suggest the implementation of the standard time established which is with consonance to the standard procedure which was adopted from the normal operator. With that recommendation, the whole operation will induce a 45.54 % increase in their productivity.

Keywords: motion and time study, process controlling, statistical process control, X-Bar R Control chart

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Authors: Rajendra Kumar Kanojia

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Treatment of fracture both bones of leg following trauma is done intially at nearby primary health care center.primary management for shock,pain,control of bleeding,plaster application. These are treated for primay fixation of fracture, debridment of wound. Then, they were refered to tertiary care where they were again and planned for further treatment. This leads to loss of lot of time, money, job, etc.

Keywords: fracture both bones leg, non-union, ilizarov, cost

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Authors: Sarika Gupta, Harshika Khanna, Ajay K Verma, Surya Kant

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Background: Drug-resistant tuberculosis (DR-TB) is a growing health challenge to global TB control efforts. Pediatric DR-TB is one of the neglected infectious diseases. In our previously published report, we have notified an increased prevalence of DR-TB in the pediatric population at a tertiary health care centre in North India which was estimated as 17.4%, 15.1%, 18.4%, and 20.3% in (%) in the year 2018, 2019, 2020, and 2021. Limited evidence exists about a pattern of drug resistance, side effect profile and programmatic outcomes of Paediatric DR-TB treatment. Therefore, this study was done to find out the pattern of resistance, side effect profile and treatment outcome. Methodology: This was a prospective cohort study conducted at the nodal drug-resistant tuberculosis centre of a tertiary care hospital in North India from January 2021 to December 2022. Subjects included children aged between 0-18 years of age with a diagnosis of DR-TB, on the basis of GeneXpert (rifampicin [RIF] resistance detected), line probe assay and drug sensitivity testing (DST) of M. tuberculosis (MTB) grown on a culture of body fluids. Children were classified as monoresistant TB, polyresistant TB (resistance to more than 1 first-line anti-TB drug, other than both INH and RIF), MDR-TB, pre-XDR-TB and XDR-TB, as per the WHO classification. All the patients were prescribed DR TB treatment as per the standard guidelines, either shorter oral DR-TB regimen or a longer all-oral MDR/XDR-TB regimen (age below five years needed modification). All the patients were followed up for side effects of treatment once per month. The patient outcomes were categorized as good outcomes if they had completed treatment and cured or were improving during the course of treatment, while bad outcomes included death or not improving during the course of treatment. Results: Of the 50 pediatric patients included in the study, 34 were females (66.7%) and 16 were male (31.4%). Around 33 patients (64.7%) were suffering from pulmonary TB, while 17 (33.3%) were suffering from extrapulmonary TB. The proportions of monoresistant TB, polyresistant TB, MDR-TB, pre-XDR-TB and XDR-TB were 2.0%, 0%, 50.0%, 30.0% and 18.0%, respectively. Good outcome was reported in 40 patients (80.0%). The 10 bad outcomes were 7 deaths (14%) and 3 (6.0%) children who were not improving. Adverse events (single or multiple) were reported in all the patients, most of which were mild in nature. The most common adverse events were metallic taste 16(31.4%), rash and allergic reaction 15(29.4%), nausea and vomiting 13(26.0%), arthralgia 11 (21.6%) and alopecia 11 (21.6%). Serious adverse event of QTc prolongation was reported in 4 cases (7.8%), but neither arrhythmias nor symptomatic cardiac side effects occurred. Vestibular toxicity was reported in 2(3.9%), and psychotic symptoms in 4(7.8%). Hepatotoxicity, hypothyroidism, peripheral neuropathy, gynaecomastia, and amenorrhea were reported in 2 (4.0%), 4 (7.8%), 2 (3.9%), 1(2.0%), and 2 (3.9%) respectively. None of the drugs needed to be withdrawn due to uncontrolled adverse events. Conclusion: Paediatric DR TB treatment achieved favorable outcomes in a large proportion of children. DR TB treatment regimen drugs were overall well tolerated in this cohort.

Keywords: pediatric, drug-resistant, tuberculosis, adverse events, treatment

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Authors: Ouahiba Taamallah, Tarek Litim

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This work relates to the physico-geometrical aspect of the surface layers of 100C6 steel having undergone the burnishing treatment by hard steel ball. The application of tip diamond burnishing promotes better roughness compared to turning. In addition, it allows the surface layers to be consolidated by work hardening phenomena. The optimal effects are closely related to the parameters of the treatment and the active part of the device. With an 80% improvement in roughness resulting from the treatment, burnishing can be defined as a finishing operation within the machining range. With a 40% gain in consolidation rate, this treatment is an efficient process for material consolidation.

Keywords: 100C6 steel, burnishing, hardening, roughness

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Authors: Bill D. Geis

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Suicide wrongful death forensic cases are the fastest rising tort in mental health law. It is estimated that suicide-related cases have accounted for 15% of U.S. malpractice claims since 2006. Most suicide-related personal injury claims fall into the legal category of “wrongful death.” Though mental health experts may be called on to address a range of forensic questions in wrongful death cases, the central consultation that most experts provide is about the negligence element—specifically, the issue of whether the clinician met the clinical standard of care in assessing, treating, and managing the deceased person’s mental health care. Standards of care, varying from U.S. state to state, are broad and address what a reasonable clinician might do in a similar circumstance. This fact leaves the issue of the suicide standard of care, in each case, up to forensic experts to put forth a reasoned estimate of what the standard of care should have been in the specific case under litigation. Because the general state guidelines for standard of care are broad, forensic experts are readily retained to provide scientific and clinical opinions about whether or not a clinician met the standard of care in their suicide assessment, treatment, and management of the case. In the past and in much of current practice, the assessment of suicide has centered on the elicitation of verbalized suicide ideation. Research in recent years, however, has indicated that the majority of persons who end their lives do not say they are suicidal at their last medical or psychiatric contact. Near-term risk assessment—that goes beyond verbalized suicide ideation—is needed. Our previous research employed structural equation modeling to predict lethal suicide risk--eight negative thought patterns (feeling like a burden on others, hopelessness, self-hatred, etc.) mediated by nine transdiagnostic clinical factors (mental torment, insomnia, substance abuse, PTSD intrusions, etc.) were combined to predict acute lethal suicide risk. This structural equation model, the Lethal Suicide Risk Pattern (LSRP), Acute model, had excellent goodness-of-fit [χ2(df) = 94.25(47)***, CFI = .98, RMSEA = .05, .90CI = .03-.06, p(RMSEA = .05) = .63. AIC = 340.25, ***p < .001.]. A further SEQ analysis was completed for this paper, adding a measure of Acute Suicide Ideation to the previous SEQ. Acceptable prediction model fit was no longer achieved [χ2(df) = 3.571, CFI > .953, RMSEA = .075, .90% CI = .065-.085, AIC = 529.550].This finding suggests that, in this additional study, immediate verbalized suicide ideation information was unhelpful in the assessment of lethal risk. The LSRP and other dynamic, near-term risk models (such as the Acute Suicide Affective Disorder Model and the Suicide Crisis Syndrome Model)—going beyond elicited suicide ideation—need to be incorporated into current clinical suicide assessment training. Without this training, the standard of care for suicide assessment is out of sync with current research—an emerging dilemma for the forensic evaluation of suicide wrongful death cases.

Keywords: forensic evaluation, standard of care, suicide, suicide assessment, wrongful death

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Authors: Rajveer, Abhinav Saxena, Sanjeev Das

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The study is focused on the strength of forged aluminum alloy (AA) 6082 (T6). Aluminum alloy 6082 belongs to Al-Mg-Si family which has a wide range of automotive applications. A decrease in the strength of AA 6082 alloy was observed after T6 treatment. The as-received (extruded), forged, and forged + heat treated samples were examined to understand the reason. These examinations were accomplished by optical (OM) and scanning electron microscope (SEM) and X-ray diffraction (XRD) studies. It was observed that the defects had an insignificant effect on the alloy strength. The alloy samples were subjected to age hardening treatment and the time to achieve peak hardening was acquired. Standard tensile specimens were prepared from as-received (extruded), forged, forged + solutionized and forged + solutionized + age hardened. Tensile tests were conducted by Instron universal testing machine. It was observed that there was a significant drop in tensile strength in the case of solutionized sample. The detailed study of the fracture samples showed that the solutionizing after forging was not the best way to increase the strength of Al 6082 alloy.

Keywords: aluminum alloy 6082, strength, forging, age hardening

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Authors: Baba Hassane Ahmed Hisseini, Abdelkrim Bennabi, Rabah Hamzaoui, Lamis Makki, Gaetan Blanck

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Most of the clay soils are known as problematic soils due to their water content, which varies greatly over time. It is observed that they are used to be subject to shrinkage and swelling, thus causing a problem of stability on the structures of civil engineering construction work. They are often excavated and placed in a storage area giving rise to the opening of new quarries. This method has become obsolete today because to protect the environment, we are leading to think differently and opening the way to new research for the improvement of the performance of this type of clay soils to reuse them in the construction field. The solidification and stabilization technique is used to improve the properties of poor quality soils to transform them into materials with a suitable performance for a new use in the civil engineering field rather than to excavate them and store them in the discharge area. In our case, the polymerization method is used for bad clay soils classified as high plasticity soil class A4 according to the French standard NF P11-300, where classical treatment methods with cement or lime are not efficient. Our work concerns clay soil treatment study using raw materials as additives for solidification and stabilization. The geopolymers are synthesized by aluminosilicates materials like fly ash, metakaolin, or blast furnace slag and activated by alkaline solution based on sodium hydroxide (NaOH), sodium silicate (Na2SiO3) or a mixture of both of them. In this study, we present the mechanical properties of the soil clay (A4 type) evolution with geopolymerisation methods treatment. Various mix design of aluminosilicates materials and alkaline solutions were carried at different percentages and different curing times of 1, 7, and 28 days. The compressive strength of the untreated clayey soil could be increased from simple to triple. It is observed that the improvement of compressive strength is associated with a geopolymerization mechanism. The highest compressive strength was found with metakaolin at 28 days.

Keywords: treatment and valorization of clay-soil, solidification and stabilization, alkali-activation of co-product, geopolymerization

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Authors: Kasra Khorsand-Kazemi, Bianca Vizcaino, Mandeep Chhajer Jain, Maryam Moradpour

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This work presents an approach to characterize a non- contact microwave sensor using waveguides for different standard liquids such as ethanol, methanol and 2-propanol (Isopropyl Alcohol). Wideband waveguides operating between 12.4GHz to 18 GHz form the core of the sensing structure. Waveguides are sensitive to changes in conductivity of the sample under test (SUT), making them an ideal tool to characterize different polar liquids. As conductivity of the sample under test increase, the loss tangent of the material increase, thereby decreasing the S21 (dB) response of the waveguide. Among all the standard liquids measured, methanol exhibits the highest conductivity and 2-Propanol exhibits the lowest. The cutoff frequency measured for ethanol, 2-propanol, and methanol are 10.28 GHz, 10.32 GHz, and 10.38 GHz respectively. The measured results can be correlated with the loss tangent results of the standard liquid measured using the dielectric probe. This conclusively enables us to characterize different liquids using waveguides expanding the potential future applications in domains ranging from water quality management to bio-medical, chemistry and agriculture.

Keywords: Waveguides, , Microwave sensors, , Standard liquids characterization, Non-contact sensing

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Authors: Ibrahim Turfanda, Soniya Rai, Karan Vadher

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Objectives— The study aims to compare real-world adherence to and persistence with dulaglutide and liraglutide in patients with type 2 diabetes (T2D) initiating treatment in UAE. Methods— This was a retrospective, non-interventional study (observation period: 01 March 2017–31 August 2019) using the UAE Dubai e-Claims database. Included: adult patients initiating dulaglutide/liraglutide 01 September 2017–31 August 2018 (index period) with: ≥1 claim for T2D in the 6 months before index date (ID); ≥1 claim for dulaglutide/liraglutide during index period; and continuous medical enrolment for ≥6 months before and ≥12 months after ID. Key endpoints, assessed 3/6/12 months after ID: adherence to treatment (proportion of days covered [PDC; PDC ≥80% considered ‘adherent’], per-group mean±standard deviation [SD] PDC); and persistence (number of continuous therapy days from ID until discontinuation [i.e., >45 days gap] or end of observation period). Patients initiating dulaglutide/liraglutide were propensity score matched (1:1) based on baseline characteristics. Between-group comparison of adherence was analysed using the McNemar test (α=0.025). Persistence was analysed using Kaplan–Meier estimates with log-rank tests (α=0.025) for between-group comparisons. This study presents 12-month outcomes. Results— Following propensity score matching, 263 patients were included in each group. Mean±SD PDC for all patients at 12 months was significantly higher in the dulaglutide versus the liraglutide group (dulaglutide=0.48±0.30, liraglutide=0.39±0.28, p=0.0002). The proportion of adherent patients favored dulaglutide (dulaglutide=20.2%, liraglutide=12.9%, p=0.0302), as did the probability of being adherent to treatment (odds ratio [97.5% CI]: 1.70 [0.99, 2.91]; p=0.03). Proportion of persistent patients also favoured dulaglutide (dulaglutide=15.2%, liraglutide=9.1%, p=0.0528), as did the probability of discontinuing treatment 12 months after ID (p=0.027). Conclusions— Based on the UAE Dubai e-Claims database data, dulaglutide initiators exhibited significantly greater adherence in terms of mean PDC versus liraglutide initiators. The proportion of adherent patients and the probability of being adherent favored the dulaglutide group, as did treatment persistence.

Keywords: adherence, dulaglutide, effectiveness, liraglutide, persistence

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Authors: Ayman A. Al Hayek, Asirvatham A. Robert, Mohamed A. Al Dawish, Rim B. Braham, Hanouf S. Goudeh, Fahad S. Al Sabaan

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Introduction: The aim of this study was to explore the impact of insulin pump therapy on diabetes treatment satisfaction and glycemic control among patients with type 1 diabetes mellitus (T1DM) in Saudi Arabia. Methods: A 6-month, prospective study was conducted among 47 patients (aged17–24 years) with T1DM who attended the Insulin Pump Clinic at Prince Sultan Military Medical City, Riyadh, Saudi Arabia, between April 2014 and November 2014. The respondents were purposively and conveniently selected and were interviewed using the Arabic version of the Diabetes Treatment Satisfaction Questionnaire at baseline, 3, and 6 months. Demographics and clinical variables including hemoglobin A1c (HbA1c) were also collected. Results: The mean (±standard deviation) age of the study cohort was 19.1 ± 1.93 years. Seventeen patients were male (36.2%) and 30 were female (63.8%). Compared to baseline, significant positive differences were found in treatment satisfaction among female patients and patients with long-standing T1DM at 6 months. Frequency of hyperglycemia and hypoglycemia declined significantly in female patient’s at 6 months and in patients who had a shorter duration of T1DM. Furthermore, significant positive differences were found in HbA1c levels among female patients and among those who had a shorter duration of T1DM compared to baseline. Both female and male patients and those with a shorter duration of T1DM showed significant decline in insulin necessity at6months when compared to baseline. Conclusion: Although multiple daily injections is a feasible preference for insulin supply, insulin pumps should also be considered for patients with T1DM as it appears to increase patients’ treatment satisfaction, decrease the frequency of hypoglycemia, hyperglycemia, and reduce HbA1c levels.

Keywords: type 1 diabetes, insulin pump, Saudi Arabia, T1DM

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Authors: Young-Kwan Choi, Gang-Wook Shin, Sung-Taek Hong

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Water supply system consumes large amount of power load during water treatment and transportation of purified water. Many energy conserving high efficiency materials such as DC motor and LED light have recently been introduced to water supply system for energy conservation. This paper performed empirical analysis on BLDC, AC motors, and comparatively analyzed the change in power according to DC power supply ratio in order to conserve energy of a next-generation water treatment system called vertical water treatment system. In addition, a DC distribution system linked with photovoltaic generation was simulated to analyze the energy conserving effect of DC load.

Keywords: vertical water treatment system, DC power supply, energy efficiency, BLDC

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Authors: Thanasit Suksutdhi

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This survey research aims to study the standard of service quality of food and beverage service staffs in hotel business by studying the service standard of three sample hotels, Siam Kempinski Hotel Bangkok, Four Seasons Resort Chiang Mai, and Banyan Tree Phuket. In order to find the international service standard of food and beverage service, triangular research, i.e. quantitative, qualitative, and survey were employed. In this research, questionnaires and in-depth interview were used for getting the information on the sequences and method of services. There were three parts of modified questionnaires to measure service quality and guest’s satisfaction including service facilities, attentiveness, responsibility, reliability, and circumspection. This study used sample random sampling to derive subjects with the return rate of the questionnaires was 70% or 280. Data were analyzed by SPSS to find arithmetic mean, SD, percentage, and comparison by t-test and One-way ANOVA. The results revealed that the service quality of the three hotels were in the international level which could create high satisfaction to the international customers. Recommendations for research implementations were to maintain the area of good service quality, and to improve some dimensions of service quality such as reliability. Training in service standard, product knowledge, and new technology for employees should be provided. Furthermore, in order to develop the service quality of the industry, training collaboration between hotel organization and educational institutions in food and beverage service should be considered.

Keywords: service standard, food and beverage department, sequence of service, service method

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Authors: Nashalla Gwyn Nyinda

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The ancient system of Tibetan Medicine, known as Sowa Rigpa across the Himalayan regions, is a systematic system of healing encouraging balance primarily through diet and behavior modifications. With the rise of the popularity of Tibetan Medicine, compliance is critical to successful treatment outcomes. As patients learn more about who they are as individuals and how their elemental balances or imbalances affect disorders and mental-emotional balance, they develop faith and dedication to their healing process. Specifically, regarding diet and behavior and the basic principles of the medical system, patient compliance increases dramatically in all treatment areas when they understand why a treatment or dietary prescription guidance is effective. Successful responses to Tibetan treatment rely on a buy-in from the patient. Trust between the slower process of Traditional medicine treatments, the Tibetan physician and the patient is a cornerstone of treatment. The resulting decrease in the use of allopathic medicine and better health outcomes for acute and chronic disorders are well documented. This paper addresses essential points of the Tibetan Medicine system, dialogue between doctor and patient focused on appropriate and seasonal changing dietetics. Such fluctuating treatment approaches, based on external elemental factors, dramatically increase treatment outcomes. Specifically, this work addresses why allopathic medicine models may need more trust development between practitioner and patient.

Keywords: compliancy in treatment, diet and lifestyle medicine, nature and elements as medicine, seasonal diets, Sowa Rigpa, traditional Tibetan medicine, treatment outcomes

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Authors: Ujwal Kishor Zore, Shankar Balajirao Kausley, Aniruddha Bhalchandra Pandit

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There are some important design parameters of activated sludge process (ASP) for wastewater treatment and they must be optimally defined to have the optimized plant working. To know them, developing a mathematical model is a way out as it is nearly commensurate the real world works. In this study, a mathematical model was developed for ASP, solved under activated sludge model no 1 (ASM 1) conditions and MATLAB tool was used to solve the mathematical equations. For its real-life validation, the developed model was tested for the inputs from the municipal wastewater treatment plant and the results were quite promising. Additionally, the most cardinal assumptions required to design the treatment plant are discussed in this paper. With the need for computerization and digitalization surging in every aspect of engineering, this mathematical model developed might prove to be a boon to many biological wastewater treatment plants as now they can in no time know the design parameters which are required for a particular type of wastewater treatment.

Keywords: waste water treatment, activated sludge process, mathematical modeling, optimization

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Authors: M. Hadji, A. Haddad, Y. Hadji

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The effects of boronizing treatment on the friction coefficient and wear behavior of 0.35 Vf TiC- Ti3 SiC2 composite were investigated. In order to modify the surface properties of Ti3SiC2, boronizing treatment was carried out through powder pack cementation in the 1150-1350 °C temperature range. After boronizing treatment, one mixture layer, composed of TiB2 and SiC, forms on the surface of Ti3SiC2. The growth of the coating is processed by inward diffusion of Boron and obeys a linear rule. The Boronizing treatment increases the hardness of Ti3SiC2 from 6 GPa to 13 GPa. In the pin-on-disc test, i twas found that the material undergoes a steady-state coefficient of friction of around 0.8 and 0.45 in case of Ti3SiC2/Al2O3 tribocouple under 7 N load for the non treated and the boronized samples, respectively. The wear resistance of Ti3SiC2 under Al2O3 ball sliding has been significantly improved, which indicated that the boronizing treatment is a promising surface modification way of Ti3SiC2.

Keywords: MAX phase, boronizing, hardness, wear

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Authors: Oliver Chunho Ma, Tszying Chang

Abstract:

Background: Traditional Chinese Medicine (TCM) has been widely used in the treatment of eczema. However, there is currently a lack of comprehensive research on the overall effectiveness of TCM in treating eczema, particularly using the Eczema Area and Severity Index (EASI) score as an evaluation tool. Meta-analysis can integrate the results of multiple studies to provide more convincing evidence. Objective: To conduct a systematic review and meta-analysis based on the EASI score to evaluate the overall effectiveness of TCM in the treatment of eczema. Specifically, the study will review and analyze published clinical studies that investigate TCM treatments for eczema and use the EASI score as an outcome measure, comparing the differences in improving the severity of eczema between TCM and other treatment modalities, such as conventional Western medicine treatments. Methods: Relevant studies, including randomized controlled trials (RCTs) and non-randomized controlled trials, that involve TCM treatment for eczema and use the EASI score as an outcome measure will be searched in medical literature databases such as PubMed, CNKI, etc. Relevant data will be extracted from the selected studies, including study design, sample size, treatment methods, improvement in EASI score, etc. The methodological quality and risk of bias of the included studies will be assessed using appropriate evaluation tools (such as the Cochrane Handbook). The results of the selected studies will be statistically analyzed, including pooling effect sizes (such as standardized mean differences, relative risks, etc.), subgroup analysis (e.g., different TCM syndromes, different treatment modalities), and sensitivity analysis (e.g., excluding low-quality studies). Based on the results of the statistical analysis and quality assessment, the overall effectiveness of TCM in improving the severity of eczema will be interpreted. Expected outcomes: By integrating the results of multiple studies, we expect to provide more convincing evidence regarding the specific effects of TCM in improving the severity of eczema. Additionally, subgroup analysis and sensitivity analysis can further elucidate whether the effectiveness of TCM treatment is influenced by different factors. Besides, we will compare the results of the meta-analysis with the clinical data from our clinic. For both the clinical data and the meta-analysis results, we will perform descriptive statistics such as means, standard deviations, percentages, etc. and compare the differences between the two using statistical tests such as independent samples t-test or non-parametric tests to assess the statistical differences between them.

Keywords: Eczema, traditional Chinese medicine, EASI, systematic review, meta-analysis

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Authors: Boy Subirosa Sabarguna, Aria Kekalih, Irzan Nurman

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Introduction: Software in the form of Clinical Decision Support System could help students in understanding the mind set of decision-making in diagnosis and treatment at the stage of general practitioners. This could accelerate and ease the learning process which previously took place by using books and experience. Method: Gather 1000 members of the National Medical Multimedia Digital Community (NM2DC) who use the “flowchart of diagnosis and treatment” software, and analyse factors related to: display, speed in learning, convenience in learning, helpfulness and usefulness in the learning process, by using the Likert Scale through online questionnaire which will further be processed using percentage. Results and Discussions: Out of the 1000 members of NM2DC, apparently: 97.0% of the members use the software and 87.5% of them are students. In terms of the analysed factors related to: display, speed in learning, convenience in learning, helpfulness and usefulness of the software’s usage, the results indicate a 90.7% of fairly good performance. Therefore, the “Flowchart of Diagnosis and Treatment” software has helped students in understanding the decision-making of diagnosis and treatment. Conclusion: the use of “Flowchart of Diagnosis and Treatment” software indicates a positive role in helping students understand decision-making of diagnosis and treatment.

Keywords: usage, software, diagnosis and treatment, medical education

Procedia PDF Downloads 335

Authors: Medhat Gad

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Wastewater treatment became a big issue in this decade due to shortage of water resources, growth of population and modern live requirements. Reuse of treated wastewater in industrial and agriculture sectors has a big demand to substitute the shortage of clean water supply as well as to save the eco system from dangerous pollutants in insufficient treated wastewater In last decades, most of wastewater treatment plants are built using primary or secondary biological treatment technology which almost does not provide enough treatment and removal of phosphorus and nitrogen. those plants which built ten to 15 years ago also now suffering from overflow which decrease the treatment efficiency of the plant. Discharging treated wastewater which contains phosphorus and nitrogen to water reservoirs and irrigation canals destroy ecosystem and aquatic life. Using chemical material to enhance treatment efficiency for domestic wastewater but it leads to huge amount of sludge which cost a lot of money. To enhance wastewater treatment, we used INNPT nano material which consists of calcium, aluminum and iron oxides and compounds plus silica, sodium and magnesium. INNPT nano material used with a dose of 100 mg/l to upgrade SBR treatment plant in Cairo Egypt -which has three treatment tanks each with a capacity of 2500 cubic meters per day - to tertiary treatment level by removing Phosphorus, Nitrogen and increase dissolved oxygen in final effluent. The results showed that the treatment retention time decreased from 9 hours in SBR system to one hour using INNPT nano material with improvement in effluent quality while increasing plant capacity to 20 k cubic meters per day. Nitrogen removal efficiency achieved 77%, while phosphorus removal efficiency achieved 90% and COD removal efficiency was 93% which all comply with tertiary treatment limits according to Egyptian law.

Keywords: INNPT technology, nanomaterial, tertiary wastewater treatment, capacity extending

Procedia PDF Downloads 133

Authors: Alan C. Lin, Ricky N. Joevan

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This paper focuses on developing a system to transfer mold base plates and standard parts faster during the stage of injection mold design. This system not only provides a way to compare the file version, but also it utilizes Siemens NX 10 to isolate the updated information into a single executable file (.dll), and then, the file can be transferred without the need of transferring the whole file. By this way, the system can help the user to download only necessary mold base plates and standard parts, and those parts downloaded are only the updated portions.

Keywords: CAD, injection molding, mold base, data retrieval

Procedia PDF Downloads 274

Authors: Hadura Abu Hasan, Zairi Jaal, P. J. McCall

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Dengue is a serious problem in Malaysia, particularly in high-density urban communities with lower socio-economic levels. This study evaluated the susceptibility of local populations of Aedesaegypti (Linnaeus), Aedesalbopictus (Skuse) and Culexquinquefasciatus (Say) from the traditional community of BaganDalam, Penang, Malaysia to lambdacyhalothrin and pirimiphos-methyl using standard World Health Organization (WHO) adult bioassay test. Unfed female mosquitoes aged 3-5 days were exposed to WHO recommended dosages of insecticides over fixed time periods with results presented as knock-down time (KT50) for each strain.The insecticide susceptible VCRU laboratory strain was usedas control. All three specieswere highly resistant to lambda-cyhalothrin with less than 10% mortality at 24 hours after treatment. In contrast, Ae.aegypti and Ae. albopictus were susceptible to pirimiphos-methyl, showing 100% mortality recorded 24 hoursafter treatment. Cx. quinquefasciatuswasclassed as ‘suspected resistant’ to pirimiphos-methyl as mortality recorded 24 hours after treatment was 94-96%. The results indicate that organophosphates such as pirimiphos-methyl might be used as alternative to pyrethroid for dengue vector control in this dengue-prone area.

Keywords: vector control, aedes aegypti, aedes albopictus, dengue, culex quinquefasciatus, residuals insecticides, pyrethroid, organophosphate, resistant, mosquito

Procedia PDF Downloads 237

Authors: Anita Padmanabhanunni

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Trauma-focused cognitive-treatment (CT) models are among the most efficacious in treating PTSD arising from exposure to rape. However, these treatment approaches are severely under-utilised by South African mental health care practitioners owing to concerns around whether treatments developed in Western clinical contexts are transportable and applicable in routine clinical settings. One way of promoting the use of these efficacious treatments in local contexts is by identifying and appraising the evidence from local outcome studies. This paper presents the findings of a systematic review of research evidence from local outcome studies on the effectiveness of CT in the treatment of rape-related PTSD in South Africa. The study found that whilst limited research has been published in South Africa on the outcome of CT in the treatment of rape survivors, the studies that are available afford insights into the effectiveness of CT.

Keywords: cognitive treatment, PTSD, South Africa, transportability

Procedia PDF Downloads 306

Authors: J. C. M. Santos, J. C. A. Sousa, A. J. Rubio, L. S. Soletti, F. Gasparotto, N. U. Yamaguchi

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Magnetic graphene has received widespread attention for their capability of water and wastewater treatment, which has been attracted many researchers in this field. A bibliometric analysis based on the Web of Science database was employed to analyze the global scientific outputs of magnetic graphene for water treatment until the present time (2012 to 2017), to improve the understanding of the research trends. The publication year, place of publication, institutes, funding agencies, journals, most cited articles, distribution outputs in thematic categories and applications were analyzed. Three major aspects analyzed including type of pollutant, treatment process and composite composition have further contributed to revealing the research trends. The most relevant research aspects of the main technologies using magnetic graphene for water treatment were summarized in this paper. The results showed that research on magnetic graphene for water treatment goes through a period of decline that might be related to a saturated field and a lack of bibliometric studies. Thus, the result of the present work will lead researchers to establish future directions in further studies using magnetic graphene for water treatment.

Keywords: composite, graphene oxide, nanomaterials, scientometrics

Procedia PDF Downloads 224

Authors: R. H. Begaydarova, B. Zh. Kultanov, B. T. Esilbaeva, G. E. Nasakaeva, Y. Yukhnevich, G. K. Alshynbekova, A. E. Dyusembaeva

Abstract:

Background: The level of middle molecules of peptides (MMP) allows to evaluate the severity and prognosis of the disease and is a criterion for the effectiveness of the treatment. The detection the products of lipidperoxidation cascade, such as conjugated dienes, malondialdehyde in biological material, has an important role in the development of pathogenesis, the diagnosis and prognosis in different parasitic diseases. Purpose of the study was to evaluate the state of endogenous intoxication and indicators of lipid peroxidation in patients with giardiasis before and after treatment. Materials and methods: Endogenous intoxication was evaluated in patients with giardiasis in the level of middle molecules of peptides (MMP) in the blood. The amount of MMP and products of lipid peroxidation were determined in the blood of 198 patients with giardiasis, 129 of them were women (65%), 69 were men (35%). The MMP level was detected for comparison in the blood of 84 healthy volunteers. The lipid peroxidation were determined in 40 healthy men and women without giardiasis and history of chronic diseases. Data were processed by conventional methods of variation statistics, we calculated the arithmetic mean (M) and standard dispersion (m). t-test (t) was used to assess differences. Results: The level of MMP in the blood was significantly higher in patients with giardiasis in comparison with group of healthy men and women. MMP concentration in the blood of women with Giardia was 2.5 times greater than that of the comparison groups of women. The level of MMP exceeds more than 6 times in men with giardiasis. The decrease in the intensity of endogenous intoxication was two weeks after antigiardia therapy, both men and women. According to the study, a statistically significant increase in the level of all the studied parameters lipid peroxidation cascade was observed in the blood of men with giardiasis, with the exception of the total primary production (NGN). The treatment of giardiasis helped to stabilize the level of almost all metabolites of lipid peroxidation cascade. The exception was level of malondialdehyde, it was significantly elevated to compare with the control group and after treatment. Conclusion: Thus, the MMP level was significantly higher in blood of patients with giardiasis than in comparison group. This is evidence of severe endogenous intoxication caused by giardia infection. The accumulation of primary and secondary products of lipid peroxidation was observed in the blood of men and women. These processes tend to be more active in men than in women. Antigiardiasis therapy contributed to the normalization of almost all the studied indicators of lipid peroxidation in the blood of participants, except the level malondialdehyde in the blood of men.

Keywords: enzymes of antioxidant protection, giardiasis, blood, treatment

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