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Happy Easter - Juniper Publishers
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Pleomorphic Adenoma Presented as Hard Palatal Mass: A Case Report | Juniper Publishers
Juniper Publishers-Open Access Journal of Otolaryngology
Authored by Lageju Nabin
Abstract
Objective: To consider one of the differential diagnoses of palatal mass as pleomorphic adenoma
Case presentation: 21-year-old female patient presented in ENT department with painless mass in right side of hard palate for 2 years which was gradually progressive and slight discomfort on tongue movement and chewing food which on examination found to be 2*2cm swelling in right hard palate with normal overlying mucosa. On radiological examination, there was heterogenous swelling with intact hard palate. With provisional diagnosis of pleomorphic adenoma, excision of mass with overlying mucosa and periosteum was done. Histopathological report confirmed the diagnosis.
Keywords: Palatal mass; Pleomorphic adenoma; Excision
Introduction
Pleomorphic adenoma is the most common salivary gland tumours accounting for 40-70% of all major and minor salivary gland tumours [1]. It is also commonest minor salivary gland benign tumours accounting 70% of all tumours [2]. Hard palate is the commonest site followed by upper lip, buccal mucosa, tongue, floor of mouth, retromolartrigone [3,4]. Common age of presentation is second decade of life [5] with slight female preference [3]. Presenting symptoms are painless slow growing mass without ulceration and surrounding inflammation which on palpation feels non-tender, firm, rubbery [6]. In this paper, we present a case of pleomorphic adenoma of minor salivary gland in hard palate who treated with wide local excision.
Case Report
21 year old female patient presented in ENT department with painless mass in right side of hard palate for 2 years which was gradually progressive and slight discomfort on tongue movement and chewing food but there was no history of ulceration, bleeding, difficulty in swallowing, breathing and swelling in neck. On examination there was single swelling in the posterior part of the right hard palate measuring 2*2cm with normal overlying mucosa which on palpation firm, non-tenderand well defined swelling (Figure 1). On radiological investigation, there was solitary heterogenous swelling in the right hard palate without calcification and bony erosion. There was scalloping of bone of hard palate due to pressure effect (Figure 2). With all this finding provisional diagnosis of pleomorphic adenoma of hard palate was made and planned for surgical excision. Surgical excision of the mass was done in total along with the overlying mucosa and taking margin from surrounding mucosa. The wound was left open to let itself heal by granulation. The per-operative findings were 2*1.5cm single well encapsulated swelling in the hard palate extending to its posterior border and on cut section it was found to be yellowish white in colour (Figure 3).
Discussion
Pleomorphic adenoma has different embryological origin. It arises from both epithelial and mesenchymal origin. They arise from intercalated and myoepithelial cells. The mass is well demarcated from surroundings by fibrous capsule [6]. Formation of the capsule is a result of fibrosis of the surrounding salivary parenchyma which is composed of the tumor and is referred to as false capsule [7]. The pleomorphic adenoma is typically a well circumscribed, encapsulated tumor. The capsule may be incomplete which is more common in minor salivary gland tumours [8]. Most of the pleomorphic adenoma occurs in major salivary glands and parotid is the commonest. It is also the commonest tumour of minor salivary glands [9]. Palate has the highest number of minor salivary glands in upper aerodigestive tract [10]. So, palate is the commonest site of minor salivary gland tumours. It is followed by lips, buccal mucosa, tongue, retromolar area, pharynx, tonsils. In palate, most common location is posterolateral aspect [11].
The tumour is cellular with background stroma which can be mucoid, myxoid, cartilaginous or hyaline [12]. In “cellular” type of pleomorphic adenoma the epithelial element is dominant and “myxoid” type possess myxomatous element. Typical pleomorphic adenoma is of mixed type. Different epithelial cell types are spindle, clear, squamous, basaloid, cuboidal, plasmacytoid, oncocytic, mucous and sebaceous [13]. It can occur in any age group, but common presentation is in age group of 30-60 years with slight female predominance. Usual presentation of palatal pleomorphic adenoma is painless, slow growing smooth dome shaped [11], rubbery, submucosal mass without mucosal ulceration [14]. If ulceration present, it may be due to trauma or biopsy or malignancy. Due to expansion of mass against bone, there can be cupped out bone resorption [15,16].
Diagnosis of pleomorphic adenoma is based on history, clinical examination and histopathology. Computed tomography scan is an adjuvant diagnostic aid helpful in revealing about the size and extension of the tumour to the adjacent structures and to rule out bony involvement. Confirmatory diagnosis will depend on histopathological examination. Treatment of palatal pleomorphic adenoma involves wide local excision of the tumor together with clear margins involving the periosteum and associated mucosa, followed by curettage or excision of the underlying bone if involved to avoid recurrence. Palatal periosteom is an effective barrier to spread [16]. As simple excision of this tumour has high rate of recurrence, it is best avoided [6]. If palate needs to be excised, it needs to be closed with island flaps. Prognosis of palatal pleomorphic adenoma is usually good with cure rate of 95%, does not recur after adequate surgical removal. The risk of recurrence is low for tumours of minor glands [17]. Tumors with a predominantly myxoid appearance are more susceptible to recur than those with other features. Other causes of recurrence are pseudopodia, capsular penetration, and tumour rupture [18]. The risk of malignant degeneration into carcinoma ex pleomorphic adenoma is rare, occurring only in 5% of all cases [19].
Conclusion
Pleomorphic adenoma is one of differential diagnoses of palatal mass. Excision of mass with adequate margin is the treatment of choice.
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Synthesis of Photoactive Ternary Cadmium Sulfoselenide Thin Film via Cost-effective Chemical Technique for Solar Cell Application | Juniper Publishers
Juniper Publishers-Open Access Journal of Polymer science
Authored by Bhosale PN
Abstract
We have successfully developed arrested precipitation technique for synthesis of photoactive Cd(S0.8Se0.2) thin film. Synthesized thin film were characterized for optical, structural, morphological and compositional analysis using UV–Vis spectrophotometer, Xray Diffraction (XRD), Field-Emission Scanning Electron Microscopy (FESEM) and Energy Dispersive Spectroscopy (EDS) analyzer techniques. Optical study shows linear nature of plot confirms direct allowed transition with optical band gap energy 2.13eV. Pure phase hexagonal nanocrystalline thin film formation confirmed through XRD pattern. FESEM micrographs indicate construction of void free and well-adherent twisted nest-like surface morphology containing tremendous grown flakes over substrate. Presence of Cd2+, S2- and Se2- elements confirmed by EDS spectrum. Finally, synthesized thin film show power conversion efficiency of 0.37 %.
Keywords: APT; Nanocrystalline; n-CdSSe; Thin film; Pure phase; η = 0.37%
Abbrevations: XRD: Xray Diffraction; FESEM: Field-Emission Scanning Electron Microscopy; CBD: Chemical Bath Deposition; CCGP: Controlled Chemical Growth Process; APT: Arrested Precipitation Technique
Introduction
In past few years, the world serious energy and environmental crisis have made more attention to development of new cost-effective and sustainable energy source [1]. Also, quest for new alternative renewable energy source is quite argent and necessary. Overall available technologies photoelectrochemical solar cell technology has believed to be cost-effective and renewable energy source for solar energy conversion. Generally, photoelectrochemical performance of semiconducting materials depends on their respective properties and essential physiochemical processes in which, i) Absorption of light radiations, ii) separation of charge carriers, iii) migration of carriers, iv) recombination of charge carriers and v) redox reaction. Also, respective properties of semiconducting material are nothing but, electronic band structure, crystal structure, chemical constituents and their microstructures.
II-VI group semiconducting compounds are the most important and highly studied semiconducting material for scientific and technological point of application due to their direct band gap [2]. Among this II-VI group semiconducting compounds, typically CdS and CdSe have 2.40 and 1.70 eV optical band gap with wide absorption band edge and excellent absorptivity in visible region [2].
These ternary CdSSe thin films synthesized by varied of method such as, sputtering [3], Chemical Bath Deposition (CBD) method [4]and solvathermal route [5]. All these methods require highly sophisticated instruments, harsh experimental condition, different surface directing agents and solvents [6]. However, in Arrested Precipitation Technique (APT) their no need to use sophisticated instrument, different solvents and harsh experimental condition. Taking into concern these features of technique, we have used APT method for synthesis of CdSSe thin films. APT method is nothing but hybrid chemical process of CBD and Controlled Chemical Growth Process (CCGP) [7].
In present investigation, we have successfully deposited Cd(S0.8Se0.2) thin film using triethanolamine as complexing agent at via APT method. Our intension is to make efficient photoelectrode for photoelectrochemical application using triethanolamine as surface directing agent. Synthesized thin film show 0.37% power conversion efficiency under illumination of 500W tungsten filament lamp (intensity 30mW cm-2). Also, thin film formation growth process by using APT is discussed detailed.
Experimental
Chemicals
All chemicals were of analytical reagent (AR) grade and used without further purification. Cadmium sulfate hydrate (CdSO4.H2O) (98%, S-D Fine Chem.), thiourea (H2N-CS-NH2) (99%, S-D Fine Chem.) selenium metal powder (99.5%, Sigma Aldrich), sodium sulfite (Na2SO3) (96%, S-D Fine Chem.), liquor ammonia (NH3) (28-30% Thomas Baker), and triethanolamine (N(CH2CH2OH)3) (99%, Merck).
Synthesis of Cd(S0.8Se0.2) thin film
In typical synthesis, initially Cd-TEA complex was prepared by triturating ‘Cd’ with TEA as complexing agent for 6 h homogenous crushing to form clear Cd-TEA complex. All metal ions and chalcogen ions precursors’ concentration is optimized at initial stage of synthesis as 0.05M. Cd-TEA complex release Cd2+ metal ions slowly and react with S2- and Se2- chalcogen ions released from dissociation of H2N-CS-NH2and Na2SeSO3 at alkaline pH, 10.4, and 50±2 °C bath temperature at 2.30h deposition time. Formation of thin films is well dependant on various preparative parameters such as, deposition time, bath temperature, pH and precursor concentration. These parameters were optimized during initial stage of thin film synthesis.
After desired deposition time deposited film was removed from bath and washed with double distilled water and dried at room temperature in air. Deposited film was yellowish red in colour and designated as Cd(S0.8Se0.2).
Characterization of thin film
Thickness of film was measured using surface profiler (AMBIOS XP-1). Optical absorption spectra were taken by using a UV-Vis-NIR spectrophotometer (Shimadzu, UV-1800). Structural properties and crystallite size were carried out using an X-ray diffractometer (Bruker AXS, D8) using Cu Ka (l= 1.5418 Å). Surface morphology and the elemental composition of the as-deposited thin films were characterized using field-emission scanning electron microscopy (FESEM) equipped with an energy dispersive X-ray spectroscopy (EDS) analyzer (Hitachi, S-4700). PEC measurements were carried out using a semiconductor parameter analyzer (Keithley SCS-4200 Semiconductor) characterization unit using 500 W tungsten filament lamp (intensity 30mW cm-2) with sulfide/polysulfide electrolyte.
Results and Discussion
Formation Growth mechanism
Main principle behind the film formation is slow ion-byion condensation of ions followed by multi nucleation process. Precipitation of metal chalcogenide thin films is occurred when ionic products (Kp) of Cd2+, S2- and Se2- ions exceed solubility product (Ksp) of Cd(SSe) in films. Slow release of metal and chalcogen ions from respective complex results into highquality and well-adherent thin films formation [7-9].
Optical absorption studies
Figure 1 shows optical absorption spectrum of Cd(S0.8Se0.2) thin film recorded using UV-VisNIR spectrophotometer in 200- 1100nm wavelength range. Maximum light absorption edge observed at 650nm. Fundamental absorption corresponds to electron excitation from valance band to conduction band, used to determine value of optical band gap energy. Optical data were demonstrated using following eq. (1) as follows,
where, A is a parameter that depends on the transition probability, h is Planck constant, Eg is optical band gap energy of material, and exponent depends on the type of transition. The values of n for direct allowed, indirect allowed, direct forbidden and indirect forbidden transitions are ½, 2, 3/2 and 3, respectively (Figure 1).
From optical absorption spectrum clearly demonstrated that linear nature of plot confirms direct allowed type transition mechanism.
Figure 2 shows plot of (ahϑ)2 vs photon energy (hϑ), value of optical band gap was calculated by extrapolating straight-line portion to X-axis. Obtained optical band gap energy is 2.13 eV, which is consistent with other reported ternary CdSSe thin films [7]. 3.3. X-ray diffraction study
Figure 3 indicates typical X-ray diffraction pattern of Cd(S0.8Se0.2) thin film deposited by using APT method. All diffraction peaks are corresponding to (002), (101), (102), (110), (103), (200) and (112) at 2θ 26.02º, 28.40º, 31.13º, 42.80º, 44.93º, 50.89º and 52.07º of hexagonal crystal structure. Calculated d-values are in well-agreement with standard d-values (JCPDS card no. 49-1459) for an (hkl) plane, confirms formation of thin films with a pure phase material.
Crystallite size is calculated by using known Scherrer formula and calculated crystallite size is 55nm. Thickness of thin film is 728nm measured by using surface profiler analysis. Crystalline nature and phase pure formed thin films are highly favorable for enhanced light absorption in solar cell application [8].
Field emission scanning electron microscopy
Surface morphology of thin films carried out by using FESEM study. Figure 4 demonstrates FESEM micrographs at different resolution of Cd(S0.8Se0.2) thin film. Low resolution FESEM image of Figure 4 (a) point out void free and well adherent film formation occurs via APT method. It shows twisted nest-like surface morphology is observed overall substrate surface.
High resolution FESEM images of Figure 4(b) clearly illustrate that twisting of nest-like morphology with irregularly grown sharp edged flakes. Such huge number of flakes winds together and formation of large network of nest-like morphology is observed from high resolution micrograph. This obtained surface morphology is beneficial for improve light absorption potential may due to crystalline nature and large surface area of nest-like morphology with twisted flakes [9].
Energy dispersive spectroscopy
Quantitative analysis of element is confirmed through EDS study. Figure 5 shows typical EDS spectrum of deposited thin film. EDS spectrum shows peaks at 3.13, 2.50 and 1.38 keV confirm the presence of Cd, S and Se elements respectively [7].
Photoelectrochemical performance
PEC performance of Cd(S0.8Se0.2) thin film was measured with standard two-electrode system. Figure 6 shows J-V curve of PEC cells. PEC performance was measured by forming Cd(S0.8Se0.2) thin film as working photoelectrode with active area 1cm2 and graphite rod (G) as counter electrode in 0.5M sulfide/polysulfide redox electrolyte. J-V measurements were done under illumination of light using 500 W tungsten filament lamp (Intensity of 30mW/ cm2). In dark, J-V curve shows diode-like rectifying characteristics. Upon illumination, curve is obtained at fourth quadrant, indicating generation of electricity and n-type conductivity nature [6-7].
Fill factor (FF) and power conversion efficiency (η %) of thin film were calculated by using equations (2) and (3) as follows,
where, Jmax and Vmax are maximum short-circuit current density and maximum open circuit voltage, Pin is input light intensity (30mW/cm2). Jsc is short-circuit current density and Voc is open circuit voltage. From J-V measurement, short circuit current density (Jsc) is 0.288mA cm-2 and that of open circuit voltage (Voc) 765mV. Calculated power conversion efficiency is 0.37% for Cd(S0.8Se0.2) thin film. Overall obtained conversion efficiency might be due to good crystallinity and developed surface morphology with large surface area [9]. Table 1 shows calculated PEC parameter.
Conclusion
Developed facile, cost-effective APT method shows potential for synthesis of thin films for solar cell. Synthesized thin film show promising properties favorable for photoelectrochemical performance is investigated. Optical study showed light absorption in visible region of solar spectrum and direct allowed transition mechanism. From XRD pattern it confirmed that formation of pure phase hexagonal crystal structure with nanocrystalline nature. FESEM analysis demonstrated synthesized surface morphology is void free and having large surface area for efficient light absorption. EDS pattern confirmed presence of Cd2+, S2- and Se2- elements in synthesized thin film. PEC performance indicated conversion efficiency of 0.37%.
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Dendritic Cells and Regulatory T Cells Changes During ECP for Chronic GvHD in Pediatric Patients | Juniper Publishers
Juniper Publishers-Open Access Journal of Blood Research & Transfusion
Authored by Berger Massimo
Mini Review
Graft-versus-host disease (GvHD) is a leading cause of post HSCT morbidity and mortality. It is mediated by alloreactive mature donor T lymphocytes, resulting in a harmful inflammatory response and tissue injury [1]. The pathophysiology of GvHD is constituted by precise sequences of immunological events such as the activation of antigen-presenting cells (APCs), activation, differentiation and migration of T cells, and finally the development of their full effector functions [2-4]. Dendritic cells (DCs) constitute the most professional APCs, promoting alloreactivity or clonal antigen-specific T cell responses. Moreover, tolerogenic DCs may play a pivotal role in GvHD exerting an immunomodulatory or even immunosuppressive effect on T cells [5]. DCs can be divided into two major subsets, plasmacytoid DCs (pDCs) and myeloid DCs (mDCs) which have distinct functions. pDCs play a pivotal role in peripheral tolerance through the generation of regulatory T (Treg). In addition to pDCs, mDCs also promote Th2 and Th0/Tr1 responses, depending on the activation signal types [6,7].
Although corticosteroids, with potent immunosuppressive and anti-inflammatory effects, are the first-line treatment for GvHD, only 25-50% of patients respond [1,8]. Extracorporeal photopheresis (ECP) is an alternative therapeutic strategy in patients who are resistant/refractory to steroids. ECP appears to act in an immunomodulatory fashion, inducing immunotolerance in GvHD by regulatory T lymphocytes, dendritic cells, in concert with the normalization of a T lymphocyte subset.
This pilot study focuses on these two cell populations, as well as on the patients’ whole immunological pattern [9-11]. Data from eleven patients affected by chronic GVHD were included and analyzed. The median age was 9 years (range 2-18), 6 out of 11 patients were females and suffered of myeloid malignancies (4 patients), acute lymphoblastic leukemia (2 patients), neuroblastoma (1 patient), Hemophagocytic Lymphohistiocytosis (1 patient), Ewing sarcoma (1 patient), Blackfan-Diamond Anemia (1 patient).
Seven patients received an unrelated Hematopoietic Stem Cell Transplantation HSCT (3 bone marrow, 3 peripheral blood, 1 cord blood), three patients had a sibling HSCT (1 patient with 1 Ag mismatch graft, all patients had bone marrow as the stem cell source) and one patient had an phenotypic identical-HSCT). All patients suffered moderate to severe cGvHD which was resistant/refractory to steroids. All patients received ECP from January 2016 to December 2016 in our center according to previously published techniques [12]. The aim of this study was to: i) monitor peripheral blood changes after 30 days of ECP and ii) describe the immunological changes in aphaeresis samples after UVA treatment.
A sample of peripheral blood (PB), a sample of apheresis pre-UVA photoactivation (pre-PA) and a sample of photoactivated apheresis (PA) were collected at the first day of ECP and every week for the first month of treatment. Informed consent was obtained from all patients. PB, pre-PA and PA samples were characterized at day 0, 8, 15, 21, 30 of ECP treatment. The percentage obtained by cytofluorimetric analysis was used to calculate the absolute number of cells/μl based on the white blood cell (WBC) number counted using a standard hemacytometer (DASIT).
Statistical analysis was performed using NCSS for Windows. Descriptive statistics are reported as medians, continuous variable differences between groups were calculated with the Student T test. The fold change was calculated by the ratio between the difference (day 30 – day 0) /day 0. The P value below 0.05 was considered as statistically significant.
As shown in Table 1, at day 30 we observed a 0.48 change of CD3+. After 30 days of treatment there was an improvement of the CD4+/CD8+ ratio from 0.49 to 0.86 (0.75 times), that resulted in a change of CD3+CD4+ (from 234 to 384 x109/L) compared to CD3+CD8+ (from 475 to 448 x109/L). Moreover, in the same period of study, we had a change of 0.75 times of CD3-CD56+ from 272 to 478 x109/L 62 and a smaller rise of CD19+ from 214 to 256 x109/L. The naïve CD4+ and CD8+ lymphocytes rose from 4 to 39x109/L (8.75-fold change, P=0.02) and from 27 to 58x109/L (1.14-fold change) over a month while their memory counterpart fell by 0.62 and 0.55-fold. When we calculated the CD4+ and CD8+ naïve/memory ratio we found a 35- and 4-fold change (P=0.01 and 0.02). Comparing the day 0 and day 30 peripheral blood samples, we observed a high rise of 0.66 and 1.14 times for mDCs (mDC from 9 to 15 x109/L [P=0.03] and pDC from 7 to 15 x109/L [P=0.05]) respectively together with a change of Tregs (from 2.9 to 9.1 x109/L, 3.5-fold change [P=0.04]). Finally, when we analyzed the changes between pre- and post-UVA photoactivation a significant change of Treg was observed (0.35-fold change, P=0.05), while a decrease in cell number was observed for CD8+ (P=0.05) (Table 2).
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Magnitude and Determinants of Opportunistic Infections Among Hiv/Aids Patients in Sphmmc, Addis Ababa, Ethiopia: Retrospective Study | Juniper Publishers
Juniper Publishers-Open Access Journal of Public Health
Authored by Addisu Deribe
Abstract
Background: Opportunistic infections (OIs) are infections that are more frequent or more severe because of immune-suppression in HIV-infected persons, and they are the major clinical manifestation of HIV patients. They indirectly affect the natural history of HIV disease. Severely immune-compromised HIV patients may develop a variety of opportunistic infections that have a significant impact on their well-being, quality of life, health care costs, and their survival. The most common opportunistic diseases in HIV patients are Candida esophagitis, Pneumocystis carinii pneumonia (PCP), disseminated Mycobacterium avium complex (MAC) infection, cytomegalovirus (CMV), Cryptococcus, kaposi sarcoma, herpes zoster, and tuberculosis.
Objective: To assess the prevalence and factors associated with opportunistic infections among HIV/AIDS patients in St. Paul’s Hospital Millennium Medical College.
Method:A retrospective observational cohort study is conducted on HIV/AIDS patients who started ART clinic in St. Paul’s Hospital Millennium Medical College from September 2014 to August 2015. Data is conducted based on a structured and pretested data collection checklist; used to collect demographic, baseline clinical and hematological characteristics and follow up condition of the patients. The data which is completed is fed and analyzed by SPSS 20.0 for windows. Results were reported as tables, pie charts and graphs.
Result: Between September, 2014 to August 2015, 315 patients were started ART follow up, out of these 188 (59.7) are females. The majority of the study patients 122 (38.7%) were in WHO stage III condition while 91(28.9%) were in WHO stage IV condition. Of the 315 patients, 149 (47.3%) had CD4 <200 cells/mm3. From the total patients 264 (83.8%) developed Opportunistic infections. TB of all forms was 137 (43.49%), 111(35.2%) have oral candidacies, 60(19%) have herpes zoster had the highest prevalence. CD4 count had an independent association with the distribution of the different forms of the opportunistic infections. The Odds of having the severe forms of the opportunistic infections was 6.162 times higher in the patients who had CD4 count less than 200.
Conclusion: TB of all forms, Oral candidacies, and herpes zoster were the predominant OIs. Only
CD count was associated with the distribution of sever forms of the OIs.
Recommendation: Skilled professionals should due attention for age group 20-30, divorced and
CD4 count <200 and the implementation of the TB and HIV collaborative activities are of critical importance.
Keywords: HIV Aids Patients; Opportunistic Infections; Art
Introduction
Background of the Study
Human immunodeficiency virus type 1 (HIV1 or HIV) has emerged as a major cause of morbidity and mortality in many low and middle income countries around the world. Africa has the highest prevalence of HIV infection and the greatest number of individuals living with HIV. Although Africa accounts for 14% of the population of the world, 68% of all HIV-infected individuals live in Sub-Saharan Africa [1]. HIV causes progressive depletion of the CD4 T cells, which leads to life-threatening opportunistic infections (OIs) or malignancies during the natural course of the disease. More than 90% of opportunistic infections are responsible for the development of AIDS morbidities and mortalities [1,2]. The natural history of HIV disease may be indirectly affected by the occurrence of opportunistic diseases, because HIV viral load increases in patients with acute opportunistic diseases. Survival in people infected with HIV has improved because of an increasingly powerful array of antiretroviral treatments, but neurological symptoms due to co morbidity conditions still remains public health important for HIV infected individuals [1,3].
The risk for the development of opportunistic infections in HIV patients depends on exposure to potential pathogens, virulence of the pathogens, the degree of host immunity, and the use of antimicrobial prophylaxis [4]. And majority of these opportunistic infections are associated with an increased hazard of death in HIV patients. Patients experiencing morbidity from opportunistic diseases may have interruptions in antiretroviral therapy causing more rapid progression of HIV disease. In addition studies found that opportunistic infections cause an up regulation in HIV replication and higher viral loads. Severely immune-compromised HIV patients may develop a variety of opportunistic infections that have a significant impact on their well-being, quality of life, health care costs, and their survival. The most common opportunistic diseases in HIV patients are Candida esophagitis, Pneumocystis carinii pneumonia (PCP), disseminated Mycobacterium avium complex (MAC) infection, cytomegalovirus (CMV), Cryptococcus, kaposi sarcoma, herpes zoster, and tuberculosis [5]. Morbidity and mortality in HIV disease result due to underlying immunosuppression which leads to life-threatening opportunistic infections (OIs) during the natural course of the disease [6]. The widespread use of ART starting in the mid-1990s has had the most profound influence on reducing opportunistic infections related mortality in HIVinfected persons in those countries in which these therapies are accessible and affordable. However, opportunistic infections continue to cause morbidity and mortality in HIV/AIDS patients even after ART. Some patients do not have a sustained response to antiretroviral agents for multiple reasons including poor adherence, drug toxicities, drug interactions, or initial acquisition of a drug-resistant strain of HIV-1. Therefore OIs continue to cause substantial morbidity and mortality in patients with HIV- 1 infection despite use of ART [7,8]. Opportunistic infections are one of the major causes of morbidity and mortality in patients with HIV infection throughout the world. Even if potent combination of antiretroviral therapy (ART) has reduced the incidence of OIs for certain patients with access to care, for those patients in the developed and developing world did not have access to care and have OIs [7,8]. The country’s response to the HIV epidemic was to establish first a task force in 1985 after the report of the first confirmed case of HIV infections and then a national AIDS council in April 2000. Finally the National council evolved into an office, the HIV/AIDS prevention and control office, HAPCO in 2002 [9].
Since December 2007 HAPCO and its health program department have taken the responsibility to coordinate the health sector response against HIV/AIDS in Ethiopia. The major components of these responses include HIV testing and Counseling (HCT), prevention of mother to child transmission (PMTCT), infection prevention, Anti retroviral therapy (ART), Opportunistic infection Management (IP) [9]. ART was introduced in Ethiopia in 2003 in selected health facilities. The first adult guide line was issued in 2003 [3]. The Ethiopian free ART program was launched in 2005. As of October 2007 the total numbers of patients ever started on treatment were 109,552 out of 187,770 ever enrolled in 272 health facilities including 150 health centers. Nearly all 99% of the patients are on first line regimen [10].
The statement of the problem Despite the fact that different studies have been conducted on the prevalence of individual opportunistic infections among HIV-infected patients in developing countries like Ethiopia, information about the magnitude and associated factors of opportunistic infections is scarce in the study area. So this study was conducted to assess the prevalence of opportunistic infections and the associated factors for the development of opportunistic infections in HIV Positive Patients taking anti-retroviral therapy (ART) in Saint Paul’s Hospital Millennium Medical College.
Objective of the Study
General Objective
To assess the prevalence and factors associated with opportunistic infections among HIV/AIDS patients in St. Paul’s Hospital Millennium Medical College.
Specific Objectives
a) To assess the prevalence of the opportunistic infections among HIV/AIDS patients that attend ART clinic of the St. Paul’s Hospital Millennium Medical College.
b) To identify factors associated with opportunistic infections among patients in the ART clinic of St. Paul’s Hospital Millennium Medical College.
Methodology
Study Setting
Saint Paul’s millennium medical college is one of the biggest referral hospitals in Ethiopia; located in Gullele, Addis Ababa. St. Paul’s Hospital Millennium Medical College as it is known today was established through a decree of the council of ministers of ministers in 2010, although the medical school opened in 2007 and the hospital was established in 1947 by the late Emperor Haile selasie. It is governed under a board federal minister of health. The college initiated Ethiopia’s first integrated modular and hybrid problem based curriculum for its undergraduate medical education, and is currently expanding to postgraduate programs and diversifying its undergraduate program offerings. St. Paul’s is in the process of building its capacity quickly in short period of time, growing from 3 to 175 faculty members in the last six years, and expanding teaching facilities. It has approximately 1800 clinical and academic, administrative and support staff who provide medical specialty services to patients who are referred from all over the county. While the in patient is 360 beds, St. Paul’s sees an average of 700 emergency and out clients daily. The study will be conducted in St. Paul’s Hospital Millennium Medical College HIV/AIDS patients who attend ART clinic.
Study Design
One year (From September 2014 to August 2015) chart review retrospective study on HIV/AIDS patients who starts follow up at ART clinic in St. Paul’s Hospital Millennium Medical College.
Source population
All adult HIV/AIDS patients who start ART follow up in St. Paul’s Hospital Millennium Medical College.
Study population. The clients enrolled in the St. Paul’s Hospital Millennium Medical College for chronic HIV/AIDS care and ART follow up were the study population. It was the clinical records of HIV/AIDS enrolled clients who were adults and above 19 years that were included in the study. All people less than 19 years old are excluded.
Inclusion and Exclusion Criteria
Inclusion Criteria: Clinical records of clients who were adults and 19 years and above were included.
Exclusion Criteria: Clinical records that did not have complete information relevant for the study were excluded.
Sample Size Determination: All patients from September 2014 to August 2015 who started ART clinic follow up and getting the services.
Data Collection Procedure: As chart review retrospective study data was conducted based on a structured and pretested data collection checklist; used to collect demographic, baseline clinical and hematological characteristics and follow up condition of the patients. The data was collected by SPHMMC clinical year students.
Study Variables
Dependent Variable: Occurrence of sever form of the opportunistic infections.
Independent Variables: Socio-demographic variables (including age, sex, religion, marital status, education level, occupation) and CD4 count.
Data Analysis /Data Quality Management: Collected data were entered and cleaned into a computer and analyzed using SPSS version 23 statistical package. Frequency distribution and percentage calculation was made to describe socio-demographic characteristics and to determine the magnitude of the relative burden of OIS in the ART clinics. Crude and adjusted odds ratio was done to determine whether any association existed with a 95% confidence interval Binary logistic regression analysis was made to see the relative effect of independent variable (sociodemographic variable) on the dependent variable (severe forms of OIS).
Operational definitions
Opportunistic Infections: They are a category of infections that occur in immune compromised hosts and considered to be a complication of HIV infection: PCP, CNS toxoplasmosis, TB of all forms.
CD4 count: Their CD4 count and socio-demographic data will be correlated with common opportunistic infections.
Ethical Consideration
Approval from St. Paul’s Hospital Millennium Medical College public health department and academic & research vice provost was received for this study prior to enrollment. Permission was taken from the responsible body of the unit. Cases were identified by their medical record number not by their names. The information collected was not discussed referring the patient’s name. The data is used only for the intended purpose of the study.
Dissemination of results
After the completion of the study the result will be presented during thesis defenses in the school of public health as a partial fulfillment of my intern-ship. The findings of this study will be circulated to St. Paul’s Hospital Millennium Medical College public health department, college’s academic and research vice provost and library.
Results
Between September, 2014 to August 2015, 315 patients were started ART follow up, out of these 188 (59.7) are females. About 77 (24.4%) of the patients are single, 140 (44.4%) are married and 68 (21.6%) are divorced. Majority, 222(70.5%) of patients were orthodox religion followers When classified by occupation majority, 109(34.6%) of the patients were Unemployed, followed by government employee and 70(22.2%) are private employee (Table 1) (Figure 1).
Of the 315 patients, 166 (52.7%) had CD4 >200 cells/mm3 and 149 (47.3%) had CD4 <200 cells/mm3. From the total patients 264 (83.8%) developed Opportunistic infections (Table 2).
The Types and Frequencies of the Opportunistic Infections
Out of the 315 clinical records assessed in 2014 for the presence of the OIs, 111(35.2%) had oral candidiasis, 78(24.8%) had pulmonary TB, 60(19%) had herpes zoster, 59(18.7%) had Extra pulmonary TB and 38 (12.1%) have recurrent bacterial pneumonia were found out to be the predominant OIs observed in the order given. When the frequencies for both pulmonary and extra pulmonary TB were combined the prevalence for TB of all forms was 137 (43.49%) making it the most predominant OI in the study subjects (Table 3).
Socio-Demographic Characteristics and the Occurrence of the Opportunistic Infections
A Multivariate logistic regression model was used to see the association between the occurrence of the opportunistic infection with socio-demographic variables, the CD4 count of the patients. The CD4 count of the clients of at this Hospital was associated with the distribution of the occurrence of OIs among the study population. Age group 31-40 and being divorced had independent association for the distribution of the different forms OIs. This age group has 18 times preventive value compared to other age groups. Being divorced has 7.1 times higher risk of developing OIs in study subjects. The CD4 count had an independent association with the distribution of the OIs. The Odds of having the severe forms of the OIs was 6.162 times higher in the patients who had CD4 count less than 200 (Table 4).
Discussion
Determining the types and relative frequencies of the major OIs and possible determinant factors is important for proper management and prevention strategy of the common OIs. The overall OI prevalence at intake and follow up in St. Paul’s Hospital Millennium Medical College ART clinics is high. The types of the OIs were various ranging from the common oral candidacies to the life threatening CNS toxoplasmosis and the fungal cryptococcal meningitis. The results of this study compared more or less in a similar manner to studies done in Ethiopia previously and other countries. This study indicated that, the overall incidence rate of OIs in patients, 111 (35.2%) have oral candidiasis, 78 (24.8%) have pulmonary TB, 60 (19%) have herpes zoster, 59 (18.7%) have Extra pulmonary TB and 38 (12.1%) have recurrent bacterial pneumonia were found out to be the predominant OIs observed in the order given. In contrast to the studies that we have mentioned above and to this study as well a prospective study on the development of OIs in HIV infected patients in the USA showed PCP as the predominant OI [11] followed by esophageal candidiasis, mycobacterium avium complex, CMV retinitis, Bacterial pneumonia, cryptococcosis and TB [11]. In the USA study there was a difference in the prevalence by sex and HIV exposure mode. Esophageal candidiasis, tuberculosis, herpes simplex were significantly higher among women. Kaposis sarcoma was frequent among men. A cross-sectional study conducted among 100 HIV positive patients in Phenome, Cambodia at 2 general hospitals revealed the following findings [6]. Oral candidiasis 80%, esophageal candidacies (39%), pulmonary TB 25%, extra – pulmonary TB 28%, cryptosporidiosis 13%, and PCP 10%. No statistical significant difference was found between gender, age, occupation or residence in the Cambodian study. The findings from this study were similar to the Cambodian one except that herpes zoster was not present in the Cambodian case.
On the other hand a screening test for the presence of opportunistic infections on 80 confirmed HIV positive patients in a tertiary care hospital in New Delhi, India showed [7], pulmonary Tuberculosis in 31% of cases, chronic diarrhea in 12% of cases, oral candidiasis in 7% of cases, herpes zoster in 7% of cases, cryptococcal meningitis in 2.5% of cases, PCP in 1.5% of cases and CNS toxoplasmosis in 1.5% of cases [8]. The current study has a similar pattern in the presentation of the OIs. A one year prospective study of consecutive patients admitted to the medical wards of Tikur Anbassa hospital had shown the morbidity and mortality patterns of patients with HIV/AIDS and the common OIs observed were, oropharyngeal candidiasis 57.4%, tuberculosis 55.6%, sepsis 24.9%, herpes zoster 16.9% and cryptoccocal meningitis 5.9%. A different study that was done at Zewiditu Memorial hospital in 2005 on 186 HIV/AIDS patients to determine the proportion of patients who developed the immune reconstitution inflammatory syndrome (IRIS) found out that prior to the start of HAA RT the patients had the following OIS [9]. Herpes zoster was present in 43% of the cases; tuberculosis in 31.4% of the cases; Oral candidacies in 16.4% of the case, toxoplasmosis of the CNS in 2.3% of the cases and PCP in 2.1% of the cases. The relative distribution of the OIs in the present study is similar to the two studies below except the slight difference in the order of the OIs.
A prospective study at Tikur Anbasa Teaching Hospital on 100 HIV positive patients in 1999 and the demographic, social and clinical presentations were reviewed. Pulmonary tuberculosis was present in 26 (26%) of cases and extra pulmonary TB in 29% of the cases. A retrospective clinical record analysis was done at the Ministry of health from 2004GC. The study was a nationwide review of 636 HIV/AIDS cases and the findings were, tuberculosis in 239 (25%) of cases; Herpes zoster in 203 (21.6%) of cases and oral candidacies in 200 (21.6%) of cases and PCP in 6 (0.6%) of cases. A retrospective cross-sectional study was done in Jimma referral hospital, south west Ethiopia on 925 HIV/AIDS patients from July 1993-June 1997. The patients were in the hospitals AIDS control program and review of the clinical profiles of the patients were; tuberculosis 239 (25%). herpes zoster 203 (21.9%), oropharyngeal candidiasis 200 (21.6%), herpes simplex 16(1.7%) and PCP 6 (0.6%).
In the above 3 studies TB both pulmonary and extrapulmonary, herpes zoster and oral candidiasis were the main presentations in the HIV/AIDS patients. In the present study also TB of all forms was 45% of the total cases and is first in rank and followed by oral candidacies which are similar to the above studies. This study indicated that, When the frequencies for both pulmonary and extra pulmonary TB were combined the prevalence for TB of all forms was 137 (43.49%) making it the most predominant OI in the study subjects. The finding in this study is consistent with the above studies done in Ethiopia. The distribution of the occurrence of OIs was similar in all sociodemographic data except the age. Risk factor found to be associated in this study was advanced clinical stage of HIV disease and CD4 level below 200. In a study to assess central nervous system opportunistic infections a retrospective study was done on the clinical records of 126 HIV infected patients in a Thailand outpatient and inpatient university hospital. Cryptococcal meningitis was present in 94(75%) of the patients followed by tuberculosis meningitis 9(7%). The explanation given of the high prevalence of cryptococcal meningitis by the authors was that cryptococcal meningitis was highly endemic in Thailand even prior to the HIV epidemic. Another study done in New York City on the prevalence cryptococcal meningitis found where the annual prevalence of the disease rose to 6% - 8.5% from a low prevalence rate of 1 case per million prior to the AIDS epidemic [11].
Ethiopia. The distribution of the occurrence of OIs was similar in all sociodemographic data except the age. Risk factor found to be associated in this study was advanced clinical stage of HIV disease and CD4 level below 200. In a study to assess central nervous system opportunistic infections a retrospective study was done on the clinical records of 126 HIV infected patients in a Thailand outpatient and inpatient university hospital. Cryptococcal meningitis was present in 94(75%) of the patients followed by tuberculosis meningitis 9(7%). The explanation given of the high prevalence of cryptococcal meningitis by the authors was that cryptococcal meningitis was highly endemic in Thailand even prior to the HIV epidemic. Another study done in New York City on the prevalence cryptococcal meningitis found where the annual prevalence of the disease rose to 6% - 8.5% from a low prevalence rate of 1 case per million prior to the AIDS epidemic [11].
Limitations of the Study
a) The study was done on a secondary data which makes the result obtained less informative than that done using a primary data using a prospective study.
b) A prospective study was not done because prospective studies take very long time, costly and need more resources.
c) Some of the studies that were reviewed for comparisons were prospective studies. The other studies were screening studies. Some others were retrospective clinical record reviews which makes direct comparison with the current study difficult.
Conclusion and Recommendation
Conclusion
Out of the clinical records assessed for the presence of OIs, TB of all forms 137 (43.49%), Oral candidiasis 111(35.2%), and herpes zoster 59(18.7%) were found out to be the predominant OIs observed. Age group 20-30 and >41 and being divorced had independent association for the distribution of the different forms OIs. Being divorced has 7.1 times higher risk of developing OIs in study subjects. The CD4 count had an independent association for the distribution of the different forms OIs. The odds of having the different forms of the OIs was 6.16 times higher in the study subjects who CD4 count less than 200 [16].
Recommendation
The ART clinic skilled health professionals need to have give attention to age group 20-30 and >41, divorced and those who had CD4 count less than 200 for proper diagnosis and management of the prevalent OIs in the population. Documentation and determination of the viral load had important factor for knowing further distribution of OIs. Encouraging documentation of viral load has vital role [17]. TB of all forms has high contribution to the disease burden and it is the leading OI presenting in 45% the cases. Strengthening of the implementation of the TB/HIV collaboration activity is of vital importance.
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Understanding and Integrating Resolution, Accuracy and Sampling Rates of Temperature Data Loggers Used in Biological and Ecological Studies-Juniper Publishers
Abstract
During the 5th Workshop about Temperature-Dependent Sex Determination held in the 38th International Sea Turtles Symposium (16-22 February 2018) in Kobe, Japan, we discussed the uncertainty of temperatures recorded by data logger and their calibration. We report here an extension of this discussion. First, we propose a way to estimate the uncertainty of the average temperature recorded using data loggers considering the accuracy of the data logger (repeatability of measurements), resolution of the data logger (resolution of its indicating device) and period of sampling temperature. Second, a general procedure of calibration is described. Functions to perform the estimates are provided in R package embryo growth freely available.
Keywords: Data logger; Temperature; Resolution; Accuracy; Uncertainty; Sampling period; Calibration
Introduction
Metabolism is the process by which energy and materials are transformed within an organism and exchanged between the organism and its environment [1]. The metabolic rate is the rate at which organisms transform energy and materials and is governed largely by two interacting processes. The first is the Boltzmann factor, which describes the temperature dependence of biochemical processes, and the second is the quarter-power allometric relation, which describes how rates of biological processes scale with body size [2]. Hence, temperature is a key factor in understanding the persistence of organisms within an ecosystem. The range of temperatures within which an organism can survive is termed its thermal niche [2]. For many vertebrates, the thermal niche is relatively wide and centered around 30°C [3]. Thus, when temperature is recorded in the purpose of defining a thermal niche, the accuracy of measurements will not have a major impact on the outcomes of this kind of study.
However, for some physiological processes, thermosensitive changes can occur within a small range of temperatures, and thus the accuracy and resolution of temperature recording instruments become much more important. For example, in turtles egg, incubation temperature during embryogenesis affects various aspects of development [4], including probability of embryo survival [5], sex determination for species with temperature-dependent sex determination [6], and morphology and body size at hatching [7]. In addition, incubation temperature can have long-term effects on the physiology and behavior of hatchlings [8]. Many researchers use data loggers inside the nest cavity to generate temperature records during incubation, to later compare them with various characteristics of hatchlings (e.g., size, performance, sex). However, the uncertainty of data logger measurements can affect the conclusions in some cases. For example, the sex ratio for the leatherback marine turtle shifts from 100% males to 100% females in less than 0.6°C at constant temperatures [9], which can be on the same magnitude as the uncertainty of temperature measurement for many experiments. Indeed, 10 out of 141 published studies on reptile egg incubation reported datalogger accuracy as 0.6 C or higher [10]. However, it is important to note that the term “accuracy” is not well defined in most of these publications.
Thus, as a first step, it is important to recall some important concepts used in metrology [11]. The word “uncertainty” means doubt, and thus in its broadest sense “uncertainty of measurement” means doubt about the validity of the result of a measurement. The uncertainty of measurement is a parameter, associated with the result of a measurement, that characterizes the dispersion of the values that could reasonably be attributed to the measurand. The measurand is a particular quantity subject to measurement. Uncertainty of measurement comprises, in general, many components. Some of these components may be evaluated from the statistical distribution of a series of measurements and can be characterized by experimental standard deviations. The other components, which also can be characterized by standard deviations, are evaluated from assumed probability distributions based on experience or other information.
The accuracy of measurement is the closeness of the agreement between the result of a measurement and a true value of the measurand. It is stressed that the term “precision” should not be used for “accuracy” and that the true value of the measurand is never known.
Repeatability of results of measurements is the closeness of the agreement between the results of successive measurements of the same measurand carried out under the same conditions of measurement. Repeatability may be expressed quantitatively in terms of the dispersion characteristics of the results using multiple of standard deviation or width of confidence interval.
One source of uncertainty of a digital instrument is the resolution of its indicating device. For example, even if the repeated indications were all identical, the uncertainty of the measurement attributable to repeatability would not be zero, for there is a range of input signals to the instrument spanning a known interval that would give the same indication. If the resolution of the indicating device is the value of the stimulus that produces a given indication X can lie with equal probability anywhere in the interval X − δx/2 to X + δx/2.
The stimulus is thus described by a rectangular probability distribution of width δx with variance u2 = (δx)2/12, implying a standard uncertainty of u = 0.29 δx for any indication. Repeatability and resolution of indicating device are uncertainty components linked to the dataloggers characteristics. Uncertainty can arise also from the experimental procedure used to obtain measurements. The experimenter can choose different time frequency of reading measurements. The objective of this work is to characterize and propose a standardized method to present uncertainties while working with temperatures recorded during embryo studies.
There are different brands of data loggers available in the market, all of them with different features. Two characteristics which will affect uncertainty of measurement are particularly important when choosing a particular model: accuracy (precision of the material to record temperature) and resolution (how many digits are recorded). In addition, the researcher must define the rate of temperature data recordings during the period when the data logger will be used. In some cases, data loggers may have high resolution but low accuracy, or limited flexibility in the rate of data collection. Ordering a set of data loggers can be a Cornelian dilemma: should the priority be optimization of accuracy, of resolution, or the sampling rate?
An important first step is to clearly conceptualize the difference between resolution and accuracy. Resolution refers to the level of specificity that the data logger will record temperature in its memory. For example, a resolution of 0.5°C indicates that temperatures will be recorded by bins of 0.5°C, even if the electronic chips can read internally the temperature with better resolution. The number of possible temperature records that can be stored during a session is positively related to the available memory but negatively related to the resolution and the range of temperatures that can be recorded. Some data loggers allow the user to choose between several options to optimize eithe the resolution or the memory (Table 1).
For commercially available temperature data loggers, accuracy is represented in the particular logger’s technical datasheet as a range (±x°C), with x representing how close an individual recorded data point is from the true value. From a statistical point of view, this statement is too imprecise to be useful, because it is not clear if the ±x indicates a confidence interval, and if it is, there is no information about the underlying distribution and the range. Furthermore, it is not known if the data are censored or truncated [12]. In order to investigate this, we contacted the technical staff of the reseller PROSENSOR (Amanvillers, France) and they defined accuracy as the “maximal uncertainty of the measure”. However, this does not provide detail concerning the statistical distribution under consideration. We also contacted the technical support group at Onset Computer (Massachusetts, USA) about their definition of accuracy, to which the leader of the support group stated “I can say that the probability of the logger being within the advertised accuracy is very high. NIST testing can confirm that.” (NIST is the U.S. Commerce Department’s National Institute of Standards and Technology, which provides calibration services for temperature recording equipment). The statement from Onset Computer confirmed that a statistical distribution underlies what temperature data logger reports but again provided no specifics about the exact distribution. We assume that in both cases, the distributions of values generated by the data loggers were either a Gaussian or a uniform distribution. For modelling purposes, we assume the values generated conform to a uniform rectangular distribution, because it is a more conservative estimate (every allowable value is equally likely) and we cannot rule out data truncation by the data loggers due to limitations of their resolution. For this uniform distribution, the minimum and maximum possible values are defined by the ±x accuracy.
The uncertainty is then a specific measure of the quality of temperature recording by data loggers, considering the accuracy, the resolution and the sampling rate. Data logger uncertainty is then defined by the 95% confidence interval of the average temperature during a certain time, recorded during set sampling period by a data logger with known accuracy and resolution (Table 1).
Furthermore, we propose a standardized method to calibrate data loggers. The experimental procedure used for data logger calibration is sometimes described with detail in publications [13,14] but often the published procedure is reported as a simple comparison with a mercury thermometer. Furthermore, even when the experimental procedure was clearly stated, the mathematical method used to correct data logger temperatures when more than 2 control temperatures are used is rarely indicated. Regular calibration testing of data loggers is important because the drift of temperature accuracy can be as large as 0.1°C/year (for UA-001-08, pers. comm. from technical support group at Onset Computer). Our standardized method of calibration uses both a precise experimental procedure and a precise mathematical procedure.
Materials and Methods
Uncertainty of a Measurement
We generated a simulation to measure the impacts of the accuracy, the resolution and the sampling rate on the quality of the average temperature data that are reported in published studies. To do this, we generated 10,000 time series of temperatures gradually changing at a rate chosen in a uniform distribution from -0.002 to +0.002°C per minute with the initial temperature being chosen in a uniform distribution from 25 to 30°C. We then retained only those records of the time series that corresponded to a specified sampling rate (e.g., for a sampling rate of 60 minutes, we retained only temperature data that occurred at the completion of every 60 minutes time bin). To incorporate errors associated with data logger accuracy, we added to each retained temperature a random number obtained from a uniform distribution centered on 0 and with minimum and maximum corresponding to the reported accuracy of each data logger. We truncated the recorded temperatures to mimic the impact of the limitations of the resolution of each data logger (the resolution effect). From a mathematical point of view, the resolution effect can be obtained using this formula:
int ((temperature + resolution / 2)*(1/ resolution))*resolution
With int being the closest allowable value based on the assumed level of resolution. This formula ensures that the truncation effect is well centered in the interval. As an example, assume a dataset has the following temperatures: 30, 30.1, 30.2, 30.3, 30.4, and 30.5°C, with assumed data logger resolution being 0.5°C. Applying this formula, the dataset is converted to what the data logger should report according to its resolution: 30.0, 30.0, 30.0, 30.5, 30.5, and 30.5°C.
Next, the uncertainty is defined as the 95% confidence interval of the difference between the true mean value and the recorded mean value during the relevant interval of time calculated for all the replicates. For the purpose of this test, we have created a function in the R package embryo growth
(version 7.3 and higher) available in CRAN:
uncertainty.datalogger (sample. rate,
accuracy, resolution,
max.time = 10 * 24 * 60,
replicates = 1000)
With sample.rate being the sample rate in minutes, accuracy being the accuracy of the data logger in °C, resolution being the resolution of the data logger in °C, and max.time being the total time period in minutes over which an average temperature is estimated. This function will generate replicates values of the average temperature for the whole period, and the uncertainty is defined by the range of 95% confidence interval of the difference between true and estimated mean temperature. Optional parameter method is used to control the output estimate as described in the help page of the function that can be displayed using ?uncertainty.datalogger.
Calibration of Data Loggers
For calibration purpose, the data loggers must be checked against at least 3 known temperatures, but better with more, and the recorded temperatures from the data loggers must be compared against temperatures concurrently read from a certified thermometer. A certified thermometer is one that has been certified as being accurate by a national standards laboratory, such as NIST in the U.S. Note that even certified thermometer should be checked for validity periodically, by sending them for testing to a national standards laboratory.
For the comparison at the known temperatures, the data loggers being tested should be immersed in a water bath (be sure the data loggers are waterproof) at the same time as the certified thermometer, preferably with water being stirred the entire time. The data logger should be programmed to record temperatures every minute, with the time of data recording noted by the researcher. At each minute the data logger records a temperature value, the researcher should also record the temperature from the certified thermometer. Begin with the water heated to the maximum anticipated temperature the data loggers will be recording during future research studies, and lastly the minimum anticipated temperature. It may be necessary to add colder water to the stirred bath if the lower end of the anticipated temperature range is below room temperature. The temperatures recorded with the certified mercury thermometer will serve as a reference to correct the temperatures recorded with the data logger. To make this calibration simpler, we have created a function: calibrate.datalogger () in the embryo growth R package
(version 7.3 and higher):
calibrate.datalogger (control.temperatures,
read.temperatures,
temperature.series, se. fit)
Where control.temperatures are the calibration temperatures, read.temperatures are the temperatures returned for each of the control.temperatures, temperature.series is a series
of temperatures to be corrected using the calibration, and se.fit indicates whether standard error of the corrected temperatures should be returned. A generalized additive model (parameter gam = TRUE) or a general linear model (parameter gam = FALSE) with Gaussian distribution of error and an identity link is used for this purpose. The help page of the function that can be displayed using?calibrate.datalogger.
Results
Uncertainty of a Measurement
The uncertainty of measures obtained with two different data logger models were estimated using uncertainty.datalogger () function with 10,000 replicates and average for 10 days.
*The IP is an international standard published by the International Electrotechnical Commission (IEC). It uses a 2-number code, the first one designates dust resistance (0 to 6) and the second one designates water resistance (0 to 8); the higher the number, the more resistant is the product.
The results for iButton DS1921G-F5# (table 1) were generated using:
uncertainty.datalogger (sample.rate=c(30, 60, 90, 120),
max.time = 10 * 24 * 60,
accuracy=1, resolution=0.5)
The results were (Table 2):
and for Tinytag Talk 2 TK-4014 (Table 2), the results were generated with:
uncertainty.datalogger (sample.rate=c (30, 60, 90, 120),
max.time = 10 * 24 * 60,
accuracy=0.5, resolution=0.05)
The results were (Table 3):
The uncertainty returned by this function corresponds to the 95% confidence interval width of the difference between true average temperature and recorded average temperature: the uncertainty of the Tinytag Talk 2 TK-4014 for the average temperature recorded every 60 minutes is around 0.07°C whereas it is only around 0.15°C for the iButton DS1921G-F5#.
It should be noted that the response was not linear and uncertainty increased as the time interval between samples increased (Figure 1). The uncertainty is more dependent on the accuracy and second on the resolution. The measures were obtained with a large range of temperatures and temperature variations, thus the estimated uncertainty can be considered as being dependent only on the data logger characteristics and the sampling rate of temperatures.
Calibration of Data Loggers
Water was heated to 40°C in a microwave oven and a UA- 001-08 data logger was immersed in the water as well as a certified mercury thermometer. Temperatures were recorded with the data logger and read in thermometer every 5 minutes until water temperature reached air temperature +5°C (Figure 2A). Then the calibration procedure has been run using the function calibrate.datalogger () in R package embryo growth. The corrected temperature recorded by data logger and the temperature recorded using certified mercury thermometer are shown in Figure 2B.
Discussion
The choice of a sampling rate should depend on the required level of uncertainty for the average temperature considered, on the available memory in the data logger, and the availability and cost of different data loggers. It is particularly useful to define precisely the uncertainty of the measured temperature when the studied phenomenon is highly sensitive to temperature change. For example, the pattern of temperature-dependent sex ratio in the marine turtle Dermochelys coriacea shifts from 100% males to 100% females in less than 0.6°C [9,15]. This range of temperatures producing both sexes is called the transitional range of temperatures (TRT). In this case, when the average temperature is studied for 10 days, which correspond to the thermosensitive period of the development (TSP) at high incubation temperatures [16], the ratio between uncertainty of average temperature and TRT can be as high as 24% (Figure 3). In such a case it will be difficult to estimate the real impact of temperature change for this characteristic.
Calibration does not seem to be a critical part of the procedure with our tested data logger: the uncertainty of data logger was on the same order than the uncertainty of certified mercury thermometer and much better than the uncertainty of certified alcohol thermometer. However, we recommend to always calibrate data logger before and after use for an experiment especially for long period of recording. Both before and after calibrated time series must be included in control. temperatures and read. temperatures parameters in the calibrate.datalogger () function. The standard error obtained for each temperature after calibration is pertinent as it includes corrections for accuracy and resolution characteristics of the data logger but also accuracy and resolution for the calibration thermometer and also temporal drift when before and after calibration temperatures are used.
The correct calibration and adequate uncertainty of data loggers according to the analyzed temperature-dependent phenomenon seem quite logical but they are not always correctly done or at least reported not in publications. When data loggers are used to record temperatures to be analyzed in the context of temperature change due to climate-change, it appears crucial that temperatures are recorded with known uncertainty that is at least smaller than the supposed effect of temperature.
For publication purpose, the function uncertainty. datalogger () can be used to evaluate the uncertainty of one measurement taking into account both accuracy and resolution effect. It can be used also to evaluate the uncertainty of series of measurements done during H hours at a h sampling rate.
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Administering Saturated Signalized Networks Through Fuzzy Technique-Juniper Publishers
Abstract
An adaptive control system is developed using a fuzzy method to improve the traffic control system performance and to reduce the overall delay for four phases simple intersections within a grid of network. The main functions of the developed control system are to accelerate the cycle time and to reduce the loss time by determining the green time for each phase based on traffic flow. The fuzzy rules are employed using visual basic and computer-based program (Excel) to run the validation process. The developed control system is tested on five intersections in a simulated network in the State of Kuwait during four different peak periods. The results indicated that the number of vehicles passing through intersection phases has increased in most phases by an average of 12.9%, 23.3%, 10.4% and by 21.2%. The green time is increased by an average of 9.1%, 5.8%, 9.9% and 6.3%. Number of intersections’ cycles remain constant at most of the time which means that the developed control system distributes the green phases’ times based on the traffic situation. The developed control system can be applied on simple intersections with four perpendicular phases that consist of collector, major arterial or minor arterial roads.
Keywords: Artificial intelligence; Fuzzy logic; Intelligent transportation systems; Traffic control systems
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Introduction
Rapid growth of personal vehicles resulted in excessive congestion. Traffic congestion affects operational management of business, energy consumption and tourism. As known to the experts’ congestion reduces human productivity and leads to delays in products and services in small and big cities. A traffic signal is among the most important traffic control devices that are used to manage traffic flow efficiently, but it may lead to traffic congestion if it is poorly handled. Most traffic signals are operated by either fixed time signal or actuated control systems. Controlling isolated traffic signal is easy specially when the intersection demand is below the capacity, but it is difficult when the intersection is within a network. Fuzzy techniques are used to solve traffic problems. It might improve road capacity, improve traffic light performance and reduce vehicle delay by adjusting parameters such as cycle time, splits, phase sequences and offsets per change of the traffic volume.
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Fuzzy Logic Traffic Control System
The artificial intelligent concept combines the objective knowledge, formula and equations, subjective knowledge, and linguistic information, to assist solving traffic problems. Fuzzy is one of the most famous artificial traffic control systems that is used to improve the traffic situation and to increase the traffic capacity. The fuzzy technique is used to develop the traffic control system due to its ability to process various data, vague and uncertain inputs of the system, and provide results that are suitable for the decision making. Fuzzy logic is capable to incorporate human knowledge and experience to respond quickly in unknown environments, adapt conditions, and an ability to involve decisions with incomplete information, complex equations, and non-linear processes. It allows the manipulation of linguistic inexact data as a useful tool in the design of the intelligent traffic control system. The fuzzy logic control system consists of different components: fuzzification, fuzzy control decisions block; rule matrix and fuzzy interference engine; and defuzzification as shown in Figure 1.
Based on a literature survey of the application of fuzzy control traffic systems, it can be observed that the implementation of fuzzy systems in transportation has a large impact on traffic levels. Consequently, the following highlights can be made: Traffic fuzzy systems had different shapes, which are often recurrent; improving flow rate, forecasting traffic capacity, controlling phase selection, and controlling signal timing. Most of the researchers used Mamdani type inference and depended on historical data to compare between the proposed and existing systems. Many researchers work on control of an isolated intersection with fuzzy control method [1-5]. Few of them work in a simple isolated intersection [6,7]. A few of them work in a roundabout intersection [8,9]. Furthermore, some researchers work on T-intersection [10,3,11]. Many others worked on twoway intersections [3,12,13]. Few researchers apply a fuzzy logic system to the coordinated control of arterial or area traffic. Finally, the results showed that the traffic performance of Fuzzy Logic Traffic Control Systems has better performance than traditional traffic signal controls, specifically during heavy and uneven traffic volume conditions.
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Existing Traffic Control System in Kuwait
The signal control system strategies used in the State of Kuwait to control the flow and vehicle movements are either fixed time or semi-actuated signal control systems. The fixed time control system is used in all the intersections through the day in non-peak periods. Whereas, the semi-actuated control system is used only for the free time periods to adjust the green phases time continuously. The order and the sequence of the phases are fixed during the fixed time control system. The traffic signal timing plans are generated in Kuwait by a Synchro program, where each intersection has its timing and phasing strategy. The block diagram for the existing system in Kuwait is shown in Figure 2.
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Proposed System
The developed control system is designed based on the principle being that the vehicle can move ahead only if there is a space for passing. The developed control system is designed using a fuzzy expert system that is different from the traditional control system methods. Detectors are placed at every entry and exit of the intersections to count the number of cars passing through the intersection. The developed control system is designed through four stages where each stage is designed through several steps. Each stage has different inputs and outputs and a different function. Figure 3 shows the design stages and the steps of each stage. Stage 1: design of the green time distribution models through steps 1 to 4, Stage 2: design of the fuzzy rules for the selection of signal timings through step 5, Stage 3: initialization of the control system through steps 6 to 9, and Stage 4: execution of the developed control system through steps 10 to 15.
Stage 1: Design of the Green Time Distribution Models
Stage 1 is realized through step 1 to step 4. At step 1, the intersections’ specifications, geometries, road types, vehicle movement strategies, traffic devices, control systems in addition to the fuzzy control systems are reviewed, analyzed and compared to develop the control system constraints and assumptions. At step 2, a list of system assumptions and constraints were specified as follow: the control system is designed for an unsynchronized simple intersection with four perpendicular phases. Each phase consists of three vehicle movements as straight-through, left, and right turns. The control system is designed for all traffic conditions (under saturation, saturation, and over saturation). The system is developed based on the flow that arrives and departs in a deterministic, uniform and steady way and distributed equally on the phases lanes. The distance between the intersections (Ld ) , ranged between (Ld )max = 2400m and ( ) 800 d L min = m. The distance length between two intersections is divided into several zones (Z). The minimum distance length unit zone ( ) 800 unit Z = m , and the last zone of the intersection phase is critical zone ( ) critical Z . The vehicle length to be used in system calculation is specified as a medium personal vehicle with length ( ) 7.5 lV = m . The timing parameters (cycle time, maximum and minimum phase green time, red clearance time and the queue detector location) for each road type and speed are specified as shown in Table 1.
At step 3, seven control systems are developed for a combination of intersection of two road types (collector, major arterial, and minor arterial) as shown in Table 2. The control systems are named by the intersection roads type.
For each control system, a scenario of eighty-one green time distribution models are developed and tabled at step 4. These tables are filled with the timing parameters (maximum cycle time, minimum green time, default time and maximum green time) that are specified based on the system designing rules as shown in Table 3.
Timing parameters are specified for a specific number of zones, but for better accuracy, each zone is divided into intervals where each interval 0.5* 400 unit = Z = m except the first and second intervals. The first interval is specified by the distance between stop-line and queue detector location ( ) q d , and the second interval is specified by the distance between queue detector location and 400 m away from queue detector. The green time for each interval is calculated as the ratio between the interval length and the whole length as in Eqn (1).
Stage 2: Design of Fuzzy Rules for Signal Timings
At step 5 sets of fuzzy rules are designed to determine the signal timing through two processes. The first process is to select the actual green time distribution model. The second process is to determine the intersection timing parameters. The fuzzy rules for the selection process are designed in step 5A which is divided into 5A.1 and 5A.2. The fuzzy rules for execution process of the developed control system are designed in step 5B, which in turn is divided into 5B.1 and 5B.2 as shown in Figure 4.
Stage 3: Initialization of the Control System
Stage 3 is designed through steps 6 to 9 for initialization of the control system. Several inputs are specified in step 6. These are to be used in different steps based on their calls and functions in the selection and actual run processes. These inputs are: the intersection in terms of road types (used for selection the control system model); distance between intersections ( ) d L (used for selection the green time distribution model); number of lanes (n ) φ ; vehicle length ( ) Vl (used for running process); and clearance time (Tc) (used for modification process). At step 7, the system processes the intersection roads’ types (input) by the first set of the fuzzy rules 5A.1, (Figure 4) to select the actual control system from the seven developed control systems. At step 8, the system retrieves the distance Ld) and calculates the number of zones at each intersection phase. At step 9, the system processes the calculated number of zones by the second set of fuzzy rules 5A.2, (Figure 4) to select the actual green time distribution model from the eighty-one models.
Stage 4: Execution of the Developed Control System
Stage 4 is designed through steps 10 to 15 for execution of the developed control system. Running the developed control system depends on the system inputs, fuzzy rules, and the flow in/out that is read by the system detectors. At step 10, the developed control system reads the traffic flow entering the intersection from the four directions by gridlock detectors that are placed at the entrance of the phases. At the same time, the control system reads the traffic flow exiting from the intersection to the surrounding four directions by step-line detectors that are placed at the stop-line. The system at step 11 calculates the vehicle residual using Eqn (2).
Where; Ri+1) φ is number of residual vehicles formed in the (cycle) i+1 , (Flowφ)out , number of vehicles entering the intersection phase during the cycle time, (Flowϕ)Out, number of vehicles exiting from the intersection phase during the green phase time, (Ri) φ , number of the residual vehicles from the (cycle) i+1 . After calculating the vehicle residual, the system calculates the queue length in each phase of the intersection as follow:
Where: Zφq is the queue length at the intersection phase in meter, nφ , number of lanes for the considered intersection phase, Vl , average vehicle length in meter.
At step 12, the control system processes the calculated vehicle queue to determine the green times (Tφ) , clearance time (Tc) , and the maximum cycle time (Tcycle)max from green time distribution model by applying the fuzzy rules (5B.1, (Figure 4). The control system at step 13 calculates the total cycle time ( )total T as follows:
Where; φ is the intersection phase, Tφ , the phase green time in the green time distribution models in second, Tc , the clearance time in second.
During the clearance time of the last phase, the system modifies the determined green time.
The modification process is an important process in the control system that happens during the clearance time of the last phase. The system at step 14 processes the vehicle queues and their locations in the intersection phases with the relation between (T)cycle and (T)total by applying the fuzzy rules (5B.2, (Figure 4) to modify and change the control system green phases times. At step 15, the control system sends to the traffic signal the actions for the next cycle timing. At step 16, the control system provides a report that includes intersection cycle time, green times, phases flow in (flow)In , phases flow out (flow)Out and vehicle queue length to be used in the system analysis.
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Results
Real life test for the validity test of the control system was not possible due to the cost constraint and excessive time needed to acquire approvals from several ministries. Therefore, historical data are used for traffic simulation of an existing grid network controlled by the developed system. Hence, system performance can be measured and compared with the existing traffic control system. The developed control system is applied to a network of thirteen intersections in Kuwait town having the system conditions and criteria. The five central intersections in the network are specified for running the developed control system by using their data to measure the system performance. The results of the individual intersections and for the network are presented next.
Intersections’ results:
The sample network considered consists of five intersections, where each intersection consists of four phases (total of 20 phases in the sample network). Table 4 shows the simulated results of the developed system compared with the existing system for vehicle passing intersections’ phases and the time needed to pass through these intersections during four considered periods.
The simulated results of the developed system for periods 6:45 to 7:00 and 14:15 to 14:30 show that 55%, i.e. 11 out of 20 phases, of the network phases exhibit increases in both the number of vehicles crossing during the green phase relative to the performance of the existing system. Furthermore, 30% of the network phases exhibit increases in the number of passing vehicles, but they show decreases in the green time. That means, there is a loss in the green time in the existing control system and the green time is distributed in insufficient way where the developed control system distributes the green time based on the traffic flow. However, 10% of the network phases show decreases in both the number of passing vehicles and the green time. Where, the existing control system distributes extra green time where it is not needed. Results show that 5% of the network phases show decreases in the number of passing vehicles and increases in the green time.
The results of the period 17:15 to 17:30 show that 85% of the network phases exhibit increases in both the number of passing vehicles and the green time. However, 15% of the network phases show decreases in both the number of passing vehicles and the green time. Furthermore, the results of the period 21:30 to 21:45 show that 65% of the network phases resulted in increases in both the number of passing vehicles and the green time. Whereas, 25% of the network phases show increases in the number of passing vehicles and decreases in the green time. For this same period, 10% of the network phases show decreases in both the number of passing vehicles and the green time. From previous analysis, 85%, i.e. 17 out of 20 phases, of the phases in the network show increases in the number of vehicles passing through phases during 6:45 to 7:00, 14:15 to 14:30, and 17:15 to 17:30 periods, while 100% of the phases in the network show increases during the period 21:30 to 21:45.
The simulated overall results of the developed system for the total number of vehicles passing intersections’ phases and the number of cycles during the four specified periods are shown in Table 5.
As can be observed from Table 5, 80% of the network intersections show increases in the total number of vehicles passing the intersections during the periods 6:45 to 7:00 and 17:15 to 17:30. On other hand, 100% of the network intersections show increases in the total number of vehicles passing the intersections during the periods 14:15 to 14:30 and 21:30 to 21:45. All the intersections showed higher number of cycles during specified period during 6:45 to 7:00. That means the developed system shortened and accelerated the cycles through the specified periods to reduce the waiting time. Forty percent of the intersections show increases during the periods 14:15 to 14:30 and 17:15 to 17:30, while 20% do not show changes in the number of cycles during these periods. Furthermore, 60% of the intersections Showed higher number of cycles during the period 21:30 to 21:45.
Table 6 presents the percentages of the differences in the number of vehicles passing intersections’ phases between the developed and existing systems, and the percentages of the differences in the green times needed to pass through these phases during the four periods (6:45 to 7:00, 14:15 to 14:30, 17:15 to 17:30, 21:30 to 21:45).
vFor period 6:45 to 7:00, the total percentages of the differences between number of vehicles passing the five intersections’ phases (20 phases) is increased by 258.2%. For the five intersections, the average percentage of the number of vehicles passing the intersections’ phases is increased by 12.91% (258.2%/20 phases).The total percentages of the differences between green time needed to pass through the five intersections’ phases is increased by 9.05% (181%/20 phases). By comparing the increasing of percentages in number of vehicles passing the intersections’ phases to the increasing of percentages in green time needed for vehicles to pass these phases, the increase in the green time is less than the increase of number of vehicles. This means, the developed control system improves the network performance by increasing number of vehicles passing the intersections’ phases during the period 6:45 to 7:00.
For period 14:15 to 14:30, the total percentages of the differences between number of vehicles passing the five intersections’ phases (20 phases) is increased by 467%. For the five intersections, whereas the average percentage of the number of vehicles passing the intersections’ phases is increased by 23.3% (467%/20 phases). The total percentages of the differences between green time needed to pass through the five intersections’ phases is increased by 5.85% (117%/20 phases).
For period 17:15 to 17:30, the total percentages of the differences between number of vehicles passing the five intersections’ phases (20 phases) is increased by 208.3%. For the five intersections, while the average percentage of the number of vehicles passing the intersections’ phases is increased by 10.4% (208.3%/20 phases). The total percentages of the differences between green time needed to pass through the five intersections’ phases is increased by 9.9% (198.1%/20 phases).
Furthermore, for period 21:30 to 21:45, the total percentages of the differences between number of vehicles passing five intersections’ phases (20 phases) is increased by 423.5%. For the five intersections, the average percentage of the number of vehicles passing the intersections’ phases is increased by 21.2% (423.5%/20 phases). The total percentages of the differences between green time needed to pass through the five intersections’ phases is increased by 6.3% (126.5%/20 phases)
Network results
The testing sample, as mentioned earlier, consisted of a grid network considering four directions; S’, N’, E’ and W’, within each direction a set of three successive intersections are considered. The increasing and decreasing tendencies in the percentage differences between number of vehicles passing through the network directions between the developed technique and the existing system, along with the necessary time for the vehicles to pass through these directions during certain tested periods, are shown in Table 7.
The results of period 6:45-7:00 show that the number of vehicles passing through the S’ direction is increased and the time to pass the vehicles through same directions is decreased, number of vehicles and the time needed to pass through the N’ direction are increased, as well as in W’ direction, while number of vehicles and the time needed to pass through E’ direction are decreased as shown in Table 7. That means, 25% of the network (direction S’) exhibits increase in the number of vehicles and decreases in the time needed to pass through S’ direction. And, 50% of the network (directions N’ and W’) exhibits increases in both the number of vehicles and the time needed to pass through these directions. Whereas, 25% of the network (direction E’) exhibits decreases in both the number of vehicles and the time needed to pass through this direction.
The results of period 14:15-14:30 show that the number of vehicles passing through the S’, E’ and W’ directions is increased and the green time to pass the vehicles through same directions is decreased. Whereas the number of vehicles passing through the N’ direction is decreased, and the green time needed to pass through the direction is increased. That means, 75% of the network (directions S’, E’ and W’) exhibits increases in the number of vehicles and decreases in the green time needed to pass through these directions. And, the 25% of the network (direction N’) exhibits decreased in the number of vehicles and increase in the green time needed to pass through N’ direction.
The results of period 17:15-17:30 show that the number of vehicles and the green time needed to pass through the S’, and N’ directions are increased. The number of vehicles passing through E’ direction is increased while the green time needed to pass through this direction is decreased. For direction W’, the number of vehicles and green time needed to pass through the direction are decreased. That means, 25% of the network (direction E’) exhibits increases in the number of vehicles passing through the direction and decreases in the green time needed to pass through this direction. Fifty percent of the network (directions S’ and N’) exhibits increases in the number of vehicles and the green time needed to pass through these directions. Furthermore, 25% of the network (direction W’) exhibits decreases in both the number of vehicles and the green time needed to pass through W’ direction.
The results of the last period 21:30-21:45 show that the number of vehicles and the green time needed to pass through the S’, N’ and W’ directions are increased. The number of vehicles passing through E’ direction is increased while the green time needed to pass through this direction is decreased. That means, 25% of the network directions represented by E’ exhibit increases in the number of vehicles passing through the direction and decreases in the green time needed to pass through this direction. While, the 75% of the directions (S’, N’, and W’) exhibits increases in both the number of vehicles and the green time needed to pass through these directions.
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Conclusion
A fuzzy system is utilized to control the setting of a network of signalized intersections. The design consisted of two stages; a modelling system for green time distribution based on the intersections roads geometric specifications; and designing fuzzy rules that are implemented by using visual basic and computerbased program (Excel). The objective of the developed control system is to increase flow crossing the various intersection phases in lesser than the existing technique by distributing the green time of the intersections’ phases based on the traffic situation.
The developed control system is applied on five intersections in a grid of a network during four different periods during the day. It is evaluated by simulating a real network using actual data, and the performance results are compared with the historical results obtained by the existing control system. The developed control system reduces the waste in the green time of some phases that are specified by the existing system. This time loss is added to the other phases of the developed control system. The developed control system increases the intersection cycle time to its maximum to increase the green interval. That appears in the cases where the number of passing vehicles and the green time are increased.
Some results show that the green time is reduced by the developed control system while the number of passing vehicles is increased. It means that the associated phase has a time loss exercised by the existing system. The existing system specifies the green time as a constant at each period while the developed control system specifies it based on the traffic situation. The developed control system reduces the green time in some phases since the traffic of these phases does not reach its critical situation. This yields in decreasing the number of passing vehicles through these phases.
For the cases where the number of vehicles passing the phases is decreased and the green time is increased, it means that application of the developed control system rules increases the total cycle time to the maximum. The developed system distributes the green time among the four phases based on the traffic situation. Thus, when a phase has long distance and long queue, the control system gives this phase further green time.
The developed control system increases the number of vehicles passing through the network directions, and at the same time increases the time, which means that the developed system reduces the time loss from the other directions and adds it to the critical direction. The developed control system decreases the trip time, which means that the system eliminates the time loss from a direction and distributes it to the other directions. For the directions where the traffic is not in a critical situation, the developed system decreases both the trip time and the number of vehicles passing in these directions in the network.
The developed system increases the number of the passing vehicles at most phases for most periods while the green time is increased in some phases and it is decreased in other phases. The developed system reduces the time loss from some phases and adds it to the phase that needs it to increase the number of vehicles passing through. Furthermore, the green time is increased in some intersections while in others remains constant where the system increases the total cycle time to the maximum and adds the extra time to the phases in need. The time is decreased in some phases by the developed system while the passing vehicles number is increased where the developed control system reduces the time loss from these phases.
The total cycle time in the developed control system is specified dynamically based on the traffic situation and the vehicle queue at the phases. Thus, the number of cycles is varying based on the traffic situation.
The developed system can be used to control the intersections having similar specifications that the developed control system is built for. The intersections should be simple with four perpendicular phases, and consist of the collector, major arterial and minor arterial roads’ specifications. Each road should include three detectors (stop line, queue, and gridlock) to obtain actual traffic data. Any changes in the variables such as clearance time, vehicle length, number of lanes, etc. should be used as new inputs to run the system.
The green times in the green time distribution models could be distributed in any other way for the similar control system model’s specifications as number of zones and the probability of combination between them. The new green time distribution models can be used by the developed control system with the same fuzzy rules.
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Combination Of Oncolytic Newcastle Disease Virus (Ndv) and Vaccine Vector Adenovirus (Adv) as a Potential Virotherapy for Cancer: A Systematic Review | Juniper Publishers
Juniper Publishers-Open Access Journal of Anatomy Physiology & Biochemistry
Authored by Ferbian Milas Siswanto
Abstract
Cancer is a disease with high morbidity and mortality, one of the leading causes of death in the world. Nowadays, the foremost clinical cancer therapy in a patient are surgery, chemotherapy and/or radiotherapy. Despite of the great amount of research on cancer and advance technology in medicine, the mortality rate of cancer remain high due to limited therapeutic effects and additional side effects of current therapy. Here we provide an overview on the virotherapy using the combination of Newcastle disease virus (NDV) and the adenovirus (AdV). Both NDV and AdV possess an oncolytic activity and a potential as vector vaccine. However, oncolytic activity of NDV is more potent than adenovirus. In contrast, the AdV potential as a vector of cancer vaccines is better than NDV. Therefore, in this paper, we discuss the development of a virotherapy combination by utilizing oncolytic activity of NDV, and vaccine vector AdV simultaneously for cancer therapy to improve the effectiveness of therapy against cancer.Conclusion: Decreased estrogen level following ovariectomy causes osteoporosis.
Keywords: Newcastle disease virus; Adenovirus; Virotherapy; Cancer
Abbrevations: NDV: Newcastle Disease Virus; AdV: Adeno Virus; VVND: Velogenic Viscerotropic Newcastle Disease; PBMC: Peripheral Mononuclear Cells; HN: Hemaglutinin-Neuraminidase; TRAIL: TNF-Related Apoptotic-Inducing Ligand; JNK: c-Jun N-terminal Kinase; NOS: Nitric Oxide Synthase; dsDNA: Double-Stranded DNA; NK: Natural Killer; CAE: Carcioembryonic Antigen; TLRs: Toll like receptors
Introduction
Cancer is a disease with high morbidity and mortality that leads to death. Until now, cancer is still the leading cause of death in humans. In 2012, approximately 14.1 million cases of cancer have been reported worldwide, and have caused the deaths of 8.2 million people (about 15% of all deaths). It is characterized by uncontrolled cell division, invade surrounding tissue, and metastasize to other organs in the body. The four most commonly reported cancers are lung, breast, colon, and prostate cancer. However, all organs in the human body can be cancer regardless of age, gender, ethnicity, diet, and environment [1]. Generally, cancer is caused by decreased cell death or increased cell proliferation. In other words, any dysregulation of cell cycle or apoptosis will result in uncontrolled cell growth or malignancy [2].Cancer occurs due to genetic and environmental factors that cause deviations in the growth regulation of stem cell populations. Improving knowledge of the molecular processes underlying cancer development, as well as advances in diagnostic techniques, radiotherapy technology, and chemotherapy, has increased the survival rate of cancer patients. However, recent therapy has not greatly improved the survival of cancer patients who have undergone metastasis. Although modern technology has been developed, cancer is still afflicted millions of people worldwide [3]. This is because, in addition to the limited therapeutic effects, radio and chemotherapy also cause side effects [1]. The ideal cancer therapy is a therapy that selectively kills malignant cells, and does not damage other normal cells in the body. Currently, radiotherapy, chemotherapy, and surgery are the most common modalities in cancer therapy. However, these therapies often cause harmful side effects [4] and often lead to resistance [5].Therefore, the development of cancer therapy with high effectivity and selectivity for cancer cells with minimum side effects becomes crucial. The idea of using bacteria and viruses to treat malignancy in humans began in the mid-1800s in which tumor regression was associated with bacterial and viral infections [6]. The development of cell culture technique and virus technology in the early 1950s led researchers to learn more about the potential of viral therapy in human and small animal tumors [7]. The virus is then proven to be useful as an oncolytic agent and immunostimulator. Newcastle disease virus (NDV) that naturally infected poultry, and adenovirus (AdV) that causes human flu, is a potential viral combination as a virotherapy and immunotherapy agent. NDV can directly kill cancer cells (oncolytic activity) and adenovirus can help to stimulate the immune system to recognize cancer cells (immunostimulator activity).
Newcastle Disease Virus (NdV) as an Oncolytic Agent
Newcastle Disease Virus (NDV) is a virus of the order Mononegavirales because it has single strand RNA, negative polarization, unbranded and linear genome [8]. Furthermore, this virus occupies the family of paramyxoviridae due to its pleomorphic envelope, round-shaped with a diameter of 100- 500nm, but some are in the form of filaments [9]. This virus causes Newcastle disease that attacks various poultry, especially chickens. Until now, Newcastle disease has been found in various parts of the world including Indonesia, and the cases of velogenic viscerotropic Newcastle disease (VVND) have been reported in Indonesia [10]. In Indonesia, Newcastle disease is endemic as indicated by the finding of this case throughout the year [9].NDV was firstly reported to possess an oncolytic activity in the mid-1950s [11]. The clinical evaluation of this virus as an anticancer agent over the last few decades shows its safety and effectivity. The effectivity of NDV application is based on high oncolytic activity, and safety of its use is based on replication that selectively attacks tumor cells and does not damage normal cells. Scientists are interested in the use of NDV because it replicates more rapidly in tumor cells than normal cells in humans, and cause oncolytic effects [12]. NDV replicates 10,000 times faster in cells undergoing neoplasmic changes than normal human cells in general [13,14]. There are several molecular pathways that cause the oncolytic effects of NDV, such as apoptosis pathway [1,15]. Induction of apoptosis by NDV includes a series of virus entry processes, replication, de novo protein synthesis and activation of caspases [16]. NDV induces apoptosis through both extrinsic and intrinsic pathways.NDV-induced apoptosis is generally mediated by intrinsic pathway during the late stage of infection, while in the early stage of infection is more likely to be mediated by extrinsic pathway [17]. Activation of intrinsic pathway involves the increased activity of p53 and Bax proteins, as well as decreased expression of the Bcl-2 gene [18] which will activate the Caspase 9. The matrix protein (M protein) of NDV binds to Bax protein and increases apoptosis [19]. Whereas, the extrinsic pathway of apoptosis is induced by NDV-mediated activation of pro-apoptotic cytokines such as IFN-α and TNF-α in peripheral mononuclear cells (PBMC) via its Hemaglutinin-Neuraminidase (HN) proteins [20,21]. The HN protein of NDV also induces expression of TNFrelated apoptotic-inducing ligand receptor (TRAIL) [22,23] which further activate caspase 8 [17]. A study has shown that NDV initiates the synthesis of nitric oxide synthase (iNOS), thus increasing apoptosis via the NFκB pathway [24,25].NDV-infected mouse PC12 pheochromocytoma cell was proved to induce the activation of reticulum endoplasma eIF2a kinase (PERK) resulting in phosphorylation of eIF2a and caspase 12 activations. Endoplasmic reticulum stress may be responsible for the activation of apoptotic pathways in cancer cells infected with NDV [26]. In addition, the induction of the external pathway by NDV also the activation of c-Jun N-terminal kinase (JNK) and p38 pathways, and decreased Akt pathway activity [27]. NDV has an excellent potential as a highly selective virotherapy candidate. This selective effect arises because of the restriction of V protein by host and secretion of virus-induced cytokines (IFN-γ and TNF-α) [28]. The first step of infection by NDV occurs in all types of cells in the body, while the second step (associated with viral replication) occurs only in tumor cells because this stage is terminated very quickly in normal cells [5]. In general, the specificity of NDV to cancer cells occurs because of damage to antiviral pathways and apoptosis in cancer cells [29].In addition to direct cytopathic effects, NDV anti-cancer activity is associated with the activation of both innate and adaptive immune responses. NDV infection initiates the macrophage-induced synthesis of enzymes that increase antitumor activity in both in vitro and in vivo studies [30]. NDV stimulates monocytes that play a role in killing tumor cells via TRAIL induction [31]. The activation of natural killer (NK) cells is also involved in the cytotoxicity mediated by NDV [20]. However, to induce host immune system, the use of cancer vaccines is believed to have far more effective effects than the immunostimulator effects of NDV. The immunotherapeutic approach aims to promote the host antitumor immune response that can destroy tumor cells in both primary and metastaticaffected sites [32]. Genetic therapy-based cancer vaccination technology has been widely developed, with the virus being the most popular vector studied. Adenovirus, in addition to having oncolytic activity, is a very potential and widely used vector on cancer gene therapy and as a vaccine to express foreign antigens [33].
Adenovirus (AdV) as a Vaccine Vector
Adenovirus is a group of viruses from the Adenoviridae family responsible for 5-10% of upper respiratory infections, gastroenteritis, conjunctivitis, and cystitis (CDC, 2015). It has no envelope, icosahedral capsid with a diameter of 70-90 nm and the double-stranded DNA (dsDNA) [34]. Adenovirus has long been used as a vector for gene therapy due to its ability to influence cell biological activity, tolerate large genetic modifications, and encode proteins without integrating into the host cell genome. More specifically, the virus is used as a vector for administration of therapeutic targets, either in the form of recombinant DNA or proteins [35].Several studies using various antigens proved that adenovirus (AdV) is potential as a vector of cancer antigens such as glycoprotein 33 (GP33) from lymphocytic viral choriomeningitis [36], carcioembryonic antigen (CAE) [37], beta-galactosidase antigen [38], GM-CSF antigen (such as T-VEC and Pexa-Vec) [39], E7 antigen from human papillomavirus [40], the gp100 antigen and TRP-2 antigen [41]. It may enhances cellular immunity mediated by T-cell CD8+ cells and IFN-γ- mediated humoral immune specific to cancer cells. The use of AdV as a vaccine vector is relatively safe to use with intradermal methods [42]. Adenovirus administration may stimulates ligand expression of Toll-like receptors (TLRs) and may alter cancer immunosuppressive and proinvasive microenvironment becoming proinflammatory, thus facilitating immunocompetent cells to fight against cancer [39,43,44].
General Perspective
Both NDV and AdV have oncolytic activity and potential as vector vaccine for cancer. However, oncolytic activity of NDV is more potent than adenovirus. In contrast, the AdV potential as a vector of cancer vaccines is better than NDV. Therefore, the development of a virotherapy combination by utilizing oncolytic activity of NDV, and vaccine vector AdV for cancer simultaneously are expected to improve the effectiveness of therapy against cancer. The use of an appropriate combination ratio of these two agents will improve their therapeutic potential for cancer [45,46].
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Comparison Between Cold/Hot Smart Water Flooding in Sandstone Reservoirs - Juniper Publishers
Juniper Publishers - Open Access Journal of Engineering Technology
Abstract
The incremental oil recovery has been investigated and approved by many laboratory and field projects using water flooding in tertiary stage. The salinity of the injected water is an important factor observed by many researchers. The more salinity decreases the more oil recovery obtained. The investigations on the hot low salinity water flooding have been conducted by many researchers and they found out that it is useful for increasing oil recovery especially heavy oil due to reducing oil viscosity and make it easy to produce to the surface. The thermal expansion of water plays an important role in the incremental oil recovery mechanism, reducing the density of the injected water relative to the aquifer water. This reduces mixing, minimizing thermal loses to the aquifer.
Hot water flooding may also increase the economic life of individual wells by as much as a factor of two. Smart water was also used to alter the reservoir wettability and increase oil recovery by manipulating the divalent cations in the injected water. In this study, we used hot and cold smart water and injected both into the sandstone saturated with crude oil in order to investigate the important role of smart water itself and hot smart water. The systematic results showed that changing some cations in the injected brines was better than to spend more money to heat the smart water. The divalent cations Ca2+ and Mg2+ was the most effective component in the smart water. In this study, we also studied the pH effect of the cold/hot smart water effluent smart water EOR.
Keywords: Smart water flooding; Sandstone reservoirs; Incremental oil recovery; Field projects; Salinityinvestigations; Aquifer; Rod sucker pumps
Introduction
Eastern Kansas oil fields contains heavy oil that is produced via rod sucker pumps. The daily production fromBartlesville Sandstone reservoir is around 500bbl/day with high water cut. Such reservoirs have a low temperature and the oil viscosity of several hundreds of centipoises. The mobility ratio is quite different between the water and the heavy oil and if a conventional water flooding would be conducted, the oil recovery could be low. A higher temperature of the water flooding prompt to reduce the oil viscosity. The hot injected water also could reduce the unequal viscosity of the water and the oil in the heated zone, and in turn, the sweep efficiency could be improved.
In this work, we injected smart water because of its results in increasing oil recovery according to many labs works and pilot based on the mechanisms that propose and qualify the effectiveness of smart water flooding such as: multicomponent ion exchange[1], double-layer expansion [2], reduction in interfacial tension and increased pH [3],fines mobilization [4], mineral dissolution [5], organic material desorption from the clay surface [6], Cation exchange on quartz surface [7], desorption of organic materials from quartz surface [8].
In the case of using thermal EOR techniques, the heat provided to the reservoir could absolutely reduce the oil viscosity and increase oil recovery. The economic overview, on the other hand, the least expensive thermally technique is hot water flooding based on oil recovery [9-11]. In this work, a combined chemical and thermal technology was applied on Bartlesville Sandstone cores to find a feasible, cost-effective EOR solution to increase oil recovery from heavy oil reservoirs without using high energy methods such as thermal techniques.
Experimental Section
Porous Media
Core samples were taken from the Bartlesville Sandstone reservoir located in east Kansas. The cores description is listed in Table 1.
Brines and Crude Oil
Reagent-grade salts were prepared with deionized water to make FW and smart water. The compositions of brines are listed in Table 2. A reservoir crude oil was delivered by Colt Energy from Bartlesville Sandstone reservoir. The oil viscosity is ~600 cp and density 0.83 at 20°C.
Core Preparation and Flooding
The experimental setup is shown in Figure 1. The cores first cleaned with toluene. The cores were then evacuated and saturated under vacuum in the FW. The same FW was used to measure the permeability. The cores were pre-aged in heavy crude oil for three weeks at 90°C. The water flooding was conducted at reservoir temperature 90°C. FW was injected into the cores until residual oil saturation was reached. After that, smart water was injected until no more oil was produced and injection pressure stabilized. The cores were saturated with the same FW and smart water was injected as follows:
i. RC1: The smart water contains 45mmole of Ca2+, and the experiment temperature was 25°C.
ii. RC2: The smart water contains 90mmole of Ca2+, and the experiment temperature was 85°C.
iii. RC3: The smart water contains 45mmole of Mg2+, and the experiment temperature was 25°C.
iv. RC4: The smart water contains 90mmole of Mg2+, and the experiment temperature was 85°C.
Results and Discussion
Reservoir core (RC1) and RC2 were flooded with smart water containing 45 and 90mmole Mg2+ at 25°C and 85°C, respectively as described in Table 2, while both RC3 and RC4 were flooded with smart water containing 45 and 90mmole Ca2+ at 25°C and 85°C, respectively.
RC1
The temperature of this experiment was set on 25°C. The core successively flooded with FW and smart water. The volume of the produced oil was collected and logged at the room temperature. The pressure readings were also recorded. The ultimate oil recovery was 54% of original oil in place (OOIP) after the core flooded with FW (Figure 2). The injection pressure started with 50 psi and rose up to 180psi and dropped until stabilizingat 41psi after injecting 2PV of FW (Figure 3). The incremental oil recovery after switching the injected brine to smart water was 5% of OOIP. The injection pressure rose up to 64psi and stabilized at 49psi.
RC2
This core was flooded the same way as RC1 except the smart water containing 90mmole of Mg2+. The temperature was 85°C for both FW and smart water flooding. The oil recovery during secondary water flooding with FW was 57% (Figure 2), the flooding was stopped after injecting 2PV of FW. The water injection stopped until no more oil was produced and until the pressure stabilized. During the FW flooding, the pressure started 52psi. The pressure increased quickly until reaching the maximum reading at 151psi. After the crude oil began to flow out the core, the pressure decreased slowly until stabilizing at 31psi. Upon switching to smart water, the incremental oil recovery was 2% of OOIP. The injection pressure increased dramatically until reaching the highest point which was 51psi and stabilized at that point.
RC3
This core and the following one (RC4) were flooded with smart water containing 45 and 90mmole of Ca2+ at 25 and 85°C, respectively. The experiment temperature is 25°C for RC3. The oil recovery with FW was 51% of OOIP (Figure 4). The injection pressure started with 66 psi and rose up to 160psi and then stabilized at 52psi (Figure 5). Upon switching to smart water, the improved oil recovery was 9% of OOIP. The injection pressure stabilized at 59psi.
RC4
The experiment temperature was set at 85°C. The same procedure was followed as in previous cores. After injecting 2PV of FW the oil recovery was 53% of OOIP. The recovery was improved to 54% after the injected brine switched to smart water, resulting in a 1% incremental recovery of OOIP. The injection pressure stabilized at 43psi.
All Cores were similar in FW but different in the experiment temperatures and the injected smart water. Both RC1 and RC2 were flooded using 45 and 90mmole of Mg2+ in the smart water but at 25°C and 85°C.
Increasing concentration of Mg2+ in smart water has the effect on reducing oil recovery during smart water flooding. Comparing RC1 and RC2, the oil recovery from RC1 by FW was 54% of OOIP, while it was 57% of OOIP from RC2. The ultimate oil recovery in RC2 was higher than in RC1 because the higher temperature.
The incremental oil recovery from RC1 using smart water was 5% of OOIP, while it was 2% of OOIP from RC2; i.e. the improved oil recovery decreased by a factor of 2.5 when doubling the concentration of the Mg2+ in the injected smart water even though the temperature was higher for RC2. Similarly, comparing RC3 with RC4, the oil recovery was 51% of OOIP for RC3 with FW flooding, while it was 53% for RC4 also due to extra heat.
The incremental oil recovery using smart water flooding was 9% of OOIP for RC3, while it was only 1% of OOIP for RC4; i.e. the improved oil recovery increased by a factor of 9 if we reduced the concentration of the Ca2+ in the injected smart water although the temperature was ambient temperature. Increasing the divalent cations in the injected smart water led to decrease the adsorption of the organic material, and in turn, the rock became too water-wet for observing smart water effect. During FW flooding, comparing all the cores in this work, the higher the temperature, the higher the oil recovery. Using hot water improves the mobility ratio due to reducing the oil phase viscosity compared with cold water. Thermal expansion of water plays an important role in injecting hot water, the lower density of hot water reduces thermal loses to the aquifer and speeds up the propagation of the temperature front through the reservoir.
The effect of increasing the temperature to 85°C with a double Mg2+ concentration in smart water (RC2) is the same as applying 25°C with a smart water containing a half concentration of Mg2+ (RC1). Increasing temperature to 85°C when smart water has double Ca2+ concentration (RC4) is a wrose scenario than using 25°C with an smart water contains a half concentration of Ca2+ (RC3). The fuel consumption using high temperature could be replaced chemically by controlling the divalent cations concentration. The fuel consumption could be more feasible when controlling the water chemistry. The good example for that is RC3 when lowering the Ca2+ to the half and also (RC1) when lowering the Mg2+ to the half. Applying ambient temperature with reducing Ca2+concentration to a half provided a higher oil recovery among all the other scenarios (60% of OOIP). Table 3 shows the summary of the results.
Conclusion
Increasing the temperature of the injected water reduces the viscosity contrast between oil and water in the heated region. This can improve the sweep efficiency. Heating the oil using hot water could reduce the oil viscosity and in turn increase oil recovery.
Hot water flooding may also increase the economic life of individual wells by as much as a factor of two. Controlling the chemistry of water could provide a better solution for increased heavy oil recovery instead of increasing the injected water temperature, that could lower the energy required to move the heavy oil from the heavy oil reservoirs in general and in this work for the eastern Kansas oil reservoirs. The conclusions can be drawn as follows:
i. The adsorption of the organic material in heavy crude oil on the sandstone decreased because of the rock became too water-wet for observing smart water flooding effect when the divalent cations presented in a higher concentration.
ii. Heating could reduce the oil viscosity, interfacial tension, and residual oil saturation which leads to potentially higher recovery factor. Yet, controlling the chemistry of water (especially divalent cations) could improve oil recovery instead of increasing the injected water temperature. Increasing temperature with tune water concentration providing a greater heavy crude oil recovery.
Acknowledgement
The authors would like to express their grateful acknowledge to Colt Energy Company. The authors thank the Higher Committee for Education Development in Iraq and the Iraqi Ministry of Oil/ Missan Oil Company for their permission to present this paper. The authors would like to express their grateful acknowledge for Sandia National Laboratories is a multimission laboratory managed and operated by National Technology and Engineering Solutions of Sandia, LLC., a wholly owned subsidiary of Honeywell International, Inc., for the U.S. Department of Energy’s National Nuclear Security Administration under contract DE-NA- 0003525.
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Observational Study: Cancer Cases Treated with Homeopathy in the Basque Country/Navarre between 2013 and 2015
Juniper Publishers-Open Access Journal of Complementary Medicine & Alternative Healthcare
Authored by Victoria Claramunt Palou
Abstract
The Study included 50 women and 15 men aged between 11 and 85 years. There we 44 patients with advanced tumour disease and 21 with early-stage disease. Conventional cancer treatment was chosen by 64 patients and one of them chose homeopathy only. Four patients made important changes in their lifestyle, and 8 had bio-decoding sessions. All patients had taken homeopathic medicines as palliative care tailored to different stages of their disease. A single drug treatment was used in 18 cases, based on the entire case. Ten cases we treated by applying Banergi protocols and constitutional medicine, and 37 cases were treated with different successive or combined drugs, depending on the state of the patient at the time, with the Minotti protocol for palliative care being applied in 9 cases. The predominant homeopathic dilutions were centesimals. The great variability of medications used on each of the patients shows the individuality of patient symptoms with the same clinical diagnosis, as well as the great variability in the criteria of homeopathy doctors when establishes a therapeutic strategy.Homeopathy has helped to control the tumour disease (patient free of disease) in 10 cases of early stage cancer and 12 cases of advanced tumour disease. Homeopathy was only palliative in 7 cases of early-stage cancer, in 22 cases of advanced tumour disease, and in five other cancers without staging. Homeopathy did not work in one case of early stage cancer, in two cases of advanced tumour disease, and in one case without staging. There were 5 cases in which results could not be assessed at the time of the study. According to the subjective assessment by the homeopathic doctor, homeopathy contributed to the control of tumour disease (patient free of disease with biological and /or imaging tests) in 22 cases, it was palliative in 34 cases, 4 patients died, and 5 cases cannot yet be evaluated. According to the assessment by the patient, it helped to control and improve their quality of life in 55 cases and it does not help them at all in 5 cases. This observational study has enabled us to evaluate the effectiveness of our work in the context of our clinical reality and more accurately describe all parameters involved in the case, including conventional treatments and their impact. Patient opinion is part of the evaluation of the results and requires questionnaires that can be adapted and standardized. Homeopaths carry out their work within an ethical framework bound by civil responsibility and respect for patient autonomy, open to collaboration with the work of the other professionals with a common goal, which is none to cure, relieve the patient, and contribute to the advancement of knowledge.
Keywords: Advanced tumour disease; Early-stage disease; Lifestyle; Bio-decoding; Palliative; minotti protocol; Patient free of disease; Staging; Standardized
Introduction
Homeopathy exercised by doctors is abided to a deontological code common to the medical profession and to a social responsibility setting established by law. Moreover, we homeopath doctors respect the patient’s autonomy and do not compete with other therapeutic possibilities. We homeopath doctors are willing to collaborate with other medicine professionals and to equip ourselves with investigation and evaluation tools that will permit progress of the scientific knowledge.What does homeopathy offer to oncology patients?Active listening, reflection scenarios, full symptomatic patient treatment and use of medicines with few and reversible adverse effects compatible with chemotherapy, radiotherapy and hormonotherapy. Another, not least important aspect is that a homeopathy treatment is short and inexpensive.Reflection scenario: raising awarenessThese four questions open a therapeutic space of active listening for the patient and the doctor (Figure 1). The patient evolves from being a case of adenocarcinoma to being an ill individual to whom we intend to help by searching for the most accurate medicine that suits him, his suffering and the tumor. The patient must understand his vulnerability and those facts, emotions or ways of life that make him sicken. For that he is given a reflection space. We do not speak about statistics or predictions. We commit ourselves to him, to help and attend his needs. Undoubtedly, in our job as homeopath doctors this active listening is part of our therapeutic grounding.Approaching the oncology patientThe oncology patient is a complex one. Besides his natural illness (the tumor), he also presents an artificial sickness derived from the adverse effects of his oncological treatment. Moreover, the impact of the diagnosis as well as the disease prognosis that, just by themselves, many times destabilize the patients, must be also be considered. For the homeopath, restoring the mental and physical equilibrium of the patient is a priority. Help him bear the treatments, make him lead the processes and maintain the hope alive, are also essential. In this case, a respectful atmosphere for cooperation would be the ideal for the patient and the treatment’s result.
Observational Study (Appendix 1)Samplea.
65patient cases with different cancer diagnosis are collected at homeopath consultations in the Basque country/ Navarre during the period 2013-2015.b. Monitoring for 18 of the cases has been done at a health public service (primary attention) as for the rest 47 cases monitoring has been done at private consultationc. Patients from both sexes: 50 women and 15 mend. Ages between 11 and 85 years olde. A total of 44 patients present an advanced tumor diseasef. 21 patients present the disease in an initial localized phase
Diagnoses
Table 1 shows the diagnoses along with the correspondent phase and number of cases. Simultaneous treatments to the homeopathy treatment (Table 2).Common treatmentCommon treatment includes a combination of different procedures in which following different protocols, chemotherapy, radiotherapy, surgery and hormonotherapy can be combined for a healing or palliative purpose.Lifestyle changeLifestyle changes include change processes in habits such as diet or tobacco consumption, as well as changes in work, personal or family relations starting by a conflict awareness raising from the patient.
Biode Coding
Awareness raising and emotional unloading in relation to the conflict that unleashes the disease following a specific technique.Used strategies at the homeopathy consultationa. All sample patients have taken palliative treatment adapted to various disease stages.b. Patients given a single medicine base on the situation and patient’s constitution: 18 cases.c. Banergi protocols and patient constitution based medicine: 10 cases.d. Other combined or successive medicines adapted for the patient: 37 cases.e. Minotti’s protocol (PAC): 9 cases.
Potency usage in prescriptions
Table 3 shows the prescribed potencies. The homeopathic medicine stimulates the healing capacity of every patient. Moreover, it also, at the same time, acts in the mental, emotional and physical areas. It is this aspect to which we refer when we speak about totality. The homeopathic medicine is compatible with other treatments and has few adverse effects. The great variety of the medicines used in each patient expresses the symptom individuality of the patients with the same clinic or anatomopathological diagnose. Also, expresses the great criteria variability of the homeopath doctor when establishing a therapeutic strategy.*Solution to the following medicines: ADN 6 CH, Hepatine 6 CH, Bone marrow 6 CH, Cardine 6 CH, Anilium 6 CH, Hairy Cranium Area 6 CH (Dr. Minotti’s formule).
Homeopathy effectiveness estimation at the case management
Homeopathy has contributed to control the tumor disease (free of disease patient) at the following cases (Table 4):a. Localized tumor disease (N0, M0): 10 casesb. Advanced disease (from phase II onwards): 12 casesHomeopathy has turned out to be palliative only at the following cases (Table 5):i. Localized tumor disease (N0, M0): 7 casesa. Advanced illness (from phase II onwards): 22 casesb. Non-determined phase cases: 5 casesii. Homeopathy has not worked in the following cases (Table 6):a. Localized tumor disease (N0, M0): 1 caseb. Advanced illness (from phase II onwards): 2 casesc. Non-determined phase cases: 1 case (Table 7)iii. Efficacy estimation based on the doctor:a. Contributes to control the tumor disease (at the actual moment, free of illness patient with biopsy, image, scoreboards, endoscopy, etc. records): 22 cases.b. Contributes only to palliate the effects of the disease or treatment (chemotherapy and radiotherapy), quality of life, tolerance to adverse effects: 34 cases.c. Dead patients: 4 cases.d. Cannot yet be established if the treatment works: 5 cases.e. Treatment does not work: 4 casesiv. Effectiveness estimation based on the patient:a. Has helped to control and improve my quality of life during the treatment: 55 cases.b. Has not helped at all: 5 cases.c. Without opinion: 5 cases.
Used homeopathic medicines1) Constitution based medications:A. Natrum Muriaticum: 9 cases.B. Pulsatilla: 8 cases.C. Lachesis: 4 cases.D. Calcarea Carbonica: 4 cases.E. Veratrum: 2 cases.F. Staphisagria: 8 cases.G. Samarium: 1 case.H. Alumina: 1 case.I. Germanium: 1 case.J. Ustilago: 1 case.K. Sepia: 8 cases.L. Aurum Metallicum: 6 cases.M. Ferrum Phosphoricum: 3 casesN. Aconitum: 3 cases.O. Sulphur: 2 casesP. Aranea Diadema: 1 case.Q. Silicea: 1 case.R. Ignatia: 1 case.S. Argentum Nitricum: 1 case.2) Medicines in relation to the tumor disease:A. Conium Maculatum: 14 cases.B. Phytolacca: 10 cases.C. Kalium Carbonicum: 4 cases.D. Chelidonium: 3 cases.E. Hydrastis Canadensis: 3 cases.F. Asteria Rubens: 2 cases.G. Rhododendron: 1 case.H. Carcinosinum: 8 cases.I. Thuya: 9 cases.J. Kalium Bichromicum: 3 cases.K. Calcarea Phosphorica: 3 cases.L. Ruta: 2 cases.M. Carbo Animalis: 2 cases.3) Table 8 shows the medicines used with palliative purpose for:A. Radio dermatitisB. MucositisC. Nauseas and vomitsD. WeaknessE. SadnessF. FearG. SwellingH. Post-operativeI. AnemiaJ. LeukopeniaK. ThrombocytopeniaL. Helps to dieM. Dyspnea.
How can we know, with accuracy, the effectiveness of our intervention?
To us, homeopaths, can be reproached that we do not publish our results, which is true, we barely do it. The purpose of the homeopathy associations and academies, is to offset this reality raising awareness amongst our colleagues of the importance of recording the cases homogenously and of publishing clinical results, at least, in our magazines. Due to the nature of the homeopathic practice, we must also explore new designs to contrast our results. We must change the subjective assessment of our work with validated tools from the general medicine sphere such as the life quality tests proposed by the EORTC (European Organization for Research and Treatment of Cancer) and other tools proposed by the ECH (European Committee for Homeopathy). In one word, use the common language of science to contrast our results. We prepare ourselves to search a respectful collaboration with other medicine professionals that help patients from a conventional perspective. This is the propose of integrative medicine: the patient improves and the science makes progress [1-6].
Conclusion
At the presented sample, we are conscious that at the time of collecting the data, the free of illness patients still have a long journey of regular medical checks and that, at worse, they might present relapses of their tumor disease. Our purpose as doctors is to be available at this stage of the patients’ life. Nowadays, one of the cancer treatments objectives, in those cases in which the illness cannot be cured, is to make the disease a chronic one. In our sample, there are two patients that present this situation and undoubtedly, homeopathy along with other procedures (palliative chemotherapy, hormonotherapy, etc.) helps them to get along with their lives.
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Analyzing Distances Based on Pixels using MATLAB: An Image Analysis Study - Juniper Publishers
Juniper Publishers - Open Access Journal of Engineering Technology
Abstract
The present research paper is addressed to the distance between major US airports using image analysis to give the user an accurate distance and estimated flight time for all major US airports. The system inputs needed are an average distance between the different US airports as well as the average flight speed. This research is to utilize pixels from an image to create a coordinate system, which allows us to calculate distances. Conversion factors will also be included in our system inputs. The user inputs for our program will be your starting location and the destination you are looking to travel to. The governing equations for our code are the system input coordinates on our image mapping and converting the distance between the coordinates to an actual distance in miles. These coordinates and the use of the equation of a line to get an accurate distance between airports in miles. Multiplying the total distance by the average plane speed, while accounting for taxi times, we got an accurate representation of the time it will take to get between airports. The user-defined functions are a multi-choice dialog box that the user is required to click on the location that they are starting at which leads to another multi choice dialog box requiring the user to input the destination they are looking to go to. The entire bases of our research were based on menu and switch cases.
Keywords: Pixels; US airports; Flight information; Matlab; Distance; Image analysis
Introduction
The distance between major US airports using image analysis to give the user an accurate distance and estimated flight time for all major US airports. The system inputs needed are an average distance between the different US airports as well as the average flight speed [1]. Conversion factors will also be included in system inputs. The user inputs for our program will be your starting location and the destination you are looking to travel to. The governing equations code are the system input coordinates on image mapping and converting the distance between the coordinates to an actual distance in miles. These coordinates and use of the equation of a line to get an accurate distance between airports in miles. Multiplying the total distance by the average plane speed, while accounting for taxi times, one can get an accurate representation of the time it will take to get between airports.
The user-defined functions are a multi-choice dialog box that the user is required to click on the location that they are starting at which leads to another multi choice dialog box requiring the user to input the destination they are looking to go to. The entire bases of this research article will be based on menu and switch cases. For example, if the user selects LAX, system use a switch case for the different combinations of airports then display the information desired by the user. To validate our program, the program can select the airport in which we want to go to. It should tell us the distance and approximate time it will take to reach the destination. We can verify our results by using online flight information including the actual distance and time and compare them to our code.
Methods and Overview Software structure GUI structures
The structure which was used for the code was sectioned based, so we could define which part of the code does what in a clear way. The first section of the code pulls up the image that was used to define where the airports, we analyzed, are on a map of the United States [2]. The commands “clear dis, clear time, and clc” were used to clear any previous distance and time calculations in the workspace and command windows to avoid confusion. After the command codes were run we told MATLAB where our image is located within the computer by creating a path using the image file address. It was necessary to use the command imread to allow MATLAB to read the image from a graphics file (Figure 1).
By finding the actual distance between the San Francisco (SAN) and Los Angeles (LAX) Airports (approximately 347 miles) we were able to define the length, in miles, that each pixel in the image represented. By finding the centroids of both SAN and LAX represented by circles on the image and then manually inputting those coordinates into our script. Applying those coordinates in the equation of a line we were able to find the pixel length between SAN and LAX. The equation of a line is in Appendix B. We discovered how many miles each pixel represented by utilizing how many pixels were present between SAN and LAX, dividing out the actual distance in miles by the pixel distance to give us our miles per pixel(map) (Figure 2).
To adjust our code to a user-friendly platform, the centroids of the top twenty US airports where represented as x and y coordinates which we hard-coded into a switch case menu. Then creating a second similar menu, so the user could select both a departure and arrival airport from separate menus while giving us two different x and y coordinates for each airport.
In Figure 3 we employed the selected airport’s coordinates into an if else statement which allowed us to create a case where the code would not work if the user selected the same departure and arrival airport. If the chosen airports where different, the coordinates are then placed into the equation of a line to find the distance in pixels between those two airports. To convert the distance from pixels to miles we multiplied our pixels by the miles per pixel(mpp) we found earlier in our code. The average flight time was found by dividing that distance in miles by the average flight speed (approximately 575 mph) and adding the average taxi times (approximately 32 minutes) to that found number.
Displaying our results in Figure 4 to the user by using fprintf statements to print the results into the command window. Finally, to display on the map where the user would be traveling to and from, we used the command “line” to draw a line on our image between the two selected airports. The result of this code is a statement clearly defining what the estimated distance and flight time between two airports that the user selects from the menus as well as a line on the map to display a visual representation of the estimated flight path (Figure 5).
Result and Discussion
To create a coordinate system, which allows us to calculate distances. We did this by using an equation of a line and a picture, which gave us the ability to convert the number of miles in one pixel. This kind of program was created to provide a simple interface for a US traveller to quickly find the distance and time for an airline flight from their departure and arrival airports. We were able to achieve this by using multiple Matlab tools, such as imread, show, switch cases, if else statements, etc (Figures 6-8).
There are multiple ways that we can make the program better and more efficient. One way is to utilize better equations, for example, we used an average flight speed; instead of this, we could introduce a fluctuating speed through differential equations. A better way to calculate the flight path would be by using flight path equations with drag. Another way we could make the program more accurate is to use a higher quality image. If the image were of higher quality, then the coordinate accuracy would be much more precise. One thing that could be taken into consideration is more variables such as wind speed, drag, and taxi times. If these variables are introduced, then the times and distances can be calculated much more precisely. If all these improvements get put into the project, then our program would run much more efficiently and accurately.
There are multiple ways that we can make the program better and more efficient. One way is to utilize better equations, for example, we used an average flight speed; instead of this, we could introduce a fluctuating speed through differential equations. A better way to calculate the flight path would be by using flight path equations with drag. Another way we could make the program more accurate is to use a higher quality image. If the image were of higher quality, then the coordinate accuracy would be much more precise. One thing that could be taken into consideration is more variables such as wind speed, drag, and taxi times. If these variables are introduced, then the times and distances can be calculated much more precisely. If all these improvements get put into the project, then our program would run much more efficiently and accurately.
Acknowledgment
Authors thank Dr. Jenna E Pink for giving ideas of using pixels as a unit for measuring distances. Authors also thank the Department of Mechanical Engineering, the University of Wisconsin-Milwaukee for proving necessary facilities to work in this area as a part of the undergraduate project.
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The Prevalence of Bovine Trypanosomiasis in JabiTehnan District of Amhara Regional State, Ethiopia
Juniper Publishers-Open Access Journal of Cell Science & Molecular Biology
Authored by Melak Wondie
Abstract
Cross sectional study was conducted in Jabi Tehnan District of West Gojjam Administrative Zone of Amhara Regional State, Ethiopia to determine the prevalence of bovine trypanosomiasis. In the parasitological survey, blood samples of 164 cattle were examined using a buffy coat technique. The Packed Cell Volume (PVC) value of each animal was also measured using hematocrit reader. The overall prevalence of trypanosomiasis was found to be 15.24% and it consists of 9.76% and 20.73% in Adankegne and Ergib peasants’ association, respectively (X2=5.783, p=0.056). The most positive cases were due to Trypanosoma congolense (T. congolense ) (80%) followed by Trypanosoma vivax (T. vivax)(20%). The mean(PCV) values of parasitaemic and aparasitaemic animals during the study period were 20.75% and 25.07%, respectively. The variation in mean PCV values were statistically significant (p=0.01). The study also demonstrated statistically significant (X2=13.886, p=0.001) variations in prevalence between sexes of cattle, which were 10.67% and 19.1% in female and male animals, respectively. The present prevalent study generated valuable information on the epidemiology of bovine trypanosomosis in the study area and revealed that trypanosomosis was an important disease affecting the livestock production
Keywords: PCV; Prevalence; Trypanosoma congolense; Trypanosoma vivax; Bovine
Introduction
Livestock is backbone of the socio-economic system of most of the rural communities of Africa [1]. Ethiopia is known for its large and diverse livestock resource endowments. Livestock is primarily kept on small holdings where it provides drought power for crop production, manure for soil fertility and fuels, serves as a sources of family diet and sources of cash income (from sale of livestock and livestock products). Despite large livestock population, Ethiopia fails to optimally utilize this resource due to different constrains facing the livestock subsector. Shortage of nutrition, reproductive insufficiency, management constraints and animal disease are the major constraints [2]. One of the diseases hampering the livestock subsector is trypanosomosis [3]. Trypanosomosis is a complex disease of protozoa that is caused by different species of unicellular parasites (trypanosome) found in the blood and other tissues of vertebrates, including livestock, wild life and people [4]. Trypanosomosis limited to the extension of natural herds particularly in Africa were the presence of the tsetse fly density access to woodland and savanna areas with good grazing potential [3]. It is a serious constraint to agricultural production in extensive areas of the tsetse infested regions which accounts over 10 million squares of the tropical Africa [5].Ethiopia is one of the countries suffering from the impact of trypanosomosis. In Ethiopia, it is estimated that some 10 to 14 million heads of cattle and an equivalent number of small ruminants together with a significant number of equines and camels, are exposed to the risk of trypanosomosis [6]. Six species of trypanosomes are recorded in Ethiopia and the most important trypanosomes in terms of economic loss in domestic livestock are the tsetse transmitted species T. congolense, T. vivax and T. brucei [3].Tsetse flies in Ethiopia are confined to western and south-western parts of the country between 33°C and 38°C E longitude and 5°C and 12°C N latitude. It is estimated to cover an area of 140, 000, 220, 000 km2[7]. Tsetse infested areas follow the major river systems; namely, Abay (Blue Nile), Baro, Akobo, Didessa, Ghibe and Omo river systems [8]. Five species of Glossina (Glossina morsitans submorsitans, G. pallidipes, G. tachinozdes, G.f. fuscipes and G. longipennis) have been recorded in Ethiopia [3]. According to National Tsetse and Trypanosomosis Investigation and Control Center [7], tsetse transmitted animal trypanosomosis still remains as one of the largest causes of livestock production losses in Ethiopia. The effects of trypanosomosis is not only the direct losses resulting from mortality, morbidity, infertility of the infested animals and costs of controlling the disease, but also due to indirect losses, which include exclusion of livestock and animal power-based crop production from the huge fertile tsetse infected areas. Annual estimated losses for Ethiopia as a result of trypanosomosis is roughly $200 million, in terms of mortality and morbidity losses in livestock (excluding utilization of fertile land for crop and livestock production) and the costs included in controlling the disease [9].The most prevalent trypanosome species in tsetse infested areas of Ethiopia are T. congolense and T. vivax. Rowlands et al. [10] reported a prevalence of 37% for T. congolense in Southeastern Ethiopia. Abebe and Jobre [11] reported an infection rate of 58% for T. congolense , 31.2% for T. vivaxand 3.5 % for T. bruceiin Southern Ethiopia. In the same report it is also indicated that 8.71% infection rate was recorded in the highlands (tsetse free areas) of which 99% is due to T. vivax. Different workers [12- 14] indicated a prevalence of 17.2%, 21% and 12 % in Metekel district, in upper Didesa Valley and Southern Rift valley areas of tsetse transmitted regions, respectively, and the dominant species was T. congolense .In the western part of Amhara Regional State bordering the Abay river basin, one of the north western tsetse belt areas of Ethiopia, tsetse transmitted trypanosomes are becoming a serious threat for livestock production and agricultural activity in particular. Reports made by the Regional Veterinary Laboratory in 1999 indicated the presence of tsetse fly transmitted trypanosomosis in three districts of the region (Bure, Jabi Tehnan, and Ankesha) bordering the Abay valley areas. A preliminary survey conducted in Dembecha district by the Ethiopian Science and Technology Commission and West Gojjam Veterinary Office in 2001 indicated a trypanosome infection rate of 23% with a dominant species of T. congolense and tsetse fly identified was G. morsitans. Therefore, this study was undertaken to determine the prevalence of bovine trypanosomosis, to identify the dominant species of trypanosomes involved, and to assess the PCV values of cattle in relation to the risk factors associated with the disease.
Materials and Methods
Study area
The study was conducted in Jabi Tehnan district of west Gojjam Administrative Zone of Amhara Regional State. The district covers an area of 112,772.1 ha and bordered by Quarit and DegaDamot in East, Burie in West, Sekela in North, and Dembecha and Abay River in the South. The annual mean temperature for most part of the district is 14-32°C and the elevation varies from 1500-2300 mm above sea level (m a. s. 1) with mean annual rain fall of 1250mm. The livestock populations that are found in Jabi Tehnan district include cattle, sheep, goats, horses, mule, donkey and poultry. Among these animals, cattle are the dominant species raised in the area. The cattle population in the district is estimated to be about 187,481[15] (Figure 1).Study animalsThe study was conducted on local Zebu cattle. These animals were raised in different villages of Adankegne and Ergib of Jabi Tehnan district. The animals examined in this particular study were representing different Kebeles. Sex and body conditions of cattle were also being recorded accordingly.
Study design
The retrospective data of cross sectional survey was conducted to determine the prevalence of bovine trypanosomosis. The two sites were selected based on their higher prevalence of trypanosomosis than any other Kebeles of Jabi Tehnan district.
Sample size and sampling methods
The sample size was calculated using previous prevalence of 11.7% by [17] and desired absolute precision of 5% as per the standard procedure described by Thrusfield [18] shown below. An estimated minimum sample size of 159 cattle was obtained; however, we were able to examine 164 cattle for our study.
Study Method and Procedure
Buffy coat technique
Blood was collected from an ear vein using heparinized microhematocrit capillary tube and the tube was sealed. A heparinized capillary tube containing blood was centrifuged for 5 minutes at 12,000rpm. After centrifugation, trypanosomes were usually found in or just above the buffy coat layer. The capillary tube was out using a diamond tipped pen 1mm below the buffy coat to include the upper most layers of the red blood cells and 3mm above to include the plasma. The content of the capillary tube was expressed on to slide, homogenized on to a clean glass slide and covered with cover slip. The slide was examined under x40 objectives and x10 eye piece for the movement of parasite [19].
Measuring of packed cell volume (PCP)
Blood samples were obtained by puncturing the marginal ear vein with a lancet and collected directly into a capillary tube. The capillary tubes were placed in micro-hematocrit centrifuge with sealed end outer most. The tube was loaded symmetrically to ensure good balance. After screwing the rotary cover and closing the centrifuge lid, the specimens were allowed to revolve at 12,00rpm for 5 minutes [4,20]. Tubes were then placed in hematocrit and the readings were expressed as a percentage of packed red cells to the total volume of whole blood. Animals with PCV ≤ 24% were considered to be anemic [21].Data analysisRow data on individual animals and parasitological examination results were inserted into MS Excel spread sheets to create a data-base. Students t-test were employed to compare between the two-independent mean PCV values of animals from an individual site (peasant’s association). Chi-square test was also employed to assess the association between the risk factors and the disease. While analyzing data, p-values (p)<0.05 were registered as statistically significant. Otherwise, recorded as insignificant.
Result
Prevalence
Out of the total 164 (75 females and 89 males) cattle examined, 25 (15.24%) were found positive to trypanosomosis. The prevalence varied between different study areas, in which 9.76% (n = 8) and 20.73% (n = 17) were recorded at Adankegne and Ergib peasant’s association, respectively. The variation in the prevalence of bovine trypanosomosis between the study sites were not statistically significant (X2= 5.783; p = 0.056) (Table 1 and Figure 2). The most prevalent trypanosome species in the study area was T. congolense (80%) followed by T. vivax(20%) (Table l and Figure 2). The prevalence of bovine trypanosomosis showed statistically significance difference between sexes of cattle, in which, higher in male animals (19.1%) as compared to females (10.67%) (X2= 13.886; p = 0.001) (Table 2 and Figure 3).
Hematological findings
Discussion
The study revealed that the prevalence of bovine trypanosomosis in the area was 15.24% (25/164) which was higher compared with the previous findings of Bitew et al. [17] in the same area (11.7%). The difference in prevalence might be due the site from which the blood samples were collected. However, there were tsetse control intervention, and continuous treatment of sick animals as well as deforestation for the cultivation of land. These activities could have led to the reduction of tsetse fly population along with the decline of tsetse borne trypanosomosis in the study area. But the continuous and longtime utilization of trypanocidal drugs particularly Diminazin aceturate in the study area contribute for the development of drug resistance, so that the prevalence of trypanosomosis was higher than the previous finding due to the above reasons.In this study, two species of trypanosomes; namely, T. congolense and T. vivax were retrieved from inspected cattle. Majority of infections were also due to T. congolense. The higher proportion of T. congolense infection in the study area was in agreement with trypanosome species prevalence data from other tsetse infested region of Ethiopia where T. congolense is the most prevalent species in cattle [11]. In the same report it was also indicated that in tsetse free area of highlands, 99% of prevalence was due to T. vivax [12-14]. But in this study area, the prevalence of T. vivaxwas less than T. congolense in both peasant associations because the two sites are located adjacent to tsetse infested belts. Leak [22] and Degneh et al. [23] also indicated that T. vivax was highly susceptible to treatment while the problems of drug resistance were higher in T. congolenseM.In the current study, higher infection rate of trypanosomosis was detected in males (19.1%) as compared to in female cattle (10.67%) with statistically significant difference (X2= 13.886; p = 0.001). Different researchers work supported this finding [22- 25]. Although the variation was not statistically significant, Yalew and Fantahun [26], and Teferi and Biniam [27] had also reported higher prevalence of bovine trypanosomes in males than in females (X2 = 0.85, p=0.35 and X2= 0.10, p>0.05, respectively). According to Gemtessa and Dera [28], the higher prevalence of trypanosomes in males rather than in females might be related to the hardworking of male animals. Similarly, the variation in the prevalence between the two sexes might also be associated with that male animals travel longer distances to tsetse abundant areas for draught and ploughing purposes, and the journey creates stress leading to susceptibility to the infection [23,)].In contrast to this study,Kitila et al. [30] at Yayo District Illuababora Zone of Western Oromia and Tamirat et al. [31] at Enemorena Ener Woreda of Gurage Zone were found higher prevalence of bovine trypanosomosis in female cattle than males.Comparing the mean PCV values of cattle, significantly (p=0.01) low PCV was recorded in parasitaemic animals (25.07%) (SD = 0.989; df = 6; t-value = 8.069) than in aparasitaemic animals (20.75%) (SD = 1.601; df = 152; t-value = 40.316). This finding was in line with previous works conducted at different regions of Ethiopia by many authors [22,25]. In the absence of other diseases causing anemia, a low PCV value of individual animals is a good indicator of trypanosome infection [23,32]. Trypanosomosis might adversely lower the PCV values of infected animals [33]. A survey conducted in cattle in Hawagelan District of West Wellega Zone [34] revealed that the mean PCV of trypanosome infected animals was significantly lower (20.8±3.2 %) compared to non-infected animals (24.9±3.8 %). A later study in Northwest Ethiopia [35] in cattle experimentally infected with T. vivaxi solates also showed that the mean PCV, Hb and total RBC count were lower (p < 0.001) in all infected groups than in noninfected control animals. In Nigeria, domestic ruminants that were naturally infected with trypanosomes had significantly lower (p<0.05) PCV and RBC counts compared to uninfected animals [36]. Lower herd average PCVs for trypanosomepositive cattle compared to trypanosome-negative cattle have also been reported from Ghana [37], Zambia [32], Cameroon [38] and Gabon [39].In spite of the fact that trypanosome infection has significant association with risk factors such as age and body condition scoring, as reported by many scholars, this study had not demonstrated and regarded as limitations.
Conclusion
From this study it is possible to conclude that trypanosomosis is an important disease and a potential threat affecting the health and productivity of cattle. The major species of trypanosomes in the study area were T. congolense and T. vivax. To sum up, infection with trypanosomosis negatively affects PCV and body condition of animals. This indicated that trypanosome infection of cattle causes loss of body weight and production. Trypanosomosis control measures should be targeted on tsetse fly destruction and control methods such as pour-on and effective trypanocidal drug applications. Similarly, rearing or raising of trypanosomosis resistance cattle breeds is now a day in practical. Otherwise, the problems will increase through the aide of global warming. In conclusion, further study on the occurrence of tsetse and trypanosomosis at different season of the year at different altitudes and species of animals should be conducted.
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A New Method to Solve Transportation Problem - Harmonic Mean Approach - Juniper Publishers
Juniper Publishers - Open Access Journal of Engineering Technology
Abstract
Transportation Problem is one of the models in the Linear Programming problem. The objective of this paper is to transport the item from the origin to the destination such that the transport cost should be minimized, and we should minimize the time of transportation. To achieve this, a new approach using harmonic mean is proposed in this model.
Keywords: Transportation; Harmonic mean;Optimum solution
Introduction
Transportation problem was first studied by F.L. Hithcock[1]. In transportation problem, different sourcessupply to different destinations of demand in such a way that the transportation cost should be minimized. We can obtain basic feasible solution by three methods. They are
North West Corner method
Least Cost method
Vogel’s Approximation method (VAM)
In these three methods, VAM method is best according to the literature. We check the optimality of the transportation problem by MODI method.
The transportation problem is classified into two types. They are balanced transportation problem and unbalanced transportation problem. If the number of sources is equal to number of demands, then it is called balanced transportation problem. If not, it is called unbalanced transportation problem. If the source of item is greater than the demand, then we should add dummy column to make the problem as balanced one. If the demand is greater than the source, then we should add the dummy row to convert the given unbalanced problem to balanced transportation problem.
In recent years, many methods are proposed to find the optimum solution for the transportation problem. Pandian &Natarajan [2] gave a new approach for solving transportation problem with mixed constraints. Korukoglu & Balli [3] discussed an improved Vogel’s Approximation method for the transportation problem. Quddos et al. [4]and Sudhakar et al. [5]developed a new method for finding an optimal solution for transportation problems. Reena et al. [6]gave the new global approach to transportation problem. Later Reena et al. [7]extended their model and gave an innovative approach to optimum solution of transportation problem. Amaravathy et al. [8]developed MDMA Method to give an optimal solution for transportation problem. Urashikumari et al. [9]investigated the new transportation problem using stepping stone method and its application. Abdul Kalam Azad et al. [10]gave an algorithmic approach to solve transportation problem with the average total opportunity cost method. Joshua et al. [11]developed a North- East Corner Method to give an initial basic feasible solution for transportation problem.
It is difficult to give the new model which fit into the real-world problems. In this paper, a new statistical method called harmonic mean is used to find the optimum solution.This method gives the solution exactly like MODI- Method and results very closer to VAM Method. We also gave the numerical example for the new method and we compared our method with existing methods such as North West Corner method, Least cost method, Vogel’s Approximation method. We checked the optimality of the solution using MODI Method. Here, we considered the balanced transportation problem also.
Harmonic mean = total number of observations/sums of the reciprocal of number.
Algorithm
Step 1: Check whether the given transportation problem is balanced or not. If not, balance or by adding dummy row or column. Then go to the next step.
Step 2: Find the harmonic mean for each row and each column. Then find the maximum value among that.
Step 3: Allocate the minimum supply or demand at the place of minimum value of the related row or column.
Step 4: Repeat the step 2 and 3 until all the demands are satisfied and all the supplies are exhausted.
Step 5: Total minimum cost = sum of the product of the cost and its corresponding allocated values of supply or demand.
Numerical Example
Table 1,2
The transportation cost is:
Table3&4
The transportation cost is:
Comparison of numerical results
The comparison between the existing method and proposed method results are given below in Table5.
Conclusion
From the comparison table, we can observe that the optimum solution obtained by the proposed method is less than that of other methods and same that of MODI Method. But, the proposed method is very easy since we have less computation works. So, we can conclude that if we use harmonic mean approach to solve transportation problem, we can get global optimum solution in a lesser step.
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Soft Clay Treatment Using Geo-Foam Beads and Bypass Cement Dust | Juniper Publishers
Juniper Publishers-Open Access Journal of Civil Engineering
Authored by Mahmoud Samir El-kady
Abstract
Soft clays are usually classified according to their undrained shear strength, Cu. Values of Cu less than 12.5kPa are associated with very soft clays, whereas, soft clays possess undrained shear strength ranging between 12.5kPa and 25kPa. In addition to the low shear strength of soft clays, they experience high compressibility upon loading. This is why soft clays are considered as problematic for foundation purposes. Also, Geo-foam is an industrial material, characterized by a very low unit weight (average of 20kg/m3) compared to that of the soil. Having a density ranging from 1.0% to 2.5% of that of soil EPS possesses a compressive strength ranging between 70kPa and 140kPa and an elastic modulus ranging between 5MPa and 12MPa, According to Horvath (1997). EPS Geo-foam blocks are used in a wide range of geotechnical applications as a light weight fill.So, the main objective of this study is to investigate the geotechnical properties of soft clay with Geo-foam beads and bypass cement dust. Also, investigate the possibility of preparing low strength excavatable fill mixtures. For studying the effect of (Geo-foam beads + CBPD) / soft clay on fluid-state and hardened properties of new fill, experimental work was carried out on two groups of mixture (A&B). Different ratios of (Geo-foam beads + CBPD) were added to the mixture to study its effect on flow consistency, dry unit weight, unconfined compressive strength, and shear strength. The results of test conducted on the materials illustrated that, cement bypass dust and excess foundry sand can be successfully used to procedure self-compaction, self-leveling excavatable flowable fill material. The unconfined compressive strength of the studied mixtures without Geo-foam ranged between 271.8kPa and 1405.14kPa at CBPD between 3.88% and 18.63%. The Cohesion values for group with Geo-foam with ranged between 50kPa and 20kPa at Geo-foam between 0.32% and 1.35%. The friction angle of group with Geo-foam with ranged between 10 and 22kPa at CBPD between 0.32% and 1.35%.
Keywords: Geo-foam Beads; Bypass Cement Dust; Flowable Fill; Shear Strength
Introduction
EPS Geo-foam blocks are used in a wide range of geotechnical applications as a light weight fill. The primary function of Geo-foam is to provide a lightweight void fill below a highway, bridge approach, embankment or parking lot [1]. EPS Geo-foam minimizes settlement on underground utilities. Geo-foam is also used in much broader applications, the major ones being as lightweight fill, green roof fill, compressible inclusions, thermal insulation, and (when appropriately formed) drainage. Expanded polystyrene (EPS) Geo-foam has been used as a geotechnical material since the 1960s. EPS Geo-foam is approximately 1% the weight of soil and less than 10% the weight of other lightweight fill alternatives. As lightweight fill, EPS Geo-foam reduces the loads imposed on adjacent and underlying soils and structures [3].EPS Geo-foam is not a general soil fill replacement material but is intended to solve engineering challenges. The use of EPS typically translates into benefits to construction schedules and lowers the overall cost of construction because it is easy to handle during construction, often without the need for special equipment, and is unaffected by occurring weather conditions [3]. EPS Geo-foam can be used to replace compressible soils or in place of heavy fill materials to prevent unacceptable loading on underlying soils and adjacent structures. The high compressive resistance of EPS Geo-foam makes it able to adequately support traffic loadings associated with secondary and interstate highways [4]. Also, using EPS Geo-foam eliminates the need for compaction and fill testing, reduces the construction time and minimizes impact to the existing roadway and adjacent structures and/or buried utilities [5]. Experimental work was carried out on two groups of mixture (A&B) and different ratios of (Geo-foam beads + CBPD) were added to the mixture to study its effect on the geotechnical properties.
Experimental Program Material characteristics
The soft clay was dried in the oven at 110C. It is passing through sieve size of 0.25mm. Soft clay characteristics are listed in Table 1.Also, the unit weight of the Geo-foam beads is 15.0kg/m3. The size of the Geo-foam beads is 5.0mm Figure 1a.Mixture proportionsThe experimental work was divided into two groups, each with the same size of 600cm3. Group A was divided into five subsamples without the use of Geo-foam and mixed with increasing percentages of CBPD (50g) for each sample and different percentages of water. In addition, the B group was divided into five sub-samples and mixed with increasing percentages of Geo-foam (5g) for each sample as well as different percentages of water with stable weight of CBPD as shown in the following Tables 2-5.
Experimental Work and Results Flow consistency
Samples were mixed for groups A-B for different percentages of water as shown in Figure 1b. The consistency flow of the samples was measured for each sample. It is found that the flow consistency increased slightly for group B than for group A. So, the flow consistency was measured in laboratory as listed in (Tables 6-7 ) for the two groups. Although the percentage of water present in the B samples, the effect of the presence of Geofoam beads than bypass cement dust on soil was clear as shown in Figure 2.Unconfined compressive strengthThe studied mixtures for each group were molded and hardened. Unconfined compressive strength was obtained by the Triaxial test for the studied mixtures as shown in Figures 3. It was found that with the increase of cement bypass dust, the unconfined compressive strength increased significantly and especially for the samples (A4 - A5) compared to a slight increase in the values of the strain% as shown in Figure 4. Also, compressive strength values are also stabilized with increasing mixing rates in cement bypass dust from approximately 14 to18% as shown in Figure 5. This shows the significant effect of cement bypass dust on compressive strength of studied samples.Shear strengthShear box test was carried out on the studied samples. The samples were loaded with increasing stresses (50-100-150kPa)and the shear stresses were calculated versus horizontal displacement (mm). We took samples (A4-B4) for examples as shown in Figures 6-7. Shear strength parameters were obtained from direct shear test and it is concluded that CBPD affected in the cohesion of the group A samples as shown in Figure 8. On the contrary, angle of internal friction was increased significantly when increasing the ratio of Geo-foam beads for group B samples as shown in Figure 9 [6-10].
Conclusion
This paper presented an experimental study of various samples of soft clay mixed with different percentages of Geofoam beads and cement bypass dust. The following conclusions may be drawn:A. The results of test conducted on the materials illustrated that, cement bypass dust and excess foundry sand can be successfully used to procedure self-compaction, selfleveling excavatable flowable fill material.B. The dry unit weight of the studied mixtures for group without Geo-foam ranged between 1.40 and 1.6 gm/cm3 at CBPD between 3.88% and 18.63%.C. The dry unit weight of the studied mixtures for group with Geo-foam ranged between 0.65 and 1.20 gm/cm3 at Geo-foam between 0.32% and 1.35%.D. The unconfined compressive strength of the studied mixtures without Geo-foam ranged between 271.8kPa and 1405.14kPa at CBPD between 3.88% and 18.63%.E. The unconfined compressive strength of the studied mixtures with Geo-foam ranged between 230kPa and 120kPa at Geo-foam between 0.32% and 1.35%.F. The Cohesion values for group without Geo-foam with ranged between 62kPa and 105kPa at CBPD between 3.88% and 18.63%.G. The Cohesion values for group with Geo-foam with ranged between 50kPa and 20kPa at Geo-foam between 0.32% and 1.35%.H. The friction angle of group without Geo-foam with ranged between 3 and 11° at CBPD between 3.88% and 18.63%.I. The friction angle of group with Geo-foam with ranged between 10° and 22° at CBPD between 0.32% and 1.35%.
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Total Costs in The Brazilian Efficiency Model of Distribution System Operators: An Analysis - Juniper Publishers
Juniper Publishers - Open Access Journal of Engineering Technology
Abstract
This study analyses the efficiency of electricity distributors in Brazil by considering total costs. The impact of the inclusion of total costs is evaluated with four different efficiency models using Data Envelopment Analysis and Stochastic Frontier Analysis. The analyses are conducted using a sample of 60 companies over two periods of time. The years 2008 to 2010 are used to calculate the efficiency frontier, and the years 2011 to 2012 are used to validate the methodology. The results show that, on average, the total costs estimated by benchmarking methods are approximately 7% lower than those observed in 2011 and 2012, that is, utilities need to reduce their total annual costs by approximately R$40 million on average.
Keywords: Efficiency; Electricity distributors; Methodologies; Electricity sector; Competitive; Environment; Incentive regulations; Operating costs; Distribution system operators; Territorial extension; Efficiency scores; Environmental variables; Tariff reviews; Remuneration; Minor components costs
Abbrevations: DSOs: Distribution System Operators; CR: Capital Remuneration; RD: Regulatory Depreciation; MC: Minor Components Costs; AC: Additional Costs; DEA: Data Envelopment Analysis; CRS: Constant Returns to Scale; VRS: Variable Returns to Scale
Introduction
Since 1990, number of infrastructure sectors around the world, including the electricity sector, have initiated long reform processes, replacing rate of return regulation with incentive regulation. Although the structures and methodologies adopted by the electricity sector have changed since the reforms, the main objective of efficiency improvement has been maintained [1].
Rate of return regulation, which was widely used before the reform process, had an adverse effect. Specifically, it encouraged companies to overinvest to obtain greater capital remuneration. This effect is known in the literature as the Averch-Johnson effect [2]. In this scenario, consumers are penalized by having to pay high tariffs.
Following the reform process, incentive regulation has become popular in the electricity transmission and distribution segments because it incentivizes companies to become more efficient [3]. Under this type of regulation, benchmarking techniques are applied to detect inefficiencies during the electricity transport process. In short, these techniques aim to compare similar companies in a competitive environment [4].
In Brazil, rate of return regulation is partially employed in the definition of capital costs, whereas incentive regulation is fully applied in the calculation of operating costs. However, economic regulation best practices follow a different trend: the adoption of incentive regulation for capital and operating costs. This practice is based on the existence of a potential trade-off between the two costs [1]. If they partially adopt rate of return regulations for capital costs and incentive regulations for operating costs, companies will simultaneously seek to raise the former and reduce the latter [5].
In this context, the present study proposes the use of total costs for the efficiency analysis of Brazilian distribution system operators (DSOs) from an incentive regulation perspective.
Several studies analyzing the efficiency of Brazilian DSOs have been published, but, to the best of our knowledge, no study has evaluated the economic effect of the adoption of total costs in the efficiency model. Xavier, Lima, Lima, and Lopes [6] propose an alternative form of efficiency analysis for Brazilian DSOs motivated by the great territorial extension. Despite the use of total costs with physical variables as a proxy, their study does not analyses the economic impact. Costa, Lopes, and Matos [7] evaluate operating cost models proposed by Brazilian regulators and discuss their main inconsistencies. Corton, Zimmermann, and Phillips [8] investigate the effect of incentive regulation on the operating costs of Brazilian DSOs, focusing on service quality. Altoé, Júnior, Lopes, Veloso, and Saurin [9] analyse the relationship between technical efficiency and some financial variables related to capital management using operating costs, costs related to service quality, and non-technical losses. Gil, Costa, Lopes, and Mayrink [10] examine the statistical correlation between efficiency scores and environmental variables using operating costs as inputs.
Despite the previous research, studies that investigate the incentive regulation effects on the total costs of Brazilian electricity distributors are still necessary. At the moment, this proposal is subject to an internal study by Brazilian regulator. However, given the global trend, a shift towards total costs will become essential. Thus, this study provides empirical evidence of the impact of adopting total costs on efficiency analysis by comparing four different models.
Brazilian Electricity Distribution Regulation
Since 2003, DSOs have been regulated by a price cap model, which specifies an average rate under which tariffs should be adjusted considering inflation and productivity targets (X factor). The electricity distribution segment has completed three tariff reviews (2003-2006, 2007-2010, and 2011-2014) and is completing the fourth (2015-2018). During a tariff review, capital and operating costs are redefined.
Capital Costs
Capital costs consist of capital remuneration (CR) and regulatory depreciation (RD). CR is the product of the remuneration rate and the net remuneration base, which corresponds to recognised investments and is not depreciated. RD is the product of the average depreciation rate and the gross remuneration base, which corresponds to total recognised investments.
In the fourth tariff review, the previous asset base was maintained and updated by the inflation index. New assets were valued according to the concept of the optimised and depreciated replacement cost, and a utilization index was applied to all accepted assets to reduce overinvestment.
A reference price base is used to calculate the average minor components costs (MC) and additional costs (AC), which make up the final fixed asset value (replacement new value-RNV), according to Equation 1:
RNV=ME+MC+AC (1)
Where:
ME-main equipment, such as circuit breakers and current transformers;
MC-fixed components associated with a particular constructional standard, such as control cables and insulators;
AC-setting up the good, consisting of design, management, assembly, and freight costs.
ME is valued according to the company’s price base, whereas MC and AD are valued according to the reference price base, which has created an incentive mechanism within capital costs.
The reference price base is structured in a modular way such that a module is associated with each type of ME according to the company’s group. The regulator applies a clustering technique to segregate 63 DSOs into five groups to take into account different levels of investment in electricity distribution systems. Each company has an average group cost considering differences between the concession areas. Once the prices of the ME, MC, and AC are known, the RNV is calculated.
Operating Costs
The Brazilian regulator applies Data Envelopment Analysis (DEA) as an efficiency analysis, with operating costs as an input. The outputs are the underground network, the over ground network, the high-voltage network, distributed energy, the number of consumers, non-technical losses, and service quality. The sample has 61 DSOs, with mean values for the variables during 2011, 2012, and 2013. The analysis preserves non-decreasing returns to scale and the input orientation. The regulator creates a confidence interval around efficiency scores because DEA has a deterministic aspect.
From these restrictions, an operating cost target is set to be reached over the regulatory period. At the time of review, the target is compared to real operating costs. The difference between real and target costs determines a regulatory trajectory. Part of the difference is incorporated at review time, and the remaining portion is considered in X Factor [11].
International Electricity Distribution Regulation
Unlike in the early years of reform, when regulators were worried about operating costs, a current emerging question is how to ensure that utilities set efficient investment levels. Over the years, DSOs have improved their performances in response to incentive regulations. However, significant investment is needed over the next few years, and this need, combined with incentives to reduce costs, accentuates a new challenge between efficiency and investment [12].
This broad view of total costs has several motivations, including the trade-off between operating and capital costs, the freedom of companies to choose different strategies, and the trade-off between cost efficiency and quality.
An analysis that segregates operating, and capital costs encourages substitution between these cost categories [13]. Consider a benchmarking model in which operating costs are the only input and the distribution network is the only output. Utilities will increase investments by focusing on maximizing output and the return to capital, resulting in greater operational efficiency; however, tariffs will increase.
Companies can adopt different combinations of operating and capital costs to operate and improve their networks [1]. When total costs are considered, a DSO is free to choose an optimal cost composition.
In addition, total costs play an important role in service quality analysis. As more DSOs invest in network reliability, total costs and quality improvement marginal costs will be higher. Therefore, a total cost model is more appropriate to evaluate this possible trade-off [14].
Finally, a total cost model is considered one of the best regulatory practices, according to Haney and Pollitt [15]. A similar result is presented by Mesquita [16], who investigates aspects of the efficiency analyses currently employed by European and Latin American countries. The analysis considers ten European countries and eight Latin American countries and finds that most of the countries surveyed use total costs.
However, adopting total costs in efficiency models can also mean a strong incentive to reduce capital costs and may jeopardize long-term investments [17]. The possible adverse effect of discouraging investment and jeopardizing the future performance of energy distribution networks has been pointed out as one of the possible causes for the non-adoption of total costs by the Brazilian regulator. However, the regulator recognizes its use as an international trend:
‘Discussions like this point toward benchmark model based on total cost, which has been a trend in international regulatory experience. However, a breakthrough in this direction requires a much deeper study and certainly a space for methodological transition and adaptation of agents’ [18].
This adverse effect is not observed by Cullmann & Nieswand [19] when analyzing incentive regulation effects on the investment behavior of 109 German DSOs. The results show an increase in investments from 2009 for both public and private companies. The authors conclude that an analysis of investment decisions should include all institutional aspects of incentive regulation.
From a similar perspective, Poudineh & Jamasb [20] explore the determinants of the investment decisions of 129 Norwegian DSOs in the period from 2004 to 2010. The results show that the main factors influencing these decisions are the rate of return under the previous period’s investment, socio-economic costs, and the lifespan of useful assets.
Cambini, Fumagalli, & Rondi [21] investigate the relationship between incentives, service quality, and the investment levels of Italian DSOs. The results indicate a causal relationship between incentives and investment levels, and, in the process of performance improvement, penalties are more effective than rewards are.
Benchmarking Methods
The most recent advances in the field of efficiency, microeconomics, and econometrics studies are focused on efficiency frontier analysis. Given the impossibility of observing theoretical efficiency frontiers, efficiency is determined by empirical boundaries, estimated by observing the minimum use of inputs given an output level or the maximum output given an input level. This study uses DEA and Stochastic Frontier Analysis (SFA) in estimating the efficiency of Brazilian DSOs.
Data Envelopment Analysis
DEA is a nonparametric methodology that uses real data to measure the relative efficiency of a DMU. It was proposed by Charnes, Cooper & Rhodes [22] to address the efficiencies of companies operating in constant returns to scale (CRS) and further extended by Banker, Charnes & Cooper [23] to variable returns to scale (VRS).
This efficiency analysis can be focused on input reduction or output expansion. The result from an input-oriented model is the maximum reduction possible in the inputs level for a given level of output. With an output-oriented focus, the model seeks the maximum output quantities that can be generated by the actual level of inputs used by the company. The efficiency scores can vary from 0 to 1, where 1 denotes the efficient company
The majority of the DEA models consider either CRS or VRS. For CRS model, outputs and inputs increase (or decrease) by the same proportion along the frontier. Where the technology exhibits increasing, constant or decreasing returns to scale along different segments of the frontier, the VRS model is indicated. The CRS model assesses the overall technical and scale efficiency, while a VRS model measures only the technical efficiency.
The efficiency score of the ith company of N companies in CRS models takes the form specified in Equation 2, where θ is a scalar (equal to the efficiency score) and λ is a Nx1 vector that represents the weight of each Decision-Making Unit in the construction of the reference company. Assuming that the companies use E inputs and M outputs, X and Y represent ExN input and MxN output matrices, respectively. The input and output column vectors for the ith company are represented by xi and yi respectively. In Equation 2, company i is compared to a linear combination of sample companies which produce at least as much of each output with the minimum possible amount of inputs. The Equation 2 is solved once for each company.
For VRS models, a convexity constraint Σλ = 1 is added that ensures that the company is compared against other companies of a similar size.
Stochastic Frontier Analysis
SFA, a parametric method, was originally developed by Aigner, Lovell, and Schmidt [24] and Meeusen and Broeck [25] and allows the estimation of the inefficiency associated with a production function or cost.
The stochastic frontier consists of
(i) a deterministic component,
(ii) a stochastic component representing random error in the estimation of the frontier, and
(iii) an inefficiency component for each company. It is calculated, in most studies, using an input-oriented Cobb- Douglas functional form with stacked data, as in Equation 3.
The SFA model allows the error to be disaggregated into two independent components, vit and uit, and to be uncorrelated with the explanatory variables [26].
The component vit is random noise that represents deviations of the deterministic component from the frontier due to the non-inclusion of an explanatory variable or measurement error. We adopt the assumption that the error vit is independent and identically distributed and normally distributed with a zero mean and constant variance. This error term has all the characteristics of the error term used in the classical linear regression model.
The uit component is a positive error term that reflects the cost inefficiency of firms. This term indicates the cost excess relative to the stochastic frontier. When this component is null, the firm is at the efficiency frontier. Aigner, Lovell, and Schmidt [24] propose using the half-normal distribution as the probability distribution for this term, as in Equation 4:
This model is referred to as SFA-ALS. Even today, this is the most common specification used in SFA models found in the literature. Subsequently, other distributions have been proposed for the u term, the most common of which are the exponential, normal truncated, and gamma distributions [26].
Methodology
Choice of variables
The choice of inputs and outputs is a crucial aspect of benchmarking methods, especially for DEA, as the discriminatory power of these methods decreases as the number of variables increases [27]. Therefore, a researcher needs to be parsimonious in choosing variables, opting for those that best describe the evaluated process.
There is no consensus on the best variables to describe the electricity distribution process. Jamasb and Pollitt [13] investigate the most frequently used variables in benchmarking studies. Among inputs, the following stand out: operating costs, number of employees, transformer capacity, and network extension. With regard to outputs, distributed energy and the number of consumers are the most common choices.
This study uses monetary and physical variables that are widely adopted in benchmarking studies as well as non-technical losses and service quality indicators. The monetary variables are operating and total costs. The physical variables are the same as those adopted by the Brazilian regulator in the current tariff cycle, namely, the underground network, the over ground network, the high-voltage network, distributed energy, and the number of consumers. Non-technical losses and the service quality indicators are also the same as those adopted by the Brazilian regulator that consider the difference between actual and expected values [18].
Data
An efficiency analysis is conducted using data from 60 Brazilian DSOs from 2008 to 2012. The dataset can be found at the website of the Brazilian regulator (www.aneel.gov.br) and was divided into two periods: 2008 to 2010 for the efficiency frontier calculation and 2011 to 2012 for the model validation.
The methodology used to calculate capital costs was the same as that used by the regulator in Technical Note 185/2014 from the Economic Regulation Superintendence [18]. Operating costs and outputs were the same as those from Technical Note 66/2015 from the Economic Regulation Superintendence database [11]. Table 1 shows sample descriptive statistics.
This data shows great variability between companies, especially for underground networks, which are only found in the capitals of large countries.
Models
Four distinct models are evaluated in Table 2: three DEA models and one SFA model. The first two models were selected to evaluate the impact of total costs on efficiency analysis. This choice was based on the literature review presented in Section 3. The last two models were included in the analysis to validate the DEA results using SFA, a guideline recommended by Bogetoft and Otto [28].
Results
The proposed methodology was applied to the four models defined in Section 5.3 using data from sixty Brazilian DSOs from 2008 to 2010. Models 1, 2, and 3 were based on DEA using an input orientation and non-decreasing returns to scale. Model 4 applied SFA and was estimated using an input-oriented cost function. Table 3,4 shows the estimated results.
The results indicate that DSOs have average efficiency scores of 0.70, 0.84, 0.80, and 0.81 in Models 1, 2, 3, and 4, respectively, which indicates room for improvement.
Model 1 considers ten utilities as efficient, including three small and seven large companies. Two of them, Eletropaulo and Light, are located in high consumer density areas. Others that have reached the frontier do not have such high densities, which implies relatively efficient input management. Other utilities have an average efficiency of 0.67. This inefficiency can be explained by low load densities and dispersed consumers, which make such areas expensive and challenging for energy distribution. Three CPFL Energia DSOs are considered efficient: Piratininga, CPFL Paulista, and RGE. These results suggest a possible advantage associated with holding characteristics, as Semolini [29] also concludes. Twenty-nine utilities have efficiency scores under 0.67, including AME, Ene. Paraíba, Ene. Sergipe, CEMIG, and CEEE. The first three are located in the Brazilian north or northeast, which are characterized as less urbanized regions with the lowest monthly income [30]. Analysis indicates that these companies should reduce operating costs by 55% on average.
Model 2, which considers total costs as inputs, indicates lower efficiency levels for three DSOs (Piratininga, CPFL Paulista, and Light). New companies are considered efficient, such as, for example, CEB, Coelce, and Cosern. Comparatively, these companies have partial productivities that are higher than their segment averages, especially for total costs and the highvoltage network ratio. Therefore, some companies’ efficiencies decrease under Model 2, whereas those of others increase, and the segment average efficiency rises from 0.70 to 0.84. The efficiency scores have a correlation of 0.76 with those of Model 1. Light is located at the efficiency frontier in Model 1. However, with total costs, the DSO receives a score of 0.90; a reduction of 10% in its efficiency. On the other hand, Cepisa achieves better results. Under Model 1, it has an efficiency of 0.59 compared to Celtins, Coelba, and João Cesa. Under Model 2, the company obtains a score of 0.88, and its peers are Celtins and Coelba. This evidence indicates that Model 1 can penalise companies that are efficient in total costs and can favour those that are efficient in operating costs.
Model 1 can distort the incentives given to companies. For example, Coelce obtains an efficiency of 0.80 in Model 1 and of 1.00 in Model 2. These results corroborate the existence of a possible trade-off between operating and capital costs. Therefore, models with total costs are more appropriate for efficiency analysis [1]. In fact, Model 1 does not capture the aspect of DSOs’ total costs.
In contrast with the previous models, Model 3 considers only seven companies to be efficient. CEB, Coelce, and Cosern have lower scores following the changes to the model, such as the exclusion of service quality and non-technical losses and the aggregation of the distribution network. Some companies, such as Coelba and RGE, remain on the frontier in all three models. The results of Model 3 results have a 0.89 correlation with those of Model 2. In addition, the efficiency of Light is considerably lower in Model 3, with a value of only 0.61. The company obtained scores of 1.00 and 0.90 in Models 1 and 2, respectively. This change can be explained by inclusion of the non-technical loss variable, given that difference between the expected and real values is minimal.
Model 4 estimates efficiency using SFA and estimates the cost function using the Cobb-Douglas functional form. An exponential probability distribution is used to estimate the inefficiency term of the u error. The coefficient on the logarithm of the products is shown in Table 5.
Table 5 shows that all estimates of the product coefficients are significant at the 5% level. The significance of the variance parameters of the error components, σ and λ, validate the use of the SFA stochastic model. We observe that the most important product is the distributed energy, which has an importance of almost 50% between the three products. The sum of the coefficients of the three products is 1.01, indicating the possibility of constant returns to scale. The results of the application of this model have a 0.76 correlation with those of Model 3, since Model 3 is constructed using the same inputs and products as this model is.
Of the sixty DSOs, thirteen companies have efficiencies greater than 0.95, and only two companies have efficiencies less than 0.5. Of these two DSOs, one is João Cesa, with a score of 0.45, but in Models 1, 2, and 3, this company is considered a benchmark. This company has the smallest outputs in the sample, and this fact may be distorting its efficiency.
Discussion
To analyses the economic impacts of the different models, we calculate:
(1) the average segment efficiency for each model,
(2) each distributor’s score divided by the average segment efficiency,
(3) the product of the previous result and the average real total cost from 2008 to 2010, and
(4) the comparison of the previous result with the average real total cost from 2011 to 2012. The results can be seen in Table 6,7.
Comparing the total costs estimated by Model 2 and the real values, we find a necessary average reduction of R$37 million, which is approximately 7% of real total costs. A similar result was found by Yu, Jamasb, and Pollitt [29], who analyse the efficiency of twelve English DSOs from 1995 to 2003. Of the sixty companies evaluated, thirty-three exhibit total costs that are higher than those defined by DEA. According to Model 2, AME needs to reduce cost by R$166 million or, in percentage terms, 35% of its total costs. Another inefficient large company is Ampla, which spends R$331 million more relative to others. Other DSOs have lower real total costs; RGE is a member of this group, with a real total cost of R$575 million versus an expected cost of R$643 million.
Coelce also uses comparatively fewer inputs, about 12% fewer than expected. Some companies have real and expected values that are very close, requiring no decrease or increase. These companies include Coelba, CPFL Paulista, and Light.
Model 3 suggests an average reduction of R$49 million, or approximately 9% of real total costs. Giannakis et al. [1] make a similar diagnosis when evaluating UK utilities between 1991 and 1999. About half of companies need to reduce their costs. This model does not include the quality and non-technical losses variables, as in other studies [1,14,29-33,]. AME remains inefficient, needing to reduce costs by R$162 million, which is R$4 million less than in Model 2. Ampla needs to reduce costs by R$364 million. As in the previous model, some utilities prove to be efficient, such as, for example, RGE, which spent R$100 million less than expected. Coelce maintains its good performance in this model, and AES Sul has an appropriate level of total costs.
Model 4 presents the lowest required cost reduction, with a value of approximately R$34 million, or 6% of costs. This result is to be expected since SFA considers data error. This model does not include environmental variables since they were not significant. These results corroborate previous work, such as that by Yu et al. [29], who conclude that environmental factors do not have significant economic or statistical impacts on the overall performances of English DSOs. The model finds the sharpest reductions with respect to Boa Vista (58%) and João Cesa (51%). In the previous models, the latter is considered efficient, with opportunities to increase total costs by 3% and 8%, respectively, in Models 2 and 3. Another utility with a similar result is Eletropaulo, which can increase total costs by R$236 million in Model 2, can increase them by R$86 million in Model 3, and should reduce costs by R$172 million in Model 4. Elektro moved in the opposite direction, as it is evaluated positively by Model 4 but needs improvement in Models 2 and 3.
Finally, when analyzing the results of all models, we find that, in average percentage terms, the total costs estimated by the benchmarking methods are not considerably smaller than those defined by the Brazilian regulator.
Conclusion
Efficiency analysis is receiving considerable attention from regulators in the electricity sector, especially in the distribution segment. Due to the natural monopoly characteristics of the electricity distribution process, utilities are not subject to market forces.
This study simulated a virtual competitive scenario among Brazilian utilities. DEA and SFA were used for efficiency analysis. Both methods calculate an efficiency frontier based on the evaluated company’s inputs and outputs to evaluate the impact of total costs.
The novelty of this study is in the use of total costs as inputs in efficiency models, specifically in the Brazilian case. Although total costs have already been evaluated by other studies, mainly in European countries, they have not been applied in a country with a considerable distribution segment growth rate, such as Brazil.
Four different models were studied. Comparing Model 1 and Model 2 allowed us to evaluate the impact of total costs on efficiency, whereas the comparison between Model 3 and Model 4 was useful to understand the robustness of the results. In the first comparison, 88% of utilities had a higher efficiency score in Model 2, with a mean difference of 0.14. In the second comparison, the efficiencies of 39 companies increased with SFA, with a correlation between the results of 0.76.
When evaluating the impact of the use of incentive regulations in total costs, we find that DSOs need to reduce their costs by an average of R$ 40 million per year, which is around 7% of total costs. This efficiency gain will affect consumers, who will pay lower tariffs.
This study evaluated the efficiency of Brazilian DSOs using total costs as an input; future studies could focus on superefficient Brazilian companies.
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