Women and Economic Self-Sufficiency: An Analysis of a Program in a Community-Based Organization

The objective of this project is to conduct an archival qualitative and quantitative study on a current program, Women On The Move (WOTM), and assess the effectiveness of this program. WOTM engaged approximately ten women deemed low income heads of household, for eighteen months, in efforts necessary to move each woman and her household to sustainable economic self-sufficiency as measured by the Self Sufficiency Standard (SSS) and the women\u27s personal self sufficiency goals. The methods used to conduct this research include an archival analysis of existing data from 2008. These data were compiled when the program was initially evaluated in 2008. The purpose of this study is to answer the question, how effective is a nine-month group teaching women how to build self-efficacy and economic self-sufficiency

Clinical evaluation of new diagnostic tests and development of testing strategies for tuberculosis diagnosis in Africa

Tuberculosis (TB) continues to kill more than 1.5 Mio people every year and causes a significant morbidity burden in the about 9 Mio patients who survived this infectious disease. Rapid and accurate TB diagnosis is considered one cornerstone of the global fight against TB. The “End TB Strategy” of the World Health Organization (WHO) is enforcing the need to develop new TB diagnostic tests, which are addressing the shortcomings of standard diagnostic tests that are currently used in TB epidemic and resource constrained settings like sub-Saharan Africa. In addition, to improved diagnostic tests, innovate testing strategies are needed to detect TB and control TB transmissions within specific risk groups such as prisoners, children and also TB contacts. In the frame of the presented habilitation project, three new diagnostic tests, namely the new Xpert MTB/RIF assay, which was endorsed by WHO in 2010, and two urine- based LAM tests, were evaluated in various clinical diagnostic studies in Tanzania. Further, a cross-sectional TB prevalence study was conducted in 13 Ethiopian prisons to study risk factors for TB in inmates and how successful currently implemented diagnostics algorithms are to detect TB in detention facilities. Finally, the isolated TB strains from these research studies were further analyzed using genotyping techniques in order to analyse mechanisms of TB transmission, spread of drug resistance and pathogenicity of TB strains in different high TB risk populations in Africa. For the Xpert MTB/RIF evaluation, the studies included adult and pediatric cohorts of patients with suspicion of TB. Further, the Xpert MTB/RIF assay was evaluated in a study with household contacts of smear-positive TB patients. Finally, the assay´s capacity to monitor TB treatment was assessed in TB patients who were enrolled in a therapeutic drug trial. The results of these studies contributed relevant information on the diagnostic accuracy of the assay and are also reflected by the current Xpert MTB/RIF policy recommendations from WHO. The most relevant findings were that Xpert MTB/RIF had a significant higher sensitivity compared to smear microscopy and detected up to 60% of smear negative, culture positive adult and paediatric TB cases. Xpert MTB/RIF performs equally well in HIV-positive and HIV-negative TB suspects and only one test in adults is sufficient to reach almost maximal sensitivity. Due to easy handling, rapid availability of test results and good performance in field conditions, the Xpert MTB/RIF test should be considered as the preferred test in contact tracing scenarios in Tanzania. However, due to sustained positive Xpert MTB/RIF results until the end of antimicrobial therapy in up to 27% of smear-positive TB patients, this assay is not useful to monitor microbiological response to TB treatment. The diagnostic capacity of the two LAM-assays was evaluated in a cohort of children with presumed TB. This study showed that LAM-sensitivity was highest, with maximal 70%, in HIV positive TB cases but had poor sensitivity, 28%, in HIV-negative TB suspects. Importantly, those groups of children suffering most from (co-) morbidities and high mortality were more likely to be LAM-positive. Therefore, specifically HIV-positive children with presumed active TB infection and advanced morbidity might benefit most from urine LAM-testing. This is in line with current WHO recommendations on the use of urine-based LAM tests. However, further scientific evidence is needed for a final evaluation of the use of LAM tests for the diagnosis of TB in clinical routine in Africa. The prison studies revealed that TB prevalence with about 450 TB cases among 100.000 convicts was twice as large as in the standard Ethiopian population. About 30% of existing TB cases were not detected by the prison health staff, whereby half on these were smear negative. Risk factors for TB in prisons were related to subject characteristics and behavior (e.g. alcohol drinking and TB contact at home) as well as to prison capacities (e.g. windows in prison cells). Genotypic analyses revealed that TB strains from prisoners were forming joint clusters with TB strains isolated from the Ethiopian standard population. These findings support the concept of interrelated TB epidemics among populations inside and outside prisons. Both sides need to be addressed in TB control programmes, and e.g. systematic and comprehensive TB screenings among new prisoners at entry as well as long-term prisoners might be an important strategy in order to end TB in high risk populations in Africa

Analysis of the Requirement for the Ships Using Methanol as Fuel

Methanol is a safe, cost-effective alternative marine fuel. It is one of promised solution for being shipping fuel because of it feedstock and produces less pollution than fossil fuel. Methanol is one of new fuel in the shipping industry; because of that there are lack of regulation for this fuel. IMO has not release regulation of using methanol as fuel but there is some draft is in process. The document that can be found to represent the draft of IMO IGF Code is report of Sub-Committee of Carriage Cargo and Containers (CCC) 3-3. Classification society that has the regulation for using methanol is LR and DNV GL. Comparing the three regulations and selecting the regulation that has high safety level is the best way to design the methanol-fueled ship. The result shows that there still some different opinion on the three regulations that regulate the methanol as ship fuel. Some regulation also doesn’t mention about the detail material that should be use in the system. Calculation method to selecting pipes thickness also different. To make it safe, the thick one should be used. Implementation the regulation on board ship resulting loses the payload of their cargo. The specific fuel consumption will be increased by factor 46% compared to fuel oil SFOC and the storage tank shall be protected by cofferdam that takes a lot of space. To safe ships space the service tank is recommended put in the main deck to prevent the use of protective cofferdam

Identity masking effectiveness and gesture recognition: Effects of eye enhancement in seeing through the mask

Face identity masking algorithms developed in recent years aim to protect the privacy of people in video recordings. These algorithms are designed to interfere with identification, while preserving information about facial actions. An important challenge is to preserve subtle actions in the eye region, while obscuring the salient identity cues from the eyes. We evaluated the effectiveness of identity-masking algorithms based on Canny filters, applied with and without eye enhancement, for interfering with identification and preserving facial actions. In Experiments 1 and 2, we tested human participants' ability to match the facial identity of a driver in a low resolution video to a high resolution facial image. Results showed that both masking methods impaired identification, and that eye enhancement did not alter the effectiveness of the Canny filter mask. In Experiment 3, we tested action preservation and found that neither method interfered significantly with driver action perception. We conclude that relatively simple, filter-based masking algorithms, which are suitable for application to low quality video, can be used in privacy protection without compromising action perception.Comment: 8 pages, 8 figure

Concept for a LNG Gas Handling System for a Dual Fuel Engine

Nowadays, ships are using LNG as main engine fuel because based on the facts that LNG has no sulphur content, and its combustion process, LNG produces low NOx content compared to heavy fuel oil and marine diesel oil. LNG is not only produces low gas emission, but may have economic advantages. In the engine laboratory of maritime studies department in Warnemunde, Germany, there is a diesel engine type MAN 6L23/30 A, where the mode operation of these engine would be changed to dual fuel engine mode operation. Therefore, in this thesis, the use dual fuel engine will be compared where it will utilize natural gas and marine diesel oil and select the required components for fuel gas supply system. By conducting the process calculation, engine MAN 6L23/30 A requires the capacity natural gas of 12.908  for 5 days at full load. A concept for LNG supply system would be arranged from storage tank until engine manifold. Germanischer Lloyd and Project Guide of dual fuel engine will be used as a guidelines to develop an optimal design and arrangement which comply with the regulation

Clinical evaluation of new diagnostic tests and development of testing strategies for tuberculosis diagnosis in Africa

Tuberculosis (TB) continues to kill more than 1.5 Mio people every year and causes a significant morbidity burden in the about 9 Mio patients who survived this infectious disease. Rapid and accurate TB diagnosis is considered one cornerstone of the global fight against TB. The “End TB Strategy” of the World Health Organization (WHO) is enforcing the need to develop new TB diagnostic tests, which are addressing the shortcomings of standard diagnostic tests that are currently used in TB epidemic and resource constrained settings like sub-Saharan Africa. In addition, to improved diagnostic tests, innovate testing strategies are needed to detect TB and control TB transmissions within specific risk groups such as prisoners, children and also TB contacts. In the frame of the presented habilitation project, three new diagnostic tests, namely the new Xpert MTB/RIF assay, which was endorsed by WHO in 2010, and two urine- based LAM tests, were evaluated in various clinical diagnostic studies in Tanzania. Further, a cross-sectional TB prevalence study was conducted in 13 Ethiopian prisons to study risk factors for TB in inmates and how successful currently implemented diagnostics algorithms are to detect TB in detention facilities. Finally, the isolated TB strains from these research studies were further analyzed using genotyping techniques in order to analyse mechanisms of TB transmission, spread of drug resistance and pathogenicity of TB strains in different high TB risk populations in Africa. For the Xpert MTB/RIF evaluation, the studies included adult and pediatric cohorts of patients with suspicion of TB. Further, the Xpert MTB/RIF assay was evaluated in a study with household contacts of smear-positive TB patients. Finally, the assay´s capacity to monitor TB treatment was assessed in TB patients who were enrolled in a therapeutic drug trial. The results of these studies contributed relevant information on the diagnostic accuracy of the assay and are also reflected by the current Xpert MTB/RIF policy recommendations from WHO. The most relevant findings were that Xpert MTB/RIF had a significant higher sensitivity compared to smear microscopy and detected up to 60% of smear negative, culture positive adult and paediatric TB cases. Xpert MTB/RIF performs equally well in HIV-positive and HIV-negative TB suspects and only one test in adults is sufficient to reach almost maximal sensitivity. Due to easy handling, rapid availability of test results and good performance in field conditions, the Xpert MTB/RIF test should be considered as the preferred test in contact tracing scenarios in Tanzania. However, due to sustained positive Xpert MTB/RIF results until the end of antimicrobial therapy in up to 27% of smear-positive TB patients, this assay is not useful to monitor microbiological response to TB treatment. The diagnostic capacity of the two LAM-assays was evaluated in a cohort of children with presumed TB. This study showed that LAM-sensitivity was highest, with maximal 70%, in HIV positive TB cases but had poor sensitivity, 28%, in HIV-negative TB suspects. Importantly, those groups of children suffering most from (co-) morbidities and high mortality were more likely to be LAM-positive. Therefore, specifically HIV-positive children with presumed active TB infection and advanced morbidity might benefit most from urine LAM-testing. This is in line with current WHO recommendations on the use of urine-based LAM tests. However, further scientific evidence is needed for a final evaluation of the use of LAM tests for the diagnosis of TB in clinical routine in Africa. The prison studies revealed that TB prevalence with about 450 TB cases among 100.000 convicts was twice as large as in the standard Ethiopian population. About 30% of existing TB cases were not detected by the prison health staff, whereby half on these were smear negative. Risk factors for TB in prisons were related to subject characteristics and behavior (e.g. alcohol drinking and TB contact at home) as well as to prison capacities (e.g. windows in prison cells). Genotypic analyses revealed that TB strains from prisoners were forming joint clusters with TB strains isolated from the Ethiopian standard population. These findings support the concept of interrelated TB epidemics among populations inside and outside prisons. Both sides need to be addressed in TB control programmes, and e.g. systematic and comprehensive TB screenings among new prisoners at entry as well as long-term prisoners might be an important strategy in order to end TB in high risk populations in Africa

Monitoring CD27 expression to evaluate Mycobacterium tuberculosis activity in HIV-1 infected individuals in vivo.

The level of bacterial activity is only poorly defined during asymptomatic Mycobacterium tuberculosis (MTB) infection. The objective was to study the capacity of a new biomarker, the expression of the T cell maturation marker CD27 on MTB-specific CD4 T cells, to identify active tuberculosis (TB) disease in subjects from a MTB and HIV endemic region. The frequency and CD27 expression of circulating MTB-specific CD4 T cells was determined in 96 study participants after stimulation with purified protein derivative (PPD) using intracellular cytokine staining for IFNgamma (IFNγ). Subjects were then stratified by their TB and HIV status. Within PPD responders, a CD27(-) phenotype was associated with active TB in HIV(-) (p = 0.0003) and HIV(+) (p = 0.057) subjects, respectively. In addition, loss of CD27 expression preceded development of active TB in one HIV seroconverter. Interestingly, in contrast to HIV(-) subjects, MTB-specific CD4 T cell populations from HIV(+) TB-asymptomatic subjects were often dominated by CD27(-) cells. These data indicate that down-regulation of CD27 on MTB-specific CD4 T cell could be used as a biomarker of active TB, potentially preceding clinical TB disease. Furthermore, these data are consistent with the hypothesis that late, chronic HIV infection is frequently associated with increased mycobacterial activity in vivo. The analysis of T cell maturation and activation markers might thus be a useful tool to monitor TB disease progression

Synthetisches Erdgas aus Wasserstoff - immer noch eine Option?

Im Rahmen des Oberlausitzer Energiesymposiums der Hochschule Zittau/Görlitz zum Thema 'Wasserstoff - ein Netz der Zukunft' stellten Prof. Dr.-Ing. habil. Tobias Zschunke und sein Team die Ergebnisse und den aktuellen Stand seiner Arbeiten auf dem Gebiet der Gasumwandlung, hier speziell der katalytischen Methanisierung, vor. In der aktuellen energiewirtschaftlichen Situation ist eine Vielzahl von Umwandlungsprozessen im Gange, so dass man leicht den Überblick verlieren kann. Prof. Dr.-Ing. habil. Tobias Zschunke, Dr. rer. nat. Fabian Rachow und Fred Haaser, M.Eng. haben im Rahmen des LaNDER³ - Impulsprojektes 4 'Katalytische Methanisierung' das Thema Power to Gas weiter vorangetrieben, um aus ungenutztem CO2 und Wasserstoff kostengünstig und energieeffizient synthetisches Erdgas herzustellen. Das Verfahren ist zwar seit 100 Jahren bekannt, aber immer noch sehr energieintensiv. Hier ist es dem Team gelungen, eine Anlage zu entwickeln, die die Anforderungen des Thermomanagements für eine effiziente Prozessführung umsetzt. Darüber hinaus gibt das Team einen allgemeinen Überblick über den Stand der Technik und die aktuellen wirtschaftlichen Aspekte.:1. Motivation 2. Einleitung 3. Sabatierreaktion 4. Eignung für die Integration grünen Stroms 5. Thermomanagement / Aufbau 6. Prozessbeschreibung 7. Ergebnisse und Ausblick 8. Quelle

Evaluation of the burden of unsuspected pulmonary tuberculosis and co-morbidity with non-communicable diseases in sputum producing adult inpatients

A high burden of tuberculosis (TB) occurs in sub-Saharan African countries and many cases of active TB and drug-resistant TB remain undiagnosed. Tertiary care hospitals provide an opportunity to study TB co-morbidity with non-communicable and other communicable diseases (NCDs/CDs). We evaluated the burden of undiagnosed pulmonary TB and multi-drug resistant TB in adult inpatients, regardless of their primary admission diagnosis, in a tertiary referral centre. In this prospective study, newly admitted adult inpatients able to produce sputum at the University Teaching Hospital, Lusaka, Zambia, were screened for pulmonary TB using fluorescent smear microscopy and automated liquid culture. The burden of pulmonary TB, unsuspected TB, TB co-morbidity with NCDs and CDs was determined. Sputum was analysed from 900 inpatients (70.6% HIV infected) 277 (30.8%) non-TB suspects, 286 (31.8%) TB suspects and 337 (37.4%) were already receiving TB treatment. 202/900 (22.4%) of patients had culture confirmed TB. TB co-morbidity was detected in 20/275 (7.3%) NCD patients, significantly associated with diabetes (P = 0.006, OR 6.571, 95%CI: 1.706-25.3). 27/202 (13.4%) TB cases were unsuspected. There were 18 confirmed cases of MDR-TB, 5 of which were unsuspected. A large burden of unsuspected pulmonary TB co-morbidity exists in inpatients with NCDs and other CDs. Pro-active sputum screening of all inpatients in tertiary referral centres in high TB endemic countries is recommended. The scale of the problem of undiagnosed MDR-TB in inpatients requires further study