Search results for: HIV/AIDS progression
828 Correlation Between the Toxicity Grade of the Adverse Effects in the Course of the Immunotherapy of Lung Cancer and Efficiency of the Treatment in Anti-PD-L1 and Anti-PD-1 Drugs - Own Clinical Experience
Authors: Anna Rudzińska, Katarzyna Szklener, Pola Juchaniuk, Anna Rodzajweska, Katarzyna Machulska-Ciuraj, Monika Rychlik- Grabowska, Michał łOziński, Agnieszka Kolak-Bruks, SłAwomir Mańdziuk
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Introduction: Immune checkpoint inhibition (ICI) belongs to the modern forms of anti-cancer treatment. Due to the constant development and continuous research in the field of ICI, many aspects of the treatment are yet to be discovered. One of the less researched aspects of ICI treatment is the influence of the adverse effects on the treatment success rate. It is suspected that adverse events in the course of the ICI treatment indicate a better response rate and correlate with longer progression-free- survival. Methodology: The research was conducted with the usage of the documentation of the Department of Clinical Oncology and Chemotherapy. Data of the patients with a lung cancer diagnosis who were treated between 2019-2022 and received ICI treatment were analyzed. Results: Out of over 133 patients whose data was analyzed, the vast majority were diagnosed with non-small cell lung cancer. The majority of the patients did not experience adverse effects. Most adverse effects reported were classified as grade 1 or grade 2 according to CTCAE classification. Most adverse effects involved skin, thyroid and liver toxicity. Statistical significance was found for the adverse effect incidence and overall survival (OS) and progression-free survival (PFS) (p=0,0263) and for the time of toxicity onset and OS and PFS (p<0,001). The number of toxicity sites was statistically significant for prolonged PFS (p=0.0315). The highest OS was noted in the group presenting grade 1 and grade 2 adverse effects. Conclusions: Obtained results confirm the existence of the prolonged OS and PFS in the adverse-effects-charged patients, mostly in the group presenting mild to intermediate (Grade 1 and Grade 2) adverse effects and late toxicity onset. Simultaneously our results suggest a correlation between treatment response rate and the toxicity grade of the adverse effects and the time of the toxicity onset. Similar results were obtained in several similar research conducted - with the proven tendency of better survival in mild and moderate toxicity; meanwhile, other studies in the area suggested an advantage in patients with any toxicity regardless of the grade. The contradictory results strongly suggest the need for further research on this topic, with a focus on additional factors influencing the course of the treatment.Keywords: adverse effects, immunotherapy, lung cancer, PD-1/PD-L1 inhibitors
Procedia PDF Downloads 89827 Creating a Digital Map to Monitor the Care of People Living with HIV/Aids in Porto Alegre, Brazil: An Experience Report
Authors: Tiago Sigal Linhares, Ana Amélia Nascimento da Silva Bones, Juliana Miola, McArthur Alexander Barrow, Airton Tetelbom Stein
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Introduction: As a result of increased globalization and changing migration trends, it is expected that a significant portion of People Living with HIV/AIDS (PLWHA) will change their place of residence over time. In order to provide better health care, monitor the HIV epidemic and plan urban public health care and policies, there is a growing need to formulate a strategy for monitoring PLWHA care, location and migration patterns. The Porto Alegre District is characterized by a high prevalence of PLWHA and is considered one of the epicenters of HIV epidemic in Latin America. Objectives: The aim of this study is to create a digital and easily editable map in order to create a visual representation of the location of PLWHA and to monitor their migration within the city and the country in an effort to promote longitudinal care. Methods: This Experience Report used Google Maps Map Creator to generate an active digital map showing the location and changes in residence of 165 PLWHA who received care at two Primary Health Care (PHC) clinics, which attended an estimated population of five thousand patients, in downtown Porto Alegre over the last four years. Their current addresses were discovered in the unified Brazilian health care system digital records (e-SUS) and updated on the map. Results: A digital map with PLWHA current residence location was created. It was possible to demonstrate visually areas with a large concentration of PLWHA and the migration of the population within the city as wells as other cities, regions and states. Conclusions: An easily reproducible and free map could aid in PLWHA monitoring, urban public health planning, target interventions and situational diagnosis. Moreover, a visual representation of PLWHA location and migration could help bring more attention and investments to areas with geographic inequities or higher prevalence of PLWHA. It also enables notification of local PHC units of monitored patients inside their area, which are in clinical risk or with treatment abandonment through active case findings, improving the care of PLWHA.Keywords: health care, medical public health, theoretical and conceptual innovations, urban public health
Procedia PDF Downloads 122826 Clinicopathological Characteristics in Male Breast Cancer: A Case Series and Literature Review
Authors: Mohamed Shafi Mahboob Ali
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Male breast cancer (MBC) is a rare entity with overall cases reported less than 1%. However, the incidence of MBC is regularly rising every year. Due to the lack of data on MBC, diagnosis and treatment are tailored to female breast cancer. MBC risk increases with age and is usually diagnosed ten years late as the disease progression is slow compared to female breast cancer (FBC). The most common feature of MBC is an intra-ductal variant, and often, upon diagnosis, the stage of the disease is already advanced. The Prognosis of MBC is often flawed, but new treatment modalities are emerging with the current knowledge and advancement. We presented a series of male breast cancer in our center, highlighting the clinicopathological, radiological and treatment options.Keywords: male, breast, cancer, clinicopathology, ultrasound, CT scan
Procedia PDF Downloads 96825 A Computational Investigation of Potential Drugs for Cholesterol Regulation to Treat Alzheimer’s Disease
Authors: Marina Passero, Tianhua Zhai, Zuyi (Jacky) Huang
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Alzheimer’s disease has become a major public health issue, as indicated by the increasing populations of Americans living with Alzheimer’s disease. After decades of extensive research in Alzheimer’s disease, only seven drugs have been approved by Food and Drug Administration (FDA) to treat Alzheimer’s disease. Five of these drugs were designed to treat the dementia symptoms, and only two drugs (i.e., Aducanumab and Lecanemab) target the progression of Alzheimer’s disease, especially the accumulation of amyloid-b plaques. However, controversial comments were raised for the accelerated approvals of either Aducanumab or Lecanemab, especially with concerns on safety and side effects of these two drugs. There is still an urgent need for further drug discovery to target the biological processes involved in the progression of Alzheimer’s disease. Excessive cholesterol has been found to accumulate in the brain of those with Alzheimer’s disease. Cholesterol can be synthesized in both the blood and the brain, but the majority of biosynthesis in the adult brain takes place in astrocytes and is then transported to the neurons via ApoE. The blood brain barrier separates cholesterol metabolism in the brain from the rest of the body. Various proteins contribute to the metabolism of cholesterol in the brain, which offer potential targets for Alzheimer’s treatment. In the astrocytes, SREBP cleavage-activating protein (SCAP) binds to Sterol Regulatory Element-binding Protein 2 (SREBP2) in order to transport the complex from the endoplasmic reticulum to the Golgi apparatus. Cholesterol is secreted out of the astrocytes by ATP-Binding Cassette A1 (ABCA1) transporter. Lipoprotein receptors such as triggering receptor expressed on myeloid cells 2 (TREM2) internalize cholesterol into the microglia, while lipoprotein receptors such as Low-density lipoprotein receptor-related protein 1 (LRP1) internalize cholesterol into the neuron. Cytochrome P450 Family 46 Subfamily A Member 1 (CYP46A1) converts excess cholesterol to 24S-hydroxycholesterol (24S-OHC). Cholesterol has been approved for its direct effect on the production of amyloid-beta and tau proteins. The addition of cholesterol to the brain promotes the activity of beta-site amyloid precursor protein cleaving enzyme 1 (BACE1), secretase, and amyloid precursor protein (APP), which all aid in amyloid-beta production. The reduction of cholesterol esters in the brain have been found to reduce phosphorylated tau levels in mice. In this work, a computational pipeline was developed to identify the protein targets involved in cholesterol regulation in brain and further to identify chemical compounds as the inhibitors of a selected protein target. Since extensive evidence shows the strong correlation between brain cholesterol regulation and Alzheimer’s disease, a detailed literature review on genes or pathways related to the brain cholesterol synthesis and regulation was first conducted in this work. An interaction network was then built for those genes so that the top gene targets were identified. The involvement of these genes in Alzheimer’s disease progression was discussed, which was followed by the investigation of existing clinical trials for those targets. A ligand-protein docking program was finally developed to screen 1.5 million chemical compounds for the selected protein target. A machine learning program was developed to evaluate and predict the binding interaction between chemical compounds and the protein target. The results from this work pave the way for further drug discovery to regulate brain cholesterol to combat Alzheimer’s disease.Keywords: Alzheimer’s disease, drug discovery, ligand-protein docking, gene-network analysis, cholesterol regulation
Procedia PDF Downloads 73824 Design of Doctor’s Appointment Scheduling Application
Authors: Shilpa Sondkar, Maithili Patil, Atharva Potnis
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The current health care landscape desires efficiency and patient satisfaction for optimal performance. Medical appointment booking apps have increased the overall efficiency of clinics, hospitals, and e-health marketplaces while simplifying processes. These apps allow patients to connect with doctors online. Not only are mobile doctor appointment apps a reliable and efficient solution, but they are also the future of clinical progression and a distinct new stage in the patient-doctor relationship. Compared to the usual queuing method, the web-based appointment system could significantly increase patients' satisfaction with registration and reduce total waiting time effectively.Keywords: appointment, patient, scheduling, design and development, Figma
Procedia PDF Downloads 86823 Rare Case of Three Metachronous Cancers Occurring over the Period of Three Years: Clinical Importance of Investigating Neoplastic Growth Discovered during Follow-Up
Authors: Marin Kanarev, Delyan Stoyanov, Ivanna Popova, Nadezhda Petrova
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Thanks to increased survival rates in patients bearing oncological malignancies due to recent developments in anti-cancer therapies and diagnostic techniques, observation of clinical cases of metachronous cancers is more common and can provide more in-depth knowledge of their development and, as a result, help clinicians apply suitable therapy. This unusual case of three metachronous tumors presented the opportunity to follow their occurrence, progression, and treatment thoroughly. A 77-year-old male presented with carcinoma ventriculi of the pylorus region, which was surgically removed via upper subtotal stomach resection, a lateral antecolical gastro-enteroanastomosis, and a subsequent Braun anastomosis. An EOX chemotherapy regimen followed. A CT scan four months later showed no indication of recurrence or dissemination. The same scan, performed as a part of the follow-up plan two years later, showed an indication of neoplastic growth in the urinary bladder. After the patient had been directed to a urologist, the suspicion was confirmed, and the growth was histologically diagnosed as a carcinoma of the urinary bladder. An immunohistochemistry test showed an expression of PDL1 of less than 5%, which resulted in treatment with GemCis chemotherapy regimen that led to full remission. Two years and seven months after the first surgery, a CT scan showed again that the two carcinomas were gone. However, four months later, elevated tumor markers prompted a PET/CT scan, which showed data indicative of recurring neoplastic growth in the region of the stomach cardia. It was diagnosed as an adenocarcinoma infiltrating the esophagus. Preoperative chemotherapy with the ECF regimen was completed in four courses, and a CT scan showed no progression of the disease. In less than a month after therapy, the patient underwent laparotomy, debridement, gastrectomy, and a subsequent mechanical terminal-lateral esophago-jejunoanasthomosis. It was verified that the tumor originated from metastasis from the carcinoma ventriculi, which was located in the pylorus. In conclusion, this case report highlights the importance of patient follow-up and studying recurring neoplastic growth. Despite the absence of symptoms, clinicians should maintain a high level of suspicion when evaluating the patient data and choosing the most suitable therapy.Keywords: carcinoma, follow-up, metachronous, neoplastic growth, recurrence
Procedia PDF Downloads 87822 Efficacy and Safety of Updated Target Therapies for Treatment of Platinum-Resistant Recurrent Ovarian Cancer
Authors: John Hang Leung, Shyh-Yau Wang, Hei-Tung Yip, Fion, Ho Tsung-chin, Agnes LF Chan
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Objectives: Platinum-resistant ovarian cancer has a short overall survival of 9–12 months and limited treatment options. The combination of immunotherapy and targeted therapy appears to be a promising treatment option for patients with ovarian cancer, particularly to patients with platinum-resistant recurrent ovarian cancer (PRrOC). However, there are no direct head-to-head clinical trials comparing their efficacy and toxicity. We, therefore, used a network to directly and indirectly compare seven newer immunotherapies or targeted therapies combined with chemotherapy in platinum-resistant relapsed ovarian cancer, including antibody-drug conjugates, PD-1 (Programmed death-1) and PD-L1 (Programmed death-ligand 1), PARP (Poly ADP-ribose polymerase) inhibitors, TKIs (Tyrosine kinase inhibitors), and antiangiogenic agents. Methods: We searched PubMed (Public/Publisher MEDLINE), EMBASE (Excerpta Medica Database), and the Cochrane Library electronic databases for phase II and III trials involving PRrOC patients treated with immunotherapy or targeted therapy plus chemotherapy. The quality of included trials was assessed using the GRADE method. The primary outcomes compared were progression-free survival, the secondary outcomes were overall survival and safety. Results: Seven randomized controlled trials involving a total of 2058 PRrOC patients were included in this analysis. Bevacizumab plus chemotherapy showed statistically significant differences in PFS (Progression-free survival) but not OS (Overall survival) for all interested targets and immunotherapy regimens; however, according to the heatmap analysis, bevacizumab plus chemotherapy had a statistically significant risk of ≥grade 3 SAEs (Severe adverse effects), particularly hematological severe adverse events (neutropenia, anemia, leukopenia, and thrombocytopenia). Conclusions: Bevacizumab plus chemotherapy resulted in better PFS as compared with all interested regimens for the treatment of PRrOC. However, statistical differences in SAEs as bevacizumab plus chemotherapy is associated with a greater risk for hematological SAE.Keywords: platinum-resistant recurrent ovarian cancer, network meta-analysis, immune checkpoint inhibitors, target therapy, antiangiogenic agents
Procedia PDF Downloads 78821 Sexual Risk Behaviours of High School Students in an Urban Town of Cameroon
Authors: Elvis Enowbeyang Tarkang
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Background: Since students in high schools in Cameroon fall within the age group hardest hit by HIV/AIDS, it is assumed that these students might be exposed to sexual risk behaviours. Sexual risk behaviours include engaging in unprotected sexual intercourse, early sexual debut, multiple sexual partners and coerced or forced sex, and these behaviours might predispose youth to HIV transmission. However, little has been explored on the sexual risk behaviours of high school learners in Cameroon. This study aimed at examining the sexual risk behaviours of high school students in an urban town of Cameroon. Method: A quantitative cross sectional design was adopted, using a self-administered questionnaire to collect data from a disproportional stratified simple random sample of 480 (240 male and 240 female) grade 10 to grade 12 students from two participating secondary school in Limbe in the Southwest region of Cameroon August 2014. Descriptive and Chi square statistics were calculated using statistical Package for Social Sciences (SPSS) version 20 software program at the level 0.05. Results: Majority of the respondents, 63.4% reported being sexually active, of whom only 33.2% used condoms consistently. Up to 37% of the sexually active respondents had multiple sexual partners in the past one year before the study, while 23% had multiple sexual partners during the study period. The mean age of first sex was 15.4 years. Among Christians, Pentecostals, 17 (58.6%) were more likely to have experienced sexual coercion than non-Pentecostals, 111 (42.2%) (p= 0.000). Christians, 41 (10.3%) were more likely to have been forced into first sex than Muslims, 0 (0.0%); while among the Christians, Pentecostals, 6 (15.0%) were more likely to have been forced into first sex than non-Pentecostals, 35 (10.9%) (p=0.004). Among the Christians, Pentecostals, 16 (66.7%) were more likely to have experienced sex by age 16 years than non-Pentecostals, 125 (64.1%) (p= 0.000). Students who lived in rented places, 32 (22.7%) were more likely to have had multiple sexual partners than those who lived in their parents’ houses, 35 (18.1%) (p= 0.000). Males, 36 (16.0%) were likely to have had multiple concurrent sexual partners than females, 14 (6.0%) (p=0.002). Students who used condoms consistently, 25 (33.3%) were more likely to have a higher perception of risk of contracting HIV than those who did not use condoms consistently, 38 (29.9%) (p=0.002). Students who lived in their parents’ houses, 35 (35.4%) were more likely to use condoms consistently during sex, than those who lived in rented places, 31 (29.8%) (p=0.021). Students who passed their examinations, 57 (30.9%) were more likely to have used condoms consistently than those with low academic profiles, 24 (27.9%) (p= 0.034). Conclusions and Recommendations: Gender, lack of parental control, religion, academic profile, poverty, place of residence and perception of risk of HIV infection were the main factors associated with sexual risk behaviours among students in urban Cameroon. The findings indicate that sexual risk behaviours exist among high school students in Limbe urban town of Cameroon. There is need for campaigns and interventions to bring about sexual behaviour change.Keywords: Cameroon, high school students, HIV/AIDS, Limbe urban town, sexual risk behaviours
Procedia PDF Downloads 331820 A Study of Issues and Mitigations on Distributed Denial of Service and Medical Internet of Things Devices
Authors: Robin Singh, Jing-Chiou Liou
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The Internet of Things (IoT) devices are being used heavily as part of our everyday routines. Through improved communication and automated procedures, its popularity has assisted users in raising the quality of work. These devices are used in healthcare in order to better collect the patient’s data for their treatment. They are generally considered safe and secure. However, there is some possibility that some loopholes do exist which manufacturers do need to identify before some hacker takes advantage of them. For this study, we focused on two medical IoT devices which are pacemakers and hearing aids. The aim of this paper is to identify if there is any likelihood of these medical devices being hijacked and used as a botnet in Distributed Denial-Of Service attacks. Moreover, some mitigation strategies are being proposed to better secureKeywords: cybersecurity, DDoS, IoT, medical devices
Procedia PDF Downloads 84819 Application of Deep Learning and Ensemble Methods for Biomarker Discovery in Diabetic Nephropathy through Fibrosis and Propionate Metabolism Pathways
Authors: Oluwafunmibi Omotayo Fasanya, Augustine Kena Adjei
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Diabetic nephropathy (DN) is a major complication of diabetes, with fibrosis and propionate metabolism playing critical roles in its progression. Identifying biomarkers linked to these pathways may provide novel insights into DN diagnosis and treatment. This study aims to identify biomarkers associated with fibrosis and propionate metabolism in DN. Analyze the biological pathways and regulatory mechanisms of these biomarkers. Develop a machine learning model to predict DN-related biomarkers and validate their functional roles. Publicly available transcriptome datasets related to DN (GSE96804 and GSE104948) were obtained from the GEO database (https://www.ncbi.nlm.nih.gov/gds), and 924 propionate metabolism-related genes (PMRGs) and 656 fibrosis-related genes (FRGs) were identified. The analysis began with the extraction of DN-differentially expressed genes (DN-DEGs) and propionate metabolism-related DEGs (PM-DEGs), followed by the intersection of these with fibrosis-related genes to identify key intersected genes. Instead of relying on traditional models, we employed a combination of deep neural networks (DNNs) and ensemble methods such as Gradient Boosting Machines (GBM) and XGBoost to enhance feature selection and biomarker discovery. Recursive feature elimination (RFE) was coupled with these advanced algorithms to refine the selection of the most critical biomarkers. Functional validation was conducted using convolutional neural networks (CNN) for gene set enrichment and immunoinfiltration analysis, revealing seven significant biomarkers—SLC37A4, ACOX2, GPD1, ACE2, SLC9A3, AGT, and PLG. These biomarkers are involved in critical biological processes such as fatty acid metabolism and glomerular development, providing a mechanistic link to DN progression. Furthermore, a TF–miRNA–mRNA regulatory network was constructed using natural language processing models to identify 8 transcription factors and 60 miRNAs that regulate these biomarkers, while a drug–gene interaction network revealed potential therapeutic targets such as UROKINASE–PLG and ATENOLOL–AGT. This integrative approach, leveraging deep learning and ensemble models, not only enhances the accuracy of biomarker discovery but also offers new perspectives on DN diagnosis and treatment, specifically targeting fibrosis and propionate metabolism pathways.Keywords: diabetic nephropathy, deep neural networks, gradient boosting machines (GBM), XGBoost
Procedia PDF Downloads 6818 The Role Of Data Gathering In NGOs
Authors: Hussaini Garba Mohammed
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Background/Significance: The lack of data gathering is affecting NGOs world-wide in general to have good data information about educational and health related issues among communities in any country and around the world. For example, HIV/AIDS smoking (Tuberculosis diseases) and COVID-19 virus carriers is becoming a serious public health problem, especially among old men and women. But there is no full details data survey assessment from communities, villages, and rural area in some countries to show the percentage of victims and patients, especial with this world COVID-19 virus among the people. These data are essential to inform programming targets, strategies, and priorities in getting good information about data gathering in any society.Keywords: reliable information, data assessment, data mining, data communication
Procedia PDF Downloads 178817 Step Method for Solving Nonlinear Two Delays Differential Equation in Parkinson’s Disease
Authors: H. N. Agiza, M. A. Sohaly, M. A. Elfouly
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Parkinson's disease (PD) is a heterogeneous disorder with common age of onset, symptoms, and progression levels. In this paper we will solve analytically the PD model as a non-linear delay differential equation using the steps method. The step method transforms a system of delay differential equations (DDEs) into systems of ordinary differential equations (ODEs). On some numerical examples, the analytical solution will be difficult. So we will approximate the analytical solution using Picard method and Taylor method to ODEs.Keywords: Parkinson's disease, step method, delay differential equation, two delays
Procedia PDF Downloads 202816 Case Report of a Secretory Carcinoma of the Salivary Gland: Clinical Management Following High-Grade Transformation
Authors: Wissam Saliba, Mandy Nicholson
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Secretory carcinoma (SC) is a rare type of salivary gland cancer. It was first realized as a distinct type of malignancy in 2010and wasinitially termed “mammary analogue secretory carcinoma” because of similarities with secretory breast cancer. The name was later changed to SC. Most SCs originate in parotid glands, and most harbour a rare gene mutation: ETV6-NTRK3. This mutation is rare in common cancers and common in rare cancers; it is present in most secretory carcinomas. Disease outcomes for SC are usually described as favourable as many cases of SC are lowgrade (LG), and cancer growth is slow. In early stages, localized therapy is usually indicated (surgery and/or radiation). Despitea favourable prognosis, a sub-set of casescan be much more aggressive.These cases tend to be of high-grade(HG).HG casesare associated with a poorer prognosis.Management of such cases can be challenging due to limited evidence for effective systemic therapy options. This case report describes the clinical management of a 46-year-oldmale patient with a unique case of SC. He was initially diagnosed with a low/intermediate grade carcinoma of the left parotid gland in 2009; he was treated with surgery and adjuvant radiation. Surgical pathology favoured primary salivary adenocarcinoma, and 2 lymph nodes were positive for malignancy. SC was not yet realized as a distinct type of cancerat the time of diagnosis, and the pathology reportvalidated this gap by stating that the specimen lacked features of the defined types of salivary carcinoma.Slow-growing pulmonary nodules were identified in 2017. In 2020, approximately 11 years after the initial diagnosis, the patient presented with malignant pleural effusion. Pathology from a pleural biopsy was consistent with metastatic poorly differentiated cancer of likely parotid origin, likely mammary analogue secretory carcinoma. The specimen was sent for Next Generation Sequencing (NGS); ETV6-NTRK3 gene fusion was confirmed, and systemic therapy was initiated.One cycle ofcarboplatin/paclitaxel was given in June 2020. He was switched to Larotrectinib (NTRK inhibitor (NTRKi)) later that month. Larotrectinib continued for approximately 9 months, with discontinuation in March 2021 due to disease progression. A second-generation NTRKi (Selitrectinib) was accessed and prescribedthrough a single patient study. Selitrectinib was well tolerated. The patient experienced a complete radiological response within~4 months. Disease progression occurred once again in October 2021. Progression was slow, and Selitrectinib continuedwhile the medical team performed a thorough search for additional treatment options. In January 2022, a liver lesion biopsy was performed, and NGS showed an NTRKG623R solvent-front resistance mutation. Various treatment pathways were considered. The patient pursuedanother investigational NTRKi through a clinical trial, and Selitrectinib was discontinued in July 2022. Excellent performance status was maintained throughout the entire course of treatment.It can be concluded that NTRK inhibitors provided satisfactory treatment efficacy and tolerance for this patient with high-grade transformation and NTRK gene fusion cancer. In the future, more clinical research is needed on systemic treatment options for high-grade transformations in NTRK gene fusion SCs.Keywords: secretory carcinoma, high-grade transformations, NTRK gene fusion, NTRK inhibitor
Procedia PDF Downloads 107815 Recessionary Tales: An Investigation into How Children with Intellectual Disability, and Their Families Experience the Current Economic Downturn
Authors: S. Flynn
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This paper offers a focused commentary on the impact of the current economic downturn on children with ID (intellectual disability), and their families, in the Republic of Ireland. It will examine the practical challenges, serious concerns, and trends in the field of disability with specific regard to the impact of the economic downturn in the Irish context. This includes the impact of cutbacks to services and supports, and the erosion of possibilities for life progression for children with ID as evident within the existing body of research. This focused commentary on core and seminal literature, policy and research will then be used to provide a discussion on what are the core points of learning for policy makers, researchers, practitioners and society as whole.Keywords: children, disability, economic, recession
Procedia PDF Downloads 310814 An Intellectual Capital as a Driver for Branding
Authors: Shyam Shukla
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A brand is the identity of a specific product, service or business. A brand can take many forms, including a name, sign, symbol, color, combination or slogan. The word brand began simply as a way to tell one person's identity from another by means of a hot iron stamp. A legally protected brand name is called a trademark. The word brand has continued to evolve to encompass identity - it affects the personality of a product, company or service. A concept brand is a brand that is associated with an abstract concept, like AIDS awareness or environmentalism, rather than a specific product, service, or business. A commodity brand is a brand associated with a commodity1. In this paper, it is tried to explore the significance of an intellectual capital for the branding of an Institution.Keywords: brand, commodity, consumer, cultural values, intellectual capital, zonal cluster
Procedia PDF Downloads 465813 Bullous Pyoderma Gangrenosum in a Patient with Anti-Phospholipid Syndrome: A Case Report and Literature Review
Authors: Yousef Alwashahi, Ahmed Almoqbali, Mayar Albahrani, Asma Alajmi
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We report a rare case of a 49-year-old Omani woman who is a known case of primary anti-phospholipid syndrome, glucose-6-phosphate dehydrogenase deficiency, and iron deficiency anaemia. During cannulation, she was found to develop bulla that progressed to ulcerations. With chronicity and recurrent abscess formation that usually increase after surgical intervention, a pathergy phenomenon was postulated. High suspicion of pyoderma gangrenosum was considered. Fortunately, the rapid progression of the disease was slowed down with corticosteroids, cyclosporin, and biological agents.Keywords: anti-phospholipid syndrome, pyoderma gangrenosum, bullous pyoderma gangrenosum, pathergy, pathergy phenomenon
Procedia PDF Downloads 90812 Technology in English Language Teaching and Its Benefits in Improving Language Skills
Authors: Yasir Naseem
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In this fast-growing and evolving world, usage and adoption of technology have displayed an essential component of the learning process, both in and out of the class, which converges and incorporates every domain of the learning aspects. It aids in learning distinct entities irrespective of their levels of challenge. It also incorporates both viewpoints of learning, i.e., competence as well as the performances of the learner. In today's learning scenario, nearly every language class ordinarily uses some form of technology. It integrates with various teaching methodologies and transforms in a way that now it grew as an integral part of the language learning courses. It has been employed to facilitate, promote, and enhances language learning. It facilitates educators in numerous ways and enhances their methodologies by equipping them to modify classroom activities, which covers every aspect of language learning.Keywords: communication, methodology, technology, skills
Procedia PDF Downloads 170811 Triple Immunotherapy to Overcome Immune Evasion by Tumors in a Melanoma Mouse Model
Authors: Mary-Ann N. Jallad, Dalal F. Jaber, Alexander M. Abdelnoor
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Introduction: Current evidence confirms that both innate and adaptive immune systems are capable of recognizing and abolishing malignant cells. The emergence of cancerous tumors in patients is, therefore, an indication that certain cancer cells can resist elimination by the immune system through a process known as “immune evasion”. In fact, cancer cells often exploit regulatory mechanisms to escape immunity. Such mechanisms normally exist to control the immune responses and prohibit exaggerated or autoimmune reactions. Recently, immunotherapies have shown promising yet limited results. Therefore this study investigates several immunotherapeutic combinations and devises a triple immunotherapy which harnesses the innate and acquired immune responses towards the annihilation of malignant cells through overcoming their ability of immune evasion, consequently hampering malignant progression and eliminating established tumors. The aims of the study are to rule out acute/chronic toxic effects of the proposed treatment combinations, to assess the effect of these combinations on tumor growth and survival rates, and to investigate potential mechanisms underlying the phenotypic results through analyzing serum levels of anti-tumor cytokines, angiogenic factors and tumor progression indicator, and the tumor-infiltrating immune-cells populations. Methodology: For toxicity analysis, cancer-free C57BL/6 mice are randomized into 9 groups: Group 1 untreated, group 2 treated with sterile saline (solvent of used treatments), group 3 treated with Monophosphoryl-lipid-A, group 4 with anti-CTLA4-antibodies, group 5 with 1-Methyl-Tryptophan (Indolamine-Dioxygenase-1 inhibitor), group 6 with both MPLA and anti-CTLA4-antibodies, group 7 with both MPLA and 1-MT, group 8 with both anti-CTLA4-antibodies and 1-MT, and group 9 with all three: MPLA, anti-CTLA4-antibodies and 1-MT. Mice are monitored throughout the treatment period and for three following months. At that point, histological sections from their main organs are assessed. For tumor progression and survival analysis, a murine melanoma model is generated by injecting analogous mice with B16F10 melanoma cells. These mice are segregated into the listed nine groups. Their tumor size and survival are monitored. For a depiction of underlying mechanisms, melanoma-bearing mice from each group are sacrificed at several time-points. Sera are tested to assess the levels of Interleukin-12 (IL-12), Vascular-Endothelial-Growth Factor (VEGF), and S100B. Furthermore, tumors are excised for analysis of infiltrated immune cell populations including T-cells, macrophages, natural killer cells and immune-regulatory cells. Results: Toxicity analysis shows that all treated groups present no signs of neither acute nor chronic toxicity. Their appearance and weights were comparable to those of control groups throughout the treatment period and for the following 3 months. Moreover, histological sections from their hearts, kidneys, lungs, and livers were normal. Work is ongoing for completion of the remaining study aims. Conclusion: Toxicity was the major concern for the success of the proposed comprehensive combinational therapy. Data generated so far ruled out any acute or chronic toxic effects. Consequently, ongoing work is quite promising and may significantly contribute to the development of more effective immunotherapeutic strategies for the treatment of cancer patients.Keywords: cancer immunotherapy, check-point blockade, combination therapy, melanoma
Procedia PDF Downloads 120810 Innate Immune Dysfunction in Niemann Pick Disease Type C
Authors: Stephanie Newman
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Niemann-Pick Type C disease is a rare, usually fatal lysosomal storage disorder. Although clinically characterized by progressive neurodegeneration, there is also evidence of altered innate immune responses such as neuroinflammation that promote disease progression. We have initiated an investigation into whether phagocytosis, an important innate immune activity and the process by which particles are ingested is defective in NPC. Using an in vitro assay, we have shown that NPC macrophages have a deficiency in the phagocytosis of different particles. We plan to investigate the mechanistic basis for impaired phagocytosis, the contribution that this deficiency makes to disease pathology, and whether therapies that have shown in vivo benefit are able to restore phagocytic activity.Keywords: Niemann Pick Disease C, phagocytosis, innate immunity, lysosomal storage disorder
Procedia PDF Downloads 391809 Gender Discrimination and Pay Gap on Tourism Labor Market
Authors: Alka Obadić
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The research concentrates on the role of tourism in generating female employment and on impact of gender discrimination in tourism sector. Unfortunately, in many countries there are still some barriers to the inclusion of women at all hierarchical levels of tourism labor market. Research analysis focuses on EU countries where tourism is a main employer of women. The analysis shows that women represent over third persons employed in the non-financial business economy and almost two thirds in core tourism activities. Women's gross hourly earnings in accommodation and food services were below those of men in the European Union and only countries who recorded increase of gender pay gap from the beginning of crisis are Bulgaria and Croatia. Women in tourism industry are still overrepresented in lower status jobs with fewer opportunities for career progression and are often treated unequally.Keywords: employment, gender discrimination, tourism, women’s participation
Procedia PDF Downloads 767808 Enabling Self-Care and Shared Decision Making for People Living with Dementia
Authors: Jonathan Turner, Julie Doyle, Laura O’Philbin, Dympna O’Sullivan
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People living with dementia should be at the centre of decision-making regarding goals for daily living. These goals include basic activities (dressing, hygiene, and mobility), advanced activities (finances, transportation, and shopping), and meaningful activities that promote well-being (pastimes and intellectual pursuits). However, there is limited involvement of people living with dementia in the design of technology to support their goals. A project is described that is co-designing intelligent computer-based support for, and with, people affected by dementia and their carers. The technology will support self-management, empower participation in shared decision-making with carers and help people living with dementia remain healthy and independent in their homes for longer. It includes information from the patient’s care plan, which documents medications, contacts, and the patient's wishes on end-of-life care. Importantly for this work, the plan can outline activities that should be maintained or worked towards, such as exercise or social contact. The authors discuss how to integrate care goal information from such a care plan with data collected from passive sensors in the patient’s home in order to deliver individualized planning and interventions for persons with dementia. A number of scientific challenges are addressed: First, to co-design with dementia patients and their carers computerized support for shared decision-making about their care while allowing the patient to share the care plan. Second, to develop a new and open monitoring framework with which to configure sensor technologies to collect data about whether goals and actions specified for a person in their care plan are being achieved. This is developed top-down by associating care quality types and metrics elicited from the co-design activities with types of data that can be collected within the home, from passive and active sensors, and from the patient’s feedback collected through a simple co-designed interface. These activities and data will be mapped to appropriate sensors and technological infrastructure with which to collect the data. Third, the application of machine learning models to analyze data collected via the sensing devices in order to investigate whether and to what extent activities outlined via the care plan are being achieved. The models will capture longitudinal data to track disease progression over time; as the disease progresses and captured data show that activities outlined in the care plan are not being achieved, the care plan may recommend alternative activities. Disease progression may also require care changes, and a data-driven approach can capture changes in a condition more quickly and allow care plans to evolve and be updated.Keywords: care goals, decision-making, dementia, self-care, sensors
Procedia PDF Downloads 169807 Visual Aid and Imagery Ramification on Decision Making: An Exploratory Study Applicable in Emergency Situations
Authors: Priyanka Bharti
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Decades ago designs were based on common sense and tradition, but after an enhancement in visualization technology and research, we are now able to comprehend the cognitive ability involved in the decoding of the visual information. However, many fields in visuals need intense research to deliver an efficient explanation for the events. Visuals are an information representation mode through images, symbols and graphics. It plays an impactful role in decision making by facilitating quick recognition, comprehension, and analysis of a situation. They enhance problem-solving capabilities by enabling the processing of more data without overloading the decision maker. As research proves that, visuals offer an improved learning environment by a factor of 400 compared to textual information. Visual information engages learners at a cognitive level and triggers the imagination, which enables the user to process the information faster (visuals are processed 60,000 times faster in the brain than text). Appropriate information, visualization, and its presentation are known to aid and intensify the decision-making process for the users. However, most literature discusses the role of visual aids in comprehension and decision making during normal conditions alone. Unlike emergencies, in a normal situation (e.g. our day to day life) users are neither exposed to stringent time constraints nor face the anxiety of survival and have sufficient time to evaluate various alternatives before making any decision. An emergency is an unexpected probably fatal real-life situation which may inflict serious ramifications on both human life and material possessions unless corrective measures are taken instantly. The situation demands the exposed user to negotiate in a dynamic and unstable scenario in the absence or lack of any preparation, but still, take swift and appropriate decisions to save life/lives or possessions. But the resulting stress and anxiety restricts cue sampling, decreases vigilance, reduces the capacity of working memory, causes premature closure in evaluating alternative options, and results in task shedding. Limited time, uncertainty, high stakes and vague goals negatively affect cognitive abilities to take appropriate decisions. More so, theory of natural decision making by experts has been understood with far more depth than that of an ordinary user. Therefore, in this study, the author aims to understand the role of visual aids in supporting rapid comprehension to take appropriate decisions during an emergency situation.Keywords: cognition, visual, decision making, graphics, recognition
Procedia PDF Downloads 268806 Strategic Management of a Geoscience Education and Training Program
Authors: Lee Ock-Sun
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The effective development of a geoscience education and training program takes account of the rapidly changing environment in the geoscience market, includes information about resource-rich countries which have international education demands. In this paper, we introduce the geoscience program run bythe International School for Geoscience Resources at the Korea Institute of Geoscience and Mineral Resources (IS-Geo of KIGAM),and show its remarkable performance. To further effective geoscience program planning and operation, we present recommendations for strategic management for customer-oriented operation with a more favorable program format and advanced training aids. Above all, the IS-Geo of KIGAM should continue improve through‘plan-do-see-feedback’activities based on the recommendations.Keywords: demand survey, geoscience program, program performance, strategic management
Procedia PDF Downloads 442805 The Relevance of Smart Technologies in Learning
Authors: Rachael Olubukola Afolabi
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Immersive technologies known as X Reality or Cross Reality that include virtual reality augmented reality, and mixed reality have pervaded into the education system at different levels from elementary school to adult learning. Instructors, instructional designers, and learning experience specialists continue to find new ways to engage students in the learning process using technology. While the progression of web technologies has enhanced digital learning experiences, analytics on learning outcomes continue to be explored to determine the relevance of these technologies in learning. Digital learning has evolved from web 1.0 (static) to 4.0 (dynamic and interactive), and this evolution of technologies has also advanced teaching methods and approaches. This paper explores how these technologies are being utilized in learning and the results that educators and learners have identified as effective learning opportunities and approaches.Keywords: immersive technologoes, virtual reality, augmented reality, technology in learning
Procedia PDF Downloads 143804 Pattern Recognition Search: An Advancement Over Interpolation Search
Authors: Shahpar Yilmaz, Yasir Nadeem, Syed A. Mehdi
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Searching for a record in a dataset is always a frequent task for any data structure-related application. Hence, a fast and efficient algorithm for the approach has its importance in yielding the quickest results and enhancing the overall productivity of the company. Interpolation search is one such technique used to search through a sorted set of elements. This paper proposes a new algorithm, an advancement over interpolation search for the application of search over a sorted array. Pattern Recognition Search or PR Search (PRS), like interpolation search, is a pattern-based divide and conquer algorithm whose objective is to reduce the sample size in order to quicken the process and it does so by treating the array as a perfect arithmetic progression series and thereby deducing the key element’s position. We look to highlight some of the key drawbacks of interpolation search, which are accounted for in the Pattern Recognition Search.Keywords: array, complexity, index, sorting, space, time
Procedia PDF Downloads 241803 A Quadratic Approach for Generating Pythagorean Triples
Authors: P. K. Rahul Krishna, S. Sandeep Kumar, Jayanthi Sunder Raj
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The article explores one of the important relations between numbers-the Pythagorean triples (triplets) which finds its application in distance measurement, construction of roads, towers, buildings and wherever Pythagoras theorem finds its application. The Pythagorean triples are numbers, that satisfy the condition “In a given set of three natural numbers, the sum of squares of two natural numbers is equal to the square of the other natural number”. There are numerous methods and equations to obtain the triplets, which have their own merits and demerits. Here, quadratic approach for generating triples uses the hypotenuse leg difference method. The advantage is that variables are few and finally only three independent variables are present.Keywords: arithmetic progression, hypotenuse leg difference method, natural numbers, Pythagorean triplets, quadratic equation
Procedia PDF Downloads 205802 Ecotourism and Orangutan Conservation in City Landscape: The Case of Semenggoh Wildlife Centre
Authors: N. E. F. Jaddil, S. Silang, J. H. Chong
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Semenggoh Wildlife Centre (SWC) begins its journey as an important orangutan rehabilitation centre in Sarawak. Strategically located about 25 km from Kuching, the capital city of Malaysian Sarawak in Borneo Island. This paper sought to access the progression of Semenggoh Wildlife Centre from a rehabilitation into one of the top ecotourism destination in Kuching. The existing semi-wild orangutans (attraction)-ecotourism interaction in city landscape setting is evaluated. With the ever-increasing demand of ecotourism activity in SWC, this study is intended to explore and understand the current status of ecotourism activity in SWC by analysing visitors, and economic statistic, issues and challenges and strategically propose way-forward to enhance the sustainability of ecotourism in SWC.Keywords: ecotourism, orangutan, Semenggoh, urban wildlife park
Procedia PDF Downloads 291801 Impact of Tourists on HIV (Human Immunodeficiency Virus) Incidence
Authors: Ofosuhene O. Apenteng, Noor Azina Ismail
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Recently tourism is a major foreign exchange earner in the World. In this paper, we propose the mathematical model to study the impact of tourists on the spread of HIV incidences using compartmental differential equation models. Simulation studies of reproduction number are used to demonstrate new insights on the spread of HIV disease. The periodogram analysis of a time series was used to determine the speed at which the disease is spread. The results indicate that with the persistent flow of tourism into a country, the disease status has increased the epidemic rate. The result suggests that the government must put more control on illegal prostitution, unprotected sexual activity as well as to emphasis on prevention policies that include the safe sexual activity through the campaign by the tourism board.Keywords: HIV/AIDS, mathematical transmission modeling, tourists, stability, simulation
Procedia PDF Downloads 391800 Organizational Commitment and Job Satisfaction among Health Professionals of a Maternity Ward in Lubango, Angola
Authors: Maria Vueba, Tchilissila A. Simoes
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Angola has a deficient health system characterized by reduced human and material resources. Nurses are the main actors combating different types of diseases simultaneously dealing with a lack of essentials tools and means. In this study, we aimed to assess the organizational commitment and job satisfaction of 51 health professionals from a maternity ward in Lubango, Angola. Participants completed the Organizational Commitment Questionnaire and the Job Satisfaction Scale and demonstrated a strong commitment towards the maternal facility, despite the majority of them were not satisfied with their work. Moreover, the gender and years of service seemed to not influence the level of commitment and satisfaction among the professionals. These results show the need for organizational restructuration (i.e., wages, career progression, supervision) to increase job satisfaction in this institution.Keywords: Africa, health professionals, organizational commitment, work satisfaction
Procedia PDF Downloads 156799 The Development of an Anaesthetic Crisis Manual for Acute Critical Events: A Pilot Study
Authors: Jacklyn Yek, Clara Tong, Shin Yuet Chong, Yee Yian Ong
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Background: While emergency manuals and cognitive aids (CA) have been used in high-hazard industries for decades, this has been a nascent field in healthcare. CAs can potentially offset the large cognitive load involved in crisis resource management and possibly facilitate the efficient performance of key steps in treatment. A crisis manual was developed based on local guidelines and the latest evidence-based information and introduced to a tertiary hospital setting in Singapore. Hence, the objective of this study is to evaluate the effectiveness of the crisis manual in guiding response and management of critical events. Methods: 7 surgical teams were recruited to participate in a series of simulated emergencies in high-fidelity operating room simulator over the period of April to June 2018. All teams consisted of a surgical consultant and medical officer/registrar, anesthesia consultant and medical officer/registrar; as well as a circulating, scrub and anesthetic nurse. Each team performed a simulated operation in which 1 or more of the crisis events occurred. The teams were randomly assigned to a scenario of the crisis manual and all teams were deemed to be equal in experience and knowledge. Before the simulation, teams were instructed on proper checklist use but the use of the checklist was optional. Results: 7 simulation sessions were performed, consisting of the following scenarios: Airway fire, Massive Transfusion Protocol, Malignant Hyperthermia, Eclampsia, and Difficult Airway. Out of the 7 surgical teams, 2 teams made use of the crisis manual – of which both teams had encountered a ‘Malignant Hyperthermia’ scenario. These team members reflected that the crisis manual assisted allowed them to work in a team, especially being able to involve the surgical doctors who were unfamiliar with the condition and management. A run chart plotted showed a possible upward trend, suggesting that with increasing awareness and training, staff would become more likely to initiate the use of the crisis manual. Conclusion: Despite the high volume load in this tertiary hospital, certain crises remain rare and clinicians are often caught unprepared. A crisis manual is an effective tool and easy-to-use repository that can improve patient outcome and encourage teamwork. With training, familiarity would allow clinicians to be increasingly comfortable with reaching out for the crisis manual. More simulation training would need to be conducted to determine its effectiveness.Keywords: crisis resource management, high fidelity simulation training, medical errors, visual aids
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