Search results for: open surgical wound model
19610 A Pattern Recognition Neural Network Model for Detection and Classification of SQL Injection Attacks
Authors: Naghmeh Moradpoor Sheykhkanloo
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Structured Query Language Injection (SQLI) attack is a code injection technique in which malicious SQL statements are inserted into a given SQL database by simply using a web browser. Losing data, disclosing confidential information or even changing the value of data are the severe damages that SQLI attack can cause on a given database. SQLI attack has also been rated as the number-one attack among top ten web application threats on Open Web Application Security Project (OWASP). OWASP is an open community dedicated to enabling organisations to consider, develop, obtain, function, and preserve applications that can be trusted. In this paper, we propose an effective pattern recognition neural network model for detection and classification of SQLI attacks. The proposed model is built from three main elements of: a Uniform Resource Locator (URL) generator in order to generate thousands of malicious and benign URLs, a URL classifier in order to: 1) classify each generated URL to either a benign URL or a malicious URL and 2) classify the malicious URLs into different SQLI attack categories, and an NN model in order to: 1) detect either a given URL is a malicious URL or a benign URL and 2) identify the type of SQLI attack for each malicious URL. The model is first trained and then evaluated by employing thousands of benign and malicious URLs. The results of the experiments are presented in order to demonstrate the effectiveness of the proposed approach.Keywords: neural networks, pattern recognition, SQL injection attacks, SQL injection attack classification, SQL injection attack detection
Procedia PDF Downloads 45819609 Results of Twenty Years of Laparoscopic Hernia Repair Surgeries
Authors: Arun Prasad
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Introduction: Laparoscopic surgery of hernia started in early 1990 and has had a mixed acceptance across the world, unlike laparoscopic cholecystectomy that has become a gold standard. Laparoscopic hernia repair claims to have less pain, less recurrence, and less wound infection compared to open hernia repair leading to early recovery and return to work. Materials and Methods: Laparoscopic hernia repair has been done in 2100 patients from 1995 till now with a follow-up data of 1350 patients. Data was analysed for results and satisfaction. Results: There is a recurrence rate of 0.1%. Early complications include bleeding, trocar injury and nerve pain. Late complications were rare. Conclusion: Laparoscopic inguinal hernia repair has a steep learning curve but after that the results and patient satisfaction are very good. It should be the procedure of choice in all bilateral and recurrent hernias.Keywords: laparoscopy, hernia, mesh, surgery
Procedia PDF Downloads 24919608 Effect of Open Burning on Soil Carbon Stock in Sugarcane Plantation in Thailand
Authors: Wilaiwan Sornpoon, Sébastien Bonnet, Savitri Garivait
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Open burning of sugarcane fields is recognized to have a negative impact on soil by degrading its properties, especially soil organic carbon (SOC) content. Better understating the effect of open burning on soil carbon dynamics is crucial for documenting the carbon sequestration capacity of agricultural soils. In this study, experiments to investigate soil carbon stocks under burned and unburned sugarcane plantation systems in Thailand were conducted. The results showed that cultivation fields without open burning during 5 consecutive years enabled to increase the SOC content at a rate of 1.37 Mg ha-1y-1. Also it was found that sugarcane fields burning led to about 15% reduction of the total carbon stock in the 0-30 cm soil layer. The overall increase in SOC under unburned practice is mainly due to the large input of organic material through the use of sugarcane residues.Keywords: soil organic carbon, soil inorganic carbon, carbon sequestration, open burning, sugarcane
Procedia PDF Downloads 29719607 Open Educational Resources (OER): Deciding upon Openness
Authors: Eunice H. Li
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This e-poster explores some of the issues that are linked to Open Educational Resources (OER). It describes how OER is explained by experts in the field and relates its value in attaining and using knowledge. ‘Open', 'open pedagogy', self-direction, freedom, and autonomy are the main issues identified for the discussion. All of these issues make essential contributions to OER in one way or another. Nevertheless, there are seemingly areas of contentions with regard to applying these concepts in teaching and learning practices. For this e-Poster, it is the teaching-learning aspects of OER that it is primarily concerned with. The basis for the discussion comes from a 2013 critique of OER presented by Jeremy Knox of the University of Edinburgh, tutor of the MSc in Digital Education Programme. This discussion is also supported by the analysis of other research work and papers in this area. The general view on OER is that it is a useful tool for the advancement of learner-centred models of education, but in whatever context, pedagogy cannot be diminished and overlooked. It should take into consideration how to deal with the issues identified above in order to allow learners to gain full benefit from OER.Keywords: open, pedagogy, e-learning technologies, autonomy, knowledge
Procedia PDF Downloads 39319606 Relationship between Trauma and Acute Scrotum: Test Torsion and Epididymal Appendix Torsion
Authors: Saimir Heta, Kastriot Haxhirexha, Virtut Velmishi, Nevila Alliu, Ilma Robo
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Background: Testicular rotation can occur at any age. The possibility to save the testicle is the fastest possible surgical intervention which is indicated by the presence of acute pain even at rest. The time element is more important to diagnose and proceed further with surgical intervention. Testicular damage is a consequence which mainly depends on the moment of onset of symptoms, at the time when the symptoms are diagnosed, the earliest action to be performed is surgical intervention. Sometimes medical tests are needed to confirm a diagnosis, or to help identify another cause for symptoms; for example, the urine test, that is used to check for infection, associated with the scrotal ultrasound test. Control of blood flow to the longitudinal supply vessels of the testicles is indicated. The sign that indicates testicular rotation is a reduction in blood flow. This is the element which is distinguished from ultrasound examination. Surgery may be needed to determine if the patient’s symptoms are caused by the rotation of the testis or any other condition. Discussion: As a surgical intervention of the emergency, the torsion of the test depends very much on the duration of the torsion, as the success in the life of the testicle depends on the fastest surgical intervention. From the previous clinic, it is noted that in any case presented to the pediatric patient diagnosed with testicular rotation, there is always a link with personal history that the patient refers to the presence of a previous episode of testicular trauma. Literature supports this fact very logically. Conclusions: Salvation without testicular atrophy depends closely on establishing the diagnosis of testicular rotation as soon as possible. Following the logic above, it can be said that the diagnosis for rotation should be performed as soon as possible, to avoid consequences that will not be favorable for the patient.Keywords: acute scrotum, test torsion, newborns, clinical presentation
Procedia PDF Downloads 14619605 Implementation of Autologous Adipose Graft from the Abdomen for Complete Fat Pad Loss of the Heel Following a Traumatic Open Fracture Secondary to a Motor Vehicle Accident: A Case Study
Authors: Ahmad Saad, Shuja Abbas, Breanna Marine
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Introduction: This study explores the potential applications of autologous pedal fat pad grafting as a minimally invasive therapeutic strategy for addressing pedal fat pad loss. Without adequate shock absorbing tissue, a patient can experience functional deficits, ulcerations, loss of quality of life, and significant limitations with ambulation. This study details a novel technique involving autologous adipose grafting from the abdomen to enhance plantar fat pad thickness in a patient involved in a severe motor vehicle accident which resulted in total fat pad loss of the heel. Autologous adipose grafting (AAG) was used following adipose allografting in an effort to recreate a normal shock absorbing surface to allow return to activities of daily living and painless ambulation. Methods: A 46-year-old male sustained multiple open pedal fractures and necrosis to the heel fat pad after a motorcycle accident, which resulted in complete loss of the calcaneal fat pad. The patient underwent serial debridement’s, utilization of wound vac therapy and split thickness skin grafting to accomplish complete closure, despite complete loss of adipose to area. Patient presented with complaints of pain on ambulation, inability to bear weight on the heel, recurrent ulcerations, admitted had not been ambulating for two years. Clinical exam demonstrated complete loss of the plantar fat pad with a thin layer of epithelial tissue overlying the calcaneal bone, allowing visibility of the osseous contour of the calcaneus. Scar tissue had formed in place of the fat pad, with thickened epithelial tissue extending from the midfoot to the calcaneus. After conservative measures were exhausted, the patient opted for initial management by adipose allograft matrix (AAM) injections. Post operative X-ray imaging revealed noticeable improvement in calcaneal fat pad thickness. At 1 year follow up, the patient was able to ambulate without assistive devices. The fat pad at this point was significantly thicker than it was pre-operatively, but the thickness did not restore to pre-accident thickness. In order to compare the take of allograft versus autografting of adipose tissue, the decision to use adipose autograft through abdominal liposuction harvesting was deemed suitable. A general surgeon completed harvesting of adipose cells from the patient’s abdomen via liposuction, and a podiatric surgeon performed the AAG injection into the heel. Total of 15 cc’s of autologous adipose tissue injected to the calcaneus. Results: There was a visual increase in the calcaneal fat pad thickness both clinically and radiographically. At the 6-week follow up, imaging revealed retention of the calcaneal fat pad thickness. Three months postop, patient returned to activities of daily living and increased quality of life due to their increased ability to ambulate. Discussion: AAG is a novel treatment for pedal fat pad loss. These treatments may be viable and reproducible therapeutic choices for patients suffering from fat pad atrophy, fat pad loss, and/or plantar ulcerations. Both treatments of AAM and AAG exhibited similar therapeutic results by providing pain relief for ambulation and allowing for patients to return to their quality of life.Keywords: podiatry, wound, adipose, allograft, autograft, wound care, limb reconstruction, injection, limb salvage
Procedia PDF Downloads 7619604 Borderline Ovarian Tumor: Management of Recurrence After Conservative Surgical Treatment
Authors: Ghorbeli Eya, Naija Lamia, Khessairi Nayssem, Saadallah Fatma, Slimane Maher, Tarek Ben Dhiab
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INTRODUCTION: Borderline ovarian tumors account for 15 to 20% of ovarian tumors. Prognostic factors of recurrence include the stage of the disease, presence of peritoneal implants, micropapillary pattern, microinvasion and intra-epithelial carcinoma. Fertility sparing constitutes a major therapeutic issue in young patients that leads to conservative surgical treatment in specific cases. METHODS: We conducted a retrospective descriptive study including patients treated at the Salah Azaiez Institute for Borderline Ovarian Tumor who underwent conservative surgical treatment from 2003 to 2018. RESULTS: Nine patients were included in our study. The median age was 33 years. Three patients were nulliparous. Given the age, conservative treatment was indicated in all these patients. Cystectomy without ovariectomy was indicated in 5 of the 9 women, which was within the margin of tumor resection on definitive anatomopathic examination in 3 of the 5 women. In contrast, given the impossibility of ovarian conservation, total annexectomy was carried out in 4 of all these women. All of the patients were followed regularly postoperatively; three had a carcinomatous transformation as an ovarian adenocarcinoma at an average interval of 18 months. Among these three patients, a single one presented intra-peritoneal metastases, requiring radical surgical treatment and adjuvant chemotherapy with 6 cures of Carbo-Taxol, with a good tolerance and a complete response. Moreover, one patient had a recurrence on the contralateral ovary as a Borderline mucinous ovarian tumor. For the remaining four women, after a median follow-up of 35 months, one patient fell spontaneously pregnant during follow-up, and three patients were in complete remission at 16 months. CONCLUSION: Borderline tumors of the ovary usually occur in young patients, which makes conservative treatment advisable if possible, but this always comes with a risk of recurrence and/or carcinomatous transformation, especially if the conservative surgical procedure was a cystectomy instead of a total annexectomy, and even more so if the resection margins were tumoral.Keywords: ovarian tumor, conservative treatment, surgical management, borderline ovarian tumor, recurrence management
Procedia PDF Downloads 1219603 Surface-Quenching Induced Cell Opening Technique in Extrusion of Thermoplastic Foamed Sheets
Authors: Abhishek Gandhi, Naresh Bhatnagar
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In this article, a new technique has been developed to manufacture open cell extruded thermoplastic foamed sheets with the aid of extrudate surface-quenching phenomenon. As the extrudate foam exits the die, its surface is rapidly quenched which results in freezing of cells on the surface, while the cells at the core continue to grow and leads to development of open-cellular microstructure at the core. Influence of chill roll temperature was found to be extremely significant in developing porous morphological attributes. Subsequently, synergistic effect of blowing agent content and chill roll temperature was examined for their expansion ratio and open-cell microstructure. Further, chill roll rotating speed was found extremely significant in obtaining open-cellular foam structures. This study intends to enhance the understanding of researchers working in the area of open-cell foam processing.Keywords: foams, porous materials, morphology, composite, microscopy, open-cell foams
Procedia PDF Downloads 44319602 Modeling of a Pendulum Test Including Skin and Muscles under Compression
Authors: M. J. Kang, Y. N. Jo, H. H. Yoo
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Pendulum tests were used to identify a stretch reflex and diagnose spasticity. Some researches tried to make a mathematical model to simulate the motions. Thighs are subject to compressive forces due to gravity during a pendulum test. Therefore, it affects knee trajectories. However, the most studies on the pendulum tests did not consider that conditions. We used Kelvin-Voight model as compression model of skin and muscles. In this study, we investigated viscoelastic behaviors of skin and muscles using gelatin blocks from experiments of the vibration of the compliantly supported beam. Then we calculated a dynamic stiffness and loss factors from the experiment and estimated a damping coefficient of the model. We also did pendulum tests of human lower limbs to validate the stiffness and damping coefficient of a skin model. To simulate the pendulum motion, we derive equations of motion. We used stretch reflex activation model to estimate muscle forces induced by the stretch reflex. To validate the results, we compared the activation with electromyography signals during experiments. The compression behavior of skin and muscles in this study can be applied to analyze sitting posture as wee as developing surgical techniques.Keywords: Kelvin-Voight model, pendulum test, skin and muscles under compression, stretch reflex
Procedia PDF Downloads 44219601 Health Benefit and Mechanism from Green Open Space: A Pathway to Connect Health to Design and Planning
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In the highly urbanized district, green open space is playing an important role in human’s health and wellbeing as a physical, aesthetic and natural environment resources. The aim of this paper is to close this gap through providing a comprehensive, qualitative meta-analysis of existing studies related to this issue. A systematic scoping of current quantitative research is conducted which mostly focused on cross-sectional survey and experimental studies. Health benefits from contact with green open space could be categorized into physical health, psychological health and social wellbeing. Mechanism for the health related to green open space could be clearly identified with the regard to natural restoration, physical activities and social capital. These results indicate a multiple pathways framework between the health benefits and mechanism. In order to support design and planning, the most evident relationship was picked up that people could psychologically benefit from green open space through outdoors physical activities. Additionally, three design and planning strategies are put forward. Various and multi-level contacts with green open space would be considered as an explanation of the pathway results and tie to bridge the health to design and planning. There is a need to carry out long-term research emphasizing on causal relationship between health and green open space through excluding cofounding factors such as self-selection.Keywords: urban green open space, planning and design, health benefit, mechanism, pathway framework
Procedia PDF Downloads 30919600 Optimal Design of Storm Water Networks Using Simulation-Optimization Technique
Authors: Dibakar Chakrabarty, Mebada Suiting
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Rapid urbanization coupled with changes in land use pattern results in increasing peak discharge and shortening of catchment time of concentration. The consequence is floods, which often inundate roads and inhabited areas of cities and towns. Management of storm water resulting from rainfall has, therefore, become an important issue for the municipal bodies. Proper management of storm water obviously includes adequate design of storm water drainage networks. The design of storm water network is a costly exercise. Least cost design of storm water networks assumes significance, particularly when the fund available is limited. Optimal design of a storm water system is a difficult task as it involves the design of various components, like, open or closed conduits, storage units, pumps etc. In this paper, a methodology for least cost design of storm water drainage systems is proposed. The methodology proposed in this study consists of coupling a storm water simulator with an optimization method. The simulator used in this study is EPA’s storm water management model (SWMM), which is linked with Genetic Algorithm (GA) optimization method. The model proposed here is a mixed integer nonlinear optimization formulation, which takes care of minimizing the sectional areas of the open conduits of storm water networks, while satisfactorily conveying the runoff resulting from rainfall to the network outlet. Performance evaluations of the developed model show that the proposed method can be used for cost effective design of open conduit based storm water networks.Keywords: genetic algorithm (GA), optimal design, simulation-optimization, storm water network, SWMM
Procedia PDF Downloads 24119599 Free Fibular Flaps in Management of Sternal Dehiscence
Authors: H. N. Alyaseen, S. E. Alalawi, T. Cordoba, É. Delisle, C. Cordoba, A. Odobescu
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Sternal dehiscence is defined as the persistent separation of sternal bones that are often complicated with mediastinitis. Etiologies that lead to sternal dehiscence vary, with cardiovascular and thoracic surgeries being the most common. Early diagnosis in susceptible patients is crucial to the management of such cases, as they are associated with high mortality rates. A recent meta-analysis of more than four hundred thousand patients concluded that deep sternal wound infections were the leading cause of mortality and morbidity in patients undergoing cardiac procedures. Long-term complications associated with sternal dehiscence include increased hospitalizations, cardiac infarctions, and renal and respiratory failures. Numerous osteosynthesis methods have been described in the literature. Surgical materials offer enough rigidity to support the sternum and can be flexible enough to allow physiological breathing movements of the chest; however, these materials fall short when managing patients with extensive bone loss, osteopenia, or general poor bone quality, for such cases, flaps offer a better closure system. Early utilization of flaps yields better survival rates compared to delayed closure or to patients treated with sternal rewiring and closed drainage. The utilization of pectoralis major flaps, rectus abdominus, and latissimus muscle flaps have all been described in the literature as great alternatives. Flap selection depends on a variety of factors, mainly the size of the sternal defect, infection, and the availability of local tissues. Free fibular flaps are commonly harvested flaps utilized in reconstruction around the body. In cases regarding sternal reconstruction with free fibular flaps, the literature exclusively discussed the flap applied vertically to the chest wall. We present a different technique applying the free fibular triple barrel flap oriented in a transverse manner, in parallel to the ribs. In our experience, this method could have enhanced results and improved prognosis as it contributes to the normal circumferential shape of the chest wall.Keywords: sternal dehiscence, management, free fibular flaps, novel surgical techniques
Procedia PDF Downloads 8919598 Influence of Ligature Tightening on Bone Fracture Risk in Interspinous Process Surgery
Authors: Dae Kyung Choi, Won Man Park, Kyungsoo Kim, Yoon Hyuk Kim
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The interspinous process devices have been recently used due to its advantages such as minimal invasiveness and less subsidence of the implant to the osteoporotic bone. In this paper, we have analyzed the influences of ligature tightening of several interspinous process devices using finite element analysis. Four types of interspinous process implants were inserted to the L3-4 spinal motion segment based on their surgical protocols. Inferior plane of L4 vertebra was fixed and 7.5 Nm of extension moment were applied on superior plane of L3 vertebra with 400N of compressive load along follower load direction and pretension of the ligature. The stability of the spinal unit was high enough than that of intact model. The higher value of pretension in the ligature led the decrease of dynamic stabilization effect in cases of the WallisTM, DiamTM, Viking, and Spear®. The results of present study could be used to evaluate surgical option and validate the biomechanical characteristics of the spinal implants.Keywords: interspinous process device, bone fracture risk, lumbar spine, finite element analysis
Procedia PDF Downloads 39819597 Valorisation of Waste Chicken Feathers: Electrospun Antibacterial Nanoparticles-Embedded Keratin Composite Nanofibers
Authors: Lebogang L. R. Mphahlele, Bruce B. Sithole
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Chicken meat is the highest consumed meat in south Africa, with a per capita consumption of >33 kg yearly. Hence, South Africa produces over 250 million kg of waste chicken feathers each year, the majority of which is landfilled or incinerated. The discarded feathers have caused environmental pollution and natural protein resource waste. Therefore, the valorisation of waste chicken feathers is measured as a more environmentally friendly and cost-effective treatment. Feather contains 91% protein, the main component being beta-keratin, a fibrous and insoluble structural protein extensively cross linked by disulfide bonds. Keratin is usually converted it into nanofibers via electrospinning for a variety of applications. keratin nanofiber composites have many potential biomedical applications for their attractive features, such as high surface-to-volume ratio and very high porosity. The application of nanofibers in the biomedical wound dressing requires antimicrobial properties for materials. One approach is incorporating inorganic nanoparticles, among which silver nanoparticles played an important alternative antibacterial agent and have been studied against many types of microbes. The objective of this study is to combine synthetic polymer, chicken feather keratin, and antibacterial nanoparticles to develop novel electrospun antibacterial nanofibrous composites for possible wound dressing application. Furthermore, this study will converting a two-dimensional electrospun nanofiber membrane to three-dimensional fiber networks that resemble the structure of the extracellular matrix (ECM)Keywords: chicken feather keratin, nanofibers, nanoparticles, nanocomposites, wound dressing
Procedia PDF Downloads 12319596 Lessons from Patients Expired due to Severe Head Injuries Treated in Intensive Care Unit of Lady Reading Hospital Peshawar
Authors: Mumtaz Ali, Hamzullah Khan, Khalid Khanzada, Shahid Ayub, Aurangzeb Wazir
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Objective: To analyse the death of patients treated in neuro-surgical ICU for severe head injuries from different perspectives. The evaluation of the data so obtained to help improve the health care delivery to this group of patients in ICU. Study Design: It is a descriptive study based on retrospective analysis of patients presenting to neuro-surgical ICU in Lady Reading Hospital, Peshawar. Study Duration: It covered the period between 1st January 2009 to 31st December 2009. Material and Methods: The Clinical record of all the patients presenting with the clinical radiological and surgical features of severe head injuries, who expired in neuro-surgical ICU was collected. A separate proforma which mentioned age, sex, time of arrival and death, causes of head injuries, the radiological features, the clinical parameters, the surgical and non surgical treatment given was used. The average duration of stay and the demographic and domiciliary representation of these patients was noted. The record was analyzed accordingly for discussion and recommendations. Results: Out of the total 112 (n-112) patients who expired in one year in the neuro-surgical ICU the young adults made up the majority 64 (57.14%) followed by children, 34 (30.35%) and then the elderly age group: 10 (8.92%). Road traffic accidents were the major cause of presentation, 75 (66.96%) followed by history of fall; 23 (20.53%) and then the fire arm injuries; 13 (11.60%). The predominant CT scan features of these patients on presentation was cerebral edema, and midline shift (diffuse neuronal injuries). 46 (41.07%) followed by cerebral contusions. 28 (25%). The correctable surgical causes were present only in 18 patients (16.07%) and the majority 94 (83.92%) were given conservative management. Of the 69 (n=69) patients in which CT scan was repeated; 62 (89.85%) showed worsening of the initial CT scan abnormalities while in 7 cases (10.14%) the features were static. Among the non surgical cases both ventilatory therapy in 7 (6.25%) and tracheostomy in 39 (34.82%) failed to change the outcome. The maximum stay in the neuro ICU leading upto the death was 48 hours in 35 (31.25%) cases followed by 31 (27.67%) cases in 24 hours; 24 (21.42%) in one week and 16 (14.28%) in 72 hours. Only 6 (5.35%) patients survived more than a week. Patients were received from almost all the districts of NWFP except. The Hazara division. There were some Afghan refugees as well. Conclusion: Mortality following the head injuries is alarmingly high despite repeated claims about the professional and administrative improvement. Even places like ICU could not change the out come according to the desired aims and objectives in the present set up. A rethinking is needed both at the individual and institutional level among the concerned quarters with a clear aim at the more scientific grounds. Only then one can achieve the desired results.Keywords: Glasgow Coma Scale, pediatrics, geriatrics, Peshawar
Procedia PDF Downloads 34319595 Focus Group Study Exploring Researchers Perspective on Open Science Policy
Authors: E. T. Svahn
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Knowledge about the factors that influence the exchange between research and society is of the utmost importance for developing collaboration between different actors, especially in future science policy development and the creation of support structures for researchers. Among other things, how researchers look at the surrounding open science policy environment and what conditions and attitudes they have for interacting with it. This paper examines the Finnish researchers' attitudes towards open science policies in 2020. Open science is an integrated part of researchers' daily lives and supports not only the effectiveness of research outputs but also the quality of research. Open science policy in ideal situation is seen as a supporting structure that enables the exchange between research and society, but in other situation, it can end up being red tape generating obstacles and hindering possibilities of making science in an efficient way. Results of this study were carried out through focus group interviews. This qualitative research method was selected because it aims to understand the phenomenon under study. In addition, focus group interviews produce diverse and rich material that would not be available with other research methods. Focus group interviews have well-established applications in social science, especially in understanding the perspectives and experiences of research subjects. In this study, focus groups were used in studying the mindset and actions of researchers. Each group's size was between 4-10 people, and the aim was to bring out different perspectives on the subject. The interviewer enabled the presentation of different perceptions and opinions, and the focus group interviews were recorded and written as text. The material was analysed using grounded theory method. The results are presented as thematic areas, theoretical model, and as direct quotations. Attitudes towards open science policy can vary greatly depending on the research area. This study shows that the open science policy demands in medicine, technology, and natural sciences compared to social sciences, educational sciences, and the humanities, varies somewhat. The variation in attitudes between different research areas can thus be largely explained by the fact that the research output and ethical code vary significantly between certain subjects. This study aims to increase understanding of the nuances to what extent open science policies should be tailored for different disciplines and research areas.Keywords: focus group interview, grounded theory, open science policy, science policy
Procedia PDF Downloads 15019594 Evaluating and Improving Healthcare Staff Knowledge of the [NG179] NICE Guidelines on Elective Surgical Care during the COVID-19 Pandemic: A Quality Improvement Project
Authors: Stavroula Stavropoulou-Tatla, Danyal Awal, Mohammad Ayaz Hossain
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The first wave of the COVID-19 pandemic saw several countries issue guidance postponing all non-urgent diagnostic evaluations and operations, leading to an estimated backlog of 28 million cases worldwide and over 4 million in the UK alone. In an attempt to regulate the resumption of elective surgical activity, the National Institute for Health and Care Excellence (NICE) introduced the ‘COVID-19 rapid guideline [NG179]’. This project aimed to increase healthcare staff knowledge of the aforementioned guideline to a targeted score of 100% in the disseminated questionnaire within 3 months at the Royal Free Hospital. A standardized online questionnaire was used to assess the knowledge of surgical and medical staff at baseline and following each 4-week-long Plan-Study-Do-Act (PDSA) cycle. During PDSA1, the A4 visual summary accompanying the guideline was visibly placed in all relevant clinical areas and the full guideline was distributed to the staff in charge together with a short briefing on the salient points. PDSA2 involved brief small-group teaching sessions. A total of 218 responses was collected. Mean percentage scores increased significantly from 51±19% at baseline to 81±16% after PDSA1 (t=10.32, p<0.0001) and further to 93±8% after PDSA2 (t=4.9, p<0.0001), with 54% of participants achieving a perfect score. In conclusion, the targeted distribution of guideline printouts and visual aids, combined with small-group teaching sessions, were simple and effective ways of educating healthcare staff about the new standards of elective surgical care at the time of COVID-19. This could facilitate the safe restoration of surgical activity, which is critical in order to mitigate the far-reaching consequences of surgical delays on an unprecedented scale during a time of great crisis and uncertainty.Keywords: COVID-19, elective surgery, NICE guidelines, quality improvement
Procedia PDF Downloads 18819593 Role of Hyperbaric Oxygen Therapy in Management of Diabetic Foot
Authors: Magdy Al Shourbagi
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Diabetes mellitus is the commonest cause of neuropathy. The common pattern is a distal symmetrical sensory polyneuropathy, associated with autonomic disturbances. Less often, Diabetes mellitus is responsible for a focal or multifocal neuropathy. Common causes for non-healing of diabetic foot are the infection and ischemia. Diabetes mellitus is associated with a defective cellular and humoral immunity. Particularly, decreased phagocytosis, decreased chemotaxis, impaired bacterial killing and abnormal lymphocytic function resulting in a reduced inflammatory reaction and defective wound healing. Hyperbaric oxygen therapy is defined by the Undersea and Hyperbaric Medical Society as a treatment in which a patient intermittently breathes 100% oxygen and the treatment chamber is pressurized to a pressure greater than sea level (1 atmosphere absolute). The pressure increase may be applied in mono-place (single person) or multi-place chambers. Multi-place chambers are pressurized with air, with oxygen given via face mask or endotracheal tube; while mono-place chambers are pressurized with oxygen. Oxygen gas plays an important role in the physiology of wound healing. Hyperbaric oxygen therapy can raise tissue oxygen tensions to levels where wound healing can be expected. HBOT increases the killing ability of leucocytes also it is lethal for certain anaerobic bacteria and inhibits toxin formation in many other anaerobes. Multiple anecdotal reports and studies in HBO therapy in diabetic patients report that HBO can be an effective adjunct therapy in the management of diabetic foot wounds and is associated with better functional outcomes.Keywords: hyperbari oxygen therapy, diabetic foot, neuropathy, multiplace chambers
Procedia PDF Downloads 28619592 Air Connectivity in Promoting Association of Southeast Asian Nations Integration: The Role of Low Cost-Carriers
Authors: Gabriella Fardhiyanti, Victor Wee
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Air connectivity is the crucial factors to boost a region economics growth. It will open the accessibility to support regional competitiveness and helps to achieve ASEAN (Association of Southeast Asian Nations) integration in term of economic integration, business investment, promote intra-regional trade, and creates the sense of belongingness among ASEAN people in the region. An increasing number of air connectivity and transportation will be benefiting the region because air transportation is a vital hub for ASEAN. The aim of this paper is to address the importance of air connectivity in promoting ASEAN Integration, by focusing on the ASEAN vision for a more integrated region. The assessment uses based on the Netscan Air connectivity model based on the flight destination and airport connectivity index, further analysis present that air connectivity significantly influence ASEAN tourism sector. Follow by the implications of open skies policy for the liberation of the aviation industry and the growth of low cost-carriers (LCCs) in the region. This paper provides recommendation and strategy for overcoming the challenges faced by ASEAN to boost ASEAN tourism integration successfully. The findings can assist in guiding policy and industry stakeholders in the future decision relating to air liberalization and more integrated system in the region.Keywords: air connectivity, ASEAN integration, low-cost carries, NetScan connectivity model, open skies policy
Procedia PDF Downloads 21219591 Histological Grade Concordance between Core Needle Biopsy and Corresponding Surgical Specimen in Breast Carcinoma
Authors: J. Szpor, K. Witczak, M. Storman, A. Orchel, D. Hodorowicz-Zaniewska, K. Okoń, A. Klimkowska
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Core needle biopsy (CNB) is well established as an important diagnostic tool in diagnosing breast cancer and it is now considered the initial method of choice for diagnosing breast disease. In comparison to fine needle aspiration (FNA), CNB provides more architectural information allowing for the evaluation of prognostic and predictive factors for breast cancer, including histological grade—one of three prognostic factors used to calculate the Nottingham Prognostic Index. Several studies have previously described the concordance rate between CNB and surgical excision specimen in determination of histological grade (HG). The concordance rate previously ascribed to overall grade varies widely across literature, ranging from 59-91%. The aim of this study is to see how the data looks like in material at authors’ institution and are the results as compared to those described in previous literature. The study population included 157 women with a breast tumor who underwent a core needle biopsy for breast carcinoma and a subsequent surgical excision of the tumor. Both materials were evaluated for the determination of histological grade (scale from 1 to 3). HG was assessed only in core needle biopsies containing at least 10 well preserved HPF with invasive tumor. The degree of concordance between CNB and surgical excision specimen for the determination of tumor grade was assessed by Cohen’s kappa coefficient. The level of agreement between core needle biopsy and surgical resection specimen for overall histologic grading was 73% (113 of 155 cases). CNB correctly predicted the grade of the surgical excision specimen in 21 cases for grade 1 tumors (Kappa coefficient κ = 0.525 95% CI (0.3634; 0.6818), 52 cases for grade 2 (Kappa coefficient κ = 0.5652 95% CI (0.458; 0.667) and 40 cases for stage 3 tumors (Kappa coefficient κ = 0.6154 95% CI (0.4862; 0.7309). The highest level of agreement was observed in grade 3 malignancies. In 9 of 42 (21%) discordant cases, the grade was higher in the CNB than in the surgical excision. This composed 6% of the overall discordance. These results correspond to the noted in the literature, showing that underestimation occurs more frequently than overestimation. This study shows that authors’ institution’s histologic grading of CNBs and surgical excisions shows a fairly good correlation and is consistent with findings in previous reports. Despite the inevitable limitations of CNB, CNB is an effective method for diagnosing breast cancer and managing treatment options. Assessment of tumour grade by CNB is useful for the planning of treatment, so in authors’ opinion it is worthy to implement it in daily practice.Keywords: breast cancer, concordance, core needle biopsy, histological grade
Procedia PDF Downloads 22519590 Numerical Modelling of Shear Zone and Its Implications on Slope Instability at Letšeng Diamond Open Pit Mine, Lesotho
Authors: M. Ntšolo, D. Kalumba, N. Lefu, G. Letlatsa
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Rock mass damage due to shear tectonic activity has been investigated largely in geoscience where fluid transport is of major interest. However, little has been studied on the effect of shear zones on rock mass behavior and its impact on stability of rock slopes. At Letšeng Diamonds open pit mine in Lesotho, the shear zone composed of sheared kimberlite material, calcite and altered basalt is forming part of the haul ramp into the main pit cut 3. The alarming rate at which the shear zone is deteriorating has triggered concerns about both local and global stability of pit the walls. This study presents the numerical modelling of the open pit slope affected by shear zone at Letšeng Diamond Mine (LDM). Analysis of the slope involved development of the slope model by using a two-dimensional finite element code RS2. Interfaces between shear zone and host rock were represented by special joint elements incorporated in the finite element code. The analysis of structural geological mapping data provided a good platform to understand the joint network. Major joints including shear zone were incorporated into the model for simulation. This approach proved successful by demonstrating that continuum modelling can be used to evaluate evolution of stresses, strain, plastic yielding and failure mechanisms that are consistent with field observations. Structural control due to geological shear zone structure proved to be important in its location, size and orientation. Furthermore, the model analyzed slope deformation and sliding possibility along shear zone interfaces. This type of approach can predict shear zone deformation and failure mechanism, hence mitigation strategies can be deployed for safety of human lives and property within mine pits.Keywords: numerical modeling, open pit mine, shear zone, slope stability
Procedia PDF Downloads 29219589 Method for Tuning Level Control Loops Based on Internal Model Control and Closed Loop Step Test Data
Authors: Arnaud Nougues
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This paper describes a two-stage methodology derived from internal model control (IMC) for tuning a proportional-integral-derivative (PID) controller for levels or other integrating processes in an industrial environment. Focus is the ease of use and implementation speed which are critical for an industrial application. Tuning can be done with minimum effort and without the need for time-consuming open-loop step tests on the plant. The first stage of the method applies to levels only: the vessel residence time is calculated from equipment dimensions and used to derive a set of preliminary proportional-integral (PI) settings with IMC. The second stage, re-tuning in closed-loop, applies to levels as well as other integrating processes: a tuning correction mechanism has been developed based on a series of closed-loop simulations with model errors. The tuning correction is done from a simple closed-loop step test and the application of a generic correlation between observed overshoot and integral time correction. A spin-off of the method is that an estimate of the vessel residence time (levels) or open-loop process gain (other integrating process) is obtained from the closed-loop data.Keywords: closed-loop model identification, IMC-PID tuning method, integrating process control, on-line PID tuning adaptation
Procedia PDF Downloads 21119588 Preventive Impact of Regional Analgesia on Chronic Neuropathic Pain After General Surgery
Authors: Beloulou Mohamed Lamine, Fedili Benamar, Meliani Walid, Chaid Dalila, Lamara Abdelhak
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Introduction: Post-surgical chronic pain (PSCP) is a pathological condition with a rather complex etiopathogenesis that extensively involves sensitization processes and neuronal damage. The neuropathic component of these pains is almost always present, with variable expression depending on the type of surgery. Objective: To assess the presumed beneficial effect of Regional Anesthesia-Analgesia Techniques (RAAT) on the development of post-surgical chronic neuropathic pain (PSCNP) in various surgical procedures. Patients and Methods: A comparative study involving 510 patients distributed across five surgical models (mastectomy, thoracotomy, hernioplasty, cholecystectomy, and major abdominal-pelvic surgery) and randomized into two groups: Group A (240) receiving conventional postoperative analgesia and Group B (270) receiving balanced analgesia, including the implementation of a Regional Anesthesia-Analgesia Technique (RAAT). These patients were longitudinally followed over a 6-month period, with postsurgical chronic neuropathic pain (PSCNP) defined by a Neuropathic Pain Score DN2≥ 3. Comparative measurements through univariate and multivariable analyses were performed to identify associations between the development of PSCNP and certain predictive factors, including the presumed preventive impact (protective effect) of RAAT. Results: At the 6th month post-surgery, 419 patients were analyzed (Group A= 196 and Group B= 223). The incidence of PSCNP was 32.2% (n=135). Among these patients with chronic pain, the prevalence of neuropathic pain was 37.8% (95% CI: [29.6; 46.5]), with n=51/135. It was significantly lower in Group B compared to Group A, with respective percentages of 31.4% vs. 48.8% (p-value = 0.035). The most significant differences were observed in breast and thoracopulmonary surgeries. In a multiple regression analysis, two predictors of PSCNP were identified: the presence of preoperative pain at the surgical site as a risk factor (OR: 3.198; 95% CI [1.326; 7.714]) and RAAT as a protective factor (OR: 0.408; 95% CI [0.173; 0.961]). Conclusion: The neuropathic component of PSCNP can be observed in different types of surgeries. Regional analgesia included in a multimodal approach to postoperative pain management has proven to be effective for acute pain and seems to have a preventive impact on the development of PSCNP and its neuropathic nature, particularly in surgeries that are more prone to chronicization.Keywords: post-surgical chronic pain, post-surgical chronic neuropathic pain, regional anesthesia-analgesia techniques, neuropathic pain score DN2, preventive impact
Procedia PDF Downloads 7219587 Antibacterial Wound Dressing Based on Metal Nanoparticles Containing Cellulose Nanofibers
Authors: Mohamed Gouda
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Antibacterial wound dressings based on cellulose nanofibers containing different metal nanoparticles (CMC-MNPs) were synthesized using an electrospinning technique. First, the composite of carboxymethyl cellulose containing different metal nanoparticles (CMC/MNPs), such as copper nanoparticles (CuNPs), iron nanoparticles (FeNPs), zinc nanoparticles (ZnNPs), cadmium nanoparticles (CdNPs) and cobalt nanoparticles (CoNPs) were synthesized, and finally, these composites were transferred to the electrospinning process. Synthesized CMC-MNPs were characterized using scanning electron microscopy (SEM) coupled with high-energy dispersive X-ray (EDX) and UV-visible spectroscopy used to confirm nanoparticle formation. The SEM images clearly showed regular flat shapes with semi-porous surfaces. All MNPs were well distributed inside the backbone of the cellulose without aggregation. The average particle diameters were 29-39 nm for ZnNPs, 29-33 nm for CdNPs, 25-33 nm for CoNPs, 23-27 nm for CuNPs and 22-26 nm for FeNPs. Surface morphology, water uptake and release of MNPs from the nanofibers in water and antimicrobial efficacy were studied. SEM images revealed that electrospun CMC-MNPs nanofibers are smooth and uniformly distributed without bead formation with average fiber diameters in the range of 300 to 450 nm. Fiber diameters were not affected by the presence of MNPs. TEM images showed that MNPs are present in/on the electrospun CMC-MNPs nanofibers. The diameter of the electrospun nanofibers containing MNPs was in the range of 300–450 nm. The MNPs were observed to be spherical in shape. The CMC-MNPs nanofibers showed good hydrophilic properties and had excellent antibacterial activity against the Gram-negative bacteria Escherichia coli and the Gram-positive bacteria Staphylococcus aureus.Keywords: electrospinning technique, metal nanoparticles, cellulosic nanofibers, wound dressing
Procedia PDF Downloads 32319586 Modeling and Simulation of Turbulence Induced in Nozzle Cavitation and Its Effects on Internal Flow in a High Torque Low Speed Diesel Engine
Authors: Ali Javaid, Rizwan Latif, Syed Adnan Qasim, Imran Shafi
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To control combustion inside a direct injection diesel engine, fuel atomization is the best tool. Controlling combustion helps in reducing emissions and improves efficiency. Cavitation is one of the most important factors that significantly affect the nature of spray before it injects into combustion chamber. Typical fuel injector nozzles are small and operate at a very high pressure, which limits the study of internal nozzle behavior especially in case of diesel engine. Simulating cavitation in a fuel injector will help in understanding the phenomenon and will assist in further development. There is a parametric variation between high speed and high torque low speed diesel engines. The objective of this study is to simulate internal spray characteristics for a low speed high torque diesel engine. In-nozzle cavitation has strong effects on the parameters e.g. mass flow rate, fuel velocity, and momentum flux of fuel that is to be injected into the combustion chamber. The external spray dynamics and subsequently the air – fuel mixing depends on a lot of the parameters of fuel injecting the nozzle. The approach used to model turbulence induced in – nozzle cavitation for high-torque low-speed diesel engine, is homogeneous equilibrium model. The governing equations were modeled using Matlab. Complete Model in question was extensively evaluated by performing 3-D time-dependent simulations on Open FOAM, which is an open source flow solver and implemented in CFD (Computational Fluid Dynamics). Results thus obtained will be analyzed for better evaporation in the near-nozzle region. The proposed analyses will further help in better engine efficiency, low emission, and improved fuel economy.Keywords: cavitation, HEM model, nozzle flow, open foam, turbulence
Procedia PDF Downloads 27819585 Alveolar Ridge Preservation in Post-extraction Sockets Using Concentrated Growth Factors: A Split-Mouth, Randomized, Controlled Clinical Trial
Authors: Sadam Elayah
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Background: One of the most critical competencies in advanced dentistry is alveolar ridge preservation after exodontia. The aim of this clinical trial was to assess the impact of autologous concentrated growth factor (CGF) as a socket-filling material and its ridge preservation properties following the lower third molar extraction. Materials and Methods: A total of 60 sides of 30 participants who had completely symmetrical bilateral impacted lower third molars were enrolled. The short-term outcome variables were wound healing, swelling and pain, clinically assessed at different time intervals (1st, 3rd & 7th days). While the long-term outcome variables were bone height & width, bone density and socket surface area in the coronal section. Cone beam computed tomography images were obtained immediately after surgery and three months after surgery as a temporal measure. Randomization was achieved by opaque, sealed envelopes. Follow-up data were compared to baseline using Paired & Unpaired t-tests. Results: The wound healing index was significantly better in the test sides (P =0.001). Regarding the facial swelling, the test sides had significantly fewer values than the control sides, particularly on the 1st (1.01±.57 vs 1.55 ±.56) and 3rd days (1.42±0.8 vs 2.63±1.2) postoperatively. Nonetheless, the swelling disappeared within the 7th day on both sides. The pain scores of the visual analog scale were not a statistically significant difference between both sides on the 1st day; meanwhile, the pain scores were significantly lower on the test sides compared with the control sides, especially on the 3rd (P=0.001) and 7th days (P˂0.001) postoperatively. Regarding long-term outcomes, CGF sites had higher values in height and width when compared to Control sites (Buccal wall 32.9±3.5 vs 29.4±4.3 mm, Lingual wall 25.4±3.5 vs 23.1±4 mm, and Alveolar bone width 21.07±1.55vs19.53±1.90 mm) respectively. Bone density showed significantly higher values in CGF sites than in control sites (Coronal half 200±127.3 vs -84.1±121.3, Apical half 406.5±103 vs 64.2±158.6) respectively. There was a significant difference between both sites in reducing periodontal pockets. Conclusion: CGF application following surgical extraction provides an easy, low-cost, and efficient option for alveolar ridge preservation. Thus, dentists may encourage using CGF during dental extractions, particularly when alveolar ridge preservation is required.Keywords: platelet, extraction, impacted teeth, alveolar ridge, regeneration, CGF
Procedia PDF Downloads 6119584 Overcoming Open Innovation Challenges with Technology Intelligence: Case of Medium-Sized Enterprises
Authors: Akhatjon Nasullaev, Raffaella Manzini, Vincent Frigant
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The prior research largely discussed open innovation practices both in large and small and medium-sized enterprises (SMEs). Open Innovation compels firms to observe and analyze the external environment in order to tap new opportunities for inbound and/or outbound flows of knowledge, ideas, work in progress innovations. As SMEs are different from their larger counterparts, they face several limitations in utilizing open innovation activities, such as resource scarcity, unstructured innovation processes and underdeveloped innovation capabilities. Technology intelligence – the process of systematic acquisition, assessment and communication of information about technological trends, opportunities and threats can mitigate this limitation by enabling SMEs to identify technological and market opportunities in timely manner and undertake sound decisions, as well as to realize a ‘first mover advantage’. Several studies highlighted firm-level barriers to successful implementation of open innovation practices in SMEs, namely challenges in partner selection, intellectual property rights and trust, absorptive capacity. This paper aims to investigate the question how technology intelligence can be useful for SMEs to overcome the barriers to effective open innovation. For this, we conduct a case study in four Estonian life-sciences SMEs. Our findings revealed that technology intelligence can support SMEs not only in inbound open innovation (taking into account inclination of most firms toward technology exploration aspects of open innovation) but also outbound open innovation. Furthermore, the results of this study state that, although SMEs conduct technology intelligence in unsystematic and uncoordinated manner, it helped them to increase their innovative performance.Keywords: technology intelligence, open innovation, SMEs, life sciences
Procedia PDF Downloads 16219583 Comparison of Anterolateral Thigh Flap with or without Acellular Dermal Matrix in Repair of Hypopharyngeal Squamous Cell Carcinoma Defect: A Retrospective Study
Authors: Yaya Gao, Bing Zhong, Yafeng Liu, Fei Chen
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Aim: The purpose of this study was to explore the difference between acellular dermal matrix (ADM) combined with anterolateral thigh (ALT) flap and ALT flap alone. Methods: HSCC patients were treated and divided into group A (ALT) and group B (ALT+ADM) between January 2014 and December 2018. We compared and analyzed the intraoperative information and postoperative outcomes of the patients. Results: There were 21 and 17 patients in group A and group B, respectively. The operation time, blood loss, defect size and anastomotic vessel selection showed no significant difference between two groups. The postoperative complications, including wound bleeding (n=0 vs. 1, p=0.459), wound dehiscence (n=0 vs. 1, p=0.459), wound infection (n=5vs.3, p=0.709), pharyngeal fistula (n=5vs.4, p=1.000) and hypoproteinemia (n=11 vs. 12, p=0.326) were comparable between the groups. Dysphagia at 6 months (number of liquid diets=0vs. 0; number of partial tube feedings=1vs. 1; number of total tube feedings=1vs. 0, p=0.655) also showed no significant differences. However, significant differences was observed in dysphagia at 12 months (number of liquid diets=0vs. 0; number of partial tube feedings=3 vs. 1; number of total tube feedings=10vs. 1, p=0.006). Conclusion: For HSCC patients, the use of the ALT flap combined ADM, compared to ALT treatment, showed better swallowing function at 12 months. The ALT flap combined ADM may serve as a safe and feasible alternative for selected HSCC patients.Keywords: hypopharyngeal squamous cell carcinoma, anterolateral thigh free flap, acellular dermal matrix, reconstruction, dysphagia
Procedia PDF Downloads 7419582 Laparoscopic Management of Cysts Mimicking Hepatic Cystic Echinococcosis in Children (A Case Series)
Authors: Assia Haif, Djelloul Achouri, Zineddine Soualili
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Introduction: Laparoscopic treatment of liver echinococcosis cyst has become popular. In parallel, the diagnostic approach of cystic liver lesions is based on the number of lesions and their distribution. The etiologies of cystic masses in children are different, and the role of imaging in their characterization and pre-therapeutic evaluation is essential. The main differential diagnoses of hepatic hydatid cysts can be discovered intraoperatively by minimally invasive surgery. Methods: The clinical data contained seven patients with hepatic cystic who underwent laparoscopic surgery in the Department of Pediatric Surgery, SETIF, Algeria, from 2015 to 2022. Results: Of reported seven patients, five are male, and the remaining two are female. Abdominal pain was the most frequent clinical signs. Biological parameters were within normal limits, Abdominal ultrasound, practiced in all cases, completed by abdominal computed tomography (CT), showed a hydatid cystic. For all patients, surgical procedures were performed under laparoscopy. Total cystectomy in four patients, fenestration or subtotal cystectomy in three patients, respectively. A histopathological feature confirmed the nature of the cysts. During the follow-up period, there was no recurrence. Conclusions: Laparoscopic liver surgery is a safe and effective approach, it is an alternative to conventional surgery and a reproducible method. Laparoscopic surgery approach should follow the same principals with those of open surgery. This surgical technique can rectify the diagnosis of hydatid cyst, the histopathological examination confirms the nature of the cystic lesion.Keywords: children, cyst, echinococcosis, laparoscopic, liver
Procedia PDF Downloads 13319581 Effect of Non-Surgical Periodontal Therapy According to Periodontal Severity
Authors: Jungbin Lim, Bohee Kang, Heelim Lee, Sunjin Kim, GeumHee Choi, Jae-Suk Jung, Suk Ji
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Nonsurgical periodontal therapies have, for several decades, been the basis of periodontal treatment concepts. The aim of this paper is to investigate the effectiveness of non-surgical periodontal therapy according to the severity of periodontitis disease. Methods: Retrospective data of patients who visited Department of periodontics in Ajou University Medical Center from 2016 to 2022 were collected. Among the patients, those who took full mouth examination of clinical parameters and non-surgical periodontal therapy were chosen for this study. Selected patients were divided into initial, moderate, and severe periodontitis based on severity and complexity of management (2018 World Workshop EFP/AAP consensus). Recall visits with clinical periodontal examination were scheduled for 1,2,3 months or 1,3,6 months after the treatment. The results were evaluated by recordings of mean probing pocket depth (mean PD), mean clinical attachment levels (mean CAL), bleeding on probing (BOP%), mean gingival index (mean GI), mean regression, mean sulcus bleeding index (mean SBI), mean plaque scores (mean PI). All statistical analyses were performed with R software, version 4.3.0. A level of significance, P<0.05, was considered to be statistically significant. Results: A total of 92 patients were included in this study. 15 patients were diagnosed as initial periodontitis, 14 moderate periodontitis, and 63 severe periodontitis. The all parameters except for mean recession decreased over time in all groups. The amount of mean PD decreased were the greatest in severe periodontitis group followed by moderate and initial, which was found to be statistically significant. The changes of mean PD were 0.15±0.05 mm, 0.37±0.06 mm, and 1.01±0.07 mm (initial, moderate, and severe, respectively, P<0.001). When comparing before and after treatment, the reductions in BOP(%), mean GI, mean SBI, and mean PI were statistically significant. Conclusion: All patients who received non-surgical periodontal therapy showed periodontal healing in terms of improvements in clinical parameters, and it was greater in the severe group.Keywords: periodontology, clinical periodontology, oral treatment, comprehensive preventive dentistry, non-surgical periodontal therapy
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