Search results for: cold treatment
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 8737

Search results for: cold treatment

5707 Pellegrini-Stieda Syndrome: A Physical Medicine and Rehabilitation Approach

Authors: Pedro Ferraz-Gameiro

Abstract:

Introduction: The Pellegrini-Stieda lesion is the result of post-traumatic calcification and/or ossification on the medial collateral ligament (MCL) of the knee. When this calcification is accompanied by gonalgia and limitation of knee flexion, it is called Pellegrini-Stieda syndrome. The pathogenesis is probably the calcification of a post-traumatic hematoma at least three weeks after the initial trauma or secondary to repetitive microtrauma. On anteroposterior radiographs, a Pellegrini-Stieda lesion is a linear vertical ossification or calcification of the proximal portion of the MCL and usually near the medial femoral condyle. Patients with Pellegrini-Stieda syndrome present knee pain associated with loss of range of motion. The treatment is usually conservative with analgesic and anti-inflammatory drugs, either systemic or intra-articular. Physical medicine and rehabilitation techniques associated with shock wave therapy can be a way of reduction of pain/inflammation. Patients who maintain instability with significant limitation of knee mobility may require surgical excision. Methods: Research was done using PubMed central using the terms Pellegrini-Stieda syndrome. Discussion/conclusion: Medical treatment is the rule, with initial rest, anti-inflammatory, and physiotherapy. If left untreated, this ossification can potentially form a significant bone mass, which can compromise the range of motion of the knee. Physical medicine and rehabilitation techniques associated with shock wave therapy are a way of reduction of pain/inflammation.

Keywords: knee, Pellegrini-Stieda syndrome, rehabilitation, shock waves therapy

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5706 Guillain Barre Syndrome in Children

Authors: A. Erragh, K. Amanzoui, M. Elharit, H. Salem, M. Ababneh, K. Elfakhr, S. Kalouch, A. Chlilek

Abstract:

Guillain-Barre syndrome (GBS) is the most common form of acute polyradiculoneuritis (PRNA). It is a medical emergency in pediatrics that requires rapid diagnosis and immediate assessment of the severity criteria for the implementation of appropriate treatment. Retrospective, descriptive study in 24 patients under the age of 18 who presented with GBS between September 2017 and July 2021 and were hospitalized in the multipurpose pediatric intensive care unit of the Abderrahim EL Harouchi children's hospital in Casablanca. The average age was 7.91 years, with extremes ranging from 18 months and 14 years and a male predominance of 75%. After a prodromal event, most often infectious (80%) and a free interval of 12 days on average, 2 types of motor disorders begin either hypo or arereflectic flaccid paralysis of the lower limbs (45.8%) or flaccid quadriplegia hypo or arereflectic (54.2%). During GBS, the most formidable complication is respiratory distress, which can occur at any time. In our study, respiratory impairment was observed in 70.8% of cases. In addition, other signs of severity, such as swallowing disorders (75%) and dysautonomic disorders (8.33%), were also observed, which justified care in the intensive care unit for all of our patients. The use of invasive ventilation was necessary in 76.5% of cases, and specific treatments based on immunoglobulins were administered in all our patients. Despite everything, the death rate remains high (25%) and is mainly due to complications related to hospitalization. Guillain Barré syndrome is, therefore, a pediatric emergency that requires rapid diagnosis and immediate assessment of severity criteria for the implementation of appropriate treatment.

Keywords: guillain barre syndrome, emergency, children, medical

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5705 Targeting Apoptosis by Novel Adamantane Analogs as an Emerging Therapy for the Treatment of Hepatocellular Carcinoma Through EGFR, Bcl-2/BAX Cascade

Authors: Hanan M. Hassan, Laila Abouzeid, Lamya H. Al-Wahaibi, George S. G. Shehatou, Ali A. El-Emam

Abstract:

Cancer is a major public health problem and the second leading cause of death worldwide. In 2020, cancer diagnosis and treatment have been negatively affected by the coronavirus 2019 (COVID-19) pandemic. During the quarantine, because of the limited access to healthcare and avoiding exposure to COVID-19 as a contagious disease; patients of cancer suffered deferments in follow-up and treatment regimens leading to substantial worsening of disease, death, and increased healthcare costs. Thus, this study is designed to investigate the molecular mechanisms by which adamantne derivatives attenuate hepatocllular carcinoma experimentally and theoretically. There is a close association between increased resistance to anticancer drugs and defective apoptosis that considered a causative factor for oncogenesis. Cancer cells use different molecular pathways to inhibit apoptosis, BAX and Bcl-2 proteins have essential roles in the progression or inhibition of intrinsic apoptotic pathways triggered by mitochondrial dysfunction. Therefore, their balance ratio can promote the cellular apoptotic fate. In this study, the in vitro cytotoxic effects of seven synthetic adamantyl isothiorea derivatives were evaluated against five human tumor cell lines by MTT assay. Compounds 5 and 6 showed the best results, mostly against hepatocellular carcinoma (HCC). Hence, in vivo studies were performed in male Sprague-Dawley (SD) rats in which experimental hepatocellular carcinoma was induced with thioacetamide (TAA) (200 mg/kg, i.p., twice weekly) for 16 weeks. The most promising compounds, 5 and 6, were administered to treat liver cancer rats at a dose of 10 mg/kg/day for an additional two weeks, and the effects were compared with doxorubicin (DR), the anticancer drug. Hepatocellular carcinoma was evidenced by a dramatic increase in liver indices, oxidative stress markers, and immunohistochemical studies that were accompanied by a plethora of inflammatory mediators and alterations in the apoptotic cascade. Our results showed that treatment with adamantane derivatives 5 and 6 significantly suppressed fibrosis, inflammation, and other histopathological insults resulting in the diminished formation of hepatocyte tumorigenesis. Moreover, administration of the tested compounds resulted in amelioration of EGFR protein expression, upregulation of BAX, and lessening down of Bcl-2 levels that prove their role as apoptosis inducers. Also, the docking simulations performed for adamantane showed good fit and binding to the EGFR protein through hydrogen bond formation with conservative amino acids, which gives a shred of strong evidence for its hepatoprotective effect. In most analyses, the effects of compound 6 were more comparable to DR than compound 5. Our findings suggest that adamantane derivatives 5 and 6 are shown to have cytotoxic activity against HCC in vitro and in vivo, by more than one mechanism, possibly by inhibiting the TLR4-MyD88-NF-κB pathway and targeting EGFR signaling.

Keywords: adamantane, EGFR, HCC, apoptosis

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5704 Probabilistic Damage Tolerance Methodology for Solid Fan Blades and Discs

Authors: Andrej Golowin, Viktor Denk, Axel Riepe

Abstract:

Solid fan blades and discs in aero engines are subjected to high combined low and high cycle fatigue loads especially around the contact areas between blade and disc. Therefore, special coatings (e.g. dry film lubricant) and surface treatments (e.g. shot peening or laser shock peening) are applied to increase the strength with respect to combined cyclic fatigue and fretting fatigue, but also to improve damage tolerance capability. The traditional deterministic damage tolerance assessment based on fracture mechanics analysis, which treats service damage as an initial crack, often gives overly conservative results especially in the presence of vibratory stresses. A probabilistic damage tolerance methodology using crack initiation data has been developed for fan discs exposed to relatively high vibratory stresses in cross- and tail-wind conditions at certain resonance speeds for limited time periods. This Monte-Carlo based method uses a damage databank from similar designs, measured vibration levels at typical aircraft operations and wind conditions and experimental crack initiation data derived from testing of artificially damaged specimens with representative surface treatment under combined fatigue conditions. The proposed methodology leads to a more realistic prediction of the minimum damage tolerance life for the most critical locations applicable to modern fan disc designs.

Keywords: combined fatigue, damage tolerance, engine, surface treatment

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5703 A Study on the Effect of Mg and Ag Additions and Age Hardening Treatment on the Properties of As-Cast Al-Cu-Mg-Ag Alloys

Authors: Ahmed. S. Alasmari, M. S. Soliman, Magdy M. El-Rayes

Abstract:

This study focuses on the effect of the addition of magnesium (Mg) and silver (Ag) on the mechanical properties of aluminum based alloys. The alloying elements will be added at different levels using the factorial design of experiments of 22; the two factors are Mg and Ag at two levels of concentration. The superior mechanical properties of the produced Al-Cu-Mg-Ag alloys after aging will be resulted from a unique type of precipitation named as Ω-phase. The formed precipitate enhanced the tensile strength and thermal stability. This paper further investigated the microstructure and mechanical properties of as cast Al–Cu–Mg–Ag alloys after being complete homogenized treatment at 520 °C for 8 hours followed by isothermally age hardening process at 190 °C for different periods of time. The homogenization at 520 °C for 8 hours was selected based on homogenization study at various temperatures and times. The alloys’ microstructures were studied by using optical microscopy (OM). In addition to that, the fracture surface investigation was performed using a scanning electronic microscope (SEM). Studying the microstructure of aged Al-Cu-Mg-Ag alloys reveal that the grains are equiaxed with an average grain size of about 50 µm. A detailed fractography study for fractured surface of the aged alloys exhibited a mixed fracture whereby the random fracture suggested crack propagation along the grain boundaries while the dimples indicated that the fracture was ductile. The present result has shown that alloy 5 has the highest hardness values and the best mechanical behaviors.

Keywords: precipitation hardening, aluminum alloys, aging, design of experiments, analysis of variance, heat treatments

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5702 The Effects of Collaborative Reflection and Class Observation on Improving the Quality of Teacher-Training Courses

Authors: Somayeh Sharifi

Abstract:

The purpose of this study is to investigate the effects of collaborative reflection and class observation on improving the quality of teacher training courses and the students reading comprehension skills. 13 inexperienced English teachers teaching elementary courses that were at the same level of proficiency were chosen. Thirteen participants were allocated in two groups, with 7 teachers in the experimental group and the other 6 teachers in the control group. Since two groups were not selected randomly, this study is a form of quasi-experimental research. In addition to a 3-day teacher training course for both groups, teachers in experimental group recorded and observed 20 sessions of their own classes and 30 sessions of experienced teachers’ class and participated in 12 meetings -3 month once a week- in which teachers shared any event that they found interesting during observations and their own teaching and compare it with strategies that they learned in teacher training courses. In contrast, the control group did not engage in any process of observation and collaboration. In order to test students' performance in English before and after the treatment, a Key English Test (KET) was employed to check students' reading skill. The result of the test shows that there is not a significant difference in mean of scores in KET pretest in and, since they are close to each other. However by considering mean and median of posttest in both classes we perceive that although both control and experimental group students' proficiency in English enhanced, there was a significant difference in experimental group students' final scores before and after treatment.

Keywords: collaborative reflection, reading comprehension, teacher training courses, key English test (KET)

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5701 Consequential Effects of Coal Utilization on Urban Water Supply Sources – a Study of Ajali River in Enugu State Nigeria

Authors: Enebe Christian Chukwudi

Abstract:

Water bodies around the world notably underground water, ground water, rivers, streams, and seas, face degradation of their water quality as a result of activities associated with coal utilization including coal mining, coal processing, coal burning, waste storage and thermal pollution from coal plants which tend to contaminate these water bodies. This contamination results from heavy metals, presence of sulphate and iron, dissolved solids, mercury and other toxins contained in coal ash, sludge, and coal waste. These wastes sometimes find their way to sources of urban water supply and contaminate them. A major problem encountered in the supply of potable water to Enugu municipality is the contamination of Ajali River, the source of water supply to Enugu municipal by coal waste. Hydro geochemical analysis of Ajali water samples indicate high sulphate and iron content, high total dissolved solids(TDS), low pH (acidity values) and significant hardness in addition to presence of heavy metals, mercury, and other toxins. This is indicative of the following remedial measures: I. Proper disposal of mine wastes at designated disposal sites that are suitably prepared. II. Proper water treatment and III. Reduction of coal related contaminants taking advantage of clean coal technology.

Keywords: effects, coal, utilization, water quality, sources, waste, contamination, treatment

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5700 Innovative Teaching Learning Techniques and Learning Difficulties of Adult Learners in Literacy Education Programmes in Calabar Metropolis, Cross River State, Nigeria

Authors: Simon Ibor Akpama

Abstract:

The study investigated the extent to which innovative teaching-learning techniques can influence and attenuate learning difficulties among adult learners participating in different literacy education programmes in Calabar Metropolis, Cross River State, Nigeria. A quasi-experimental design was adopted to collect data from a sample size of 150 participants of the programme. The sample was drawn using the simple random sampling method. As an experimental study, the 150 participants were divided into two equal groups –the first was the experimental group while the second was the control. A pre-test was administered to the two groups which were later exposed to a post-test after treatment. Two instruments were used for data collection. The first was the guide for the Literacy Learning Difficulties Inventory (LLDI). Three hypotheses were postulated and tested as .05 level of significance using Analysis of Covariance (ANOVA) test statistics. Results of the analysis firstly showed that the two groups (treatment and control) did not differ in the pre-test regarding their literacy learning difficulties. Secondly, the result showed that for each hypothesis, innovative teaching-learning techniques significantly influenced adult learners’ (participants) literacy learning difficulties. Based on these findings, the study recommends the use of innovative teaching-learning techniques in adult literacy education centres to mitigate the learning difficulties of adult learners in literacy education programmes in Calabar Metropolis.

Keywords: teaching, learning, techniques, innovative, difficulties, programme

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5699 Effect of Acid-Basic Treatments of Lingocellulosic Material Forest Wastes Wild Carob on Ethyl Violet Dye Adsorption

Authors: Abdallah Bouguettoucha, Derradji Chebli, Tariq Yahyaoui, Hichem Attout

Abstract:

The effect of acid -basic treatment of lingocellulosic material (forest wastes wild carob) on Ethyl violet adsorption was investigated. It was found that surface chemistry plays an important role in Ethyl violet (EV) adsorption. HCl treatment produces more active acidic surface groups such as carboxylic and lactone, resulting in an increase in the adsorption of EV dye. The adsorption efficiency was higher for treated of lingocellulosic material with HCl than for treated with KOH. Maximum biosorption capacity was 170 and 130 mg/g, for treated of lingocellulosic material with HCl than for treated with KOH at pH 6 respectively. It was also found that the time to reach equilibrium takes less than 25 min for both treated materials. The adsorption of basic dye (i.e., ethyl violet or basic violet 4) was carried out by varying some process parameters, such as initial concentration, pH and temperature. The adsorption process can be well described by means of a pseudo-second-order reaction model showing that boundary layer resistance was not the rate-limiting step, as confirmed by intraparticle diffusion since the linear plot of Qt versus t^0.5 did not pass through the origin. In addition, experimental data were accurately expressed by the Sips equation if compared with the Langmuir and Freundlich isotherms. The values of ΔG° and ΔH° confirmed that the adsorption of EV on acid-basic treated forest wast wild carob was spontaneous and endothermic in nature. The positive values of ΔS° suggested an irregular increase of the randomness at the treated lingocellulosic material -solution interface during the adsorption process.

Keywords: adsorption, isotherm models, thermodynamic parameters, wild carob

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5698 Using Audio-Visual Aids and Computer-Assisted Language Instruction to Overcome Learning Difficulties of Sound System in Students of Special Needs

Authors: Sadeq Al Yaari, Ayman Al Yaari, Adham Al Yaari, Montaha Al Yaari, Aayah Al Yaari, Sajedah Al Yaari

Abstract:

Background & Objectives: Audio-visual aids and computer-assisted language instruction (CALI) effects are strong in teaching language components (sound system, grammatical structures and vocabulary) to students of special needs. To explore the effects of the audio-visual aids and CALI in teaching sound system to this class of students by speech language therapists (SLTs), an experiment has been undertaken to evaluate their performance during their study of the sound system course. Methods: Forty students (males and females) of special needs at al-Malādh school for teaching students of special needs in Dhamar (Yemen) range between 8 and 18 years old underwent this experimental study while they were studying language sound system course. Pre-and-posttests have been administered at the begging and end of the semester. Students' treatment was compared to a similar group (control group) of the same number under the same environment. Whereas the first group was taught using audio-visual aids and CALI, the second was not. Students' performances were linguistically and statistically evaluated. Results & conclusions: Compared with the control group, the treatment group showed significantly higher scores in the posttest (72.32% vs. 31%). Compared with females, males scored higher marks (1421 vs. 1472). Thus, we should take the audio-visual aids and CALI into consideration in teaching sound system to students of special needs.

Keywords: language components, sound system, audio-visual aids, CALI, students, special needs, SLTs

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5697 Investigation of the Effects of Dry Needling With Stretching Upper Trapezius Muscle on Clinical Outcomes in Participants With Active Myofascial Trigger Point.

Authors: Marzieh Yassin, Fereshteh Navaee, Javad Sarrafzadeh, Reza Salehi

Abstract:

Introduction: Myofascial trigger point (MTrP) is one of the most common sources of musculoskeletal pain. Approximately 30-85% of the patients with musculoskeletal pains would experience MTrP in their life. The prevalence of MTrP has reported in the patients seen in a general orthopedic clinic, general medical clinic and specialty pain management centers, 21%, 30% and 93% respectively. Nowadays, dry needling is suggested as a standard treatment for MTrPs. The purpose of the present study was to examine the effectiveness of dry needling with stretching upper trapezius muscle on pain and pain pressure threshold in participants with active myofascial trigger point. Methods: Thirty participants with an active myofascial trigger point of the upper trapezius muscle were randomly divided into two groups: dry needling with passive stretch (n=15) and passive stretch alone (n=15). They received 5 sessions of the treatments for three weeks. The outcomes were pain intensity and pain pressure threshold that were assessed with visual analogue scale and algometer respectively. Results: Significant improvement in pain and pain pressure threshold was observed in both groups (P=0.0001) after the treatment. Also, the results showed a significant difference in measurements between two groups (P<0.05). Conclusion: Dry needling with passive stretch can be more effective on pain and pain pressure threshold than passive stretching alone in short term in participants with active myofascial trigger points.

Keywords: dry needling, myofascial pain syndrome, myofascial trigger point, stretching

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5696 New Targets Promoting Oncolytic Virotherapy

Authors: Felicia Segeth, Florian G. Klein, Lea Berger, Andreas Kolk, Per S. Holm

Abstract:

The entry of oncolytic viruses (OVs) into clinical application opens groundbreaking changes in current and future treatment regimens. However, despite their potent anti-cancer activity in vitro, clinical studies revealed limitations of OVs as monotherapy. The same applies to CDK 4/6 inhibitors (CDK4/6i) targeting cell cycle as well as bromodomain and extra-terminal domain inhibitors (BETi) targeting gene expression. In this study, the anti-tumoral effect of XVir-N-31, an YB-1 dependent oncolytic adenovirus, was evaluated in combination with Ribociclib, a CDK4/6i, and JQ1, a BETi. The head and neck squamous cell carcinoma (HNSCC) cell lines Fadu, SAS, and Cal-33 were used. DNA replication and gene expression of XVir-N-31 was measured by RT-qPCR, protein expression by western blotting, and cell lysis by SRB assays. Treatment with CDK4/6i and BETi increased viral gene expression, viral DNA replication, and viral particle formation. The data show that the combination of oncolytic adenovirus XVir-N-31 with CDK4/6i & BETi acts highly synergistic in cancer cell lysis. Furthermore, additional molecular analyses on this subject demonstrate that the positive transcription elongation factor P-TEFb plays a decisive role in this regard, indicating an influence of the combinational therapy on gene transcription control. The combination of CDK4/6i & BETi and XVir-N-31 is an attractive strategy to achieve substantial cancer cell killing and is highly suitable for clinical testing.

Keywords: adenovirus, BET, CDK4/6, HNSCC, P-TEFb, YB-1

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5695 Psoriasis Diagnostic Test Development: Exploratory Study

Authors: Salam N. Abdo, Orien L. Tulp, George P. Einstein

Abstract:

The purpose of this exploratory study was to gather the insights into psoriasis etiology, treatment, and patient experience, for developing psoriasis and psoriatic arthritis diagnostic test. Data collection methods consisted of a comprehensive meta-analysis of relevant studies and psoriasis patient survey. Established meta-analysis guidelines were used for the selection and qualitative comparative analysis of psoriasis and psoriatic arthritis research studies. Only studies that clearly discussed psoriasis etiology, treatment, and patient experience were reviewed and analyzed, to establish a qualitative data base for the study. Using the insights gained from meta-analysis, an existing psoriasis patient survey was modified and administered to collect additional data as well as triangulate the results. The hypothesis is that specific types of psoriatic disease have specific etiology and pathophysiologic pattern. The following etiology categories were identified: bacterial, environmental/microbial, genetic, immune, infectious, trauma/stress, and viral. Additional results, obtained from meta-analysis and confirmed by patient survey, were the common age of onset (early to mid-20s) and type of psoriasis (plaque; mild; symmetrical; scalp, chest, and extremities, specifically elbows and knees). Almost 70% of patients reported no prescription drug use due to severe side effects and prohibitive cost. These results will guide the development of psoriasis and psoriatic arthritis diagnostic test. The significant number of medical publications classified psoriatic arthritis disease as inflammatory of an unknown etiology. Thus numerous meta-analyses struggle to report any meaningful conclusions since no definitive results have been reported to date. Therefore, return to the basics is an essential step to any future meaningful results. To date, medical literature supports the fact that psoriatic disease in its current classification could be misidentifying subcategories, which in turn hinders the success of studies conducted to date. Moreover, there has been an enormous commercial support to pursue various immune-modulation therapies, thus following a narrow hypothesis/mechanism of action that is yet to yield resolution of disease state. Recurrence and complications may be considered unacceptable in a significant number of these studies. The aim of the ongoing study is to focus on a narrow subgroup of patient population, as identified by this exploratory study via meta-analysis and patient survey, and conduct an exhaustive work up, aiming at mechanism of action and causality before proposing a cure or therapeutic modality. Remission in psoriasis has been achieved and documented in medical literature, such as immune-modulation, phototherapy, various over-the-counter agents, including salts and tar. However, there is no psoriasis and psoriatic arthritis diagnostic test to date, to guide the diagnosis and treatment of this debilitating and, thus far, incurable disease. Because psoriasis affects approximately 2% of population, the results of this study may affect the treatment and improve the quality of life of a significant number of psoriasis patients, potentially millions of patients in the United States alone and many more millions worldwide.

Keywords: biologics, early diagnosis, etiology, immune disease, immune modulation therapy, inflammation skin disorder, phototherapy, plaque psoriasis, psoriasis, psoriasis classification, psoriasis disease marker, psoriasis diagnostic test, psoriasis marker, psoriasis mechanism of action, psoriasis treatment, psoriatic arthritis, psoriatic disease, psoriatic disease marker, psoriatic patient experience, psoriatic patient quality of life, remission, salt therapy, targeted immune therapy

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5694 Intensity Modulated Radiotherapy of Nasopharyngeal Carcinomas: Patterns of Loco Regional Relapse

Authors: Omar Nouri, Wafa Mnejja, Nejla Fourati, Fatma Dhouib, Wicem Siala, Ilhem Charfeddine, Afef Khanfir, Jamel Daoud

Abstract:

Background and objective: Induction chemotherapy (IC) followed by concomitant chemo radiotherapy with intensity modulated radiation (IMRT) technique is actually the recommended treatment modality for locally advanced nasopharyngeal carcinomas (NPC). The aim of this study was to evaluate the prognostic factors predicting loco regional relapse with this new treatment protocol. Patients and methods: A retrospective study of 52 patients with NPC treated between June 2016 and July 2019. All patients received IC according to the protocol of the Head and Neck Radiotherapy Oncology Group (Gortec) NPC 2006 (3 TPF courses) followed by concomitant chemo radiotherapy with weekly cisplatin (40 mg / m2). Patients received IMRT with integrated simultaneous boost (SIB) of 33 daily fractions at a dose of 69.96 Gy for high-risk volume, 60 Gy for intermediate risk volume and 54 Gy for low-risk volume. Median age was 49 years (19-69) with a sex ratio of 3.3. Forty five tumors (86.5%) were classified as stages III - IV according to the 2017 UICC TNM classification. Loco regional relapse (LRR) was defined as a local and/or regional progression that occurs at least 6 months after the end of treatment. Survival analysis was performed according to Kaplan-Meier method and Log-rank test was used to compare anatomy clinical and therapeutic factors that may influence loco regional free survival (LRFS). Results: After a median follow up of 42 months, 6 patients (11.5%) experienced LRR. A metastatic relapse was also noted for 3 of these patients (50%). Target volumes coverage was optimal for all patient with LRR. Four relapses (66.6%) were in high-risk target volume and two (33.3%) were borderline. Three years LRFS was 85,9%. Four factors predicted loco regional relapses: histologic type other than undifferentiated (UCNT) (p=0.027), a macroscopic pre chemotherapy tumor volume exceeding 100 cm³ (p=0.005), a reduction in IC doses exceeding 20% (p=0.016) and a total cumulative cisplatin dose less than 380 mg/m² (p=0.0.34). TNM classification and response to IC did not impact loco regional relapses. Conclusion: For nasopharyngeal carcinoma, tumors with initial high volume and/or histologic type other than UCNT, have a higher risk of loco regional relapse. Therefore, they require a more aggressive therapeutic approaches and a suitable monitoring protocol.

Keywords: loco regional relapse, modulation intensity radiotherapy, nasopharyngeal carcinoma, prognostic factors

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5693 Response of Newzealand Rabbits to Drinking Water Treated with PolyDADMAC

Authors: Amna Beshir Medani Ahmed, Samia Mohammed Ali El Badwi, Ahmed El Amin Mohammed

Abstract:

This work has been managed to yield toxicity information on water treatment agents in the Sudan namely polyDADMAC, using New Zealand rabbits at multiple daily oral doses for a period of 10 weeks. Thirty-three heads of New Zealand rabbits were divided into 11 groups, each of three. Group 1 animals were the undosed controls. Test groups of either species were given polyDADMAC at similar dose rates of 0.5, 2.5, 4.5, 10, 15, 20, 25, 50, 100 and 150 mg/kg body weight respectively for groups 2,3,4,5,6,7,8,9,10 and 11. Clinical signs were closely observed with postmortem and histopathological examinations. Chemical investigations included enzymatic concentrations of ALP, GOT, CK, GPT and LDH together with hematological changes in Hb, PCV, RBCs and WBCs. Mortalities occurred to variable degrees irrespective of the dose level. On polyDADMAC challenge, the test species showed clinical signs of dullness, loss of weight, anorexia, diarrhea, difficulty in respiration, hind limb paralysis and recumbency. Notably oral dosing with polyDADMAC caused lung emphysema, hepatic and renal dysfunctions, irregularity in enzymatic activities and serum metabolites, sloughing of intestinal epithelium, decreased electrolytes in serum, and splenic haemosiderosis. On evaluation of the above results, polyDADMAC was considered toxic to New Zealand rabbits at all dose rates tried. Practical implications of the results were highlighted and suggestions for future work were put forward.

Keywords: polydiallyldiethylaluminiumchloride (polyDADMAC), nubian goats, toxicity of drinking water, treatment of drinking water using chemicals

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5692 Refractory Cardiac Arrest: Do We Go beyond, Do We Increase the Organ Donation Pool or Both?

Authors: Ortega Ivan, De La Plaza Edurne

Abstract:

Background: Spain and other European countries have implemented Uncontrolled Donation after Cardiac Death (uDCD) programs. After 15 years of experience in Spain, many things have changed. Recent evidence and technical breakthroughs achieved in resuscitation are relevant for uDCD programs and raise some ethical concerns related to these protocols. Aim: To rethink current uDCD programs in the light of recent evidence on available therapeutic procedures applicable to victims of out-of-hospital cardiac arrest (OHCA). To address the following question: What is the current standard of treatment owed to victims of OHCA before including them in an uDCD protocol? Materials and Methods: Review of the scientific and ethical literature related to both uDCD programs and innovative resuscitation techniques. Results: 1) The standard of treatment received and the chances of survival of victims of OHCA depend on whether they are classified as Non-Heart Beating Patients (NHBP) or Non-Heart-Beating-Donors (NHBD). 2) Recent studies suggest that NHBPs are likely to survive, with good quality of life, if one or more of the following interventions are performed while ongoing CPR -guided by suspected or known cause of OHCA- is maintained: a) direct access to a Cath Lab-H24 or/and to extra-corporeal life support (ECLS); b) transfer in induced hypothermia from the Emergency Medical Service (EMS) to the ICU; c) thrombolysis treatment; d) mobile extra-corporeal membrane oxygenation (mini ECMO) instituted as a bridge to ICU ECLS devices. 3) Victims of OHCA who cannot benefit from any of these therapies should be considered as NHBDs. Conclusion: Current uDCD protocols do not take into account recent improvements in resuscitation and need to be adapted. Operational criteria to distinguish NHBDs from NHBP should seek a balance between the technical imperative (to do whatever is possible), considerations about expected survival with quality of life, and distributive justice (costs/benefits). Uncontrolled DCD protocols can be performed in a way that does not hamper the legitimate interests of patients, potential organ donors, their families, the organ recipients, and the health professionals involved in these processes. Families of NHBDs’ should receive information which conforms to the ethical principles of respect of autonomy and transparency.

Keywords: uncontrolled donation after cardiac death resuscitation, refractory cardiac arrest, out of hospital cardiac, arrest ethics

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5691 Potential of Ozonation and Phytoremediation to Reduce Hydrocarbon Levels Remaining after the Pilot Scale Microbial Based Bioremediation (Land-Farming) of a Heavily Polluted Soil

Authors: Hakima Althalb

Abstract:

Petroleum contamination of sandy soils is a severe environmental problem in Libya, but relatively little work has been carried out to optimize the bioremediation of such heavily contaminated soil, particularly at a pilot scale. The purpose of this research was to determine the potential for the microbial-based bioremediation of hydrocarbon-contaminated soil obtained from an oil refinery in Libya and to assess the potential of both ozonation and phytoremediation (both applied after initial bioremediation) to reduce residual hydrocarbon levels. Plots containing 500 kg soil (triplicates) (contaminated soil diluted with clean soil 50% volume) were set up, (designated as Land Treatment Units; LTUs) containing five different nutrient levels and mixtures (Urea + NPK (nitrogen; phosphor; potassium) mixtures) to obtain C:N:P ratios 100:10:1, and monitored for 90 days. Hydrocarbon levels, microbial numbers, and toxicity (EC50 using luminescent microbial based tests) were assessed. Hydrocarbon levels in non-diluted and diluted soil ranged from 20 733-22 366 mg/kg and from 16 000-17 000 mg/kg respectively. Although all the land treatment units revealed a significant hydrocarbon reduction over time, the highest reduction in hydrocarbon levels obtained was around 60%. For example, 63% hydrocarbon removal was observed using a mixture of urea and NPK with a C:N:P ratio of 100:10:1). Soil toxicity (as assessed using luminescence based toxicity assays) reduced in line with the reduction in total petroleum hydrocarbons observed. However, as relatively high residual TPH (total petroleum hydrocarbon) levels (ranging from 6033-14166mg/kg) were still present after initial bioremediation two ‘post-treatments’ (phytoremediation and ozonation) were attempted to remove residual hydrocarbons remaining. Five locally grown (agriculturally important) plant species were tested. The germination of all plants examined was strongly inhibited (80-100%) and seedlings failed to grow well in the contaminated soil, indicating that the previously bioremediated soils were still toxic to the plants. Subsequent ozonation followed by another bioremediation of soil was more successful than phytoremediation. But even the most promising successful treatment in this study (ozonation for 6 hours at 25ppm followed by bioremediation) still only removed approximately 31% of the residual hydrocarbons. Overall, this work showed that the bioremediation of such highly contaminated soils is difficult and that a combination of treatments would be required to achieve successful remediation. Even after initial dilution and bioremediation the soils remained toxic to plant growth and were therefore not suitable for phytoremediation.

Keywords: bioremediation, petroleum hydrocarbons, ozone, phytoremediation

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5690 Portable Water Treatment for Flood Resilience

Authors: Alireza Abbassi Monjezi, Mohammad Hasan Shaheed

Abstract:

Flood, caused by excessive rainfall, monsoon, cyclone and tsunami is a common disaster in many countries of the world especially sea connected low-lying countries. A stand-alone self-powered water filtration module for decontamination of floodwater has been designed and modeled. A combination forward osmosis – low pressure reverse osmosis (FO-LPRO) system powered by solar photovoltaic-thermal (PVT) energy is investigated which could overcome the main barriers to water supply for remote areas and ensure off-grid filtration. The proposed system is designed to be small scale and portable to provide on-site potable water to communities that are no longer themselves mobile nor can be reached quickly by the aid agencies. FO is an osmotically driven process that uses osmotic pressure gradients to drive water across a controlled pore membrane from a feed solution (low osmotic pressure) to a draw solution (high osmotic pressure). This drops the demand for high hydraulic pressures and therefore the energy demand. There is also a tendency for lower fouling, easier fouling layer removal and higher water recovery. In addition, the efficiency of the PVT unit will be maximized through freshwater cooling which is integrated into the system. A filtration module with the capacity of 5 m3/day is modeled to treat floodwater and provide drinking water. The module can be used as a tool for disaster relief, particularly in the aftermath of flood and tsunami events.

Keywords: flood resilience, membrane desalination, portable water treatment, solar energy

Procedia PDF Downloads 276
5689 Antiinflammatory and Wound Healing Activity of Sedum Essential Oils Growing in Kazakhstan

Authors: Dmitriy Yu. Korulkin, Raissa A. Muzychkina

Abstract:

The last decade the growth of severe and disseminated forms of inflammatory diseases is observed in Kazakhstan, in particular, septic shock, which progresses on 3-15% of patients with infectious complications of postnatal period. In terms of the rate of occurrence septic shock takes third place after hemorrhagic and cardiovascular shock, in terms of lethality it takes first place. The structure of obstetric sepsis has significantly changed. Currently the first place is taken by postabortive sepsis (40%) that is connected with usage of imperfect methods of artificial termination of pregnancy in late periods (intraamnial injection of sodium chloride, glucose). The second place is taken by postnatal sepsis (32%); the last place is taken by septic complications of caesarean section (28%). In this connection, search for and assessment of effectiveness of new medicines for treatment of postoperative infectious complications, having biostimulating effect and speeding up regeneration processes, is very promising and topical. Essential oil was obtained by the method hydrodistillation air-dry aerial part of Sedum L. plants using Clevenger apparatus. Pilot batch of plant medicinal product based on Sedum essential oils was produced by Chimpharm JSC, Santo Member of Polpharma Group (Kazakhstan). During clinical test of the plant medicinal product based on Sedum L. essential oils 37 female patients at the age from 35 to 57 with clinical signs of complicated postoperative processes and 12 new mothers with clinical signs of inflammatory process on sutures on anterior abdominal wall after caesarean section and partial disruption of surgical suture line on perineum were examined. Medicine usage methods - surgical wound treatment 2 times a day, treatment with other medicines of local action was not performed. Before and after treatment general clinical test, determination of immune status, bacterioscopic test of wound fluid was performed to all women, medical history data was taken into account, wound cleansing and healing time, full granulations, side effects and complications, satisfaction with the used medicine was assessed. On female patients with inflammatory infiltration and partial disruption of surgical suture line anesthetic wound healing effect of plant medicinal product based on Sedum L. essential oils was observed as early as on the second day after beginning of using it, wound cleansing took place, as a rule, within the first row days. Hyperemia in the area of suture line also was not observed for 2-3-d day of usage of medicine, good constant course was observed. The absence of clinical effect on this group of patients was not registered. The represented data give evidence of that clinical effect was accompanied with normalization of changed laboratory findings. No allergic responses or side effects were observed during usage of the plant medicinal products based on Sedum L. essential oils.

Keywords: antiinflammatory, bioactive substances, essential oils, isolation, sedum L., wound healing

Procedia PDF Downloads 256
5688 Analysis of Long-term Results After External Dacryocystorhinostomy Surgery in Patients Suffered from Diabetes Mellitus

Authors: N. Musayeva, N. Rustamova, N. Bagirov, S. Ibadov

Abstract:

Purpose: to analyze the long-term results of external dacryocystorhinostomy (DCR), which remains the preferred primary procedure in the surgical treatment of lacrimal duct obstruction in chronic dacryocystitis. Methodology: long-term results of external DCR (after 3 years) performed on 90 patients (90 eyes) with chronic dacryocystitis from 2018 to 2020 were evaluated. The Azerbaijan National Center of Ophthalmology, named after acad. Zarifa Aliyeva. 15 of the patients were men, 75 – women. The average age was 45±3.2 years. Surgical operations were performed under local anesthesia. All patients suffered from diabetes mellitus for more than 3 years. All patients underwent external DCR and silicone drainage (tube) was implanted. In the postoperative period (after 3 years), lacrimation, purulent discharge, and the condition of the scar at the operation site were assessed. Results: All patients were under observation for more than 18 months. In general, the effectiveness of the surgical operation was 93.34%. Recurrence of disease was observed in 6 patients and in 3 patients (3.33%), the scar at the site of the operation was rough (non-cosmetic). In 3 patients (3.33%) – the surgically formed anastomosis between the lacrimal sac and the nasal bone was obstructed by scar tissue. These patients were reoperated by trans canalicular laser DCR. Conclusion: Despite the long-term (more than a hundred years) use of external DCR, it remains one of the primary techniques in the surgery of chronic dacryocystitis. Due to the high success rate and good long-term results of DCR in the treatment of chronic dacryocystitis in patients suffering from diabetes mellitus, we recommend external DCR for this group of patients.

Keywords: chronic dacryocystitis, diabetes mellitus, external dacryocystorhinostomy, long-term results

Procedia PDF Downloads 54
5687 Impacts of Public Insurance on Health Access and Outcomes: Evidence from India

Authors: Titir Bhattacharya, Tanika Chakraborty, Prabal K. De

Abstract:

Maternal and child health continue to be a significant policy focus in developing countries, including India. An emerging model in health care is the creation of public and private partnerships. Since the construction of physical infrastructure is costly, governments at various levels have tried to implement social health insurance schemes where a trust calculates insurance premiums and medical payments. Typically, qualifying families get full subsidization of the premium and get access to private hospitals, in addition to low cost public hospitals, for their tertiary care needs. We analyze one such pioneering social insurance scheme in the Indian state of Andhra Pradesh (AP). The Rajiv Aarogyasri program (RA) was introduced by the Government of AP on a pilot basis in 2007 and implemented in 2008. In this paper, we first examine the extent to which access to reproductive health care changed. For example, the RA scheme reimburses hospital deliveries leading us to expect an increase in institutional deliveries, particularly in private hospitals. Second, we expect an increase in institutional deliveries to also improve child health outcomes. Hence, we estimate if the program improved infant and child mortality. We use District Level Health Survey data to create annual birth cohorts from 2000-2015. Since AP was the only state in which such a state insurance program was implemented, the neighboring states constituted a plausible control group. Combined with the policy timing, and the year of birth, we employ a difference-indifference strategy to identify the effects of RA on the residents of AP. We perform several checks against threats to identification, including testing for pre-treatment trends between the treatment and control states. We find that the policy significantly lowered infant and child mortality in AP. We also find that deliveries in private hospitals increased, and government hospitals decreased, showing a substitution effect of the relative price change. Finally, as expected, out-of-pocket costs declined for the treatment group. However, we do not find any significant effects for usual preventive care such as vaccination, showing that benefits of insurance schemes targeted at the tertiary level may not trickle down to the primary care level.

Keywords: public health insurance, maternal and child health, public-private choice

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5686 Effect of Nutrition Education on the Control and Function of Insulin-Dependent Diabetes Patients

Authors: Rahil Sahragard, Mahmoud Hatami, Rostam Bahadori Khalili

Abstract:

Diabetes is one of the most important health problems in the world and a chronic disease requiring continuous care and therefore, it is necessary for patients to undergo self-care and nutrition education. This study was conducted to evaluate the effect of nutrition education on the metabolic control of diabetic patients in Tehran in 2015. An experimental study was conducted on 100 patients who had previously been approved by a specialist physician for diabetes and at least one year after their onset. At first, patients without any knowledge of the educational program were selected as sample and from them a checklist containing demographic and specific information about diabetes was filled and were taken three fasting blood glucose and three times fasting blood glucose (5 p.m.) Then, the patients received face-to-face training in the same conditions for 2 weeks in a Mehregan hospital of Tehran, and received 3 months of training, while they were fully monitored and during this time, samples that had a cold or blood pressure-related disease or were admitted to the hospital were excluded from the study. After the end of the study, the checklist was filled again and 3 fasting blood glucose and 3 fasting blood glucose samples were taken, the results were statistically analyzed by MC Nemar's statistical test. The research findings were performed on 100 patients 41.7% male and 58.3% women, the range of age was between 22 and 60 years old, with a duration of diabetes ranging from 1 to 15 years. Abnormal fasting blood glucose from 95% to 48.3% (P <0.0001) and non-fasting blood glucose decreased from 91.6% to 71.2% (P <0.001). Research has shown that training on blood glucose control has been successful, therefore, it is recommended that more research is done in the field of education to help patients with diabetes more comfortable.

Keywords: nutrition education, diabetes, function, insulin, chronic, metabolic control

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5685 Basic Study on a Thermal Model for Evaluating The Environment of Infant Facilities

Authors: Xin Yuan, Yuji Ryu

Abstract:

The indoor environment has a significant impact on occupants and a suitable indoor thermal environment can improve the children’s physical health and study efficiency during school hours. In this study, we explored the thermal environment in infant facilities classrooms for infants and children aged 1-5 and evaluated their thermal comfort. An infant facility in Fukuoka, Japan was selected for a case study to capture the infant and children’s thermal comfort characteristics in summer and winter from August 2019 to February 2020. Previous studies have pointed out using PMV indices to evaluate the thermal comfort for children could create errors that may lead to misleading results. Thus, to grasp the actual thermal environment and thermal comfort characteristics of infants and children, we retrieved the operative temperature of each child through the thermal model, based on the sensible heat transfer from the skin to the environment, and the measured classroom indoor temperature, relative humidity, and pocket temperature of children’s shorts. The statistical and comparative analysis of the results shows that (1) the operative temperature showed a large individual difference among children, with the maximum reached 6.25 °C. (2) The children might feel slightly cold in the classrooms in summer, with the frequencies of operative temperature within the interval of 26-28 ºC were only 5.33% and 16.6% for children respectively. (3) The thermal environment around children is more complicated in winter the operative temperature could exceed or fail to reach the thermal comfort temperature zone (20-23 ºC interval). (4) The environmental conditions surrounding the children may account for the reduction of their thermal comfort. The findings contribute to improving the understanding of the infant and children’s thermal comfort and provide valuable information for designers and governments to develop effective strategies for the indoor thermal environment considering the perspective of children.

Keywords: infant and children, thermal environment, thermal model, operative temperature.

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5684 Religion and Suicide: Exploration of the Relationship Between Religiosity and Suicidal Ideation among Young Adults

Authors: Sandra D. Prewitt

Abstract:

Introduction—The purpose of the extant study was to explore the relationship between religiosity and suicidal ideation. Through this exploration, further knowledge was sought relevant to gaining a better understanding regarding the higher suicide rate continuing to be experienced by young adults. Endeavoring to discover why the suicide rate continues to increase for the subject population, depression and anxiety emerged as major contributory risk factors. Although religiosity has been shown to be related to the reduced risk of suicidal behavior, the curative value of religion relevant to suicide prevention and treatment has not been sufficiently recognized. Considering the enormity of the current suicide problem, pursuits relevant to discovering effective tools enabling impactful prevention and treatment strategies remain essential to reducing suicide deaths. Methodology—The subject study was conducted utilizing a systematic literature review (SLR) which required the researcher to perform searches of appropriate databases, toward the goal of acquiring advanced knowledge based upon existing studies relevant to the subject matter under consideration. Major Findings—Depression and anxiety have been identified as two potential pathways leading to increased suicidal behavior. On the contrary, religiosity emerged as an important protective factor associated with less depression and therefore, fewer instances of suicidal thoughts. The protective nature of religion has been shown to extend to young adults without regard to the presence of identified potential suicidal behavior pathways.

Keywords: anxiety, depression, religion, suicide

Procedia PDF Downloads 199
5683 Fortification of Concentrated Milk Protein Beverages with Soy Proteins: Impact of Divalent Cations and Heating Treatment on the Physical Stability

Authors: Yichao Liang, Biye Chen, Xiang Li, Steven R. Dimler

Abstract:

This study investigated the effects of adding calcium and magnesium chloride on heat and storage stability of milk protein concentrate-soy protein isolate (8:2 respectively) mixtures containing 10% w/w total protein subjected to the in-container sterilization (115 °C x 15 min). The particle size does not change when emulsions are heated at pH between 6.7 and 7.3 irrespective of the mixed protein ratio. Increasing concentration of divalent cation salts resulted in an increase in protein particle size, dry sediment formation and sediment height and a decrease in pH, heat stability and hydration in milk protein concentrate-soy protein isolate mixtures solutions on sterilization at 115°C. Fortification of divalent cation salts in milk protein concentrate-soy protein isolate mixture solutions resulted in an accelerated protein sedimentation and two unique sediment regions during accelerated storage stability testing. Moreover, the heat stability decreased upon sterilization at 115°C, with addition of MgCl₂ causing a greater increase in sedimentation velocity and compressibility than CaCl₂. Increasing pH value of protein milk concentrate-soy protein isolate mixtures solutions from 6.7 to 7.2 resulted in an increase in viscosity following the heat treatment. The study demonstrated that the type and concentration of divalent cation salts used strongly impact heat and storage stability of milk protein concentrate-soy protein isolate mixture nutritional beverages.

Keywords: divalent cation salts, heat stability, milk protein concentrate, soy protein isolate, storage stability

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5682 Investigation of Azol Resistance in Aspergillosis Caused by Gradient Test and Agar Plaque Methods

Authors: Zeynep Yazgan, Gökhan Aygün, Reyhan Çalışkan

Abstract:

Objective: Invasive fungal infections are a serious threat in terms of morbidity and mortality, especially in immunocompromised patients. The most frequently isolated agents are Aspergillus genus fungi, and sensitivity to azoles, which are the first choice in treatment, decreases. In our study, we aimed to investigate the use of the agar plate screening method as a fast, easy, and practical method in determining azole resistance in Aspergillus spp. species. Methods: Our study was conducted with 125 Aspergillus spp. isolates produced from various clinical samples. Aspergillus spp. isolates were identified by conventional methods and azole resistance was determined by gradient test and agar plate screening method. Broth microdilution method was applied to resistant isolates, and CypA-L98H and CypA-M220 mutations in the cyp51A gene were investigated. Results: In our study, 55 A. fumigatus complex (44%), 42 A. flavus (33.6%), 6 A. terreus (5%), 4 A. niger (3%) and 18 Aspergillus spp. (14%) were identified. With the gradient test method, resistance to VOR and POS was detected in 1 (1.8%) of A.fumigatus isolates, and resistance to ITR was detected in 3 (5.45%). With the agar plate method, 1 of the A.fumigatus isolates (1.8%) had VOR, ITR, POS, 1 of the A.terreus isolates (16.7%) had VOR, 1 of the A.niger isolates (25%) had ITR. Resistance to VOR and POS was detected in 2 Aspergillus spp. isolates (11%), and resistance to ITR was detected in 1 (5.6%). Sensitivity and specificity were determined as 100% for VOR and POS in A. fumigatus species, 33.3% and 100% for ITR, respectively, 100% for ITR in A. flavus species, and 100% for ITR and POS in A. terreus species. By broth microdilution method in 7 isolates in which resistance was detected by gradient test and/or agar plate screening method; 1 A.fumigatus resistant to ITR, VOR, POS, 2 A.fumigatus resistant to ITR, 2 Aspergillus spp. ITR, VOR, POS MICs were determined as 2µg/ml and 8µg/ml, 8µg/ml and >32µg/ml, 0.5µg/ml and 4µg/ml, respectively. CypA-L98H mutations were detected in 5 of these isolates, CypA-M220 mutations were detected in 6, and no mutation was detected in 1. CypA-L98H and CypA-M220 mutations were detected in 1 isolate for which resistance was not detected. Conclusion: The need for rapid antifungal susceptibility screening tests is increasing in the treatment of aspergillosis. Although the sensitivity of the agar plate method was determined to be 33.3% for A.fumigatus ITR in our study, its sensitivity and specificity were determined to be 100% for ITR, VOR, and POS in other species. The low sensitivity value detected for A.fumigatus showed that agar plate drug concentrations should be updated in accordance with the latest regulations of EUCAST guidelines. The CypA-L98H and CypA-M220 mutations detected in our study suggested that the distribution of azole resistance-related mutations in different regions in our country should be investigated. In conclusion, it is thought that the agar plate method, which can be easily applied to detect azole resistance, is a fast and practical method in routine use and can contribute to both the determination of effective treatment strategies and the generation of epidemiological data.

Keywords: Aspergillus, agar plate, azole resistance, cyp51A, cypA-L98H, cypA-M220

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5681 A Script for Presentation to the Management of a Teaching Hospital on MYCIN: A Clinical Decision Support System

Authors: Rashida Suleiman, Asamoah Jnr. Boakye, Suleiman Ahmed Ibn Ahmed

Abstract:

In recent years, there has been an enormous success in discoveries of scientific knowledge in medicine coupled with the advancement of technology. Despite all these successes, diagnoses and treatment of diseases have become complex. MYCIN is a groundbreaking illustration of a clinical decision support system (CDSS), which was developed to assist physicians in the diagnosis and treatment of bacterial infections by providing suggestions for antibiotic regimens. MYCIN was one of the earliest expert systems to demonstrate how CDSSs may assist human decision-making in complicated areas. Relevant databases were searched using google scholar, PubMed and general Google search, which were peculiar to clinical decision support systems. The articles were then screened for a comprehensive overview of the functionality, consultative style and statistical usage of MYCIN, a clinical decision support system. Inferences drawn from the articles showed some usage of MYCIN for problem-based learning among clinicians and students in some countries. Furthermore, the data demonstrated that MYCIN had completed clinical testing at Stanford University Hospital following years of research. The system (MYCIN) was shown to be extremely accurate and effective in diagnosing and treating bacterial infections, and it demonstrated how CDSSs might enhance clinical decision-making in difficult circumstances. Despite the challenges MYCIN presents, the benefits of its usage to clinicians, students and software developers are enormous.

Keywords: clinical decision support system, MYCIN, diagnosis, bacterial infections, support systems

Procedia PDF Downloads 119
5680 Effect of Bull Exposure on Post-Partum Estrus Interval in Nili-Ravi Buffaloes

Authors: Muhammad Saleem Akhtar, Mushtaq Hussain Lashari, Ejaz Ahmad, Tanveer Ahmad, Laeeq Akbar Lodhi, Ijaz Ahmad, Masood Akhtar

Abstract:

The objective of this study was to determine the effect of bull exposure continuously or intermittently or its excretory products after calving on postpartum interval to estrus, in Nili-Ravi buffalo. Forty-eight buffaloes of Nili-Ravi breed were allocated one of the four treatments in a totally randomized plan using a 4 x 1 factorial design. The four treatment groups were BEC (Bull Exposed Continuously), BEI (Bull Exposed Intermittently), EPB (Excretory Products of Bull) and BNE (Bull Not Exposed). BEC; buffaloes (n = 12) were exposed continuously to the physical presence of a bull whereas in BEI; buffaloes (n = 12) were exposed intermittently to the physical presence of bull. EPB; buffaloes (n = 12) were exposed to discharge waste (urine and feces) of bull and BNE buffaloes (n = 12) were not exposed to a bull or discharge waste of bulls. Buffaloes were exposed on day 15 after parturition. Day 15 postpartum represented d 0 for each treatment. The postpartum interval from calving to first behavioural estrus was 66.88 days in BEC, 75.12 days in BEI, 77.28 days in EPB and 76.5 days in BNE treatments. Postpartum interval to first behavioural estrus was shorter in BEC than BEI, EPB, and BNE treatments. There was no significant difference in postpartum interval to estrus between BEI, EPB and BNE treatments. In present study, the percentage of buffaloes showing estrus during experimental period was 75.0%, 66.66%, 66.66% and 58.33% in BEC, BEI, EPB and BNE treatments, respectively. The mean serum progesterone concentration did not differ significantly between BEC and other (BEI, EPB, and BNE) treatments. It was concluded that presence of bull has positive effect in reducing calving interval in Nili Ravi buffalo.

Keywords: calving interval, biostimulation, buffalo, bull exposure

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5679 Iterative Method for Lung Tumor Localization in 4D CT

Authors: Sarah K. Hagi, Majdi Alnowaimi

Abstract:

In the last decade, there were immense advancements in the medical imaging modalities. These advancements can scan a whole volume of the lung organ in high resolution images within a short time. According to this performance, the physicians can clearly identify the complicated anatomical and pathological structures of lung. Therefore, these advancements give large opportunities for more advance of all types of lung cancer treatment available and will increase the survival rate. However, lung cancer is still one of the major causes of death with around 19% of all the cancer patients. Several factors may affect survival rate. One of the serious effects is the breathing process, which can affect the accuracy of diagnosis and lung tumor treatment plan. We have therefore developed a semi automated algorithm to localize the 3D lung tumor positions across all respiratory data during respiratory motion. The algorithm can be divided into two stages. First, a lung tumor segmentation for the first phase of the 4D computed tomography (CT). Lung tumor segmentation is performed using an active contours method. Then, localize the tumor 3D position across all next phases using a 12 degrees of freedom of an affine transformation. Two data set where used in this study, a compute simulate for 4D CT using extended cardiac-torso (XCAT) phantom and 4D CT clinical data sets. The result and error calculation is presented as root mean square error (RMSE). The average error in data sets is 0.94 mm ± 0.36. Finally, evaluation and quantitative comparison of the results with a state-of-the-art registration algorithm was introduced. The results obtained from the proposed localization algorithm show a promising result to localize alung tumor in 4D CT data.

Keywords: automated algorithm , computed tomography, lung tumor, tumor localization

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5678 Magneto-Hydrodynamic Mixed Convection of Water-Al2O3 Nanofluid in a Wavy Lid-Driven Cavity

Authors: Farshid Fathinia

Abstract:

This paper examines numerically the laminar steady magneto-hydrodynamic mixed convection flow and heat transfer in a wavy lid-driven cavity filled with water-Al2O3 nanofluid using FDM method. The left and right sidewalls of the cavity have a wavy geometry and are maintained at a cold and hot temperature, respectively. The top and bottom walls are considered flat and insulated while, the bottom wall moves from left to right direction with a uniform lid-driven velocity. A magnetic field is applied vertically downward on the bottom wall of the cavity. Based on the numerical results, the effects of the dominant parameters such as Rayleigh number, Hartmann number, solid volume fraction, and wavy wall geometry parameters are examined. The numerical results are obtained for Hartmann number varying as 0 ≤ Ha ≤ 0.6, Rayleigh numbers varying as 103≤ Ra ≤105, and the solid volume fractions varying as 0 ≤ φ ≤ 0.0003. Comparisons with previously published numerical works on mixed convection in a nanofluid filled cavity are performed and good agreements between the results are observed. It is found that the flow circulation and mean Nusselt number decrease as the solid volume fraction and Hartmann number increase. Moreover, the convection enhances when the amplitude ratio of the wavy surface increases. The results also show that both the flow and thermal fields are significantly affected by the amplitude ratio (i.e., wave form) of the wavy wall.

Keywords: nanofluid, mixed convection, magnetic field, wavy cavity, lid-driven, SPH method

Procedia PDF Downloads 296