Search results for: patient's peak skin dose

Authors: Waheed Akhtar

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Bears in Asia facing multiple threats and challenges such as hunting, illegal trading, habitat loss, and human conflicts. According to IUCN Red List, the Asiatic black bear (Ursus thibetanus) is listed as Vulnerable since 1990, population declining by 49% during the last 30 years. The present study was conducted in Manglawar (DwaSaro Mountain) from April-August 2021, to collect all the information on Asiatic black bear observation, illegal hunting, and cub poaching. According to the response of the local community, very intensive illegal hunting and cub poaching were observed. Hunters usually installed many traps in the routes of black bears and when they move in the winter season the cubs get trapped and they collect them and kept in a specialized wooden box that is mainly helpful for further transportation. These cubs are then brought to the concerned Market where they sell them to many dealers. One of the potential observers of the illegal trading responds towards the Market price of the cubs, “The average price of the black bear cub is ranging from 45000-50000 Pakistani Rupees”. Apart from cubs' poaching, the black bear is also hunted for its skin, claws, and teeth.

Keywords: first report, illegal hunting, cub poaching, parts trading, Ursus thibetanus

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Authors: Rajashekar Badam, Vedarajan Raman, Noriyoshi Matsumi

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Efficiency of energy converting and storage systems like fuel cells and Li-Air battery principally depended on oxygen reduction reaction (ORR) which occurs at cathode. As the kinetics of the ORR is very slow, it becomes the rate determining step. Exploring carbon substrates for enhancing the dispersion and activity of the metal catalyst and commercially viable simple preparation method is a very crucial area of research in the field of energy materials. Hence, many researchers made large number of carbon-based ORR materials today. But, there are hardly few studies on the effect of interaction between Pt-carbon and carbon-electrolyte on activity. In this work, we have prepared functionalized carbon-based Pt catalyst (Pt-FAB) with enhanced interfacial properties that lead to efficient ORR catalysis. The present work deals with a single-pot method to exfoliate and functionalized acetylene black with enhanced interaction with Pt as well as electrolyte. Acetylene black was functionalized and exfoliated using a facile single pot acid treatment method. The resulted FAB was further decorated with Pt-nano particles (Pt-np). The TEM images of Pt-FAB with uniformly decorated Pt-np of ~3 nm. Further, XPS studies of Pt 4f peak revealed that Pt0 peak was shifted by 0.4 eV in Pt-FAB compared to binding energy of typical Pt⁰ found in Pt/C. The shift can be ascribed to the modulation of electronic state and strong electronic interaction of Pt with carbon. Modulated electronic structure of Pt and strong electronic interaction of Pt with FAB enhances the catalytic activity and durability respectively. To understand the electrode electrolyte interface, electrochemical impedance spectroscopy was carried out. These measurements revealed that the charge transfer resistance of electrode to electrolyte for Pt-FAB is 10 times smaller than that of conventional Pt/C. The interaction with electrolyte helps reduce the interface boundaries, which in turn affects the overall catalytic performance of the electrode. Cyclic voltammetric measurements in 0.1M HClO₄ aq. at a potential scan rate of 50 mVs-1 was employed to evaluate electrochemical surface area (ECSA) of Pt. ECSA of Pt-FAB was found to be as high as 67.2 m²g⁻¹. The three-electrode system showed very high ORR catalytic activity. Mass activity at 0.9 V vs. RHE showed 460 A/g which is much higher than the DOE target values for the year 2020. Further, it showed enhanced performance by showing 723 mW/cm² of highest power density and 1006 mA/cm² of current density at 0.6 V in fuel cell single cell type configuration and 1030 mAhg⁻¹ of rechargeable capacity in Li air battery application. The higher catalytic activity can be ascribed to the improved interaction of FAB with Pt and electrolyte. The aforementioned results evince that Pt-FAB will be a promising cathode material for efficient ORR with significant cyclability for its application in fuel cells and Li-Air batteries. In conclusion, a disordered material was prepared from AB and was systematically characterized. The extremely high ORR activity and ease of preparation make it competent for replacing commercially available ORR materials.

Keywords: functionalized acetylene black, oxygen reduction reaction, fuel cells, Functionalized battery

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Authors: Khalid H. Abass

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Al-Ni-Cr alloy contains different ratios of Ni and Cr was prepared by mixing Al, Ni and Cr at 800oC under an argon atmosphere. The prepared alloys were heated for 1300 hr to 560oC, and then cooled rapidly by water at the ambient temperature. Surface morphology for alloys is studied by scanning electron microscope (SEM). The resultant homogeneous surface is a result of heat treatment. The X-ray diffraction patterns showed (111), (200), and (220) diffraction lines from cubic Al crystal structure, and suggested that the intensity of peak (111) orientation is predominant. Three binary phases were observed and grown in alloys: Al3Ni (Orthorhombic, a = 6.598Ǻ, b = 7.352 Ǻ, c = 4.802 Ǻ), Cr9Al17 (Rhombohedra, a = 12.910 Ǻ, c = 15.677), and Ni2Cr3 (Tetragonal, a = 8.82 Ǻ, c = 4.58 Ǻ). The average crystallite sizes of the prepared samples were found to be from 3000 to 3094 nm by SEM, which is much smaller than that estimated from XRD data. Corrosion resistance increases with increasing Ni-Cr content in Al alloys. The electrical volume resistivity decreased with increasing Ni-Cr content at low frequency. This behavior can be seen generally at 50Hz, where the electrical volume resistivity reached the value of 3.98×10-8Ω.cm for the ratio Al-1.8 at.%Ni-0.18at.%Cr.

Keywords: Al-Ni-Cr alloy, corrosion current, electrical volume resistivity, binary phase, homogeneous surface

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Authors: Lenka Morávková, Zuzana Sedláková, Jiří Vejražka, Věra Jandová, Pavel Izák

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The need to minimize the costs of biogas upgrading leads to a continuous search for new and more effective membrane materials. The improvement of biogas combustion efficiency is connected with polar gases removal from a feed stream. One of the possibilities is the use of water–swollen polyamide layer of thin film composite reverse osmosis membrane for simultaneous carbon dioxide and hydrogen sulphide removal. Transport properties and basic characteristics of a thin film composite membrane were compared in the term of appropriate water-swollen membrane choice for biogas upgrading. SEM analysis showed that the surface of the best performing composites changed significantly upon swelling by water. The surface changes were found to be a proof that the selective skin polyamide layer was swollen well. Further, the presence of a sufficient number of associative centers, namely amido groups, inside the upper layer of the hydrophilic thin composite membrane can play an important role in the polar gas separation from a non-polar gas. The next key factor is a high porosity of the membrane support.

Keywords: biogas upgrading, carbon dioxide separation, hydrogen sulphide separation, water-swollen membrane

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Authors: Davide Forcellini

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The most recent development of earthquake engineering is based on concept of design consisting in prescribed performance rather than the more traditional prescriptive approaches. The paper aims to assess the effects of isolation devices and soil structure interaction on a benchmark bridge adopting a Performance-Based Earthquake Engineering methodology. Several isolated configurations of abutments and pier connections are compared performing the most representative isolation devices. Isolation systems suitability depends on many factors, mainly connected with ground effects. In this regard, the second purpose of this paper is to assess the effects of soil-structure interaction (SSI) on the studied bridge configurations. Contributions of isolation technique and soil structure interaction are assessed evaluating the resistance effects applied to Peak Ground Acceleration (PGA) levels in terms of cost and time repair quantities.

Keywords: base isolation, bridge, earthquake engineering, non linearity, PBEE methodology, seismic assessment, soil structure interaction

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Authors: Ali A. Alshatwi, Vaiyapuri S. Periasamy, Jegan Athinarayanan

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Engineered nanoparticles’ usage rapidly increased in various applications in the last decade due to their unusual properties. However, there is an ever increasing concern to understand their toxicological effect in human health. Particularly, metal and metal oxide nanoparticles have been used in various sectors including biomedical, food and agriculture. But their impact on human health is yet to be fully understood. In this present investigation, we assessed the toxic effect of engineered nanoparticles (ENPs) including Ag, MgO and Co3O4 nanoparticles (NPs) on human mesenchymal stem cells (hMSC) adopting cell viability and cellular morphological changes as tools The results suggested that silver NPs are more toxic than MgO and Co3O4NPs. The ENPs induced cytotoxicity and nuclear morphological changes in hMSC depending on dose. The cell viability decreases with increase in concentration of ENPs. The cellular morphology studies revealed that ENPs damaged the cells. These preliminary findings have implications for the use of these nanoparticles in food industry with systematic regulations.

Keywords: cobalt oxide, human mesenchymal stem cells, MgO, silver

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Authors: Kamal Kaushik, Trisha, Dandapni, Sambit Nanda, A. Mukherjee, S. Pradhan

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INTRODUCTION: As complexity in radiotherapy practice and processes are increasing, there is a need to assure quality control to a greater extent. At present, no international literature available with regards to the optimal quality control indicators for radiotherapy; moreover, few clinical audits have been conducted in the field of radiotherapy. The primary aim is to improve the processes that directly impact clinical outcomes for patients in terms of patient safety and quality of care. PROCEDURE: A team of an Oncologist, a Medical Physicist and a Radiation Therapist was formed for weekly clinical audits of patient’s undergoing radiotherapy audits The stages for audits include Pre planning audits, Simulation, Planning, Daily QA, Implementation and Execution (with image guidance). Errors in all the parts of the chain were evaluated and recorded for the development of further departmental protocols for radiotherapy. EVALUATION: The errors at various stages of radiotherapy chain were evaluated and recorded for comparison before starting the clinical audits in the department of radiotherapy and after starting the audits. It was also evaluated to find the stage in which maximum errors were recorded. The clinical audits were used to structure standard protocols (in the form of checklist) in department of Radiotherapy, which may lead to further reduce the occurrences of clinical errors in the chain of radiotherapy. RESULTS: The aim of this study is to perform a comparison between number of errors in different part of RT chain in two groups (A- Before Audit and B-After Audit). Group A: 94 pts. (48 males,46 female), Total no. of errors in RT chain:19 (9 needed Resimulation) Group B: 94 pts. (61 males,33 females), Total no. of errors in RT chain: 8 (4 needed Resimulation) CONCLUSION: After systematic periodic clinical audits percentage of error in radiotherapy process reduced more than 50% within 2 months. There is a great need in improving quality control in radiotherapy, and the role of clinical audits can only grow. Although clinical audits are time-consuming and complex undertakings, the potential benefits in terms of identifying and rectifying errors in quality control procedures are potentially enormous. Radiotherapy being a chain of various process. There is always a probability of occurrence of error in any part of the chain which may further propagate in the chain till execution of treatment. Structuring departmental protocols and policies helps in reducing, if not completely eradicating occurrence of such incidents.

Keywords: audit, clinical, radiotherapy, improving functionality

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Authors: Abiola Falilat Ibraheem, Akinyimika Sowunmi, Valerie Otti

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Background: Introduction of innovative cancer clinical trials to Nigeria is a critical step in addressing global inequities of cancer burden. Low health and clinical trial literacy among Nigerian patients have been sighted as a significant barrier to ensuring that patients enrolled in clinical trials are truly informed. Video intervention has been shown to be the most proactive method to improving patient’s clinical trial knowledge. In the US, video interventions have been successful at improving education about cancer clinical trials among minority patients. Thus, this study aimed to apply and adapt video interventions addressing attitudinal barriers peculiar to Nigerian patients. Methods: A hospital-based representative mixed-method study was conducted at the Lagos State University Teaching Hospital (LASUTH) from July to December 2020, comprising of cancer patients aged 18 and above. Patients were randomly selected during every clinic day, of which 63 patients volunteered to participate in this study. We first administered a cancer literacy survey to determine patients’ knowledge about clinical trials. For patients who had prior knowledge, a pre-intervention test was administered, after which a 15-minute video (attitudes and intention to enroll in therapeutic clinical trials (AIET)) to improve patients’ knowledge, perception, and attitudes towards clinical trials was played, and then ended by administering a post-intervention test to the patients. For patients who had no prior knowledge, the AIET video was played for them, followed by the post-intervention test. Results: Out of 63 patients sampled, 43 (68.3%) had breast cancer. On average, patients agreed to understand their cancer diagnosis and treatment very well. 84.1% of patients had never heard about cancer clinical trials, and 85.7% did not know what cancer clinical trials were. There was a strong positive relationship (r=0.916) between the pretest and posttest, which means that the intervention improved patients’ knowledge, perception, and attitudes about cancer clinical trials. In the focus groups, patients recommended adapting the video in Nigerian settings and representing all religions in order to address trust in local clinical trialists. Conclusion: Due to the small size of patients, change in clinical trial knowledge was not statistically significant. However, there is a trend suggesting that culturally adapted video interventions can be used to improve knowledge and perception about cancer clinical trials.

Keywords: clinical trials, culturally targeted intervention, patient education, video intervention

Procedia PDF Downloads 125

Authors: O. Davies, K. Veravalli, P. Panwalkar, M. Tofighi, P. Butterick, B. Healy, A. Mofidi

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Vancomycin resistant enterococcus infection is a condition that usually impacts ICUs, transplant, dialysis, and cancer units, often as a nosocomial infection. After an outbreak in the acute trauma and orthopaedic unit in Morriston hospital, we aimed to access the conditions that predispose VRE infections in our unit. Thirteen cases of VRE infection and five cases of VRE colonisations were identified in patients who were treated for orthopaedic care between 1/1/2020 and 1/11/2021. Cases were reviewed to identify predisposing factors, specifically looking at age, presenting condition and treatment, presence of infection and antibiotic care, active haemo-oncological condition, long term renal dialysis, previous hospitalisation, VRE predisposition, and clearance (PREVENT) scores, and outcome of care. The presenting condition, treatment, presence of postoperative infection, VRE scores, age was compared between colonised and the infected cohort. VRE type in both colonised and infection group was Enterococcus Faecium in all but one patient. The colonised group had the same age (T=0.6 P>0.05) and sex (2=0.115, p=0.74), presenting condition and treatment which consisted of peri-femoral fixation or arthroplasty in all patients. The infected group had one case of myelodysplasia and four cases of chronic renal failure requiring dialysis. All of the infected patient had sustained an infected complication of their fracture fixation or arthroplasty requiring reoperation and antibiotics. The infected group had an average VRE predisposition score of 8.5 versus the score of 3 in the colonised group (F=36, p<0.001). PREVENT score was 7 in the infected group and 2 in the colonised group(F=153, p<0.001). Six patients(55%) succumbed to their infection, and one VRE infection resulted in limb loss. In the orthopaedic cohort, VRE infection is a nosocomial condition that has peri-femoral predilection and is seen in association with immunosuppression or renal failure. The VRE infection cohort has been treated for infective complication of original surgery weeks prior to VRE infection. Based on our findings, we advise avoidance of infective complications, change of practice in use of antibiotics and use radical surgery and surveillance for VRE infections beyond infective precautions. PREVENT score shows that the infected group are unlikely to clear their VRE in the future but not the colonised group.

Keywords: surgical site infection, enterococcus, orthopaedic surgery, vancomycin resistance

Procedia PDF Downloads 124

Authors: Peter Park, Alfonso Ayala, Douglas Saeks, Jordan Miller, Carmen Flores, Karen Nelson

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Introduction Hip fractures account for more than 300,000 hospital admissions every year. Many present as fragility fractures in geriatric patients with multiple medical comorbidities. Standardized protocols for the multidisciplinary management of this patient population have been shown to improve patient outcomes. A hip fracture protocol was implemented at a Level I Trauma center with a focus on pre-operative medical optimization and early surgical care. This study evaluates the efficacy of that protocol, including the early transition period. Methods A retrospective review was performed of all patients ages 60 and older with isolated hip fractures who were managed surgically between 2020 and 2022. This included patients 1 year prior and 1 year following the implementation of a hip fracture protocol at a Level I Trauma center. Results 530 patients were identified: 249 patients were treated before, and 281 patients were treated after the protocol was instituted. There was no difference in mean age (p=0.35), gender (p=0.3), or Charlson Comorbidity Index (p=0.38) between the cohorts. Following the implementation of the protocol, there were observed increases in time to surgery (27.5h vs. 33.8h, p=0.01), hospital length of stay (6.3d vs. 9.7d, p<0.001), and ED LOS (5.1h vs. 6.2h, p<0.001). There were no differences in in-hospital mortality (2.01% pre vs. 3.20% post, p=0.39) and complication rates (25% pre vs 26% post, p=0.76). A trend towards improved outcomes was seen after the early transition period but failed to yield statistical significance. Conclusion Early medical management and surgical intervention are key determining factors affecting outcomes following fragility hip fractures. The implementation of a hip fracture protocol at this institution has not yet significantly affected these parameters. This could in part be due to the restrictions placed at this institution during the COVID-19 pandemic. Despite this, the time to OR pre-and post-implementation was quicker than figures reported elsewhere in literature. Further longitudinal data will be collected to determine the final influence of this protocol. Significance/Clinical Relevance Given the increasing number of elderly people and the high morbidity and mortality associated with hip fractures in this population finding cost effective ways to improve outcomes in the management of these injuries has the potential to have enormous positive impact for both patients and hospital systems.

Keywords: hip fracture, geriatric, treatment algorithm, preoperative optimization

Procedia PDF Downloads 61

Authors: Takashi Ehara, Takayoshi Nakanishi, Kohei Sasaki, Marina Abe, Hiroshi Abe, Kiyoaki Abe, Ryo Iizaka, Takuya Sato

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CuAlO₂ thin films are prepared on Si or sapphire substrate by sol-gel method using two kinds of sols. One is combination of Cu acetate and Al acetate basic, and the other is Cu nitrate and Al nitrate. In the case of acetate sol, XRD peaks of CuAlO₂ observed at annealing temperature of 800-950 ºC on both Si and sapphire substrates. In contrast, in the case of the films prepared using nitrate on Si substrate, XRD peaks of CuAlO₂ have been observed only at the annealing temperature of 800-850 ºC. At annealing temperature of 850ºC, peaks of other species have been observed beside the CuAlO₂ peaks, then, the CuAlO₂ peaks disappeared at annealing temperature of 900 °C with increasing in intensity of the other peaks. Intensity of the other peaks decreased at annealing temperature of 950 ºC with appearance of broad SiO₂ peak. In the present, we ascribe these peaks as metal silicide.

Keywords: CuAlO2, silicide, thin Films, transparent conducting oxide

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Authors: Nurdan Tumbek Tekeoglu

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With rising importance in all over the world, crowdfunding has become a new financing and marketing method for film industry. Crowdfunding is a new practice in film industry for funding a film project by raising monetary contributions from a large group of people. By crowdfunding an estimate fund of 20 billion USD has been raised in 2015. Through the crowdfunding platforms not only the film makers, but also the entrepreneurs and nongovernmental organizations finance and market their projects. Among the prominent crowdfunding platforms in Turkey, we can list Crowdfon, Fonlabeni, Kickstarter, Indiego, Bi Ayda, and Fongogo platforms. In 2014 the Turkish film industry celebrated its 100th anniversary and reached its peak producing around 150-200 films a year reminding the brilliant years of Yesilcam period. In general feature films apply for crowdfunding. Until April 2015 more than 190 films applied for crowdfunding platforms. Crowdfunding has a promising future in Turkey, since donation traditions has an important place in Turkish culture traditionally. This paper is exploring the marketing of the crowdfunding platforms established in Turkey in order for the films meet their target groups during the pre-production period.

Keywords: crowdfunding, marketing of films, Turkey, Turkish film industry

Procedia PDF Downloads 332

Authors: Yael Rieder, Yael Gilboa, S. O. Adva, Efrat Halevi, Ronnie Tepper

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Background: Operation of ultrasound equipment is a core skill for many clinical specialties. As part of the training program at -Simultech- a simulation center for Ob\Gyn at the Meir Medical Center, Israel, teaching how to operate ultrasound equipment requires dealing with misunderstandings of spatial and 3D orientation, failure of the operator to hold a transducer correctly, and limited ability to evaluate the data on the screen. We have developed a platform intended to endow physicians and sonographers with clinical and operational skills of obstetric ultrasound. Simultech's simulations are focused on medical knowledge, risk management, technology operations and physician-patient communication. The simulations encompass extreme work conditions. Setup: Between eight and ten of the eight hundred and fifty physicians and sonographers of the Clalit health services from seven hospitals and eight community centers across Israel, participate in individual Ob/Gyn training sessions each week. These include Ob/Gyn specialists, experts, interns, and sonographers. Innovative teaching and training methodologies: The six-hour training program includes: (1) An educational computer program that challenges trainees to deal with medical questions based upon ultrasound pictures and films. (2) Sophisticated hands-on simulators that challenge the trainees to practice correct grip of the transducer, elucidate pathology, and practice daily tasks such as biometric measurements and analysis of sonographic data. (3) Participation in a video-taped simulation which focuses on physician-patient communications. In the simulation, the physician is required to diagnose the clinical condition of a hired actress based on the data she provides and by evaluating the assigned ultrasound films accordingly. Giving ‘bad news’ to the patient may put the physician in a stressful situation that must be properly managed. (4) Feedback at the end of each phase is provided by a designated trainer, not a physician, who is specially qualified by Ob\Gyn senior specialists. (5) A group exercise in which the trainer presents a medico-legal case in order to encourage the participants to use their own experience and knowledge to conduct a productive ‘brainstorming’ session. Medical cases are presented and analyzed by the participants together with the trainer's feedback. Findings: (1) The training methods and content that Simultech provides allows trainees to review their medical and communications skills. (2) Simultech training sessions expose physicians to both basic and new, up-to-date cases, refreshing and expanding the trainee's knowledge. (3) Practicing on advanced simulators enables trainees to understand the sonographic space and to implement the basic principles of ultrasound. (4) Communications simulations were found to be beneficial for trainees who were unaware of their interpersonal skills. The trainer feedback, supported by the recorded simulation, allows the trainee to draw conclusions about his performance. Conclusion: Simultech was found to contribute to physicians at all levels of clinical expertise who deal with ultrasound. A break in daily routine together with attendance at a neutral educational center can vastly improve performance and outlook.

Keywords: medical training, simulations, ultrasound, Simultech

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Authors: Vivi Anggraini, Afshin Asadi, Bujang B. K. Huat

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Earth structures constructed of marine clay soils have tendency to crack. In order to improve the flexural strength and brittleness, a technique of mixing short fibers is introduced to the soil lime mixture. Coir fiber was used in this study as reinforcing elements. An experimental investigation consisting primarily of flexural tensile tests was conducted to examine the influence of coir fibers on the flexural behaviour of the reinforced soils. The test results demonstrated that the coir fibers were effective in improving the flexural strength and young’s modulus of all soils were examined and ductility after peak strength for reinforced marine clay soil was treated by lime. 5% lime treated soil and 1% coir fiber reinforced soil specimen’s demonstrated good strength and durability when submerged in water and retained 45% of their air-cured strengths.

Keywords: flexural strength, durabilty, lime, coir fibers, bending force, ductility

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Authors: Akhter Hussain Najar

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Honey bees are the best insect grown on earth and are taking the lead in the global ecosystem. Life on earth depends upon honey bees pollinating each and every flower in its reign. The global economy is balanced by providing financial attribute due to the use of valuable resources generated from honey bees like honey, royal jelly, bee venom, propolis, bee wax even queens from parent colonies is now in demand. Livelihood stability is also maintained by the rearing of honey bees; beekeeping became a new professional work to be cared for by the experts. Indigenous methodologies are used to rear honey bees. The rearing of honey bees showed variation in different states like Uttar Pradesh, Rajasthan, Haryana, Punjab, Jammu, Kashmir, etc. The production of honey depends upon the area and the availability of crops and the colonies of beekeepers in these states. However, the kind of honey from Jammu and Kashmir, like Accacia and Solai, has different color and odour from the honey generated in the rest of the states. However, the nature and viscosity vary from state to state. But in the last few years, the honey from Jammu and Kashmir has given different shapes when kept at room temperature due to unconditional rainfall during honey peak season in J&K.

Keywords: ecosystem pollen, pollination, honey bee

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Authors: Saniya Ablatt, Matthew Jacobsson, Jamie Whisler, Austin Forbes

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Postoperative pancreatic fistula (POPF) is a complication that occurs in up to 41% of patients after pancreaticoduodenectomy. Although certain characteristics such as individual patient anatomy are known risk factors for POPF, the effect of barbed suture techniques remains underexplored. This study examines whether the use of Stratafix barbed suture versus PDS impacts the risk of developing POPF. After obtaining IRB exemption, a retrospective chart review was initiated involving patients who underwent pancreaticoduodenectomy for the treatment of malignant or premalignant lesions of the pancreas at our institution between April 1st 2020 and April 30th 2022. Patients were stratified into 2 groups respective to the technique used to suture the pancreatico-jejunal anastomosis: Group 1 was composed to patients in which 4.0 Stratafix® suture was used n=41. Group 1 was composed to patients in which 4.0 PDS suture was used n=42. Data regarding patient age, sex, BMI, presence or absence of biochemical leak, presence or absence of grade B & C postoperative pancreatic fistulas, rate and type of in hospital complication, rate of reoperation, 30 day readmission rate, 90 day mortality, and total mortality were compared between groups. 83 patients were included in our study with 42 receiving Stratafix and 41 receiving PDS (50.6% vs 49.4%). Stratafix patients had less biochemical leaks (0.0% vs 4.8%, p=0.19) and higher rates of POPF but this was not statistically significant (7.2% vs 2.4%, p=0.26). Additionally, there was no difference between the use of stratafix versus PDS on the risk of clinically relevant grade B or C POPF (p=0.26, OR=3.25 [CI= 0.74-16.43]). Of the independent variables including age, race, sex, BMI, and ASA class, BMI greater than 25 increased the risk of clinically relevant POPF by 7.7 times compared to patients with BMI less than 25 (p=0.03, OR=7.79 [1.04-88.51]). Despite no significant difference in primary outcomes, the Stratafix group had lower rates of secondary outcomes including 90-day mortality; bleeding, cardiac, and infectious complications; reoperation; and 30-day readmission. On statistical analysis, Stratafix decreased the risk of 30-day readmission (p=0.04, OR=0.21, CI=0.04-0.97) and had a marginally significant effect on the risk of reoperation (p=0.08, OR=0.24, CI=0.04-1.26). There was no difference between the use of Stratafix versus PDS on the risk of POPF (p=0.26). However, Stratafix decreased the risk of 30-day readmission (p=0.04) and BMI greater than 25 increased the risk of clinically relevant POPF (p=0.03).

Keywords: pancreas, hepatobiliary surgery, hepatobiliary, pancreatic leak, biochemical leak, fistula, pancreatic fistula

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Authors: J. Silva, P. Arezes, R. Schierl, N. Costa

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In order to study environmental contamination by cytostatic drugs in Portugal hospitals, sampling campaigns were conducted in three hospitals in 2015 (112 samples). Platinum containing drugs and fluorouracil were chosen because both were administered in high amounts. The detection limit was 0.01 pg/cm² for platinum and 0.1 pg/cm² for fluorouracil. The results show that spills occur mainly on the patient`s chair, while the most referenced occurrence is due to an inadequately closed wrapper. Day hospitals facilities were detected as having the largest number of contaminated samples and with higher levels of contamination.

Keywords: cytostatic, contamination, hospital, procedures, handling

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Authors: T. S. Beerenahally, S. Amruthavalli, C. M. Munegowda, Leelavathi, Nagarathna

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Introduction: In majority of urban India, the health system is split between different authorities being responsible for the health care of urban population. We believe that, apart from poor awareness and financial barriers to care, there are other health system barriers which affect quality and access to care for people with diabetes. In this paper, we attempted to identify health system complexity that determines access to public health system for diabetes care in KG Halli, a poor urban neighborhood in Bengaluru. The KG Halli has been a locus of a health systems research from 2009 to 2015. Methodology: The source of data is from the observational field-notes written by research team as part of urban health action research project (UHARP). Field notes included data from the community and the public primary care center. The data was generated by the community health assistants and the other research team members during regular home visits and interaction with individuals who self-reported to be diabetic over four years as part of UHARP. Results: It emerged during data analysis that the patients were not keen on utilizing primary public health center for many reasons. Patient has felt that the service provided at the center was not integrated. There was lack of availability of medicines, with a regular stock out of medicines in a year and laboratory service for investigation was limited. Many of them said that the time given by the providers was not sufficient and there was also a feeling of providers not listening to them attentively. The power dynamics played a huge role in communication. Only the consultation was available for free of cost at the public primary care center. The patient had to spend for the investigations and the major portion for medicine. Conclusion: Diabetes is a chronic disease that poses an important emerging public health concern. Most of the financial burden is borne by the family as the public facilities have failed to provide free care in India. Our study indicated various factors including individual beliefs, stigma and financial constraints affecting compliance to diabetes care.

Keywords: diabetes care, disintegrated health system, quality of care, urban health

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Authors: Mandeep Kumar, Hari Singh

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The effective optimization of machining process parameters affects dramatically the cost and production time of machined components as well as the quality of the final products. This paper presents the optimization aspects of a Wire Electrical Discharge Machining operation using Inconel X-750 as work material. The objective considered in this study is minimization of the dimensional deviation. Six input process parameters of WEDM namely spark gap voltage, pulse-on time, pulse-off time, wire feed rate, peak current and wire tension, were chosen as variables to study the process performance. Taguchi's design of experiments methodology has been used for planning and designing the experiments. The analysis of variance was carried out for raw data as well as for signal to noise ratio. Four input parameters and one two-factor interaction have been found to be statistically significant for their effects on the response of interest. The confirmation experiments were also performed for validating the predicted results.

Keywords: ANOVA, DOE, inconel, machining, optimization

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Authors: Isao Tomita

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The detection of environmental gases, 12CO_2, 13CO_2, and CH_4, using near-infrared semiconductor lasers with a short laser path length is studied by means of wavelength-modulation spectroscopy. The developed system is compact and has high sensitivity enough to detect the absorption peaks of isotopic 13CO_2 of a 3-% CO_2 gas at 2 um with a path length of 2.4 m, where its peak size is two orders of magnitude smaller than that of the ordinary 12CO_2 peaks. In addition, the detection of 12CO_2 peaks of a 385-ppm (0.0385-%) CO_2 gas in the air is made at 2 um with a path length of 1.4 m. Furthermore, in pursuing the detection of an ancient environmental CH_4 gas confined to a bubble in ice at the polar regions, measurements of the absorption spectrum for a trace gas of CH_4 in a small area are attempted. For a 100-% CH_4 gas trapped in a 1 mm^3 glass container, the absorption peaks of CH_4 are obtained at 1.65 um with a path length of 3 mm, and also the gas pressure is extrapolated from the measured data.

Keywords: environmental gases, Near-Infrared Laser Detection, Wavelength-Modulation Spectroscopy, gas pressure

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Authors: Hamza A. Al-Sewadi, Akram N. A. Aldakari

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Copyright protection and ownership proof of digital multimedia are achieved nowadays by digital watermarking techniques. A text watermarking algorithm for protecting the property rights and ownership judgment of color images is proposed in this paper. Embedding is achieved by inserting texts elements randomly into the color image as noise. The YIQ image processing model is found to be faster than other image processing methods, and hence, it is adopted for the embedding process. An optional choice of encrypting the text watermark before embedding is also suggested (in case required by some applications), where, the text can is encrypted using any enciphering technique adding more difficulty to hackers. Experiments resulted in embedding speed improvement of more than double the speed of other considered systems (such as least significant bit method, and separate color code methods), and a fairly acceptable level of peak signal to noise ratio (PSNR) with low mean square error values for watermarking purposes.

Keywords: steganography, watermarking, time complexity measurements, private keys

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Authors: D. K. Maurya, S. M. Saini

Abstract:

We investigate theoretically the electronic and optical properties of YNi₄Si-type HoNi₄Si compound from first principle calculations. Calculations are performed using full-potential augmented plane wave (FPLAPW) method in the frame work of density functional theory (DFT). The Coulomb corrected local-spin density approximation (LSDA+U) in the self-interaction correction (SIC) has been used for exchange-correlation potential. Analysis of the calculated band structure of HoNi₄Si compound demonstrates their metallic character. We found Ni-3d states mainly contribute to density of states from -5.0 eV to the Fermi level while the Ho-f states peak stands tall in comparison to the small contributions made by the Ni-d and Ho-d states above Fermi level, which is consistent with experiment, in HoNi4Si compound. Our calculated optical conductivity compares well with the experimental data and the results are analyzed in the light of band to band transitions.

Keywords: electronic properties, density of states, optical properties, LSDA+U approximation, YNi₄Si-type HoNi4Si compound

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Authors: Ivonne N. Pérez-Sánchez. María L. Rascón- Gasca, Angélica Riveros-Rosas, Rebeca Robles García

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Introduction: Primary caregivers of cancer patients have health problems related to their lack of time, stress, and fiscal strain. Their health problems could affect their patients’ health and also increase the expenses in public health. Aim: To describe self-care and risk behaviors in a sample of Mexican primary caregiver and the relation of these behaviors with emotional distress (caregiver burden, anxiety and depression symptoms), coping and sociodemographic variables. Method: Participated in this study 173 caregivers of a third level reference medical facility (age: M=49.4, SD=13.5) females 78%, males 22%, 57.5% were caregivers of patients with terminal cancer (CPTC), and 40.5% were caregivers of patients on oncology treatment (CPOT). Results: The 75.7% of caregivers reported to have had health problem in last six months as well as several symptoms which were related to emotional distress, these symptoms were more frequently between CPTC and female caregivers. A half (47.3%) of sample reported have had difficulties in caring their health; these difficulties were related to emotional distress and lower coping, more affected caregivers were who attend male patients and CPTC. The 76.8% of caregivers had health problems in last six months, but 26.5% of them waited to search medical care until they were very sick, and 11% didn't do it. Also, more than a half of sample (56.1%) admitted to have risk behaviors as drink alcohol, smoke or overeating for feeling well, these caregivers showed high emotional distress and lower coping. About caregivers healthy behaviors, 80% of them had a hobby; 27.2% do exercise usually and between 12% to 60% did medical checkups (glucose tests, blood pressure and cholesterol tests, eye exams and watched their weight), these caregivers had lower emotional distress and high coping, some variables related health behaviors were: care only one patient or a female patient and be a CPOT, social support, high educational level and experience as a caregiver in past. The half of caregivers were worrying to develop cancer in the future; this idea was 2.5 times more frequent in caregiver with problems to care their health. Conclusions: The results showed a big proportion of caregivers with medical problems. High emotional distress and low coping were related to physical symptoms, risk behaviors, and low self-care; poor self-care was frequently even in caregiver who have chronic illness.

Keywords: cancer, primary caregiver, risk behaviors, self-care

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Authors: Rajveer, Abhinav Saxena, Sanjeev Das

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The study is focused on the strength of forged aluminum alloy (AA) 6082 (T6). Aluminum alloy 6082 belongs to Al-Mg-Si family which has a wide range of automotive applications. A decrease in the strength of AA 6082 alloy was observed after T6 treatment. The as-received (extruded), forged, and forged + heat treated samples were examined to understand the reason. These examinations were accomplished by optical (OM) and scanning electron microscope (SEM) and X-ray diffraction (XRD) studies. It was observed that the defects had an insignificant effect on the alloy strength. The alloy samples were subjected to age hardening treatment and the time to achieve peak hardening was acquired. Standard tensile specimens were prepared from as-received (extruded), forged, forged + solutionized and forged + solutionized + age hardened. Tensile tests were conducted by Instron universal testing machine. It was observed that there was a significant drop in tensile strength in the case of solutionized sample. The detailed study of the fracture samples showed that the solutionizing after forging was not the best way to increase the strength of Al 6082 alloy.

Keywords: aluminum alloy 6082, strength, forging, age hardening

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Authors: X. Wang, T. J. Craft, H. Iacovides

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When handling the near-wall regions of turbulent flows, it is necessary to account for the viscous effects which are important over the thin near-wall layers. Low-Reynolds- number turbulence models do this by including explicit viscous and also damping terms which become active in the near-wall regions, and using very fine near-wall grids to properly resolve the steep gradients present. In order to overcome the cost associated with the low-Re turbulence models, a more advanced wall function approach has been implemented within OpenFoam and tested together with a standard log-law based wall function in the prediction of flows which involve 2-D shock wave/turbulent boundary layer interactions (SWTBLIs). On the whole, from the calculation of the impinging shock interaction, the three turbulence modelling strategies, the Lauder-Sharma k-ε model with Yap correction (LS), the high-Re k-ε model with standard wall function (SWF) and analytical wall function (AWF), display good predictions of wall-pressure. However, the SWF approach tends to underestimate the tendency of the flow to separate as a result of the SWTBLI. The analytical wall function, on the other hand, is able to reproduce the shock-induced flow separation and returns predictions similar to those of the low-Re model, using a much coarser mesh.

Keywords: SWTBLIs, skin-friction, turbulence modeling, wall function

Procedia PDF Downloads 334

Authors: Ahmed Lotfy, Andrey V. Pozdniakov, Vadim C. Zolotorevskiy

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The purpose of this research is to provide a competitive alternative to aluminum silicon alloys used in automotive applications. This alternative was created by developing three types of composites Al-5%Cu- (B₄C, BN or Si₃N₄) particulates with a low coefficient of thermal expansion. Stir casting was used to synthesis composites containing 2, 5 and 7 wt. % of B₄C, Si₃N₄ and 2, 5 of BN followed by squeeze casting. The squeeze casting process decreased the porosity of the final composites. The composites exhibited a fairly uniform particle distribution throughout the matrix alloy. The microstructure and XRD results of the composites suggested a significant reaction occurred at the interface between the particles and alloy. Increasing the aging temperature from 200 to 250°C decreased the hardness values of the matrix and the composites and decreased the time required to reach the peak. Turner model was used to calculate the expected values of thermal expansion coefficient CTE of matrix and its composites. Deviations between calculated and experimental values of CTE were not exceeded 10%. Al-5%Cu-B₄C composites experimentally showed the lowest values of CTE (17-19)·10-6 °С-1 and (19-20) ·10-6 °С-1 in the temperature range 20-100 °С and 20-200 °С respectively.

Keywords: aluminum matrix composites, coefficient of thermal expansion, X-ray diffraction, squeeze casting, electron microscopy,

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Authors: T. G. Pathrikar, A. D. Urhekar, M. P. Bansal

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To find out S. aureus from patient samples on the basis of coagulase test. We have evaluated slide coagulase (n=46 positive), tube coagulase (n=48 positive) and DNase test (n=44, positive) , We have isolated and identified MRSA from various clinical samples and specimens by disc diffusion method determined the incidence of MRSA 50% in patients. Found out the in vitro antimicrobial susceptibility pattern of MRSA isolates and also the MIC of MRSA of oxacillin by E-Test.

Keywords: cefoxitin disc diffusion MRSA detection, e – test, S. aureus devastating pathogen, tube coagulase confirmation

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Authors: Miksusanti, Herlina, Wiwin

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The research about modification uwi starch (Dioscorea alata L) by using propylene oxide has been done. Concentration of propylene oxide were 6%(v/w), 8%(v/w), and 10%(v/w). The amilograf parameters after modification were characteristic breakdown viscosity 43 BU and setback viscosity 975 BU. The modification starch have edible properties according to FDA (Food and Drug Administration) which have degree of modification < 7%, degree of substitution < 0,1 and propylene oxide concentration < 10%(v/w). The best propylene oxide in making of edible film was 8 %( v/w). The starch control can be made into edible film with thickness 0,136 mm, tensile strength 20,4605 MPa and elongation 22%. Modification starch of uwi can be made into edible film with thickness 0,146 mm, tensile strength 25, 3521 Mpa, elongation 30% and water vapor transmission 7, 2651 g/m2/24 hours. FTIR characterization of uwi starch showed the occurrence of hydroxypropylation. The peak spectrum at 2900 cm-1 showed bonding of C-H from methyl group, which is characteristic for modification starch with hydroxypropyl. Characterization with scanning electron microscopy showed that modification of uwi starch has turned the granule of starch to be fully swallon.

Keywords: uwi starch, edible film, propylen oxide, modification

Procedia PDF Downloads 281

Authors: Mariette Swanepoel, Terry Ellapen, Henriette Hammil, Juandre Williams, Timothy Qumbu

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The biomechanical consequence of pes planus is a topic seldom reviewed in regards to energy expenditure and predisposition to injury. However its comprehension in the field of foot rehabilitation, pre-and post-surgery is fundamental to successful patient management. This short communication unites the present literature to provide the reader with better insight on the consequence of pes planus, foot mechanics and its predisposition to injury at the foot and tibiofemoral joint. Further, the consideration of synergistic dominance of the foot invertors to compensate for the ineffective torque production of the fibularis longus due pes planus is presented.

Keywords: pes planus, fibularis longus, synergistic dominance, injury

Procedia PDF Downloads 271

Authors: Jane E. A. Lewis, Paul Williams, Jane H. Davies

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Introduction: There is, at present, a clear and recognized need to optimize the diagnosis of peripheral arterial disease (PAD), particularly in non-specialist settings such as primary care, and this arises from several key facts. Firstly, PAD is a highly prevalent condition. In 2010, it was estimated that globally, PAD affected more than 202 million people and furthermore, this prevalence is predicted to further escalate. The disease itself, although frequently asymptomatic, can cause considerable patient suffering with symptoms such as lower limb pain, ulceration, and gangrene which, in worse case scenarios, can necessitate limb amputation. A further and perhaps the most eminent consequence of PAD arises from the fact that it is a manifestation of systemic atherosclerosis and therefore is a powerful predictor of coronary heart disease and cerebrovascular disease. Objective: This cross sectional study aimed to individually and cumulatively compare sensitivity and specificity of the (i) ankle brachial index (ABI) and (ii) pulse volume waveform (PVW) recorded by the same automated device, with the presence or absence of peripheral arterial disease (PAD) being verified by an Ultrasound Duplex Scan (UDS). Methods: Patients (n = 205) referred for lower limb arterial assessment underwent an ABI and PVW measurement using volume plethysmography followed by a UDS. Presence of PAD was recorded for ABI if < 0.9 (noted if > 1.30) if PVW was graded as 2, 3 or 4 or a hemodynamically significant stenosis > 50% with UDS. Outcome measure was agreement between measured ABI and interpretation of the PVW for PAD diagnosis, using UDS as the reference standard. Results: Sensitivity of ABI was 80%, specificity 91%, and overall accuracy 88%. Cohen’s kappa revealed good agreement between ABI and UDS (k = 0.7, p < .001). PVW sensitivity 97%, specificity 81%, overall accuracy 84%, with a good level of agreement between PVW and UDS (k = 0.67, p < .001). The combined sensitivity of ABI and PVW was 100%, specificity 76%, and overall accuracy 85% (k = 0.67, p < .001). Conclusions: Combing these two diagnostic modalities within one device provided a highly accurate method of ruling out PAD. Such a device could be utilized within the primary care environment to reduce the number of unnecessary referrals to secondary care with concomitant cost savings, reduced patient inconvenience, and prioritization of urgent PAD cases.

Keywords: ankle brachial index, peripheral arterial disease, pulse volume waveform, ultrasound duplex scan

Procedia PDF Downloads 147