Search results for: neonatal mortality rate
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 8852

Search results for: neonatal mortality rate

5792 Laparoscopic Curative Resection for Right-Sided Colonic Tumours: Initial Experience from a Cancer Hospital of a Developing Country

Authors: Awais Naeem, Osama Shakeel, Aamir Ali Syed, Shahid Khattak

Abstract:

Introduction: Laparoscopic right hemicolectomy is an advanced cancer surgery in today's era. The aim of this study was to evaluate the surgical and initial oncological outcomes after curative, laparoscopic resection of right sided colonic tumors. Also to compare our results with those of previous randomized trials. Methods And Procedures: We retrospectively analyzed the medical record files of all the patients who presented to our hospital with the diagnosis of right sided colon carcinoma from January 2012 to December 2017 and underwent laparoscopic right hemicolectomy. Demographics, operative findings and histopathological reports were all recorded on a preformed data sheet. All the analysis was performed on SPSS 20. Results: Total of 48 patients were included. There were 37 male and 11 female patients with mean age of 49.7 (range from 25 – 82). Mean hospital stay was 8.25 ± 3.17 days. Blood loss was 80mls and operative mean time was 240 minutes. Eighteen patients had extended right hemicolectomy. Median length of the specimen retrieved was 31cm (range, 14-59cm). Mean size of tumor was 6.44cm + 2.53. Total number of lymph nodes removed was 20.5 + 8.3. All had R0 resection. Post-operatively 2 patients had pelvic collection and there was no 30 day mortality. In 33 patients there was T3 disease, 5 had T2 and 10 had T4 disease. There was distant recurrence in 4 patients with peritoneal metastasis in 3 and liver metastasis in 1 patient. Forty-six patients are still alive and 44 are disease free. The mean follow-up period was 25.31 (12 to 60) months. Conclusion: Our early experience with Laparascopic Right hemicolectomy as a safe and oncologically feasible surgical option. We attained comparable surgical results with curative intent.

Keywords: right hemicolectomy, right sided colonic tumors, laparoscopic, curative intent

Procedia PDF Downloads 109
5791 Factors Adversely Associated with Breastfeeding among Obese Mothers in Malaysia

Authors: Syahrul Bariah Abdul Hamid, Colin W. Binns, Jun Hui Chih

Abstract:

The total of obese mothers is growing throughout Asia. Breastfeeding provides the perfect nutrition for infants, by promoting a higher IQ and protecting against childhood and adult diseases. A prospective cohort study was carried out of mothers attending eight antenatal clinics run by the Ministry of Health in Selangor, Malaysia to document the prevalence of obesity and its relationship with breastfeeding outcomes. Mothers were enrolled during the antenatal period and followed up until 6 months postpartum to document breastfeeding outcomes. A total of 652 Malay mothers were recruited for the study a response rate of 93.1 %. The pre-pregnancy body mass index (BMI) of the mothers showed that 36.5% of the mothers were overweight or obese. There were a total of 78 obese mothers in the sample and 41 (52.6%) of these mothers were able to initiate breastfeeding within one hour of birth compared to 238/337 (70.6 %, χ² 9.35, p<0.001) of those with a normal BMI. At 6 months, 23.1 % of obese mothers were exclusively breastfeeding their infants, compared to 56.0 % of the normal BMI mothers. On the other hand, the rate of infant formula feeding was higher in the obese mothers by 53.8 % compared to 19.0 % among normal weight mothers, χ² 37.6, p<0.001). Further analysis suggested these factors were found to be positively associated with discontinued exclusive breastfeeding at 6 months among obese mothers; mothers whom delayed breastfeeding initiation, had health problems during pregnancy, caesarean delivery, reported had insufficient colostrum/milk and babies had sucking problems at or before 4 weeks. Besides that, mothers who perceived their biological mothers had preference towards formula feeding or were ambivalent about the feeding method and had biological mothers without experience in breastfeeding for more than 1 month also were more likely to discontinue exclusive breastfeeding at 6 months. These findings suggested that the greater the pre-pregnant BMI, the earlier the cessation of exclusive breastfeeding and they were also less likely to initiate breastfeeding and have less adequate milk supply. Future investigations of the effects of maternal obesity on breastfeeding outcomes should be conducted along with effective interventions to advance the care of obese women at reproductive age and their children.

Keywords: exclusive breastfeeding, body mass index (BMI), breastfeeding discontinuation, maternal obesity

Procedia PDF Downloads 181
5790 The Effect of Metformin in Combination with Dexamethasone on the CXCR4 Level in Multiple Myeloma Cell Line

Authors: Seyede Sanaz Seyedebrahimi, Shima Rahimi, Shohreh Fakhari, Ali Jalili

Abstract:

Background: CXCR4, as a chemokine receptor, plays well-known roles in various types of cancers. Several studies have been conducted to overcome CXCR4 axis acts in multiple myeloma (MM) pathogenesis and progression. Dexamethasone, a standard treatment for multiple myeloma, has been shown to increase CXCR4 levels in multiple myeloma cell lines. Herein, we focused on the effects of metformin and dexamethasone on CXCR4 at the cellular level and the migration rate of cell lines after exposure to a combination compared to single-agent models. Materials and Method: Multiple myeloma cell lines (U266 and RPMI8226) were cultured with different metformin and dexamethasone concentrations in single-agent and combination models. The simultaneous combination doses were calculated by CompuSyn software. Cell surface and mRNA expression of CXCR4 were determined using flow cytometry and the quantitative reverse transcription-polymerase chain reaction (qRT-PCR) assay, respectively. The Transwell cell migration assay evaluated the migration ability. Results: In concurred with previous studies, our results showed a dexamethasone up-regulation effect on CXCR4 in a dose-dependent manner. Although, the metformin single-agent model could reduce CXCR4 expression of U266 and RPMI8226 in cell surface and mRNA expression level. Moreover, the administration of metformin and dexamethasone simultaneously exerted a higher suppression effect on CXCR4 expression than the metformin single-agent model. The migration rate through the combination model's matrigel membrane was remarkably lower than the metformin and dexamethasone single-agent model. Discussion: According to our findings, the combination of metformin and dexamethasone effectively inhibited dexamethasone-induced CXCR4 expression in multiple myeloma cell lines. As a result, metformin may be counted as an alternative medicine combined with other chemotherapies to combat multiple myeloma. However, more research is required.

Keywords: CXCR4, dexamethasone, metformin, migration, multiple myeloma

Procedia PDF Downloads 137
5789 Comparative Evaluation of a Dynamic Navigation System Versus a Three-Dimensional Microscope in Retrieving Separated Endodontic Files: An in Vitro Study

Authors: Mohammed H. Karim, Bestoon M. Faraj

Abstract:

Introduction: This study aimed to compare the effectiveness of a Dynamic Navigation System (DNS) and a three-dimensional microscope in retrieving broken rotary NiTi files when using trepan burs and the extractor system. Materials and Methods: Thirty maxillary first bicuspids with sixty separate roots were split into two comparable groups based on a comprehensive Cone-Beam Computed Tomography (CBCT) analysis of the root length and curvature. After standardized access opening, glide paths, and patency attainment with the K file (sizes 10 and 15), the teeth were arranged on 3D models (three per quadrant, six per model). Subsequently, controlled-memory heat-treated NiTi rotary files (#25/0.04) were notched 4 mm from the tips and fractured at the apical third of the roots. The C-FR1 Endo file removal system was employed under both guidance to retrieve the fragments, and the success rate, canal aberration, treatment time and volumetric changes were measured. The statistical analysis was performed using IBM SPSS software at a significance level of 0.05. Results: The microscope-guided group had a higher success rate than the DNS guidance, but the difference was insignificant (p > 0.05). In addition, the microscope-guided drills resulted in a substantially lower proportion of canal aberration, required less time to retrieve the fragments and caused minimal change in the root canal volume (p < 0.05). Conclusion: Although dynamically guided trephining with the extractor can retrieve separated instruments, it is inferior to three-dimensional microscope guidance regarding treatment time, procedural errors, and volume change.

Keywords: separated instruments retrieval, dynamic navigation system, 3D video microscope, trephine burs, extractor

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5788 Two Major Methods to Control Thermal Resistance of Focus Ring for Process Uniformity Enhance

Authors: Jin-Uk Park

Abstract:

Recently, the semiconductor industry is rapidly demanding complicated structures and mass production. From the point of view of mass production, the ETCH industry is concentrating on maintaining the ER (Etch rate) of the wafer edge constant regardless of changes over time. In this study, two major thermal factors affecting process were identified and controlled. First, the filler of the thermal pad was studied. Second, the significant difference of handling the thermal pad during PM was studied.

Keywords: etcher, thermal pad, wet cleaning, thermal conductivity

Procedia PDF Downloads 179
5787 Assessment of Ocular Morbidity, Knowledge and Barriers to Access Eye Care Services among the Children Live in Offshore Island, Bangladesh

Authors: Abir Dey, Shams Noman

Abstract:

Introduction: Offshore Island is the remote and isolated area from the terrestrial mainland. They are deprived of their needs. The children from an offshore island are usually underserved in the case of health care because it is a remote area where the health care systems are quite poor compared to mainland. So, the proper information is required for appropriate planning to reduce underlying causes behind visual deprivation among the surviving children of the Offshore Island. Purpose: The purpose of this study was to determine ocular morbidities, knowledge, and barriers of eye care services among children in an Offshore Island. Methods: The study team visited, and all data were collected from different rural communities at Sandwip Upazila, Chittagong district for screening the children aged 5-16 years old by doing spot examination. The whole study was conducted in both qualitative and quantitative methods. To determine ocular status of children, examinations were done under skilled Ophthalmologists and Optometrists. A focus group discussion was held. The sample size was 490. It was a community based descriptive study and the sampling method was purposive sampling. Results: In total 490 children, about 56.90% were female and 43.10% were male. Among them 456 were school-going children (93.1%) and 34 were non-school going children (6.9%). In this study the most common ocular morbidity was Allergic Conjunctivitis (35.2%). Other mentionable ocular morbidities were Refractive error (27.7%), Blepharitis (13.8%), Meibomian Gland Dysfunction (7.5%), Strabismus (6.3%) and Amblyopia (6.3%). Most of the non-school going children were involved in different types of domestic work like farming, fishing, etc. About 90.04% children who had different ocular abnormalities could not attend to the doctor due to various reasons. Conclusions: The ocular morbidity was high in rate on the offshore island. Eye health care facility was also not well established there. Awareness should be raised about necessity of maintaining hygiene and eye healthcare among the island people. Timely intervention through available eye care facilities and management can reduce the ocular morbidity rate in that area.

Keywords: morbidities, screening, barriers, offshore island, knowledge

Procedia PDF Downloads 139
5786 Comparative Evaluation of Pentazocine and Tramadol as Pre-Emptive Analgesics for Ovariohysterectomy in Female Dogs

Authors: Venkatgiri, Ranganath, L. Nagaraja, B. N. Sagar Pandav, S. M. Usturge, D. Dilipkumar, B. V. Shivprakash, B. Bhagwanthappa, D. Jahangir

Abstract:

A comparative evaluation of Tramadol and Pentazocine as a pre-emptive analgesic in clinical cases of female dogs undergoing ovariohysterectomy was undertaken during this study. During the study, the following parameters were assessed viz., Rectal temperature (ᵒF), Respiratory rate (breaths/min) and Heart rate (beats/min). Hematological and biochemical parameters viz., total erythrocyte count (TEC) (millions/cmm), hemoglobin (g %), otal leucocytes count (TLC) (thousands/cmm), differential leucocytes count (DLC) (%), serum creatinine (mg/dl), plasma protein (mg/dl), blood glucose (mg/dl) was estimated before the surgery and after administration of general anaesthesia and immediate postoperative periods of 0, 12 and 24 hr respectively. Mean Total Pain Score (MTPS) includes measurement of parameters like posture, vocalization, activity level, response to palpation and agitation at different intervals was calculated before surgery and after administration of general anesthesia and post-operative periods of 1, 2, 4, 6, 12hrs and 24 hrs respectively. Mean Total Pain Score (MTPS) was given for each parameter (Posture, Vocalization, Activity Level, Response to Palpation and Agitation) like 0,1,2,3. (maximum score will be given was 4.). Results were revealed in all three groups including control group. There were significant minor alterations in physiological, hematological and biochemical parameters. MTPS (mean total pain score) were revealed and found a significant alteration when compared with control group. In conclusion, Tramadol found to be a better analgesic and had up to 8hrs of analgesic effect and Pentazocine is superior in post-operative pain management when compared to Tramadol because this group of dogs experienced less surgical stress, consumed less anesthetic dose, they recovered early, and they had less MTPS score.

Keywords: dog, pentazocine, tramadol, ovariohysterectomy

Procedia PDF Downloads 150
5785 A New Technology for Metformin Hydrochloride Mucoadhesive Microparticles Preparation Utilizing BÜCHI Nano-Spray Dryer B-90

Authors: Tamer M. Shehata

Abstract:

Objective: Currently, mucoadhesive microparticles acquired a high interest in both research and pharmaceutical technology fields. Recently, BÜCHI lunched its latest fourth generation nano spray dryer B-90 used for nanoparticle production. B-90 offers an elegant technology combined particle engineering and drying in one step. In our laboratory, we successfully developed a new formulation for metformin hydrochloride, mucoadhesive microparticles utilizing B-90 technology for treatment of type 2-diabetis. Method: Gelatin or sodium alginate, natural occurring polymers with mucoadhesive properties, solely or in combination was used in our formulation trials. Preformulation studies (atomization head mesh size, flow rate, head temperature, polymer solution viscosity and surface tension) and postformulation characters (particle size, flowability, surface scan and dissolution profile) were evaluated. Finally, hypoglycemic effect of the selected formula was evaluated in streptozotocin-induced diabetic rats. Spray head with 7 µm hole, flow rate of 3.5 mL/min and head temperature 120 ºC were selected. Polymer viscosity was less than 11.5 cP with surface tension less than 70.1 dyne/cm. Result: Discrete, non aggregated particles and free flowing powders with particle size was less than 2000 nm were obtained. Gelatin and sodium alginate combination in ratio 1:3 were successfully sustained the in vitro release profile of the drug. Hypoglycemic evaluation of the previous formula, showed a significant reduction of blood glucose level over 24 h. Conclusion: B-90 technology can open a new era of , mucoadhesive microparticles preparation offering convenient dosage form that can enhance compliance of type 2 diabetic patients.

Keywords: mucoadhesive, microparticles, technology, diabetis

Procedia PDF Downloads 277
5784 Appraisal of the Impact Strength on Mild Steel Cladding Weld Metal Geometry

Authors: Chukwuemeka Daniel Ezeliora, Chukwuebuka Lawrence Ezeliora

Abstract:

The research focused on the appraisal of impact strength on mild steel cladding weld metal geometry. Over the years, poor welding has resulted in failures in engineering components, poor material quality, the collapse of welded materials, and failures in material strength. This is as a result of poor selection and combination of welding input process parameters. The application of the Tungsten Inert Gas (TIG) welding method with weld specimen of length 60; width 40, and thickness of 10 was used for the experiment. A butt joint method was prepared for the welding, and tungsten inert gas welding process was used to perform the twenty (20) experimental runs. A response surface methodology was used to model and to analyze the system. For an adequate polynomial approximation, the experimental design was used to collect the data. The key parameters considered in this work are welding current, gas flow rate, welding speed, and voltage. The range of the input process parameters was selected from the literature and the design. The steps followed to achieve the experimental design and results is the use of response surface method (RSM) implemented in central composite design (CCD) to generate the design matrix, to obtain quadratic model, and evaluate the interactions in the factors as well as optimizing the factors and the response. The result expresses that the best impact strength of the mild steel cladding weld metal geometry is 115.419 Joules. However, it was observed that the result of the input factors is; current 180.4 amp, voltage 23.99 volt, welding speed 142.7 mm.s and gas flow rate 10.8 lit/min as the optimum of the input process parameters. The optimal solution gives a guide for optimal impact strength of the weldment when welding with tungsten inert gas (TIG) under study.

Keywords: mild steel, impact strength, response surface, bead geometry, welding

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5783 Random Walks and Option Pricing for European and American Options

Authors: Guillaume Leduc

Abstract:

In this paper, we describe a broad setting under which the error of the approximation can be quantified, controlled, and for which convergence occurs at a speed of n⁻¹ for European and American options. We describe how knowledge of the error allows for arbitrarily fast acceleration of the convergence.

Keywords: random walk approximation, European and American options, rate of convergence, option pricing

Procedia PDF Downloads 442
5782 Rule of Natural Synthetic Chemical on Lead Immobilization in Polluted Sandy Soils

Authors: Saud S. AL Oud

Abstract:

Soil contamination can have dire consequences, such as loss of ecosystem and agricultural productivity, diminished food chain quality, tainted water resources, economic loss, and human and animal illness. In recent years, attention has focused on the development of in situ immobilization methods that are generally less expensive and disruptive to the natural landscape, hydrology, and ecosystems than are conventional excavation treatments, and disposal methods. Soft, inexpensive, and efficient agents were used in the present research to immobilize Pb in polluted sandy soil. Five agents, either naturally occurring or chemically prepared, were used for this purpose. These agents include; iron ore (72% Fe2O3), cement, a mixture of calcite and shale rich in aluminum (CASH), and two chemically prepared amorphous materials of Al- and Fe-gel. These agents were selected due to their ability to specifically adsorb heavy metals onto their surface OH functional groups, which provide permanent immobilization of metal pollutants and reduce the fraction that is potentially mobile or bioavailable. The efficiency of these agents in immobilizing Pb were examined in a laboratory experiment, in which two rates (0.5 and 1.0 %) of tested agents were added to the polluted soils containing total contents of Pb ranging from 17.4-49.8 mg/kg. The results show that all immobilizing agents were succeed in minimizing the mobile form of Pb as extracted by 0.5 N HNO3. The extracted Pb decreased with increasing addition rate of immobilizing agents. At addition rate of 0.5%, HNO3 extractable-Pb varied widely depending on the agents type and were found to represent 21-67% of the initial values. All agents were able to reduce mobile Pb to levels lower than that (2.0 mg/kg) reported for non polluted soil, particularly for soils had initials of mobile Pb less than 10 mg/kg. Both iron oxide and CASH had the highest efficiency in immobilizing Pb, followed by cement, then amorphous materials of Fe and Al hydroxides.

Keywords: soil, synthetic chemical, lead, immobilization, polluted

Procedia PDF Downloads 223
5781 Pregnancy Outcomes among Syrian Refugee and Jordanian Women: A Comparative Study

Authors: Karimeh Alnuaimi, Manal Kassab, Reem Ali, Khitam Mohammad, Kholoud Shattnawi

Abstract:

Aim: To compare pregnancy outcomes of Syrian refugee women and Jordanian women. Background and introduction: The current conflict in Syria continues to displace thousands to neighboring countries, including Jordan. Pregnant refugee women are therefore facing many difficulties are known to increase the prevalence of poor reproductive health outcomes and antenatal complications. However, there is very little awareness of whether Syrian refugee women have different risks of pregnancy outcomes than Jordanian women. Methods: Using a retrospective cohort design, we examined pregnancy outcomes for Syrian refugee (N = 616) and Jordanian women (N = 644) giving birth at two governmental Hospitals in the north of Jordan, between January 1, 2014, and December 31, 2014. A checklist of 13 variables was utilized. The primary outcome measures were delivery by Caesarean section, maternal complications, low birth weight (< 2500 g), Apgar score and preterm delivery (< 37 weeks' gestational age). Results: Statistical analysis revealed that refugee mothers had a significant increase in the rate of cesarean section and the higher rate of anemia, a lower neonates’ weight, and Apgar scores when compared to their Jordanian counterparts. Discussion and Conclusion: Results were congruent with findings from other studies in the region and worldwide. Minimizing inequalities in pregnancy outcomes between Syrian refugees and Jordan women is a healthcare priority. Implications for nursing and health policy: The findings could guide the planning and development of health policies in Jordan that would help to alleviate the situation regarding refugee populations. The action is required by the policy makers, specifically targeting public and primary health care services, to address the problem of adequately meeting the need for antenatal care of this vulnerable population.

Keywords: pregnancy, Syrian refugee, Jordanian women, comparative study

Procedia PDF Downloads 346
5780 Pharmacokinetic Modeling of Valsartan in Dog following a Single Oral Administration

Authors: In-Hwan Baek

Abstract:

Valsartan is a potent and highly selective antagonist of the angiotensin II type 1 receptor, and is widely used for the treatment of hypertension. The aim of this study was to investigate the pharmacokinetic properties of the valsartan in dogs following oral administration of a single dose using quantitative modeling approaches. Forty beagle dogs were randomly divided into two group. Group A (n=20) was administered a single oral dose of valsartan 80 mg (Diovan® 80 mg), and group B (n=20) was administered a single oral dose of valsartan 160 mg (Diovan® 160 mg) in the morning after an overnight fast. Blood samples were collected into heparinized tubes before and at 0.5, 1, 1.5, 2, 2.5, 3, 4, 6, 8, 12 and 24 h following oral administration. The plasma concentrations of the valsartan were determined using LC-MS/MS. Non-compartmental pharmacokinetic analyses were performed using WinNonlin Standard Edition software, and modeling approaches were performed using maximum-likelihood estimation via the expectation maximization (MLEM) algorithm with sampling using ADAPT 5 software. After a single dose of valsartan 80 mg, the mean value of maximum concentration (Cmax) was 2.68 ± 1.17 μg/mL at 1.83 ± 1.27 h. The area under the plasma concentration-versus-time curve from time zero to the last measurable concentration (AUC24h) value was 13.21 ± 6.88 μg·h/mL. After dosing with valsartan 160 mg, the mean Cmax was 4.13 ± 1.49 μg/mL at 1.80 ± 1.53 h, the AUC24h was 26.02 ± 12.07 μg·h/mL. The Cmax and AUC values increased in proportion to the increment in valsartan dose, while the pharmacokinetic parameters of elimination rate constant, half-life, apparent of total clearance, and apparent of volume of distribution were not significantly different between the doses. Valsartan pharmacokinetic analysis fits a one-compartment model with first-order absorption and elimination following a single dose of valsartan 80 mg and 160 mg. In addition, high inter-individual variability was identified in the absorption rate constant. In conclusion, valsartan displays the dose-dependent pharmacokinetics in dogs, and Subsequent quantitative modeling approaches provided detailed pharmacokinetic information of valsartan. The current findings provide useful information in dogs that will aid future development of improved formulations or fixed-dose combinations.

Keywords: dose-dependent, modeling, pharmacokinetics, valsartan

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5779 A Systematic Review for the Association between Active Smoking and Latent Tuberculosis Infection

Authors: Pui Hong Chung, Wing Chi Ho, Jun Li, Cyrus Leung, Ek Yeoh

Abstract:

Background: Cigarette smoking is associated with poor tuberculosis (TB) outcomes in terms of progression of active TB, relapse of TB and TB-related mortality, but the association with latent tuberculosis infection (LTBI) is unclear. The systematic review conducted aimed at studying the association between active smoking and LTBI, and likelihood of dose-response relationship. Methods: Two independent reviewers searched three electronic databases comprising PudMed, Medline by EBSCOHOST, ExcerptaMedica Database (EMBASE), from inception up to 31st Dec 2015 for studies reporting data on current smoking and the LTBI with tuberculin skin test (TST) or interferon-γ release assays (IGRAs) results, comparing the odds ratios (ORs) of outcome measure of TST or IGRAs among current smokers with 95% confidence intervals (CI). Results: Seven studies were identified, including six cross-sectional studies and one longitudinal cohort study. The outcome measures from three studies were in TST, three studies in IGRAs and one for both tests. For TST, OR ranging from 1.39 to 3.40 (95% CI) with all studies shown positive association between cigarette smoking and LTBI. For IGRAs, OR ranging from 0.47 to 1.89 (95% CI) with one study shown the negative association that might be related to impaired interferon-gamma production in immunosuppressive persons. One identified study demonstrated positive dose-response relationship in TST result. Conclusions: Cigarette smoking is likely to be a risk factor of LTBI. There is the important implication for TB and tobacco control program to halt TB by empowering public health policy. Further study is also needed to provide more evidence of the dose-response model/relationship.

Keywords: latent tuberculosis infection, systematic review, active smoking, model

Procedia PDF Downloads 241
5778 A Comparative Study on Biochar from Slow Pyrolysis of Corn Cob and Cassava Wastes

Authors: Adilah Shariff, Nurhidayah Mohamed Noor, Alexander Lau, Muhammad Azwan Mohd Ali

Abstract:

Biomass such as corn and cassava wastes if left to decay will release significant quantities of greenhouse gases (GHG) including carbon dioxide and methane. The biomass wastes can be converted into biochar via thermochemical process such as slow pyrolysis. This approach can reduce the biomass wastes as well as preserve its carbon content. Biochar has the potential to be used as a carbon sequester and soil amendment. The aim of this study is to investigate the characteristics of the corn cob, cassava stem, and cassava rhizome in order to identify their potential as pyrolysis feedstocks for biochar production. This was achieved by using the proximate and elemental analyses as well as calorific value and lignocellulosic determination. The second objective is to investigate the effect of pyrolysis temperature on the biochar produced. A fixed bed slow pyrolysis reactor was used to pyrolyze the corn cob, cassava stem, and cassava rhizome. The pyrolysis temperatures were varied between 400 °C and 600 °C, while the heating rate and the holding time were fixed at 5 °C/min and 1 hour, respectively. Corn cob, cassava stem, and cassava rhizome were found to be suitable feedstocks for pyrolysis process because they contained a high percentage of volatile matter more than 80 mf wt.%. All the three feedstocks contained low nitrogen and sulphur content less than 1 mf wt.%. Therefore, during the pyrolysis process, the feedstocks give off very low rate of GHG such as nitrogen oxides and sulphur oxides. Independent of the types of biomass, the percentage of biochar yield is inversely proportional to the pyrolysis temperature. The highest biochar yield for each studied temperature is from slow pyrolysis of cassava rhizome as the feedstock contained the highest percentage of ash compared to the other two feedstocks. The percentage of fixed carbon in all the biochars increased as the pyrolysis temperature increased. The increment of pyrolysis temperature from 400 °C to 600 °C increased the fixed carbon of corn cob biochar, cassava stem biochar and cassava rhizome biochar by 26.35%, 10.98%, and 6.20% respectively. Irrespective of the pyrolysis temperature, all the biochars produced were found to contain more than 60 mf wt.% fixed carbon content, much higher than its feedstocks.

Keywords: biochar, biomass, cassava wastes, corn cob, pyrolysis

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5777 Boundary Feedback Stabilization of an Overhead Crane Model

Authors: Abdelhadi Elharfi

Abstract:

A problem of boundary feedback (exponential) stabilization of an overhead crane model represented by a PDE is considered. For any $r>0$, the exponential stability at the desired decay rate $r$ is solved in semi group setting by a collocated-type stabiliser of a target system combined with a term involving the solution of an appropriate PDE.

Keywords: feedback stabilization, semi group and generator, overhead crane system

Procedia PDF Downloads 393
5776 A Self-Directed Home Yoga Program for Women with Breast Cancer during Chemotherapy

Authors: Hiroko Komatsu, Kaori Yagasaki

Abstract:

Background: Cancer-related cognitive impairment is a common problem seen in cancer patients undergoing chemotherapy. Physical activity may show beneficial effects on the cognitive function in such patients. Therefore, we have developed a self-directed home yoga program for cancer patients with cognitive symptoms during chemotherapy. This program involves a DVD presenting a combination of yoga courses based on patient preferences to be practiced at home. This study was performed to examine the feasibility of this program. In addition, we also examined changes in cognitive function and quality of life (QOL) in these patients participating in the program. Methods: This prospective feasibility study was conducted in a 500-bed general hospital in Tokyo, Japan. The study population consisted of breast cancer patients undergoing chemotherapy as the initial therapy. This feasibility study used a convenience sample with estimation of recruitment rate in a single facility with the availability of trained nurses and physicians to ensure safe yoga intervention. The aim of the intervention program was to improve cognitive function by means of both physical and mental activation via yoga, consisting of physical practice, breathing exercises, and meditation. Information on the yoga program was provided as a booklet, with an instructor-guided group yoga class during the orientation, and a self-directed home yoga program on DVD with yoga logs. Results: The recruitment rate was 44.7%, and the study population consisted of 18 women with a mean age of 43.9 years. This study showed high rates of retention, adherence, and acceptability of the yoga program. Improvements were only observed in the cognitive aspects of fatigue, and there were serious adverse events during the program. Conclusion: The self-directed home yoga program discussed here was both feasible and safe for breast cancer patients showing cognitive symptoms during chemotherapy. The patients also rated the program as useful, interesting, and satisfactory. Participation in the program was associated with improvements in cognitive fatigue but not cognitive function.

Keywords: yoga, cognition, breast cancer, chemotherapy, quality of life

Procedia PDF Downloads 245
5775 Mainstreaming Environmentally-Friendly Household Management Practice through Indonesian Women Social Gathering

Authors: Erinetta P. Anjani, Karina Mariz, Rifqi K. Fathianto

Abstract:

While Islam teaches its’ followers to be mindful of God’s creation, including the environment, Indonesia as one of the world’s largest Muslim country, is now also world’s second-largest plastic waste contributor. The problem of waste is a complicated matter in Indonesia and is worsening because many landfills are now on verge of overcapacity. The causes of this problem are at least due to two things. First is Indonesia’s bad waste management. Second, people’s low of eco-literacy, as can be seen in massive use of non-degradable materials, low rate of waste separation, low rate of recycling and up cycling, whereas households are the largest source of waste in Indonesia. Mostly dealing with patriarchal culture, women in Indonesia play big and important role in their households, from family matter to household management (including waste management), to economic matter. Uniquely, the majority of Muslim women in Indonesia are engaged in -arisan- women social gathering or in -majelis ta’lim- women community in Islamic prayer, which serves as a social mechanism. As many NGOs are working on tackling environmental issues by raising awareness in order for the people to adapt a more environmentally-friendly household management practices, the problem of waste in Indonesia is meeting a bright light. Using qualitative data and descriptive analysis, the following is a proposal for a program intended to spread eco-literacy for waste management to women in Indonesia through their social gathering in order for them to gain awareness and start implementing eco-actions in their households. We attempt Waste4Change, a social company which provides environmentally-friendly waste management services, to reach women with modules that consist of environmental education, trainings, and workshops. We will then monitor and counsel the women to make sure if the lesson is going to be fully applied in their houses. The program will take place nearby University of Indonesia, Depok, West Java.

Keywords: eco-literacy, environmental education, household waste management, Muslim women social gathering, Waste4Change

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5774 Mediation Analysis of the Efficacy of the Nimotuzumab-Cisplatin-Radiation (NCR) Improve Overall Survival (OS): A HPV Negative Oropharyngeal Cancer Patient (HPVNOCP) Cohort

Authors: Akshay Patil

Abstract:

Objective: Mediation analysis identifies causal pathways by testing the relationships between the NCR, the OS, and an intermediate variable that mediates the relationship between the Nimotuzumab-cisplatin-radiation (NCR) and OS. Introduction: In randomized controlled trials, the primary interest is in the mechanisms by which an intervention exerts its effects on the outcomes. Clinicians are often interested in how the intervention works (or why it does not work) through hypothesized causal mechanisms. In this work, we highlight the value of understanding causal mechanisms in randomized trial by applying causal mediation analysis in a randomized trial in oncology. Methods: Data was obtained from a phase III randomized trial (Subgroup of HPVNOCP). NCR is reported to significantly improve the OS of patients locally advanced head and neck cancer patients undergoing definitive chemoradiation. Here, based on trial data, the mediating effect of NCR on patient overall survival was systematically quantified through progression-free survival(PFS), disease free survival (DFS), Loco-regional failure (LRF), and the disease control rate (DCR), Overall response rate (ORR). Effects of potential mediators on the HR for OS with NCR versus cisplatin-radiation (CR) were analyzed by Cox regression models. Statistical analyses were performed using R software Version 3.6.3 (The R Foundation for Statistical Computing) Results: Effects of potential mediator PFS was an association between NCR treatment and OS, with an indirect-effect (IE) 0.76(0.62 – 0.95), which mediated 60.69% of the treatment effect. Taking into account baseline confounders, the overall adjusted hazard ratio of death was 0.64 (95% CI: 0.43 – 0.96; P=0.03). The DFS was also a significant mediator and had an IE 0.77 (95% CI; 0.62-0.93), 58% mediated). Smaller mediation effects (maximum 27%) were observed for LRF with IE 0.88(0.74 – 1.06). Both DCR and ORR mediated 10% and 15%, respectively, of the effect of NCR vs. CR on the OS with IE 0.65 (95% CI; 0.81 – 1.08) and 0.94(95% CI; 0.79 – 1.04). Conclusion: Our findings suggest that PFS and DFS were the most important mediators of the OS with nimotuzumab to weekly cisplatin-radiation in HPVNOCP.

Keywords: mediation analysis, cancer data, survival, NCR, HPV negative oropharyngeal

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5773 Comparison of Tribological and Mechanical Properties of White Metal Produced by Laser Cladding and Conventional Methods

Authors: Jae-Il Jeong, Hoon-Jae Park, Jung-Woo Cho, Yang-Gon Kim, Jin-Young Park, Joo-Young Oh, Si-Geun Choi, Seock-Sam Kim, Young Tae Cho, Chan Gyu Kim, Jong-Hyoung Kim

Abstract:

Bearing component has strongly required to decrease vibration and wear to achieve high durability and life time. In the industry field, bearing durability is improved by surface treatment on the bearing surface by centrifugal casting or gravity casting production method. However, this manufacturing method has caused problems such as long processing time, defect rate, and health harmful effect. To solve this problem, there is a laser cladding deposition treatment, which provides fast processing and food adhesion. Therefore, optimum conditions of white metal laser deposition should be studied to minimize bearing contact axis wear using laser cladding techniques. In this study, we deposit a soft white metal layer on SCM440, which is mainly used for shaft and bolt. On laser deposition process, the laser power and powder feed rate and laser head speed factors are controlled to find out the optimal conditions. We also measure hardness using micro Vickers, analyze FE-SEM (Field Emission Scanning Electron Microscope) and EDS (Energy Dispersive Spectroscopy) to study the mechanical properties and surface characteristics with various parameters change. Furthermore, this paper suggests the optimum condition of laser cladding deposition to apply in industrial fields. This work was supported by the Industrial Innovation Project of the Korea Evaluation Institute of Industrial Technology (KEIT) granted financial resource from the Ministry of Trade, Industry & Energy, Republic of Korea (Research no. 10051653).

Keywords: laser deposition, bearing, white metal, mechanical properties

Procedia PDF Downloads 249
5772 Changes in Pulmonary Functions in Diabetes Mellitus Type 2

Authors: N. Anand, P. S. Nayyer, V. Rana, S. Verma

Abstract:

Background: Diabetes mellitus is a group of disorders characterized by hyperglycemia and associated with microvascular and macrovascular complications. Among the lesser known complications is the involvement of respiratory system. Changes in pulmonary volume, diffusion and elastic properties of lungs as well as the performance of the respiratory muscles lead to a restrictive pattern in lung functions. The present study was aimed to determine the changes in various parameters of pulmonary function tests amongst patients with Type 2 Diabetes Mellitus and also try to study the effect of duration of Diabetes Mellitus on pulmonary function tests. Methods: It was a cross sectional study performed at Dr Baba Saheb Ambedkar Hospital and Medical College in, Delhi, A Tertiary care referral centre which included 200 patients divided into 2 groups. The first group included diagnosed patients with diabetes and the second group included controls. Cases and controls symptomatic for any acute or chronic Respiratory or Cardiovascular illness or a history of smoking were excluded. Both the groups were subjected to spirometry to evaluate for the pulmonary function tests. Result: The mean Forced Vital Capacity (FVC), Forced Expiratory Volume in first second (FEV1), Peak Expiratory Flow Rate(PEFR) was found to be significantly decreased ((P < 0.001) as compared to controls while the mean ratio of Forced Expiratory Volume in First second to Forced Vital Capacity was not significantly decreased( p>0.005). There was no correlation seen with duration of the disease. Conclusion: Forced Vital Capacity (FVC), Forced Expiratory Volume in first second (FEV1), Peak Expiratory Flow Rate(PEFR) were found to be significantly decreased in patients of Diabetes mellitus while ratio of Forced Expiratory Volume in First second to Forced Vital Capacity (FEV1/FVC) was not significantly decreased. The duration of Diabetes mellitus was not found to have any statistically significant effect on Pulmonary function tests (p > 0.005).

Keywords: diabetes mellitus, pulmonary function tests, forced vital capacity, forced expiratory volume in first second

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5771 Optimal Perturbation in an Impulsively Blocked Channel Flow

Authors: Avinash Nayak, Debopam Das

Abstract:

The current work implements the variational principle to find the optimum initial perturbation that provides maximum growth in an impulsively blocked channel flow. The conventional method for studying temporal stability has always been through modal analysis. In most of the transient flows, this modal analysis is still followed with the quasi-steady assumption, i.e. change in base flow is much slower compared to perturbation growth rate. There are other studies where transient analysis on time dependent flows is done by formulating the growth of perturbation as an initial value problem. But the perturbation growth is sensitive to the initial condition. This study intends to find the initial perturbation that provides the maximum growth at a later time. Here, the expression of base flow for blocked channel is derived and the formulation is based on the two dimensional perturbation with stream function representing the perturbation quantity. Hence, the governing equation becomes the Orr-Sommerfeld equation. In the current context, the cost functional is defined as the ratio of disturbance energy at a terminal time 'T' to the initial energy, i.e. G(T) = ||q(T)||2/||q(0)||2 where q is the perturbation and ||.|| defines the norm chosen. The above cost functional needs to be maximized against the initial perturbation distribution. It is achieved with the constraint that perturbation follows the basic governing equation, i.e. Orr-Sommerfeld equation. The corresponding adjoint equation is derived and is solved along with the basic governing equation in an iterative manner to provide the initial spatial shape of the perturbation that provides the maximum growth G (T). The growth rate is plotted against time showing the development of perturbation which achieves an asymptotic shape. The effects of various parameters, e.g. Reynolds number, are studied in the process. Thus, the study emphasizes on the usage of optimal perturbation and its growth to understand the stability characteristics of time dependent flows. The assumption of quasi-steady analysis can be verified against these results for the transient flows like impulsive blocked channel flow.

Keywords: blocked channel flow, calculus of variation, hydrodynamic stability, optimal perturbation

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5770 Shear Stress and Oxygen Concentration Manipulation in a Micropillars Microfluidic Bioreactor

Authors: Deybith Venegas-Rojas, Jens Budde, Dominik Nörz, Manfred Jücker, Hoc Khiem Trieu

Abstract:

Microfluidics is a promising approach for biomedicine cell culture experiments with microfluidic bioreactors (MBR), which can provide high precision in volume and time control over mass transport and microenvironments in small-scale studies. Nevertheless, shear stress and oxygen concentration are important factors that affect the microenvironment and then the cell culture. It is presented a novel MBR design in which differences in geometry, shear stress, and oxygen concentration were studied and optimized for cell culture. The aim is to mimic the in vivo condition with biocompatible materials and continuous perfusion of nutrients, a healthy shear stress, and oxygen concentration. The design consists of a capture system of PDMS micropillars which keep cells in place, so it is not necessary any hydrogel or complicated scaffolds for cells immobilization. Besides, the design allows continuous supply with nutrients or even any other chemical for cell experimentation. Finite element method simulations were used to study and optimize the effect of parameters such as flow rate, shear stress, oxygen concentration, micropillars shape, and dimensions. The micropillars device was fabricated with microsystem technology such as soft-lithography, deep reactive ion etching, self-assembled monolayer, replica molding, and oxygen plasma bonding. Eight different geometries were fabricated and tested, with different flow rates according to the simulations. During the experiments, it was observed the effect of micropillars size, shape, and configuration for stability and shear stress control when increasing flow rate. The device was tested with several successful HepG2 3D cell cultures. With this MBR, the aforementioned parameters can be controlled in order to keep a healthy microenvironment according to specific necessities of different cell types, with no need of hydrogels and can be used for a wide range of experiments with cells.

Keywords: cell culture, micro-bioreactor, microfluidics, micropillars, oxygen concentration, shear stress

Procedia PDF Downloads 274
5769 An Extension of the Generalized Extreme Value Distribution

Authors: Serge Provost, Abdous Saboor

Abstract:

A q-analogue of the generalized extreme value distribution which includes the Gumbel distribution is introduced. The additional parameter q allows for increased modeling flexibility. The resulting distribution can have a finite, semi-infinite or infinite support. It can also produce several types of hazard rate functions. The model parameters are determined by making use of the method of maximum likelihood. It will be shown that it compares favourably to three related distributions in connection with the modeling of a certain hydrological data set.

Keywords: extreme value theory, generalized extreme value distribution, goodness-of-fit statistics, Gumbel distribution

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5768 Early Gastric Cancer Prediction from Diet and Epidemiological Data Using Machine Learning in Mizoram Population

Authors: Brindha Senthil Kumar, Payel Chakraborty, Senthil Kumar Nachimuthu, Arindam Maitra, Prem Nath

Abstract:

Gastric cancer is predominantly caused by demographic and diet factors as compared to other cancer types. The aim of the study is to predict Early Gastric Cancer (ECG) from diet and lifestyle factors using supervised machine learning algorithms. For this study, 160 healthy individual and 80 cases were selected who had been followed for 3 years (2016-2019), at Civil Hospital, Aizawl, Mizoram. A dataset containing 11 features that are core risk factors for the gastric cancer were extracted. Supervised machine algorithms: Logistic Regression, Naive Bayes, Support Vector Machine (SVM), Multilayer perceptron, and Random Forest were used to analyze the dataset using Python Jupyter Notebook Version 3. The obtained classified results had been evaluated using metrics parameters: minimum_false_positives, brier_score, accuracy, precision, recall, F1_score, and Receiver Operating Characteristics (ROC) curve. Data analysis results showed Naive Bayes - 88, 0.11; Random Forest - 83, 0.16; SVM - 77, 0.22; Logistic Regression - 75, 0.25 and Multilayer perceptron - 72, 0.27 with respect to accuracy and brier_score in percent. Naive Bayes algorithm out performs with very low false positive rates as well as brier_score and good accuracy. Naive Bayes algorithm classification results in predicting ECG showed very satisfactory results using only diet cum lifestyle factors which will be very helpful for the physicians to educate the patients and public, thereby mortality of gastric cancer can be reduced/avoided with this knowledge mining work.

Keywords: Early Gastric cancer, Machine Learning, Diet, Lifestyle Characteristics

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5767 The Impact of Agricultural Product Export on Income and Employment in Thai Economy

Authors: Anucha Wittayakorn-Puripunpinyoo

Abstract:

The research objectives were 1) to study the situation and its trend of agricultural product export of Thailand 2) to study the impact of agricultural product export on income of Thai economy 3) the impact of agricultural product export on employment of Thai economy and 4) to find out the recommendations of agricultural product export policy of Thailand. In this research, secondary data were collected as yearly time series data from 1990 to 2016 accounted for 27 years. Data were collected from the Bank of Thailand database. Primary data were collected from the steakholders of agricultural product export policy of Thailand. Data analysis was applied descriptive statistics such as arithmetic mean, standard deviation. The forecasting of agricultural product was applied Mote Carlo Simulation technique as well as time trend analysis. In addition, the impact of agricultural product export on income and employment by applying econometric model while the estimated parameters were utilized the ordinary least square technique. The research results revealed that 1) agricultural product export value of Thailand from 1990 to 2016 was 338,959.5 Million Thai baht with its growth rate of 4.984 percent yearly, in addition, the forecasting of agricultural product export value of Thailand has increased but its growth rate has been declined 2) the impact of agricultural product export has positive impact on income in Thai economy, increasing in agricultural product export of Thailand by 1 percent would lead income increased by 0.0051 percent 3) the impact of agricultural product export has positive impact on employment in Thai economy, increasing in agricultural product export of Thailand by 1 percent would lead income increased by 0.079 percent and 4) in the future, agricultural product export policy would focused on finished or semi-finished agricultural product instead of raw material by applying technology and innovation in to make value added of agricultural product export. The public agricultural product export policy would support exporters in private sector in order to encourage them as agricultural exporters in Thailand.

Keywords: agricultural product export, income, employment, Thai economy

Procedia PDF Downloads 290
5766 Main Tendencies of Youth Unemployment and the Regulation Mechanisms for Decreasing Its Rate in Georgia

Authors: Nino Paresashvili, Nino Abesadze

Abstract:

The modern world faces huge challenges. Globalization changed the socio-economic conditions of many countries. The current processes in the global environment have a different impact on countries with different cultures. However, an alleviation of poverty and improvement of living conditions is still the basic challenge for the majority of countries, because much of the population still lives under the official threshold of poverty. It is very important to stimulate youth employment. In order to prepare young people for the labour market, it is essential to provide them with the appropriate professional skills and knowledge. It is necessary to plan efficient activities for decreasing an unemployment rate and for developing the perfect mechanisms for regulation of a labour market. Such planning requires thorough study and analysis of existing reality, as well as development of corresponding mechanisms. Statistical analysis of unemployment is one of the main platforms for regulation of the labour market key mechanisms. The corresponding statistical methods should be used in the study process. Such methods are observation, gathering, grouping, and calculation of the generalized indicators. Unemployment is one of the most severe socioeconomic problems in Georgia. According to the past as well as the current statistics, unemployment rates always have been the most problematic issue to resolve for policy makers. Analytical works towards to the above-mentioned problem will be the basis for the next sustainable steps to solve the main problem. The results of the study showed that the choice of young people is not often due to their inclinations, their interests and the labour market demand. That is why the wrong professional orientation of young people in most cases leads to their unemployment. At the same time, it was shown that there are a number of professions in the labour market with a high demand because of the deficit the appropriate specialties. To achieve healthy competitiveness in youth employment, it is necessary to formulate regional employment programs with taking into account the regional infrastructure specifications.

Keywords: unemployment, analysis, methods, tendencies, regulation mechanisms

Procedia PDF Downloads 367
5765 Fresh Amnion Membrane Grafting for the Regeneration of Skin in Full Thickness Burn in Newborn - Case Report

Authors: Priyanka Yadav, Umesh Bnasal, Yashvinder Kumar

Abstract:

The placenta is an important structure that provides oxygen and nutrients to the growing fetus in utero. It is usually thrown away after birth, but it has a therapeutic role in the regeneration of tissue. It is covered by the amniotic membrane, which can be easily separated into the amnion layer and the chorion layer—the amnion layer act as a biofilm for the healing of burn wound and non-healing ulcers. The freshly collected membrane has stem cells, cytokines, growth factors, and anti-inflammatory properties, which act as a biofilm for the healing of wounds. It functions as a barrier and prevents heat and water loss and also protects from bacterial contamination, thus supporting the healing process. The application of Amnion membranes has been successfully used for wound and reconstructive purposes for decades. It is a very cheap and easy process and has shown superior results to allograft and xenograft. However, there are very few case reports of amnion membrane grafting in newborns; we intend to highlight its therapeutic importance in burn injuries in newborns. We present a case of 9 days old male neonate who presented to the neonatal unit of Maulana Azad Medical College with a complaint of fluid-filled blisters and burns wound on the body for six days. He was born outside the hospital at 38 weeks of gestation to a 24-year-old primigravida mother by vaginal delivery. The presentation was cephalic and the amniotic fluid was clear. His birth weight was 2800 gm and APGAR scores were 7 and 8 at 1 and 5 minutes, respectively. His anthropometry was appropriate for gestational age. He developed respiratory distress after birth requiring oxygen support by nasal prongs for three days. On the day of life three, he developed blisters on his body, starting from than face then over the back and perineal region. At a presentation on the day of life nine, he had blisters and necrotic wound on the right side of the face, back, right shoulder and genitalia, affecting 60% of body surface area with full-thickness loss of skin. He was started on intravenous antibiotics and fluid therapy. Pus culture grew Pseudomonas aeuroginosa, for which culture-specific antibiotics were started. Plastic surgery reference was taken and regular wound dressing was done with antiseptics. He had a storming course during the hospital stay. On the day of life 35 when the baby was hemodynamically stable, amnion membrane grafting was done on the wound site; for the grafting, fresh amnion membrane was removed under sterile conditions from the placenta obtained by caesarean section. It was then transported to the plastic surgery unit in half an hour in a sterile fluid where the graft was applied over the infant’s wound. The amnion membrane grafting was done twice in two weeks for covering the whole wound area. After successful uptake of amnion membrane, skin from the thigh region was autografted over the whole wound area by Meek technique in a single setting. The uptake of autograft was excellent and most of the areas were healed. In some areas, there was patchy regeneration of skin so dressing was continued. The infant was discharged after three months of hospital stay and was later followed up in the plastic surgery unit of the hospital.

Keywords: amnion membrane grafting, autograft, meek technique, newborn, regeneration of skin

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5764 The Impact of Artificial Intelligence on Pharmacy and Pharmacology

Authors: Mamdouh Milad Adly Morkos

Abstract:

Despite having the greatest rates of mortality and morbidity in the world, low- and middle-income (LMIC) nations trail high-income nations in terms of the number of clinical trials, the number of qualified researchers, and the amount of research information specific to their people. Health inequities and the use of precision medicine may be hampered by a lack of local genomic data, clinical pharmacology and pharmacometrics competence, and training opportunities. These issues can be solved by carrying out health care infrastructure development, which includes data gathering and well-designed clinical pharmacology training in LMICs. It will be advantageous if there is international cooperation focused at enhancing education and infrastructure and promoting locally motivated clinical trials and research. This paper outlines various instances where clinical pharmacology knowledge could be put to use, including pharmacogenomic opportunities that could lead to better clinical guideline recommendations. Examples of how clinical pharmacology training can be successfully implemented in LMICs are also provided, including clinical pharmacology and pharmacometrics training programmes in Africa and a Tanzanian researcher's personal experience while on a training sabbatical in the United States. These training initiatives will profit from advocacy for clinical pharmacologists' employment prospects and career development pathways, which are gradually becoming acknowledged and established in LMICs. The advancement of training and research infrastructure to increase clinical pharmacologists' knowledge in LMICs would be extremely beneficial because they have a significant role to play in global health

Keywords: electromagnetic solar system, nano-material, nano pharmacology, pharmacovigilance, quantum theoryclinical simulation, education, pharmacology, simulation, virtual learning low- and middle-income, clinical pharmacology, pharmacometrics, career development pathways

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5763 Catered Lunch Suspected Outbreak in a Garment Factory, Sleman District, Yogyakarta, Indonesia, 2017

Authors: Rieski Prihastuti, Meliana Depo, Trisno A. Wibowo, Misinem

Abstract:

On October 19, 2017, Yogyakarta Islamic Hospital reported 38 garment employees with nausea, vomiting, headache, abdominal pain, and diarrhea after they had lunch on October 18, 2017, to Sleman District Health Office. Objectives of this study were to ensure the outbreak and identify source and route of transmission. Case-control study was conducted to analyze food items that caused the outbreak. A case was defined as a person who got symptoms such as abdominal pain, diarrhea, nausea with/without vomiting, fever, and headache after they had lunch on October 18, 2017. Samples included leftover lunch box, vomit, tap water and drinking water had been sent to the laboratory. Data were analyzed descriptively as frequency table and analyzed by using chi-square in bivariate analysis. All of 196 garment employee was included in this study. The common symptoms of this outbreak were abdominal pain (84.4%), diarrhea (72.8%), nausea (61.6%), headache (52.8%), vomiting (12.8%), and fever (6.4%) with median incubation period 13 hours (range 1-34 hours). Highest attack rate and odds ratio was found in grilled chicken (Attack Rate 58,49%) with Odds Ratio 11,023 (Confidence Interval 95% 1.383 - 87.859; p value 0,005). Almost all samples showed mold, except drinking water. Based on its sign and symptoms, also incubation period, diarrheal Bacillus cereus and Clostridium perfringens were suspected to be the causative agent of the outbreak. Limitation of this study was improper sample handling and no sample of food handler and stools in the food caterer. Outbreak investigation training needed to be given to the hospital worker, and monitoring should be done to the food caterer to prevent another outbreak.

Keywords: disease outbreak, foodborne disease, food poisoning, outbreak

Procedia PDF Downloads 140