Search results for: postoperative radiation therapy
421 Exploring Error-Minimization Protocols for Upper-Limb Function During Activities of Daily Life in Chronic Stroke Patients
Authors: M. A. Riurean, S. Heijnen, C. A. Knott, J. Makinde, D. Gotti, J. VD. Kamp
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Objectives: The current study is done in preparation for a randomized controlled study investigating the effects of an implicit motor learning protocol implemented using an extension-supporting glove. It will explore different protocols to find out which is preferred when studying motor learn-ing in the chronic stroke population that struggles with hand spasticity. Design: This exploratory study will follow 24 individuals who have a chronic stroke (> 6 months) during their usual care journey. We will record the results of two 9-Hole Peg Tests (9HPT) done during their therapy ses-sions with a physiotherapist or in their home before and after 4 weeks of them wearing an exten-sion-supporting glove used to employ the to-be-studied protocols. The participants will wear the glove 3 times/week for one hour while performing their activities of daily living and record the times they wore it in a diary. Their experience will be monitored through telecommunication once every week. Subjects: Individuals that have had a stroke at least 6 months prior to participation, hand spasticity measured on the modified Ashworth Scale of maximum 3, and finger flexion motor control measured on the Motricity Index of at least 19/33. Exclusion criteria: extreme hemi-neglect. Methods: The participants will be randomly divided into 3 groups: one group using the glove in a pre-set way of decreasing support (implicit motor learning), one group using the glove in a self-controlled way of decreasing support (autonomous motor learning), and the third using the glove with constant support (as control). Before and after the 4-week period, there will be an intake session and a post-assessment session. Analysis: We will compare the results of the two 9HPTs to check whether the protocols were effective. Furthermore, we will compare the results between the three groups to find the preferred one. A qualitative analysis will be run of the experience of participants throughout the 4-week period. Expected results: We expect that the group using the implicit learning protocol will show superior results.Keywords: implicit learning, hand spasticity, stroke, error minimization, motor task
Procedia PDF Downloads 59420 Compliance Of Dialysis patients With Nutrition Guidelines: Insights From A Questionnaire
Authors: Zeiler M., Stadler D., Schmaderer C.
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Over the years of dialysis treatment, most patients experience significant weight loss. The primary emphasis in earlier research was the underlying mechanism of protein energy wasting and the subsequent malnutrition inflammation syndrome. In the interest to provide an effective and rapid solution for the patients, the aim of this study is identifying individual influences of their assumed reduced dietary intake, such as nausea, appetite loss and taste changes, and to determine whether the patients adhere to their nutrition guidelines. A prospective, controlled study with 38 end-stage renal disease patients was performed using a questionnaire to reflect their diet within the last 12 months. Thereby, the daily intake for the most important macro-and micronutrients was calculated to be compared with the individual KDQOI-guideline value, as well as controls matched in age and gender. The majority of the study population did not report symptoms commonly associated with dialysis, such as nausea or inappetence, and denied any change in dietary behavior since receiving renal replacement therapy. The patients’ daily intake of energy (3080kcal ± 1266) and protein (89,9g [53,4-142,0]) did not differ significantly from the controls (energy intake: 3233kcal ± 1046, p=0,597; protein intake: 103,7g [90,1-125,5], p=0,120). The average difference to the individual calculated KDQOI-guideline was +176,0kcal ± 1156 (p=0,357) for energy intake and -1,75g ± 45,9 (p=0,491) for protein intake. However, there was an observed imbalance in the distribution of macronutrients, with a preference for fats over proteins. The patients’ daily intake of sodium (5,4g [ 2,95-10,1]) was higher than in the controls (4,1g [2,04-5,99], p= 0,058) whereas both values for potassium (3,7g ± 1,84) and phosphorous (1,79g ± 0,91) went significantly below the controls’ values (potassium intake: 4,89g ± 1,74, p=0,014; phosphorous intake: 2,04g ± 0,64, p=0,038). Thus, the values exceeded the calculated KDQOI-recommendation by + 3,3g [0,63-7,90] (p<0,001) for sodium, +1,49g ± 1,84 (p<0,001) for potassium and +0,89g ± 0,91 (p<0,001) for phosphorous. Contrary to the assumption, the patients did not under-eat. Nevertheless, their diets did not align with the recommended values. These findings highlight the need for intervention and education among patients and that regular dietary monitoring could prevent unhealthy nutrition habits. The elaboration of individual references instead of standardized guidelines could increase the compliance to the advised diet so that interdisciplinary comorbidities do not develop or worsen.Keywords: compliance, dialysis, end-stage renal disease, KDQOI, malnutrition, nutrition guidelines, questionnaire, salt intake
Procedia PDF Downloads 68419 Successful Rehabilitation of Recalcitrant Knee Pain Due to Anterior Cruciate Ligament Injury Masked by Extensive Skin Graft: A Case Report
Authors: Geum Yeon Sim, Tyler Pigott, Julio Vasquez
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A 38-year-old obese female with no apparent past medical history presented with left knee pain. Six months ago, she sustained a left knee dislocation in a motor vehicle accident that was managed with a skin graft over the left lower extremity without any reconstructive surgery. She developed persistent pain and stiffness in her left knee that worsened with walking and stair climbing. Examination revealed healed extensive skin graft over the left lower extremity, including the left knee. Palpation showed moderate tenderness along the superior border of the patella, exquisite tenderness over MCL, and mild tenderness on the tibial tuberosity. There was normal sensation, reflexes, and strength in her lower extremities. There was limited active and passive range of motion of her left knee during flexion. There was instability noted upon the valgus stress test of the left knee. Left knee magnetic resonance imaging showed high-grade (grade 2-3) injury of the proximal superficial fibers of the MCL and diffuse thickening and signal abnormality of the cruciate ligaments, as well as edema-like subchondral marrow signal change in the anterolateral aspect of the lateral femoral condyle weight-bearing surface. There was also notable extensive scarring and edema of the skin, subcutaneous soft tissues, and musculature surrounding the knee. The patient was managed with left knee immobilization for five months, which was complicated by limited knee flexion. Physical therapy consisting of quadriceps, hamstrings, gastrocnemius stretching and strengthening, range of motion exercises, scar/soft tissue mobilization, and gait training was given with marked improvement in pain and range of motion. The patient experienced a further reduction in pain as well as an improvement in function with home exercises consisting of continued strengthening and stretching.Keywords: ligamentous injury, trauma, rehabilitation, knee pain
Procedia PDF Downloads 108418 An Energy and Economic Comparison of Solar Thermal Collectors for Domestic Hot Water Applications
Authors: F. Ghani, T. S. O’Donovan
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Today, the global solar thermal market is dominated by two collector types; the flat plate and evacuated tube collector. With regards to the number of installations worldwide, the evacuated tube collector is the dominant variant primarily due to the Chinese market but the flat plate collector dominates both the Australian and European markets. The market share of the evacuated tube collector is, however, growing in Australia due to a common belief that this collector type is ‘more efficient’ and, therefore, the better choice for hot water applications. In this study, we investigate this issue further to assess the validity of this statement. This was achieved by methodically comparing the performance and economics of several solar thermal systems comprising of; a low-performance flat plate collector, a high-performance flat collector, and an evacuated tube collector coupled with a storage tank and pump. All systems were simulated using the commercial software package Polysun for four climate zones in Australia to take into account different weather profiles in the study and subjected to a thermal load equivalent to a household comprising of four people. Our study revealed that the energy savings and payback periods varied significantly for systems operating under specific environmental conditions. Solar fractions ranged between 58 and 100 per cent, while payback periods range between 3.8 and 10.1 years. Although the evacuated tube collector was found to operate with a marginally higher thermal efficiency over the selective surface flat plate collector due to reduced ambient heat loss, the high-performance flat plate collector outperformed the evacuated tube collector on thermal yield. This result was obtained as the flat plate collector possesses a significantly higher absorber to gross collector area ratio over the evacuated tube collector. Furthermore, it was found for Australian regions operating with a high average solar radiation intensity and ambient temperature, the lower performance collector is the preferred choice due to favorable economics and reduced stagnation temperature. Our study has provided additional insight into the thermal performance and economics of the two prevalent solar thermal collectors currently available. A computational investigation has been carried out specifically for the Australian climate due to its geographic size and significant variation in weather. For domestic hot water applications were fluid temperatures between 50 and 60 degrees Celsius are sought, the flat plate collector is both technically and economically favorable over the evacuated tube collector. This research will be useful to system design engineers, solar thermal manufacturers, and those involved in policy to encourage the implementation of solar thermal systems into the hot water market.Keywords: solar thermal, energy analysis, flat plate, evacuated tube, collector performance
Procedia PDF Downloads 210417 Impact of UV on Toxicity of Zn²⁺ and ZnO Nanoparticles to Lemna minor
Authors: Gabriela Kalcikova, Gregor Marolt, Anita Jemec Kokalj, Andreja Zgajnar Gotvajn
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Since the 90’s, nanotechnology is one of the fastest growing fields of science. Nanomaterials are increasingly becoming part of many products and technologies. Metal oxide nanoparticles are among the most used nanomaterials. Zinc oxide nanoparticles (nZnO) is widely used due to its versatile properties; it has been used in products including plastics, paints, food, batteries, solar cells and cosmetic products. It is also a very effective photocatalyst used for water treatment. Such expanding application of nZnO increases their possible occurrence in the environment. In the aquatic ecosystem nZnO interact with natural environmental factors such as UV radiation, and thus it is essential to evaluate possible interaction between them. In this context, the aim of our study was to evaluate combined ecotoxicity of nZnO and Zn²⁺ on duckweed Lemna minor in presence or absence UV. Inhibition of vegetative growth of duckweed Lemna minor was monitored over a period of 7 days in multi-well plates. After the experiment, specific growth rate was determined. ZnO nanoparticles used were of primary size 13.6 ± 1.7 nm. The test was conducted with nominal nZnO and Zn²⁺ (in form of ZnCl₂) concentrations of 1, 10, 100 mg/L. Experiment was repeated with presence of natural intensity of UV (8h UV, 10 W/m² UVA, 0.5 W/m² UVB). Concentration of Zn during the test was determined by ICP-MS. In the regular experiment (absence of UV) the specific growth rate was slightly increased by low concentrations of nZnO and Zn²⁺ in comparison to control. However, 10 and 100 mg/L of Zn²⁺ resulted in 45% and 68% inhibition of the specific growth rate, respectively. In case of nZnO both concentrations (10 and 100 mg/L) resulted in similar ~ 30% inhibition and the response was not dose-dependent. The lack of the dose-response relationship is often observed in case of nanoparticles. The possible explanation is that the physical impact prevails instead of chemical ones. In the presence of UV the toxicity of Zn²⁺ was increased and 100 mg/L of Zn²⁺ caused total inhibition of the specific growth rate (100%). On the other hand, 100 mg/L of nZnO resulted in low inhibition (19%) in comparison to the experiment without UV (30%). It is thus expected, that tested nZnO is low photoactive, but could have a good UV absorption and/or reflective properties and thus protect duckweed against UV impacts. Measured concentration of Zn in the test suspension decreased only about 4% after 168h in the case of ZnCl₂. On the other hand concentration of Zn in nZnO test decreased by 80%. It is expected that nZnO were partially dissolved in the medium and at the same time agglomeration and sedimentation of particles took place and thus the concentration of Zn at the water level decreased. Results of our study indicated, that nZnO combined with UV of natural intensity does not increase toxicity of nZnO, but slightly protect the plant against UV negative effects. When Zn²⁺ and ZnO results are compared it seems that dissolved Zn plays a central role in the nZnO toxicity.Keywords: duckweed, environmental factors, nanoparticles, toxicity
Procedia PDF Downloads 333416 Still Hepatocellular Carcinoma Risk Despite Proper Treatment of Chronic Viral Hepatitis
Authors: Sila Akhan, Muge Toygar, Murat Sayan, Simge Fidan
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Chronic viral hepatitis B, C, and D can cause hepatocellular carcinoma (HCC), cirrhosis and death. The proper treatment reduce the risk of development of HCC importantly, but not to zero point. Materials and Methods: We analysed retrospectively our chronic viral hepatitis B, C and D patients who attended to our Infectious Diseases policlinic between 2004-2018. From 589 biopsy-proven chronic hepatitis patients 3 have hepatocellular carcinoma on our follow up. First case is 74 years old patient. His HCV infection diagnosis was made 8 years ago. First treatment was pegylated interferon plus ribavirin only 28 weeks, because of HCV RNA breakthrough under treatment. In 2013 he was retreated with telaprevir, pegylated interferon plus ribavirin 24 weeks. But at the end of the therapy HCV RNA was found 1.290.000 IU/mL. He has abdominal ultrasonography (US) controls and alpha-fetoprotein (AFP) at 6 months intervals. All seemed normal until 2015 then he has an abdominal magnetic resonance imaging (MRI) and found HCC by chance. His treatment began in Oncology Clinic after verified with biopsy of HCC. And then sofosbuvir/ledipasvir was given to him for HCV 24 weeks. Sustained virologic response (SVR) was obtained. He is on cure for HCV infection and under control of Oncology for HCC. Second patient is 36 years old man. He knows his HBV infection since 2008. HBsAg and HBeAg positive; HDV RNA negative. Liver biopsy revealed grade:4, stage 3-4 according modified Knodell scoring system. In 2010 tenofovir treatment was began. His abdominal US and AFP were normal. His controls took place at 6 months intervals and HBV DNA negative, US, and AFP were normal until 2016 continuously. AFP found 37 above the normal range and then HCC was found in MRI. Third patient is 57 years old man. As hepatitis B infection was first diagnosed; he has cirrhosis and was began tenofovir as treatment. In short time he has HCC despite normal AFP values. Conclusion: In Mediterranian countries including Turkey naturally occurring pre-S/S variants are more than 75% of all chronic hepatitis B patients. This variants may contribute to the development of progressive liver damage and hepatocarcinogenesis. HCV-induced development of HCC is a gradual process and is affected by the duration of disease and viral genotype. All the chronic viral hepatitis patients should be followed up in 6 months intervals not only with US and AFP for HCC. Despite they have proper treatment there is always the risk development of HCC. Chronic hepatitis patients cannot be dropped from follow up even treated well. Procedia PDF Downloads 138415 Exercise Training for Management Hypertensive Patients: A Systematic Review and Meta-Analysis
Authors: Noor F. Ilias, Mazlifah Omar, Hashbullah Ismail
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Exercise training has been shown to improve functional capacity and is recommended as a therapy for management of blood pressure. Our purpose was to establish whether different exercise capacity produces different effect size for Cardiorespiratory Fitness (CRF), systolic (SBP) and diastolic (DBP) blood pressure in patients with hypertension. Exercise characteristic is required in order to have optimal benefit from the training, but optimal exercise capacity is still unwarranted. A MEDLINE search (1985 to 2015) was conducted for exercise based rehabilitation trials in hypertensive patients. Thirty-seven studies met the selection criteria. Of these, 31 (83.7%) were aerobic exercise and 6 (16.3%) aerobic with additional resistance exercise, providing a total of 1318 exercise subjects and 819 control, the total of subjects was 2137. We calculated exercise volume and energy expenditure through the description of exercise characteristics. 4 studies (18.2%) were 451kcal - 900 kcal, 12 (54.5%) were 900 kcal – 1350 kcal and 6 (27.3%) >1351kcal per week. Peak oxygen consumption (peak VO2) increased by mean difference of 1.44 ml/kg/min (95% confidence interval [CI]: 1.08 to 1.79 ml/kg/min; p = 0.00001) with weighted mean 21.2% for aerobic exercise compare to aerobic with additional resistance exercise 4.50 ml/kg/min (95% confidence interval [CI]: 3.57 to 5.42 ml/kg/min; p = 0.00001) with weighted mean 14.5%. SBP was clinically reduce for both aerobic and aerobic with resistance training by mean difference of -4.66 mmHg (95% confidence interval [CI]: -5.68 to -3.63 mmHg; p = 0.00001) weighted mean 6% reduction and -5.06 mmHg (95% confidence interval [CI]: -7.32 to -2.8 mmHg; p = 0.0001) weighted mean 5% reduction respectively. Result for DBP was clinically reduce for aerobic by mean difference of -1.62 mmHg (95% confidence interval [CI]: -2.09 to -1.15 mmHg; p = 0.00001) weighted mean 4% reduction and aerobic with resistance training reduce by mean difference of -3.26 mmHg (95% confidence interval [CI]: -4.87 to -1.65 mmHg; p = 0.0001) weighted mean 6% reduction. Optimum exercise capacity for 451 kcal – 900 kcal showed greater improvement in peak VO2 and SBP by 2.76 ml/kg/min (95% confidence interval [CI]: 1.47 to 4.05 ml/kg/min; p = 0.0001) with weighted mean 40.6% and -16.66 mmHg (95% confidence interval [CI]: -21.72 to -11.60 mmHg; p = 0.00001) weighted mean 9.8% respectively. Our data demonstrated that aerobic exercise with total volume of 451 kcal – 900 kcal/ week energy expenditure may elicit greater changes in cardiorespiratory fitness and blood pressure in hypertensive patients. Higher exercise capacity weekly does not seem better result in management hypertensive patients.Keywords: blood Pressure, exercise, hypertension, peak VO2
Procedia PDF Downloads 282414 Cost Effectiveness Analysis of a Community Intervention for Anti-Retroviral Therapy Delivery in Cambodia
Authors: Esabelle Lo Yan Yam, Pheak Chhoun, Sovannary Tuot, Emily Lancsar, Siyan Yi
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Persons living with HIV (PLHIV) need lifelong antiretroviral treatment (ART) to keep their viral load suppressed to an undetectable level, maintain a healthy immune system, and reduce the risk of transmitting HIV to others. However, many factors affect PLHIV's adherence to ART, including access to antiretrovirals (ARV), stigma, lack of social support, and the burden of seeking lifelong care. Community-based care has been shown to be instrumental in the experience of PLHIV in many countries, including Cambodia. In this study based in Cambodia, a community-based ART delivery (CAD) intervention involving community action workers (CAWs) who are PLHIVs was introduced. These workers collect pre-packaged ARVs from the ART clinics and dispense them to PLHIVs in the communities. The quasi-experimental study involved approximately 2000 stable PLHIV in the intervention arm and another 2000 PLHIV in the control arm (receiving usual care). A cost-effectiveness analysis is currently conducted to complement the clinical effectiveness of the CAD intervention on the care continuum and treatment outcomes for stable PLHIV, as well as the operational effectiveness in increasing the efficiency of the ART clinics and the health system. The analysis will consider health system and societal perspectives based on primary outcomes, including retention in care, viral load suppression, and adherence to ART. Additionally, a consultation with the National Centre for HIV/AIDS, Dermatology, and STD under the Cambodia Ministry of Health will be done to discuss the conduct of a budget impact analysis that can quantify the financial impact on the government's budget when adopting the CAD intervention at the provincial and national levels. The budget impact analysis will take into consideration various scaling-up scenarios for the interventions in the country. The research will assess the cost-effectiveness of the CAD intervention to support national stakeholders in Cambodia to make an informed decision on the adoption and scaling up of the intervention in Cambodia. The results are currently being analyzed and will be available at the time of the conference.Keywords: Cambodia, community intervention, economic evaluation, global health, HIV/AIDs, implementation research
Procedia PDF Downloads 48413 Neonatal Subcutaneous Fat Necrosis with Severe Hypercalcemia: Case Report
Authors: Atitallah Sofien, Bouyahia Olfa, Krifi farah, Missaoui Nada, Ben Rabeh Rania, Yahyaoui Salem, Mazigh Sonia, Boukthir Samir
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Introduction: Subcutaneous fat necrosis of the newborn (SCFN) is a rare acute hypodermatitis characterized by skin lesions in the form of infiltrated, hard plaques and subcutaneous nodules, with a purplish-red color, occurring between the first and sixth week of life. SCFN is generally a benign condition that spontaneously regresses without sequelae, but it can be complicated by severe hypercalcemia. Methodology: This is a retrospective case report of neonatal subcutaneous fat necrosis complicated with severe hypercalcemia and nephrocalcinosis. Results: This is a case of a female newborn with a family history of a hypothyroid mother on Levothyrox, born to non-consanguineous parents and from a well-monitored pregnancy. The newborn was delivered by cesarean section at 39 weeks gestation due to severe preeclampsia. She was admitted to the Neonatal Intensive Care Unit at 1 hour of life for the management of grade 1 perinatal asphyxia and immediate neonatal respiratory distress related to transient respiratory distress. Hospitalization was complicated by a healthcare-associated infection, requiring intravenous antibiotics for ten days, with a good clinical and biological response. On the 20th day of life, she developed skin lesions in the form of indurated purplish-red nodules on the back and on both arms. A SCFN was suspected. A calcium level test was conducted, which returned a result of 3 mmol/L. The rest of the phosphocalcic assessment was normal, with early signs of nephrocalcinosis observed on renal ultrasound. The diagnosis of SCFN complicated by nephrocalcinosis associated with severe hypercalcemia was made, and the condition improved with intravenous hydration and corticosteroid therapy. Conclusion: SCFN is a rare and generally benign hypodermatitis in newborns with an etiology that is still poorly understood. Despite its benign nature, SCFN can be complicated by hypercalcemia, which can sometimes be life-threatening. Therefore, it is important to conduct a thorough skin examination of newborns, especially those with risk factors, to detect and correct any potential hypercalcemia.Keywords: subcutaneous fat necrosis, newborn, hypercalcemia, nephrocalcinosis
Procedia PDF Downloads 58412 Biodegradable Polymeric Vesicles Containing Magnetic Nanoparticles, Quantum Dots and Anticancer Drugs for Drug Delivery and Imaging
Authors: Fei Ye, Åsa Barrefelt, Manuchehr Abedi-Valugerdi, Khalid M. Abu-Salah, Salman A. Alrokayan, Mamoun Muhammed, Moustapha Hassan
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With appropriate encapsulation in functional nanoparticles drugs are more stable in physiological environment and the kinetics of the drug can be more carefully controlled and monitored. Furthermore, targeted drug delivery can be developed to improve chemotherapy in cancer treatment, not only by enhancing intracellular uptake by target cells but also by reducing the adverse effects in non-target organs. Inorganic imaging agents, delivered together with anti-cancer drugs, enhance the local imaging contrast and provide precise diagnosis as well as evaluation of therapy efficacy. We have developed biodegradable polymeric vesicles as a nanocarrier system for multimodal bio-imaging and anticancer drug delivery. The poly (lactic-co-glycolic acid) PLGA) vesicles were fabricated by encapsulating inorganic imaging agents of superparamagnetic iron oxide nanoparticles (SPION), manganese-doped zinc sulfide (MN:ZnS) quantum dots (QDs) and the anticancer drug busulfan into PLGA nanoparticles via an emulsion-evaporation method. T2-weighted magnetic resonance imaging (MRI) of PLGA-SPION-Mn:ZnS phantoms exhibited enhanced negative contrast with r2 relaxivity of approximately 523 s-1 mM-1 Fe. Murine macrophage (J774A) cellular uptake of PLGA vesicles started fluorescence imaging at 2 h and reached maximum intensity at 24 h incubation. The drug delivery ability PLGA vesicles was demonstrated in vitro by release of busulfan. PLGA vesicles degradation was studied in vitro, showing that approximately 32% was degraded into lactic and glycolic acid over a period of 5 weeks. The biodistribution of PLGA vesicles was investigated in vivo by MRI in a rat model. Change of contrast in the liver could be visualized by MRI after 7 min and maximal signal loss detected after 4 h post-injection of PLGA vesicles. Histological studies showed that the presence of PLGA vesicles in organs was shifted from the lungs to the liver and spleen over time.Keywords: biodegradable polymers, multifunctional nanoparticles, quantum dots, anticancer drugs
Procedia PDF Downloads 472411 Rare Diagnosis in Emergency Room: Moyamoya Disease
Authors: Ecem Deniz Kırkpantur, Ozge Ecmel Onur, Tuba Cimilli Ozturk, Ebru Unal Akoglu
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Moyamoya disease is a unique chronic progressive cerebrovascular disease characterized by bilateral stenosis or occlusion of the arteries around the circle of Willis with prominent arterial collateral circulation. The occurrence of Moyamoya disease is related to immune, genetic and other factors. There is no curative treatment for Moyamoya disease. Secondary prevention for patients with symptomatic Moyamoya disease is largely centered on surgical revascularization techniques. We present here a 62-year old male presented with headache and vision loss for 2 days. He was previously diagnosed with hypertension and glaucoma. On physical examination, left eye movements were restricted medially, both eyes were hyperemic and their movements were painful. Other neurological and physical examination were normal. His vital signs and laboratory results were within normal limits. Computed tomography (CT) showed dilated vascular structures around both lateral ventricles and atherosclerotic changes inside the walls of internal carotid artery (ICA). Magnetic resonance imaging (MRI) and angiography (MRA) revealed dilated venous vascular structures around lateral ventricles and hyper-intense gliosis in periventricular white matter. Ischemic gliosis around the lateral ventricles were present in the Digital Subtracted Angiography (DSA). After the neurology, ophthalmology and neurosurgery consultation, the patient was diagnosed with Moyamoya disease, pulse steroid therapy was started for vision loss, and super-selective DSA was planned for further investigation. Moyamoya disease is a rare condition, but it can be an important cause of stroke in both children and adults. It generally affects anterior circulation, but posterior cerebral circulation may also be affected, as well. In the differential diagnosis of acute vision loss, occipital stroke related to Moyamoya disease should be considered. Direct and indirect surgical revascularization surgeries may be used to effectively revascularize affected brain areas, and have been shown to reduce risk of stroke.Keywords: headache, Moyamoya disease, stroke, visual loss
Procedia PDF Downloads 267410 Antimicrobial Effects and Phytochemical Analysis of Chrysophyllum Albidum Plant Parts (Leaves, Roots and Seeds) Extracts on Bacterial Isolates from Urinary Catheters
Authors: Ebere Christian Ugochukwu, Okafor Josephine, Oyawoye Tomisin
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The occurrence of multidrug resistance patterns that have been developed by bacteria has made it difficult to properly treat infections using standard clinical medications. Hence, the use of herbs as an alternative source of therapy is considered cheap and easily accessible to locals. This research explored the antimicrobial effects of aqueous and ethanolic extracts obtained from Chrysophyllum albidum (commonly called ‘Agbalumo’ in southwest Nigeria and ‘Udara’ in the eastern and southern parts of Nigeria) plant parts (leaves, roots and seeds) against bacteria isolated from urinary catheter tips. The following isolates were obtained; Pseudomonas aeruginosa, Staphylococcus aureus, Escherichia coli, Proteus mirabilis, and Klebsiella aerogenes. The agar well diffusion method was used. The average percentages of antimicrobial resistance of the isolates to gentamycin were 45.5% for P. aeruginosa, 42.1% for E. coli, 46.9% for K. aerogenes, and ˃90% for other isolates. Qualitative phytochemical screening of the plant parts extracts was done using chemical test for the screening and identification of bioactive chemical constituents. The ethanolic extract mixtures (leaf, root and seed) had the greatest effect on all the isolates, with inhibition zones (IZs) ranging from 8-26 mm and MICs ranging from <16-32 mg/ml. The Potencies of the C. albidum extracts based on the IZ and MIC values were greater in the extract mixtures, followed by those in the roots. Phytochemical screening revealed that all the extracts contained phenol except for the seeds while tannins were present in all the extracts except the leaves. The activity of the ethanolic extracts of each part at high and low concentrations was greater than that of the aqueous extracts at the same concentrations (p<0.05). The acute toxicity results showed that the LD50 of the extracts was ˃5000 mg/body weight, indicating no toxicity. The antibacterial activities of the extract mixtures and roots on the isolates confirmed the use of C. albidum in folk medicine for the treatment of CAUTIs, hence indicating its antibacterial potential for use in novel antibiotic production.Keywords: antimicrobials, susceptibility, minimum inhibitory concentration, extracts
Procedia PDF Downloads 29409 Health Information Needs and Utilization of Information and Communication Technologies by Medical Professionals in a Northern City of India
Authors: Sonika Raj, Amarjeet Singh, Vijay Lakshmi Sharma
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Introduction: In 21st century, due to revolution in Information and Communication Technologies (ICTs), there has been phenomenal development in quality and quantity of knowledge in the field of medical science. So, the access to relevant information to physicians is critical to the delivery of effective healthcare services to patients. The study was conducted to assess the information needs and attitudes of the medical professionals; to determine the sources and channels of information used by them; to ascertain the current usage of ICTs and the barriers faced by them in utilization of ICTs in health information access. Methodology: This descriptive cross-sectional study was carried in 2015 on hundred medical professionals working in public and private sectors of Chandigarh. The study used both quantitative and qualitative method for data collection. A semi structured questionnaire and interview schedule was used to collect data on information seeking needs, access to ICTs and barriers to healthcare information access. Five Data analysis was done using SPSS-16 and qualitative data was analyzed using thematic approach. Results: The most preferred sources to access healthcare information were internet (85%), trainings (61%) and communication with colleagues (57%). They wanted information on new drug therapy and latest developments in respective fields. All had access to computer with but almost half assessed their computer knowledge as average and only 3% had received training regarding usage. Educational status (p=0.004), place of work (p=0.004), number of years in job (p=0.004) and sector of job (p=0.04) of doctors were found to be significantly associated with their active search for information. The major themes that emerged from in-views were need; types and sources of healthcare information; exchange of information among different levels of healthcare providers; usage of ICTs to obtain and share information; barriers to access of healthcare information and quality of health information materials and involvement in their development process Conclusion and Recommendations: The medical professionals need information in their in their due course of work. However, information needs of medical professionals were not being adequately met. There should be training of professional regarding internet skills and the course on bioinformatics should be incorporated in the curricula of medical students. The policy framework must be formulated that will encourage and promote the use of ICTs as tools for health information access and dissemination.Keywords: health information, ICTs, medical professionals, qualitative
Procedia PDF Downloads 349408 Using Arts in ESL Classroom
Authors: Nazia Shehzad
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Language and art can supplement and correlate each other. Through the ages art has been a means of visual expression used to convey a wide series of incarnated ideas. Art can take the perceiver into different times and into different worlds. It can also be used to introduce different levels of vocabulary to the learners of a second language. Learning a second language for most students is a very difficult and strenuous experience. They are not only trying to accommodate to a new language but are also trying to adjust to themselves and a new environment. They are anxious about almost everything, but they are especially self-conscious about their performance in the classroom. By relocating the focus from the student to an object, everyone participates, thus waiving a certain degree of self-consciousness. The experience, a student has with art in the classroom has to be gratifying for both the student and the teacher. If the atmosphere in the classroom is too grave it will not serve any useful purpose. Art is an excellent way to teach English and encourage collaboration and interaction between students of all ages. As making art involves many different processes, it is wonderful for classification and following/giving instructions. It is also an effective way to achieve and implement language of characterization and comparison and vocabulary acquirement for the elements of design (shape, size, color, texture, tone etc.) is so much more entertaining if done in a practical and hands-on way. Expressing ideas and feelings through art is also of immeasurable value where students are at the beginning stages of English language acquisition and for many of my Saudi students it was a form of therapy. It is also a way to respect, search, examine and share the cultural traditions of different cultures, and of the students themselves. Art not only provides a field for ideas to keep aimless, meandering minds of students' busy but is also a productive tool to analyze English language in a new order. As an ESL teacher, using art is a highly compelling way to bridge the gap between student and teacher. It’s difficult to keep students concentrated, especially when they speak a different language. To get students to actually learn and explore something in your foreign language lesson, artwork is your best friend. Many teachers feel that through amalgamation of the arts into their academic lessons students are able to learn more profoundly because they use diverse ways of thinking and problem solving. Teachers observe that drawing often retains students who might otherwise be dispassionate and can help students move ahead simple recall when they are asked to make connections and come up with an exclusive interpretation through an artwork or drawing. Students use observation skills when they are drawing, and this can help to persuade students who might otherwise remain silent or need more time to process information.Keywords: amalgamation of arts, expressing ideas and feelings through arts, effective way to achieve and implement language, language and art can supplement and correlate each other
Procedia PDF Downloads 359407 Airon Project: IoT-Based Agriculture System for the Optimization of Irrigation Water Consumption
Authors: África Vicario, Fernando J. Álvarez, Felipe Parralejo, Fernando Aranda
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The irrigation systems of traditional agriculture, such as gravity-fed irrigation, produce a great waste of water because, generally, there is no control over the amount of water supplied in relation to the water needed. The AIRON Project tries to solve this problem by implementing an IoT-based system to sensor the irrigation plots so that the state of the crops and the amount of water used for irrigation can be known remotely. The IoT system consists of a sensor network that measures the humidity of the soil, the weather conditions (temperature, relative humidity, wind and solar radiation) and the irrigation water flow. The communication between this network and a central gateway is conducted by means of long-range wireless communication that depends on the characteristics of the irrigation plot. The main objective of the AIRON project is to deploy an IoT sensor network in two different plots of the irrigation community of Aranjuez in the Spanish region of Madrid. The first plot is 2 km away from the central gateway, so LoRa has been used as the base communication technology. The problem with this plot is the absence of mains electric power, so devices with energy-saving modes have had to be used to maximize the external batteries' use time. An ESP32 SOC board with a LoRa module is employed in this case to gather data from the sensor network and send them to a gateway consisting of a Raspberry Pi with a LoRa hat. The second plot is located 18 km away from the gateway, a range that hampers the use of LoRa technology. In order to establish reliable communication in this case, the long-term evolution (LTE) standard is used, which makes it possible to reach much greater distances by using the cellular network. As mains electric power is available in this plot, a Raspberry Pi has been used instead of the ESP32 board to collect sensor data. All data received from the two plots are stored on a proprietary server located at the irrigation management company's headquarters. The analysis of these data by means of machine learning algorithms that are currently under development should allow a short-term prediction of the irrigation water demand that would significantly reduce the waste of this increasingly valuable natural resource. The major finding of this work is the real possibility of deploying a remote sensing system for irrigated plots by using Commercial-Off-The-Shelf (COTS) devices, easily scalable and adaptable to design requirements such as the distance to the control center or the availability of mains electrical power at the site.Keywords: internet of things, irrigation water control, LoRa, LTE, smart farming
Procedia PDF Downloads 84406 Identification of Potential Small Molecule Inhibitors Against β-hCG for Cancer Therapy: An In-Silico Study
Authors: Shreya Sara Ittycheria, K. C. Sivakumar, Shijulal Nelson Sathi, Priya Srinivas
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hCG, a heterodimer composed of α and β subunits, is a peptide hormone having numerous biological functions. Although hCG is expressed by placenta during pregnancy, ectopic β-hCG secretion is observed in many non-trophoblastic tumors including that of breast. In-vitro and in-vivo studies done in the lab, have proved that BRCA1 defective cancers express β-hCG and when β-hCG is expressed or supplemented, it promotes tumor progression and exhibits resistance to carboplatin and ABT888, in such cancers but not in BRCA1 wild type cancers. In cancer cells, instead of binding to its regular receptor, LH-CGR, β-hCG binds with Transforming Growth Factor Receptor 2 (TGFβRII) and phosphorylates it resulting in faster tumor progression through the Smad signaling pathway. Targeting β-hCG could be a potential therapeutic strategy for managing BRCA1 defective cancers. Here, molecular docking and dynamic simulation studies were done to identify potential small molecule inhibitors against β-hCG as there are currently no such inhibitors reported. The binding sites of TGFβRII on β-hCG were identified from the top 10 predicted complexes from Z Dock. Virtual screening of selected commercially available small molecules from various libraries such as ZINC, NCI and Life Chemicals amounting to a total of 50,025 molecules were done. Four potential small molecule inhibitors were identified, RgcbPs-1, RgcbPs-2, RgcbPs-3 and RgcbPs-4 with binding affinities -60.778 kcal/mol, -45.447 kcal/mol, -65.2268 kcal/mol and -82.040 kcal/mol respectively. Further, 100ns Molecular Dynamics (MD) simulation showed that these molecules form stable complexes with β-hCG. RgcbPs-1 maintains hydrogen bonds with Q54, L52, Q46, C100, G36, C57, C38 residues, RgcbPs-2 maintains hydrogen bonds with A83 residue, RgcbPs-3 maintains hydrogen bonds with C57, Y58, R94, G101 residues and RgcbPs-4 maintains hydrogen bonds with G36, C38, T40, C57, D99, C100, G101 and L104 residues of β-hCG all of which coincide with the TGFβRII binding site on β-hCG. These results show that these two inhibitors could be used either singly or in combination for inhibiting β-hCG from binding to TGFβRII and thereby directly inhibiting the tumorigenesis pathway.Keywords: β-hCG, breast cancer, dynamic simulations, molecular docking, small molecule inhibitors, virtual screening.
Procedia PDF Downloads 106405 Co-produced Databank of Tailored Messages to Support Enagagement to Digitial Health Interventions
Authors: Menna Brown, Tania Domun
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Digital health interventions are effective across a wide array of health conditions spanning physical health, lifestyle behaviour change, and mental health and wellbeing; furthermore, they are rapidly increasing in volume within both the academic literature and society as commercial apps continue to proliferate the digital health market. However, adherence and engagement to digital health interventions remains problematic. Technology-based personalised and tailored reminder strategies can support engagement to digital health interventions. Interventions which support individuals’ mental health and wellbeing are of critical importance in the wake if the COVID-19 pandemic. Student and young person’s mental health has been negatively affected and digital resources continue to offer cost effective means to address wellbeing at a population level. Develop a databank of digital co-produced tailored messages to support engagement to a range of digital health interventions including those focused on mental health and wellbeing, and lifestyle behaviour change. Qualitative research design. Participants discussed their views of health and wellbeing, engagement and adherence to digital health interventions focused around a 12-week wellbeing intervention via a series of focus group discussions. They worked together to co-create content following a participatory design approach. Three focus group discussions were facilitated with (n=15) undergraduate students at one Welsh university to provide an empirically derived, co-produced, databank of (n=145) tailored messages. Messages were explored and categorised thematically, and the following ten themes emerged: Autonomy, Recognition, Guidance, Community, Acceptance, Responsibility, Encouragement, Compassion, Impact and Ease. The findings provide empirically derived, co-produced tailored messages. These have been made available for use, via ‘ACTivate your wellbeing’ a digital, automated, 12-week health and wellbeing intervention programme, based on acceptance and commitment therapy (ACT). The purpose of which is to support future research to evaluate the impact of thematically categorised tailored messages on engagement and adherence to digital health interventions.Keywords: digital health, engagement, wellbeing, participatory design, positive psychology, co-production
Procedia PDF Downloads 121404 Comparison of Extracellular miRNA from Different Lymphocyte Cell Lines and Isolation Methods
Authors: Christelle E. Chua, Alicia L. Ho
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The development of a panel of differential gene expression signatures has been of interest in the field of biomarker discovery for radiation exposure. In the absence of the availability of exposed human subjects, lymphocyte cell lines have often been used as a surrogate to human whole blood, when performing ex vivo irradiation studies. The extent of variation between different lymphocyte cell lines is currently unclear, especially with regard to the expression of extracellular miRNA. This study compares the expression profile of extracellular miRNA isolated from different lymphocyte cell lines. It also compares the profile of miRNA obtained when different exosome isolation kits are used. Lymphocyte cell lines were created using lymphocytes isolated from healthy adult males of similar racial descent (Chinese American and Chinese Singaporean) and immortalised with Epstein-Barr virus. The cell lines were cultured in exosome-free cell culture media for 72h and the cell culture supernatant was removed for exosome isolation. Two exosome isolation kits were used. Total exosome isolation reagent (TEIR, ThermoFisher) is a polyethylene glycol (PEG)-based exosome precipitation kit, while ExoSpin (ES, Cell Guidance Systems) is a PEG-based exosome precipitation kit that includes an additional size exclusion chromatography step. miRNA from the isolated exosomes were isolated using miRNEASY minikit (Qiagen) and analysed using nCounter miRNA assay (Nanostring). Principal component analysis (PCA) results suggested that the overall extracellular miRNA expression profile differed between the lymphocyte cell line originating from the Chinese American donor and the cell line originating from the Chinese Singaporean donor. As the gender, age and racial origins of both donors are similar, this may suggest that there are other genetic or epigenetic differences that account for the variation in extracellular miRNA gene expression in lymphocyte cell lines. However, statistical analysis showed that only 3 miRNA genes had a fold difference > 2 at p < 0.05, suggesting that the differences may not be of that great a significance as to impact overall conclusions drawn from different cell lines. Subsequent analysis using cell lines from other donors will give further insight into the reproducibility of results when difference cell lines are used. PCA results also suggested that the method of exosome isolation impacted the expression profile. 107 miRNA had a fold difference > 2 at p < 0.05. This suggests that the inclusion of an additional size exclusion chromatography step altered the subset of the extracellular vesicles that were isolated. In conclusion, these results suggest that extracellular miRNA can be isolated and analysed from exosomes derived from lymphocyte cell lines. However, care must be taken in the choice of cell line and method of exosome isolation used.Keywords: biomarker, extracellular miRNA, isolation methods, lymphocyte cell line
Procedia PDF Downloads 199403 Analysis of Thermal Comfort in Educational Buildings Using Computer Simulation: A Case Study in Federal University of Parana, Brazil
Authors: Ana Julia C. Kfouri
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A prerequisite of any building design is to provide security to the users, taking the climate and its physical and physical-geometrical variables into account. It is also important to highlight the relevance of the right material elements, which arise between the person and the agent, and must provide improved thermal comfort conditions and low environmental impact. Furthermore, technology is constantly advancing, as well as computational simulations for projects, and they should be used to develop sustainable building and to provide higher quality of life for its users. In relation to comfort, the more satisfied the building users are, the better their intellectual performance will be. Based on that, the study of thermal comfort in educational buildings is of relative relevance, since the thermal characteristics in these environments are of vital importance to all users. Moreover, educational buildings are large constructions and when they are poorly planned and executed they have negative impacts to the surrounding environment, as well as to the user satisfaction, throughout its whole life cycle. In this line of thought, to evaluate university classroom conditions, it was accomplished a detailed case study on the thermal comfort situation at Federal University of Parana (UFPR). The main goal of the study is to perform a thermal analysis in three classrooms at UFPR, in order to address the subjective and physical variables that influence thermal comfort inside the classroom. For the assessment of the subjective components, a questionnaire was applied in order to evaluate the reference for the local thermal conditions. Regarding the physical variables, it was carried out on-site measurements, which consist of performing measurements of air temperature and air humidity, both inside and outside the building, as well as meteorological variables, such as wind speed and direction, solar radiation and rainfall, collected from a weather station. Then, a computer simulation based on results from the EnergyPlus software to reproduce air temperature and air humidity values of the three classrooms studied was conducted. The EnergyPlus outputs were analyzed and compared with the on-site measurement results to be possible to come out with a conclusion related to the local thermal conditions. The methodological approach included in the study allowed a distinct perspective in an educational building to better understand the classroom thermal performance, as well as the reason of such behavior. Finally, the study induces a reflection about the importance of thermal comfort for educational buildings and propose thermal alternatives for future projects, as well as a discussion about the significant impact of using computer simulation on engineering solutions, in order to improve the thermal performance of UFPR’s buildings.Keywords: computer simulation, educational buildings, EnergyPlus, humidity, temperature, thermal comfort
Procedia PDF Downloads 386402 The Importance of Oral Mucosal Biopsy Selection Site in Areas of Field Change: A Case Report
Authors: Timmis W., Simms M., Thomas C.
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This case discusses the management of two floors of mouth (FOM) Squamous Cell Carcinomas (SCC) not identified upon initial biopsy. A 51 year-old male presented with right FOM erythroleukoplakia. Relevant medical history included alcoholic dependence syndrome and alcoholic liver disease. Relevant drug therapy encompassed acamprosate, folic acid, hydroxocobalamin and thiamine. The patient had a 55.5 pack-year smoking history and alcohol dependence from age 14, drinking 16 units/day. FOM incisional biopsy and histopathological analysis diagnosed Carcinoma in situ. Treatment involved wide local excision. Specimen analysis revealed two separate foci of pT1 moderately differentiated SCCs. Carcinoma staging scans revealed no pathological lymphadenopathy, no local invasion or metastasis. SCCs had been excised in completion with narrow margins. MDT discussion concluded that in view of the field changes it would be difficult to identify specific areas needing further excision, although techniques such as Lugol’s Iodine were considered. Further surgical resection, surgical neck management and sentinel lymph node biopsy was offered. The patient declined intervention, primary management involved close monitoring alongside alcohol and smoking cessation referral. Narrow excisional margins can increase carcinoma recurrence risk. Biopsy failed to identify SCCs, despite sampling an area of clinical concern. For gross field change multiple incisional biopsies should be considered to increase chance of accurate diagnosis and appropriate treatment. Coupling of tobacco and alcohol has a synergistic effect, exponentially increasing the relative risk of oral carcinoma development. Tobacco and alcoholic control is fundamental in reducing treatment‑related side effects, recurrence risk and second primary cancer development.Keywords: alcohol dependence, biopsy, oral carcinoma, tobacco
Procedia PDF Downloads 112401 Evaluation to Assess the Impact of Newcastle Infant Partnership Approach
Authors: Samantha Burns, Melissa Brown, Judith Rankin
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Background: As a specialised intervention, NEWPIP provides a service which supports both parents and their babies from conception to two years, who are experiencing issues which may affect the quality of their relationship and development of the infant. This evaluation of the NEWPIP approach was undertaken in response to the need for rich, in-depth data to understand the lived experiences of the parents who experienced the service to improve the service. NEWPIP is currently one of 34 specialised parent–infant relationship teams across England. This evaluation contributes to increasing understanding of the impact and effectiveness of this specialised service to inform future practice. Aim: The aim of this evaluation was to explore the perspectives and experiences of parents or caregivers (service users), to assess the impact of the NEWPIP service on the parents themselves and the relationship with their baby. Methods: The exploratory nature of the aim and focus on service users’ experience and perspectives provided scope for a qualitative approach for this evaluation. This consisted of 10 semi-structured interviews with parents who had received the service within the last two years. Recruitment involved both purposive and convenience sampling. The interviews took place between February 2021 – March 2021, lasting between 30-90 minutes and were guided by open-ended questions from a topic guide. The interviews adopted a narrative approach to enable the parents to share their lived experiences. The researchers transcribed the interviews and analysed the data thematically by using a coding method which is grounded in the data. Results: The analysis and findings from the data gathered illuminated an approach which supports parents to build a better bond with their baby and provides a safe space for parents to heal through their relationships. While the parents shared their experiences, the interviews were intended to receive feedback, so questions were asked about what could be improved and what recommendations could be offered to Children North East. Guided by the voice of the parents, this evaluation provides recommendations to support the future of the NEWPIP approach. Conclusions: The NEWPIP approach appears to successfully provide early and flexible support for new parents, increasing a parent’s confidence in their ability to not only cope but thrive as a new parent.Keywords: maternal health, mental health, parent infant relationship, therapy
Procedia PDF Downloads 192400 The Influence of Family of Origin on Children: A Comprehensive Model and Implications for Positive Psychology and Psychotherapy
Authors: Meichen He, Xuan Yang
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Background: In the field of psychotherapy, the role of the family of origin is of utmost importance. Over the past few decades, both individual-oriented and family-oriented approaches to child therapy have shown moderate success in reducing children's psychological and behavioral issues. Objective: However, in exploring how the family of origin influences individuals, it has been noted that there is a lack of comprehensive measurement indicators and an absence of an exact model to assess the impact of the family of origin on individual development. Therefore, this study aims to develop a model based on a literature review regarding the influence of the family of origin on children. Specifically, it will examine the effects of factors such as education level, economic status, maternal age, family integration, family violence, marital conflict, parental substance abuse, and alcohol consumption on children's self-confidence and life satisfaction. Through this research, we aim to further investigate the impact of the family of origin on children and provide directions for future research in positive psychology and psychotherapy. Methods: This study will employ a literature review methodology to gather and analyze relevant research articles on the influence of the family of origin on children. Subsequently, we will conduct quantitative analyses to establish a comprehensive model explaining how family of origin factors affect children's psychological and behavioral outcomes. Findings: the research has revealed that family of origin factors, including education level, economic status, maternal age, family integration, family violence, marital conflict, parental drug and alcohol consumption, have an impact on children's self-confidence and life satisfaction. These factors can affect children's psychological well-being and happiness through various pathways. Implications: The results of this study will contribute to a better understanding of the influence of the family of origin on children and provide valuable directions for future research in positive psychology and psychotherapy. This research will enhance awareness of children's psychological well-being and lay the foundation for improving psychotherapeutic methods.Keywords: family of origion, positive psychology, developmental psychology, family education, social psychology, educational psychology
Procedia PDF Downloads 164399 Traditional Medicine and Islamic Holistic Approach in Palliative Care Management of Terminal Illpatient of Cancer
Authors: Mohammed Khalil Ur Rahman, Mohammed Alsharon, Arshad Muktar, Zahid Shaik
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Any ailment can go into terminal stages, cancer being one such disease which is many times detected in latent stages. Cancer is often characterized by constitutional symptoms which are agonizing in nature which disturbs patients and their family as well. In order to relieve such intolerable symptoms treatment modality employed is known to be ‘Palliative Care’. The goal of palliative care is to enhance patient’s quality of life by relieving or rather reducing the distressing symptoms of patients such as pain, nausea/ vomiting, anorexia/loss of appetite, excessive salivation, mouth ulcers, weight loss, constipation, oral thrush, emaciation etc. which are due to the effect of disease or due to the undergoing treatment such as chemotherapy, radiation etc. Ayurveda and Unani as well as other traditional medicines is getting more and more international attention in recent years and Ayurveda and Unani holistic perspective of the disease, it seems that there are many herbs and herbomineral preparation which can be employed in the treatment of malignancy and also in palliative care. Though many of them have yet to be scientifically proved as anti-cancerous but there is definitely a positive lead that some of these medications relieve the agonising symptoms thereby making life of the patient easy. Health is viewed in Islam in a holistic way. One of the names of the Quran is al-shifa' meaning ‘that which heals’ or ‘the restorer of health’ to refer to spiritual, intellectual, psychological, and physical health. The general aim of medical science, according to Islam, is to secure and adopt suitable measures which, with Allah’s permission, help to preserve or restore the health of the human body. Islam motivates the Physician to view the patient as one organism. The patient has physical, social, psychological, and spiritual dimensions that must be considered in synthesis with an integrated, holistic approach. Aims & Objectives: - To suggest herbs which are mentioned in Ayurveda Unani with potential palliative activity in case of Cancer patients. - Most of tibb nabawi [Prophetic Medicine] is preventive medicine and must have been divinely inspired. - Spiritual Aspects of Healing: Prayer, dua, recitation of the Quran - Remembrance of Allah play a central role.Materials & Method: Literary review of the herbs supported with experiential evidence will be discussed. Discussion: On the basis of collected data subject will be discussed in length. Conclusion: Will be presented in paper.Keywords: palliative care, holistic, Ayurvedic and Unani traditional system of medicine, Quran, hadith
Procedia PDF Downloads 339398 Screening of Phytochemicals Compounds from Chasmanthera dependens and Carissa edulis as Potential Inhibitors of Carbonic Anhydrases CA II (3HS4) Receptor using a Target-Based Drug Design
Authors: Owonikoko Abayomi Dele
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Epilepsy is an unresolved disease that needs urgent attention. It is a brain disorder that affects over sixty-five (65) million people around the globe. Despite the availability of commercial anti-epileptic drugs, the war against this unmet condition is yet to be resolved. Most epilepsy patients are resistant to available anti-epileptic medications thus the need for affordable novel therapy against epilepsy is a necessity. Numerous phytochemicals have been reported for their potency, efficacy and safety as therapeutic agents against many diseases. This study investigated 99 isolated phytochemicals from Chasmanthera dependens and Carissa edulis against carbonic anhydrase (ii) drug target. The absorption, distribution, metabolism, excretion and toxicity (ADMET) of the isolated compounds were examined using admet SAR-2 web server while Swiss ADME was used to analyze the oral bioavailability, drug-likeness and lead-likeness properties of the selected leads. PASS web server was used to predict the biological activities of selected leads while other important physicochemical properties and interactions of the selected leads with the active site of the target after successful molecular docking simulation with the pyrx virtual screening tool were also examined. The results of these study identified seven lead compounds; C49- alpha-carissanol (-7.6 kcal/mol), C13- Catechin (-7.4 kcal/mol), C45- Salicin (-7.4 kcal/mol), C6- Bisnorargemonine (-7.3 kcal/mol), C36- Pallidine (-7.1 kcal/mol), S4- Lacosamide (-7.1 kcal/mol), and S7- Acetazolamide (-6.4 kcal/mol) for CA II (3HS4 receptor). These leads compounds are probable inhibitors of this drug target due to the observed good binding affinities and favourable interactions with the active site of the drug target, excellent ADMET profiles, PASS Properties, drug-likeness, lead-likeness and oral bioavailability properties. The identified leads have better binding energies as compared to the binding energies of the two standards. Thus, seven identified lead compounds can be developed further towards the development of new anti-epileptic medications.Keywords: drug-likeness, phytochemicals, carbonic anhydrases, metalloeazymes, active site, ADMET
Procedia PDF Downloads 56397 Pregnancy Rate and Outcomes after Uterine Fibroid Embolization Single Centre Experience in the Middle East from the United Arab Emirates at Alain Hospital
Authors: Jamal Alkoteesh, Mohammed Zeki, Mouza Alnaqbi
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Objective: To evaluate pregnancy outcomes, complications and neonatal outcomes in women who had previously undergone uterine arterial embolization. Design: Retrospective study. In this study, most women opted for UFE as a fertility treatment after failure of myomectomy or in vitro fertilization, or because hysterectomy was the only suggested option. Background. Myomectomy is the standard approach in patients with fibroids desiring a future pregnancy. However, myomectomy may be difficult in cases of numerous interstitial and/or submucous fibroids.In these cases, UFE has the advantage of embolizing all fibroids in one procedure. This procedure is an accepted nonsurgical treatment for symptomatic uterine fibroids. Study Methods: A retrospective study of 210 patients treated with UFE for symptomatic uterine fibroids between 2011-2016 was performed. UFE was performed using ((PVA; Embozen, Beadblock) (500-900 µm in diameter). Pregnancies were identified using screening questionnaires and the study database. Of the 210 patients who received UFE treatment, 35 women younger than the age of 40 wanted to conceive and had been unable. All women in our study were advised to wait six months or more after UFE before attempting to become pregnant, of which the reported time range before attempting to conceive was seven to 33 months (average 20 months). RESULTS: In a retrospective chart review of patients younger than the age of 40 (35 patients,18 patients reported 23 pregnancies, of which five were miscarriages. Two more pregnancies were complicated by premature labor. Of the 23 pregnancies, 16 were normal full-term pregnancies, 15 women had conceived once, and four had become pregnant twice. The remaining patients did not conceive. In the study, there was no reported intrauterine growth retardation in the prenatal period, fetal distress during labor, or problems related to uterine integrity. Two patients reported minor problems during pregnancy that were borderline oligohydramnios and low-lying placenta. In the cohort of women who did conceive, overall, 16 out of 18 births proceeded normally without any complications (86%). Eight women delivered by cesarean section, and 10 women had normal vaginal delivery. In this study of 210 women, UFE had a fertility rate of 47%. Our group of 23 pregnancies was small, but did confirm successful pregnancy after UFE. The 45.7% pregnancy rate in women below the age of 40 years old who completed a term pregnancy compares favorably with women who underwent myomectomy via other method. Of the women in the cohort who did conceive, subsequent birth proceeded normally (86%). Conclusion: Pregnancy after UFE is well-documented. The risks of infertility following embolization, premature menopause, and hysterectomy are small, as is the radiation exposure during embolization. Fertility rates appear similar to patients undergoing myomectomy.UFE should not be contraindicated in patients who want to conceive and they should be able to choose between surgical options and UFE.Keywords: fibroid, pregnancy, therapeutic embolization, uterine artery
Procedia PDF Downloads 228396 BSYJ Promoting Homing and Differentiation of Mesenchymal Stem Cells at the Retina of Age-Related Macular Degeneration Model Mice Induced by Sodium Iodate
Authors: Lina Liang, Kai Xu, Jing Zhang
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Purpose: Age-related macular degeneration (AMD) is a major leading cause of visual impairment and blindness with no cure currently established. Cell replacement is discussed as a potential therapy for AMD. Besides intravitreal injection and subretinal injection, intravenous administration has been explored as an alternative route. This study is to observe the effect of BSYJ, a traditional Chinese medicine on the homing and differentiation of mesenchymal stem cells transplanted via tail vein injection in an age-related macular degeneration mouse model. Methods: Four-week-old C57BL/6J mice were injected with 40 mg/kg NaIO₃ to induce age-related macular degeneration model. At the second day after NaIO₃ injection, 1×10⁷ GFP labeled bone marrow-derived mesenchymal stem cells (GFP-MSCs) were transplanted via tali vein injection into the experimental mice. Then the mice were randomly divided into two groups, gavaged with either BSYJ solution (BSYJ group, n=12) or distilled water (DW group, n=12). 12 age-matched healthy C57BL/6J mice were fed regularly as normal control. At day 7, day 14, and day 28 after treatment, retina flat mounting was used to detect the homing of mesenchymal stem cells at the retina. Double-labeling immunofluorescence was used to determine the differentiation of mesenchymal stem cells. Results: At 7, 14, 28 days after treatment, the numbers of GFP-MSCs detected by retina flatmount were 10.2 ± 2.5, 14.5 ± 3.4 and 18.7 ± 5.8, respectively in the distilled water group, while 15.7 ± 3.8, 32.3 ± 3.5 and 77.3 ± 6.4 in BSYJ group, the differences between the two groups were significant (p < 0.05). At 28 days after treatment, it was shown by double staining immunofluorescence that there were more GFP positive cells in the retina of BSYJ group than that of the DW group, but none of the cells expressed RPE specific genes such as RPE65 and CRALBP, or photoreceptor genes such as recoverin and rhodopsin either in BSYJ group or DW group. However, GFAP positive cells were found among the cells labeled with GFP, and the double labeling cells were much more in the BSYJ group than the distilled water group. Conclusion: BSYJ could promote homing of mesenchymal stem cells at the retina of age-related macular degeneration model mice induced by NaIO₃, and the differentiation towards to glial cells. Acknowledgement: National Natural Foundation of China (No: 81473736, 81674033,81973912).Keywords: BSYJ, differentiation, homing, mesenchymal stem cells
Procedia PDF Downloads 145395 Exposure to Radon on Air in Tourist Caves in Bulgaria
Authors: Bistra Kunovska, Kremena Ivanova, Jana Djounova, Desislava Djunakova, Zdenka Stojanovska
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The carcinogenic effects of radon as a radioactive noble gas have been studied and show a strong correlation between radon exposure and lung cancer occurrence, even in the case of low radon levels. The major part of the natural radiation dose in humans is received by inhaling radon and its progenies, which originates from the decay chain of U-238. Indoor radon poses a substantial threat to human health when build-up occurs in confined spaces such as homes, mines and caves and the risk increases with the duration of radon exposure and is proportional to both the radon concentration and the time of exposure. Tourist caves are a case of special environmental conditions that may be affected by high radon concentration. Tourist caves are a recognized danger in terms of radon exposure to cave workers (guides, employees working in shops built above the cave entrances, etc.), but due to the sensitive nature of the cave environment, high concentrations cannot be easily removed. Forced ventilation of the air in the caves is considered unthinkable due to the possible harmful effects on the microclimate, flora and fauna. The risks to human health posed by exposure to elevated radon levels in caves are not well documented. Various studies around the world often detail very high concentrations of radon in caves and exposure of employees but without a follow-up assessment of the overall impact on human health. This study was developed in the implementation of a national project to assess the potential health effects caused by exposure to elevated levels of radon in buildings with public access under the National Science Fund of Bulgaria, in the framework of grant No КП-06-Н23/1/07.12.2018. The purpose of the work is to assess the radon level in Bulgarian caves and the exposure of the visitors and workers. The number of caves (sampling size) was calculated for simple random selection from total available caves 65 (sampling population) are 13 caves with confidence level 95 % and confidence interval (margin of error) approximately 25 %. A measurement of the radon concentration in air at specific locations in caves was done by using CR-39 type nuclear track-etch detectors that were placed by the participants in the research team. Despite the fact that all of the caves were formed in karst rocks, the radon levels were rather different from each other (97–7575 Bq/m3). An assessment of the influence of the orientation of the caves in the earth's surface (horizontal, inclined, vertical) on the radon concentration was performed. Evaluation of health hazards and radon risk exposure causing by inhaling the radon and its daughter products in each surveyed caves was done. Reducing the time spent in the cave has been recommended in order to decrease the exposure of workers.Keywords: tourist caves, radon concentration, exposure, Bulgaria
Procedia PDF Downloads 189394 A Research on the Improvement of Small and Medium-Sized City in Early-Modern China (1895-1927): Taking Southern Jiangsu as an Example
Authors: Xiaoqiang Fu, Baihao Li
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In 1895, the failure of Sino-Japanese prompted the trend of comprehensive and systematic study of western pattern in China. In urban planning and construction, urban reform movement sprang up slowly, which aimed at renovating and reconstructing the traditional cities into modern cities similar to the concessions. During the movement, Chinese traditional city initiated a process of modern urban planning for its modernization. Meanwhile, the traditional planning morphology and system started to disintegrate, on the contrary, western form and technology had become the paradigm. Therefore, the improvement of existing cities had become the prototype of urban planning of early modern China. Currently, researches of the movement mainly concentrate on large cities, concessions, railway hub cities and some special cities resembling those. However, the systematic research about the large number of traditional small and medium-sized cities is still blank, up to now. This paper takes the improvement constructions of small and medium-sized cities in Southern region of Jiangsu Province as the research object. First of all, the criteria of small and medium-sized cities are based on the administrative levels of general office and cities at the county level. Secondly, the suitability of taking the Southern Jiangsu as the research object. The southern area of Jiangsu province called Southern Jiangsu for short, was the most economically developed region in Jiangsu, and also one of the most economically developed and the highest urbanization regions in China. As the most developed agricultural areas in ancient China, Southern Jiangsu formed a large number of traditional small and medium-sized cities. In early modern times, with the help of the Shanghai economic radiation, geographical advantage and powerful economic foundation, Southern Jiangsu became an important birthplace of Chinese national industry. Furthermore, the strong business atmosphere promoted the widespread urban improvement practices, which were incomparable of other regions. Meanwhile, the demonstration of Shanghai, Zhenjiang, Suzhou and other port cities became the improvement pattern of small and medium-sized city in Southern Jiangsu. This paper analyzes the reform movement of the small and medium-sized cities in Southern Jiangsu (1895-1927), including the subjects, objects, laws, technologies and the influence factors of politic and society, etc. At last, this paper reveals the formation mechanism and characteristics of urban improvement movement in early modern China. According to the paper, the improvement of small-medium city was a kind of gestation of the local city planning culture in early modern China,with a fusion of introduction and endophytism.Keywords: early modern China, improvement of small-medium city, southern region of Jiangsu province, urban planning history of China
Procedia PDF Downloads 260393 Identification and Characterization of Polysaccharide Biosynthesis Protein (CAPD) of Enterococcus faecium
Authors: Liaqat Ali, Hubert E. Blum, Türkân Sakinc
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Enterococcus faecium is an emerging multidrug-resistant nosocomial pathogen increased dramatically worldwide and causing bacteremia, endocarditis, urinary tract and surgical site infections in immunocomprised patients. The capsular polysaccharides that contribute to pathogenesis through evasion of the host innate immune system are also involved in hindering leukocyte killing of enterococci. The gene cluster (enterococcal polysaccharide antigen) of E. faecalis encoding homologues of many genes involved in polysaccharide biosynthesis. We identified two putative loci with 22 kb and 19 kb which contained 11 genes encoding for glycosyltransferases (GTFs); this was confirmed by using genome comparison of already sequenced strains that has no homology to known capsule genes and the epa-locus. The polysaccharide-conjugate vaccines have rapidly emerged as a suitable strategy to combat different pathogenic bacteria, therefore, we investigated a polysaccharide biosynthesis CapD protein in E. faecium contains 336 amino acids and had putative function for N-linked glycosylation. The deletion/knock-out capD mutant was constructed and complemented by homologues recombination method and confirmed by using PCR and sequencing. For further characterization and functional analysis, in-vitro cell culture and in-vivo a mouse infection models were used. Our ΔcapD mutant shows a strong hydrophobicity and all strains exhibited biofilm production. Subsequently, the opsonic activity was tested in an opsonophagocytic assay which shows increased in mutant compared complemented and wild type strains but more than two fold decreased in colonization and adherence was seen on surface of uroepithelial cells. However, a significant higher bacterial colonialization was observed in capD mutant during animal bacteremia infection. Unlike other polysaccharides biosynthesis proteins, CapD does not seems to be a major virulence factor in enterococci but further experiments and attention is needed to clarify its function, exact mechanism and involvement in pathogenesis of enteroccocal nosocomial infections eventually to develop a vaccine/ or targeted therapy.Keywords: E. faecium, pathogenesis, polysaccharides, biofilm formation
Procedia PDF Downloads 333392 Enhance Concurrent Design Approach through a Design Methodology Based on an Artificial Intelligence Framework: Guiding Group Decision Making to Balanced Preliminary Design Solution
Authors: Loris Franchi, Daniele Calvi, Sabrina Corpino
Abstract:
This paper presents a design methodology in which stakeholders are assisted with the exploration of a so-called negotiation space, aiming to the maximization of both group social welfare and single stakeholder’s perceived utility. The outcome results in less design iterations needed for design convergence while obtaining a higher solution effectiveness. During the early stage of a space project, not only the knowledge about the system but also the decision outcomes often are unknown. The scenario is exacerbated by the fact that decisions taken in this stage imply delayed costs associated with them. Hence, it is necessary to have a clear definition of the problem under analysis, especially in the initial definition. This can be obtained thanks to a robust generation and exploration of design alternatives. This process must consider that design usually involves various individuals, who take decisions affecting one another. An effective coordination among these decision-makers is critical. Finding mutual agreement solution will reduce the iterations involved in the design process. To handle this scenario, the paper proposes a design methodology which, aims to speed-up the process of pushing the mission’s concept maturity level. This push up is obtained thanks to a guided negotiation space exploration, which involves autonomously exploration and optimization of trade opportunities among stakeholders via Artificial Intelligence algorithms. The negotiation space is generated via a multidisciplinary collaborative optimization method, infused by game theory and multi-attribute utility theory. In particular, game theory is able to model the negotiation process to reach the equilibria among stakeholder needs. Because of the huge dimension of the negotiation space, a collaborative optimization framework with evolutionary algorithm has been integrated in order to guide the game process to efficiently and rapidly searching for the Pareto equilibria among stakeholders. At last, the concept of utility constituted the mechanism to bridge the language barrier between experts of different backgrounds and differing needs, using the elicited and modeled needs to evaluate a multitude of alternatives. To highlight the benefits of the proposed methodology, the paper presents the design of a CubeSat mission for the observation of lunar radiation environment. The derived solution results able to balance all stakeholders needs and guaranteeing the effectiveness of the selection mission concept thanks to its robustness in valuable changeability. The benefits provided by the proposed design methodology are highlighted, and further development proposed.Keywords: concurrent engineering, artificial intelligence, negotiation in engineering design, multidisciplinary optimization
Procedia PDF Downloads 136