Search results for: post cancer maxillary reconstruction

Authors: David Mafullul, Jiang Lei, Edward Goacher, Jibin Francis

Abstract:

PURPOSE: Timely decompressive surgery for cauda equina syndrome (CES) is dependent on efficient referral pathways for patients presenting at local primary or secondary centres to tertiary spinal centres in the United Kingdom (UK). Identifying modifiable points of delay within this process is important as minimising time between presentation and surgery may improve patient outcomes. This study aims to analyse whether adequacy of referral impacts on time to surgery in CES. MATERIALS AND METHODS: Data from all cases of confirmed CES referred to a single tertiary UK hospital between August 2017 to December 2019, via a suspected CES e-referral pathway, were obtained retrospectively. Referral adequacy was defined by the inclusion of sufficient information to determine the presence or absence of several NICE ‘red flags’. Correlation between referral adequacy and delay from referral-to-surgery was then analysed. RESULTS: In total, 118 confirmed CES cases were included. Adequate documentation for saddle anaesthesia was associated with reduced delays of more than 48 hours from referral-to-surgery [X2(1, N=116)=7.12, p=.024], an effect partly attributable to these referrals being accepted sooner [U=16.5; n1=27, n2=4, p=.029, r=.39]. Other red flags had poor association with delay. Referral adequacy was better for somatic red flags [bilateral sciatica (97.5%); severe or progressive bilateral neurological deficit of the legs (95.8%); saddle anaesthesia (91.5%)] compared to autonomic red flags [loss of anal tone (80.5%); urinary retention (79.7%); faecal incontinence or lost sensation of rectal fullness (57.6%)]. Although referral adequacy for urinary retention was 79.7%, only 47.5% of referrals documented a post-void residual numerical value. CONCLUSIONS: Adequate documentation of saddle anaesthesia in e-referrals is associated with reduced delay-to-surgery for confirmed CES, partly attributable to these referrals being accepted sooner. Other red flags had poor association with delay to surgery. Referral adequacy for autonomic red flags, including documentation for post-void residuals, has significant room for improvement.

Keywords: cauda equina, cauda equina syndrome, neurosurgery, spinal surgery, decompression, delay, referral, referral adequacy

Procedia PDF Downloads 39

Authors: Wisam Ismail, Sarah Hosgood, Michael Nicholson

Abstract:

The research hypothesis is that early post-transplant allograft fibrosis will be linked to donor factors and that acute rejection and/or delayed graft function in the recipient will be independent risk factors for the development of fibrosis. This research hypothesis is to explore whether acute rejection/delay graft function has an effect on the renal transplant fibrosis within the first year post live donor kidney transplant between 1998 and 2009. Methods: The study has been designed to identify five time points of the renal transplant biopsies [0 (pre-transplant), 1 month, 3 months, 6 months and 12 months] for 300 live donor renal transplant patients over 12 years period between March 1997 – August 2009. Paraffin fixed slides were collected from Leicester General Hospital and Leicester Royal Infirmary. These were routinely sectioned at a thickness of 4 Micro millimetres for standardization. Conclusions: Fibrosis at 1 month after the transplant was found significantly associated with baseline fibrosis (p<0.001) and HTN in the transplant recipient (p<0.001). Dialysis after the transplant showed a weak association with fibrosis at 1 month (p=0.07). The negative coefficient for HTN (-0.05) suggests a reduction in fibrosis in the absence of HTN. Fibrosis at 1 month was significantly associated with fibrosis at baseline (p 0.01 and 95%CI 0.11 to 0.67). Fibrosis at 3, 6 or 12 months was not found to be associated with fibrosis at baseline (p=0.70. 0.65 and 0.50 respectively). The amount of fibrosis at 1 month is significantly associated with graft survival (p=0.01 and 95%CI 0.02 to 0.14). Rejection and severity of rejection were not found to be associated with fibrosis at 1 month. The amount of fibrosis at 1 month was significantly associated with graft survival (p=0.02) after adjusting for baseline fibrosis (p=0.01). Both baseline fibrosis and graft survival were significant predictive factors. The amount of fibrosis at 1 month was not found to be significantly associated with rejection (p=0.64) after adjusting for baseline fibrosis (p=0.01). The amount of fibrosis at 1 month was not found to be significantly associated with rejection severity (p=0.29) after adjusting for baseline fibrosis (p=0.04). Fibrosis at baseline and HTN in the recipient were found to be predictive factors of fibrosis at 1 month. (p 0.02, p <0.001 respectively). Age of the donor, their relation to the patient, the pre-op Creatinine, artery, kidney weight and warm time were not found to be significantly associated with fibrosis at 1 month. In this complex model baseline fibrosis, HTN in the recipient and cold time were found to be predictive factors of fibrosis at 1 month (p=0.01,<0.001 and 0.03 respectively). Donor age was found to be a predictive factor of fibrosis at 6 months. The above analysis was repeated for 3, 6 and 12 months. No associations were detected between fibrosis and any of the explanatory variables with the exception of the donor age which was found to be a predictive factor of fibrosis at 6 months.

Keywords: fibrosis, transplant, renal, rejection

Procedia PDF Downloads 230

Authors: Tien Hui Chiang

Abstract:

Along with the predominant influence of neo-liberalism, public managerialism is viewed as a panacea for curing the institutionalized weakness caused by the monopoly of the public sector. In the name of efficiency, its outcome-led approach acquires a legitimate status and, in turn, it transforms into the discourse of performativity, reformulating the souls of individual members into the form of docile bodies who are willing to demonstrate their own ability in organizational contributions. The evaluation system and the organizational reconstruction are viewed as the crucial means for achieving this mission. Inevitably, university teachers are confined within a rigid and bureaucratic setting, in which they do not have too much latitude but are subject to the commands of senior administrators. However, the notion of duality highlights the interaction between structural constraints and agency. If the actor discovers the rules or properties of social structure, he/she is able to transform structural constraints into resources for developing creative actions, conceptualized as an agency. This study was designed for examining how duality operates within this hierarchical arrangement formed by public managerialism. Fourteen informants were interviewed from February to August 2014. The findings show that the evaluation system created the culture of neo-academicalism, addressing excellence in research and, in turn, motivating academic-oriented teachers. This correspondence provided a gateway for them to win honor, dignity, and prestige in groups. However, unlike the concept of duality, this agency was operating within the institutionalized context, regulated by structural constraint. Furthermore, complying with the rule/property of social structure was able to secure their advantages.

Keywords: public managerialism, social discourse, neo-academicalism, duality, structural constraint, agency

Procedia PDF Downloads 238

Authors: Kristin Thooft

Abstract:

— Increasing pressure to manage healthcare costs has resulted in shifting care towards ambulatory settings and is driving a focus on cost transparency. There are few nurse staffing to workload models developed for ambulatory settings, less for multi-specialty clinics. Of the existing models, few have been evaluated against outcomes to understand any impact. This evaluation took place after the AWARD model for nurse staffing to workload was implemented in a multi-specialty clinic at a regional healthcare system in the Midwest. The multi-specialty clinic houses 26 medical and surgical specialty practices. The AWARD model was implemented in two specialty practices in October 2020. Donabedian’s Structure-Process-Outcome (SPO) model was used to evaluate outcomes based on changes to the structure and processes of care provided. The AWARD model defined and quantified the processes, recommended changes in the structure of day-to-day nurse staffing. Cost of care per patient visit, total visits, a total nurse performed visits used as structural and process measures, influencing the outcomes of cost of care and access to care. Independent t-tests were used to compare the difference in variables pre-and post-implementation. The SPO model was useful as an evaluation tool, providing a simple framework that is understood by a diverse care team. No statistically significant changes in the cost of care, total visits, or nurse visits were observed, but there were differences. Cost of care increased and access to care decreased. Two weeks into the post-implementation period, the multi-specialty clinic paused all non-critical patient visits due to a second surge of the COVID-19 pandemic. Clinic nursing staff was re-allocated to support the inpatient areas. This negatively impacted the ability of the Nurse Manager to utilize the AWARD model to plan daily staffing fully. The SPO framework could be used for the ongoing assessment of nurse staffing performance. Additional variables could be measured, giving a complete picture of the impact of nurse staffing. Going forward, there must be a continued focus on the outcomes of care and the value of nursing

Keywords: ambulatory, clinic, evaluation, outcomes, staffing, staffing model, staffing to workload

Procedia PDF Downloads 173

Authors: Marcela Karmazínová, Jindrich Melcher, Lubomír Vítek, Petr Cikrle

Abstract:

The paper deals with the diagnostics of steel roof structure of the winter sports stadiums built in 1970 year. The necessity of the diagnostics has been given by the requirement to the evaluation design of this structure, which has been caused by the new situation in the field of the loadings given by the validity of the European Standards in the Czech Republic from 2010 year. Due to these changes in the normative rules, in practice, existing structures are gradually subjected to the evaluation design and depending on its results to the strengthening or reconstruction, respectively. The steel roof is composed of plane truss main girders, purlins and bracings and the roof structure is supported by two arch main girders with the span of L=84 m. The in situ diagnostics of the roof structure was oriented to the following parts: (i) determination and evaluation of the actual material properties of used steel and (ii) verification of the actual dimensions of the structural members. For the solution, the non-destructive methods have been used for in situ measurement. For the indicative determination of steel strengths the modified method based on the determination of Rockwell’s hardness has been used. For the verification of the member’s dimensions (thickness of hollow sections) the ultrasound method has been used. This paper presents the results obtained using these testing methods and their evaluation, from the viewpoint of the usage for the subsequent static assessment and design evaluation of the existing structure. For the comparison, the examples of the similar evaluations realized for steel structures of the stadiums in Olomouc and Jihlava cities are briefly illustrated, too.

Keywords: actual dimensions, destructive methods, diagnostics, existing steel structure, indirect non-destructive methods, Rockwel’s hardness, sport hall, steel strength, ultrasound method.

Procedia PDF Downloads 342

Authors: N. G. I. Aroshana, S. Edirisooriya

Abstract:

Construction of highway is the most emerging development tendency in Sri Lanka. With these development activities, there are a lot of environmental and social issues started. Landscape fragmentation is one of the main issues that highly effect to the environment by the construction of expressways. Sri Lankan expressway system getting effort to treat fragmented landscape by using highway crossing structures. This paper designates, a highway post construction landscape study on the effectiveness of the landscape connectivity structures to restore connectivity. Geographic Information Systems (GIS), least cost path tool has been used in the selected two plots; 25km alone the expressway to identify animal crossing paths. Animal accident data use as measure for determining the most contributed plot for landscape connectivity. Number of patches, Mean patch size, Class area use as a parameter to determine the most effective land use class to reestablish the landscape connectivity. The findings of the research express scrub, grass and marsh were the most positively affected land use typologies for increase the landscape connectivity. It represents the growth increased by 8% within the 12 years of time. From the least cost analysis within the plot one, 28.5% of total animal crossing structures are within the high resistance land use classes. Southern expressway used reinforced compressed earth technologies for construction. It has been controlled the growth of the climax community. According to all findings, it could assume that involvement of the landscape crossing structures contributes to re-establish connectivity, but it is not enough to restore the majority of disturbance performed by the expressway. Connectivity measures used within the study can use as a tool for re-evaluate future involvement of highway crossing structures. Proper placement of the highway crossing structures leads to increase the rate of connectivity. The study recommends that monitoring the all stages (preconstruction, construction and post construction) of the project and preliminary design, and the involvement of the research applied connectivity assessment strategies helps to overcome the complication regarding the re-establishment of landscape connectivity using the highway crossing structures that facilitate the growth of flora and fauna.

Keywords: landscape fragmentation, least cost path, land use analysis, landscape connectivity structures

Procedia PDF Downloads 149

Authors: Hong Geng, Zaiyu Fan

Abstract:

With the acceleration of urbanization and motorization in China, the scale of cities and the travel distance of residents are constantly expanding, and the number of cars is continuously increasing, so the urban traffic problem is more and more serious. Traffic congestion, environmental pollution, energy consumption, travel safety and direct interference between traffic and other urban activities are increasingly prominent problems brought about by motorized development. This not only has a serious impact on the lives of the residents but also has a major impact on the healthy development of the city. The paper found that, in order to solve the development of motorization, a number of problems will arise; urban planning and traffic planning and design in residential planning often take into account the development of motorized traffic but neglects the demand for street life. This kind of planning has resulted in the destruction of the traditional communication space of the residential area, the pollution of noise and exhaust gas, and the potential safety risks of the residential area, which has disturbed the previously quiet and comfortable life of the residential area, resulting in the inconvenience of residents' life and the loss of street vitality. Based on these facts, this paper takes a residential area in Wuhan as the research object, through the actual investigation and research, from the perspective of micro-transformation analysis, combined with the concept of traffic micro-reconstruction governance. And research puts forward the residential traffic optimization strategies such as strengthening the interaction and connection between the residential area and the urban street system, street traffic classification and organization.

Keywords: micro-transformation, residential traffic, residents demand, traffic microcirculation

Procedia PDF Downloads 116

Authors: Tuba Bagatarhan, Digdem Muge Siyez

Abstract:

The aim of this research is to examine the effects of the psycho-education program on problem-solving skills of parents of high school students in the risk group for Internet addiction. A quasi-experimental design based on the pre-test, post-test and follow up test including experimental and control groups was used in the research. The independent variable of the study was the parent psycho-education program on problem-solving skills; the dependent variable was the problem-solving skills of parents. The research was conducted with the parents of 52 tenth-grade students in the risk group for Internet addiction from two high schools and volunteer to participate research on evaluation of the effectiveness of internet addiction prevention psycho-education program within the scope of another study. In this study, as 26 students were in the experimental groups in the first-high school, the parents of these 26 students were asked if they would like to participate in the parent psycho-education program on parental problem-solving skills. The parents were volunteer to participate in parent psycho-education program assigned experimental group (n=13), the other parents assigned control group 1 (n=13) in the first high school. The parents of the 26 students were randomly assigned to the control group 2 (n=13) and control group 3 (n=13) in the second high school. The data of the research was obtained via the problem behavior scale - coping - parents form and demographic questionnaire. Four-session parent psycho-education program to cope with Internet addiction and other problem behaviors in their children was applied to the experimental group. No program was applied to the control group 1, control group 2 and control group 3. In addition, an internet addiction prevention psycho-education program was applied to the children of the parents in experimental group and control group 1 within the scope of another study. In the analysis of the obtained data, two-factor variance analysis for repeated measures on one factor was used. Bonferroni post-hoc test was used to find the source of intergroup difference. According to the findings, the psycho-education program significantly increases parents’ problem-solving abilities, and the increase has continued throughout the follow-up test.

Keywords: internet addiction, parents, prevention, psyho-education

Procedia PDF Downloads 182

Authors: H. Demirtaş, İ. H. Kara, H. Ahlatcı

Abstract:

Welding failures of steel pipes in power plants usually occur in weld zones. This is similar for the economizer, water walls and superheaters in the power plants where SA 210 Gr. C steel pipes are used. Although these steel pipes have very good welding properties, the welding parameters are also important for the welding life. Welding processes of this pipes are carried out by TIG and SMA techniques. In this study SA 210 Gr. C steel pipes were welded by TIG method and investigated how PWHT affected the welding properties. The results show that this steel does not require post weld heat treatment.

Keywords: SA 210 Gr. C steel pipes, TIG welding, HAZ region, Widmanstatten ferrite

Procedia PDF Downloads 298

Authors: Lijuan Zhou, Mengqi Wu, Changyong Niu

Abstract:

Attributed graph clustering can utilize the graph topology and node attributes to uncover hidden community structures and patterns in complex networks, aiding in the understanding and analysis of complex systems. Utilizing contrastive learning for attributed graph clustering can effectively exploit meaningful implicit relationships between data. However, existing attributed graph clustering methods based on contrastive learning suffer from the following drawbacks: 1) Complex data augmentation increases computational cost, and inappropriate data augmentation may lead to semantic drift. 2) The selection of positive and negative samples neglects the intrinsic cluster structure learned from graph topology and node attributes. Therefore, this paper proposes a method called self-supervised Attributed Graph Clustering with Dual Contrastive Loss constraints (AGC-DCL). Firstly, Siamese Multilayer Perceptron (MLP) encoders are employed to generate two views separately to avoid complex data augmentation. Secondly, the neighborhood contrastive loss is introduced to constrain node representation using local topological structure while effectively embedding attribute information through attribute reconstruction. Additionally, clustering-oriented contrastive loss is applied to fully utilize clustering information in global semantics for discriminative node representations, regarding the cluster centers from two views as negative samples to fully leverage effective clustering information from different views. Comparative clustering results with existing attributed graph clustering algorithms on six datasets demonstrate the superiority of the proposed method.

Keywords: attributed graph clustering, contrastive learning, clustering-oriented, self-supervised learning

Procedia PDF Downloads 54

Authors: Maari Sugawara

Abstract:

This arts-based research is about "self-torture": the interplay of seemingly opposing elements of pain, pleasure, submission, and power. It asserts that "self-torture" can be considered a nontrivial mediation between the aesthetic and the sociopolitical. It explores what the author calls queered self-torture; "self-torture" marked by an ambivalence that allows the oppressed to resist, and their counter-valorization occasionally functions as therapeutic solutions to the problems they highlight and condense. The research goal is to deconstruct normative self-torture and propose queered self-torture as a fertile ground for considering the complexities of desire that allow the oppressed to practice freedom. While “self-torture” manifests in many societies, this research focuses on cultural and national identity in post-WWII Japan using this lens of self-torture, as masochism functions as the very basis for Japanese cultural and national identity to ensure self-preservation. This masochism is defined as an impulse to realize a sense of pride and construct an identity through the acceptance of subordination, shame, and humiliation in the face of an all-powerful Other; the dominant Euro-America. It could be argued that this self-torture is a result of Japanese cultural annihilation and the trauma of the nation's defeat to the US. This is the definition of "self-torturous thresholds," the author’s post-WWII Japan psycho-historical diagnosis; when this threshold is crossed, the oppressed begin to torture themselves; the oppressors no longer need to do anything to maintain their power. The oppressed are already oppressing themselves. The term "oppressed" here refers to Japanese individuals and residents of Japan who are subjected to oppressive “white” heteropatriarchal supremacist structures and values that serve colonialist interests. There are three stages in "self-torturous thresholds": (1) the oppressors no longer need to oppress because the oppressed voluntarily commit to self-torture; (2) the oppressed find pleasure in self-torture; and (3) the oppressed achieve queered self-torture, to achieve alternative futures. Using the conceptualization of "self-torture," this research examines and critiques pleasure, desire, capital, and power in postwar Japan, which enables the discussion of the data-colonizing “Moonshot Research and Development program”. If the oppressed want to divest from the habits of normative self-torture, which shape what is possible in both our present and future, we need methods to feel and know that the alternative results of self-torture are possible. Phase three will be enacted using Sarah Ahmed's queer methodology to reorient national and cultural identity away from heteronormativity. Through theoretical analysis, textual analysis, archival research, ethnographic interviews, and digital art projects, including experimental documentary as a method to capture the realities of the individuals who are practicing self-torture, this research seeks to reveal how self-torture may become not just a vehicle of pleasure but also a mode of critiquing power and achieving freedom. It seeks to encourage the imaginings of queer Japanese futures, where the marginalized survive Japan’s natural and man-made disasters and Japan’s Imperialist past and present rather than submitting to the country’s continued violence.

Keywords: arts-based research, Japanese studies, interdisciplinary arts, queer studies, cultural studies, popular culture, BDSM, sadomasochism, sexuality, VR, AR, digital art, visual arts, speculative fiction

Procedia PDF Downloads 73

Authors: Pongchan Na-Lampang

Abstract:

The objective of this study was to compare the results of transport of slaughter pigs to slaughterhouse by 2 methods, i.e. individual confined and group confined on the truck on meat quality. The pigs were transported for 1 h on a distance of 70 km. The stocking densities were 0.35 m2/pig and 0.48 m2 for group and individual crate treatment, respectively. It was found that meat quality of pigs transported by 2 different methods as measured in terms of pH level (at 45 min and 48 hr post mortem), color (brightness, redness and yellowness) and water holding capacity was not significantly different.

Keywords: market pig, transportation, meat quality, confinement

Procedia PDF Downloads 389

Authors: Emni Omar Daw Hussin, Pathmawathi Subramanian, Wong Li Ping

Abstract:

Background: To provide quality care at the end of life, nurses should possess knowledge and skills to provide effective end-of-life care, as well as develop the attitudes and interpersonal competence to provide compassionate care. Aim: This study aimed to assess nurses’ knowledge and attitude towards end of life care and caring for terminal ill patients and to examine relationships among demographic variables and nurse’s knowledge and attitudes toward end of life care and caring for terminal ill patients. Method: a cross-sectional study was conducted at 1 tertiary hospital located in Kuala Lumpur, Malaysia. Self-administrative questionnaire was used to collect data from 553 nurses from over all departments except emergency department, operation theater and outpatient clinic. Two tools were used in this study, the Frommelt’s Attitude Toward Care of the Dying (FATCOD) Scale to assess the nurses’ attitude and End of Life Knowledge Assessment to assess the nurses’ knowledge. Result: the result of this study yielded that, the majority of participants (54.8%) and (54.4%) have less positive attitude and knowledge towards end of life care and caring for terminal ill patients respectively. As well as there is no significant relationship were found between nurses’ ethnicity, religion, and the total score of FATCOD scale; End of Life Knowledge Assessment score. On other hand there is significant relationship among nurses’ age, working experience, level of education, attending any post basic courses and the total score of both FATCOD scale and End of Life Knowledge Assessment. Conclusion: A lack of education and experience and post basic course about end of life care and palliative care may contribute to the negative attitudes and poor knowledge regarding end of life care. Providing sufficient courses about end of life care could enhance the nurses’ knowledge towards end of life care, as well as providing a reflective narrative environment in which nurses can express their personal feelings about death and dying could be a potentially effective approach. Implication for Practice: This study elaborates the need for further research to develop an effective educational programs to enhance nurses’ knowledge and to promote positive attitude towards death and dying, as well as enhance communication skills, and coping strategies.

Keywords: knowledge, attitude, nurse, end of life care

Procedia PDF Downloads 444

Authors: L. Kashyap, S. Jha, D. Shende, V. K. Mohan, P. Khanna, A. Aravindan, S. Kashyap, L. Singh, S. Aggarwal

Abstract:

Obesity is associated with a chronic inflammatory state. During surgery, there is an interplay between anaesthetic and surgical stress vis-a-vis the already present complex immune state. Moreover, the postoperative period is dictated by inflammation, which is crucial for wound healing and regeneration. An excess of inflammatory response might hamper recovery besides increasing the risk for infection and complications. There is definite evidence of the immunosuppressive role of inhaled anaesthetic agents. This immune modulation may be brought into effect directly by influencing the innate and adaptive immunity cells. The effects of propofol on immune mechanisms in has been widely elucidated because of its popularity. It reduces superoxide generation, elastase release, and chemotaxis. However, there is no unequivocal proof of one’s superiority over the other. Hence, an anaesthetic regimen with lesser inflammatory potential and specific to the obese patient is needed. OBESITA trial protocol (2019) by Sousa and co-workers in progress aims to test the hypothesis that anaesthesia with sevoflurane results in a weaker proinflammatory response compared to propofol, as evidenced by lower IL-6 and other biomarkers and an increased macrophage differentiation into M2 phenotype in adipose tissue. IL-6 was used as the objective parameter to evaluate inflammation as it is regulated by both surgery and anesthesia. It is the most sensitive marker of the inflammatory response to tissue damage since it is released within minutes by blood leukocytes. We hypothesized that maintenance of anaesthesia with propofol would lead to less inflammation than that with desflurane. Aims: The effect of two anaesthetic techniques, total intravenous anaesthesia (TIVA) with propofol and desflurane, on surgical stress response was evaluated. The primary objective was to compare serum interleukin-6 (IL-6) levels before and after surgery. Methods: In this prospective single-blinded randomized controlled trial undertaken, 30 obese patients (BMI>30 kg/m2) undergoing laparoscopic bariatric surgery under general anaesthesia were recruited. Patients were randomized to receive desflurane or TIVA using a target-controlled infusion for maintenance of anaesthesia. As a marker of inflammation, pre-and post-surgery IL-6 levels were compared. Results: After surgery, IL-6 levels increased significantly in both groups. The rise in IL-6 was less with TIVA than with desflurane; however, it did not reach significance. IL-6 rise post-surgery correlated positively with the complexity of procedure and duration of surgery and anaesthesia, rather than anaesthetic technique. Both groups did not differ in terms of intra-operative hemodynamic and respiratory variables, time to awakening, postoperative pulmonary complications, and duration of hospital stay. The incidence of nausea was significantly higher with desflurane than with TIVA. Conclusion: Inflammatory response did not differ as a function of anaesthetic technique when propofol and desflurane were compared. Also, patient and surgical variables dictated post-operative inflammation more than the anaesthetic factors. Further, larger sample size is needed to confirm or refute these findings.

Keywords: bariatric, biomarkers, inflammation, laparoscopy

Procedia PDF Downloads 123

Authors: L. Mallesha, C. S. Karthik, P. Mallu

Abstract:

A series of new [1-(substituted-benzoyl)-piperidin-4-yl]-(2,4-difluoro-phenyl)-methanone oxime derivatives, 3(a-f) were synthesized and characterized by different spectral studies. All compounds were evaluated for their in vitro antibacterial activity against bacterial strains. These compounds were screened for their antioxidant activity by DPPH• and Fe2+ chelating assay. Antiproliferative effects were evaluated using the MTT assay method against two human cancer cell lines and one astrocytoma brain tumor cell line. Compound 3b exhibited moderate antibacterial activity when compared with other compounds. All the compounds showed antioxidant activity, where compound 3f was the best radical scavenger and Fe2+ ion scavenger. Compounds, 3b, and 3d showed good activity on all cell lines, whereas the other compounds in the series exhibited moderate activity.

Keywords: Piperidine, antibacterial, antioxidant, antiproliferative

Procedia PDF Downloads 414

Authors: E. Samain, T. Aussenac, D. van Tuinen, S. Selim

Abstract:

Plant growth promoting rhizobacteria are known as potential biofertilizers and plant resistance inducers. The present work aims to study the durability of the resistance induced as a response to wheat seeds inoculation with PB2 and its influence by Z. tritici strains. The internal and external roots colonization have been determined in vitro, seven days post inoculation, by measuring the colony forming unit (CFU). In planta experimentations were done under controlled conditions included four wheat cultivars with different levels of resistance against Septoria Leaf Blotch (SLB) and four Z. tritici strains with high aggressiveness and resistance levels to fungicides. Plantlets were inoculated with PB2 at sowing and infected with Z. tritici at 3 leaves or tillering growth stages. The infection level with SLB was evaluated at 17 days post inoculation using real-time quantitative polymerase chain reaction (PCR). Results showed that PB2 has a high potential of wheat root external colonization (> 10⁶ CFU/g of root). However, the internal colonization seems to be cultivar dependent. Indeed, PB2 has not been observed as endophytic for one cultivar but has a high level of internal colonization with more than 104 CFU/g of root concerning the three others. Two wheat cultivars (susceptible and moderated resistant) were used to investigate PB2-induced resistance (PB2-IR). After the first infection with Z. tritici, results showed that PB2-IR has conferred a high protection efficiency (40-90%) against SLB in the two tested cultivars. Whereas the PB2-IR was effective against all tested strains with the moderate resistant cultivar, it was higher with the susceptible cultivar (> 64%) but against three of the four tested strains. Concerning the durability of the PB2-IR, after the second infection timing, it has been observed a significant decrease (10-59%) depending strains in the moderate resistant cultivar. Contrarily, the susceptible cultivar showed a stable and high protection level (76-84%) but against three of the four tested strains and interestingly, the strain that overcame PB2-IR was not the same as that of the first infection timing. To conclude, PB2 induces a high and durable resistance against Z. tritici. The PB2-IR is pathogen strain, plant growth stage and genotype dependent. These results may explain the loss of the induced resistance effectiveness under field conditions.

Keywords: induced resistance, Paenibacillus sp. strain B2, wheat genotypes, Zymoseptoria tritici

Procedia PDF Downloads 149

Authors: H. Pasternak, A. Chwastek

Abstract:

The paper describes the results from a research project about repair of welds. The repair was carried out by grinding the flawed seams and re-welding them. The main task was to determine the FAT classes of original state and after repair of seams according to the assessment procedures, such as nominal, structural and effective notch stress approach. The first part shows the results of the tests, the second part encloses numerical analysis and evaluation of results to determine the fatigue strength classes according to three assessment procedures.

Keywords: cyclic loading, fatigue crack, post-weld treatment, seams’ repair

Procedia PDF Downloads 259

Authors: Karla Kristine Bay, Jovie Ann Gabin, Allana Joyce Sasotona

Abstract:

This research employed an Interpretative Phenomenological Analysis to explore the experiences of Children in Conflict with the Law (CICL) which gave light to their concept of ‘friends’. Derived from this context are the following objectives of the study: 1) determining the differentiation of the forms of friends of the CICL; 2) presenting the process of attachment towards detachment in the formation of friendship; and 3) discussing the experiences, and reflections of the CICL on the ‘self’ out of their encounter with friendship. Using the data gathered from the individual drawings of the CICL of their representations of the self, family, friends, community, and Bahay Kalinga as subjects in the meaning-making process utilizing Filipino Psychology methods of pagtatanong-tanong (interview), and pakikipagkwentuhan (conversation), data analysis produced a synthesis of seventeen individual cases. Overall results generated three superordinate themes on the differentiation of the forms of friends which include friends with good influences, friends with bad influences, and friends within the family. While two superordinate themes were produced on the process of attachment towards detachment, namely social, emotional, and psychological experiences on the process of attachment, and emotional and psychological experiences on the process of detachment. Lastly, two superordinate themes were created on the experiences, and reflections of the CICL on the ‘self’ out of their encounter with friendship. This consists of the recognition of the ‘self’ as a responsible agent in developing healthy relationships between the self and others, and reconstruction of the self from the collective experiences of healing, forgiveness, and acceptance. These findings, together with supporting theories discussed the impact of friendship on the emergence of criminal behavior and other dispositions; springing from the child’s dissociation from the family that led to finding belongingness from an external group called friends.

Keywords: children in conflict with the law, criminal behavior, friends, interpretative phenomenological analysis

Procedia PDF Downloads 235

Authors: A. Raj Kumar, S. Bilaloglu

Abstract:

Stroke is a leading cause of adult disability worldwide. We depend on our hands for our activities of daily living(ADL). Although many patients regain the ability to walk, they continue to experience long-term hand motor impairments. As the number of individuals with young stroke is increasing, there is a critical need for effective approaches for rehabilitation of hand function post-stroke. Motor relearning for dexterity requires task-specific kinesthetic, tactile and visual feedback. However, when a stroke results in both sensory and motor impairment, it becomes difficult to ascertain when and what type of sensory substitutions can facilitate motor relearning. In an ideal situation, real-time task-specific data on the ability to learn and data-driven feedback to assist such learning will greatly assist rehabilitation for dexterity. We have found that kinesthetic and tactile information from the unaffected hand can assist patients re-learn the use of optimal fingertip forces during a grasp and lift task. Measurement of fingertip grip force (GF), load forces (LF), their corresponding rates (GFR and LFR), and other metrics can be used to gauge the impairment level and progress during learning. Currently ATI mini force-torque sensors are used in research settings to measure and compute the LF, GF, and their rates while grasping objects of different weights and textures. Use of the ATI sensor is cost prohibitive for deployment in clinical or at-home rehabilitation. A cost effective mechatronic device is developed to quantify GF, LF, and their rates for stroke rehabilitation purposes using off-the-shelf components such as load cells, flexi-force sensors, and an Arduino UNO microcontroller. A salient feature of the device is its integration with an interactive gaming environment to render a highly engaging user experience. This paper elaborates the integration of kinesthetic and tactile sensing through computation of LF, GF and their corresponding rates in real time, information processing, and interactive interfacing through augmented reality for visual feedback.

Keywords: feedback, gaming, kinesthetic, rehabilitation, tactile

Procedia PDF Downloads 240

Authors: Lancer Scott

Abstract:

Purpose: High quality clinical disaster medicine requires providers working collaboratively to care for multiple patients in chaotic environments; however, many providers lack adequate training. To address this deficit, we created a competency-based, 5-hour Emergency Preparedness Training (EPT) curriculum using didactics, small-group discussion, and kinetic learning. The goal was to evaluate the effect of a short course on improving provider knowledge, confidence and skills in disaster scenarios. Methods: Diverse groups of medical university students, health care professionals, and community members were enrolled between 2011 and 2014. The course consisted of didactic lectures, small group exercises, and two live, multi-patient mass casualty incident (MCI) scenarios. The outcome measures were based on core competencies and performance objectives developed by a curriculum task force and assessed via trained facilitator observation, pre- and post-testing, and a course evaluation. Results: 708 participants completed were trained between November 2011 and August 2014, including 49.9% physicians, 31.9% medical students, 7.2% nurses, and 11% various other healthcare professions. 100% of participants completed the pre-test and 71.9% completed the post-test, with average correct answers increasing from 39% to 60%. Following didactics, trainees met 73% and 96% of performance objectives for the two small group exercises and 68.5% and 61.1% of performance objectives for the two MCI scenarios. Average trainee self-assessment of both overall knowledge and skill with clinical disasters improved from 33/100 to 74/100 (overall knowledge) and 33/100 to 77/100 (overall skill). The course assessment was completed by 34.3% participants, of whom 91.5% highly recommended the course. Conclusion: A relatively short, intensive EPT course can improve the ability of a diverse group of disaster care providers to respond effectively to mass casualty scenarios.

Keywords: clinical disaster medicine, training, hospital preparedness, surge capacity, education, curriculum, research, performance, training, student, physicians, nurses, health care providers, health care

Procedia PDF Downloads 193

Authors: Erna Judith Roach, Nalini Bhaskaranand

Abstract:

Background & Significance: Asthma is the most common chronic disease among children. Education is the cornerstone of management of asthma to help the affected children. In India there are about 1.5- 3.0 million asthmatic children in the age group of 5-11 years. Many parents face management dilemmas in administration of medications to their children. Mothers being primary caregivers of children are often responsible for administering medications to them. The purpose of the study was to develop an educational package on techniques of drug administration for mothers of asthmatic children and determine its effectiveness in terms of improvement in skill in drug administration. Methodology: A quasi- experimental time series pre-test post -test control group design was used. Mothers of asthmatic children attending paediatric outpatient departments of selected hospitals along with their children between 5 and 12 years were included. Sample size consisted of 40 mothers in the experimental and 40 mothers in the control groups. Block randomization was used to assign samples to both the groups. The data collection instruments used were Baseline Proforma, Clinical Proforma, Daily asthma drug intake and symptoms diary and Observation Rating Scales on technique of using a metered dose inhaler with spacer; metered dose inhaler with facemask; metered dose inhaler alone and dry powder inhaler. The educational package consisted of a video and booklet on techniques of drug administration. Data were collected at baseline, 1, 3 and 6 months. Findings: The mean post-test scores in techniques of drug administration were higher than the mean pre-test scores in the experimental group in all techniques. The Friedman test (p < 0.01), Wilcoxon Signed Rank test (p < 0.008) and Mann Whitney U (p < 0.01) showed statistically significant difference in the experimental group than the control group. There was significant decrease in the average number of symptom days (11 Vs. 4 days/ month) and hospital visits (5 to 1 per month) in the experimental group when compared to the control group. Conclusion: The educational package was found to be effective in improving the skill of mothers in drug administration in all the techniques, especially with using the metered dose inhaler with spacer.

Keywords: childhood asthma, drug administration, mothers of children, inhaler

Procedia PDF Downloads 423

Authors: Merzak Laribi, Abdelmadjid Kasser

Abstract:

Thermal spraying processes are widely used to produce coatings on original constructions as well as in repair and maintenance of long standing structures. A lot of efforts forwarding to develop thermal spray coatings technology have been focused on improving mechanical characteristics, minimizing residual stress level and reducing porosity of the coatings. The specific aim of this paper is to determine either residual stresses distribution or wear resistance of stainless steel coating thermally sprayed on a carbon steel substrate. Internal stresses determination was performed using an extensometric method in combination with a simultaneous progressive electrolytic polishing. The procedure consists of measuring micro-deformations using a bi-directional extensometric gauges glued on the substrate side of the materials. Very thin layers of the deposits are removed by electrochemical polishing across the sample surface. Micro-deformations are instantaneously measured, leading to residual stresses calculation after each removal. Wear resistance of the coating has been determined using a ball-on-plate tribometer. Friction coefficient is instantaneously measured during the tribological test. Attention was particularly focused on the influence of a post-annealing at 850 °C for one hour in vacuum either on the residual stresses distribution or on the wear resistance behavior under specific wear and lubrication conditions. The obtained results showed that the microstructure of the obtained arc sprayed stainless steel coating is classical. It is homogeneous and contains un-melted particles, metallic oxides and also pores and micro-cracks. The internal stresses are in compression in the coating. They are more or less scattered between -50 and -270 MPa on the surface and decreased more at the interface. The value at the surface of the substrate is about –700 MPa, partially due to the molten particles impact with the substrate. The post annealing has reduced the residual stresses in both coating and surface of the steel substrate so that the hole material becomes more relaxed. Friction coefficient has an average value of 0.3 and 0.4 respectively for non annealed and annealed specimen. It is rather oil lubrication which is really benefit so that friction coefficient is decreased to about 0.06.

Keywords: residual stresses, wear resistance, stainless steel, coating, thermal spraying, annealing, lubrication

Procedia PDF Downloads 126

Authors: Majid Bayatian, Mohammadreza Ashouri

Abstract:

Releasing hazardous chemicals is one of the major problems for office buildings in the chemical industry and, therefore, environmental risks are inherent to these environments. The adverse health effects of the airborne concentration of benzene have been a matter of significant concern, especially in oil refineries. The chronic and acute adverse health effects caused by benzene exposure have attracted wide attention. Acute exposure to benzene through inhalation could cause headaches, dizziness, drowsiness, and irritation of the skin. Chronic exposures have reported causing aplastic anemia and leukemia at the occupational settings. Association between chronic occupational exposure to benzene and the development of aplastic anemia and leukemia were documented by several epidemiological studies. Numerous research works have investigated benzene emissions and determined benzene concentration at different locations of the refinery plant and stated considerable health risks. The high cost of industrial control measures requires justification through lifetime health risk assessment of exposed workers and the public. In the present study, a Computational Fluid Dynamics (CFD) model has been proposed to assess the exposure risk of office building around a refinery due to its release of benzene. For simulation, GAMBIT, FLUENT, and CFD Post software were used as pre-processor, processor, and post-processor, and the model was validated based on comparison with experimental results of benzene concentration and wind speed. Model validation results showed that the model is highly validated, and this model can be used for health risk assessment. The simulation and risk assessment results showed that benzene could be dispersion to an office building nearby, and the exposure risk has been unacceptable. According to the results of this study, a validated CFD model, could be very useful for decision-makers for control measures and possibly support them for emergency planning of probable accidents. Also, this model can be used to assess exposure to various types of accidents as well as other pollutants such as toluene, xylene, and ethylbenzene in different atmospheric conditions.

Keywords: health risk assessment, office building, Benzene, numerical simulation, CFD

Procedia PDF Downloads 130

Authors: Brendah Nagula, Omolo Fredrick Okalebo, Ronald Ssengendo, Ivan Bamweyana

Abstract:

The Kampala Physical Development Plan (KPDP) was developed in 2012 and projected both long term and short term developments within the City .The purpose of the plan was to not only shape the city into a spatially planned area but also to control the urban sprawl trends that had expanded with pronounced instances of informal settlements. This plan was approved by the National Physical Planning Board and a signature was appended by the Minister in 2013. Much as the KPDP plan has been implemented using different approaches such as detailed planning, development control, subdivision planning, carrying out construction inspections, greening and beautification, there is still limited knowledge on the level of conformance towards this plan. Therefore, it is yet to be determined whether it has been effective in shaping the City into an ideal spatially planned area. Attaining a clear picture of the level of conformance towards the KPDP 2012 through evaluation between the planned and the existing land use in Kampala City was performed. Methods such as Supervised Classification and Post Classification Change Detection were adopted to perform this evaluation. Scrutiny of findings revealed Central Division registered the lowest level of conformance to the planning standards specified in the KPDP 2012 followed by Nakawa, Rubaga, Kawempe, and Makindye. Furthermore, mixed-use development was identified as the land use with the highest level of non-conformity of 25.11% and institutional land use registered the highest level of conformance of 84.45 %. The results show that the aspect of location was not carefully considered while allocating uses in the KPDP whereby areas located near the Central Business District have higher land rents and hence require uses that ensure profit maximization. Also, the prominence of development towards mixed-use denotes an increased demand for land towards compact development that was not catered for in the plan. Therefore in order to transform Kampala city into a spatially planned area, there is need to carefully develop detailed plans especially for all the Central Division planning precincts indicating considerations for land use densification.

Keywords: spatial plan, post classification change detection, Kampala city, landuse

Procedia PDF Downloads 92

Authors: O. R. Adeniyi, A. Ayandiji

Abstract:

Losses are common in most vegetables because the fruit ripens rapidly and most plantain products can only be stored for a few days thereby limiting their utilization. Plantain (and banana) is highly perishable at the ambient temperature prevalent in the tropics. The specific objective of this study is to identify the socioeconomic characteristics of banana/plantain dealers and determine the perceived effect of the losses incurred in the process of marketing banana/plantain. The study was carried out in Ondo and Lagos states of south-western Nigeria. Purposive sampling technique was used to collect information from “Kolawole plantain depot”, the point of purchase in Ondo State and “Alamutu plantain market” in Mushin the point of sales in Lagos state. Preliminary study was conducted with the use of primary data collected through well-structured questionnaires administered on 60 respondents and 55 fully completed ones analysed. Budgeting, gross margin and multiple linear regression were used for analyses. Most merchants were found to be in the middle age class (30-50 years), majority of whom were female and completed their secondary school education, with eighty percent having more than 5 years’ experience of in banana/plantain marketing. The highest losses were incurred during transportation and these losses constitute about 5.62 percent of the potential total revenue. On the average, loss in gross margin is about ₦6,000.00 per merchant. The impacts of these losses are reflected in the continuously reducing level of their income. Age of the respondents played a major role in determining the level of care in the handling of the fruits. The middle age class tends to be more favoured. In conclusion, the merchants need adequate and sustainable transportation and storage facilities as a matter of utmost urgency. There is the need for government to encourage producers of the product (farmers) by giving them motivating incentives and ensuring that the environment is made conducive also for dealers by providing adequate storage facilities and ready markets locally and possibly for export.

Keywords: post-harvest, losses, plantain, banana, simple regression

Procedia PDF Downloads 319

Authors: Ishith Seth, Lyndel Hewitt, Takako Yabe, James Wykes, Jonathan Clark, Bruce Ashford

Abstract:

Background: Vastus lateralis (VL) can be used to reconstruct defects of the head and neck. Whilst the advantages are documented, donor-site morbidity is not well described. This study aimed to assess donor-site morbidity after VL flap harvest. The results will determine future directions for preventative and post-operative care to improve patient health outcomes. Methods: Ten participants (mean age 55 years) were assessed for the presence of donor-site morbidity after VL harvest. Musculoskeletal (pain, muscle strength, muscle length, tactile sensation), quality of life (SF-12), and lower limb function (lower extremity function, gait (function and speed), sit to stand were assessed using validated and standardized procedures. Outcomes were compared to age-matched healthy reference values or the non-operative side. Analyses were conducted using descriptive statistics and non-parametric tests. Results: There was no difference in muscle strength (knee extension), muscle length, ability to sit-to-stand, or gait function (all P > 0.05). Knee flexor muscle strength was significantly less on the operated leg compared to the non-operated leg (P=0.02) and walking speed was slower than age-matched healthy values (P<0.001). Thigh tactile sensation was impaired in 89% of participants. Quality of life was significantly less for the physical health component of the SF-12 (P<0.001). The mental health component of the SF-12 was similar to healthy controls (P=0.26). Conclusion: There was no effect on donor site morbidity with regards to knee extensor strength, pain, walking function, ability to sit-to-stand, and muscle length. VL harvest affected donor-site knee flexion strength, walking speed, tactile sensation, and physical health-related quality of life.

Keywords: vastus lateralis, morbidity, head and neck, surgery, donor-site morbidity

Procedia PDF Downloads 242

Authors: Vinod Kumar

Abstract:

Background: Tissue Plasminogen Activator (tPA) showed a level 1 benefit in acute stroke (within 3-6 hrs). Intracarotid sodium nitroprusside (ICSNP) has been studied in this context with a wide treatment window, fast recovery and affordability. This work proposes two mechanisms for acute cases and one mechanism for chronic cases, which are interrelated, for physiological recovery. a)Retrograde Neurotransmission (acute cases): 1)Normal excitatory impulse: at the synaptic level, glutamate activates NMDA receptors, with nitric oxide synthetase (NOS) on the postsynaptic membrane, for further propagation by the calcium-calmodulin complex. Nitric oxide (NO, produced by NOS) travels backward across the chemical synapse and binds the axon-terminal NO receptor/sGC of a presynaptic neuron, regulating anterograde neurotransmission (ANT) via retrograde neurotransmission (RNT). Heme is the ligand-binding site of the NO receptor/sGC. Heme exhibits > 10,000-fold higher affinity for NO than for oxygen (the 10,000-fold effect) and is completed in 20 msec. 2)Pathological conditions: normal synaptic activity, including both ANT and RNT, is absent. A NO donor (SNP) releases NO from NOS in the postsynaptic region. NO travels backward across a chemical synapse to bind to the heme of a NO receptor in the axon terminal of a presynaptic neuron, generating an impulse, as under normal conditions. b)Vasospasm: (acute cases) Perforators show vasospastic activity. NO vasodilates the perforators via the NO-cAMP pathway. c)Long-Term Potentıatıon (LTP): (chronic cases) The NO–cGMP-pathway plays a role in LTP at many synapses throughout the CNS and at the neuromuscular junction. LTP has been reviewed both generally and with respect to brain regions specific for memory/learning. Aims/Study Des’gn: The principles of “generation of impulses from the presynaptic region to the postsynaptic region by very potent RNT (10,000-fold effect)” and “vasodilation of arteriolar perforators” are the basis of the authors’ hypothesis to treat stroke cases. Case-control prospective study. Mater’als And Methods: The experimental population included 82 stroke patients (10 patients were given control treatments without superfusion or with 5% dextrose superfusion, and 72 patients comprised the ICSNP group). The mean time for superfusion was 9.5 days post-stroke. Pre- and post-ICSNP status was monitored by NIHSS, MRI and TCD. Results: After 90 seconds in the ICSNP group, the mean change in the NIHSS score was a decrease of 1.44 points, or 6.55%; after 2 h, there was a decrease of 1.16 points; after 24 h, there was an increase of 0.66 points, 2.25%, compared to the control-group increase of 0.7 points, or 3.53%; at 7 days, there was an 8.61-point decrease, 44.58%, compared to the control-group increase of 2.55 points, or 22.37%; at 2 months in ICSNP, there was a 6.94-points decrease, 62.80%, compared to the control-group decrease of 2.77 points, or 8.78%. TCD was documented and improvements were noted. Conclusions: ICSNP is a swift-acting drug in the treatment of stroke, acting within 90 seconds on day 9.5 post-stroke with a small decrease after 24 hours. The drug recovers from this decrease quickly.

Keywords: brain infarcts, intracarotid sodium nitroprusside, perforators, vasodilatıons, retrograde transmission, the 10, 000-fold effect

Procedia PDF Downloads 309

Authors: Fernando Martinez Soto, Gaetano Di Mino

Abstract:

The application of rubber into bituminous mixtures requires attention and care during mixing and compaction. Rubber modifies the properties because it reacts in the internal structure of bitumen at high temperatures changing the performance of the mixture (interaction process of solvents with binder-rubber aggregate). The main change is the increasing of the viscosity and elasticity of the binder due to the larger sizes of the rubber particles by dry process but, this positive effect is counteracted by short mixing times, compared to wet technology, and due to the transport processes, curing time and post-compaction of the mixtures. Therefore, negative effects as swelling of rubber particles, rebounding effect of the specimens and thermal changes by different expansion of the structure inside the mixtures, can change the mechanical properties of the rubberized blends. Based on the dry technology, different asphalt-rubber binders using devulcanized or natural rubber (truck and bus tread rubber), have served to demonstrate these effects and how to solve them into two dense-gap graded rubber modified asphalt concrete mixes (RUMAC) to enhance the stability, workability and durability of the compacted samples by Superpave gyratory compactor method. This paper specifies the procedures developed in the Department of Civil Engineering of the University of Palermo during September 2016 to March 2017, for characterizing the post-compaction and mix-stability of the one conventional mixture (hot mix asphalt without rubber) and two gap-graded rubberized asphalt mixes according granulometry for rail sub-ballast layers with nominal size of Ø22.4mm of aggregates according European standard. Thus, the main purpose of this laboratory research is the application of ambient ground rubber from scrap tires processed at conventional temperature (20ºC) inside hot bituminous mixtures (160-220ºC) as a substitute for 1.5%, 2% and 3% by weight of the total aggregates (3.2%, 4.2% and, 6.2% respectively by volumetric part of the limestone aggregates of bulk density equal to 2.81g/cm³) considered, not as a part of the asphalt binder. The reference bituminous mixture was designed with 4% of binder and ± 3% of air voids, manufactured for a conventional bitumen B50/70 at 160ºC-145ºC mix-compaction temperatures to guarantee the workability of the mixes. The proportions of rubber proposed are #60-40% for mixtures with 1.5 to 2% of rubber and, #20-80% for mixture with 3% of rubber (as example, a 60% of Ø0.4-2mm and 40% of Ø2-4mm). The temperature of the asphalt cement is between 160-180 ºC for mixing and 145-160 ºC for compaction, according to the optimal values for viscosity using Brookfield viscometer and 'ring and ball' - penetration tests. These crumb rubber particles act as a rubber-aggregate into the mixture, varying sizes between 0.4mm to 2mm in a first fraction, and 2-4mm as second proportion. Ambient ground rubber with a specific gravity of 1.154g/cm³ is used. The rubber is free of loose fabric, wire, and other contaminants. It was found optimal results in real beams and cylindrical specimens with each HMA mixture reducing the swelling effect. Different factors as temperature, particle sizes of rubber, number of cycles and pressures of compaction that affect the interaction process are explained.

Keywords: crumb-rubber, gyratory compactor, rebounding effect, superpave mix-design, swelling, sub-ballast railway

Procedia PDF Downloads 243

Authors: Priyanka Jain, Ashish K. Sharma, Esha Shukla, K. J. Mukherjee

Abstract:

We propose a paradigm shift in our approach to design improved platforms for recombinant protein production, by addressing system level issues rather than the individual steps associated with recombinant protein synthesis like transcription, translation, etc. We demonstrate that by controlling and modulating the cellular stress response (CSR), which is responsible for feedback control of protein synthesis, we can generate hyper-producing strains. We did transcriptomic profiling of post-induction cultures, expressing different types of protein, to analyze the nature of this cellular stress response. We found significant down-regulation of substrate utilization, translation, and energy metabolism genes due to generation CSR inside the host cell. However, transcription profiling has also shown that many genes are up-regulated post induction and their role in modulating the CSR is unclear. We hypothesized that these up-regulated genes trigger signaling pathways, generating the CSR and concomitantly reduce the recombinant protein yield. To test this hypothesis, we knocked out the up-regulated genes, which did not have any downstream regulatees, and analyzed their impact on cellular health and recombinant protein expression. Two model proteins i.e., GFP and L-Asparaginase were chosen for this analysis. We observed a significant improvement in expression levels, with some knock-outs showing more than 7-fold higher expression compared to control. The 10 best single knock-outs were chosen to make 45 combinations of all possible double knock-outs. A further increase in expression was observed in some of these double knock- outs with GFP levels being highest in a double knock-out ΔyhbC + ΔelaA. However, for L-Asparaginase which is a secretory protein, the best results were obtained using a combination of ΔelaA+ΔcysW knock-outs. We then tested all the knock outs for their ability to enhance the expression of a 'difficult-to-express' protein. The Rubella virus E1 protein was chosen and tagged with sfGFP at the C-terminal using a linker peptide for easy online monitoring of expression of this fusion protein. Interestingly, the highest increase in Rubella-sGFP levels was obtained in the same double knock-out ΔelaA + ΔcysW (5.6 fold increase in expression yield compared to the control) which gave the highest expression for L-Asparaginase. However, for sfGFP alone, the ΔyhbC+ΔmarR knock-out gave the highest level of expression. These results indicate that there is a fair degree of commonality in the nature of the CSR generated by the induction of different proteins. Transcriptomic profiling of the double knock out showed that many genes associated with the translational machinery and energy biosynthesis did not get down-regulated post induction, unlike the control where these genes were significantly down-regulated. This confirmed our hypothesis of these genes playing an important role in the generation of the CSR and allowed us to design a strategy for making better expression hosts by simply knocking out key genes. This strategy is radically superior to the previous approach of individually up-regulating critical genes since it blocks the mounting of the CSR thus preventing the down-regulation of a very large number of genes responsible for sustaining the flux through the recombinant protein production pathway.

Keywords: cellular stress response, GFP, knock-outs, up-regulated genes

Procedia PDF Downloads 228

Authors: Rima Al Garni, Emad Al Shdaifat, Sahar Elmetwalli, Mohammad Alzaid, Abdulrahman Alghothayyan, Sara Al Abd Al Hai, Seham Al Rashidi

Abstract:

Aim: To investigate the prevalence of non-adherence of patients on haemodialysis and explore their perception of the importance of adherence to the therapeutic regime and estimate the predictors for adherence to the therapeutic regime. Background: End-stage renal disease is commonly treated by haemodialysis. Haemodialysis treatment alone is not effective in replacing kidney function. Diet and fluid restrictions, along with supplementary medications, are mandatory for the survival and well-being of patients. Hence, adherence to this therapeutic regimen is essential. However, non-adherence to diet and fluid restrictions, medications, and dialysis is common among patients on haemodialysis. Design: Descriptive cross-sectional method was applied to investigate the prevalence of non-adherence to treatment, including adherence to diet and fluid restrictions, medications, and dialysis sessions. Methods: Structured interviews were conducted using the Arabic version of the End-Stage Renal Disease Adherence Questionnaire. The sample included 230 patients undergoing haemodialysis in the Eastern Region of Saudi Arabia. Data were analysed using descriptive statistics and multiple regressions. Results/Findings: Most patients had good adherence (71.3%), and only 3.9% had poor adherence. The divorced or widowed patient had higher adherence compared with single (P=0.011) and married participants (P=0.045) through using the post hoc test. Patients above 60 years had higher adherence compared to patients below 40 years old (P=0.016) using the post hoc test. For the perception of the importance of adherence to the therapeutic regime subscale, two-thirds of the patients had lower scores (<=11). Conclusion: Adherence to therapeutic regime is high for three fourth of patients undergoing haemodialysis in the Eastern Region of Saudi Arabia; this finding is similar to results abstracted from the local literature. This result would help us highlight the needs of patients who are not compliant with their treatment plans and investigate the consequences of non-adherence on their well-being and general health. Hence, plan individualised therapeutic programmes that could raise their awareness and influence their adherence to therapeutic regimes.

Keywords: adherence to treatment, haemodialysis, end stage renal disease, diet and fluid restrictions

Procedia PDF Downloads 92