Search results for: high dosage drugs
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 21203

Search results for: high dosage drugs

17993 Augmented Tourism: Definitions and Design Principles

Authors: Eric Hawkinson

Abstract:

After designing and implementing several iterations of implementations of augmented reality (AR) in tourism, this paper takes a deep look into design principles and implementation strategies of using AR at destination tourism settings. The study looks to define augmented tourism from past implementations as well as several cases, uses designed and implemented for tourism. The discussion leads to formation of frameworks and best practices for AR as well as virtual reality( VR) to be used in tourism settings. Some main affordances include guest autonomy, customized experiences, visitor data collection and increased electronic word-of-mouth generation for promotion purposes. Some challenges found include the need for high levels of technology infrastructure, low adoption rates or ‘buy-in’ rates, high levels of calibration and customization, and the need for maintenance and support services. Some suggestions are given as to how to leverage the affordances and meet the challenges of implementing AR for tourism.

Keywords: augmented tourism, augmented reality, eTourism, virtual tourism, tourism design

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17992 One-Step Synthesis and Characterization of Biodegradable ‘Click-Able’ Polyester Polymer for Biomedical Applications

Authors: Wadha Alqahtani

Abstract:

In recent times, polymers have seen a great surge in interest in the field of medicine, particularly chemotherapeutics. One recent innovation is the conversion of polymeric materials into “polymeric nanoparticles”. These nanoparticles can be designed and modified to encapsulate and transport drugs selectively to cancer cells, minimizing collateral damage to surrounding healthy tissues, and improve patient quality of life. In this study, we have synthesized pseudo-branched polyester polymers from bio-based small molecules, including sorbitol, glutaric acid and a propargylic acid derivative to further modify the polymer to make it “click-able" with an azide-modified target ligand. Melt polymerization technique was used for this polymerization reaction, using lipase enzyme catalyst NOVO 435. This reaction was conducted between 90- 95 °C for 72 hours. The polymer samples were collected in 24-hour increments for characterization and to monitor reaction progress. The resulting polymer was purified with the help of methanol dissolving and filtering with filter paper then characterized via NMR, GPC, FTIR, DSC, TGA and MALDI-TOF. Following characterization, these polymers were converted to a polymeric nanoparticle drug delivery system using solvent diffusion method, wherein DiI optical dye and chemotherapeutic drug Taxol can be encapsulated simultaneously. The efficacy of the nanoparticle’s apoptotic effects were analyzed in-vitro by incubation with prostate cancer (LNCaP) and healthy (CHO) cells. MTT assays and fluorescence microscopy were used to assess the cellular uptake and viability of the cells after 24 hours at 37 °C and 5% CO2 atmosphere. Results of the assays and fluorescence imaging confirmed that the nanoparticles were successful in both selectively targeting and inducing apoptosis in 80% of the LNCaP cells within 24 hours without affecting the viability of the CHO cells. These results show the potential of using biodegradable polymers as a vehicle for receptor-specific drug delivery and a potential alternative for traditional systemic chemotherapy. Detailed experimental results will be discussed in the e-poster.

Keywords: chemotherapeutic drug, click chemistry, nanoparticle, prostat cancer

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17991 Delineation of Oil – Polluted Sites in Ibeno LGA, Nigeria, Using Microbiological and Physicochemical Characterization

Authors: Ime R. Udotong, Justina I. R. Udotong, Ofonime U. M. John

Abstract:

Mobil Producing Nigeria Unlimited (MPNU), a subsidiary of ExxonMobil and the highest crude oil & condensate producer in Nigeria has its operational base and an oil terminal, the Qua Iboe terminal (QIT) located at Ibeno, Nigeria. Other oil companies like Network Exploration and Production Nigeria Ltd, Frontier Oil Ltd; Shell Petroleum Development Company Ltd; Elf Petroleum Nigeria Ltd and Nigerian Agip Energy, a subsidiary of the Italian ENI E&P operate onshore, on the continental shelf and in deep offshore of the Atlantic Ocean, respectively with the coastal waters of Ibeno, Nigeria as the nearest shoreline. This study was designed to delineate the oil-polluted sites in Ibeno, Nigeria using microbiological and physico-chemical characterization of soils, sediments and ground and surface water samples from the study area. Results obtained revealed that there have been significant recent hydrocarbon inputs into this environment as observed from the high counts of hydrocarbonoclastic microorganisms in excess of 1% at all the stations sampled. Moreover, high concentrations of THC, BTEX and heavy metals contents in all the samples analyzed corroborate the high recent crude oil input into the study area. The results also showed that the pollution of the different environmental media sampled were of varying degrees, following the trend: Ground water > surface water > sediments > soils.

Keywords: microbiological characterization, oil-polluted sites, physico-chemical analyses, total hydrocarbon content

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17990 Assessment of Alteration in High Density Lipo Protein, Apolipoprotein A1, Serum Glutamic Pyruvic Transaminase and Serum Glutamic Oxaloacetic Transaminase in Oral Submucous Fibrosis Patients

Authors: Marina Lazar Chandy, N. Kannan, Rajendra Patil, Vinod Mathew, Ajmal Mohamed, P. K. Sreeja, Renju Jose

Abstract:

Introduction- Arecoline, a major constituent of arecanut has shown to have some effect on liver. The use of arecanut is found to be the most common etiological factor for the development of Oral Submucous fibrosis (O.S.M.F). The effect of arecanut usage on liver in patients with O.S.M.F needs to be assessed. Lipids play a role in structural maintenance of cell. Alterations of lipid profile were noted in cancer patients. O.S.M.F being a precancerous lesion can have some effect on the level of lipids in the body. Objectives: This study was done to assess the alterations in liver enzymes (Serum Glutamic Pyruvic Transaminase(S.G.P.T ,Serum Glutamic Oxaloacetic Transaminase(S.G.O.T)) and lipid metabolism (High Density Lipoprotien(H.D.L) and Apo Lipoprotien A1 (Apo A1)) in patients with O.S.M.F. Methods-130 patients were taken for the study,100 patients with O.S.M.F and 30 as control group without O.S.M.F. Fasting blood sugar levels were taken, centrifuged and analyzed for S.G.P.T,S.G.O.T, H.D.L and Apo A1 using semi automated spectrophotometer. Results: After statistical analysis, it was concluded that there is an elevation of levels of S.G.P.T, S.G.O.T, and decreased levels of H.D.L, Apo A1 for O.S.M.F group when compared with control group. With increased grade of O.S.M.F. and duration of habit, S.G.P.T. & S.G.O.T. increased whereas, H.D.L. & Apo A1 decreased. All the values were statistically significant at p<0.01.

Keywords: apolipoprotien A1, high density lipoprotien, oral submucous fibrosis, serum glutamic oxaloacetic transaminase

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17989 Automated 3D Segmentation System for Detecting Tumor and Its Heterogeneity in Patients with High Grade Ovarian Epithelial Cancer

Authors: Dimitrios Binas, Marianna Konidari, Charis Bourgioti, Lia Angela Moulopoulou, Theodore Economopoulos, George Matsopoulos

Abstract:

High grade ovarian epithelial cancer (OEC) is fatal gynecological cancer and the poor prognosis of this entity is closely related to considerable intratumoral genetic heterogeneity. By examining imaging data, it is possible to assess the heterogeneity of tumorous tissue. This study proposes a methodology for aligning, segmenting and finally visualizing information from various magnetic resonance imaging series in order to construct 3D models of heterogeneity maps from the same tumor in OEC patients. The proposed system may be used as an adjunct digital tool by health professionals for personalized medicine, as it allows for an easy visual assessment of the heterogeneity of the examined tumor.

Keywords: image segmentation, ovarian epithelial cancer, quantitative characteristics, image registration, tumor visualization

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17988 Direct Measurement of Pressure and Temperature Variations During High-Speed Friction Experiments

Authors: Simon Guerin-Marthe, Marie Violay

Abstract:

Thermal Pressurization (TP) has been proposed as a key mechanism involved in the weakening of faults during dynamic ruptures. Theoretical and numerical studies clearly show how frictional heating can lead to an increase in pore fluid pressure due to the rapid slip along faults occurring during earthquakes. In addition, recent laboratory studies have evidenced local pore pressure or local temperature variation during rotary shear tests, which are consistent with TP theoretical and numerical models. The aim of this study is to complement previous ones by measuring both local pore pressure and local temperature variations in the vicinity of a water-saturated calcite gouge layer subjected to a controlled slip velocity in direct double shear configuration. Laboratory investigation of TP process is crucial in order to understand the conditions at which it is likely to become a dominant mechanism controlling dynamic friction. It is also important in order to understand the timing and magnitude of temperature and pore pressure variations, to help understanding when it is negligible, and how it competes with other rather strengthening-mechanisms such as dilatancy, which can occur during rock failure. Here we present unique direct measurements of temperature and pressure variations during high-speed friction experiments under various load point velocities and show the timing of these variations relatively to the slip event.

Keywords: thermal pressurization, double-shear test, high-speed friction, dilatancy

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17987 Using Passive Cooling Strategies to Reduce Thermal Cooling Load for Coastal High-Rise Buildings of Jeddah, Saudi Arabia

Authors: Ahmad Zamzam

Abstract:

With the development of the economy in recent years, Saudi Arabia has been maintaining high economic growth. Therefore, its energy consumption has increased dramatically. This economic growth reflected on the expansion of high-rise tower's construction. Jeddah coastal strip (cornice) has many high-rise buildings planned to start next few years. These projects required a massive amount of electricity that was not planned to be supplied by the old infrastructure. This research studies the effect of the building envelope on its thermal performance. It follows a parametric simulation methodology using Ecotect software to analyze the effect of the building envelope design on its cooling energy load for an office high-rise building in Jeddah, Saudi Arabia, which includes building geometrical form, massing treatments, orientation and glazing type effect. The research describes an integrated passive design approach to reduce the cooling requirement for high-rise building through an improved building envelope design. The research used Ecotect to make four simulation studies; the first simulation compares the thermal performance of five high-rise buildings, presenting the basic shape of the plan. All the buildings have the same plan area and same floor height. The goal of this simulation is to find out the best shape for the thermal performance. The second simulation studies the effect of orientation on the thermal performance by rotating the same building model to find out the best and the worst angle for the building thermal performance. The third simulation studies the effect of the massing treatment on the total cooling load. It compared five models with different massing treatment, but with the same total built up area. The last simulation studied the effect of the glazing type by comparing the total cooling load of the same building using five different glass type and also studies the feasibility of using these glass types by studying the glass cost effect. The results indicate that using the circle shape as building plan could reduce the thermal cooling load by 40%. Also, using shading devices could reduce the cooling loads by 5%. The study states that using any of the massing grooving, recess or any treatment that could increase the outer exposed surface is not preferred and will decrease the building thermal performance. Also, the result shows that the best direction for glazing and openings from thermal performance viewpoint in Jeddah is the North direction while the worst direction is the East one. The best direction angle for openings - regarding the thermal performance in Jeddah- is 15 deg West and the worst is 250 deg West (110 deg East). Regarding the glass type effect, comparing to the double glass with air fill type as a reference case, the double glass with Air-Low-E will save 14% from the required amount of the thermal cooling load annually. Argon fill and triple glass will save 16% and 17% from the total thermal cooling load respectively, but for the glass cost purpose, using the Argon fill and triple glass is not feasible.

Keywords: passive cooling, reduce thermal load, Jeddah, building shape, energy

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17986 Performance Analysis of High Temperature Heat Pump Cycle for Industrial Process

Authors: Seon Tae Kim, Robert Hegner, Goksel Ozuylasi, Panagiotis Stathopoulos, Eberhard Nicke

Abstract:

High-temperature heat pumps (HTHP) that can supply heat at temperatures above 200°C can enhance the energy efficiency of industrial processes and reduce the CO₂ emissions connected with the heat supply of these processes. In the current work, the thermodynamic performance of 3 different vapor compression cycles, which use R-718 (water) as a working medium, have been evaluated by using a commercial process simulation tool (EBSILON Professional). All considered cycles use two-stage vapor compression with intercooling between stages. The main aim of the study is to compare different intercooling strategies and study possible heat recovery scenarios within the intercooling process. This comparison has been carried out by computing the coefficient of performance (COP), the heat supply temperature level, and the respective mass flow rate of water for all cycle architectures. With increasing temperature difference between the heat source and heat sink, ∆T, the COP values decreased as expected, and the highest COP value was found for the cycle configurations where both compressors have the same pressure ratio (PR). The investigation on the HTHP capacities with optimized PR and exergy analysis has also been carried out. The internal heat exchanger cycle with the inward direction of secondary flow (IHX-in) showed a higher temperature level and exergy efficiency compared to other cycles. Moreover, the available operating range was estimated by considering mechanical limitations.

Keywords: high temperature heat pump, industrial process, vapor compression cycle, R-718 (water), thermodynamic analysis

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17985 Possible Exposure of Persons with Cardiac Pacemakers to Extremely Low Frequency (ELF) Electric and Magnetic Fields

Authors: Leena Korpinen, Rauno Pääkkönen, Fabriziomaria Gobba, Vesa Virtanen

Abstract:

The number of persons with implanted cardiac pacemakers (PM) has increased in Western countries. The aim of this paper is to investigate the possible situations where persons with a PM may be exposed to extremely low frequency (ELF) electric (EF) and magnetic fields (MF) that may disturb their PM. Based on our earlier studies, it is possible to find such high public exposure to EFs only in some places near 400 kV power lines, where an EF may disturb a PM in unipolar mode. Such EFs cannot be found near 110 kV power lines. Disturbing MFs can be found near welding machines. However, we do not have measurement data from welding. Based on literature and earlier studies at Tampere University of Technology, it is difficult to find public EF or MF exposure that is high enough to interfere with PMs.

Keywords: cardiac pacemaker, electric field, magnetic field, electrical engineering

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17984 A Novel Nanocomposite Membrane Designed for the Treatment of Oil/Gas Produced Water

Authors: Zhaoyang Liu, Detao Qin, Darren Delai Sun

Abstract:

The onshore production of oil and gas (for example, shale gas) generates large quantities of wastewater, referred to be ‘produced water’, which contains high contents of oils and salts. The direct discharge of produced water, if not appropriately treated, can be toxic to the environment and human health. Membrane filtration has been deemed as an environmental-friendly and cost-effective technology for treating oily wastewater. However, conventional polymeric membranes have their drawbacks of either low salt rejection rate or high membrane fouling tendency when treating oily wastewater. Recent years, forward osmosis (FO) membrane filtration has emerged as a promising technology with its unique advantages of low operation pressure and less membrane fouling tendency. However, until now there is still no report about FO membranes specially designed and fabricated for treating the oily and salty produced water. In this study, a novel nanocomposite FO membrane was developed specially for treating oil- and salt-polluted produced water. By leveraging the recent advance of nanomaterials and nanotechnology, this nanocomposite FO membrane was designed to be made of double layers: an underwater oleophobic selective layer on top of a nanomaterial infused polymeric support layer. Wherein, graphene oxide (GO) nanosheets were selected to add into the polymeric support layer because adding GO nanosheets can optimize the pore structures of the support layer, thus potentially leading to high water flux for FO membranes. In addition, polyvinyl alcohol (PVA) hydrogel was selected as the selective layer because hydrated and chemically-crosslinked PVA hydrogel is capable of simultaneously rejecting oil and salt. After nanocomposite FO membranes were fabricated, the membrane structures were systematically characterized with the instruments of TEM, FESEM, XRD, ATR-FTIR, surface zeta-potential and Contact angles (CA). The membrane performances for treating produced waters were tested with the instruments of TOC, COD and Ion chromatography. The working mechanism of this new membrane was also analyzed. Very promising experimental results have been obtained. The incorporation of GO nanosheets can reduce internal concentration polarization (ICP) effect in the polymeric support layer. The structural parameter (S value) of the new FO membrane is reduced by 23% from 265 ± 31 μm to 205 ± 23 μm. The membrane tortuosity (τ value) is decreased by 20% from 2.55 ± 0.19 to 2.02 ± 0.13 μm, which contributes to the decrease of S value. Moreover, the highly-hydrophilic and chemically-cross-linked hydrogel selective layer present high antifouling property under saline oil/water emulsions. Compared with commercial FO membrane, this new FO membrane possesses three times higher water flux, higher removal efficiencies for oil (>99.9%) and salts (>99.7% for multivalent ions), and significantly lower membrane fouling tendency (<10%). To our knowledge, this is the first report of a nanocomposite FO membrane with the combined merits of high salt rejection, high oil repellency and high water flux for treating onshore oil/gas produced waters. Due to its outstanding performance and ease of fabrication, this novel nanocomposite FO membrane possesses great application potential in wastewater treatment industry.

Keywords: nanocomposite, membrane, polymer, graphene oxide

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17983 MIM and Experimental Studies of the Thermal Drift in an Ultra-High Precision Instrument for Dimensional Metrology

Authors: Kamélia Bouderbala, Hichem Nouira, Etienne Videcoq, Manuel Girault, Daniel Petit

Abstract:

Thermal drifts caused by the power dissipated by the mechanical guiding systems constitute the main limit to enhance the accuracy of an ultra-high precision cylindricity measuring machine. For this reason, a high precision compact prototype has been designed to simulate the behaviour of the instrument. It ensures in situ calibration of four capacitive displacement probes by comparison with four laser interferometers. The set-up includes three heating wires for simulating the powers dissipated by the mechanical guiding systems, four additional heating wires located between each laser interferometer head and its respective holder, 19 Platinum resistance thermometers (Pt100) to observe the temperature evolution inside the set-up and four Pt100 sensors to monitor the ambient temperature. Both a Reduced Model (RM), based on the Modal Identification Method (MIM) was developed and optimized by comparison with the experimental results. Thereafter, time dependent tests were performed under several conditions to measure the temperature variation at 19 fixed positions in the system and compared to the calculated RM results. The RM results show good agreement with experiment and reproduce as well the temperature variations, revealing the importance of the RM proposed for the evaluation of the thermal behaviour of the system.

Keywords: modal identification method (MIM), thermal behavior and drift, dimensional metrology, measurement

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17982 Evaluation of Microwave-Assisted Pretreatment for Spent Coffee Grounds

Authors: Shady S. Hassan, Brijesh K. Tiwari, Gwilym A. Williams, Amit K. Jaiswal

Abstract:

Waste materials from a wide range of agro-industrial processes may be used as substrates for microbial growth, and subsequently the production of a range of high value products and bioenergy. In addition, utilization of these agro-residues in bioprocesses has the dual advantage of providing alternative substrates, as well as solving their disposal problems. Spent coffee grounds (SCG) are a by-product (45%) of coffee processing. SCG is a lignocellulosic material, which is composed mainly of cellulose, hemicelluloses, and lignin. Thus, a pretreatment process is required to facilitate an efficient enzymatic hydrolysis of such carbohydrates. In this context, microwave pretreatment of lignocellulosic biomass without the addition of harsh chemicals represents a green technology. Moreover, microwave treatment has a high heating efficiency and is easy to implement. Thus, microwave pretreatment of SCG without adding of harsh chemicals investigated as a green technology to enhance enzyme hydrolysis. In the present work, microwave pretreatment experiments were conducted on SCG at varying power levels (100, 250, 440, 600, and 1000 W) for 60 s. By increasing microwave power to a certain level (which vary by varying biomass), reducing sugar increases, then reducing sugar from biomass start to decrease with microwave power increase beyond this level. Microwave pretreatment of SCG at 60s followed by enzymatic hydrolysis resulted in total reducing sugars of 91.6 ± 7.0 mg/g of biomass (at microwave power of 100 w). Fourier transform Infrared Spectroscopy (FTIR) was employed to investigate changes in functional groups of biomass after pretreatment, while high-performance liquid chromatography (HPLC) was employed for determination of glucose. Pretreatment of lignocellulose using microwave was found to be an effective and energy efficient technology to improve saccharification and glucose yield. Energy performance will be evaluated for the microwave pretreatment, and the enzyme hydrolysate will be used as media component substitute for the production of ethanol and other high value products.

Keywords: lignocellulose, microwave, pretreatment, spent coffee grounds

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17981 Ytterbium Advantages for Brachytherapy

Authors: S. V. Akulinichev, S. A. Chaushansky, V. I. Derzhiev

Abstract:

High dose rate (HDR) brachytherapy is a method of contact radiotherapy, when a single sealed source with an activity of about 10 Ci is temporarily inserted in the tumor area. The isotopes Ir-192 and (much less) Co-60 are used as active material for such sources. The other type of brachytherapy, the low dose rate (LDR) brachytherapy, implies the insertion of many permanent sources (up to 200) of lower activity. The pulse dose rate (PDR) brachytherapy can be considered as a modification of HDR brachytherapy, when the single source is repeatedly introduced in the tumor region in a pulse regime during several hours. The PDR source activity is of the order of one Ci and the isotope Ir-192 is currently used for these sources. The PDR brachytherapy is well recommended for the treatment of several tumors since, according to oncologists, it combines the medical benefits of both HDR and LDR types of brachytherapy. One of the main problems for the PDR brachytherapy progress is the shielding of the treatment area since the longer stay of patients in a shielded canyon is not enough comfortable for them. The use of Yb-169 as an active source material is the way to resolve the shielding problem for PDR, as well as for HRD brachytherapy. The isotope Yb-169 has the average photon emission energy of 93 KeV and the half-life of 32 days. Compared to iridium and cobalt, this isotope has a significantly lower emission energy and therefore requires a much lighter shielding. Moreover, the absorption cross section of different materials has a strong Z-dependence in that photon energy range. For example, the dose distributions of iridium and ytterbium have a quite similar behavior in the water or in the body. But the heavier material as lead absorbs the ytterbium radiation much stronger than the iridium or cobalt radiation. For example, only 2 mm of lead layer is enough to reduce the ytterbium radiation by a couple of orders of magnitude but is not enough to protect from iridium radiation. We have created an original facility to produce the start stable isotope Yb-168 using the laser technology AVLIS. This facility allows to raise the Yb-168 concentration up to 50 % and consumes much less of electrical power than the alternative electromagnetic enrichment facilities. We also developed, in cooperation with the Institute of high pressure physics of RAS, a new technology for manufacturing high-density ceramic cores of ytterbium oxide. Ceramics density reaches the limit of the theoretical values: 9.1 g/cm3 for the cubic phase of ytterbium oxide and 10 g/cm3 for the monoclinic phase. Source cores from this ceramics have high mechanical characteristics and a glassy surface. The use of ceramics allows to increase the source activity with fixed external dimensions of sources.

Keywords: brachytherapy, high, pulse dose rates, radionuclides for therapy, ytterbium sources

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17980 Thermo-Mechanical Approach to Evaluate Softening Behavior of Polystyrene: Validation and Modeling

Authors: Salah Al-Enezi, Rashed Al-Zufairi, Naseer Ahmad

Abstract:

A Thermo-mechanical technique was developed to determine softening point temperature/glass transition temperature (Tg) of polystyrene exposed to high pressures. The design utilizes the ability of carbon dioxide to lower the glass transition temperature of polymers and acts as plasticizer. In this apparatus, the sorption of carbon dioxide to induce softening of polymers as a function of temperature/pressure is performed and the extent of softening is measured in three-point-flexural-bending mode. The polymer strip was placed in the cell in contact with the linear variable differential transformer (LVDT). CO2 was pumped into the cell from a supply cylinder to reach high pressure. The results clearly showed that full softening point of the samples, accompanied by a large deformation on the polymer strip. The deflection curves are initially relatively flat and then undergo a dramatic increase as the temperature is elevated. It was found that increasing the pressure of CO2 causes the temperature curves to shift from higher to lower by increment of about 45 K, over the pressure range of 0-120 bars. The obtained experimental Tg values were validated with the values reported in the literature. Finally, it is concluded that the defection model fits consistently to the generated experimental results, which attempts to describe in more detail how the central deflection of a thin polymer strip affected by the CO2 diffusions in the polymeric samples.

Keywords: softening, high-pressure, polystyrene, CO₂ diffusions

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17979 The Selectivities of Pharmaceutical Spending Containment: Social Profit, Incentivization Games and State Power

Authors: Ben Main Piotr Ozieranski

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State government spending on pharmaceuticals stands at 1 trillion USD globally, promoting criticism of the pharmaceutical industry's monetization of drug efficacy, product cost overvaluation, and health injustice. This paper elucidates the mechanisms behind a state-institutional response to this problem through the sociological lens of the strategic relational approach to state power. To do so, 30 expert interviews, legal and policy documents are drawn on to explain how state elites in New Zealand have successfully contested a 30-year “pharmaceutical spending containment policy”. Proceeding from Jessop's notion of strategic “selectivity”, encompassing analyses of the enabling features of state actors' ability to harness state structures, a theoretical explanation is advanced. First, a strategic context is described that consists of dynamics around pharmaceutical dealmaking between the state bureaucracy, pharmaceutical pricing strategies (and their effects), and the industry. Centrally, the pricing strategy of "bundling" -deals for packages of drugs that combine older and newer patented products- reflect how state managers have instigated an “incentivization game” that is played by state and industry actors, including HTA professionals, over pharmaceutical products (both current and in development). Second, a protective context is described that is comprised of successive legislative-judicial responses to the strategic context and characterized by the regulation and the societalisation of commercial law. Third, within the policy, the achievement of increased pharmaceutical coverage (pharmaceutical “mix”) alongside contained spending is conceptualized as a state defence of a "social profit". As such, in contrast to scholarly expectations that political and economic cultures of neo-liberalism drive pharmaceutical policy-making processes, New Zealand's state elites' approach is shown to be antipathetic to neo-liberals within an overall capitalist economy. The paper contributes an analysis of state pricing strategies and how they are embedded in state regulatory structures. Additionally, through an analysis of the interconnections of state power and pharmaceutical value Abrahams's neo-liberal corporate bias model for pharmaceutical policy analysis is problematised.

Keywords: pharmaceutical governance, pharmaceutical bureaucracy, pricing strategies, state power, value theory

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17978 High Sensitive Graphene-Based Strain Sensors for SHM of Composite Laminates

Authors: A. Rinaldi, A. Proietti, C. Aquarelli, F. Marra, A. Tamburrano, M. Ciminello, M. S. Sarto

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A new type of high sensitive piezoresistive sensors based on graphene was developed within the SARISTU project for application on Structural Health Monitoring (SHM). The new sensor consists of a graphene-based film, obtained through the spray deposition of a colloidal suspension of Multi-Layer Graphene (MLGs) nano platelets over a substrate. MLGs are produced by liquid exfoliation of thermally expanded Graphite Intercalation Compound. An array of 8 sensors is produced by spray deposition over an aeronautical CFRC plate of dimensions 550 mm (length) × 550 mm (width) × 3 mm (thickness). Electromechanical tests were performed in order to assess the sensitivity of the new piezoresistive sensors, which are characterized by an isotropic response. In the quasi-static characterizations, the CFRC plate was clamped on one side and loaded on the opposite one. The local strain map of the plate was then obtained from displacement measurements and numerical analysis. The dynamic tests were performed lying the plate over an anti-vibration table and actuating a piezoelectric element located in the middle of the sensing array. The obtained experimental results demonstrated that the sensors possess a good repeatability and a high constant gauge factor (~200) in the applied strain range 0.001%-0.02%. Moreover, they can follow dynamics up to 400 kHz and for this reason they are good candidates for Lamb-wave analysis.

Keywords: graphene, strain sensor, spray deposition, lamb-wave analysis

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17977 Cost Based Analysis of Risk Stratification Tool for Prediction and Management of High Risk Choledocholithiasis Patients

Authors: Shreya Saxena

Abstract:

Background: Choledocholithiasis is a common complication of gallstone disease. Risk scoring systems exist to guide the need for further imaging or endoscopy in managing choledocholithiasis. We completed an audit to review the American Society for Gastrointestinal Endoscopy (ASGE) scoring system for prediction and management of choledocholithiasis against the current practice at a tertiary hospital to assess its utility in resource optimisation. We have now conducted a cost focused sub-analysis on patients categorized high-risk for choledocholithiasis according to the guidelines to determine any associated cost benefits. Method: Data collection from our prior audit was used to retrospectively identify thirteen patients considered high-risk for choledocholithiasis. Their ongoing management was mapped against the guidelines. Individual costs for the key investigations were obtained from our hospital financial data. Total cost for the different management pathways identified in clinical practice were calculated and compared against predicted costs associated with recommendations in the guidelines. We excluded the cost of laparoscopic cholecystectomy and considered a set figure for per day hospital admission related expenses. Results: Based on our previous audit data, we identified a77% positive predictive value for the ASGE risk stratification tool to determine patients at high-risk of choledocholithiasis. 47% (6/13) had an magnetic resonance cholangiopancreatography (MRCP) prior to endoscopic retrograde cholangiopancreatography (ERCP), whilst 53% (7/13) went straight for ERCP. The average length of stay in the hospital was 7 days, with an additional day and cost of £328.00 (£117 for ERCP) for patients awaiting an MRCP prior to ERCP. Per day hospital admission was valued at £838.69. When calculating total cost, we assumed all patients had admission bloods and ultrasound done as the gold standard. In doing an MRCP prior to ERCP, there was a 130% increase in cost incurred (£580.04 vs £252.04) per patient. When also considering hospital admission and the average length of stay, it was an additional £1166.69 per patient. We then calculated the exact costs incurred by the department, over a three-month period, for all patients, for key investigations or procedures done in the management of choledocholithiasis. This was compared to an estimate cost derived from the recommended pathways in the ASGE guidelines. Overall, 81% (£2048.45) saving was associated with following the guidelines compared to clinical practice. Conclusion: MRCP is the most expensive test associated with the diagnosis and management of choledocholithiasis. The ASGE guidelines recommend endoscopy without an MRCP in patients stratified as high-risk for choledocholithiasis. Our audit that focused on assessing the utility of the ASGE risk scoring system showed it to be relatively reliable for identifying high-risk patients. Our cost analysis has shown significant cost savings per patient and when considering the average length of stay associated with direct endoscopy rather than an additional MRCP. Part of this is also because of an increased average length of stay associated with waiting for an MRCP. The above data supports the ASGE guidelines for the management of high-risk for choledocholithiasis patients from a cost perspective. The only caveat is our small data set that may impact the validity of our average length of hospital stay figures and hence total cost calculations.

Keywords: cost-analysis, choledocholithiasis, risk stratification tool, general surgery

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17976 Generation Y in Organizations: Distinctive Characteristics and Behavior at Work of Moroccan YERs

Authors: Fatima Ezzahra Siragi, Omar Benaini

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For many years, Generation Y has been at the center of controversies. This topic made the buzz in the Media as well as in scientific literature. Previous research led to contradictory results; some scholars considered this population a wealth for companies, while the others believe it constitutes a young danger in need of proper control. Existing literature has almost studied Generation Y in developed countries; very rare studies were conducted in developing countries. To our knowledge, no published articles have treated Generation Y in Morocco. The purpose of this research is to examine the distinctive characteristics of Generation Y in Morocco as well as their behavior at work. Using quantitative method, the study was conducted on a sample of 250 Moroccan employees that have a high educational level and who belong to Generation Y. Our results have shown high resemblance between Moroccan and Occidental Yers (France, USA, Canada …)

Keywords: Behavior in Organizations, Generation Y, Key Characteristics, Moroccan Yers, Motivation

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17975 Ultra High Performance Concrete Using Special Aggregates for Irregular Structures (the New Concrete Technology)

Authors: Arjun, A. D. Singh

Abstract:

Concrete the basic material using in construction across the global these days. The purpose of this special concrete is to provide extra strength and stability for irregular structure where the center of gravity is disturbed. In this paper an effort has been made to use different type of material aggregates has been discussed. We named As "STAR Aggregates" which has qualities to resist Shear, tension and compression forces. We have been divided into coarse aggregates and fine aggregates according to their sizes. Star Aggregates has interlocking behavior and cutting edge technology. Star aggregates had been draft and deign in Auto CAD and then analysis in ANSYS software. by using special aggregates we deign concrete grade of M40 for mega structures and irregular structure. This special concrete with STAR aggregates use in construction for irregular structure like Bridges, Skyscrapers or in deigned buildings.

Keywords: star aggregates, high performance concrete, material aggregates, interlocking

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17974 Evaluation of Iranian Standard for Assessment of Liquefaction Potential of Cohesionless Soils Based on SPT

Authors: Reza Ziaie Moayad, Azam Kouhpeyma

Abstract:

In-situ testing is preferred to evaluate the liquefaction potential in cohesionless soils due to high disturbance during sampling. Although new in-situ methods with high accuracy have been developed, standard penetration test, the simplest and the oldest in-situ test, is still used due to the profusion of the recorded data. This paper reviews the Iranian standard of evaluating liquefaction potential in soils (codes 525) and compares the liquefaction assessment methods based on SPT results on cohesionless soil in this standard with the international standards. To this, methods for assessing liquefaction potential which are presented by Cetin et al. (2004), Boulanger and Idriss (2014) are compared with what is presented in standard 525. It is found that although the procedure used in Iranian standard of evaluating the potential of liquefaction has not been updated according to the new findings, it is a conservative procedure.

Keywords: cohesionless soil, liquefaction, SPT, standard 525

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17973 Effect of Anion and Amino Functional Group on Resin for Lipase Immobilization with Adsorption-Cross Linking Method

Authors: Heri Hermansyah, Annisa Kurnia, A. Vania Anisya, Adi Surjosatyo, Yopi Sunarya, Rita Arbianti, Tania Surya Utami

Abstract:

Lipase is one of biocatalyst which is applied commercially for the process in industries, such as bioenergy, food, and pharmaceutical industry. Nowadays, biocatalysts are preferred in industries because they work in mild condition, high specificity, and reduce energy consumption (high pressure and temperature). But, the usage of lipase for industry scale is limited by economic reason due to the high price of lipase and difficulty of the separation system. Immobilization of lipase is one of the solutions to maintain the activity of lipase and reduce separation system in the process. Therefore, we conduct a study about lipase immobilization with the adsorption-cross linking method using glutaraldehyde because this method produces high enzyme loading and stability. Lipase is immobilized on different kind of resin with the various functional group. Highest enzyme loading (76.69%) was achieved by lipase immobilized on anion macroporous which have anion functional group (OH). However, highest activity (24,69 U/g support) through olive oil emulsion method was achieved by lipase immobilized on anion macroporous-chitosan which have amino (NH2) and anion (OH-) functional group. In addition, it also success to produce biodiesel until reach yield 50,6% through interesterification reaction and after 4 cycles stable 63.9% relative with initial yield. While for Aspergillus, niger lipase immobilized on anion macroporous-kitosan have unit activity 22,84 U/g resin and yield biodiesel higher than commercial lipase (69,1%) and after 4 cycles stable reach 70.6% relative from initial yield. This shows that optimum functional group on support for immobilization with adsorption-cross linking is the support that contains amino (NH2) and anion (OH-) functional group because they can react with glutaraldehyde and binding with enzyme prevent desorption of lipase from support through binding lipase with a functional group on support.

Keywords: adsorption-cross linking, immobilization, lipase, resin

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17972 The Safety Transfer in Acute Critical Patient by Telemedicine (START) Program at Udonthani General Hospital

Authors: Wisit Wichitkosoom

Abstract:

Objective:The majority of the hisk-risk patients (ST-elevation myocardial infarction (STEMI), Acute cerebrovascular accident, Sepsis, Acute Traumatic patient ) are admitted to district or lacal hospitals (average 1-1.30 hr. from Udonthani general hospital, Northeastern province, Thailand) without proper facilities. The referral system was support to early care and early management at pre-hospital stage and prepare for the patient data to higher hospital. This study assessed the reduction in treatment delay achieved by pre-hospital diagnosis and referral directly to Udonthani General Hospital. Methods and results: Four district or local hospitals without proper facilities for treatment the very high-risk patient were serving the study region. Pre-hospital diagnoses were established with the simple technology such as LINE, SMS, telephone and Fax for concept of LEAN process and then the telemedicine, by ambulance monitoring (ECG, SpO2, BT, BP) in both real time and snapshot mode was administrated during the period of transfer for safety transfer concept (inter-hospital stage). The standard treatment for patients with STEMI, Intracranial injury and acute cerebrovascular accident were done. From 1 October 2012 to 30 September 2013, the 892 high-risk patients transported by ambulance and transferred to Udonthani general hospital were registered. Patients with STEMI diagnosed pre-hospitally and referred directly to the Udonthani general hospital with telemedicine closed monitor (n=248). The mortality rate decreased from 11.69% in 2011 to 6.92 in 2012. The 34 patients were arrested on the way and successful to CPR during transfer with the telemedicine consultation were 79.41%. Conclusion: The proper innovation could apply for health care system. The very high-risk patients must had the closed monitoring with two-way communication for the “safety transfer period”. It could modified to another high-risk group too.

Keywords: safety transfer, telemedicine, critical patients, medical and health sciences

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17971 Customers' Attitudes towards Marketing Mix Affecting Purchasing Behavior of Starbucks Coffee (Thailand) Customers in Bangkok

Authors: Polamorn Tamprateep, Warapong Thakanun

Abstract:

This researchs' objectives are: 1. To study the customer demographics that affects the purchasing behavior; 2. To study the marketing mix that affects the purchasing behavior; 3. To study the relationship between purchasing behavior and customers’ perception of Brand Equity. Population of this research is Starbucks Coffee (Thailand) customers in Bangkok. The tool used in this study was questionnaire created from concepts, theories and related researches. The study showed that, of 400 respondents, overall opinion received high score (xˉ= 3.77). When each item is considered, it was found that ‘Staff are knowledgeable in providing service.’, ‘ Staff are friendly.’, ‘Staff possess good communication skill with customers.’, ‘Staff know all types of coffee well.’, and ‘Staff are enthusiastic in giving service.’, all these items received high score with a mean of 3.92, 3.87, 3.77, 3.71 and 3.63, respectively.

Keywords: mix attitude of the product, consumer, buying behavior, Starbucks

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17970 Nutritional Properties and Lipid Oxidation Assessments of Sucuks Prepared with Camel (Camelus Dromedarius) Meat and Hump

Authors: Mina Kargozari, Isabel Revilla Martin, Ángel A. Carbonell-Barrachina

Abstract:

Different formulations of Turkish fermented sausages (sucuks) prepared with camel meat-hump (CH), camel meat-beef fat (CB), beef-hump (BH) and beef-beef fat (BB), were characterized. The sausages were analytically compared to determine differences in proximate composition and total cholesterol content (TCC), quality parameters such as fatty acids profile and fat quality characteristics, and lipid oxidation parameters including peroxide value, thiobarbituric acid-reactive substances (TBARS) and resulted carbonyl compounds. The PUFAs/SFAs ratio was higher in CB and BB samples than CH and BH (p<0.05). The higher calculated atherogenic and thrombogenic indexes (AI and TI) were obtained from the samples made with hump (p< 0.05) as a result of high amounts of their SFAs. The CH sausages contained high amount of total fat (p<0.05) among all samples. The CB sucuks exhibited the highest protein content and the lowest TCC and rancidity at the end of ripening (p<0.05). The TBARS results showed that beef fat samples were more susceptible to lipid oxidation. Moreover, no significant difference (p<0.05) was observed for the values of short aldehydes among the sucuk samples excepting nonanal. This study demonstrated that supplementing camel meat for the production of dry-fermented sausage resulted in high quality products with good functional and nutritional characteristics.

Keywords: fermented sausages, quality properties, SPME, total cholesterol content

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17969 Bioinformatics High Performance Computation and Big Data

Authors: Javed Mohammed

Abstract:

Right now, bio-medical infrastructure lags well behind the curve. Our healthcare system is dispersed and disjointed; medical records are a bit of a mess; and we do not yet have the capacity to store and process the crazy amounts of data coming our way from widespread whole-genome sequencing. And then there are privacy issues. Despite these infrastructure challenges, some researchers are plunging into bio medical Big Data now, in hopes of extracting new and actionable knowledge. They are doing delving into molecular-level data to discover bio markers that help classify patients based on their response to existing treatments; and pushing their results out to physicians in novel and creative ways. Computer scientists and bio medical researchers are able to transform data into models and simulations that will enable scientists for the first time to gain a profound under-standing of the deepest biological functions. Solving biological problems may require High-Performance Computing HPC due either to the massive parallel computation required to solve a particular problem or to algorithmic complexity that may range from difficult to intractable. Many problems involve seemingly well-behaved polynomial time algorithms (such as all-to-all comparisons) but have massive computational requirements due to the large data sets that must be analyzed. High-throughput techniques for DNA sequencing and analysis of gene expression have led to exponential growth in the amount of publicly available genomic data. With the increased availability of genomic data traditional database approaches are no longer sufficient for rapidly performing life science queries involving the fusion of data types. Computing systems are now so powerful it is possible for researchers to consider modeling the folding of a protein or even the simulation of an entire human body. This research paper emphasizes the computational biology's growing need for high-performance computing and Big Data. It illustrates this article’s indispensability in meeting the scientific and engineering challenges of the twenty-first century, and how Protein Folding (the structure and function of proteins) and Phylogeny Reconstruction (evolutionary history of a group of genes) can use HPC that provides sufficient capability for evaluating or solving more limited but meaningful instances. This article also indicates solutions to optimization problems, and benefits Big Data and Computational Biology. The article illustrates the Current State-of-the-Art and Future-Generation Biology of HPC Computing with Big Data.

Keywords: high performance, big data, parallel computation, molecular data, computational biology

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17968 Synthesis and Characterization of Doped Li₄Ti₅O₁₂/TiO2 as Potential Anode Materials for Li-Ion Batteries

Authors: S. Merazga, F. Boudeffar, A. Bouaoua, A. Cheriet, M. Berouaken, M. Mebarki, K. Ayouz, N. Gabouze

Abstract:

Several anode materials as transition metal oxides (Fe3O4, SnO2 a, SnO2, LiCoO2, and Li₄Ti₅O₁₂) has been used. Although titanium oxide has attracted great attention as a; superior electrode for Li-ion batteries due tohis excellent characteristic such as: high capacity, low cost and non-toxicity. In this work, the Synthesis and Characterization of Si Doped Li₄Ti₅O₁₂ with hydrothermal Method was electrochemically evaluated. The SEM images shows that the morphology of LTO powders sizes in the range 70nm.The electrochemical properties of synthesizer nanopowders are investigated for use as an anode active material for lithium-ion batteries by galvanostatic techniques in Li-half cells, obtaining reversible discharge capacity of 173.8 mAh/g at 0.1C even upon 100 cycles.Though the doped powders exhibit an upgrade in The electrical conductivity , This is suitable for use as a high-power cathode material for lithium-ion batteries.

Keywords: LTO, li-ion, battteries, anode

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17967 Numerical Analysis of Supersonic Impinging Jets onto Resonance Tube

Authors: Shinji Sato, M. M. A. Alam, Manabu Takao

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In recent, investigation of an unsteady flow inside the resonance tube have become a strongly motivated research field for their potential application as high-frequency actuators. By generating a shock wave inside the resonance tube, a high temperature and pressure can be achieved inside the tube, and this high temperature can also be used to ignite a jet engine. In the present research, a computational fluid dynamics (CFD) analysis was carried out to investigate the flow inside the resonance tube. The density-based solver of rhoCentralFoam in OpenFOAM was used to numerically simulate the flow. The supersonic jet that was driven by a cylindrical nozzle with a nominal exit diameter of φd = 20.3 mm impinged onto the resonance tube. The jet pressure ratio was varied between 2.6 and 7.8. The gap s between the nozzle exit and tube entrance was changed between 1.5d and 3.0d. The diameter and length of the tube were taken as D = 1.25d and L=3.0D, respectively. As a result, when a supersonic jet has impinged onto the resonance tube, a compression wave was found generating inside the tube and propagating towards the tube end wall. This wave train resulted in a rise in the end wall gas temperature and pressure. While, in an outflow phase, the gas near tube enwall was found cooling back isentropically to its initial temperature. Thus, the compression waves repeated a reciprocating motion in the tube like a piston, and a fluctuation in the end wall pressures and temperatures were observed. A significant change was found in the end wall pressures and temperatures with a change of jet flow conditions. In this study, the highest temperature was confirmed at a jet pressure ratio of 4.2 and a gap of s=2.0d

Keywords: compressible flow, OpenFOAM, oscillations, a resonance tube, shockwave

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17966 Investigation of the Effect of Impulse Voltage to Flashover by Using Water Jet

Authors: Harun Gülan, Muhsin Tunay Gencoglu, Mehmet Cebeci

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The main function of the insulators used in high voltage (HV) transmission lines is to insulate the energized conductor from the pole and hence from the ground. However, when the insulators fail to perform this insulation function due to various effects, failures occur. The deterioration of the insulation results either from breakdown or surface flashover. The surface flashover is caused by the layer of pollution that forms conductivity on the surface of the insulator, such as salt, carbonaceous compounds, rain, moisture, fog, dew, industrial pollution and desert dust. The source of the majority of failures and interruptions in HV lines is surface flashover. This threatens the continuity of supply and causes significant economic losses. Pollution flashover in HV insulators is still a serious problem that has not been fully resolved. In this study, a water jet test system has been established in order to investigate the behavior of insulators under dirty conditions and to determine their flashover performance. Flashover behavior of the insulators is examined by applying impulse voltages in the test system. This study aims to investigate the insulator behaviour under high impulse voltages. For this purpose, a water jet test system was installed and experimental results were obtained over a real system and analyzed. By using the water jet test system instead of the actual insulator, the damage to the insulator as a result of the flashover that would occur under impulse voltage was prevented. The results of the test system performed an important role in determining the insulator behavior and provided predictability.

Keywords: insulator, pollution flashover, high impulse voltage, water jet model

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17965 Advancing Microstructure Evolution in Tungsten Through Rolling in Laser Powder Bed Fusion

Authors: Narges Shayesteh Moghaddam

Abstract:

Tungsten (W), a refractory metal known for its remarkably high melting temperature, offers tremendous potential for use in challenging environments prevalent in sectors such as space exploration, defense, and nuclear industries. Additive manufacturing, especially the Laser Powder-Bed Fusion (LPBF) technique, emerges as a beneficial method for fabricating tungsten parts. This technique enables the production of intricate components while simultaneously reducing production lead times and associated costs. However, the inherent brittleness of tungsten and its tendency to crack under high-temperature conditions pose significant challenges to the manufacturing process. Our research primarily focuses on the process of rolling tungsten parts in a layer-by-layer manner in LPBF and the subsequent changes in microstructure. Our objective is not only to identify the alterations in the microstructure but also to assess their implications on the physical properties and performance of the fabricated tungsten parts. To examine these aspects, we conducted an extensive series of experiments that included the fabrication of tungsten samples through LPBF and subsequent characterization using advanced materials analysis techniques. These investigations allowed us to scrutinize shifts in various microstructural features, including, but not limited to, grain size and grain boundaries occurring during the rolling process. The results of our study provide crucial insights into how specific factors, such as plastic deformation occurring during the rolling process, influence the microstructural characteristics of the fabricated parts. This information is vital as it provides a foundation for understanding how the parameters of the layer-by-layer rolling process affect the final tungsten parts. Our research significantly broadens the current understanding of microstructural evolution in tungsten parts produced via the layer-by-layer rolling process in LPBF. The insights obtained will play a pivotal role in refining and optimizing manufacturing parameters, thus improving the mechanical properties of tungsten parts and, therefore, enhancing their performance. Furthermore, these findings will contribute to the advancement of manufacturing techniques, facilitating the wider application of tungsten parts in various high-demand sectors. Through these advancements, this research represents a significant step towards harnessing the full potential of tungsten in high-temperature and high-stress applications.

Keywords: additive manufacturing, rolling, tungsten, refractory materials

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17964 A Patient-Centered Approach to Clinical Trial Development: Real-World Evidence from a Canadian Medical Cannabis Clinic

Authors: Lucile Rapin, Cynthia El Hage, Rihab Gamaoun, Maria-Fernanda Arboleda, Erin Prosk

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Introduction: Sante Cannabis (SC), a Canadian group of clinics dedicated to medical cannabis, based in Montreal and in the province of Quebec, has served more than 8000 patients seeking cannabis-based treatment over the past five years. As randomized clinical trials with natural medical cannabis are scarce, real-world evidence offers the opportunity to fill research gaps between scientific evidence and clinical practice. Data on the use of medical cannabis products from SC patients were prospectively collected, leading to a large real-world database on the use of medical cannabis. The aim of this study was to report information on the profiles of both patients and prescribed medical cannabis products at SC clinics, and to assess the safety of medical cannabis among Canadian patients. Methods: This is an observational retrospective study of 1342 adult patients who were authorized with medical cannabis products between October 2017 and September 2019. Information regarding demographic characteristics, therapeutic indications for medical cannabis use, patterns in dosing and dosage form of medical cannabis and adverse effects over one-year follow-up (initial and 4 follow-up (FUP) visits) were collected. Results: 59% of SC patients were female, with a mean age of 56.7 (SD= 15.6, range= (19-97)). Cannabis products were authorized mainly for patients with a diagnosis of chronic pain (68.8% of patients), cancer (6.7%), neurological disorders (5.6%), and mood disorders (5.4 %). At initial visit, a large majority (70%) of patients were authorized exclusively medical cannabis products, 27% were authorized a combination of pharmaceutical cannabinoids and medical cannabis and 3% were prescribed only pharmaceutical cannabinoids. This pattern was recurrent over the one-year follow-up. Overall, oil was the preferred formulation (average over visits 72.5%) followed by a combination of oil and dry (average 19%), other routes of administration accounted for less than 4%. Patients were predominantly prescribed products with a balanced THC:CBD ratio (59%-75% across visits). 28% of patients reported at least one adverse effect (AE) at the 3-month follow-up visit and 12% at the six-month FUP visit. 84.8% of total AEs were mild and transient. No serious AE was reported. Overall, the most common side effects reported were dizziness (11.95% of total AEs), drowsiness (11.4%), dry mouth (5.5%), nausea (4.8%), headaches (4.6%), cough (4.4%), anxiety (4.1%) and euphoria (3.5%). Other adverse effects accounted for less than 3% of total AE. Conclusion: Our results confirm that the primary area of clinical use for medical cannabis is in pain management. Patients in this cohort are largely utilizing plant-based cannabis oil products with a balanced ratio of THC:CBD. Reported adverse effects were mild and included dizziness and drowsiness. This real-world data confirms the tolerable safety profile of medical cannabis and suggests medical indications not yet validated in controlled clinical trials. Such data offers an important opportunity for the investigation of the long-term effects of cannabinoid exposure in real-life conditions. Real-world evidence can be used to direct clinical trial research efforts on specific indications and dosing patterns for product development.

Keywords: medical cannabis, safety, real-world data, Canada

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