Search results for: therapeutic gardens UCLA loneliness scale
4304 Effects of Spectrotemporal Modulation of Music Profiles on Coherence of Cardiovascular Rhythms
Authors: I-Hui Hsieh, Yu-Hsuan Hu
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The powerful effect of music is often associated with changes in physiological responses such as heart rate and respiration. Previous studies demonstrate that Mayer waves of blood pressure, the spontaneous rhythm occurring at 0.1 Hz, corresponds to a progressive crescendo of the musical phrase. However, music contain dynamic changes in temporal and spectral features. As such, it remains unclear which aspects of musical structures optimally affect synchronization of cardiovascular rhythms. This study investigates the independent contribution of spectral pattern, temporal pattern, and dissonance level on synchronization of cardiovascular rhythms. The regularity of acoustical patterns occurring at a periodic rhythm of 0.1 Hz is hypothesized to elicit the strongest coherence of cardiovascular rhythms. Music excerpts taken from twelve pieces of Western classical repertoire were modulated to contain varying degrees of pattern regularity of the acoustic envelope structure. Three levels of dissonance were manipulated by varying the harmonic structure of the accompanying chords. Electrocardiogram and photoplethysmography signals were recorded for 5 minutes of baseline and simultaneously while participants listen to music excerpts randomly presented over headphones in a sitting position. Participants were asked to indicate the pleasantness of each music excerpt by adjusting via a slider presented on screen. Analysis of the Fourier spectral power of blood pressure around 0.1 Hz showed a significant difference between music excerpts characterized by spectral and temporal pattern regularity compared to the same content in random pattern. Phase coherence between heart rate and blood pressure increased significantly during listening to spectrally-regular phrases compared to its matched control phrases. The degree of dissonance of the accompanying chord sequence correlated with level of coherence between heart rate and blood pressure. Results suggest that low-level auditory features of music can entrain coherence of autonomic physiological variables. These findings have potential implications for using music as a clinical and therapeutic intervention for regulating cardiovascular functions.Keywords: cardiovascular rhythms, coherence, dissonance, pattern regularity
Procedia PDF Downloads 1484303 Characterization of 3D Printed Re-Entrant Chiral Auxetic Geometries
Authors: Tatheer Zahra
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Auxetic materials have counteractive properties due to re-entrant geometry that enables them to possess Negative Poisson’s Ratio (NPR). These materials have better energy absorbing and shock resistance capabilities as compared to conventional positive Poisson’s ratio materials. The re-entrant geometry can be created through 3D printing for convenient application of these materials. This paper investigates the mechanical properties of 3D printed chiral auxetic geometries of various sizes. Small scale samples were printed using an ordinary 3D printer and were tested under compression and tension to ascertain their strength and deformation characteristics. A maximum NPR of -9 was obtained under compression and tension. The re-entrant chiral cell size has been shown to affect the mechanical properties of the re-entrant chiral auxetics.Keywords: auxetic materials, 3D printing, Negative Poisson’s Ratio, re-entrant chiral auxetics
Procedia PDF Downloads 1234302 Canthin-6-One Alkaloid Inhibits NF-κB and AP-1 Activity: An Inhibitory Action At Transcriptional Level
Authors: Fadia Gafri, Kathryn Mckintosh, Louise Young, Alan Harvey, Simon Mackay, Andrew Paul, Robin Plevin
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Nuclear factor-kappa B (NF-κB) is a ubiquitous transcription factor found originally to play a key role in regulating inflammation. However considerable evidence links this pathway to the suppression of apoptosis, cellular transformation, proliferation and invasion (Aggarwal et al., 2006). Moreover, recent studies have also linked inflammation to cancer progression making NF-κB overall a promising therapeutic target for drug discovery (Dobrovolskaia & Kozlov, 2005). In this study we examined the effect of the natural product canthin-6-one (SU182) as part of a CRUK small molecule drug discovery programme for effects upon the NF-κB pathway. Initial studies demonstrated that SU182 was found to have good potency against the inhibitory kappa B kinases (IKKs) at 30M in vitro. However, at concentrations up to 30M, SU182 had no effect upon TNFα stimulated loss in cellular IκBα or p65 phosphorylation in the keratinocyte cell line NCTC2544. Nevertheless, 30M SU182 reduced TNF-α / PMA-induced NF-κB-linked luciferase reporter activity to (22.9 ± 5%) and (34.6± 3 %, P<0.001) respectively, suggesting an action downstream of IKK signalling. Indeed, SU182 neither decreased NF-κB-DNA binding as assayed by EMSA nor prevented the translocation of p65 (NF-κB) to the nucleus assessed by immunofluorescence and subcellular fractionation. In addition to the inhibition of transcriptional activity of TNFα-induced NF-κB reporter activity SU182 significantly reduced PMA-induced AP-1-linked luciferase reporter activity to about (48± 9% at 30M, P<0.001) . This mode of inhibition was not sufficient to prevent the activation of NF-κB dependent induction of other proteins such as COX-2 and iNOS, or activated MAP kinases (p38, JNK and ERK1/2) in LPS stimulated RAW 264.7 macrophages. Taken together these data indicate the potential for SU182 to interfere with the transcription factors NF-κB and AP-1 at transcriptional level. However, no potential anti-inflammatory effect was indicated, further investigation for other NF-κB dependent proteins linked to survival are also required to identify the exact mechanism of action.Keywords: Canthin-6-one, NF-κB, AP-1, phosphorylation, Nuclear translocation, DNA-binding activity, inflammatory proteins.
Procedia PDF Downloads 4584301 Challenges and Opportunities for Online Consumer Selling Process Development in Coming Years in World
Authors: Prakash Prajapati
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E commerce is certainly one of the business alternatives that individual will have to analyze in the forthcoming years. E-commerce is said to bring about arched type conversion in the world for exchange market. Prognosis E-commerce is presenting dreadful business advancement in our country. Endorsed by ascending online user base & mobile phone presentation, Indian e-commerce has been splendid development in the last few years. Conceding India’s analytical dividend and spiraling internet admittance, the sector is contracted to scale higher heights. Although, India’s overall peddle opportunity is consequential, the sector is beset with some deliberate challenges. The current study has been proceeded to explore the present scenario, status & future advancement of e-commerce in India and review the challenges and opportunities of e-commerce in India.Keywords: online selling, retail selling online, product process, business opportunity
Procedia PDF Downloads 1464300 A Fermatean Fuzzy MAIRCA Approach for Maintenance Strategy Selection of Process Plant Gearbox Using Sustainability Criteria
Authors: Soumava Boral, Sanjay K. Chaturvedi, Ian Howard, Kristoffer McKee, V. N. A. Naikan
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Due to strict regulations from government to enhance the possibilities of sustainability practices in industries, and noting the advances in sustainable manufacturing practices, it is necessary that the associated processes are also sustainable. Maintenance of large scale and complex machines is a pivotal task to maintain the uninterrupted flow of manufacturing processes. Appropriate maintenance practices can prolong the lifetime of machines, and prevent associated breakdowns, which subsequently reduces different cost heads. Selection of the best maintenance strategies for such machines are considered as a burdensome task, as they require the consideration of multiple technical criteria, complex mathematical calculations, previous fault data, maintenance records, etc. In the era of the fourth industrial revolution, organizations are rapidly changing their way of business, and they are giving their utmost importance to sensor technologies, artificial intelligence, data analytics, automations, etc. In this work, the effectiveness of several maintenance strategies (e.g., preventive, failure-based, reliability centered, condition based, total productive maintenance, etc.) related to a large scale and complex gearbox, operating in a steel processing plant is evaluated in terms of economic, social, environmental and technical criteria. As it is not possible to obtain/describe some criteria by exact numerical values, these criteria are evaluated linguistically by cross-functional experts. Fuzzy sets are potential soft-computing technique, which has been useful to deal with linguistic data and to provide inferences in many complex situations. To prioritize different maintenance practices based on the identified sustainable criteria, multi-criteria decision making (MCDM) approaches can be considered as potential tools. Multi-Attributive Ideal Real Comparative Analysis (MAIRCA) is a recent addition in the MCDM family and has proven its superiority over some well-known MCDM approaches, like TOPSIS (Technique for Order Preference by Similarity to Ideal Solution) and ELECTRE (ELimination Et Choix Traduisant la REalité). It has a simple but robust mathematical approach, which is easy to comprehend. On the other side, due to some inherent drawbacks of Intuitionistic Fuzzy Sets (IFS) and Pythagorean Fuzzy Sets (PFS), recently, the use of Fermatean Fuzzy Sets (FFSs) has been proposed. In this work, we propose the novel concept of FF-MAIRCA. We obtain the weights of the criteria by experts’ evaluation and use them to prioritize the different maintenance practices according to their suitability by FF-MAIRCA approach. Finally, a sensitivity analysis is carried out to highlight the robustness of the approach.Keywords: Fermatean fuzzy sets, Fermatean fuzzy MAIRCA, maintenance strategy selection, sustainable manufacturing, MCDM
Procedia PDF Downloads 1384299 Fam111b Gene Dysregulation Contributes to the Malignancy in Fibrosarcoma, Poor Clinical Outcomes in Poiktmp and a Low-cost Method for Its Mutation Screening
Authors: Cenza Rhoda, Falone Sunda, Elvis Kidzeru, Nonhlanhla P. Khumalo, Afolake Arowolo
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Introduction: The human FAM111B gene mutations are associated with POIKTMP, a rare multi-organ fibrosing disease. Recent studies also reported the overexpression of FAM111B in specific cancers. However, the role of FAM111B in these pathologies, particularly fibrosarcoma, remains unknown. Materials and Methods: FAM111B RNA expression in some cancer cell lines was assessed in silico and validated in vitro in these cell lines and skin fibroblasts derived from the South African family member affected by POIKTMP with the heterozygous FAM111B gene mutation: NM_198947.4: c.1861T>G (p. Tyr621Asp or Y621D) by qPCR and western blot. The cellular function of FAM111B was also studied in HT1080 using various cell-based functional assays and a simple and cost-effective PCR-RFLP method for genotyping/screening FAM111B gene mutations described. Results: Expression studies showed upregulated FAM111B mRNA and protein in the cancer cells. High FAM111B expression with robust nuclear localization occurred in HT1080. Additionally, expression data and cell-based assays indicated that FAM111B led to the upregulation of cell migration and decreased cell apoptosis and cell proliferation modulation. FAM111B Y621D mutation showed similar effects on cell migration but minimal impact on cell apoptosis. FAM111B mRNA and protein expression were markedly downregulated (p ≤ 0.05) in the patient's skin-derived fibroblasts. Lastly, the PCR-RFLP method successfully genotyped FAM111B Y621D gene mutation. Discussion: FAM111B is a cancer-associated nuclear protein: Its modulation by mutations may enhance cell migration and proliferation and decrease apoptosis, as seen in cancers and POIKTMP/fibrosis, thus representing a viable therapeutic target in these disorders. Furthermore, the PCR-RFLP method could prove a valuable tool for FAM111B mutation validation or screening in resource-constrained laboratories.Keywords: FAM111B, POIKTMP, cancer, fibrosis, PCR-RFLP
Procedia PDF Downloads 1214298 Enhanced Cytotoxic Effect of Expanded NK Cells with IL12 and IL15 from Leukoreduction Filter on K562 Cell Line Exhibits Comparable Cytotoxicity to Whole Blood
Authors: Abdulbaset Mazarzaei
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Natural killer (NK) cells are innate immune effectors that play a pivotal role in combating tumors and infected cells. In recent years, the therapeutic potential of NK cells has gained significant attention due to their remarkable cytotoxic ability. This study focuses on investigating the cytotoxic effect of expanded NK cells enriched with interleukin 12 (IL12) and interleukin 15 (IL15), derived from the leukoreduction filter, on the K562 cell line. Firstly, NK cells were isolated from whole blood samples obtained from healthy volunteers. These cells were subsequently expanded ex vivo using a combination of feeder cells, IL12, and IL15. The expanded NK cells were then harvested and assessed for their cytotoxicity against K562, a well-established human chronic myelogenous leukemia cell line. The cytotoxicity was evaluated using flow cytometry assay. Results demonstrate that the expanded NK cells significantly exhibited enhanced cytotoxicity against K562 cells compared to non-expanded NK cells. Interestingly, the expanded NK cells derived specifically from IL12 and IL15-enriched leukoreduction filters showed a robust cytotoxic effect similar to the whole blood-derived NK cells. These findings suggest that IL12 and IL15 in the leukoreduction filter are crucial in promoting NK cell cytotoxicity. Furthermore, the expanded NK cells displayed relatively similar cytotoxicity profiles to whole blood-derived NK cells, indicating their comparable capability in targeting and eliminating tumor cells. This observation is of significant relevance as expanded NK cells from the leukoreduction filter could potentially serve as a readily accessible and efficient source for adoptive immunotherapy. In conclusion, this study highlights the significant cytotoxic effect of expanded NK cells enriched with IL12 and IL15 obtained from the leukoreduction filter on the K562 cell line. Moreover, it emphasizes that these expanded NK cells exhibit comparable cytotoxicity to whole blood-derived NK cells. These findings reinforce the potential clinical utility of using expanded NK cells from the leukoreduction filter as an effective strategy in adoptive immunotherapy for the treatment of cancer. Further studies are warranted to explore the broader implications of this approach in clinical settings.Keywords: natural killer (NK) cells, Cytotoxicity, Leukoreduction filter, IL-12 and IL-15 Cytokines
Procedia PDF Downloads 654297 Attachment and Self Esteem among Adolescents of Separated Parents
Authors: Aswathy Sampath
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The study examined the levels of self esteem and attachment among adolescents of divorced and non-divorced parents. Adolescent is a period which is most prodigious yet stressful period of development in a human’s life hence it is important to study the effects on them. The study was conducted on total 60 adolescents, 30 in each group, from the area of Trivandrum, Kerala as it is the top rated in the number of divorce cases in India. The data was collected using Rosenberg’s self esteem scale and IPPA (father, mother and peer) The results of this study were analyzed using t test and found that there is no significance difference in the level of self esteem and attachment (father, mother and peer). This is due to the cultural elements that give support to the individual and also the type of family as it is much different from the west. Although, there was no significant result, there were higher mean scores in the attachment towards peer for children who are from separated family background or in other words adolescents whose parents were divorced. This tells us the essence of social support.Keywords: adolescent, attachment, self esteem, separation
Procedia PDF Downloads 3864296 A Study of Electrowetting-Assisted Mold Filling in Nanoimprint Lithography
Authors: Wei-Hsuan Hsu, Yi-Xuan Huang
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Nanoimprint lithography (NIL) possesses the advantages of sub-10-nm feature and low cost. NIL patterns the resist with physical deformation using a mold, which can easily reproduce the required nano-scale pattern. However, the variation of process parameters and environmental conditions seriously affect reproduction quality. How to ensure the quality of imprinted pattern is essential for industry. In this study, the authors used the electrowetting technology to assist mold filling in the NIL process. A special mold structure was designed to cause electrowetting. During the imprinting process, when a voltage was applied between the mold and substrate, the hydrophilicity/hydrophobicity of the surface of the mold can be converted. Both simulation and experiment confirmed that the electrowetting technology can assist mold filling and avoid incomplete filling rate. The proposed method can also reduce the crack formation during the de-molding process. Therefore, electrowetting technology can improve the process quality of NIL.Keywords: electrowetting, mold filling, nano-imprint, surface modification
Procedia PDF Downloads 1724295 Anaerobic Digestion of Spent Wash through Biomass Development for Obtaining Biogas
Authors: Sachin B. Patil, Narendra M. Kanhe
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A typical cane molasses based distillery generates 15 L of waste water per liter of alcohol production. Distillery waste with COD of over 1,00,000 mg/l and BOD of over 30,000 mg/l ranks high amongst the pollutants produced by industries both in magnitude and strength. Treatment and safe disposal of this waste is a challenging task since long. The high strength of waste water renders aerobic treatment very expensive and physico-chemical processes have met with little success. Thermophilic anaerobic treatment of distillery waste may provide high degree of treatment and better recovery of biogas. It may prove more feasible in most part of tropical country like India, where temperature is suitable for thermophilic micro-organisms. Researchers have reviled that, at thermophilic conditions due to increased destruction rate of organic matter and pathogens, higher digestion rate can be achieved. Literature review reveals that the variety of anaerobic reactors including anaerobic lagoon, conventional digester, anaerobic filter, two staged fixed film reactors, sludge bed and granular bed reactors have been studied, but little attempts have been made to evaluate the usefulness of thermophilic anaerobic treatment for treating distillery waste. The present study has been carried out, to study feasibility of thermophilic anaerobic digestion to facilitate the design of full scale reactor. A pilot scale anaerobic fixed film fixed bed reactor (AFFFB) of capacity 25m3 was designed, fabricated, installed and commissioned for thermophilic (55-65°C) anaerobic digestion at a constant pH of 6.5-7.5, because these temperature and pH ranges are considered to be optimum for biogas recovery from distillery wastewater. In these conditions, working of the reactor was studied, for different hydraulic retention times (HRT) (0.25days to 12days) and variable organic loading rates (361.46 to 7.96 Kg COD/m3d). The parameters such as flow rate and temperature, various chemical parameters such as pH, chemical oxygen demands (COD), biogas quantity, and biogas composition were regularly monitored. It was observed that, with the increase in OLR, the biogas production was increased, but the specific biogas yield decreased. Similarly, with the increase in HRT, the biogas production got decrease, but the specific biogas yield was increased. This may also be due to the predominant activity of acid producers to methane producers at the higher substrate loading rates. From the present investigation, it can be concluded that for thermophilic conditions the highest COD removal percentage was obtained at an HRT of 08 days, thereafter it tends to decrease from 8 to 12 days HRT. There is a little difference between COD removal efficiency of 8 days HRT (74.03%) and 5 day HRT (78.06%), therefore it would not be feasible to increase the reactor size by 1.5 times for mere 4 percent more efficiency. Hence, 5 days HRT is considered to be optimum, at which the biogas yield was 98 m3/day and specific biogas yield was 0.385 CH4 m3/Kg CODr.Keywords: spent wash, anaerobic digestion, biomass, biogas
Procedia PDF Downloads 2654294 Optimization of Rehabilitation in Scapolohumeral Periarthrosis Using Botulinum Toxin
Authors: M. A. Akulov, V. O. Zaharov, A. A. Tomskij
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Introduction: Scapulohumeral periarthrosis, resulting as a reaction to mechanical injury of shoulder tendons and muscles, is associated with high incidence of temporal and permanent disability. There is a strong need for investigation of treatment of that patient group. Severe pain leads to limitation of movements range, which result in secondary alterations of joint capsule and ligamentous apparatus. Muscle tension and edema, swelling of fascial and fibrous structures result in nerve and vascular compression in intramuscular and osseo-muscular-fibrous spaces. Botulinum toxin injection leads to decrease of muscle tone, increase of movements range and associated pain alleviation. Study aim: Optimization of rehabilitation process in scapolohumeral periarthrosis using Xeomin. Patients and methods: 40 patients aged 37-56 years with scapulohumeral periarthrosis were evaluated. Patients were divided into two groups according to treatment regimen. The first (main) group included 21 patients, receiving intramuscular Xeomin 150-200 U in the area of brachio-scapular joint and trigger points (inducing motion range limitation and pain). Treatment procedures were combined with physical therapy and osteopathic procedures. The second (control) group included 19 patients, receiving conventional physical therapy and osteopathic procedures. The evaluation and efficacy comparison was carried out using McGill pain questionnaire, Clinical Global Impression scale (CGI), and patient-reported increase of brachio-scapular joint movement range and pain decrease at 1, 3 and 6 months of treatment. Results. The study demonstrated a significant improvement in the main group after one month of treatment, which persisted during months of treatment. At baseline, rank pain index on McGill pain questionnaire was 18,4±4,9 and 17,8±5,1 in the main and control group, respectively (p > 0,05). At 1 month of treatment we observed a significant decrease of pain syndrome (no pain or modest pain) and increase of movement range in angular degrees in the main group (р < 0,05). In the control group significant improvements were observed only on the 3 month of treatment (р < 0,05), but at 6 months of treatment the improvement in pain syndrome and motion range in brachio-scapular joint was significantly smaller, than in the main group. Rank pain index on McGill pain scale was 5,2±1,8 in the main group compared to 12,0±2,6 in the control group (р < 0,05). At 6 months of treatment patients in the first group reported a significant/highly significant improvement of general health on CGI, whereas in the second group most patients reported a minimal improvement. We observed a sustained and persistent improvement of motion range in brachio-scapular joint in the main group. Conclusion: Xeomin injections as a part of rehabilitation process in scapulohumeral periarthrosis lead to reduced time and increased quality of rehabilitation.Keywords: botulinum toxin, rehabilitation, scapulohumeral periarthrosis
Procedia PDF Downloads 2794293 Application of Topical Imiquimod for Treatment Cervical Intraepithelial Neoplasia in Young Women: A Preliminary Result of a Pilot Study
Authors: Phill-Seung Jung, Dae-Yeon Kim
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Objectives: In young, especially nulliparous women, it is not easy to decide on excisional therapy for cervical intraepithelial neoplasia (CIN). We aimed to evaluate how effective topical imiquimod is in the treatment of high-grade CIN so that excisional therapy can be avoided in young women. Methods: Patients with CIN were allocated to this pilot study. They did not want excisional therapy and agreed with topical imiquimod therapy, which required once-a-week hospital visit for 8 weeks for the application of imiquimod to the cervix by a gynecologic oncologist. If the lesion got worse during treatment, it was decided to convert imiquimod therapy to excisional therapy. Results: A total of 36 patients with a median age of 29 years (range, 22–41 years) agreed to receive topical imiquimod therapy. Of these, 32 patients (88.9%) were positive for high-risk human papillomavirus (HR HPV). Twenty-five patients (69.4%) had low-grade squamous intraepithelial lesion (LSIL), and 11 (30.6%) had high-grade squamous intraepithelial lesion (HSIL) on their initial LBC. Twenty-eight patients underwent punch biopsy, which showed CIN 1 in 7 (19.4%), CIN 2 in 11 (30.6%), and CIN 3 in 10 (27.8%) patients. Twenty patients finished the 8-week imiquimod therapy. Among them, 14 patients had CIN 2 or 3, and 6 patients had CIN 1. HR HPV was positive in 12 patients. On the last examination, 14 patients (70.0%) had negative intraepithelial lesions, 3 (15.0%) had atypical squamous cells of undetermined significance, and 1 (5.0%) had LSIL. Two patients had persistent HSIL: 1 patient underwent loop electrosurgical excision procedure, resulting in CIN 3 with positive resection margin, and the other patient underwent punch biopsy, resulting in intermediate cells and restarted imiquimod therapy. Only 7 patients were negative for HR HPV. Conclusions: This study showed that topical imiquimod therapy was effective for the treatment of high-grade CIN, with a histologic regression rate of 85.7% (14/20) and HPV eradication rate of 25.0% (8/32). Based on our findings, topical imiquimod therapy might have a successful therapeutic effect in young women with CIN 2-3 so that they can avoid excisional therapy. In addition, it could be a more reassuring treatment option for CIN 1 than just follow-up after few months. To confirm its efficacy, a phase II study with larger cohort would be needed.Keywords: Imiquimod, Cervical Intraepthelial Neoplasia, Cervical Dysplasia, Human Papillomavirus
Procedia PDF Downloads 2514292 Poly(N-Vinylcaprolactam-Co-Itaconic Acid-Co-Ethylene Glycol Dimethacrylate)-Based Microgels Embedded in Chitosan Matrix for Controlled Release of Ketoprofen
Authors: Simone F. Medeiros, Jessica M. Fonseca, Gizelda M. Alves, Danilo M. Santos, Sérgio P. Campana-Filho, Amilton M. Santos
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Stimuli responsive and biocompatible hydrogel nanoparticles have gained special attention as systems for potential applications in controlled release of drugs to improve their therapeutic efficacy while minimizing side effects. In this work, novel solid dispersions based on thermo- and pH-responsive poly(N-vinylcaprolactam-co-itaconic acid-co-ethylene- glycol dimethacrylate) hydrogel nanoparticles embedded in chitosan matrices were prepared via spray drying for controlled release of ketoprofen. Firstly, the hydrogel nanoparticles containing ketoprofen were prepared via precipitation polymerization and their stimuli-responsive behavior, thermal properties, chemical composition, encapsulation efficiency and morphology were characterized. Then, hydrogel nanoparticles with different particles size were embedded into chitosan matrices via spray-drying. Scanning electron microscopy (SEM) analyses were performed to investigate the particles size, dispersity and morphology. Finally, ketoprofen release profiles were studied as a function of pH and temperature. Chitosan/poly(NVCL-co-IA-co-EGDMA)-ketoprofen microparticles presented spherical shape, rough surface and pronounced agglomeration, indicating that hydrogels nanoparticles loaded with ketoprofen modified the surface of chitosan matrix. The maximum encapsulation efficiency of ketoprofen into hydrogel nanoparticles was 57.8% and the electrostatic interactions between amino groups from chitosan and carboxylic groups from hydrogel nanoparticles were able to control ketoprofen release. The hydrogel nanoparticles themselves were capable to retard the release of ketoprofen-loaded until 48h of in vitro release tests, while their incorporation into chitosan matrix achieved a maximum percentage of drug release of 45%, using a mass ratio of chitosan: poly(NVCL-co-IA-co-EGDMA equal to 10:7, and 69%, using a mass ratio of chitosan: poly(NVCL-co-IA-co-EGDMA equal to 5:2.Keywords: hydrogel nanoparticles, poly(N-vinylcaprolactam-co-itaconic acid-co-ethylene- glycol dimethacrylate), chitosan, ketoprofen, spray-drying
Procedia PDF Downloads 2654291 Electrode Engineering for On-Chip Liquid Driving by Using Electrokinetic Effect
Authors: Reza Hadjiaghaie Vafaie, Aysan Madanpasandi, Behrooz Zare Desari, Seyedmohammad Mousavi
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High lamination in microchannel is one of the main challenges in on-chip components like micro total analyzer systems and lab-on-a-chips. Electro-osmotic force is highly effective in chip-scale. This research proposes a microfluidic-based micropump for low ionic strength solutions. Narrow microchannels are designed to generate an efficient electroosmotic flow near the walls. Microelectrodes are embedded in the lateral sides and actuated by low electric potential to generate pumping effect inside the channel. Based on the simulation study, the fluid velocity increases by increasing the electric potential amplitude. We achieve a net flow velocity of 100 µm/s, by applying +/- 2 V to the electrode structures. Our proposed low voltage design is of interest in conventional lab-on-a-chip applications.Keywords: integration, electrokinetic, on-chip, fluid pumping, microfluidic
Procedia PDF Downloads 2954290 Assessment of Acute Oral Toxicity Studies and Anti Diabetic Activity of Herbal Mediated Nanomedicine
Authors: Shanker Kalakotla, Krishna Mohan Gottumukkala
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Diabetes is a metabolic disorder characterized by hyperglycemia, carbohydrates, altered lipids and proteins metabolism. In recent research nanotechnology is a blazing field for the researchers; latterly there has been prodigious excitement in the nanomedicine and nano pharmacological area for the study of silver nanoparticles synthesis using natural products. Biological methods have been used to synthesize silver nanoparticles in presence of medicinally active antidiabetic plants, and this intention made us assess the biologically synthesized silver nanoparticles from the seed extract of Psoralea corylfolia using 1 mM silver nitrate solution. The synthesized herbal mediated silver nanoparticles (HMSNP’s) then subjected to various characterization techniques such as XRD, SEM, EDX, TEM, DLS, UV and FT-IR respectively. In current study, the silver nanoparticles tested for in-vitro anti-diabetic activity and possible toxic effects in healthy female albino mice by following OECD guidelines-425. Herbal mediated silver nanoparticles were successfully obtained from bioreduction of silver nitrate using Psoralea corylifolia plant extract. Silver nanoparticles have been appropriately characterized and confirmed using different types of equipment viz., UV-vis spectroscopy, XRD, FTIR, DLS, SEM and EDX analysis. From the behavioral observations of the study, the female albino mice did not show sedation, respiratory arrest, and convulsions. Test compounds did not cause any mortality at the dose level tested (i.e., 2000 mg/kg body weight) doses till the end of 14 days of observation and were considered safe. It may be concluded that LD50 of the HMSNPs was 2000mg/kg body weight. Since LD50 of the HMSNPs was 2000mg/kg body weight, so the preferred dose range for HMSNPs falls between the levels of 200 and 400 mg/kg. Further In-vivo pharmacological models and biochemical investigations will clearly elucidate the mechanism of action and will be helpful in projecting the currently synthesized silver nanoparticles as a therapeutic target in treating chronic ailments.Keywords: herbal mediated silver nanoparticles, HMSNPs, toxicity of silver nanoparticles, PTP1B in-vitro anti-diabetic assay female albino mice, 425 OECD guidelines
Procedia PDF Downloads 2734289 Prevalence and Correlates of Complementary and Alternative Medicine Use among Diabetic Patients in Lebanon: A Cross-Sectional Study
Authors: Farah Naja, Mohamad Alameddine
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Background: The difficulty of compliance to therapeutic and lifestyle management of type 2 diabetes mellitus (T2DM) encourages patients to use complementary and alternative medicine (CAM) therapies. Little is known about the prevalence and mode of CAM use among diabetics in the Eastern Mediterranean Region in general and Lebanon in particular. Objective: To assess the prevalence and modes of CAM use among patients with T2DM residing in Beirut, Lebanon. Methods: A cross-sectional survey of T2DM patients was conducted on patients recruited from two major referral centers - a public hospital and a private academic medical center in Beirut. In a face-to-face interview, participants completed a survey questionnaire comprised of three sections: socio-demographic, diabetes characteristics and types and modes of CAM use. Descriptive statistics, univariate and multivariate logistic regression analyses were utilized to assess the prevalence, mode and correlates of CAM use in the study population. The main outcome in this study (CAM use) was defined as using CAM at least once since diagnosis with T2DM. Results: A total of 333 T2DM patients completed the survey (response rate: 94.6%). Prevalence of CAM use in the study population was 38%, 95% CI (33.1-43.5). After adjustment, CAM use was significantly associated with a “married” status, a longer duration of T2DM, the presence of disease complications, and a positive family history of the disease. Folk foods and herbs were the most commonly used CAM followed by natural health products. One in five patients used CAM as an alternative to conventional treatment. Only 7 % of CAM users disclosed the CAM use to their treating physician. Health care practitioners were the least cited (7%) as influencing the choice of CAM among users. Conclusion: The use of CAM therapies among T2DM patients in Lebanon is prevalent. Decision makers and care providers must fully understand the potential risks and benefits of CAM therapies to appropriately advise their patients. Attention must be dedicated to educating T2DM patients on the importance of disclosing CAM use to their physicians especially patients with a family history of diabetes, and those using conventional therapy for a long time.Keywords: nutritional supplements, type 2 diabetes mellitus, complementary and alternative medicine (CAM), conventional therapy
Procedia PDF Downloads 3494288 Global Convergence of a Modified Three-Term Conjugate Gradient Algorithms
Authors: Belloufi Mohammed, Sellami Badreddine
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This paper deals with a new nonlinear modified three-term conjugate gradient algorithm for solving large-scale unstrained optimization problems. The search direction of the algorithms from this class has three terms and is computed as modifications of the classical conjugate gradient algorithms to satisfy both the descent and the conjugacy conditions. An example of three-term conjugate gradient algorithm from this class, as modifications of the classical and well known Hestenes and Stiefel or of the CG_DESCENT by Hager and Zhang conjugate gradient algorithms, satisfying both the descent and the conjugacy conditions is presented. Under mild conditions, we prove that the modified three-term conjugate gradient algorithm with Wolfe type line search is globally convergent. Preliminary numerical results show the proposed method is very promising.Keywords: unconstrained optimization, three-term conjugate gradient, sufficient descent property, line search
Procedia PDF Downloads 3754287 Optical Switching Based On Bragg Solitons in A Nonuniform Fiber Bragg Grating
Authors: Abdulatif Abdusalam, Mohamed Shaban
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In this paper, we consider the nonlinear pulse propagation through a nonuniform birefringent fiber Bragg grating (FBG) whose index modulation depth varies along the propagation direction. Here, the pulse propagation is governed by the nonlinear birefringent coupled mode (NLBCM) equations. To form the Bragg soliton outside the photonic bandgap (PBG), the NLBCM equations are reduced to the well known NLS type equation by multiple scale analysis. As we consider the pulse propagation in a nonuniform FBG, the pulse propagation outside the PBG is governed by inhomogeneous NLS (INLS) rather than NLS. We, then, discuss the formation of soliton in the FBG known as Bragg soliton whose central frequency lies outside but close to the PBG of the grating structure. Further, we discuss Bragg soliton compression due to a delicate balance between the SPM and the varying grating induced dispersion. In addition, Bragg soliton collision, Bragg soliton switching and possible logic gates have also been discussed.Keywords: Bragg grating, non uniform fiber, non linear pulse
Procedia PDF Downloads 3174286 Derivation of Neutrino Mass Parameters from the Study of Neutrinoless Double Beta Decay
Authors: Sabin Stoica
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In this paper the theoretical challenges in the study of neutrinoless double beta decay are reviewed. Then, new upper limits of the neutrino mass parameters in the case of three isotopes are derived; 48Ca, 76Ge, and 82Se, assuming two possible mechanisms of occurrence of this nuclear process, namely the exchange of i) light left-handed neutrinos and ii) heavy right-handed neutrinos, between two nucleons inside the nucleus. The derivation is based on accurate calculations of the phase space factors and nuclear matrix elements performed with new high-performance computer codes, which are described in more detail in recent publications. These results are useful both for a better understanding of the scale of neutrino absolute mass and for the planning of future double beta decay experiments.Keywords: double beta decay, neutrino properties, nuclear matrix elements, phase space factors
Procedia PDF Downloads 6004285 Unusual Presentation of Colorectal Cancer within Inguinal Hernia: A Systemic Review of Reported Cases
Authors: Sena Park
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Background: The concurrent presentation with colorectal cancer in the inguinal hernia has been extremely rare. Due to its rarity, its presentation may lead to diagnostic and therapeutic dilemmas. We aim to review all the reported cases on colorectal cancer incarcerated in the inguinal hernia in the last 20 years, and discuss the operative approaches. Methods: We identified all case reports on colorectal cancer within inguinal hernia using PUBMED (2002-2022) and MEDLINE (2002-2022). The search strategy included the following keywords: colorectal cancer (title/abstract) AND inguinal hernia (title/abstract) OR incarceration (title/abstract). The search did not include letters, book chapters, systemic reviews, meta-analysis and editorials. Results: In the last 20 years, a total of 19 cases on colorectal cancer within the inguinal hernia were identified. The age of the patients ranged between 48 and 89. Majority of the patients were male (95%). Most commonly involved part of the large intestine was sigmoid colon (79%). Of all the cases, 79 percent of patients received open procedure and 21 percent had laparoscopic procedure. Discussion: Inguinal hernias are common with an incidence of approximately 1.7 percent. Colorectal cancer is the one of the leading causes of cancer-related mortality worldwide. However, their concurrent presentation has been extremely rare. In the last 20 years, 19 cases on concurrent presentation of colorectal cancer and inguinal hernia have been reported. Most patients who had open procedures had two incisions of groin incision and a midline laparotomy. There were 4 cases where the oncological resection was performed laparoscopically. The advantages of laparoscopic resection include reduced blood lost, reduced post-operative pain, reduced length of hospital stay and similar number of lymph nodes taken. From the review of the cases in the last 20 years, both open and laparoscopic approaches seemed to be safe and achieve adequate oncological resections. Conclusion: This is a brief overview of reported cases of colorectal cancer presenting with inguinal hernia concurrently. Due to its rarity, there are no current guidelines on operative approach in clinical practice. The experience in the last 20 years supports both open and laparoscopic approach.Keywords: colorectal cancer, inguinal hernia, incarceration, operative approach
Procedia PDF Downloads 1014284 Split-Share Structure Reform and Statutory Audit Fees in China
Authors: Hsiao-Wen Wang
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The split-share structure reform in China represents one of the most significant milestones in the evolution of the capital market. With the goal of converting non-tradable shares into tradable shares, the reform laid the foundation and supported the development of full-scale privatization. This study explores China’s split-share structure reform and its impact on statutory audit fees. This study finds that auditors earn a significant statutory audit fee premium after the split-share structure reform. The Big 4 auditors who provide better audit quality receive higher statutory audit fee premium than non-Big 4 auditors after the share reform, which is attributable to their brand reputation, rather than the relative market dominance.Keywords: chinese split-share structure reform, statutory audit fees, big-4 auditors, corporate governance
Procedia PDF Downloads 3984283 Hierarchical Surface Inspired by Lotus-Leaf for Electrical Generators from Waterdrop
Authors: Jaewook Ha, Jin-beak Kim, Seongmin Kim
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In order to solve global warming and climate change issues, increased efforts have been devoted towards clean and sustainable energy sources as well as new energy generating devices. Nanogenerator is a device that converts mechanical/thermal energy as produced by small-scale physical change into electricity. Here we propose that nature-leaf surface could be used for preparation of a triboelectric nanogenerator. The nature-leaf surface consists of polydimethylsiloxane microscale pillars and polytetrafluoroethylene nanoparticles. Interaction between the nature-leaf surface and water was studied and the electrical outputs from the motion of single water drop were measured. A 40-μL water drop can generate a peak voltage of 1 V and a peak current of 0.7 μA. This nanogenerator might be used to drive electric devices in the outdoor environments in a sustainable manner.Keywords: hierarchical surface, lotus-leaf, electrical generator, waterdrop
Procedia PDF Downloads 2934282 Forensic Investigation Into the Variation of Geological Properties of Soils Bintulu, Sarawak
Authors: Jaithish John
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In this paper a brief overview is provided of the developments in interdisciplinary knowledge exchange with use of soil and geological (earth) materials in the search for evidence. The aim is to provide background information on the role and value of understanding ‘earth materials’ from the crime scene through to microscopic scale investigations to support law enforcement agencies in solving criminal and environmental concerns and investigations. This involves the sampling, analysis, interpretation and explanation presentation of all these evidences. In this context, field and laboratory methods are highlighted for the controlled / referenced sample, alibi sample and questioned sample. The aim of forensic analyses of earth materials is to associate these samples taken from a questioned source to determine if there are similar and outstanding characteristics features of earth materials crucial to support the investigation to the questioned earth materials and compare it to the controlled / referenced sample and alibi samples.Keywords: soil, texture, grain, microscopy
Procedia PDF Downloads 844281 Zeolite 4A-confined Ni-Co Nanocluster: An Efficient and Durable Electrocatalyst for Alkaline Methanol Oxidation Reaction
Authors: Sarmistha Baruah, Akshai Kumar, Nageswara Rao Peela
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The global energy crisis due to the dependence on fossil fuels and its limited reserves as well as environmental pollution are key concerns to the research communities. However, the implementation of alcohol-based fuel cells such as methanol is anticipated as a reliable source of future energy technology due to their high energy density, environment friendliness, ease of storage, transportation, etc. To drive the anodic methanol oxidation reaction (MOR) in direct methanol fuel cells (DMFCs), an active and long-lasting catalyst is necessary for efficient energy conversion from methanol. Recently, transition metal-zeolite-based materials have been considered versatile catalysts for a variety of industrial and lab-scale processes. Large specific surface area, well-organized micropores, and adjustable acidity/basicity are characteristics of zeolites that make them excellent supports for immobilizing small-sized and highly dispersed metal species. Significant advancement in the production and characterization of well-defined metal clusters encapsulated within zeolite matrix has substantially expanded the library of materials available, and consequently, their catalytic efficacy. In this context, we developed bimetallic Ni-Co catalysts encapsulated within LTA (also known as 4A) zeolite via a method combined with the in-situ encapsulation of metal species using hydrothermal treatment followed by a chemical reduction process. The prepared catalyst was characterized using advanced characterization techniques, such as X-ray diffraction (XRD), field emission transmission electron microscope (FETEM), field emission scanning electron microscope (FESEM), energy dispersive X-ray (EDX), and X-ray photoelectron spectroscopy (XPS). The electrocatalytic activity of the catalyst for MOR was carried out in an alkaline medium at room temperature using techniques such as cyclic voltammetry (CV), and chronoamperometry (CA). The resulting catalyst exhibited better catalytic activity of 12.1 mA cm-2 at 1.12 V vs Ag/AgCl and retained remarkable stability (~77%) even after 1000 cycles CV test for the electro-oxidation of methanol in alkaline media without any significant microstructural changes. The high surface area, better Ni-Co species integration in the zeolite, and the ample amount of surface hydroxyl groups contribute to highly dispersed active sites and quick analyte diffusion, which provide notable MOR kinetics. Thus, this study will open up new possibilities to develop a noble metal-free zeolite-based electrocatalyst due to its simple synthesis steps, large-scale fabrication, improved stability, and efficient activity for DMFC application.Keywords: alkaline media, bimetallic, encapsulation, methanol oxidation reaction, LTA zeolite.
Procedia PDF Downloads 654280 Post-Quantum Resistant Edge Authentication in Large Scale Industrial Internet of Things Environments Using Aggregated Local Knowledge and Consistent Triangulation
Authors: C. P. Autry, A. W. Roscoe, Mykhailo Magal
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We discuss the theoretical model underlying 2BPA (two-band peer authentication), a practical alternative to conventional authentication of entities and data in IoT. In essence, this involves assembling a virtual map of authentication assets in the network, typically leading to many paths of confirmation between any pair of entities. This map is continuously updated, confirmed, and evaluated. The value of authentication along multiple disjoint paths becomes very clear, and we require analogues of triangulation to extend authentication along extended paths and deliver it along all possible paths. We discover that if an attacker wants to make an honest node falsely believe she has authenticated another, then the length of the authentication paths is of little importance. This is because optimal attack strategies correspond to minimal cuts in the authentication graph and do not contain multiple edges on the same path. The authentication provided by disjoint paths normally is additive (in entropy).Keywords: authentication, edge computing, industrial IoT, post-quantum resistance
Procedia PDF Downloads 1974279 Performance Study of PV Power plants in Algeria
Authors: Razika Ihaddadene, Nabila Ihaddadene
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This paper aims to highlight the importance of the application of the IEC 61724 standard in the study of the performance analysis of photovoltaic power plants on a monthly and annual scale. Likewise, the comparison of two photovoltaic power plants with two different climates was carried out in order to determine the effect of climatic parameters on the analysis of photovoltaic performances. All data from the Ain Skhouna and Adrar photovoltaic power plants for 2018 and the data from the Saida1 field for one month in 2019 were used. The results of the performance analysis according to the indicated standard show that the Saida PV power plant performs better than the Adrar PV power plant, which is due to the effect of increasing the ambient temperature. Increasing ambient temperature increases losses decreases system efficiency and performance ratio. It presents a key element in the proper functioning of PV plants.Keywords: pv power plants, IEC 61724 norm, grid connected pv, algeria
Procedia PDF Downloads 774278 Modelization of Land Degradation by Desertification Using Medalus Method, Case Study of the Wilaya of Saida, Algeria
Authors: Fekir Youcef, Mederbal Khalladi, M. A. Hamadouche, D. Anteur
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Algeria is one of the countries that are highly affected by desertification which is the consequence of several factors. For this purpose, there is a need to study this problem by quantitative approaches. In this study, we apply the MEDALUS method (Mediterranean Desertification and Land Use) to a watershed located in Saida town in semi-arid environment in the south west of Algeria. The method is based on sensitive areas identification by making use of the different parameters that may affect the desertification process such as vegetation, soil, climate and management. Spatial analyses are strong tools that allow modelization of each indicator. Results show that according to European standards, a large scale of the watershed falls into critical classes. And therefore, the modelization approach can be an effective way to study and understand the desertification showing an example of the project of the green dam that limits the desertification process to affect the north areas off Algeria.Keywords: Algeria, desertification, MEDALUS, modelization
Procedia PDF Downloads 3894277 The Location-Routing Problem with Pickup Facilities and Heterogeneous Demand: Formulation and Heuristics Approach
Authors: Mao Zhaofang, Xu Yida, Fang Kan, Fu Enyuan, Zhao Zhao
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Nowadays, last-mile distribution plays an increasingly important role in the whole industrial chain delivery link and accounts for a large proportion of the whole distribution process cost. Promoting the upgrading of logistics networks and improving the layout of final distribution points has become one of the trends in the development of modern logistics. Due to the discrete and heterogeneous needs and spatial distribution of customer demand, which will lead to a higher delivery failure rate and lower vehicle utilization, last-mile delivery has become a time-consuming and uncertain process. As a result, courier companies have introduced a range of innovative parcel storage facilities, including pick-up points and lockers. The introduction of pick-up points and lockers has not only improved the users’ experience but has also helped logistics and courier companies achieve large-scale economy. Against the backdrop of the COVID-19 of the previous period, contactless delivery has become a new hotspot, which has also created new opportunities for the development of collection services. Therefore, a key issue for logistics companies is how to design/redesign their last-mile distribution network systems to create integrated logistics and distribution networks that consider pick-up points and lockers. This paper focuses on the introduction of self-pickup facilities in new logistics and distribution scenarios and the heterogeneous demands of customers. In this paper, we consider two types of demand, including ordinary products and refrigerated products, as well as corresponding transportation vehicles. We consider the constraints associated with self-pickup points and lockers and then address the location-routing problem with self-pickup facilities and heterogeneous demands (LRP-PFHD). To solve this challenging problem, we propose a mixed integer linear programming (MILP) model that aims to minimize the total cost, which includes the facility opening cost, the variable transport cost, and the fixed transport cost. Due to the NP-hardness of the problem, we propose a hybrid adaptive large-neighbourhood search algorithm to solve LRP-PFHD. We evaluate the effectiveness and efficiency of the proposed algorithm by using instances generated based on benchmark instances. The results demonstrate that the hybrid adaptive large neighbourhood search algorithm is more efficient than MILP solvers such as Gurobi for LRP-PFHD, especially for large-scale instances. In addition, we made a comprehensive analysis of some important parameters (e.g., facility opening cost and transportation cost) to explore their impacts on the results and suggested helpful managerial insights for courier companies.Keywords: city logistics, last-mile delivery, location-routing, adaptive large neighborhood search
Procedia PDF Downloads 784276 An Evolutionary Algorithm for Optimal Fuel-Type Configurations in Car Lines
Authors: Charalampos Saridakis, Stelios Tsafarakis
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Although environmental concern is on the rise across Europe, current market data indicate that adoption rates of environmentally friendly vehicles remain extremely low. Against this background, the aim of this paper is to a) assess preferences of European consumers for clean-fuel cars and their characteristics and b) design car lines that optimize the combination of fuel types among models in the line-up. In this direction, the authors introduce a new evolutionary mechanism and implement it to stated-preference data derived from a large-scale choice-based conjoint experiment that measures consumer preferences for various factors affecting clean-fuel vehicle (CFV) adoption. The proposed two-step methodology provides interesting insights into how new and existing fuel-types can be combined in a car line that maximizes customer satisfaction.Keywords: clean-fuel vehicles, product line design, conjoint analysis, choice experiment, differential evolution
Procedia PDF Downloads 2794275 Preliminary Results of Psychiatric Morbidity for Oncology Outpatients
Authors: Camille Plant, Katherine McGill, Pek Ang
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Oncology patients face a host of unique challenges, which are physical, psychological and philosophical in nature. This preliminary study aimed to explore the psychiatric morbidity of oncology patients in an outpatient setting at a major public hospital in Australia. The study found that 33 patients were referred to a Psychiatrist by a Clinical Psychologist or treating Oncologist. These patients attended an outpatient Psychiatry appointment at the Calvary Mater Hospital, Newcastle, over a 7 month period (June 2017-January 2018). Of these, 45% went on to have a follow-up appointment. The Clinical Global Impressions Scale (CGI) was used to gather symptom severity scores at baseline and at follow-up. The CGI is a clinician determined instrument that provides an assessment of global functioning. It is comprised of two companion one-item measures: the CGI-Severity (CGI-S) rates mental illness severity, and the CGI-Improvement (CGI-I) rates change in condition or improvement from initiation of treatment. Patients referred to a Psychiatrist were observed to be on average in the Markedly ill approaching Severely ill range (CGI-S average of 5.5). However, those patients who attended a follow-up appointment were on average only Moderately Ill at baseline (CGI-S average of 3.9). Despite these follow patients not being severely mentally ill initially, the contact was helpful, as their CGI-S scores improved on average to the Mildly Ill range (CGI-S average of 2.8). A Mixed ANOVA revealed that there was a significant improvement in mental illness severity post-follow-up appointment (Greenhouse-Geisser .000). There was a near even proportion of males and females attending appointments (58% female), and slightly more females attended a follow-up (60% female). Males were on average more mentally ill at baseline compared to females at baseline (male average M=3.86, female average M=3.56), and males had a greater reduction in mental illness severity on average compared to females (male average M=2.71, female average 3.00). This was approaching significance (.073) and would be important to explore with a larger sample size. Change in clinical condition for follow-up patients was also recorded. It was found that more than half of patients (53%) were observed to experience Minimal improvement in attending at least one follow-up appointment. There was no change for 27% of patients, and there were no patients who were worse at follow up. As this was a preliminary study with small sample size, future research conducted could explore whether there are any significant gender differences, such as whether males experience the significantly greater reduction in symptoms of mental illness compared to females, as well as any effects of cancer stage or type on psychiatric outcomes. Future research could also investigate outcomes for those patients who concurrently access a Clinical Psychologist alongside the Psychiatrist. A limitation of the study is that the outcome measure is a brief item rating completed by the clinician.Keywords: clinical global impressions scale, psychiatry, morbidity, oncology, outcomes, psychiatry
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