Search results for: nerve and tendon transfer surgery

Authors: D. Ramajo, S. Corzo, M. Nigro

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A Multi-dimensional computational fluid dynamics (CFD) two-phase model was developed with the aim to simulate the in-core coolant circuit of a pressurized heavy water reactor (PHWR) of a commercial nuclear power plant (NPP). Due to the fact that this PHWR is a Reactor Pressure Vessel type (RPV), three-dimensional (3D) detailed modelling of the large reservoirs of the RPV (the upper and lower plenums and the downcomer) were coupled with an in-house finite volume one-dimensional (1D) code in order to model the 451 coolant channels housing the nuclear fuel. Regarding the 1D code, suitable empirical correlations for taking into account the in-channel distributed (friction losses) and concentrated (spacer grids, inlet and outlet throttles) pressure losses were used. A local power distribution at each one of the coolant channels was also taken into account. The heat transfer between the coolant and the surrounding moderator was accurately calculated using a two-dimensional theoretical model. The implementation of subcooled boiling and condensation models in the 1D code along with the use of functions for representing the thermal and dynamic properties of the coolant and moderator (heavy water) allow to have estimations of the in-core steam generation under nominal flow conditions for a generic fission power distribution. The in-core mass flow distribution results for steady state nominal conditions are in agreement with the expected from design, thus getting a first assessment of the coupled 1/3D model. Results for nominal condition were compared with those obtained with a previous 1/3D single-phase model getting more realistic temperature patterns, also allowing visualize low values of void fraction inside the upper plenum. It must be mentioned that the current results were obtained by imposing prescribed fission power functions from literature. Therefore, results are showed with the aim of point out the potentiality of the developed model.

Keywords: PHWR, CFD, thermo-hydraulic, two-phase flow

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Authors: Lea Boidin, Martha Baydoun, Bertrand Leroux, Olivier Morales, Samir Acherar, Celine Frochot, Nadira Delhem

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Ovarian cancer (OC) is one of the most defying diseases in gynecologic oncology. Even though surgery remains crucial in the therapy of patients with primary ovarian cancer, recurrent recidivism calls for the development of new therapy protocols to propose for patients dealing with this cancer. FRα is described as a tumor‐associated antigen in OC, where FRα expression is usually linked with more poorly differentiated, aggressive tumors. The Photodynamic treatment (PDT) available data have shown improvements in the uptake of small tumors and in the induction of a proper anti-tumoral immune response. In order to target specifically peritoneal metastatis, which overexpress FRα, a new-patented PS coupled with folic acid has been developed in our team. Herein we propose PDT using this new patented PS for PDT applied in an in vivo mice model. The efficacy of the treatment was evaluated in mice without and with PBMC reconstitution. Mice were divided into four groups: Non-Treated, PS, Light Only, and PDT Treated and subjected to illumination by laser set at 668nm with a duration of illumination of 45 minutes (or 1 min of illumination followed by 2 minutes of pause repeated 45 times). When mice were not reconstituted and after fractionized PDT protocol, a significant decrease in the tumor volume was noticed. An induction in the anti-tumoral cytokine IFNγ chaperoned this decrease while a subsequent inhibition in the cytokine TGFβ. Even more crucial, when mice were reconstituted and upon PDT, the fold of tumor decrease was even higher. An immune response was activated decoded with an increase in NK, CD3 +, LT helper and Cytotoxic T cells. Thereafter, an increase in the expression of the cytokines IFNγ and TNFα were noticed while an inhibition in TGFβ, IL8 and IL10 accompanied this immune response activation. Therefore, our work has shown for the first time that a fractionized PDT protocol using a folate-targeted PDT is effective for treatment of ovarian cancer. The interest in using PDT in this case, goes beyond the local induction of tumor apoptosis only, but can promote subsequent anti-tumor response. Most of the therapies currently used to treat ovarian cancer, have an uncooperative outcomes on the host immune response. The readiness of a tumor adjuvant treatment like PDT adequate in eliminating the tumor and in concert stimulating anti-tumor immunity would be weighty.

Keywords: folate receptor, ovarian cancer, photodynamic therapy, humanized mice model

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Authors: Cathal Merz, Gareth O’Donnell

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Coil reinforced thin-walled (CRTW) tubes are used in medicine to treat problems affecting blood vessels within the body through minimally invasive procedures. The CRTW tube considered in this research makes up part of such a device and is inserted into the patient via their femoral or brachial arteries and manually navigated to the site in need of treatment. This procedure replaces the requirement to perform open surgery but is limited by reduction of blood vessel lumen diameter and increase in tortuosity of blood vessels deep in the brain. In order to maximize the capability of these procedures, CRTW tube devices are being manufactured with decreasing wall thicknesses in order to deliver treatment deeper into the body and to allow passage of other devices through its inner diameter. This introduces significant stresses to the device materials which have resulted in an observed increase in the breaking of the proximal segment of the device into two separate pieces after it has failed by buckling. As there is currently no international standard for measuring the mechanical properties of these CRTW tube devices, it is difficult to accurately analyze this problem. The aim of the current work is to address this discrepancy in the biomedical device industry by developing a measurement system that can be used to quantify the effect of process and design changes on CRTW tube performance, aiding in the development of better performing, next generation devices. Using materials testing frames, micro-computed tomography (micro-CT) imaging, experiment planning, analysis of variance (ANOVA), T-tests and regression analysis, test methods have been developed for assessing the impact of process and design changes on the device. The major findings of this study have been an insight into the suitability of buckle and three-point bend tests for the measurement of the effect of varying processing factors on the device’s performance, and guidelines for interpreting the output data from the test methods. The findings of this study are of significant interest with respect to verifying and validating key process and design changes associated with the device structure and material condition. Test method integrity evaluation is explored throughout.

Keywords: neurovascular catheter, coil reinforced tube, buckling, three-point bend, tensile

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Authors: Petr Daniel Edward Kovarik, Malcolm Jackson, Charles Kelly, Rahul Patil, Shahid Iqbal

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Introduction: Recognition of the presence of extra capsular spread (ECS) has been a major change in the TNM 8th edition published by the American Joint Committee on Cancer in 2018. Irrespective of the size or number of lymph nodes, the presence of ECS makes N3b disease a stage IV disease. The objective of this retrospective observational study was to conduct a comparative analysis of survival outcomes in patients with lymph node-positive cutaneous head and neck squamous cell carcinoma (CHNSCC) based on their TNM 7th and TNM 8th editions classification. Materials and Methods: From January 2010 to December 2020, 71 patients with CHNSCC were identified from our centre’s database who were treated with radical surgery and adjuvant radiotherapy. All histopathological reports were reviewed, and comprehensive nodal mapping was performed. The data were collected retrospectively and survival outcomes were compared using TNM 7th and 8th editions. Results: The median age of the whole group of 71 patients was 78 years, range 54 – 94 years, 63 were male and 8 female. In total, 2246 lymph nodes were analysed; 195 were positive for cancer. ECS was present in 130 lymph nodes, which led to a change in TNM staging. The details on N-stage as per TNM 7th edition was as follows; pN1 = 23, pN2a = 14, pN2b = 32, pN2c = 0, pN3 = 2. After incorporating the TNM 8th edition criterion (presence of ECS), the details on N-stage were as follows; pN1 = 6, pN2a = 5, pN2b = 3, pN2c = 0, pN3a = 0, pN3b = 57. This showed an increase in overall stage. According to TNM 7th edition, there were 23 patients were with stage III and remaining 48 patients, stage IV. As per TNM 8th edition, there were only 6 patients with stage III as compared to 65 patients with stage IV. For all patients, 2-year disease specific survival (DSS) and overall survival (OS) were 70% and 46%. 5-year DSS and OS rates were 66% and 20% respectively. Comparing the survival between stage III and stage IV of the two cohorts using both TNM 7th and 8th editions, there is an obvious greater survival difference between the stages if TNM 8th staging is used. However, meaningful statistics were not possible as the majority of patients (n = 65) were with stage IV and only 6 patients were stage III in the TNM 8th cohort. Conclusion: Our study provides a comprehensive analysis on lymph node data mapping in this specific patient population. It shows a better differentiation between stage III and stage IV in the TNM 8th edition as compared to TNM 7th however meaningful statistics were not possible due to the imbalance of patients in the sub-cohorts of the groups.

Keywords: cutaneous head and neck squamous cell carcinoma, extra capsular spread, neck lymphadenopathy, TNM 7th and 8th editions

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Authors: Yoftahe Nigussie Worku

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This report unveils a meticulous project focused on the design intricacies of a Fire Tube Boiler tailored for the efficient generation of saturated steam. The overarching objective is to produce 2000kg/h of saturated steam at 12-bar design pressure, achieved through the development of an advanced fire tube boiler. This design is meticulously crafted to harmonize cost-effectiveness and parameter refinement, with a keen emphasis on material selection for component parts, construction materials, and production methods throughout the analytical phases. The analytical process involves iterative calculations, utilizing pertinent formulas to optimize design parameters, including the selection of tube diameters and overall heat transfer coefficients. The boiler configuration incorporates two passes, a strategic choice influenced by tube and shell size considerations. The utilization of heavy oil fuel no. 6, with a higher heating value of 44000kJ/kg and a lower heating value of 41300kJ/kg, results in a fuel consumption of 140.37kg/hr. The boiler achieves an impressive heat output of 1610kW with an efficiency rating of 85.25%. The fluid flow pattern within the boiler adopts a cross-flow arrangement strategically chosen for inherent advantages. Internally, the welding of the tube sheet to the shell, secured by gaskets and welds, ensures structural integrity. The shell design adheres to European Standard code sections for pressure vessels, encompassing considerations for weight, supplementary accessories (lifting lugs, openings, ends, manhole), and detailed assembly drawings. This research represents a significant stride in optimizing fire tube boiler technology, balancing efficiency and safety considerations in the pursuit of enhanced saturated steam production.

Keywords: fire tube, saturated steam, material selection, efficiency

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Authors: L. Szymanski, S. Wiak, Z. Kolacinski, G. Raniszewski, L. Pietrzak, Z. Staniszewska

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There exist more than one hundred different types of cancer, and therefore no particular treatment is offered to people struggling with this disease. The character of treatment proposed to a patient will depend on a variety of factors such as type of the cancer diagnosed, advancement of the disease, its location in the body, as well as personal preferences of a patient. None of the commonly known methods of cancer-fighting is recognised as a perfect cure, however great advances in this field have been made over last few decades. Once a patient is diagnosed with cancer, he is in need of medical care and professional treatment for upcoming months, and in most cases even for years. Among the principal modes of treatment offered by medical centres, one can find radiotherapy, chemotherapy, and surgery. All of them can be applied separately or in combination, and the relative contribution of each is usually determined by medical specialist in agreement with a patient. In addition to the conventional treatment option, every day more complementary and alternative therapies are integrated into mainstream care. There is one promising cancer modality - hyperthermia therapy which is based on exposing body tissues to high temperatures. This treatment is still being investigated and is not widely available in hospitals and oncological centres. There are two kinds of hyperthermia therapies with direct and indirect heating. The first is not commonly used due to low efficiency and invasiveness, while the second is deeply investigated and a variety of methods have been developed, including ultrasounds, infrared sauna, induction heating and magnetic hyperthermia. The aim of this work was to examine possibilities of heating magnetic nanoparticles under the influence of electromagnetic field for cancer treatment. For this purpose, multiwalled carbon nanotubes used as nanocarriers for iron particles were investigated for its heating properties. The samples were subjected to an alternating electromagnetic field with frequency range between 110-619 kHz. Moreover, samples with various concentrations of carbon nanotubes were examined. The lowest frequency of 110 kHz and sample containing 10 wt% of carbon nanotubes occurred to influence the most effective heating process. Description of hyperthermia therapy aiming at enhancing currently available cancer treatment was also presented in this paper. Most widely applied conventional cancer modalities such as radiation or chemotherapy were also described. Methods for overcoming the most common obstacles in conventional cancer modalities, such as invasiveness and lack of selectivity, has been presented in magnetic hyperthermia characteristics, which explained the increasing interest of the treatment.

Keywords: hyperthermia, carbon nanotubes, cancer colon cells, ligands

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Authors: Matthias Steffan, Franz Haas

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The production process grinding is one of the latest steps in a value-added manufacturing chain. Within this step, workpiece geometry and surface roughness are determined. Up to this process stage, considerable costs and energy have already been spent on components. According to the current state of the art, therefore, large safety reserves are calculated in order to guarantee a process capability. Especially for non-circular grinding, this fact leads to considerable losses of process efficiency. With present technology, various non-circular geometries on a workpiece must be grinded subsequently in an oscillating process where X- and Q-axis of the machine are coupled. With the approach of RPM-Synchronous Noncircular Grinding, such workpieces can be machined in an ordinary plung grinding process. Therefore, the workpieces and the grinding wheels revolutionary rate are in a fixed ratio. A non-circular grinding wheel is used to transfer its geometry onto the workpiece. The authors use a worldwide unique machine tool that was especially designed for this technology. Highest revolution rates on the workpiece spindle (up to 4500 rpm) are mandatory for the success of this grinding process. This grinding approach is performed in a two-step process. For roughing, a highly porous vitrified bonded grinding wheel with medium grain size is used. It ensures high specific material removal rates for efficiently producing the non-circular geometry on the workpiece. This process step is adapted by a force control algorithm, which uses acquired data from a three-component force sensor located in the dead centre of the tailstock. For finishing, a grinding wheel with a fine grain size is used. Roughing and finishing are performed consecutively among the same clamping of the workpiece with two locally separated grinding spindles. The approach of RPM-Synchronous Noncircular Grinding shows great efficiency enhancement in non-circular grinding. For the first time, three-dimensional non-circular shapes can be grinded that opens up various fields of application. Especially automotive industries show big interest in the emerging trend in finishing machining.

Keywords: efficiency enhancement, finishing machining, non-circular grinding, rpm-synchronous grinding

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Authors: Anita Lazurko, Laszlo Pinter, Jeremy Richardson

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Uncertain climate projections, multiple possible development futures, and a financing gap create challenges for water infrastructure decision making. In contrast to conventional predict-plan-act methods, an emerging decision paradigm that enables social-ecological resilience supports decisions that are appropriate for uncertainty and leverage social, ecological, and economic multifunctionality. Concurrently, water infrastructure project finance plays a powerful role in sustainable infrastructure development but remains disconnected from discourse in socio-ecological resilience. At the time of research, a project to transfer water from Lesotho to Botswana through South Africa in the Orange-Senqu River Basin was at the pre-feasibility stage. This case was analysed through documents and interviews to investigate how uncertainty and multifunctionality are conceptualised and considered in decisions for the resilience of water infrastructure and to explore bridging concepts that might allow project finance to better enable socio-ecological resilience. Interviewees conceptualised uncertainty as risk, ambiguity and ignorance, and multifunctionality as politically-motivated shared benefits. Numerous efforts to adopt emerging decision methods that consider these terms were in use but required compromises to accommodate the persistent, conventional decision paradigm, though a range of future opportunities was identified. Bridging these findings to finance revealed opportunities to consider a more comprehensive scope of risk, to leverage risk mitigation measures, to diffuse risks and benefits over space, time and to diverse actor groups, and to clarify roles to achieve multiple objectives for resilience. In addition to insights into how multiple decision paradigms interact in real-world decision contexts, the research highlights untapped potential at the juncture between socio-ecological resilience and project finance.

Keywords: socio-ecological resilience, finance, multifunctionality, uncertainty

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Authors: Christie DeGregorio

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In today's rapidly evolving educational landscape, adult learners are becoming an increasingly significant demographic. These individuals often possess a wealth of life experiences and diverse interests that can greatly influence their learning styles. Recognizing and incorporating these interests into educational practices can lead to enhanced engagement, motivation, and overall learning outcomes for adult learners. This essay aims to explore the significance of incorporating adult learners' interests into learning styles and provide an overview of the methodologies used in related studies. When investigating the incorporation of adult learners' interests into learning styles, researchers have employed various methodologies to gather valuable insights. These methodologies include surveys, interviews, case studies, and classroom observations. Surveys and interviews allow researchers to collect self-reported data directly from adult learners, providing valuable insights into their interests, preferences, and learning styles. Case studies offer an in-depth exploration of individual adult learners, highlighting how their interests can be integrated into personalized learning experiences. Classroom observations provide researchers with a firsthand understanding of the dynamics between adult learners' interests and their engagement within a learning environment. The major findings from studies exploring the incorporation of adult learners' interests into learning styles reveal the transformative impact of this approach. Firstly, aligning educational content with adult learners' interests increases their motivation and engagement in the learning process. By connecting new knowledge and skills to topics they are passionate about, adult learners become active participants in their own education. Secondly, integrating interests into learning styles fosters a sense of relevance and applicability. Adult learners can see the direct connection between the knowledge they acquire and its real-world applications, which enhances their ability to transfer learning to various contexts. Lastly, personalized learning experiences tailored to individual interests enable adult learners to take ownership of their educational journey, promoting lifelong learning habits and self-directedness.

Keywords: integration, personalization, transferability, learning style

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Authors: Anuja Singh, Avik K. Pati, Ashok K. Mishra

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Organic fluorophores with π-conjugated scaffolds are important because of their interesting optoelectronic properties. In recent years, our lab has been engaged in understanding the photophysics of small diacetylene bridged fluorophores and found the diynes as a promising class of π-conjugated fluorophores. Building on this understanding, recently we have focused on the photophysics of a less explored class of cross-conjugated Y-shaped enediynes (one double and two triple bonds). Here we present the photophysical properties of such enediynes which show interesting photophysical properties that include dual emissions from locally excited (LE) and intramolecular charge transfer (ICT) states and ring size dependent aggregate fluorescence in non-aqueous media. The dyes also show prominent aggregate fluorescence in mixed-aqueous solvents and solid powder form. We further show that the solid state fluorescence can be reversibly switched multiple of cycles by external stimuli, highlighting their potential applications in solid states. The enediynes with push-pull electronic substituents/moieties exhibit high contrast fluorescence color switching upon continuous photon illumination. The intriguing photophysical outcomes of the enediynyl fluorophores are judiciously exploited to generate single-component white light emission in binary solvent mixtures and sense polar aprotic vapor in polymer film matrices. The photophysical behavior of the dyes is further successfully utilized to monitor the microenvironment changes of biologically relevant anisotropic media such as bile salts. In summary, the newly introduced cross-conjugated enediynes enrich the toolbox of organic fluorophores and vouch to display versatile applications.

Keywords: aggregation in solution and solid state, enediynes, physical photochemistry and photophysics, vapor sensing and white light emission

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Authors: Hilal Keklicek, Baris Cetin, Yeliz Salci, Ayla Fil, Umut Altinkaynak, Kadriye Armutlu

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Objectives and Goals: Spasticity is a common symptom characterized with a velocity dependent increase in tonic stretch reflexes (muscle tone) in patient with multiple sclerosis (MS). Hypertonic muscles affect the normal plantigrade contact by disturbing accommodation of foot to the ground while walking. It is important to know the differences between healthy and neurologic foot features for management of spasticity related deformities and/or determination of rehabilitation purposes and contents. This study was planned with the aim of investigating the dynamic plantar pressure distribution in individuals with MS and determining the differences between healthy individuals (HI). Methods: Fifty-five individuals with MS (108 foot with spasticity according to Modified Ashworth Scale) and 20 HI (40 foot) were the participants of the study. The dynamic pedobarograph was utilized for evaluation of dynamic loading parameters. Participants were informed to walk at their self-selected speed for seven times to eliminate learning effect. The parameters were divided into 2 categories including; maximum loading pressure (N/cm2) and time of maximum pressure (ms) were collected from heal medial, heal lateral, mid foot, heads of first, second, third, fourth and fifth metatarsal bones. Results: There were differences between the groups in maximum loading pressure of heal medial (p < .001), heal lateral (p < .001), midfoot (p=.041) and 5th metatarsal areas (p=.036). Also, there were differences between the groups the time of maximum pressure of all metatarsal areas, midfoot, heal medial and heal lateral (p < .001) in favor of HI. Conclusions: The study provided basic data about foot pressure distribution in individuals with MS. Results of the study primarily showed that spasticity of lower extremity muscle disrupted the posteromedial foot loading. Secondarily, according to the study result, spasticity lead to inappropriate timing during load transfer from hind foot to forefoot.

Keywords: multiple sclerosis, plantar pressure distribution, gait, norm values

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Authors: Gholba Niranjan Dilip, Anil Kumar

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Conduct of accurate reliable mapping of oil palm plantations and census of individual palm trees is a huge challenge. This study addresses this challenge and developed an optimized solution implemented deep learning techniques on remote sensing data. The oil palm is a very important tropical crop. To improve its productivity and land management, it is imperative to have accurate census over large areas. Since, manual census is costly and prone to approximations, a methodology for automated census using panchromatic images from Cartosat-2, SkySat and World View-3 satellites is demonstrated. It is selected two different study sites in Indonesia. The customized set of training data and ground-truth data are created for this study from Cartosat-2 images. The pre-trained model of Single Shot MultiBox Detector (SSD) Lite MobileNet V2 Convolutional Neural Network (CNN) from the TensorFlow Object Detection API is subjected to transfer learning on this customized dataset. The SSD model is able to generate the bounding boxes for each oil palm and also do the counting of palms with good accuracy on the panchromatic images. The detection yielded an F-Score of 83.16 % on seven different images. The detections are buffered and dissolved to generate polygons demarcating the boundaries of the oil palm plantations. This provided the area under the plantations and also gave maps of their location, thereby completing the automated census, with a fairly high accuracy (≈100%). The trained CNN was found competent enough to detect oil palm crowns from images obtained from multiple satellite sensors and of varying temporal vintage. It helped to estimate the increase in oil palm plantations from 2014 to 2021 in the study area. The study proved that high-resolution panchromatic satellite image can successfully be used to undertake census of oil palm plantations using CNNs.

Keywords: object detection, oil palm tree census, panchromatic images, single shot multibox detector

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Authors: Darius Jakimavicius

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Artificial intelligence is the subject of intense debate in the international arena, identified both as a technological breakthrough and as a component of the strategic stability effect. Both the kinetic and non-kinetic development of AI and its application in the national strategies of the great powers may trigger a change in the security situation. Artificial intelligence is generally faster, more capable and more efficient than humans, and there is a temptation to transfer decision-making and control responsibilities to artificial intelligence. Artificial intelligence, which, once activated, can select and act on targets without further intervention by a human operator, blurs the boundary between human or robot (machine) warfare, or perhaps human and robot together. Artificial intelligence acts as a force multiplier that speeds up decision-making and reaction times on the battlefield. The role of humans is increasingly moving away from direct decision-making and away from command and control processes involving the use of force. It is worth noting that the autonomy and precision of AI systems make the process of strategic stability more complex. Deterrence theory is currently in a phase of development in which deterrence is undergoing further strain and crisis due to the complexity of the evolving models enabled by artificial intelligence. Based on the concept of strategic stability and deterrence theory, it is appropriate to develop further research on the development and impact of AI in order to assess AI from both a scientific and technical perspective: to capture a new niche in the scientific literature and academic terminology, to clarify the conditions for deterrence, and to identify the potential uses, impacts and possibly quantities of AI. The research problem is the impact of artificial intelligence developed by great powers on strategic stability. This thesis seeks to assess the impact of AI on strategic stability and deterrence principles, with human exclusion from the decision-making and control loop as a key axis. The interaction between AI and human actions and interests can determine fundamental changes in great powers' defense and deterrence, and the development and application of AI-based great powers strategies can lead to a change in strategic stability.

Keywords: artificial inteligence, strategic stability, deterrence theory, decision making loop

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Authors: Mukesh K. Dwivedi, Rajeshwar N. Srivastava, Amit K. Bhagat, Saloni Raj

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Introduction: Management of Pressure Ulcer (PU) is an ongoing clinical challenge particularly in traumatic paraplegia patients in developing countries where socio economic conditions often dictate treatment modalities. When negative pressure wound therapy (NPWT) was introduced, there were a series of devices (V.A.C., KCI, San Antonio, TX) manufactured. These devices for NPWT are costly and hard to afford by patients in developing countries like India. Considering this limitation, this study was planned to design an RCT to compare NPWT by an indigenized locally constructed NPD and conventional gauze dressing for the treatment of PU. Material and Methods: This RCT (CTRI/2014/09/0050) was conducted in the Department of Orthopaedic Surgery at King George’s Medical University (KGMU), India. Thirty-four (34) subjects of traumatic paraplegia having PU of stage 3 or 4, were enrolled and randomized in two treatment groups (NPWT Group & Conventional dressing group). The outcome measures of this study were surface area and depth of PU, exudates, microorganisms and matrix metalloproteinase-8 (MMP-8) during 0 to 9 weeks follow-ups. Levels of MMP-8 were analyzed in the tissues of PU at week 0, 3, 6 and week 9 by Enzyme Linked Immuno Sorbent Assay (ELISA). Results: Significantly reduced length of PU in NPWT group was observed at week 6 (p=0.04) which further reduced at week 9 (p=0.001) as compared to conventionally treated group. Similarly significant reduction of width and depth of PU was observed in NPWT at week 9 (p<0.05). The exudate became significantly (p=0.001) lower in NPWT group as compared with conventionally treated group from 6th to 9th week. Clearance and conversion of slough into red granulation tissue was significantly higher in NPWT group (p=0.001). At week 9, the wound culture was negative in all the subjects of NPWT group, while it was positive in 10 (41⋅6%) subjects of conventional group. Significantly lower level of MMP-8 was observed in subjects of NPWT group at week 6 (0.006**), and continually more reduction was observed at week 9 (<0.0001**) as compared to the conventional group. Conclusion: NPWT by locally constructed NPD is better wound care procedure for management of PU. Our device gave similar results as commercially available devices. Reduction of level of MMP-8 and increased rate of healing was achieved by negative pressure wound therapy (NPWT) as compared to conventional dressing.

Keywords: NPWT, NPD, MMP8, ELISA

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Authors: Mustafa Al Sukar, Azzam Sleit, Abdullatif Abu-Dalhoum, Bassam Al-Kasasbeh

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Use and abuse of drugs by teens is very common and can have dangerous consequences. The drugs contribute to physical and sexual aggression such as assault or rape. Some teenagers regularly use drugs to compensate for depression, anxiety or a lack of positive social skills. Teen resort to smoking should not be minimized because it can be "gateway drugs" for other drugs (marijuana, cocaine, hallucinogens, inhalants, and heroin). The combination of teenagers' curiosity, risk taking behavior, and social pressure make it very difficult to say no. This leads most teenagers to the questions: "Will it hurt to try once?" Nowadays, technological advances are changing our lives very rapidly and adding a lot of technologies that help us to track the risk of drug abuse such as smart phones, Wireless Sensor Networks (WSNs), Internet of Things (IoT), etc. This technique may help us to early discovery of drug abuse in order to prevent an aggravation of the influence of drugs on the abuser. In this paper, we have developed a Decision Support System (DSS) for detecting the drug abuse using Artificial Neural Network (ANN); we used a Multilayer Perceptron (MLP) feed-forward neural network in developing the system. The input layer includes 50 variables while the output layer contains one neuron which indicates whether the person is a drug addict. An iterative process is used to determine the number of hidden layers and the number of neurons in each one. We used multiple experiment models that have been completed with Log-Sigmoid transfer function. Particularly, 10-fold cross validation schemes are used to access the generalization of the proposed system. The experiment results have obtained 98.42% classification accuracy for correct diagnosis in our system. The data had been taken from 184 cases in Jordan according to a set of questions compiled from Specialists, and data have been obtained through the families of drug abusers.

Keywords: drug addiction, artificial neural networks, multilayer perceptron (MLP), decision support system

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Authors: Simone Belli, Sergio Minniti, Valeria Santoro

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ICTs and technology transfer can benefit and move a country forward in economic and social development. However, ICT and access to the Internet have been inequitably distributed in most developing countries. In terms of science production and dissemination, this divide articulates itself also through the inequitable distribution of access to scientific knowledge and networks, which results in the exclusion of developing countries from the center of science. Developing countries are on the fringe of Science and Technology (S&T) production due not only to low investment in research but also to the difficulties to access international scholarly literature. In this respect, Open access (OA) initiatives and knowledge infrastructure represent key elements for both producing significant changes in scholarly communication and reducing the problems of developing countries. The spreading of the OA movement in the region, exemplified by the growth of regional and national initiatives, such as the creation of OA institutional repositories (e.g. SciELO and Redalyc) and the establishing of supportive governmental policies, provides evidence of the significant role that OA is playing in reducing the scientific gap between Latin American countries and improving their participation in the so-called ‘global knowledge commons’. In this paper, we map OA publications in Latin America and observe how Latin American countries are moving forward and becoming a leading force in widening access to knowledge. Our analysis, developed as part of the H2020 EULAC Focus research project, is based on mixed methods and consists mainly of a bibliometric analysis of OA publications indexed in the most important scientific databases (Web of Science and Scopus) and OA regional repositories, as well as the qualitative analysis of documents related to the main OA initiatives in Latin America. Through our analysis, we aim at reflecting critically on what policies, international standards, and best practices might be adapted to incorporate OA worldwide and improve the infrastructure of the global knowledge commons.

Keywords: open access, LAC countries, scientific publications, bibliometric analysis

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Authors: Joanna Cabaj, Sylwia Baluta, Karol Malecha, Kamila Drzozga

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Catecholamines are the principal neurotransmitters that mediate a variety of the central nervous system functions, such as motor control, cognition, emotion, memory processing, and endocrine modulation. Dysfunctions in catecholamine neurotransmission are induced in some neurologic and neuropsychiatric diseases. Changeable neurotransmitters level in biological fluids can be a marker of several neurological disorders. Because of its significance in analytical techniques and diagnostics, sensitive and selective detection of neurotransmitters is increasingly attracting a lot of attention in different areas of bio-analysis or biomedical research. Recently, fluorescent techniques for detection of catecholamines have attracted interests due to their reasonable cost, convenient control, as well as maneuverability in biological environments. Nevertheless, with the observed need for a sensitive and selective catecholamines sensor, the development of a convenient method for this neurotransmitter is still at its basic level. The manipulation of nanostructured materials in conjunction with biological molecules has led to the development of a new class of hybrid modified biosensors in which both enhancement of charge transport and biological activity preservation may be obtained. Immobilization of biomaterials on electrode surfaces is the crucial step in fabricating electrochemical as well as optical biosensors and bioelectronic devices. Continuing systematic investigation in the manufacturing of enzyme–conducting sensitive systems, here is presented a convenient fluorescence sensing strategy for catecholamines detection based on FRET (fluorescence resonance energy transfer) phenomena observed for, i.e., complexes of Fe²⁺ and epinephrine. The biosensor was constructed using low temperature co-fired ceramics technology (LTCC). This sensing system used the catalytical oxidation of catecholamines and quench of the strong luminescence of obtained complexes due to FRET. The detection process was based on the oxidation of substrate in the presence of the enzyme–laccase/tyrosinase.

Keywords: biosensor, conducting polymer, enzyme, FRET, LTCC

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Authors: Arpit Gite

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Purpose: We have evaluated the role of Total Neoadjuvant Therapy in patients with Locally Advanced Rectal cancer by giving Chemoradiotherapy followed by consolidation chemotherapy (CRT-CNCT) and, after that, the strategy of wait and watch. Methods: In this prospective case series, we evaluated the results of three locally advanced Rectal cancers, two cases Stage II (cT3N0) and one case Stage III ( cT4aN2). All three patients' growth was 4-6 cm from the anal verge. We have treated with Chemoradiotherapy to dose of 45Gy/25 Fractions to elective nodal regions (Inguinal node in anal canal Involvement)and Primary and mesorectum (Phase I) followed by 14.4Gy/8 Fractions to Primary and Mesorectum(Phase II) to a total dose of 59.4Gy/33 Fractions with concurrent chemotherapy Tab Capecitabine 825mg/m2 PO BD with Radiation therapy. After 6 weeks of completion of Chemoradiotherapy, advised six cycles of consolidative chemotherapy, CAPEOX regimen, Oxaliplatin 130mg/m2 on day 1 and Capecitabine 1000mg/m2 PO BD on days 1-14 repeated on a 21-day cycle for a total of six cycles. The primary endpoint is Disease-free survival (DFS); the secondary endpoint is adverse events related to chemoradiotherapy. Radiation toxicity is assessed by RTOG criteria, and chemotherapy toxicity is assessed by Common Terminology Criteria for Adverse Events (CTCAE) Version 5.0. Results: After 6 weeks of completion of Chemoradiotherapy, we did PET-CT of all three patients; all three patients had a clinically complete response and we advised 6 cycles of consolidative chemotherapy. After completion of consolidative chemotherapy, again PET-CT and sigmoidoscopy, all three patients had complete response on PET-CT and no lesions on sigmoidoscopy and kept all three patients on wait and watch.2 patients had Grade 2 skin toxicities,1 patient had Grade 1 skin toxicity, .2 patients had Grade 2 lower GI toxicities, and 1 patient had Grade lower GI toxicity, both according to RTOG criteria. 3 patients had Grade 2 diarrhea due to capecitabine, and 1 patient had Grade 1 thrombocytopenia due to oxaliplatin assessed by Common Terminology Criteria for Adverse Events (CTCAE) Version 5.0. Conclusion: Sphincter Preservation is possible with this regimen in those who don’t want to opt for surgery or in case of low-lying rectal cancer.

Keywords: locally advanced rectal cancer, sphincter preservation, chemoradiotherapy, consolidative chemotherapy

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Authors: Marin Kanarev, Delyan Stoyanov, Ivanna Popova, Nadezhda Petrova

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Thanks to increased survival rates in patients bearing oncological malignancies due to recent developments in anti-cancer therapies and diagnostic techniques, observation of clinical cases of metachronous cancers is more common and can provide more in-depth knowledge of their development and, as a result, help clinicians apply suitable therapy. This unusual case of three metachronous tumors presented the opportunity to follow their occurrence, progression, and treatment thoroughly. A 77-year-old male presented with carcinoma ventriculi of the pylorus region, which was surgically removed via upper subtotal stomach resection, a lateral antecolical gastro-enteroanastomosis, and a subsequent Braun anastomosis. An EOX chemotherapy regimen followed. A CT scan four months later showed no indication of recurrence or dissemination. The same scan, performed as a part of the follow-up plan two years later, showed an indication of neoplastic growth in the urinary bladder. After the patient had been directed to a urologist, the suspicion was confirmed, and the growth was histologically diagnosed as a carcinoma of the urinary bladder. An immunohistochemistry test showed an expression of PDL1 of less than 5%, which resulted in treatment with GemCis chemotherapy regimen that led to full remission. Two years and seven months after the first surgery, a CT scan showed again that the two carcinomas were gone. However, four months later, elevated tumor markers prompted a PET/CT scan, which showed data indicative of recurring neoplastic growth in the region of the stomach cardia. It was diagnosed as an adenocarcinoma infiltrating the esophagus. Preoperative chemotherapy with the ECF regimen was completed in four courses, and a CT scan showed no progression of the disease. In less than a month after therapy, the patient underwent laparotomy, debridement, gastrectomy, and a subsequent mechanical terminal-lateral esophago-jejunoanasthomosis. It was verified that the tumor originated from metastasis from the carcinoma ventriculi, which was located in the pylorus. In conclusion, this case report highlights the importance of patient follow-up and studying recurring neoplastic growth. Despite the absence of symptoms, clinicians should maintain a high level of suspicion when evaluating the patient data and choosing the most suitable therapy.

Keywords: carcinoma, follow-up, metachronous, neoplastic growth, recurrence

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Authors: Elson Szeto

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Over the past 15 years, digital technology has ubiquitously penetrated societies around the world. New values of e-learning are emerging in the preparation of future talents, while e-learning is a key driver of widening participation and knowledge transfer in Chinese higher education. As a vibrant, Chinese society in Asia, Hong Kong’s new generation university students, perhaps the digital natives, have been learning with e-learning since their basic education. They can acquire new knowledge with the use of different forms of e-learning as a generic competence. These students who embrace this competence further their study journeys in higher education. This project reviews the Government’s policy of Information Technology in Education which has largely put forward since 1998. So far, primary to secondary education has embraced advantages of e-learning capability to advance the learning of different subject knowledge. Yet, e-learning capacity in higher education is yet to be fully examined in Hong Kong. The study reported in this paper is a pilot investigation into e-learning capacity in Chinese higher education in the region. By conducting a qualitative case study of Hong Kong, the investigation focuses on (1) the institutional ICT settings in general; (2) the pedagogic responses to e-learning in specific; and (3) the university students’ satisfaction of e-learning. It is imperative to revisit the e-learning capacity for promoting effective learning amongst university students, supporting new knowledge acquisition and embracing new opportunities in the 21st century. As a pilot case study, data will be collected from individual interviews with the e-learning management team members of a university, teachers who use e-learning for teaching and students who attend courses comprised of e-learning components. The findings show the e-learning capacity of the university and the key components of leveraging e-learning capability as a university-wide learning settings. The findings will inform institutions’ senior management, enabling them to effectively enhance institutional e-learning capacity for effective learning and teaching and new knowledge acquisition. Policymakers will be aware of new potentials of e-learning for the preparation of future talents in this society at large.

Keywords: capability, e-learning, higher education, student learning

Procedia PDF Downloads 258

Authors: Maria L. G. Lourenço, Keylla H. N. P. Pereira, Viviane Y. Hibaru, Fabiana F. Souza, Joao C. P. Ferreira, Simone B. Chiacchio, Luiz H. A. Machado

Abstract:

In veterinary medicine, the standard procedure during a caesarian section is clamping the umbilical cord immediately after birth. In human neonates, when the umbilical cord is kept intact after birth, blood continues to flow from the cord to the newborn, but this procedure may prove to be difficult in dogs due to the shorter umbilical cord and the number of newborns in the litter. However, a possible detachment of the placenta while keeping the umbilical cord intact may make the residual blood to flow to the neonate. This study compared the effects on neonatal vitality between clamping and no clamping the umbilical cord of dogs born through cesarean section, assessing them through Apgar and reflex scores. Fifty puppies delivered from 16 bitches were randomly allocated to receive clamping of the umbilical cord immediately (n=25) or to not receive the clamping until breathing (n=25). The neonates were assessed during the first five min of life and once again 10 min after the first assessment. The differences observed between the two moments were significant (p < 0.01) for both the Apgar and reflex scores. The differences observed between the groups (clamped vs. not clamped) were not significant for the Apgar score in the 1st moment (p=0.1), but the 2nd moment was significantly (p < 0.01) in the group not clamped, as well as significant (p < 0.05) for the reflex score in the 1st moment and 2nd moment (p < 0.05), revealing higher neonatal vitality in the not clamped group. The differences observed between the moments (1st vs. 2nd) of each group as significant (p < 0.01), revealing higher neonatal vitality in the 2nd moments. In the no clamping group, after removing the neonates together with the umbilical cord and the placenta, we observed that the umbilical cords were full of blood at the time of birth and later became whitish and collapsed, demonstrating the blood transfer. The results suggest that keeping the umbilical cord intact for at least three minutes after the onset breathing is not detrimental and may contribute to increase neonate vitality in puppies delivered by cesarean section.

Keywords: puppy vitality, newborn dog, cesarean section, Apgar score

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Authors: Kira Toxopeus, Kamran Siddiqui

Abstract:

Channel flows are common in a wide range of engineering applications. In some types of channel flows, particularly the ones involving chemical or biological processes, the control of the flow temperature is crucial to maintain the optimal conditions for the chemical reaction or to control the growth of biological species. This often becomes an issue when the flow experiences temperature fluctuations due to external conditions. While active heating and cooling could regulate the channel temperature, it may not be feasible logistically or economically and is also regarded as a non-sustainable option. Thermal energy storage utilizing phase change material (PCM) could provide the required thermal regulation sustainably by storing the excess heat from the channel and releasing it back as required, thus regulating the channel temperature within a range in the proximity of the PCM melting temperature. However, in designing such systems, the configuration of the PCM storage within the channel is critical as it could influence the channel flow dynamics, which would, in turn, affect the heat exchange between the channel fluid and the PCM. The present research is focused on the investigation of the flow dynamical behavior in the channel during heat transfer from the channel flow to the PCM thermal energy storage. Offset vertical columns in a narrow channel were used that contained the PCM. Two different column shapes, square and circular, were considered. Water was used as the channel fluid that entered the channel at a temperature higher than that of the PCM melting temperature. Hence, as the water was passing through the channel, the heat was being transferred from the water to the PCM, causing the PCM to store the heat through a phase transition from solid to liquid. Particle image velocimetry (PIV) was used to measure the two-dimensional velocity field of the channel flow as it flows between the PCM columns. Thermocouples were also attached to the PCM columns to measure the PCM temperature at three different heights. Three different water flow rates (0.5, 0.75 and 1.2 liters/min) were considered. At each flow rate, experiments were conducted at three different inlet water temperatures (28ᵒC, 33ᵒC and 38ᵒC). The results show that the flow rate and the inlet temperature influenced the flow behavior inside the channel.

Keywords: channel flow, phase change material, thermal energy storage, thermal regulation

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Authors: Jakub Gren

Abstract:

The recent transfer of banking supervision to the ECB has expanded its influence as of a non-majoritarian and technocratic policy-shaper in EU supervisory policies. To fulfil the main policy objectives of the Single Supervisory Mechanism, the ECB has been tasked with building a single supervisory approach to supervised banks across the euro area and is now exclusively responsible for direct supervision of the largest ‘significant’ euro area banks and the oversight of the remaining ‘less significant’ banks. This enhanced supranational position of the ECB significantly alters the EU institutional order and creates powerful incentives to actively pursue integrationist agenda by the ECB. However, this drastic shift has a little impact upon adapting the ECB’s new supervisory mandate to the requirements of democratic legitimacy. Whereas the ECB’s strong pre-crisis independence and limited accountability could be reconciled with democratic principles through a clearly articulated price stability mandate, independence and limited accountability in the context of a more complex supervisory mandate is problematic. Hence, in order to ensure the democratic legitimacy of the ECB/SSM’s supervisory policies, the ECB’s supervisory mandate requires both a lower scope of independence and higher accountability requirements. To address this situation, organizational separation (“Chinese Wall”) between the ECB monetary and supervisory arms was introduced. This separation includes different reporting lines and the relocation of the ECB’s monetary function to a new building complex while leaving its supervisory function at the Euro-tower (“Two Towers”). This paper argues that these measures are not sufficient to establish proper checks and balances on the ECB’s powers to pursue euro zone’s wide supervisory policies. As a remedy, this contribution suggests that the ECB’s Treaties-embedded independence, as set out by art. 130 TFEU, designed to carry out its monetary function shall not be fully applicable to its supervisory function. Indeed functional and conditional reading of this provision to ECB supervisory function could enhance the legitimacy of future ECB’s supervisory action.

Keywords: accountability and transparency, democratic governance, financial management, rule of law

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Authors: Ana C. Sousa, Beatriz C. Santos, Fátima N. Serralha

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The Tagus estuary is heavily affected by industrial and urban activities, making bioremediation studies crucial for environmental preservation. Fuel contamination in the area can arise from various anthropogenic sources, such as oil spills from shipping, fuel storage and transfer operations, and industrial discharges. These pollutants can cause severe harm to the ecosystem and the organisms, including humans, that inhabit it. Nonetheless, there are always natural organisms with the ability to resist these pollutants and transform them into non-toxic or harmless substances, which defines the process of bioremediation. Exploring the microbial communities existing in soil and their capacity to break down hydrocarbons has the potential to enhance the development of more efficient bioremediation approaches. The aim of this investigation was to explore the existence of hydrocarbonoclastic microorganisms in six locations within the Tagus estuary, three on the north bank: Trancão River, Praia Fluvial do Cais das Colinas and Praia de Algés, and three on the south bank: Praia Fluvial de Alcochete, Praia Fluvial de Alburrica, and Praia da Trafaria. In all studied locations, native microorganisms of the genus Pseudomonas were identified. The bioremediation rate of common hydrocarbons like gasoline, hexane, and toluene was assessed using the redox indicator 2,6-dichlorophenolindophenol (DCPIP). Effective hydrocarbon-degrading bacterial strains were identified in all analyzed areas, despite adverse environmental conditions. The highest bioremediation rates were achieved for gasoline (68%) in Alburrica, hexane (65%) in Algés, and toluene (79%) in Algés. Generally, the bacteria demonstrated efficient degradation of hydrocarbons added to the culture medium, with higher rates of aerobic biodegradation of hydrocarbons observed. These findings underscore the necessity for further in situ studies to better comprehend the relationship between native microbial communities and the potential for pollutant degradation in soil.

Keywords: biodegradability rate, hydrocarbonoclastic microorganisms, soil bioremediation, tagus estuary

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Authors: Nicholas C. Rose, Christopher D. Spicer

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The regeneration of damaged or diseased tissues would provide an invaluable therapeutic tool in biological research and medicine. Cells must be provided with a number of different biochemical signals in order to form mature tissue through complex signaling networks that are difficult to recreate in synthetic materials. The ability to attach and detach bioactive proteins from material in an iterative and dynamic manner would therefore present a powerful way to mimic natural biochemical signaling cascades for tissue growth. We propose to reversibly attach these bioactive proteins using ortho-boronoimine (oBI) linkages and related derivatives formed by the reaction of an ortho-boronobenzaldehyde with a nucleophilic amine derivative. To enable the use of oBIs for biomaterial modification, we have studied binding and cleavage processes with precise detail in the context of small molecule models. A panel of oBI complexes has been synthesized and screened using a novel Förster resonance energy transfer (FRET) assay, using a cyanine dye FRET pair (Cy3 and Cy5), to identify the most reactive boron-aldehyde/amine nucleophile pairs. Upon conjugation of the dyes, FRET occurs under Cy3 excitation and the resultant ratio of Cy3:Cy5 emission directly correlates to conversion. Reaction kinetics and equilibria can be accurately quantified for reactive pairs, with dissociation constants of oBI derivatives in water (KD) found to span 9-orders of magnitude (10⁻²-10⁻¹¹ M). These studies have provided us with a better understanding of oBI linkages that we hope to exploit to reversibly attach bioconjugates to materials. The long-term aim of the project is to develop a modular biomaterial platform that can be used to help combat chronic diseases such as osteoarthritis, heart disease, and chronic wounds by providing cells with potent biological stimuli for tissue engineering.

Keywords: dynamic, bioconjugation, bornoimine, rapid, physiological

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Authors: P. Efstathiou, E. Kouskouni, Z. Manolidou, K. Karageorgou, M. Tseroni, A. Efstathiou, V. Karyoti, I. Agrafa

Abstract:

Aim: The aim of this prospective comparative study is to evaluate the reduction of microbial flora on the surface of an axillary digital thermometer, made of antimicrobial copper, in relation with a common digital thermometer. Material – Methods: A brand new digital electronic thermometer implemented with antimicrobial copper (Cu 70% - Nic 30%, low lead) on the two edges of the device (top and bottom: World Patent Number WO2013064847 and Register Number by the Hellenic Copper Development Institute No 11/2012) was manufactured and a comparative study with common digital electronic thermometer was conducted on 18 ICU (Intensive Care Unit) patients of three different hospitals. The thermometry was performed in accordance with the projected International Nursing Protocols for body temperature measurement. A total of 216 microbiological samples were taken from the axillary area of the patients, using both of the investigated body temperature devises. Simultaneously the “Halo” phenomenon (phenomenon “Stefanis”) was studied at the non-antimicrobial copper-implemented parts of the antimicrobial digital electronic thermometer. Results: In all samples collected from the surface of the antimicrobial electronic digital thermometer, the reduction of microbial flora (Klebsiella spp, Staphylococcus aureus, Staphylococcus epidermitis, Candida spp, Pneudomonas spp) was progressively reduced to 99% in two hours after the thermometry. The above flora was found in the axillary cavity remained the same in common thermometer. The statistical analysis (SPSS 21) showed a statistically significant reduction of the microbial load (N = 216, < 0.05). Conclusions: The hospital-acquired infections are linked to the transfer of pathogens due to the multi-usage of medical devices from both health professionals and patients, such as axillary thermometers. The use of antimicrobial digital electronic thermometer minimizes microbes' transportation between patients and health professionals while having all the conditions of reliability, proper functioning, security, ease of use and reduced cost.

Keywords: antimicrobial copper, cross infections, digital thermometers, ICU

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Authors: Hakan Duger, Alparslan Ersoy, Canan Ersoy

Abstract:

Diabetes mellitus is the most common etiology of end-stage renal disease (ESRD). Also, diabetic nephropathy is the etiology of ESRD in approximately 23% of kidney transplant recipients. A successful kidney transplant improves the quality of life and reduces the mortality risk for most patients. However, patients require close follow-up after transplantation due to medical complications. Diabetes mellitus can affect patient morbidity and mortality due to possible effects of immunosuppressive therapy on glucose metabolism. We compared the frequency of medical complications and the outcomes in diabetic and non-diabetic kidney transplant recipients. Materials and Methods: This retrospective study conducted in 498 patients who underwent kidney transplant surgery at our center in 10-year periods. The patients were divided into two groups: diabetics (46 ± 10 year, 26 males, 16 females) and non-diabetics (39 ± 12 year, 259 males, 197 females). The medical complications, graft functions, causes of graft loss and death were obtained from medical records. Results: There was no significant difference between recipient age, duration of dialysis, body mass index, gender, donor type, donor age, dialysis type, histories of HBV, HCV and coronary artery disease between two groups. The history of hypertension in diabetics was higher (69% vs. 36%, p < 0.001). The ratios of hypertension (50.1% vs. 57.1%), pneumonia (21.9% vs. 20%), urinary infection (16.9% vs. 20%), transaminase elevation (11.5% vs. 20%), hyperpotasemia (14.7% vs. 17.1%), hyponatremia (9.7% vs. 20%), hypotension (7.1% vs. 7.9%), hypocalcemia (1.4% vs. 0%), thrombocytopenia (8.6% vs. 8.6%), hypoglycemia (0.7% vs. 0%) and neutropenia (1.8% vs. 0%) were comparable in non-diabetic and diabetic groups, respectively. The frequency of hyperglycaemia in diabetics was higher (8.6% vs. 54.3%, p < 0.001). After transplantation, primary non-function (3.4% vs. 2.6%), delayed graft function (25.1% vs. 34.2%) and acute rejection (7.3% vs. 10.5%) ratios of in non-diabetic and diabetic groups were similar, respectively. Hospitalization durations in non-diabetics and diabetics were 22.5 ± 17.5 and 18.7 ± 13 day (p=0.094). Mean serum creatinine levels in non-diabetics and diabetics were 1.54 ± 0.74 and 1.52 ± 0.62 mg/dL at 6th month. Forty patients had graft loss. The ratios of graft loss and death in non-diabetic and diabetic groups were 8.2% vs. 7.1% and 7.1% vs. 2.6% (p > 0.05). There was no significant relationship between graft and patient survivals with the development of medical complication. Conclusion: As a result, medical complications are common in the early period. Hyperglycaemia was frequently seen following transplantation due to the effects of immunosuppressant regimens. However, the frequency of other medical complications in diabetic patients did not differ from non-diabetic one. The most important cause of death is still infections. The development of medical complications during the first 6 months did not significantly affect transplant outcomes.

Keywords: kidney transplantation, diabetes mellitus, complication, graft function

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Authors: Muhammad Nasar-U-Minallah, Dagmar Haase, Salman Qureshi, Safdar Ali Shirazi

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Urban green spaces (UGS) play a key role in the urban ecology of an area since they provide significant ecological services to compensate for natural environment functions damaged by the rapid growth of urbanization. The transformation of urban green specs to impervious landscapes has been recognized as a key factor prompting the distinctive urban heat and associated microclimatic changes. There is no doubt that urban green spaces offer a range of ecosystem services that can help to mitigate the ill effects of urbanization, heat anomalies, and climate change. The present study attempts to appraise the impact of urban green spaces on the urban thermal environment for the development of the microclimatic conditions in Lahore, Pakistan. The influence of urban heat has been studied through Landsat 8 data. The land surface temperature (LST) of Lahore was computed through the Radiative transfer method (RTM). The spatial variation of land surface temperature is retrieved to describe their local heat effect on urban microclimate. The association between the LST, normalized difference vegetation index, and the normalized difference built-up index are investigated to explore the impact of the urban green spaces and impervious surfaces on urban microclimate. The results of this study show significant changes in (impervious land surface 18% increase) land use within the study area. However, conversion of natural green cover to commercial and residential uses considerably increases the LST. Furthermore, results show that green spaces were the major heat sinks while impervious landscapes were the major heat source in the study area. Urban green spaces reveal 1 to 3℃ lower LST associated with their surrounding urban built-up area. This study shows that urban green spaces will help to mitigate the effect of urban microclimate and it is significant for the sustainable urban environment as well as to improve the quality of life of the urban inhabitants.

Keywords: thermal environmental, urban green space, cooling effect, microclimate, Lahore

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Authors: P. Y. Chiang, Y. H. Chen, Y. J. Lin, C. C. Chang, W. C. Hsu

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The number of the elderly in the world population and the rate of falls in this increasing numbers of older people are increasing. Decreasing muscle strength and an increasing risk of falling are associated with the ageing process. Because the effects of seated stepping training on the walking performance in the elderly remain unclear, the main purpose of the proposed study is to perform electromyography analysis during walking and seated stepping in the elderly. Four surface EMG electrodes were sticked on the surface of lower limbs muscles, including vastus lateralis (VL), and gastrocnemius (GT) of both sides. Before test, maximal voluntary contraction (MVC) of the respective muscle was obtained using manual muscle testing. The analog raw data of EMG signals were digitized with a sampling frequency of 2000 Hz. The signals were fully rectified and the linear envelope were calculated. Stepping motion cycle was separated into two phases by stepping timing (ST) and pedal return timing (PRT). ST refer to the time when the pedal marker reached the highest height, representing the contra-lateral leg was going to release the pedal. PRT refer to the time when the pedal marker reached the lowest height, representing the contra-lateral leg was going to step the pedal. We assumed that ST acted the same role in initial contact during walking, and PRT for toe-off. The period from ST to next PRT was called pushing phase (PP), during which the leg would start to step with resistance, and we compare this phase with the stance phase in level walking. The period from PRT to next ST was called returning phase (RP), during which leg would not have any resistance in this phase, and we compare this phase with the swing phase in level walking. VL and Gastro muscular activation had similar patterns in both side. The ability may transfer to those needed during loading response, mid-stance and terminal swing phase. User needed to make more effort in stepping compared with walking with similar timing; thus the strengthening of the VL and Gastro may be helpful to improve the walking endurance and efficiency for the elderly.

Keywords: elderly, electromyography, seated stepping, walking

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Authors: Xiyue Wang, Shaoning Yan

Abstract:

Cities in China today is faced with an increasingly serious river ecological crisis accompanying with the development of urbanization: waterlogging on account of the fragmented urban natural hydrological system; the limited ecological function of the hydrological system caused by a destruction of water system and waterfront ecological environment. Additionally, the eco-hydrological processes of rivers are affected by various environmental factors, which are more complex in the context of urban environment. Therefore, efficient hydrological monitoring and analysis tools, accurate and visual hydrological and hydraulic models are becoming more important basis for decision-makers and an important way for landscape architects to solve urban hydrological problems, formulating sustainable and forward-looking schemes. The study mainly introduces the river and flood analysis model based on the platform of Autodesk Civil 3D. Taking the Luanhe River in Qian'an City of Hebei Province as an example, the 3D models of the landform, river, embankment, shoal, pond, underground stream and other land features were initially built, with which the water transfer simulation analysis, river floodplain analysis, and river ecology analysis were carried out, ultimately the real-time visualized simulation and analysis of rivers in various hypothetical scenarios were realized. Through the establishment of digital hydrological and hydraulic model, the hydraulic data can be accurately and intuitively simulated, which provides basis for rational water system and benign urban ecological system design. Though, the hydrological and hydraulic model based on Autodesk Civil3D own its boundedness: the interaction between the model and other data and software is unfavorable; the huge amount of 3D data and the lack of basic data restrict the accuracy and application range. The hydrological and hydraulic model based on Autodesk Civil3D platform provides more possibility to access convenient and intelligent tool for urban planning and monitoring, a solid basis for further urban research and design.

Keywords: visualization, hydrological and hydraulic model, Autodesk Civil 3D, urban river

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