Search results for: radiation therapy enhancement
850 The Conservation of the Roman Mosaics in the Museum of Sousse, Tunisia: Between Doctrines and Practices
Authors: Zeineb Yousse, Fakher Kharrat
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Mosaic is a part of a broad universal cultural heritage; sometimes it represents a rather essential source for the researches on the everyday life of some of the previous civilizations. Tunisia has one of the finest and largest collections of mosaics in the world, which is essentially exhibited in the Museums of Bardo and Sousse. Restored and reconstituted, they bear witnesses to hard work. Our paper deals with the discipline of conservation of Roman mosaics based on the proceedings of the workshop of the Museum of Sousse. Thus, we highlight two main objectives. In the first place, it is a question of revealing the techniques adopted by professionals to handle mosaics and to which school of conservation these techniques belong. In the second place, we are going to interpret the works initiated to preserve the archaeological heritage in order to protect it in present time and transmit it to future generations. To this end, we paid attention to four Roman mosaics currently exhibited in the Museum of Sousse. These Mosaics show different voids or gaps at the level of their surfaces and the method used to fill these gaps seems to be interesting to analyze. These mosaics are known under the names of: Orpheus Charming the Animals, Gladiator and Bears, Stud farm of Sorothus and finally Head of Medusa. The study on the conservation passes through two chained phases. We start with a small historical overview in order to gather information related to the original location, the date of its composition as well as the description of its image. Afterward, the intervention process is analyzed by handling three complementary elements which are: diagnosis of the existing state, the study of the medium processing and the study of the processing of the tesselatum surface which includes the pictorial composition of the mosaic. Furthermore, we have implemented an evaluation matrix with six operating principles allowing the assessment of the appropriateness of the intervention. These principles are the following: minimal intervention, reversibility, compatibility, visibility, durability, authenticity and enhancement. Various accumulated outcomes are pointing out the techniques used to fill the gaps as well as the level of compliance with the principles of conservation. Accordingly, the conservation of mosaics in Tunisia is a practice that combines various techniques without really arguing about the choice of a particular theory.Keywords: conservation, matrix, museum of Sousse, operating particular theory, principles, Roman mosaics
Procedia PDF Downloads 329849 Sudanese Dietitian’s Role in the Provision of Parenteral Nutrition: The Past, Present, and Future
Authors: Reem Osama Yousif Ali, Osama Yousif Ali Al Gibali
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Introduction: Balanced nutrition is undeniably essential for maintaining health, body functions, and integrity of cell metabolism; however, some sick patients cannot tolerate oral or enteral feeding to meet their nutritional needs, so partial or total parenteral nutrition (PN) may be the most suitable alternative route in such situations. Dietitians are fundamental personnel among the medical team to ensure the proper provision of PN service, which was introduced in Sudan in the 1980s. Objective: The study aimed to recognize the dietitians' awareness of parenteral nutrition and their role in providing this service in Sudan – Khartoum State. Methodology: Formulated questionnaire forms composed of twelve questions were distributed to the dietitians working in four tertiary level hospitals. Results: The majority (75%) of the responded dietitians had reasonable knowledge about the importance of PN, its advantages, and its indications. Sixty percent of them were mindful of the PN side effects. Most of the dietitians were aware of the different assessment measurements and PN calculations and were exposed in their clinical practice to patients who were in need of PN, but only a few of them (about 30%) had the actual chance to participate in the formulation and application of PN therapy. The unavailability of the multidisciplinary team, lack of the required equipment and financial support, and associated complications were basic obstacles to the provision of long-term PN service in Khartoum state hospitals. Conclusion: Although dietitians in Khartoum state hospitals have good information about PN definition, indications, accesses, and assessment measures, they do not have enough knowledge and clinical exposure that make them confident to provide the PN service. Establishing a few models of parenteral nutrition units in tertiary hospitals will be of great help, as well as providing the dietitian's training in the area of parenteral nutrition. Further study can explore more requirements to run this service.Keywords: nutrition support, dietitian, Sudan, parenteral nutrition, nutrition support team
Procedia PDF Downloads 105848 Lateral Capacity of Helical-Pile Groups Subjected to Bearing Combined Loads
Authors: Hesham Hamdy Abdelmohsen, Ahmed Shawky Abdul Azizb, Mona Fawzy Aldaghma
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Helical piles have earned considerable attention as an effective deep foundation alternative due to their rapid installation process and their dual purpose in compression and tension. These piles find common uses as foundations for structures like solar panels, wind turbines, offshore platforms, and some kinds of retaining walls. These structures usually transfer different combinations of loads to their helical-pile foundations in the form of axial and lateral loads. Extensive research has been conducted to investigate and understand the behavior of these piles under the influence of either axial or lateral loads. However, the impacts of loading patterns that may act on the helical piles as combinations of axial compression and lateral loads still need more efforts of research work. This paper presents the results of an experimental (Lab tests) and numerical (PLAXIS-3D) study performed on vertical helical-pile groups under the action of combined loads as axial compression (bearing loads), acting successively with lateral (horizontal) loads. The study aims to clarify the effects of key factors, like helix location and direction of lateral load, on the lateral capacity of helical-pile groups and, consequently, on group efficiency. Besides the variation of helix location and lateral load direction, three patterns of successive bearing combined loads were considered, in which the axial vertical compression load was either zero, V1 or V2, whereas the lateral horizontal loads were varied under each vertical compression load. The study concluded that the lateral capacity of the helical-pile group is significantly affected by helix location within the length of the pile shaft. The optimal lateral performance is achieved with helices at a depth ratio of H/L = 0.4. Furthermore, groups of rectangular plan distribution exhibit greater lateral capacity if subjected to lateral horizontal load in the direction of its long axis. Additionally, the research emphasizes that the presence of vertical compression loading can enhance the lateral capacity of the group. This enhancement depends on the value of the vertical compression load, lateral load direction, and helix location, which highlights the complex interaction effect of these factors on the efficiency of helical-pile groups.Keywords: helical piles, experimental, numerical, lateral loading, group efficiency
Procedia PDF Downloads 32847 Iterative Reconstruction Techniques as a Dose Reduction Tool in Pediatric Computed Tomography Imaging: A Phantom Study
Authors: Ajit Brindhaban
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Background and Purpose: Computed Tomography (CT) scans have become the largest source of radiation in radiological imaging. The purpose of this study was to compare the quality of pediatric Computed Tomography (CT) images reconstructed using Filtered Back Projection (FBP) with images reconstructed using different strengths of Iterative Reconstruction (IR) technique, and to perform a feasibility study to assess the use of IR techniques as a dose reduction tool. Materials and Methods: An anthropomorphic phantom representing a 5-year old child was scanned, in two stages, using a Siemens Somatom CT unit. In stage one, scans of the head, chest and abdomen were performed using standard protocols recommended by the scanner manufacturer. Images were reconstructed using FBP and 5 different strengths of IR. Contrast-to-Noise Ratios (CNR) were calculated from average CT number and its standard deviation measured in regions of interest created in the lungs, bone, and soft tissues regions of the phantom. Paired t-test and the one-way ANOVA were used to compare the CNR from FBP images with IR images, at p = 0.05 level. The lowest strength value of IR that produced the highest CNR was identified. In the second stage, scans of the head was performed with decreased mA(s) values relative to the increase in CNR compared to the standard FBP protocol. CNR values were compared in this stage using Paired t-test at p = 0.05 level. Results: Images reconstructed using IR technique had higher CNR values (p < 0.01.) in all regions compared to the FBP images, at all strengths of IR. The CNR increased with increasing IR strength of up to 3, in the head and chest images. Increases beyond this strength were insignificant. In abdomen images, CNR continued to increase up to strength 5. The results also indicated that, IR techniques improve CNR by a up to factor of 1.5. Based on the CNR values at strength 3 of IR images and CNR values of FBP images, a reduction in mA(s) of about 20% was identified. The images of the head acquired at 20% reduced mA(s) and reconstructed using IR at strength 3, had similar CNR as FBP images at standard mA(s). In the head scans of the phantom used in this study, it was demonstrated that similar CNR can be achieved even when the mA(s) is reduced by about 20% if IR technique with strength of 3 is used for reconstruction. Conclusions: The IR technique produced better image quality at all strengths of IR in comparison to FBP. IR technique can provide approximately 20% dose reduction in pediatric head CT while maintaining the same image quality as FBP technique.Keywords: filtered back projection, image quality, iterative reconstruction, pediatric computed tomography imaging
Procedia PDF Downloads 148846 High Performance Liquid Cooling Garment (LCG) Using ThermoCore
Authors: Venkat Kamavaram, Ravi Pare
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Modern warfighters experience extreme environmental conditions in many of their operational and training activities. In temperatures exceeding 95°F, the body’s temperature regulation can no longer cool through convection and radiation. In this case, the only cooling mechanism is evaporation. However, evaporative cooling is often compromised by excessive humidity. Natural cooling mechanisms can be further compromised by clothing and protective gear, which trap hot air and moisture close to the body. Creating an efficient heat extraction apparel system that is also lightweight without hindering dexterity or mobility of personnel working in extreme temperatures is a difficult technical challenge and one that needs to be addressed to increase the probability for the future success of the US military. To address this challenge, Oceanit Laboratories, Inc. has developed and patented a Liquid Cooled Garment (LCG) more effective than any on the market today. Oceanit’s LCG is a form-fitting garment with a network of thermally conductive tubes that extracts body heat and can be worn under all authorized and chemical/biological protective clothing. Oceanit specifically designed and developed ThermoCore®, a thermally conductive polymer, for use in this apparel, optimizing the product for thermal conductivity, mechanical properties, manufacturability, and performance temperatures. Thermal Manikin tests were conducted in accordance with the ASTM test method, ASTM F2371, Standard Test Method for Measuring the Heat Removal Rate of Personal Cooling Systems Using a Sweating Heated Manikin, in an environmental chamber using a 20-zone sweating thermal manikin. Manikin test results have shown that Oceanit’s LCG provides significantly higher heat extraction under the same environmental conditions than the currently fielded Environmental Control Vest (ECV) while at the same time reducing the weight. Oceanit’s LCG vests performed nearly 30% better in extracting body heat while weighing 15% less than the ECV. There are NO cooling garments in the market that provide the same thermal extraction performance, form-factor, and reduced weight as Oceanit’s LCG. The two cooling garments that are commercially available and most commonly used are the Environmental Control Vest (ECV) and the Microclimate Cooling Garment (MCG).Keywords: thermally conductive composite, tubing, garment design, form fitting vest, thermocore
Procedia PDF Downloads 114845 Chemical, Structural and Mechanical Optimization of Zr-Based Bulk Metallic Glass for Biomedical Applications
Authors: Eliott Guérin, Remi Daudin, Georges Kalepsi, Alexis Lenain, Sebastien Gravier, Benoit Ter-Ovanessian, Damien Fabregue, Jean-Jacques Blandin
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Due to interesting compromise between mechanical and corrosion properties, Zr-based BMGs are attractive for biomedical applications. However, the enhancement of their glass forming ability (GFA) is often achieved by addition of toxic elements like Ni or Be, which is of course a problem for such applications. Consequently, the development of Ni-free Be-free Zr-based BMGs is of great interest. We have developed a Zr-based (Ni and Be-free) amorphous metallic alloy with an elastic limit twice the one of Ti-6Al-4V. The Zr56Co28Al16 composition exhibits a yield strength close to 2 GPa and low Young’s modulus (close to 90 GPa) [1-2]. In this work, we investigated Niobium (Nb) addition through substitution of Zr up to 8 at%. Cobalt substitution has already been reported [3], but we chose Zr substitution to preserve the glass forming ability. In this case, we show that the glass forming ability for 5 mm diameters rods is maintained up to 3 at% of Nb substitution using suction casting in cooper moulds. Concerning the thermal stability, we measure a strong compositional dependence on the glass transition (Tg). Using DSC analysis (heating rate 20 K/min), we show that the Tg rises from 752 K for 0 at% of Nb to 759 K for 3 at% of Nb. Yet, the thermal range between Tg and the crystallisation temperature (Tx) remains almost unchanged from 33 K to 35 K. Uniaxial compression tests on 2 mm diameter pillars and 3 points bending (3PB) tests on 1 mm thick plates are performed to study the Nb addition on the mechanical properties and the plastic behaviour. With these tests, an optimal Nb concentration is found, improving both plasticity and fatigue resistance. Through interpretations of DSC measurements, an attempt is made to correlate the modifications of the mechanical properties with the structural changes. The optimized chemical, structural and mechanical properties through Nb addition are encouraging to develop the potential of this BMG alloy for biomedical applications. For this purpose, we performed polarisation, immersion and cytotoxicity tests. The figure illustrates the polarisation response of Zr56Co28Al16, Zr54Co28Al16Nb2 and TA6V as a reference after 2h of open circuit potential. The results show that the substitution of Zr by a small amount of Nb significantly improves the corrosion resistance of the alloy.Keywords: metallic glasses, amorphous metal, medical, mechanical resistance, biocompatibility
Procedia PDF Downloads 149844 EU-SOLARIS: The European Infrastructure for Concentrated Solar Thermal and Solar Chemistry Technologies
Authors: Vassiliki Drosou, Theoni Oikonomou
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EU-SOLARIS will form a new legal entity to explore and implement improved rules and procedures for Research Infrastructures (RI) for Concentrated Solar Thermal (CST) and solar chemistry technologies, in order to optimize RI development and R&D coordination. It is expected to be the first of its kind, where industrial needs and private funding will play a significant role. The success of EU-SOLARIS initiative will be the establishment of a new governance body, aided by sustainable financial models. EU-SOLARIS is expected to be an important tool, which will provide the most complete, high quality scientific infrastructure portfolio at international level and to facilitate researchers' access to highly specialised research infrastructure through a single access point. This will be accomplished by linking scientific communities, industry and universities involved in the CST sector. The access to be offered by EU-SOLARIS will guarantee the direct contact of experienced scientists with newcomers and interested students. The set of RIs participating in EU-SOLARIS will offer access to state of the art infrastructures, high-quality services, and will enable users to conduct high quality research. Access to these facilities will contribute to the enhancement of the European research area by: -Opening installations to European and non-European scientists, coming from both academia and industry, thus improving co-operation. -Improving scientific critical mass in domains where knowledge is now widely dispersed. -Generating strong Europe-wide R&D project consortia, increasing the competitiveness of each member alone. EU-SOLARIS will be created in the framework of a European project, co-funded by the 7th Framework Programme of the European Union –whose initiative is to foster, contribute and promote the scientific and technological development of the CST and solar chemistry technologies. Primary objective of EU-SOLARIS is to contribute to the improvement of the state of the art of these technologies with the aim of preserving and reinforcing the European leadership in this field, in which EU-SOLARIS is expected to be a valuable instrument. EU-SOLARIS scope, activities, objectives, current status and vision will be given in the article. Moreover, the rules, processes and criteria regulating the access to the research infrastructures included in EU-SOLARIS will be presented.Keywords: concentrated solar thermal (CST) technology, renewable energy sources, research infrastructures, solar chemistry
Procedia PDF Downloads 238843 The Effect of Antibiotic Use on Blood Cultures: Implications for Future Policy
Authors: Avirup Chowdhury, Angus K. McFadyen, Linsey Batchelor
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Blood cultures (BCs) are an important aspect of management of the septic patient, identifying the underlying pathogen and its antibiotic sensitivities. However, while the current literature outlines indications for initial BCs to be taken, there is little guidance for repeat sampling in the following 5-day period and little information on how antibiotic use can affect the usefulness of this investigation. A retrospective cohort study was conducted using inpatients who had undergone 2 or more BCs within 5 days between April 2016 and April 2017 at a 400-bed hospital in the west of Scotland and received antibiotic therapy between the first and second BCs. The data for BC sampling was collected from the electronic microbiology database, and cross-referenced with data from the hospital electronic prescribing system. Overall, 283 BCs were included in the study, taken from 92 patients (mean 3.08 cultures per patient, range 2-10). All 92 patients had initial BCs, of which 83 were positive (90%). 65 had a further sample within 24 hours of commencement of antibiotics, with 35 positive (54%). 23 had samples within 24-48 hours, with 4 (17%) positive; 12 patients had sampling at 48-72 hours, 12 at 72-96 hours, and 10 at 96-120 hours, with none positive. McNemar’s Exact Test was used to calculate statistical significance for patients who received blood cultures in multiple time blocks (Initial, < 24h, 24-120h, > 120h). For initial vs. < 24h-post BCs (53 patients tested), the proportion of positives fell from 46/53 to 29/53 (one-tailed P=0.002, OR 3.43, 95% CI 1.48-7.96). For initial vs 24-120h (n=42), the proportions were 38/42 and 4/42 respectively (P < 0.001, OR 35.0, 95% CI 4.79-255.48). For initial vs > 120h (n=36), these were 33/36 and 2/36 (P < 0.001,OR ∞). These were also calculated for a positive in initial or < 24h vs. 24-120h (n=42), with proportions of 41/42 and 4/42 (P < 0.001, OR 38.0, 95% CI 5.22-276.78); and for initial or < 24h vs > 120h (n=36), with proportions of 35/36 and 2/36 respectively (P < 0.001, OR ∞). This data appears to show that taking an initial BC followed by a BC within 24 hours of antibiotic commencement would maximise blood culture yield while minimising the risk of false negative results. This could potentially remove the need for as many as 46% of BC samples without adversely affecting patient care. BC yield decreases sharply after 48 hours of antibiotic use, and may not provide any clinically useful information after this time. Further multi-centre studies would validate these findings, and provide a foundation for future health policy generation.Keywords: antibiotics, blood culture, efficacy, inpatient
Procedia PDF Downloads 173842 Hybrid Fermentation System for Improvement of Ergosterol Biosynthesis
Authors: Alexandra Tucaliuc, Alexandra C. Blaga, Anca I. Galaction, Lenuta Kloetzer, Dan Cascaval
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Ergosterol (ergosta-5,7,22-trien-3β-ol), also known as provitamin D2, is the precursor of vitamin D2 (ergocalciferol), because it is converted under UV radiation to this vitamin. The natural sources of ergosterol are mainly the yeasts (Saccharomyces sp., Candida sp.), but it can be also found in fungus (Claviceps sp.) or plants (orchids). In the yeasts cells, ergosterol is accumulated in membranes, especially in free form in the plasma membrane, but also as esters with fatty acids in membrane lipids. The chemical synthesis of ergosterol does not represent an efficient method for its production, in these circumstances, the most attractive alternative for producing ergosterol at larger-scale remains the aerobic fermentation using S. cerevisiae on glucose or by-products from agriculture of food industry as substrates, in batch or fed-batch operating systems. The aim of this work is to analyze comparatively the influence of aeration efficiency on ergosterol production by S. cerevisiae in batch and fed-batch fermentations, by considering different levels of mixing intensity, aeration rate, and n-dodecane concentration. The effects of the studied factors are quantitatively described by means of the mathematical correlations proposed for each of the two fermentation systems, valid both for the absence and presence of oxygen-vector inside the broth. The experiments were carried out in a laboratory stirred bioreactor, provided with computer-controlled and recorded parameters. n-Dodecane was used as oxygen-vector and the ergosterol content inside the yeasts cells has been considered at the fermentation moment related to the maximum concentration of ergosterol, 9 hrs for batch process and 20 hrs for fed-batch one. Ergosterol biosynthesis is strongly dependent on the dissolved oxygen concentration. The hydrocarbon concentration exhibits a significant influence on ergosterol production mainly by accelerating the oxygen transfer rate. Regardless of n-dodecane addition, by maintaining the glucose concentration at a constant level in the fed-batch process, the amount of ergosterol accumulated into the yeasts cells has been almost tripled. In the presence of hydrocarbon, the ergosterol concentration increased by over 50%. The value of oxygen-vector concentration corresponding to the maximum level of ergosterol depends mainly on biomass concentration, due to its negative influences on broth viscosity and interfacial phenomena of air bubbles blockage through the adsorption of hydrocarbon droplets–yeast cells associations. Therefore, for the batch process, the maximum ergosterol amount was reached for 5% vol. n-dodecane, while for the fed-batch process for 10% vol. hydrocarbon.Keywords: bioreactors, ergosterol, fermentation, oxygen-vector
Procedia PDF Downloads 189841 Instant Data-Driven Robotics Fabrication of Light-Transmitting Ceramics: A Responsive Computational Modeling Workflow
Authors: Shunyi Yang, Jingjing Yan, Siyu Dong, Xiangguo Cui
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Current architectural façade design practices incorporate various daylighting and solar radiation analysis methods. These emphasize the impact of geometry on façade design. There is scope to extend this knowledge into methods that address material translucency, porosity, and form. Such approaches can also achieve these conditions through adaptive robotic manufacturing approaches that exploit material dynamics within the design, and alleviate fabrication waste from molds, ultimately accelerating the autonomous manufacturing system. Besides analyzing the environmental solar radiant in building facade design, there is also a vacancy research area of how lighting effects can be precisely controlled by engaging the instant real-time data-driven robot control and manipulating the material properties. Ceramics carries a wide range of transmittance and deformation potentials for robotics control with the research of its material property. This paper presents one semi-autonomous system that engages with real-time data-driven robotics control, hardware kit design, environmental building studies, human interaction, and exploratory research and experiments. Our objectives are to investigate the relationship between different clay bodies or ceramics’ physio-material properties and their transmittance; to explore the feedback system of instant lighting data in robotic fabrication to achieve precise lighting effect; to design the sufficient end effector and robot behaviors for different stages of deformation. We experiment with architectural clay, as the material of the façade that is potentially translucent at a certain stage can respond to light. Studying the relationship between form, material properties, and porosity can help create different interior and exterior light effects and provide façade solutions for specific architectural functions. The key idea is to maximize the utilization of in-progress robotics fabrication and ceramics materiality to create a highly integrated autonomous system for lighting facade design and manufacture.Keywords: light transmittance, data-driven fabrication, computational design, computer vision, gamification for manufacturing
Procedia PDF Downloads 123840 Hydrogen Production By Photoreforming Of n-Butanol And Structural Isomers Over Pt Doped Titanate Catalyst
Authors: Hristina Šalipur, Jasmina Dostanić, Davor Lončarević, Matej Huš
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Photocatalytic water splitting/alcohol photoreforming has been used for the conversion of sunlight energy in the process of hydrogen production due to its sustainability, environmental safety, effectiveness and simplicity. Titanate nanotubes are frequently studied materials since they combine the properties of photo-active semiconductors with the properties of layered titanates, such as the ion-exchange ability. Platinum (Pt) doping into titanate structure has been considered an effective strategy in better separation efficiency of electron-hole pairs and lowering the overpotential for hydrogen production, which results in higher photocatalytic activity. In our work, Pt doped titanate catalysts were synthesized via simple alkaline hydrothermal treatment, incipient wetness impregnation method and temperature-programmed reduction. The structural, morphological and optical properties of the prepared catalysts were investigated using various characterization techniques such as X-ray diffraction (XRD), scanning electron microscopy (SEM), N2 physisorption, and diffuse reflectance spectroscopy (DRS). The activities of the prepared Pt-doped titanate photocatalysts were tested for hydrogen production via photocatalytic water splitting/alcohol photoreforming process under simulated solar light irradiation. Characterization of synthesized Pt doped titanate catalysts showed crystalline anatase phase, preserved nanotubular structure and high specific surface area. The result showed enhancement of activity in photocatalytic water splitting/alcohol photoreforming in the following order 2-butanol>1-butanol>tert-butanol, with obtained maximal hydrogen production rate of 7.5, 5.3 and 2 mmol g-1 h-1, respectively. Different possible factors influencing the hole scavenging ability, such as hole scavenger redox potential and diffusivity, adsorption and desorption rate of the hole scavenger on the surface and stability of the alcohol radical species generated via hole scavenging, were investigated. The theoretical evaluation using density functional theory (DFT) further elucidated the reaction kinetics and detailed mechanism of photocatalytic water splitting/alcohol photoreforming.Keywords: hydrogen production, platinum, semiconductor, water splitting, density functional theory
Procedia PDF Downloads 113839 Minimal Invasive Esophagectomy for Esophageal Cancer: An Institutional Review From a Dedicated Centre of Pakistan
Authors: Nighat Bakhtiar, Ali Raza Khan, Shahid Khan Khattak, Aamir Ali Syed
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Introduction: Chemoradiation followed by resection has been the standard therapy for resectable (cT1-4aN0-3M0) esophageal carcinoma. The optimal surgical approach remains a matter of debate. Therefore, the purpose of this study was to share our experiences of minimal invasive esophagectomies concerning morbidity, mortality and oncological quality. This study aims to enlighten the world about the surgical outcomes after minimally invasive esophagectomy at Shaukat Khanum Hospital Lahore. Objective: The purpose of this study is to review an institutional experience of Surgical outcomes of Minimal Invasive esophagectomies for esophageal cancer. Methodology: This retrospective study was performed after ethical approval at Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH&RC) Pakistan. Patients who underwent Minimal Invasive esophagectomies for esophageal cancer from March 2018 to March 2023 were selected. Data was collected through the human information system (HIS) electronic database of SKMCH&RC. Data was described using mean and median with minimum and maximum values for quantitative variables. For categorical variables, a number of observations and percentages were reported. Results: A total of 621 patients were included in the study, with the mean age of the patient was 39 years, ranging between 18-58 years. Mean Body Mass Index of patients was 21.2.1±4.1. Neo-adjuvant chemoradiotherapy was given to all patients. The mean operative time was 210.36 ± 64.51 minutes, and the mean blood loss was 121 milliliters. There was one mortality in 90 days, while the mean postoperative hospital stay was 6.58 days with a 4.64 standard deviation. The anastomotic leak rate was 4.2%. Chyle leak was observed in 12 patients. Conclusion: The minimal invasive technique is a safe approach for esophageal cancers, with minimal complications and fast recovery.Keywords: minimal invasive, esophagectomy, laparscopic, cancer
Procedia PDF Downloads 74838 Role of Intralesional Tranexamic Acid in Comparison of Oral Tranexamic Acid in the Treatment of Melasma
Authors: Lubna Khondker
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Background: Melasma is a common pigmentary dermatosis, manifested by hyperpigmented macules or patches on the face, commonly occurring in females due to an acquired disorder in the melanogenesis process. Although several treatments are currently used, it remains a great challenge due to recurrence and refractory nature. It was recently reported that tranexamic acid (TA-plasmin inhibitor) is an effective treatment for melasma. Objective: This study aims to compare the efficacy and side effects of intralesional injection of Tranexamic acid with oral Tranexamic acid in the treatment of melasma. Methods: A clinical trial was done in the Department of Dermatology and Venereology, Bangabandhu Sheikh Mujib Medical University, for a period of 4 years. A total of 100 patients with melasma who did not respond to topical therapy were included in the study as group A and group B. Group A Patients were administered intralesional injection (10 mg/ml) of Tranexamic acid( TA) weekly for 6 weeks, and group B patients were treated with oral tranexamic acid 250 mg 12 hourly for 12 weeks after taking informed consent. The severity and extent of pigmentation were assessed by the modified melasma area severity index (MASI). The response to treatment was assessed by MASI at 4 weeks, 8 weeks, and 12 weeks after stopping treatment. Results: The study showed the MASI scores at the baseline, 4 weeks, 8 weeks, and 12 weeks in group A were 18.23±1.22, 6.14±3.26, 3.21±2.14 and 2.11±2.01 respectively, and in group B, 17.87±1.12, 11.21±6.25, 6.57±4.26 and 6.41±4.17 respectively. The mean MASI significantly reduced in group A compared to group B in the 4th, 8th, and 12th weeks. The present study showed that among group A patients, 56% rated excellent (>75% reduction) in outcome, 32% good (50-75% reduction), 8% moderate (25-50% reduction) and only 4% (<25% reduction) was unsatisfactory and among group B patients, 14% rated excellent in outcome, 28% good, 36% moderate and 22% was unsatisfactory. Overall improvement in our study in group A was 96% and in group B 78%. Side effects were negligible, and all the patients tolerated the treatment well. Conclusion: Based on our results, intralesional Tranexamic acid (10 mg/ml) is more effective and safer than oral Tranexamic acid in the treatment of melasma.Keywords: intralesional tranexamic acid, melasma, oral tranexamic acid, MASI score
Procedia PDF Downloads 61837 Implementation of Inclusive Education in DepEd-Dasmarinas: Basis for Inclusion Program Framework
Authors: Manuela S. Tolentino, John G. Nepomuceno
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The purpose of this investigation was to assess the implementation of inclusive education (IE) in 6 elementary and 5 secondary public schools in the City Schools Division of Dasmarinas. Participants in this study were 11 school heads, 73 teachers, 22 parents and 22 students (regular and with special needs) who were selected using purposive sampling. A 30-item questionnaire was used to gather data on the extent of the implementation of IE in the division while focus group discussion (FGD) was used to gather insights on what facilitate and hinder the implementation of the IE program. This study assessed the following variables: school culture and environment, inclusive education policy implementation, and curriculum design and practices. Data were analyzed using frequency count, mean and ranking. Results revealed that participants have similar assessment on the extent of the implementation of IE. School heads rated school culture and environment as highest in terms of implementation while teachers and pupils chose curriculum design and practices. On the other hand, parents felt that inclusive education policies are implemented best. School culture and environment are given high ratings. Participants perceived that the IE program in the division is making everyone feel welcome regardless of age, sex, social status, physical, mental and emotional state; students with or without disability are equally valued, and students help each. However, some aspects of the IE program implementation are given low ratings namely: partnership between staff, parents and caregivers, school’s effort to minimize discriminatory practice, and stakeholders sharing the philosophy of inclusion. As regards education policy implementation, indicators with the highest ranks were school’s effort to admit students from the locality especially students with special needs, and the implementation of the child protection policy and anti-bullying policy. The results of the FGD revealed that both school heads and teachers possessed the welcoming gesture to accommodate students with special needs. This can be linked to the increasing enrolment of SNE in the division. However, limitations of the teachers’ knowledge on handling learners, facilities and collaboration among stakeholders hinder the implementation of IE program. Based on the findings, inclusion program framework was developed for program enhancement. This will be the basis for the improvement of the program’s efficiency, the relationship between stakeholders, and formulation of solutions.Keywords: inclusion, inclusive education, framework, special education
Procedia PDF Downloads 171836 The Enhancement of Target Localization Using Ship-Borne Electro-Optical Stabilized Platform
Authors: Jaehoon Ha, Byungmo Kang, Kilho Hong, Jungsoo Park
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Electro-optical (EO) stabilized platforms have been widely used for surveillance and reconnaissance on various types of vehicles, from surface ships to unmanned air vehicles (UAVs). EO stabilized platforms usually consist of an assembly of structure, bearings, and motors called gimbals in which a gyroscope is installed. EO elements such as a CCD camera and IR camera, are mounted to a gimbal, which has a range of motion in elevation and azimuth and can designate and track a target. In addition, a laser range finder (LRF) can be added to the gimbal in order to acquire the precise slant range from the platform to the target. Recently, a versatile functionality of target localization is needed in order to cooperate with the weapon systems that are mounted on the same platform. The target information, such as its location or velocity, needed to be more accurate. The accuracy of the target information depends on diverse component errors and alignment errors of each component. Specially, the type of moving platform can affect the accuracy of the target information. In the case of flying platforms, or UAVs, the target location error can be increased with altitude so it is important to measure altitude as precisely as possible. In the case of surface ships, target location error can be increased with obliqueness of the elevation angle of the gimbal since the altitude of the EO stabilized platform is supposed to be relatively low. The farther the slant ranges from the surface ship to the target, the more extreme the obliqueness of the elevation angle. This can hamper the precise acquisition of the target information. So far, there have been many studies on EO stabilized platforms of flying vehicles. However, few researchers have focused on ship-borne EO stabilized platforms of the surface ship. In this paper, we deal with a target localization method when an EO stabilized platform is located on the mast of a surface ship. Especially, we need to overcome the limitation caused by the obliqueness of the elevation angle of the gimbal. We introduce a well-known approach for target localization using Unscented Kalman Filter (UKF) and present the problem definition showing the above-mentioned limitation. Finally, we want to show the effectiveness of the approach that will be demonstrated through computer simulations.Keywords: target localization, ship-borne electro-optical stabilized platform, unscented kalman filter
Procedia PDF Downloads 520835 Production of Single-Chain Antibodies against Common Epitopes of ErbB1 and ErbB2 Using Phage Display Antibody Library
Authors: Gholamreza Hashemitabr, Reza Valadan, Alireza Rafiei, Mohammad Reza Bassami
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Breast cancer is the most common malignancy among women worldwide. Cancer cells use a complex multilayer network of epidermal growth factor receptors (EGFRs) signaling pathways to support their survival and growth. The overlapping networks of EGFRs signaling pathways account for the failure of most ErbB-targeted therapies. The aim of this study was to enrich a pool of recombinant antibody fragments against common epitopes of ErbB1 and ErbB2 in order to simultaneous blockade of ErbBs signaling pathways. ErbB1 and ErbB2 were expressed stably in VERO cells. Selection of recombinant antibodies was performed on live cells expressing either of ErbB1 and ErbB2 receptors using subtractive phage display approach. The results of PCR and DNA fingerprinting in the last round of panning showed that most clones contained insert (80% and 85% for ErbB1 and ErbB2 respectively) with an identical restriction pattern. The selected clones showed positive reaction to both ErbB1 and ErbB2 receptors in phage-ELISA test. Furthermore, the resulting soluble antibody fragments recognized common epitopes of both immunoprecipitated ErbB1 and ErbB2 in western blot. Additionally, the antibodies directed against the dimerization domain of ErbB1 demonstrated a significant absorbance in EGF-stimulated VERO/ErbB1 cells than non-stimulated cells (1.91 and 1.09 respectively). Moreover, the results of dimerization inhibition test showed that these antibodies blocked ErbB1 and ErbB2 dimerization on the surface of ErbB1 and ErbB2 expressing VERO cells. Regarding the importance of pan-ErbB approach to cancer therapy, the antibodies developed here might provide novel therapeutics for simultaneous blockade of ErbBs signaling pathways.Keywords: breast cancer, single-chain antibody, ErbB1, ErbB2, epitope
Procedia PDF Downloads 649834 Fabrication and Characteristics of Ni Doped Titania Nanotubes by Electrochemical Anodization
Authors: J. Tirano, H. Zea, C. Luhrs
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It is well known that titanium dioxide is a semiconductor with several applications in photocatalytic process. Its band gap makes it very interesting in the photoelectrodes manufacturing used in photoelectrochemical cells for hydrogen production, a clean and environmentally friendly fuel. The synthesis of 1D titanium dioxide nanostructures, such as nanotubes, makes possible to produce more efficient photoelectrodes for solar energy to hydrogen conversion. In essence, this is because it increases the charge transport rate, decreasing recombination options. However, its principal constraint is to be mainly sensitive to UV range, which represents a very low percentage of solar radiation that reaches earth's surface. One of the alternatives to modifying the TiO2’s band gap and improving its photoactivity under visible light irradiation is to dope the nanotubes with transition metals. This option requires fabricating efficient nanostructured photoelectrodes with controlled morphology and specific properties able to offer a suitable surface area for metallic doping. Hence, currently one of the central challenges in photoelectrochemical cells is the construction of nanomaterials with a proper band position for driving the reaction while absorbing energy over the VIS spectrum. This research focuses on the synthesis and characterization of Nidoped TiO2 nanotubes for improving its photocatalytic activity in solar energy conversion applications. Initially, titanium dioxide nanotubes (TNTs) with controlled morphology were synthesized by two-step potentiostatic anodization of titanium foil. The anodization was carried out at room temperature in an electrolyte composed of ammonium fluoride, deionized water and ethylene glycol. Consequent thermal annealing of as-prepared TNTs was conducted in the air between 450 °C - 550 °C. Afterwards, the nanotubes were superficially modified by nickel deposition. Morphology and crystalline phase of the samples were carried out by SEM, EDS and XRD analysis before and after nickel deposition. Determining the photoelectrochemical performance of photoelectrodes is based on typical electrochemical characterization techniques. Also, the morphological characterization associated electrochemical behavior analysis were discussed to establish the effect of nickel nanoparticles modification on the TiO2 nanotubes. The methodology proposed in this research allows using other transition metal for nanotube surface modification.Keywords: dimensionally stable electrode, nickel nanoparticles, photo-electrode, TiO₂ nanotubes
Procedia PDF Downloads 177833 Proposal of a Rectenna Built by Using Paper as a Dielectric Substrate for Electromagnetic Energy Harvesting
Authors: Ursula D. C. Resende, Yan G. Santos, Lucas M. de O. Andrade
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The recent and fast development of the internet, wireless, telecommunication technologies and low-power electronic devices has led to an expressive amount of electromagnetic energy available in the environment and the smart applications technology expansion. These applications have been used in the Internet of Things devices, 4G and 5G solutions. The main feature of this technology is the use of the wireless sensor. Although these sensors are low-power loads, their use imposes huge challenges in terms of an efficient and reliable way for power supply in order to avoid the traditional battery. The radio frequency based energy harvesting technology is especially suitable to wireless power sensors by using a rectenna since it can be completely integrated into the distributed hosting sensors structure, reducing its cost, maintenance and environmental impact. The rectenna is an equipment composed of an antenna and a rectifier circuit. The antenna function is to collect as much radio frequency radiation as possible and transfer it to the rectifier, which is a nonlinear circuit, that converts the very low input radio frequency energy into direct current voltage. In this work, a set of rectennas, mounted on a paper substrate, which can be used for the inner coating of buildings and simultaneously harvest electromagnetic energy from the environment, is proposed. Each proposed individual rectenna is composed of a 2.45 GHz patch antenna and a voltage doubler rectifier circuit, built in the same paper substrate. The antenna contains a rectangular radiator element and a microstrip transmission line that was projected and optimized by using the Computer Simulation Software (CST) in order to obtain values of S11 parameter below -10 dB in 2.45 GHz. In order to increase the amount of harvested power, eight individual rectennas, incorporating metamaterial cells, were connected in parallel forming a system, denominated Electromagnetic Wall (EW). In order to evaluate the EW performance, it was positioned at a variable distance from the internet router, and a 27 kΩ resistive load was fed. The results obtained showed that if more than one rectenna is associated in parallel, enough power level can be achieved in order to feed very low consumption sensors. The 0.12 m2 EW proposed in this work was able to harvest 0.6 mW from the environment. It also observed that the use of metamaterial structures provide an expressive growth in the amount of electromagnetic energy harvested, which was increased from 0. 2mW to 0.6 mW.Keywords: electromagnetic energy harvesting, metamaterial, rectenna, rectifier circuit
Procedia PDF Downloads 166832 Realistic Modeling of the Preclinical Small Animal Using Commercial Software
Authors: Su Chul Han, Seungwoo Park
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As the increasing incidence of cancer, the technology and modality of radiotherapy have advanced and the importance of preclinical model is increasing in the cancer research. Furthermore, the small animal dosimetry is an essential part of the evaluation of the relationship between the absorbed dose in preclinical small animal and biological effect in preclinical study. In this study, we carried out realistic modeling of the preclinical small animal phantom possible to verify irradiated dose using commercial software. The small animal phantom was modeling from 4D Digital Mouse whole body phantom. To manipulate Moby phantom in commercial software (Mimics, Materialise, Leuven, Belgium), we converted Moby phantom to DICOM image file of CT by Matlab and two- dimensional of CT images were converted to the three-dimensional image and it is possible to segment and crop CT image in Sagittal, Coronal and axial view). The CT images of small animals were modeling following process. Based on the profile line value, the thresholding was carried out to make a mask that was connection of all the regions of the equal threshold range. Using thresholding method, we segmented into three part (bone, body (tissue). lung), to separate neighboring pixels between lung and body (tissue), we used region growing function of Mimics software. We acquired 3D object by 3D calculation in the segmented images. The generated 3D object was smoothing by remeshing operation and smoothing operation factor was 0.4, iteration value was 5. The edge mode was selected to perform triangle reduction. The parameters were that tolerance (0.1mm), edge angle (15 degrees) and the number of iteration (5). The image processing 3D object file was converted to an STL file to output with 3D printer. We modified 3D small animal file using 3- Matic research (Materialise, Leuven, Belgium) to make space for radiation dosimetry chips. We acquired 3D object of realistic small animal phantom. The width of small animal phantom was 2.631 cm, thickness was 2.361 cm, and length was 10.817. Mimics software supported efficiency about 3D object generation and usability of conversion to STL file for user. The development of small preclinical animal phantom would increase reliability of verification of absorbed dose in small animal for preclinical study.Keywords: mimics, preclinical small animal, segmentation, 3D printer
Procedia PDF Downloads 366831 An overview of Using Functional Communication Training to Decrease Maladaptive Behaviors for Individuals Diagnosed with Intellectual Disability and Autism Spectrum Disorders at an Extensive Support Needs Residential Program
Authors: Ali Mahamat
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This paper explores the application of Functional Communication Training (FCT) as an intervention to decrease maladaptive behaviors among individuals diagnosed with Intellectual Disability (ID) and Autism Spectrum Disorders (ASD) within an extensive support needs residential program. Evidence suggests that FCT can be ef ective in promoting positive behavioral changes and enhancing communication skills in this population. The prevalence of maladaptive behaviors in individuals with ID and ASD is a significant concern for caregivers and professionals in residential programs. These behaviors can include aggression, self-injury, and disruptive activities, which can impede the individual's quality of life. Functional Communication Training (FCT) has been identified as a potential solution to these challenges, providing individuals with the communication skills needed to express their needs and desires effectively. Method: A quasi-experimental design was used to investigate the effectiveness of FCT in a residential setting for individuals with ID and ASD. Participants included individuals with varying degrees of ID and ASD who exhibited maladaptive behaviors. A baseline was established for each participant's behavior before introducing FCT as an intervention. The FCT intervention involved teaching the individuals alternative, functionally equivalent communication behaviors to replace maladaptive behaviors. The training was implemented in the participants' natural environment and was incorporated into their daily routines. The intervention period lasted for six months, with follow-ups conducted at three months and six months post-intervention.Results indicated a significant decrease in maladaptive behaviors for individuals who received the FCT intervention. In addition, an enhancement in communication skills was observed, with the majority of participants demonstrating an increased ability to express their needs and desires appropriately. The findings of this study provide support for the effectiveness of FCT in reducing maladaptive behaviors in individuals with ID and ASD in a residential setting. Moreover, the study highlights the importance of incorporating functional communication skills training in the daily routines of these individuals. By providing these individuals with an effective means of communication, FCT not only reduces the occurrence of maladaptive behaviors but also improves the quality of life for these individuals. However, future research should explore the long-term effects of FCT and consider the influence of individual differences on the effectiveness of the intervention.Keywords: functional communication training, intellectual disability, autism spectrum disorders, maladaptive behavior, residential program
Procedia PDF Downloads 25830 Initiation of Paraptosis-Like PCD Pathway in Hepatocellular Carcinoma Cell Line by Hep88 mAb through the Binding of Mortalin (HSPA9) and Alpha-Enolase
Authors: Panadda Rojpibulstit, Suthathip Kittisenachai, Songchan Puthong, Sirikul Manochantr, Pornpen Gamnarai, Sasichai Kangsadalampai, Sittiruk Roytrakul
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Hepatocellular carcinoma (HCC) is the most primary hepatic cancer worldwide. Nowadays a targeted therapy via monoclonal antibodies (mAbs) specific to tumor-associated antigen is continually developed in HCC treatment. In this regard, after establishing and consequently exploring Hep88 mAb’s tumoricidal effect on hepatocellular carcinoma cell line (HepG2 cell line), the Hep88 mAb’s specific Ag from both membrane and cytoplasmic fractions of HepG2 cell line was identified by 2-D gel electrophoresis and western blot analysis. After in-gel digestion and subsequent analysis by liquid chromatography-mass spectrometry (LC-MS), mortalin (HSPA9) and alpha-enolase were identified. The recombinant proteins specific to Hep88 mAb were cloned and expressed in E.coli BL21 (DE3). Moreover, alteration of HepG2 and Chang liver cell line after being induced by Hep88 mAb for 1-3 days was investigated using a transmission electron microscope. The result demonstrated that Hep88 mAb can bind to the recombinant mortalin (HSPA9) andalpha-enolase. In addition, gradual appearance of mitochondria vacuolization and endoplasmic reticulum dilatation were observed. Taken together, paraptosis-like programmed cell death (PCD) of HepG2 is induced by binding of mortalin (HSPA9) and alpha-enolase to Hep88 mAb. Mortalin depletion by formation of Hep88 mAb-mortalin (HSPA9) complex might initiate transcription-independent of p53-mediated apoptosis. Additionally, Hep88 mAb-alpha-enolase complex might initiate HepG2 cells energy exhaustion by glycolysis pathway obstruction. These results imply that Hep88 mAb might be a promising tool for development of an effective treatment of HCC in the next decade.Keywords: Hepatocellular carcinoma, Monoclonal antibody, Paraptosis-like program cell death, Transmission electron microscopy, mortalin (HSPA9), alpha-enolase
Procedia PDF Downloads 361829 Enhancement of Morphogenetic Potential to Obtain Elite Varities of Sauropus androgynous (L.) Merr. through Somatic Embryogenesis
Authors: S. Padma, D. H. Tejavathi
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Somatic embryogenesis is a remarkable illustration of the dictum of plant totipotency where developmental reconstruction of somatic cells takes place towards the embryogenic pathway. It recapitulates the morphological and developmental process that occurs in zygotic embryogenesis. S. androgynous commonly called as multivitamin plant. The leaves are consumed as green leafy vegetable by the Southeast Asian communities due to their rich nutritional profile. Despite being a good nutritional vegetable with proteins, vitamins, minerals, amino acids, it is warned for excessive intake due to the presence of alkoloid called papaverine. Papaverine at higher concentrations is toxic and leads to a syndrome called Bronchiolitis Obliterans. In the present study, morphogenetic potential of shoot tip, leaf and nodal explants of Sauropus androgynous was investigated to develop and enhance the reliable plant regeneration protocol via somatic embryogenesis. Somatic embryos were derived directly from the embryogenic callus derived from shoot tip, node and leaf cultures on Phillips and Collins (L2) medium supplemented with NAA at various concentrations ranging from 5.3 µM/l to 26.85 µM/l within two months of inoculation. Thus obtained embryos were sub cultured to modified L2 media supplemented with increased vitamin level for the further growth. Somatic embryos with well-developed cotyledons were transferred to normal and modified L2 basal medium for conversion. The plantlets thus obtained were subjected to brief acclimatization before transferring them to land. About 95% of survival rate was recorded. The augmentation process of culturing various explants through somatic embryogenesis using synthetic medium with various plant growth regulators under controlled conditions have aggrandized the commercial production of Sauropus making it easily available over the conventional propagation methods. In addition, regeneration process through somatic embryogenesis has ameliorated the development of desired character in Sauropus with low papaverine content thereby providing a valuable resource to the food and pharmaceutical industry. Based on this research, plant tissue culture techniques have shown promise for economical and convenient application in Sauropus androgynous breeding.Keywords: L2 medium, multivitamin plant, NAA, papaverine
Procedia PDF Downloads 207828 The Transcutaneous Auricular Vagus Nerve Stimulation in Treatment of Depression and Anxiety Disorders in Recovery Patient with Feeding and Eating Disorders
Authors: Y. Melis, E. Apicella, E. Dozio, L. Mendolicchio
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Introduction: Feeding and Eating Disorders (FED) represent the psychiatric pathology with the highest mortality rate and one of the major disorders with the highest psychiatric and clinical comorbidity. The vagus nerve represents one of the main components of the sympathetic and parasympathetic nervous system and is involved in important neurophysiological functions. In FED, there is a spectrum of symptoms which with TaVNS (Transcutaneous Auricular Vagus Nerve Stimulation) therapy, is possible to have a therapeutic efficacy. Materials and Methods: Sample subjects are composed of 15 female subjects aged > 18 ± 51. Admitted to a psychiatry community having been diagnosed according to DSM-5: anorexia nervosa (AN) (N= 9), bulimia nervosa (BN) (N= 5), binge eating disorder (BED) (N= 1). The protocol included 9 weeks of Ta-VNS stimulation at a frequency of 1.5-3.5 mA for 4 hours per day. The variables detected are the following: Heart Rate Variability (HRV), Hamilton Depression Rating Scale (HAMD-HDRS-17), Body Mass Index (BMI), Beck Anxiety Index (BAI). Results: Data analysis showed statistically significant differences between recording times (p > 0.05) in HAM-D (t0 = 18.28 ± 5.31; t4 = 9.14 ± 7.15), in BAI (t0 = 24.7 ± 10.99; t4 = 13.8 ± 7.0). The reported values show how during (T0-T4) the treatment there is a decay of the degree in the depressive state, in the state of anxiety, and an improvement in the value of BMI. In particular, the BMI in the AN-BN sub-sample had a minimum gain of 5% and a maximum of 11%. The analysis of HRV did not show a clear change among subjects, thus confirming the discordance of the activity of the sympathetic and parasympathetic nervous system in FED. Conclusions: Although the sample does not possess a relevant value to determine long-term efficacy of Ta-VNS or on a larger population, this study reports how the application of neuro-stimulation in FED may become a further approach therapeutic. Indeed, substantial improvements are highlighted in the results and confirmed hypotheses proposed by the study.Keywords: feeding and eating disorders, neurostimulation, anxiety disorders, depression
Procedia PDF Downloads 145827 Three-Dimensional Computer Graphical Demonstration of Calcified Tissue and Its Clinical Significance
Authors: Itsuo Yokoyama, Rikako Kikuti, Miti Sekikawa, Tosinori Asai, Sarai Tsuyoshi
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Introduction: Vascular access for hemodialysis therapy is often difficult, even for experienced medical personnel. Ultrasound guided needle placement have been performed occasionally but is not always helpful in certain cases with complicated vascular anatomy. Obtaining precise anatomical knowledge of the vascular structure is important to prevent access-related complications. With augmented reality (AR) device such as AR glasses, the virtual vascular structure is shown superimposed on the actual patient vessels, thus enabling the operator to maneuver catheter placement easily with free both hands. We herein report our method of AR guided vascular access method in dialysis treatment Methods: Three dimensional (3D) object of the arm with arteriovenous fistula is computer graphically created with 3D software from the data obtained by computer tomography, ultrasound echogram, and image scanner. The 3D vascular object thus created is viewed on the screen of the AR digital display device (such as AR glass or iPad). The picture of the vascular anatomical structure becomes visible, which is superimposed over the real patient’s arm, thereby the needle insertion be performed under the guidance of AR visualization with ease. By this method, technical difficulty in catheter placement for dialysis can be lessened and performed safely. Considerations: Virtual reality technology has been applied in various fields and medical use is not an exception. Yet AR devices have not been widely used among medical professions. Visualization of the virtual vascular object can be achieved by creation of accurate three dimensional object with the help of computer graphical technique. Although our experience is limited, this method is applicable with relative easiness and our accumulating evidence has suggested that our method of vascular access with the use of AR can be promising.Keywords: abdominal-aorta, calcification, extraskeletal, dialysis, computer graphics, 3DCG, CT, calcium, phosphorus
Procedia PDF Downloads 163826 Decisional Regret in Men with Localized Prostate Cancer among Various Treatment Options and the Association with Erectile Functioning and Depressive Symptoms: A Moderation Analysis
Authors: Caren Hilger, Silke Burkert, Friederike Kendel
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Men with localized prostate cancer (PCa) have to choose among different treatment options, such as active surveillance (AS) and radical prostatectomy (RP). All available treatment options may be accompanied by specific psychological or physiological side effects. Depending on the nature and extent of these side effects, patients are more or less likely to be satisfied or to struggle with their treatment decision in the long term. Therefore, the aim of this study was to assess and explain decisional regret in men with localized PCa. The role of erectile functioning as one of the main physiological side effects of invasive PCa treatment, depressive symptoms as a common psychological side effect, and the association of erectile functioning and depressive symptoms with decisional regret were investigated. Men with localized PCa initially managed with AS or RP (N=292) were matched according to length of therapy (mean 47.9±15.4 months). Subjects completed mailed questionnaires assessing decisional regret, changes in erectile functioning, depressive symptoms, and sociodemographic variables. Clinical data were obtained from case report forms. Differences among the two treatment groups (AS and RP) were calculated using t-tests and χ²-tests, relationships of decisional regret with erectile functioning and depressive symptoms were computed using multiple regression. Men were on average 70±7.2 years old. The two treatment groups differed markedly regarding decisional regret (p<.001, d=.50), changes in erectile functioning (p<.001, d=1.2), and depressive symptoms (p=.01, d=.30), with men after RP reporting higher values, respectively. Regression analyses showed that after adjustment for age, tumor risk category, and changes in erectile functioning, depressive symptoms were still significantly associated with decisional regret (B=0.52, p<.001). Additionally, when predicting decisional regret, the interaction of changes in erectile functioning and depressive symptoms reached significance for men after RP (B=0.52, p<.001), but not for men under AS (B=-0.16, p=.14). With increased changes in erectile functioning, the association of depressive symptoms with decisional regret became stronger in men after RP. Decisional regret is a phenomenon more prominent in men after RP than in men under AS. Erectile functioning and depressive symptoms interact in their prediction of decisional regret. Screening and treating depressive symptoms might constitute a starting point for interventions aiming to reduce decisional regret in this target group.Keywords: active surveillance, decisional regret, depressive symptoms, erectile functioning, prostate cancer, radical prostatectomy
Procedia PDF Downloads 218825 Screening of Lactic Acid Bacteria Isolated from Traditional Fermented Products: Potential Probiotic Bacteria with Antimicrobial and Cytotoxic Activities
Authors: Genesis Julyus T. Agcaoili, Esperanza C. Cabrera
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Thirty (30) isolates of lactic acid bacteria (LAB) from traditionally-prepared fermented products specifically fermented soy-bean paste, fermented mustard and fermented rice-fish mixture were studied for their in vitro antimicrobial and cytotoxic activities. Seventeen (17) isolates were identified as Lactobacillus plantarum, while 13 isolates were identified as Enterococcus spp using 16s rDNA sequences. Disc diffusion method was used to determine the antibacterial activity of LAB against Staphylococcus aureus (ATCC 25923) and Escherichia coli (ATCC 25922), while the modified agar overlay method was used to determine the antifungal activity of LAB isolates on the yeast Candida albicans, and the dermatophytes Microsporum gypseum, Trichophyton rubrum and Epidermophyton floccosum. The filter-sterilized LAB supernatants were evaluated for their cytotoxicity to mammalian colon cancer cell lines (HT-29 and HCT116) and normal human dermal fibrolasts (HDFn) using resazurin assay (PrestoBlueTM). Colchicine was the positive control. No antimicrobial activity was observed against the bacterial test organisms and the yeast Candida albicans. On the other hand, all of the tested LAB strains were fungicidal for all the test dermatophytes. Cytotoxicity index profiles of the supernatants of the 15 randomly picked LABs and negative control (brain heart infussion broth) suggest nontoxicity to the cells when compared to colchicine, whereas all LAB supernatants were found to be cytotoxic to HT-29 and HCT116 colon cancer cell lines. Results provide strong support for the role of the lactic acid bacteria studied in antimicrobial treatment and anticancer therapy.Keywords: antimicrobial, fermented products, fungicidal activity, lactic acid bacteria, probiotics
Procedia PDF Downloads 237824 Correlation between Flexible Flatfoot and Lumbosacral Angle
Authors: Moustafa Elwan, Sohier Shehata, Fatma Sedek, Manar Hussine
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One of the most risky factors that lead to a foot injury during physical activities are both high and low arched feet. Normally the medial longitudinal arch of the foot develops in the first 10 years of life, so flexible flat foot has an inversely relationship with age in the first decade, all over the world, the prevalence of flat foot is increasing. In approximately 15% of foot deformities cases, the deformity does not disappear and remains throughout adulthood, 90% of the clinical cases are complaining from foot problems are due to flatfoot. Flatfoot creates subtalar over pronation, which creates tibial and femoral medial rotation, and that is accompanied with increases of pelvic tilting anteriorly, which may influence the lumbar vertebrae alignment by increasing muscle tension and rotation. Objective: To study the impact of the flexible flatfoot on lumbosacral angle (angle of Ferguson). Methods: This experiment included 40 volunteers (14 females &26 males) gathered from the Faculty of Physical Therapy, Modern University of Technology and Information, Cairo, Egypt, for each participant, four angles were measured in the foot( talar first metatarsal angle, lateral talocalcaneal angle, , Calcaneal first metatarsal angle, calcaneal inclination angle) and one angle in the lumbar region (lumbosacral angle). Measurement of these angles was conducted by using Surgimap Spine software (version 2.2.9.6). Results: The results demonstrated that there was no significant correlation betweenFerguson angle and lateral talocalcaneal (r=0.164, p=0.313). Also, there was no significant correlation between Ferguson angle and talo first metatarsal “Meary’s angle" (r=0.007, p=0.968). Moreover, there was no significant correlation between Ferguson angle and calcaneal-first metatarsal angle (r=0.083, p=0.612). Also, there was no significant correlation between Ferguson angle and calcaneal inclination angle (r= 0.032, p= 0.846). Conclusion: It can be concluded that there is no significant correlation between the flexible flat foot and lumbosacral angle So, more study should be conducted in large sample and different ages and conditions of foot problems.Keywords: calcaneal first metatarsal, calcaneal inclination, flatfoot, ferguson’s angle, lateral talocalcaneal angle, lumbosacral angle, and talar first metatarsal angle
Procedia PDF Downloads 133823 Synthesis of Liposomal Vesicles by a Novel Supercritical Fluid Process
Authors: Wen-Chyan Tsai, Syed S. H. Rizvi
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Organic solvent residues are always associated with liposomes produced by the traditional techniques like the thin film hydration and reverse phase evaporation methods, which limit the applications of these vesicles in the pharmaceutical, food and cosmetic industries. Our objective was to develop a novel and benign process of liposomal microencapsulation by using supercritical carbon dioxide (SC-CO2) as the sole phospholipid-dissolving medium and a green substitute for organic solvents. This process consists of supercritical fluid extraction followed by rapid expansion via a nozzle and automatic cargo suction. Lecithin and cholesterol mixed in 10:1 mass ratio were dissolved in SC-CO2 at 20 ± 0.5 MPa and 60 oC. After at least two hours of equilibrium, the lecithin/cholesterol-laden SC-CO2 was passed through a 1000-micron nozzle and immediately mixed with the cargo solution to form liposomes. Liposomal micro-encapsulation was conducted at three pressures (8.27, 12.41, 16.55 MPa), three temperatures (75, 83 and 90 oC) and two flow rates (0.25 ml/sec and 0.5 ml/sec). Liposome size, zeta potential and encapsulation efficiency were characterized as functions of the operating parameters. The average liposomal size varied from 400-500 nm to 1000-1200 nm when the pressure was increased from 8.27 to 16.55 MPa. At 12.41 MPa, 90 oC and 0.25 ml per second of 0.2 M glucose cargo loading rate, the highest encapsulation efficiency of 31.65 % was achieved. Under a confocal laser scanning microscope, large unilamellar vesicles and multivesicular vesicles were observed to make up a majority of the liposomal emulsion. This new approach is a rapid and continuous process for bulk production of liposomes using a green solvent. Based on the results to date, it is feasible to apply this technique to encapsulate hydrophilic compounds inside the aqueous core as well as lipophilic compounds in the phospholipid bilayers of the liposomes for controlled release, solubility improvement and targeted therapy of bioactive compounds.Keywords: liposome, micro encapsulation, supercritical carbon dioxide, non-toxic process
Procedia PDF Downloads 431822 Exposure to Nature: An Underutilized Component of Student Mental Health
Authors: Jeremy Bekker, Guy Salazar
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Introduction: Nature-exposure interventions on university campuses may serve as an effective addition to overburdened counseling and student support centers. Nature-exposure interventions can work as a preventative well-being enhancement measure on campuses, which can be used adjacently with existing health resources. Specifically, this paper analyzes how spending time in nature impacts psychological well-being, cognitive functioning, and physical health. The poster covers the core findings and recommendations of this paper, which has been previously published in the BYU undergraduate psychology journal Intuition. Research Goals and Method: The goal of this paper was to outline the potential benefits of nature exposure for students’ physical health, mental well-being, and academic success. Another objective of this paper was to outline potential research-based interventions that use campus green spaces to improve student outcomes. Given that the core objective of this paper was to identify and establish research-based nature exposure interventions that could be used on college campuses, a broad literature review focused on these areas. Specifically, the databases Scopus and PsycINFO were used to screen for research focused on psychological well-being, physical health, cognitive functioning, and nature exposure interventions. Outcomes: Nature exposure has been shown to help increase positive affect, life satisfaction, happiness, coping ability and subjective well-being. Further, nature exposure has been shown to decrease negative affect, lower mental distress, reduce cognitive load, and decrease negative psychological symptoms. Finally, nature exposure has been shown to lead to better physical health. Findings and Recommendations: Potential interventions include adding green space to university buildings and grounds, dedicating already natural environments as nature restoration areas, and providing means for outdoor excursions. Potential limitations and suggested areas for future research are also addressed. Many campuses already contain green spaces, defined as any part of an environment that is predominately made of natural elements, and these green spaces comprise an untapped resource that is relatively cheap and simple.Keywords: nature exposure, preventative care, undergraduate mental health, well-being intervention
Procedia PDF Downloads 214821 Combination of Diane-35 and Metformin to Treat Early Endometrial Carcinoma in PCOS Women with Insulin Resistance
Authors: Xin Li, Yan-Rong Guo, Jin-Fang Lin, Yi Feng, Håkan Billig, Ruijin Shao
Abstract:
Background: Young women with polycystic ovary syndrome (PCOS) have a high risk of developing endometrial carcinoma. There is a need for the development of new medical therapies that can reduce the need for surgical intervention so as to preserve the fertility of these patients. The aim of the study was to describe and discuss cases of PCOS and insulin resistance (IR) women with early endometrial carcinoma while being co-treated with Diane-35 and metformin. Methods: Five PCOS-IR women who were scheduled for diagnosis and therapy for early endometrial carcinoma were recruited. The hospital records and endometrial pathology reports were reviewed. All patients were co-treated with Diane-35 and metformin for 6 months to reverse the endometrial carcinoma and preserve their fertility. Before, during, and after treatment, endometrial biopsies and blood samples were obtained and oral glucose tolerance tests were performed. Endometrial pathology was evaluated. Body weight (BW), body mass index (BMI), follicle-stimulating hormone (FSH), luteinizing hormone (LH), total testosterone (TT), sex hormone-binding globulin (SHBG), free androgen index (FAI), insulin area under curve (IAUC), and homeostasis model assessment of insulin resistance (HOMA-IR) were determined. Results: Clinical stage 1a, low grade endometrial carcinoma was confirmed before treatment. After 6 months of co-treatment, all patients showed normal epithelia. No evidence of atypical hyperplasia or endometrial carcinoma was found. Co-treatment resulted in significant decreases in BW, BMI, TT, FAI, IAUC, and HOMA-IR in parallel with a significant increase in SHBG. There were no differences in the FSH and LH levels after co-treatment. Conclusions: Combined treatment with Diane-35 and metformin has the potential to revert the endometrial carcinoma into normal endometrial cells in PCOS-IR women. The cellular and molecular mechanisms behind this effect merit further investigation.Keywords: PCOS, progesterone resistance, insulin resistance, steroid hormone receptors, endometrial carcinoma
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