Search results for: likelihood ratio
1414 Peculiarities of the Clinical Course of the Osteoarthritis in Shift-Workers: Analysis of Clinical Data and Questionnaries
Authors: Oksana Mykytyuk
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Chronic desynchronosis is an important factor of progression of osteoarthritis in shift workers. 80 patients with primary osteoarthritis (female:male ratio = 3:1, average age: 57.6 years, average disease duration: 6.4 years, radiological stage: II-III) were examined, 42% reported systematic night shift-work for more than two years. Full clinical examination was performed, all patients filled in SF-36, WOMAC questonnaries, marked visual analog scales for estimation of pain intensity and general well-being. Patients who had been exposed to night work had significantly worse clinical course of osteoarthritis marked by more (27.5%, p < 0.05) extensive pain syndrome, especially at night hours, (10.00 pm-2.00 am period) and estimated life quality as poorer comparing those working at day time. Osteoarthritis initiation occurred at earlier age in them comparing those who worked in non-shifted regimen. They showed a trend to generalized affliction of bigger quantity of joint groups, higher frequency of synovitis as well. Shift-workers administered higher doses of non-steroid anti-inflammatory drugs (NSAIDs) and estimated their effect as lower (39.6% average daily relief vs 62.5% in non-shift workers after 10 days of regular application of therapy). Frequency of chronic NSAID-induced gastropathy was 25% higher among night-workers. Shift-workers are predisposed to worse course of osteoarthritis with marked clinical symptoms, requiring higher doses on NSAIDs and with inclination towards bigger frequency of complication. That should be kept in mind while developing individual treatment and secondary prophylaxis strategy.Keywords: desynchronosis, osteoarthritis, questionnaries, shift-work
Procedia PDF Downloads 1271413 The Factors Affecting on Promoting Productivity from Nurses' View
Authors: Mahnaz Sanjari, Sedigheh Salemi, Mohammad Mirzabeigi
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Nowadays, the world is facing a crisis of workforce and one of the most striking examples is the shortage of nurses. Nursing workforce productivity is related by various factors such as absenteeism, professional effectiveness and quality care. This cross-sectional study was conducted in 700 nurses who work in government hospitals from 35 hospitals of 9 provinces in Iran. The study was approved by the Nursing Council and was carried out with the authorization of the Research Ethics Committee. The questionnaire included 33 questions and 4 sub categories such as human resource, education and management. The reliability was evaluated by Cronbach's alpha (α=0/85). Statistical analyzes were performed, using SPSS version 16. The result showed that nurses emphasized on "respect to nurse-to-bed ratio" and less importance item was "using less experienced nurse". In addition, another important factor in clinical productivity is "Proper physical structure and amenities","good communication with colleagues" and "having good facilities". Also, "human resources at all levels of standard", "promoting on merit" and "well defined relationship in health system" are another important factors in productivity from nurse` view. The main managerial factor is "justice between employees" and the main educational component of productivity is “updating nursing knowledge”. The results show that more than half of the participants emphasized on the management and educational factors. Productivity as one of the main part of the health care quality leads to appropriate use of human and organizational resources, reduce cost services, and organizational development.Keywords: productivity, nursing services, workforce, cost services
Procedia PDF Downloads 3441412 Removal of Nickel and Vanadium from Crude Oil by Using Solvent Extraction and Electrochemical Process
Authors: Aliya Kurbanova, Nurlan Akhmetov, Abilmansur Yeshmuratov, Yerzhigit Sugurbekov, Ramiz Zulkharnay, Gulzat Demeuova, Murat Baisariyev, Gulnar Sugurbekova
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Last decades crude oils have tended to become more challenge to process due to increasing amounts of sour and heavy crude oils. Some crude oils contain high vanadium and nickel content, for example Pavlodar LLP crude oil, which contains more than 23.09 g/t nickel and 58.59 g/t vanadium. In this study, we used two types of metal removing methods such as solvent extraction and electrochemical. The present research is conducted for comparative analysis of the deasphalting with organic solvents (cyclohexane, carbon tetrachloride, chloroform) and electrochemical method. Applying the cyclic voltametric analysis (CVA) and Inductively coupled plasma mass spectrometry (ICP MS), these mentioned types of metal extraction methods were compared in this paper. Maximum efficiency of deasphalting, with cyclohexane as the solvent, in Soxhlet extractor was 66.4% for nickel and 51.2% for vanadium content from crude oil. Percentage of Ni extraction reached maximum of approximately 55% by using the electrochemical method in electrolysis cell, which was developed for this research and consists of three sections: oil and protonating agent (EtOH) solution between two conducting membranes which divides it from two capsules of 10% sulfuric acid and two graphite electrodes which cover all three parts in electrical circuit. Ions of metals pass through membranes and remain in acid solutions. The best result was obtained in 60 minutes with ethanol to oil ratio 25% to 75% respectively, current fits into the range from 0.3A to 0.4A, voltage changed from 12.8V to 17.3V.Keywords: demetallization, deasphalting, electrochemical removal, heavy metals, petroleum engineering, solvent extraction
Procedia PDF Downloads 3261411 Valorisation of Waste Chicken Feathers: Electrospun Antibacterial Nanoparticles-Embedded Keratin Composite Nanofibers
Authors: Lebogang L. R. Mphahlele, Bruce B. Sithole
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Chicken meat is the highest consumed meat in south Africa, with a per capita consumption of >33 kg yearly. Hence, South Africa produces over 250 million kg of waste chicken feathers each year, the majority of which is landfilled or incinerated. The discarded feathers have caused environmental pollution and natural protein resource waste. Therefore, the valorisation of waste chicken feathers is measured as a more environmentally friendly and cost-effective treatment. Feather contains 91% protein, the main component being beta-keratin, a fibrous and insoluble structural protein extensively cross linked by disulfide bonds. Keratin is usually converted it into nanofibers via electrospinning for a variety of applications. keratin nanofiber composites have many potential biomedical applications for their attractive features, such as high surface-to-volume ratio and very high porosity. The application of nanofibers in the biomedical wound dressing requires antimicrobial properties for materials. One approach is incorporating inorganic nanoparticles, among which silver nanoparticles played an important alternative antibacterial agent and have been studied against many types of microbes. The objective of this study is to combine synthetic polymer, chicken feather keratin, and antibacterial nanoparticles to develop novel electrospun antibacterial nanofibrous composites for possible wound dressing application. Furthermore, this study will converting a two-dimensional electrospun nanofiber membrane to three-dimensional fiber networks that resemble the structure of the extracellular matrix (ECM)Keywords: chicken feather keratin, nanofibers, nanoparticles, nanocomposites, wound dressing
Procedia PDF Downloads 1321410 The Overlooked Problem Among Surgical Patients: Preoperative Anxiety at Ethiopian University Hospital
Authors: Yohtahe Woldegerima Berhe, Tadesse Belayneh Melkie, Girmay Fitiwi Lema, Marye Getnet, Wubie Birlie Chekol
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Introduction: Anxiety was repeatedly reported as the worst aspect of the perioperative time. The objective of this study was to assess the prevalence of preoperative anxiety among adult surgical patients at the University of Gondar Comprehensive Specialized Hospital (UoGCSH), Northwest Ethiopia. Methodology: Hospital-based cross-sectional study was conducted among surgical patients at the university hospital. After obtaining ethical approval, 407 surgical patients were approached during the preoperative period. Preoperative anxiety was assessed by the State-Trait Anxiety Inventory. The association between variables was determined by using binary logistic regression analysis. The strength of association was described in adjusted odds ratio (AOR) and a p-value < 0.05 at a 95% confidence interval which was considered statistically significant. Results: A total of 400 patients were included in this study, with a 98.3% response rate. Preoperative anxiety was observed among 237 (59.3%) patients, and the median (IQR) STAI score was 50 (40 – 56.7). age ≥ 60 years (AOR: 5.7, CI: 1.6 – 20.4, P: 0.007), emergency surgery (AOR: 2.5, CI: 1.3 – 4.7, P: 0.005), preoperative pain (AOR: 2.6, CI: 1.2 – 5.4, P: 0.005), and rural residency (AOR: 1.8, CI: 1.1 – 2.9, P: 0.031) were found significantly associated with preoperative anxiety. Conclusions: The prevalence of preoperative anxiety among surgical patients was high. Older age (≥ 60 years), emergency surgery, preoperative pain, and rural residency were found to be significantly associated with preoperative anxiety. Assessment for preoperative anxiety should be a routine component of preoperative assessment of both elective and emergency surgical patients. Preoperative pain should be appropriately managed as it can help to reduce preoperative anxiety. Optimal anxiety reduction methods should be investigated and implemented in the hospital.Keywords: preoperative anxiety, anxiety, anxiety of anesthesia and surgery, state-trait anxiety inventory, preoperative care
Procedia PDF Downloads 151409 Pilot-free Image Transmission System of Joint Source Channel Based on Multi-Level Semantic Information
Authors: Linyu Wang, Liguo Qiao, Jianhong Xiang, Hao Xu
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In semantic communication, the existing joint Source Channel coding (JSCC) wireless communication system without pilot has unstable transmission performance and can not effectively capture the global information and location information of images. In this paper, a pilot-free image transmission system of joint source channel based on multi-level semantic information (Multi-level JSCC) is proposed. The transmitter of the system is composed of two networks. The feature extraction network is used to extract the high-level semantic features of the image, compress the information transmitted by the image, and improve the bandwidth utilization. Feature retention network is used to preserve low-level semantic features and image details to improve communication quality. The receiver also is composed of two networks. The received high-level semantic features are fused with the low-level semantic features after feature enhancement network in the same dimension, and then the image dimension is restored through feature recovery network, and the image location information is effectively used for image reconstruction. This paper verifies that the proposed multi-level JSCC algorithm can effectively transmit and recover image information in both AWGN channel and Rayleigh fading channel, and the peak signal-to-noise ratio (PSNR) is improved by 1~2dB compared with other algorithms under the same simulation conditions.Keywords: deep learning, JSCC, pilot-free picture transmission, multilevel semantic information, robustness
Procedia PDF Downloads 1201408 Improving Biodegradation Behavior of Fabricated WE43 Magnesium Alloy by High-Temperature Oxidation
Authors: Jinge Liu, Shuyuan Min, Bingchuan Liu, Bangzhao Yin, Bo Peng, Peng Wen, Yun Tian
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WE43 magnesium alloy can be additively manufactured via laser powder bed fusion (LPBF) for biodegradable applications, but the as-built WE43 exhibits an excessively rapid corrosion rate. High-temperature oxidation (HTO) was performed on the as-built WE43 to improve its biodegradation behavior. A sandwich structure including an oxide layer at the surface, a transition layer in the middle, and the matrix was generated influenced by the oxidation reaction and diffusion of RE atoms when heated at 525 ℃for 8 hours. The oxide layer consisted of Y₂O₃ and Nd₂O₃ oxides with a thickness of 2-3 μm. The transition layer is composed of α-Mg and Y₂O₃ with a thickness of 60-70 μm, while Mg24RE5 could be observed except α-Mg and Y₂O₃. The oxide layer and transition layer appeared to have an effective passivation effect. The as-built WE43 lost 40% weight after the in vitro immersion test for three days and finally broke into debris after seven days of immersion. The high-temperature oxidation samples kept the structural integrity and lost only 6.88 % weight after 28-day immersion. The corrosion rate of HTO samples was significantly controlled, which improved the biocompatibility of the as-built WE43 at the same time. The samples after HTO had better osteogenic capability according to ALP activity. Moreover, as built WE43 performed unqualified in cell adhesion and hemolytic test due to its excessively rapid corrosion rate. While as for HTO samples, cells adhered well, and the hemolysis ratio was only 1.59%.Keywords: laser powder bed fusion, biodegradable metal, high temperature oxidation, biodegradation behavior, WE43
Procedia PDF Downloads 1051407 Offline High Voltage Diagnostic Test Findings on 15MVA Generator of Basochhu Hydropower Plant
Authors: Suprit Pradhan, Tshering Yangzom
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Even with availability of the modern day online insulation diagnostic technologies like partial discharge monitoring, the measurements like Dissipation Factor (tanδ), DC High Voltage Insulation Currents, Polarization Index (PI) and Insulation Resistance Measurements are still widely used as a diagnostic tools to assess the condition of stator insulation in hydro power plants. To evaluate the condition of stator winding insulation in one of the generators that have been operated since 1999, diagnostic tests were performed on the stator bars of 15 MVA generators of Basochhu Hydropower Plant. This paper presents diagnostic study done on the data gathered from the measurements which were performed in 2015 and 2016 as part of regular maintenance as since its commissioning no proper aging data were maintained. Measurement results of Dissipation Factor, DC High Potential tests and Polarization Index are discussed with regard to their effectiveness in assessing the ageing condition of the stator insulation. After a brief review of the theoretical background, the strengths of each diagnostic method in detecting symptoms of insulation deterioration are identified. The interesting results observed from Basochhu Hydropower Plant is taken into consideration to conclude that Polarization Index and DC High Voltage Insulation current measurements are best suited for the detection of humidity and contamination problems and Dissipation Factor measurement is a robust indicator of long-term ageing caused by oxidative degradation.Keywords: dissipation Factor (tanδ), polarization Index (PI), DC High Voltage Insulation Current, insulation resistance (IR), Tan Delta Tip-Up, dielectric absorption ratio
Procedia PDF Downloads 3121406 Continuous FAQ Updating for Service Incident Ticket Resolution
Authors: Kohtaroh Miyamoto
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As enterprise computing becomes more and more complex, the costs and technical challenges of IT system maintenance and support are increasing rapidly. One popular approach to managing IT system maintenance is to prepare and use an FAQ (Frequently Asked Questions) system to manage and reuse systems knowledge. Such an FAQ system can help reduce the resolution time for each service incident ticket. However, there is a major problem where over time the knowledge in such FAQs tends to become outdated. Much of the knowledge captured in the FAQ requires periodic updates in response to new insights or new trends in the problems addressed in order to maintain its usefulness for problem resolution. These updates require a systematic approach to define the exact portion of the FAQ and its content. Therefore, we are working on a novel method to hierarchically structure the FAQ and automate the updates of its structure and content. We use structured information and the unstructured text information with the timelines of the information in the service incident tickets. We cluster the tickets by structured category information, by keywords, and by keyword modifiers for the unstructured text information. We also calculate an urgency score based on trends, resolution times, and priorities. We carefully studied the tickets of one of our projects over a 2.5-year time period. After the first 6 months, we started to create FAQs and confirmed they improved the resolution times. We continued observing over the next 2 years to assess the ongoing effectiveness of our method for the automatic FAQ updates. We improved the ratio of tickets covered by the FAQ from 32.3% to 68.9% during this time. Also, the average time reduction of ticket resolution was between 31.6% and 43.9%. Subjective analysis showed more than 75% reported that the FAQ system was useful in reducing ticket resolution times.Keywords: FAQ system, resolution time, service incident tickets, IT system maintenance
Procedia PDF Downloads 3381405 Convertible Lease, Risky Debt and Financial Structure with Growth Option
Authors: Ons Triki, Fathi Abid
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The basic objective of this paper is twofold. It resides in designing a model for a contingent convertible lease contract that can ensure the financial stability of a company and recover the losses of the parties to the lease in the event of default. It also aims to compare the convertible lease contract on inefficiencies resulting from the debt-overhang problem and asset substitution with other financing policies. From this perspective, this paper highlights the interaction between investments and financing policies in a dynamic model with existing assets and a growth option where the investment cost is financed by a contingent convertible lease and equity. We explore the impact of the contingent convertible lease on the capital structure. We also check the reliability and effectiveness of the use of the convertible lease contract as a means of financing. Findings show that the rental convertible contract with a sufficiently high conversion ratio has less severe inefficiencies arising from risk-shifting and debt overhang than those entailed by risky debt and pure-equity financing. The problem of underinvestment pointed out by Mauer and Ott (2000) and the problem of overinvestment mentioned by Hackbarth and Mauer (2012) may be reduced under contingent convertible lease financing. Our findings predict that the firm value under contingent convertible lease financing increases globally with asset volatility instead of decreasing with business risk. The study reveals that convertible leasing contracts can stand for a reliable solution to ensure the lessee and quickly recover the counterparties of the lease upon default.Keywords: contingent convertible lease, growth option, debt overhang, risk-shifting, capital structure
Procedia PDF Downloads 721404 Improvement of Ventilation and Thermal Comfort Using the Atrium Design for Traditional Folk Houses-Fujian Earthen Building
Authors: Ying-Ming Su
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Fujian earthen building which was known as a classic for ecological buildings was listed on the world heritage in 2008 (UNESCO) in China. Its design strategy can be applied to modern architecture planning and design. This study chose two different cases (Round Atrium: Er-Yi Building, Double Round Atrium: Zhen-Chen Building) of earthen building in Fu-Jian to compare the ventilation effects of different atrium forms. We adopt field measurements and computational fluid dynamics (CFD) simulation of temperature, humidity, and wind environment to identify the relationship between external environment and atrium about comfort and to confirm the relationship about atrium H/W (height/width). Results indicate that, through the atrium convection effect, it makes the natural wind guides to each space surrounded and keeps indoor comfort. It illustrates that the smaller the ratio of the H/W which is the relationship between the height and the width of an atrium is, the greater the wind speed generated within the street valley. Moreover, the wind speed is very close to the reference wind speed. This field measurement verifies that the value of H/W has great influence of solar radiation heat and sunshine shadows. The ventilation efficiency is: Er-Yi Building (H/W =0.2778) > Zhen-Chen Building (H/W=0.3670). Comparing the cases with the same shape but with different H/W, through the different size patios, airflow revolves in the atriums and can be brought into each interior space. The atrium settings meet the need of building ventilation, and can adjust the humidity and temperature within the buildings. It also creates good ventilation effect.Keywords: traditional folk houses, atrium, tulou, ventilation, building microclimate
Procedia PDF Downloads 4751403 Geospatial Techniques and VHR Imagery Use for Identification and Classification of Slums in Gujrat City, Pakistan
Authors: Muhammad Ameer Nawaz Akram
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The 21st century has been revealed that many individuals around the world are living in urban settlements than in rural zones. The evolution of numerous cities in emerging and newly developed countries is accompanied by the rise of slums. The precise definition of a slum varies countries to countries, but the universal harmony is that slums are dilapidated settlements facing severe poverty and have lacked access to sanitation, water, electricity, good living styles, and land tenure. The slum settlements always vary in unique patterns within and among the countries and cities. The core objective of this study is the spatial identification and classification of slums in Gujrat city Pakistan from very high-resolution GeoEye-1 (0.41m) satellite imagery. Slums were first identified using GPS for sample site identification and ground-truthing; through this process, 425 slums were identified. Then Object-Oriented Analysis (OOA) was applied to classify slums on digital image. Spatial analysis softwares, e.g., ArcGIS 10.3, Erdas Imagine 9.3, and Envi 5.1, were used for processing data and performing the analysis. Results show that OOA provides up to 90% accuracy for the identification of slums. Jalal Cheema and Allah Ho colonies are severely affected by slum settlements. The ratio of criminal activities is also higher here than in other areas. Slums are increasing with the passage of time in urban areas, and they will be like a hazardous problem in coming future. So now, the executive bodies need to make effective policies and move towards the amelioration process of the city.Keywords: slums, GPS, satellite imagery, object oriented analysis, zonal change detection
Procedia PDF Downloads 1341402 Synthesis, Characterization, and Application of Novel Trihexyltetradecyl Phosphonium Chloride for Extractive Desulfurization of Liquid Fuel
Authors: Swapnil A. Dharaskar, Kailas L. Wasewar, Mahesh N. Varma, Diwakar Z. Shende
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Owing to the stringent environmental regulations in many countries for production of ultra low sulfur petroleum fractions intending to reduce sulfur emissions results in enormous interest in this area among the scientific community. The requirement of zero sulfur emissions enhances the prominence for more advanced techniques in desulfurization. Desulfurization by extraction is a promising approach having several advantages over conventional hydrodesulphurization. Present work is dealt with various new approaches for desulfurization of ultra clean gasoline, diesel and other liquid fuels by extraction with ionic liquids. In present paper experimental data on extractive desulfurization of liquid fuel using trihexyl tetradecyl phosphonium chloride has been presented. The FTIR, 1H-NMR, and 13C-NMR have been discussed for the molecular confirmation of synthesized ionic liquid. Further, conductivity, solubility, and viscosity analysis of ionic liquids were carried out. The effects of reaction time, reaction temperature, sulfur compounds, ultrasonication, and recycling of ionic liquid without regeneration on removal of dibenzothiphene from liquid fuel were also investigated. In extractive desulfurization process, the removal of dibenzothiophene in n-dodecane was 84.5% for mass ratio of 1:1 in 30 min at 30OC under the mild reaction conditions. Phosphonium ionic liquids could be reused five times without a significant decrease in activity. Also, the desulfurization of real fuels, multistage extraction was examined. The data and results provided in present paper explore the significant insights of phosphonium based ionic liquids as novel extractant for extractive desulfurization of liquid fuels.Keywords: ionic liquid, PPIL, desulfurization, liquid fuel, extraction
Procedia PDF Downloads 6091401 Production of New Hadron States in Effective Field Theory
Authors: Qi Wu, Dian-Yong Chen, Feng-Kun Guo, Gang Li
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In the past decade, a growing number of new hadron states have been observed, which are dubbed as XYZ states in the heavy quarkonium mass regions. In this work, we present our study on the production of some new hadron states. In particular, we investigate the processes Υ(5S,6S)→ Zb (10610)/Zb (10650)π, Bc→ Zc (3900)/Zc (4020)π and Λb→ Pc (4312)/Pc (4440)/Pc (4457)K. (1) For the production of Zb (10610)/Zb (10650) from Υ(5S,6S) decay, two types of bottom-meson loops were discussed within a nonrelativistic effective field theory. We found that the loop contributions with all intermediate states being the S-wave ground state bottom mesons are negligible, while the loops with one bottom meson being the broad B₀* or B₁' resonance could provide the dominant contributions to the Υ(5S)→ Zb⁽'⁾ π. (2) For the production of Zc (3900)/Zc (4020) from Bc decay, the branching ratios of Bc⁺→ Z (3900)⁺ π⁰ and Bc⁺→ Zc (4020)⁺ π⁰ are estimated to be of order of 10⁽⁻⁴⁾ and 10⁽⁻⁷⁾ in an effective Lagrangian approach. The large production rate of Zc (3900) could provide an important source of the production of Zc (3900) from the semi-exclusive decay of b-flavored hadrons reported by D0 Collaboration, which can be tested by the exclusive measurements in LHCb. (3) For the production of Pc (4312), Pc (4440) and Pc (4457) from Λb decay, the ratio of the branching fraction of Λb→ Pc K was predicted in a molecular scenario by using an effective Lagrangian approach, which is weakly dependent on our model parameter. We also find the ratios of the productions of the branching fractions of Λb→ Pc K and Pc→ J/ψ p can be well interpreted in the molecular scenario. Moreover, the estimated branching fractions of Λb→ Pc K are of order 10⁽⁻⁶⁾, which could be tested by further measurements in LHCb Collaboration.Keywords: effective Lagrangian approach, hadron loops, molecular states, new hadron states
Procedia PDF Downloads 1321400 Addressing Primary Care Clinician Burnout in a Value Based Care Setting During the COVID-19 Pandemic
Authors: Robert E. Kenney, Efrain Antunez, Samuel Nodal, Ameer Malik, Richard B. Aguilar
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Physician burnout has gained much attention during the COVID pandemic. After-hours workload, HCC coding, HEDIS metrics, and clinical documentation negatively impact career satisfaction. These and other influences have increased the rate of physicians leaving the workforce. In addition, roughly 1% of the entire physician workforce will be retiring earlier than expected based on pre-pandemic trends. The two Medical Specialties with the highest rates of burnout are Family Medicine and Primary Care. With a predicted shortage of primary care physicians looming, the need to address physician burnout is crucial. Commonly reported issues leading to clinician burnout are clerical documentation requirements, increased time working on Electronic Health Records (EHR) after hours, and a decrease in work-life balance. Clinicians experiencing burnout with physical and emotional exhaustion are at an increased likelihood of providing lower quality and less efficient patient care. This may include a lack of suitable clinical documentation, medication reconciliation, clinical assessment, and treatment plans. While the annual baseline turnover rates of physicians hover around 6-7%, the COVID pandemic profoundly disrupted the delivery of healthcare. A report found that 43% of physicians switched jobs during the initial two years of the COVID pandemic (2020 and 2021), tripling the expected average annual rate to 21.5 %/yr. During this same time, an average of 4% and 1.5% of physicians retired or left the workforce for a non-clinical career, respectively. The report notes that 35.2% made career changes for a better work-life balance and another 35% reported the reason as being unhappy with their administration’s response to the pandemic. A physician-led primary care-focused health organization, Cano Health (CH), based out of Florida, sought to preemptively address this problem by implementing several supportive measures. Working with >120 clinics and >280 PCPs from Miami to Tampa and Orlando, managing nearly 120,000 Medicare Advantage lives, CH implemented a number of changes to assist with the clinician’s workload. Supportive services such as after hour and home visits by APRNs, in-clinic care managers, and patient educators were implemented. In 2021, assistive Artificial Intelligence Software (AIS) was integrated into the EHR platform. This AIS converts free text within PDF files into a usable (copy-paste) format facilitating documentation. The software also systematically and chronologically organizes clinical data, including labs, medical records, consultations, diagnostic images, medications, etc., into an easy-to-use organ system or chronic disease state format. This reduced the excess time and documentation burden required to meet payor and CMS guidelines. A clinician Documentation Support team was employed to improve the billing/coding performance. The effects of these newly designed workflow interventions were measured via analysis of clinician turnover from CH’s hiring and termination reporting software. CH’s annualized average clinician turnover rate in 2020 and 2021 were 17.7% and 12.6%, respectively. This represents a 30% relative reduction in turnover rate compared to the reported national average of 21.5%. Retirement rates during both years were 0.1%, demonstrating a relative reduction of >95% compared to the national average (4%). This model successfully promoted the retention of clinicians in a Value-Based Care setting.Keywords: clinician burnout, COVID-19, value-based care, burnout, clinician retirement
Procedia PDF Downloads 821399 Advanced Magnetic Resonance Imaging in Differentiation of Neurocysticercosis and Tuberculoma
Authors: Rajendra N. Ghosh, Paramjeet Singh, Niranjan Khandelwal, Sameer Vyas, Pratibha Singhi, Naveen Sankhyan
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Background: Tuberculoma and neurocysticercosis (NCC) are two most common intracranial infections in developing country. They often simulate on neuroimaging and in absence of typical imaging features cause significant diagnostic dilemmas. Differentiation is extremely important to avoid empirical exposure to antitubercular medications or nonspecific treatment causing disease progression. Purpose: Better characterization and differentiation of CNS tuberculoma and NCC by using morphological and multiple advanced functional MRI. Material and Methods: Total fifty untreated patients (20 tuberculoma and 30 NCC) were evaluated by using conventional and advanced sequences like CISS, SWI, DWI, DTI, Magnetization transfer (MT), T2Relaxometry (T2R), Perfusion and Spectroscopy. rCBV,ADC,FA,T2R,MTR values and metabolite ratios were calculated from lesion and normal parenchyma. Diagnosis was confirmed by typical biochemical, histopathological and imaging features. Results: CISS was most useful sequence for scolex detection (90% on CISS vs 73% on routine sequences). SWI showed higher scolex detection ability. Mean values of ADC, FA,T2R from core and rCBV from wall of lesion were significantly different in tuberculoma and NCC (P < 0.05). Mean values of rCBV, ADC, T2R and FA for tuberculoma and NCC were (3.36 vs1.3), (1.09x10⁻³vs 1.4x10⁻³), (0.13 x10⁻³ vs 0.09 x10⁻³) and (88.65 ms vs 272.3 ms) respectively. Tuberculomas showed high lipid peak, more choline and lower creatinine with Ch/Cr ratio > 1. T2R value was most significant parameter for differentiation. Cut off values for each significant parameters have proposed. Conclusion: Quantitative MRI in combination with conventional sequences can better characterize and differentiate similar appearing tuberculoma and NCC and may be incorporated in routine protocol which may avoid brain biopsy and empirical therapy.Keywords: advanced functional MRI, differentiation, neurcysticercosis, tuberculoma
Procedia PDF Downloads 5671398 The Feasibility of Anaerobic Digestion at 45⁰C
Authors: Nuruol S. Mohd, Safia Ahmed, Rumana Riffat, Baoqiang Li
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Anaerobic digestion at mesophilic and thermophilic temperatures have been widely studied and evaluated by numerous researchers. Limited extensive research has been conducted on anaerobic digestion in the intermediate zone of 45°C, mainly due to the notion that limited microbial activity occurs within this zone. The objectives of this research were to evaluate the performance and the capability of anaerobic digestion at 45°C in producing class A biosolids, in comparison to a mesophilic and thermophilic anaerobic digestion system operated at 35°C and 55°C, respectively. In addition to that, the investigation on the possible inhibition factors affecting the performance of the digestion system at this temperature will be conducted as well. The 45°C anaerobic digestion systems were not able to achieve comparable methane yield and high-quality effluent compared to the mesophilic system, even though the systems produced biogas with about 62-67% methane. The 45°C digesters suffered from high acetate accumulation, but sufficient buffering capacity was observed as the pH, alkalinity and volatile fatty acids (VFA)-to-alkalinity ratio were within recommended values. The accumulation of acetate observed in 45°C systems were presumably due to the high temperature which contributed to high hydrolysis rate. Consequently, it produced a large amount of toxic salts that combined with the substrate making them not readily available to be consumed by methanogens. Acetate accumulation, even though contributed to 52 to 71% reduction in acetate degradation process, could not be considered as completely inhibitory. Additionally, at 45°C, no ammonia inhibition was observed and the digesters were able to achieve volatile solids (VS) reduction of 47.94±4.17%. The pathogen counts were less than 1,000 MPN/g total solids, thus, producing Class A biosolids.Keywords: 45°C anaerobic digestion, acetate accumulation, class A biosolids, salt toxicity
Procedia PDF Downloads 3041397 Toxic Ingredients Contained in Our Cosmetics
Authors: El Alia Boularas, H. Bekkar, H. Larachi, H. Rezk-kallah
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Introduction: Notwithstanding cosmetics are used in life every day, these products are not all innocuous and harmless, as they may contain ingredients responsible for allergic reactions and, possibly, for other health problems. Additionally, environmental pollution should be taken into account. Thus, it is time to investigate what is ‘hidden behind beauty’. Aims: 1.To investigate prevalence of 13 chemical ingredients in cosmetics being object of concern, which the Algerians use regularly. 2.To know the profile of questioned consumers and describe their opinion on cosmetics. Methods: The survey was carried out in year 2013 over a period of 3 months, among Algerian Internet users having an e-mail address or a Facebook account.The study investigated 13 chemical agents showing health and environmental problems, selected after analysis of the recent studies published on the subject, the lists of national and international regulatory references on chemical hazards, and querying the database Skin Deep presented by the Environmental Working Group. Results: 300 people distributed all over the Algerian territory participated in the survey, providing information about 731 cosmetics; 86% aged from 20 to 39 years, with a sex ratio=0,27. A percentage of 43% of the analyzed cosmetics contained at least one of the 13 toxic ingredients. The targeted ingredient that has been most frequently reported was ‘perfume’ followed by parabens and PEG.85% of the participants declared that cosmetics ‘can contain toxic substances’, 27% asserted that they verify regularly the list of ingredients when they buy cosmetics, 61% said that they try to avoid the toxic ingredients, among whom 24 % were more vigilant on the presence of parabens, 95% were in favour of the strengthening of the Algerian laws on cosmetics. Conclusion: The results of the survey provide the indication of a widespread presence of toxic chemical ingredients in personal care products that Algerians use daily.Keywords: Algerians consumers, cosmetics, survey, toxic ingredients
Procedia PDF Downloads 2771396 A Statistical Analysis on the Comparison of First and Second Waves of COVID-19 and Importance of Early Actions in Public Health for Third Wave in India
Authors: Maitri Dave
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Coronaviruses (CoV) is such infectious virus which has impacted globally in a more dangerous manner causing severe lung problems and leaving behind more serious diseases among the people. This pandemic has affected globally and created severe respiratory problems, and damaged the lungs. India has reported the first case of COVID-19 in January 2020. The first wave of COVID-19 took place from April to September of 2020. Soon after, a second peak is also noticed in the month of March 2021, which in turn becomes more dangerous due to a lack of supply of medical equipment. It created resource deficiency globally, specifically in India, where some necessary life-saving equipment like ventilators and oxygenators were not sufficient to cater to the demand-supply ratio effectively. Through carefully examining such a situation, India began to execute the process of vaccination in the month of January 2021 and successfully administered 25,46,71,259 doses of vaccines till now, which is only 15.5% of the total population while only 3.6% of the total population is fully vaccinated. India has authorized the British Oxford–AstraZeneca vaccine (Covishield), the Indian BBV152 (Covaxin) vaccine, and the Russian Sputnik V vaccine for emergency use. In the present study, we have collected all the data state wisely of both first and second wave and analyzed them using MS Excel Version 2019 and SPSS Statistics Version 26. Following the trends, we have predicted the characteristics of the upcoming third wave of COVID-19 and recommended some strategies, early actions, and measures that can be taken by the public health system in India to combat the third wave more effectively.Keywords: COVID-19, vaccination, Covishiled, Coronavirus
Procedia PDF Downloads 2161395 Effect of L-Dopa on Performance and Carcass Characteristics in Broiler Chickens
Authors: B. R. O. Omidiwura, A. F. Agboola, E. A. Iyayi
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Pure form of L-Dopa is used to enhance muscular development, fat breakdown and suppress Parkinson disease in humans. However, the L-Dopa in mucuna seed, when present with other antinutritional factors, causes nutritional disorders in monogastric animals. Information on the utilisation of pure L-Dopa in monogastric animals is scanty. Therefore, effect of L-Dopa on growth performance and carcass characteristics in broiler chickens was investigated. Two hundred and forty one-day-old chicks were allotted to six treatments, which consisted of a positive control (PC) with standard energy (3100Kcal/Kg) and negative control (NC) with high energy (3500Kcal/Kg). The rest 4 diets were NC+0.1, NC+0.2, NC+0.3 and NC+0.4% L-Dopa, respectively. All treatments had 4 replicates in a completely randomized design. Body weight gain, final weight, feed intake, dressed weight and carcass characteristics were determined. Body weight gain and final weight of birds fed PC were 1791.0 and 1830.0g, NC+0.1% L-Dopa were 1827.7 and 1866.7g and NC+0.2% L-Dopa were 1871.9 and 1910.9g respectively, and the feed intake of PC (3231.5g), were better than other treatments. The dressed weight at 1375.0g and 1357.1g of birds fed NC+0.1% and NC+0.2% L-Dopa, respectively, were similar but better than other treatments. Also, the thigh (202.5g and 194.9g) and the breast meat (413.8g and 410.8g) of birds fed NC+0.1% and NC+0.2% L-Dopa, respectively, were similar but better than birds fed other treatments. The drum stick of birds fed NC+0.1% L-Dopa (220.5g) was observed to be better than birds on other diets. Meat to bone ratio and relative organ weights were not affected across treatments. L-Dopa extract, at levels tested, had no detrimental effect on broilers, rather better bird performance and carcass characteristics were observed especially at 0.1% and 0.2% L-Dopa inclusion rates. Therefore, 0.2% inclusion is recommended in diets of broiler chickens for improved performance and carcass characteristics.Keywords: broilers, carcass characteristics, l-dopa, performance
Procedia PDF Downloads 3091394 An Investigation into Why Liquefaction Charts Work: A Necessary Step toward Integrating the States of Art and Practice
Authors: Tarek Abdoun, Ricardo Dobry
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This paper is a systematic effort to clarify why field liquefaction charts based on Seed and Idriss’ Simplified Procedure work so well. This is a necessary step toward integrating the states of the art (SOA) and practice (SOP) for evaluating liquefaction and its effects. The SOA relies mostly on laboratory measurements and correlations with void ratio and relative density of the sand. The SOP is based on field measurements of penetration resistance and shear wave velocity coupled with empirical or semi-empirical correlations. This gap slows down further progress in both SOP and SOA. The paper accomplishes its objective through: a literature review of relevant aspects of the SOA including factors influencing threshold shear strain and pore pressure buildup during cyclic strain-controlled tests; a discussion of factors influencing field penetration resistance and shear wave velocity; and a discussion of the meaning of the curves in the liquefaction charts separating liquefaction from no liquefaction, helped by recent full-scale and centrifuge results. It is concluded that the charts are curves of constant cyclic strain at the lower end (Vs1 < 160 m/s), with this strain being about 0.03 to 0.05% for earthquake magnitude, Mw ≈ 7. It is also concluded, in a more speculative way, that the curves at the upper end probably correspond to a variable increasing cyclic strain and Ko, with this upper end controlled by over consolidated and preshaken sands, and with cyclic strains needed to cause liquefaction being as high as 0.1 to 0.3%. These conclusions are validated by application to case histories corresponding to Mw ≈ 7, mostly in the San Francisco Bay Area of California during the 1989 Loma Prieta earthquake.Keywords: permeability, lateral spreading, liquefaction, centrifuge modeling, shear wave velocity charts
Procedia PDF Downloads 2971393 Cyclic Behaviour of Wide Beam-Column Joints with Shear Strength Ratios of 1.0 and 1.7
Authors: Roy Y. C. Huang, J. S. Kuang, Hamdolah Behnam
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Beam-column connections play an important role in the reinforced concrete moment resisting frame (RCMRF), which is one of the most commonly used structural systems around the world. The premature failure of such connections would severely limit the seismic performance and increase the vulnerability of RCMRF. In the past decades, researchers primarily focused on investigating the structural behaviour and failure mechanisms of conventional beam-column joints, the beam width of which is either smaller than or equal to the column width, while studies in wide beam-column joints were scarce. This paper presents the preliminary experimental results of two full-scale exterior wide beam-column connections, which are mainly designed and detailed according to ACI 318-14 and ACI 352R-02, under reversed cyclic loading. The ratios of the design shear force to the nominal shear strength of these specimens are 1.0 and 1.7, respectively, so as to probe into differences of the joint shear strength between experimental results and predictions by design codes of practice. Flexural failure dominated in the specimen with ratio of 1.0 in which full-width plastic hinges were observed, while both beam hinges and post-peak joint shear failure occurred for the other specimen. No sign of premature joint shear failure was found which is inconsistent with ACI codes’ prediction. Finally, a modification of current codes of practice is provided to accurately predict the joint shear strength in wide beam-column joint.Keywords: joint shear strength, reversed cyclic loading, seismic vulnerability, wide beam-column joints
Procedia PDF Downloads 3231392 Preparation of Carbon Nanofiber Reinforced HDPE Using Dialkylimidazolium as a Dispersing Agent: Effect on Thermal and Rheological Properties
Authors: J. Samuel, S. Al-Enezi, A. Al-Banna
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High-density polyethylene reinforced with carbon nanofibers (HDPE/CNF) have been prepared via melt processing using dialkylimidazolium tetrafluoroborate (ionic liquid) as a dispersion agent. The prepared samples were characterized by thermogravimetric (TGA) and differential scanning calorimetric (DSC) analyses. The samples blended with imidazolium ionic liquid exhibit higher thermal stability. DSC analysis showed clear miscibility of ionic liquid in the HDPE matrix and showed single endothermic peak. The melt rheological analysis of HDPE/CNF composites was performed using an oscillatory rheometer. The influence of CNF and ionic liquid concentration (ranging from 0, 0.5, and 1 wt%) on the viscoelastic parameters was investigated at 200 °C with an angular frequency range of 0.1 to 100 rad/s. The rheological analysis shows the shear-thinning behavior for the composites. An improvement in the viscoelastic properties was observed as the nanofiber concentration increases. The progress in the modulus values was attributed to the structural rigidity imparted by the high aspect ratio CNF. The modulus values and complex viscosity of the composites increased significantly at low frequencies. Composites blended with ionic liquid exhibit slightly lower values of complex viscosity and modulus over the corresponding HDPE/CNF compositions. Therefore, reduction in melt viscosity is an additional benefit for polymer composite processing as a result of wetting effect by polymer-ionic liquid combinations.Keywords: high-density polyethylene, carbon nanofibers, ionic liquid, complex viscosity
Procedia PDF Downloads 1271391 Comparison of Soil Test Extractants for Determination of Available Soil Phosphorus
Authors: Violina Angelova, Stefan Krustev
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The aim of this work was to evaluate the effectiveness of different soil test extractants for the determination of available soil phosphorus in five internationally certified standard soils, sludge and clay (NCS DC 85104, NCS DC 85106, ISE 859, ISE 952, ISE 998). The certified samples were extracted with the following methods/extractants: CaCl₂, CaCl₂ and DTPA (CAT), double lactate (DL), ammonium lactate (AL), calcium acetate lactate (CAL), Olsen, Mehlich 3, Bray and Kurtz I, and Morgan, which are commonly used in soil testing laboratories. The phosphorus in soil extracts was measured colorimetrically using Spectroquant Pharo 100 spectrometer. The methods used in the study were evaluated according to the recovery of available phosphorus, facility of application and rapidity of performance. The relationships between methods are examined statistically. A good agreement of the results from different soil test was established for all certified samples. In general, the P values extracted by the nine extraction methods significantly correlated with each other. When grouping the soils according to pH, organic carbon content and clay content, weaker extraction methods showed analogous trends; also among the stronger extraction methods, common tendencies were found. Other factors influencing the extraction force of the different methods include soil: solution ratio, as well as the duration and power of shaking the samples. The mean extractable P in certified samples was found to be in the order of CaCl₂ < CAT < Morgan < Bray and Kurtz I < Olsen < CAL < DL < Mehlich 3 < AL. Although the nine methods extracted different amounts of P from the certified samples, values of P extracted by the different methods were strongly correlated among themselves. Acknowledgment: The financial support by the Bulgarian National Science Fund Projects DFNI Н04/9 and DFNI Н06/21 are greatly appreciated.Keywords: available soil phosphorus, certified samples, determination, soil test extractants
Procedia PDF Downloads 1511390 Design and Manufacture of a Hybrid Gearbox Reducer System
Authors: Ahmed Mozamel, Kemal Yildizli
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Due to mechanical energy losses and a competitive of minimizing these losses and increases the machine efficiency, the need for contactless gearing system has raised. In this work, one stage of mechanical planetary gear transmission system integrated with one stage of magnetic planetary gear system is designed as a two-stage hybrid gearbox system. The permanent magnets internal energy in the form of the magnetic field is used to create meshing between contactless magnetic rotors in order to provide self-system protection against overloading and decrease the mechanical loss of the transmission system by eliminating the friction losses. Classical methods, such as analytical, tabular method and the theory of elasticity are used to calculate the planetary gear design parameters. The finite element method (ANSYS Maxwell) is used to predict the behaviors of a magnetic gearing system. The concentric magnetic gearing system has been modeled and analyzed by using 2D finite element method (ANSYS Maxwell). In addition to that, design and manufacturing processes of prototype components (a planetary gear, concentric magnetic gear, shafts and the bearings selection) of a gearbox system are investigated. The output force, the output moment, the output power and efficiency of the hybrid gearbox system are experimentally evaluated. The viability of applying a magnetic force to transmit mechanical power through a non-contact gearing system is presented. The experimental test results show that the system is capable to operate continuously within the range of speed from 400 rpm to 3000 rpm with the reduction ratio of 2:1 and maximum efficiency of 91%.Keywords: hybrid gearbox, mechanical gearboxes, magnetic gears, magnetic torque
Procedia PDF Downloads 1521389 Community Forest Management and Ecological and Economic Sustainability: A Two-Way Street
Authors: Sony Baral, Harald Vacik
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This study analyzes the sustainability of community forest management in two community forests in Terai and Hills of Nepal, representing four forest types: 1) Shorearobusta, 2) Terai hardwood, 3) Schima-Castanopsis, and 4) other Hills. The sustainability goals for this region include maintaining and enhancing the forest stocks. Considering this, we analysed changes in species composition, stand density, growing stock volume, and growth-to-removal ratio at 3-5 year intervals from 2005-2016 within 109 permanent forest plots (57 in the Terai and 52 in the Hills). To complement inventory data, forest users, forest committee members, and forest officials were consulted. The results indicate that the relative representation of economically valuable tree species has increased. Based on trends in stand density, both forests are being sustainably managed. Pole-sized trees dominated the diameter distribution, however, with a limited number of mature trees and declined regeneration. The forests were over-harvested until 2013 but under-harvested in the recent period in the Hills. In contrast, both forest types were under-harvested throughout the inventory period in the Terai. We found that the ecological dimension of sustainable forest management is strongly achieved while the economic dimension is lacking behind the current potential. Thus, we conclude that maintaining a large number of trees in the forest does not necessarily ensure both ecological and economical sustainability. Instead, priority should be given on a rational estimation of the annual harvest rates to enhance forest resource conditions together with regular benefits to the local communities.Keywords: community forests, diversity, growing stock, forest management, sustainability, nepal
Procedia PDF Downloads 971388 Understanding Mathematics Achievements among U. S. Middle School Students: A Bayesian Multilevel Modeling Analysis with Informative Priors
Authors: Jing Yuan, Hongwei Yang
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This paper aims to understand U.S. middle school students’ mathematics achievements by examining relevant student and school-level predictors. Through a variance component analysis, the study first identifies evidence supporting the use of multilevel modeling. Then, a multilevel analysis is performed under Bayesian statistical inference where prior information is incorporated into the modeling process. During the analysis, independent variables are entered sequentially in the order of theoretical importance to create a hierarchy of models. By evaluating each model using Bayesian fit indices, a best-fit and most parsimonious model is selected where Bayesian statistical inference is performed for the purpose of result interpretation and discussion. The primary dataset for Bayesian modeling is derived from the Program for International Student Assessment (PISA) in 2012 with a secondary PISA dataset from 2003 analyzed under the traditional ordinary least squares method to provide the information needed to specify informative priors for a subset of the model parameters. The dependent variable is a composite measure of mathematics literacy, calculated from an exploratory factor analysis of all five PISA 2012 mathematics achievement plausible values for which multiple evidences are found supporting data unidimensionality. The independent variables include demographics variables and content-specific variables: mathematics efficacy, teacher-student ratio, proportion of girls in the school, etc. Finally, the entire analysis is performed using the MCMCpack and MCMCglmm packages in R.Keywords: Bayesian multilevel modeling, mathematics education, PISA, multilevel
Procedia PDF Downloads 3361387 Self-Healing Phenomenon Evaluation in Cementitious Matrix with Different Water/Cement Ratios and Crack Opening Age
Authors: V. G. Cappellesso, D. M. G. da Silva, J. A. Arndt, N. dos Santos Petry, A. B. Masuero, D. C. C. Dal Molin
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Concrete elements are subject to cracking, which can be an access point for deleterious agents that can trigger pathological manifestations reducing the service life of these structures. Finding ways to minimize or eliminate the effects of this aggressive agents’ penetration, such as the sealing of these cracks, is a manner of contributing to the durability of these structures. The cementitious self-healing phenomenon can be classified in two different processes. The autogenous self-healing that can be defined as a natural process in which the sealing of this cracks occurs without the stimulation of external agents, meaning, without different materials being added to the mixture, while on the other hand, the autonomous seal-healing phenomenon depends on the insertion of a specific engineered material added to the cement matrix in order to promote its recovery. This work aims to evaluate the autogenous self-healing of concretes produced with different water/cement ratios and exposed to wet/dry cycles, considering two ages of crack openings, 3 days and 28 days. The self-healing phenomenon was evaluated using two techniques: crack healing measurement using ultrasonic waves and image analysis performed with an optical microscope. It is possible to observe that by both methods, it possible to observe the self-healing phenomenon of the cracks. For young ages of crack openings and lower water/cement ratios, the self-healing capacity is higher when compared to advanced ages of crack openings and higher water/cement ratios. Regardless of the crack opening age, these concretes were found to stabilize the self-healing processes after 80 days or 90 days.Keywords: sealf-healing, autogenous, water/cement ratio, curing cycles, test methods
Procedia PDF Downloads 1601386 Ecological-Economics Evaluation of Water Treatment Systems
Authors: Hwasuk Jung, Seoi Lee, Dongchoon Ryou, Pyungjong Yoo, Seokmo Lee
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The Nakdong River being used as drinking water sources for Pusan metropolitan city has the vulnerability of water management due to the fact that industrial areas are located in the upper Nakdong River. Most citizens of Busan think that the water quality of Nakdong River is not good, so they boil or use home filter to drink tap water, which causes unnecessary individual costs to Busan citizens. We need to diversify water intake to reduce the cost and to change the weak water source. Under this background, this study was carried out for the environmental accounting of Namgang dam water treatment system compared to Nakdong River water treatment system by using emergy analysis method to help making reasonable decision. Emergy analysis method evaluates quantitatively both natural environment and human economic activities as an equal unit of measure. The emergy transformity of Namgang dam’s water was 1.16 times larger than that of Nakdong River’s water. Namgang Dam’s water shows larger emergy transformity than that of Nakdong River’s water due to its good water quality. The emergy used in making 1 m3 tap water from Namgang dam water treatment system was 1.26 times larger than that of Nakdong River water treatment system. Namgang dam water treatment system shows larger emergy input than that of Nakdong river water treatment system due to its construction cost of new pipeline for intaking Namgang daw water. If the Won used in making 1 m3 tap water from Nakdong river water treatment system is 1, Namgang dam water treatment system used 1.66. If the Em-won used in making 1 m3 tap water from Nakdong river water treatment system is 1, Namgang dam water treatment system used 1.26. The cost-benefit ratio of Em-won was smaller than that of Won. When we use emergy analysis, which considers the benefit of a natural environment such as good water quality of Namgang dam, Namgang dam water treatment system could be a good alternative for diversifying intake source.Keywords: emergy, emergy transformity, Em-won, water treatment system
Procedia PDF Downloads 3061385 MAGE-A3 and PRAME Gene Expression and EGFR Mutation Status in Non-Small-Cell Lung Cancer
Authors: Renata Checiches, Thierry Coche, Nicolas F. Delahaye, Albert Linder, Fernando Ulloa Montoya, Olivier Gruselle, Karen Langfeld, An de Creus, Bart Spiessens, Vincent G. Brichard, Jamila Louahed, Frédéric F. Lehmann
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Background: The RNA-expression levels of cancer-testis antigens MAGE A3 and PRAME were determined in resected tissue from patients with primary non-small-cell lung cancer (NSCLC) and related to clinical outcome. EGFR, KRAS and BRAF mutation status was determined in a subset to investigate associations with MAGE A3 and PRAME expression. Methods: We conducted a single-centre, uncontrolled, retrospective study of 1260 tissue-bank samples from stage IA-III resected NSCLC. The prognostic value of antigen expression (qRT-PCR) was determined by hazard-ratio and Kaplan-Meier curves. Results: Thirty-seven percent (314/844) of tumours expressed MAGE-A3, 66% (723/1092) expressed PRAME and 31% (239/839) expressed both. Respective frequencies in squamous-cell tumours and adenocarcinomas were 43%/30% for MAGE A3 and 80%/44% for PRAME. No correlation with stage, tumour size or patient age was found. Overall, no prognostic value was identified for either antigen. A trend to poorer overall survival was associated with MAGE-A3 in stage IIIB and with PRAME in stage IB. EGFR and KRAS mutations were found in 10.1% (28/311) and 33.8% (97/311) of tumours, respectively. EGFR (but not KRAS) mutation status was negatively associated with PRAME expression. Conclusion: No clear prognostic value for either PRAME or MAGE A3 was observed in the overall population, although some observed trends may warrant further investigation.Keywords: MAGE A3, PRAME, cancer-testis gene, NSCLC, survival, EGFR
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