Search results for: systemic inflamatory response syndrome
2776 Enhancing Transfer Path Analysis with In-Situ Component Transfer Path Analysis for Interface Forces Identification
Authors: Raef Cherif, Houssine Bakkali, Wafaa El Khatiri, Yacine Yaddaden
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The analysis of how vibrations are transmitted between components is required in many engineering applications. Transfer path analysis (TPA) has been a valuable engineering tool for solving Noise, Vibration, and Harshness (NVH problems using sub-structuring applications. The most challenging part of a TPA analysis is estimating the equivalent forces at the contact points between the active and the passive side. Component TPA in situ Method calculates these forces by inverting the frequency response functions (FRFs) measured at the passive subsystem, relating the motion at indicator points to forces at the interface. However, matrix inversion could pose problems due to the ill-conditioning of the matrices leading to inaccurate results. This paper establishes a TPA model for an academic system consisting of two plates linked by four springs. A numerical study has been performed to improve the interface forces identification. Several parameters are studied and discussed, such as the singular value rejection and the number and position of indicator points chosen and used in the inversion matrix.Keywords: transfer path analysis, matrix inverse method, indicator points, SVD decomposition
Procedia PDF Downloads 822775 Modeling, Analysis and Control of a Smart Composite Structure
Authors: Nader H. Ghareeb, Mohamed S. Gaith, Sayed M. Soleimani
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In modern engineering, weight optimization has a priority during the design of structures. However, optimizing the weight can result in lower stiffness and less internal damping, causing the structure to become excessively prone to vibration. To overcome this problem, active or smart materials are implemented. The coupled electromechanical properties of smart materials, used in the form of piezoelectric ceramics in this work, make these materials well-suited for being implemented as distributed sensors and actuators to control the structural response. The smart structure proposed in this paper is composed of a cantilevered steel beam, an adhesive or bonding layer, and a piezoelectric actuator. The static deflection of the structure is derived as function of the piezoelectric voltage, and the outcome is compared to theoretical and experimental results from literature. The relation between the voltage and the piezoelectric moment at both ends of the actuator is also investigated and a reduced finite element model of the smart structure is created and verified. Finally, a linear controller is implemented and its ability to attenuate the vibration due to the first natural frequency is demonstrated.Keywords: active linear control, lyapunov stability theorem, piezoelectricity, smart structure, static deflection
Procedia PDF Downloads 3852774 Effect of Metarhizium robertsii in Rhipicephalus microplus hemocytes
Authors: Jessica P. Fiorotti, Maria C. Freitas, Caio J. B. Coutinho-Rodrigues, Mariana G. Camargo, Emily S. Mesquita, Amanda R. C. Corval, Ricardo O. B. Bitencourt, Allan F. Marciano, Diva D. Spadacci-Morena, Patricia S. Golo, Isabele C. Angelo, Vania R. E. P. Bittencourt
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The bovine tick, Rhipicephalus microplus, is an arthropod of great importance in veterinary medicine leading to anemia, weight loss, animals' leather depreciation and also acting as a vector of many pathogens. In this way, the parasitism causes a loss of 3.24 billion dollars per year in Brazil. Knowingly, entomopathogenic fungi act as natural controller of some arthropods, acting mainly by active penetration through the cuticle. However, it can also act on the hemolymph and through the production of mycotoxins. Hemocytes are responsible for the cellular immune response and participate in the processes of phagocytosis, nodulation and encapsulation and may undergo changes when challenged by pathogens. The aim of the present study was to evaluate changes in R. microplus hemocytes after inoculation of Metarhizium robertsii using transmission electron microscopy. The isolate ARSEF 2575 and 200 engorged R. microplus females were used. The groups were divided into control, in which the females were inoculated with 5 μL of sterile distilled water solution and 0.1% Tween 80, and a group inoculated with 5 μL of fungal suspension at the concentration of 10⁷ conidia mL⁻¹. The experiment was performed in duplicate and each group contained 50 females. Twenty-four hours after fungal inoculation, hemolymph was collected through the cuticle dorsal surface perforation of the tick females. After collection, the hemolymph samples were centrifuged at 500 x g for 3 minutes at 4 °C, the plasma was discarded and the hemocyte pellet was resuspended in 50 μl PBS. The suspension material was fixed in 2% glutaraldehyde in Millonig buffer for three hours. After fixation, the material was centrifuged at 500 x g for 3 minutes, the supernatant was discarded and the cells were resuspended in a wash solution. Subsequently, the cells were post-fixed with 1% osmium tetroxide in phosphate buffer for one hour at room temperature and dehydrated in increasing concentrations of ethanol, and then embedded in Epon resin. The ultrathin sections were examined under the LEO EM 906E transmission electron microscopy at 80kV. The ultrastructural results revealed that.in control group, the cells were considered intact, in which the granulocytes were observed with granules of different electrodensities, intact mitochondria and cytoplasm without vacuolization. In addition, granulocytes showed plasma membrane projections similar to pseudopodia. Plasmatocytes presented as irregularly shaped cells, with the eccentric nucleus, agranular cytoplasm and some cells presented pseudopodia. Nevertheless, in the group exposed to the fungus, most of the cells presented in degeneration. The granulocytes found had fewer granules in the cytoplasm and more vacuoles. Plasmatocytes, after treatment, presented many vacuoles also in the cytoplasm and the lysosomes presented great amount of electrodense material in their interior. Thus, the results suggest that the fungus has a depressant action in the immune system of the tick, not only by the cell degranulation, but also suggesting that this leads to morphological changes in the hemocytes and may even trigger processes such as phagocytosis.Keywords: bovine tick, cellular defense, entomopathogenic fungi, immune response
Procedia PDF Downloads 1882773 Mesalazine-Induced Myopericarditis in a Professional Athlete
Authors: Tristan R. Fraser, Christopher D. Steadman, Christopher J. Boos
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Myopericarditis is an inflammation syndrome characterised by clinical diagnostic criteria for pericarditis, such as chest pain, combined with evidence of myocardial involvement, such as elevation of biomarkers of myocardial damage, e.g., troponins. It can rarely be a complication of therapeutics used for dysregulated immune-mediated diseases such as inflammatory bowel disease (IBD), for example, mesalazine. The infrequency of mesalazine-induced myopericarditis adds to the challenge in its recognition. Rapid diagnosis and the early introduction of treatment are crucial. This case report follows a 24-year-old professional footballer with a past medical history of ulcerative colitis, recently started on mesalazine for disease control. Three weeks after mesalazine was initiated, he was admitted with fever, shortness of breath, and chest pain worse whilst supine and on deep inspiration, as well as elevated venous blood cardiac troponin T level (cTnT, 288ng/L; normal: <13ng/L). Myocarditis was confirmed on initial inpatient cardiac MRI, revealing the presence of florid myocarditis with preserved left ventricular systolic function and an ejection fraction of 67%. This was a longitudinal case study following the progress of a single individual with myopericarditis over four acute hospital admissions over nine weeks, with admissions ranging from two to five days. Parameters examined included clinical signs and symptoms, serum troponin, transthoracic echocardiogram, and cardiac MRI. Serial measurements of cardiac function, including cardiac MRI and transthoracic echocardiogram, showed progressive deterioration of cardiac function whilst mesalazine was continued. Prior to cessation of mesalazine, transthoracic echocardiography revealed a small global pericardial effusion of < 1cm and worsening left ventricular systolic function with an ejection fraction of 45%. After recognition of mesalazine as a potential cause and consequent cessation of the drug, symptoms resolved, with cardiac MRI performed as an outpatient showing resolution of myocardial oedema. The patient plans to make a return to competitive sport. Patients suffering from myopericarditis are advised to refrain from competitive sport for at least six months in order to reduce the risk of cardiac remodelling and sudden cardiac death. Additional considerations must be taken in individuals for whom competitive sport is an essential component of their livelihood, such as professional athletes. Myopericarditis is an uncommon, however potentially serious medical condition with a wide variety of aetiologies, including viral, autoimmune, and drug-related causes. Management is mainly supportive and relies on prompt recognition and removal of the aetiological process. Mesalazine-induced myopericarditis is a rare condition; as such increasing awareness of mesalazine as a precipitant of myopericarditis is vital for optimising the management of these patients.Keywords: myopericarditis, mesalazine, inflammatory bowel disease, professional athlete
Procedia PDF Downloads 1352772 Clinical Pathway for Postoperative Organ Transplantation
Authors: Tahsien Okasha
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Transplantation medicine is one of the most challenging and complex areas of modern medicine. Some of the key areas for medical management are the problems of transplant rejection, during which the body has an immune response to the transplanted organ, possibly leading to transplant failure and the need to immediately remove the organ from the recipient. When possible, transplant rejection can be reduced through serotyping to determine the most appropriate donor-recipient match and through the use of immunosuppressant drugs. Postoperative care actually begins before the surgery in terms of education, discharge planning, nutrition, pulmonary rehabilitation, and patient/family education. This also allows for expectations to be managed. A multidisciplinary approach is the key, and collaborative team meetings are essential to ensuring that all team members are "on the same page." .The following clinical pathway map and guidelines with the aim to decrease alteration in clinical practice and are intended for those healthcare professionals who look after organ transplant patients. They are also intended to be useful to both medical and surgical trainees as well as nurse specialists and other associated healthcare professionals involved in the care of organ transplant patients. This pathway is general pathway include the general guidelines that can be applicable for all types of organ transplant with special considerations to each organ.Keywords: postoperative care, organ transplant, clinical pathway, patient
Procedia PDF Downloads 4572771 Usage Of the Transpedicular Screw Fixation Method in the Treatment of Pediatric Patients with Injuries of the Thoracic and Lumbar Spine.
Authors: S. D. Zalepugin, A. E. Murzich, D. G. Satskevich, A. B. Palivanov
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Introduction. The incidence of spinal injuries in patients under 18 years of age has increased significantly in recent years, which represents a significant economic, social and medical problem. The most common method of surgical stabilization of spinal fractures in pediatric patients is transpedicular posterior spinal fusion, which is widely used by spinal neurosurgeons in adult patients. Purpose of the study: This study evaluates the results of treatment of thoracolumbar spine lesions in children using the transpedicular screw fixation method. Materials and methods. From 2019 to 2024, 35 children with injuries to the thoracic and lumbar spine underwent surgical treatment using the transpedicular screw fixation method. Among the injured, girls prevailed (21 cases, 60%). The age of the victims ranged from 9 to 17 years. The main causes of damage were: catatrauma (19 cases), road accident (5 cases), sports injury (6 cases), and other reasons - 5 cases. In 5 cases, suicidal attempts occurred. Co-injury was observed in most cases (20 patients, or 57%), which is natural for high-energy injury. Vertebral-spinal injury with neurological disorders was observed in 13 patients, the disorders ranged from mild inferior (4 children) to moderate/severe paraparesis (5 patients) and inferior paraplegia (4 children). 6 children had pelvic organ dysfunction in the form of urinary and fecal retention or incontinence. All thirty-five patients, within a period of 1 to 57 days after the injury, underwent several surgical interventions from the posterior surgical access using a screw fixation method (posterior decompression + spinal fusion). In 12 cases, it was necessary to perform the second stage of surgical treatment - anterior decompression of the spinal cord or its roots. Verticalization of patients was carried out within 1 to 5 days after surgery. Results. In all patients, the nearest, up to 1 year, results were evaluated. In children operated in 2019-2021, the results were studied in terms of 3 to 5 years. The procedures used, clinical results and the quality of the fixative installation were assessed. All patients managed to achieve positive results. The use of internal fixation made it possible to carry out early verticalization of children, eliminate pain syndrome and achieve a regression of neurological disorders in most patients (especially in cases when the operation was performed early after injury - from 1 to 3 days). Within the first month, the ability to self-care was fully restored. Bone fusion was observed within 6-12 months after surgery. There were no complications after surgery. The analysis of postoperative radiographs, CT and MRI images revealed the correct standing of the screws in all cases. Conclusion. The posterior spinal fusion using the new method of screw fixation in pediatric patients allows to achieve durable stabilization of damage, begins early rehabilitation of patients and reduces the duration of hospital treatment by 2-3 times. Thus, we recommend the use of a transpedicular fixator in children as a reliable, technically feasible method for restoring spinal stability with a low risk of intra- and postoperative complications.Keywords: pediatric patients, spinal injuries, transpedicular stabilization, operative treatment
Procedia PDF Downloads 32770 Developmental Difficulties Prevalence and Management Capacities among Children Including Genetic Disease in a North Coastal District of Andhra Pradesh, India: A Cross-sectional Study
Authors: Koteswara Rao Pagolu, Raghava Rao Tamanam
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The present study was aimed to find out the prevalence of DD's in Visakhapatnam, one of the north coastal districts of Andhra Pradesh, India during a span of five years. A cross-sectional investigation was held at District early intervention center (DEIC), Visakhapatnam from 2016 to 2020. To identify the pattern and trend of different DD's including seasonal variations, a retrospective analysis of the health center's inpatient database for the past 5 years was done. Male and female children aged 2 months-18 years are included in the study with the prior permission of the concerned medical officer. The screening tool developed by the Ministry of health and family welfare, India, was used for the study. Among 26,423 cases, children with birth defects are 962, 2229 with deficiencies, 7516 with diseases, and 15716 with disabilities were admitted during the study period. From birth defects, congenital deafness occurred in large numbers with 22.66%, and neural tube defect observed in a small number of cases with 0.83% during the period. From the side of deficiencies, severe acute malnutrition has mostly occurred (66.80 %) and a small number of children were affected with goiter (1.70%). Among the diseases, dental carriers (67.97%) are mostly found and these cases were at peak during the years 2016 and 2019. From disabilities, children with vision impairment (20.55%) have mostly approached the center. Over the past 5 years, the admission rate of down's syndrome and congenital deafness cases showed a rising trend up to 2019 and then declined. Hearing impairment, motor delay, and learning disorder showed a steep rise and gradual decline trend, whereas severe anemia, vitamin-D deficiency, otitis media, reactive airway disease, and attention deficit hyperactivity disorder showed a declining trend. However, congenital heart diseases, dental caries, and vision impairment admission rates showed a zigzag pattern over the past 5 years. This center had inadequate diagnostic facilities related to genetic disease management. For advanced confirmation, the cases are referred to a district government hospital or private diagnostic laboratories in the city for genetic tests. Information regarding the overall burden and pattern of admissions in the health center is obtained by the review of DEIC records. Through this study, it is observed that the incidence of birth defects, as well as genetic disease burden, is high in the Visakhapatnam district. Hence there is a need for strengthening of management services for these diseases in this region.Keywords: child health screening, developmental delays, district early intervention center, genetic disease management, infrastructural facility, Visakhapatnam district
Procedia PDF Downloads 2122769 Time Variance and Spillover Effects between International Crude Oil Price and Ten Emerging Equity Markets
Authors: Murad A. Bein
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This paper empirically examines the time-varying relationship and spillover effects between the international crude oil price and ten emerging equity markets, namely three oil-exporting countries (Brazil, Mexico, and Russia) and seven Central and Eastern European (CEE) countries (Bulgaria, Croatia, Czech Republic, Hungary, Poland, Romania, and Slovakia). The results revealed that there are spillover effects from oil markets into almost all emerging equity markets save Slovakia. Besides, the oil supply glut had a homogenous effect on the emerging markets, both net oil-exporting, and oil-importing countries (CEE). Further, the time variance drastically increased during financial turmoil. Indeed, the time variance remained high from 2009 to 2012 in response to aggregate demand shocks (global financial crisis and Eurozone debt crisis) and quantitative easing measures. Interestingly, the time variance was slightly higher for the oil-exporting countries than for some of the CEE countries. Decision-makers in emerging economies should therefore seek policy coordination when dealing with financial turmoil.Keywords: crude oil, spillover effects, emerging equity, time-varying, aggregate demand shock
Procedia PDF Downloads 1222768 Exploring Augmented Reality in Graphic Design: A Hybrid Pedagogical Model for Design Education
Authors: Nan Hu, Wujun Wang
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In the ever-changing digital arena, augmented reality (AR) applications have transitioned from technological enthusiasm into business endeavors, signaling a near future in which AR applications are integrated into daily life. While practitioners in the design industry continue to explore AR’s potential for innovative communication, educators have taken steps to incorporate AR into the curricula for design, explore its creative potential, and realize early initiatives for teaching AR in design-related disciplines. In alignment with recent advancements, this paper presents a pedagogical model for a hybrid studio course in which students collaborate with AR alongside 3D modeling and graphic design. The course extended students’ digital capacity, fostered their design thinking skills, and immersed them in a multidisciplinary design process. This paper outlines the course and evaluates its effectiveness by discussing challenges encountered and outcomes generated in this particular pedagogical context. By sharing insights from the teaching experience, we aim to empower the community of design educators and offer institutions a valuable reference for advancing their curricular approaches. This paper is a testament to the ever-evolving landscape of design education and its response to the digital age.Keywords: 3D, AR, augmented reality, design thinking, graphic design
Procedia PDF Downloads 682767 Environmentally Adaptive Acoustic Echo Suppression for Barge-in Speech Recognition
Authors: Jong Han Joo, Jung Hoon Lee, Young Sun Kim, Jae Young Kang, Seung Ho Choi
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In this study, we propose a novel technique for acoustic echo suppression (AES) during speech recognition under barge-in conditions. Conventional AES methods based on spectral subtraction apply fixed weights to the estimated echo path transfer function (EPTF) at the current signal segment and to the EPTF estimated until the previous time interval. We propose a new approach that adaptively updates weight parameters in response to abrupt changes in the acoustic environment due to background noises or double-talk. Furthermore, we devised a voice activity detector and an initial time-delay estimator for barge-in speech recognition in communication networks. The initial time delay is estimated using log-spectral distance measure, as well as cross-correlation coefficients. The experimental results show that the developed techniques can be successfully applied in barge-in speech recognition systems.Keywords: acoustic echo suppression, barge-in, speech recognition, echo path transfer function, initial delay estimator, voice activity detector
Procedia PDF Downloads 3712766 Islanding Detection of Wind Turbine by Rate of Change of Frequency (ROCOF) and Rate of change of Power (ROCOP) Method
Authors: Vipulkumar Jagodana
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Recently the use of renewable sources has increased, these sources include fuel cell, photo voltaic, and wind turbine. Islanding occurs when one portion of grid is isolated from remaining grid. Use of the renewable sources can provide continuous power to isolated portion in islanding condition. One of the common renewable sources is wind generation using wind turbine. The efficiency of wind generation can be increased in combination with conventional sources. When islanding occurs, few parameters change which may be frequency, voltage, active power, and harmonics. According to large change in one of these parameters islanding is detected. In this paper, two passive methods Rate of Change of Frequency (ROCOF) and Rate of change of Power (ROCOP) have been implemented for islanding detection of small wind-turbine. Islanding detection of both methods have been simulated in PSCAD. Simulation results show at different islanding inception angle response of ROCOF and ROCOP.Keywords: islanding, adopted methods, PSCAD simulation, comparison
Procedia PDF Downloads 2242765 Rejuvenation of Premature Ovarian Failure with Stem Cells/IVA Technique
Authors: Elham Vojoudi, Marzieh Mehrafza, Ahmad Hosseini, Azadeh Raofi, Maryam Najafi
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Premature ovarian failure (POF) has become one of the main causes of infertility in women of childbearing age and the incidence of this disorder is increasing year by year. In these patients, poor ovarian response (POR) to gonadotropins reflects a diminished ovarian reserve (DOR) that gives place to few follicles despite aggressive stimulation. Up to now, egg donation is the only way to resolve infertility problems in POF patients. Therefore, some novel aspects such as activating (Akt signaling pathway) and inhibiting (Hippo-signaling) elements have been identified as IVA procedure that promotes primordial follicle activation. In this study, we used the newly developed technique (combination of in vitro activation of dormant follicles (IVA) and stem cell therapy) to promote ovarian follicle growth much more efficiently than the natural, in vivo process for women with POF. Transplantation of Warton Jelly-MSCs to the ovaries of POF patients rescued overall ovarian function. Participants (10 patients) were followed up monthly for a period of six months by hormonal (AMH, FSH, LH and E2), clinical (resuming menstruation), and US (folliculometry) outcomes after a laparoscopic operation. In summary, IVA/WJ-MSC transplantation may provide an effective treatment for POF.Keywords: POF, in vitro activation, stem cell therapy, infertility
Procedia PDF Downloads 1292764 Analysis of the Diffusion Behavior of an Information and Communication Technology Platform for City Logistics
Authors: Giulio Mangano, Alberto De Marco, Giovanni Zenezini
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The concept of City Logistics (CL) has emerged to improve the impacts of last mile freight distribution in urban areas. In this paper, a System Dynamics (SD) model exploring the dynamics of the diffusion of a ICT platform for CL management across different populations is proposed. For the development of the model two sources have been used. On the one hand, the major diffusion variables and feedback loops are derived from a literature review of existing diffusion models. On the other hand, the parameters are represented by the value propositions delivered by the platform as a response to some of the users’ needs. To extract the most important value propositions the Business Model Canvas approach has been used. Such approach in fact focuses on understanding how a company can create value for her target customers. These variables and parameters are thus translated into a SD diffusion model with three different populations namely municipalities, logistics service providers, and own account carriers. Results show that, the three populations under analysis fully adopt the platform within the simulation time frame, highlighting a strong demand by different stakeholders for CL projects aiming at carrying out more efficient urban logistics operations.Keywords: city logistics, simulation, system dynamics, business model
Procedia PDF Downloads 2642763 Effect of Renin Angiotensin Pathway Inhibition on the Efficacy of Anti-programmed Cell Death (PD-1/L-1) Inhibitors in Advanced Non-small Cell Lung Cancer Patients- Comparison of Single Hospital Retrospective Assessment to the Published Literature
Authors: Esther Friedlander, Philip Friedlander
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The use of immunotherapy that inhibits programmed death-1 (PD-1) or its ligand PD-L1 confers survival benefits in patients with non-small cell lung cancer (NSCLC). However, approximately 45% of patients experience primary treatment resistance, necessitating the development of strategies to improve efficacy. While the renin-angiotensin system (RAS) has systemic hemodynamic effects, tissue-specific regulation exists along with modulation of immune activity in part through regulation of myeloid cell activity, leading to the hypothesis that RAS inhibition may improve anti-PD-1/L-1 efficacy. A retrospective analysis was conducted that included 173 advanced solid tumor cancer patients treated at Valley Hospital, a community Hospital in New Jersey, USA, who were treated with a PD-1/L-1 inhibitor in a defined time period showing a statistically significant relationship between RAS pathway inhibition (RASi through concomitant treatment with an ACE inhibitor or angiotensin receptor blocker) and positive efficacy to the immunotherapy that was independent of age, gender and cancer type. Subset analysis revealed strong numerical benefit for efficacy in both patients with squamous and nonsquamous NSCLC as determined by documented clinician assessment of efficacy and by duration of therapy. A PUBMED literature search was now conducted to identify studies assessing the effect of RAS pathway inhibition on anti-PD-1/L1 efficacy in advanced solid tumor patients and compare these findings to those seen in the Valley Hospital retrospective study with a focus on NSCLC specifically. A total of 11 articles were identified assessing the effects of RAS pathway inhibition on the efficacy of checkpoint inhibitor immunotherapy in advanced cancer patients. Of the 11 studies, 10 assessed the effect on survival of RASi in the context of treatment with anti-PD-1/PD-L1, while one assessed the effect on CTLA-4 inhibition. Eight of the studies included patients with NSCLC, while the remaining 2 were specific to genitourinary malignancies. Of the 8 studies, two were specific to NSCLC patients, with the remaining 6 studies including a range of cancer types, of which NSCLC was one. Of these 6 studies, only 2 reported specific survival data for the NSCLC subpopulation. Patient characteristics, multivariate analysis data and efficacy data seen in the 2 NSLCLC specific studies and in the 2 basket studies, which provided data on the NSCLC subpopulation, were compared to that seen in the Valley Hospital retrospective study supporting a broader effect of RASi on anti-PD-1/L1 efficacy in advanced NSLCLC with the majority of studies showing statistically significant benefit or strong statistical trends but with one study demonstrating worsened outcomes. This comparison of studies extends published findings to the community hospital setting and supports prospective assessment through randomized clinical trials of efficacy in NSCLC patients with pharmacodynamic components to determine the effect on immune cell activity in tumors and on the composition of the tumor microenvironment.Keywords: immunotherapy, cancer, angiotensin, efficacy, PD-1, lung cancer, NSCLC
Procedia PDF Downloads 682762 The English Classroom: Scope and Space for Motivation
Authors: Madhavi Godavarthy
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The globalized world has been witnessing the ubiquity of the English language and has made it mandatory that students be equipped with the required Communication and soft skills. For students and especially for students studying in technical streams, gaining command over the English language is only a part of the bigger challenges they will face in the future. Linguistic capabilities if blended with the right attitude and a positive personality would deliver better results in the present environment of the digitalized world. An English classroom has that ‘space’; a space if utilized well by the teacher can pay rich dividends. The prescribed syllabus for English in the process of adapting itself to the challenges of a more and more technical world has meted out an indifferent treatment in including ‘literary’ material in their curriculum. A debate has always existed regarding the same and diversified opinions have been given. When the student is motivated to reach Literature through intrinsic motivation, it may contribute to his/her personality-development. In the present paper, the element of focus is on the scope and space to motivate students by creating a specific space for herself/himself amidst the schedules of the teaching-learning processes by taking into consideration a few literary excerpts for the purpose.Keywords: English language, teaching and learning process, reader response theory, intrinsic motivation, literary texts
Procedia PDF Downloads 6132761 Preliminary Design of Maritime Energy Management System: Naval Architectural Approach to Resolve Recent Limitations
Authors: Seyong Jeong, Jinmo Park, Jinhyoun Park, Boram Kim, Kyoungsoo Ahn
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Energy management in the maritime industry is being required by economics and in conformity with new legislative actions taken by the International Maritime Organization (IMO) and the European Union (EU). In response, the various performance monitoring methodologies and data collection practices have been examined by different stakeholders. While many assorted advancements in operation and technology are applicable, their adoption in the shipping industry stays small. This slow uptake can be considered due to many different barriers such as data analysis problems, misreported data, and feedback problems, etc. This study presents a conceptual design of an energy management system (EMS) and proposes the methodology to resolve the limitations (e.g., data normalization using naval architectural evaluation, management of misrepresented data, and feedback from shore to ship through management of performance analysis history). We expect this system to make even short-term charterers assess the ship performance properly and implement sustainable fleet control.Keywords: data normalization, energy management system, naval architectural evaluation, ship performance analysis
Procedia PDF Downloads 4482760 Optimization of Geometric Parameters of Microfluidic Channels for Flow-Based Studies
Authors: Parth Gupta, Ujjawal Singh, Shashank Kumar, Mansi Chandra, Arnab Sarkar
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Microfluidic devices have emerged as indispensable tools across various scientific disciplines, offering precise control and manipulation of fluids at the microscale. Their efficacy in flow-based research, spanning engineering, chemistry, and biology, relies heavily on the geometric design of microfluidic channels. This work introduces a novel approach to optimise these channels through Response Surface Methodology (RSM), departing from the conventional practice of addressing one parameter at a time. Traditionally, optimising microfluidic channels involved isolated adjustments to individual parameters, limiting the comprehensive understanding of their combined effects. In contrast, our approach considers the simultaneous impact of multiple parameters, employing RSM to efficiently explore the complex design space. The outcome is an innovative microfluidic channel that consumes an optimal sample volume and minimises flow time, enhancing overall efficiency. The relevance of geometric parameter optimization in microfluidic channels extends significantly in biomedical engineering. The flow characteristics of porous materials within these channels depend on many factors, including fluid viscosity, environmental conditions (such as temperature and humidity), and specific design parameters like sample volume, channel width, channel length, and substrate porosity. This intricate interplay directly influences the performance and efficacy of microfluidic devices, which, if not optimized, can lead to increased costs and errors in disease testing and analysis. In the context of biomedical applications, the proposed approach addresses the critical need for precision in fluid flow. it mitigate manufacturing costs associated with trial-and-error methodologies by optimising multiple geometric parameters concurrently. The resulting microfluidic channels offer enhanced performance and contribute to a streamlined, cost-effective process for testing and analyzing diseases. A key highlight of our methodology is its consideration of the interconnected nature of geometric parameters. For instance, the volume of the sample, when optimized alongside channel width, length, and substrate porosity, creates a synergistic effect that minimizes errors and maximizes efficiency. This holistic optimization approach ensures that microfluidic devices operate at their peak performance, delivering reliable results in disease testing. A key highlight of our methodology is its consideration of the interconnected nature of geometric parameters. For instance, the volume of the sample, when optimized alongside channel width, length, and substrate porosity, creates a synergistic effect that minimizes errors and maximizes efficiency. This holistic optimization approach ensures that microfluidic devices operate at their peak performance, delivering reliable results in disease testing. A key highlight of our methodology is its consideration of the interconnected nature of geometric parameters. For instance, the volume of the sample, when optimized alongside channel width, length, and substrate porosity, creates a synergistic effect that minimizes errors and maximizes efficiency. This holistic optimization approach ensures that microfluidic devices operate at their peak performance, delivering reliable results in disease testing.Keywords: microfluidic device, minitab, statistical optimization, response surface methodology
Procedia PDF Downloads 662759 Transverse Vibration of Elastic Beam Resting on Variable Elastic Foundation Subjected to moving Load
Authors: Idowu Ibikunle Albert, Atilade Adesanya Oluwafemi, Okedeyi Abiodun Sikiru, Mustapha Rilwan Adewale
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These present-day all areas of transport have experienced large advances characterized by increases in the speeds and weight of vehicles. As a result, this paper considered the Transverse Vibration of an Elastic Beam Resting on a Variable Elastic Foundation Subjected to a moving Load. The beam is presumed to be uniformly distributed and has simple support at both ends. The moving distributed moving mass is assumed to move with constant velocity. The governing equations, which are fourth-order partial differential equations, were reduced to second-order partial differential equations using an analytical method in terms of series solution and solved by a numerical method using mathematical software (Maple). Results show that an increase in the values of beam parameters, moving Mass M, and k-stiffness K, significantly reduces the deflection profile of the vibrating beam. In the results, it was equally found that moving mass is greater than moving force.Keywords: elastic beam, moving load, response of structure, variable elastic foundation
Procedia PDF Downloads 1192758 Healthcare Seeking Behaviors of Parents Who Have Children with Disabilities: A Case Study at the Effutu Municipality, Winneba-Central Region, Ghana-West Africa
Authors: Priscilla Deede Hammond
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Healthcare seeking behaviour has emerged as a tool to tackle perceived ill-health by taking remedial actions. And currently, efforts are being directed towards encouraging people (especially parents) to learn and use health-promoting behaviours in seeking their children’s healthcare. Regardless of these efforts, most parents encounter challenges with raising a child with a disability. The purpose of the study was to explore the healthcare-seeking behaviours of parents of children with disabilities. In order to achieve the purpose of the study, a case study design was employed where the researcher used a qualitative approach such as semi-structured interview to gather the required data. Data from participants were analysed using a thematic analysis approach. It was revealed from the findings of the study that, some of the parents after the first diagnosis by health professionals consulted a spiritualist or a herbalist for help. Also, some parents stated that their response to their children’s healthcare depended on the severity of the sickness. The study recommends the Ministry of Gender, Children and Social Protection and other social agencies such as the Social Welfare Department to provide health assessment and financial support to families of children with disabilities.Keywords: healthcare, health, parents, disabilities
Procedia PDF Downloads 2222757 Aeroelastic Stability Analysis in Turbomachinery Using Reduced Order Aeroelastic Model Tool
Authors: Chandra Shekhar Prasad, Ludek Pesek Prasad
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In the present day fan blade of aero engine, turboprop propellers, gas turbine or steam turbine low-pressure blades are getting bigger, lighter and thus, become more flexible. Therefore, flutter, forced blade response and vibration related failure of the high aspect ratio blade are of main concern for the designers, thus need to be address properly in order to achieve successful component design. At the preliminary design stage large number of design iteration is need to achieve the utter free safe design. Most of the numerical method used for aeroelastic analysis is based on field-based methods such as finite difference method, finite element method, finite volume method or coupled. These numerical schemes are used to solve the coupled fluid Flow-Structural equation based on full Naiver-Stokes (NS) along with structural mechanics’ equations. These type of schemes provides very accurate results if modeled properly, however, they are computationally very expensive and need large computing recourse along with good personal expertise. Therefore, it is not the first choice for aeroelastic analysis during preliminary design phase. A reduced order aeroelastic model (ROAM) with acceptable accuracy and fast execution is more demanded at this stage. Similar ROAM are being used by other researchers for aeroelastic and force response analysis of turbomachinery. In the present paper new medium fidelity ROAM is successfully developed and implemented in numerical tool to simulated the aeroelastic stability phenomena in turbomachinery and well as flexible wings. In the present, a hybrid flow solver based on 3D viscous-inviscid coupled 3D panel method (PM) and 3d discrete vortex particle method (DVM) is developed, viscous parameters are estimated using boundary layer(BL) approach. This method can simulate flow separation and is a good compromise between accuracy and speed compared to CFD. In the second phase of the research work, the flow solver (PM) will be coupled with ROM non-linear beam element method (BEM) based FEM structural solver (with multibody capabilities) to perform the complete aeroelastic simulation of a steam turbine bladed disk, propellers, fan blades, aircraft wing etc. The partitioned based coupling approach is used for fluid-structure interaction (FSI). The numerical results are compared with experimental data for different test cases and for the blade cascade test case, experimental data is obtained from in-house lab experiments at IT CAS. Furthermore, the results from the new aeroelastic model will be compared with classical CFD-CSD based aeroelastic models. The proposed methodology for the aeroelastic stability analysis of gas turbine or steam turbine blades, or propellers or fan blades will provide researchers and engineers a fast, cost-effective and efficient tool for aeroelastic (classical flutter) analysis for different design at preliminary design stage where large numbers of design iteration are required in short time frame.Keywords: aeroelasticity, beam element method (BEM), discrete vortex particle method (DVM), classical flutter, fluid-structure interaction (FSI), panel method, reduce order aeroelastic model (ROAM), turbomachinery, viscous-inviscid coupling
Procedia PDF Downloads 2642756 Synaesthetic Metaphors in Persian: a Cognitive Corpus Based and Comparative Perspective
Authors: A. Afrashi
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Introduction: Synaesthesia is a term denoting the perception or description of the perception of one sense modality in terms of another. In literature, synaesthesia refers to a technique adopted by writers to present ideas, characters or places in such a manner that they appeal to more than one sense like hearing, seeing, smell etc. at a given time. In everyday language too we find many examples of synaesthesia. We commonly hear phrases like ‘loud colors’, ‘frozen silence’ and ‘warm colors’, ‘bitter cold’ etc. Empirical cognitive studies have proved that synaesthetic representations both in literature and everyday languages are constrained ie. they do not map randomly among sensory domains. From the beginning of the 20th century Synaesthesia has been a research domain both in literature and structural linguistics. However the exploration of cognitive mechanisms motivating synaesthesia, have made it an important topic in 21st century cognitive linguistics and literary studies. Synaesthetic metaphors are linguistic representations of those mental mechanisms, the study of which reveals invaluable facts about perception, cognition and conceptualization. According to the main tenets of cognitive approach to language and literature, unified and similar cognitive mechanisms are active both in everyday language and literature, and synaesthesia is one of those cognitive mechanisms. Main objective of the present research is to answer the following questions: What types of sense transfers are accessible in Persian synaesthetic metaphors. How are these types of sense transfers cognitively explained. What are the results of cross-linguistic comparative study of synaestetic metaphors based on the existing observations? Methodology: The present research employs a cognitive - corpus based method, and the theoretical framework adopted to analyze linguistic synaesthesia is the contemporary theory of metaphor, where conceptual metaphor is the result of systemic mappings across cognitive domains. Persian Language Data- base (PLDB) in the Institute for Humanities and Cultural Studies which consists mainly of Persian modern prose, is searched for synaesthetic metaphors. Then for each metaphorical structure, the source and target domains are determined. Then sense transfers are identified and the types of synaesthetic metaphors recognized. Findings: Persian synaesthetic metaphors conform to the hierarchical distribution principle, according to which transfers tend to go from touch to taste to smell to sound and to sight, not vice versa. In other words mapping from more accessible or basic concepts onto less accessible or less basic ones seems more natural. Furthermore the most frequent target domain in Persian synaesthetic metaphors is sound. Certain characteristics of Persian synaesthetic metaphors are comparable with existing related researches carried on English, French, Hungarian and Chinese synaesthetic metaphors. Conclusion: Cognitive corpus based approaches to linguistic synaesthesia, are applicable to stylistics and literary criticism and this recent research domain is an efficient approach to study cross linguistic variations to find out which of the five senses is dominant cross linguistically and cross culturally as the target domain in metaphorical mappings , and so forth receiving dominance in conceptualizations.Keywords: cognitive semantics, conceptual metaphor, synaesthesia, corpus based approach
Procedia PDF Downloads 5612755 The Effectiveness of Prenatal Breastfeeding Education on Breastfeeding Uptake Postpartum: A Systematic Review
Authors: Jennifer Kehinde, Claire O’Donnell, Annmarie Grealish
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Introduction: Breastfeeding has been shown to provide numerous health benefits for both infants and mothers. The decision to breastfeed is influenced by physiological, psychological, and emotional factors. However, the importance of equipping mothers with the necessary knowledge for successful breastfeeding practice cannot be ruled out. The decline in global breastfeeding rate can be linked to a lack of adequate breastfeeding education during the prenatal stage. This systematic review examined the effectiveness of prenatal breastfeeding education on breastfeeding uptake postpartum. Method: This review was undertaken and reported in conformity with the Preferred Reporting Items for Systemic Reviews and Meta-Analysis statement (PRISMA) and was registered on the international prospective register for systematic reviews (PROSPERO: CRD42020213853). A PICO analysis (population, intervention, comparison, outcome) was undertaken to inform the choice of keywords in the search strategy to formulate the review question, which was aimed at determining the effectiveness of prenatal breastfeeding educational programs in improving breastfeeding uptake following birth. A systematic search of five databases (Cumulative Index to Nursing and Allied Health Literature, Medline, Psych INFO, and Applied Social Sciences Index and Abstracts) was searched between January 2014 until July 2021 to identify eligible studies. Quality assessment and narrative synthesis were subsequently undertaken. Results: Fourteen studies were included. All 14 studies used different types of breastfeeding programs; eight used a combination of curriculum-based breastfeeding education programs, group prenatal breastfeeding counselling, and one-to-one breastfeeding educational programs, which were all delivered in person; four studies used web-based learning platforms to deliver breastfeeding education prenatally which were both delivered online and face to face over a period of 3 weeks to 2 months with follow-up periods ranging from 3 weeks to 6 months; one study delivered breastfeeding educational intervention using mother-to-mother breastfeeding support groups in promoting exclusive breastfeeding, and one study disseminated breastfeeding education to participants based on the theory of planned behaviour. The most effective interventions were those that included both theory and hands-on demonstrations. Results showed an increase in breastfeeding uptake, breastfeeding knowledge, an increase in a positive attitude to breastfeeding, and an increase in maternal breastfeeding self-efficacy among mothers who participated in breastfeeding educational programs during prenatal care. Conclusion: Prenatal breastfeeding education increases women’s knowledge of breastfeeding. Mothers who are knowledgeable about breastfeeding and hold a positive approach towards breastfeeding have the tendency to initiate breastfeeding and continue for a lengthened period. Findings demonstrate a general correlation between prenatal breastfeeding education and increased breastfeeding uptake postpartum. The high level of positive breastfeeding outcomes inherent in all the studies can be attributed to prenatal breastfeeding education. This review provides rigorous contemporary evidence that healthcare professionals and policymakers can apply when developing effective strategies to improve breastfeeding rates and ultimately improve the health outcomes of mothers and infants.Keywords: breastfeeding, breastfeeding programs, breastfeeding self-efficacy, prenatal breastfeeding education
Procedia PDF Downloads 832754 Social Media Marketing Efforts to Influence Brand Equity and Consumer Behavior: The Case of Luxury Fashion Brands in Pakistan
Authors: Syed Rashid Hussain Shah, Sumera Syed, Nida Mushtaq
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Social media is not only acting as a medium of communication; rather it has provided a platform where customers can actually live with the brands they so dearly envy and interact with others with same interest. Organizations are making social media marketing efforts (SMME) to convert this opportunity into a meaningful experience. It may be resembled or considered as an act of branding where the notion is not only to understand the consumer behavior but also developing a strong link with them. Ultimately the quest is to influence and bend it into a mutual benefit of the stakeholders. This study investigates SMME of brands with the help of five dimensions (i.e., entertainment, interaction, trendiness, customization and word of mouth). The study has found that there is no significant impact of SMME as a construct on brand equity and consumer behavior. However, few of the dimensions (i.e. customization and word of mouth), have been found to have influence on brand equity (brand association, brand image) and consumer response (brand preferences).Keywords: social media marketing efforts (SMME), brand equity, preference, loyalty price premium, luxury brands, international
Procedia PDF Downloads 3532753 The Reducing Agent of Glycerol for the Reduction of Metal Oxides under Microwave Heating
Authors: Kianoosh Shojae
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In recent years, the environmental challenges due to the excessive use of fossil fuels have led to heightened greenhouse gas production. In response, biodiesel has emerged as a cleaner alternative, offering reduced pollutant emissions compared to traditional fuels. The large-scale production of biodiesel, involving ester exchange of animal fats or vegetable oils, results in a surplus of crude glycerin. With environmental regulations on the rise and an increasing demand for biodiesel, glycerin production has seen a significant upswing. This paper focuses on the economic significance of glycerin through its pyrolysis as a raw material, particularly in the synthesis of metals. As industries pivoted towards cleaner fuels, glycerin, as a byproduct of biodiesel production, is poised to remain a cost-effective and surplus product. In this work, for evaluating the possible performance of using the gaseous products from the pyrolysis reaction of glycerol, we concerned the glycerin pyrolysis reactions, emphasizing the catalytic role of activated carbon, various reaction pathways and the impact of carrier gas flow rate on hydrogen production, providing valuable insights into the evolving landscape of sustainable fuel alternatives.Keywords: biodiesel, glycerin pyrolysis, activated carbon catalysis, syngas
Procedia PDF Downloads 532752 SLAMF5 Regulates Myeloid Cells Activation in the Eae Model
Authors: Laura Bellassen, Idit Shachar
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Multiple sclerosis (MS) is a chronic neurological disorder characterized by demyelination of the central nervous system (CNS), leading to a wide range of physical and cognitive impairments. Myeloid cells in the CNS, such microglia and border associated macrophage cells, participate in the neuroinflammation in MS. Activation of those cells in MS contributes to the inflammatory response in the CNS and recruitment of immune cells in the this compartment. SLAMF5 is a cell surface receptor that functions as a homophilic adhesion molecule, whose signaling can activate or inhibit leukocyte function. In the current study we followed the expression and function of SLAMF5 in myeloid cells in the CNS and in the periphery in the murine model for MS, the experimental autoimmune encephalomyelitis model (EAE). Our results show that SLAMF5 deficiency or blocking decreases the expression of activation molecules and costimulatory molecules such as MHCII and CD80, resulting in delayed onset and reduced progression of the disease. Moreover, blocking SLAMF5 in peripheral monocytes derived from MS patients and iPSC-derived microglia cells, controls the expression of HLA-DR and CD80. Thus, SLAMF5 is a regulator of myeloid cells function and can serve as a therapeutic target in autoimmune disorders as Multiple Sclerosis.Keywords: multiple sclerosis, EAE model, myeloid cells, new antibody, neuroimmunology
Procedia PDF Downloads 522751 Band Gap Tuning Based on Adjustable Stiffness of Local Resonators
Authors: Hossein Alimohammadi, Kristina Vassiljeva, Hassan HosseinNia, Eduard Petlenkov
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This research article discusses the mechanisms for bandgap tuning of beam-type resonators to achieve broadband vibration suppression through adjustable stiffness. The method involves changing the center of mass of the cantilever-type resonator to achieve piezo-free tuning of stiffness. The study investigates the effect of the center of masses variation (δ) of attached masses on the bandgap and vibration suppression performance of a non-uniform beam-type resonator within a phononic structure. The results suggest that the cantilever-type resonator beam can be used to achieve tunability and real-time control and indicate that varying δ significantly impacts the bandgap and transmittance response. Additionally, the research explores the use of the first and second modes of resonators for tunability and real-time control. These findings examine the feasibility of this approach, demonstrate the potential for improving resonator performance, and provide insights into the design and optimization of metamaterial beams for vibration suppression applications.Keywords: bandgap, adjustable stiffness, spatial variation, tunability
Procedia PDF Downloads 832750 Assessment of Digital Literacy Skills of Librarians in Tertiary Institutions Inniger State
Authors: Mustapha Abdulkadir Gana, Jibrin Attahiru Alhassan, Adamu Musa Baba
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The exponential growth of information sources, resources and the continued Communication Technology (ICT) sophistication of libraries all over the world call for capable and ICT compliant librarians in Nigeria, this article assesses the digital literacy skills of librarians in tertiary institutions in Niger state. The survey research method was applied in the study using a random sampling technique to draw the sample. Fifty-eight copies of the questionnaire were administered while forty-nine copies were completed, returned, and used in the study, which represents 84% of the response rate. Two research questions were answered, and data were analyzed using Statistical Package for the Social Sciences (SPSS). The finding uncovered that the librarians lack the requisite digital literacy skills to access the wealth of digital information resources available. The study recommends some steps to turn around the situations amongst; librarians must be empowered with all necessary digital literacy skills, embark on rigorous training and retraining programs, workshops, conferences, and seminars, there should also be a coherent training policy for the librarians on a sustainable basis to increase their requisite digital literacy skills.Keywords: digital, information, literacy, skills
Procedia PDF Downloads 1472749 A Comprehensive Evaluation of IGBTs Performance under Zero Current Switching
Authors: Ly. Benbahouche
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Currently, several soft switching topologies have been studied to achieve high power switching efficiency, reduced cost, improved reliability and reduced parasites. It is well known that improvement in power electronics systems always depend on advanced in power devices. The IGBT has been successfully used in a variety of switching applications such as motor drives and appliance control because of its superior characteristics. The aim of this paper is focuses on simulation and explication of the internal dynamics of IGBTs behaviour under the most popular soft switching schemas that is Zero Current Switching (ZCS) environments. The main purpose of this paper is to point out some mechanisms relating to current tail during the turn-off and examination of the response at turn-off with variation of temperature, inductance L, snubber capacitors Cs, and bus voltage in order to achieve an improved understanding of internal carrier dynamics. It is shown that the snubber capacitor, the inductance and even the temperature controls the magnitude and extent of the tail current, hence the turn-off time (switching speed of the device). Moreover, it has also been demonstrated that the ZCS switching can be utilized efficiently to improve and reduce the power losses as well as the turn-off time. Furthermore, the turn-off loss in ZCS was found to depend on the time of switching of the device.Keywords: PT-IGBT, ZCS, turn-off losses, dV/dt
Procedia PDF Downloads 3152748 Clash of Civilizations without Civilizational Groups: Revisiting Samuel P. Huntington´s Clash of Civilizations Theory
Authors: Jamal Abdi
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This paper is largely a response/critique of Samuel P. Huntington´s Clash of Civilizations thesis. The overriding argument is that Huntington´s thesis is characterized by failure to distinguish between ´groups´ and ´categories´. Multinational civilizations overcoming their internal collective action problems, which would enable them to pursue a unified strategy vis-à-vis the West, is a rather foundational assumption in his theory. Without assigning sufficient intellectual attention to the processes through which multinational civilizations may gain capacity for concerted action i.e. become a group, he contended that the post-cold-war world would be shaped in large measure by interactions among seven or eight major civilizations. Thus, failure in providing a convincing analysis of multi-national civilizations´ transition from categories to groups is a significant weakness in Huntington´s clash theory. It is also suggested that so-called Islamic terrorism and the war on terror is not to be taken as an expression of presence of clash between a Western and an Islamic civilization, as terrorist organizations would be superfluous in a world characterized by clash of civilizations. Consequences of multinational civilizations becoming a group are discussed in relation to contemporary Western superiority.Keywords: categories, civilizations, clash, groups, groupness
Procedia PDF Downloads 1712747 Tyrosine Rich Fraction as an Immunomodulatory Agent from Ficus Religiosa Bark
Authors: S. A. Nirmal, G. S. Asane, S. C. Pal, S. C. Mandal
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Objective: Ficus religiosa Linn (Moraceae) is being used in traditional medicine to improve immunity hence present work was undertaken to validate this use scientifically. Material and Methods: Dried, powdered bark of F. religiosa was extracted successively using petroleum ether and 70% ethanol in soxhlet extractor. The extracts obtained were screened for immunomodulatory activity by delayed type hypersensitivity (DTH), neutrophil adhesion test and cyclophosphamide-induced neutropenia in Swiss albino mice at the dose of 50 and 100 mg/kg, i.p. 70% ethanol extract showed significant immunostimulant activity hence subjected to column chromatography to produce tyrosine rich fraction (TRF). TRF obtained was screened for immunomodulatory activity by above methods at the dose of 10 mg/kg, i.p. Results: TRF showed potentiation of DTH response in terms of significant increase in the mean difference in foot-pad thickness and it significantly increased neutrophil adhesion to nylon fibers by 48.20%. Percentage reduction in total leukocyte count and neutrophil by TRF was found to be 43.85% and 18.72%, respectively. Conclusion: Immunostimulant activity of TRF was more pronounced and thus it has great potential as a source for natural health products.Keywords: Ficus religiosa, immunomodulatory, cyclophosphamide, neutropenia
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