Search results for: bi-leaflet pulmonary valve

Authors: Rithika Sriram, Kiran M. Bhojwani

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Introduction : Tuberculosis of the head and neck has proved to be a diagnostic challenge for otorhinolarynologists around the world. These lesions are often misdiagnosed as cancer. So in order to contribute to a better understanding of these lesions, we have conducted our study among patients affected by TB in the head and neck region with the objective of assessing the various manifestations, presentations, diagnostic techniques, risk factors such as smoking and alcohol consumption, coexisting illnesses and treatment modalities. Materials and Methods: This was a retrospective study conducted over a three year period (2012-2014) in 2 hospitals affliated to Kasturba Medical College in Mangalore, South India. A semi structured proforma was used to capture information from the medical records pertaining to the various objectives of the study such as clinical features and history of smoking. Data was analysed using SPSS version 16.0 and results obtained were depicted as percentages. Chi square test was used to find association between the variables and p<0.05 was considered statistically significant. Results: 104 patients were found to have TB of the head and neck and among them,the most common manifestation was found to be Tubercular Lymphadenitis (86.53%), followed by laryngeal TB (4.8%), submandibular gland TB (3.8%), deep neck space abscess(3.8%) and adenotonsillar TB. FNAC was found to be the gold standard for the diagnosis of TB disease of the lymph node.26% of the patients had coexisting HIV infection and 16.3% of the patients had associated pulmonary TB. More than 20% of the patients were smokers. Most patients were treated using ATT. Conclusion: Tuberculosis affecting regions of head and neck is no longer uncommon. Sufficient knowledge and appropriate diagnostic means is required while dealing with these lesions and must be included in the differential diagnosis of pathological lesions of head and neck.

Keywords: FNAC, Mangalore, smoking, tuberculosis

Procedia PDF Downloads 263

Authors: K. Doi, T. Nishimura, H. Fujimoto, T. Tanaka

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It has been known that visually impaired persons have some problems in getting visual information. Therefore, information accessibility for the visually impaired persons is very important in a current information society. Some application software with read-aloud function for using personal computer and smartphone are getting more and more popular among visually impaired persons in the world. On the other hand, it is also very important for being able to learn how to read and write characters such as Braille and Visual character. Braille typewriter has been widely used in learning Braille. And also raised-line drawing kits as writing material has been used for decades for especially acquired visually impaired persons. However, there are some drawbacks such as the drawn line cannot be erased. Moreover, visibility of drawing lines is not so good for visually impaired with low vision. We had significant number of requests for developing new writing material for especially acquired visually impaired persons instead of raised-line drawing kits. For conducting development research of novel writing material, we could receive a research grant from ministry of health, labor and welfare in Japanese government. In this research, we developed writing material typed pens and pencils with Beeswax-discharge instead of conventional raised-line drawing kits. This writing material was equipped with cartridge heater for melting beeswax and its heat controller. When this pen users held down the pen tip on the regular paper such as fine paper and so on, the melted beeswax could be discharged from pen tip with valve structure. The beeswax was discharged at 100 gf of holding down force based on results of our previous trial study. The shape of pen tip was semispherical for becoming low friction between pen tip and surface of paper. We conducted one basic experiment to evaluate influence of the curvature of pen tip on ease to write. Concretely, the conditions of curvature was 0.15, 0.35, 0.50, 1.00 mm. The following four interval scales were used as indexes of subjective assessment during writing such as feeling of smooth motion of pen, feeling of comfortable writing, sense of security and feeling of writing fatigue. Ten subjects were asked to participate in this experiment. The results reveal that subjects could draw easily when the radius of the pen tip was 1.00 mm, and lines drawn with beeswax-discharge writing material were easy to perceive.

Keywords: beeswax-discharge writing material, raised-line drawing kits, visually impaired persons, pen tip

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Authors: Ana Miguel

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Purpose: Glaucoma is the second cause of worldwide blindness and the first cause of irreversible blindness. Trabeculectomy, the standard glaucoma surgery, has a success rate between 36.0% and 98.0% at three years and a high complication rate, leading to the development of different surgeries, micro-invasive glaucoma surgeries (MIGS). MIGS devices are diverse and have various indications, risks, and effectiveness. We intended to review MIGS’ surgical techniques, indications, contra-indications, and IOP effect. Methods: We performed a literature review of MIGS to differentiate the devices and their reported effectiveness compared to traditional surgery (tubes and blebs). We also conducted a video review of the last 1000 glaucoma surgeries of the author (including MIGS, but also trabeculectomy, deep sclerectomy, and tubes of Ahmed and Baerveldt) performed at glaucoma and advanced anterior segment fellowship in Canada and France, to describe preferred surgical techniques for each. Results: We present the videos with surgical techniques and pearls for each surgery. Glaucoma surgeries included: 1- bleb surgery (namely trabeculectomy, with releasable sutures or with slip knots, deep sclerectomy, Ahmed valve, Baerveldt tube), 2- MIGS with bleb, also known as MIBS (including XEN 45, XEN 63, and Preserflo), 3- MIGS increasing supra-choroidal flow (iStar), 4-MIGS increasing trabecular flow (iStent, gonioscopy-assisted transluminal trabeculotomy - GATT, goniotomy, excimer laser trabeculostomy -ELT), and 5-MIGS decreasing aqueous humor production (endocyclophotocoagulation, ECP). There was also needling (ab interno and ab externo) performed at the operating room and irido-zonulo-hyaloïdectomy (IZHV). Each technique had different indications and contra-indications. Conclusion: MIGS are valuable in glaucoma surgery, such as traditional surgery with trabeculectomy and tubes. All glaucoma surgery can be combined with phacoemulsification (there may be a synergistic effect on MIGS + cataract surgery). In addition, some MIGS may be combined for further intraocular pressure lowering effect (for example, iStents with goniotomy and ECP). A good surgical technique and postoperative management are fundamental to increasing success and good practice in all glaucoma surgery.

Keywords: glaucoma, migs, surgery, video, review

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Authors: Erwin Chan, Aravind Subramaniyan, Siti Abdullah Fatehah, Steve Lian Kuling

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Foam assisted lift technology is proven across the industry to provide efficient deliquification in gas wells. Such deliquification is typically achieved by delivering the foamer chemical downhole via capillary strings. In highly liquid loaded wells where capillary strings are not readily available, foamer can be delivered via batch injection or bull-heading. The latter techniques differ from the former in that cap strings allow for liquid to be unloaded continuously, whereas foamer batches require that periodic batching be conducted for the liquid to be unloaded. Although batch injection allows for liquid to be unloaded in wells with suitable water to gas (WGR) ratio and condensate to gas (CGR) ratio without well intervention for capillary string installation, this technique comes with its own set of challenges - for foamer to de-liquify liquids, the chemical needs to reach perforation locations where gas bubbling is observed. In highly scaled perforation zones in certain wells, foamer delivered in batches is unable to reach the gas bubbling zone, thus achieving poor lift efficiency. This paper aims to discuss the techniques and challenges for unloading liquid via batch injection in scaled perforation wells X and Y, whose WGR is 6bbl/MMscf, whose scale build-up is observed at the bottom of perforation interval, whose water column is 400 feet, and whose ‘bubbling zone’ is less than 100 feet. Variables such as foamer Z dosage, batching technique, and well flow control valve opening times are manipulated during the duration of the trial to achieve maximum liquid unloading and gas rates. During the field trial, the team has found optimal values between the three aforementioned parameters for best unloading results, in which each cycle’s gas and liquid rates are compared with baselines with similar flowing tubing head pressures (FTHP). It is discovered that amongst other factors, a good agitation technique is a primary determinant for efficient liquid unloading. An average increment of 2MMscf/d against an average production of 4MMscf/d at stable FTHP is recorded during the trial.

Keywords: foam, foamer, gas lift, liquid unloading, scale, batch injection

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Authors: P. R. Chauhan, S. K. Tyagi

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Adsorption refrigeration technology offers a sustainable and energy-efficient cooling alternative over traditional refrigeration technologies for meeting the fast-growing cooling demands. With its ability to utilize natural refrigerants, low-grade heat sources, and modular configurations, it has the potential to revolutionize the cooling industry. Despite these benefits, the commercial viability of this technology is hampered by several fundamental limiting constraints, including its large size, low uptake capacity, and poor performance as a result of deficient heat and mass transfer characteristics. The primary cause of adequate heat and mass transfer characteristics and magnitude of exergy loss in various real processes of adsorption cooling system can be assessed by the entropy generation rate analysis, i. e. Second law of Thermodynamics. Therefore, this article presents the second law of thermodynamic-based investigation in terms of entropy generation rate (EGR) to identify the energy losses in various processes of the HPCC-based adsorption system using MATLAB R2021b software. The adsorption technology-based cooling system consists of two beds made up of silica gel and arranged in a single stage, while the water is employed as a refrigerant, coolant, and hot fluid. The variation in process-wise EGR is examined corresponding to cycle time, and a comparative analysis is also presented. Moreover, the EGR is also evaluated in the external units, such as the heat source and heat sink unit used for regeneration and heat dump, respectively. The research findings revealed that the combination of adsorber and desorber, which operates across heat reservoirs with a higher temperature gradient, shares more than half of the total amount of EGR. Moreover, the EGR caused by the heat transfer process is determined to be the highest, followed by a heat sink, heat source, and mass transfer, respectively. in case of heat transfer process, the operation of the valve is determined to be responsible for more than half (54.9%) of the overall EGR during the heat transfer. However, the combined contribution of the external units, such as the source (18.03%) and sink (21.55%), to the total EGR, is 35.59%. The analysis and findings of the present research are expected to pinpoint the source of the energy waste in HPCC based adsorption cooling systems.

Keywords: adsorption cooling cycle, heat transfer, mass transfer, entropy generation, silica gel-water

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Authors: Naser Shagerdi Esmaeli, Mohsen Hamidpour

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Background and Objective: Hematopoietic stem cell transplantation (HSCT) has been widely used for treating oncological and hematological diseases. Although HSCT has helped to improve patient survival, the risk of developing an infection during hospitalization is an important cause of morbidity and mortality. This study aimed to analyze the infection profile during hospitalization and the associated risk factors among patients undergoing autologous HSCT at the University Hospital, Shahid Ghazi Tabatabaei Hospital, Tabriz, Iran. Subjects and Methods: This was a cross-sectional study on patients undergoing autologous HSCT at a public university hospital. Methods: Patients with febrile neutropenia between 2015 and 2018 were retrospectively evaluated regarding their infection profile and associated risk factors. This survey included: bacterial culture and blood culture on specific media. Results: Infection occurred in 57.2% of 56 patients with febrile neutropenia. The main source of infection was the central venous catheter (25.9%). Infection was chiefly due to Gram-positive bacteria, although Gram-negative-related infections were more severe and caused a higher death rate. Sex, age, skin color, nutritional status, and underlying disease were not associated with the development of infection. Patients with severe mucositis (Grades III and IV) had a higher infection rate (P < 0.001). Patients who developed pulmonary complications during hospitalization had higher infection rates (P = 0.002). Infection was the main cause of death (57.1%) in the study sample. Conclusion: Strategies aimed at reducing infection-related mortality rates among patients undergoing autologous HSCT are necessary.

Keywords: hematopoietic stem cell, autologous bone marrow transplantation, infection profile, tabriz, Iran

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Authors: Azza EL-Medany, Jamila EL-Medany

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Lung fibrosis is a common side effect of the chemotherapeutic agent, bleomycin. Current evidence suggests that reactive oxygen species may play a key role in the development of lung fibrosis. The present work studied the effect of green tea extract on bleomycin–induced lung fibrosis in rats. Animals were divided into three groups: (1) Saline control group; (2) bleomycin group in which rats were injected with bleomycin (15mg/kg,i.p.) three times a week for four weeks; (3) bleomycin and green tea group in which green tea extract was given to rats (100mg/kg/day, p.o) a week prior to bleomycin and daily during bleomycin injections for 4 weeks until the end of the experiment. Bleomycin–induced pulmonary injury and lung fibrosis that was indicated by increased lung hydroxyproline content, elevated nitric oxide synthase, myeoloperoxidase (MPO), platelet activating factor (PAF), tumor necrosis factor α (TNF_α), transforming growth factor 1β (TGF1β) and angiotensin converting enzyme (ACE) activity in lung tissues. On the other hand, bleomycin induced a reduction in reduced glutathione concentration (GSH). Moreover, bleomycin resulted in a severe histological changes in lung tissues revealed as lymphocytes and neutrophils infiltration, increased collagen deposition and fibrosis. Co-administration of bleomycin and green tea extract reduced bleomycin–induced lung injury as evaluated by the significant reduction in hydroxyproline content, nitric oxide synthase activity, levels of MPO, PAF, TNF-α, and ACE in lung tissues. Furthermore, green tea extract ameliorated bleomycin– induced reduction in GSH concentration. Finally, histological evidence supported the ability of green tea extract to attenuate bleomycin–induced lung fibrosis and consolidation. Thus, the finding of the present study provides that green tea may serve as a novel target for potential therapeutic treatment of lung fibrosis.

Keywords: bleomycin, lung fibrosis, green tea, oxygen species

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Authors: Heru Al Amin

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Sarcoidosis is a granulomatous inflammatory disorder of unclear etiology that can affect multiple different organ systems. Isolated cardiac sarcoidosis is a very rare condition that causes lethal arrhythmia and heart failure. A definite diagnosis of cardiac sarcoidosis remains challenging. The use of multimodality imaging plays a pivotal role in the diagnosis of this entity. Case summary: In this report, we discuss a case of a 50-year-old woman who presented with recurrent palpitation, dizziness, vertigo and presyncope. Electrocardiogram revealed variable heart blocks, including first-degree AV block, second-degree AV block, high-degree AV block, complete AV block, trifascicular block and sometimes supraventricular arrhythmia. Twenty-four hours of Holter monitoring show atrial bigeminy, first-degree AV block and trifascicular block. Transthoracic echocardiography showed Thinning of basal anteroseptal and inferred septum with LV dilatation with reduction of Global Longitudinal Strain. A dual-chamber pacemaker was implanted. CT Coronary angiogram showed no coronary artery disease. Cardiac magnetic resonance revealed basal anteroseptal and inferior septum thinning with focal edema with LGE suggestive of sarcoidosis. Computed tomography of the chest showed no lymphadenopathy or pulmonary infiltration. 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) of the whole body showed. We started steroids and followed up with the patient. Conclusion: This case serves to highlight the challenges in identifying and managing isolated CS in a young patient with recurrent syncope with variable heart block. Early, even late initiation of steroids can improve arrhythmia as well as left ventricular function.

Keywords: cardiac sarcoidosis, conduction abnormality, syncope, cardiac MRI

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Authors: Leila Asadollahi

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Dry powder inhalers (DPIs) have come a long way since their creation, starting with the Spinhaler Fisons in 1967. For optimal performance, it is important to consider the interplay between formulation, device, and patient. DPIs have shown great potential in treating systemic disorders, as evidenced by their success in clinical practices. Ongoing clinical trials and market availability of DPI products for systemic disease treatment are also examined. Furthermore, the current COVID-19 pandemic has sparked increased interest in dry powder inhalation as a potential avenue for vaccines and antiviral drugs, prompting further exploration of its applications. To achieve optimal treatment outcomes for respiratory diseases, a thorough understanding of the various types of DPIs currently available is crucial. These include single-dose, multiple-unit dose, and multi-dose DPIs. This informative article delves into the administration of drugs via inhalation, examining its diverse routes of administration. Additionally, it illuminates the exciting advancements in inhalation delivery systems and investigates the latest therapeutic approaches for the treatment of respiratory ailments. Additionally, the article discusses the historical development of DPIs and the need for improved designs to enhance efficacy and patient adherence. The potential of DPIs in treating systemic diseases is also examined. Overall, this review provides valuable insights into the advancements, challenges, and future prospects of inhalation drug delivery systems, highlighting the potential they hold for respiratory and systemic disorders. The review aims to provide valuable insights into the advancements, challenges, and future prospects of inhalation drug delivery systems, highlighting the potential they hold for respiratory and systemic disorders.

Keywords: dry powder inhalers (DPIs), respiratory diseases, systemic disorders, pulmonary drug delivery

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Authors: Saeed Farivar, Mohsen Kahrom

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The purpose of this work is to develop a physical simulation model for the purpose of studying the effect of various design parameters on the performance of packaged-liquid chillers. This paper presents a steady-state model for predicting the performance of package-Liquid chiller over a wide range of operation condition. The model inputs are inlet conditions; geometry and output of model include system performance variable such as power consumption, coefficient of performance (COP) and states of refrigerant through the refrigeration cycle. A computer model that simulates the steady-state cyclic performance of a vapor compression chiller is developed for the purpose of performing detailed physical design analysis of actual industrial chillers. The model can be used for optimizing design and for detailed energy efficiency analysis of packaged liquid chillers. The simulation model takes into account presence of all chiller components such as compressor, shell-and-tube condenser and evaporator heat exchangers, thermostatic expansion valve and connection pipes and tubing’s by thermo-hydraulic modeling of heat transfer, fluids flow and thermodynamics processes in each one of the mentioned components. To verify the validity of the developed model, a 7.5 USRT packaged-liquid chiller is used and a laboratory test stand for bringing the chiller to its standard steady-state performance condition is build. Experimental results obtained from testing the chiller in various load and temperature conditions is shown to be in good agreement with those obtained from simulating the performance of the chiller using the computer prediction model. An entropy-minimization-based optimization analysis is performed based on the developed analytical performance model of the chiller. The variation of design parameters in construction of shell-and-tube condenser and evaporator heat exchangers are studied using the developed performance and optimization analysis and simulation model and a best-match condition between the physical design and construction of chiller heat exchangers and its compressor is found to exist. It is expected that manufacturers of chillers and research organizations interested in developing energy-efficient design and analysis of compression chillers can take advantage of the presented study and its results.

Keywords: optimization, packaged liquid chiller, performance, simulation

Procedia PDF Downloads 260

Authors: Li-Ting Huang, Yu-Hsiang Shen, Cing-Ciao Ke, Sheng-Pin Tseng, Fan-Pin Tseng, Yu-Ching Ni, Chia-Yu Lin

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Chest radiography is the most common technique for the diagnosis and follow-up of pulmonary diseases. However, the lesions superimposed with normal structures are difficult to be detected in chest radiography. Chest tomosynthesis is a relatively new technique to obtain 3D section images from a set of low-dose projections acquired over a limited angular range. However, there are some limitations with chest tomosynthesis. Patients undergoing tomosynthesis have to be able to hold their breath firmly for 10 seconds. A digital tomosynthesis system with advanced reconstruction algorithm and high-stability motion mechanism was developed by our research group. The potential for the system to perform a bidirectional chest scan within 10 seconds is expected. The purpose of this study is to realize the influences of the scan speed on the image quality for our digital tomosynthesis system. The major factors that lead image blurring are the motion of the X-ray source and the patient. For the fore one, an experiment of imaging a chest phantom with three different scan speeds, which are 6 cm/s, 8 cm/s, and 15 cm/s, was proceeded to understand the scan speed influences on the image quality. For the rear factor, a normal SD (Sprague-Dawley) rat was imaged with it alive and sacrificed to assess the impact on the image quality due to breath motion. In both experiments, the profile of the ROIs (region of interest) and the CNRs (contrast-to-noise ratio) of the ROIs to the normal tissue of the reconstructed images was examined to realize the degradations of the qualities of the images. The preliminary results show that no obvious degradation of the image quality was observed with increasing scan speed, possibly due to the advanced designs for the hardware and software of the system. It implies that higher speed (15 cm/s) than that of the commercialized tomosynthesis system (12 cm/s) for the proposed system is achieved, and therefore a complete chest scan within 10 seconds is expected.

Keywords: chest radiography, digital tomosynthesis, image quality, scan speed

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Authors: Luciano Tarantino, Emanuele Balzano, Paolo Tarantino, Riccardo Aurelio Nasto, Aurelio Nasto

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Liver transplantation (OLT) is contraindicate in Portal Vein tumor Thrombosis (PVTT) from Hepatocellular Carcinoma at hepatic hilum(pH-HCC) Surgery,Thermal ablation and chemotherapy show poorer outcomes Electrochemotherapy (ECT) has been successfully used in patients with pH-HCC with PVTT. We report the results of ECT as downstaging aimed to definitive cure by OLT. F.P. 53 years HBV related Cirrhosis Child-Pugh B7 class; EGDS F2 aesophageal Varices. Diabetes. April 2016 : Enhanced Computed Tomography (CT) detected HCC(n.3 nodules in VII-VIII-VI;diameter range=25 cm) and PVTT of right portal vein. The patient was considered ineligible for OLT. May 2016: first ablation session with percutaneous Radiofrequency-ablation(RFA) of 3 HCC-nodules . August 2016: second ablation session with ECT of PVTT. CT october 2016: disappearance of PVTT and patent right portal vein. No intraparenchymal recurrence. CT march 2017: No recurrence in portal vein and in the left lobe. local recurrence in the VII-VIII segments. May 2017 : transarterial chemoembolization (TACE) of right lobe recurrences. CT October 2017: patent right portal vein. No recurrence. The patient was reconsidered for OLT. He underwent OLT in April 2018. At 36-months follow-up , no intrahepatic recurrence of HCC occurred. March 2021: enhanced CT and PET/CT detected a single small nodule (1.5 cm) uptaking tracer in the left upper pulmonary lobe, no hepatic recurrence . CT-guided FNB showed metastasis from HCC . June 2021: left lung upper lobectomy . At the current time the patient is alive and recurrence-free at 64 months follow-up. ECT Could be aneffective technique as pre-OLT dowstaging in HCC with PVTT.

Keywords: liver tumor ablation, interventional ultrasound, electrochemotherapy, liver transplantation

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Authors: Sabrina N. Rabelo, Tiago de F. Paulino, Willian M. Duarte, Samer Sawalha, Luiz Machado

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Energy use is one of the main indicators for the economic and social development of a country, reflecting directly in the quality of life of the population. The expansion of energy use together with the depletion of fossil resources and the poor efficiency of energy systems have led many countries in recent years to invest in renewable energy sources. In this context, solar-assisted heat pump has become very important in energy industry, since it can transfer heat energy from the sun to water or another absorbing source. The direct-expansion solar assisted heat pump (DX-SAHP) water heater system operates by receiving solar energy incident in a solar collector, which serves as an evaporator in a refrigeration cycle, and the energy reject by the condenser is used for water heating. In this paper, a DX-SAHP using carbon dioxide as refrigerant (R744) was assembled, and the influence of the variation of the water mass flow rate in the system was analyzed. The parameters such as high pressure, water outlet temperature, gas cooler outlet temperature, evaporator temperature, and the coefficient of performance were studied. The mainly components used to assemble the heat pump were a reciprocating compressor, a gas cooler which is a countercurrent concentric tube heat exchanger, a needle-valve, and an evaporator that is a copper bare flat plate solar collector designed to capture direct and diffuse radiation. Routines were developed in the LabVIEW and CoolProp through MATLAB software’s, respectively, to collect data and calculate the thermodynamics properties. The range of coefficient of performance measured was from 3.2 to 5.34. It was noticed that, with the higher water mass flow rate, the water outlet temperature decreased, and consequently, the coefficient of performance of the system increases since the heat transfer in the gas cooler is higher. In addition, the high pressure of the system and the CO₂ gas cooler outlet temperature decreased. The heat pump using carbon dioxide as a refrigerant, especially operating with solar radiation has been proven to be a renewable source in an efficient system for heating residential water compared to electrical heaters reaching temperatures between 40 °C and 80 °C.

Keywords: water mass flow rate, R-744, heat pump, solar evaporator, water heater

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Authors: Malik Muhammad Arslan, Muneeb Ullah, Dai Shihan, Daniyal Haider, Xiaodong Yang

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Chest X-rays are instrumental in the detection and monitoring of a wide array of diseases, including viral infections such as COVID-19, tuberculosis, pneumonia, lung cancer, and various cardiac and pulmonary conditions. To enhance the accuracy of diagnosis, artificial intelligence (AI) algorithms, particularly deep learning models like Convolutional Neural Networks (CNNs), are employed. However, these deep learning models demand a substantial and varied dataset to attain optimal precision. Generative Adversarial Networks (GANs) can be employed to create new data, thereby supplementing the existing dataset and enhancing the accuracy of deep learning models. Nevertheless, GANs have their limitations, such as issues related to stability, convergence, and the ability to distinguish between authentic and fabricated data. In order to overcome these challenges and advance the detection and classification of CXR normal and abnormal images, this study introduces a distinctive technique known as DCWGAN (Diverse Conditional Wasserstein GAN) for generating synthetic chest X-ray (CXR) images. The study evaluates the effectiveness of this Idiosyncratic DCWGAN technique using the ResNet50 model and compares its results with those obtained using the traditional GAN approach. The findings reveal that the ResNet50 model trained on the DCWGAN-generated dataset outperformed the model trained on the classic GAN-generated dataset. Specifically, the ResNet50 model utilizing DCWGAN synthetic images achieved impressive performance metrics with an accuracy of 0.961, precision of 0.955, recall of 0.970, and F1-Measure of 0.963. These results indicate the promising potential for the early detection of diseases in CXR images using this Inimitable approach.

Keywords: CNN, classification, deep learning, GAN, Resnet50

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Authors: Margaret Elaine J. Villamayor, Lobert A. Padua, Neil S. Bacaltos, Virgilio P. Bañez

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Significance: This study aimed to determine the prevalence of Hepatobiliary Tuberculosis (HBTB) with biliary obstruction and to compare the outcomes of ERCP versus PTBD in these patients. Methodology: This is a cross-sectional study involving patients from PGH who underwent biliary drainage from HBTB from January 2009 to June 2014. HBTB was defined as having evidence of TB (culture, smear, PCR, histology) or clinical diagnosis with the triad of jaundice, fever, and calcifications on imaging with other causes of jaundice excluded. The primary outcome was successful drainage and secondary outcomes were mean hospital stay and complications. Simple logistic regression was used to identify factors associated with success of drainage, z-test for two proportions to compare outcomes of ERCP versus PTBD and t-test to compare mean hospital stay post-procedure. Results: There were 441 patients who underwent ERCP and PTBD, 19 fulfilled the inclusion criteria. 11 underwent ERCP while 8 had PTBD. There were more successful cases in PTBD versus ERCP but this was not statistically significant (p-value 0.3615). Factors such as age, gender, location and nature of obstruction, vices, coexisting pulmonary or other extrapulmonary TB and presence of portal hypertension did not affect success rates in these patients. The PTBD group had longer mean hospital stay but this was not significant (p-value 0.1880). There were no complications reported in both groups. Conclusion: HBTB comprises 4.3% of the patients undergoing biliary drainage in PGH. Both ERCP and PTBD are equally safe and effective in the management of biliary obstruction from HBTB.

Keywords: cross-sectional, hepatobiliary tuberculosis, obstructive jaundice, endoscopic retrograde cholangiopancreatography, percutaneous transhepatic biliary drainage

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Authors: Mohammadjavad Mehrabanpour, Maryam Ranjbar Bushehri, Dorsa Mehrabanpour

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Respiratory diseases are the most important problems in the country’s poultry industry, particularly when it comes to broiler flocks. Ornithobacterium rhinotracheale (ORT) is a species that causes poor performance in growth rate, egg production, and mortality. This pathogen causes a respiratory infection including pulmonary alveolar inflammation, and pneumonia of birds throughout the world. Newcastle disease (ND) is a highly contagious disease in poultry, and also, it causes considerable losses to the poultry industry. The aim of this study was to evaluate the simultaneous occurrence of ORT and ND and NDV isolation by inoculation in embryonated eggs and confirmed by RT-PCR in broiler chicken flocks in Fars province. In this study, 318 blood and 85 tissue samples (brain, trachea, liver, and cecal tonsils) were collected from 15 broiler chicken farms. Survey serum antibody titers against ORT by using a commercial enzyme-linked immunosorbent assay (ELISA) kit performed. Evaluation of antibody titer against ND virus is performed by hemagglutination inhibition test. Virus isolation with chick embryo eggs 9-11 and RT-PCR method were carried out. A total of 318 serum samples, 135 samples (42.5%) were positive for antibodies to ORT and titer of HI antibodies against NDV in 122 serum samples (38/4%) were 7-10 (log2) and 61 serum samples (19/2%) had occurrence antibody titer against Newcastle virus and ORT. Results of the present study indicated that 20 tissue samples were positive in embryonated egg and in rapid hemagglutination (HA) test. HI test with specific ND positive serum confirmed that 6 of 20 samples. PCR confirmed that all six samples were positive and PCR products of samples indicated 535-base pair fragments in electrophrosis. Due to the great economic importance of these two diseases in the poultry industry, it is necessary to design and implement a comprehensive plan for prevention and control of these diseases.

Keywords: ELISA, Ornithobacterium rhinotracheale, newcastle disease, seroprevalence

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Authors: Louise Elizabeth Bolton

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Statement of the problem: There are an estimated 328 million cases of COPD worldwide. It is likely to become the third biggest cause of death by 2030. The impact of living with palliative care needs arising from COPD disrupts an individual’s existential situation. Understandings of individuals' existential situations within COPD are limited within the research literature and are rarely addressed within clinical practice, yet existential suffering has been linked to poor health-related quality of life for those living with other chronic conditions. The purpose of this integrative review is to provide a synthesis of existing evidence on existential suffering for those living with palliative care needs arising from COPD. Methods: This is an integrative review undertaken in accordance with PRISMA guidelines. Nine electronic databases were searched from April 2019 to January 2021. Thirty-five empirical research papers of both qualitative and quantitative methodologies, alongside systematic literature reviews, were included. Data analysis was undertaken using an integrative thematic analysis approach. Findings: Identified themes of existential suffering when living with palliative care needs arising from COPD are as follows: Liminality, Lamented Life, Loss of Personal Liberty, Life Meaning and Existential isolation. The absence of life meaning and purpose was of most importance to patients. Conclusion and Significance: This integrative review provides a synthesis of international evidence upon the presence of existential suffering. It is present and of significant impact within the daily lives of those living with palliative care needs arising from COPD. The absence of life meaning has the most significant impact, requiring further exploration of both its physical and psychological impact. Rediscovery of life meaning diminishes feelings of worthlessness and hopelessness in daily life and facilitates feelings of inner peace. For those with COPD living with such a relentless symptom burden, a positive existential situation is desirable.

Keywords: palliative care, COPD, existential suffering, end of life care

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Authors: Kamil Ganaev, Elina Vlasova, Andrei Shiryaev, Renat Akchurin

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De novo atrial fibrillation (AF) after coronary artery bypass grafting (CABG) is a common complication. To date, there are no data on the possible effect of diffuse lesions of coronary arteries on the incidence of postoperative AF complications. Methods. Patients operated on-pump under hypothermic conditions during the calendar year (2020) were studied. Inclusion criteria - isolated CABG and achievement of complete myocardial revascularization. Patients with a history of AF moderate and severe valve dysfunction, hormonal thyroid pathology, initial CHF(Congestive heart failure), as well as patients with developed perioperative complications (IM, acute heart failure, massive blood loss) and deceased were excluded. Thus 227 patients were included; mean age 65±9 years; 69% were men. 89% of patients had a 3-vessel lesion of the coronary artery; the remainder had a 2-vessel lesion. Mean LV size: 3.9±0.3 cm, indexed LV volume: 29.4±5.3 mL/m2. Two groups were considered: D (n=98), patients with diffuse coronary heart disease, and L (n=129), patients with local coronary heart disease. Clinical and demographic characteristics in the groups were comparable. Rhythm assessment: continuous bedside ECG monitoring up to 5 days; ECG CT at 5-7 days after CABG; daily routine ECG registration. Follow-up period - postoperative hospital period. Results. The Median follow-up period was 9 (7;11) days. POFP (Postoperative atrial fibrillation) was detected in 61/227 (27%) patients: 34/98 (35%) in group D versus 27/129 (21%) in group L; p<0.05. Moreover, the values of revascularization index in groups D and L (3.9±0.7 and 3.8±0.5, respectively) were equal, and the mean time Cardiopulmonary bypass (CPB) (107±27 and 80±13min), as well as the mean ischemic time (67±17 and 55±11min) were significantly longer in group D (p<0.05). However, a separate analysis of these parameters in patients with and without developed AF did not reveal any significant differences in group D (CPB time 99±21.2 min, ischemic time 63±12.2 min), or in group L (CPB time 88±13.1 min, ischemic time 58.7±13.2 min). Conclusion. With the diffuse nature of coronary lesions, the incidence of AF in the hospital period after isolated CABG definitely increases. To better understand the role of severe coronary atherosclerosis in the development of POAF, it is necessary to distinguish the influence of organic features of atrial and ventricular myocardium (as a consequence of chronic coronary disease) from the features of surgical correction in diffuse coronary lesions.

Keywords: atrial fibrillation, diffuse coronary artery disease, coronary artery bypass grafting, local coronary artery disease

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Authors: Induja R. Nimma, Anand Reddy Maligireddy, Artur Schneider, Melissa Lyle

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Background: Although heart failure is one of the most common causes of hospitalization in adult patients, there is limited knowledge on outcomes following initial hospitalization for COVID-19 with heart failure (HCF-19). We felt it pertinent to analyze 30-day readmission causes and outcomes among patients with HCF-19 using the United States using real-world big data via the National readmission database. Objective: The aim is to describe the rate and causes of readmissions and morbidity of heart failure with coinciding COVID-19 (HFC-19) in the United States, using the 2020 National Readmission Database (NRD). Methods: A descriptive, retrospective study was conducted on the 2020 NRD, a nationally representative sample of all US hospitalizations. Adult (>18 years) inpatient admissions with COVID-19 with HF and readmissions in 30 days were selected based on the International Classification of Diseases-Tenth Revision, Procedure Code. Results: In 2020, 2,60,372 adult patients were hospitalized with COVID-19 and HF. The median age was 74 (IQR: 64-83), and 47% were female. The median length of stay was 7(4-13) days, and the total cost of stay was 62,025 (31,956 – 130,670) United States dollars, respectively. Among the index hospital admissions, 61,527 (23.6%) died, and 22,794 (11.5%) were readmitted within 30 days. The median age of patients readmitted in 30 days was 73 (63-82), 45% were female, and 1,962 (16%) died. The most common principal diagnosis for readmission in these patients was COVID-19= 34.8%, Sepsis= 16.5%, HF = 7.1%, AKI = 2.2%, respiratory failure with hypoxia =1.7%, and Pneumonia = 1%. Conclusion: The rate of readmission in patients with heart failure exacerbations is increasing yearly. COVID-19 was observed to be the most common principal diagnosis in patients readmitted within 30 days. Complicated hypertension, chronic pulmonary disease, complicated diabetes, renal failure, alcohol use, drug use, and peripheral vascular disorders are risk factors associated with readmission. Familiarity with the most common causes and predictors for readmission helps guide the development of initiatives to minimize adverse outcomes and the cost of medical care.

Keywords: Covid-19, heart failure, national readmission database, readmission outcomes

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Authors: Siyamak Sarafraz, Reza Esmaeil Pour, Saeed Jamshidi, Asghar Molaei Dehkordi

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Cutting transport is one of the major problems in directional and extended reach oil and gas wells. Lack of sufficient attention to this issue may bring some troubles such as casing running, stuck pipe, excessive torque and drag, hole pack off, bit wear, decreased the rate of penetration (ROP), increased equivalent circulation density (ECD) and logging. Since it is practically impossible to directly observe the behavior of deep wells, a test setup was designed to investigate cutting transport phenomena. This experimental work carried out to scrutiny behavior of the effective variables in cutting transport. The test setup contained a test section with 17 feet long that made of a 3.28 feet long transparent glass pipe with 3 inch diameter, a storage tank with 100 liters capacity, drill pipe rotation which made of stainless steel with 1.25 inches diameter, pump to circulate drilling fluid, valve to adjust flow rate, bit and a camera to record all events which then converted to RGB images via the Image Processing Toolbox. After preparation of test process, each test performed separately, and weights of the output particles were measured and compared with each other. Observation charts were plotted to assess the behavior of viscosity, flow rate and RPM in inclinations of 0°, 30°, 60° and 90°. RPM was explored with other variables such as flow rate and viscosity in different angles. Also, effect of different flow rate was investigated in directional conditions. To access the precise results, captured image were analyzed to find out bed thickening and particles behave in the annulus. The results of this experimental study demonstrate that drill string rotation helps particles to be suspension and reduce the particle deposition cutting movement increased significantly. By raising fluid velocity, laminar flow converted to turbulence flow in the annulus. Increases in flow rate in horizontal section by considering a lower range of viscosity is more effective and improved cuttings transport performance.

Keywords: cutting transport, directional drilling, flow rate, hole cleaning, pipe rotation

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Authors: Rona Lee Suelo-Calanao, Mahmoud Loubani

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Objective: Sternal wound infection (SWI) following cardiac operation has a significant impact on patient morbidity and mortality. It also contributes to longer hospital stays and increased treatment costs. SWI management is mainly focused on treatment rather than prevention. This study looks at the effect of closed incision negative pressure therapy (ciNPT) dressing to help reduce the incidence of superficial SWI in high-risk patients after cardiac surgery. The ciNPT dressing was evaluated at 3 cardiac hospitals in the United Kingdom". Methods: All patients who had cardiac surgery from 2013 to 2021 were included in the study. The patients were classed as high risk if they have two or more of the recognised risk factors: obesity, age above 80 years old, diabetes, and chronic obstructive pulmonary disease. Patients receiving standard dressing (SD) and patients using ciNPT were propensity matched, and the Fisher’s exact test (two-tailed) and unpaired T-test were used to analyse categorical and continuous data, respectively. Results: There were 766 matched cases in each group. Total SWI incidences are lower in the ciNPT group compared to the SD group (43 (5.6%) vs 119 (15.5%), P=0.0001). There are fewer deep sternal wound infections (14(1.8%) vs. 31(4.04%), p=0.0149) and fewer superficial infections (29(3.7%) vs. 88 (11.4%), p=0.0001) in the ciNPT group compared to the SD group. However, the ciNPT group showed a longer average length of stay (11.23 ± 13 days versus 9.66 ± 10 days; p=0.0083) and higher mean logistic EuroSCORE (11.143 ± 13 versus 8.094 ± 11; p=0.0001). Conclusion: Utilization of ciNPT as an approach to help reduce the incidence of superficial and deep SWI may be effective in high-risk patients requiring cardiac surgery.

Keywords: closed incision negative pressure therapy, surgical wound infection, cardiac surgery complication, high risk cardiac patients

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Authors: Naif Mohsen Alharbi

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This paper present failure occurred on flexible coupling installed at oil anf gas operation. Also it presents maintenance ideas implemented on the flexible coupling installed to transmit high torque from gearbox to pump. Basically, the machine train is including steam turbine which drives the pump and there is gearbox located in between for speed reduction. investigation are identifying the root causes, solving and developing the technology designs or bad actor. This report provides the study intentionally for continues operation optimization, utilize the advanced opportunity and implement a improvement. Objective: The main objectives of the investigation are identifying the root causes, solving and developing the technology designs or bad actor. Ultimately, fulfilling the operation productivity, also ensuring better technology, quality and design by solutions. This report provides the study intentionally for continues operation optimization, utilize the advanced opportunity and implemet improvement. Method: The method used in this project was a very focused root cause analysis procedure that incorporated engineering analysis and measurements. The analysis method extensively covers the measuring of the complete coupling dimensions. Including the membranes thickness, hubs, bore diameter and total length, dismantle flexible coupling to diagnose how deep the coupling has been affected. Also, defining failure modes, so that the causes could be identified and verified. Moreover, Vibration analysis and metallurgy test. Lastly applying several solutions by advanced tools (will be mentioned in detail). Results and observation: Design capacity: Coupling capacity is an inadequate to fulfil 100% of operating conditions. Therefore, design modification of service factor to be at least 2.07 is crucial to address this issue and prevent recurrence of similar scenario, especially for the new upgrading project. Discharge fluctuation: High torque flexible coupling encountered during the operation. Therefore, discharge valve behaviour, tuning, set point and general conditions revaluated and modified subsequently, it can be used as baseline for upcoming Coupling design project. Metallurgy test: Material of flexible coupling membrane (discs) tested at the lab, for a detailed metallurgical investigation, better material grade has been selected for our operating conditions,

Keywords: high speed machine, reliabilty, flexible coupling, rotating equipment

Procedia PDF Downloads 51

Authors: Nikhil A. Gavhane, Sachin Shah, Ishant S. Mahajan, Pawan D. Bahekar

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Introduction: Millions of people are affected with dengue fever every year, which drives up healthcare expenses in many low-income countries. Organ failure and other serious symptoms may result. Another worldwide public health problem is sickle cell anaemia, which is most prevalent in Africa, the Caribbean, and Europe. Dengue epidemics have reportedly occurred in locations with a high frequency of sickle cell disease, compounding the health problems in these areas. Aims and Objectives: This study examines dengue infection in sickle cell disease-afflicted pre-schoolers. Method:This Retrospective cohort study examined paediatric patients. Young people with sickle cell disease (SCD), dengue infection, and a control group without SCD or dengue were studied. Data on demographics, SCD consequences, medical treatments, and laboratory findings were gathered to analyse the influence of SCD on dengue severity and clinical outcomes, classified as severe or non-severe by the 2009 WHO classification. Using fever or admission symptoms, the research estimated acute illness duration. Result: Table 1 compares haemoglobin genotype-based dengue episode features in SS, SC, and controls. Table 2 shows that severe dengue cases are older, have longer admission delays, and have particular symptoms. Table 3's multivariate analysis indicates SS genotype's high connection with severe dengue, multiorgan failure, and acute pulmonary problems. Table 4 relates severe dengue to greater white blood cell counts, anaemia, liver enzymes, and reduced lactate dehydrogenase. Conclusion: This study is valuable but confined to hospitalised dengue patients with sickle cell illness. Small cohorts limit comparisons. Further study is needed since findings contradict predictions.

Keywords: dengue, chills, headache, severe myalgia, vomiting, nausea, prostration

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Authors: Syed Beenish Rufai, Sarman Singh

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Background: Performance of Genotype MTBDRsl (Hain Life science GmbH Germany) for detection of mutations associated with second-line drug resistance is well known. However, less evidence regarding the association of mutations and genetic background of strains is known which, in the future, is essential for clinical management of anti-tuberculosis drugs in those settings where the probability of particular genotype is predominant. Material and Methods: During this retrospective study, a total of 259 MDR-TB isolates obtained from pulmonary TB patients were tested for second-line drug susceptibility testing (DST) using Genotype MTBDRsl VER 1.0 and compared with BACTEC MGIT-960 as a reference standard. All isolates were further characterized using spoligotyping. The spoligo patterns obtained were compared and analyzed using SITVIT_WEB. Results: Of total 259 MDR-TB isolates which were screened for second-line DST by Genotype MTBDRsl, mutations were found to be associated with gyrA, rrs and emb genes in 82 (31.6%), 2 (0.8%) and 90 (34.7%) isolates respectively. 16 (6.1%) isolates detected mutations associated with both FQ as well as to AG/CP drugs (XDR-TB). No mutations were detected in 159 (61.4%) isolates for corresponding gyrA and rrs genes. Genotype MTBDRsl showed a concordance of 96.4% for detection of sensitive isolates in comparison with second-line DST by BACTEC MGIT-960 and 94.1%, 93.5%, 60.5% and 50% for detection of XDR-TB, FQ, EMB, and AMK/CAP respectively. D94G was the most prevalent mutation found among (38 (46.4%)) OFXR isolates (37 FQ mono-resistant and 1 XDR-TB) followed by A90V (23 (28.1%)) (17 FQ mono-resistant and 6 XDR-TB). Among AG/CP resistant isolates A1401G was the most frequent mutation observed among (11 (61.1%)) isolates (2 AG/CP mono-resistant isolates and 9 XDR-TB isolates) followed by WT+A1401G (6 (33.3%)) and G1484T (1 (5.5%)) respectively. On spoligotyping analysis, Beijing strain (46%) was found to be the most predominant strain among pre-XDR and XDR TB isolates followed by CAS (30%), X (6%), Unique (5%), EAI and T each of 4%, Manu (3%) and Ural (2%) respectively. Beijing strain was found to be strongly associated with D94G (47.3%) and A90V mutations by (47.3%) and 34.8% followed by CAS strain by (31.6%) and 30.4% respectively. However, among AG/CP resistant isolates, only Beijing strain was found to be strongly associated with A1401G and WT+A1401G mutations by 54.5% and 50% respectively. Conclusion: Beijing strain was found to be strongly associated with the most prevalent mutations among pre-XDR and XDR TB isolates. Acknowledgments: Study was supported with Grant by All India Institute of Medical Sciences, New Delhi reference No. P-2012/12452.

Keywords: tuberculosis, line probe assay, XDR TB, drug susceptibility

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Authors: Carmela Monterroso, Marc Romero-Estonllo, Carlos Pascual, Beatriz Rodríguez-Garrido

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The mobilization of heavy metals from polluted soils causes their transfer to natural waters, with consequences for ecosystems and human health. Phytostabilization techniques are applied to reduce this mobility, through the establishment of a vegetal cover and the application of soil amendments. In this work, the capacity of different organic amendments to improve water quality and reduce the mobility of metals in mine-tailings was evaluated. A field pilot test was carried out with leaching columns installed on an old Cu mine ore (NW of Spain) which forms part of the PhytoSUDOE network of phytomanaged contaminated field sites (PhytoSUDOE/ Phy2SUDOE Projects (SOE1/P5/E0189 and SOE4/P5/E1021)). Ten columns (1 meter high by 25 cm in diameter) were packed with untreated mine tailings (control) or those treated with organic amendments. Applied amendments were based on different combinations of municipal wastes, bark chippings, biomass fly ash, and nanoparticles like aluminum oxides or ferrihydrite-type iron oxides. During the packing of the columns, rhizon-samplers were installed at different heights (10, 20, and 50 cm) from the top, and pore water samples were obtained by suction. Additionally, in each column, a bottom leachate sample was collected through a valve installed at the bottom of the column. After packing, the columns were sown with grasses. Water samples were analyzed for: pH and redox potential, using combined electrodes; salinity by conductivity meter: bicarbonate by titration, sulfate, nitrate, and chloride, by ion chromatography (Dionex 2000); phosphate by colorimetry with ammonium molybdate/ascorbic acid; Ca, Mg, Fe, Al, Mn, Zn, Cu, Cd, and Pb by flame atomic absorption/emission spectrometry (Perkin Elmer). Porewater and leachate from the control columns (packed with unamended mine tailings) were extremely acidic and had a high concentration of Al, Fe, and Cu. In these columns, no plant development was observed. The application of organic amendments improved soil conditions, which allowed the establishment of a dense cover of grasses in the rest of the columns. The combined effect of soil amendment and plant growth had a positive impact on water quality and reduced mobility of aluminum and heavy metals.

Keywords: leaching, organic amendments, phytostabilization, polluted soils

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Authors: Jeounghee Kim

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Objective: To describe the incidence of complication, according to the stage of Traumatic Spinal Cord Injury (TSCI) which was treated at Asan Medical Center (AMC), Korea. Hereafter, it should be developed in nursing management protocol of traumatic SCI. Methods. Retrospectively reviewed hospital records about the patients who were admitted AMC Patients with traumatic spinal cord injury until January 2005 and December 2016 were analyzed (n=97). AMC is a single institution of 2,700 beds where patients with trauma and severe trauma can be treated. Patients who were admitted to the emergency room due to spinal cord injury and who underwent intensive care unit, general ward, and rehabilitation ward. To identify long-term complications, we excluded patients who were operated on to other hospitals after surgery. Complications such as respiratory(pneumonia, atelectasis, pulmonary embolism, and others), cardiovascular (hypotension), urinary (autonomic dysreflexia, urinary tract infection (UTI), neurogenic bladder, and others), and skin systems (pressure ulcers) from the time of admission were examined through medical records and images. Results: SCI was graded according to ASIA scale. The initial grade was checked at admission. (grade A 55(56.7%), grade B 14(14.4)%, grade C 11(11.3%), grade D 15(15.5%), and grade E 2(2.1%). The grade was rechecked when the patient was discharged after treatment. (grade A 43(44.3%), grade B 15(15.5%), grade C 12(12.4%), grade D 21(21.6%), and grade E 6(6.2%). The most common complication after SCI was UTI 24cases (mean 36.5day), sore 24cases (40.5day), and Pneumonia which was 23 cases after 10days averagely. The other complications after SCI were neuropathic pain 19 cases, surgical site infection 4 cases. 53.6% of patient who had SCI were educated about intermittent catheterization at discharge from hospital. The mean hospital stay of all SCI patients was 61days. Conclusion: The Complications after traumatic SCI were developed at various stages from acute phase to chronic phase. Nurses need to understand fully the time-course of complication in traumatic SCI to provide evidence-based practice.

Keywords: spinal cord injury, complication, nursing, rehabilitation

Procedia PDF Downloads 199

Authors: Ivan Maguire, Ciprian Briciu, Alan Barrett, Dara Kervick, Jens Ducrèe, Fiona Regan

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With the ever-increasing myriad of applications of which microfluidic devices are capable, reliable fluidic actuation development has remained fundamental to the success of these microfluidic platforms. There are a number of approaches which can be taken in order to integrate liquid actuation on microfluidic platforms, which can usually be split into two primary categories; active microvalves and passive microvalves. Active microvalves are microfluidic valves which require a physical parameter change by external, or separate interaction, for actuation to occur. Passive microvalves are microfluidic valves which don’t require external interaction for actuation due to the valve’s natural physical parameters, which can be overcome through sample interaction. The purpose of this paper is to illustrate how further improvements to past microvalve solutions can largely enhance systematic reliability and performance, with both novel active and passive microvalves demonstrated. Covered within this scope will be two alternative and novel microvalve solutions for centrifugal microfluidic platforms; a revamped pneumatic-dissolvable film active microvalve (PAM) strategy and a spray-on Sol-Gel based hydrophobic passive microvalve (HPM) approach. Both the PAM and the HPM mechanisms were demonstrated on a centrifugal microfluidic platform consisting of alternating layers of 1.5 mm poly(methyl methacrylate) (PMMA) (for reagent storage) sheets and ~150 μm pressure sensitive adhesive (PSA) (for microchannel fabrication) sheets. The PAM approach differs from previous SOLUBON™ dissolvable film methods by introducing a more reliable and predictable liquid delivery mechanism to microvalve site, thus significantly reducing premature activation. This approach has also shown excellent synchronicity when performed in a multiplexed form. The HPM method utilises a new spray-on and low curing temperature (70°C) sol-gel material. The resultant double layer coating comprises a PMMA adherent sol-gel as the bottom layer and an ultra hydrophobic silica nano-particles (SNPs) film as the top layer. The optimal coating was integrated to microfluidic channels with varying cross-sectional area for assessing microvalve burst frequencies consistency. It is hoped that these microvalving solutions, which can be easily added to centrifugal microfluidic platforms, will significantly improve automation reliability.

Keywords: centrifugal microfluidics, hydrophobic microvalves, lab-on-a-disc, pneumatic microvalves

Procedia PDF Downloads 174

Authors: Yara Saleh, Sebastien Antherieu, Romain Dusautoir, Jules Sotty, Laurent Alleman, Ludivine Canivet, Esperanza Perdrix, Pierre Dubot, Anne Platel, Fabrice Nesslany, Guillaume Garcon, Jean-Marc Lo-Guidice

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Air pollution is one of the leading causes of premature death worldwide. Among air pollutants, particulate matter (PM) is a major health risk factor, through the induction of cardiopulmonary diseases and lung cancers. They are composed of coarse, fine and ultrafine particles (PM10, PM2.5, and PM0.1 respectively). Ultrafine particles are emerging unregulated pollutants that might have greater toxicity than larger particles, since they are more abundant and consequently have higher surface area per unit of mass. Our project aims to develop a relevant in vivo model of sub-chronic exposure to atmospheric particles in order to elucidate the specific respiratory impact of ultrafine particles compared to fine particulate matter. Quasi-ultrafine (PM0.18) and fine (PM2.5) particles have been collected in the urban industrial zone of Dunkirk in north France during a 7-month campaign, and submitted to physico-chemical characterization. BALB/c mice were then exposed intranasally to 10µg of PM0.18 or PM2.5 3 times a week. After 1 or 3-month exposure, broncho alveolar lavages (BAL) were performed and lung tissues were harvested for histological and transcriptomic analyses. The physico-chemical study of the collected particles shows that there is no major difference in elemental and surface chemical composition between PM0.18 and PM2.5. Furthermore, the results of the cytological analyses carried out show that both types of particulate fractions can be internalized in lung cells. However, the cell count in BAL and preliminary transcriptomic data suggest that PM0.18 could be more reactive and induce a stronger lung inflammation in exposed mice than PM2.5. Complementary studies are in progress to confirm these first data and to identify the metabolic pathways more specifically associated with the toxicity of ultrafine particles.

Keywords: environmental pollution, lung affect, mice, ultrafine particles

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Authors: Karlygash Tulendieva

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Presently vaccination is the most effective method of prevention of flu and its complications. The purpose of this study was to analyze the impact of the increase of coverage of the population of South Kazakhstan region with flu vaccination and decrease of the ARVI morbidity. The analysis was performed on the data of flu vaccination of risk groups, including children under one year and pregnant women. Data on ARVI morbidity during 2010-2015 and data on vaccination were taken from the reports of the Epidemiological Surveillance Unit of Department of Consumers’ Rights Protection of South Kazakhstan region. Coverage with flu vaccination of the risk groups was annually increasing and in 2015 it reached 16% (450,000/2,800,682) from the total population. The ARVI morbidity rate in the entire population in 2010 was 2,010.4 per 100,000 of the population and decreased 3.2 times to 609.9 per 100,000 of the population in 2015. Annual growth was observed from 2010 to 2015 of specific weight of the vaccinated main risk groups: healthcare workers by 51% (from 17,331 in 2010 to 33,538 in 2015), children with chronic pulmonary and cardio-vascular diseases, immune deficiency, weak and sickly children above six months by 39% (from 63,122 in 2010 to 158,023 in 2015), adults with chronic co-morbidities by 27% (from 44,271 in 2010 to 162,595 in 2015), persons above 65 by 17% (from 10,276 in 2010 to 57,875 in 2015), and annual coverage of pregnant women on second or third trimester from 34,443 in 2010 to 37,969 in 2015. Starting from 2013 and until 2015 vaccination was performed in the region with coverage of at least 90% of children from 6 months to one year. The ARVI morbidity in this age group decreased 3.3 times from 8,687.8 per 100,000 of the population in 2010 to 2,585.8 per 100,000 of the population in 2015. Vaccination of pregnant women on 2-3 trimester was started in the region in 2012. Annual increase of vaccination coverage of pregnant women from 86.1% (34,443/40,000) in 2012 to 95% (37,969/40,000) in 2015 decreased the morbidity 1.5 times from 4,828.8 per 100,000 of population in 2012 to 3,022.7 per 100,000 of population in 2015. Following the increase of vaccination coverage of the population in South Kazakhstan region, the trend was observed of decrease of ARVI morbidity rates among the population and main risk groups, among pregnant women and children under one year.

Keywords: acute respiratory viral infections, flu, risk groups, vaccination

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Authors: B. Petrović, M. Petrović, L. Rutonjski, I. Djan, V. Ivanović

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Objective: Cardiac pacemakers are very sensitive to radiotherapy treatment from two sources: electromagnetic influence from the medical linear accelerator producing ionizing radiation- influencing electronics within the pacemaker, and the absorption of dose to the device. On the other hand, patients with cardiac pacemakers at the place of a tumor are rather rare, and single clinic hardly has experience with the management of such patients. The widely accepted international guidelines for management of radiation oncology patients recommend that these patients should be closely monitored and examined before, during and after radiotherapy treatment by cardiologist, and their device and condition followed up. The number of patients having both cancer and pacemaker, is growing every year, as both cancer incidence, as well as cardiac diseases incidence, are inevitably growing figures. Materials and methods: Female patient, age 69, was diagnozed with valvular cardiomyopathy and got implanted a pacemaker in 2005 and prosthetic mitral valve in 1993 (cancer was diagnosed in 2012). She was stable cardiologically and came to radiation therapy department with the diagnosis of right breast cancer, with the tumor in upper lateral quadrant of the right breast. Since she had all lymph nodes positive (28 in total), she had to have irradiated the supraclavicular region, as well as the breast with the tumor bed. She previously received chemotherapy, approved by the cardiologist. The patient was estimated to be with the high risk as device was within the field of irradiation, and the patient had high dependence on her pacemaker. The radiation therapy plan was conducted as 3D conformal therapy. The delineated target was breast with supraclavicular region, where the pacemaker was actually placed, with the addition of a pacemaker as organ at risk, to estimate the dose to the device and its components as recommended, and the breast. The targets received both 50 Gy in 25 fractions (where 20% of a pacemaker received 50 Gy, and 60% of a device received 40 Gy). The electrode to the heart received between 1 Gy and 50 Gy. Verification of dose planned and delivered was performed. Results: Evaluation of the patient status according to the guidelines and especially evaluation of all associated risks to the patient during treatment was done. Patient was irradiated by prescribed dose and followed up for the whole year, with no symptoms of failure of the pacemaker device during, or after treatment in follow up period. The functionality of a device was estimated to be unchanged, according to the parameters (electrode impedance and battery energy). Conclusion: Patient was closely monitored according to published guidelines during irradiation and afterwards. Pacemaker irradiated with the full dose did not show any signs of failure despite recommendations data, but in correlation with other published data.

Keywords: cardiac pacemaker, breast cancer, radiotherapy treatment planning, complications of treatment

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