Search results for: joint detection
Commenced in January 2007
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Edition: International
Paper Count: 4429

Search results for: joint detection

439 A Case-Series Analysis of Tuberculosis in Patients at Internal Medicine Department

Authors: Cherif Y., Ghariani R., Derbal S., Farhati S., Ben Dahmen F., Abdallah M.

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Introduction: Tuberculosis (TBC) is a frequent infection and is still a major public health problem in Tunisia. The aim of this work is to focus on diagnostic and therapeutic characteristics of TBC in patients referred to our internal medicine department. Patients and Methods: The study was retrospective and descriptive of a cohort of consecutive cases treated from January 2016 to December 2019, collecting patients with latent or patent TBC. Twenty-eight medical records of adults diagnosed with TBC were reviewed. Results: Twenty-eight patients, including 18 women and 10 men, were diagnosed with TBC. Their mean age is 48 years (range: 22-78 years). Five patients have a medical history of diabetes mellitus, 1 patient was followed for systemic lupus erythematosus treated with corticosteroids and immunosuppressant drugs, and another was treated with corticosteroids for Mac Duffy syndrome. The TBC is latent in 12 cases and patent in 16 cases. The most common symptoms were fever and weight loss and were found in 10 cases, a cough in 2 cases, sputum in 3 cases, lymph nodes in 4 cases, erythema nodosum in 2 cases, and neurological signs in 3 cases. Lymphopenia is noticed in 3 cases and a biological inflammatory syndrome in 18 of the cases. The purified protein derivate reaction was positive in 17 cases, anergic in 3 cases, negative in 5 cases, and not done in 3 cases. The acid-fast bacilli stain culture was strongly positive in one patient. The histopathological study was conclusive in 11 patients and showed granulomatosis with caseous necrosis. TBC was pulmonary in 7 patients, lymph node in 7 cases, peritoneal in 7 cases, digestive in 1 case, neuromeningeal in 3 cases, and thyroïd in 1 case. Seven patients had multifocal TBC. All the patients received anti-tuberculosis treatment with a mean duration of 8 months with no failure or relapse with an average follow-up time of 10.58 months. Conclusion: Diagnosis and management of TBC remain essential to avoid serious complications. The survey is necessary to ensure timely detection and treatment of infected adults to decrease its incidence. The best treatment remains preventive through vaccination and improving social and economic conditions.

Keywords: tuberculosis, infection, autoimmune disease, granulomatosis

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438 Application of Aerogeomagnetic and Ground Magnetic Surveys for Deep-Seated Kimberlite Pipes in Central India

Authors: Utkarsh Tripathi, Bikalp C. Mandal, Ravi Kumar Umrao, Sirsha Das, M. K. Bhowmic, Joyesh Bagchi, Hemant Kumar

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The Central India Diamond Province (CIDP) is known for the occurrences of primary and secondary sources for diamonds from the Vindhyan platformal sediments, which host several kimberlites, with one operating mine. The known kimberlites are Neo-Proterozoic in age and intrude into the Kaimur Group of rocks. Based on the interpretation of areo-geomagnetic data, three potential zones were demarcated in parts of Chitrakoot and Banda districts, Uttar Pradesh, and Satna district, Madhya Pradesh, India. To validate the aero-geomagnetic interpretation, ground magnetic coupled with a gravity survey was conducted to validate the anomaly and explore the possibility of some pipes concealed beneath the Vindhyan sedimentary cover. Geologically the area exposes the milky white to buff-colored arkosic and arenitic sandstone belonging to the Dhandraul Formation of the Kaimur Group, which are undeformed and unmetamorphosed providing almost transparent media for geophysical exploration. There is neither surface nor any geophysical indication of intersections of linear structures, but the joint patterns depict three principal joints along NNE-SSW, ENE-WSW, and NW-SE directions with vertical to sub-vertical dips. Aeromagnetic data interpretation brings out three promising zones with the bi-polar magnetic anomaly (69-602nT) that represent potential kimberlite intrusive concealed below at an approximate depth of 150-170m. The ground magnetic survey has brought out the above-mentioned anomalies in zone-I, which is congruent with the available aero-geophysical data. The magnetic anomaly map shows a total variation of 741 nT over the area. Two very high magnetic zones (H1 and H2) have been observed with around 500 nT and 400 nT magnitudes, respectively. Anomaly zone H1 is located in the west-central part of the area, south of Madulihai village, while anomaly zone H2 is located 2km apart in the north-eastern direction. The Euler 3D solution map indicates the possible existence of the ultramafic body in both the magnetic highs (H1 and H2). The H2 high shows the shallow depth, and H1 shows a deeper depth solution. In the reduced-to-pole (RTP) method, the bipolar anomaly disappears and indicates the existence of one causative source for both anomalies, which is, in all probabilities, an ultramafic suite of rock. The H1 magnetic high represents the main body, which persists up to depths of ~500m, as depicted through the upward continuation derivative map. Radially Averaged Power Spectrum (RAPS) shows the thickness of loose sediments up to 25m with a cumulative depth of 154m for sandstone overlying the ultramafic body. The average depth range of the shallower body (H2) is 60.5-86 meters, as estimated through the Peters half slope method. Magnetic (TF) anomaly with BA contour also shows high BA value around the high zones of magnetic anomaly (H1 and H2), which suggests that the causative body is with higher density and susceptibility for the surrounding host rock. The ground magnetic survey coupled with the gravity confirms a potential target for further exploration as the findings are co-relatable with the presence of the known diamondiferous kimberlites in this region, which post-date the rocks of the Kaimur Group.

Keywords: Kaimur, kimberlite, Euler 3D solution, magnetic

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437 Open Fields' Dosimetric Verification for a Commercially-Used 3D Treatment Planning System

Authors: Nashaat A. Deiab, Aida Radwan, Mohamed Elnagdy, Mohamed S. Yahiya, Rasha Moustafa

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This study is to evaluate and investigate the dosimetric performance of our institution's 3D treatment planning system, Elekta PrecisePLAN, for open 6MV fields including square, rectangular, variation in SSD, centrally blocked, missing tissue, square MLC and MLC shaped fields guided by the recommended QA tests prescribed in AAPM TG53, NCS report 15 test packages, IAEA TRS 430 and ESTRO booklet no.7. The study was performed for Elekta Precise linear accelerator designed for clinical range of 4, 6 and 15 MV photon beams with asymmetric jaws and fully integrated multileaf collimator that enables high conformance to target with sharp field edges. Seven different tests were done applied on solid water equivalent phantom along with 2D array dose detection system, the calculated doses using 3D treatment planning system PrecisePLAN, compared with measured doses to make sure that the dose calculations are accurate for open fields including square, rectangular, variation in SSD, centrally blocked, missing tissue, square MLC and MLC shaped fields. The QA results showed dosimetric accuracy of the TPS for open fields within the specified tolerance limits. However large square (25cm x 25cm) and rectangular fields (20cm x 5cm) some points were out of tolerance in penumbra region (11.38 % and 10.9 %, respectively). For the test of SSD variation, the large field resulted from SSD 125 cm for 10cm x 10cm filed the results recorded an error of 0.2% at the central axis and 1.01% in penumbra. The results yielded differences within the accepted tolerance level as recommended. Large fields showed variations in penumbra. These differences between dose values predicted by the TPS and the measured values at the same point may result from limitations of the dose calculation, uncertainties in the measurement procedure, or fluctuations in the output of the accelerator.

Keywords: quality assurance, dose calculation, 3D treatment planning system, photon beam

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436 Applying Unmanned Aerial Vehicle on Agricultural Damage: A Case Study of the Meteorological Disaster on Taiwan Paddy Rice

Authors: Chiling Chen, Chiaoying Chou, Siyang Wu

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Taiwan locates at the west of Pacific Ocean and intersects between continental and marine climate. Typhoons frequently strike Taiwan and come with meteorological disasters, i.e., heavy flooding, landslides, loss of life and properties, etc. Global climate change brings more extremely meteorological disasters. So, develop techniques to improve disaster prevention and mitigation is needed, to improve rescue processes and rehabilitations is important as well. In this study, UAVs (Unmanned Aerial Vehicles) are applied to take instant images for improving the disaster investigation and rescue processes. Paddy rice fields in the central Taiwan are the study area. There have been attacked by heavy rain during the monsoon season in June 2016. UAV images provide the high ground resolution (3.5cm) with 3D Point Clouds to develop image discrimination techniques and digital surface model (DSM) on rice lodging. Firstly, image supervised classification with Maximum Likelihood Method (MLD) is used to delineate the area of rice lodging. Secondly, 3D point clouds generated by Pix4D Mapper are used to develop DSM for classifying the lodging levels of paddy rice. As results, discriminate accuracy of rice lodging is 85% by image supervised classification, and the classification accuracy of lodging level is 87% by DSM. Therefore, UAVs not only provide instant images of agricultural damage after the meteorological disaster, but the image discriminations on rice lodging also reach acceptable accuracy (>85%). In the future, technologies of UAVs and image discrimination will be applied to different crop fields. The results of image discrimination will be overlapped with administrative boundaries of paddy rice, to establish GIS-based assist system on agricultural damage discrimination. Therefore, the time and labor would be greatly reduced on damage detection and monitoring.

Keywords: Monsoon, supervised classification, Pix4D, 3D point clouds, discriminate accuracy

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435 The Exposure to Endocrine Disruptors during Pregnancy and Relation to Steroid Hormones

Authors: L. Kolatorova, J. Vitku, K. Adamcova, M. Simkova, M. Hill, A. Parizek, M. Duskova

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Endocrine disruptors (EDs) are substances leaching from various industrial products, which are able to interfere with the endocrine system. Their harmful effects on human health are generally well-known, and exposure during fetal development may have lasting effects. Fetal exposure and transplacental transport of bisphenol A (BPA) have been recently studied; however, less is known about alternatives such as bisphenol S (BPS), bisphenol F (BPF) and bisphenol AF (BPAF), which have started to appear in consumer products. The human organism is usually exposed to the mixture of EDs, out of which parabens are otherwise known to transfer placenta. The usage of many cosmetic, pharmaceutical and consumer products during the pregnancy that may contain parabens and bisphenols has led to the need for investigation. The aim of the study was to investigate the transplacental transport of BPA, its alternatives, and parabens, and to study their relation to fetal steroidogenesis. BPA, BPS, BPF, BPAF, methylparaben, ethylparaben, propylparaben, butylparaben, benzylparaben and 15 steroids including estrogens, corticoids, androgens and immunomodulatory ones were determined in 27 maternal (37th week of gestation) and cord plasma samples using liquid chromatography - tandem mass spectrometry methods. The statistical evaluation of the results showed significantly higher levels of BPA (p=0.0455) in cord plasma compared to maternal plasma. The results from multiple regression models investigated that in cord plasma, methylparaben, propylparaben and the sum of all measured parabens were inversely associated with testosterone levels. To our best knowledge, this study is the first attempt to determine the levels of alternative bisphenols in the maternal and cord blood, and also the first study reporting the simultaneous detection of bisphenols, parabens, and steroids in these biological fluids. Our study confirmed the transplacental transport of BPA, with likely accumulation in the fetal compartment. The negative association of cord blood parabens and testosterone levels highlights their possible risks, especially for the development of male fetuses. Acknowledgements: This work was supported by the project MH CR 17-30528 A from the Czech Health Research Council, MH CZ - DRO (Institute of Endocrinology - EÚ, 00023761) and by the MEYS CR (OP RDE, Excellent research - ENDO.CZ).

Keywords: bisphenol, endocrine disruptor, paraben, pregnancy, steroid

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434 Selection of Most Appropriate Poplar and Willow Cultivars for Landfill Remediation Using Plant Physiology Parameters

Authors: Andrej Pilipović, Branislav Kovačević, Marina Milović, Lazar Kesić, Saša Pekeč, Leopold Poljaković-Pajnik, Saša Orlović

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The effect of landfills on the environment reflects in the dispersion of the contaminants on surrounding soils by the groundwater plume. Such negative effect can be mitigated with the establishment of vegetative buffers surrounding landfills. The “TreeRemEnergy” project funded by the Science Fund of Republic of Serbia – Green program focuses on development of phytobuffers for landfill phytoremediation with the use of Short Rotation Woody Crops (SRWC) plantations that can be further used for the biomass for energy. One of the goals of the project is to select most appropriate poplar (Populus sp.) and willow (Salix sp.) clones through phytorecurrent selection that involves testing of various breeding traits. Physiological parameters serve as a significant contribution to the breeding process aimed to early detection of potential candidates. This study involved testing of the effect of the landfill soils on the photosynthetic processes of the selected poplar and willow candidates. For this purpose, measurements of the gas exchange, chlorophyll content and chlorophyll fluorescence were measured on the tested plants. Obtained results showed that there were differences in the influence of the controlled sources of variation on examined physiological parameters. The effect of clone was significant in all parameters, while the effect of the substrate was not statistically significant in any of measured parameters. However, the effect of interaction Clone×Substrate was significant in intercellular CO2 concentration(ci), stomatal conductance (gs) and transpiration rate (E), suggesting that water regime of the tested clones showed different response to the tested soils. Some clones showed more “generalist” behavior (380, 107/65/9, and PE19/66), while “specialist” behavior was recorded in clones PE4/68, S1-8, and 79/64/2. On the other hand, there was no significant effect of the tested substrate on the pigments content measured with SPAD meter. Results of this study allowed us to narrow the group of clones for further trails in field conditions.

Keywords: clones, net photosynthesis, WUE, transpiration, stomatal conductance, SPAD

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433 Design and Implementation of an Affordable Electronic Medical Records in a Rural Healthcare Setting: A Qualitative Intrinsic Phenomenon Case Study

Authors: Nitika Sharma, Yogesh Jain

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Introduction: An efficient Information System helps in improving the service delivery as well provides the foundation for policy and regulation of other building blocks of Health System. Health care organizations require an integrated working of its various sub-systems. An efficient EMR software boosts the teamwork amongst the various sub-systems thereby resulting in improved service delivery. Although there has been a huge impetus to EMR under the Digital India initiative, it has still not been mandated in India. It is generally implemented in huge funded public or private healthcare organizations only. Objective: The study was conducted to understand the factors that lead to the successful adoption of an affordable EMR in the low level healthcare organization. It intended to understand the design of the EMR and address the solutions to the challenges faced in adoption of the EMR. Methodology: The study was conducted in a non-profit registered Healthcare organization that has been providing healthcare facilities to more than 2500 villages including certain areas that are difficult to access. The data was collected with help of field notes, in-depth interviews and participant observation. A total of 16 participants using the EMR from different departments were enrolled via purposive sampling technique. The participants included in the study were working in the organization before the implementation of the EMR system. The study was conducted in one month period from 25 June-20 July 2018. The Ethical approval was taken from the institute along with prior approval of the participants. Data analysis: A word document of more than 4000 words was obtained after transcribing and translating the answers of respondents. It was further analyzed by focused coding, a line by line review of the transcripts, underlining words, phrases or sentences that might suggest themes to do thematic narrative analysis. Results: Based on the answers the results were thematically grouped under four headings: 1. governance of organization, 2. architecture and design of the software, 3. features of the software, 4. challenges faced in adoption and the solutions to address them. It was inferred that the successful implementation was attributed to the easy and comprehensive design of the system which has facilitated not only easy data storage and retrieval but contributes in constructing a decision support system for the staff. Portability has lead to increased acceptance by physicians. The proper division of labor, increased efficiency of staff, incorporation of auto-correction features and facilitation of task shifting has lead to increased acceptance amongst the users of various departments. Geographical inhibitions, low computer literacy and high patient load were the major challenges faced during its implementation. Despite of dual efforts made both by the architects and administrators to combat these challenges, there are still certain ongoing challenges faced by organization. Conclusion: Whenever any new technology is adopted there are certain innovators, early adopters, late adopters and laggards. The same pattern was followed in adoption of this software. He challenges were overcome with joint efforts of organization administrators and users as well. Thereby this case study provides a framework of implementing similar systems in public sector of countries that are struggling for digitizing the healthcare in presence of crunch of human and financial resources.

Keywords: EMR, healthcare technology, e-health, EHR

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432 The Effects of Ultrasound on the Extraction of Ficus deltoidea Leaves

Authors: Nur Aimi Syairah Mohd Abdul Alim, Azilah Ajit, A. Z. Sulaiman

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The present study aimed to investigate the effects of ultrasound-assisted extraction (UAE) on the extraction of Vitexin and Iso-Vitexin from Ficus deltoidea plants. In recent years, ultrasound technology has been found to be a potential herbal extraction technique. The passage of ultrasound energy in a liquid medium generates mechanical agitation and other physical effects due to acoustic cavitation. The main goal is to optimised ultrasonic-assisted extraction condition providing the highest extraction yield with the most desirable antioxidant activity and stability. Thus, a series of experiments has been developed to investigate the effect of ultrasound energy on the vegetal material and the implemented parameters by using HPLC-photodiode array detection. The influences of several experimental parameters on the ultrasonic extraction of Ficus deltoidea leaves were investigated: extraction time (1-8 h), solvent-to-water ratio (1:10 to 1:50), temperature (50–100 °C), duty cycle (10–continuous sonication) and intensity. The extracts at the optimized condition were compared with those obtained by conventional boiling extraction, in terms of bioactive constituents yield and chemical composition. The compounds of interest identified in the extracts were Vitexin and Isovitexin, which possess anti-diabetic, anti-oxidant and anti-cancer properties. Results showed that the main variables affecting the extraction process were temperature and time. Though in less extent, solvent-to-water ratio, duty cycle and intensity are also demonstrated to be important parameters. The experimental values under optimal conditions were in good consistent with the predicted values, which suggested that ultrasonic-assisted extraction (UAE) is more efficient process as compared to conventional boiling extraction. It recommended that ultrasound extraction of Ficus deltoidea plants are feasible to replace the traditional time-consuming and low efficiency preparation procedure in the future modernized and commercialized manufacture of this highly valuable herbal medicine.

Keywords: Ficus, ultrasounds, vitexin, isovitexin

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431 Characterization of Fungal Endophytes in Leaves, Stems and Roots of African Yam Bean (Sphenostylis sternocarpa Hochst ex. A. Rich Harms)

Authors: Iyabode A. Kehinde, Joshua O. Oyekanmi, Jumoke T. Abimbola, Olajumoke E. Ayanda

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African yam bean (AYB), (Sphenostylis stenocarpa) is a leguminous crop that provides nutritionally rich seeds, tubers and leaves for human consumption. AYB potentials as an important food security crop is yet to be realized and thus classified as underutilized crop. Underutilization of the crop has been partly associated with scarce information on the incidence and characterization of fungal endophytes infecting vascular parts of AYB. Accurate and robust detection of these endophytic fungi is essential for diagnosis, modeling, surveillance and protection of germplasm (seed) health. This work aimed at isolating and identifying fungal endophytes associated with leaves, stems and roots of AYB in Ogun State, Nigeria. This study investigated both cultural and molecular properties of endophytic fungi in AYB for its characterization and diversity. Fungal endophytes were isolated and culturally identified. DNA extraction, PCR amplification using ITS primers and analyses of nucleotide sequences of ribosomal DNA fragments were conducted on selected isolates. BLAST analysis was conducted on consensus nucleotide sequences of 28 out of 30 isolates and results showed similar homology with genera of Rhizopus, Cunninghamella, Fusarium, Aspergillus, Penicillium, Alternaria, Diaporthe, Nigrospora, Purpureocillium, Corynespora, Magnaporthe, Macrophomina, Curvularia, Acrocalymma, Talaromyces and Simplicillium. Slight similarity was found with endophytes associated with soybean. Phylogenetic analysis by maximum likelihood method showed high diversity among the general. These organisms have high economic importance in crop improvement. For an instance, Purpureocillium lilacinum showed high potential in control of root rot caused by nematodes in tomatoes. Though some can be pathogens, but many of the fungal endophytes have beneficial attributes to plant in host health, uptake of nutrients, disease suppression, and host immunity.

Keywords: molecular characterization, African Yam Bean, fungal endophyte, plant parts

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430 The Impact of the COVID-19 on the Cybercrimes in Hungary and the Possible Solutions for Prevention

Authors: László Schmidt

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Technological and digital innovation is constantly and dynamically evolving, which poses an enormous challenge to both lawmaking and law enforcement. To legislation because artificial intelligence permeates many areas of people’s daily lives that the legislator must regulate. it can see how challenging it is to regulate e.g. self-driving cars/taxis/camions etc. Not to mention cryptocurrencies and Chat GPT, the use of which also requires legislative intervention. Artificial intelligence also poses an extraordinary challenge to law enforcement. In criminal cases, police and prosecutors can make great use of AI in investigations, e.g. in forensics, DNA samples, reconstruction, identification, etc. But it can also be of great help in the detection of crimes committed in cyberspace. In the case of cybercrime, on the one hand, it can be viewed as a new type of crime that can only be committed with the help of information systems, and that has a specific protected legal object, such as an information system or data. On the other hand, it also includes traditional crimes that are much easier to commit with the help of new tools. According to Hungarian Criminal Code section 375 (1), any person who, for unlawful financial gain, introduces data into an information system, or alters or deletes data processed therein, or renders data inaccessible, or otherwise interferes with the functioning of the information system, and thereby causes damage, is guilty of a felony punishable by imprisonment not exceeding three years. The Covid-19 coronavirus epidemic has had a significant impact on our lives and our daily lives. It was no different in the world of crime. With people staying at home for months, schools, restaurants, theatres, cinemas closed, and no travel, criminals have had to change their ways. Criminals were committing crimes online in even greater numbers than before. These crimes were very diverse, ranging from false fundraising, the collection and misuse of personal data, extortion to fraud on various online marketplaces. The most vulnerable age groups (minors and elderly) could be made more aware and prevented from becoming victims of this type of crime through targeted programmes. The aim of the study is to show the Hungarian judicial practice in relation to cybercrime and possible preventive solutions.

Keywords: cybercrime, COVID-19, Hungary, criminal law

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429 Sexual Dimorphism in the Sensorial Structures of the Antenna of Thygater aethiops (Hymenoptera: Apidae) and Its Relation with Some Corporal Parameters

Authors: Wendy Carolina Gomez Ramirez, Rodulfo Ospina Torres

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Thygater aethiops is a species of solitary bee with a neotropical distribution that has been adapted to live in urban environments. This species of bee presents a marked sexual dimorphism since the males have antenna almost as long as their body different from the females that present antenna with smaller size. In this work, placoid sensilla were studied, which are structures that appear in the antenna and are involved in the detection of substances both, for reproduction and for the search of food. The aim of this study was to evaluate the differences between these sensory structures in the different sexes, for which males and females were captured. Later some body measures were taken such as fresh weight with abdomen and without it, since the weight could be modified by the stomach content; other measures were taken as the total antenna length and length of the flagellum and flagelomere. After negative imprints of the antenna were made using nail polish, the imprint was cut with a microblade and mounted onto a microscope slide. The placoid sensilla were visible on the imprint, so they were counted manually on the 100x objective lens of the optical microscope. Initially, the males presented a specific distribution pattern in two types of sensilla: trichoid and placoid, the trichoid were found aligned in the dorsal face of the antenna and the placoid were distributed along the entire antenna; that was different to the females since they did not present a distribution pattern the sensilla were randomly organized. It was obtained that the males, because they have a longer antenna, have a greater number of sensilla in relation to the females. Additionally, it was found that there was no relationship between the weight and the number of sensilla, but there was a positive relationship between the length of the antenna, the length of the flagellum and the number of sensilla. The relationship between the number of sensilla per unit area in each of the sexes was also calculated, which showed that, on average, males have 4.2 ± 0.38 sensilla per unit area and females present 2.2 ± 0.20 and likewise a significant difference between sexes. This dimorphism found may be related to the sexual behavior of the species, since it has been demonstrated that males are more adapted to the perception of substances related to reproduction than to the search of food.

Keywords: antenna, olfactory organ, sensilla, sexual dimorphism, solitary bees

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428 Identification of Candidate Congenital Heart Defects Biomarkers by Applying a Random Forest Approach on DNA Methylation Data

Authors: Kan Yu, Khui Hung Lee, Eben Afrifa-Yamoah, Jing Guo, Katrina Harrison, Jack Goldblatt, Nicholas Pachter, Jitian Xiao, Guicheng Brad Zhang

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Background and Significance of the Study: Congenital Heart Defects (CHDs) are the most common malformation at birth and one of the leading causes of infant death. Although the exact etiology remains a significant challenge, epigenetic modifications, such as DNA methylation, are thought to contribute to the pathogenesis of congenital heart defects. At present, no existing DNA methylation biomarkers are used for early detection of CHDs. The existing CHD diagnostic techniques are time-consuming and costly and can only be used to diagnose CHDs after an infant was born. The present study employed a machine learning technique to analyse genome-wide methylation data in children with and without CHDs with the aim to find methylation biomarkers for CHDs. Methods: The Illumina Human Methylation EPIC BeadChip was used to screen the genome‐wide DNA methylation profiles of 24 infants diagnosed with congenital heart defects and 24 healthy infants without congenital heart defects. Primary pre-processing was conducted by using RnBeads and limma packages. The methylation levels of top 600 genes with the lowest p-value were selected and further investigated by using a random forest approach. ROC curves were used to analyse the sensitivity and specificity of each biomarker in both training and test sample sets. The functionalities of selected genes with high sensitivity and specificity were then assessed in molecular processes. Major Findings of the Study: Three genes (MIR663, FGF3, and FAM64A) were identified from both training and validating data by random forests with an average sensitivity and specificity of 85% and 95%. GO analyses for the top 600 genes showed that these putative differentially methylated genes were primarily associated with regulation of lipid metabolic process, protein-containing complex localization, and Notch signalling pathway. The present findings highlight that aberrant DNA methylation may play a significant role in the pathogenesis of congenital heart defects.

Keywords: biomarker, congenital heart defects, DNA methylation, random forest

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427 The Incidence of Cardiac Arrhythmias Using Trans-Telephonic, Portable Electrocardiography Recorder, in Out-Patients Faculty of Medicine Ramathibodi Hospital

Authors: Urasri Imsomboon, Sopita Areerob, Kanchaporn Kongchauy, Tuchapong Ngarmukos

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Objective: The Trans-telephonic Electrocardiography (ECG) monitoring is used to diagnose of infrequent cardiac arrhythmias and improve outcome of early detection and treatment on suspected cardiac patients. The objectives of this study were to explore incidence of cardiac arrhythmia using Trans-Telephonic and to explore time to first symptomatic episode and documented cardiac arrhythmia in outpatients. Methods: Descriptive research study was conducted between February 1, 2016, and December 31, 2016. A total of 117 patients who visited outpatient clinic were purposively selected. Research instruments in this study were the personal data questionnaire and the record form of incidence of cardiac arrhythmias using Trans-Telephonic ECG recorder. Results: A total of 117 patients aged between 15-92 years old (mean age 52.7 ±17.1 years), majority of studied sample was women (64.1%). The results revealed that 387 ECGs (Average 2.88 ECGs/person, SD = 3.55, Range 0 – 21) were sent to Cardiac Monitoring Center at Coronary Care Unit. Of these, normal sinus rhythm was found mostly 46%. Top 5 of cardiac arrhythmias were documented at the time of symptoms: sinus tachycardia 43.5%, premature atrial contraction 17.7%, premature ventricular contraction 14.3%, sinus bradycardia 11.5% and atrial fibrillation 8.6%. Presenting symptom were tachycardia 94%, palpitation 83.8%, dyspnea 51.3%, chest pain 19.6%, and syncope 14.5%. Mostly activities during symptom were no activity 64.8%, sleep 55.6% and work 25.6%.The mean time until the first symptomatic episode occurred on average after 6.88 ± 7.72 days (median 3 days). The first documented cardiac arrhythmia occurred on average after 9 ± 7.92 days (median 7 day). The treatments after patients known actual cardiac arrhythmias were observe themselves 68%, continue same medications 15%, got further investigations (7 patients), and corrected causes of cardiac arrhythmias via invasive cardiac procedures (5 patients). Conclusion: Trans-telephonic: portable ECGs recorder is effective in the diagnosis of suspected symptomatic cardiac arrhythmias in outpatient clinic.

Keywords: cardiac arrhythmias, diagnosis, outpatient clinic, trans-telephonic: portable ECG recorder

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426 Numerical Analysis of Mandible Fracture Stabilization System

Authors: Piotr Wadolowski, Grzegorz Krzesinski, Piotr Gutowski

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The aim of the presented work is to recognize the impact of mini-plate application approach on the stress and displacement within the stabilization devices and surrounding bones. The mini-plate osteosynthesis technique is widely used by craniofacial surgeons as an improved replacement of wire connection approach. Many different types of metal plates and screws are used to the physical connection of fractured bones. Below investigation is based on a clinical observation of patient hospitalized with mini-plate stabilization system. Analysis was conducted on a solid mandible geometry, which was modeled basis on the computed tomography scan of the hospitalized patient. In order to achieve most realistic connected system behavior, the cortical and cancellous bone layers were assumed. The temporomandibular joint was simplified to the elastic element to allow physiological movement of loaded bone. The muscles of mastication system were reduced to three pairs, modeled as shell structures. Finite element grid was created by the ANSYS software, where hexahedral and tetrahedral variants of SOLID185 element were used. A set of nonlinear contact conditions were applied on connecting devices and bone common surfaces. Properties of particular contact pair depend on screw - mini-plate connection type and possible gaps between fractured bone around osteosynthesis region. Some of the investigated cases contain prestress introduced to the mini-plate during the application, what responds the initial bending of the connecting device to fit the retromolar fossa region. Assumed bone fracture occurs within the mandible angle zone. Due to the significant deformation of the connecting plate in some of the assembly cases the elastic-plastic model of titanium alloy was assumed. The bone tissues were covered by the orthotropic material. As a loading were used the gauge force of magnitude of 100N applied in three different locations. Conducted analysis shows significant impact of mini-plate application methodology on the stress distribution within the miniplate. Prestress effect introduces additional loading, which leads to locally exceed the titanium alloy yield limit. Stress in surrounding bone increases rapidly around the screws application region, exceeding assumed bone yield limit, what indicate the local bone destruction. Approach with the doubled mini-plate shows increased stress within the connector due to the too rigid connection, where the main path of loading leads through the mini-plates instead of plates and connected bones. Clinical observations confirm more frequent plate destruction of stiffer connections. Some of them could be an effect of decreased low cyclic fatigue capability caused by the overloading. The executed analysis prove that the mini-plate system provides sufficient support to mandible fracture treatment, however, many applicable solutions shifts the entire system to the allowable material limits. The results show that connector application with the initial loading needs to be carefully established due to the small material capability tolerances. Comparison to the clinical observations allows optimizing entire connection to prevent future incidents.

Keywords: mandible fracture, mini-plate connection, numerical analysis, osteosynthesis

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425 A Significant Clinical Role for the Capitalbio™ DNA Microarray in the Diagnosis of Multidrug-Resistant Tuberculosis in Patients with Tuberculous Spondylitis Simultaneous with Pulmonary Tuberculosis in High Prevalence Settings in China

Authors: Wenjie Wu, Peng Cheng, Zehua Zhang, Fei Luo, Feng Wu, Min Zhong, Jianzhong Xu

Abstract:

Background: There has been limited research into the therapeutic efficacy of rapid diagnosis of spinal tuberculosis complicated with pulmonary tuberculosis. We attempted to discover whether the utilization of a DNA microarray assay to detect multidrug-resistant spinal tuberculosis complicated with pulmonary tuberculosis can improve clinical outcomes. Methods: A prospective study was conducted from February 2006 to September 2015. One hundred and forty-three consecutive culture–confirmed, clinically and imaging diagnosed MDR-TB patients with spinal tuberculosis complicated by pulmonary tuberculosis were enrolled into the study. The initial time to treatment for MDR-TB, the method of infection control, radiological indicators of spinal tubercular infectious foci, culture conversion, and adverse drug reactions were compared with the standard culture methods. Results: Of the total of 143 MDR-TB patients, 68 (47.6%) were diagnosed by conventional culture methods and 75 (52.4%) following the implementation of detection using the DNA microarray. Patients in the microarray group began rational use of the second-line drugs schedule more speedily than sufferers in the culture group (17.3 vs. 74.1 days). Among patients were admitted to a general tuberculosis ward, those from the microarray group spent less time in the ward than those from the culture group (7.8 vs. 49.2 days). In those patients with six months follow-up (n=134), patients in the microarray group had a higher rate of sputum negativity conversion at six months (89% vs. 73%). In the microarray group, the rate of drug adverse reactions was significantly lower (22.2% vs. 67.7%). At the same time, they had a more obvious reduction of the area with spinal tuberculous lesions in radiological examinations (77% vs. 108%). Conclusions: The application of the CapitalBio™ DNA Microarray assay caused noteworthy clinical advances including an earlier time to begin MDR-TB treatment, increased sputum culture conversion, improved infection control measures and better radiographical results

Keywords: tuberculosis, multidrug-resistant, tuberculous spondylitis, DNA microarray, clinical outcomes

Procedia PDF Downloads 279
424 Ligandless Extraction and Determination of Trace Amounts of Lead in Pomegranate, Zucchini and Lettuce Samples after Dispersive Liquid-Liquid Microextraction with Ultrasonic Bath and Optimization of Extraction Condition with RSM Design

Authors: Fariba Tadayon, Elmira Hassanlou, Hasan Bagheri, Mostafa Jafarian

Abstract:

Heavy metals are released into water, plants, soil, and food by natural and human activities. Lead has toxic roles in the human body and may cause serious problems even in low concentrations, since it may have several adverse effects on human. Therefore, determination of lead in different samples is an important procedure in the studies of environmental pollution. In this work, an ultrasonic assisted-ionic liquid based-liquid-liquid microextraction (UA-IL-DLLME) procedure for the determination of lead in zucchini, pomegranate, and lettuce has been established and developed by using flame atomic absorption spectrometer (FAAS). For UA-IL-DLLME procedure, 10 mL of the sample solution containing Pb2+ was adjusted to pH=5 in a glass test tube with a conical bottom; then, 120 μL of 1-Hexyl-3-methylimidazolium hexafluoro phosphate (CMIM)(PF6) was rapidly injected into the sample solution with a microsyringe. After that, the resulting cloudy mixture was treated by ultrasonic for 5 min, then the separation of two phases was obtained by centrifugation for 5 min at 3000 rpm and IL-phase diluted with 1 cc ethanol, and the analytes were determined by FAAS. The effect of different experimental parameters in the extraction step including: ionic liquid volume, sonication time and pH was studied and optimized simultaneously by using Response Surface Methodology (RSM) employing a central composite design (CCD). The optimal conditions were determined to be an ionic liquid volume of 120 μL, sonication time of 5 min, and pH=5. The linear ranges of the calibration curve for the determination by FAAS of lead were 0.1-4 ppm with R2=0.992. Under optimized conditions, the limit of detection (LOD) for lead was 0.062 μg.mL-1, the enrichment factor (EF) was 93, and the relative standard deviation (RSD) for lead was calculated as 2.29%. The levels of lead for pomegranate, zucchini, and lettuce were calculated as 2.88 μg.g-1, 1.54 μg.g-1, 2.18 μg.g-1, respectively. Therefore, this method has been successfully applied for the analysis of the content of lead in different food samples by FAAS.

Keywords: Dispersive liquid-liquid microextraction, Central composite design, Food samples, Flame atomic absorption spectrometry.

Procedia PDF Downloads 275
423 Developing Manufacturing Process for the Graphene Sensors

Authors: Abdullah Faqihi, John Hedley

Abstract:

Biosensors play a significant role in the healthcare sectors, scientific and technological progress. Developing electrodes that are easy to manufacture and deliver better electrochemical performance is advantageous for diagnostics and biosensing. They can be implemented extensively in various analytical tasks such as drug discovery, food safety, medical diagnostics, process controls, security and defence, in addition to environmental monitoring. Development of biosensors aims to create high-performance electrochemical electrodes for diagnostics and biosensing. A biosensor is a device that inspects the biological and chemical reactions generated by the biological sample. A biosensor carries out biological detection via a linked transducer and transmits the biological response into an electrical signal; stability, selectivity, and sensitivity are the dynamic and static characteristics that affect and dictate the quality and performance of biosensors. In this research, a developed experimental study for laser scribing technique for graphene oxide inside a vacuum chamber for processing of graphene oxide is presented. The processing of graphene oxide (GO) was achieved using the laser scribing technique. The effect of the laser scribing on the reduction of GO was investigated under two conditions: atmosphere and vacuum. GO solvent was coated onto a LightScribe DVD. The laser scribing technique was applied to reduce GO layers to generate rGO. The micro-details for the morphological structures of rGO and GO were visualised using scanning electron microscopy (SEM) and Raman spectroscopy so that they could be examined. The first electrode was a traditional graphene-based electrode model, made under normal atmospheric conditions, whereas the second model was a developed graphene electrode fabricated under a vacuum state using a vacuum chamber. The purpose was to control the vacuum conditions, such as the air pressure and the temperature during the fabrication process. The parameters to be assessed include the layer thickness and the continuous environment. Results presented show high accuracy and repeatability achieving low cost productivity.

Keywords: laser scribing, lightscribe DVD, graphene oxide, scanning electron microscopy

Procedia PDF Downloads 107
422 Efficiently Degradation of Perfluorooctanoic Acid, an Emerging Contaminant, by a Hybrid Process of Membrane Distillation Process and Electro-Fenton

Authors: Afrouz Yousefi, Mohtada Sadrzadeh

Abstract:

The widespread presence of poly- and perfluoroalkyl substances (PFAS) poses a significant concern due to their ability to accumulate in living organisms and their persistence in the environment, thanks to their robust carbon-fluorine (C-F) bonds, which require substantial energy to break (485 kJ/mol). The prevalence of toxic PFAS compounds can be highly detrimental to ecosystems, wildlife, and human health. Ongoing efforts are dedicated to investigating methods for fully breaking down and eliminating PFAS from the environment. Among the various techniques employed, advanced oxidation processes have shown promise in completely breaking down emerging contaminants in wastewater. However, the drawback lies in the relatively slow reaction rates of these processes and the substantial energy input required, which currently impedes their widespread commercial adoption. We developed a hybrid process, comprising electro-Fenton as an advanced oxidation process and membrane distillation, to simultaneously degrade organic PFAS pollutants and extract pure water from the mixture. In this study, environmentally persistent perfluorooctanoic acid (PFOA), as an emerging contaminant, was used to study the effectiveness of the electro-Fenton/membrane distillation hybrid system. The PFOA degradation studies were conducted in two modes: electro-Fenton and electro-Fenton coupled with membrane distillation. High-performance liquid chromatography with ultraviolet detection (HPLC-UV), ion-chromatography (measuring fluoride ion concentration), total organic carbon (TOC) decay, mineralization current efficiency (MCE), and specific energy consumption (SEC) were evaluated for a single EF and hybrid EF-MD processes. In contrast to a single EF reaction, TOC decay improved significantly in the EF-MD process. Overall, the MCE of hybrid processes surpassed 100% while it remained under 50% for a single EF reaction. Calculations of specific energy consumption (SEC) demonstrated a substantial decrease of nearly one-third in energy usage when integrating the EF reaction with the MD process.

Keywords: water treatment, PFAS, membrane distillation, electro-Fenton, advanced oxidation

Procedia PDF Downloads 55
421 Molecular Approach for the Detection of Lactic Acid Bacteria in the Kenyan Spontaneously Fermented Milk, Mursik

Authors: John Masani Nduko, Joseph Wafula Matofari

Abstract:

Many spontaneously fermented milk products are produced in Kenya, where they are integral to the human diet and play a central role in enhancing food security and income generation via small-scale enterprises. Fermentation enhances product properties such as taste, aroma, shelf-life, safety, texture, and nutritional value. Some of these products have demonstrated therapeutic and probiotic effects although recent reports have linked some to death, biotoxin infections, and esophageal cancer. These products are mostly processed from poor quality raw materials under unhygienic conditions resulting to inconsistent product quality and limited shelf-lives. Though very popular, research on their processing technologies is low, and none of the products has been produced under controlled conditions using starter cultures. To modernize the processing technologies for these products, our study aims at describing the microbiology and biochemistry of a representative Kenyan spontaneously fermented milk product, Mursik using modern biotechnology (DNA sequencing) and their chemical composition. Moreover, co-creation processes reflecting stakeholders’ experiences on traditional fermented milk production technologies and utilization, ideals and senses of value, which will allow the generation of products based on common ground for rapid progress will be discussed. Knowledge of the value of clean starting raw material will be emphasized, the need for the definition of fermentation parameters highlighted, and standard equipment employment to attain controlled fermentation discussed. This presentation will review the available information regarding traditional fermented milk (Mursik) and highlight our current research work on the application of molecular approaches (metagenomics) for the valorization of Mursik production process through starter culture/ probiotic strains isolation and identification, and quality and safety aspects of the product. The importance of the research and future research areas on the same subject will also be highlighted.

Keywords: lactic acid bacteria, high throughput biotechnology, spontaneous fermentation, Mursik

Procedia PDF Downloads 280
420 Biodegradation of Endoxifen in Wastewater: Isolation and Identification of Bacteria Degraders, Kinetics, and By-Products

Authors: Marina Arino Martin, John McEvoy, Eakalak Khan

Abstract:

Endoxifen is an active metabolite responsible for the effectiveness of tamoxifen, a chemotherapeutic drug widely used for endocrine responsive breast cancer and chemo-preventive long-term treatment. Tamoxifen and endoxifen are not completely metabolized in human body and are actively excreted. As a result, they are released to the water environment via wastewater treatment plants (WWTPs). The presence of tamoxifen in the environment produces negative effects on aquatic lives due to its antiestrogenic activity. Because endoxifen is 30-100 times more potent than tamoxifen itself and also presents antiestrogenic activity, its presence in the water environment could result in even more toxic effects on aquatic lives compared to tamoxifen. Data on actual concentrations of endoxifen in the environment is limited due to recent discovery of endoxifen pharmaceutical activity. However, endoxifen has been detected in hospital and municipal wastewater effluents. The detection of endoxifen in wastewater effluents questions the treatment efficiency of WWTPs. Studies reporting information about endoxifen removal in WWTPs are also scarce. There was a study that used chlorination to eliminate endoxifen in wastewater. However, an inefficient degradation of endoxifen by chlorination and the production of hazardous disinfection by-products were observed. Therefore, there is a need to remove endoxifen from wastewater prior to chlorination in order to reduce the potential release of endoxifen into the environment and its possible effects. The aim of this research is to isolate and identify bacteria strain(s) capable of degrading endoxifen into less hazardous compound(s). For this purpose, bacteria strains from WWTPs were exposed to endoxifen as a sole carbon and nitrogen source for 40 days. Bacteria presenting positive growth were isolated and tested for endoxifen biodegradation. Endoxifen concentration and by-product formation were monitored. The Monod kinetic model was used to determine endoxifen biodegradation rate. Preliminary results of the study suggest that isolated bacteria from WWTPs are able to growth in presence of endoxifen as a sole carbon and nitrogen source. Ongoing work includes identification of these bacteria strains and by-product(s) of endoxifen biodegradation.

Keywords: biodegradation, bacterial degraders, endoxifen, wastewater

Procedia PDF Downloads 205
419 Applications and Development of a Plug Load Management System That Automatically Identifies the Type and Location of Connected Devices

Authors: Amy Lebar, Kim L. Trenbath, Bennett Doherty, William Livingood

Abstract:

Plug and process loads (PPLs) account for 47% of U.S. commercial building energy use. There is a huge potential to reduce whole building consumption by targeting PPLs for energy savings measures or implementing some form of plug load management (PLM). Despite this potential, there has yet to be a widely adopted commercial PLM technology. This paper describes the Automatic Type and Location Identification System (ATLIS), a PLM system framework with automatic and dynamic load detection (ADLD). ADLD gives PLM systems the ability to automatically identify devices as they are plugged into the outlets of a building. The ATLIS framework takes advantage of smart, connected devices to identify device locations in a building, meter and control their power, and communicate this information to a central database. ATLIS includes five primary capabilities: location identification, communication, control, energy metering and data storage. A laboratory proof of concept (PoC) demonstrated all but the data storage capabilities and these capabilities were validated using an office building scenario. The PoC can identify when a device is plugged into an outlet and the location of the device in the building. When a device is moved, the PoC’s dashboard and database are automatically updated with the new location. The PoC implements controls to devices from the system dashboard so that devices maintain correct schedules regardless of where they are plugged in within a building. ATLIS’s primary technology application is improved PLM, but other applications include asset management, energy audits, and interoperability for grid-interactive efficient buildings. A system like ATLIS could also be used to direct power to critical devices, such as ventilators, during a brownout or blackout. Such a framework is an opportunity to make PLM more widespread and reduce the amount of energy consumed by PPLs in current and future commercial buildings.

Keywords: commercial buildings, grid-interactive efficient buildings (GEB), miscellaneous electric loads (MELs), plug loads, plug load management (PLM)

Procedia PDF Downloads 127
418 Magnetophotonics 3D MEMS/NEMS System for Quantitative Mitochondrial DNA Defect Profiling

Authors: Dar-Bin Shieh, Gwo-Bin Lee, Chen-Ming Chang, Chen Sheng Yeh, Chih-Chia Huang, Tsung-Ju Li

Abstract:

Mitochondrial defects have a significant impact in many human diseases and aging associated phenotypes. The pathogenic mitochondrial DNA (mtDNA) mutations are diverse and usually present as heteroplasmic. mtDNA 4977bps deletion is one of the common mtDNA defects, and the ratio of mutated versus normal copy is significantly associated with clinical symptoms thus their quantitative detection has become an important unmet needs for advanced disease diagnosis and therapeutic guidelines. This study revealed a Micro-electro-mechanical-system (MEMS) enabled automatic microfluidic chip that only required minimal sample. The system integrated multiple laboratory operation steps into a Lab-on-a-Chip for high-sensitive and prompt measurement. The entire process including magnetic nanoparticle based mtDNA extraction in chip, mutation selective photonic DNA cleavage, and nanoparticle accelerated photonic quantitative polymerase chain reaction (qPCR). All subsystems were packed inside a miniature three-dimensional micro structured system and operated in an automatic manner. Integration of magnetic beads with microfluidic transportation could promptly extract and enrich the specific mtDNA. The near infrared responsive magnetic nanoparticles enabled micro-PCR to be operated by pulse-width-modulation controlled laser pulsing to amplify the desired mtDNA while quantified by fluorescence intensity captured by a complementary metal oxide system array detector. The proportions of pathogenic mtDNA in total DNA were thus obtained. Micro capillary electrophoresis module was used to analyze the amplicone products. In conclusion, this study demonstrated a new magnetophotonic based qPCR MEMS system that successfully detects and quantify specific disease related DNA mutations thus provides a promising future for rapid diagnosis of mitochondria diseases.

Keywords: mitochondrial DNA, micro-electro-mechanical-system, magnetophotonics, PCR

Procedia PDF Downloads 211
417 Lessons Learned through a Bicultural Approach to Tsunami Education in Aotearoa New Zealand

Authors: Lucy H. Kaiser, Kate Boersen

Abstract:

Kura Kaupapa Māori (kura) and bilingual schools are primary schools in Aotearoa/New Zealand which operate fully or partially under Māori custom and have curricula developed to include Te Reo Māori and Tikanga Māori (Māori language and cultural practices). These schools were established to support Māori children and their families through reinforcing cultural identity by enabling Māori language and culture to flourish in the field of education. Māori kaupapa (values), Mātauranga Māori (Māori knowledge) and Te Reo are crucial considerations for the development of educational resources developed for kura, bilingual and mainstream schools. The inclusion of hazard risk in education has become an important issue in New Zealand due to the vulnerability of communities to a plethora of different hazards. Māori have an extensive knowledge of their local area and the history of hazards which is often not appropriately recognised within mainstream hazard education resources. Researchers from the Joint Centre for Disaster Research, Massey University and East Coast LAB (Life at the Boundary) in Napier were funded to collaboratively develop a toolkit of tsunami risk reduction activities with schools located in Hawke’s Bay’s tsunami evacuation zones. A Māori-led bicultural approach to developing and running the education activities was taken, focusing on creating culturally and locally relevant materials for students and schools as well as giving students a proactive role in making their communities better prepared for a tsunami event. The community-based participatory research is Māori-centred, framed by qualitative and Kaupapa Maori research methodologies and utilizes a range of data collection methods including interviews, focus groups and surveys. Māori participants, stakeholders and the researchers collaborated through the duration of the project to ensure the programme would align with the wider school curricula and kaupapa values. The education programme applied a tuakana/teina, Māori teaching and learning approach in which high school aged students (tuakana) developed tsunami preparedness activities to run with primary school students (teina). At the end of the education programme, high school students were asked to reflect on their participation, what they had learned and what they had enjoyed during the activities. This paper draws on lessons learned throughout this research project. As an exemplar, retaining a bicultural and bilingual perspective resulted in a more inclusive project as there was variability across the students’ levels of confidence using Te Reo and Māori knowledge and cultural frameworks. Providing a range of different learning and experiential activities including waiata (Māori songs), pūrākau (traditional stories) and games was important to ensure students had the opportunity to participate and contribute using a range of different approaches that were appropriate to their individual learning needs. Inclusion of teachers in facilitation also proved beneficial in assisting classroom behavioral management. Lessons were framed by the tikanga and kawa (protocols) of the school to maintain cultural safety for the researchers and the students. Finally, the tuakana/teina component of the education activities became the crux of the programme, demonstrating a path for Rangatahi to support their whānau and communities through facilitating disaster preparedness, risk reduction and resilience.

Keywords: school safety, indigenous, disaster preparedness, children, education, tsunami

Procedia PDF Downloads 115
416 Challenges of Outreach Team Leaders in Managing Ward Based Primary Health Care Outreach Teams in National Health Insurance Pilot Districts in Kwazulu-Natal

Authors: E. M. Mhlongo, E. Lutge

Abstract:

In 2010, South Africa’s National Department of Health (NDoH) launched national primary health care (PHC) initiative to strengthen health promotion, disease prevention, and early disease detection. The strategy, called Re-engineering Primary Health Care (rPHC), aims to support a preventive and health-promoting community-based PHC model by using community-based outreach teams (known in South Africa as Ward-based Primary Health Care Outreach teams or WBPHCOTs). These teams provide health education, promote healthy behaviors, assess community health needs, manage minor health problems, and support linkages to health services and health facilities. Ward based primary health care outreach teams are supervised by a professional nurse who is the outreach team leader. In South Africa, the WBPHCOTs have been established, registered, and are reporting their activities in the District Health Information System (DHIS). This study explored and described the challenges faced by outreach team leaders in supporting and supervising the WBPHCOTs. Qualitative data were obtained through interviews conducted with the outreach team leaders at a sub-district level. Thematic analysis of data was done. Findings revealed some challenges faced by team leaders in day to day execution of their duties. Issues such as staff shortages, inadequate resources to carry out health promotion activities, and lack of co-operation from team members may undermine the capacity of team leaders to support and supervise the WBPHCOTs. Many community members are under the impression that the outreach team is responsible for bringing the clinic to the community while the outreach teams do not carry any medication/treatment with them when doing home visits. The study further highlights issues around the challenges of WBPHCOTs at a household level. In conclusion, the WBPHCOTs are an important component of National Health Insurance (NHI), and in order for NHI to be optimally implemented, the issues raised in this research should be addressed with some urgency.

Keywords: community health worker, national health insurance, primary health care, ward-based primary health care outreach teams

Procedia PDF Downloads 131
415 A Copula-Based Approach for the Assessment of Severity of Illness and Probability of Mortality: An Exploratory Study Applied to Intensive Care Patients

Authors: Ainura Tursunalieva, Irene Hudson

Abstract:

Continuous improvement of both the quality and safety of health care is an important goal in Australia and internationally. The intensive care unit (ICU) receives patients with a wide variety of and severity of illnesses. Accurately identifying patients at risk of developing complications or dying is crucial to increasing healthcare efficiency. Thus, it is essential for clinicians and researchers to have a robust framework capable of evaluating the risk profile of a patient. ICU scoring systems provide such a framework. The Acute Physiology and Chronic Health Evaluation III and the Simplified Acute Physiology Score II are ICU scoring systems frequently used for assessing the severity of acute illness. These scoring systems collect multiple risk factors for each patient including physiological measurements then render the assessment outcomes of individual risk factors into a single numerical value. A higher score is related to a more severe patient condition. Furthermore, the Mortality Probability Model II uses logistic regression based on independent risk factors to predict a patient’s probability of mortality. An important overlooked limitation of SAPS II and MPM II is that they do not, to date, include interaction terms between a patient’s vital signs. This is a prominent oversight as it is likely there is an interplay among vital signs. The co-existence of certain conditions may pose a greater health risk than when these conditions exist independently. One barrier to including such interaction terms in predictive models is the dimensionality issue as it becomes difficult to use variable selection. We propose an innovative scoring system which takes into account a dependence structure among patient’s vital signs, such as systolic and diastolic blood pressures, heart rate, pulse interval, and peripheral oxygen saturation. Copulas will capture the dependence among normally distributed and skewed variables as some of the vital sign distributions are skewed. The estimated dependence parameter will then be incorporated into the traditional scoring systems to adjust the points allocated for the individual vital sign measurements. The same dependence parameter will also be used to create an alternative copula-based model for predicting a patient’s probability of mortality. The new copula-based approach will accommodate not only a patient’s trajectories of vital signs but also the joint dependence probabilities among the vital signs. We hypothesise that this approach will produce more stable assessments and lead to more time efficient and accurate predictions. We will use two data sets: (1) 250 ICU patients admitted once to the Chui Regional Hospital (Kyrgyzstan) and (2) 37 ICU patients’ agitation-sedation profiles collected by the Hunter Medical Research Institute (Australia). Both the traditional scoring approach and our copula-based approach will be evaluated using the Brier score to indicate overall model performance, the concordance (or c) statistic to indicate the discriminative ability (or area under the receiver operating characteristic (ROC) curve), and goodness-of-fit statistics for calibration. We will also report discrimination and calibration values and establish visualization of the copulas and high dimensional regions of risk interrelating two or three vital signs in so-called higher dimensional ROCs.

Keywords: copula, intensive unit scoring system, ROC curves, vital sign dependence

Procedia PDF Downloads 141
414 Research on the Conservation Strategy of Territorial Landscape Based on Characteristics: The Case of Fujian, China

Authors: Tingting Huang, Sha Li, Geoffrey Griffiths, Martin Lukac, Jianning Zhu

Abstract:

Territorial landscapes have experienced a gradual loss of their typical characteristics during long-term human activities. In order to protect the integrity of regional landscapes, it is necessary to characterize, evaluate and protect them in a graded manner. The study takes Fujian, China, as an example and classifies the landscape characters of the site at the regional scale, middle scale, and detailed scale. A multi-scale approach combining parametric and holistic approaches is used to classify and partition the landscape character types (LCTs) and landscape character areas (LCAs) at different scales, and a multi-element landscape assessment approach is adopted to explore the conservation strategies of the landscape character. Firstly, multiple fields and multiple elements of geography, nature and humanities were selected as the basis of assessment according to the scales. Secondly, the study takes a parametric approach to the classification and partitioning of landscape character, Principal Component Analysis, and two-stage cluster analysis (K-means and GMM) in MATLAB software to obtain LCTs, combines with Canny Operator Edge Detection Algorithm to obtain landscape character contours and corrects LCTs and LCAs by field survey and manual identification methods. Finally, the study adopts the Landscape Sensitivity Assessment method to perform landscape character conservation analysis and formulates five strategies for different LCAs: conservation, enhancement, restoration, creation, and combination. This multi-scale identification approach can efficiently integrate multiple types of landscape character elements, reduce the difficulty of broad-scale operations in the process of landscape character conservation, and provide a basis for landscape character conservation strategies. Based on the natural background and the restoration of regional characteristics, the results of landscape character assessment are scientific and objective and can provide a strong reference in regional and national scale territorial spatial planning.

Keywords: parameterization, multi-scale, landscape character identify, landscape character assessment

Procedia PDF Downloads 84
413 Study of Relation between P53 and Mir-146a Rs2910164 Polymorphism in Cervical Lesion

Authors: Hossein Rassi, Marjan Moradi Fard, Masoud Houshmand

Abstract:

Background: Cervical cancer is multistep disease that is thought to result from an interaction between genetic background and environmental factors. Human papillomavirus (HPV) infection is the leading risk factor for cervical intraepithelial neoplasia(CIN)and cervical cancer. In other hand, some of p53 and miRNA polymorphism may plays an important role in carcinogenesis. This study attempts to clarify the relation of p53 genotypes and miR-146a rs2910164 polymorphism in cervical lesions. Method: Forty two archival samples with cervical lesion retired from Khatam hospital and 40 sample from healthy persons used as control group. A simple and rapid method was used to detect the simultaneous amplification of the HPV consensus L1 region and HPV-16,-18, -11, -31, 33 and -35 along with the b-globin gene as an internal control. We use Multiplex PCR for detection of P53 and miR-146a rs2910164 genotypes in our lab. Finally, data analysis was performed using the 7 version of the Epi Info(TM) 2012 software and test chi-square(x2) for trend. Results: Cervix lesions were collected from 42 patients with Squamous metaplasia, cervical intraepithelial neoplasia, and cervical carcinoma. Successful DNA extraction was assessed by PCR amplification of b-actin gene (99bp). According to the results, p53 GG genotype and miR-146a rs2910164 CC genotype was significantly associated with increased risk of cervical lesions in the study population. In this study, we detected 13 HPV 18 from 42 cervical cancer. Conclusion: The connection between several SNP polymorphism and human virus papilloma in rare researches were seen. The reason of these differences in researches' findings can result in different kinds of races and geographic situations and also differences in life grooves in every region. The present study provided preliminary evidence that a p53 GG genotype and miR-146a rs2910164 CC genotype may effect cervical cancer risk in the study population, interacting synergistically with HPV 18 genotype. Our results demonstrate that the testing of p53 codon 72 polymorphism genotypes and miR-146a rs2910164 polymorphism genotypes in combination with HPV18 can serve as major risk factors in the early identification of cervical cancers. Furthermore, the results indicate the possibility of primary prevention of cervical cancer by vaccination against HPV18 in Iran.

Keywords: cervical cancer, p53, miR-146a, rs2910164, polymorphism

Procedia PDF Downloads 461
412 Effect of a Nutritional Supplement Containing Euterpe oleracea Mart., Inulin, Phaseolus vulgaris and Caralluma fimbriata in Persons with Metabolic Syndrome

Authors: Eduardo Cabrera-Rode, Janet Rodriguez, Aimee Alvarez, Ragmila Echevarria, Antonio D. Reyes, Ileana Cubas-Duenas, Silvia E. Turcios, Oscar Diaz-Diaz

Abstract:

Obex is a nutritional supplement to help weight loss naturally. In addition, this supplement has a satiating effect that helps control the craving to eat between meals. The purpose of this study was to evaluate the effect of Obex in the metabolic syndrome (MS). This was an open label pilot study conducted in 30 patients with MS and ages between 29 and 60 years old. Participants received Obex, at a dose of one sachet before (30 to 45 minutes) the two main meals (lunch and dinner) daily (mean two sachets per day) for 3 months. The content of the sachets was dissolved in a glass of water or fruit juice. Obex ingredients: Açai (Euterpe oleracea Mart.) berry, inulin, Phaseolus vulgaris, Caralluma fimbriata, inositol, choline, arginine, ornitine, zinc sulfate, carnitine fumarate, methionine, calcium pantothenate, pyridoxine and folic acid. In addition to anthropometric measures and blood pressure, fasting plasma glucose, total cholesterol, triglycerides and HDL-cholesterol and insulin were determined. Insulin resistance was assessed by HOMA-IR index. Three indirect indexes were used to calculate insulin sensitivity [QUICKI index (Quantitative insulin sensitivity check index), Bennett index and Raynaud index]. Metabolic syndrome was defined according to the Joint Interim Statement (JIS) criteria. The JIS criteria require at least three of the following components: (1) abdominal obesity (waist circumference major or equal major or equal 94 cm for men or 80 cm for women), (2) triglycerides major or equal 1.7 mmol/L, (3) HDL cholesterol minor 1.03 mmol/L for men or minor 1.30 mmol/L for women, (4) systolic/diastolic blood pressure major or equal 130/85mmHg or use antihypertensive drugs, and (5) fasting plasma glucose major or equal 5.6 mmol/L or known treatment for diabetes. This study was approved by the Ethical and Research Committee of the National Institute of Endocrinology, Cuba and conducted according to the Declaration of Helsinki. Obex is registered as a food supplement in the National Institute of Nutrition and Food, Havana, Cuba. Written consent was obtained from all patients before the study. The clinical trial had been registered at ClinicalTrials.gov. After three months of treatment, 43.3% (13/30) of participants decreased the frequency of MS. Compared to baseline, Obex significantly reduced body weight, BMI, waist circumference, and waist/hip ratio and improved HDL-c (p<0.0001) and in addition to lowering blood pressure (p<0.05). After Obex intake, subjects also have shown a reduction in fasting plasma glucose (p<0.0001) and insulin sensitivity was enhanced (p=0.001). No adverse effects were seen in any of the participants during the study. In this pilot study, consumption of Obex decreased the prevalence of MS due to the improved selected components of the metabolic syndrome, indicating that further studies are warranted. Obex emerges as an effective and well tolerated treatment for preventing or delaying MS and therefore potential reduction of cardiovascular risk.

Keywords: nutritional supplement, metabolic syndrome, weight loss, insulin resistance

Procedia PDF Downloads 289
411 Investigation p53 and miR-146a rs2910164 Polymorphism in Cervical Lesion

Authors: Hossein Rassi, Marjan Moradi fard, Masoud Houshmand

Abstract:

Background: Cervical cancer is multistep disease that is thought to result from an interaction between genetic background and environmental factors. Human Papillomavirus (HPV) infection is the leading risk factor for Cervical Intraepithelial Neoplasia (CIN) and cervical cancer. In other hand, some of p53 and miRNA polymorphism may plays an important role in carcinogenesis. This study attempts to clarify the relation of p53 genotypes and miR-146a rs2910164 polymorphism in cervical lesions. Method: Forty two archival samples with cervical lesion retired from Khatam hospital and 40 sample from healthy persons used as control group. A simple and rapid method was used to detect the simultaneous amplification of the HPV consensus L1 region and HPV-16,-18, -11, -31, 33, and -35 along with the b-globin gene as an internal control. We use Multiplex PCR for detection of P53 and miR-146a rs2910164 genotypes in our lab. Finally, data analysis was performed using the 7 version of the Epi Info(TM) 2012 software and test chi-square(x2) for trend. Results: Cervix lesions were collected from 42 patients with Squamous metaplasia, cervical intraepithelial neoplasia, and cervical carcinoma. Successful DNA extraction was assessed by PCR amplification of b-actin gene (99 bp). According to the results, p53 GG genotype and miR-146a rs2910164 CC genotype was significantly associated with increased risk of cervical lesions in the study population. In this study, we detected 13 HPV 18 from 42 cervical cancer. Conclusion: The connection between several SNP polymorphism and human virus papilloma in rare researches were seen. The reason of these differences in researches' findings can result in different kinds of races and geographic situations and also differences in life grooves in every region. The present study provided preliminary evidence that a p53 GG genotype and miR-146a rs2910164 CC genotype may effect cervical cancer risk in the study population, interacting synergistically with HPV 18 genotype. Our results demonstrate that the testing of p53 codon 72 polymorphism genotypes and miR-146a rs2910164 polymorphism genotypes in combination with HPV18 can serve as major risk factors in the early identification of cervical cancers. Furthermore, the results indicate the possibility of primary prevention of cervical cancer by vaccination against HPV18 in Iran.

Keywords: cervical cancer, miR-146a rs2910164 polymorphism, p53 polymorphism, intraepithelial, neoplasia, HPV

Procedia PDF Downloads 392
410 Lead Chalcogenide Quantum Dots for Use in Radiation Detectors

Authors: Tom Nakotte, Hongmei Luo

Abstract:

Lead chalcogenide-based (PbS, PbSe, and PbTe) quantum dots (QDs) were synthesized for the purpose of implementing them in radiation detectors. Pb based materials have long been of interest for gamma and x-ray detection due to its high absorption cross section and Z number. The emphasis of the studies was on exploring how to control charge carrier transport within thin films containing the QDs. The properties of QDs itself can be altered by changing the size, shape, composition, and surface chemistry of the dots, while the properties of carrier transport within QD films are affected by post-deposition treatment of the films. The QDs were synthesized using colloidal synthesis methods and films were grown using multiple film coating techniques, such as spin coating and doctor blading. Current QD radiation detectors are based on the QD acting as fluorophores in a scintillation detector. Here the viability of using QDs in solid-state radiation detectors, for which the incident detectable radiation causes a direct electronic response within the QD film is explored. Achieving high sensitivity and accurate energy quantification in QD radiation detectors requires a large carrier mobility and diffusion lengths in the QD films. Pb chalcogenides-based QDs were synthesized with both traditional oleic acid ligands as well as more weakly binding oleylamine ligands, allowing for in-solution ligand exchange making the deposition of thick films in a single step possible. The PbS and PbSe QDs showed better air stability than PbTe. After precipitation the QDs passivated with the shorter ligand are dispersed in 2,6-difloupyridine resulting in colloidal solutions with concentrations anywhere from 10-100 mg/mL for film processing applications, More concentrated colloidal solutions produce thicker films during spin-coating, while an extremely concentrated solution (100 mg/mL) can be used to produce several micrometer thick films using doctor blading. Film thicknesses of micrometer or even millimeters are needed for radiation detector for high-energy gamma rays, which are of interest for astrophysics or nuclear security, in order to provide sufficient stopping power.

Keywords: colloidal synthesis, lead chalcogenide, radiation detectors, quantum dots

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