Search results for: image guided therapy

Authors: Chiou-Fang Liou

Abstract:

Cancer has been one of the most life-threaten diseases worldwide for 30+ years. The influences of cancer illness include symptoms from cancer itself along with its treatments. The quality of life among patients diagnosed with cancer during cancer treatments has been conceptualized within four domains: Functional Well-Being, Social Well-Being, Physical Well-Being, and Emotional Well-Being. Patients with cancer often need to make adjustments to face all the challenges. The middle-range theory of Resourcefulness and Quality of life has been applied to explore factors contributing to cancer patients’ needs. Resourcefulness is defined as sets of skills that can be learned and consisted of Person and Social Resourcefulness. Empirical evidence also supported a possible relationship between Resourcefulness and Quality of Life. However, little is known about the extent to which the two concepts are related to each other. This study, therefore, applied a multivariate technique, Canonical Correlation Analysis, to identify the relationship between the two sets of variables with multi-dimensional measures, the Resourcefulness and Quality of Life in Cancer patients receiving treatments. After IRB approval, this multi-centered study took place at two medical centers in the Central Region of Taiwan. Sample A total of 186 patients with various cancer diagnoses and either receiving radiation therapy or chemotherapy consented to and answered questionnaires. The Import findings of the Generalized F test identified two typical sets with several linear relations and explained a total of 79.1% of the total variance. The first typical set found Personal Resourcefulness negatively related to Social Well-being, Functional being, Emotional Well-being, and Physical, in that order. The second typical set found Social Resourcefulness negatively related to Functional Well-being and Physical-being yet positively related to Social Well-being and Emotional Well-being. Discussion and Conclusion, The results of this presented study supported the statistically significant relationship between two sets of variables that are consistent with the theory. In addition, the results are considerably important in cancer patients receiving cancer treatments.

Keywords: cancer, canonical correlation analysis, quality of life, resourcefulness

Procedia PDF Downloads 80

Authors: Eda Ozkara San

Abstract:

Nurse educators have been charged by several nursing organizations and accrediting bodies to provide innovative and evidence-based educational experiences, both didactic and clinical, to help students to develop the knowledge, skills, and attitudes needed to provide culturally competent nursing care to patients. Clinical simulation, which offers the opportunity for students to practice nursing skills in a risk-free, controlled environment and helps develop self-efficacy (confidence) within the nursing role. As one simulation method, the standardized patients (SPs) simulation helps educators to teach nursing students variety of skills in nursing, medicine, and other health professions. It can be a helpful tool for nurse educators to enhance cultural competence of nursing students. An alarming gap exists within the literature concerning the effectiveness of SP strategy to enhance cultural competence development of diverse student groups, who must work with patients from various backgrounds. This grant-supported, longitudinal, one-group, pretest and post-test educational intervention study aimed to examine the effect of the Diverse Standardized Patient Simulation (DSPS) cultural competence education strategy on students’ (n = 53) transcultural self-efficacy (TSE). The researcher-developed multidimensional DSPS strategy involved careful integration of transcultural nursing skills guided by the Cultural Competence and Confidence (CCC) model. As a carefully orchestrated teaching and learning strategy by specifically utilizing the SP pedagogy, the DSPS also followed international guidelines and standards for the design, implementation, evaluation, and SP training; and had content validity review. The DSPS strategy involved two simulation scenarios targeting underrepresented patient populations (Muslim immigrant woman with limited English proficiency and Irish-Italian American gay man with his partner (Puerto Rican) to be utilized in a second-semester, nine-credit, 15-week medical-surgical nursing course at an urban public US university. Five doctorally prepared content experts reviewed the DSPS strategy for content validity. The item-level content validity index (I-CVI) score was calculated between .80-1.0 on the evaluation forms. Jeffreys’ Transcultural Self-Efficacy Tool (TSET) was administered as a pretest and post-test to assess students’ changes in cognitive, practical, and affective dimensions of TSE. Results gained from this study support that the DSPS cultural competence education strategy assisted students to develop cultural competence and caused statistically significant changes (increase) in students’ TSE perceptions. Results also supported that all students, regardless of their background, benefit (and require) well designed cultural competence education strategies. The multidimensional DSPS strategy is found to be an effective way to foster nursing students’ cultural competence development. Step-by-step description of the DSPS provides an easy adaptation of this strategy with different student populations and settings.

Keywords: cultural competence development, the cultural competence and confidence model, CCC model, educational intervention, transcultural self-efficacy, TSE, transcultural self-efficacy tool, TSET

Procedia PDF Downloads 147

Authors: Chodidjah, Edi Dharmana, Hardhono, Sarjadi

Abstract:

Breast cancer treatment options including surgery, radiation therapy, chemotherapy, and immunotherapy have not been effective. Besides, they have side effects. Keladi Tikus (Typhonium flagelliforme) has been shown to improve immune system, suppress tumor growth and induce apoptosis. One of the parameters for immune system, tumor growth and apoptosis is IFNγ (Interferon γ), VEGF (Vascular Endothelial Growth Factor) and Caspase 3 respectively. The aim of this study was to examine the effect of the administration of Keladi Tikus tuber extract at the dose of 200 mg/kgBW, 400 mg/KgBW, and 800 mg/kgBW on the level of IFNγ, VEGF and caspase 3 expression. In this experimental study using post test randomized control group design, 24 CH3 mice with tumor were randomly divided into 4 groups including control group and treated groups: Treated with 0.2 cc extract of Keladi Tikus at the dose of 200 mg/kgBW, 400 mg/kgBW, 800 mg/kgBW, respectively for 30 days. On day 31 the lymphatic tissue was taken and evaluated for its level of IFNγ, using ELISA. The tumor tissue was taken and subjected to immunohistochemistry staining for VEGF and caspase 3 expression evaluation. The data on IFNγ, VEGF and Caspase 3 expression were analyzed using One Way Anova with significant level of 0.05. One Way Anova resulted in p<0.05. LSD test showed that the level of IFNγ and Caspase 3 for control group was different from that of treated groups. There was no significant different between the treated group of 400 mg/KgBW and 800mg/KgBW. VEGF expressions for all the treated groups were significant. In conclusion, the oral administration of ethanolic extract of Keladi Tikus (Typhonium flagelliforme) at the dose of 200mg/kgBW, 400 mg/kgBW,800 mg/kgBW increases IFNγ, Caspase 3 and decreases VEGF expression in C3H mice with adenocarsinoma mamma.

Keywords: Typhonium flagelliforme, IFNγ, caspase 3, VEGF

Procedia PDF Downloads 419

Authors: Rodrigo Coelho

Abstract:

We believe that in the majority of the “recent production of public space", the overvaluation of the "image", of the "ephemeral" and of the "objectual", has come to determine the configuration of banal and (more or less) arbitrary "public spaces", mostly linked to a problem of “outdoor decoration”, reflecting a clear sign of uncertainty and arbitrariness about the meaning, the role and shape of public space and public art.This "inconsistency" which is essentially linked to the loss of urban, but also social, cultural and political, vocation of the disciplines that “shape” the urban space (but is also linked to the lack of urban and technical culture of techinicians and policy makers) converted a significant set of the recently built "public space" and “urban art” into diffuse and multi-referenced pieces, which generally shares the inability of confering to the urban space, civic, aesthetic, social and symbolic meanings. In this sense we consider it is essential to undertake a theoretical reflection on the values, the meaning(s) and the shape(s) that open space, and urban art may (or must) take in the current urban and cultural context, in order to redeem for public space its status of significant physical reference, able to embody a spatial and urban identity, and simultaneously enable the collective accession and appropriation of public space. Taking as reference public space interventions built in the last decade on the European context, we will seek to explore and defend the need of considering public space as a true place of exception, an exceptional support where the emphasis is placed on the quality of the experience, especially by the relations public space/urban art can established with the city, with nature and geography in a broad sense, referring us back to a close and inseparable and timeless relationship between nature and culture.

Keywords: art, city, nature, public space

Procedia PDF Downloads 446

Authors: Aadiv Shah, Hari Nair, Vedant Mittal, Alice Cheeran

Abstract:

Present-day agricultural practices such as blanket spraying not only lead to excessive usage of pesticides but also harm the overall crop yield. This paper introduces an algorithm to optimize the traversal of an unmanned aerial vehicle (UAV) in constrained environments. The proposed system focuses on the agricultural application of targeted spraying for locust elimination. Given a satellite image of a farm, target zones that are prone to locust swarm formation are detected through the calculation of the normalized difference vegetation index (NDVI). This is followed by determining the optimal path for traversal of a UAV through these target zones using the proposed algorithm in order to perform pesticide spraying in the most efficient manner possible. Unlike the classic travelling salesman problem involving point-to-point optimization, the proposed algorithm determines an optimal path for multiple regions, independent of its geometry. Finally, the paper explores the idea of implementing reinforcement learning to model complex environmental behaviour and make the path planning mechanism for UAVs agnostic to external environment changes. This system not only presents a solution to the enormous losses incurred due to locust attacks but also an efficient way to automate agricultural practices across the globe in order to improve farmer ergonomics.

Keywords: locust, NDVI, optimization, path planning, reinforcement learning, UAV

Procedia PDF Downloads 246

Authors: Husham Bayazed

Abstract:

Purpose of Presentation: The eye is one of a few sites in the body with immune privilege (IP). However, this IP is relatively easily bypassed in the face of sufficient strong local or systemic immunological responses. As immune responses are crucial elements of the repair response, the eye has developed distinct mechanisms to deliver immune responses to injury in the avascular regions of the eye. This presentation may cover and provide an overview of the mechanisms that dictate immune cell trafficking to the local ocular microenvironment in response to different autoimmune and inflammatory-mediated diseases. Recent Findings: Literature reviews declare that immune responses and inflammation play a key role in a diverse range of eye diseases. In recent years, our understanding of ocular immune responses has widely spread in ocular surface inflammation, uveitis, age-related macular degeneration (AMD), glaucoma, transplantation rejection, and other ocular diseases. It is becoming increasingly clear that multiple seemingly unrelated diseases involve immune responses with common themes in their ocular pathogenesis. Recent studies are focusing on elucidating the pathogenesis of ocular inflammatory disease to identify new targets for immunotherapy that will not only improve efficacy but also minimize adverse effects from traditional therapy. Summary: While IP was believed to protect the eye from day-to-day inflammatory insults, however, it is relatively easily breached in the face of different strong local or systemic immunological and inflammatory responses. Therefore, the ocular immune response encapsulates the full range of classical and non-classical immune responses and demonstrates many features which are reflected in other tissues, but eye tissues, by modifying these responses, may reveal unexpected and novel findings which are relevant to immune responses generally. This may have therapeutic potential for new targeting immunotherapy, restoring immune tolerance in ocular autoimmune and inflammatory diseases, and preventing rejection such as stem cells, currently being considered for treatment of worldwide blinding diseases such as AMD.

Keywords: ocular diseases, immunology, immune privilege, immunotherapy

Procedia PDF Downloads 74

Authors: Yue Sun, Yuan Wang

Abstract:

Most of the earliest national industries in Wuhan are located along the Hanjiang River, and Qiaokou is considered to be a gathering place for Dahankou old industrial base. Zongguan Waterworks, Pacific Soap Factory, Fuxin Flour Factory, Nanyang Tobacco Factory and other hundred-year-old factories are located along Hanjiang River in Qiaokou District, especially the Gutian Industrial Zone, which was listed as one of 156 national restoration projects at the beginning of the founding of the People’s Republic of China. After decades of development, Qiaokou has become the gathering place of the chemical industry and secondary industry, causing damage to the city and serious pollution, becoming a marginalized area forgotten by the central city. In recent years, with the accelerated pace of urban renewal, Qiaokou has been constantly reforming and innovating, and has begun drastic changes in the transformation of old cities and the development of new districts. These factories have been listed as key reconstruction projects, and a large number of industrial heritage with historical value and full urban memory have been relocated, demolished and reformed, with only a few factory buildings preserved. Through the methods of industrial archaeology, image analysis, typology and field investigation, this paper analyzes and summarizes the spatial characteristics of industrial heritage in Qiaokou District, explores urban renewal from the perspective of industrial heritage protection, and provides design strategies for the regeneration of urban industrial sites and industrial heritage.

Keywords: industrial heritage, urban renewal, protection, urban memory

Procedia PDF Downloads 144

Authors: Mohamed Abdel-Hamid, Olfat Gamil Shaker, Doha El-Sayed Ellakwa, Eman Fathy Abdel-Maksoud

Abstract:

Introduction: Despite advances in the knowledge of the molecular virology of hepatitis C virus (HCV), the mechanisms of hepatocellular injury in HCV infection are not completely understood. Hepatitis C viral infection (HCV) influences the susceptibility to apoptosis. This could lead to insufficient antiviral immune response and persistent viral infection. Aim of this study: was to examine whether BCL-2 gene polymorphism at codon 43 (+127G/A or Ala43Thr) has an impact on development of hepatocellular carcinoma caused by chronic hepatitis C Egyptian patients. Subjects and Methods: The study included three groups; group 1: composing of 30 patients with hepatocellular carcinoma (HCC), group 2 composing of 30 patients with HCV, group 3 composing of 30 healthy subjects matching the same age and socioeconomic status were taken as a control group. Gene polymorphism of BCL2 (Ala43Thr) were evaluated by PCR-RFLP technique and measured for all patients and controls. Results: The summed 43Thr genotype was more frequent and statistically significant in HCC patients as compared to control group. This genotype of BCL2 gene may inhibit the programmed cell death which leads to disturbance in tissue and cells homeostasis and reduction in immune regulation. This result leads to viral replication and HCV persistence. Moreover, virus produces variety of mechanisms to block genes participated in apoptosis. This mechanism proves that HCV patients who have 43Thr genotype are more susceptible to HCC. Conclusion: The data suggest for the first time that the BCL2 polymorphism is associated with the susceptibility to HCC in Egyptian populations and might be used as molecular markers for evaluating HCC risk. This study clearly demonstrated that Chronic HCV exhibit a deregulation of apoptosis with the disease progression. This provides an insight into the pathogenesis of chronic HCV infection, and may contribute to the therapy.

Keywords: BCL2 gene, Hepatitis C Virus, Hepatocellular carcinoma, sensitivity, specificity, apoptosis

Procedia PDF Downloads 504

Authors: Friday G. Okibe, Edit B. Agbaji, Victor O. Ajibola, Christain C. Onoyima

Abstract:

Controlled drug delivery systems reduce dose-dependent toxicity associated with potent drugs, including anticancer drugs. In this research, hydroxyapatite (HA) and hydroxyapatite-sodium alginate nanocomposites (HASA) were successfully prepared and characterized using Fourier Transform Infrared spectroscopy (FTIR) and Scanning Electron Microscopy (SEM). The FTIR result showed absorption peaks characteristics of pure hydroxyapatite (HA), and also confirmed the chemical interaction between hydroxyapatite and sodium alginate in the formation of the composite. Image analysis from SEM revealed nano-sized hydroxyapatite and hydroxyapatite-sodium alginate nanocomposites with irregular morphologies. Particle size increased with the formation of the nanocomposites relative to pure hydroxyapatite, with no significant change in particles morphologies. Drug loading and in-vitro drug release study were carried out using synthetic body fluid as the release medium, at pH 7.4 and 37 °C and under perfect sink conditions. The result shows that drug loading is highest for pure hydroxyapatite and decreased with increasing quantity of sodium alginate. However, the release study revealed that HASA-5%wt and HASA-20%wt presented better release profile than pure hydroxyapatite, while HASA-33%wt and HASA-50%wt have poor release profiles. This shows that Methotrexate-loaded hydroxyapatite-sodium alginate if prepared under optimal conditions is a potential carrier for effective delivery of Methotrexate.

Keywords: drug-delivery, hydroxyapatite, methotrexate, nanocomposites, sodium alginate

Procedia PDF Downloads 271

Authors: M. A. Munteanu, A. M. Lungu, A. I. Chivescu, V. Teodorescu, E. Tufanoiu, C. Nicolae, T. I. Nanea

Abstract:

Introduction: Sodium-glucose co-transporter 2 inhibitors (SGLT2i), which were first developed as antidiabetic medications, have demonstrated numerous positive benefits on the cardiovascular system, especially in the prevention of heart failure (HF). HF is a challenging, multifaceted disease that needs all-encompassing therapy. It should not be viewed as a limited form of heart illness but rather as a systemic disease that leads to multiple organ failure and death. SGLT2i is an extremely effective tool for treating HF by using its pleiotropic effects. In addition to its use in patients with diabetes mellitus who are at high cardiovascular risk or who have already experienced a cardiovascular event, SGLT2i administration has been shown to have positive effects on a variety of HF manifestations and stages, regardless of the patient's presence of diabetes mellitus. Material and Methods: According to the guide, 110 patients (83 males and 27 females) with heart failure with mildly reduced ejection fraction (HFmrEF), with T2D and neoplasia, were enrolled in the prospective study. The structural and functional state of the left ventricle myocardium and ejection fraction was assessed through echocardiography. Patients were randomized to receive once-daily dapagliflozin 10 mg. Results: Patients with HFmrEF were divided into 3 subgroups according to age. 7% (8) patients aged < 45 years, 35% (28) patients aged between 46-59 years, and 58% (74) patients aged> 60 years. The most prevalent comorbidities were hypertension (43.1%), coronary heart disease (40%), and obesity (33.2%). Study drug discontinuation and serious adverse events were not frequent in the subgroups, in either men or women, until now. Conclusions: SGLT-2 inhibitors are a novel class of antidiabetic agents that have demonstrated positive efficacy and safety outcomes in the setting of HFmrEF. Until now, in our study, dapagliflozin was safe and well-tolerated irrespective of sex.

Keywords: diabetes mellitus type 2, Sodium-glucose co-transporters-2 inhibitors, heart failure, neoplasia

Procedia PDF Downloads 85

Authors: Andriy Fedorenko

Abstract:

Background Early closure of the open abdomen is a priority after damage control laparotomy to prevent retraction of fascial layers and prevent hernia formation that requires definitive repair at a later stage. This substantially reduces the complications associated with ventral hernia formation for up to a year after initial surgery. TopClosure® is an innovative method that employs stress-relaxation and mechanical creep for skin stretching. Its use enables the primary closure of large abdominal wall defects and mitigates large ventral hernia formation. Materials and Methods A 7-year-old girl presented with severe blast injury. She underwent initial laparotomy in a facility within the conflict zone and was transferred in a state of septic shock to our facility for further care. Her abdominal injuries included liver lacerations, multiple perforations of the transverse colon and ileum, and a 8x16cm oblique abdominal wall defect. Further damage control laparotomy was performed with primary suture of the colon and ileum and temporary closure of the abdomen using a Bagota bag. Twelve hours later, negative pressure wound therapy (NPWT) was applied to the abdominal wound after relook laparotomy. Five days later, TopClosure® was applied to the lower part of the wound incorporating NPWT to the upper wound. Results The patient suffered leak from the colonic suture line and required relaparotomy. TopClosure® abdominal closure was achieved after every laparotomy. Conclusion TopClosure® utilizes the viscoelastic properties of the skin achieving full closure of the abdominal wall (including the fascia and skin),eliminating the need for prolonged NPWT, skin graft, and delayed ventral hernia repair surgery.

Keywords: topclosure, abdominal wall defect, hernia, damage control

Procedia PDF Downloads 74

Authors: Chang Li Yu

Abstract:

Resistances commonly happened during sexual offenders treatment program (SOTP), and removing resistances was one of the treatment goals on it. Studies concerning treatment effectiveness relied on pre- and post-treatment evaluations, however, no significant difference on resistance revealed after treatment, and the above consequences generally contributed to the low motivation for change instead. Therefore, the aim of this study was to investigate the resistance across each stage of change among sexual offenders (SO). The present study recruited prisoned SO in Taiwan, excluding those with literacy difficulties; finally, 272 participants were included. Of all participants completed revised version of URICA (University of Rhode Island Change Assessment) and resistance scale specifically for SO. The former included four stages of change: pre-contemplation (PC), contemplation (C), action (A), and maintain (M); the later composed eight types of resistance: system blaming, victims blaming, problems with treatment alliance, social justification, hopelessness, isolation, psychological reactance, and passive reactance. Both of the instruments were with well reliability and validity. Descriptive statistics and ANOVA were performed. All of 272 participants, age under 25 were 18(6.6%), 25-39 were 133(48.9%), 40-54 were 102(37.5%), and age over 55 were 19(7.0%); college level and above were 53(19.5%), high school level were 110(40.4%), and under high school level were 109(40.1%); first offended were 117(43.0%), and recidivist were 23(8.5%). Further deleting data with missing values and invalid questionnaires, SO with stage of change on PC were 43(18.9%), C were 109(47.8%), A were 70(30.7%), and on M were 6(2.6%). One-way ANOVA showed significant differences on every kind of resistances, excepting isolation and passive reactance. Post-hoc analysis showed that SO with different stages had their main resistance. There are two contributions to the present study. First, this study provided a clinical and theoretical measurement of evaluation that was never used in the past. Second, this study used an evidence-based methodology to prove a clinical perspective differed from the past, suggesting that resistances to treatment on SO appear the whole therapeutic process, when SO progress into the next stage of change, clinicians have to deal with their main resistance for working through the therapy.

Keywords: resistance, sexual offenders treatment program (SOTP), motivation for change, prisoned sexual offender

Procedia PDF Downloads 242

Authors: Mai Awad

Abstract:

This paper aims to focus on the phenomenon of martyrdom—particularly its performative aspect—and how social and popular cultural representations address the multiple meanings of the loaded image of a Palestinian martyr. This focus will help us to explore the possible reasons that might push Palestinians to consider pursuing “martyrdom” or suicide operations. Tracing what happened in the past and what is currently happening (that is, haunting) will aid in theorizing how the act/practice of “martyrdom” is produced. It is believed that there are social and political forces, particularly in a colonial society like Palestine, that influence the subject and its experience. But what is unique about this paper is its attempt to disclose the invisible, hidden narratives and complexities of Palestinian life that we do not see. By giving “martyrs” a chance to speak and express their own narratives—since “martyrs” usually leave written letters for their families, which are published after their death—this study must broaden the whole picture and discuss what is missing. The analytic method to be used: For the methodology, the paper recruits discourse analysis as a method for tracing the emergence, circulation, and productivity of the martyrdom discourse across a range of social practices in Palestinians’ everyday life after the Nakba. The paper analyzes the letters that “martyrs” left to their families, relatives, and the Palestinian community after their death. By letting “martyrs” speak for themselves and hearing their unique discourses, the research would suggest that more explanation is needed to describe the “martyr” identity. Hence, it is not possible to study the “martyr” identity in Palestine without understanding the colonial context that governs it and shapes their subjective experience.

Keywords: martyrdom, palestine, haunting, nakba 1948

Procedia PDF Downloads 64

Authors: Modi Alsubaie, Willem Kuyken, Rebecca Abbott, Barnaby Dunn, Chris Dickens, Tina Keil, William Henley

Abstract:

Background: Recently, there has been an increased interest in studying the effects of mindfulness-based interventions for people with psychological and physical problems. However, the mechanisms of action in these interventions that lead to beneficial physical and psychological outcomes have yet to be clearly identified. Purpose: The aim of this paper is to review, systematically, the evidence to date on the mechanisms of action in mindfulness interventions in populations with physical and/or psychological conditions. Method: Searches of seven databases (PsycINFO, Medline (Ovid), Cochrane Central Register of Controlled Trials, EMBASE, CINAHL, AMED, ClinicalTrials.gov) were undertaken in June 2014 and July 2015. We evaluated to what extent the studies we identified met the criteria suggested by Kazdin for establishing mechanisms of action within a psychological treatment (2007, 2009). Results: We identified four trials examining mechanisms of mindfulness interventions in those with comorbid psychological and physical health problems and 14 in those with psychological conditions. These studies examined a diverse range of potential mechanisms, including mindfulness and rumination. Of these candidate mechanisms, the most consistent finding was that greater self-reported change in mindfulness mediated superior clinical outcomes. However, very few studies fully met the Kazdin criteria for examining treatment mechanisms. Conclusion: There was evidence that global changes in mindfulness are linked to better outcomes. This evidence pertained more to interventions targeting psychological rather than physical health conditions. While there is promising evidence that MBCT/MBSR intervention effects are mediated by hypothesised mechanisms, there is a lack of methodological rigour in the field of testing mechanisms of action for both MBCT and MBSR, which precludes definitive conclusions.

Keywords: MBCT, MBSR, mechanisms, physical conditions, psychological conditions, systematic review

Procedia PDF Downloads 329

Authors: Zyrah Lou R. Samar, Genecarlo Liwanag

Abstract:

Type 2 Diabetes Mellitus is the more prevalent type, caused by a combination of insulin resistance and inadequate insulin response to hyperglycemia1. Aside from pharmacologic interventions, medical nutrition therapy is an integral part of the management of patients with Type 2 Diabetes Mellitus. Whey protein, which is one of the best protein sources, has been investigated for its applicability in improving glycemic control in patients with Type 2 Diabetes Mellitus. This systematic review and meta-analysis was conducted to measure the magnitude of the effect of whey protein on glycemic control in type 2 diabetes mellitus. The aim of this review is to evaluate the efficacy and safety of whey protein in patients with type 2 diabetes mellitus. Methods: A systematic electronic search for studies in the PubMed and Cochrane Collaboration database was done. Included in this review were randomized controlled trials of whey protein enrolling patients with type 2 diabetes mellitus. Three reviewers independently searched, assessed, and extracted data from the individual studies. Results: A systematic literature search on online databases such as Cochrane Central Registry, PubMed, and Herdin Plus was conducted in April to September 2021 to identify eligible studies. The search yielded 21 randomized controlled trials after removing duplicates. Only 5 articles were included after reviewing the full text, which met the criteria for selection. Conclusion: Whey protein supplementation significantly reduced fasting blood glucose. However, it did not reduce post-prandial blood glucose, HbA1c level, and weight when compared with the placebo. There has been a considerate heterogeneity across all studies, which may have contributed/confounded its effects. A larger sample size and better inclusion, and a more specific study may be included in the future reviews.

Keywords: whey protein, diabetes, nutrition, fasting blood sugar, postprandial glucose, HbA1c, weight reduction

Procedia PDF Downloads 103

Authors: Benjaporn Buranrat, Nootchanat Mairuae

Abstract:

Cratoxylum formosum (Jack) Dyer (CF) has been used for the traditional medicines in South East Asian and Thailand. Normally, northeast Thai vegetables have proven cytotoxic to many cancer cells. Therefore, the present study aims to explore the molecular mechanisms underlying CF-induced cancer cell death and apoptosis on breast and liver cancer cells. The cytotoxicity and antiproliferative effects of CF on the human breast MCF-7 and liver HepG2 cancer cell lines were evaluated using sulforhodamine B assay and colony formation assay. Cell migration assay was measured using wound healing assay. The apoptosis induction mechanisms were investigated through reactive oxygen species formation, caspase 3 activity, and JC-1 activity. Gene expression by real-time PCR and apoptosis related protein levels by Western blot analysis. CF induced MCF-7 and HepG2 cell death by time- and dose-dependent manner. Furthermore, CF had the greater cytotoxic potency on MCF-7 more than HepG2 cells with IC50 values of 85.70+4.52 μM and 219.03±9.96 μM respectively, at 24 h. Treatment with CF also caused a dose-dependent decrease in colony forming ability and cell migration, especially on MCF-7 cells. CF induced ROS formation, increased caspase 3 activities, and decreased the mitochondrial membrane potential, and causing apoptotic body production and DNA fragmentation. CF significantly decreased expression of the cell cycle regulatory protein RAC1 and downstream proteins, cdk6. Additionally, CF enhanced p21 and reduced cyclin D1 protein levels. CF leaf extract induced cell death, apoptosis, antimigration in both of MCF-7 and HepG2 cells. CF could be useful for developing to anticancer drug candidate for breast and liver cancer therapy.

Keywords: cratoxylum formosum (jack) dyer, breast cancer, liver cancer, cell death

Procedia PDF Downloads 206

Authors: Recep Kesli, Cengiz Demir, Onur Turkyilmaz, Hayriye Tokay

Abstract:

Objective: Gram-negative rods are a large group of bacteria, and include many families, genera, and species. Most clinical isolates belong to the family Enterobacteriaceae. Resistance due to the production of extended-spectrum β-lactamases (ESBLs) is a difficulty in the handling of Enterobacteriaceae infections, but other mechanisms of resistance are also emerging, leading to multidrug resistance and threatening to create panresistant species. We aimed in this study to evaluate resistance rates of Gram-negative rods bacteria isolated from clinical specimens in Microbiology Laboratory, Afyon Kocatepe University, ANS Research and Practice Hospital, between October 2012 and September 2015. Methods: The Gram-negative rods strains were identified by conventional methods and VITEK 2 automated identification system (bio-Mérieux, Marcy l’etoile, France). Antibiotic resistance tests were performed by both the Kirby-Bauer disk-diffusion and automated Antimicrobial Susceptibility Testing (AST, bio-Mérieux, Marcy l’etoile, France) methods. Disk diffusion results were evaluated according to the standards of Clinical and Laboratory Standards Institute (CLSI). Results: Of the totally isolated 1.701 Enterobacteriaceae strains 1434 (84,3%) were Klebsiella pneumoniae, 171 (10%) were Enterobacter spp., 96 (5.6%) were Proteus spp., and 639 Nonfermenting gram negatives, 477 (74.6%) were identified as Pseudomonas aeruginosa, 135 (21.1%) were Acinetobacter baumannii and 27 (4.3%) were Stenotrophomonas maltophilia. The ESBL positivity rate of the totally studied Enterobacteriaceae group were 30.4%. Antibiotic resistance rates for Klebsiella pneumoniae were as follows: amikacin 30.4%, gentamicin 40.1%, ampicillin-sulbactam 64.5%, cefepime 56.7%, cefoxitin 35.3%, ceftazidime 66.8%, ciprofloxacin 65.2%, ertapenem 22.8%, imipenem 20.5%, meropenem 20.5 %, and trimethoprim-sulfamethoxazole 50.1%, and for 114 Enterobacter spp were detected as; amikacin 26.3%, gentamicin 31.5%, cefepime 26.3%, ceftazidime 61.4%, ciprofloxacin 8.7%, ertapenem 8.7%, imipenem 12.2%, meropenem 12.2%, and trimethoprim-sulfamethoxazole 19.2 %. Resistance rates for Proteus spp. were: 24,3% meropenem, 26.2% imipenem, 20.2% amikacin 10.5% cefepim, 33.3% ciprofloxacin and levofloxacine, 31.6% ceftazidime, 20% ceftriaxone, 15.2% gentamicin, 26.6% amoxicillin-clavulanate, and 26.2% trimethoprim-sulfamethoxale. Resistance rates of P. aeruginosa was found as follows: Amikacin 32%, gentamicin 42 %, imipenem 43%, merpenem 43%, ciprofloxacin 50%, levofloxacin 52%, cefepim 38%, ceftazidim 63%, piperacillin/tacobactam 85%, for Acinetobacter baumannii; Amikacin 53.3%, gentamicin 56.6 %, imipenem 83%, merpenem 86%, ciprofloxacin 100%, ceftazidim 100%, piperacillin/tacobactam 85 %, colisitn 0 %, and for S. malthophilia; levofloxacin 66.6 % and trimethoprim/sulfamethoxozole 0 %. Conclusions: This study showed that resistance in Gram-negative rods was a serious clinical problem in our hospital and suggested the need to perform typification of the isolated bacteria with susceptibility testing regularly in the routine laboratory procedures. This application guided to empirical antibiotic treatment choices truly, as a consequence of the reality that each hospital shows different resistance profiles.

Keywords: antibiotic resistance, gram negative rods, ESBL, VITEK 2

Procedia PDF Downloads 329

Authors: Saad Al-Shibli, Nasser Amjad, Muna Al Kubaisi, Norra Harun, Shaikh Mizan

Abstract:

Leptin is a multifunctional hormone produced mainly by adipocyte. Leptin and its receptor have long been found associated with breast cancer. The main aim of this study is to investigate the correlation between Leptin/Leptin receptor and the clinicopathological features of breast cancer. Blood samples for ELISA, tissue samples from tumors and adjacent breast tissue were taken from 51 women with breast cancer with a control group of 40 women with a negative mammogram. Leptin and Leptin receptor in the tissues were estimated by immunohistochemistry (IHC). They were localized at the subcellular level by immunocytochemistry using transmission electron microscopy (TEM). Our results showed significant difference in serum leptin level between control and the patient group, but no difference between pre and post-operative serum leptin levels in the patient group. By IHC, we found that the majority of the breast cancer cells studied, stained positively for leptin and leptin receptors with co-expression of leptin and its receptors. No significant correlation was found between leptin/leptin receptors expression with the race, menopausal status, lymph node metastasis, estrogen receptor expression, progesterone receptor expression, HER2 expression and tumor size. Majority of the patients with distant metastasis were associated with high leptin and leptin receptor expression. TEM views both Leptin and Leptin receptor were found highly concentrated within and around the nucleus of the cancer breast cells, indicating nucleus is their principal seat of actions while the adjacent breast epithelial cells showed that leptin gold particles are scattered all over the cell with much less than that of the cancerous cells. However, presence of high concentration of leptin does not necessarily prove its over-expression, because it could be internalized from outside by leptin receptor in the cells. In contrast, leptin receptor is definitely over-expressed in the ductal breast cancer cells. We conclude that reducing leptin levels, blocking its downstream tissue specific signal transduction, and/or blocking the upstream leptin receptor pathway might help in prevention and therapy of breast cancer.

Keywords: breast cancer, expression, leptin, leptin receptors

Procedia PDF Downloads 134

Authors: Hongping Lu, Kelbinur Tursun, Yaru Li, Yu Zhang, Shunai Liu, Ming Han

Abstract:

Objective: To investigate whether NS5ATP9 is involved in IL-6 mediated autophagy and the relationship between IL-6 and NS5ATP9 in liver cancer cells. Methods: 1. Detect the mRNA and protein levels of Beclin 1 after HepG2 cells were treated with or without recombinant human IL-6 protein. 2. Measure and compare of the changes of autophagy-related genes with their respective control, after IL-6 was silenced or neutralized with monoclonal antibody against human IL-6. 3. HepG2 cells were incubated with 50 ng/ml of IL-6 in the presence or absence of PDTC. The expression of NS5ATP9 was analyzed by Western blot after 48 h. 4. After NS5ATP9-silenced HepG2 cells had been treated with 50 ng/ml recombinant IL-6 protein, we detected the Beclin 1 and LC3B (LC3Ⅱ/Ⅰ) expression. 5. HepG2 cells were transfected with pNS5ATP9, si-NS5ATP9, and their respective control. Total RNA was isolated from cells and analyzed for IL-6. 6. Silence or neutralization of IL-6 in HepG2 cells which has been transfected with NS5ATP9. Beclin 1 and LC3 protein levels were analyzed by Western blot. Result: 1. After HepG2 were treated with recombinant human IL-6 protein, the expression of endogenous Beclin 1 was up-regulated at mRNA and protein level, and the conversion of endogenous LC3-I to LC3-II was also increased. These results indicated that IL-6 could induce autophagy. 2. When HepG2 cells were treated with IL-6 siRNA or monoclonal antibody against human IL-6, the expression of autophagy-related genes were decreased. 3. Exogenous human IL-6 recombinant protein up-regulated NS5ATP9 via NF-κB activation. 4. The expression of Beclin 1 and LC3B was down-regulated after IL-6 treated NS5ATP9-silenced HepG2 cells. 5. NS5ATP9 could reverse regulates IL-6 expression in HepG2 cells. 6. Silence or neutralization of IL-6 attenuates NS5ATP9-induced autophagy slightly. Conclusion: Our results implied that in HCC patients, maybe the higher level of IL-6 in the serum promoted the expression of NS5ATP9 and induced autophagy in cancer cells. And the over-expression of NS5ATP9 which induced by IL-6, in turn, increased IL-6 expression, further, promotes the IL-6/NS5ATP9-mediated autophagy and affects the progression of tumor. Therefore, NS5ATP9 silence might be a potential target for HCC therapy.

Keywords: autophagy, Hepatocellular carcinoma, IL-6, microenvironment, NS5ATP9

Procedia PDF Downloads 246

Authors: Lina María Martínez Sánchez, Juliana Molina Valencia, Esteban Vallejo Agudelo, Daniel Gallego González, María Isabel Pérez Palacio, Juan Ricardo Gaviria García, María De Los Ángeles Rodríguez Gázquez, Gloria Inés Martínez Domínguez

Abstract:

Alternative and complementary therapies constitute a vast and complex combination of interventions, philosophies, approaches, and therapies that acquire a holistic healthcare point of view, becoming an alternative for the treatment of patients with chronic pain. Objective: determine the characteristics of the use of alternative and complementary therapies in patients with chronic pain who consulted in a medical institution. Methodology: cross-sectional and descriptive study, with a population of patients that assisted to the outpatient consultation and met the eligibility criteria. Sampling was not conducted. A form was used for the collection of demographic and clinical variables and the Holistic Complementary and Alternative Medicine Questionnaire (HCAMQ) was validated. The analysis and processing of information was carried out using the SPSS program vr.19. Results: 220 people with chronic pain were included. The average age was 54.7±16.2 years, 78.2% were women, and 75.5% belonged to the socioeconomic strata 1 to 3. Musculoskeletal pain (77.7%), migraine (15%) and neuralgia (9.1%) were the most frequently types of chronic pain. 33.6% of participants have used some kind of alternative and complementary therapy; the most frequent were: homeopathy (14.5%), phytotherapy (12.7%), and acupuncture (11.4%). The total average HCAMQ score for the study group was 30.2±7.0 points, which shows a moderate attitude toward the use of complementary and alternative medicine. The highest scores according to the type of pain were: neuralgia (32.4±5.8), musculoskeletal pain (30.5±6.7), fibromyalgia (29.6±7.3) and migraine (28.5±8.8). The reliability of the HCAMQ was acceptable (Cronbach's α: 0.6). Conclusion: it was noted that the types of chronic pain and the clinical or therapeutic management of patients correspond to the data available in current literature. Despite the moderate attitude toward the use of these alternative and complementary therapies, one of every three patients uses them.

Keywords: chronic pain, complementary therapies, homeopathy, acupuncture analgesia

Procedia PDF Downloads 511

Authors: Haifa Saleh, Kamiran Abduka, Robin Kalfat, Riadh Al-Mahaidi

Abstract:

The effectiveness of using pre-stressing steel bars for shear strengthening of high strength reinforced concrete (RC) slabs was assessed. Two large-scale RC slabs were tested, one without shear reinforcement and the second strengthened against punching shear failure using pre-stressing steel bars. The two slabs had the same dimensions, flexural reinforcement ratio, loading and support arrangements. The experimental program including the method of strengthening, set up and instrumentation are described in this paper. The experimental results are analyzed and discussed in terms of the structural behavior of the RC slabs, the performance of pre-stressing steel bolts and failure modes. The results confirmed that the shear strengthening technique increased the shear capacity, ductility and yield capacity of the slab by up to 15%, 44%, and 22%, respectively compared to the unstrengthened slab. The strengthening technique also successfully contributed to changing the failure mode from a brittle punching shear mode to ductile flexural failure mode. Vic3D digital image correlation system (photogrammetry) was also used in this research. This technique holds several advantages over traditional contact instrumentations including that it is inexpensive, it produces results that are simple to analyze and it is remote visualization technique. The displacement profile along the span of the slab and rotation has been found and compared with the results obtained from traditional sensors. The performance of the photogrammetry technique was very good and the results of both measurements were in very close agreement.

Keywords: flat slab, photogrammetry, punching shear, strengthening

Procedia PDF Downloads 159

Authors: Justyna Minkiewicz

Abstract:

Artificial Intelligence (AI) applied in the arts may influence the development of AI knowledge in other sectors and then also impact mutual collaboration with the artistic environment. Hence this collaboration may also impact the development of art projects. The paper will reflect the qualitative research outcomes based on in-depth (IDI) interviews within the marketing sector in Poland and desk research. Art is a reflection of the spirit of our times. Moreover, now we are experiencing a significant acceleration in the development of technologies and their use in various sectors. The leading technologies that contribute to the development of the economy, including the creative sector, embrace technologies such as artificial intelligence, blockchain, extended reality, voice processing, and virtual beings. Artificial intelligence is one of the leading technologies developed for several decades, which is currently reaching a high level of interest and use in various sectors. However, the conducted research has shown that there is still low awareness of artificial intelligence and its wide application in various sectors. The study will show how artists use artificial intelligence in their art projects and how it can be translated into practice within the business. At the same time, the paper will raise awareness of the need for businesses to be inspired by the artistic environment. The research proved that there is still a need to popularize knowledge about this technology which is crucial for many sectors. Art projects are tools to develop knowledge and awareness of society and also various sectors. At the same time, artists may benefit from such collaboration. The paper will include selected aspects of mutual relations, areas of possible inspiration, and possible transfers of technological solutions. Those are AI applications in creative industries such as advertising and film, image recognition in art, and projects from different sectors.

Keywords: artificial intelligence, business, art, creative industry, technology

Procedia PDF Downloads 95

Authors: Fatima M. Jadu, Asmaa A. Alzahrani, Maha A. Almutairi, Salma O. Al-Amoudi, Mawya A. Khafaji

Abstract:

Introduction: Estimating the potential radiation risk for a widely used imaging technique such as cone beam CT (CBCT) is crucial. The aim of this study was to examine the effect of varying two CBCT technical factors, the voxel size (VOX) and the Field-of-View (FOV) centralization, on the radiation dose. Methodology: The head and neck slices of a RANDO® man phantom (Alderson Research Laboratories) were used with nanoDot™ OSLD dosimeters to measure the absorbed radiation dose at 25 predetermined sites. Imaging was done using the i-CAT® (Imaging Science International, Hatfield, PA, USA) CBCT unit. The VOX was changed for every three cycles of exposures from 0.2mm to 0.3mm and then 0.4mm. Then the FOV was centered on the maxilla and mandible alternatively while holding all other factors constant. Finally, the effective radiation dose was calculated for each view and voxel setting. Results: The effective radiation dose was greatest when the smallest VOX was chosen. When the FOV was centered on the maxilla, the highest radiation doses were recorded in the eyes and parotid glands. While on the mandible, the highest radiation doses were recorded in the sublingual and submandibular glands. Conclusion: Minor variations in the CBCT exposure factors significantly affect the effective radiation dose and thus the radiation risk to the patient. Therefore, extreme care must be taken when choosing these parameters especially for vulnerable patients such as children.

Keywords: CBCT, cone beam CT, effective dose, field of view, mandible, maxilla, resolution, voxel

Procedia PDF Downloads 261

Authors: C. Fortin, D. Tokmeninova, O. Ushakova

Abstract:

Among 500 Russian universities Skolkovo Institute of Science and Technology (Skoltech) is one of the youngest (established in 2011), quite small and vastly international, comprising 20 percent of international students and 70 percent of faculty with significant academic experience at top-100 universities (QS, THE). The institute has emerged from close collaboration with MIT and leading Russian universities. Skoltech is an entirely English speaking environment. Skoltech curriculum plans of ten Master programs are based on the CDIO learning outcomes model. However, despite the Institute’s unique focus on industrial innovations and startups, one of the main challenges has become an evident large proportion of nearly half of MSc graduates entering PhD programs at Skoltech or other universities rather than industry or entrepreneurship. In order to increase the share of students joining the industrial sector after graduation, Skoltech started implementing a number of unique practices with a focus on employers’ expectations incorporated into the curriculum redesign. In this sense, extended knowledge exchange with industrial partners via collaboration in learning activities, industrial projects and assessments became essential for students’ headway into industrial and entrepreneurship pathways. Current academic curriculum includes the following types of components based on extended knowledge exchange with industrial partners: innovation workshop, industrial immersion, special industrial tracks, MSc defenses. Innovation workshop is a 4 week full time diving into the Skoltech vibrant ecosystem designed to foster innovators, focuses on teamwork, group projects, and sparks entrepreneurial instincts from the very first days of study. From 2019 the number of mentors from industry and startups significantly increased to guide students across these sectors’ demands. Industrial immersion is an exclusive part of Skoltech curriculum where students after the first year of study spend 8 weeks in an industrial company carrying out an individual or team project and are guided jointly by both Skoltech and company supervisors. The aim of the industrial immersion is to familiarize students with relevant needs of Russian industry and to prepare graduates for job placement. During the immersion a company plays the role of a challenge provider for students. Skoltech has started a special industrial track comprising deep collaboration with IPG Photonics – a leading R&D company and manufacturer of high-performance fiber lasers and amplifiers for diverse applications. The track is aimed to train a new cohort of engineers and includes a variety of activities for students within the “Photonics” MSc program. It is expected to be a successful story and used as an example for similar initiatives with other Russian high-tech companies. One of the pathways of extended knowledge exchange with industrial partners is an active involvement of potential employers in MSc Defense Committees to review and assess MSc thesis projects and to participate in defense procedures. The paper will evaluate the effect and results of the above undertaken measures.

Keywords: Curriculum redesign, knowledge exchange model, learning outcomes framework, stakeholder engagement

Procedia PDF Downloads 77

Authors: Ramesh Chand Chauhan, Sanjay Kumar Rai, Shashi kant, Rakesh Lodha, Nand Kumar

Abstract:

Background: With a better understanding of HIV pathogenesis and availability of antiretroviral therapy more children are growing and entering in teenage group; informing children of their own HIV status has become an important aspect of long-term disease management. There is little evidence of how and when this type of disclosure takes place in a resource-limited setting. Methods: A cross-sectional study was conducted from June 2010 to May 2011 among a dyads of 156 HIV-infected children and their caregivers, those were visiting pediatric clinic at a tertiary care hospital in Delhi, India. The study protocol was approved by the Institute Ethics Committee. After taking written informed consent; pretested structured questionnaire was administered to caregivers during routine clinic visits. Information regarding socio-demographic characteristics, awareness of HIV infection status among children and their perception regarding disclosure was collected. Mean and frequencies were calculated and chi-square and logistic regression test were applied. Results: The mean age of children was 8.4 ±3.45 years. Among them 73.7% were male and 39.1% were orphans. Among 156 enrolled children, 74.4% (n=116) were of ≥ 6 years and were assessed for disclosure. Only 18.1% (n=21) children had been informed of their HIV status. Of those under 9 years, 6.4% knew their status, whereas 18.4% of 9-11 years and 35.5% of 12-14 years children knew they had HIV. Awareness among males (23.3%) was higher than females (3.3%). Both age and sex of child were significantly (p<0.01) associated with disclosure status. Other factors favoring disclosure were orphan-hood, non-perinatal mode of transmission (OR = 4.32; 95% CI 1.01-7.12), ART initiation (OR = 4.21; 95% CI 1.03-6.98), and caregiver educated beyond primary level (OR = 1.89; 95% CI 1.03-3.26). Repeated enquiry regarding the visit to clinic was the most common reason (66.6%) for disclosure. In 52.4% children disclosure was done with the involvement of other family members. 82.5% caregivers felt the age of > 10 years is appropriate for disclosing the HIV infection status to the child. Conclusion: Detailed guidelines on disclosure are required focusing on children of school-going age with perinatal infection who are not on ART and with caregivers of low educational status.

Keywords: HIV, children, India, disclosure

Procedia PDF Downloads 630

Authors: Angelis P. Barlampas

Abstract:

Purpose or Learning Objective It is well known that previous examinations play a major role in futural diagnosis, thus avoiding unnecessary new exams that cost in time and money both for the patient and the health system. A case is presented in which past patient’s results, in combination with the least needed new tests, give an easy final diagnosis. Methods or Background A middle aged man visited the emergency department complaining of hard controlled, persisting fever for the last few days. Laboratory tests showed an elevated number of white blood cells with neutrophil shift and abnormal CRP. The patient was admitted to hospital a month ago for continuing lungs symptomatology after a recent covid-19 infection. Results or Findings Computed tomography scanning showed a solid mass with spiculating margins in right lower lobe. After intravenous iodine contrast administration, there was mildly peripheral enhancement and eccentric non enhancing area. A pneumonic cancer was suspected. Comparison with the patient’s latest computed tomography revealed no mass in the area of interest but only signs of recent post covid-19 lung parenchyma abnormalities. Any new mass that appears in a month’s time span can not be a cancer but a benign lesion. It was obvious that an abscess was the most suitable explanation. The patient was admitted to hospital, and antibiotic therapy was given, with very good results. After a few days, the patient was afebrile and in good condition. Conclusion In this case , a PET scan or a biopsy was avoided, thanks to the patient’s medical history and the availability of previous examinations. It is worthy encouraging the patients to keep their medical records and organizing more efficiently the health system with the current technology of archiving the medical examinations, too.

Keywords: covid-19, chest ct, cancer, abscess, fever

Procedia PDF Downloads 54

Authors: Elena Selezneva

Abstract:

Over the last two decades, an unprecedented growth in uncertainty and volatility in all aspects of the business environment has caused major global supply chain disruptions and malfunctions. The effects of one failed company in a supply chain can ripple up and down the chain, causing a number of entities or an entire supply chain to collapse. The complicating factor is that an increasingly unstable and unpredictable business environment fuels the growing complexity of global supply chain networks. That makes supply chain operations extremely unpredictable and hard to manage with the established methods and strategies. It has caused the premature demise of many companies around the globe as they could not withstand or adapt to the storm of change. Solutions to this problem are not easy to come by. There is a lack of new empirically tested theories and practically viable supply chain resilience strategies. The mainstream organizational approach to managing supply chain resilience is rooted in well-established theories developed in the 1960-1980s. However, their effectiveness is questionable in currently extremely volatile business environments. The systems thinking approach offers an alternative view of supply chain resilience. Still, it is very much in the development stage. The aim of this explorative research is to investigate supply chain management strategies that are successful in taming complexity in volatile business environments and creating resilience in supply chains. The design of this research methodology was guided by an interpretivist paradigm. A literature review informed the selection of the systems thinking approach to supply chain resilience. Therefore, an explorative single case study of Ventilator Challenge UK was selected as a case study for its extremely resilient performance of its supply chain during a period of national crisis. Ventilator Challenge UK is intensive care ventilators supply project for the NHS. It ran for 3.5 months and finished in 2020. The participants moved on with their lives, and most of them are not employed by the same organizations anymore. Therefore, the study data includes documents, historical interviews, live interviews with participants, and social media postings. The data analysis was accomplished in two stages. First, data were thematically analyzed. In the second stage, pattern matching and pattern identification were used to identify themes that formed the findings of the research. The findings from the Ventilator Challenge UK case study supply management practices demonstrated all the features of an adaptive dynamic system. They cover all the elements of supply chain and employ an entire arsenal of adaptive dynamic system strategies enabling supply chain resilience. Also, it is not a simple sum of parts and strategies. Bonding elements and connections between the components of a supply chain and its environment enabled the amplification of resilience in the form of systemic emergence. Enablers are categorized into three subsystems: supply chain central strategy, supply chain operations, and supply chain communications. Together, these subsystems and their interconnections form the resilient supply chain system framework conceptualized by the author.

Keywords: enablers of supply chain resilience, supply chain resilience strategies, systemic approach in supply chain management, resilient supply chain system framework, ventilator challenge UK

Procedia PDF Downloads 80

Authors: Hsin-Yu Lin, Ching-Hsia Hung

Abstract:

Obstructive sleep apnea (OSA) is characterized by a complete or partial obstruction of the upper airway during sleep. The vulnerable sites of upper airway collapses are consequences of sleep state-dependent reductions in tone in specific pharyngeal dilators. Clinical examinations reveal multilevel collapses of the upper airway among the patients with OSA. Therefore, an anatomically-based oropharyngeal rehabilitation should comprise a multilevel approach, including retropalatal, retroglossal, hypopharyngeal, temporomandibular, and facial levels, all of which involve different muscle groups and contribute to multifunctional interaction and coordination, such as swallowing, breathing, and phonation. The purpose of the study was to exam the effects of this rehabilitation program with a multilevel approach. In this study, fifteen subjects with newly diagnosed moderate or severe OSA (Apnea-Hypopnea-Index≥15) were randomized into an intervention group and control group. The intervention group (N=8) underwent a 12-week-intervention of a hospital-based rehabilitation program, while the control group (N=7) was kept on the waiting list. The 12-week-intervention comprised an anatomically based multilevel approach. The primary outcome was Polysomnography (PSG) data, and the secondary outcome was oropharyngeal and respiratory muscle function. In the intervention group, Apnea-Hypopnea-Index significantly improved (46.96±19.45 versus 32.78±10.78 events/h, p=0.017) compared with control group (35.77±17.49 versus 42.96±17.32 events/h, p=0.043). While the control group remained no change, the intervention group demonstrated other PSG outcomes significantly improvement, including arousal index (46.04±18.9 versus 32.98±8.35/h, p=0.035), mean SpO2 (92.88±2.1 versus 94.13±1.46%, p=0.039). Besides, the intervention group demonstrated significant improvement in oropharyngeal and respiratory muscle function compared to the control group. This anatomically-based oropharyngeal rehabilitation with a multilevel approach can be proven as a non-invasive therapy for patients with OSA.

Keywords: obstructive sleep apnea, upper airway, oropharyngeal rehabilitation, multilevel approach

Procedia PDF Downloads 100

Authors: V. K. Tewari, M. Hussain, H. K. D.Gupta

Abstract:

Aims/Background: The existing Intraoperative-MRI(IMRI) of developed countries is too costly to be utilized in any developing country. We have used the preexisting 3-side open 0.2-tesla MRI for IMRI in India so that the maximum benefit of the goal of IMRI is attained with cost effective state of the art surgeries. Material/Methods: We have operated 36-cases since 13thNov2005 via IMRI to till date. The table of MRI is used as an operating table which can be taken to the P3 level and as and when we require MRI to be done then the table can slide to P1 level so that the intraoperative monitoring can be done. The oxygen/nitrous tubes were taken out from vent made in the wall of the MRI room to outside. The small handy Boyel’s trolley was taken inside the MRI room with a small monitor. Anesthesia is been given in the MRI room itself. Usual skin markings were given with the help of scout MRI fields so the preciseness is increased. Craniotomy flap raised or the laminectomy and the dura opened in the similar fashion by same instruments as for the non IMRI case. Now corticectomy is planned after the T1 contrast image to localize and minimize the cortical resection. Staged and multiple P3 to P1 position and vice versa is planned respectively so that the resection is optimized to around 0.5 mm for radiotherapy. Immediate preclosure hematoma and edemas can be differentiated and cared for it. Results: Same MRI images as compared to highly expensive MRI of western world are achieved. Conclusion: 0.2 tesla Intraoperative MRI can be used for operative work for cranial and spinal cases easily with highly cost effectiveness.

Keywords: intraoperative MRI, 0.2 tesla intraoperative MRI, cost effective intraoperative MRI, medical and health sciences

Procedia PDF Downloads 452

Authors: Dovilė Bačėninaitė, Karina Džermeikaitė, Justinas Kirvela, Ramūnas Antanaitis

Abstract:

Bacteria are often present in the mouth of cattle. Some of them can cause abscesses. Starting with severe swelling of the mouth, muscle spasm, or locked jaw, it can lead to inability to open its mouth, move the neck, cause pain while eating. While the calf is unable to eat properly, it becomes more susceptible to infectious diseases, lower weight gain can be observed. Abscesses can be considered as a continuum of oral disease, whereby early stages of the lumpy jaw could proceed from gingivitis to periodontal disease. In the event of tissue damage, bacteria can enter the bloodstream, even cause sepsis. The most common lesions occur when animals eat sharp grass, coarse fodder, sharp, piercing foreign bodies (this is especially common for calves when they are trying to eat inedible objects). A crossbred Holstein calf presented with a history of proliferative outgrowth in the mandibular region. On clinical examination, needle aspiration, mandibular swelling revealed sticky, white curd-like fluid containing. Pus bacteriology revealed gram-negative cocci. They were sensitive to amoxicillin, cephalexin, enrofloxacin, ceftiofur. Blood morphology was in physiological ranges. The calf was treated surgically. The growth was excised, the puss drained and the wound was flushed with potassium permanganate solution (0,01%). A week after clinical surgery examination was performed. The swelling was decreased. Superficial bacterial infections are often associated with poor hygiene, which should be improved before treatment is commenced. Clipping away dirty hair and gently washing affected areas of skin daily with solutions such as povidone-iodine, potassium permanganate is effective. Appropriate antibiotic therapy, based on sensitivity testing, may be used where there is evidence of systemic illness.

Keywords: calf, abscess, lumpy jaw, pus, Streptococcus, Staphylococcus, Actinobacillus, infection

Procedia PDF Downloads 270