Search results for: interface treatment form

Authors: K. L. Pan, M. B. Chang

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Nitrogen oxides (NOₓ) is regarded as one of the most important air pollutants. It not only causes adverse environmental effects but also harms human lungs and respiratory system. As a post-combustion treatment, selective catalytic reduction (SCR) possess the highest NO removal efficiency ( ≥ 85%), which is considered as the most effective technique for removing NO from gas streams. However, injection of reducing agent such as NH₃ is requested, and it is costly and may cause secondary pollution. Reduction of NO with carbon monoxide (CO) as reducing agent has been previously investigated. In this process, the key step involves the NO adsorption and dissociation. Also, the high performance mainly relies on the amounts of oxygen vacancy on catalyst surface and redox ability of catalyst, because oxygen vacancy can activate the N-O bond to promote its dissociation. Additionally, perfect redox ability can promote the adsorption of NO and oxidation of CO. Typically, noble metals such as iridium (Ir), platinum (Pt), and palladium (Pd) are used as catalyst for the reduction of NO with CO; however, high cost has limited their applications. Recently, transition metal oxides have been investigated for the reduction of NO with CO, especially CuₓOy, CoₓOy, Fe₂O₃, and MnOₓ are considered as effective catalysts. However, deactivation is inevitable as oxygen (O₂) exists in the gas streams because active sites (oxygen vacancies) of catalyst are occupied by O₂. In this study, Cu-Ce-Fe-Co is prepared and supported on activated carbon by impregnation method to form 10% wt. Cu-Ce-Fe-Co/activated carbon catalyst. Generally, addition of activated carbon on catalyst can bring several advantages: (1) NO can be effectively adsorbed by interaction between catalyst and activated carbon, resulting in the improvement of NO removal, (2) direct NO decomposition may be achieved over carbon associated with catalyst, and (3) reduction of NO could be enhanced by a reducing agent over carbon-supported catalyst. Therefore, 10% wt. Cu-Ce-Fe-Co/activated carbon may have better performance for reduction of NO with CO. Experimental results indicate that NO conversion achieved with 10% wt. Cu-Ce-Fe-Co/activated carbon reaches 83% at 150°C with 300 ppm NO and 10,000 ppm CO. As temperature is further increased to 200°C, 100% NO conversion could be achieved, implying that 10% wt. Cu-Ce-Fe-Co/activated carbon prepared has good activity for the reduction of NO with CO. In order to investigate the effect of O₂ on reduction of NO with CO, 1-5% O₂ are introduced into the system. The results indicate that NO conversions still maintain at ≥ 90% with 1-5% O₂ conditions at 200°C. It is worth noting that effect of O₂ on reduction of NO with CO could be significantly improved as carbon is used as support. It is inferred that carbon support can react with O₂ to produce CO₂ as O₂ exists in the gas streams. Overall, 10% wt. Cu-Ce-Fe-Co/activated carbon is demonstrated with good potential for reduction of NO with CO, and possible mechanisms will be elucidated in this paper.

Keywords: nitrogen oxides (NOₓ), carbon monoxide (CO), reduction of NO with CO, carbon material, catalysis

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Authors: H. Y. Al-Matubsi, G. A. Oriquat, M. Abu-Samak, O. A. Al Hanbali, M. Salim

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Background: Uncontrolled diabetes mellitus (DM) is an etiological factor for recurrent pregnancy loss and major congenital malformations in the offspring. Antioxidant therapy has been advocated to overcome the oxidant-antioxidant disequilibrium inherent in diabetes. The aims of this study were to evaluate the protective effect of lipoic acid (LA) on fetal outcome and to elucidate changes that may be involved in the mechanism(s) implicit diabetic fetopathy. Methods: Female rats were rendered hyperglycemic using streptozocin and then mated with normal male rat. Pregnant non-diabetic (group1; n=9; and group2; n=7) or pregnant diabetic (group 3; n=10; and group 4; n=8) rats were treated daily with either lipoic acid (LA) (30 mg/kg body weight; groups 2 and 4) or vehicle (groups 1 and 3) between gestational days 0 and 15. On day 15 of gestation, the rats were sacrificed, and the fetuses, placentas and membranes dissected out of the uterine horns. Following morphological examination, the fetuses, placentas and membranes were homogenized, and used to measure cyclooxygenases (COX) activities and metabolisms of prostaglandin (PG) E2 (PGEM) and PGF2 (PGFM) levels. Maternal liver and plasma total glutathione levels were also determined. Results: Supplementation of diabetic rats with LA was found to significantly (P<0.05) reduce resorption rates in diabetic rats and increased mean fetal weight compared to diabetic group. Treatment of diabetic rats with LA leads to a significant (P<0.05) increase in liver and plasma total glutathione, in comparison with diabetic rats. Decreased levels of PGEM and elevated levels of PGFM in the fetuses, placentas and membranes were characteristic of experimental diabetic gestation associated with malformation. LA treatment to diabetic mothers failed to normalize levels of PGEM to the non-diabetic control rats. However, the levels of PGEM in malformed fetuses from LA-treated diabetic mothers was significantly (P < 0.05) higher than those in malformed fetuses from diabetic rats. Conclusions: We conclude that LA can reduce congenital malformations in the offspring of diabetic rats at day 15 of gestation. However, LA treatment did not completely prevent the occurrence of malformations, other factors, such as arachidonic acid deficiency and altered prostaglandin metabolismmay be involved in the pathogenesis of diabetes-induced congenital malformations.

Keywords: diabetes, lipoic acid, pregnancy, prostaglandins

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Authors: Albert Suryaprawira

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Patients requiring correction of severe Class III skeletal discrepancy historically has been among the most challenging treatments for orthodontists. Correction of an aesthetic and functional problem is crucially important. This is a case report of an adult male aged 18 years who complained of difficulty in chewing and speaking. Patient has a prominent profile with mandibular excess. The pre-treatment cephalometric radiograph was taken to analyse the skeletal problem and to measure the amount of bone movement and the prediction soft tissue response. The panoramic radiograph was also taken to analyse bone quality, bone abnormality, third molar impaction, etc. Before the surgery, the pre-surgical cephalometric radiograph was taken to re-evaluate the plan and to settle the final amount of bone cut. After the surgery, the post-surgical cephalometric radiograph was taken to confirm the result with the plan. The superimposition between those radiographs was performed to analyse the outcome. It includes the superimposition of the cranial base, maxilla, and mandible. Superimposition is important to describe the amount of hard and soft tissue movement. It is also important to predict the possibility of relapse after the surgery. The patient needs to understand all the surgical plan, outcome and relapse prevention. The surgery included mandibular set back by bilateral sagittal split osteotomies. Although the discrepancy was severe using this combination of treatment and the use of radiographic superimposition, an aesthetically pleasing and stable result was achieved.

Keywords: cephalometric, mandibular set back, orthognathic, superimposition

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Authors: Tsai-chun Lai, Szu-ju Fu, Tzu-lin Lee, Yuh-Lien Chen

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There is much evidence that exposure to fine particulate matter (PM) from air pollution increases the risk of cardiovascular morbidity and mortality. According to previous reports, PM in the air enters the respiratory tract, contacts the alveoli, and enters the blood circulation, leading to the progression of cardiovascular disease. PM pollution may also lead to cardiometabolic disturbances, increasing the risk of cardiovascular disease. The effects of PM on cardiac function and mitochondrial damage are currently unknown. We used mice and rat cardiomyocytes (H9c2) as animal and in vitro cell models, respectively, to simulate an air pollution environment using PM. These results indicate that the apoptosis-related factor PUMA, a regulator of apoptosis upregulated by p53, is increased in mice treated with PM. Apoptosis was aggravated in cardiomyocytes treated with PM, as measured by TUNEL assay and Annexin V/PI. Western blot results showed that CASPASE3 was significantly increased and BCL2 (B-cell lymphoid 2) was significantly decreased under PM treatment. Concurrent exposure to PM increases mitochondrial reactive oxygen species (ROS) production by MitoSOX Red staining. Furthermore, using Mitotracker staining, PM treatment significantly shortened mitochondrial length, indicating mitochondrial fission. The expression of mitochondrial fission-related proteins p-DRP1 (phosphodynamics-related protein 1) and FIS1 (mitochondrial fission 1 protein) was significantly increased. Based on these results, the exposure to PM worsens mitochondrial function and leads to cardiomyocyte apoptosis.

Keywords: particulate matter, cardiomyocyte, apoptosis, mitochondria

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Authors: K. Meera Saheb, K. Krishna Bhaskar

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Complex structures used in many fields of engineering are made up of simple structural elements like beams, plates etc. These structural elements, sometimes carry concentrated masses at discrete points, and when subjected to severe dynamic environment tend to vibrate with large amplitudes. The frequency amplitude relationship is very much essential in determining the response of these structural elements subjected to the dynamic loads. For Timoshenko beams, the effects of shear deformation and rotary inertia are to be considered to evaluate the fundamental linear and nonlinear frequencies. A commonly used method for solving vibration problem is energy method, or a finite element analogue of the same. In the present Coupled Displacement Field method the number of undetermined coefficients is reduced to half when compared to the famous Rayleigh Ritz method, which significantly simplifies the procedure to solve the vibration problem. This is accomplished by using a coupling equation derived from the static equilibrium of the shear flexible structural element. The prime objective of the present paper here is to study, in detail, the effect of a central concentrated mass on the large amplitude free vibrations of uniform shear flexible beams. Accurate closed form expressions for linear frequency parameter for uniform shear flexible beams with a central concentrated mass was developed and the results are presented in digital form.

Keywords: coupled displacement field, coupling equation, large amplitude vibrations, moderately thick plates

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Authors: Isalira Peroba Ramos, Cherley Borba Vieira de Andrade, Grazielle Suhett, Camila Salata, Paulo Cesar Canary, Guilherme Visconde Brasil, Antonio Carlos Campos de Carvalho, Regina Coeli dos Santos Goldenberg

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Background: The therapeutic options for patients with cancer now include increasingly complex combinations of medications, radiation therapy (RT), and surgical intervention. Many of these treatments have important potential adverse cardiac effects and are likely to have significant effects on patient outcomes. Cell therapy appears to be promising for the treatment of chronic and degenerative diseases, including cardiomyopathy induced by RT, as the current therapeutic options are insufficient. Aims: To evaluate the potential of bone marrow mesenchymal cells (BMMCs) in radioinduced cardiac damage Methods: Female Wistar rats, 3 months old (Ethics Committee 054/14), were divided into 2 groups, non-treated irradiated group (IR n=15) and irradiated and BMMC treated (IRT n=10). Echocardiography was performed to evaluate heart function. After euthanasia, 3 months post treatment; the left ventricle was removed and prepared for RT-qPCR (VEGF and Pro Collagen I) and histological (picrosirius) analysis. Results: In both groups, 45 days after irradiation, ejection fraction (EF) was in the normal range for these animals (> 70%). However, the BMMC treated group had EF (83.1%±2.6) while the non-treated IR group showed a significant reduction (76.1%±2.6) in relation to the treated group. In addition, we observed an increase in VEGF gene expression and a decrease in Pro Collagen I in IRT when compared to IR group. We also observed by histology that the collagen deposition was reduced in IRT (10.26%±0.83) when compared to IR group (25.29%±0.96). Conclusions: Treatment with BMMCs was able to prevent ejection fraction reduction and collagen deposition in irradiated animals. The increase of VEGF and the decrease of pro collagen I gene expression might explain, at least in part, the cell therapy benefits. All authors disclose no financial or personal relationships with individuals or organizations that could be perceived to bias their work. Sources of funding: FAPERJ, CAPES, CNPq, MCT.

Keywords: mesenchymal cells, radioation, cardiotoxicity, bone marrow

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Authors: Arvin Baes

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This study was conducted to assess the holistic needs of cancer patients in terms of physiological, psychological, social, and spiritual needs and to determine how they respond through coping. It was conducted from January-April 2018 from various hospitals in Laguna, with 20 respondents. It utilized a survey descriptive type of research, a checklist type of questionnaire, and purposive sampling in selecting the respondents. It was found out that in terms of physiological needs, fatigue is the most common symptoms they experienced. In terms of psychological, social, and spiritual needs, most of the patients experienced a significant concern. Meanwhile, in coping, religion dominates among the 14 strategies followed by Use of Emotional Support and Positive Reframing, and Substance Use obtained the lowest response. Most of the respondents were female, and its significant relationship in terms of Positive Reframing agrees significantly. In coping and civil status, Positive Reframing and Humor are significant among married respondents. In coping and stage of cancer, 'Positive Reframing' and 'Humor' are significant with the stage of cancer. In coping and treatment modalities, Active Coping, Use of Emotional Support, and Religion are significantly related to patients’ treatment modalities. There is also a significant relationship between Active Coping and Physiological Needs, Religion and Psychological Needs, and Self-blaming and Psychological, Social, and Spiritual Needs. Thus, it is concluded that holistic needs and coping are essential to each other to meet the wholeness of cancer patients. A formulated care intervention program would be beneficial among this group of patients.

Keywords: coping strategies, cancer, cancer patients, holistic needs

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Authors: Yuri Teterin, Lomali Generdukaev, Dmitry Blagovestnov, Peter Yartcev

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Introduction: Under the definition "large biliary stones," we referred to stones over 1.5 cm, in which standard transpapillary litho extraction techniques were unsuccessful. Electrohydraulic and laser contact lithotripsy under SpyGlass control have been actively applied for the last decade in order to improve endoscopic treatment results. Aims and Methods: Between January 2019 and July 2022, the N.V. Sklifosovsky Research Institute of Emergency Care treated 706 patients diagnosed with choledocholithiasis who underwent biliary stones removed from the common bile duct. Of them, in 57 (8, 1%) patients, the use of a Dormia basket or Biliary stone extraction balloon was technically unsuccessful due to the size of the stones (more than 15 mm in diameter), which required their destruction. Mechanical lithotripsy was used in 35 patients, and electrohydraulic and laser lithotripsy under SpyGlass direct visualization system - in 26 patients. Results: The efficiency of mechanical lithotripsy was 72%. Complications in this group were observed in 2 patients. In both cases, on day one after lithotripsy, acute pancreatitis developed, which resolved on day three with conservative therapy (Clavin-Dindo type 2). The efficiency of contact lithotripsy was in 100% of patients. Complications were not observed in this group. Bilirubin level in this group normalized on the 3rd-4th day. Conclusion: Our study showed the efficacy and safety of electrohydraulic and laser lithotripsy under SpyGlass control in a well-defined group of patients with large bile duct stones.

Keywords: contact lithotripsy, choledocholithiasis, SpyGlass, cholangioscopy, laser, electrohydraulic system, ERCP

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Authors: Chih-Chia Lin, Ching-Ying Huang, Cheng-Hong Liu, Wen-Lin Wang

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A complete fuel cell stack comprises several single cells with end plates, bipolar plates, gaskets and membrane electrode assembly (MEA) components. Electrons generated from cells are conducted through bipolar plates. The amount of cells' components increases as the stack voltage increases, complicating the fuel cell assembly process and mass production. Stack assembly error influence cell performance. PEM fuel cell stack importing laser welding technique could eliminate transverse deformation between bipolar plates to promote stress uniformity of cell components as bipolar plates and MEA. Simultaneously, bipolar plates were melted together using laser welding to decrease interface resistance. A series of experiments as through-plan and in-plan resistance measurement test was conducted to observe the laser welding effect. The result showed that the through-plane resistance with laser welding was a drop of 97.5-97.6% when the contact pressure was about 1MPa to 3 MPa, and the in-plane resistance was not significantly different for laser welding.

Keywords: PEM fuel cell, laser welding, through-plan, in-plan, resistance

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Authors: Iman Shabanzadeh

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The purpose of this research is to understand the lived experience of private sector entrepreneurs in facing the sources of freedom and unfreedom and benefiting from opportunities and basic capabilities in the process of realizing entrepreneurial ability in order to get closer to the macro situation of the narrative of human development in Iranian society. Therefore, the main question of the present research is to figure out what sources of freedom and social opportunities and unfreedom entrepreneurs in Iran's society benefit from the process of transforming their potential entrepreneurial abilities into entrepreneurial and business enterprises. In terms of methodology, the current research method will be thematic analysis in the form of semi-structured interviews with entrepreneurs active in small and medium-sized enterprises in Tehran, whose process of establishing and expanding their entrepreneurial activity has been in the last two decades. By examining the possibilities and refusals of advancing these people in the three stages of 'Idea creation and desire for entrepreneurship’, ‘Starting and creating a business’, and finally, ‘Continuing and expanding the business’, the findings of the research show the impact of five main resources for people to realize their potential talents, from the stage of creating an idea to expanding their business. These sources include' family institution,’ ‘education institution,’ ‘social norms and beliefs,’ ‘government and market,’ and ‘personality components of the entrepreneur.’ Finally, the findings are reported in three levels of basic themes (fifteen items), organizing themes (five items), and comprehensive themes (one item) and in the form of a theme network.

Keywords: entrepreneurship, human development, capability, sources of freedom

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Authors: T. C. Ng, R. Radzi, T. K. Ng, H. C. Chen

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The analgesic effects of lidocaine-bupivacaine block in cats undergoing routine orchiectomy were determined in this controlled, randomized, and blinded study. Twelve cats were randomly assigned to two groups. Cats in local block group received subcutaneous infiltration of 1 mg/kg of 2% lidocaine and 1 mg/kg of 0.5% bupivacaine into the scrotal sac. Cats in control group received equivolume of saline. Both groups were induced with mixture of ketamine (15 mg/kg) and acepromazine (0.1 mg/kg) intramuscularly and maintained on sevoflurane via facemask. Non-invasive blood pressures (BP), heart (HR), and respiratory rate (RR) were measured intra-operatively at specific events. Post-operatively, all cats received meloxicam, 0.2 mg/kg subcutaneously. Pain scores were determined at 4, 8, and 24 hours postoperatively. Mechanical pressure thresholds (MPT) at the perineum and metatarsus were determined at 2, 4, 8, and 24 hours postoperatively. Intra-operatively, the BP and HR tended to be higher in the control group. The increment in HR peaked during traction and autoligation of the spermatic cord in the control group. There was no treatment difference in RR. Post-operatively, pain scores in the group given local blocks were lower than the control group at 4 hour post-operation. There was no treatment difference in the post-operative HR, RR, BP and MPT values. In conclusion, subcutaneous infiltration of lidocaine-bupivacaine into the scrotal sac before orchiectomy improved intra-operative hemodynamic stability and provided better analgesia up to 4 hours post-surgery.

Keywords: analgesia, bupivacaine, cat, lidocaine, local block, orchiectomy

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Authors: Emielex M. Aguilar, Kristen Angela G. Cruz, Czarina Joie L. Rivera, Francis Dave C. Tan, Gavino Ivan N. Tanodra, Dianne Katrina G. Usana, Mary Grace T. Valentin, Nico Albert S. Vasquez, Edwin Monico C. Wee

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The risk of diabetes mellitus is increasing in the Philippines, with Metformin and Insulin as drugs commonly used for its management. The use of herbal medicines has grown increasingly, especially among the elderly population. Moringa oleifera or malunggay is one of the most common plants in the country, and several studies have shown the plant to exhibit a hypoglycemic property with its flavonoid content. This study aims to investigate the possible effects of concomitant use of Metformin and powdered M. oleifera leaves (PMOL) on blood glucose levels. Twenty male Sprague-Dawley rats were equally distributed into four groups. Fasting blood glucose levels of the rats were measured prior to experimentation. The following treatments were administered to the four groups, respectively: glucose only 2 g/kg; glucose 2 g/kg + Metformin 100 mg/kg; glucose 2 g/kg + PMOL 200 mg/kg; and glucose 2 g/kg + PMOL 200 mg/kg and Metformin 100 mg/kg. Blood glucose levels were determined on the 1st, 2nd, 3rd, and 4th hour post-treatment and compared between groups. Statistical analysis showed that the type of intervention did not show significance in the reduction of blood glucose levels when compared with the other groups (p=0.378), while the effect of time exhibited significance (p=0.000). The interaction between the type of intervention and time of blood glucose measurement was shown to be significant (p=0.024). Within each group, the control and PMOL-treated groups showed significant reduction in blood glucose levels over time with p-values of 0.000 and 0.000, respectively, while the Metformin-treated and the combination groups had p-values of 0.062 and 0.093, respectively, which are not significant. The descriptive data also showed that the mean total reduction of blood glucose levels of the Metformin and PMOL combination treatment group was lower than the PMOL-treated group alone, while the mean total reduction of blood glucose levels of the combination group was higher than the Metformin-treated group alone. Based on the results obtained, the combination of Metformin and PMOL did not significantly lower the blood glucose levels of the rats as compared to the other groups. However, the concomitant use of Metformin and PMOL may affect each other’s blood glucose lowering activity. Additionally, prolonged time of exposure and delay in the first blood glucose measurement after treatment could exhibit a significant effect in the blood glucose levels. Further studies are recommended regarding the effects of the concomitant use of the two agents on blood glucose levels.

Keywords: blood glucose levels, concomitant use, metformin, Moringa oleifera

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Authors: Georgitta Joseph Valiyamattam

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Autism spectrum disorders (ASD) are a growing phenomenon in India with over 10 million cases being recorded. Children with various levels and forms of ASD can be a major challenge both within the context of regular or special schooling. According to statistics by the Centers for Disease Control and Prevention (CDC), one in every 88 children today is born with autism spectrum disorder (ASD) against a ratio of one in 110 few years back. The growing number of children with autism spectrum disorders places greater demands on health services and necessitates the roping in of non-traditional modes of treatment to complement or even substitute traditional health care methods when possible. Research evidence, particularly from Western countries, as also some parts of Asia, suggests that animal-assisted therapy, or zootherapy, may be used as an effective individual or complementary therapeutic tool for increasing overall wellbeing and quality of life among children with Autism spectrum disorders. The paper through a case-study format seeks to evaluate the efficacy (initial stage) of animal assisted therapy (canine-therapy with visiting dog: breed-Golden retriever), as a non-conventional treatment modality for improving cognitive functioning and managing the behavioral and psychological symptoms of Autism Spectrum Disorders. As a pilot study forming the basis for subsequent larger application of AAT, it analyses areas of efficacy as also the challenges faced, both with regard to the mode of therapy, as also particular to the Indian setting.

Keywords: animal assisted therapy, autism, canine therapy, analyzing initial efficacy

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Authors: Yasaman Sanayei, Alireza Bahiraie

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This paper presents a systematic methodology based on the application of artificial neural networks for sequencing batch reactor (SBR). The SBR is a fill-and-draw biological wastewater technology, which is specially suited for nutrient removal. Employing reactive dye by Sphingomonas paucimobilis bacteria at sequence batch reactor is a novel approach of dye removal. The influent COD, MLVSS, and reaction time were selected as the process inputs and the effluent COD and BOD as the process outputs. The best possible result for the discrete pole parameter was a= 0.44. In orderto adjust the parameters of ANN, the Levenberg-Marquardt (LM) algorithm was employed. The results predicted by the model were compared to the experimental data and showed a high correlation with R2> 0.99 and a low mean absolute error (MAE). The results from this study reveal that the developed model is accurate and efficacious in predicting COD and BOD parameters of the dye-containing wastewater treated by SBR. The proposed modeling approach can be applied to other industrial wastewater treatment systems to predict effluent characteristics. Note that SBR are normally operated with constant predefined duration of the stages, thus, resulting in low efficient operation. Data obtained from the on-line electronic sensors installed in the SBR and from the control quality laboratory analysis have been used to develop the optimal architecture of two different ANN. The results have shown that the developed models can be used as efficient and cost-effective predictive tools for the system analysed.

Keywords: artificial neural network, COD removal, SBR, Sphingomonas paucimobilis

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Authors: Hakam Alkhateeb

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Oleuropein, the main constituent of leaves and fruits of the olive tree, has been demonstrated to exert beneficial effects on parameters relevant to the normal homeostatic mechanisms of glucose regulation in rat skeletal muscle. However, the antidiabetic effect of oleuropein, to our knowledge, has not been examined. Therefore, in this study, we examined whether oleuropein ameliorated palmitate-induced insulin resistance in skeletal muscle. To examine this question, insulin resistance was rapidly induced by incubating (12h) soleus muscle with a high concentration of palmitate(2mM). Subsequently, we attempted to restore insulin sensitivity by incubating (12h) muscles with oleuropien (1.5mM), while maintaining high concentrations of palmitate. Palmitate treatment for 12 h reduced insulin-stimulated glucose transport, GLUT4 translocationandAS160 phosphorylation. Oleuropein treatment (12 h) fully restoredinsulin-stimulated glucose transport, GLUT4translocationandAS160 phosphorylation. Inhibition of PI3K phosphorylation with wortmannin (1µM)did not affect the oleuropein-induced improvements in insulin-stimulated glucose transport, GLUT4 translocation, and AS160 phosphorylation. These results suggested that the improvements in these parameters cannot account for activating PI3K pathway. Taken altogether, it appears that oleuropein, through activation of another pathway like activated protein kinase (AMPK), may provide a possible strategy by which they ameliorate palmitate-induced insulin resistance in skeletal muscles.

Keywords: AS160, diabetes, GLUT4, oleuropein

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Authors: Wentao He, Jingxi Liu, De Xie

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It is necessary to manage the fatigue crack growth (FCG) once those cracks are detected during in-service inspections. In this paper, a simulation program (FCG-System) is developed utilizing the commercial software ABAQUS with its object-oriented programming interface to simulate the fatigue crack path and to compute the corresponding fatigue life. In order to apply FCG-System in large-scale marine structures, the substructure modeling technique is integrated in the system under the consideration of structural details and load shedding during crack growth. Based on the nodal forces and nodal displacements obtained from finite element analysis, a formula for shell elements to compute stress intensity factors is proposed in the view of virtual crack closure technique. The cracks initiating from the intersection of flange and the end of the web-stiffener are investigated for fatigue crack paths and growth lives under water pressure loading and axial force loading, separately. It is found that the FCG-System developed by authors could be an efficient tool to perform fatigue crack growth analysis on marine structures.

Keywords: crack path, fatigue crack, fatigue live, FCG-system, virtual crack closure technique

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Authors: Mujahid S. Alharbi

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The construction of process plants in oil and gas-producing countries, such as Saudi Arabia, necessitates substantial investment in design and building. Each new plant, while unique, includes common building types, suggesting an opportunity for design standardization. This study investigates the adoption of standardized Issue For Construction (IFC) packages for non-process buildings in Saudi Aramco. A SWOT analysis presents the strengths, weaknesses, opportunities, and threats of this approach. The approach's benefits are illustrated using the Hawiyah Unayzah Gas Reservoir Storage Program (HUGRSP) as a case study. Standardization not only offers significant cost savings and operational efficiencies but also expedites project timelines, reduces the potential for change orders, and fosters local economic growth by allocating building tasks to local contractors. Standardization also improves project management by easing interface constraints between different contractors and promoting adaptability to future industry changes. This research underscores the standardization of non-process buildings as a powerful strategy for cost optimization, efficiency enhancement, and local economic development in process plant construction within the oil and gas sector.

Keywords: building, construction, management, project, standardization

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Authors: Indu Bala Sethi, Meena Sewhag, Rakesh Kumar, Parveen Kumar

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Field experiment was conducted at Pulse Research Area of CCS Haryana Agricultural University, Hisar during rabi 2012-13 to study the economics of chickpea cultivars as influenced by sowing time and seed rate on sandy loam soils under irrigated conditions. The factorial experiment consisting of 24 treatment combinations with two sowing time (1st fortnight of November and 1st fortnight of December.) and four cultivars (H09-23, H08-18, C-235 and HC-1) kept in main plots while three seed rates viz. 40 kg ha-1, 50 kg ha-1 and 60 kg ha-1 was laid out in split plot design with three replications. The crop was sown with common row spacing of 30 cm as per the dates of sowing. The fertilizer was applied in the form of di- ammonium phosphate. The soil of the experimental site was deep sandy loam having pH of 7.9, EC of 0.13 dS/m and low in organic carbon (0.34%), low in available N status (193.36 kg ha-1), medium in available P2O5 (32.18 kg ha-1) and high in available K2O (249.67 kg ha-1). The crop was irrigated as and when required so as to maintain adequate soil moisture in the root zone The crop was sprayed with monocrotophos (1.25 l/ha) at initiation of flowering and at pod filling stage to protect the crop from pod borer attack. The yield was measured at the time of harvest. The cost of field preparation, sowing of seeds, thinning, weeding, plant protection, harvesting and cleaning contributed to fixed cost. The experiment was laid out in a split plot design with two sowing time (1st fortnight of November and 1st fortnight of December.) and four cultivars (H09-23, H08-18, C-235 and HC-1) kept in main plots while three seed rates viz. 40 kg ha-1, 50 kg ha-1 and 60 kg ha-1 were kept in subplots and replicated thrice. Results revealed that 1st fortnight of November sowing recorded significantly higher gross (Rs.1, 01,254 ha-1), net returns (Rs. 68,504 ha-1) and BC (3.09) ratio as compared to delayed crop of chickpea. Highest gross (Rs.91826 ha-1), net returns (Rs. 59076ha-1) and BC ratio (2.81) was recorded with H08-18. Higher value of cost of cultivation of chickpea was observed in higher seed rate than the lower ones. However no significant variation in net and gross returns was observed due to seed rates. Highest BC (2.72) ratio was recorded with 50 kg ha-1 which differs significantly from 60 kg ha-1 but was at par with 40 kg ha-1. This is because of higher grain yield obtained with 50 kg ha-1 seed rate. Net profit for farmers growing chickpea with seed rate of 50 kg ha-1 was higher than the farmers growing chickpea with seed rate of 40 and 60 kg ha.

Keywords: chickpea, cultivars, seed rate, sowing time

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Authors: Yao Song, Danni Cheng, Jianjun Ren

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Objectives: We aimed to explore the prognostic effects of absolute values and dynamic changes of common hematological indices on oropharynx squamous cell carcinoma (OPSCC) patients treated with radiation. Methods and materials: The absolute values of white blood cell (WBC), absolute neutrophil count (ANC), absolute lymphocyte count (ALC), hemoglobin (Hb), platelet (Plt), albumin (Alb), neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) at baseline (within 45 days before radiation), 1-, 3-, 6- and 12-months after the start of radiotherapy were retrospectively collected. Locally-estimated smoothing scatterplots were used to describe the smooth trajectory of each index. A mixed-effect model with a random slope was fitted to describe the changing rate and trend of indices over time. Cox proportional hazard analysis was conducted to assess the correlation between hematological indices and treatment outcomes. Results: Of the enrolled 85 OPSCC patients, inflammatory indices, such as WBC and ALC, dropped rapidly during acute treatment and gradually recovered, while NLR and PLR increased at first three months and subsequently declined within 3-12 months. Higher absolute value or increasing trend of nutritional indices (Alb and Hb) was associated with better prognosis (all p<0.05). In contrast, patients with higher absolute value or upward trend of inflammatory indices (WBC, ANC, Plt, PLR and NLR) had worse survival (all p<0.05). Conclusions: The absolute values and dynamic changes of hematological indices were valuable prognostic factors for OPSCC patients who underwent radiotherapy.

Keywords: hematological indices, oropharyngeal cancer, radiotherapy, NLR, PLR

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Authors: Marwa M. Abu-Serie, Marwa M. Eltarahony

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The search for reliable, effective, and safe nanoparticles (NPs) as a treatment for cancer is a pressing priority. In this study, Cu-NPs were fabricated by Streptomyces cyaneofuscatus through simultaneous bioreduction strategy of copper nitrate salt. The as-prepared Cu-NPs subjected to structural analysis; energy-dispersive X-ray spectroscopy, elemental mapping, X-ray diffraction, transmission electron microscopy, and ζ-potential. These biological synthesized Cu-NPs were mixed with disulfiram (DS), forming a nanocomplex of Cu-DS with a size of ~135 nm. The prepared nanocomplex (nanoCu-DS) exhibited higher anticancer activity than that of free complex of DS-Cu, Cu-NPs, and DS alone. This was illustrated by the lowest IC50 of nanoCu-DS (< 4 µM) against human breast and liver cancer cell lines comparing with DS-Cu, Cu-NPs, and DS (~8, 22.98-33.51 and 11.95-14.86, respectively). Moreover, flow cytometric analysis confirmed that higher apoptosis percentage range of nanoCu-DS-treated in MDA-MB 231, MCF-7, Huh-7, and HepG-2 cells (51.24-65.28%) than free complex of Cu-DS ( < 4.5%). Regarding inhibition potency of liver and breast cancer cell migration, no significant difference was recorded between free and nanocomplex. Furthermore, nanoCu-DS suppressed gene expression of β-catenine, Akt, and NF-κB and upregulated p53 expression (> 3, >15, > 5 and ≥ 3 folds, respectively) more efficiently than free complex (all ~ 1 fold) in MDA-MB 231 and Huh-7 cells. Our finding proved this prepared nano complex has a powerful anticancer activity relative to free complex, thereby offering a promising cancer treatment.

Keywords: biologically prepared Cu-NPs, breast cancer cell lines, liver cancer cell lines, nanoCu- disulfiram

Procedia PDF Downloads 189

Authors: Mohammad Tayefeh Norooz, Amirhossein Kargarzadeh

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Overweight and obesity as an abnormality are health threatening factors. Body mass index (BMI) above 25 is referred to as overweight and above 30 as obese. Apollo Endosurgery, Inc., a pioneering company in endoscopy surgeries, is poised to revolutionize patient care with its minimally invasive treatment options. Some product solutions are designed to improve patient outcomes and redefine the future of healthcare. Weight gain post-weight-loss surgery may stem from an enlarged stomach opening, reducing fullness and increasing food intake. Apollo Endosurgery's OverStitch system, a minimally invasive approach, addresses this by using sutures to reduce stomach opening size. This reflects Apollo's commitment to transformative improvements in healing endoscopy, emphasizing a shift towards minimally invasive options. The system's versatility and precision in full-thickness suturing offer treatment alternatives, exemplified in applications like Endoscopic Sleeve Gastroplasty for reshaping obesity management. Apollo’s dedication to pioneering advancements suggests ongoing breakthroughs in minimally invasive surgery, positioning the OverStitch systems as a testament to innovation in patient care.

Keywords: apollo endosurgery, endoscopic sleeve gastroplasty, weight loss system, overstitch endoscopic suturing system, therapeutic, perforations, fistula

Procedia PDF Downloads 63

Authors: Somnath Bhattacharyya

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The mobile adsorbed surface charge on hydrophobic surfaces can modify the velocity slip condition as well as create a Marangoni stress at the interface. The functionalized hydrophobic walls of micro/nanopores, e.g., graphene nanochannels, may possess physio-sorbed ions. The lateral mobility of the physisorbed absorbed ions creates a friction force as well as an electric force, leading to a modification in the velocity slip condition at the hydrophobic surface. In addition, the non-uniform distribution of these surface ions creates a surface tension gradient, leading to a Marangoni stress. The impact of the mobile surface charge on streaming potential and electrochemical energy conversion efficiency in a pressure-driven flow of ionized liquid through the nanopore is addressed. Also, enhanced electro-osmotic flow through the hydrophobic nanochannel is also analyzed. The mean-filed electrokinetic model is modified to take into account the short-range non-electrostatic steric interactions and the long-range Coulomb correlations. The steric interaction is modeled by considering the ions as charged hard spheres of finite radius suspended in the electrolyte medium. The electrochemical potential is modified by including the volume exclusion effect, which is modeled based on the BMCSL equation of state. The electrostatic correlation is accounted for in the ionic self-energy. The extremal of the self-energy leads to a fourth-order Poisson equation for the electric field. The ion transport is governed by the modified Nernst-Planck equation, which includes the ion steric interactions; born force arises due to the spatial variation of the dielectric permittivity and the dielectrophoretic force on the hydrated ions. This ion transport equation is coupled with the Navier-Stokes equation describing the flow of the ionized fluid and the 3fourth-order Poisson equation for the electric field. We numerically solve the coupled set of nonlinear governing equations along with the prescribed boundary conditions by adopting a control volume approach over a staggered grid arrangement. In the staggered grid arrangements, velocity components are stored on the midpoint of the cell faces to which they are normal, whereas the remaining scalar variables are stored at the center of each cell. The convection and electromigration terms are discretized at each interface of the control volumes using the total variation diminishing (TVD) approach to capture the strong convection resulting from the highly enhanced fluid flow due to the modified model. In order to link pressure to the continuity equation, we adopt a pressure correction-based iterative SIMPLE (Semi-Implicit Method for Pressure-Linked Equations) algorithm, in which the discretized continuity equation is converted to a Poisson equation involving pressure correction terms. Our results show that the physisorbed ions on a hydrophobic surface create an enhanced slip velocity when streaming potential, which enhances the convection current. However, the electroosmotic flow attenuates due to the mobile surface ions.

Keywords: microfluidics, electroosmosis, streaming potential, electrostatic correlation, finite sized ions

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Authors: Tina Naser Torabi

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Prevalence of allergy is affected by different factors according to its base and seasonal weather changes, and it also needs various treatments.Although reasons of allergy existence are not clear but generally, allergens cause reaction between antigen and antibody because of their antigenic traits. In this state, allergens cause immune system to make mistake and identify safe material as threat, therefore function of immune system impaired because of histamine secretion. There are different reasons for allergy, but herbal reasons are on top of the list, although animal causes cannot be ignored. Important point is that allergenic compounds, cause making dedicated antibody, so in general every kind of allergy is different from the other one. Therefore, most of the plants in herbal allergenic category can cause various allergies for human beings, such as respiratory allergies, nutritional allergies, injection allergies, infection allergies, touch allergies, that each of them show different symptoms based on the reason of allergy and also each of them requires different prevention and treatment. Geographical condition is another effective factor in allergy. Seasonal changes, weather condition, herbal coverage variety play important roles in different allergies. It goes without saying that humid climate and herbal coverage variety in different seasons especially spring cause most allergies in human beings in Iran and India that are discussed in this article. These two countries are good choices for allergy prevalence because of their condition, various herbal coverage, human and animal factors. Hay fever is one of the allergies, although the reasons of its prevalence are unknown yet. It is one of the most popular allergies in Iran and India because of geographical, human, animal and herbal factors. Hay fever is on top of the list in these two countries. Significant point about these two countries is that herbal factor is the most important factor in prevalence of hay fever. Variety of herbal coverage especially in spring during herbal pollination is the main reason of hay fever prevalence in these two countries. Based on the research result of Pharmacognosy and Phytochemistry, pollination of some plants in spring is major reason of hay fever prevalence in these countries. If airborne pollens in pollination season enter the human body through air, they will cause allergic reactions in eyes, nasal mucosa, lungs, and respiratory system, and if these particles enter the body of potential person through food, they will cause allergic reactions in mouth, stomach, and other digestive systems. Occasionally, chemical materials produced by human body such as Histamine cause problems like: developing of nasal polyps, nasal blockage, sleep disturbance, risk of asthma developing, blood vasodilation, sneezing, eye tears, itching and swelling of eyes and nasal mucosa, Urticaria, decrease in blood pressure, and rarely trauma, anesthesia, anaphylaxis and finally death. This article is going to study the reasons of hay fever prevalence in Iran and India and presents prevention and treatment Method from Phytochemistry and Pharmocognocy point of view by using local natural products in these two countries.

Keywords: hay fever, India, Iran, natural treatment, phytochemistry

Procedia PDF Downloads 166

Authors: Wan-Tzu Yen, Yu-Chen Luo, I-Ping Liu, Po-Hsuan Yeh, Sheng-Hsun Fu, Yuh-Lang Lee

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Self-assembled characteristics and adsorption performance of 1-dodecylamine molecules on gold (Au) (111) surfaces were characterized via cyclic voltammetry (CV), surface-enhanced infrared absorption spectroscopy (SEIRAS) and scanning tunneling microscopy (STM). The present study focused on the formation of 1-dodecylamine (DDA) on a gold surface with respect to the ex-situ arrangement of an adlayer on the Au(111) surface, and phase transition at potential dynamics carried out by EC-STM. This study reveals that alkyl amine molecules were formed an adsorption pattern with highly regular “lie down shape” on Au(111) surface, even in an extreme acid system (pH = 1). Acidic electrolyte (HClO₄) could protonate the surface of alkyl amine of a monolayer of the gold surface when potential shifts to negative. The quite stability of 1-dodecylamine on the gold surface maintained the monolayer across the potential window (0.1-0.8V). This transform model was confirmed by EC-STM. In addition, amine-modified Au(111) electrode adlayer used to examine how to affect an electron transfer across an interface using [Fe(CN)₆]³⁻/[Fe(CN)₆]⁴⁻ redox pair containing 0.1 M HClO₄ solution.

Keywords: cyclic voltammetry, dodecylamine, gold (Au)(111), scanning tunneling microscopy, self-assembled monolayer, surface-enhanced infrared absorption spectroscopy

Procedia PDF Downloads 198

Authors: Ramy Shaaban

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The purpose of this study was to examine the difference in clinical reasoning skills of students when using virtual audiology cases with and without collaborative assistance from major learning approaches important to clinical reasoning skills and computer-based learning models: Situated Learning Theory, Social Development Theory, Scaffolding, and Collaborative Learning. A quasi-experimental design was conducted at two United States universities to examine whether there is a significant difference in clinical reasoning skills between three treatment groups using IUP Audiosim software. Two computer-based audiology case simulations were developed, and participants were randomly placed into the three groups: no collaboration, virtual collaboration, and live collaboration. The clinical reasoning data were analyzed using One-Way ANOVA and Tukey posthoc analyses. The results show that there was a significant difference in clinical reasoning skills between the three treatment groups. The score obtained by the no collaboration group was significantly less than the scores obtained by the virtual and live collaboration groups. Collaboration, whether virtual or in person, has a positive effect on students’ clinical reasoning. These results with audiology students indicate that combining collaboration models with scaffolding and embedding situated learning and social development theories into the design of future virtual patients has the potential to improve students’ clinical reasoning skills.

Keywords: clinical reasoning, virtual patients, collaborative learning, scaffolding

Procedia PDF Downloads 214

Authors: Teh Kean Kheng, Low Soon Yee, Burra Venkata Durga Kumar

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In 2022, as the future world becomes increasingly computer-related, more individuals are attempting to study coding for themselves or in school. This is because they have discovered the value of learning code and the benefits it will provide them. But learning coding is difficult for most people. Even senior programmers that have experience for a decade year still need help from the online source while coding. The reason causing this is that coding is not like talking to other people; it has the specific syntax to make the computer understand what we want it to do, so coding will be hard for normal people if they don’t have contact in this field before. Coding is hard. If a user wants to learn bash code with bash prompt, it will be harder because if we look at the bash prompt, we will find that it is just an empty box and waiting for a user to tell the computer what we want to do, if we don’t refer to the internet, we will not know what we can do with the prompt. From here, we can conclude that the bash prompt is not user-friendly for new users who are learning bash code. Our goal in writing this paper is to give an idea to implement a user-friendly Bash prompt in Ubuntu OS using Artificial Intelligent (AI) to lower the threshold of learning in Bash code, to make the user use their own words and concept to write and learn Bash code.

Keywords: user-friendly, bash code, artificial intelligence, threshold, semantic similarity, lexical similarity

Procedia PDF Downloads 142

Authors: Elizabeth O. Odewale, Sachithra T. Wanasinghe, Aaron S. Rury

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Cavity polaritons form when molecular excitons strongly couple to photons in carefully constructed optical cavities. These polaritons, which are hybrid light-matter states possessing a unique combination of photonic and excitonic properties, present the opportunity to manipulate the properties of various semiconductor materials. The systematic manipulation of materials through polariton formation could potentially improve the functionalities of many optoelectronic devices such as lasers, light-emitting diodes, photon-based quantum computers, and solar cells. However, the prospects of leveraging polariton formation for novel devices and device operation depend on more complete connections between the properties of molecular chromophores, and the hybrid light-matter states they form, which remains an outstanding scientific goal. Specifically, for most optoelectronic applications, it is paramount to understand how polariton formation affects the spectra of light absorbed by molecules coupled strongly to cavity photons. An essential feature of a polariton state is its dispersive energy, which occurs due to the enhanced spatial delocalization of the polaritons relative to bare molecules. To leverage the spatial delocalization of cavity polaritons, angle-resolved photoluminescence excitation spectroscopy was employed in characterizing light emission from the polaritonic states. Using lasers of appropriate energies, the polariton branches were resonantly excited to understand how molecular light absorption changes under different strong light-matter coupling conditions. Since an excited state has a finite lifetime, the photon absorbed by the polariton decays non-radiatively into lower-lying molecular states, from which radiative relaxation to the ground state occurs. The resulting fluorescence is collected across several angles of excitation incidence. By modeling the behavior of the light emission observed from the lower-lying molecular state and combining this result with the output of angle-resolved transmission measurements, inferences are drawn about how the behavior of molecules changes when they form polaritons. These results show how the intrinsic properties of molecules, such as the excitonic lifetime, affect the rate at which the polaritonic states relax. While it is true that the lifetime of the photon mediates the rate of relaxation in a cavity, the results from this study provide evidence that the lifetime of the molecular exciton also limits the rate of polariton relaxation.

Keywords: flourescece, molecules in cavityies, optical cavity, photoluminescence excitation, spectroscopy, strong coupling

Procedia PDF Downloads 73

Authors: Ayperi̇ Haspolat Özcan, Meltem Anafarta Şendağ

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This study aimed to establish a model in the light of current approaches for understanding the mediating role of early maladaptive schemas in the relationship between attachment and anger. Accordingly, the proposed mediation model was tested by mediation with bootstrapping technique, considering gender and attachment figure differences. The university students (N= 444) with ages ranging from 17 to 28 participated in the study. Participants filled out Parental and Peer Attachment Scale Short Form, Young Schema Questionnaire - Short Form 3, Trait Anger and Anger Expression Scales. The mediating role of early maladaptive schemas (impaired autonomy, disconnection and rejection, unrelenting standards, other-directedness, and impaired limits) in the relationship between attachment (mother and father) and anger aspects (trait anger, anger in, anger out and anger control) were found to be significant for both male and female participants. Separate mediation analyses for both genders and different attachment figures have also drawn attention to noticeable differences in the results. Specifically, for females, various paths were discovered in predicting various aspects of anger (anger in, anger out, anger control, and trait anger). On the other hand, for males only anger directed inwards was found to be predicted by any source of attachment through disconnection and rejection schema only. These obvious gender differences in understanding the mechanism of anger are discussed in the light of cultural gender roles and the social acceptance of anger in males. In the area of application, the study of various aspects of anger with particular attention to attachment and early maladaptive schemas as well as the importance of distinguishing the gender differences are emphasized as important points.

Keywords: anger expression, attachment, early maladaptive schemas, trait anger

Procedia PDF Downloads 288

Authors: Jorge Martínez-Rodríguez, Esther Pérez-Carrillo, Diana Laura Anchondo Álvarez, Julia Lucía Leal Villarreal, Mariana Juárez Dominguez, Luisa Fernanda Torres Hernández, Daniela Salinas Morales, Erick Heredia-Olea

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Maize tortillas are a staple food in Mexico which are mostly made by nixtamalization, which includes the cooking and steeping of maize kernels in alkaline conditions. The cooking step in nixtamalization demands a lot of energy and also generates nejayote, a water pollutant, at the end of the process. The aim of this study was to reduce the cooking time by adding a maize soaking step before nixtamalization while maintaining the quality properties of masa and tortillas. Maize kernels were soaked for 36 h to increase moisture up to 36%. Then, the effect of different cooking times (0, 5, 10, 15, 20, 20, 25, 30, 35, 45-control and 50 minutes) was evaluated on viscosity profile (RVA) of masa to select the treatments with a profile similar or equal to control. All treatments were left steeping overnight and had the same milling conditions. Treatments selected were 20- and 25-min cooking times which had similar values for pasting temperature (79.23°C and 80.23°C), Maximum Viscosity (105.88 Cp and 96.25 Cp) and Final Viscosity (188.5 Cp and 174 Cp) to those of 45 min-control (77.65 °C, 110.08 Cp, and 186.70 Cp, respectively). Afterward, tortillas were produced with the chosen treatments (20 and 25 min) and for control, then were analyzed for texture, damage starch, colorimetry, thickness, and average diameter. Colorimetric analysis of tortillas only showed significant differences for yellow/blue coordinates (b* parameter) at 20 min (0.885), unlike the 25-minute treatment (1.122). Luminosity (L*) and red/green coordinates (a*) showed no significant differences from treatments with respect control (69.912 and 1.072, respectively); however, 25 minutes was closer in both parameters (73.390 and 1.122) than 20 minutes (74.08 and 0.884). For the color difference, (E), the 25 min value (3.84) was the most similar to the control. However, for tortilla thickness and diameter, the 20-minute with 1.57 mm and 13.12 cm respectively was closer to those of the control (1.69 mm and 13.86 cm) although smaller to it. On the other hand, the 25 min treatment tortilla was smaller than both 20 min and control with 1.51 mm thickness and 13.590 cm diameter. According to texture analyses, there was no difference in terms of stretchability (8.803-10.308 gf) and distance for the break (95.70-126.46 mm) among all treatments. However, for the breaking point, all treatments (317.1 gf and 276.5 gf for 25 and 20- min treatment, respectively) were significantly different from the control tortilla (392.2 gf). Results suggest that by adding a soaking step and reducing cooking time by 25 minutes, masa and tortillas obtained had similar functional and textural properties to the traditional nixtamalization process.

Keywords: tortilla, nixtamalization, corn, lime cooking, RVA, colorimetry, texture, masa rheology

Procedia PDF Downloads 177

Authors: A. Dean, M. Pitcher, L. Storer, K. Shanahan, I. Rio, B. Mann

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Purpose: Breast cancer survivors are at risk of specific physical and psycho-social issues, such as arm swelling, fatigue, and depression. Firstly, we investigate symptoms reported by Australia breast cancer survivors upon completion of definitive treatment. Secondly, we evaluate the appropriateness and effectiveness of a multi-centre pilot program nurse-led clinic to identify these issues and make timely referrals to available services. Methods: Patients post-definitive treatment (excluding ongoing hormonal therapy) for early breast cancer or ductal carcinoma in situ were invited to participate. An hour long appointment with a breast care nurse (BCN) was scheduled. In preparation, patients completed validated quality-of-life surveys (FACT-B, Menopause Rating Scale, Distress Thermometer). During the appointment, issues identified in the surveys were addressed and referrals to appropriate services arranged. Results: 183 of 274 (67%) eligible patients attended a nurse-led clinic. Mean age 56.8 years (range 29-87 years), 181/183 women, 105/183 post-menopausal. 96 (55%) participants reported significant level of distress; 31 (18%) participants reported extreme distress or depression. Distress stemmed from a lack of energy (56/175); poor quality of sleep (50/176); inability to work or participate in household activities (35/172) and problems with sex life (28/89). 166 referrals were offered; 94% of patients accepted the referrals. 65% responded to a follow-up survey: the majority of women either strongly agreed or agreed that the BCN was overwhelmingly supportive, helpful in making referrals, and compassionate towards them. 39% reported making lifestyle changes as a result of the BCN. Conclusion: Breast cancer survivors experience a unique set of challenges, including low mood, difficulty sleeping, problems with sex life and fear of disease recurrence. The nurse-led clinic model is an appropriate and effective method to ensure physical and psycho-social issues are identified and managed in a timely manner. This model empowers breast cancer survivors with information about their diagnosis and available services.

Keywords: early breast cancer, survivorship, breast care nursing, oncology nursing and cancer care

Procedia PDF Downloads 399