Search results for: high distress target
21977 Barriers for Appropriate Palliative Symptom Management: A Qualitative Research in Kazakhstan, a Medium-Income Transitional-Economy Country
Authors: Ibragim Issabekov, Byron Crape, Lyazzat Toleubekova
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Background: Palliative care substantially improves the quality of life of terminally-ill patients. Symptom control is one of the keystones in the management of patients in palliative care settings, lowering distress as well as improving the quality of life of patients with end-stage diseases. The most common symptoms causing significant distress for patients are pain, nausea and vomiting, increased respiratory secretions and mental health issues like depression. Aims are: 1. to identify best practices in symptom management in palliative patients in accordance with internationally approved guidelines and compare aforementioned with actual practices in Kazakhstan; to evaluate the criteria for assessing symptoms in terminally-ill patients, 2. to review the availability and utilization of pharmaceutical agents for pain control, management of excessive respiratory secretions, nausea, and vomiting, and delirium and 3. to develop recommendations for the systematic approach to end-of-life symptom management in Kazakhstan. Methods: The use of qualitative research methods together with systematic literature review have been employed to provide a rigorous research process to evaluate current approaches for symptom management of palliative patients in Kazakhstan. Qualitative methods include in-depth semi-structured interviews of the healthcare professionals involved in palliative care provision. Results: Obstacles were found in appropriate provision of palliative care. Inadequate education and training to manage severe symptoms, poorly defined laws and regulations for palliative care provision, and a lack of algorithms and guidelines for care were major barriers in the effective provision of palliative care. Conclusion: Assessment of palliative care in this medium-income transitional-economy country is one of the first steps in the initiation of integration of palliative care into the existing health system. Achieving this requires identifying obstacles and resolving these issues.Keywords: end-of-life care, middle income country, palliative care, symptom control
Procedia PDF Downloads 20021976 Characterization of Platelet Mitochondrial Metabolism in COVID-19 Caused Acute Respiratory Distress Syndrome (ARDS)
Authors: Anna Höfer, Johannes Herrmann, Patrick Meybohm, Christopher Lotz
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Mitochondria are pivotal for energy supply and regulation of cellular functions. Deficiencies of mitochondrial metabolism have been implicated in diverse stressful conditions including infections. Platelets are key mediators for thrombo-inflammation during development and resolution of acute respiratory distress syndrome (ARDS). Previous data point to an exhausted platelet phenotype in critically-ill patients with coronavirus 19 disease (COVID-19) impacting the course of disease. The objective of this work was to characterize platelet mitochondrial metabolism in patients suffering from COVID-19 ARDSA longitudinal analysis of platelet mitochondrial metabolism in 24 patients with COVID-19 induced ARDS compared to 35 healthy controls (ctrl) was performed. Blood samples were analyzed at two time points (t1=day 1; t2=day 5-7 after study inclusion). The activity of mitochondrial citrate synthase was photometrically measured. The impact of oxidative stress on mitochondrial permeability was assessed by a photometric calcium-induced swelling assay and the activity of superoxide dismutase (SOD) by a SOD assay kit. The amount of protein carbonylation and the activity of mitochondria complexes I-IV were photometrically determined. Levels of interleukins (IL)-1α, IL-1β and tumor necrosis factor (TNF-) α were measured by a Multiplex assay kit. Median age was 54 years, 63 % were male and BMI was 29.8 kg/m2. SOFA (12; IQR: 10-15) and APACHE II (27; IQR: 24-30) indicated critical illness. Median Murray Score was 3.4 (IQR: 2.8-3.4), 21/24 (88%) required mechanical ventilation and V-V ECMO support in 14/24 (58%). Platelet counts in ARDS did not change during ICU stay (t1: 212 vs. t2: 209 x109/L). However, mean platelet volume (MPV) significantly increased (t1: 10.6 vs. t2: 11.9 fL; p<0.0001). Citrate synthase activity showed no significant differences between ctrl and ARDS patients. Calcium induced swelling was more pronounced in patients at t1 compared to t2 and to ctrl (50µM; t1: 0.006 vs. ctrl: 0.016 ΔOD; p=0.001). The amount of protein carbonylation as marker for irreversible proteomic modification constantly increased during ICU stay and compared to ctrl., without reaching significance. In parallel, superoxid dismutase activity gradually declined during ICU treatment vs. ctrl (t2: - 29 vs. ctrl.: - 17 %; p=0.0464). Complex I analysis revealed significantly stronger activity in ARDS vs. ctrl. (t1: 0.633 vs. ctrl.: 0.415 ΔOD; p=0.0086). There were no significant differences in complex II, III or IV activity in platelets from ARDS patients compared to ctrl. IL-18 constantly increased during the observation period without reaching significance. IL-1α and TNF-α did not differ from ctrl. However, IL-1β levels were significantly elevated in ARDS (t1: 16.8; t2: 16.6 vs. ctrl.: 12.4 pg/mL; p1=0.0335, p2=0.0032). This study reveals new insights in platelet mitochondrial metabolism during COVID-19 caused ARDS. it data point towards enhanced platelet activity with a pronounced turnover rate. We found increased activity of mitochondria complex I and evidence for enhanced oxidative stress. In parallel, protective mechanisms against oxidative stress were narrowed with elevated levels of IL-1β likely causing a pro-apoptotic environment. These mechanisms may contribute to platelet exhaustion in ARDS.Keywords: acute respiratory distress syndrome (ARDS), coronavirus 19 disease (COVID-19), oxidative stress, platelet mitochondrial metabolism
Procedia PDF Downloads 5921975 Functionalized Nanoparticles for Drug Delivery Applications
Authors: Temesgen Geremew
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Functionalized nanoparticles have emerged as a revolutionary platform for drug delivery, offering significant advantages over traditional methods. By strategically modifying their surface properties, these nanoparticles can be designed to target specific tissues and cells, significantly reducing off-target effects and enhancing therapeutic efficacy. This targeted approach allows for lower drug doses, minimizing systemic exposure and potential side effects. Additionally, functionalization enables controlled release of the encapsulated drug, improving drug stability and reducing the frequency of administration, leading to improved patient compliance. This work explores the immense potential of functionalized nanoparticles in revolutionizing drug delivery, addressing limitations associated with conventional therapies and paving the way for personalized medicine with precise and targeted treatment strategies.Keywords: nanoparticles, drug, nanomaterials, applications
Procedia PDF Downloads 6721974 A Model for Diagnosis and Prediction of Coronavirus Using Neural Network
Authors: Sajjad Baghernezhad
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Meta-heuristic and hybrid algorithms have high adeer in modeling medical problems. In this study, a neural network was used to predict covid-19 among high-risk and low-risk patients. This study was conducted to collect the applied method and its target population consisting of 550 high-risk and low-risk patients from the Kerman University of medical sciences medical center to predict the coronavirus. In this study, the memetic algorithm, which is a combination of a genetic algorithm and a local search algorithm, has been used to update the weights of the neural network and develop the accuracy of the neural network. The initial study showed that the accuracy of the neural network was 88%. After updating the weights, the memetic algorithm increased by 93%. For the proposed model, sensitivity, specificity, positive predictivity value, value/accuracy to 97.4, 92.3, 95.8, 96.2, and 0.918, respectively; for the genetic algorithm model, 87.05, 9.20 7, 89.45, 97.30 and 0.967 and for logistic regression model were 87.40, 95.20, 93.79, 0.87 and 0.916. Based on the findings of this study, neural network models have a lower error rate in the diagnosis of patients based on individual variables and vital signs compared to the regression model. The findings of this study can help planners and health care providers in signing programs and early diagnosis of COVID-19 or Corona.Keywords: COVID-19, decision support technique, neural network, genetic algorithm, memetic algorithm
Procedia PDF Downloads 6621973 A Study on the Establishment of a 4-Joint Based Motion Capture System and Data Acquisition
Authors: Kyeong-Ri Ko, Seong Bong Bae, Jang Sik Choi, Sung Bum Pan
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A simple method for testing the posture imbalance of the human body is to check for differences in the bilateral shoulder and pelvic height of the target. In this paper, to check for spinal disorders the authors have studied ways to establish a motion capture system to obtain and express motions of 4-joints, and to acquire data based on this system. The 4 sensors are attached to the both shoulders and pelvis. To verify the established system, the normal and abnormal postures of the targets listening to a lecture were obtained using the established 4-joint based motion capture system. From the results, it was confirmed that the motions taken by the target was identical to the 3-dimensional simulation.Keywords: inertial sensor, motion capture, motion data acquisition, posture imbalance
Procedia PDF Downloads 51521972 In-silico Target Identification and Molecular Docking of Withaferin A and Withanolide D to Understand their Anticancer Therapeutic Potential
Authors: Devinder Kaur Sugga, Ekamdeep Kaur, Jaspreet Kaur, C. Rajesh, Preeti Rajesh, Harsimran Kaur
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Withanolides are steroidal lactones and are highly oxygenated phytoconstituents that can be developed as potential anti-carcinogenic agents. The two main withanolides, namely Withaferin A and Withanolides D, have been extensively studied for their pharmacological activities. Both these withanolides are present in the Withania somnifera (WS) leaves belonging to the family Solanaceae, also known as “Indian ginseng .”In this study effects of WS leaf extract on the MCF7 breast cancer cell line were investigated by performing a 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay to evaluate the cytotoxic effects and in vitro wound-healing assay to study the effect on cancer cell migration. Our data suggest WS extracts have cytotoxic effects and are effective anti-migrating agents and thus can be a source of potential candidates for the development of potential agents against metastasis. Thus, it can be a source of potential candidates for the development of potential agents against metastasis. Insight into these results, the in-silico approach to identify the possible protein targets interacting with withanolides was taken. Protein kinase C alpha (PKCα) was among the selected 5 top-ranked target proteins identified by the Swiss Target Prediction tool. PKCα is known to promote the growth and invasion of cancer cells and is being evaluated as a prognostic biomarker and therapeutic target in clinically aggressive tumors. Molecular docking of Withaferin A and Withanolides D was performed using AutoDock Vina. Both the bioactive compounds interacted with PKCα. The targets predicted using this approach will serve as leads for the possible therapeutic potential of withanolides, the bioactive ingredients of WS extracts, as anti-cancer drugs.Keywords: withania somnifera, withaferin A, withanolides D, PKCα
Procedia PDF Downloads 14621971 Statistical Characteristics of Code Formula for Design of Concrete Structures
Authors: Inyeol Paik, Ah-Ryang Kim
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In this research, a statistical analysis is carried out to examine the statistical properties of the formula given in the design code for concrete structures. The design formulas of the Korea highway bridge design code - the limit state design method (KHBDC) which is the current national bridge design code and the design code for concrete structures by Korea Concrete Institute (KCI) are applied for the analysis. The safety levels provided by the strength formulas of the design codes are defined based on the probabilistic and statistical theory.KHBDC is a reliability-based design code. The load and resistance factors of this code were calibrated to attain the target reliability index. It is essential to define the statistical properties for the design formulas in this calibration process. In general, the statistical characteristics of a member strength are due to the following three factors. The first is due to the difference between the material strength of the actual construction and that used in the design calculation. The second is the difference between the actual dimensions of the constructed sections and those used in design calculation. The third is the difference between the strength of the actual member and the formula simplified for the design calculation. In this paper, the statistical study is focused on the third difference. The formulas for calculating the shear strength of concrete members are presented in different ways in KHBDC and KCI. In this study, the statistical properties of design formulas were obtained through comparison with the database which comprises the experimental results from the reference publications. The test specimen was either reinforced with the shear stirrup or not. For an applied database, the bias factor was about 1.12 and the coefficient of variation was about 0.18. By applying the statistical properties of the design formula to the reliability analysis, it is shown that the resistance factors of the current design codes satisfy the target reliability indexes of both codes. Also, the minimum resistance factors of the KHBDC which is written in the material resistance factor format and KCE which is in the member resistance format are obtained and the results are presented. A further research is underway to calibrate the resistance factors of the high strength and high-performance concrete design guide.Keywords: concrete design code, reliability analysis, resistance factor, shear strength, statistical property
Procedia PDF Downloads 31921970 A Two-Stage Adaptation towards Automatic Speech Recognition System for Malay-Speaking Children
Authors: Mumtaz Begum Mustafa, Siti Salwah Salim, Feizal Dani Rahman
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Recently, Automatic Speech Recognition (ASR) systems were used to assist children in language acquisition as it has the ability to detect human speech signal. Despite the benefits offered by the ASR system, there is a lack of ASR systems for Malay-speaking children. One of the contributing factors for this is the lack of continuous speech database for the target users. Though cross-lingual adaptation is a common solution for developing ASR systems for under-resourced language, it is not viable for children as there are very limited speech databases as a source model. In this research, we propose a two-stage adaptation for the development of ASR system for Malay-speaking children using a very limited database. The two stage adaptation comprises the cross-lingual adaptation (first stage) and cross-age adaptation. For the first stage, a well-known speech database that is phonetically rich and balanced, is adapted to the medium-sized Malay adults using supervised MLLR. The second stage adaptation uses the speech acoustic model generated from the first adaptation, and the target database is a small-sized database of the target users. We have measured the performance of the proposed technique using word error rate, and then compare them with the conventional benchmark adaptation. The two stage adaptation proposed in this research has better recognition accuracy as compared to the benchmark adaptation in recognizing children’s speech.Keywords: Automatic Speech Recognition System, children speech, adaptation, Malay
Procedia PDF Downloads 39721969 Rapid, Label-Free, Direct Detection and Quantification of Escherichia coli Bacteria Using Nonlinear Acoustic Aptasensor
Authors: Shilpa Khobragade, Carlos Da Silva Granja, Niklas Sandström, Igor Efimov, Victor P. Ostanin, Wouter van der Wijngaart, David Klenerman, Sourav K. Ghosh
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Rapid, label-free and direct detection of pathogenic bacteria is critical for the prevention of disease outbreaks. This paper for the first time attempts to probe the nonlinear acoustic response of quartz crystal resonator (QCR) functionalized with specific DNA aptamers for direct detection and quantification of viable E. coli KCTC 2571 bacteria. DNA aptamers were immobilized through biotin and streptavidin conjugation, onto the gold surface of QCR to capture the target bacteria and the detection was accomplished by shift in amplitude of the peak 3f signal (3 times the drive frequency) upon binding, when driven near fundamental resonance frequency. The developed nonlinear acoustic aptasensor system demonstrated better reliability than conventional resonance frequency shift and energy dissipation monitoring that were recorded simultaneously. This sensing system could directly detect 10⁽⁵⁾ cells/mL target bacteria within 30 min or less and had high specificity towards E. coli KCTC 2571 bacteria as compared to the same concentration of S.typhi bacteria. Aptasensor response was observed for the bacterial suspensions ranging from 10⁽⁵⁾-10⁽⁸⁾ cells/mL. Conclusively, this nonlinear acoustic aptasensor is simple to use, gives real-time output, cost-effective and has the potential for rapid, specific, label-free direction detection of bacteria.Keywords: acoustic, aptasensor, detection, nonlinear
Procedia PDF Downloads 56621968 Classification of EEG Signals Based on Dynamic Connectivity Analysis
Authors: Zoran Šverko, Saša Vlahinić, Nino Stojković, Ivan Markovinović
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In this article, the classification of target letters is performed using data from the EEG P300 Speller paradigm. Neural networks trained with the results of dynamic connectivity analysis between different brain regions are used for classification. Dynamic connectivity analysis is based on the adaptive window size and the imaginary part of the complex Pearson correlation coefficient. Brain dynamics are analysed using the relative intersection of confidence intervals for the imaginary component of the complex Pearson correlation coefficient method (RICI-imCPCC). The RICI-imCPCC method overcomes the shortcomings of currently used dynamical connectivity analysis methods, such as the low reliability and low temporal precision for short connectivity intervals encountered in constant sliding window analysis with wide window size and the high susceptibility to noise encountered in constant sliding window analysis with narrow window size. This method overcomes these shortcomings by dynamically adjusting the window size using the RICI rule. This method extracts information about brain connections for each time sample. Seventy percent of the extracted brain connectivity information is used for training and thirty percent for validation. Classification of the target word is also done and based on the same analysis method. As far as we know, through this research, we have shown for the first time that dynamic connectivity can be used as a parameter for classifying EEG signals.Keywords: dynamic connectivity analysis, EEG, neural networks, Pearson correlation coefficients
Procedia PDF Downloads 21421967 The Role of Parental Stress and Emotion Regulation in Responding to Children’s Expression of Negative Emotion
Authors: Lizel Bertie, Kim Johnston
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Parental emotion regulation plays a central role in the socialisation of emotion, especially when teaching young children to cope with negative emotions. Despite evidence which shows non-supportive parental responses to children’s expression of negative emotions has implications for the social and emotional development of the child, few studies have investigated risk factors which impact parental emotion socialisation processes. The current study aimed to explore the extent to which parental stress contributes to both difficulties in parental emotion regulation and non-supportive parental responses to children’s expression of negative emotions. In addition, the study examined whether parental use of expressive suppression as an emotion regulation strategy facilitates the influence of parental stress on non-supportive responses by testing the relations in a mediation model. A sample of 140 Australian adults, who identified as parents with children aged 5 to 10 years, completed an online questionnaire. The measures explored recent symptoms of depression, anxiety, and stress, the use of expressive suppression as an emotion regulation strategy, and hypothetical parental responses to scenarios related to children’s expression of negative emotions. A mediated regression indicated that parents who reported higher levels of stress also reported higher levels of expressive suppression as an emotion regulation strategy and increased use of non-supportive responses in relation to young children’s expression of negative emotions. These findings suggest that parents who experience heightened symptoms of stress are more likely to both suppress their emotions in parent-child interaction and engage in non-supportive responses. Furthermore, higher use of expressive suppression strongly predicted the use of non-supportive responses, despite the presence of parental stress. Contrary to expectation, no indirect effect of stress on non-supportive responses was observed via expressive suppression. The findings from the study suggest that parental stress may become a more salient manifestation of psychological distress in a sub-clinical population of parents while contributing to impaired parental responses. As such, the study offers support for targeting overarching factors such as difficulties in parental emotion regulation and stress management, not only as an intervention for parental psychological distress, but also the detection and prevention of maladaptive parenting practices.Keywords: emotion regulation, emotion socialisation, expressive suppression, non-supportive responses, parental stress
Procedia PDF Downloads 16021966 Accurate Calculation of the Penetration Depth of a Bullet Using ANSYS
Authors: Eunsu Jang, Kang Park
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In developing an armored ground combat vehicle (AGCV), it is a very important step to analyze the vulnerability (or the survivability) of the AGCV against enemy’s attack. In the vulnerability analysis, the penetration equations are usually used to get the penetration depth and check whether a bullet can penetrate the armor of the AGCV, which causes the damage of internal components or crews. The penetration equations are derived from penetration experiments which require long time and great efforts. However, they usually hold only for the specific material of the target and the specific type of the bullet used in experiments. Thus, penetration simulation using ANSYS can be another option to calculate penetration depth. However, it is very important to model the targets and select the input parameters in order to get an accurate penetration depth. This paper performed a sensitivity analysis of input parameters of ANSYS on the accuracy of the calculated penetration depth. Two conflicting objectives need to be achieved in adopting ANSYS in penetration analysis: maximizing the accuracy of calculation and minimizing the calculation time. To maximize the calculation accuracy, the sensitivity analysis of the input parameters for ANSYS was performed and calculated the RMS error with the experimental data. The input parameters include mesh size, boundary condition, material properties, target diameter are tested and selected to minimize the error between the calculated result from simulation and the experiment data from the papers on the penetration equation. To minimize the calculation time, the parameter values obtained from accuracy analysis are adjusted to get optimized overall performance. As result of analysis, the followings were found: 1) As the mesh size gradually decreases from 0.9 mm to 0.5 mm, both the penetration depth and calculation time increase. 2) As diameters of the target decrease from 250mm to 60 mm, both the penetration depth and calculation time decrease. 3) As the yield stress which is one of the material property of the target decreases, the penetration depth increases. 4) The boundary condition with the fixed side surface of the target gives more penetration depth than that with the fixed side and rear surfaces. By using above finding, the input parameters can be tuned to minimize the error between simulation and experiments. By using simulation tool, ANSYS, with delicately tuned input parameters, penetration analysis can be done on computer without actual experiments. The data of penetration experiments are usually hard to get because of security reasons and only published papers provide them in the limited target material. The next step of this research is to generalize this approach to anticipate the penetration depth by interpolating the known penetration experiments. This result may not be accurate enough to be used to replace the penetration experiments, but those simulations can be used in the early stage of the design process of AGCV in modelling and simulation stage.Keywords: ANSYS, input parameters, penetration depth, sensitivity analysis
Procedia PDF Downloads 40121965 The Development of the Psychosomatic Nursing Model from an Evidence-Based Action Research on Proactive Mental Health Care for Medical Inpatients
Authors: Chia-Yi Wu, Jung-Chen Chang, Wen-Yu Hu, Ming-Been Lee
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In nearly all physical health conditions, suicide risk is increased compared to healthy people even after adjustment for age, gender, mental health, and substance use diagnoses. In order to highlight the importance of suicide risk assessment for the inpatients and early identification and engagement for inpatients’ mental health problems, a study was designed aiming at developing a comprehensive psychosomatic nursing engagement (PSNE) model with standardized operation procedures informing how nurses communicate, assess, and engage with the inpatients with emotional distress. The purpose of the study was to promote the gatekeeping role of clinical nurses in performing brief assessment and interventions to detect depression and anxiety symptoms among the inpatients, particularly in non-psychiatric wards. The study will be carried out in a 2000-bed university hospital in Northern Taiwan in 2019. We will select a ward for trial and develop feasible procedures and in-job training course for the nurses to offer mental health care, which will also be validated through professional consensus meeting. The significance of the study includes the following three points: (1) The study targets at an important but less-researched area of PSNE model in the cultural background of Taiwan, where hospital service is highly accessible, but mental health and suicide risk assessment are hardly provided by non-psychiatric healthcare personnel. (2) The issue of PSNE could be efficient and cost-effective in the identification of suicide risks at an early stage to prevent inpatient suicide or to reduce future suicide risk by early treatment of mental illnesses among the high-risk group of hospitalized patients who are more than three-times lethal to suicide. (3) Utilizing a brief tool with its established APP ('The Five-item Brief Symptom Rating Scale, BSRS-5'), we will invent the standardized procedure of PSNE and referral steps in collaboration with the medical teams across the study hospital. New technological tools nested within nursing assessment/intervention will concurrently be invented to facilitate better care quality. The major outcome measurements will include tools for early identification of common mental distress and suicide risks, i.e., the BSRS-5, revised BSRS-5, and the 9-item Concise Mental Health Checklist (CMHC-9). The main purpose of using the CMHC-9 in clinical suicide risk assessment is mainly to provide care and build-up therapeutic relationship with the client, so it will also be used to nursing training highlighting the skills of supportive care. Through early identification of the inpatients’ depressive symptoms or other mental health care needs such as insomnia, anxiety, or suicide risk, the majority of the nursing clinicians would be able to engage in critical interventions that alleviate the inpatients’ suffering from mental health problems, given a feasible nursing input.Keywords: mental health care, clinical outcome improvement, clinical nurses, suicide prevention, psychosomatic nursing
Procedia PDF Downloads 10821964 Intensity Modulated Radiotherapy of Nasopharyngeal Carcinomas: Patterns of Loco Regional Relapse
Authors: Omar Nouri, Wafa Mnejja, Nejla Fourati, Fatma Dhouib, Wicem Siala, Ilhem Charfeddine, Afef Khanfir, Jamel Daoud
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Background and objective: Induction chemotherapy (IC) followed by concomitant chemo radiotherapy with intensity modulated radiation (IMRT) technique is actually the recommended treatment modality for locally advanced nasopharyngeal carcinomas (NPC). The aim of this study was to evaluate the prognostic factors predicting loco regional relapse with this new treatment protocol. Patients and methods: A retrospective study of 52 patients with NPC treated between June 2016 and July 2019. All patients received IC according to the protocol of the Head and Neck Radiotherapy Oncology Group (Gortec) NPC 2006 (3 TPF courses) followed by concomitant chemo radiotherapy with weekly cisplatin (40 mg / m2). Patients received IMRT with integrated simultaneous boost (SIB) of 33 daily fractions at a dose of 69.96 Gy for high-risk volume, 60 Gy for intermediate risk volume and 54 Gy for low-risk volume. Median age was 49 years (19-69) with a sex ratio of 3.3. Forty five tumors (86.5%) were classified as stages III - IV according to the 2017 UICC TNM classification. Loco regional relapse (LRR) was defined as a local and/or regional progression that occurs at least 6 months after the end of treatment. Survival analysis was performed according to Kaplan-Meier method and Log-rank test was used to compare anatomy clinical and therapeutic factors that may influence loco regional free survival (LRFS). Results: After a median follow up of 42 months, 6 patients (11.5%) experienced LRR. A metastatic relapse was also noted for 3 of these patients (50%). Target volumes coverage was optimal for all patient with LRR. Four relapses (66.6%) were in high-risk target volume and two (33.3%) were borderline. Three years LRFS was 85,9%. Four factors predicted loco regional relapses: histologic type other than undifferentiated (UCNT) (p=0.027), a macroscopic pre chemotherapy tumor volume exceeding 100 cm³ (p=0.005), a reduction in IC doses exceeding 20% (p=0.016) and a total cumulative cisplatin dose less than 380 mg/m² (p=0.0.34). TNM classification and response to IC did not impact loco regional relapses. Conclusion: For nasopharyngeal carcinoma, tumors with initial high volume and/or histologic type other than UCNT, have a higher risk of loco regional relapse. Therefore, they require a more aggressive therapeutic approaches and a suitable monitoring protocol.Keywords: loco regional relapse, modulation intensity radiotherapy, nasopharyngeal carcinoma, prognostic factors
Procedia PDF Downloads 12821963 Neonatal Subcutaneous Fat Necrosis with Severe Hypercalcemia: Case Report
Authors: Atitallah Sofien, Bouyahia Olfa, Krifi farah, Missaoui Nada, Ben Rabeh Rania, Yahyaoui Salem, Mazigh Sonia, Boukthir Samir
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Introduction: Subcutaneous fat necrosis of the newborn (SCFN) is a rare acute hypodermatitis characterized by skin lesions in the form of infiltrated, hard plaques and subcutaneous nodules, with a purplish-red color, occurring between the first and sixth week of life. SCFN is generally a benign condition that spontaneously regresses without sequelae, but it can be complicated by severe hypercalcemia. Methodology: This is a retrospective case report of neonatal subcutaneous fat necrosis complicated with severe hypercalcemia and nephrocalcinosis. Results: This is a case of a female newborn with a family history of a hypothyroid mother on Levothyrox, born to non-consanguineous parents and from a well-monitored pregnancy. The newborn was delivered by cesarean section at 39 weeks gestation due to severe preeclampsia. She was admitted to the Neonatal Intensive Care Unit at 1 hour of life for the management of grade 1 perinatal asphyxia and immediate neonatal respiratory distress related to transient respiratory distress. Hospitalization was complicated by a healthcare-associated infection, requiring intravenous antibiotics for ten days, with a good clinical and biological response. On the 20th day of life, she developed skin lesions in the form of indurated purplish-red nodules on the back and on both arms. A SCFN was suspected. A calcium level test was conducted, which returned a result of 3 mmol/L. The rest of the phosphocalcic assessment was normal, with early signs of nephrocalcinosis observed on renal ultrasound. The diagnosis of SCFN complicated by nephrocalcinosis associated with severe hypercalcemia was made, and the condition improved with intravenous hydration and corticosteroid therapy. Conclusion: SCFN is a rare and generally benign hypodermatitis in newborns with an etiology that is still poorly understood. Despite its benign nature, SCFN can be complicated by hypercalcemia, which can sometimes be life-threatening. Therefore, it is important to conduct a thorough skin examination of newborns, especially those with risk factors, to detect and correct any potential hypercalcemia.Keywords: subcutaneous fat necrosis, newborn, hypercalcemia, nephrocalcinosis
Procedia PDF Downloads 5821962 Risk, Capital Buffers, and Bank Lending: The Adjustment of Euro Area Banks
Authors: Laurent Maurin, Mervi Toivanen
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This paper estimates euro area banks’ internal target capital ratios and investigates whether banks’ adjustment to the targets have an impact on credit supply and holding of securities during the financial crisis in 2005-2011. Using data on listed banks and country-specific macro-variables a partial adjustment model is estimated in a panel context. The results indicate, firstly, that an increase in the riskiness of banks’ balance sheets influences positively on the target capital ratios. Secondly, the adjustment towards higher equilibrium capital ratios has a significant impact on banks’ assets. The impact is found to be more size-able on security holdings than on loans, thereby suggesting a pecking order.Keywords: Euro area, capital ratios, credit supply, partial adjustment model
Procedia PDF Downloads 44821961 How Influencers Influence: The Effects of Social Media Influencers Influence on Purchase Intention and the Differences among Generation X and Millennials
Authors: Samatha Ss Sutton, Kaouther Kooli
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In recent years social media influences (SMI) have become integrated into many companies marketing strategies to create buzz, target new and younger markets and further expand social media coverage in business (Lim et al 2017). SMI’s can be defined as online personalities with a substantial number of followers, across one or more social media platforms, with influence on their followers (Lou and Yuan 2018). Recently expenditure on influencer marketing has increased exponentially becoming an important area for marketing opportunities and strategies in the future (Lou and Yuan 2018). In order to market products and brands effectively through SMI’s it is important for business to understand the attributes of SMI that effect purchase intention (Lim et al 2017) of their followers and whether or not these attributes vary across generations so to market effectively to their specific segment or target market. The present study involves quantitative research to understand the attributes by which influence differs across generations namely Generation X and Millennials and its effects on purchase intentions of these generational groups. A survey will be conducted using an online questionnaire. Structural Equation Modelling and Multi group analysis will be applied. The study provides insight to marketers/decision makers on how to use influencers accordingly with their target consumer.Keywords: social media marketing, social media influencers, attitude towards social media influencers, intention to purchase
Procedia PDF Downloads 13621960 Machine Learning for Targeting of Conditional Cash Transfers: Improving the Effectiveness of Proxy Means Tests to Identify Future School Dropouts and the Poor
Authors: Cristian Crespo
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Conditional cash transfers (CCTs) have been targeted towards the poor. Thus, their targeting assessments check whether these schemes have been allocated to low-income households or individuals. However, CCTs have more than one goal and target group. An additional goal of CCTs is to increase school enrolment. Hence, students at risk of dropping out of school also are a target group. This paper analyses whether one of the most common targeting mechanisms of CCTs, a proxy means test (PMT), is suitable to identify the poor and future school dropouts. The PMT is compared with alternative approaches that use the outputs of a predictive model of school dropout. This model was built using machine learning algorithms and rich administrative datasets from Chile. The paper shows that using machine learning outputs in conjunction with the PMT increases targeting effectiveness by identifying more students who are either poor or future dropouts. This joint targeting approach increases effectiveness in different scenarios except when the social valuation of the two target groups largely differs. In these cases, the most likely optimal approach is to solely adopt the targeting mechanism designed to find the highly valued group.Keywords: conditional cash transfers, machine learning, poverty, proxy means tests, school dropout prediction, targeting
Procedia PDF Downloads 20421959 Conceptual Design of Unmanned Aerial Targets
Authors: M. Adamski, J. Cwiklak
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The contemporary battlefield creates a demand for more costly and highly advanced munitions. Training personnel responsible for operations, as well as an immediate execution of combat tasks, which engage real assets, is unrealistic and economically not feasible. Owing to a wide array of exploited simulators and various types of imitators, it is possible to reduce the costs. One of the effective elements of training, which can be applied in the training of all service branches, are imitators of aerial targets. This research serves as an introduction to the commencement of design analysis over a real aerial target imitator. Within the project, the basic aerodynamic calculations were made, which enabled to determine its geometry, design layout, performance, as well as the mass balance of individual components. The conducted calculations of the parameters of flight characteristics come closer to the real performance of such unmanned aerial vehicles.Keywords: aerial target, aerodynamics, imitator, performance
Procedia PDF Downloads 39721958 Contribution for Rural Development Trough Training in Organic Farming
Authors: Raquel P. F. Guiné, Daniela V. T. A. Costa, Paula M. R. Correia, Moisés Castro, Luis T. Guerra, Cristina A. Costa
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The aim of this work was to characterize a potential target group of people interested in participating into a training program in organic farming in the context of mobile-learning. The information sought addressed in particular, but not exclusively, possible contents, formats and forms of evaluation that will contribute to define the course objectives and curriculum, as well as to ensure that the course meets the needs of the learners and their preferences. The sample was selected among different European countries. The questionnaires were delivered electronically for answering online and in the end 135 consented valid questionnaires were obtained. The results allowed characterizing the target group and identifying their training needs and preferences towards m-learning formats, giving valuable tools to design the training offer.Keywords: mobile-learning, organic farming, rural development, survey
Procedia PDF Downloads 50221957 End to End Monitoring in Oracle Fusion Middleware for Data Verification
Authors: Syed Kashif Ali, Usman Javaid, Abdullah Chohan
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In large enterprises multiple departments use different sort of information systems and databases according to their needs. These systems are independent and heterogeneous in nature and sharing information/data between these systems is not an easy task. The usage of middleware technologies have made data sharing between systems very easy. However, monitoring the exchange of data/information for verification purposes between target and source systems is often complex or impossible for maintenance department due to security/access privileges on target and source systems. In this paper, we are intended to present our experience of an end to end data monitoring approach at middle ware level implemented in Oracle BPEL for data verification without any help of monitoring tool.Keywords: service level agreement, SOA, BPEL, oracle fusion middleware, web service monitoring
Procedia PDF Downloads 48021956 The Using of Hybrid Superparamagnetic Magnetite Nanoparticles (Fe₃O₄)- Graphene Oxide Functionalized Surface with Collagen, to Target the Cancer Stem Cell
Authors: Ahmed Khalaf Reyad Raslan
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Cancer stem cells (CSCs) describe a class of pluripotent cancer cells that behave analogously to normal stem cells in their ability to differentiate into the spectrum of cell types observed in tumors. The de-differentiation processes, such as an epithelial-mesenchymal transition (EMT), are known to enhance cellular plasticity. Here, we demonstrate a new hypothesis to use hybrid superparamagnetic magnetite nanoparticles (Fe₃O₄)- graphene oxide functionalized surface with Collagen to target the cancer stem cell as an early detection tool for cancer. We think that with the use of magnetic resonance imaging (MRI) and the new hybrid system would be possible to track the cancer stem cells.Keywords: hydrogel, alginate, reduced graphene oxide, collagen
Procedia PDF Downloads 14521955 Spatial Distribution of Virus-Transmitting Aphids of Plants in Al Bahah Province, Saudi Arabia
Authors: Sabir Hussain, Muhammad Naeem, Yousif Aldryhim, Susan E. Halbert, Qingjun Wu
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Plant viruses annually cause severe economic losses in crop production and globally, different aphid species are responsible for the transmission of such viruses. Additionally, aphids are also serious pests of trees, and agricultural crops. Al Bahah Province, Kingdom of Saudi Arabia (KSA) has a high native and introduced plant species with a temperate climate that provides ample habitats for aphids. In this study, we surveyed virus-transmitting aphids from the Province to highlight their spatial distributions and hot spot areas for their target control strategies. During our fifteen month's survey in Al Bahah Province, three hundred and seventy samples of aphids were collected using both beating sheets and yellow water pan traps. Consequently, fifty-four aphid species representing 30 genera belonging to four families were recorded from Al Bahah Province. Alarmingly, 35 aphid species from our records are virus transmitting species. The most common virus transmitting aphid species based on number of collecting samples, were Macrosiphum euphorbiae (Thomas, 1878), Brachycaudus rumexicolens (Patch, 1917), Uroleucon sonchi (Linnaeus, 1767), Brachycaudus helichrysi (Kaltenbach, 1843), and Myzus persicae (Sulzer, 1776). The numbers of samples for the forementioned species were 66, 24, 23, 22, and 20, respectively. The widest range of plant hosts were found for M. euphorbiae (39 plant species), B. helichrysi (12 plant species), M. persicae (12 plant species), B. rumexicolens (10 plant species), and U. sonchi (9 plant species). The hottest spot areas were found in Al-Baha, Al Mekhwah and Biljarashi cities of the province on the basis of their abundance. This study indicated that Al Bahah Province has relatively rich aphid diversity due to the relatively high plant diversity in a favorable climatic condition. ArcGIS tools can be helpful for biologists to implement the target control strategies against these pests in the integrated pest management, and ultimately to save money and time.Keywords: Al Bahah province, aphid-virus interaction, biodiversity, global information system
Procedia PDF Downloads 18421954 Chemical Amelioration of Expansive Soils
Authors: B. R. Phanikumar, Sana Suri
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Expansive soils swell when they absorb water and shrink when water evaporates from them. Hence, lightly loaded civil engineering structures found in these soils are subjected to severe distress. Therefore, there is a need to ameliorate or improve these swelling soils through some innovative methods. This paper discusses chemical stabilisation of expansive soils, a technique in which chemical reagents such as lime and calcium chloride are added to expansive soils to reduce the volumetric changes occurring in expansive soils and also to improve their engineering behaviour.Keywords: expansive soils, swelling, shrinkage, amelioration, lime, calcium chloride
Procedia PDF Downloads 31521953 An Alternative Nano Design Strategy by Neutralized AMPS and Soy Bean Lecithin to Form Nanoparticles
Authors: Esra Cansever Mutlu, Muge Sennaroglu Bostan, Fatemeh Bahadori, Ebru Toksoy Oner, Mehmet S. Eroglu
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Paclitaxel is used in treatment of different cancer types mainly breast, ovarian, lung and Kaposi’s sarcoma. It is poorly soluble in water; therefore, currently used formulations tremendously show side-effects and high toxicity. Encapsulation of the drug in a nano drug carrier which causes both reducing side effects and increasing drug activity is a desired new approach for the nano-medicine to target the site of cancer. In this study, synthesis of a novel nano paclitaxel formulation made of a new amphiphilic monomer was followed by the investigation of its pharmacological properties. UV radical polymerization was carried out by using the monomer Lecithin-2-Acrylamido-2-methylpropane (L-AMPS) and the drug-spacer, to obtain sterically high stabilized, biocompatible and biodegradable phospholipid nanoparticles, in which the drug paclitaxel (Pxl) was encapsulated (NanoPxl). Particles showed high drug loading capacity (68%) and also hydrodynamic size less than 200 nm with slight negative surface charge. The drug release profile was obtained and in vitro cytotoxicity test was performed on MCF-7 cell line. Consequently, these data indicated that paclitaxel loaded Lecithin-AMPS/PCL-MAC nanoparticles can be considered as a new, safe and effective nanocarrier for the treatment of breast cancer.Keywords: paclitaxel, nanoparticle, drug delivery, L-AMPS
Procedia PDF Downloads 32021952 Target and Equalizer Design for Perpendicular Heat-Assisted Magnetic Recording
Authors: P. Tueku, P. Supnithi, R. Wongsathan
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Heat-Assisted Magnetic Recording (HAMR) is one of the leading technologies identified to enable areal density beyond 1 Tb/in2 of magnetic recording systems. A key challenge to HAMR designing is accuracy of positioning, timing of the firing laser, power of the laser, thermo-magnetic head, head-disk interface and cooling system. We study the effect of HAMR parameters on transition center and transition width. The HAMR is model using Thermal Williams-Comstock (TWC) and microtrack model. The target and equalizer are designed by the minimum mean square error (MMSE). The result shows that the unit energy constraint outperforms other constraints.Keywords: heat-assisted magnetic recording, thermal Williams-Comstock equation, microtrack model, equalizer
Procedia PDF Downloads 35121951 Innovation of Teaching Methods in Vocational Education with Popularity Development Process
Authors: Hong Zeng
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In the process of popularization of higher education, it is necessary to innovate teaching methods in order to make the students cultivated suitable for the needs of social development. This paper discusses the limitations and shortcomings of the traditional teaching method of teaching approach to a person's aptitude, personality, and interest and introduces the new teaching method of teaching approach to a person's personality. The teaching approach to a person's personality is a target teaching method that aims to develop students' potential and cultivate professional talents. Therefore, teachers should be professional and can adopt modern teaching methods from the Internet so that students can clearly understand the course and the knowledge structure. Finally, the students using new teaching methods can enhance their motivation to study and quickly acquire professional skills.Keywords: higher education, personality, target education, student-centered
Procedia PDF Downloads 11921950 Micro RNAs (194 and 135a) as Biomarkers and Therapeutic Targets in Type 2 Diabetic Rats
Authors: H. Haseena Banu, D. Karthick, R. Stalin, E. Nandha Kumar, T. P. Sachidanandam, P. Shanthi
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Background of the study: Type 2 diabetes is emerging as the predominant metabolic disorder in the world among adults characterized mainly by the resistance of the insulin sensitive tissues towards insulin followed by the decrease in the insulin secretion. The treatment for this disease usually involves treatment with oral synthetic drugs which are known to cause several side effects. Therefore, identification of new biomarkers as therapeutic target is the need of the hour. miRNAs are small, non–protein-coding RNAs that negatively regulate gene expression by promoting degradation and/or inhibit the translation of target mRNAs and have emerged as biomarkers in predicting diabetes mellitus. Objective of the study: To elucidate the therapeutic role of gallic acid in modulating the alterations in glucose metabolism induced by miRNAs 194 and 135a in Type 2 diabetic rats. Materials and Methods: T2D was induced in rats by feeding them with a high fat diet for 2 weeks followed by intraperitoneal injection of 35 mg/kg/body weight (b.wt.) of streptozotocin. Microarrays were used to assess the expression of miRNAs in control, diabetic and gallic acid treated rats. Gene expression studies were carried out by RT PCR analysis. Results: Forty one miRNAs were differentially expressed in Type 2 diabetic rats. Among these, the expression of miRNA 194 was significantly decreased whereas miRNA 135a was significantly increased in Type 2 diabetic rats. The glucose metabolism was also altered significantly in skeletal muscle of Type 2 diabetic rats. Conclusion: T2D is associated with alterations in the expression of miRNAs in skeletal muscle. Both these miRNAs 194 and 135a play an important role in glucose metabolism in skeletal muscle of diabetic rats. Gallic acid effectively ameliorated the alterations in glucose metabolism. Hence, both these miRNAs can serve as biomarkers and therapeutic targets in diabetes mellitus. The study also establishes the role of gallic acid as therapeutic agent. Acknowledgment: The financial assistance provided in the form of ICMR women scientist by ICMR DHR INDIA is gratefully acknowledged here.Keywords: gallic acid, high fat diet, type 2 diabetes mellitus, miRNAs
Procedia PDF Downloads 34921949 A Case Report: The Role of Gut Directed Hypnotherapy in Resolution of Irritable Bowel Syndrome in a Medication Refractory Pediatric Male Patient
Authors: Alok Bapatla, Pamela Lutting, Mariastella Serrano
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Background: Irritable Bowel Syndrome (IBS) is a functional gastrointestinal disorder characterized by abdominal pain associated with altered bowel habits in the absence of an underlying organic cause. Although the exact etiology of IBS is not fully understood, one of the leading theories postulates a pathology within the Brain-Gut Axis that leads to an overall increase in gastrointestinal sensitivity and pejorative changes in gastrointestinal motility. Research and clinical practice have shown that Gut Directed Hypnotherapy (GDH) has a beneficial clinical role in improving Mind-Gut control and thereby comorbid conditions such as anxiety, abdominal pain, constipation, and diarrhea. Aims: This study presents a 17-year old male with underlying anxiety and a one-year history of IBS-Constipation Predominant Subtype (IBS-C), who has demonstrated impressive improvement of symptoms following GDH treatment following refractory trials with medications including bisacodyl, senna, docusate, magnesium citrate, lubiprostone, linaclotide. Method: The patient was referred to a licensed clinical psychologist specializing in clinical hypnosis and cognitive-behavioral therapy (CBT), who implemented “The Standardized Hypnosis Protocol for IBS” developed by Dr. Olafur S. Palsson, Psy.D at the University of North Carolina at Chapel Hill. The hypnotherapy protocol consisted of a total of seven weekly 45-minute sessions supplemented with a 20-minute audio recording to be listened to once daily. Outcome variables included the GAD-7, PHQ-9 and DCI-2, as well as self-ratings (ranging 0-10) for pain (intensity and frequency), emotional distress about IBS symptoms, and overall emotional distress. All variables were measured at intake prior to administration of the hypnosis protocol and at the conclusion of the hypnosis treatment. A retrospective IBS Questionnaire (IBS Severity Scoring System) was also completed at the conclusion of the GDH treatment for pre-and post-test ratings of clinical symptoms. Results: The patient showed improvement in all outcome variables and self-ratings, including abdominal pain intensity, frequency of abdominal pain episodes, emotional distress relating to gut issues, depression, and anxiety. The IBS Questionnaire showed a significant improvement from a severity score of 400 (defined as severe) prior to GDH intervention compared to 55 (defined as complete resolution) at four months after the last session. IBS Questionnaire subset questions that showed a significant score improvement included abdominal pain intensity, days of pain experienced per 10 days, satisfaction with bowel habits, and overall interference of life affected by IBS symptoms. Conclusion: This case supports the existing research literature that GDH has a significantly beneficial role in improving symptoms in patients with IBS. Emphasis is placed on the numerical results of the IBS Questionnaire scoring, which reflects a patient who initially suffered from severe IBS with failed response to multiple medications, who subsequently showed full and sustained resolutionKeywords: pediatrics, constipation, irritable bowel syndrome, hypnotherapy, gut-directed hypnosis
Procedia PDF Downloads 19821948 Characterization of Kopff Crater Using Remote Sensing Data
Authors: Shreekumari Patel, Prabhjot Kaur, Paras Solanki
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Moon Mineralogy Mapper (M3), Miniature Radio Frequency (Mini-RF), Kaguya Terrain Camera images, Lunar Orbiter Laser Altimeter (LOLA) digital elevation model (DEM) and Lunar Reconnaissance Orbiter Camera (LROC)- Narrow angle camera (NAC) and Wide angle camera (WAC) images were used to study mineralogy, surface physical properties, and age of the 42 km diameter Kopff crater. M3 indicates the low albedo crater floor to be high-Ca pyroxene dominated associated with floor fracture suggesting the igneous activity of the gabbroic material. Signature of anorthositic material is sampled on the eastern edge as target material is excavated from ~3 km diameter impact crater providing access to the crustal composition. Several occurrences of spinel were detected in northwestern rugged terrain. Our observation can be explained by exposure of spinel by this crater that impacted onto the inner rings of Orientale basin. Spinel was part of the pre-impact target, an intrinsic unit of basin ring. Crater floor was dated by crater counts performed on Kaguya TC images. Nature of surface was studied in detail with LROC NAC and Mini-RF. Freshly exposed surface and boulder or debris seen in LROC NAC images have enhanced radar signal in comparison to mature terrain of Kopff crater. This multidisciplinary analysis of remote sensing data helps to assess lunar surface in detail.Keywords: crater, mineralogy, moon, radar observations
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