Search results for: repetitive control

Authors: H. El-Messiry, M. El-Zainy, D. Ghazy

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Diabetes is a metabolic disease that results in a variety of oral health complications. Green tea is a natural antioxidant proved to have powerful effects against diabetes. The aim of this study was to compare between the effect of insulin and green tea on the Parotid gland of streptozotocin induced diabetic Albino rats by using light and transmission electron microscopy. Forty male Albino rats were divided into control group and diabetic groups. The diabetic group received a single injection of 40 mg/kg of streptozotocin intra-peritoneal under anesthesia and was further subdivided into three subgroups: The diabetic untreated subgroup which was untreated for two weeks, the insulin treated subgroup which has received insulin subcutaneously in a daily dose of 5 IU/kg body weight/day for two weeks and a green tea treated subgroup received a daily dose of 1 ml/ 100 gm body weight intragastrically for two weeks. Rats were terminated and parotid glands were dissected and processed for light and transmission electron microscopic examination. Histological examination of the diabetic untreated subgroup revealed acinar cells with pyknotic and hyperchromatic nuclei with cytoplasmic vacuolations. Ultrastructurally, acinar cells showed nuclear pleomorphism, dilated rough endoplasmic reticulum and swollen mitochondria with damaged cristae. Inflammatory cell infiltration was detected both histologically and ultrastructurally. Ducts showed signs of degeneration with loss of their normal outline and stagnated secretion within the lumen. However, insulin and green tea treated subgroups showed minimal degenerative damage and were almost similar to the control with minimal changes. Treatment of the parotid gland of the streptozotocin induced diabetic rats with GT was closely comparable to the traditional insulin therapy in reducing signs of histological and ultrastructural damage.

Keywords: diabetes, green tea, insulin, parotid

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Authors: Rajesh S. Mony, Vaidyaratnam Oushadhasala

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An attempt is made in this study to evolve a drug development modality based on classical Ayurvedic knowledge base as well as on modern scientific methodology. The present study involves (a) identification of a specific ailment condition, (b) the selection of a polyherbal formulation, (c) deciding suitable extraction procedure, (d) confirming the efficacy of the combination by in-vitro trials and (e) fixing up the recommended dose. The ailment segment selected is arthritic condition. The selected herbal combination is Kunturushka, Vibhitaki, Guggulu, Haridra, Maricha and Nirgundi. They were selected as per Classical Ayurvedic references, Authentified as per API (Ayurvedic Pharmacopeia of India), Extraction of each drug was done by different ratios of Hydroalcoholic menstrums, Invitro assessment of each extract after removing residual solvent for anti-Inflammatory, anti-arthritic activities (by UV-Vis. Spectrophotometer with positive control), Invitro assessment of each extract for COX enzyme inhibition (by UV-Vis. Spectrophotometer with positive control), Selection of the extracts was made having good in-vitro activity, Performed the QC testing of each selected extract including HPTLC, that is the in process QC specifications, h. Decision of the single dose with mixtures of selected extracts was made as per the level of in-vitro activity and available toxicology data, Quantification of major groups like Phenolics, Flavonoids, Alkaloids and Bitters was done with both standard Spectrophotometric and Gravimetric methods, Method for Marker assay was developed and validated by HPTLC and a good resolved HPTLC finger print was developed for the single dosage API (Active Pharmaceutical Ingredient mixture of extracts), Three batches was prepared to fix the in process and API (Active Pharmaceutical Ingredient) QC specifications.

Keywords: drug development, antiinflammatory, quality stardardisation, planar chromatography

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Authors: Aurelija Burinskienė, Dalė Dzemydienė, Arūnas Miliauskas

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This research aims at developing the approach for more effective freight delivery and transportation process management. The road congestions and the identification of causes are important, as well as the context information recognition and management. The measure of many parameters during the transportation period and proper control of driver work became the problem. The number of vehicles per time unit passing at a given time and point for drivers can be evaluated in some situations. The collection of data is mainly used to establish new trips. The flow of the data is more complex in urban areas. Herein, the movement of freight is reported in detail, including the information on street level. When traffic density is extremely high in congestion cases, and the traffic speed is incredibly low, data transmission reaches the peak. Different data sets are generated, which depend on the type of freight delivery network. There are three types of networks: long-distance delivery networks, last-mile delivery networks and mode-based delivery networks; the last one includes different modes, in particular, railways and other networks. When freight delivery is switched from one type of the above-stated network to another, more data could be included for reporting purposes and vice versa. In this case, a significant amount of these data is used for control operations, and the problem requires an integrated methodological approach. The paper presents an approach for providing e-services for drivers by including the assessment of the multi-component infrastructure needed for delivery of freights following the network type. The construction of such a methodology is required to evaluate data flow conditions and overloads, and to minimize the time gaps in data reporting. The results obtained show the possibilities of the proposing methodological approach to support the management and decision-making processes with functionality of incorporating networking specifics, by helping to minimize the overloads in data reporting.

Keywords: transportation networks, freight delivery, data flow, monitoring, e-services

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Authors: Aditi Acharya

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Environmental pollution is threatening the environmental and human health in the most drastic way. This paper provides insight about the affects of environmental pollution in the perspective of water pollution. Sewage in drinking water, the increasing contamination of water bodies and water resources and the human beings are the major contributors, increasing the harsh activities of pollution. The research presents information about the sources of pollution, its impacts and control activities to be undertaken to make our environment free from water pollution.

Keywords: environmental pollution, water pollution, nanotechnology, nanomaterials

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Authors: Chris Thurlbourne

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Due to the continual demand for material to build, and a limit of good environmental material credentials of 'normal' building materials, there is a need to look at new and reconditioned material types - both biogenic and non-biogenic - and a field of research that accompanies this. This research development focuses on biogenic and non-biogenic material engineering and the impact of our environment on new and reconditioned material types. In our building industry and all the industries involved in constructing our built environment, building material types can be broadly categorized into two types, biogenic and non-biogenic material properties. Both play significant roles in shaping our built environment. Regardless of their properties, all material types originate from our earth, whereas many are modified through processing to provide resistance to 'forces of nature', be it rain, wind, sun, gravity, or whatever the local environmental conditions throw at us. Modifications are succumbed to offer benefits in endurance, resistance, malleability in handling (building with), and ergonomic values - in all types of building material. We assume control of all building materials through rigorous quality control specifications and regulations to ensure materials perform under specific constraints. Yet materials confront an external environment that is not controlled with live forces undetermined, and of which materials naturally act and react through weathering, patination and discoloring, promoting natural chemical reactions such as rusting. The purpose of the paper is to present recent research that explores the after-life of specific new and reconditioned biogenic and non-biogenic material types and how the understanding of materials' natural processes of transformation when exposed to the external climate, can inform initial design decisions. With qualities to receive in a transient and contingent manner, ecological relationships between material, the colonizing organisms and resulting performances invite opportunities for new design explorations for the benefit of both the needs of human society and the needs of our natural environment. The research follows designing for the benefit of both and engaging in both biogenic and non-biogenic material engineering whilst embracing the continual demand for colonization - human and environment, and the aptitude of a material to be colonized by one or several groups of living organisms without necessarily undergoing any severe deterioration, but embracing weathering, patination and discoloring, and at the same time establishing new habitat. The research follows iterative prototyping processes where knowledge has been accumulated via explorations of specific material performances, from laboratory to construction mock-ups focusing on the architectural qualities embedded in control of production techniques and facilitating longer-term patinas of material surfaces to extend the aesthetic beyond common judgments. Experiments are therefore focused on how the inherent material qualities drive a design brief toward specific investigations to explore aesthetics induced through production, patinas and colonization obtained over time while exposed and interactions with external climate conditions.

Keywords: biogenic and non-biogenic, natural processes of transformation, colonization, patina

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Authors: Vojtech Stejskal, Hana Skalova, Petr Kvapil, George Hutchinson

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Algae growth has been an important issue in water management of water plants, ponds and lakes, swimming pools, aquaculture & fish farms, gardens or golf courses for last decades. There are solutions based on chemical or biological principles. Apart of these traditional principles for inhibition of algae growth and biofilm production there are also physical methods which are very competitive compared to the traditional ones. Ultrasonic technology is one of these alternatives. Ultrasonic emitter is able to eliminate the biofilm which behaves as a host and attachment point for algae and is original reason for the algae growth. The ultrasound waves prevent majority of the bacteria in planktonic form becoming strongly attached sessile bacteria that creates welcoming layer for the biofilm production. Biofilm creation is very fast – in the serene water it takes between 30 minutes to 4 hours, depending on temperature and other parameters. Ultrasound device is not killing bacteria. Ultrasound waves are passing through bacteria, which retract as if they were in very turbulent water even though the water is visually completely serene. In these conditions, bacteria does not excrete the polysaccharide glue they use to attach to the surface of the pool or pond, where ultrasonic technology is used. Ultrasonic waves decrease the production of biofilm on the surfaces in the selected area. In case there are already at the start of the application of ultrasonic technology in a pond or basin clean inner surfaces, the biofilm production is almost absolutely inhibited. This paper talks about two different pilot applications – one in Czech Republic and second in United States of America, where the used ultrasonic technology (AlgaeControl) is coming from. On both sites, there was used Mezzo Ultrasonic Algae Control System with very positive results not only on biofilm production, but also algae growth in the surrounding area. Technology has been successfully tested in two different environments. The poster describes the differences and their influence on the efficiency of ultrasonic technology application. Conclusions and lessons learned can be possibly applied also on other sites within Europe or even further.

Keywords: algae growth, biofilm production, ultrasonic solution, ultrasound

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Authors: Mohammad Hossain Mohammadi, Saif Al Ameri, Sana Ziaei, Jinane Mounsef

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Automated enumeration of the number of hand fingers is widely used in several motion gaming and distance control applications, and is discussed in several published papers as a starting block for hand recognition systems. The automated finger enumeration technique should not only be accurate, but also must have a fast response for a moving-picture input. The high performance of video in motion games or distance control will inhibit the program’s overall speed, for image processing software such as Matlab need to produce results at high computation speeds. Since an automated finger enumeration with minimum error and processing time is desired, a comparative study between two finger enumeration techniques is presented and analyzed in this paper. In the pre-processing stage, various image processing functions were applied on a real-time video input to obtain the final cleaned auto-cropped image of the hand to be used for the two techniques. The first technique uses the known morphological tool of skeletonization to count the number of skeleton’s endpoints for fingers. The second technique uses a radial distance method to enumerate the number of fingers in order to obtain a one dimensional hand representation. For both discussed methods, the different steps of the algorithms are explained. Then, a comparative study analyzes the accuracy and speed of both techniques. Through experimental testing in different background conditions, it was observed that the radial distance method was more accurate and responsive to a real-time video input compared to the skeletonization method. All test results were generated in Matlab and were based on displaying a human hand for three different orientations on top of a plain color background. Finally, the limitations surrounding the enumeration techniques are presented.

Keywords: comparative study, hand recognition, fingertip detection, skeletonization, radial distance, Matlab

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Authors: Leandros A. Maglaras, Jianmin Jiang

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The protection of the national infrastructures from cyberattacks is one of the main issues for national and international security. The funded European Framework-7 (FP7) research project CockpitCI introduces intelligent intrusion detection, analysis and protection techniques for Critical Infrastructures (CI). The paradox is that CIs massively rely on the newest interconnected and vulnerable Information and Communication Technology (ICT), whilst the control equipment, legacy software/hardware, is typically old. Such a combination of factors may lead to very dangerous situations, exposing systems to a wide variety of attacks. To overcome such threats, the CockpitCI project combines machine learning techniques with ICT technologies to produce advanced intrusion detection, analysis and reaction tools to provide intelligence to field equipment. This will allow the field equipment to perform local decisions in order to self-identify and self-react to abnormal situations introduced by cyberattacks. In this paper, an intrusion detection module capable of detecting malicious network traffic in a Supervisory Control and Data Acquisition (SCADA) system is presented. Malicious data in a SCADA system disrupt its correct functioning and tamper with its normal operation. OCSVM is an intrusion detection mechanism that does not need any labeled data for training or any information about the kind of anomaly is expecting for the detection process. This feature makes it ideal for processing SCADA environment data and automates SCADA performance monitoring. The OCSVM module developed is trained by network traces off line and detects anomalies in the system real time. The module is part of an IDS (intrusion detection system) developed under CockpitCI project and communicates with the other parts of the system by the exchange of IDMEF messages that carry information about the source of the incident, the time and a classification of the alarm.

Keywords: cyber-security, SCADA systems, OCSVM, intrusion detection

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Authors: Ahmad Ali Shahid, Mukhtar Ahmed

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The demand for long staple fiber having better strength and length is increasing with the introduction of modern spinning and weaving industry in Pakistan. Work on gene discovery from developing cotton fibers has helped to identify dozens of genes that take part in cotton fiber development and several genes have been characterized for their role in fiber development. Sucrose synthase (SuS) is a key enzyme in the metabolism of sucrose in a plant cell, in cotton fiber it catalyzes a reversible reaction, but preferentially converts sucrose and UDP into fructose and UDP-glucose. UDP-glucose (UDPG) is a nucleotide sugar act as a donor for glucose residue in many glycosylation reactions and is essential for the cytosolic formation of sucrose and involved in the synthesis of cell wall cellulose. The study was focused on successful Agrobacterium-mediated stable transformation of SuS gene in pCAMBIA 1301 into cotton under a CaMV35S promoter. Integration and expression of the gene were confirmed by PCR, GUS assay, and real-time PCR. Young leaves of SuS overexpressing lines showed increased total soluble sugars and plant biomass as compared to non-transgenic control plants. Cellulose contents from fiber were significantly increased. SEM analysis revealed that fibers from transgenic cotton were highly spiral and fiber twist number increased per unit length when compared with control. Morphological data from field plants showed that transgenic plants performed better in field conditions. Incorporation of genes related to cotton fiber length and quality can provide new avenues for fiber improvement. The utilization of this technology would provide an efficient import substitution and sustained production of long-staple fiber in Pakistan to fulfill the industrial requirements.

Keywords: agrobacterium-mediated transformation, cotton fiber, sucrose synthase gene, staple length

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Authors: Emmanuel Bernard, Rebecca L. Cordell, Akeem A. Abayomi, Rose Alani, Paul S. Monks

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This study investigates the prevalence and extent of BTEX (Benzene, Toluene, Ethylbenzene, and Xylene) contamination in Leicester, United Kingdom, and Lagos, Nigeria, through field measurements at roadside (RS) and urban background (UB) sites. Using thermal desorption gas chromatography mass spectrometry (TD-GC-MS), BTEX concentrations were quantified. In Leicester, the average RS concentration was 24.9 ± 8.9 μg/m³, and the UB concentration was 12.7 ± 5.7 μg/m³. In Lagos, the RS concentration was significantly higher at 106 ± 39.3 μg/m³, and the UB concentration was 20.1 ± 8.9 μg/m³. The RS concentration in Lagos was approximately 4.3 times higher than in Leicester, while the UB concentration was about 1.6 times higher. These disparities are attributed to differences in road infrastructure, traffic regulation compliance, fuel and oil quality, and local activities. In Leicester, the highest UB concentration (20.5 ± 1.7 μg/m³) was at Knighton Village, near the heavily polluted RS Wigston roundabout. In Lagos, the highest concentration (172.1 ± 12.2 μg/m³) was at Ojuelegba, a major transportation hub. Correlation analysis revealed strong positive relationships between the concentrations of BTEX compounds in both cities, suggesting common sources such as vehicular emissions and industrial activities. The ratios of toluene to benzene (T:B) and m/p xylene to ethylbenzene (m/p X:E) were analysed to infer source contributions and the photochemical age of air masses. The T:B ratio in Leicester ranged from 0.44 to 0.71, while in Lagos, it ranged from 1.36 to 2.17. The m/p X:E ratio in Leicester ranged from 2.11 to 2.19, like other UK cities, while in Lagos, it ranged from 1.65 to 2.32, indicating relatively fresh emissions. This study highlights significant differences in BTEX concentrations between Leicester and Lagos, emphasizing the need for tailored pollution control strategies to address the specific sources and conditions in different urban environments.

Keywords: BTEX contamination, urban air quality, thermal desorption GC-MS, roadside emissions, urban background sites, vehicular emissions, pollution control strategies

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Authors: K. Shyamnath, K. Suresh Kutty

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The purpose of the study was to find out the effect of three resistance training methods on performance-related variables of powerlifters. A total of forty male students (N=40) who had participated in Kannur University powerlifting championship were selected as subjects. The age group of the subjects ranged from 18 years old to 25 years old. The selected subjects were equally divided into four groups (n=10) of three experimental groups and a control group. The experimental Group I underwent traditional resistance training (TRTG), Group II underwent combined traditional resistance training and plyometrics (TRTPG), and Group III underwent combined traditional resistance training and resistance training with high rhythm (TRTHRG). Group IV acted as the control group (CG) receiving no training during the experimental period. The duration of the experimental period was sixteen weeks, five days per week. Powerlifting performance was assessed by the 1RM test in the squat, bench press and deadlift. Performance-related variables assessed were chest girth, arm girth, forearm girth, thigh girth, and calf girth. Pre-test and post-test were conducted a day before and two days after the experimental period on all groups. Analysis of covariance (ANCOVA) was applied to analyze the significant difference. The 0.05 level of confidence was fixed as the level of significance to test the F ratio obtained by the analysis of covariance. The result indicates that there is a significant effect of all the selected resistance training methods on the performance and selected performance-related variables of powerlifters. Combined traditional resistance training and plyometrics and combined traditional resistance training and resistance training with high rhythm proved better than the traditional resistance training in improving performance and selected performance-related variables of powerlifters. There was no significant difference between combined traditional resistance training and plyometrics and combined traditional resistance training and resistance training with high rhythm in improving performance and selected performance-related variables of powerlifters.

Keywords: girth, plyometrics, powerlifting, resistance training

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Authors: Magdalena Bury-Kaminska, Aneta Szudy-Szczyrek, Aleksandra Nowaczynska, Olga Jankowska-Lecka, Marek Hus, Klaudia Kot

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Introduction: The aim of the research was to determine the changes in cognitive functioning in patients with plasma cell myeloma by comparing patients’ state before the treatment and during chemotherapy as well as to determine the biological factors that can be used to predict patients’ cognitive state. Methods: The patients underwent the research procedure twice: before chemotherapy and after 4-6 treatment cycles. A psychological test and measurement of the following biological variables were carried out: TNF-α (tumor necrosis factor), IL-6 (interleukin 6), IL-10 (interleukin 10), BDNF (brain-derived neurotrophic factor). The following research methods were implemented: the Montreal Cognitive Assessment (MoCA), Battery of Tests for Assessing Cognitive Functions PU1, experimental and clinical trials based on the Choynowski’s Memory Scale, Stroop Color-Word Interference Test (SCWT), depression measurement questionnaire. Results: The analysis of the research showed better cognitive functions of patients during chemotherapy in comparison to the phase before it. Moreover, neurotrophin BDNF allows to predict the level of selected cognitive functions (semantic fluency and execution control) already at the diagnosis stage. After 4-6 cycles, it is also possible to draw conclusions concerning the extent of working memory based on the level of BDNF. Cytokine TNF-α allows us to predict the level of letter fluency during anti-cancer treatment. Conclusions: It is possible to presume that BDNF has a protective influence on patients’ cognitive functions and working memory and that cytokine TNF-α co-occurs with a diminished execution control and better material grouping in terms of phonological fluency. Acknowledgment: This work was funded by the National Science Center in Poland [grant no. 2017/27/N/HS6/02057.

Keywords: chemobrain, cognitive impairment, non−central nervous system cancers, hematologic diseases

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Authors: Karim Hrratha, Khaled Essalahb, Christophe Morellc, Henry Chermettec, Salima Boughdiria

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Among the carbon-carbon bond formation types, allylation of active methylene compounds with cyclic Baylis-Hillman (BH) alcohols is a reliable and widely used method. This reaction is a very attractive tool in organic synthesis of biological and biodiesel compounds. Thus, in view of an insistent and peremptory request for an efficient and straightly method for synthesizing the desired product, a thorough analysis of various aspects of the reaction processes is an important task. The product afforded by the reaction of active methylene with BH alcohols depends largely on the experimental conditions, notably on the catalyst properties. All experiments reported that catalysis is needed for this reaction type because of the poor ability of alcohol hydroxyl group to be as a suitable leaving group. Within the catalysts, several transition- metal based have been used such as palladium in the presence of acid or base and have been considered as reliable methods. Furthemore, acid catalysts such as BF3.OEt2, BiX3 (X= Cl, Br, I, (OTf)3), InCl3, Yb(OTf)3, FeCl3, p-TsOH and H-montmorillonite have been employed to activate the C-C bond formation through the alkylation of active methylene compounds. Interestingly a report of a smoothly process for the ability of 4-imethyaminopyridine(DMAP) to catalyze the allylation reaction of active methylene compounds with cyclic Baylis-Hillman (BH) alcohol appeared recently. However, the reaction mechanism remains ambiguous, since the C- allylation process leads to an unexpected product (noted P1), corresponding to a direct allylation instead of conjugate allylation, which involves the most electrophilic center according to the electron withdrawing group CO effect. The main objective of the present theoretical study is to better understand the role of the DMAP catalytic activity as well as the process leading to the end- product (P1) for the catalytic reaction of a cyclic BH alcohol with active methylene compounds. For that purpose, we have carried out computations of a set of active methylene compounds varying by R1 and R2 toward the same alcohol, and we have attempted to rationalize the mechanisms thanks to the acid–base approach, and conceptual DFT tools such as chemical potential, hardness, Fukui functions, electrophilicity index and dual descriptor, as these approaches have shown a good prediction of reactions products.The present work is then organized as follows: In a first part some computational details will be given, introducing the reactivity indexes used in the present work, then Section 3 is dedicated to the discussion of the prediction of the selectivity and regioselectivity. The paper ends with some concluding remarks. In this work, we have shown, through DFT method at the B3LYP/6-311++G(d,p) level of theory that: The allylation of active methylene compounds with cyclic BH alcohol is governed by orbital control character. Hence the end- product denoted P1 is generated by direct allylation.

Keywords: DFT calculation, gas phase pKa, theoretical mechanism, orbital control, charge control, Fukui function, transition state

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Authors: Juan A. G. Carrio, Prasad Talluri, Sergio G. Echeverrigaray, Antonio H. Castro Neto

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Hydrogen as a fuel and environmentally pleasant energy carrier is part of this transition towards low-carbon systems. The extensive deployment of hydrogen production, purification and transport infrastructures still represents significant challenges. Independent of the production process, the hydrogen generally is mixed with light hydrocarbons and other undesirable gases that need to be removed to obtain H₂ with the required purity for end applications. In this context, membranes are one of the simplest, most attractive, sustainable, and performant technologies enabling hydrogen separation and purification. They demonstrate high separation efficiencies and low energy consumption levels in operation, which is a significant leap compared to current energy-intensive options technologies. The unique characteristics of 2D laminates have given rise to a diversity of research on their potential applications in separation systems. Specifically, it is already known in the scientific literature that graphene oxide-based membranes present the highest reported selectivity of H₂ over other gases. This work explores the potential of a new type of 2D materials-based membranes in separating H₂ from CO₂ and CH₄. We have developed nanostructured composites based on 2D materials that have been applied in the fabrication of membranes to maximise H₂ selectivity and permeability, for different gas mixtures, by adjusting the membranes' characteristics. Our proprietary technology does not depend on specific porous substrates, which allows its integration in diverse separation modules with different geometries and configurations, looking to address the technical performance required for industrial applications and economic viability. The tuning and precise control of the processing parameters allowed us to control the thicknesses of the membranes below 100 nanometres to provide high permeabilities. Our results for the selectivity of new nanostructured 2D materials-based membranes are in the range of the performance reported in the available literature around 2D materials (such as graphene oxide) applied to hydrogen purification, which validates their use as one of the most promising next-generation hydrogen separation and purification solutions.

Keywords: membranes, 2D materials, hydrogen purification, nanocomposites

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Authors: Mohamed M. Zaki, Maha M. Hady

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Salmonella spp. have been categorized as the world’s biggest threats to human health and poultry products are mostly incriminated sources. In Egypt, it was found that S. enteritidis and S. typhimurium are the most prevalent ones in poultry farms. It is recommended to eliminate salmonella from living bird by competing for salmonella contamination in feed in order to establish a healthy gut. The Feed acidifiers are the group of feed additives containing low-molecular-weight organic acids and/ or their salts which act as performance promoters by lowering the pH in the gut, optimizes digestion and inhibit bacterial growth. The inclusion of organic acid in pure form nonetheless effective in feed, yet, it is difficult to handle in feed mills as it is corrosive and produce more losses during pelleting process. The current study aimed at to evaluate the impact of incorporation of sodium diformate (SDF) and a commercial acidifier, CA (a mixture of butyric and propionic acids and their ammonium salts) at 0.4% dietary levels on broilers performance and the control S. enteritidis infection. Two hundreds and seventy unsexed cobb chickens were allotted in one of three treatments (90/ group) which were, the control (no acidifier, C- &C+), the 0.4% SDF (SDF- & SDF +) and the 0.4% CA (CA- & CA +) dietary levels for 35 days. Before the allocation of the groups, ten extra birds and a diet sample were bacteriologically examined to ensure negative contamination with salmonella. The birds were raised on deep-litter separated pens and had free access to feed and water all the time. The experimentally formulated diets were kept at 40C. After 24h access to the different dietary treatments, all the birds in the positive groups (n=15/ replicate) were inoculated intra-crop with 0.2 ml of 24 h broth culture of S. entertidis containing 1X 107 organisms while the negative-treated groups were inoculated with the same amount of the negative broth and second inoculation was done at 22 d of age. Colocal swabs were collected individually from all birds 2 h pre-inoculation to assure the absence of salmonella, then 1, 3, 5, 7, 21 days post-inoculation to recover salmonella. Performance parameter (body weight gain and feed efficiency) were calculated. Mortalities were recorded and reisolation of the salmonella was adopted to ensure it was the inoculated ones. The results revealed that the dietary acidification with sodium diformate significantly improved broilers performance and tends to produce heavier birds as compared to the negative control and CA groups. Moreover, the dietary inclusion of both acidifiers at level of 0.4% was able to eliminate mortalities completely at the relevant inoculation time. Regarding the shedding of S. enteritidius in positive groups, the SDF treatment resulted in significant (p<0.05) cessation of the shedding at 3 days post-inoculation compared to 7 days post-inoculation for the CA-group. In conclusion, sodium diformate at 0.4% dietary level in broiler diets has a valuable effect not only on broilers performance but also by eliminating S. enteritidis the main source of salmonella contamination in poultry farms which is feed.

Keywords: acidifier, broilers, Salmonalla spp, sodium diformate

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Authors: Hesti Ghassani, Tessa Septiadi

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In the world we live on today, young generation highly influences the future of a nation. We have to concern that the condition of the country in 20 years later depending by the character of young adults these days. Therefore, it is important that we have to support and control the teenagers especially in one of developing countries in which I live in: Indonesia. Indonesia is a home to 240 million people. It diverse in languages, cultures, as well as attitudes. The differences among each individual lead us to think that there is something we have to take care of. It is necessary to pay attention to the nutrition consumed by the nation. We initiate to control the food consumed by young generation as early as a primary students. Nutrition affects the immune of the body, neuron system, and, most importantly brain. One of the nutrition that has to be fulfilled is milk. However, most of the population in Indonesia isn’t aware of the importance of consuming milk as their daily basis. We’ve formed an innovation called the Brilliant Candy which is affordable and rich in nutrition. So that is why the paper made by literature study to solve the problem with effective ways using available resources, practice and cheap. Brilliant Candy consists of Centella asiatica extract mixed with Soy milk. Centella asiatica contains of alkaloid which give the energy to brain and circulate oxygen. Based on the research of Sathya and Ganga, Centella asiatica can increase the intelligence. Indeed, Centella asiatica can relieve stress, and help us in staying focus. Soy milk is a kind of milk which come from extracted soybean. Soybean is rich in flafonoid. It has various advantages for our body. Which can also support child nutrition consumed. Soybean boosts immune system, helps digestive system, and in terms of food, soy bean exists as a source of nutrition. A method to get extraction of Centella asiatica is namely maserasi using ethanol. While making soybean milk with got the pollen of soybean. Both materials get mixed processed into hard candy with congelation of.

Keywords: Indonesia, Centella asiatica, Soy milk, alkaloid, flafonoid

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Authors: Camila Plaza, Stefan Felder

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In October 2014, the TARMED reform was implemented in Switzerland. In an effort to even out the financial standing of general practitioners (including pediatricians) relative to that of specialists in the outpatient sector, the reform tackled two aspects: on the one hand, GPs would be able to bill an additional 9 CHF per patient, once per consult per day. This is referred to as the surcharge position. As a second measure, it reduced the fees for certain technical services targeted to specialists (e.g., imaging, surgical technical procedures, etc.). Given the fee-for-service reimbursement system in Switzerland, we predict that physicians reacted to the economic incentives of the reform by increasing the consults per patient and decreasing the average amount of time per consult. Within this framework, our treatment group is formed by GPs and our control group by those specialists who were not affected by the reform. Using monthly insurance claims panel data aggregated at the physician praxis level (provided by SASIS AG), for the period of January 2013-December 2015, we run difference in difference panel data models with physician and time fixed effects in order to test for the causal effects of the reform. We account for seasonality, and control for physician characteristics such as age, gender, specialty, and physician experience. Furthermore, we run the models on subgroups of physicians within our sample so as to account for heterogeneity and treatment intensities. Preliminary results support our hypothesis. We find evidence of an increase in consults per patients and a decrease in time per consult. Robustness checks do not significantly alter the results for our outcome variable of consults per patient. However, we do find a smaller effect of the reform for time per consult. Thus, the results of this paper could provide policymakers a better understanding of physician behavior and their sensitivity to financial incentives of reforms (both past and future) under the current reimbursement system.

Keywords: difference in differences, financial incentives, health reform, physician behavior

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Authors: Chi H. Lin, Chi C. Lin, Chih L. Hsieh

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Motor Imagery (MI) alone or combined with action observation (AO) has been shown to enhance motor performance and skill learning. The most effective way to combine these techniques has received limited scientific scrutiny. In the present study, we examined the effects of simultaneous (i.e., observing an action whilst imagining carrying out the action concurrently), alternate (i.e., observing an action and then doing imagery related to that action consecutively) and synthesis (alternately perform action observation and imagery action and then perform observation and imagery action simultaneously) AOMI combinations on improving golf putting performance and learning. Participants, 45 university students who had no formal experience of using imagery for the study, were randomly allocated to one of four training groups: simultaneous action observation and motor imagery (S-AOMI), alternate action observation and motor imagery (A-AOMI), synthesis action observation and motor imagery (A-S-AOMI), and a control group. And it was applied 'Different Experimental Groups with Pre and Post Measured' designs. Participants underwent eighteen times of different interventions, which were happened three times a week and lasting for six weeks. We analyzed the information we received based on two-factor (group × times) mixed between and within analysis of variance to discuss the real effects on participants' golf putting performance and learning about different intervention methods of different types of combined action observation and motor imagery. After the intervention, we then used imagery questionnaire and journey to understand the condition and suggestion about different motor imagery and action observation intervention from the participants. The results revealed that the three experimental groups both are effective in putting performance and learning but not for the control group, and the A-S-AOMI group is significantly better effect than S-AOMI group on golf putting performance and learning. The results confirmed the effect of motor imagery combined with action observation on the performance and learning of golf putting. In particular, in the groups of synthesis, motor imagery, or action observation were alternately performed first and then performed motor imagery, and action observation simultaneously would have the best effectiveness.

Keywords: motor skill learning, motor imagery, action observation, simulation

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Authors: Anne N. Heirman, Song Duimel, Rob van Son, Lisette van der Molen, Richard Dirven, Gyorgi B. Halmos, Julia van Weert, Michiel W.M. van den Brekel

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Objectives: Treatments for head-neck cancer are drastic and often significantly impact the quality of life and appearance of patients. Shared decision-making (SDM) beholds a collaboration between patient and doctor in which the most suitable treatment can be chosen by integrating patient preferences, values, and medical information. SDM has a lot of advantages that would be useful in making difficult treatment choices. The objective of this study was to determine the current level of SDM among patients and head-and-neck surgeons. Methods: Consultations of patients with a non-cutaneous head-and-neck malignancy facing a treatment decision were selected and included. If given informed consent, the consultation was recorded with an audio recorder, and the patient and surgeon filled in a questionnaire immediately after the consultation. The SDM level of the consultation was scored objectively by independent observers who judged audio recordings of the consultation using the OPTION5-scale, ranging from 0% (no SDM) to 100% (optimum SDM), as well as subjectively by patients (using the SDM-Q-9 and Control preference scale) and clinicians (SDM-Q-Doc, modified control preference scale) percentages. Preliminary results: Five head-neck surgeons have each at least seven recorded conversations with different patients. One of them was trained in SDM. The other four had no experience with SDM. Most patients were male (74%), and oropharyngeal carcinoma was the most common diagnosis (41%), followed by oral cancer (33%). Five patients received palliative treatment of which two patients were not treated recording guidelines. At this moment, all recordings are scored by the two independent observers. Analysis of the results will follow soon. Conclusion: The current study will determine to what extent there is a discrepancy between the objective and subjective level of shared decision-making (SDM) during a doctor-patient consultation in Head-and-Neck surgery. The results of the analysis will follow shortly.

Keywords: head-and-neck oncology, patient involvement, physician-patient relations, shared decision making

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Authors: Ionelia Taranu, Gina Cecilia Pistol, Mihai Alexandru Gras, Mihai Laurentiu Palade, Mariana Stancu, Veronica Sanda Chedea

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In the last decade bioactive compounds from grape waste are investigated as new therapeutic agents for the inhibition of carcinogenesis and other diseases. The objective of this study was to characterize several bioactive compounds (polyphenols and polyunsaturated fatty acids) of a dried grape pomace (GP) derived from a Romanian winery and further to evaluate their effect on inflammation and oxidative markers in liver of pig used as animal model. The total polyphenol concentration of pomace was 36.2g gallic acid equiv /100g. The pomace was rich in polyphenols from the flavonoids group, the main class being flavanols (epicatechins, catechin, epigallocatechin, procyanidins) and antocyanins (Malvidin 3-O-glucoside). The highest concentration was recorded for epicatechin (51.96g/100g) and procyanidin dimer (22.79g/100g). A high concentration of total polyunsaturated fatty acids (PUFA) especially ω-6 fatty acids (59.82 g/100g fat) was found in grape pomace. 20 crossbred TOPIG hybrid fattening pigs were randomly assigned (n = 10) to two experimental treatments: a normal diet (control group) and a diet included 5% grape pomace (GP group) for 24 days. The GP diet lowered the gene expression and protein concentration of IL-1β, IL-8, TNF-α and IFN-γ cytokines in liver suggesting an anti-inflammatory effect of GP diet. Concentration of hepatic TBARS also decreased, but the total antioxidant capacity (liver TEAC) and activity and gene expression of antioxidant enzymes (superoxide dismutase, catalase and glutathione peroxidase) did not differ between the GP and control diet. The results showed that GP diet exerted an anti-inflammatory effect, but the 5% dietary inclusion modulated only partially the oxidative stress.

Keywords: animal model, inflammation, grape waste, immune organs

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Authors: S. H. Nasseri, A. Ebrahimnejad

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Fuzzy set theory has been applied to many fields, such as operations research, control theory, and management sciences. In this paper, we consider two classes of fuzzy linear programming (FLP) problems: Fuzzy number linear programming and linear programming with trapezoidal fuzzy variables problems. We state our recently established results and develop fuzzy primal simplex algorithms for solving these problems. Finally, we give illustrative examples.

Keywords: fuzzy linear programming, fuzzy numbers, duality, sensitivity analysis

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Authors: Daniel F. Sava, Anton Ficai, Bogdan S. Vasile, Georgeta Voicu, Ecaterina Andronescu

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The energy crisis and environmental contamination are very serious problems, therefore searching for better and sustainable renewable energy is a must. It is predicted that the global energy demand will double until 2050. Solar water splitting and photocatalysis are considered as one of the solutions to these issues. The use of oxide semiconductors for solar water splitting and photocatalysis started in 1972 with the experiments of Fujishima and Honda on TiO2 electrodes. Since then, the evolution of nanoscience and characterization methods leads to a better control of size, shape and properties of materials. Although the past decade advancements are astonishing, for these applications the properties have to be controlled at a much finer level, allowing the control of charge-carrier lives, energy level positions, charge trapping centers, etc. Graphene has attracted a lot of attention, since its discovery in 2004, due to the excellent electrical, optical, mechanical and thermal properties that it possesses. These properties make it an ideal support for photocatalysts, thus graphene composites with oxide semiconductors are of great interest. We present in this work the synthesis and characterization of graphene-related materials and oxide semiconductors and their different composites. These materials can be used in constructing devices for different applications (batteries, water splitting devices, solar cells, etc), thus showing their application flexibility. The synthesized materials are different morphologies and sizes of TiO2, ZnO and Fe2O3 that are obtained through hydrothermal, sol-gel methods and graphene oxide which is synthesized through a modified Hummer method and reduced with different agents. Graphene oxide and the reduced form could also be used as a single material for transparent conductive films. The obtained single materials and composites were characterized through several methods: XRD, SEM, TEM, IR spectroscopy, RAMAN, XPS and BET adsorption/desorption isotherms. From the results, we see the variation of the properties with the variation of synthesis parameters, size and morphology of the particles.

Keywords: composites, graphene, hydrothermal, renewable energy

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Authors: Sophia Cyril Vincent

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Background: As per the Indian Census 2011, there is nearly 104 million elderly population aged above 60 years (53 million females and 51 males), and the count is expected to be 173 million by the end of 2026. Nearly 5.5% of women and 1.5% of men are living alone.1 In India, even though it is the moral duty of the children to take care of aged parents, many elders are landing in old age homes due to the social transformation factors like mushrooming of nuclear families, migration of children, cultural echoes, differences in mindset and values. Nearly 728 old age homes are seen across the country, out of which 78 old age homes with approximately 3000 inmates are seen only in Bangalore2. The existing literature shows that elderly women residing in old age homes experience the challenges like- loneliness, health issues, rejection from children, grief, death anxiety, etc, which leads to mental and physical wellbeing in numerous and tangible ways3. Hence the best and cost-effective way to improve the meaning and quality of life among elderly females is logotherapy, a type of psychotherapeutic analysis and treatment, motivating and driving force4 within the human experience to lead a decent life. Aim: The current research is aimed at studying the effectiveness of a logotherapy intervention on meaning and quality of life among elderly women of old age homes. Samples:200 women aged < 60 years and staying in the old age home for more than 1 year were randomly allocated to the control group and experimental group. Methodology: Using the Meaning in life questionnaire (MLQ)and the World health organization quality of life (WHOQOL) questionnaire, meaning and quality of life were assessed among both groups' women. Intensive Logotherapy and meaning in life program for five days were provided for the experimental group and the control group, with no treatment. Result: Under analysis. Conclusion: It is the right of the elderly woman to lead a happy and peaceful life till her death irrespective of the residing place. Hence, continuous monitoring and effective management are necessary for elderly women.

Keywords: quality of life, meaning of life, logo therapy, old age home

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Authors: Radhwane Boudjelthia

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The most recent earthquakes that occurred in the world and particularly in Algeria, have killed thousands of people and severe damage. The example that is etched in our memory is the last earthquake in the regions of Boumerdes and Algiers (Boumerdes earthquake of May 21, 2003). For all the actors involved in the building process, the earthquake is the litmus test for construction. The goal we set ourselves is to contribute to the implementation of a thoughtful approach to the seismic protection of structures. For many engineers, the most conventional approach protection works (buildings and bridges) the effects of earthquakes is to increase rigidity. This approach is not always effective, especially when there is a context that favors the phenomenon of resonance and amplification of seismic forces. Therefore, the field of earthquake engineering has made significant inroads among others catalyzed by the development of computational techniques in computer form and the use of powerful test facilities. This has led to the emergence of several innovative technologies, such as the introduction of special devices insulation between infrastructure and superstructure. This approach, commonly known as "seismic isolation" to absorb the significant efforts without the structure is damaged and thus ensuring the protection of lives and property. In addition, the restraints to the construction by the ground shaking are located mainly at the supports. With these moves, the natural period of construction is increasing, and seismic loads are reduced. Thus, there is an attenuation of the seismic movement. Likewise, the insulation of the base mechanism may be used in combination with earthquake dampers in order to control the deformation of the insulation system and the absolute displacement of the superstructure located above the isolation interface. On the other hand, only can use these earthquake dampers to reduce the oscillation amplitudes and thus reduce seismic loads. The use of damping devices represents an effective solution for the rehabilitation of existing structures. Given all these acceleration reducing means considered passive, much research has been conducted for several years to develop an active control system of the response of buildings to earthquakes.

Keywords: earthquake, building, seismic forces, displacement, resonance, response

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Authors: Ambrish Tiwari, Sudhasini Panda, Archana Singh, Kalpana Luthra, S. K. Sharma

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Introduction: On the basis of available literature we know that various host factors play a role in outcome of Tuberculosis (TB) infection by modulating innate immunity. One such factor is Inducible Nitric Oxide Synthase enzyme (iNOS) which help in the production of Nitric Oxide (NO), an antimicrobial agent. Expression of iNOS is in control of various host factors in which Vitamin D along with its nuclear receptor Vitamin D receptor (VDR) is one of them. Vitamin D along with its receptor also produces cathelicidin (antimicrobicidal agent). With this background, we attempted to investigate the levels of Vitamin D and NO along with their associated molecules in tuberculosis patients and household contacts as compared to healthy controls and assess the implication of these findings in susceptibility to tuberculosis (TB). Study subjects and methods: 100 active TB patients, 75 household contacts, and 70 healthy controls were taken. VDR and iNOS mRNA levels were studied using real-time PCR. Serum VDR, cathelicidin, iNOS levels were measured using ELISA. Serum Vitamin D levels were measured in serum samples using chemiluminescence based immunoassay. NO was measured using colorimetry based kit. Results: VDR and iNOS mRNA levels were found to be lower in active TB group compared to household contacts and healthy controls (P=0.0001 and 0.005 respectively). The serum levels of Vitamin D were also found to be lower in active TB group as compared to healthy controls (P =0.001). Levels of cathelicidin and NO was higher in patient group as compared to other groups (p=0.01 and 0.5 respectively). However, the expression of VDR and iNOS and levels of vitamin D was significantly (P < 0.05) higher in household contacts compared to both active TB and healthy control groups. Inference: Higher levels of Vitamin D along with VDR and iNOS expression in household contacts as compared to patients suggest that vitamin D might have a protective role against TB which prevents activation of the disease. From our data, we can conclude that decreased vitamin D levels could be implicated in disease progression and we can use cathelicidin and NO as a biomarker for early diagnosis of pulmonary tuberculosis.

Keywords: vitamin D, VDR, iNOS, tuberculosis

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Authors: Junaid Mahmood Alam

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Revalidating and harmonizing clinical chemistry analytical principles and optimizing methods through quality control programs and assessments is the preeminent means to attain optimal outcome within the clinical laboratory services. Present study reports revalidation of our existing IFCC regularized analytical methods, particularly hepatic and thyroid function tests, by optimization of precision analyses and processing through external and internal quality assessments and regression determination. Parametric components of hepatic (Bilirubin ALT, γGT, ALP), cardiac (LDH, AST, Trop I) and thyroid/pituitary (T3, T4, TSH, FT3, FT4) function tests were used to validate analytical techniques on automated chemistry and immunological analyzers namely Hitachi 912, Cobas 6000 e601, Cobas c501, Cobas e411 with UV kinetic, colorimetric dry chemistry principles and Electro-Chemiluminescence immunoassay (ECLi) techniques. Process of validation and revalidation was completed with evaluating and assessing the precision analyzed Preci-control data of various instruments plotting against each other with regression analyses R2. Results showed that: Revalidation and optimization of respective parameters that were accredited through CAP, CLSI and NEQAPP assessments depicted 99.0% to 99.8% optimization, in addition to the methodology and instruments used for analyses. Regression R2 analysis of BilT was 0.996, whereas that of ALT, ALP, γGT, LDH, AST, Trop I, T3, T4, TSH, FT3, and FT4 exhibited R2 0.998, 0.997, 0.993, 0.967, 0.970, 0.980, 0.976, 0.996, 0.997, 0.997, and R2 0.990, respectively. This confirmed marked harmonization of analytical methods and instrumentations thus revalidating optimized precision standardization as per IFCC recommended guidelines. It is concluded that practices of revalidating and harmonizing the existing or any new services should be followed by all clinical laboratories, especially those associated with tertiary care hospital. This is will ensure deliverance of standardized, proficiency tested, optimized services for prompt and better patient care that will guarantee maximum patients’ confidence.

Keywords: revalidation, standardized, IFCC, CAP, harmonized

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Authors: O. A. Apampa, Y. A. Jimoh

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The paper reports the investigation of Corn Cob Ash as a chemical stabilizing agent for laterite soils. Corn cob feedstock was obtained from Maya, a rural community in the derived savannah agro-ecological zone of South-Western Nigeria and burnt to ashes of pozzolanic quality. Reddish brown silty clayey sand material characterized as AASHTO A-2-6(3) lateritic material was obtained from a borrow pit in Abeokuta and subjected to strength characterization tests according to BS 1377: 2000. The soil was subsequently mixed with CCA in varying percentages of 0-7.5% at 1.5% intervals. The influence of CCA stabilized soil was determined for the Atterberg limits, compaction characteristics, CBR and the unconfined compression strength. The tests were repeated on laterite cement-soil mixture in order to establish a basis for comparison. The result shows a similarity in the compaction characteristics of soil-cement and soil-CCA. With increasing addition of binder from 1.5% to 7.5%, Maximum Dry Density progressively declined while the OMC steadily increased. For the CBR, the maximum positive impact was observed at 1.5% CCA addition at a value of 85% compared to the control value of 65% for the cement stabilization, but declined steadily thereafter with increasing addition of CCA, while that of soil-cement continued to increase with increasing addition of cement beyond 1.5% though at a relatively slow rate. Similar behavior was observed in the UCS values for the soil-CCA mix, increasing from a control value of 0.4 MN/m2 to 1.0 MN/m2 at 1.5% CCA and declining thereafter, while that for soil-cement continued to increase with increasing cement addition, but at a slower rate. This paper demonstrates that CCA is effective for chemical stabilization of a typical Nigerian AASHTO A-2-6 lateritic soil at maximum stabilizer content limit of 1.5% and therefore recommends its use as a way of finding further application for agricultural waste products and achievement of environmental sustainability in line with the ideals of the millennium development goals because of the economic and technical feasibility of the processing of the cobs from corn.

Keywords: corn cob ash, pozzolan, cement, laterite, stabilizing agent, cation exchange capacity

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Authors: Arnold M. Brener, Lesbek Tashimov, Ablakim S. Muratov

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The paper deals with the special model for coagulation kernels which represents new control parameters in the Smoluchowski equation for binary aggregation. On the base of the model the new approach to evaluating aggregative stability of disperse systems has been submitted. With the help of this approach the simple estimates for aggregative stability of various types of hydrophilic nano-suspensions have been obtained.

Keywords: aggregative stability, coagulation kernels, disperse systems, mathematical model

Procedia PDF Downloads 309

Authors: Paul Moses Ndegwa, Teresia Kabucho, Lucy Wanjiru, Esther Wanjiru, Brian Githaiga, Jecinta Wambui

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Health outcome has improved in the country since 2013 following the adoption of the new constitution in Kenya with devolved governance with administration and health planning functions transferred to county governments. 2018-2022 development agenda prioritized universal healthcare coverage, food security, and nutrition, however, the emergence of Covid-19 and the increase of non-communicable diseases pose a challenge and constrain in an already overwhelmed health system. A study was conducted July-November 2021 to establish key challenges in achieving universal healthcare coverage within the county and best practices for improved non-communicable disease control. 14 health workers ranging from nurses, doctors, public health officers, clinical officers, and pharmaceutical technologists were purposely engaged to provide critical information through questionnaires by a trained duo observing ethical procedures on confidentiality. Data analysis. Communicable diseases are major causes of morbidity and mortality. Non-communicable diseases contribute to approximately 39% of deaths. More than 45% of the population does not have access to safe drinking water. Study noted geographic inequality with respect to distribution and use of health resources including competing non-health priorities. 56% of health workers are nurses, 13% clinical officers, 7% doctors, 9%public health workers, 2% are pharmaceutical technologists. Poor-quality data limits the validity of disease-burdened estimates and research activities. Risk factors include unsafe water, sanitation, hand washing, unsafe sex, and malnutrition. Key challenge in achieving universal healthcare coverage is the rise in the relative contribution of non-communicable diseases. Improve targeted disease control with effective and equitable resource allocation. Develop high infectious disease control mechanisms. Improvement of quality data for decision making. Strengthen electronic data-capture systems. Increase investments in the health workforce to improve health service provision and achievement of universal health coverage. Create a favorable environment to retain health workers. Fill in staffing gaps resulting in shortages of doctors (7%). Develop a multi-sectional approach to health workforce planning and management. Need to invest in mechanisms that generate contextual evidence on current and future health workforce needs. Ensure retention of qualified, skilled, and motivated health workforce. Deliver integrated people-centered health services.

Keywords: multi-sectional approach, equity, people-centered, health workforce retention

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Authors: J. Yan, B. Pieper, B. Bucsky, B. Nasseri, S. Klotz, H. H. Sievers, S. Mohamed

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Cryoablation is evermore applied for interventional treatment of paroxysmal (PAAF) or persistent atrial fibrillation (PEAF). In the cardiac surgery, this procedure is often combined with coronary arterial bypass graft (CABG) and valve operations. Three different methods are feasible in this sense in respect to practicing extents and mechanisms such as lone left atrial cryoablation, Cox-Maze IV and III in our heart center. 415 patients (68 ± 0.8ys, male 68.2%) with predisposed atrial fibrillation who initially required either coronary or valve operations were enrolled and divided into 3 matched groups according to deployed procedures: CryoLA-group (cryoablation of lone left atrium, n=94); Cox-Maze-IV-group (n=93) and Cox-Maze-III-group (n=8). All patients additionally received closure of the left atrial appendage (LAA) and regularly underwent three-year ambulant follow-up assessments (3, 6, 9, 12, 18, 24, 30 and 36 months). Burdens of atrial fibrillation were assessed directly by means of cardiac monitor (Reveal XT, Medtronic) or of 3-day Holter electrocardiogram. Herewith, attacks frequencies of AF and their circadian patterns were systemically analyzed. Furthermore, anticoagulants and regular rate-/rhythm-controlling medications were evaluated and listed in terms of anti-rate and anti-rhythm regimens. Concerning PAAF treatment, Cox Maze IV procedure provided therapeutically acceptable effect as lone left atrium (LA) cryoablation did (5.25 ± 5.25% vs. 10.39 ± 9.96% AF-burden, p > 0.05). Interestingly, Cox Maze III method presented a better short-term effect in the PEAF therapy in comparison to lone cryoablation of LA and Cox Maze IV (0.25 ± 0.23% vs. 15.31 ± 5.99% and 9.10 ± 3.73% AF-burden within the first year, p < 0.05). But this therapeutic advantage went lost during ongoing follow-ups (26.65 ± 24.50% vs. 8.33 ± 8.06% and 15.73 ± 5.88% in 3rd follow-up year). In this way, lone LA-cryoablation established its antiarrhythmic efficacy and 69.5% patients were released from the Vit-K-antagonists, while Cox Maze IV liberated 67.2% patients from continuous anticoagulant medication. The AF-recurrences mostly performed such attacks property as less than 60min duration for all 3 procedures (p > 0.05). In the sense of the circadian distribution of the recurrence attacks, weighted by ongoing follow-ups, lone LA cryoablation achieved and stabilized the antiarrhythmic effects over time, which was especially observed in the treatment of PEAF, while Cox Maze IV and III had their antiarrhythmic effects weakened progressively. This phenomenon was likewise evaluable in the therapy of circadian rhythm of reverting AF-attacks. Furthermore, the strategy of rate control was much more often applied to support and maintain therapeutic successes obtained than the one of rhythm control. Derived from experiences in our heart center, lone LA cryoablation presented equivalent effects in the treatment of AF in comparison to Cox Maze IV and III procedures. These therapeutic successes were especially investigable in the patients suffering from persistent AF (PEAF). Additional supportive strategies such as rate control regime should be initialized and implemented to improve the therapeutic effects of the cryoablations according to appropriate criteria.

Keywords: AF-burden, atrial fibrillation, cardiac monitor, COX MAZE, cryoablation, Holter, LAA

Procedia PDF Downloads 204