Search results for: therapeutic response
2346 The Development of Crisis Distance Education at Kuwait University During the COVID-19 Pandemic
Authors: Waleed Alanzi
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The purpose of this qualitative study was to add to the existing literature and provide a more detailed understanding of the individual experiences and perceptions of 15 Deans at the University of Kuwait regarding their first year of planning, developing, and implementing crisis distance education (CDE) in response to the COVID-19 epidemic. An interpretative phenomenological approach was applied, using the thematic analysis of interview transcripts to describe the challenging journeys taken by each of the Deans from the first-person point of view. There was objective evidence, manifested by four primary themes (“Obstacles to the implementation of CDE”; “Planning for CDE”; “Training for CDE,” and “Future Directions”) to conclude that the faculty members, technical staff, administrative staff, and students generally helped each other to overcome the obstacles associated with planning and implementing CDE. The idea that CDE may turn homes into schools and parents into teachers was supported. The planning and implementation of CDE were inevitably associated with a certain amount of confusion, as well as disruptions in the daily routines of staff and students, as well as significant changes in their responsibilities. There were contradictory ideas about the future directions of distance education after the pandemic. Previous qualitative research on the implementation of CDE at higher education institutions in the Arab world has focused mainly on the experiences and perceptions of students; however, little is known about the experiences and perceptions of the students at the University of Kuwait during the COVID19 pandemic, providing a rationale and direction for future research.Keywords: distance learning, qualitative research, COVID-19 epidemic, Kuwait university
Procedia PDF Downloads 1052345 The Role of Piceatannol in Counteracting Glyceraldehyde-3-Phosphate Dehydrogenase Aggregation and Nuclear Translocation
Authors: Joanna Gerszon, Aleksandra Rodacka
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In the pathogenesis of neurodegenerative diseases such as Alzheimer's disease and Parkinson's disease, protein and peptide aggregation processes play a vital role in contributing to the formation of intracellular and extracellular protein deposits. One of the major components of these deposits is the oxidatively modified glyceraldehyde-3-phosphate dehydrogenase (GAPDH). Therefore, the purpose of this research was to answer the question whether piceatannol, a stilbene derivative, counteracts and/or slows down oxidative stress-induced GAPDH aggregation. The study also aimed to determine if this natural occurring compound prevents unfavorable nuclear translocation of GAPDH in hippocampal cells. The isothermal titration calorimetry (ITC) analysis indicated that one molecule of GAPDH can bind up to 8 molecules of piceatannol (7.3 ± 0.9). As a consequence of piceatannol binding to the enzyme, the loss of activity was observed. Parallel with GAPDH inactivation the changes in zeta potential, and loss of free thiol groups were noted. Nevertheless, the ligand-protein binding does not influence the secondary structure of the GAPDH. Precise molecular docking analysis of the interactions inside the active center allowed to presume that these effects are due to piceatannol ability to assemble a covalent binding with nucleophilic cysteine residue (Cys149) which is directly involved in the catalytic reaction. Molecular docking also showed that simultaneously 11 molecules of ligand can be bound to dehydrogenase. Taking into consideration obtained data, the influence of piceatannol on level of GAPDH aggregation induced by excessive oxidative stress was examined. The applied methods (thioflavin-T binding-dependent fluorescence as well as microscopy methods - transmission electron microscopy, Congo Red staining) revealed that piceatannol significantly diminishes level of GAPDH aggregation. Finally, studies involving cellular model (Western blot analyses of nuclear and cytosolic fractions and confocal microscopy) indicated that piceatannol-GAPDH binding prevents GAPDH from nuclear translocation induced by excessive oxidative stress in hippocampal cells. In consequence, it counteracts cell apoptosis. These studies demonstrate that by binding with GAPDH, piceatannol blocks cysteine residue and counteracts its oxidative modifications, that induce oligomerization and GAPDH aggregation as well as it prevents hippocampal cells from apoptosis by retaining GAPDH in the cytoplasm. All these findings provide a new insight into the role of piceatannol interaction with GAPDH and present a potential therapeutic strategy for some neurological disorders related to GAPDH aggregation. This work was supported by the by National Science Centre, Poland (grant number 2017/25/N/NZ1/02849).Keywords: glyceraldehyde-3-phosphate dehydrogenase, neurodegenerative disease, neuroprotection, piceatannol, protein aggregation
Procedia PDF Downloads 1672344 Enhancement in Digester Efficiency and Numerical Analysis for Optimal Design Parameters of Biogas Plant Using Design of Experiment Approach
Authors: Rajneesh, Priyanka Singh
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Biomass resources have been one of the main energy sources for mankind since the dawn of civilization. There is a vast scope to convert these energy sources into biogas which is a clean, low carbon technology for efficient management and conversion of fermentable organic wastes into a cheap and versatile fuel and bio/organic manure. Thus, in order to enhance the performance of anaerobic digester, an optimizing analysis of resultant parameters (organic dry matter (oDM) content, methane percentage, and biogas yield) has been done for a plug flow anaerobic digester having mesophilic conditions (20-40°C) with the wet fermentation process. Based on the analysis, correlations for oDM, methane percentage, and biogas yield are derived using multiple regression analysis. A statistical model is developed to correlate the operating variables using the design of experiment approach by selecting central composite design (CCD) of a response surface methodology. Results shown in the paper indicates that as the operating temperature increases the efficiency of digester gets improved provided that the pH and hydraulic retention time (HRT) remains constant. Working in an optimized range of carbon-nitrogen ratio for the plug flow digester, the output parameters show a positive change with the variation of dry matter content (DM).Keywords: biogas, digester efficiency, design of experiment, plug flow digester
Procedia PDF Downloads 3782343 Effect of Nanoparticles Concentration, pH and Agitation on Bioethanol Production by Saccharomyces cerevisiae BY4743: An Optimization Study
Authors: Adeyemi Isaac Sanusi, Gueguim E. B. Kana
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Nanoparticles have received attention of the scientific community due to their biotechnological potentials. They exhibit advantageous size, shape and concentration-dependent catalytic, stabilizing, immunoassays and immobilization properties. This study investigates the impact of metallic oxide nanoparticles (NPs) on ethanol production by Saccharomyces cerevisiae BY4743. Nine different nanoparticles were synthesized using precipitation method and microwave treatment. The nanoparticles synthesized were characterized by Fourier Transform Infra-Red spectroscopy (FTIR), scanning electron microscopy (SEM) and transmission electron microscopy (TEM). Fermentation processes were carried out at varied NPs concentrations (0 – 0.08 wt%). Highest ethanol concentrations were achieved after 24 h using Cobalt NPs (5.07 g/l), Copper NPs (4.86 g/l) and Manganese NPs (4.74 g/l) at 0.01 wt% NPs concentrations, which represent 13%, 8.7% and 5.4% increase respectively over the control (4.47 g/l). The lowest ethanol concentration (0.17 g/l) was obtained when 0.08 wt% of Silver NPs was used. And lower ethanol concentrations were observed at higher NPs concentration. Ethanol concentration decrease after 24 h for all the processes. In all set up with NPs, the pH was observed to be stable and the stability was directly proportional to nanoparticles concentrations. These findings suggest that the presence of some of the NPs in the bioprocesses has catalytic and pH stabilizing potential. Ethanol production by Saccharomyces cerevisiae BY4743 was enhanced in the presence of Cobalt NPs, Copper NPs and Manganese NPs. Optimization study using response surface methodology (RSM) will further elucidate the impact of these nanoparticles on bioethanol production.Keywords: agitation, bioethanol, nanoparticles concentration, optimization, pH value
Procedia PDF Downloads 1882342 Traffic Forecasting for Open Radio Access Networks Virtualized Network Functions in 5G Networks
Authors: Khalid Ali, Manar Jammal
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In order to meet the stringent latency and reliability requirements of the upcoming 5G networks, Open Radio Access Networks (O-RAN) have been proposed. The virtualization of O-RAN has allowed it to be treated as a Network Function Virtualization (NFV) architecture, while its components are considered Virtualized Network Functions (VNFs). Hence, intelligent Machine Learning (ML) based solutions can be utilized to apply different resource management and allocation techniques on O-RAN. However, intelligently allocating resources for O-RAN VNFs can prove challenging due to the dynamicity of traffic in mobile networks. Network providers need to dynamically scale the allocated resources in response to the incoming traffic. Elastically allocating resources can provide a higher level of flexibility in the network in addition to reducing the OPerational EXpenditure (OPEX) and increasing the resources utilization. Most of the existing elastic solutions are reactive in nature, despite the fact that proactive approaches are more agile since they scale instances ahead of time by predicting the incoming traffic. In this work, we propose and evaluate traffic forecasting models based on the ML algorithm. The algorithms aim at predicting future O-RAN traffic by using previous traffic data. Detailed analysis of the traffic data was carried out to validate the quality and applicability of the traffic dataset. Hence, two ML models were proposed and evaluated based on their prediction capabilities.Keywords: O-RAN, traffic forecasting, NFV, ARIMA, LSTM, elasticity
Procedia PDF Downloads 2262341 Theoretical Investigation of the Origin of Interfacial Ferromagnetism of (LaNiO₃)n/(CaMnO₃)m Superlattices
Authors: Jiwuer Jilili, Iogann Tolbatov, Mousumi U. Kahaly
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Metal to insulator transition and interfacial magnetism of the LaNiO₃ based superlattice are main interest due to thickness dependent electronic response and tunable magnetic behavior. We investigate the structural, electronic, and magnetic properties of recently experimentally synthesized (LaNiO₃)n/(CaMnO₃)m superlattices with varying LaNiO₃ thickness using density functional theory. The effect of the on-site Coulomb interaction is discussed. In switching from zero to finite U value for Ni atoms, LaNiO₃ shows transitions from half-metallic to metallic character, while spinning ordering changes from paramagnetic to ferromagnetic (FM). For CaMnO₃, U < 3 eV on Mn atoms results in G-type anti-FM spin ordering whereas increasing U value yields FM ordering. In superlattices, metal to insulator transition was achieved with a reduction of LaNiO₃ thickness. The system with one layer of LaNiO₃ yields insulating character. Increasing LaNiO₃ to two layers and above results in the onset of the metallic character with a major contribution from Ni and Mn 3d eg states. Our results for interfacial ferromagnetism, induced Ni magnetic moments and novel antiferromagnetically coupled Ni atoms are consistent with the recent experimental findings. The possible origin of the emergent magnetism is proposed in terms of the exchange interaction and Anderson localization.Keywords: density functional theory, interfacial magnetism, metal-insulator transition, Ni magnetism.
Procedia PDF Downloads 2302340 The Therapeutic Potential, Functions, and Use of Ibogaine
Authors: João Pedro Zanella, Michel J. O. Fagundes
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Introduction: Drug use has been practised by humans universally for millennia, not excluding any population from these habits, however, the rampant drug use is a global concern due to the harm that affects the health of the world population. In this sense, it is observed the reduction of lasting and effective public policies for the resolution, increasing the demand for treatment services. With this comes ibogaine, an alkaloid derived from the root of an African bush (Tabernanthe Iboga), found mostly in Gabon and used widely by the native Bwiti population in rituals, and also other social groups, which demonstrates efficacy against chemical dependence, psychic and emotional disorders, opioid withdrawal was first confirmed by a study in rats done by Michailo Dzoljic and associates in 1988 and again in 1994. Methods: A brief description of the plant, its neurohumoral potential and the effects caused by ingested doses, in a simplified and objective way, will be discussed in the course of this abstract. Results: Ibogaine is not registered or passed by Anvisa, regarding safety and efficacy, and cannot be sold in Brazil. Its illegal trade reaches R$ 5 thousand for a session with the proceeds of the root, and its effect can last up to 72 hours, attributing Iboga's psychoactive effects to the alkaloid called ibogaine. The shrub where Ibogaine is located has pink and yellow flowers, and its fruit produced does not have psychoactive substances, but its root bark contains 6 to 7% indolic alkaloids. Besides extraction from the iboga plant, ibogaine hydrochloride can be semisynthesized from voacangine, another plant alkaloid that acts as a precursor. Its potential has the ability to perform multiple interactions with the neurotransmitter system, which are closely associated with addiction, including nicotinic, opioid and serotoninergic systems. Studies carried out by Edwards found that the doses administered of Iboga should be determined by a health professional when its purpose is to treat individuals for dependence on other drugs. Its use in small doses may cause an increase in sensibility, impaired vision and motor alterations; in moderate quantities, hallucinations, motor and neurological alterations and impaired vision; in high quantities it may cause hallucinations with personal events at a deeper level lasting up to 24 hours or more, followed by motor and visual alterations. Conclusion: The product extracted from the Iboga plant is of great importance in controlling addiction, reducing the need for the use of narcotics by patients, thus gaining a space of extreme importance in the treatment of users of psychoactive substances. It is remarkable the progress of the latest’s research about the usefulness of Ibogaine, and its benefits for certain treatments, even with the restriction of its sale in Brazil. Besides this, Ibogaine has an additional benefit of helping the patient to gain self-control over their destructive behaviours.Keywords: alkaloids, dependence, Gabon, ibogaine
Procedia PDF Downloads 842339 Students' Experience Perception in Courses Taught in New Delivery Modes Compared to Traditional Modes
Authors: Alejandra Yanez, Teresa Benavides, Zita Lopez
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Even before COVID-19, one of the most important challenges that Higher Education faces today is the need for innovative educational methodologies and flexibility. We could all agree that one of the objectives of Higher Education is to provide students with a variety of intellectual and practical skills that, at the same time, will help them develop competitive advantages such as adaptation and critical thinking. Among the strategic objectives of Universidad de Monterrey (UDEM) has been to provide flexibility and satisfaction to students in the delivery modes of the academic offer. UDEM implemented a methodology that combines face to face with synchronous and asynchronous as delivery modes. UDEM goal, in this case, was to implement new technologies and different teaching methodologies that will improve the students learning experience. In this study, the experience of students during courses implemented in new delivery mode was compared with students in courses with traditional delivery modes. Students chose openly either way freely. After everything students around the world lived in 2020 and 2021, one can think that the face to face (traditional) delivery mode would be the one chosen by students. The results obtained in this study reveal that both delivery modes satisfy students and favor their learning process. We will show how the combination of delivery modes provides flexibility, so the proposal is that universities can include them in their academic offer as a response to the current student's learning interests and needs.Keywords: flexibility, new delivery modes, student satisfaction, academic offer
Procedia PDF Downloads 1012338 Analgesic Efficacy of Opiorphin and Its Analogue
Authors: Preet Singh, Kavitha Kongara, Dave Harding, Neil Ward, Paul Chambers
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The objective of this study was to compare the analgesic efficacy of opiorphin and its analogue with a mu-receptor agonist; morphine. Opiorphins (Gln-Arg-Phe-Ser-Arg) belong to the family of endogenous enkephalinase inhibitors, found in saliva of humans. They are inhibitors of two Zinc metal ectopeptidases (Neutral endopeptidase NEP, and amino-peptidase APN) which are responsible for the inactivation of the endogenous opioids; endorphins and enkephalins. Morphine and butorphanol exerts their analgesic effects by mimicking the actions of endorphins and enkephalins. The opiorphin analogue was synthesized based on the structure activity relationship of the amino acid sequence of opiorphin. The pharmacological profile of the analogue was tested by replacing Serine at position 4 with Proline. The hot plate and tail flick test were used to demonstrate the analgesic efficacy. There was a significant increase in the time for the tail flick response after an injection of opiorphin, which was similar to the morphine effect. There was no increase in time in the hot plate test after an injection of opiorphin. The results suggest that opiorphin works at spinal level only rather than both spinal and supraspinal. Further work is required to confirm our results. We did not find analgesic activity of the opiorphin analogue. Thus, Serine at position 4 is also important for its pharmacological action. Further work is required to illustrate the role of serine at position 4 in opiorphin.Keywords: analgesic peptides, endogenous opioids, morphine, opiorphin
Procedia PDF Downloads 3252337 Assessment of Rock Masses Performance as a Support of Lined Rock Cavern for Isothermal Compressed Air Energy Storage
Authors: Vathna Suy, Ki-Il Song
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In order to store highly pressurized gas such as an isothermal compressed air energy storage, Lined Rock Caverns (LRC) are constructed underground and supported by layers of concrete, steel and rock masses. This study aims to numerically investigate the performance of rock masses which serve as a support of Lined Rock Cavern subjected to high cyclic pressure loadings. FLAC3D finite different software is used for the simulation since the software can effectively model the behavior of concrete lining and steel plate with its built-in structural elements. Cyclic pressure loadings are applied onto the inner surface of the cavern which then transmitted to concrete, steel and eventually to the surrounding rock masses. Changes of stress and strain are constantly monitored throughout all the process of loading operations. The results at various monitoring locations are then extracted and analyzed to assess the response of the rock masses, specifically on its ability to absorb energy during loadings induced by the changes of cyclic pressure loadings inside the cavern. By analyzing the obtained data of stress-strain relation and taking into account the behavior of materials under the effect of strain-dependency, conclusions on the performance of rock masses subjected to high cyclic loading conditions are drawn.Keywords: cyclic loading, FLAC3D, lined rock cavern (LRC), strain-dependency
Procedia PDF Downloads 2452336 A Bayesian Hierarchical Poisson Model with an Underlying Cluster Structure for the Analysis of Measles in Colombia
Authors: Ana Corberan-Vallet, Karen C. Florez, Ingrid C. Marino, Jose D. Bermudez
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In 2016, the Region of the Americas was declared free of measles, a viral disease that can cause severe health problems. However, since 2017, measles has reemerged in Venezuela and has subsequently reached neighboring countries. In 2018, twelve American countries reported confirmed cases of measles. Governmental and health authorities in Colombia, a country that shares the longest land boundary with Venezuela, are aware of the need for a strong response to restrict the expanse of the epidemic. In this work, we apply a Bayesian hierarchical Poisson model with an underlying cluster structure to describe disease incidence in Colombia. Concretely, the proposed methodology provides relative risk estimates at the department level and identifies clusters of disease, which facilitates the implementation of targeted public health interventions. Socio-demographic factors, such as the percentage of migrants, gross domestic product, and entry routes, are included in the model to better describe the incidence of disease. Since the model does not impose any spatial correlation at any level of the model hierarchy, it avoids the spatial confounding problem and provides a suitable framework to estimate the fixed-effect coefficients associated with spatially-structured covariates.Keywords: Bayesian analysis, cluster identification, disease mapping, risk estimation
Procedia PDF Downloads 1512335 Effect of Cabbage and Cauliflower Emitted Volatile Organic Compounds on Foraging Response of Plutella xylostella
Authors: Sumbul Farhat, Pratyay Vaibhav, Sarah Jain, Kapinder Kumar, Archna Kumar
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The Diamondback Moth, Plutella xylostella (Linnaeus), is a major pest of cole crops that causes approximately 50% loss in global production. The utilization of inorganic pesticides is reflected in the development of resistance to this pest. Thus, there is a great need for an eco-friendly, sustainable strategy for the control of this pest. Although this pest, several natural enemies are reported worldwide, none of them can control it efficiently. Therefore, a proposed study is planned to understand the Volatile Organic Compounds (VOCs) mediated signaling interaction mechanism of the plant, pest, and natural enemy. For VOCs collection during different deployment stages of Cabbage POI, Green Ball, Pusa Cabbage, Cabbage Local, Snowball 16, Kanchan Plus, Pusa Meghna, Farm Sona Hybrid F1, and Samridhi F1 Hybrid, the Solid-phase microextraction (SPME) method was employed. Characterization of VOCs was conducted by Gas Chromatography-Mass Spectrometry (GC-MS). The impact of collected VOCs was assessed through Y-Tube Bioassays. The results indicate that the Cabbage variety Green Ball shows maximum repellency for P. xylostella (-100%). The cues present in this variety may be exploited for efficient management of P. xylostella in the cole crop ecosystem.Keywords: Plutella xylostella, cole crops, volatile organic compounds, GC-MS, Green Ball
Procedia PDF Downloads 1262334 Numerical Simulation on Deformation Behaviour of Additively Manufactured AlSi10Mg Alloy
Authors: Racholsan Raj Nirmal, B. S. V. Patnaik, R. Jayaganthan
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The deformation behaviour of additively manufactured AlSi10Mg alloy under low strains, high strain rates and elevated temperature conditions is essential to analyse and predict its response against dynamic loading such as impact and thermomechanical fatigue. The constitutive relation of Johnson-Cook is used to capture the strain rate sensitivity and thermal softening effect in AlSi10Mg alloy. Johnson-Cook failure model is widely used for exploring damage mechanics and predicting the fracture in many materials. In this present work, Johnson-Cook material and damage model parameters for additively manufactured AlSi10Mg alloy have been determined numerically from four types of uniaxial tensile test. Three different uniaxial tensile tests with dynamic strain rates (0.1, 1, 10, 50, and 100 s-1) and elevated temperature tensile test with three different temperature conditions (450 K, 500 K and 550 K) were performed on 3D printed AlSi10Mg alloy in ABAQUS/Explicit. Hexahedral elements are used to discretize tensile specimens and fracture energy value of 43.6 kN/m was used for damage initiation. Levenberg Marquardt optimization method was used for the evaluation of Johnson-Cook model parameters. It was observed that additively manufactured AlSi10Mg alloy has shown relatively higher strain rate sensitivity and lower thermal stability as compared to the other Al alloys.Keywords: ABAQUS, additive manufacturing, AlSi10Mg, Johnson-Cook model
Procedia PDF Downloads 1702333 Seismic Response of Large-Scale Rectangular Steel-Plate Concrete Composite Shear Walls
Authors: Siamak Epackachi, Andrew S. Whittaker, Amit H. Varma
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An experimental program on steel-plate concrete (SC) composite shear walls was executed in the NEES laboratory at the University at Buffalo. Four large-size specimens were tested under displacement-controlled cyclic loading. The design variables considered in the testing program included wall thickness, reinforcement ratio, and faceplate slenderness ratio. The aspect ratio (height-to-length) of the four walls was 1.0. Each SC wall was installed on top of a re-usable foundation block. A bolted baseplate to RC foundation connection was used for all four walls. The walls were identified to be flexure-critical. This paper presents the damage to SC walls at different drift ratios, the cyclic force-displacement relationships, energy dissipation and equivalent viscous damping ratios, the strain and stress fields in the steel faceplates and the contribution of the steel faceplates to the total shear load, the variation of vertical strain in the steel faceplates along the length of the wall, near the base, at different drift ratios, the contributions of shear, flexure, and base rotation to the total lateral displacement, the displacement ductility of the SC walls, and the cyclic secant stiffness of the four SC walls.Keywords: steel-plate composite shear wall, safety-related nuclear structure, flexure-critical wall, cyclic loading
Procedia PDF Downloads 3502332 Visual Text Analytics Technologies for Real-Time Big Data: Chronological Evolution and Issues
Authors: Siti Azrina B. A. Aziz, Siti Hafizah A. Hamid
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New approaches to analyze and visualize data stream in real-time basis is important in making a prompt decision by the decision maker. Financial market trading and surveillance, large-scale emergency response and crowd control are some example scenarios that require real-time analytic and data visualization. This situation has led to the development of techniques and tools that support humans in analyzing the source data. With the emergence of Big Data and social media, new techniques and tools are required in order to process the streaming data. Today, ranges of tools which implement some of these functionalities are available. In this paper, we present chronological evolution evaluation of technologies for supporting of real-time analytic and visualization of the data stream. Based on the past research papers published from 2002 to 2014, we gathered the general information, main techniques, challenges and open issues. The techniques for streaming text visualization are identified based on Text Visualization Browser in chronological order. This paper aims to review the evolution of streaming text visualization techniques and tools, as well as to discuss the problems and challenges for each of identified tools.Keywords: information visualization, visual analytics, text mining, visual text analytics tools, big data visualization
Procedia PDF Downloads 3992331 Effect of Probiotics and Vitamin B on Plasma Interferon-Gamma and Interleukin-6 Levels in Active Pulmonary Tuberculosis
Authors: Yulistiani Yulistiani, Zamrotul Izzah, Lintang Bismantara, Wenny Putri Nilamsari, Arif Bachtiar, Budi Suprapti
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Interferon-gamma (IFN-γ) and interleukin-6 (IL-6) are pro-inflammatory cytokines, which have the protective immune response against Tuberculosis (TB). Indeed, pro-inflammatory cytokines Mycobacterium tuberculosis antigen-specific CD4+ and CD8+ T cells and NK cells increase the level of production of IFN-γ, a cytokine critical for augmenting the microbicidal activity of phagocytes. On the other hand, M. tuberculosis reduces the effects of IFN-γ by inhibiting the transcription of IFN-γ- responsive genes and by inducing the secretion of IL-6, which inhibits IFN-γ signaling. Probiotics Lactobacillus sp. and Bifidobacterium sp. were known to increase IFN-γ production in vivo, while vitamin B1, B6, and B12 worked on macrophages and releasing cytokines. Therefore, the present study was to evaluate the effect of probiotics and vitamin B supplement on changes of plasma cytokine levels in active pulmonary TB. From October to November 2016, twelve M. tuberculosis-infected patients starting anti-TB drugs were recruited, then divided into two groups. Seven patients were given a combination of probiotics and vitamin B, while five patients were in the control group. Plasma IFN-γ and IL-6 levels were measured by the ELISA kit before and a month after treatment. IFN-γ levels raised in four patients receiving the supplement (P = 0.743), while IL-6 increased in three patients in this group until day 30 of treatment (P = 0.298). Taken together, these results show the promising effect of probiotics and vitamin B on stimulation of IFN-γ and IL-6 production during intensive therapy of TB.Keywords: interferon-gamma, interleukin-6, probiotic, tuberculosis
Procedia PDF Downloads 3492330 The Role of Vitamin D Supplementation in Augmenting IFN-γ Production in Response to Mycobacterium Tuberculosis Infection: A Randomized Controlled Trial
Authors: Muhammad Imran Hussain, Ramisha Ibtisam, Tayyaba Fatima, Huba Khalid, Ayesha Aziz, Khansa, Adan Sitara, Anam Shahzad, Aymen Jabeen
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Vitamin D supports the immune system fight TB by inhibiting Interferon-gamma (IFN-γ) and lowering host inflammation. The purpose of the research was to see if giving the vitamin D supplements to TB patients affected their prognosis. A randomized placebo control study of 200 TB patients was performed among which 106 received 400,000 IU of injectable vitamin D3 and 94 received placebo for 2 doses. Assessment was carried out at the end of every month for 3 months. IFN-γ responses to whole blood stimulation generated by the Mycobacterium tuberculosis sonicate (MTBs) antigen and early secreted and T cell activated 6 kDa (ESAT6) were assessed at 0 and 12 weeks. The statistical analysis used descriptive statistics (mean and standard deviation), Friedman's test and Fisher's test. The vitamin D group gained significantly more weight (+3.90 pounds) and had less persistent lung disease on imaging (1.33 zones vs. 1.84 zones). They also had a 50% decrease in cavity size. Additionally, patients with low baseline serum concentrations of 25-(OH)D had a significant increase in MTB-induced IFN-γ production after taking vitamin D supplements. Vitamin D administration in large amounts can hasten the recovery of TB patients. The findings point is a therapeutically useful activity of Vitamin D's in the management for tuberculosis.Keywords: tuberculosis, vitamin D, interferon gamma, protein, infection
Procedia PDF Downloads 522329 Influence of Cucurbitacin-Containing Phytonematicides on Growth of Rough Lemon (Citrus jambhiri)
Authors: Raisibe V. Mathabatha, Phatu W. Mashela, Nehemiah M. Mokgalong
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Occasional incidence of phytotoxicity in Nemarioc-BL and Nemafric-AL phytonematicides to crops raises credibility challenges that could negate their registration as commercial products. Responses of plants to phytonematicides are characterized by the existence of stimulation, neutral and inhibition phases, with the mid-point of the former being referred to as the Mean Concentration Stimulation Point (MSCP = Dm + Rh/2). The objective of this study was to determine the MCSP and the overall sensitivity (∑k) of Nemarioc-AL and Nemafric-BL phytonematicides to rough lemon seedling rootstocks using the Curve-fitting Allelochemical Response Dosage (CARD) computer-based model. Two parallel greenhouse experiments were initiated, with seven dilutions of each phytonematicide arranged in a randomised complete block design, replicated nine times. Six-month-old rough lemon seedlings were transplanted into 20-cm-diameter plastic pots, filled with steam-pasteurised river sand (300°C for 3 h) and Hygromix-T growing mixture. Treatments at 0, 2, 4, 8, 16, 32 and 164% dilutions were applied weekly at 300 ml/plant. At 84 days after the treatments, analysis of variance-significant plant variables was subjected to the CARD model to generate appropriate biological indices. Computed MCSP values for Nemarioc-AL and Nemafric-BL phytonematicides on rough lemon were 29 and 38%, respectively, whereas ∑k values were 1 and 0, respectively. At the applied concentrations, rough lemon seedlings were highly sensitive to Nemarioc-AL and Nemafric-BL phytonematicides.Keywords: crude extracts, cucurbitacins, effective microbes, fruit extracts
Procedia PDF Downloads 1462328 The Participation of Experts in the Criminal Policy on Drugs: The Proposal of a Cannabis Regulation Model in Spain by the Cannabis Policy Studies Group
Authors: Antonio Martín-Pardo
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With regard to the context in which this paper is inserted, it is noteworthy that the current criminal policy model in which we find immersed, denominated by some doctrine sector as the citizen security model, is characterized by a marked tendency towards the discredit of expert knowledge. This type of technic knowledge has been displaced by the common sense and by the daily experience of the people at the time of legislative drafting, as well as by excessive attention to the short-term political effects of the law. Despite this criminal-political adverse scene, we still find valuable efforts in the side of experts to bring some rationality to the legislative development. This is the case of the proposal for a new cannabis regulation model in Spain carried out by the Cannabis Policy Studies Group (hereinafter referred as ‘GEPCA’). The GEPCA is a multidisciplinary group composed by authors with multiple/different orientations, trajectories and interests, but with a common minimum objective: the conviction that the current situation regarding cannabis is unsustainable and, that a rational legislative solution must be given to the growing social pressure for the regulation of their consumption and production. This paper details the main lines through which this technical proposal is developed with the purpose of its dissemination and discussion in the Congress. The basic methodology of the proposal is inductive-expository. In that way, firstly, we will offer a brief, but solid contextualization of the situation of cannabis in Spain. This contextualization will touch on issues such as the national regulatory situation and its relationship with the international context; the criminal, judicial and penitentiary impact of the offer and consumption of cannabis, or the therapeutic use of the substance, among others. In second place, we will get down to the business properly by detailing the minutia of the three main cannabis access channels that are proposed. Namely: the regulated market, the associations of cannabis users and personal self-cultivation. In each of these options, especially in the first two, special attention will be paid to both, the production and processing of the substance and the necessary administrative control of the activity. Finally, in a third block, some notes will be given on a series of subjects that surround the different access options just mentioned above and that give fullness and coherence to the proposal outlined. Among those related issues we find some such as consumption and tenure of the substance; the issue of advertising and promotion of cannabis; consumption in areas of special risk (work or driving v. g.); the tax regime; the need to articulate evaluation instruments for the entire process; etc. The main conclusion drawn from the analysis of the proposal is the unsustainability of the current repressive system, clearly unsuccessful, and the need to develop new access routes to cannabis that guarantee both public health and the rights of people who have freely chosen to consume it.Keywords: cannabis regulation proposal, cannabis policies studies group, criminal policy, expertise participation
Procedia PDF Downloads 1192327 Damage of Laminated Corrugated Sandwich Panels under Inclined Impact Loading
Authors: Muhammad Kamran, Xue Pu, Naveed Ahmed
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Sandwich foam structures are efficient in impact energy absorption and making components lightweight; however their efficient use require a detailed understanding of its mechanical response. In this study, the foam core, laminated facings’ sandwich panel with internal triangular rib configuration is impacted by a spherical steel projectile at different angles using ABAQUS finite element package and damage mechanics is studied. Laminated ribs’ structure is sub-divided into three formations; all zeros, all 45 and optimized combination of zeros and 45 degrees. Impact velocity is varied from 250 m/s to 500 m/s with an increment of 50 m/s. The impact damage can significantly demolish the structural integrity and energy absorption due to fiber breakage, matrix cracking, and de-bonding. Macroscopic fracture study of the panel and core along with load-displacement responses and failure modes are the key parameters in the design of smart ballistic resistant structures. Ballistic impact characteristics of panels are studied on different speed, different inclination angles and its dependency on the base, and core materials, ribs formation, and cross-sectional spaces among them are determined. Impact momentum, penetration and kinetic energy absorption data and curves are compiled to predict the first and proximity impact in an effort to enhance the dynamic energy absorption.Keywords: dynamic energy absorption, proximity impact, sandwich panels, impact momentum
Procedia PDF Downloads 3882326 Enhancement of Mulberry Leaf Yield and Water Productivity in Eastern Dry Zone of Karnataka, India
Authors: Narayanappa Devakumar, Chengalappa Seenappa
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The field experiments were conducted during Rabi 2013 and summer 2014 at College of Sericulture, Chintamani, Chickaballapur district, Karnataka, India to find out the response of mulberry to different methods, levels of irrigation and mulching. The results showed that leaf yield and water productivity of mulberry were significantly influenced by different methods, levels of irrigation and mulching. Subsurface drip with lower level of irrigation at 0.8 CPE (Cumulative Pan Evaporation) recorded higher leaf yield and water productivity (42857 kg ha-1 yr-1and 364.41 kg hacm-1) than surface drip with higher level of irrigation at 1.0 CPE (38809 kg ha-1 yr-1 and 264.10 kg hacm-1) and micro spray jet (39931 kg ha-1 yr-1 and 271.83 kg hacm-1). Further, subsurface drip recorded minimum water used to produce one kg of leaf and to earn one rupee of profit (283 L and 113 L) compared to surface drip (390 L and 156 L) and micro spray jet (379 L and 152 L) irrigation methods. Mulberry leaf yield increased and water productivity decreased with increased levels of irrigation. However, these results indicated that irrigation of mulberry with subsurface drip increased leaf yield and water productivity by saving 20% of irrigation water than surface drip and micro spray jet irrigation methods in Eastern Dry Zone (EDZ) of Karnataka.Keywords: cumulative pan evaporation, mulaberry, subsurface drip irrigation, water productivity
Procedia PDF Downloads 2812325 Facilitating Social Connections with Neurodivergent Adolescents: An Exploratory Study of Youth Experiences in a Social Group Based on Dungeons and Dragons
Authors: Jonathon Smith, Alba Agostino
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Autism, also referred to as autism spectrum disorder (ASD), is commonly associated with difficulties in social and communication skills. Other characteristics common to autistic individuals include repetitive behaviours, difficulties adhering to routine, as well as paying attention. Recent findings indicate that autism is the fastest-growing neurodevelopmental disorder in North America, yet programming aimed at improving the quality of autistic individual’s real-world social interactions is limited. Although there are social skills programs for autistic youth, participation appears to improve social knowledge, but that knowledge does not improve social competence or transfer to the participant’s daily social interactions. Peers are less likely to interact with autistic people based thin slice judgements, meaning that even when an autistic youth has successfully completed a social skills program, they most likely will still be rejected by peers and not have a social group to participate in. Recently, many researchers are exploring therapeutic interventions using Dungeon and Dragons (D&D) for conditions such as social anxiety, loneliness, and identity exploration. D&D is a table-top role-playing game (TTRPG) based on social play experience where the players must communicate, plan, negotiate, and compromise with other players to achieve a shared goal. The game encourages players to assume the role of their character and act out their play within the rules of the game with the guidance of the games dungeon master. The popularity Dungeons and Dragons has increased at a rapid rate, and many suggest that there social-emotional benefits of joining and participating in these types of gaming experiences, however this is an under researched topic and studies examining the benefits of such games is lacking in the field. The main purpose of this exploratory study is to examine the autistic youth’s experiences of participating in a D&D club. Participants of this study were four high functioning autistic youth between the ages of 14-18 (average age – 16) enrolled in a D&D Club that was specifically designed for neurodiverse youth. The youth participation with the club ranged from 4 months to 8 months. All participants completed a 30–40-minute semi-structured interview where they were able to express their perceptions as participants of the D&D club. Preliminary findings suggest that the game provided a place for the youth to engage in authentic social interactions. Additionally, preliminary results suggest that the youth report being in a positive space with other neurodivergent youth created an atmosphere where they felt confident and could connect with others. The findings from this study will aid clinicians, researchers, and educators in developing programming aimed at improving social interactions and connections for autistic youth.Keywords: autism, social connection, dungeons and dragons, neurodivergent affirming space
Procedia PDF Downloads 272324 Amifostine Analogue, Drde-30, Attenuates Radiation-Induced Lung Injury in Mice
Authors: Aastha Arora, Vikas Bhuria, Saurabh Singh, Uma Pathak, Shweta Mathur, Puja P. Hazari, Rajat Sandhir, Ravi Soni, Anant N. Bhatt, Bilikere S. Dwarakanath
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Radiotherapy is an effective curative and palliative option for patients with thoracic malignancies. However, lung injury, comprising of pneumonitis and fibrosis, remains a significant clin¬ical complication of thoracic radiation, thus making it a dose-limiting factor. Also, injury to the lung is often reported as part of multi-organ failure in victims of accidental radiation exposures. Radiation induced inflammatory response in the lung, characterized by leukocyte infiltration and vascular changes, is an important contributing factor for the injury. Therefore, countermeasure agents to attenuate radiation induced inflammatory response are considered as an important approach to prevent chronic lung damage. Although Amifostine, the widely used, FDA approved radio-protector, has been found to reduce the radiation induced pneumonitis during radiation therapy of non-small cell lung carcinoma, its application during mass and field exposure is limited due to associated toxicity and ineffectiveness with the oral administration. The amifostine analogue (DRDE-30) overcomes this limitation as it is orally effective in reducing the mortality of whole body irradiated mice. The current study was undertaken to investigate the potential of DRDE-30 to ameliorate radiation induced lung damage. DRDE-30 was administered intra-peritoneally, 30 minutes prior to 13.5 Gy thoracic (60Co-gamma) radiation in C57BL/6 mice. Broncheo- alveolar lavage fluid (BALF) and lung tissues were harvested at 12 and 24 weeks post irradiation for studying inflammatory and fibrotic markers. Lactate dehydrogenase (LDH) leakage, leukocyte count and protein content in BALF were used as parameters to evaluate lung vascular permeability. Inflammatory cell signaling (p38 phosphorylation) and anti-oxidant status (MnSOD and Catalase level) was assessed by Western blot, while X-ray CT scan, H & E staining and trichrome staining were done to study the lung architecture and collagen deposition. Irradiation of the lung increased the total protein content, LDH leakage and total leukocyte count in the BALF, reflecting endothelial barrier dysfunction. These disruptive effects were significantly abolished by DRDE-30, which appear to be linked to the DRDE-30 mediated abrogation of activation of the redox-sensitive pro- inflammatory signaling cascade, the MAPK pathway. Concurrent administration of DRDE-30 with radiation inhibited radiation-induced oxidative stress by strengthening the anti-oxidant defense system and abrogated p38 mitogen-activated protein kinase activation, which was associated with reduced vascular leak and macrophage recruitment to the lungs. Histopathological examination (by H & E staining) of the lung showed radiation-induced inflammation of the lungs, characterized by cellular infiltration, interstitial oedema, alveolar wall thickening, perivascular fibrosis and obstruction of alveolar spaces, which were all reduced by pre-administration of DRDE-30. Structural analysis with X-ray CT indicated lung architecture (linked to the degree of opacity) comparable to un-irradiated mice that correlated well with the lung morphology and reduced collagen deposition. Reduction in the radiation-induced inflammation and fibrosis brought about by DRDE-30 resulted in a profound increase in animal survival (72 % in the combination vs 24% with radiation) observed at the end of 24 weeks following irradiation. These findings establish the potential of the Amifostine analogue, DRDE-30, in reducing radiation induced pulmonary injury by attenuating the inflammatory and fibrotic responses.Keywords: amifostine, fibrosis, inflammation, lung injury radiation
Procedia PDF Downloads 5102323 Parametric Investigation of Wire-Cut Electric Discharge Machining on Steel ST-37
Authors: Mearg Berhe Gebregziabher
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Wire-cut electric discharge machining (WEDM) is one of the advanced machining processes. Due to the development of the current manufacturing sector, there has been no research work done before about the optimization of the process parameters based on the availability of the workpiece of the Steel St-37 material in Ethiopia. Material Removal Rate (MRR) is considered as the experimental response of WCEDM. The main objective of this work is to investigate and optimize the process parameters on machining quality that gives high MRR during machining of Steel St-37. Throughout the investigation, Pulse on Time (TON), Pulse off Time (TOFF) and Velocities of Wire Feed (WR) are used as variable parameters at three different levels, and Wire tension, flow rate, type of dielectric fluid, type of the workpiece and wire material and dielectric flow rate are keeping as constants for each experiment. The Taguchi methodology, as per Taguchi‟ 's standard L9 (3^3) Orthogonal Array (OA), has been carried out to investigate their effects and to predict the optimal combination of process parameters over MRR. Signal to Noise ratio (S/N) and Analysis of Variance (ANOVA) were used to analyze the effect of the parameters and to identify the optimum cutting parameters on MRR. MRR was measured by using the Electronic Balance Model SI-32. The results indicated that the most significant factors for MRR are TOFF, TON and lastly WR. Taguchi analysis shows that, the optimal process parameters combination is A2B2C2, i.e., TON 6μs, TOFF 29μs and WR 2 m/min. At this level, the MRR of 0.414 gram/min has been achieved.Keywords: ANOVA, MRR, parameter, Taguchi Methode
Procedia PDF Downloads 432322 The Role of Formal and Informal Social Support in Predicting the Involvement of Mothers and Fathers of Young Children with Autism Spectrum Disorder
Authors: Adi Sharabi, Dafna Marom-Golan
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Parents’ involvement in the care of their children with Autism Spectrum Disorder (ASD) and its beneficial effect on the children’s developmental and educational outcomes is well documented. At the same time, parents of children with ASD tend to experience greater psychological distress than parents of children with other developmental disabilities or with typical development. Positive social support is an important resource used by parents to reduce their psychological distress. The goal of the current research was to examine the contribution of formal and informal social support in explaining mothers’ and fathers’ involvement with their young children with ASD. The sample consisted of 107 parents who live in Israel (61 mothers and 46 fathers) of children aged between 2 and 7, all diagnosed with ASD and attending special kindergartens or special day care for children with ASD. Parental involvement and social support perception were assessed. Initial analysis focused on the relations between involvement, support, and demographic variables. In addition, analysis of variance (ANOVA) was conducted to test differences between mothers and fathers. Two hierarchical multiple regression analyses were performed to examine the predicted factors in the involvement model while controlling for group (mothers/fathers). Results indicate that mothers reported significantly higher levels of parenting involvement than fathers. Mothers reported higher levels of general involvement and all sub-types of involvement. For example, mothers reported that they were more interested in and have higher levels of attendance in their child’s educational program. They were also more collaborative in their child’s educational therapeutic program, and socialized with other parents of children from their child’s kindergarten than fathers. Mothers’ involvement was found to be related to their informal support (non-formal relatives). Findings also reveal significant differences between mothers and fathers on the formal support subscale measure of specializes services. Fathers, more than mothers, reported more specializes services support such as social workers or professional therapists. Separate hierarchical multiple regression analyses revealed a unique gender difference in the factors that explained parental involvement. Specifically, informal support only had a unique positive contribution in explaining mothers’, but not fathers’ involvement. This study highlights the central role of mothers in maintaining constant contact with the educational system and the professionals who help care for their child with ASD. At the same time, this research emphasizes the crucial role of both mothers and fathers in their child's development and well-being at every development stage, particularly in early development. Further, different kinds of social support seem to relate to the different kinds of parental involvement. It is in the best interest of educators and family therapists who work with families with children with ASD to support the cohesiveness of the family and the collaboration of the parents by understanding and respecting the way each member addresses the responsibilities of parenting a child with ASD, and her or his need for different types of social support.Keywords: parental differences, parental involvement, social support, specialized support services
Procedia PDF Downloads 2472321 Weighted Data Replication Strategy for Data Grid Considering Economic Approach
Authors: N. Mansouri, A. Asadi
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Data Grid is a geographically distributed environment that deals with data intensive application in scientific and enterprise computing. Data replication is a common method used to achieve efficient and fault-tolerant data access in Grids. In this paper, a dynamic data replication strategy, called Enhanced Latest Access Largest Weight (ELALW) is proposed. This strategy is an enhanced version of Latest Access Largest Weight strategy. However, replication should be used wisely because the storage capacity of each Grid site is limited. Thus, it is important to design an effective strategy for the replication replacement task. ELALW replaces replicas based on the number of requests in future, the size of the replica, and the number of copies of the file. It also improves access latency by selecting the best replica when various sites hold replicas. The proposed replica selection selects the best replica location from among the many replicas based on response time that can be determined by considering the data transfer time, the storage access latency, the replica requests that waiting in the storage queue and the distance between nodes. Simulation results utilizing the OptorSim show our replication strategy achieve better performance overall than other strategies in terms of job execution time, effective network usage and storage resource usage.Keywords: data grid, data replication, simulation, replica selection, replica placement
Procedia PDF Downloads 2602320 Intelligent Chatbot Generating Dynamic Responses Through Natural Language Processing
Authors: Aarnav Singh, Jatin Moolchandani
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The proposed research work aims to build a query-based AI chatbot that can answer any question related to any topic. A chatbot is software that converses with users via text messages. In the proposed system, we aim to build a chatbot that generates a response based on the user’s query. For this, we use natural language processing to analyze the query and some set of texts to form a concise answer. The texts are obtained through web-scrapping and filtering all the credible sources from a web search. The objective of this project is to provide a chatbot that is able to provide simple and accurate answers without the user having to read through a large number of articles and websites. Creating an AI chatbot that can answer a variety of user questions on a variety of topics is the goal of the proposed research project. This chatbot uses natural language processing to comprehend user inquiries and provides succinct responses by examining a collection of writings that were scraped from the internet. The texts are carefully selected from reliable websites that are found via internet searches. This project aims to provide users with a chatbot that provides clear and precise responses, removing the need to go through several articles and web pages in great detail. In addition to exploring the reasons for their broad acceptance and their usefulness across many industries, this article offers an overview of the interest in chatbots throughout the world.Keywords: Chatbot, Artificial Intelligence, natural language processing, web scrapping
Procedia PDF Downloads 662319 Assessment of Analytical Equations for the Derivation of Young’s Modulus of Bonded Rubber Materials
Authors: Z. N. Haji, S. O. Oyadiji, H. Samami, O. Farrell
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The prediction of the vibration response of rubber products by analytical or numerical method depends mainly on the predefined intrinsic material properties such as Young’s modulus, damping factor and Poisson’s ratio. Such intrinsic properties are determined experimentally by subjecting a bonded rubber sample to compression tests. The compression tests on such a sample yield an apparent Young’s modulus which is greater in magnitude than the intrinsic Young’s modulus of the rubber. As a result, many analytical equations have been developed to determine Young’s modulus from an apparent Young’s modulus of bonded rubber materials. In this work, the applicability of some of these analytical equations is assessed via experimental testing. The assessment is based on testing of vulcanized nitrile butadiene rubber (NBR70) samples using tensile test and compression test methods. The analytical equations are used to determine the intrinsic Young’s modulus from the apparent modulus that is derived from the compression test data of the bonded rubber samples. Then, these Young’s moduli are compared with the actual Young’s modulus that is derived from the tensile test data. The results show significant discrepancy between the Young’s modulus derived using the analytical equations and the actual Young’s modulus.Keywords: bonded rubber, quasi-static test, shape factor, apparent Young’s modulus
Procedia PDF Downloads 1732318 Salinity Response of Some Chickpea (Cicer arietinum L.) Genotypes in Germination and Seedling Growth of Periods
Authors: Onder Aldemir, Ercan Ceyhan
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The research was conducted to determine effects of salt concentrations on emergence and seedling development of chickpea genotypes. Trials were performed during the year of 2013 on the laboratory and greenhouse of Agricultural Faculty, Selcuk University. Emergency trial was set up according to ‘Randomized Plots Design’ by two factors and four replications; greenhouse trial was also set up according to ‘Randomized Plots Design’ by two factors with three replications. The chickpea genotypes; CA119, CA132, CA149, CA150, CA215, CA222, CA235, CA261, Bozkır and Gokce were used as material for both of the trials. Effects of the five doses of salt concentrations (control, 30 mM, 60 mM, 90 mM and 120 mM) on the ratio of emergency, speed of emergency, average time for emergency, index of sensibility, length of shoot and root, fresh weight of shoot and root, dry weight of shoot and root, index of salt tolerance were evaluated. Responses of the chickpea genotypes for salt concentrations were found different. Comparing to the control, all of the investigated characteristics on the chickpea genotypes showed significant reduction by depending on the increasing salt level. According to the effects of salt application, the chickpea genotypes Gokce, CA215 and CA222 were the most tolerant in respect to plant dry weights while the chickpea genotypes CA149 and CA150 were the most sensitive.Keywords: chickpea, emergence, salt tolerant, seedling development
Procedia PDF Downloads 2342317 Ventilator Associated Pneumonia in a Medical Intensive Care Unit, Incidence and Risk Factors: A Case Control Study
Authors: Ammar Asma, Bouafia Nabiha, Ben Cheikh Asma, Ezzi Olfa, Mahjoub Mohamed, Sma Nesrine, Chouchène Imed, Boussarsar Hamadi, Njah Mansour
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Background: Ventilator-associated pneumonia (VAP) is currently recognized as one of the most relevant causes of morbidity and mortality among intensive care unit (ICU) patients worldwide. Identifying modifiable risk factors for VAP could be helpful for future controlled interventional studies aiming at improving prevention of VAP. The purposes of this study were to determine the incidence and risk factors for VAP in in a Tunisian medical ICU. Materials / Methods: A retrospective case-control study design based on the prospective database collected over a 14-month period from September 15th, 2015 through November 15th, 2016 in an 8-bed medical ICU. Patients under ventilation for over 48 h were included. The number of cases was estimated by Epi-info Software with the power of statistical test equal to 90 %. Each case patient was successfully matched to two controls according to the length of mechanical ventilation (MV) before VAP for cases and the total length of MV in controls. VAP in the ICU was defined according to American Thoracic Society; Infectious Diseases Society of America guidelines. Early onset or late-onset VAP were defined whether the infectious process occurred within or after 96 h of ICU admission. Patients’ risk factors, causes of admission, comorbidities and respiratory specimens collected were reviewed. Univariate and multivariate analyses were performed to determine variables associated with VAP with a p-value < 0.05. Results: During the period study, a total of 169 patients under mechanical ventilation were considered, 34 patients (20.11%) developed at least one episode of VAP in the ICU. The incidence rate for VAP was 14.88/1000 ventilation days. Among these cases, 9 (26.5 %) were early-onset VAP and 25 (73.5 %) were late-onset VAP. It was a certain diagnosis in 66.7% of cases. Tracheal aspiration was positive in 80% of cases. Multi-drug resistant Acinerobacter baumanii was the most common species detected in cases; 67.64% (n=23). The rate of mortality out of cases was 88.23% (n= 30). In univariate analysis, the patients with VAP were statistically more likely to suffer from cardiovascular diseases (p=0.035) and prolonged duration of sedation (p=0.009) and tracheostomy (p=0.001), they also had a higher number of re-intubation (p=0.017) and a longer total time of intubation (p=0.012). Multivariate analysis showed that cardiovascular diseases (OR= 4.44; 95% IC= [1.3 - 14]; p=0.016), tracheostomy (OR= 4.2; 95% IC= [1.16 -15.12]; p= 0.028) and prolonged duration of sedation (OR=1.21; 95% IC= [1.07, 1.36]; p=0.002) were independent risk factors for the development of VAP. Conclusion: VAP constitutes a therapeutic challenge in an ICU setting, therefore; strategies that effectively prevent VAP are needed. An infection control-training program intended to all professional heath care in this unit insisting on bundles and elaboration of procedures are planned to reduce effectively incidence rate of VAP.Keywords: case control study, intensive care unit, risk factors, ventilator associated pneumonia
Procedia PDF Downloads 395