Search results for: natural treatment
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 13354

Search results for: natural treatment

9094 Effect of Acid-Basic Treatments of Lingocellulosic Material Forest Wastes Wild Carob on Ethyl Violet Dye Adsorption

Authors: Abdallah Bouguettoucha, Derradji Chebli, Tariq Yahyaoui, Hichem Attout

Abstract:

The effect of acid -basic treatment of lingocellulosic material (forest wastes wild carob) on Ethyl violet adsorption was investigated. It was found that surface chemistry plays an important role in Ethyl violet (EV) adsorption. HCl treatment produces more active acidic surface groups such as carboxylic and lactone, resulting in an increase in the adsorption of EV dye. The adsorption efficiency was higher for treated of lingocellulosic material with HCl than for treated with KOH. Maximum biosorption capacity was 170 and 130 mg/g, for treated of lingocellulosic material with HCl than for treated with KOH at pH 6 respectively. It was also found that the time to reach equilibrium takes less than 25 min for both treated materials. The adsorption of basic dye (i.e., ethyl violet or basic violet 4) was carried out by varying some process parameters, such as initial concentration, pH and temperature. The adsorption process can be well described by means of a pseudo-second-order reaction model showing that boundary layer resistance was not the rate-limiting step, as confirmed by intraparticle diffusion since the linear plot of Qt versus t^0.5 did not pass through the origin. In addition, experimental data were accurately expressed by the Sips equation if compared with the Langmuir and Freundlich isotherms. The values of ΔG° and ΔH° confirmed that the adsorption of EV on acid-basic treated forest wast wild carob was spontaneous and endothermic in nature. The positive values of ΔS° suggested an irregular increase of the randomness at the treated lingocellulosic material -solution interface during the adsorption process.

Keywords: adsorption, isotherm models, thermodynamic parameters, wild carob

Procedia PDF Downloads 277
9093 Using Audio-Visual Aids and Computer-Assisted Language Instruction to Overcome Learning Difficulties of Sound System in Students of Special Needs

Authors: Sadeq Al Yaari, Ayman Al Yaari, Adham Al Yaari, Montaha Al Yaari, Aayah Al Yaari, Sajedah Al Yaari

Abstract:

Background & Objectives: Audio-visual aids and computer-assisted language instruction (CALI) effects are strong in teaching language components (sound system, grammatical structures and vocabulary) to students of special needs. To explore the effects of the audio-visual aids and CALI in teaching sound system to this class of students by speech language therapists (SLTs), an experiment has been undertaken to evaluate their performance during their study of the sound system course. Methods: Forty students (males and females) of special needs at al-Malādh school for teaching students of special needs in Dhamar (Yemen) range between 8 and 18 years old underwent this experimental study while they were studying language sound system course. Pre-and-posttests have been administered at the begging and end of the semester. Students' treatment was compared to a similar group (control group) of the same number under the same environment. Whereas the first group was taught using audio-visual aids and CALI, the second was not. Students' performances were linguistically and statistically evaluated. Results & conclusions: Compared with the control group, the treatment group showed significantly higher scores in the posttest (72.32% vs. 31%). Compared with females, males scored higher marks (1421 vs. 1472). Thus, we should take the audio-visual aids and CALI into consideration in teaching sound system to students of special needs.

Keywords: language components, sound system, audio-visual aids, CALI, students, special needs, SLTs

Procedia PDF Downloads 46
9092 Geochemical Baseline and Origin of Trace Elements in Soils and Sediments around Selibe-Phikwe Cu-Ni Mining Town, Botswana

Authors: Fiona S. Motswaiso, Kengo Nakamura, Takeshi Komai

Abstract:

Heavy metals may occur naturally in rocks and soils, but elevated quantities of them are being gradually released into the environment by anthropogenic activities such as mining. In order to address issues of heavy metal water and soil pollution, a distinction needs to be made between natural and anthropogenic anomalies. The current study aims at characterizing the spatial distribution of trace elements and evaluate site-specific geochemical background concentrations of trace elements in the mine soils examined, and also to discriminate between lithogenic and anthropogenic sources of enrichment around a copper-nickel mining town in Selibe-Phikwe, Botswana. A total of 20 Soil samples, 11 river sediment, and 9 river water samples were collected from an area of 625m² within the precincts of the mine and the smelter. The concentrations of metals (Cu, Ni, Pb, Zn, Cr, Ni, Mn, As, Pb, and Co) were determined by using an ICP-MS after digestion with aqua regia. Major elements were also determined using ED-XRF. Water pH and EC were measured on site and recorded while soil pH and EC were also determined in the laboratory after performing water elution tests. The highest Cu and Ni concentrations in soil are 593mg/kg and 453mg/kg respectively, which is 3 times higher than the crustal composition values and 2 times higher than the South African minimum allowable levels of heavy metals in soils. The level of copper contamination was higher than that of nickel and other contaminants. Water pH levels ranged from basic (9) to very acidic (3) in areas closer to the mine/smelter. There is high variation in heavy metal concentration, eg. Cu suggesting that some sites depict regional natural background concentrations while other depict anthropogenic sources.

Keywords: contamination, geochemical baseline, heavy metals, soils

Procedia PDF Downloads 162
9091 Judging Restoration Success of Kamisaigo River Japan

Authors: Rita Lopa, Yukihiro Shimatani

Abstract:

The focus of this research is 880m extension development along the Kamisaigo River. The river is flowing tributary of grade 2 rivers Fukutsu City, Fukuoka Prefecture. This river is a small-scale urban river and the river was formerly a straight concrete sea wall construction. The river runs through National Highway No. 3 from the confluence of Saigo River. The study covers the river basin about 326 ha with a catchment area of 20.63 ha and 4,700 m3 capacity regulating pond. The river is not wide, shallow, and has a straight alignment with active (un-vegetated) river channel sinuosity (ratio of river length to valley length) ranging between 1 and 1.3. However, the alignment of the low-flow river channel does have meandering or sinuous characteristics. Flooding is likely to occur. It has become difficult to live in the environment for organisms of the river. Hydrophilic is very low (children cannot play). There is little connection with the local community. Overall, the Kamisaigo River watershed is heavily urbanized and from a morphological, biological and habitat perspective, Kamisaigo River functions marginally not well. For river improvement and maintenance of the Kamisaigo River, the workshop was conducted in the form of planning for the proposed model is presented by the Watershed Management Laboratory. This workshop showed the relationship between citizens, City Government, and University of mutual trust has been established, that have been made landscape, environment, usage, etc.: retaining wall maintenance, hydrophilic zone, landscape zone, nature walks zone: adjacent medical facilities and adjacent to large commercial facilities. Propose of Nature walks zone with point of the design: provide slope that the wheelchair can access and walking paths to enjoy the scenery, and summary of the Kamisaigo River workshop: creating a multi-model study and creation of natural rivers.

Keywords: river restoration, river improvement, natural rivers, Saigo River

Procedia PDF Downloads 357
9090 A Case Study: Triumph Over Infertility and Premature Menopause Through Lifestyle Modification

Authors: Flora Tajiki

Abstract:

Infertility is a pervasive issue affecting women globally, profoundly impacting their psychological well-being and quality of life. This case study traces the six-year journey of a 35-year-old Iranian woman who married at 29 and grappled with infertility and premature menopause. Three years post-marriage, her initial pregnancy resulted in a miscarriage, followed by a year without successful conception. Diagnostic evaluations revealed small ovaries and a low AMH level of 0.19, leading to a diagnosis of premature menopause. Despite her primary therapist's recommendation to use a donated egg, she opted to pursue a comprehensive lifestyle modification approach through remote consultation with the author. The regimen encompassed regular physical activity, weight management, stress control, sleep regulation, meditation, abdominal massages, diaphragmatic breathing, and dietary changes toward a high-protein, low-carbohydrate diet. The recommended diet included nuts such as almonds and pistachios, as well as sprouted grains like wheat and mung beans. She was further advised to maintain adequate hydration and eliminate sugar, milk, preservatives, and processed foods. Regular follow-ups were conducted. Approximately three months into the regimen, the lifestyle overhaul led to a weight reduction from 99 kg to 89 kg and improved stress management. Remarkably, despite a continued decrease in AMH levels, she conceived naturally four months after adopting these lifestyle changes and is now the mother of a healthy 10-month-old girl. Similar cases under this healthy lifestyle approach, despite having low AMH levels, also resulted in successful pregnancies without IVF or hormone therapy. This underscores that AMH levels are not the sole determinant of fertility and that lifestyle modifications can play a significant role in overcoming infertility and achieving natural conception.

Keywords: egg donation, infertility, lifestyle Modification, natural conception, premature menopause

Procedia PDF Downloads 18
9089 Investigation of the Effects of Dry Needling With Stretching Upper Trapezius Muscle on Clinical Outcomes in Participants With Active Myofascial Trigger Point.

Authors: Marzieh Yassin, Fereshteh Navaee, Javad Sarrafzadeh, Reza Salehi

Abstract:

Introduction: Myofascial trigger point (MTrP) is one of the most common sources of musculoskeletal pain. Approximately 30-85% of the patients with musculoskeletal pains would experience MTrP in their life. The prevalence of MTrP has reported in the patients seen in a general orthopedic clinic, general medical clinic and specialty pain management centers, 21%, 30% and 93% respectively. Nowadays, dry needling is suggested as a standard treatment for MTrPs. The purpose of the present study was to examine the effectiveness of dry needling with stretching upper trapezius muscle on pain and pain pressure threshold in participants with active myofascial trigger point. Methods: Thirty participants with an active myofascial trigger point of the upper trapezius muscle were randomly divided into two groups: dry needling with passive stretch (n=15) and passive stretch alone (n=15). They received 5 sessions of the treatments for three weeks. The outcomes were pain intensity and pain pressure threshold that were assessed with visual analogue scale and algometer respectively. Results: Significant improvement in pain and pain pressure threshold was observed in both groups (P=0.0001) after the treatment. Also, the results showed a significant difference in measurements between two groups (P<0.05). Conclusion: Dry needling with passive stretch can be more effective on pain and pain pressure threshold than passive stretching alone in short term in participants with active myofascial trigger points.

Keywords: dry needling, myofascial pain syndrome, myofascial trigger point, stretching

Procedia PDF Downloads 67
9088 Encapsulated Western Red Cedar (Thuja Plicata) Essential Oil as a Prospective Biopesticide against Phytophthora Pathogens

Authors: Aleksandar M. Radojković, Jovana M. Ćirković, Sanja Z. Perać, Jelena N. Jovanović, Zorica M. Branković, Slobodan D. Milanović, Ivan Lj. Milenković, Jovan N. Dobrosavljević, Nemanja V. Simović, Vanja M. Tadić, Ana R. Žugić, Goran O. Branković

Abstract:

In many parts of the world, various Phytophthora species pose a serious threat to forests and crops. With the rapidly growing international trade in plants and the ongoing impacts of climate change, the harmful effects of plant pathogens of the genus Phytophthora are increasing, damaging the biodiversity and sustainability of forest ecosystems. This genus is one of the most destructive plant pathogens, causing the majority of fine root (66%) and collar rot diseases (90%) of woody plant species worldwide. Eco-friendly biopesticides, based on plant-derived products, such as essential oils (EOs), are one of the promising solutions to this problem. In this study, among three different EOs investigated (Chamaecyparis lawsoniana (A. Murr.) Parl., Thuja plicata Donn ex D.Don and Juniperus communis L.), western red cedar (Thuja plicata) essential oil almost completely inhibited the growth of three Phytophthora species (P. plurivora Jung and Burgess, P. quercina Jung, and P. ×cambivora (Petri) Buisman) during seven days of exposure for the EO concentrations of 0.1% and 0.5% (v/v). To prolong the inhibiting effect, Thuja plicata EO was encapsulated into a biopolymer matrix consisting of a chitosan-gelatin mixture to form a water-in-oil emulsion. This approach allowed the prolonged effect of the essential oil by its slow release from the biopolymer matrix and protection of the active components from atmospheric influences. Thus, it was demonstrated that encapsulated Thuja plicata EO consisting of sustainable bioproducts is efficient in controlling of Phytophthora species and can be considered a means of protection in natural and semi-natural ecosystems.

Keywords: emulsions, essential oils, phytophthora, thuja plicata

Procedia PDF Downloads 92
9087 New Targets Promoting Oncolytic Virotherapy

Authors: Felicia Segeth, Florian G. Klein, Lea Berger, Andreas Kolk, Per S. Holm

Abstract:

The entry of oncolytic viruses (OVs) into clinical application opens groundbreaking changes in current and future treatment regimens. However, despite their potent anti-cancer activity in vitro, clinical studies revealed limitations of OVs as monotherapy. The same applies to CDK 4/6 inhibitors (CDK4/6i) targeting cell cycle as well as bromodomain and extra-terminal domain inhibitors (BETi) targeting gene expression. In this study, the anti-tumoral effect of XVir-N-31, an YB-1 dependent oncolytic adenovirus, was evaluated in combination with Ribociclib, a CDK4/6i, and JQ1, a BETi. The head and neck squamous cell carcinoma (HNSCC) cell lines Fadu, SAS, and Cal-33 were used. DNA replication and gene expression of XVir-N-31 was measured by RT-qPCR, protein expression by western blotting, and cell lysis by SRB assays. Treatment with CDK4/6i and BETi increased viral gene expression, viral DNA replication, and viral particle formation. The data show that the combination of oncolytic adenovirus XVir-N-31 with CDK4/6i & BETi acts highly synergistic in cancer cell lysis. Furthermore, additional molecular analyses on this subject demonstrate that the positive transcription elongation factor P-TEFb plays a decisive role in this regard, indicating an influence of the combinational therapy on gene transcription control. The combination of CDK4/6i & BETi and XVir-N-31 is an attractive strategy to achieve substantial cancer cell killing and is highly suitable for clinical testing.

Keywords: adenovirus, BET, CDK4/6, HNSCC, P-TEFb, YB-1

Procedia PDF Downloads 118
9086 Evaluation of Certain Medicinal Plants for in vitro Anti-Oxidant and Anti-Glycation Activities

Authors: K. Shailaja

Abstract:

The advanced glycation end products (AGEs) formed between the reducing sugar and protein as a result of Oxidative stress and non-enzymatic glycosylation play an important role in pathogenesis of diabetes and aging complication. Glycation results in the production of free radicals. The oxidation process is believed to play an important role in AGEs formation. Thus agents with antioxidative property and antiglycation activity may retard the process of AGEs formation. Selected medicinal plants for the present study include Catharanthus roseus, Bougainvillea spectabilis (pink flowers), Cinnamomum tamala, Cinnamomum zeylanica, Abutilon indicum, Asparagus racemosus, and Sapindus emarginatus. The crude ethanolic extracts of the selected medicinal plants at varying concentrations ranging from 1-100 mg/ml were evaluated for in vitro antioxidant and protein glycation activities by FRAP and glucose-BSA assay respectively. Among all the plants tested, Bougainvillea spectabilis, Catharanthus roseus and Abutilon indicum showed strong antioxidant activity The antioxidant activity was expressed as mg of Gallic acid/ gm sample which was found to be 4.3 mg, 1.3mg, and 1.3mg respectively for Bougainvillea spectabilis, Catharanthus roseus and Abutilon indicum. The results of inhibition of the initial glycation product i.e., fructosamine was found to be 35% for Asparagus racemosus, Cinnamomum tamala and Abutilon indicum followed by the other plant extracts. The results indicate that these plants are potential sources of natural antioxidants which have free radical scavenging activity and might be used not only for reducing oxidative stress in diabetes but also open a new research avenues in the field of Natural Products.

Keywords: in vitro antioxidant activity, anti-glycation activity, ethanol extracts, polyphenols, Catharanthus roseus, Cinnamomum tamala

Procedia PDF Downloads 430
9085 Psoriasis Diagnostic Test Development: Exploratory Study

Authors: Salam N. Abdo, Orien L. Tulp, George P. Einstein

Abstract:

The purpose of this exploratory study was to gather the insights into psoriasis etiology, treatment, and patient experience, for developing psoriasis and psoriatic arthritis diagnostic test. Data collection methods consisted of a comprehensive meta-analysis of relevant studies and psoriasis patient survey. Established meta-analysis guidelines were used for the selection and qualitative comparative analysis of psoriasis and psoriatic arthritis research studies. Only studies that clearly discussed psoriasis etiology, treatment, and patient experience were reviewed and analyzed, to establish a qualitative data base for the study. Using the insights gained from meta-analysis, an existing psoriasis patient survey was modified and administered to collect additional data as well as triangulate the results. The hypothesis is that specific types of psoriatic disease have specific etiology and pathophysiologic pattern. The following etiology categories were identified: bacterial, environmental/microbial, genetic, immune, infectious, trauma/stress, and viral. Additional results, obtained from meta-analysis and confirmed by patient survey, were the common age of onset (early to mid-20s) and type of psoriasis (plaque; mild; symmetrical; scalp, chest, and extremities, specifically elbows and knees). Almost 70% of patients reported no prescription drug use due to severe side effects and prohibitive cost. These results will guide the development of psoriasis and psoriatic arthritis diagnostic test. The significant number of medical publications classified psoriatic arthritis disease as inflammatory of an unknown etiology. Thus numerous meta-analyses struggle to report any meaningful conclusions since no definitive results have been reported to date. Therefore, return to the basics is an essential step to any future meaningful results. To date, medical literature supports the fact that psoriatic disease in its current classification could be misidentifying subcategories, which in turn hinders the success of studies conducted to date. Moreover, there has been an enormous commercial support to pursue various immune-modulation therapies, thus following a narrow hypothesis/mechanism of action that is yet to yield resolution of disease state. Recurrence and complications may be considered unacceptable in a significant number of these studies. The aim of the ongoing study is to focus on a narrow subgroup of patient population, as identified by this exploratory study via meta-analysis and patient survey, and conduct an exhaustive work up, aiming at mechanism of action and causality before proposing a cure or therapeutic modality. Remission in psoriasis has been achieved and documented in medical literature, such as immune-modulation, phototherapy, various over-the-counter agents, including salts and tar. However, there is no psoriasis and psoriatic arthritis diagnostic test to date, to guide the diagnosis and treatment of this debilitating and, thus far, incurable disease. Because psoriasis affects approximately 2% of population, the results of this study may affect the treatment and improve the quality of life of a significant number of psoriasis patients, potentially millions of patients in the United States alone and many more millions worldwide.

Keywords: biologics, early diagnosis, etiology, immune disease, immune modulation therapy, inflammation skin disorder, phototherapy, plaque psoriasis, psoriasis, psoriasis classification, psoriasis disease marker, psoriasis diagnostic test, psoriasis marker, psoriasis mechanism of action, psoriasis treatment, psoriatic arthritis, psoriatic disease, psoriatic disease marker, psoriatic patient experience, psoriatic patient quality of life, remission, salt therapy, targeted immune therapy

Procedia PDF Downloads 118
9084 Reinforcing Effects of Natural Micro-Particles on the Dynamic Impact Behaviour of Hybrid Bio-Composites Made of Short Kevlar Fibers Reinforced Thermoplastic Composite Armor

Authors: Edison E. Haro, Akindele G. Odeshi, Jerzy A. Szpunar

Abstract:

Hybrid bio-composites are developed for use in protective armor through positive hybridization offered by reinforcement of high-density polyethylene (HDPE) with Kevlar short fibers and palm wood micro-fillers. The manufacturing process involved a combination of extrusion and compression molding techniques. The mechanical behavior of Kevlar fiber reinforced HDPE with and without palm wood filler additions are compared. The effect of the weight fraction of the added palm wood micro-fillers is also determined. The Young modulus was found to increase as the weight fraction of organic micro-particles increased. However, the flexural strength decreased with increasing weight fraction of added micro-fillers. The interfacial interactions between the components were investigated using scanning electron microscopy. The influence of the size, random alignment and distribution of the natural micro-particles was evaluated. Ballistic impact and dynamic shock loading tests were performed to determine the optimum proportion of Kevlar short fibers and organic micro-fillers needed to improve impact strength of the HDPE. These results indicate a positive hybridization by deposition of organic micro-fillers on the surface of short Kevlar fibers used in reinforcing the thermoplastic matrix leading to enhancement of the mechanical strength and dynamic impact behavior of these materials. Therefore, these hybrid bio-composites can be promising materials for different applications against high velocity impacts.

Keywords: hybrid bio-composites, organic nano-fillers, dynamic shocking loading, ballistic impacts, energy absorption

Procedia PDF Downloads 113
9083 Intensity Modulated Radiotherapy of Nasopharyngeal Carcinomas: Patterns of Loco Regional Relapse

Authors: Omar Nouri, Wafa Mnejja, Nejla Fourati, Fatma Dhouib, Wicem Siala, Ilhem Charfeddine, Afef Khanfir, Jamel Daoud

Abstract:

Background and objective: Induction chemotherapy (IC) followed by concomitant chemo radiotherapy with intensity modulated radiation (IMRT) technique is actually the recommended treatment modality for locally advanced nasopharyngeal carcinomas (NPC). The aim of this study was to evaluate the prognostic factors predicting loco regional relapse with this new treatment protocol. Patients and methods: A retrospective study of 52 patients with NPC treated between June 2016 and July 2019. All patients received IC according to the protocol of the Head and Neck Radiotherapy Oncology Group (Gortec) NPC 2006 (3 TPF courses) followed by concomitant chemo radiotherapy with weekly cisplatin (40 mg / m2). Patients received IMRT with integrated simultaneous boost (SIB) of 33 daily fractions at a dose of 69.96 Gy for high-risk volume, 60 Gy for intermediate risk volume and 54 Gy for low-risk volume. Median age was 49 years (19-69) with a sex ratio of 3.3. Forty five tumors (86.5%) were classified as stages III - IV according to the 2017 UICC TNM classification. Loco regional relapse (LRR) was defined as a local and/or regional progression that occurs at least 6 months after the end of treatment. Survival analysis was performed according to Kaplan-Meier method and Log-rank test was used to compare anatomy clinical and therapeutic factors that may influence loco regional free survival (LRFS). Results: After a median follow up of 42 months, 6 patients (11.5%) experienced LRR. A metastatic relapse was also noted for 3 of these patients (50%). Target volumes coverage was optimal for all patient with LRR. Four relapses (66.6%) were in high-risk target volume and two (33.3%) were borderline. Three years LRFS was 85,9%. Four factors predicted loco regional relapses: histologic type other than undifferentiated (UCNT) (p=0.027), a macroscopic pre chemotherapy tumor volume exceeding 100 cm³ (p=0.005), a reduction in IC doses exceeding 20% (p=0.016) and a total cumulative cisplatin dose less than 380 mg/m² (p=0.0.34). TNM classification and response to IC did not impact loco regional relapses. Conclusion: For nasopharyngeal carcinoma, tumors with initial high volume and/or histologic type other than UCNT, have a higher risk of loco regional relapse. Therefore, they require a more aggressive therapeutic approaches and a suitable monitoring protocol.

Keywords: loco regional relapse, modulation intensity radiotherapy, nasopharyngeal carcinoma, prognostic factors

Procedia PDF Downloads 128
9082 Response of Newzealand Rabbits to Drinking Water Treated with PolyDADMAC

Authors: Amna Beshir Medani Ahmed, Samia Mohammed Ali El Badwi, Ahmed El Amin Mohammed

Abstract:

This work has been managed to yield toxicity information on water treatment agents in the Sudan namely polyDADMAC, using New Zealand rabbits at multiple daily oral doses for a period of 10 weeks. Thirty-three heads of New Zealand rabbits were divided into 11 groups, each of three. Group 1 animals were the undosed controls. Test groups of either species were given polyDADMAC at similar dose rates of 0.5, 2.5, 4.5, 10, 15, 20, 25, 50, 100 and 150 mg/kg body weight respectively for groups 2,3,4,5,6,7,8,9,10 and 11. Clinical signs were closely observed with postmortem and histopathological examinations. Chemical investigations included enzymatic concentrations of ALP, GOT, CK, GPT and LDH together with hematological changes in Hb, PCV, RBCs and WBCs. Mortalities occurred to variable degrees irrespective of the dose level. On polyDADMAC challenge, the test species showed clinical signs of dullness, loss of weight, anorexia, diarrhea, difficulty in respiration, hind limb paralysis and recumbency. Notably oral dosing with polyDADMAC caused lung emphysema, hepatic and renal dysfunctions, irregularity in enzymatic activities and serum metabolites, sloughing of intestinal epithelium, decreased electrolytes in serum, and splenic haemosiderosis. On evaluation of the above results, polyDADMAC was considered toxic to New Zealand rabbits at all dose rates tried. Practical implications of the results were highlighted and suggestions for future work were put forward.

Keywords: polydiallyldiethylaluminiumchloride (polyDADMAC), nubian goats, toxicity of drinking water, treatment of drinking water using chemicals

Procedia PDF Downloads 373
9081 Refractory Cardiac Arrest: Do We Go beyond, Do We Increase the Organ Donation Pool or Both?

Authors: Ortega Ivan, De La Plaza Edurne

Abstract:

Background: Spain and other European countries have implemented Uncontrolled Donation after Cardiac Death (uDCD) programs. After 15 years of experience in Spain, many things have changed. Recent evidence and technical breakthroughs achieved in resuscitation are relevant for uDCD programs and raise some ethical concerns related to these protocols. Aim: To rethink current uDCD programs in the light of recent evidence on available therapeutic procedures applicable to victims of out-of-hospital cardiac arrest (OHCA). To address the following question: What is the current standard of treatment owed to victims of OHCA before including them in an uDCD protocol? Materials and Methods: Review of the scientific and ethical literature related to both uDCD programs and innovative resuscitation techniques. Results: 1) The standard of treatment received and the chances of survival of victims of OHCA depend on whether they are classified as Non-Heart Beating Patients (NHBP) or Non-Heart-Beating-Donors (NHBD). 2) Recent studies suggest that NHBPs are likely to survive, with good quality of life, if one or more of the following interventions are performed while ongoing CPR -guided by suspected or known cause of OHCA- is maintained: a) direct access to a Cath Lab-H24 or/and to extra-corporeal life support (ECLS); b) transfer in induced hypothermia from the Emergency Medical Service (EMS) to the ICU; c) thrombolysis treatment; d) mobile extra-corporeal membrane oxygenation (mini ECMO) instituted as a bridge to ICU ECLS devices. 3) Victims of OHCA who cannot benefit from any of these therapies should be considered as NHBDs. Conclusion: Current uDCD protocols do not take into account recent improvements in resuscitation and need to be adapted. Operational criteria to distinguish NHBDs from NHBP should seek a balance between the technical imperative (to do whatever is possible), considerations about expected survival with quality of life, and distributive justice (costs/benefits). Uncontrolled DCD protocols can be performed in a way that does not hamper the legitimate interests of patients, potential organ donors, their families, the organ recipients, and the health professionals involved in these processes. Families of NHBDs’ should receive information which conforms to the ethical principles of respect of autonomy and transparency.

Keywords: uncontrolled donation after cardiac death resuscitation, refractory cardiac arrest, out of hospital cardiac, arrest ethics

Procedia PDF Downloads 237
9080 Potential of Ozonation and Phytoremediation to Reduce Hydrocarbon Levels Remaining after the Pilot Scale Microbial Based Bioremediation (Land-Farming) of a Heavily Polluted Soil

Authors: Hakima Althalb

Abstract:

Petroleum contamination of sandy soils is a severe environmental problem in Libya, but relatively little work has been carried out to optimize the bioremediation of such heavily contaminated soil, particularly at a pilot scale. The purpose of this research was to determine the potential for the microbial-based bioremediation of hydrocarbon-contaminated soil obtained from an oil refinery in Libya and to assess the potential of both ozonation and phytoremediation (both applied after initial bioremediation) to reduce residual hydrocarbon levels. Plots containing 500 kg soil (triplicates) (contaminated soil diluted with clean soil 50% volume) were set up, (designated as Land Treatment Units; LTUs) containing five different nutrient levels and mixtures (Urea + NPK (nitrogen; phosphor; potassium) mixtures) to obtain C:N:P ratios 100:10:1, and monitored for 90 days. Hydrocarbon levels, microbial numbers, and toxicity (EC50 using luminescent microbial based tests) were assessed. Hydrocarbon levels in non-diluted and diluted soil ranged from 20 733-22 366 mg/kg and from 16 000-17 000 mg/kg respectively. Although all the land treatment units revealed a significant hydrocarbon reduction over time, the highest reduction in hydrocarbon levels obtained was around 60%. For example, 63% hydrocarbon removal was observed using a mixture of urea and NPK with a C:N:P ratio of 100:10:1). Soil toxicity (as assessed using luminescence based toxicity assays) reduced in line with the reduction in total petroleum hydrocarbons observed. However, as relatively high residual TPH (total petroleum hydrocarbon) levels (ranging from 6033-14166mg/kg) were still present after initial bioremediation two ‘post-treatments’ (phytoremediation and ozonation) were attempted to remove residual hydrocarbons remaining. Five locally grown (agriculturally important) plant species were tested. The germination of all plants examined was strongly inhibited (80-100%) and seedlings failed to grow well in the contaminated soil, indicating that the previously bioremediated soils were still toxic to the plants. Subsequent ozonation followed by another bioremediation of soil was more successful than phytoremediation. But even the most promising successful treatment in this study (ozonation for 6 hours at 25ppm followed by bioremediation) still only removed approximately 31% of the residual hydrocarbons. Overall, this work showed that the bioremediation of such highly contaminated soils is difficult and that a combination of treatments would be required to achieve successful remediation. Even after initial dilution and bioremediation the soils remained toxic to plant growth and were therefore not suitable for phytoremediation.

Keywords: bioremediation, petroleum hydrocarbons, ozone, phytoremediation

Procedia PDF Downloads 183
9079 Portable Water Treatment for Flood Resilience

Authors: Alireza Abbassi Monjezi, Mohammad Hasan Shaheed

Abstract:

Flood, caused by excessive rainfall, monsoon, cyclone and tsunami is a common disaster in many countries of the world especially sea connected low-lying countries. A stand-alone self-powered water filtration module for decontamination of floodwater has been designed and modeled. A combination forward osmosis – low pressure reverse osmosis (FO-LPRO) system powered by solar photovoltaic-thermal (PVT) energy is investigated which could overcome the main barriers to water supply for remote areas and ensure off-grid filtration. The proposed system is designed to be small scale and portable to provide on-site potable water to communities that are no longer themselves mobile nor can be reached quickly by the aid agencies. FO is an osmotically driven process that uses osmotic pressure gradients to drive water across a controlled pore membrane from a feed solution (low osmotic pressure) to a draw solution (high osmotic pressure). This drops the demand for high hydraulic pressures and therefore the energy demand. There is also a tendency for lower fouling, easier fouling layer removal and higher water recovery. In addition, the efficiency of the PVT unit will be maximized through freshwater cooling which is integrated into the system. A filtration module with the capacity of 5 m3/day is modeled to treat floodwater and provide drinking water. The module can be used as a tool for disaster relief, particularly in the aftermath of flood and tsunami events.

Keywords: flood resilience, membrane desalination, portable water treatment, solar energy

Procedia PDF Downloads 288
9078 Optimization of Culture Conditions of Paecilomyces Tenuipes, Entomopathogenic Fungi Inoculated into the Silkworm Larva, Bombyx Mori

Authors: Sung-Hee Nam, Kwang-Gill Lee, You-Young Jo, HaeYong Kweon

Abstract:

Entomopathogenic fungi is a Cordyceps species that is isolated from dead silkworm and cicada. Fungi on cicadas were described in old Chinese medicinal books and From ancient times, vegetable wasps and plant worms were widely known to have active substance and have been studied for pharmacological use. Among many fungi belonging to the genus Cordyceps, Cordyceps sinensis have been demonstrated to yield natural products possessing various biological activities and many bioactive components. Generally, It is commonly used to replenish the kidney and soothe the lung, and for the treatment of fatigue. Due to their commercial and economic importance, the demand for Cordyceps has been rapidly increased. However, a supply of Cordyceps specimen could not meet the increasing demand because of their sole dependence on field collection and habitat destruction. Because it is difficult to obtain many insect hosts in nature and the edibility of host insect needs to be verified in a pharmacological aspect. Recently, this setback was overcome that P. tenuipes was able to be cultivated in a large scale using silkworm as host. Pharmacological effects of P. tenuipes cultured on silkworm such as strengthening immune function, anti-fatigue, anti-tumor activity and controlling liver etc have been proved. They are widely commercialized. In this study, we attempted to establish a method for stable growth inhibition of P. tenuipes on silkworm hosts and an optimal condition for synnemata formation. To determine optimum culturing conditions, temperature and light conditions were varied. The length and number of synnemata was highest at 25℃ temperature and 100~300 lux illumination. On an average, the synnemata of wild P. tenuipes measures 70 ㎜ in length and 20 in number; those of the cultured strain were relatively shorter and more in number. The number of synnemata may have increased as a result of inoculating the host with highly concentrated conidia, while the length may have decreased due to limited nutrition per individual. It is not able that changes in light illumination cause morphological variations in the synnemata. However, regulation of only light and temperature could not produce stromata like perithecia, asci, and ascospores. Yamanaka reported that although a complete fruiting body can be produced under optimal culture conditions, it should be regarded as synnemata because it does not develop into an ascoma bearing ascospores.

Keywords: paecilomyces tenuipes, entomopathogenic fungi, silkworm larva, bombyx mori

Procedia PDF Downloads 320
9077 Inhibition Effect of Natural Junipers Extract towards Steel Corrosion in HCl Solution

Authors: L. Bammou, M. Belkhaouda R. Salghi, L. Bazzi, B. Hammouti

Abstract:

Steel and steel-based alloys of different grades steel are extensively used in numerous applications where acid solutions are widely applied such as industrial acid pickling, industrial acid cleaning and oil-well acidizing. The use of chemical inhibitors is one of the most practical methods for the protection against corrosion in acidic media. Most of the excellent acid inhibitors are organic compounds containing nitrogen, oxygen, phosphorus and sulphur. The use of non-toxic inhibitors called green or eco-friendly environmental inhibitors is one of the solutions possible to prevent the corrosion of the material. These advantages have incited us to draw a large part of program of our laboratory to examine natural substances as corrosion inhibitors such as: prickly pear seed oil, Argan oil, Argan extract, Fennel oil, Rosemary oil, Thymus oil, Lavender oil, Jojoba oil, Pennyroyal Mint oil, and Artemisia. In the present work, we investigate the corrosion inhibition of steel in 1 M HCl by junipers extract using weight loss, potentiodynamic polarization and electrochemical impedance spectroscopy (EIS) methods. The result obtained of junipers extract (JE) shows excellent inhibition properties for the corrosion of C38 steel in 1M HCl at 298K, and the inhibition efficiency increases with increasing of the JE concentration. The inhibitor efficiencies determined by weight loss, Tafel polarisation and EIS methods are in reasonable agreement. Based on the polarisation results, the investigated junipers extract can be classified as mixed inhibitor. The calculated structural parameters show increase of the obtained Rct values and decrease of the capacitance, Cdl, with JE concentration increase. It is suggested to attribute this to the increase of the thickness of the adsorption layer at steel surface. The adsorption model obeys to the Langmuir adsorption isotherm. The adsorption process is a spontaneous and exothermic process.

Keywords: corrosion inhibition, steel, friendly inhibitors, Tafel polarisation

Procedia PDF Downloads 522
9076 Antiinflammatory and Wound Healing Activity of Sedum Essential Oils Growing in Kazakhstan

Authors: Dmitriy Yu. Korulkin, Raissa A. Muzychkina

Abstract:

The last decade the growth of severe and disseminated forms of inflammatory diseases is observed in Kazakhstan, in particular, septic shock, which progresses on 3-15% of patients with infectious complications of postnatal period. In terms of the rate of occurrence septic shock takes third place after hemorrhagic and cardiovascular shock, in terms of lethality it takes first place. The structure of obstetric sepsis has significantly changed. Currently the first place is taken by postabortive sepsis (40%) that is connected with usage of imperfect methods of artificial termination of pregnancy in late periods (intraamnial injection of sodium chloride, glucose). The second place is taken by postnatal sepsis (32%); the last place is taken by septic complications of caesarean section (28%). In this connection, search for and assessment of effectiveness of new medicines for treatment of postoperative infectious complications, having biostimulating effect and speeding up regeneration processes, is very promising and topical. Essential oil was obtained by the method hydrodistillation air-dry aerial part of Sedum L. plants using Clevenger apparatus. Pilot batch of plant medicinal product based on Sedum essential oils was produced by Chimpharm JSC, Santo Member of Polpharma Group (Kazakhstan). During clinical test of the plant medicinal product based on Sedum L. essential oils 37 female patients at the age from 35 to 57 with clinical signs of complicated postoperative processes and 12 new mothers with clinical signs of inflammatory process on sutures on anterior abdominal wall after caesarean section and partial disruption of surgical suture line on perineum were examined. Medicine usage methods - surgical wound treatment 2 times a day, treatment with other medicines of local action was not performed. Before and after treatment general clinical test, determination of immune status, bacterioscopic test of wound fluid was performed to all women, medical history data was taken into account, wound cleansing and healing time, full granulations, side effects and complications, satisfaction with the used medicine was assessed. On female patients with inflammatory infiltration and partial disruption of surgical suture line anesthetic wound healing effect of plant medicinal product based on Sedum L. essential oils was observed as early as on the second day after beginning of using it, wound cleansing took place, as a rule, within the first row days. Hyperemia in the area of suture line also was not observed for 2-3-d day of usage of medicine, good constant course was observed. The absence of clinical effect on this group of patients was not registered. The represented data give evidence of that clinical effect was accompanied with normalization of changed laboratory findings. No allergic responses or side effects were observed during usage of the plant medicinal products based on Sedum L. essential oils.

Keywords: antiinflammatory, bioactive substances, essential oils, isolation, sedum L., wound healing

Procedia PDF Downloads 268
9075 Analysis of Long-term Results After External Dacryocystorhinostomy Surgery in Patients Suffered from Diabetes Mellitus

Authors: N. Musayeva, N. Rustamova, N. Bagirov, S. Ibadov

Abstract:

Purpose: to analyze the long-term results of external dacryocystorhinostomy (DCR), which remains the preferred primary procedure in the surgical treatment of lacrimal duct obstruction in chronic dacryocystitis. Methodology: long-term results of external DCR (after 3 years) performed on 90 patients (90 eyes) with chronic dacryocystitis from 2018 to 2020 were evaluated. The Azerbaijan National Center of Ophthalmology, named after acad. Zarifa Aliyeva. 15 of the patients were men, 75 – women. The average age was 45±3.2 years. Surgical operations were performed under local anesthesia. All patients suffered from diabetes mellitus for more than 3 years. All patients underwent external DCR and silicone drainage (tube) was implanted. In the postoperative period (after 3 years), lacrimation, purulent discharge, and the condition of the scar at the operation site were assessed. Results: All patients were under observation for more than 18 months. In general, the effectiveness of the surgical operation was 93.34%. Recurrence of disease was observed in 6 patients and in 3 patients (3.33%), the scar at the site of the operation was rough (non-cosmetic). In 3 patients (3.33%) – the surgically formed anastomosis between the lacrimal sac and the nasal bone was obstructed by scar tissue. These patients were reoperated by trans canalicular laser DCR. Conclusion: Despite the long-term (more than a hundred years) use of external DCR, it remains one of the primary techniques in the surgery of chronic dacryocystitis. Due to the high success rate and good long-term results of DCR in the treatment of chronic dacryocystitis in patients suffering from diabetes mellitus, we recommend external DCR for this group of patients.

Keywords: chronic dacryocystitis, diabetes mellitus, external dacryocystorhinostomy, long-term results

Procedia PDF Downloads 69
9074 Evaluation of Triage Performance: Nurse Practice and Problem Classifications

Authors: Atefeh Abdollahi, Maryam Bahreini, Babak Choobi Anzali, Fatemeh Rasooli

Abstract:

Introduction: Triage becomes the main part of organization of care in Emergency department (ED)s. It is used to describe the sorting of patients for treatment priority in ED. The accurate triage of injured patients has reduced fatalities and improved resource usage. Besides, the nurses’ knowledge and skill are important factors in triage decision-making. The ability to define an appropriate triage level and their need for intervention is crucial to guide to a safe and effective emergency care. Methods: This is a prospective cross-sectional study designed for emergency nurses working in four public university hospitals. Five triage workshops have been conducted every three months for emergency nurses based on a standard triage Emergency Severity Index (ESI) IV slide set - approved by Iranian Ministry of Health. Most influential items on triage performance were discussed through brainstorming in workshops which then, were peer reviewed by five emergency physicians and two head registered nurses expert panel. These factors that might distract nurse’ attention from proper decisions included patients’ past medical diseases, the natural tricks of triage and system failure. After permission had been taken, emergency nurses participated in the study and were given the structured questionnaire. Data were analysed by SPSS 21.0. Results: 92 emergency nurses enrolled in the study. 30 % of nurses reported the past history of chronic disease as the most influential confounding factor to ascertain triage level, other important factors were the history of prior admission, past history of myocardial infarction and heart failure to be 20, 17 and 11 %, respectively. Regarding the concept of difficulties in triage practice, 54.3 % reported that the discussion with patients and family members was difficult and 8.7 % declared that it is hard to stay in a single triage room whole day. Among the participants, 45.7 and 26.1 % evaluated the triage workshops as moderately and highly effective, respectively. 56.5 % reported overcrowding as the most important system-based difficulty. Nurses were mainly doubtful to differentiate between the triage levels 2 and 3 according to the ESI VI system. No significant correlation was found between the work record of nurses in triage and the uncertainty in determining the triage level and difficulties. Conclusion: The work record of nurses hardly seemed to be effective on the triage problems and issues. To correct the deficits, training workshops should be carried out, followed by continuous refresher training and supportive supervision.

Keywords: assessment, education, nurse, triage

Procedia PDF Downloads 233
9073 Impacts of Public Insurance on Health Access and Outcomes: Evidence from India

Authors: Titir Bhattacharya, Tanika Chakraborty, Prabal K. De

Abstract:

Maternal and child health continue to be a significant policy focus in developing countries, including India. An emerging model in health care is the creation of public and private partnerships. Since the construction of physical infrastructure is costly, governments at various levels have tried to implement social health insurance schemes where a trust calculates insurance premiums and medical payments. Typically, qualifying families get full subsidization of the premium and get access to private hospitals, in addition to low cost public hospitals, for their tertiary care needs. We analyze one such pioneering social insurance scheme in the Indian state of Andhra Pradesh (AP). The Rajiv Aarogyasri program (RA) was introduced by the Government of AP on a pilot basis in 2007 and implemented in 2008. In this paper, we first examine the extent to which access to reproductive health care changed. For example, the RA scheme reimburses hospital deliveries leading us to expect an increase in institutional deliveries, particularly in private hospitals. Second, we expect an increase in institutional deliveries to also improve child health outcomes. Hence, we estimate if the program improved infant and child mortality. We use District Level Health Survey data to create annual birth cohorts from 2000-2015. Since AP was the only state in which such a state insurance program was implemented, the neighboring states constituted a plausible control group. Combined with the policy timing, and the year of birth, we employ a difference-indifference strategy to identify the effects of RA on the residents of AP. We perform several checks against threats to identification, including testing for pre-treatment trends between the treatment and control states. We find that the policy significantly lowered infant and child mortality in AP. We also find that deliveries in private hospitals increased, and government hospitals decreased, showing a substitution effect of the relative price change. Finally, as expected, out-of-pocket costs declined for the treatment group. However, we do not find any significant effects for usual preventive care such as vaccination, showing that benefits of insurance schemes targeted at the tertiary level may not trickle down to the primary care level.

Keywords: public health insurance, maternal and child health, public-private choice

Procedia PDF Downloads 96
9072 Religion and Suicide: Exploration of the Relationship Between Religiosity and Suicidal Ideation among Young Adults

Authors: Sandra D. Prewitt

Abstract:

Introduction—The purpose of the extant study was to explore the relationship between religiosity and suicidal ideation. Through this exploration, further knowledge was sought relevant to gaining a better understanding regarding the higher suicide rate continuing to be experienced by young adults. Endeavoring to discover why the suicide rate continues to increase for the subject population, depression and anxiety emerged as major contributory risk factors. Although religiosity has been shown to be related to the reduced risk of suicidal behavior, the curative value of religion relevant to suicide prevention and treatment has not been sufficiently recognized. Considering the enormity of the current suicide problem, pursuits relevant to discovering effective tools enabling impactful prevention and treatment strategies remain essential to reducing suicide deaths. Methodology—The subject study was conducted utilizing a systematic literature review (SLR) which required the researcher to perform searches of appropriate databases, toward the goal of acquiring advanced knowledge based upon existing studies relevant to the subject matter under consideration. Major Findings—Depression and anxiety have been identified as two potential pathways leading to increased suicidal behavior. On the contrary, religiosity emerged as an important protective factor associated with less depression and therefore, fewer instances of suicidal thoughts. The protective nature of religion has been shown to extend to young adults without regard to the presence of identified potential suicidal behavior pathways.

Keywords: anxiety, depression, religion, suicide

Procedia PDF Downloads 219
9071 Fortification of Concentrated Milk Protein Beverages with Soy Proteins: Impact of Divalent Cations and Heating Treatment on the Physical Stability

Authors: Yichao Liang, Biye Chen, Xiang Li, Steven R. Dimler

Abstract:

This study investigated the effects of adding calcium and magnesium chloride on heat and storage stability of milk protein concentrate-soy protein isolate (8:2 respectively) mixtures containing 10% w/w total protein subjected to the in-container sterilization (115 °C x 15 min). The particle size does not change when emulsions are heated at pH between 6.7 and 7.3 irrespective of the mixed protein ratio. Increasing concentration of divalent cation salts resulted in an increase in protein particle size, dry sediment formation and sediment height and a decrease in pH, heat stability and hydration in milk protein concentrate-soy protein isolate mixtures solutions on sterilization at 115°C. Fortification of divalent cation salts in milk protein concentrate-soy protein isolate mixture solutions resulted in an accelerated protein sedimentation and two unique sediment regions during accelerated storage stability testing. Moreover, the heat stability decreased upon sterilization at 115°C, with addition of MgCl₂ causing a greater increase in sedimentation velocity and compressibility than CaCl₂. Increasing pH value of protein milk concentrate-soy protein isolate mixtures solutions from 6.7 to 7.2 resulted in an increase in viscosity following the heat treatment. The study demonstrated that the type and concentration of divalent cation salts used strongly impact heat and storage stability of milk protein concentrate-soy protein isolate mixture nutritional beverages.

Keywords: divalent cation salts, heat stability, milk protein concentrate, soy protein isolate, storage stability

Procedia PDF Downloads 331
9070 Measurement of Radon Exhalation Rate, Natural Radioactivity, and Radiation Hazard Assessment in Soil Samples from the Surrounding Area of Kasimpur Thermal Power Plant Kasimpur (U. P.), India

Authors: Anil Sharma, Ajay Kumar Mahur, R. G. Sonkawade, A. C. Sharma, R. Prasad

Abstract:

In coal fired thermal power stations, large amount of fly ash is produced after burning of coal. Fly ash is spread and distributed in the surrounding area by air and may be deposited on the soil of the region surrounding the power plant. Coal contains increased levels of these radionuclides and fly ash may increase the radioactivity in the soil around the power plant. Radon atoms entering into the pore space from the mineral grain are transported by diffusion and advection through this space until they in turn decay or are released into the atmosphere. In the present study, Soil samples were collected from the region around a Kasimpur Thermal Power Plant, Kasimpur, Aligarh (U.P.). Radon activity, radon surface exhalation and mass exhalation rates were measured using “sealed can technique” using LR 115-type II nuclear track detectors. Radon activities vary from 92.9 to 556.8 Bq m-3 with mean value of 279.8 Bq m-3. Surface exhalation rates (EX) in these samples are found to vary from 33.4 to 200.2 mBq m-2 h-1 with an average value of 100.5 mBq m-2 h-1 whereas, Mass exhalation rates (EM) vary from 1.2 to 7.7 mBq kg-1 h-1 with an average value of 3.8 mBq kg-1 h-1. Activity concentrations of radionuclides were measured in these samples by using a low level NaI (Tl) based gamma ray spectrometer. Activity concentrations of 226Ra 232Th and 40K vary from 12 to 49 Bq kg-1, 24 to 49 Bq kg-1 and 135 to 546 Bq kg-1 with overall mean values of 30.3 Bq kg-1, 38.5 Bq kg-1 and 317.8 Bq kg-1, respectively. Radium equivalent activity has been found to vary from 80.0 to 143.7 Bq kg-1 with an average value of 109.7 Bq kg-1. Absorbed dose rate varies from 36.1 to 66.4 nGy h-1 with an average value of 50.4 nGy h-1 and corresponding outdoor annual effective dose varies from 0.044 to 0.081 mSv with an average value of 0.061 mSv. Values of external and internal hazard index Hex, Hin in this study vary from 0.21 to 0.38 and 0.27 to 0.50 with an average value of 0.29 and 0.37, Respectively. The results will be discussed in light of various factors.

Keywords: natural radioactivity, radium equivalent activity, absorbed dose rate, gamma ray spectroscopy

Procedia PDF Downloads 362
9069 Investigation of Azol Resistance in Aspergillosis Caused by Gradient Test and Agar Plaque Methods

Authors: Zeynep Yazgan, Gökhan Aygün, Reyhan Çalışkan

Abstract:

Objective: Invasive fungal infections are a serious threat in terms of morbidity and mortality, especially in immunocompromised patients. The most frequently isolated agents are Aspergillus genus fungi, and sensitivity to azoles, which are the first choice in treatment, decreases. In our study, we aimed to investigate the use of the agar plate screening method as a fast, easy, and practical method in determining azole resistance in Aspergillus spp. species. Methods: Our study was conducted with 125 Aspergillus spp. isolates produced from various clinical samples. Aspergillus spp. isolates were identified by conventional methods and azole resistance was determined by gradient test and agar plate screening method. Broth microdilution method was applied to resistant isolates, and CypA-L98H and CypA-M220 mutations in the cyp51A gene were investigated. Results: In our study, 55 A. fumigatus complex (44%), 42 A. flavus (33.6%), 6 A. terreus (5%), 4 A. niger (3%) and 18 Aspergillus spp. (14%) were identified. With the gradient test method, resistance to VOR and POS was detected in 1 (1.8%) of A.fumigatus isolates, and resistance to ITR was detected in 3 (5.45%). With the agar plate method, 1 of the A.fumigatus isolates (1.8%) had VOR, ITR, POS, 1 of the A.terreus isolates (16.7%) had VOR, 1 of the A.niger isolates (25%) had ITR. Resistance to VOR and POS was detected in 2 Aspergillus spp. isolates (11%), and resistance to ITR was detected in 1 (5.6%). Sensitivity and specificity were determined as 100% for VOR and POS in A. fumigatus species, 33.3% and 100% for ITR, respectively, 100% for ITR in A. flavus species, and 100% for ITR and POS in A. terreus species. By broth microdilution method in 7 isolates in which resistance was detected by gradient test and/or agar plate screening method; 1 A.fumigatus resistant to ITR, VOR, POS, 2 A.fumigatus resistant to ITR, 2 Aspergillus spp. ITR, VOR, POS MICs were determined as 2µg/ml and 8µg/ml, 8µg/ml and >32µg/ml, 0.5µg/ml and 4µg/ml, respectively. CypA-L98H mutations were detected in 5 of these isolates, CypA-M220 mutations were detected in 6, and no mutation was detected in 1. CypA-L98H and CypA-M220 mutations were detected in 1 isolate for which resistance was not detected. Conclusion: The need for rapid antifungal susceptibility screening tests is increasing in the treatment of aspergillosis. Although the sensitivity of the agar plate method was determined to be 33.3% for A.fumigatus ITR in our study, its sensitivity and specificity were determined to be 100% for ITR, VOR, and POS in other species. The low sensitivity value detected for A.fumigatus showed that agar plate drug concentrations should be updated in accordance with the latest regulations of EUCAST guidelines. The CypA-L98H and CypA-M220 mutations detected in our study suggested that the distribution of azole resistance-related mutations in different regions in our country should be investigated. In conclusion, it is thought that the agar plate method, which can be easily applied to detect azole resistance, is a fast and practical method in routine use and can contribute to both the determination of effective treatment strategies and the generation of epidemiological data.

Keywords: Aspergillus, agar plate, azole resistance, cyp51A, cypA-L98H, cypA-M220

Procedia PDF Downloads 71
9068 SockGEL/PLUG: Injectable Nano-Scaled Hydrogel Platforms for Oral and Maxillofacial Interventional Application

Authors: Z. S. Haidar

Abstract:

Millions of teeth are removed annually, and dental extraction is one of the most commonly performed surgical procedures globally. Whether due to caries, periodontal disease, or trauma, exodontia and the ensuing wound healing and bone remodeling processes of the resultant socket (hole in the jaw bone) usually result in serious deformities of the residual alveolar osseous ridge and surrounding soft tissues (reduced height/width). Such voluminous changes render the placement of a proper conventional bridge, denture, or even an implant-supported prosthesis extremely challenging. Further, most extractions continue to be performed with no regard for preventing the onset of alveolar osteitis (also known as dry socket, a painful and difficult-to-treat/-manage condition post-exodontia). Hence, such serious resorptive morphological changes often result in significant facial deformities and a negative impact on the overall Quality of Life (QoL) of patients (and oral health-related QoL); alarming, particularly for the geriatric with compromised healing and in light of the thriving longevity statistics. Despite advances in tissue/wound grafting, serious limitations continue to exist, including efficacy and clinical outcome predictability, cost, treatment time, expertise, and risk of immune reactions. For cases of dry socket, specifically, the commercially available and often-prescribed home remedies are highly-lacking. Indeed, most are not recommended for use anymore. Alveogyl is a fine example. Hence, there is a great market demand and need for alternative solutions. Herein, SockGEL/PLUG (patent pending), an innovative, all-natural, drug-free, and injectable thermo-responsive hydrogel, was designed, formulated, characterized, and evaluated as an osteogenic, angiogenic, anti-microbial, and pain-soothing suture-free intra-alveolar dressing, safe and efficacious for use in fresh extraction sockets, immediately post-exodontia. It is composed of FDA-approved, biocompatible and biodegradable polymers, self-assembled electro-statically to formulate a scaffolding matrix to (1) prevent the on-set of alveolar osteitis via securing the fibrin-clot in situ and protecting/sealing the socket from contamination/infection; and (2) endogenously promote/accelerate wound healing and bone remodeling to preserve the volume of the alveolus. The intrinsic properties of the SockGEL/PLUG hydrogel were evaluated physical-chemical-mechanically for safety (cell viability), viscosity, rheology, bio-distribution, and essentially, capacity to induce wound healing and osteogenesis (small defect, in vivo) without any signaling cues from exogenous cells, growth factors or drugs. The proposed animal model of cranial critical-sized and non-vascularized bone defects shall provide new and critical insights into the role and mechanism of the employed natural bio-polymer blend and gel product in endogenous reparative regeneration of soft tissues and bone morphogenesis. Alongside, the fine-tuning of our modified formulation method will further tackle appropriateness, reproducibility, scalability, ease, and speed in producing stable, biodegradable, and sterilizable thermo-sensitive matrices (3-dimensional interpenetrating yet porous polymeric network) suitable for the intra-socket application. Findings are anticipated to provide sufficient evidence to translate into pilot clinical trials and validate the innovation before engaging the market for feasibility, acceptance, and cost-effectiveness studies.

Keywords: hydrogel, nanotechnology, bioengineering, bone regeneration, nanogel, drug delivery

Procedia PDF Downloads 112
9067 A Script for Presentation to the Management of a Teaching Hospital on MYCIN: A Clinical Decision Support System

Authors: Rashida Suleiman, Asamoah Jnr. Boakye, Suleiman Ahmed Ibn Ahmed

Abstract:

In recent years, there has been an enormous success in discoveries of scientific knowledge in medicine coupled with the advancement of technology. Despite all these successes, diagnoses and treatment of diseases have become complex. MYCIN is a groundbreaking illustration of a clinical decision support system (CDSS), which was developed to assist physicians in the diagnosis and treatment of bacterial infections by providing suggestions for antibiotic regimens. MYCIN was one of the earliest expert systems to demonstrate how CDSSs may assist human decision-making in complicated areas. Relevant databases were searched using google scholar, PubMed and general Google search, which were peculiar to clinical decision support systems. The articles were then screened for a comprehensive overview of the functionality, consultative style and statistical usage of MYCIN, a clinical decision support system. Inferences drawn from the articles showed some usage of MYCIN for problem-based learning among clinicians and students in some countries. Furthermore, the data demonstrated that MYCIN had completed clinical testing at Stanford University Hospital following years of research. The system (MYCIN) was shown to be extremely accurate and effective in diagnosing and treating bacterial infections, and it demonstrated how CDSSs might enhance clinical decision-making in difficult circumstances. Despite the challenges MYCIN presents, the benefits of its usage to clinicians, students and software developers are enormous.

Keywords: clinical decision support system, MYCIN, diagnosis, bacterial infections, support systems

Procedia PDF Downloads 147
9066 Inclusive, Just and Effective Transition: Comparing Market-Based and Redistributive Approaches to Sustainability

Authors: Karen Bell

Abstract:

While there is broad agreement among governments and civil society globally about the need to develop more sustainable societies, the best way to achieve this is still contested. In particular, there are differences regarding whether to continue to implement market-based approaches or to move to alternative redistributive-based approaches. In this paper, ‘Green Economy’ and ‘Living Well’ strategies are compared as examples of these two different strategies for achieving social, ecological and economic sustainability. The paper is based on a 3-year ESRC funded project on transitions to sustainability which examines the implementation of the ‘Green Economy’ paradigm in South Korea and the 'Living Well' paradigm in Bolivia. As well as outlining and analysing secondary data, the paper also draws on over 100 interviews with a range of local stakeholders in these countries carried out by the author between and including 2016 and 2018. The work indicates that the Living Well paradigm seems to better integrate social, ecological and economic concerns and may better deliver sustainability in the time frame necessary than the dominant Green Economy paradigm. This seems to be primarily because Living Well emphasises redistribution to reduce inequality and ensure human needs are met; living in harmony with nature, taking into account natural limits and cycles; respecting traditional values and practices where these support sustainability and human well-being; sovereignty and local control of natural resources; and participative decision-making, based on grassroots community organising. It is, therefore, argued that to achieve inclusive, just and effective transitions to sustainability we should aim to foster equality, respect planetary limits, build on local traditions, bring resources into public ownership and enhance participatory democracy. This will require a radically different approach to that offered within the market-based agenda currently dominating global sustainability debates and activities.

Keywords: environmental transition, green economy, inclusive sustainability, living well, sustainable transition

Procedia PDF Downloads 134
9065 Effect of Bull Exposure on Post-Partum Estrus Interval in Nili-Ravi Buffaloes

Authors: Muhammad Saleem Akhtar, Mushtaq Hussain Lashari, Ejaz Ahmad, Tanveer Ahmad, Laeeq Akbar Lodhi, Ijaz Ahmad, Masood Akhtar

Abstract:

The objective of this study was to determine the effect of bull exposure continuously or intermittently or its excretory products after calving on postpartum interval to estrus, in Nili-Ravi buffalo. Forty-eight buffaloes of Nili-Ravi breed were allocated one of the four treatments in a totally randomized plan using a 4 x 1 factorial design. The four treatment groups were BEC (Bull Exposed Continuously), BEI (Bull Exposed Intermittently), EPB (Excretory Products of Bull) and BNE (Bull Not Exposed). BEC; buffaloes (n = 12) were exposed continuously to the physical presence of a bull whereas in BEI; buffaloes (n = 12) were exposed intermittently to the physical presence of bull. EPB; buffaloes (n = 12) were exposed to discharge waste (urine and feces) of bull and BNE buffaloes (n = 12) were not exposed to a bull or discharge waste of bulls. Buffaloes were exposed on day 15 after parturition. Day 15 postpartum represented d 0 for each treatment. The postpartum interval from calving to first behavioural estrus was 66.88 days in BEC, 75.12 days in BEI, 77.28 days in EPB and 76.5 days in BNE treatments. Postpartum interval to first behavioural estrus was shorter in BEC than BEI, EPB, and BNE treatments. There was no significant difference in postpartum interval to estrus between BEI, EPB and BNE treatments. In present study, the percentage of buffaloes showing estrus during experimental period was 75.0%, 66.66%, 66.66% and 58.33% in BEC, BEI, EPB and BNE treatments, respectively. The mean serum progesterone concentration did not differ significantly between BEC and other (BEI, EPB, and BNE) treatments. It was concluded that presence of bull has positive effect in reducing calving interval in Nili Ravi buffalo.

Keywords: calving interval, biostimulation, buffalo, bull exposure

Procedia PDF Downloads 256