Search results for: mini gastric bypass
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 493

Search results for: mini gastric bypass

73 Miniature Fast Steering Mirrors for Space Optical Communication on NanoSats and CubeSats

Authors: Sylvain Chardon, Timotéo Payre, Hugo Grardel, Yann Quentel, Mathieu Thomachot, Gérald Aigouy, Frank Claeyssen

Abstract:

With the increasing digitalization of society, access to data has become vital and strategic for individuals and nations. In this context, the number of satellite constellation projects is growing drastically worldwide and is a next-generation challenge of the New Space industry. So far, existing satellite constellations have been using radio frequencies (RF) for satellite-to-ground communications, inter-satellite communications, and feeder link communication. However, RF has several limitations, such as limited bandwidth and low protection level. To address these limitations, space optical communication will be the new trend, addressing both very high-speed and secured encrypted communication. Fast Steering Mirrors (FSM) are key components used in optical communication as well as space imagery and for a large field of functions such as Point Ahead Mechanisms (PAM), Raster Scanning, Beam Steering Mirrors (BSM), Fine Pointing Mechanisms (FPM) and Line of Sight stabilization (LOS). The main challenges of space FSM development for optical communication are to propose both a technology and a supply chain relevant for high quantities New Space approach, which requires secured connectivity for high-speed internet, Earth planet observation and monitoring, and mobility applications. CTEC proposes a mini-FSM technology offering a stroke of +/-6 mrad and a resonant frequency of 1700 Hz, with a mass of 50 gr. This FSM mechanism is a good candidate for giant constellations and all applications on board NanoSats and CubeSats, featuring a very high level of miniaturization and optimized for New Space high quantities cost efficiency. The use of piezo actuators offers a high resonance frequency for optimal control, with almost zero power consumption in step and stay pointing, and with very high-reliability figures > 0,995 demonstrated over years of recurrent manufacturing for Optronics applications at CTEC.

Keywords: fast steering mirror, feeder link, line of sight stabilization, optical communication, pointing ahead mechanism, raster scan

Procedia PDF Downloads 80
72 Identification of Potent and Selective SIRT7 Anti-Cancer Inhibitor via Structure-Based Virtual Screening and Molecular Dynamics Simulation

Authors: Md. Fazlul Karim, Ashik Sharfaraz, Aysha Ferdoushi

Abstract:

Background: Computational medicinal chemistry approaches are used for designing and identifying new drug-like molecules, predicting properties and pharmacological activities, and optimizing lead compounds in drug development. SIRT7, a nicotinamide adenine dinucleotide (NAD+)-dependent deacylase which regulates aging, is an emerging target for cancer therapy with mounting evidence that SIRT7 downregulation plays important roles in reversing cancer phenotypes and suppressing tumor growth. Activation or altered expression of SIRT7 is associated with the progression and invasion of various cancers, including liver, breast, gastric, prostate, and non-small cell lung cancer. Objectives: The goal of this work was to identify potent and selective bioactive candidate inhibitors of SIRT7 by in silico screening of small molecule compounds obtained from Nigella sativa (N. sativa). Methods: SIRT7 structure was retrieved from The Research Collaboratory for Structural Bioinformatics Protein Data Bank (RCSB PDB), and its active site was identified using CASTp and metaPocket. Molecular docking simulation was performed with PyRx 0.8 virtual screening software. Drug-likeness properties were tested using SwissADME and pkCSM. In silico toxicity was evaluated by Osiris Property Explorer. Bioactivity was predicted by Molinspiration software. Antitumor activity was screened for Prediction of Activity Spectra for Substances (PASS) using Way2Drug web server. Molecular dynamics (MD) simulation was carried out by Desmond v3.6 package. Results: A total of 159 bioactive compounds from the N. Sativa were screened against the SIRT7 enzyme. Five bioactive compounds: chrysin (CID:5281607), pinocembrin (CID:68071), nigellidine (CID:136828302), nigellicine (CID:11402337), and epicatechin (CID:72276) were identified as potent SIRT7 anti-cancer candidates after docking score evaluation and applying Lipinski's Rule of Five. Finally, MD simulation identified Chrysin as the top SIRT7 anti-cancer candidate molecule. Conclusion: Chrysin, which shows a potential inhibitory effect against SIRT7, can act as a possible anti-cancer drug candidate. This inhibitor warrants further evaluation to check its pharmacokinetics and pharmacodynamics properties both in vitro and in vivo.

Keywords: SIRT7, antitumor, molecular docking, molecular dynamics simulation

Procedia PDF Downloads 79
71 Diagnostic Contribution of the MMSE-2:EV in the Detection and Monitoring of the Cognitive Impairment: Case Studies

Authors: Cornelia-Eugenia Munteanu

Abstract:

The goal of this paper is to present the diagnostic contribution that the screening instrument, Mini-Mental State Examination-2: Expanded Version (MMSE-2:EV), brings in detecting the cognitive impairment or in monitoring the progress of degenerative disorders. The diagnostic signification is underlined by the interpretation of the MMSE-2:EV scores, resulted from the test application to patients with mild and major neurocognitive disorders. The original MMSE is one of the most widely used screening tools for detecting the cognitive impairment, in clinical settings, but also in the field of neurocognitive research. Now, the practitioners and researchers are turning their attention to the MMSE-2. To enhance its clinical utility, the new instrument was enriched and reorganized in three versions (MMSE-2:BV, MMSE-2:SV and MMSE-2:EV), each with two forms: blue and red. The MMSE-2 was adapted and used successfully in Romania since 2013. The cases were selected from current practice, in order to cover vast and significant neurocognitive pathology: mild cognitive impairment, Alzheimer’s disease, vascular dementia, mixed dementia, Parkinson’s disease, conversion of the mild cognitive impairment into Alzheimer’s disease. The MMSE-2:EV version was used: it was applied one month after the initial assessment, three months after the first reevaluation and then every six months, alternating the blue and red forms. Correlated with age and educational level, the raw scores were converted in T scores and then, with the mean and the standard deviation, the z scores were calculated. The differences of raw scores between the evaluations were analyzed from the point of view of statistic signification, in order to establish the progression in time of the disease. The results indicated that the psycho-diagnostic approach for the evaluation of the cognitive impairment with MMSE-2:EV is safe and the application interval is optimal. The alternation of the forms prevents the learning phenomenon. The diagnostic accuracy and efficient therapeutic conduct derive from the usage of the national test norms. In clinical settings with a large flux of patients, the application of the MMSE-2:EV is a safe and fast psycho-diagnostic solution. The clinicians can draw objective decisions and for the patients: it doesn’t take too much time and energy, it doesn’t bother them and it doesn’t force them to travel frequently.

Keywords: MMSE-2, dementia, cognitive impairment, neuropsychology

Procedia PDF Downloads 515
70 Introducing the Concept of Sustainable Learning: Redesigning the Social Studies and Citizenship Education Curriculum in the Context of Saudi Arabia

Authors: Aiydh Aljeddani, Fran Martin

Abstract:

Sustainable human development is an essential component of a sustainable economic, social and environmental development. Addressing sustainable learning only through the addition of new teaching methods, or embedding certain approaches, is not sufficient on its own to support the goals of sustainable human development. This research project seeks to explore how the process of redesigning the current principles of curriculum based on the concept of sustainable learning could contribute to preparing a citizen who could later contribute towards sustainable human development. Multiple qualitative methodologies were employed in order to achieve the aim of this study. The main research methods were teachers’ field notes, artefacts, informal interviews (unstructured interview), a passive participant observation, a mini nominal group technique (NGT), a weekly diary, and weekly meeting. The study revealed that the integration of a curriculum for sustainable development, in addition to the use of innovative teaching approaches, highly valued by students and teachers in social studies’ sessions. This was due to the fact that it created a positive atmosphere for interaction and aroused both teachers and students’ interest. The content of the new curriculum also contributed to increasing students’ sense of shared responsibility through involving them in thinking about solutions for some global issues. This was carried out through addressing these issues through the concept of sustainable development and the theory of Thinking Activity in a Social Context (TASC). Students had interacted with sustainable development sessions intellectually and they also practically applied it through designing projects and cut-outs. Ongoing meetings and workshops to develop work between both the researcher and the teachers, and by the teachers themselves, played a vital role in implementing the new curriculum. The participation of teachers in the development of the project through working papers, exchanging experiences and introducing amendments to the students' environment was also critical in the process of implementing the new curriculum. Finally, the concept of sustainable learning can contribute to the learning outcomes much better than the current curriculum and it can better develop the learning objectives in educational institutions.

Keywords: redesigning, social studies and citizenship education curriculum, sustainable learning, thinking activity in a social context

Procedia PDF Downloads 231
69 From Battles to Balance and Back: Document Analysis of EU Copyright in the Digital Era

Authors: Anette Alén

Abstract:

Intellectual property (IP) regimes have traditionally been designed to integrate various conflicting elements stemming from private entitlement and the public good. In IP laws and regulations, this design takes the form of specific uses of protected subject-matter without the right-holder’s consent, or exhaustion of exclusive rights upon market release, and the like. More recently, the pursuit of ‘balance’ has gained ground in the conceptualization of these conflicting elements both in terms of IP law and related policy. This can be seen, for example, in European Union (EU) copyright regime, where ‘balance’ has become a key element in argumentation, backed up by fundamental rights reasoning. This development also entails an ever-expanding dialogue between the IP regime and the constitutional safeguards for property, free speech, and privacy, among others. This study analyses the concept of ‘balance’ in EU copyright law: the research task is to examine the contents of the concept of ‘balance’ and the way it is operationalized and pursued, thereby producing new knowledge on the role and manifestations of ‘balance’ in recent copyright case law and regulatory instruments in the EU. The study discusses two particular pieces of legislation, the EU Digital Single Market (DSM) Copyright Directive (EU) 2019/790 and the finalized EU Artificial Intelligence (AI) Act, including some of the key preparatory materials, as well as EU Court of Justice (CJEU) case law pertaining to copyright in the digital era. The material is examined by means of document analysis, mapping the ways ‘balance’ is approached and conceptualized in the documents. Similarly, the interaction of fundamental rights as part of the balancing act is also analyzed. Doctrinal study of law is also employed in the analysis of legal sources. This study suggests that the pursuit of balance is, for its part, conducive to new battles, largely due to the advancement of digitalization and more recent developments in artificial intelligence. Indeed, the ‘balancing act’ rather presents itself as a way to bypass or even solidify some of the conflicting interests in a complex global digital economy. Indeed, such a conceptualization, especially when accompanied by non-critical or strategically driven fundamental rights argumentation, runs counter to the genuine acknowledgment of new types of conflicting interests in the copyright regime. Therefore, a more radical approach, including critical analysis of the normative basis and fundamental rights implications of the concept of ‘balance’, is required to readjust copyright law and regulations for the digital era. Notwithstanding the focus on executing the study in the context of the EU copyright regime, the results bear wider significance for the digital economy, especially due to the platform liability regime in the DSM Directive and with the AI Act including objectives of a ‘level playing field’ whereby compliance with EU copyright rules seems to be expected among system providers.

Keywords: balance, copyright, fundamental rights, platform liability, artificial intelligence

Procedia PDF Downloads 31
68 Mediterranean Diet, Duration of Admission and Mortality in Elderly, Hospitalized Patients: A Cross-Sectional Study

Authors: Christos Lampropoulos, Maria Konsta, Ifigenia Apostolou, Vicky Dradaki, Tamta Sirbilatze, Irini Dri, Christina Kordali, Vaggelis Lambas, Kostas Argyros, Georgios Mavras

Abstract:

Objectives: Mediterranean diet has been associated with lower incidence of cardiovascular disease and cancer. The purpose of our study was to examine the hypothesis that Mediterranean diet may protect against mortality and reduce admission duration in elderly, hospitalized patients. Methods: Sample population included 150 patients (78 men, 72 women, mean age 80±8.2). The following data were taken into account in analysis: anthropometric and laboratory data, dietary habits (MedDiet score), patients’ nutritional status [Mini Nutritional Assessment (MNA) score], physical activity (International Physical Activity Questionnaires, IPAQ), smoking status, cause and duration of current admission, medical history (co-morbidities, previous admissions). Primary endpoints were mortality (from admission until 6 months afterwards) and duration of admission, compared to national guidelines for closed consolidated medical expenses. Logistic regression and linear regression analysis were performed in order to identify independent predictors for mortality and admission duration difference respectively. Results: According to MNA, nutrition was normal in 54/150 (36%) of patients, 46/150 (30.7%) of them were at risk of malnutrition and the rest 50/150 (33.3%) were malnourished. After performing multivariate logistic regression analysis we found that the odds of death decreased 30% per each unit increase of MedDiet score (OR=0.7, 95% CI:0.6-0.8, p < 0.0001). Patients with cancer-related admission were 37.7 times more likely to die, compared to those with infection (OR=37.7, 95% CI:4.4-325, p=0.001). According to multivariate linear regression analysis, admission duration was inversely related to Mediterranean diet, since it is decreased 0.18 days on average for each unit increase of MedDiet score (b:-0.18, 95% CI:-0.33 - -0.035, p=0.02). Additionally, the duration of current admission increased on average 0.83 days for each previous hospital admission (b:0.83, 95% CI:0.5-1.16, p<0.0001). The admission duration of patients with cancer was on average 4.5 days higher than the patients who admitted due to infection (b:4.5, 95% CI:0.9-8, p=0.015). Conclusion: Mediterranean diet adequately protects elderly, hospitalized patients against mortality and reduces the duration of hospitalization.

Keywords: Mediterranean diet, malnutrition, nutritional status, prognostic factors for mortality

Procedia PDF Downloads 313
67 Netnography Research in Leisure, Tourism, and Hospitality: Lessons from Research and Education

Authors: Marisa P. De Brito

Abstract:

The internet is affecting the way the industry operates and communicates. It is also becoming a customary means for leisure, tourism, and hospitality consumers to seek and exchange information and views on hotels, destinations events and attractions, or to develop social ties with other users. On the one hand, the internet is a rich field to conduct leisure, tourism, and hospitality research; on the other hand, however, there are few researchers formally embracing online methods of research, such as netnography. Within social sciences, netnography falls under the interpretative/ethnographic research methods umbrella. It is an adaptation of anthropological techniques such as participant and non-participant observation, used to study online interactions happening on social media platforms, such as Facebook. It is, therefore, a research method applied to the study of online communities, being the term itself a contraction of the words network (as on internet), and ethnography. It was developed in the context of marketing research in the nineties, and in the last twenty years, it has spread to other contexts such as education, psychology, or urban studies. Since netnography is not universally known, it may discourage researchers and educators from using it. This work offers guidelines for researchers wanting to apply this method in the field of leisure, tourism, and hospitality or for educators wanting to teach about it. This is done by means of a double approach: a content analysis of the literature side-by-side with educational data, on the use of netnography. The content analysis is of the incidental research using netnography in leisure, tourism, and hospitality in the last twenty years. The educational data is the author and her colleagues’ experience in coaching students throughout the process of writing a paper using primary netnographic data - from identifying the phenomenon to be studied, selecting an online community, collecting and analyzing data to writing their findings. In the end, this work puts forward, on the one hand, a research agenda, and on the other hand, an educational roadmap for those wanting to apply netnography in the field or the classroom. The educator’s roadmap will summarise what can be expected from mini-netnographies conducted by students and how to set it up. The research agenda will highlight for which issues and research questions the method is most suitable; what are the most common bottlenecks and drawbacks of the method and of its application, but also where most knowledge opportunities lay.

Keywords: netnography, online research, research agenda, educator's roadmap

Procedia PDF Downloads 182
66 Structural Property and Mechanical Behavior of Polypropylene–Elemental Sulfur (S8) Composites: Effect of Sulfur Loading

Authors: S. Vijay Kumar, Kishore K. Jena, Saeed M. Alhassan

Abstract:

Elemental sulfur is currently produced on the level of 70 million tons annually by petroleum refining, majority of which is used in the production of sulfuric acid, fertilizer and other chemicals. Still, over 6 million tons of elemental sulfur is generated in excess, which creates exciting opportunities to develop new chemistry to utilize sulfur as a feedstock for polymers. Development of new polymer composite materials using sulfur is not widely explored and remains an important challenge in the field. Polymer nanocomposites prepared by carbon nanotube, graphene, silica and other nanomaterials were well established. However, utilization of sulfur as filler in the polymer matrix could be an interesting study. This work is to presents the possibility of utilizing elemental sulfur as reinforcing fillers in the polymer matrix. In this study we attempted to prepare polypropylene/sulfur nanocomposite. The physical, mechanical and morphological properties of the newly developed composites were studied according to the sulfur loading. In the sample preparation, four levels of elemental sulfur loading (5, 10, 20 and 30 wt. %) were designed. Composites were prepared by the melt mixing process by using laboratory scale mini twin screw extruder at 180°C for 15 min. The reaction time and temperature were maintained constant for all prepared composites. The structure and crystallization behavior of composites was investigated by Raman, FTIR, XRD and DSC analysis. It was observed that sulfur interfere with the crystalline arrangement of polypropylene and depresses the crystallization, which affects the melting point, mechanical and thermal stability. In the tensile test, one level of test temperature (room temperature) and crosshead speed (10 mm/min) was designed. Tensile strengths and tensile modulus of the composites were slightly decreased with increasing in filler loading, however, percentage of elongation improved by more than 350% compared to neat polypropylene. The effect of sulfur on the morphology of polypropylene was studied with TEM and SEM techniques. Microscope analysis revels that sulfur is homogeneously dispersed in polymer matrix and behaves as single phase arrangement in the polymer. The maximum elongation for the polypropylene can be achieved by adjusting the sulfur loading in the polymer. This study reviles the possibility of using elemental sulfur as a solid plasticizer in the polypropylene matrix.

Keywords: crystallization, elemental sulfur, morphology, thermo-mechanical properties, polypropylene, polymer nanocomposites

Procedia PDF Downloads 346
65 Incidences and Factors Associated with Perioperative Cardiac Arrest in Trauma Patient Receiving Anesthesia

Authors: Visith Siriphuwanun, Yodying Punjasawadwong, Suwinai Saengyo, Kittipan Rerkasem

Abstract:

Objective: To determine incidences and factors associated with perioperative cardiac arrest in trauma patients who received anesthesia for emergency surgery. Design and setting: Retrospective cohort study in trauma patients during anesthesia for emergency surgery at a university hospital in northern Thailand country. Patients and methods: This study was permitted by the medical ethical committee, Faculty of Medicine at Maharaj Nakorn Chiang Mai Hospital, Thailand. We clarified data of 19,683 trauma patients receiving anesthesia within a decade between January 2007 to March 2016. The data analyzed patient characteristics, traumas surgery procedures, anesthesia information such as ASA physical status classification, anesthesia techniques, anesthetic drugs, location of anesthesia performed, and cardiac arrest outcomes. This study excluded the data of trauma patients who had received local anesthesia by surgeons or monitoring anesthesia care (MAC) and the patient which missing more information. The factor associated with perioperative cardiac arrest was identified with univariate analyses. Multiple regressions model for risk ratio (RR) and 95% confidence intervals (CI) were used to conduct factors correlated with perioperative cardiac arrest. The multicollinearity of all variables was examined by bivariate correlation matrix. A stepwise algorithm was chosen at a p-value less than 0.02 was selected to further multivariate analysis. A P-value of less than 0.05 was concluded as statistically significant. Measurements and results: The occurrence of perioperative cardiac arrest in trauma patients receiving anesthesia for emergency surgery was 170.04 per 10,000 cases. Factors associated with perioperative cardiac arrest in trauma patients were age being more than 65 years (RR=1.41, CI=1.02–1.96, p=0.039), ASA physical status 3 or higher (RR=4.19–21.58, p < 0.001), sites of surgery (intracranial, intrathoracic, upper intra-abdominal, and major vascular, each p < 0.001), cardiopulmonary comorbidities (RR=1.55, CI=1.10–2.17, p < 0.012), hemodynamic instability with shock prior to receiving anesthesia (RR=1.60, CI=1.21–2.11, p < 0.001) , special techniques for surgery such as cardiopulmonary bypass (CPB) and hypotensive techniques (RR=5.55, CI=2.01–15.36, p=0.001; RR=6.24, CI=2.21–17.58, p=0.001, respectively), and patients who had a history of being alcoholic (RR=5.27, CI=4.09–6.79, p < 0.001). Conclusion: Incidence of perioperative cardiac arrest in trauma patients receiving anesthesia for emergency surgery was very high and correlated with many factors, especially age of patient and cardiopulmonary comorbidities, patient having a history of alcoholic addiction, increasing ASA physical status, preoperative shock, special techniques for surgery, and sites of surgery including brain, thorax, abdomen, and major vascular region. Anesthesiologists and multidisciplinary teams in pre- and perioperative periods should remain alert for warning signs of pre-cardiac arrest and be quick to manage the high-risk group of surgical trauma patients. Furthermore, a healthcare policy should be promoted for protecting against accidents in high-risk groups of the population as well.

Keywords: perioperative cardiac arrest, trauma patients, emergency surgery, anesthesia, factors risk, incidence

Procedia PDF Downloads 169
64 Functional Performance Needs of Individuals with Intellectual and Developmental Disabilities

Authors: Noor Taleb Ismael, Areej Abd Al Kareem Al Titi, Ala'a Fayez Jaber

Abstract:

Objectives: To investigate self-perceived functional performance among adults with IDD who are Jordanian residential care and rehabilitation centers residents. Also, to investigate their functional abilities (i.e., motor, and cognitive). In addition, to determine the motor and cognitive predictors of their functional performance. Methods: The study utilized a cross-sectional descriptive design; the sample included 180 individuals with IDD (90 males and 90 females) aged 18 to 75 years. The inclusion criteria encompassed: 1) Adults with a confirmed IDD by their physician’s professional and 2) residents in Jordanian Residential Care and Rehabilitation Centers affiliated with the Jordanian Ministry of Social Development. The exclusion criteria were: 1) bedridden or totally dependent on their care providers; 2) who had an accident or acquired neurological conditions. Researchers conducted semi-structured interviews to complete the outcome measures that include the Canadian Occupational Performance Measure (COPM), the Functional Independence Measure (FIM), the Montreal Cognitive Assessment (MoCA), the Mini-Mental Status Examination (MMSE), and the sociodemographic questionnaire. Data analyses consisted of descriptive statistics, analysis of frequencies, correlation, and regression analyses. Result: Individuals with IDD showed low functional performance in all daily life areas, including self-care, productivity, and leisure; there was severe cognitive impairment and poor independence and functional performance. (COPM Performance M= 1.433, SD±.57021, COPM Satisfaction M= 1.31, SD±.54, FIM M= 3.673, SD± 1.7918). Two predictive models were validated for the COPM performance and FIM total scores. First, significant predictors of high self-perceived functional performance on COPM were high scores on FIM Motor sub scores, FIM cognitive sub scores, young age, and having a high school educational level (R2=0.603, p=0.012). Second, significant predictors of high functional capacity on FIM were a high score on the COPM performance subscale, a high MMSE score, and having a cerebral palsy (CP) diagnosis (R2=0.671, p<0.001). Conclusions: Evaluating functional performance and associated factors is important in rehabilitation to provide better services and improve health and QoL for individuals with IDD. This study suggested conducting future studies targeting integrated individuals with IDD who live with their families in the communities.

Keywords: functional performance, intellectual and developmental disabilty, cognitive abilities, motor abilities

Procedia PDF Downloads 48
63 Functional Impairment in South African Children with ADHD: Design, Implementation and Evaluation of a Targeted Intervention

Authors: Mareli Fischer, Kevin G. F. Thomas

Abstract:

Although Attention-Deficit/Hyperactivity Disorder (ADHD) is one of the most prevalent childhood neurobehavioural disorders, little empirical research has been published on its clinical presentation in Africa, and, globally, few studies evaluate ADHD intervention programs that emphasize parent training. Hence, Stage 1 of this research programme aimed to describe the functional impairment of South African children with ADHD, and also sought to investigate the influence of sociodemographic variables (e.g., sex, age, socioeconomic status, family environment) and clinical variables (e.g., ADHD subtype and comorbidity) on the degree of that impairment. We used the Mini International Neuropsychiatric Interview for Children and Adolescents as a diagnostic tool, and the Child Behavior Checklist, the Strengths and Difficulties Questionnaire, and the Impairment Rating Scale as measures of functional impairment. Results from this stage of the research indicated that South African children and adolescents who meet diagnostic criteria for ADHD experience most functional impairment in the school domain, as well as in the area of social functioning. None of the measured sociodemographic variables had a significant detrimental or protective effect on how ADHD symptoms impacted on functioning. In terms of comorbidity, the presence of Major Depressive Disorder, Conduct Disorder, and Oppositional Defiant Disorder were all associated with significantly impaired overall functioning. Stage 2 of the research programme aimed to design, implement, and evaluate a child-specific intervention that targeted the primary areas of impairment identified in Stage 1. Existing literature suggests that a positive parent-training programme, in the group format, is one of the best options for cost-effective and successful ADHD intervention. Hence, the intervention took that form. Parents were taught basic behaviour analysis concepts within a supportive group context. Evaluation of the intervention’s efficacy used many of the same measures as in Stage 1, but also featured semi-structured interviews with participants and naturalistic observation of parent-child interaction. We will discuss preliminary results of that evaluation. Studying functional impairment and designing intervention plans in this way will pave the way for evidence-based treatment plans for children and adolescents diagnosed with ADHD.

Keywords: attention deficit/hyperactivity disorder, children, intervention, parenting groups

Procedia PDF Downloads 431
62 Teaching Kindness as Moral Virtue in Preschool Children: The Effectiveness of Picture-Storybook Reading and Hand-Puppet Storytelling

Authors: Rose Mini Agoes Salim, Shahnaz Safitri

Abstract:

The aim of this study is to test the effectiveness of teaching kindness in preschool children by using several techniques. Kindness is a physical act or emotional support aimed to build or maintain relationships with others. Kindness is known to be essential in the development of moral reasoning to distinguish between the good and bad things. In this study, kindness is operationalized as several acts including helping friends, comforting sad friends, inviting friends to play, protecting others, sharing, saying hello, saying thank you, encouraging others, and apologizing. It is mentioned that kindness is crucial to be developed in preschool children because this is the time the children begin to interact with their social environment through play. Furthermore, preschool children's cognitive development makes them begin to represent the world with words, which then allows them to interact with others. On the other hand, preschool children egocentric thinking makes them still need to learn to consider another person's perspective. In relation to social interaction, preschool children need to be stimulated and assisted by adult to be able to pay attention to other and act with kindness toward them. On teaching kindness to children, the quality of interaction between children and their significant others is the key factor. It is known that preschool children learn about kindness by imitating adults on their two way interaction. Specifically, this study examines two types of teaching techniques that can be done by parents as a way to teach kindness, namely the picture-storybook reading and hand-puppet storytelling. These techniques were examined because both activities are easy to do and both also provide a model of behavior for the child based on the character in the story. To specifically examine those techniques effectiveness in teaching kindness, two studies were conducted. Study I involves 31 children aged 5-6 years old with picture-storybook reading technique, where the intervention is done by reading 8 picture books for 8 days. In study II, hand-puppet storytelling technique is examined to 32 children aged 3-5 years old. The treatments effectiveness are measured using an instrument in the form of nine colored cards that describe the behavior of kindness. Data analysis using Wilcoxon Signed-rank test shows a significant difference on the average score of kindness (p < 0.05) before and after the intervention has been held. For daily observation, a ‘kindness tree’ and observation sheets are used which are filled out by the teacher. Two weeks after interventions, an improvement on all kindness behaviors measured is intact. The same result is also gained from both ‘kindness tree’ and observational sheets.

Keywords: kindness, moral teaching, storytelling, hand puppet

Procedia PDF Downloads 252
61 Television Is Useful in Promoting Safe Sexual Practices to Student Populations: A Mixed-Methods Questionnaire Exploring the Impact of Channel Four’s ‘It’s a Sin (2021)’

Authors: Betsy H. Edwards

Abstract:

Background: Public Health England recognises unprotected sex and consequent transmission of sexually transmitted infections (STIs) as significant problems within student populations. Government surveys show that 50% of sexually-active young adults engage in unprotected sex with new partners, with 10% never using condoms. The recent Channel Four mini-series ‘It’s a Sin’ dramatises the 1980s AIDS epidemic and has been praised for its educational value and for promoting safe sexual practices to its viewers. This mixed-methods questionnaire study aims to investigate whether the series can change attitudes towards safe sex in student populations, can promote the use of condoms in student populations, and whether television, in general, is a useful tool for promoting health education. Methods: A questionnaire, created on Microsoft Forms, was distributed to students at the University of Birmingham via Facebook groups between September 2021 and May 2022. To consent, participants had to be aged 18 or over, a student at the university, have seen the entire series of ‘It’s a Sin’, and read the study information. Data was confidentially stored within the University’s secured OneDrive in accordance with the study’s approved ethics application. Quantitative questions measured participants’ attitudes and behaviours using Likert scales. Qualitative data was analysed using thematic analysis. Quantitative Results: 78 students completed the questionnaire. 43 participants (55%) felt that the series ‘It’s a Sin’ promoted safe sex. 74 participants (96%) and 31 participants (39%) said they were ‘very likely’ or ‘likely’ to use condoms with a casual partner during penetrative sex and oral sex respectively. 27 participants (35%) felt that watching ‘It’s a Sin’ made them more likely to use condoms; of these 27 participants, all were ‘very likely’ or ‘likely’ to use condoms during penetrative sex, and 9 were ‘very likely’ or ‘likely’ to during oral sex. 49 participants (63%) and 53 participants (68%) felt that television is a good way to provide health education and to promote healthy behaviours respectively. Qualitative Results: 56 participants (72%) gave reasons why the series had been associated with an increased uptake in HIV testing. Three themes emerged: increased education and attention, decreased stigmatisation, and relatability of characters on screen. Conclusions: This study suggests that the series ‘It’s a Sin’ can influence attitudes towards and the uptake of safe sexual practices. It would be useful for further research - using larger, randomised samples - to explore impacts upon populations lesser-educated about sexual health, who potentially have more to gain from watching series such as ‘It’s a Sin’.

Keywords: GUM, It's a sin, media, sexual health, students, television, tv

Procedia PDF Downloads 96
60 Exploring the Relationship Between Helicobacter Pylori Infection and the Incidence of Bronchogenic Carcinoma

Authors: Jose R. Garcia, Lexi Frankel, Amalia Ardeljan, Sergio Medina, Ali Yasback, Omar Rashid

Abstract:

Background: Helicobacter pylori (H. pylori) is a gram-negative, spiral-shaped bacterium that affects nearly half of the population worldwide and humans serve as the principal reservoir. Infection rates usually follow an inverse relationship with hygiene practices and are higher in developing countries than developed countries. Incidence varies significantly by geographic area, race, ethnicity, age, and socioeconomic status. H. pylori is primarily associated with conditions of the gastrointestinal tract such as atrophic gastritis and duodenal peptic ulcers. Infection is also associated with an increased risk of carcinogenesis as there is evidence to show that H. pylori infection may lead to gastric adenocarcinoma and mucosa-associated lymphoid tissue (MALT) lymphoma. It is suggested that H. pylori infection may be considered as a systemic condition, leading to various novel associations with several different neoplasms such as colorectal cancer, pancreatic cancer, and lung cancer, although further research is needed. Emerging evidence suggests that H. pylori infection may offer protective effects against Mycobacterium tuberculosis as a result of non-specific induction of interferon- γ (IFN- γ). Similar methods of enhanced immunity may affect the development of bronchogenic carcinoma due to the antiproliferative, pro-apoptotic and cytostatic functions of IFN- γ. The purpose of this study was to evaluate the correlation between Helicobacter pylori infection and the incidence of bronchogenic carcinoma. Methods: The data was provided by a Health Insurance Portability and Accountability Act (HIPAA) compliant national database to evaluate the patients infected versus patients not infected with H. pylori using ICD-10 and ICD-9 codes. Access to the database was granted by the Holy Cross Health, Fort Lauderdale for the purpose of academic research. Standard statistical methods were used. Results:-Between January 2010 and December 2019, the query was analyzed and resulted in 163,224 in both the infected and control group, respectively. The two groups were matched by age range and CCI score. The incidence of bronchogenic carcinoma was 1.853% with 3,024 patients in the H. pylori group compared to 4.785% with 7,810 patients in the control group. The difference was statistically significant (p < 2.22x10-16) with an odds ratio of 0.367 (0.353 - 0.383) with a confidence interval of 95%. The two groups were matched by treatment and incidence of cancer, which resulted in a total of 101,739 patients analyzed after this match. The incidence of bronchogenic carcinoma was 1.929% with 1,962 patients in the H. pylori and treatment group compared to 4.618% with 4,698 patients in the control group with treatment. The difference was statistically significant (p < 2.22x10-16) with an odds ratio of 0.403 (0.383 - 0.425) with a confidence interval of 95%.

Keywords: bronchogenic carcinoma, helicobacter pylori, lung cancer, pathogen-associated molecular patterns

Procedia PDF Downloads 183
59 Frequency of Problem Drinking and Depression in Males with a History of Alcohol Consumption Admitted to a Tertiary Care Setting in Southern Sri Lanka

Authors: N. H. D. P. Fonseka, I. H. Rajapakse, A. S. Dissanayake

Abstract:

Background: Problem drinking, namely alcohol dependence (AD) and alcohol abuse (AA) are associated with major medical, social and economic adverse consequences. Problem drinking behavior is noted among those admitted to hospitals due to alcohol-related medical/surgical complaints as well as those with unrelated complaints. Literature shows an association between alcohol consumption and depression. Aims of this study were to determine the frequency of problem drinking and depression among males with a history of alcohol consumption tertiary care setting in Southern Sri Lanka. Method: Two-hundred male patients who consumed alcohol, receiving care in medical and surgical wards in Teaching Hospital Galle, were assessed. A validated J12 questionnaire of the Mini International Neuropsychiatric Interview was administered to determine frequency AA and AD. A validated PHQ 9 questionnaire to determine the prevalence and severity of depression. Results: Sixty-three participants (31%) had problem drinking. Of them, 61% had AD, and 39% had AA. Depression was noted in 39 (19%) subjects. In those who reported alcohol consumption not amounting to problem drinking, depression was noted in 23 (16%) participants. Mild depression was seen in 17, moderate in five and moderately severe in one. Among those who had problem drinking, 16 (25%) had depression. Mild depression was seen in four, moderate in seven, moderately severe in three and severe in two. Conclusions: A high proportion alcohol users had problem drinking. Adverse consequences associated with problem drinking places a major strain on the health system especially in a low resource setting where healthcare spending is limited and alcohol cessation support services are not well organised. Thus alcohol consumption and problem drinking behaviour need to be inquired into all medical consultations. Community prevalence of depression in Sri Lanka is approximately 10%. Depression among those consuming alcohol was two times higher compared to the general population. The rates of depression among those with problem drinking were especially high being 2.5 times more common than in the general population. A substantial proportion of these patients with depression had moderately severe or severe depression. When depression coexists with problem drinking, it may increase the tendency to consume alcohol as well as act as a barrier to the success of alcohol cessation interventions. Thus screening all patients who consume alcohol for depression, especially those who are problem drinkers becomes an important step in their clinical evaluation. In addition, in view of the high prevalence of problem drinking and coexistent depression, the need to organize a structured alcohol cessation support service in Sri Lanka as well as the need for increasing access to psychological evaluation and treatment of those with problem drinking are highlighted.

Keywords: alcohol abuse, alcohol, depression, problem drinking

Procedia PDF Downloads 160
58 Agricultural Mechanization for Transformation

Authors: Lawrence Gumbe

Abstract:

Kenya Vision 2030 is the country's programme for transformation covering the period 2008 to 2030. Its objective is to help transform Kenya into a newly industrializing, middle-income, exceeding US$10000, country providing a high quality of life to all its citizens by 2030, in a clean and secure environment. Increased agricultural and production and productivity is crucial for the realization of Vision 2030. Mechanization of agriculture in order to achieve greater yields is the only way to achieve these objectives. There are contending groups and views on the strategy for agricultural mechanization. The first group are those who oppose the widespread adoption of advanced technologies (mostly internal combustion engines and tractors) in agricultural mechanization as entirely inappropriate in most situations in developing countries. This group argues that mechanically powered -agricultural mechanization often leads to displacement of labour and hence increased unemployment, and this results in a host of other socio-economic problems, amongst them, rural-urban migration, inequitable distribution of wealth and in many cases an increase in absolute poverty, balance of payments due to the need to import machinery, fuel and sometimes technical assistance to manage them. The second group comprises of those who view the use of the improved hand tools and animal powered technology as transitional step between the most rudimentary step in technological development (characterized by entire reliance on human muscle power) and the advanced technologies (characterized 'by reliance on tractors and other machinery). The third group comprises those who regard these intermediate technologies (ie. improved hand tools and draught animal technology in agriculture) as a ‘delaying’ tactic and they advocate the use of mechanical technologies as-the most appropriate. This group argues that alternatives to the mechanical technologies do not just exist as a practical matter, or, if they are available, they are inefficient and they cannot be compared to the mechanical technologies in terms of economics and productivity. The fourth group advocates a compromise between groups two and third above. This group views the improved hand tools and draught animal technology as more of an 18th century technology and the modem tractor and combine harvester as too advanced for developing countries. This group has been busy designing an ‘intermediate’, ‘appropriate’, ‘mini’, ‘micro’ tractor for use by farmers in developing countries. This paper analyses and concludes on the different agricultural mechanization strategies available to Kenya and other third world countries

Keywords: agriculture, mechanazation, transformation, industrialization

Procedia PDF Downloads 338
57 Getting to Know ICU Nurses and Their Duties

Authors: Masih Nikgou

Abstract:

ICU nurses or intensive care nurses are highly specialized and trained healthcare personnel. These nurses provide nursing care for patients with life-threatening illnesses or conditions. They provide the experience, knowledge and specialized skills that patients need to survive and recover. Intensive care nurses (ICU) are trained to make momentary decisions and act quickly when the patient's condition changes. Their primary work environment is in the hospital in intensive care units. Typically, ICU patients require a high level of care. ICU nurses work in challenging and complex fields in their nursing profession. They have the primary duty of caring for and saving patients who are fighting for their lives. Intensive care (ICU) nurses are highly trained to provide exceptional care to patients who depend on 24/7 nursing care. A patient in the ICU is often equipped with a ventilator, intubated and connected to several life support machines and medical equipment. Intensive Care Nurses (ICU) have full expertise in considering all aspects of bringing back their patients. Some of the specific responsibilities of ICU nurses include (a) Assessing and monitoring the patient's progress and identifying any sudden changes in the patient's medical condition. (b) Administration of drugs intravenously by injection or through gastric tubes. (c) Provide regular updates on patient progress to physicians, patients, and their families. (d) According to the clinical condition of the patient, perform the approved diagnostic or treatment methods. (e) In case of a health emergency, informing the relevant doctors. (f) To determine the need for emergency interventions, evaluate laboratory data and vital signs of patients. (g) Caring for patient needs during recovery in the ICU. (h) ICU nurses often provide emotional support to patients and their families. (i) Regulating and monitoring medical equipment and devices such as medical ventilators, oxygen delivery devices, transducers, and pressure lines. (j) Assessment of pain level and sedation needs of patients. (k) Maintaining patient reports and records. As the name suggests, critical care nurses work primarily in ICU health care units. ICUs are completely healthy and have proper lighting with strict adherence to health and safety from medical centers. ICU nurses usually move between the intensive care unit, the emergency department, the operating room, and other special departments of the hospital. ICU nurses usually follow a standard shift schedule that includes morning, afternoon, and night schedules. There are also other relocation programs depending on the hospital and region. Nurses who are passionate about data and managing a patient's condition and outcomes typically do well as ICU nurses. An inquisitive mind and attention to processes are equally important. ICU nurses are completely compassionate and are not afraid to advocate for their patients and family members. who are distressed.

Keywords: nursing, intensive care unit, pediatric intensive care unit, mobile intensive care unit, surgical intensive care unite

Procedia PDF Downloads 78
56 Synthesis, Molecular Modeling and Study of 2-Substituted-4-(Benzo[D][1,3]Dioxol-5-Yl)-6-Phenylpyridazin-3(2H)-One Derivatives as Potential Analgesic and Anti-Inflammatory Agents

Authors: Jyoti Singh, Ranju Bansal

Abstract:

Fighting pain and inflammation is a common problem faced by physicians while dealing with a wide variety of diseases. Since ancient time nonsteroidal anti-inflammatory agents (NSAIDs) and opioids have been the cornerstone of treatment therapy, however, the usefulness of both these classes is limited due to severe side effects. NSAIDs, which are mainly used to treat mild to moderate inflammatory pain, induce gastric irritation and nephrotoxicity whereas opioids show an array of adverse reactions such as respiratory depression, sedation, and constipation. Moreover, repeated administration of these drugs induces tolerance to the analgesic effects and physical dependence. Further discovery of selective COX-2 inhibitors (coxibs) suggested safety without any ulcerogenic side effects; however, long-term use of these drugs resulted in kidney and hepatic toxicity along with an increased risk of secondary cardiovascular effects. The basic approaches towards inflammation and pain treatment are constantly changing, and researchers are continuously trying to develop safer and effective anti-inflammatory drug candidates for the treatment of different inflammatory conditions such as osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, psoriasis and multiple sclerosis. Synthetic 3(2H)-pyridazinones constitute an important scaffold for drug discovery. Structure-activity relationship studies on pyridazinones have shown that attachment of a lactam at N-2 of the pyridazinone ring through a methylene spacer results in significantly increased anti-inflammatory and analgesic properties of the derivatives. Further introduction of the heterocyclic ring at lactam nitrogen results in improvement of biological activities. Keeping in mind these SAR studies, a new series of compounds were synthesized as shown in scheme 1 and investigated for anti-inflammatory, analgesic, anti-platelet activities and docking studies. The structures of newly synthesized compounds have been established by various spectroscopic techniques. All the synthesized pyridazinone derivatives exhibited potent anti-inflammatory and analgesic activity. Homoveratryl substituted derivative was found to possess highest anti-inflammatory and analgesic activity displaying 73.60 % inhibition of edema at 40 mg/kg with no ulcerogenic activity when compared to standard drugs indomethacin. Moreover, 2-substituted-4-benzo[d][1,3]dioxole-6-phenylpyridazin-3(2H)-ones derivatives did not produce significant changes in bleeding time and emerged as safe agents. Molecular docking studies also illustrated good binding interactions at the active site of the cyclooxygenase-2 (hCox-2) enzyme.

Keywords: anti-inflammatory, analgesic, pyridazin-3(2H)-one, selective COX-2 inhibitors

Procedia PDF Downloads 200
55 Neoliberalism and Environmental Justice: A Critical Examination of Corporate Greenwashing

Authors: Arnav M. Raval

Abstract:

This paper critically examines the neoliberal economic model and its role in enabling corporate greenwashing, a practice where corporations deceptively market themselves as environmentally responsible while continuing harmful environmental practices. Through a rigorous focus on the neoliberal emphasis of free markets, deregulation, and minimal government intervention, this paper explores how these policies have set the stage for corporations to externalize environmental costs and engage in superficial sustainability initiatives. Within this framework, companies often bypass meaningful environmental reform, opting for strategies that enhance their public image without addressing their actual environmental impacts. The paper also draws on the works of critical theorists Theodor Adorno, Max Horkheimer, and Herbert Marcuse, particularly their critiques of capitalist society and its tendency to commodify social values. This paper argues that neoliberal capitalism has commodified environmentalism, transforming genuine ecological responsibility into a marketable product. Through corporate social responsibility initiatives, corporations have created the illusion of sustainability while masking deeper environmental harm. Under neoliberalism, these initiatives often serve as public relations tools rather than genuine commitments to environmental justice and sustainability. This commodification has become particularly dangerous because as it manipulates consumer perceptions and diverts attention away from the structural causes of environmental degradation. The analysis also examines how greenwashing practices have disproportionately affected marginalized communities, particularly in the global South, where environmental costs are often externalized. As these corporations promote their “sustainability” in wealthier markets, these marginalized communities bear the brunt of their pollution, resource depletion, and other forms of environmental degradation. This dynamic underscores the inherent injustice within neoliberal environmental policies, as those most vulnerable to environmental risks are often neglected, as companies reap the benefits of corporate sustainability efforts at their expense. Finally, this paper calls for a fundamental transition away from neoliberal market-driven solutions, which prioritize corporate profit over genuine ecological reform. It advocates for stronger regulatory frameworks, transparent third-party certifications, and a more collective approach to environmental governance. In order to ensure genuine corporate accountability, governments and institutions must move beyond superficial green initiatives and market-based solutions, shifting toward policies that enforce real environmental responsibility and prioritize environmental justice for all communities. Through the critique of the neoliberal system and its commodification of environmentalism, this paper has highlighted the urgent need to rethink how environmental responsibility is defined and enacted in the corporate world. Without systemic change, greenwashing will continue to undermine both ecological sustainability and social justice, leaving the most vulnerable populations to suffer the consequences.

Keywords: critical theory, environmental justice, greenwashing, neoliberalism

Procedia PDF Downloads 17
54 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
53 Optimized Renewable Energy Mix for Energy Saving in Waste Water Treatment Plants

Authors: J. D. García Espinel, Paula Pérez Sánchez, Carlos Egea Ruiz, Carlos Lardín Mifsut, Andrés López-Aranguren Oliver

Abstract:

This paper shortly describes three main actuations over a Waste Water Treatment Plant (WWTP) for reducing its energy consumption: Optimization of the biological reactor in the aeration stage by including new control algorithms and introducing new efficient equipment, the installation of an innovative hybrid system with zero Grid injection (formed by 100kW of PV energy and 5 kW of mini-wind energy generation) and an intelligent management system for load consumption and energy generation control in the most optimum way. This project called RENEWAT, involved in the European Commission call LIFE 2013, has the main objective of reducing the energy consumptions through different actions on the processes which take place in a WWTP and introducing renewable energies on these treatment plants, with the purpose of promoting the usage of treated waste water for irrigation and decreasing the C02 gas emissions. WWTP is always required before waste water can be reused for irrigation or discharged in water bodies. However, the energetic demand of the treatment process is high enough for making the price of treated water to exceed the one for drinkable water. This makes any policy very difficult to encourage the re-use of treated water, with a great impact on the water cycle, particularly in those areas suffering hydric stress or deficiency. The cost of treating waste water involves another climate-change related burden: the energy necessary for the process is obtained mainly from the electric network, which is, in most of the cases in Europe, energy obtained from the burning of fossil fuels. The innovative part of this project is based on the implementation, adaptation and integration of solutions for this problem, together with a new concept of the integration of energy input and operative energy demand. Moreover, there is an important qualitative jump between the technologies used and the alleged technologies to use in the project which give it an innovative character, due to the fact that there are no similar previous experiences of a WWTP including an intelligent discrimination of energy sources, integrating renewable ones (PV and Wind) and the grid.

Keywords: aeration system, biological reactor, CO2 emissions, energy efficiency, hybrid systems, LIFE 2013 call, process optimization, renewable energy sources, wasted water treatment plants

Procedia PDF Downloads 352
52 Nursing Experience in the Intensive Care of a Lung Cancer Patient with Pulmonary Embolism on Extracorporeal Membrane Oxygenation

Authors: Huang Wei-Yi

Abstract:

Objective: This article explores the intensive care nursing experience of a lung cancer patient with pulmonary embolism who was placed on ECMO. Following a sudden change in the patient’s condition and a consensus reached during a family meeting, the decision was made to withdraw life-sustaining equipment and collaborate with the palliative care team. Methods: The nursing period was from October 20 to October 27, 2023. The author monitored physiological data, observed, provided direct care, conducted interviews, performed physical assessments, and reviewed medical records. Together with the critical care team and bypass personnel, a comprehensive assessment was conducted using Gordon's Eleven Functional Health Patterns to identify the patient’s health issues, which included pain related to lung cancer and invasive devices, fear of death due to sudden deterioration, and altered tissue perfusion related to hemodynamic instability. Results: The patient was admitted with fever, back pain, and painful urination. During hospitalization, the patient experienced sudden discomfort followed by cardiac arrest, requiring multiple CPR attempts and ECMO placement. A subsequent CT angiogram revealed a pulmonary embolism. The patient's condition was further complicated by severe pain due to compression fractures, and a diagnosis of terminal lung cancer was unexpectedly confirmed, leading to emotional distress and uncertainty about future treatment. Throughout the critical care process, ECMO was removed on October 24, stabilizing the patient’s body temperature between 36.5-37°C and maintaining a mean arterial pressure of 60-80 mmHg. Pain management, including Morphine 8mg in 0.9% N/S 100ml IV drip q6h PRN and Ultracet 37.5 mg/325 mg 1# PO q6h, kept the pain level below 3. The patient was transferred to the ward on October 27 and discharged home on October 30. Conclusion: During the care period, collaboration with the medical team and palliative care professionals was crucial. Adjustments to pain medication, symptom management, and lung cancer-targeted therapy improved the patient’s physical discomfort and pain levels. By applying the unique functions of nursing and the four principles of palliative care, positive encouragement was provided. Family members, along with social workers, clergy, psychologists, and nutritionists, participated in cross-disciplinary care, alleviating anxiety and fear. The consensus to withdraw ECMO and life-sustaining equipment enabled the patient and family to receive high-quality care and maintain autonomy in decision-making. A follow-up call on November 1 confirmed that the patient was emotionally stable, pain-free, and continuing with targeted lung cancer therapy.

Keywords: intensive care, lung cancer, pulmonary embolism, ECMO

Procedia PDF Downloads 27
51 Into the Dreamweaver’s World of the Mandaya and the Tboli: From Folklore to the Woven Fabric

Authors: Genevieve Jorolan Quintero

Abstract:

In Mindanao, the southern island of the Philippines, two provinces, Davao Oriental and Tboli of South Cotabato, respectively, are homes to indigenous communities known for their dream weavers. Davao Oriental is home to the Mandaya, while Lake Sebu is home to the Tboli. The dream weavers are mostly women who have continued the tradition of weaving, a spiritual practice of handicraft embodying the beliefs of the community. It is believed that a weaver is guided by the Tagamaling, or the nature spirit in Mandaya mythology, and Fu Dalu, or the spirit of the abaca among the Tboli. In the dream, the Tagamaling or Fu Dalu reveals to the weaver the design or the pattern of the dagmay as the abaca woven cloth is called among the Mandaya and the tnalak among the Tboli. The weaver then undertakes the production of this nature-spirit-inspired fabric based on her memory of the dream. This interaction between the spirit world and the human world inspired the theme of the short story with the title Loom of Dreams, published in 2015 by Kritika Kultura, an international peer-reviewed journal of language and literary/cultural studies of the Ateneo de Manila University in the Philippines. In Lake Sebu, a collection of the legendary tnalak with various designs is preserved by the cultural advocate and tnalak collector Reden S. Ulo. About a hundred tnalak designs are housed in a mini museum. The paper discusses how the dagmay and the tnalak of the two Philippine indigenous communities, the Mandaya and the Tboli, embody their folklore and cultural heritage. The specific objectives are: 1. To describe the role of the dreamweavers among the Mandaya and Tboli communities in the Philippines; 2. To analyse how folklore influences the designs on the woven fabric, the dagmay, and the tnalak, and 3. To discuss how dream-weaving helps preserve culture legacy. Ethnography was used in the conduct of this research. Specifically, the following data collection methods were done: 1. a series of visits to the Mandaya and Tboli communities; 2. face-to-face interviews with the respondents from the communities, and 3. the recording of the interviews with the knowledge-bearers and material culture keepers from both communities, the narratives of which were used as a basis for the data analysis. The influence of folklore in the culture and the arts of the indigenous communities is significantly evident in the designs of the dagmay and the tnalak. As the dream weavers continue to weave the dagmay and the tnalak, this cultural legacy will continue to prosper and be preserved for posterity.

Keywords: dreamweaver's, Mandaya, mindanao, Philippine folklore, Tboli

Procedia PDF Downloads 99
50 Rapid Soil Classification Using Computer Vision, Electrical Resistivity and Soil Strength

Authors: Eugene Y. J. Aw, J. W. Koh, S. H. Chew, K. E. Chua, Lionel L. J. Ang, Algernon C. S. Hong, Danette S. E. Tan, Grace H. B. Foo, K. Q. Hong, L. M. Cheng, M. L. Leong

Abstract:

This paper presents a novel rapid soil classification technique that combines computer vision with four-probe soil electrical resistivity method and cone penetration test (CPT), to improve the accuracy and productivity of on-site classification of excavated soil. In Singapore, excavated soils from local construction projects are transported to Staging Grounds (SGs) to be reused as fill material for land reclamation. Excavated soils are mainly categorized into two groups (“Good Earth” and “Soft Clay”) based on particle size distribution (PSD) and water content (w) from soil investigation reports and on-site visual survey, such that proper treatment and usage can be exercised. However, this process is time-consuming and labour-intensive. Thus, a rapid classification method is needed at the SGs. Computer vision, four-probe soil electrical resistivity and CPT were combined into an innovative non-destructive and instantaneous classification method for this purpose. The computer vision technique comprises soil image acquisition using industrial grade camera; image processing and analysis via calculation of Grey Level Co-occurrence Matrix (GLCM) textural parameters; and decision-making using an Artificial Neural Network (ANN). Complementing the computer vision technique, the apparent electrical resistivity of soil (ρ) is measured using a set of four probes arranged in Wenner’s array. It was found from the previous study that the ANN model coupled with ρ can classify soils into “Good Earth” and “Soft Clay” in less than a minute, with an accuracy of 85% based on selected representative soil images. To further improve the technique, the soil strength is measured using a modified mini cone penetrometer, and w is measured using a set of time-domain reflectometry (TDR) probes. Laboratory proof-of-concept was conducted through a series of seven tests with three types of soils – “Good Earth”, “Soft Clay” and an even mix of the two. Validation was performed against the PSD and w of each soil type obtained from conventional laboratory tests. The results show that ρ, w and CPT measurements can be collectively analyzed to classify soils into “Good Earth” or “Soft Clay”. It is also found that these parameters can be integrated with the computer vision technique on-site to complete the rapid soil classification in less than three minutes.

Keywords: Computer vision technique, cone penetration test, electrical resistivity, rapid and non-destructive, soil classification

Procedia PDF Downloads 218
49 Biological Significance of Long Intergenic Noncoding RNA LINC00273 in Lung Cancer Cell Metastasis

Authors: Ipsita Biswas, Arnab Sarkar, Ashikur Rahaman, Gopeswar Mukherjee, Subhrangsu Chatterjee, Shamee Bhattacharjee, Deba Prasad Mandal

Abstract:

One of the major reasons for the high mortality rate of lung cancer is the substantial delays in disease detection at late metastatic stages. It is of utmost importance to understand the detailed molecular signaling and detect the molecular markers that can be used for the early diagnosis of cancer. Several studies explored the emerging roles of long noncoding RNAs (lncRNAs) in various cancers as well as lung cancer. A long non-coding RNA LINC00273 was recently discovered to promote cancer cell migration and invasion, and its positive correlation with the pathological stages of metastasis may prove it to be a potential target for inhibiting cancer cell metastasis. Comparing real-time expression of LINC00273 in various human clinical cancer tissue samples with normal tissue samples revealed significantly higher expression in cancer tissues. This long intergenic noncoding RNA was found to be highly expressed in human liver tumor-initiating cells, human gastric adenocarcinoma AGS cell line, as well as human non-small cell lung cancer A549 cell line. SiRNA and shRNA-induced knockdown of LINC00273 in both in vitro and in vivo nude mice significantly subsided AGS and A549 cancer cell migration and invasion. LINC00273 knockdown also reduced TGF-β induced SNAIL, SLUG, VIMENTIN, ZEB1 expression, and metastasis in A549 cells. Plenty of reports have suggested the role of microRNAs of the miR200 family in reversing epithelial to mesenchymal transition (EMT) by inhibiting ZEB transcription factors. In this study, hsa-miR-200a-3p was predicted via IntaRNA-Freiburg RNA tools to be a potential target of LINC00273 with a negative free binding energy of −8.793 kcal/mol, and this interaction was verified as a confirmed target of LINC00273 by RNA pulldown, real-time PCR and luciferase assay. Mechanistically, LINC00273 accelerated TGF-β induced EMT by sponging hsa-miR-200a-3p which in turn liberated ZEB1 and promoted prometastatic functions in A549 cells in vitro as verified by real-time PCR and western blotting. The similar expression patterns of these EMT regulatory pathway molecules, viz. LINC00273, hsa-miR-200a-3p, ZEB1 and TGF-β, were also detected in various clinical samples like breast cancer tissues, oral cancer tissues, lung cancer tissues, etc. Overall, this LINC00273 mediated EMT regulatory signaling can serve as a potential therapeutic target for the prevention of lung cancer metastasis.

Keywords: epithelial to mesenchymal transition, long noncoding RNA, microRNA, non-small-cell lung carcinoma

Procedia PDF Downloads 156
48 Drying Shrinkage of Concrete: Scale Effect and Influence of Reinforcement

Authors: Qier Wu, Issam Takla, Thomas Rougelot, Nicolas Burlion

Abstract:

In the framework of French underground disposal of intermediate level radioactive wastes, concrete is widely used as a construction material for containers and tunnels. Drying shrinkage is one of the most disadvantageous phenomena of concrete structures. Cracks generated by differential shrinkage could impair the mechanical behavior, increase the permeability of concrete and act as a preferential path for aggressive species, hence leading to an overall decrease in durability and serviceability. It is of great interest to understand the drying shrinkage phenomenon in order to predict and even to control the strains of concrete. The question is whether the results obtained from laboratory samples are in accordance with the measurements on a real structure. Another question concerns the influence of reinforcement on drying shrinkage of concrete. As part of a global project with Andra (French National Radioactive Waste Management Agency), the present study aims to experimentally investigate the scale effect as well as the influence of reinforcement on the development of drying shrinkage of two high performance concretes (based on CEM I and CEM V cements, according to European standards). Various sizes of samples are chosen, from ordinary laboratory specimens up to real-scale specimens: prismatic specimens with different volume-to-surface (V/S) ratios, thin slices (thickness of 2 mm), cylinders with different sizes (37 and 160 mm in diameter), hollow cylinders, cylindrical columns (height of 1000 mm) and square columns (320×320×1000 mm). The square columns have been manufactured with different reinforcement rates and can be considered as mini-structures, to approximate the behavior of a real voussoir from the waste disposal facility. All the samples are kept, in a first stage, at 20°C and 50% of relative humidity (initial conditions in the tunnel) in a specific climatic chamber developed by the Laboratory of Mechanics of Lille. The mass evolution and the drying shrinkage are monitored regularly. The obtained results show that the specimen size has a great impact on water loss and drying shrinkage of concrete. The specimens with a smaller V/S ratio and a smaller size have a bigger drying shrinkage. The correlation between mass variation and drying shrinkage follows the same tendency for all specimens in spite of the size difference. However, the influence of reinforcement rate on drying shrinkage is not clear based on the present results. The second stage of conservation (50°C and 30% of relative humidity) could give additional results on these influences.

Keywords: concrete, drying shrinkage, mass evolution, reinforcement, scale effect

Procedia PDF Downloads 183
47 Localized and Time-Resolved Velocity Measurements of Pulsatile Flow in a Rectangular Channel

Authors: R. Blythman, N. Jeffers, T. Persoons, D. B. Murray

Abstract:

The exploitation of flow pulsation in micro- and mini-channels is a potentially useful technique for enhancing cooling of high-end photonics and electronics systems. It is thought that pulsation alters the thickness of the hydrodynamic and thermal boundary layers, and hence affects the overall thermal resistance of the heat sink. Although the fluid mechanics and heat transfer are inextricably linked, it can be useful to decouple the parameters to better understand the mechanisms underlying any heat transfer enhancement. Using two-dimensional, two-component particle image velocimetry, the current work intends to characterize the heat transfer mechanisms in pulsating flow with a mean Reynolds number of 48 by experimentally quantifying the hydrodynamics of a generic liquid-cooled channel geometry. Flows circulated through the test section by a gear pump are modulated using a controller to achieve sinusoidal flow pulsations with Womersley numbers of 7.45 and 2.36 and an amplitude ratio of 0.75. It is found that the transient characteristics of the measured velocity profiles are dependent on the speed of oscillation, in accordance with the analytical solution for flow in a rectangular channel. A large velocity overshoot is observed close to the wall at high frequencies, resulting from the interaction of near-wall viscous stresses and inertial effects of the main fluid body. The steep velocity gradients at the wall are indicative of augmented heat transfer, although the local flow reversal may reduce the upstream temperature difference in heat transfer applications. While unsteady effects remain evident at the lower frequency, the annular effect subsides and retreats from the wall. The shear rate at the wall is increased during the accelerating half-cycle and decreased during deceleration compared to steady flow, suggesting that the flow may experience both enhanced and diminished heat transfer during a single period. Hence, the thickness of the hydrodynamic boundary layer is reduced for positively moving flow during one half of the pulsation cycle at the investigated frequencies. It is expected that the size of the thermal boundary layer is similarly reduced during the cycle, leading to intervals of heat transfer enhancement.

Keywords: Heat transfer enhancement, particle image velocimetry, localized and time-resolved velocity, photonics and electronics cooling, pulsating flow, Richardson’s annular effect

Procedia PDF Downloads 346
46 Rapid Soil Classification Using Computer Vision with Electrical Resistivity and Soil Strength

Authors: Eugene Y. J. Aw, J. W. Koh, S. H. Chew, K. E. Chua, P. L. Goh, Grace H. B. Foo, M. L. Leong

Abstract:

This paper presents the evaluation of various soil testing methods such as the four-probe soil electrical resistivity method and cone penetration test (CPT) that can complement a newly developed novel rapid soil classification scheme using computer vision, to improve the accuracy and productivity of on-site classification of excavated soil. In Singapore, excavated soils from the local construction industry are transported to Staging Grounds (SGs) to be reused as fill material for land reclamation. Excavated soils are mainly categorized into two groups (“Good Earth” and “Soft Clay”) based on particle size distribution (PSD) and water content (w) from soil investigation reports and on-site visual survey, such that proper treatment and usage can be exercised. However, this process is time-consuming and labor-intensive. Thus, a rapid classification method is needed at the SGs. Four-probe soil electrical resistivity and CPT were evaluated for their feasibility as suitable additions to the computer vision system to further develop this innovative non-destructive and instantaneous classification method. The computer vision technique comprises soil image acquisition using an industrial-grade camera; image processing and analysis via calculation of Grey Level Co-occurrence Matrix (GLCM) textural parameters; and decision-making using an Artificial Neural Network (ANN). It was found from the previous study that the ANN model coupled with ρ can classify soils into “Good Earth” and “Soft Clay” in less than a minute, with an accuracy of 85% based on selected representative soil images. To further improve the technique, the following three items were targeted to be added onto the computer vision scheme: the apparent electrical resistivity of soil (ρ) measured using a set of four probes arranged in Wenner’s array, the soil strength measured using a modified mini cone penetrometer, and w measured using a set of time-domain reflectometry (TDR) probes. Laboratory proof-of-concept was conducted through a series of seven tests with three types of soils – “Good Earth”, “Soft Clay,” and a mix of the two. Validation was performed against the PSD and w of each soil type obtained from conventional laboratory tests. The results show that ρ, w and CPT measurements can be collectively analyzed to classify soils into “Good Earth” or “Soft Clay” and are feasible as complementing methods to the computer vision system.

Keywords: computer vision technique, cone penetration test, electrical resistivity, rapid and non-destructive, soil classification

Procedia PDF Downloads 239
45 Anisakidosis in Turkey: Serological Survey and Risk for Humans

Authors: E. Akdur Öztürk, F. İrvasa Bilgiç, A. Ludovisi , O. Gülbahar, D. Dirim Erdoğan, M. Korkmaz, M. Á. Gómez Morales

Abstract:

Anisakidosis is a zoonotic human fish-borne parasitic disease caused by accidental ingestion of anisakid third-stage larvae (L3) of members of the Anisakidae family present in infected marine fish or cephalopods. Infection with anisakid larvae can lead to gastric, intestinal, extra-gastrointestinal and gastroallergic forms of the disease. Anisakid parasites have been reported in almost all seas, particularly in the Mediterranean Sea. There is a remarkably high level of risk exposure to these zoonotic parasites as they are present in economically and ecologically important fish of Europe. Anisakid L3 larvae have been also detected in several fish species from the Aegean Sea. Turkey is a peninsular country surrounded by Black, Aegean and the Mediterranean Sea. In this country, fishing habit and fishery product consumption are highly common. In recent years, there was also an increase in the consumption of raw fish due to the increasing interest in the cuisine of the Far East countries. In different regions of Turkey, A. simplex (inMerluccius Merluccius Scomber japonicus, Trachurus mediterraneus, Sardina pilchardus, Engraulis encrasicolus, etc.), Anisakis spp., Contraceucum spp., Pseudoterronova spp. and, C. aduncum were identified as well. Although it is accepted both the presence of anisakid parasites in fish and fishery products in Turkey and the presence of Turkish people with allergic manifestations after fish consumption, there are no reports of human anisakiasis in this country. Given the high prevalence of anisakid parasites in the country, the absence of reports is likely not due to the absence of clinical cases rather to the unavailability of diagnostic tools and the low awareness of the presence of this infection. The aim of the study was to set up an IgE-Western Blot (WB) based test to detect the anisakidosis sensitization among Turkish people with a history of allergic manifestation related to fish consumption. To this end, crude worm antigens (CWA) and allergen enriched fraction (50-66% ) were prepared from L3 of A. simplex (s.l.) collected from Lepidopus caudatus fished in the Mediterranean Sea. These proteins were electrophoretically separated and transferred into the nitrocellulose membranes. By WB, specific proteins recognized by positive control serum samples from sensitized patients were visualized on nitrocellulose membranes by a colorimetric reaction. The CWA and 50–66% fraction showed specific bands, mainly due to Ani s 1 (20-22 kD) and Ani s 4 (9-10 kD). So far, a total of 7 serum samples from people with allergic manifestation and positive skin prick test (SPT) after fish consumption, have been tested and all of them resulted negative by WB, indicating the lack of sensitization to anisakids. This preliminary study allowed to set up a specific test and evidence the lack of correlation between both tests, SPT and WB. However, the sample size should be increased to estimate the anisakidosis burden in Turkish people.

Keywords: anisakidosis, fish parasite, serodiagnosis, Turkey

Procedia PDF Downloads 141
44 Evaluation of Cryoablation Procedures in Treatment of Atrial Fibrillation from 3 Years' Experiences in a Single Heart Center

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

Abstract:

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

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

Procedia PDF Downloads 204