Search results for: presence
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4832

Search results for: presence

4412 Patient Outcomes Following Out-of-Hospital Cardiac Arrest

Authors: Scott Ashby, Emily Granger, Mark Connellan

Abstract:

Background: In-hospital management of Out-of-Hospital Cardiac Arrest (OHCA) is complex as the aetiologies are varied. Acute coronary angiography has been shown to improve outcomes for patients with coronary occlusion as the cause; however, these patients are difficult to identify. ECG results may help identify these patients, but the accuracy of this diagnostic test is under debate, and requires further investigation. Methods: Arrest and hospital management information was collated retrospectively for OHCA patients who presented to a single clinical site between 2009 and 2013. Angiography results were then collected and checked for significance with survival to discharge. The presence of a severe lesion (>70%) was then compared to categorised ECG findings, and the accuracy of the test was calculated. Results: 104 patients were included in this study, 44 survived to discharge, 52 died and 8 were transferred to other clinical sites. Angiography appears to significantly correlate with survival to discharge. ECG showed 54.8% sensitivity for detecting the presence of a severe lesion within the group that received angiography. A combined criterion including any ECG pathology showed 100% sensitivity and negative predictive value, however, a low specificity and positive predictive value. Conclusion: In the cohort investigated, ST elevation on ECG is not a sensitive enough screening test to be used to determine whether OHCA patients have coronary stenosis as the likely cause of their arrest, and more investigation into whether screening with a combined ECG criterion, or whether all patients should receive angiography routinely following OHCA is needed.

Keywords: out of hospital cardiac arrest, coronary angiography, resuscitation, emergency medicine

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4411 Experimental Work to Estimate the Strength of Ferrocement Slabs Incorporating Silica Fume and Steel Fibre

Authors: Mohammed Mashrei

Abstract:

Ferrocement is a type of thin reinforced concrete made of cement-sand matrix with closely spaced relatively small diameter wire meshes, with or without steel bars of small diameter called skeletal steel. This work concerns on the behavior of square ferrocement slabs of dimensions (500) mm x (500) mm and 30 mm subjected to a central load. This study includes testing thirteen ferrocement slabs. The main variables considered in the experimental work are the number of wire mesh layers, percentage of silica fume and the presence of steel fiber. The effects of these variables on the behavior and load carrying capacity of tested slabs under central load were investigated. From the experimental results, it is found that by increasing the percentage of silica fume from (0 to 1.5, 3, 4.5 and 6) of weight of cement the ultimate loads are affected. Also From this study, it is observed that the load carrying capacity increases with the presence of steel fiber reinforcement, the ductility is high in the case of steel fibers. The increasing wire mesh layer from six to ten layers increased the load capacity by 76%. Also, a reduction in width of crack with increasing in number of cracks in the samples that content on steel fibers comparing with samples without steel fibers was observed from the results.

Keywords: ferrocement, fibre, silica fume, slab, strength

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4410 Incidence of Post Endoscopic Retrograde Cholangiopancreatography Biliary Ascariasis Diagnosed on Ultrasound

Authors: Shehzad Khan, Jehangir Khan, Shah Babar, Rashid Mahmood, Rizwan Khan, Sanya Hadi

Abstract:

Ascaris lumbricoides are familiar with the roundworm that causes biliary infections in humans. Nevertheless, ascariasis is primarily found in the jejunum and transferred in numerous body parts with the intake of Ascaris lumbricoides present in food and water. These study methods were implemented at the Saidu Teaching Hospital Radiology Department from December 2021 to January 2023. This study includes the participants suffering from biliary ascariasis admitted or visited Saidu Teaching Hospital in that time frame. Clinical assessment of the participants was done based on the appearance of signs and symptoms present in them. The participant's laboratory test was done to determine the level of basic body parameters. After that ultrasonography was used to diagnose the presence and appearance of worms. Endoscopic retrograde cholangiopancreatography (ERCP) was used to extract worms from biliary channels, and the incidence of post-ERCP biliary ascariasis was accessed with ultrasonography. This study's results show the presence of numerous types of worms in the biliary channels of patients. Also, the level of body parameters, for instance, neutrophil, hemoglobin, and others, were compared at the time of admission and at the time of discharge from the hospital. Furthermore, the incidence of post-ERCP biliary ascariasis was reported as 4% in females, and 1% in males, respectively.

Keywords: Ascaris, biliary, ERCP, ultrasound

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4409 Magnetic Structure and Transitions in 45% Mn Substituted HoFeO₃: A Neutron Diffraction Study

Authors: Karthika Chandran, Pulkit Prakash, Amitabh Das, Santhosh P. N.

Abstract:

Rare earth orthoferrites (RFeO₃) exhibit interesting and useful magnetic properties like multiferroicity, magnetodielectric coupling, spin reorientation (SR) and exchange bias. B site doped RFeO₃ are attracting attention due to the complex and tuneable magnetic transitions. In this work, 45% Mn-doped HoFeO₃ polycrystalline sample (HoFe₀.₅₅Mn₀.₄₅O₃) was synthesized by a solid-state reaction method. The magnetic structure and transitions were studied by magnetization measurements and neutron powder diffraction methods. The neutron diffraction patterns were taken at 13 different temperatures from 7°K to 300°K (7°K and 25°K to 300°K in 25°K intervals). The Rietveld refinement was carried out by using a FULLPROF suite. The magnetic space groups and the irreducible representations were obtained by SARAh module. The room temperature neutron diffraction refinement results indicate that the sample crystallizes in an orthorhombic perovskite structure with Pnma space group with lattice parameters a = 5.6626(3) Ǻ, b = 7.5241(3) Ǻ and c = 5.2704(2) Ǻ. The temperature dependent magnetization (M-T) studies indicate the presence of two magnetic transitions in the system ( TN Fe/Mn~330°K and TSR Fe/Mn ~290°K). The inverse susceptibility vs. temperature curve shows a linear behavior above 330°K. The Curie-Weiss fit in this region gives negative Curie constant (-34.9°K) indicating the antiferromagnetic nature of the transition. The neutron diffraction refinement results indicate the presence of mixed magnetic phases Γ₄(AₓFᵧG

Keywords: neutron powder diffraction, rare earth orthoferrites, Rietveld analysis, spin reorientation

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4408 Climate Related Variability and Stock-Recruitment Relationship of the North Pacific Albacore Tuna

Authors: Ashneel Ajay Singh, Naoki Suzuki, Kazumi Sakuramoto,

Abstract:

The North Pacific albacore (Thunnus alalunga) is a temperate tuna species distributed in the North Pacific which is of significant economic importance to the Pacific Island Nations and Territories. Despite its importance, the stock dynamics and ecological characteristics of albacore still, have gaps in knowledge. The stock-recruitment relationship of the North Pacific stock of albacore tuna was investigated for different density-dependent effects and a regime shift in the stock characteristics in response to changes in environmental and climatic conditions. Linear regression analysis for recruit per spawning biomass (RPS) and recruitment (R) against the female spawning stock biomass (SSB) were significant for the presence of different density-dependent effects and positive for a regime shift in the stock time series. Application of Deming regression to RPS against SSB with the assumption for the presence of observation and process errors in both the dependent and independent variables confirmed the results of simple regression. However, R against SSB results disagreed given variance level of < 3 and agreed with linear regression results given the assumption of variance ≥ 3. Assuming the presence of different density-dependent effects in the albacore tuna time series, environmental and climatic condition variables were compared with R, RPS, and SSB. The significant relationship of R, RPS and SSB were determined with the sea surface temperature (SST), Pacific Decadal Oscillation (PDO) and multivariate El Niño Southern Oscillation (ENSO) with SST being the principal variable exhibiting significantly similar trend with R and RPS. Recruitment is significantly influenced by the dynamics of the SSB as well as environmental conditions which demonstrates that the stock-recruitment relationship is multidimensional. Further investigation of the North Pacific albacore tuna age-class and structure is necessary for further support the results presented here. It is important for fishery managers and decision makers to be vigilant of regime shifts in environmental conditions relating to albacore tuna as it may possibly cause regime shifts in the albacore R and RPS which should be taken into account to effectively and sustainability formulate harvesting plans and management of the species in the North Pacific oceanic region.

Keywords: Albacore tuna, Thunnus alalunga, recruitment, spawning stock biomass, recruits per spawning biomass, sea surface temperature, pacific decadal oscillation, El Niño southern oscillation, density-dependent effects, regime shift

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4407 The Biofertilizer Effect of Pseudomonas of Salt Soils of the North-West Algerian, Study of Comportment of Bean (Vicia Faba)

Authors: Djoudi Abdelhak, Djibaoui Rachid, Reguieg Yassaad Houcine

Abstract:

Our study focuses on the identification of some species of Pseudomonas (P4, P5, P7 and P8) isolated from saline soils in northwestern Algeria and the effect of their metabolites on the growth of Alternaria alternata the causative agent of the blight of the bean disease (Vicia faba). We are also interested in stimulating the growth of this plant species in saline conditions (60 mM/l NaCl) and the absence of salts. The analysis focuses on rates of inhibition of mycelial growth of Alternaria alternata strain and the rate of growth of plants inoculated with strains of Pseudomonas expressed by biometrics. According to the results of the in-vitro test, P5 and P8 species and their metabolites showed a significant effect on mycelia growth and production of spores of Alternaria alternata. The in-vivo test shows that the species P8 and P5 were significantly and positively influencing the growth in biometric parameters of the bean in saline and salt-free condition. Inoculation with strain P5 has promoted the growth of the bean in stem height, stem fresh weight and dry weight of stems of 108.59%, 115.28%, 104.33%, respectively, in the presence of salt Inoculation with strain P5 has fostered the growth of the bean stem fresh weight of 112.47% in the presence of salt The effect of Pseudomonas species on the development of Vicia faba and the growth of Alternaria alternata is considering new techniques and methods of biological production and crop protection.

Keywords: pseudomonas, vicia faba, alternaria alternata, promoting of plant growth

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4406 In silico Statistical Prediction Models for Identifying the Microbial Diversity and Interactions Due to Fixed Periodontal Appliances

Authors: Suganya Chandrababu, Dhundy Bastola

Abstract:

Like in the gut, the subgingival microbiota plays a crucial role in oral hygiene, health, and cariogenic diseases. Human activities like diet, antibiotics, and periodontal treatments alter the bacterial communities, metabolism, and functions in the oral cavity, leading to a dysbiotic state and changes in the plaques of orthodontic patients. Fixed periodontal appliances hinder oral hygiene and cause changes in the dental plaques influencing the subgingival microbiota. However, the microbial species’ diversity and complexity pose a great challenge in understanding the taxa’s community distribution patterns and their role in oral health. In this research, we analyze the subgingival microbial samples from individuals with fixed dental appliances (metal/clear) using an in silico approach. We employ exploratory hypothesis-driven multivariate and regression analysis to shed light on the microbial community and its functional fluctuations due to dental appliances used and identify risks associated with complex disease phenotypes. Our findings confirm the changes in oral microbiota composition due to the presence and type of fixed orthodontal devices. We identified seven main periodontic pathogens, including Bacteroidetes, Actinobacteria, Proteobacteria, Fusobacteria, and Firmicutes, whose abundances were significantly altered due to the presence and type of fixed appliances used. In the case of metal braces, the abundances of Bacteroidetes, Proteobacteria, Fusobacteria, Candidatus saccharibacteria, and Spirochaetes significantly increased, while the abundance of Firmicutes and Actinobacteria decreased. However, in individuals With clear braces, the abundance of Bacteroidetes and Candidatus saccharibacteria increased. The highest abundance value (P-value=0.004 < 0.05) was observed with Bacteroidetes in individuals with the metal appliance, which is associated with gingivitis, periodontitis, endodontic infections, and odontogenic abscesses. Overall, the bacterial abundances decrease with clear type and increase with metal type of braces. Regression analysis further validated the multivariate analysis of variance (MANOVA) results, supporting the hypothesis that the presence and type of the fixed oral appliances significantly alter the bacterial abundance and composition.

Keywords: oral microbiota, statistical analysis, fixed or-thodontal appliances, bacterial abundance, multivariate analysis, regression analysis

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4405 Characterization the Internal Corrosion Behavior by Using Natural Inhibitor in Crude Oil of Low Carbon Steel Pipeline

Authors: Iman Adnan Annon, Kadhim F. Alsultan

Abstract:

This study investigate the internal corrosion of low carbon steel pipelines in the crude oil, as well as prepare and use natural and locally available plant as a natural corrosion inhibiter, the nature extraction achieved by two types of solvents in order to show the solvent effect on inhibition process, the first being distilled water and the second is diethyl ether. FT-IR spectra and using a chemical reagents achieved to detection the presence of many active groups and the presence of tannins, phenols, and alkaloids in the natural extraction. Some experiments were achieved to estimate the performance of a new inhibitor, one of these tests include corrosion measurement by simple immersion in crude oil within and without inhibitors which added in different amounts 30,40,50and 60 ppm at tow temperature 300 and 323k, where the best inhibition efficiencies which get when added the inhibitors in a critical amounts or closest to it, since for the aqueous extract (EB-A) the inhibition efficiency reached (94.4) and (86.71)% at 300 and 323k respectively, and for diethyl ether extract (EB-D) reached (82.87) and (84.6)% at 300 and 323k respectively. Optical microscopy examination have been conducted to evaluate the corrosion nature where it show a clear difference in the topography of the immersed samples surface after add the inhibitors at two temperatures. The results show that the new corrosion inhibitor is not only equivalent to a chemical inhibitor but has greatly improvement properties such as: high efficiency, low cost, non-toxic, easily to produce, and nonpolluting as compared with chemical inhibitor.

Keywords: corrosion in pipeline, inhibitors, crude oil, carbon steel, types of solvent

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4404 Characterization of InGaAsP/InP Quantum Well Lasers

Authors: K. Melouk, M. Dellakrachaï

Abstract:

Analytical formula for the optical gain based on a simple parabolic-band by introducing theoretical expressions for the quantized energy is presented. The model used in this treatment take into account the effects of intraband relaxation. It is shown, as a result, that the gain for the TE mode is larger than that for TM mode and the presence of acceptor impurity increase the peak gain.

Keywords: InGaAsP, laser, quantum well, semiconductor

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4403 Preservation of Traditional Algerian Sausage Against Microbial Activity by the Garlic (Allium Sativum L.)

Authors: Abed Hannane, Rouag Noureddine

Abstract:

The present study aims to evaluate the association of fresh garlic (Allium sativum L.) and storage at 4°C in preserving the microbiological, nutritional, and sanitary quality of Merguez-type sausages prepared and sold locally from meat offal. The analysis focused on the evaluation of the microbiological quality of fifteen samples randomly taken from several butcheries in the wilaya of BBA, eastern Algeria. The bacteriological analysis revealed the presence of 6.88.10⁵ CFU/g of total aerobic bacteria, 5.39.10⁵ CFU/g of total coliforms, 2.23.10⁵ CFU/g of fecal coliforms, 2.43.103 CFU/g of Escherichia coli and 1.8.10⁵ CFU/g of coagulase-positive staphylococci, values higher than Algerian standards. The addition of fresh garlic as an antibacterial preservative at concentrations of 0.06, 0.12, 0.18, and 0.24 g/g to ground beef samples and stored in the refrigerator at 4°C for 15 days. The addition of garlic to Merguez made it possible to significantly reduce the presence of different bacterial groups during their refrigerated storage, compared to untreated meat, bringing it below the standards defined in the matter. Thus, the use of garlic as a food additive at a concentration of 0.12 g/g was sufficient to obtain levels according to Algerian standards equal to 1.8.10⁴ CFU/g of total aerobic bacteria, 9.48.10³ CFU/ g of total coliforms, 3.68.10³ UFC/g fecal coliforms, 4.56.10² UFC/g of E.coli 2.39.10⁴ UFC/g of coagulase-positive staphylococci. It is clear that thanks to the addition of garlic to Merguez, the sanitary quality has been improved by reducing the aerobic bacterial load and increasing the shelf life at 4°C.

Keywords: antimicrobial effect, garlic, sausage, storage

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4402 Physical Habitat Simulation and Comparison within a Lerma River Reach, with Respect to the Same but Modified Reach, to Create a Linear Park

Authors: Garcia-Rodriguez Ezequiel, Luis A. Ochoa-Franco, Adrian I. Cervantes-Servin

Abstract:

In this work, the Ictalurus punctatus species estimated available physical habitat is compared with the estimated physical habitat for the same but modified river reach, with the aim of creating a linear park, along a length of 5 500 m. To determine the effect of ecological park construction, on physical habitat of the Lerma river stretch of study, first, the available habitat for the Ictalurus punctatus species was estimated through the simulation of the physical habitat, by using surveying, hydraulics, and habitat information gotten at the river reach in its actual situation. Second, it was estimated the available habitat for the above species, upon the simulation of the physical habitat through the proposed modification for the ecological park creation. Third, it is presented a comparison between both scenarios in terms of available habitat estimated for Ictalurus punctatus species, concluding that in cases of adult and spawning life stages, changes in the channel to create an ecological park would produce a considerable loss of potentially usable habitat (PUH), while in the case of the juvenile life stage PUH remains virtually unchanged, and in the case of life stage fry the PUH would increase due to the presence of velocities and depths of lesser magnitude, due to the presence of minor flow rates and lower volume of the wet channel. It is expected that habitat modification for linear park construction may produce the lack of Ictalurus punktatus species conservation at the river reach of the study.

Keywords: Habitat modification, Ictalurus punctatus, Lerma, river, linear park

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4401 Spatial and Seasonal Distribution of Persistent Organic Pollutant (Polychlorinated Biphenyl) Along the Course of Buffalo River, Eastern Cape Province, South Africa

Authors: Abdulrazaq Yahaya, Omobola Okoh, Anthony Okoh

Abstract:

Polychlorinated biphenyls (PCBs) are generated from short emission or leakage from capacitors and electrical transformers, industrial chemicals wastewater discharge and careless disposal of wastes. They are toxic, semi-volatile compounds which can persist in the environment, hence classified as persistent organic pollutants. Their presence in the environmental matrices has become a global concern. In this study, we assessed the concentrations and distribution patterns of 19 polychlorinated biphenyls congeners (PCB 1, 5, 18, 31, 44, 52, 66, 87, 101, 110, 138, 141, 151, 153, 170, 180, 183, 187, and 206) at six sampling points in water along the course of Buffalo River, Eastern Cape, South Africa. Solvent extraction followed by sulphuric acid, potassium permanganate and silica gel cleanup were used in this study. The analysis was done with gas chromatography electron capture detector (GC-ECD). The results of the analysis of all the 19 PCBs congeners ranged from not detectable to 0.52 ppb and 2.5 ppb during summer and autumn periods respectively. These values are generally higher than the World Health Organization (WHO) maximum permissible limit. Their presence in the waterbody suggests an increase in anthropogenic activities over the seasons. In view of their volatility, the compounds are transportable over long distances by air currents away from their point of origin putting the health of the communities at risk, thus suggesting the need for strict regulations on the use as well as save disposal of this group of compounds in the communities.

Keywords: organic pollutants, polychlorinated biphenyls, pollution, solvent extraction

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4400 A Comprehensive Analysis of the Phylogenetic Signal in Ramp Sequences in 211 Vertebrates

Authors: Lauren M. McKinnon, Justin B. Miller, Michael F. Whiting, John S. K. Kauwe, Perry G. Ridge

Abstract:

Background: Ramp sequences increase translational speed and accuracy when rare, slowly-translated codons are found at the beginnings of genes. Here, the results of the first analysis of ramp sequences in a phylogenetic construct are presented. Methods: Ramp sequences were compared from 211 vertebrates (110 Mammalian and 101 non-mammalian). The presence and absence of ramp sequences were analyzed as a binary character in a parsimony and maximum likelihood framework. Additionally, ramp sequences were mapped to the Open Tree of Life taxonomy to determine the number of parallelisms and reversals that occurred, and these results were compared to what would be expected due to random chance. Lastly, aligned nucleotides in ramp sequences were compared to the rest of the sequence in order to examine possible differences in phylogenetic signal between these regions of the gene. Results: Parsimony and maximum likelihood analyses of the presence/absence of ramp sequences recovered phylogenies that are highly congruent with established phylogenies. Additionally, the retention index of ramp sequences is significantly higher than would be expected due to random chance (p-value = 0). A chi-square analysis of completely orthologous ramp sequences resulted in a p-value of approximately zero as compared to random chance. Discussion: Ramp sequences recover comparable phylogenies as other phylogenomic methods. Although not all ramp sequences appear to have a phylogenetic signal, more ramp sequences track speciation than expected by random chance. Therefore, ramp sequences may be used in conjunction with other phylogenomic approaches.

Keywords: codon usage bias, phylogenetics, phylogenomics, ramp sequence

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4399 Altering Surface Properties of Magnetic Nanoparticles with Single-Step Surface Modification with Various Surface Active Agents

Authors: Krupali Mehta, Sandip Bhatt, Umesh Trivedi, Bhavesh Bharatiya, Mukesh Ranjan, Atindra D. Shukla

Abstract:

Owing to the dominating surface forces and large-scale surface interactions, the nano-scale particles face difficulties in getting suspended in various media. Magnetic nanoparticles of iron oxide offer a great deal of promise due to their ease of preparation, reasonable magnetic properties, low cost and environmental compatibility. We intend to modify the surface of magnetic Fe₂O₃ nanoparticles with selected surface modifying agents using simple and effective single-step chemical reactions in order to enhance dispersibility of magnetic nanoparticles in non-polar media. Magnetic particles were prepared by hydrolysis of Fe²⁺/Fe³⁺ chlorides and their subsequent oxidation in aqueous medium. The dried particles were then treated with Octadecyl quaternary ammonium silane (Terrasil™), stearic acid and gallic acid ester of stearyl alcohol in ethanol separately to yield S-2 to S-4 respectively. The untreated Fe₂O₃ was designated as S-1. The surface modified nanoparticles were then analysed with Dynamic Light Scattering (DLS), Fourier Transform Infrared spectroscopy (FTIR), X-Ray Diffraction (XRD), Thermogravimetric Gravimetric Analysis (TGA) and Scanning Electron Microscopy and Energy dispersive X-Ray analysis (SEM-EDAX). Characterization reveals the particle size averaging 20-50 nm with and without modification. However, the crystallite size in all cases remained ~7.0 nm with the diffractogram matching to Fe₂O₃ crystal structure. FT-IR suggested the presence of surfactants on nanoparticles’ surface, also confirmed by SEM-EDAX where mapping of elements proved their presence. TGA indicated the weight losses in S-2 to S-4 at 300°C onwards suggesting the presence of organic moiety. Hydrophobic character of modified surfaces was confirmed with contact angle analysis, all modified nanoparticles showed super hydrophobic behaviour with average contact angles ~129° for S-2, ~139.5° for S-3 and ~151° for S-4. This indicated that surface modified particles are super hydrophobic and they are easily dispersible in non-polar media. These modified particles could be ideal candidates to be suspended in oil-based fluids, polymer matrices, etc. We are pursuing elaborate suspension/sedimentation studies of these particles in various oils to establish this conjecture.

Keywords: iron nanoparticles, modification, hydrophobic, dispersion

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4398 Allelopathic Effect of Foliar Extracts of Leucaena leucocephala on Germination and Growth Behavior of Zea mays L.

Authors: Guru Prasad Satsangi, Shiv Shankar Gautam

Abstract:

Allelopathy is a potential area of research for sustainable agriculture. It is environmentally safe, can conserve the available resources, and also may mitigate the problems raised by synthetic chemicals. The allelo-chemicals are secondary metabolites produced by plants, which are the byproducts of the primary metabolic process. These allelo-chemicals may be stimulatory, inhibitory, or may have no effect on the growth of the other plants. It has been observed in the present study that foliar extracts of Leucaena leucocephala showed an inhibitory effect on the germination of the test crop maize. The results revealed that at different concentrations of Leucaena leucocephala foliar extract, caused a significant inhibition in germination and growth behavior of Zea mays L. seedlings. Minimum germination and growth occurred in 100 % concentration, and an increase in extract concentrations result in a decrease in the germination. Bioassay also depicted that this inhibitory effect was proportional to the concentration of the extract as the higher concentration having a lesser stimulatory effect or vice versa. The phytochemical analysis of the secondary metabolites from foliar extracts of Leucaena leucocephala L. showed the presence of tannins, saponins, phenols, alkaloids, and flavanoids. Among various extracts, the presence of methanol extract was found in a significant amount of phytochemicals, followed by the aqueous and ethanol extracts. Leaves showed a significantly higher amount of the allelochemicals.

Keywords: allelopathic effect, germination /growth behavior , foliar extracts, Leucaena leucceophala , Zea mays L.

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4397 Bile Salt Induced Microstructural Changes of Gemini Surfactant Micelles

Authors: Vijaykumar Patel, P. Bahadur

Abstract:

Microstructural evolution of a cationic gemini surfactant 12-4-12 micelles in the presence of bile salts has been investigated using different techniques. A negative value of interaction parameter evaluated from surface tension measurements is a signature of strong synergistic interaction between oppositely charged surfactants. Both the bile salts compete with each other in inducing the micellar transition of 12-4-12 micelles depending on their hydrophobicity. Viscosity measurements disclose that loading of bile salts induces morphological changes in 12-4-12 micelles; sodium deoxycholate is more efficient in altering the aggregation behaviour of 12-4-12 micelles compared to sodium cholate and presents pronounced increase in viscosity and micellar growth which is suppressed at elevated temperatures. A remarkable growth of 12-4-12 micelles in the presence of sodium deoxycholate at low pH has been ascribed to the solubilization of bile acids formed in acidic medium. Small angle neutron scattering experiments provided size and shape of 12-4-12/bile salt mixed micelles are explicated on the basis of hydrophobicity of bile salts. The location of bile salts in micelle was determined from nuclear overhauser effect spectroscopy. The present study characterizes 12-4-12 gemini-bile salt mixed systems which significantly enriches our knowledge, and such a structural transition provides an opportunity to use these bioamphiphiles as delivery vehicles and in some pharmaceutical formulations.

Keywords: gemini surfactants, bile salts, SANS (small angle neutron scattering), NOESY (nuclear overhauser effect spectroscopy)

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4396 Varietal Behavior of Some Chickpea Genotypes to Wilt Disease Induced by Fusarium oxysporum f.sp. ciceris

Authors: Rouag N., Khalifa M. W., Bencheikh A., Abed H.

Abstract:

The behavior study of forty-two varieties and genotypes of chickpeas regarding root wilt disease induced by Fusarium oxysporum under the natural conditions of infection was conducted at the ITGC experimental station in Sétif. The infected plants of the different chickpea genotypes have shown multiple symptoms in the field caused by the local strain of Fusarium oxysporum f.sp.cecris belonging to race II of the pathogen. These symptoms ranged from lateral or partial wilting of some ramifications to total desiccation of the plant, sometimes combined with the very slow growth of symptomatic plants. The results of the search for sources of resistance to Fusarium wilt of chickpeas in the 42 genotypes tested revealed that in terms of infection rate, the presence of 7 groups and no genotype showed absolute resistance. While in terms of severity, the results revealed the presence of three homogeneous groups. The first group formed by the most resistant genotypes, in this case, Flip10-368C; Flip11-77C; Flip11-186C; Flip11-124C; Flip11-142C, Flip11-152C; Flip11-69C; Ghab 05; Flip11-159C; Flip11-90C; Flip10-357C and Flip11-37C while the second group is the FLIP genotype 10-382C which was found to be the most sensitive for the natural infection test. Thus, the genotypes of Cicer arietinum L., which have shown significant levels of resistance to Fusarium wilt, can be integrated into breeding and improvement programs.

Keywords: chickpea, Cicer arietinum, Fusarium oxysporum, genotype resistance

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4395 Tracking of Linarin from the Ethyl Acetate Fraction of Melinjo (Gnetum gnemon L.) Seeds Using Preparative High Performance Liquid Chromatography

Authors: Asep Sukohar, Ramadhan Triyandi, Muhammad Iqbal, Sahidin, Suharyani

Abstract:

Introduction: Resveratrol is a class of bioactive chemicals found in melinjo, which has a wide range of biological actions. The purpose of this study is to determine the linarin content of the melinjo fraksi by using preparative-high-performance liquid chromatography (prep-HPLC). Method: Extraction used the soxhletation method with 96% ethanol solvent. Fractionation used ethyl acetate and ethanol in a ratio of 1:1. Tracing of linarin compound used prep-HPLC with a mobile phase ratio of distilled water: methanol (55: 45, v/v). The presence of linarin was detected using a wavelength of 215 nm. Fourier Transform Infrared (FTIR) was used to identify the functional groups of compound. Result: The retention time required to elute the ethyl acetate fraction was 2.601 minutes. Compound separation identification using Fourier Transform Infrared Spectroscopy - Quest Attenuated Total Reflectance (FTIR - QATR) has a similarity value range with standards from 0 to 1000. The elution results of the ethyl acetate fraction have similar values with the standard compounds linarin (668), resveratrol (578), and catechin (455). Conclusion: Tracing for active compound in the ethyl acetate fraction of Gnetum Gnemon L. using prep-HPLC showed a strong suspicion of the presence of linarin compound.

Keywords: Gnetum gnemon L., linarin, prep-HPLC, fraction ethyl acetate

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4394 Sulfamethoxazole Degradation by Conventional Fenton and Microwave-Assisted Fenton Reaction

Authors: Derradji Chebli, Abdallah Bouguettoucha, Zoubir Manaa, Amrane Abdeltif

Abstract:

Pharmaceutical products, such as sulfamethoxazole (SMX) are rejected in the environment at trace level by human and animals (ng/L to mg/L), in their original form or as byproducts. Antibiotics are toxic contaminants for the aquatic environment, owing to their adverse effects on the aquatic life and humans. Even at low concentrations, they can negatively impact biological water treatment leading to the proliferation of antibiotics-resistant pathogens. It is therefore of major importance to develop efficient methods to limit their presence in the aquatic environment. In this aim, advanced oxidation processes (AOP) appear relevant compared to other methods, since they are based on the production of highly reactive free radicals, and especially ●OH. The objective of this work was to evaluate the degradation of SMX by microwave-assisted Fenton reaction (MW/Fe/H2O2). Hydrogen peroxide and ferrous ions concentrations, as well as the microwave power were optimized. The results showed that the SMX degradation by MW/Fe/H2O2 followed a pseudo-first order kinetic. The treatment of 20 mg/L initial SMX by the Fenton reaction in the presence of microwave showed the positive impact of this latter owing to the higher degradation yields observed in a reduced reaction time if compared to the conventional Fenton reaction, less than 5 min for a total degradation. In addition, increasing microwave power increased the degradation kinetics. Irrespective of the application of microwave, the optimal pH for the Fenton reaction remained 3. Examination of the impact of the ionic strength showed that carbonate and sulfate anions increased the rate of SMX degradation.

Keywords: antibiotic, degradation, elimination, fenton, microwave, polluant

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4393 A Methodological Concept towards a Framework Development for Social Software Adoption in Higher Education System

Authors: Kenneth N. Ohei, Roelien Brink

Abstract:

For decades, teaching and learning processes have centered on the traditional approach (Web 1.0) that promoted teacher-directed pedagogical practices. Currently, there is a realization that the traditional approach is not adequate to effectively address and improve all student-learning outcomes. The subsequent incorporation of social software, Information, and Communication Technology (ICT) tools in universities may serve as complementary to support educational goals, offering students the affordability and opportunity to educational choices and learning platforms. Consequently, educators’ inability to incorporate these instructional ICT tools in their teaching and learning practices remains a challenge. This will signify that educators still lack the ICT skills required to administer lectures and bridging learning gaps. This study probes a methodological concept with the aim of developing a framework towards the adoption of social software in HES to help facilitate business processes and can build social presence among students. A mixed method will be appropriate to develop a comprehensive framework needed in Higher Educational System (HES). After research have been conducted, the adoption of social software will be based on the developed comprehensive framework which is supposed to impact positively on education and approach of delivery, improves learning experience, engagement and finally, increases educational opportunities and easy access to educational contents.

Keywords: blended and integrated learning, learning experience and engagement, higher educational system, HES, information and communication technology, ICT, social presence, Web 1.0, Web 2.0, Web 3.0

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4392 A Comparative Analysis on Survival in Patients with Node Positive Cutaneous Head and Neck Squamous Cell Carcinoma as per TNM 7th and Tnm 8th Editions

Authors: Petr Daniel Edward Kovarik, Malcolm Jackson, Charles Kelly, Rahul Patil, Shahid Iqbal

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Introduction: Recognition of the presence of extra capsular spread (ECS) has been a major change in the TNM 8th edition published by the American Joint Committee on Cancer in 2018. Irrespective of the size or number of lymph nodes, the presence of ECS makes N3b disease a stage IV disease. The objective of this retrospective observational study was to conduct a comparative analysis of survival outcomes in patients with lymph node-positive cutaneous head and neck squamous cell carcinoma (CHNSCC) based on their TNM 7th and TNM 8th editions classification. Materials and Methods: From January 2010 to December 2020, 71 patients with CHNSCC were identified from our centre’s database who were treated with radical surgery and adjuvant radiotherapy. All histopathological reports were reviewed, and comprehensive nodal mapping was performed. The data were collected retrospectively and survival outcomes were compared using TNM 7th and 8th editions. Results: The median age of the whole group of 71 patients was 78 years, range 54 – 94 years, 63 were male and 8 female. In total, 2246 lymph nodes were analysed; 195 were positive for cancer. ECS was present in 130 lymph nodes, which led to a change in TNM staging. The details on N-stage as per TNM 7th edition was as follows; pN1 = 23, pN2a = 14, pN2b = 32, pN2c = 0, pN3 = 2. After incorporating the TNM 8th edition criterion (presence of ECS), the details on N-stage were as follows; pN1 = 6, pN2a = 5, pN2b = 3, pN2c = 0, pN3a = 0, pN3b = 57. This showed an increase in overall stage. According to TNM 7th edition, there were 23 patients were with stage III and remaining 48 patients, stage IV. As per TNM 8th edition, there were only 6 patients with stage III as compared to 65 patients with stage IV. For all patients, 2-year disease specific survival (DSS) and overall survival (OS) were 70% and 46%. 5-year DSS and OS rates were 66% and 20% respectively. Comparing the survival between stage III and stage IV of the two cohorts using both TNM 7th and 8th editions, there is an obvious greater survival difference between the stages if TNM 8th staging is used. However, meaningful statistics were not possible as the majority of patients (n = 65) were with stage IV and only 6 patients were stage III in the TNM 8th cohort. Conclusion: Our study provides a comprehensive analysis on lymph node data mapping in this specific patient population. It shows a better differentiation between stage III and stage IV in the TNM 8th edition as compared to TNM 7th however meaningful statistics were not possible due to the imbalance of patients in the sub-cohorts of the groups.

Keywords: cutaneous head and neck squamous cell carcinoma, extra capsular spread, neck lymphadenopathy, TNM 7th and 8th editions

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4391 Electrochemical Sensor Based on Poly(Pyrogallol) for the Simultaneous Detection of Phenolic Compounds and Nitrite in Wastewater

Authors: Majid Farsadrooh, Najmeh Sabbaghi, Seyed Mohammad Mostashari, Abolhasan Moradi

Abstract:

Phenolic compounds are chief environmental contaminants on account of their hazardous and toxic nature on human health. The preparation of sensitive and potent chemosensors to monitor emerging pollution in water and effluent samples has received great consideration. A novel and versatile nanocomposite sensor based on poly pyrogallol is presented for the first time in this study, and its electrochemical behavior for simultaneous detection of hydroquinone (HQ), catechol (CT), and resorcinol (RS) in the presence of nitrite is evaluated. The physicochemical characteristics of the fabricated nanocomposite were investigated by emission-scanning electron microscopy (FE-SEM), energy-dispersive X-ray spectroscopy (EDS), and Brunauer-Emmett-Teller (BET). The electrochemical response of the proposed sensor to the detection of HQ, CT, RS, and nitrite is studied using cyclic voltammetry (CV), chronoamperometry (CA), differential pulse voltammetry (DPV), and electrochemical impedance spectroscopy (EIS). The kinetic characterization of the prepared sensor showed that both adsorption and diffusion processes can control reactions at the electrode. In the optimized conditions, the new chemosensor provides a wide linear range of 0.5-236.3, 0.8-236.3, 0.9-236.3, and 1.2-236.3 μM with a low limit of detection of 21.1, 51.4, 98.9, and 110.8 nM (S/N = 3) for HQ, CT and RS, and nitrite, respectively. Remarkably, the electrochemical sensor has outstanding selectivity, repeatability, and stability and is successfully employed for the detection of RS, CT, HQ, and nitrite in real water samples with the recovery of 96.2%–102.4%, 97.8%-102.6%, 98.0%–102.4% and 98.4%–103.2% for RS, CT, HQ, and nitrite, respectively. These outcomes illustrate that poly pyrogallol is a promising candidate for effective electrochemical detection of dihydroxybenzene isomers in the presence of nitrite.

Keywords: electrochemical sensor, poly pyrogallol, phenolic compounds, simultaneous determination

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4390 A Study of a Plaque Inhibition Through Stenosed Bifurcation Artery considering a Biomagnetic Blood Flow and Elastic Walls

Authors: M. A. Anwar, K. Iqbal, M. Razzaq

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Background and Objectives: This numerical study reflects the magnetic field's effect on the reduction of plaque formation due to stenosis in a stenosed bifurcated artery. The entire arterythe wall is assumed as linearly elastic, and blood flow is modeled as a Newtonian, viscous, steady, incompressible, laminar, biomagnetic fluid. Methods: An Arbitrary Lagrangian-Eulerian (ALE) technique is employed to formulate the hemodynamic flow in a bifurcated artery under the effect of the asymmetric magnetic field by two-way Fluid-structure interaction coupling. A stable P2P1 finite element pair is used to discretize thenonlinear system of partial differential equations. The resulting nonlinear system of algebraic equations is solved by the Newton Raphson method. Results: The numerical results for displacement, velocity magnitude, pressure, and wall shear stresses for Reynolds numbers, Re = 500, 1000, 1500, 2000, in the presence of magnetic fields are presented graphically. Conclusions: The numerical results show that the presence of the magnetic field influences the displacement and flows velocity magnitude considerably. The magnetic field reduces the flow separation, recirculation area adjacent to stenosis and gives rise to wall shear stress.

Keywords: bifurcation, elastic walls, finite element, wall shear stress,

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4389 The Effect of Crack Size, Orientation and Number on the Elastic Modulus of a Cracked Body

Authors: Mark T. Hanson, Alan T. Varughese

Abstract:

Osteoporosis is a disease affecting bone quality which in turn can increase the risk of low energy fractures. Treatment of osteoporosis using Bisphosphonates has the beneficial effect of increasing bone mass while at the same time has been linked to the formation of atypical femoral fractures. This has led to the increased study of micro-fractures in bones of patients using Bisphosphonate treatment. One of the mechanics related issues which have been identified in this regard is the loss in stiffness of bones containing one or many micro-fractures. Different theories have been put forth using fracture mechanics to determine the effect of crack presence on elastic properties such as modulus. However, validation of these results in a deterministic way has not been forthcoming. The present analysis seeks to provide this deterministic evaluation of fracture’s effect on the elastic modulus. In particular, the effect of crack size, crack orientation and crack number on elastic modulus is investigated. In particular, the Finite Element method is used to explicitly determine the elastic modulus reduction caused by the presence of cracks in a representative volume element. Single cracks of various lengths and orientations are examined as well as cases of multiple cracks. Cracks in tension as well as under shear stress are considered. Although the focus is predominantly two-dimensional, some three-dimensional results are also presented. The results obtained show the explicit reduction in modulus caused by the parameters of crack size, orientation and number noted above. The present results allow the interpretation of the various theories which currently exist in the literature.

Keywords: cracks, elastic, fracture, modulus

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4388 Erosion Wear of Cast Al-Si Alloys

Authors: Pooja Verma, Rajnesh Tyagi, Sunil Mohan

Abstract:

Al-Si alloys are widely used in various components such as liner-less engine blocks, piston, compressor bodies and pumps for automobile sector and aerospace industries due to their excellent combination of properties like low thermal expansion coefficient, low density, excellent wear resistance, high corrosion resistance, excellent cast ability, and high hardness. The low density and high hardness of primary Si phase results in significant reduction in density and improvement in wear resistance of hypereutectic Al-Si alloys. Keeping in view of the industrial importance of the alloys, hypereutectic Al-Si alloys containing 14, 16, 18 and 20 wt. % of Si were prepared in a resistance furnace using adequate amount of deoxidizer and degasser and their erosion behavior was evaluated by conducting tests at impingement angles of 30°, 60°, and 90° with an erodent discharge rate of 7.5 Hz, pressure 1 bar using erosion test rig. Microstructures of the cast alloys were examined using Optical microscopy (OM) and scanning electron microscopy (SEM) and the presence of Si particles was confirmed by x-ray diffractometer (XRD). The mechanical properties and hardness were measured using uniaxial tension tests at a strain rate of 10-3/s and Vickers hardness tester. Microstructures of the alloys and X-ray examination revealed the presence of primary and eutectic Si particles in the shape of cuboids or polyhedral and finer needles. Yield strength (YS), ultimate tensile strength (UTS), and uniform elongation of the hypereutectic Al-Si alloys were observed to increase with increasing content of Si. The optimal strength and ductility was observed for Al-20 wt. % Si alloy which is significantly higher than the Al-14 wt. % Si alloy. The increased hardness and the strength of the alloys with increasing amount of Si has been attributed presence of Si in the solid solution which creates strain, and this strain interacts with dislocations resulting in solid-solution strengthening. The interactions between distributed primary Si particles and dislocations also provide Orowan strengthening leading to increased strength. The steady state erosion rate was found to decrease with increasing angle of impact as well as Si content for all the alloys except at 900 where it was observed to increase with the increase in the Si content. The minimum erosion rate is observed in Al-20 wt. % Si alloy at 300 and 600 impingement angles because of its higher hardness in comparison to other alloys. However, at 90° impingement angle the wear rate for Al-20 wt. % Si alloy is found to be the minimum due to deformation, subsequent cracking and chipping off material.

Keywords: Al-Si alloy, erosion wear, cast alloys, dislocation, strengthening

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4387 Incidence of Fungal Infections and Mycotoxicosis in Pork Meat and Pork By-Products in Egyptian Markets

Authors: Ashraf Samir Hakim, Randa Mohamed Alarousy

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The consumption of food contaminated with molds (microscopic filamentous fungi) and their toxic metabolites results in the development of food-borne mycotoxicosis. The spores of molds are ubiquitously spread in the environment and can be detected everywhere. Ochratoxin A is a potentially carcinogenic fungal toxin found in a variety of food commodities , not only is considered the most abundant and hence the most commonly detected member but also is the most toxic one.Ochratoxin A is the most abundant and hence the most commonly detected member, but is also the most toxic of the three. A very limited research works concerning foods of porcine origin in Egypt were obtained in spite of presence a considerable swine population and consumers. In this study, the quality of various ready-to-eat local and imported pork meat and meat byproducts sold in Egyptian markets as well as edible organs as liver and kidney were assessed for the presence of various molds and their toxins as a raw material. Mycological analysis was conducted on (n=110) samples which included pig livers n=10 and kidneys n=10 from the Basateen slaughter house; local n=70 and 20 imported processed pork meat byproducts.The isolates were identified using traditional mycological and biochemical tests while, Ochratoxin A levels were quantitatively analyzed using the high performance liquid. Results of conventional mycological tests for detecting the presence of fungal growth (yeasts or molds) were negative, while the results of mycotoxins concentrations were be greatly above the permiceable limits or "tolerable weekly intake" (TWI) of ochratoxin A established by EFSA in 2006 in local pork and pork byproducts while the imported samples showed a very slightly increasing.Since ochratoxin A is stable and generally resistant to heat and processing, control of ochratoxin A contamination lies in the control of the growth of the toxin-producing fungi. Effective prevention of ochratoxin A contamination therefore depends on good farming and agricultural practices. Good Agricultural Practices (GAP) including methods to reduce fungal infection and growth during harvest, storage, transport and processing provide the primary line of defense against contamination with ochratoxin A. To the best of our knowledge this is the first report of mycological assessment, especially the mycotoxins in pork byproducts in Egypt.

Keywords: Egyptian markets, mycotoxicosis, ochratoxin A, pork meat, pork by-products

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4386 Advancements in Dielectric Materials: A Comprehensive Study on Properties, Synthesis, and Applications

Authors: M. Mesrar, T. Lamcharfi, Nor-S. Echatoui, F. Abdi

Abstract:

The solid-state reaction method was used to synthesize ferroelectric systems with lead-free properties, specifically (1-x-y)(Na₀.₅Bi₀.₅)TiO₃-xBaTiO₃-y(K₀.₅ Bi₀.₅)TiO₃. To achieve a pure perovskite phase, the optimal calcination temperature was determined to be 1000°C for 4 hours. X-ray diffraction (XRD) analysis identified the presence of the morphotropic phase boundary (MPB) in the (1-x-y)NBT xBT-yKBT ceramics for specific molar compositions, namely (0.95NBT-0.05BT, 0.84NBT-0.16KBT, and 0.79NBT-0.05BT-0.16KBT). To enhance densification, the sintering temperature was set at 1100°C for 4 hours. Scanning electron microscopy (SEM) images exhibited homogeneous distribution and dense packing of the grains in the ceramics, indicating a uniform microstructure. These materials exhibited favorable characteristics, including high dielectric permittivity, low dielectric loss, and diffused phase transition behavior. The ceramics composed of 0.79NBT-0.05BT-0.16KBT exhibited the highest piezoelectric constant (d33=148 pC/N) and electromechanical coupling factor (kp = 0.292) among all compositions studied. This enhancement in piezoelectric properties can be attributed to the presence of the morphotropic phase boundary (MPB) in the material. This study presents a comprehensive approach to improving the performance of lead-free ferroelectric systems of composition 0.79(Na₀.₅Bi₀.₅)Ti O₃-0.05BaTiO₃-0.16(K₀.₅Bi₀.₅)TiO₃.

Keywords: solid-state method, (1-x-y)NBT-xBT-yKBT, morphotropic phase boundary, Raman spectroscopy, dielectric properties

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4385 Synergistic Sorption of Cr(VI) and Cu(II) onto Sweet Potato Vine from Binary Mixtures Cr(VI)-Cu(II)

Authors: Chang Liu, Nuria Fiol, Isabel Villaescusa, Jordi Poch

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Over the last decades, biosorption has been an alternative to costly wastewaters treatment for metal removal. Most of the literature on metal biosorption was devoted to studying of single metal ions but nowadays studies on multi-components biosorption are booming. Hexavalent chromium is usually found in mixtures with divalent metal ions in industries wastewaters. However, studies on the simultaneous removal of Cr(VI) and divalent metals are hardly found and the cooperative or competitive mechanism governing each metal ions sorption is still unclear. In this work, simultaneous sorption of Cr(VI) and Cu(II) from their binary mixtures by using sweet potato vine (SPV) was investigated. Sweet potato is one of the four major grain crops in China. Each year about 2000 tons of SPV are generated as by-products. SPV could be a low-cost biosorbent for metal ions due to its rich in cellulose and lignin. In this work, the sorption of Cr(VI) and Cu(II) from their binary mixtures solutions was studied by using SPV sorbent. Equilibrium studies were carried out in binary mixtures in which Cr(VI) and Cu(II) concentration was both varied between 0.1 mM and 0.3 mM, Cr(VI) and Cu(II) single solutions were also prepared as comparison. All the experiments were performed at pH 3±0.05 under 30±2°C for 7 days to make sure sorption achieved equilibrium. Results showed that (i) chromium was partially (10.93%-42.04%) eliminated under studied conditions through reduction and sorption of hexavalent and trivalent forms. The presence of Cu(II) exerts a synergistic effect on the overall sorption process in all the cases of the 0.1-0.3 mM binary mixtures concentration range. (ii) Cr(VI) removal by SPV is favoured by the presence of Cu(II) in solution, because more protons needed for Cr(VI) reduction are available due to Cu(II)-proton competition; however sorption of the formed Cr(III) is unfavoured as a result of the competition between Cr(III) and Cu(II) for protons and sorbent active sites. (iii) Copper was partially (9.26%-13.91%) sorbed onto SPV under studied conditions. The presence of Cr(VI) in binary mixtures also exerts a synergistic effect on the Cu(II) removal in all the cases of the 0.1-0.3 mM binary mixtures concentration range. The results of the present work indicate that sweet potato vine can be successfully employed for the simultaneously removal of Cr(VI) and Cu(II) in binary mixtures, taking advantage of the synergistic effect provoked by one of the metal ion to each other, even though the acquisition of higher removal yields has to be further investigated. Acknowledgements—This work has been financially supported by Ministry of Human Resources and Social Security of PRC (Anhui15), Education Department of Anhui Province (KJ2016A270) and Anhui Normal University (2015rcpy33, 2014bsqdjj53).

Keywords: sweet potato vine, chromium reduction, divalent metal, synergistic sorption

Procedia PDF Downloads 151
4384 Risperidone for the Treatment of Retentive Fecal Incontinence in Children and Adolescents: A Randomize Clinical Trial

Authors: Ghazal Zahed, Leila Tabatabaee, Amirhossein Hosseini, Somaye Fatahi

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Functional retentive overflow incontinence (Retentive FI) is the most common cause of fecal soiling in children. Affected patients may have more problems with their parents and peer group, self-esteem issues, and more psychiatric comorbidities than the general population. Therapeutic interventions for Retentive FI and related problems and comorbid conditions are needed at the same time. Based on the clinical experiences, patients with retentive FI and comorbid psychiatric disorders, were accelerated in their treatment of fecal incontinence when they were being treated with Risperidone for their psychiatric comorbidities, therefore this study was conducted to evaluate the effect of Risperidone in the treatment of Retentive FI in children and adolescents. In this double-blind randomized clinical trial, 136 patients aged 4-18 years eligible for the study were randomly divided into two groups receiving Risperidone and placebo. About half of these patients had newly diagnosed psychiatric disorders and were drug naïve, this was considered in their division. In addition to polyethylene glycol, all the participants received family counseling and education for withholding behaviors and related behavioral interventions, and nonpharmacological interventions for psychiatric comorbidities. A significant correlation was observed between the duration of treatment with risperidone and the presence of psychiatric comorbidities (P <0.001) for diurnal fecal incontinence. Based on our findings in this study, Risperidone, used commonly for psychiatric disorders in children and adolescents, may be useful in the treatment of retentive fecal incontinence in the presence of psychiatric comorbidities, and along with other interventions.

Keywords: Retentive Fecal Incontinence, Risperidone, Treatment, Pediatric, Encopresis, Atypical Antipsychotics, Fecal Soiling

Procedia PDF Downloads 90
4383 The Implementation of a Nurse-Driven Palliative Care Trigger Tool

Authors: Sawyer Spurry

Abstract:

Problem: Palliative care providers at an academic medical center in Maryland stated medical intensive care unit (MICU) patients are often referred late in their hospital stay. The MICU has performed well below the hospital quality performance metric of 80% of patients who expire with expected outcomes should have received a palliative care consult within 48 hours of admission. Purpose: The purpose of this quality improvement (QI) project is to increase palliative care utilization in the MICU through the implementation of a Nurse-Driven PalliativeTriggerTool to prompt the need for specialty palliative care consult. Methods: MICU nursing staff and providers received education concerning the implications of underused palliative care services and the literature data supporting the use of nurse-driven palliative care tools as a means of increasing utilization of palliative care. A MICU population specific criteria of palliative triggers (Palliative Care Trigger Tool) was formulated by the QI implementation team, palliative care team, and patient care services department. Nursing staff were asked to assess patients daily for the presence of palliative triggers using the Palliative Care Trigger Tool and present findings during bedside rounds. MICU providers were asked to consult palliative medicinegiven the presence of palliative triggers; following interdisciplinary rounds. Rates of palliative consult, given the presence of triggers, were collected via electronic medical record e-data pull, de-identified, and recorded in the data collection tool. Preliminary Results: Over 140 MICU registered nurses were educated on the palliative trigger initiative along with 8 nurse practitioners, 4 intensivists, 2 pulmonary critical care fellows, and 2 palliative medicine physicians. Over 200 patients were admitted to the MICU and screened for palliative triggers during the 15-week implementation period. Primary outcomes showed an increase in palliative care consult rates to those patients presenting with triggers, a decreased mean time from admission to palliative consult, and increased recognition of unmet palliative care needs by MICU nurses and providers. Conclusions: Anticipatory findings of this QI project would suggest a positive correlation between utilizing palliative care trigger criteria and decreased time to palliative care consult. The direct outcomes of effective palliative care results in decreased length of stay, healthcare costs, and moral distress, as well as improved symptom management and quality of life (QOL).

Keywords: palliative care, nursing, quality improvement, trigger tool

Procedia PDF Downloads 172