Search results for: patient's peak skin dose
Commenced in January 2007
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Paper Count: 6402

Search results for: patient's peak skin dose

1842 Nanopriming Potential of Metal Nanoparticles against Internally Seed Borne Pathogen Ustilago triciti

Authors: Anjali Sidhu, Anju Bala, Amit Kumar

Abstract:

Metal nanoparticles have the potential to revolutionize the agriculture owing to sizzling interdisciplinary nano-technological application domain. Numerous patents and products incorporating engineered nanoparticles (NPs) entered into agro-applications with the collective goal to promote proficiency as well as sustainability with lower input and generating meager waste than conventional products and approaches. Loose smut of wheat caused by Ustilago segetum tritici is an internally seed-borne pathogen. It is dormant in the seed unless the seed germinates and its symptoms are expressed at the reproductive stage of the plant only. Various seed treatment agents are recommended for this disease but due to the inappropriate methods of seed treatments used by farmers, each and every seed may not get treated, and the infected seeds escape the fungicidal action. The antimicrobial potential and small size of nanoparticles made them the material of choice as they could enter each seed and restrict the pathogen inside the seed due to the availability of more number of nanoparticles per unit volume of the nanoformulations. Nanoparticles of diverse nature known for their in vitro antimicrobial activity viz. ZnO, MgO, CuS and AgNPs were synthesized, surface modified and characterized by traditional methods. They were applied on infected wheat seeds which were then grown in pot conditions, and their mycelium was tracked in the shoot and leaf region of the seedlings by microscopic staining techniques. Mixed responses of inhibition of this internal mycelium were observed. The time and method of application concluded to be critical for application, which was optimised in the present work. The results implicated that there should be field trails to get final fate of these pot trails up to commercial level. The success of their field trials could be interpreted as a revolution to replace high dose organic fungicides of high residue behaviour.

Keywords: metal nanoparticles, nanopriming, seed borne pathogen, Ustilago segetum tritici

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1841 Identification of Toxic Metal Deposition in Food Cycle and Its Associated Public Health Risk

Authors: Masbubul Ishtiaque Ahmed

Abstract:

Food chain contamination by heavy metals has become a critical issue in recent years because of their potential accumulation in bio systems through contaminated water, soil and irrigation water. Industrial discharge, fertilizers, contaminated irrigation water, fossil fuels, sewage sludge and municipality wastes are the major sources of heavy metal contamination in soils and subsequent uptake by crops. The main objectives of this project were to determine the levels of minerals, trace elements and heavy metals in major foods and beverages consumed by the poor and non-poor households of Dhaka city and assess the dietary risk exposure to heavy metal and trace metal contamination and potential health implications as well as recommendations for action. Heavy metals are naturally occurring elements that have a high atomic weight and a density of at least 5 times greater than that of water. Their multiple industrial, domestic, agricultural, medical and technological applications have led to their wide distribution in the environment; raising concerns over their potential effects on human health and the environment. Their toxicity depends on several factors including the dose, route of exposure, and chemical species, as well as the age, gender, genetics, and nutritional status of exposed individuals. Because of their high degree of toxicity, arsenic, cadmium, chromium, lead, and mercury rank among the priority metals that are of public health significance. These metallic elements are considered systemic toxicants that are known to induce multiple organ damage, even at lower levels of exposure. This review provides an analysis of their environmental occurrence, production and use, potential for human exposure, and molecular mechanisms of toxicity, and carcinogenicity.

Keywords: food chain, determine the levels of minerals, trace elements, heavy metals, production and use, human exposure, toxicity, carcinogenicity

Procedia PDF Downloads 266
1840 Chemopreventive and Therapeutic Efficacy of Salsola inermis Extract against N-Nitrosodiethylamine-Initiated and Phenobarbital-Promoted Hepatocellular Carcinogenesis in Wistar Rats

Authors: Ahlam H. Mahmoud, Samir F. Zohny, Ibrahim H. Boraia, Faten S. Bayoumic, Eman Eissa

Abstract:

Hepatocellular carcinoma is one of the most common cancers worldwide and is known to be resistant to conventional chemotherapy. Therefore, we aimed to assess the Salsola inermis extract as a novel chemopreventive and/or therapeutic agent against N-nitrosodiethylamine (DNE)/phenobarbital (PB)-induced hepatocarcinogenesis in rats. Adult male Wistar albino rats were divided into five groups: group1 rats were served as normal controls; group 2 rats were injected intraperitoneally with S. inermis extract (100 mg/kg body weight/day) for 20 weeks; group 3 rats were subjected to two-phase hepatocarcinogenic regimen (initiation of hepatocarcinogenesis was performed by a single intraperitoneal injection of DEN at a dose of 200 mg/kg body weight, 2 weeks later, the carcinogenic effect was promoted by supplementation of rats with 0.05% PB for 16 weeks); group 4 rats were injected intraperitoneally with S. inermis extract 2 weeks prior to the injection of DEN, the daily injection of S. inermis extract was then continued for 18 weeks along with two-phase hepatocarcinogenic regimen (chemoprevention group); and group 5 rats were subjected to the two-phase hepatocarcinogenic regimen, and then, the animals were injected intraperitoneally with S. inermis extract for 4 weeks (treatment group). The activities of serum liver enzymes and levels of total bilirubin, conjugated bilirubin, α-fetoprotein, vascular endothelial growth factor (VEGF) and soluble intercellular adhesion molecule-1 (sICAM-1) in serum were decreased in chemopreventive and treated rats compared with DEN/PB-administered rats. Interestingly, the serum levels of total protein and albumin were normalized in chemopreventive and treated rats. Moreover, the majority of chemopreventive and treated rats showed an almost normal histological pattern of liver. In conclusion, S. inermis extract possessed chemopreventive and therapeutic activities against hepatocarcinogenesis in rats partially through the inhibition of VEGF and sICAM-1.

Keywords: Salsola inermis extract, hepatocarcinogenesis, α–fetoprotein, VEGF, sICAM-1

Procedia PDF Downloads 355
1839 Influence of Shading on a BIPV System’s Performance in an Urban Context: Case Study of BIPV Systems of the Science Center of Complexity Building of the National and Autonomous University of Mexico in Mexico City

Authors: Viridiana Edith Ardura Perea, José Luis Bermúdez Alcocer

Abstract:

The purpose of this paper is to establish the influence of shading on a Building Integrated Photovoltaic (BIPV) system´s performance in an urban context. The PV systems of the Science Center of Complexity (Centro de Ciencias de la Complejidad) Building based in the Main Campus of the National and Autonomous University of Mexico (UNAM) in Mexico City was taken as case study.  The PV systems are placed on the rooftop and on the south façade of the building.  The south-façade PV system, operating as sunshades, consists of two strings:  one at the ground floor and the other one at the first floor.  According to the building’s facility manager, the south-façade PV system generates 42% less electricity per kilowatt peak (kWp) installed than the one on the roof.  The methods applied in this study were Solar Radiation Analysis (SRA) simulations performed with the Insight 360 Plug-in from Revit 2018® and an on-site measurement using specialized tools.  The results of the SRA simulations showed that the shading casted by the PV system placed on the first floor on top of the PV system of the ground floor decreases its solar incident radiation over 50%.  The simulation outcome was compared and validated to the measured data obtained from the on-site measurement.  In conclusion, the loss factor achieved from the shading of the PVs is due to the surroundings and the PV system´s own design.  The south-façade BIPV system’s deficient design generates critical losses on its performance and decreases its profitability.

Keywords: building integrated photovoltaics design, energy analysis software, shading losses, solar radiation analysis

Procedia PDF Downloads 159
1838 Prediction of Survival Rate after Gastrointestinal Surgery Based on The New Japanese Association for Acute Medicine (JAAM Score) With Neural Network Classification Method

Authors: Ayu Nabila Kusuma Pradana, Aprinaldi Jasa Mantau, Tomohiko Akahoshi

Abstract:

The incidence of Disseminated intravascular coagulation (DIC) following gastrointestinal surgery has a poor prognosis. Therefore, it is important to determine the factors that can predict the prognosis of DIC. This study will investigate the factors that may influence the outcome of DIC in patients after gastrointestinal surgery. Eighty-one patients were admitted to the intensive care unit after gastrointestinal surgery in Kyushu University Hospital from 2003 to 2021. Acute DIC scores were estimated using the new Japanese Association for Acute Medicine (JAAM) score from before and after surgery from day 1, day 3, and day 7. Acute DIC scores will be compared with The Sequential Organ Failure Assessment (SOFA) score, platelet count, lactate level, and a variety of biochemical parameters. This study applied machine learning algorithms to predict the prognosis of DIC after gastrointestinal surgery. The results of this study are expected to be used as an indicator for evaluating patient prognosis so that it can increase life expectancy and reduce mortality from cases of DIC patients after gastrointestinal surgery.

Keywords: the survival rate, gastrointestinal surgery, JAAM score, neural network, machine learning, disseminated intravascular coagulation (DIC)

Procedia PDF Downloads 238
1837 Corneal Confocal Microscopy As a Surrogate Marker of Neuronal Pathology In Schizophrenia

Authors: Peter W. Woodruff, Georgios Ponirakis, Reem Ibrahim, Amani Ahmed, Hoda Gad, Ioannis N. Petropoulos, Adnan Khan, Ahmed Elsotouhy, Surjith Vattoth, Mahmoud K. M. Alshawwaf, Mohamed Adil Shah Khoodoruth, Marwan Ramadan, Anjushri Bhagat, James Currie, Ziyad Mahfoud, Hanadi Al Hamad, Ahmed Own, Peter Haddad, Majid Alabdulla, Rayaz A. Malik

Abstract:

Introduction:- We aimed to test the hypothesis that, using corneal confocal microscopy (a non-invasive method for assessing corneal nerve fibre integrity), patients with schizophrenia would show neuronal abnormalities compared with healthy participants. Schizophrenia is a neurodevelopmental and progressive neurodegenerative disease, for which there are no validated biomarkers. Corneal confocal microscopy (CCM) is a non-invasive ophthalmic imaging biomarker that can be used to detect neuronal abnormalities in neuropsychiatric syndromes. Methods:- Patients with schizophrenia (DSM-V criteria) without other causes of peripheral neuropathy and healthy controls underwent CCM, vibration perception threshold (VPT) and sudomotor function testing. The diagnostic accuracy of CCM in distinguishing patients from controls was assessed using the area under the curve (AUC) of the Receiver Operating Characterstics (ROC) curve. Findings:- Participants with schizophrenia (n=17) and controls (n=38) with comparable age (35.7±8.5 vs 35.6±12.2, P=0.96) were recruited. Patients with schizophrenia had significantly higher body weight (93.9±25.5 vs 77.1±10.1, P=0.02), lower Low Density Lipoproteins (2.6±1.0 vs 3.4±0.7, P=0.02), but comparable systolic and diastolic blood pressure, HbA1c, total cholesterol, triglycerides and High Density Lipoproteins were comparable with control participants. Patients with schizophrenia had significantly lower corneal nerve fiber density (CNFD, fibers/mm2) (23.5±7.8 vs 35.6±6.5, p<0.0001), branch density (CNBD, branches/mm2) (34.4±26.9 vs 98.1±30.6, p<0.0001), and fiber length (CNFL, mm/mm2) (14.3±4.7 vs 24.2±3.9, p<0.0001) but no difference in VPT (6.1±3.1 vs 4.5±2.8, p=0.12) and electrochemical skin conductance (61.0±24.0 vs 68.9±12.3, p=0.23) compared with controls. The diagnostic accuracy of CNFD, CNBD and CNFL to distinguish patients with schizophrenia from healthy controls were, according to the AUC, (95% CI): 87.0% (76.8-98.2), 93.2% (84.2-102.3), 93.2% (84.4-102.1), respectively. Conclusion:- In conclusion, CCM can be used to help identify neuronal changes and has a high diagnostic accuracy to distinguish subjects with schizophrenia from healthy controls.

Keywords:

Procedia PDF Downloads 258
1836 Passively Q-Switched 914 nm Microchip Laser for LIDAR Systems

Authors: Marco Naegele, Klaus Stoppel, Thomas Dekorsy

Abstract:

Passively Q-switched microchip lasers enable the great potential for sophisticated LiDAR systems due to their compact overall system design, excellent beam quality, and scalable pulse energies. However, many near-infrared solid-state lasers show emitting wavelengths > 1000 nm, which are not compatible with state-of-the-art silicon detectors. Here we demonstrate a passively Q-switched microchip laser operating at 914 nm. The microchip laser consists of a 3 mm long Nd:YVO₄ crystal as a gain medium, while Cr⁴⁺:YAG with an initial transmission of 98% is used as a saturable absorber. Quasi-continuous pumping enables single pulse operation, and low duty cycles ensure low overall heat generation and power consumption. Thus, thermally induced instabilities are minimized, and operation without active cooling is possible while ambient temperature changes are compensated by adjustment of the pump laser current only. Single-emitter diode pumping at 808 nm leads to a compact overall system design and robust setup. Utilization of a microchip cavity approach ensures single-longitudinal mode operation with spectral bandwidths in the picometer regime and results in short laser pulses with pulse durations below 10 ns. Beam quality measurements reveal an almost diffraction-limited beam and enable conclusions concerning the thermal lens, which is essential to stabilize the plane-plane resonator. A 7% output coupler transmissivity is used to generate pulses with energies in the microjoule regime and peak powers of more than 600 W. Long-term pulse duration, pulse energy, central wavelength, and spectral bandwidth measurements emphasize the excellent system stability and facilitate the utilization of this laser in the context of a LiDAR system.

Keywords: diode-pumping, LiDAR system, microchip laser, Nd:YVO4 laser, passively Q-switched

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1835 A General Framework for Knowledge Discovery Using High Performance Machine Learning Algorithms

Authors: S. Nandagopalan, N. Pradeep

Abstract:

The aim of this paper is to propose a general framework for storing, analyzing, and extracting knowledge from two-dimensional echocardiographic images, color Doppler images, non-medical images, and general data sets. A number of high performance data mining algorithms have been used to carry out this task. Our framework encompasses four layers namely physical storage, object identification, knowledge discovery, user level. Techniques such as active contour model to identify the cardiac chambers, pixel classification to segment the color Doppler echo image, universal model for image retrieval, Bayesian method for classification, parallel algorithms for image segmentation, etc., were employed. Using the feature vector database that have been efficiently constructed, one can perform various data mining tasks like clustering, classification, etc. with efficient algorithms along with image mining given a query image. All these facilities are included in the framework that is supported by state-of-the-art user interface (UI). The algorithms were tested with actual patient data and Coral image database and the results show that their performance is better than the results reported already.

Keywords: active contour, bayesian, echocardiographic image, feature vector

Procedia PDF Downloads 406
1834 Impact of Combined Heat and Power (CHP) Generation Technology on Distribution Network Development

Authors: Sreto Boljevic

Abstract:

In the absence of considerable investment in electricity generation, transmission and distribution network (DN) capacity, the demand for electrical energy will quickly strain the capacity of the existing electrical power network. With anticipated growth and proliferation of Electric vehicles (EVs) and Heat pump (HPs) identified the likelihood that the additional load from EV changing and the HPs operation will require capital investment in the DN. While an area-wide implementation of EVs and HPs will contribute to the decarbonization of the energy system, they represent new challenges for the existing low-voltage (LV) network. Distributed energy resources (DER), operating both as part of the DN and in the off-network mode, have been offered as a means to meet growing electricity demand while maintaining and ever-improving DN reliability, resiliency and power quality. DN planning has traditionally been done by forecasting future growth in demand and estimating peak load that the network should meet. However, new problems are arising. These problems are associated with a high degree of proliferation of EVs and HPs as load imposes on DN. In addition to that, the promotion of electricity generation from renewable energy sources (RES). High distributed generation (DG) penetration and a large increase in load proliferation at low-voltage DNs may have numerous impacts on DNs that create issues that include energy losses, voltage control, fault levels, reliability, resiliency and power quality. To mitigate negative impacts and at a same time enhance positive impacts regarding the new operational state of DN, CHP system integration can be seen as best action to postpone/reduce capital investment needed to facilitate promotion and maximize benefits of EVs, HPs and RES integration in low-voltage DN. The aim of this paper is to generate an algorithm by using an analytical approach. Algorithm implementation will provide a way for optimal placement of the CHP system in the DN in order to maximize the integration of RES and increase in proliferation of EVs and HPs.

Keywords: combined heat & power (CHP), distribution networks, EVs, HPs, RES

Procedia PDF Downloads 186
1833 Revising Our Ideas on Revisions: Non-Contact Bridging Plate Fixation of Vancouver B1 and B2 Periprosthetic Femoral Fractures

Authors: S. Ayeko, J. Milton, C. Hughes, K. Anderson, R. G. Middleton

Abstract:

Background: Periprosthetic femoral fractures (PFF) in association with hip hemiarthroplasty or total hip arthroplasty is a common and serious complication. In the Vancouver Classification system algorithm, B1 fractures should be treated with Open Reduction and Internal Fixation (ORIF) and preferentially revised in combination with ORIF if B2 or B3. This study aims to assess patient outcomes after plate osteosynthesis alone for Vancouver B1 and B2 fractures. The main outcome is the 1-year re-revision rate, and secondary outcomes are 30-day and 1-year mortality. Method: This is a retrospective single-centre case-series review from January 2016 to June 2021. Vancouver B1 and B2, non-malignancy fractures in adults over 18 years of age treated with polyaxial Non-Contact Bridging plate osteosynthesis, have been included. Outcomes were gathered from electronic notes and radiographs. Results: There were 50 B1 and 64 B2 fractures. 26 B2 fractures were managed with ORIF and revision, 39 ORIF alone. Of the revision group, one died within 30 days (3.8%), one at one year (3.8%), and two were revised within one year (7.7). Of the B2 ORIF group, three died within 30-day mortality (7.96%), eight at one year (21.1%), and 0 were revised in 1 year. Conclusion: This study has demonstrated that satisfactory outcomes can be achieved with ORIF, excluding revision in the management of B2 fractures.

Keywords: arthroplasty, bridging plate, periprosthetic fracture, revision surgery

Procedia PDF Downloads 90
1832 A Comprehensive Comparative Study on Seasonal Variation of Parameters Involved in Site Characterization and Site Response Analysis by Using Microtremor Data

Authors: Yehya Rasool, Mohit Agrawal

Abstract:

The site characterization and site response analysis are the crucial steps for reliable seismic microzonation of an area. So, the basic parameters involved in these fundamental steps are required to be chosen properly in order to efficiently characterize the vulnerable sites of the study region. In this study, efforts are made to delineate the variations in the physical parameter of the soil for the summer and monsoon seasons of the year (2021) by using Horizontal-to-Vertical Spectral Ratios (HVSRs) recorded at five sites of the Indian Institute of Technology (Indian School of Mines), Dhanbad, Jharkhand, India. The data recording at each site was done in such a way that less amount of anthropogenic noise was recorded at each site. The analysis has been done for five seismic parameters like predominant frequency, H/V ratio, the phase velocity of Rayleigh waves, shear wave velocity (Vs), compressional wave velocity (Vp), and Poisson’s ratio for both the seasons of the year. From the results, it is observed that these parameters majorly vary drastically for the upper layers of soil, which in turn may affect the amplification ratios and probability of exceedance obtained from seismic hazard studies. The HVSR peak comes out to be higher in monsoon, with a shift in predominant frequency as compared to the summer season of the year 2021. Also, the drastic reduction in shear wave velocity (up to ~10 m) of approximately 7%-15% is also perceived during the monsoon period with a slight decrease in compressional wave velocity. Generally, the increase in the Poisson ratios is found to have higher values during monsoon in comparison to the summer period. Our study may be very beneficial to various agricultural and geotechnical engineering projects.

Keywords: HVSR, shear wave velocity profile, Poisson ratio, microtremor data

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1831 Duplicated Common Bile Duct: A Recipe for Injury

Authors: David Armany, Matthew Allaway, Preet Gosal, Senarath Edirimanne

Abstract:

A potentially devastating complication of routine laparoscopic cholecystectomy includes iatrogenic bile duct injuries, which represent a stable incidence rate of 0.3% over the past three decades. Whilst related to several relative risks such as surgeon experience and patient factors (older age, male sex), misinterpretation of biliary tree anatomy remains the most common cause, accounting for 80% of iatrogenic Common Bile Duct injuries. Whilst extremely rare, a duplicate common bile duct anomaly remains a potential variation to encounter during biliary surgery, with 30 recognised cases in the worldwide literature, of which type Vb accounts for 4. We report the case of a rare type Vb variation encountered during intra-operative laparoscopic cholecystectomy and confirmed on cholangiogram. To our knowledge, this is the first documented Type Vb case encountered in an Australian population. Given these anomalies are asymptomatic and can perpetuate iatrogenic common bile duct injuries, awareness of all subtypes is crucial. Irrevocably, preoperative Magnetic Resonance Cholangiopancreatography can help recognise these anomalies before the operating theatre; however, their widespread adoption is limited by expensive and availability.

Keywords: duplicated common bile duct, type Vb, cholecystitis, MRCP, cholangiogram, iatrogenic CBD

Procedia PDF Downloads 80
1830 Health Risk Assessment of Exposing to Benzene in Office Building around a Chemical Industry Based on Numerical Simulation

Authors: Majid Bayatian, Mohammadreza Ashouri

Abstract:

Releasing hazardous chemicals is one of the major problems for office buildings in the chemical industry and, therefore, environmental risks are inherent to these environments. The adverse health effects of the airborne concentration of benzene have been a matter of significant concern, especially in oil refineries. The chronic and acute adverse health effects caused by benzene exposure have attracted wide attention. Acute exposure to benzene through inhalation could cause headaches, dizziness, drowsiness, and irritation of the skin. Chronic exposures have reported causing aplastic anemia and leukemia at the occupational settings. Association between chronic occupational exposure to benzene and the development of aplastic anemia and leukemia were documented by several epidemiological studies. Numerous research works have investigated benzene emissions and determined benzene concentration at different locations of the refinery plant and stated considerable health risks. The high cost of industrial control measures requires justification through lifetime health risk assessment of exposed workers and the public. In the present study, a Computational Fluid Dynamics (CFD) model has been proposed to assess the exposure risk of office building around a refinery due to its release of benzene. For simulation, GAMBIT, FLUENT, and CFD Post software were used as pre-processor, processor, and post-processor, and the model was validated based on comparison with experimental results of benzene concentration and wind speed. Model validation results showed that the model is highly validated, and this model can be used for health risk assessment. The simulation and risk assessment results showed that benzene could be dispersion to an office building nearby, and the exposure risk has been unacceptable. According to the results of this study, a validated CFD model, could be very useful for decision-makers for control measures and possibly support them for emergency planning of probable accidents. Also, this model can be used to assess exposure to various types of accidents as well as other pollutants such as toluene, xylene, and ethylbenzene in different atmospheric conditions.

Keywords: health risk assessment, office building, Benzene, numerical simulation, CFD

Procedia PDF Downloads 114
1829 The Evolution of the Strategic Plasma Industry

Authors: Zahra Ghasemi, Fatemeh Babaei

Abstract:

Plasma-derived medicinal products are vital categories of biological therapies. These products are used to treat rare, chronic, severe, and life-threatening conditions, such as bleeding disorders (Hemophilia A and B), hemolytic disease of the fetus and newborn, severe infections, burns and liver diseases, and other diseases caused by the absence or malfunction of certain proteins. In addition, they improve the patient’s quality of life. The process of producing plasma-derived medicinal products begins with the collection of human plasma from healthy donors. This initial stage is complex and is monitored with high precision and sensitivity by global authorities to maintain the quality and safety of the final products as well as the health of the donors. The amount of manufactured plasma-derived medicinal products depends on the availability of its raw material, human plasma, so collecting enough plasma for fractionation is essential. Therefore, adopting a suitable national policy regarding plasma donation, establishing collection centers, and increasing public awareness of the importance of plasma donation will improve any country’s conditions regarding the timely and sufficient supply of these medicines. In this study, we tried to briefly examine the importance of sustainability of the plasma industry and its situation in our beloved country of Iran.

Keywords: plasma, source plasma, plasma-derived medicinal products, fractionation

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1828 Solid Lipid Nanoparticles of Levamisole Hydrochloride

Authors: Surendra Agrawal, Pravina Gurjar, Supriya Bhide, Ram Gaud

Abstract:

Levamisole hydrochloride is a prominent anticancer drug in the treatment of colon cancer but resulted in toxic effects due poor bioavailability and poor cellular uptake by tumor cells. Levamisole is an unstable drug. Incorporation of this molecule in solid lipids may minimize their exposure to the aqueous environment and partly immobilize the drug molecules within the lipid matrix-both of which may protect the encapsulated drugs against degradation. The objectives of the study were to enhance bioavailability by sustaining drug release and to reduce the toxicities associated with the therapy. Solubility of the drug was determined in different lipids to select the components of Solid Lipid Nanoparticles (SLN). Pseudoternary phase diagrams were created using aqueous titration method. Formulations were subjected to particle size and stability evaluation to select the final test formulations which were characterized for average particle size, zeta potential, and in-vitro drug release and percentage transmittance to optimize the final formulation. SLN of Levamisole hydrochloride was prepared by Nanoprecipitation method. Glyceryl behenate (Compritol 888 ATO) was used as core comprising of Tween 80 as surfactant and Lecithin as co-surfactant in (1:1) ratio. Entrapment efficiency (EE) was found to be 45.89%. Particle size was found in the range of 100-600 nm. Zeta potential of the formulation was -17.0 mV revealing the stability of the product. In-vitro release study showed that 66 % drug released in 24 hours in pH 7.2 which represent that formulation can give controlled action at the intestinal environment. In pH 5.0 it showed 64% release indicating that it can even release drug in acidic environment of tumor cells. In conclusion, results revealed SLN to be a promising approach to sustain the drug release so as to increase bioavailability and cellular uptake of the drug with reduction in toxic effects as dose has been reduced with controlled delivery.

Keywords: SLN, nanoparticulate delivery of levamisole, pharmacy, pharmaceutical sciences

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1827 Passive Seismic in Hydrogeological Prospecting: The Case Study from Hard Rock and Alluvium Plain

Authors: Prarabdh Tiwari, M. Vidya Sagar, K. Bhima Raju, Joy Choudhury, Subash Chandra, E. Nagaiah, Shakeel Ahmed

Abstract:

Passive seismic, a wavefield interferometric imaging, low cost and rapid tool for subsurface investigation is used for various geotechnical purposes such as hydrocarbon exploration, seismic microzonation, etc. With the recent advancement, its application has also been extended to groundwater exploration by means of finding the bedrock depth. Council of Scientific & Industrial Research (CSIR)-National Geophysical Research Institute (NGRI) has experimented passive seismic studies along with electrical resistivity tomography for groundwater in hard rock (Choutuppal, Hyderabad). Passive Seismic with Electrical Resistivity (ERT) can give more clear 2-D subsurface image for Groundwater Exploration in Hard Rock area. Passive seismic data were collected using a Tromino, a three-component broadband seismometer, to measure background ambient noise and processed using GRILLA software. The passive seismic results are found corroborating with ERT (Electrical Resistivity Tomography) results. For data acquisition purpose, Tromino was kept over 30 locations consist recording of 20 minutes at each station. These location shows strong resonance frequency peak, suggesting good impedance contrast between different subsurface layers (ex. Mica rich Laminated layer, Weathered layer, granite, etc.) This paper presents signature of passive seismic for hard rock terrain. It has been found that passive seismic has potential application for formation characterization and can be used as an alternative tool for delineating litho-stratification in an urban condition where electrical and electromagnetic tools cannot be applied due to high cultural noise. In addition to its general application in combination with electrical and electromagnetic methods can improve the interpreted subsurface model.

Keywords: passive seismic, resonant frequency, Tromino, GRILLA

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1826 A Xenon Mass Gauging through Heat Transfer Modeling for Electric Propulsion Thrusters

Authors: A. Soria-Salinas, M.-P. Zorzano, J. Martín-Torres, J. Sánchez-García-Casarrubios, J.-L. Pérez-Díaz, A. Vakkada-Ramachandran

Abstract:

The current state-of-the-art methods of mass gauging of Electric Propulsion (EP) propellants in microgravity conditions rely on external measurements that are taken at the surface of the tank. The tanks are operated under a constant thermal duty cycle to store the propellant within a pre-defined temperature and pressure range. We demonstrate using computational fluid dynamics (CFD) simulations that the heat-transfer within the pressurized propellant generates temperature and density anisotropies. This challenges the standard mass gauging methods that rely on the use of time changing skin-temperatures and pressures. We observe that the domes of the tanks are prone to be overheated, and that a long time after the heaters of the thermal cycle are switched off, the system reaches a quasi-equilibrium state with a more uniform density. We propose a new gauging method, which we call the Improved PVT method, based on universal physics and thermodynamics principles, existing TRL-9 technology and telemetry data. This method only uses as inputs the temperature and pressure readings of sensors externally attached to the tank. These sensors can operate during the nominal thermal duty cycle. The improved PVT method shows little sensitivity to the pressure sensor drifts which are critical towards the end-of-life of the missions, as well as little sensitivity to systematic temperature errors. The retrieval method has been validated experimentally with CO2 in gas and fluid state in a chamber that operates up to 82 bar within a nominal thermal cycle of 38 °C to 42 °C. The mass gauging error is shown to be lower than 1% the mass at the beginning of life, assuming an initial tank load at 100 bar. In particular, for a pressure of about 70 bar, just below the critical pressure of CO2, the error of the mass gauging in gas phase goes down to 0.1% and for 77 bar, just above the critical point, the error of the mass gauging of the liquid phase is 0.6% of initial tank load. This gauging method improves by a factor of 8 the accuracy of the standard PVT retrievals using look-up tables with tabulated data from the National Institute of Standards and Technology.

Keywords: electric propulsion, mass gauging, propellant, PVT, xenon

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1825 An Evidence Map of Cost-Utility Studies in Non-Small Cell Lung Cancer

Authors: Cassandra Springate, Alexandra Furber, Jack E. Hines

Abstract:

Objectives: To create an evidence map of the cost-utility studies available with non-small cell lung cancer patients, and identify the geographical settings and interventions used. Methods: Using the Disease, Study Type, and Model Type filters in heoro.com we identified all cost-utility studies published between 1960 and 2017 with patients with non-small cell lung cancer. These papers were then indexed according to pre-specified categories. Results: Heoro.com identified 89 independent publications, published between 1995 and 2017. Of the 89 papers, 74 were published since 2010, 28 were from the USA, and 35 were from Europe, 16 of which were from the UK. Other publications were from China and Japan (13), Canada (9), Australia and New Zealand (4), and other countries (8). Fifty-nine studies included a chemotherapy intervention, of which 23 included erlotinib or gefitinib, 21 included pemetrexed or docetaxel, others included nivolumab (3), pembrolizumab (2), crizotinib (2), denosumab (2), necitumumab (1), and bevacizumab (1). Also, 19 studies modeled screening, staging, or surveillance strategies. Conclusions: The cost-utility studies found for NSCLC most commonly looked at the effectiveness of different chemotherapy treatments, with some also evaluating the addition of screening strategies. Most were also conducted with patient data from the USA and Europe.

Keywords: cancer, cost-utility, economic model, non-small cell lung cancer

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1824 Analysis of the AZF Region in Slovak Men with Azoospermia

Authors: J. Bernasovská, R. Lohajová Behulová, E. Petrejčiková, I. Boroňová, I. Bernasovský

Abstract:

Y chromosome microdeletions are the most common genetic cause of male infertility and screening for these microdeletions in azoospermic or severely oligospermic men is now standard practice. Analysis of the Y chromosome in men with azoospermia or severe oligozoospermia has resulted in the identification of three regions in the euchromatic part of the long arm of the human Y chromosome (Yq11) that are frequently deleted in men with otherwise unexplained spermatogenic failure. PCR analysis of microdeletions in the AZFa, AZFb and AZFc regions of the human Y chromosome is an important screening tool. The aim of this study was to analyse the type of microdeletions in men with fertility disorders in Slovakia. We evaluated 227 patients with azoospermia and with normal karyotype. All patient samples were analyzed cytogenetically. For PCR amplification of sequence-tagged sites (STS) of the AZFa, AZFb and AZFc regions of the Y chromosome was used Devyser AZF set. Fluorescently labeled primers for all markers in one multiplex PCR reaction were used and for automated visualization and identification of the STS markers we used genetic analyzer ABi 3500xl (Life Technologies). We reported 13 cases of deletions in the AZF region 5,73%. Particular types of deletions were recorded in each region AZFa,b,c .The presence of microdeletions in the AZFc region was the most frequent. The study confirmed that percentage of microdeletions in the AZF region is low in Slovak azoospermic patients, but important from a prognostic view.

Keywords: AZF, male infertility, microdeletions, Y chromosome

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1823 Effect of Madecassoside on the Antioxidant Status of Streptozotocin-Nicotinamide Induced Diabetes in Sprague-Dawley Rats

Authors: C. Mayuren, C. K. Paul Wang, K. Purushotham, C. Dinesh Kumar

Abstract:

Diabetes Mellitus (DM) is one of the most common non-communicable diseases globally. Although significant advances have led to better understanding of the condition and the development of effective therapies and preventive strategies, the pathway to cure remains elusive and DM prevails as a serious medical challenge in the 21st century. Oxidative stress has been suggested to contribute to the progression and pathophysiological conditions of diabetes. Madecassoside (MA) a major pentacyclic triterpenoid, has been demonstrated to possess various biological activities. However, no attempt has been made to study the antioxidant activity in diabetic rats. Therefore, the present study is aimed to evaluate the antioxidant effect of MA on streptozotocin-nicotinamide induced type-2 diabetes in Sprague-Dawley rats. The study protocol was approved by the institutional ethical committee prior to the conduct of research. Adult male Sprague-Dawley rats weighing 250-300 g were used in the study. The animals were rendered diabetic with a single intraperitoneal dose of streptozotocin (65 mg/kg) and nicotinamide (110 mg/kg). The diabetic animals after a stabilisation period of 14 days received various treatments (Madecassoside 50 mg/kg; Glimepiride 2.5 mg/kg) suspended in 0.5% carboxymethyl cellulose orally, for a period of 28 days. The animals fasted overnight after the last treatment were sacrificed and the pancreas, liver and kidneys were isolated. The weighted quantity of the samples of various treatments were homogenised in ice-cold condition and were subjected to lipid peroxidation, catalase and superoxide dismutase assay. The data’s obtained were subjected to statistical analysis. Diabetic rats showed significant increase in lipid peroxidation and decrease in enzymatic antioxidant levels. All the treated groups had significantly higher SOD, CAT and reduced LPO activity in the pancreas, liver and kidney. Results suggest madecassoside to have potential antioxidant effect against the diabetic model. However further investigations are necessary to study the mechanism at the cellular level.

Keywords: antioxidant, diabetes, madecassoside, nicotinamide, streptozotocin

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1822 A Benchmark System for Testing Medium Voltage Direct Current (MVDC-CB) Robustness Utilizing Real Time Digital Simulation and Hardware-In-Loop Theory

Authors: Ali Kadivar, Kaveh Niayesh

Abstract:

The integration of green energy resources is a major focus, and the role of Medium Voltage Direct Current (MVDC) systems is exponentially expanding. However, the protection of MVDC systems against DC faults is a challenge that can have consequences on reliable and safe grid operation. This challenge reveals the need for MVDC circuit breakers (MVDC CB), which are in infancies of their improvement. Therefore will be a lack of MVDC CBs standards, including thresholds for acceptable power losses and operation speed. To establish a baseline for comparison purposes, a benchmark system for testing future MVDC CBs is vital. The literatures just give the timing sequence of each switch and the emphasis is on the topology, without in-depth study on the control algorithm of DCCB, as the circuit breaker control system is not yet systematic. A digital testing benchmark is designed for the Proof-of-concept of simulation studies using software models. It can validate studies based on real-time digital simulators and Transient Network Analyzer (TNA) models. The proposed experimental setup utilizes data accusation from the accurate sensors installed on the tested MVDC CB and through general purpose input/outputs (GPIO) from the microcontroller and PC Prototype studies in the laboratory-based models utilizing Hardware-in-the-Loop (HIL) equipment connected to real-time digital simulators is achieved. The improved control algorithm of the circuit breaker can reduce the peak fault current and avoid arc resignation, helping the coordination of DCCB in relay protection. Moreover, several research gaps are identified regarding case studies and evaluation approaches.

Keywords: DC circuit breaker, hardware-in-the-loop, real time digital simulation, testing benchmark

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1821 Influence of IL-1β on Hamster Blastocyst Hatching via Regulation of Hatching Associated Proteases

Authors: Madhulika Pathak, Polani Seshagiri, Vani Venkatappa

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Blastocyst hatching is an indispensable process for successful implantation. One of the major reasons for implantation failure in IVF clinic is poor quality of embryo, which are not development/hatching-competent. Therefore, attempts are required to develop or enhance the culture system with a molecule recapitulating the autocrine/paracrine factors containing the environment of in-vivo endometrial milieu. We have tried to explore the functional molecules involved in the hamster hatching phenomenon. Blastocyst hatching is governed by several molecules that are entwined and regulate this process, among which cytokines are known to be expressed and are still least explored. Two of such cytokines we have used for our study are IL-1β and its natural antagonist IL-1ra to understand the functional dynamics of cytokines involved in the hatching process. Using hamster, an intriguing experimental model for hatching behavior, we have shown the mRNA (qPCR) and protein (ICC) expression of IL-1β, IL-1ra and IL-1 receptor type 1 throughout all the stages of morula, blastocyst and hatched blastocyst. Post-asserting the expression, the functional role is shown by supplementation studies, where IL-1β supplementation showed enhancement in hatching level (IL-1β treated: 84.1 ± 4.2% vs control: 63.7 ± 3.1 %, N=11), further confirmed by the diminishing effect of IL-1ra on hatching rate (IL-1ra treated: 27.5 ± 11.1% vs control: 67.9 ± 3.1%). The exogenous supplementation of IL-1ra decreased the survival rate of embryos and affected the viability in dose-dependent manner, establishing the importance of IL-1β in blastocyst cell survival. Previously, the cathepsin L and B were established as the proteases that were involved in the hamster hatching process. The inducing effect of IL-1β was correlated with enhanced mRNA level, as analyzed by qPCR, for both CAT L (by 1.9 ± 0.5 fold) and CAT B (by 3.5 ± 0.1) fold which was diminished in presence of IL-1ra (Cat L by 88 percent and Cat B by 94 percent. Moreover, using a specific fluorescent substrate-based assay kit, the enzymatic activity of these proteases was found to be increased in presence of IL-1β (Cat L by 2.1 ± 0.1 fold and CAT B by 2.3 ± 0.7 fold) and was curtailed in presence of IL-1ra. These observations provide functional insights with respect to the involvement of cytokines in the hatching process. This has implications in understanding the hatching biology and improving the embryo development quality in IVF clinics.

Keywords: Blastocyst, Cytokines, Hatching, Interleukin

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1820 Isolation Preserving Medical Conclusion Hold Structure via C5 Algorithm

Authors: Swati Kishor Zode, Rahul Ambekar

Abstract:

Data mining is the extraction of fascinating examples on the other hand information from enormous measure of information and choice is made as indicated by the applicable information extracted. As of late, with the dangerous advancement in internet, stockpiling of information and handling procedures, privacy preservation has been one of the major (higher) concerns in data mining. Various techniques and methods have been produced for protection saving data mining. In the situation of Clinical Decision Support System, the choice is to be made on the premise of the data separated from the remote servers by means of Internet to diagnose the patient. In this paper, the fundamental thought is to build the precision of Decision Support System for multiple diseases for different maladies and in addition protect persistent information while correspondence between Clinician side (Client side) also, the Server side. A privacy preserving protocol for clinical decision support network is proposed so that patients information dependably stay scrambled amid diagnose prepare by looking after the accuracy. To enhance the precision of Decision Support System for various malady C5.0 classifiers and to save security, a Homomorphism encryption algorithm Paillier cryptosystem is being utilized.

Keywords: classification, homomorphic encryption, clinical decision support, privacy

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1819 Influence of Degassing on the Curing Behaviour and Void Occurrence Properties of Epoxy / Anhydride Resin System

Authors: Latha Krishnan, Andrew Cobley

Abstract:

Epoxy resin is most widely used as matrices for composites of aerospace, automotive and electronic applications due to its outstanding mechanical properties. These properties are chiefly predetermined by the chemical structure of the prepolymer and type of hardener but can also be varied by the processing conditions such as prepolymer and hardener mixing, degassing and curing conditions. In this research, the effect of degassing on the curing behaviour and the void occurrence is experimentally evaluated for epoxy /anhydride resin system. The epoxy prepolymer was mixed with an anhydride hardener and accelerator in an appropriate quantity. In order to investigate the effect of degassing on the curing behaviour and void content of the resin, the uncured resin samples were prepared using three different methods: 1) no degassing 2) degassing on prepolymer and 3) degassing on mixed solution of prepolymer and hardener with an accelerator. The uncured resins were tested in differential scanning calorimeter (DSC) to observe the changes in curing behaviour of the above three resin samples by analysing factors such as gel temperature, peak cure temperature and heat of reaction/heat flow in curing. Additionally, the completely cured samples were tested in DSC to identify the changes in the glass transition temperature (Tg) between the three samples. In order to evaluate the effect of degassing on the void content and morphology changes in the cured epoxy resin, the fractured surfaces of cured epoxy resin were examined under the scanning electron microscope (SEM). In addition, the amount of void, void geometry and void fraction were also investigated using an optical microscope and image J software (image analysis software). It was found that degassing at different stages of resin mixing had significant effects on properties such as glass transition temperature, the void content and void size of the epoxy/anhydride resin system. For example, degassing (vacuum applied on the mixed resin) has shown higher glass transition temperature (Tg) with lower void content.

Keywords: anhydride epoxy, curing behaviour, degassing, void occurrence

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1818 Post COVID-19 Pandemic Determinants of Depression and Anxiety Among the Moroccan Population

Authors: Kaoutar Chbihi, Aziza Menouni, Imane Berni, Tarik Abchouch, Samir El Jaafari

Abstract:

The unpredictability and ambiguity of a pandemic, combined with the economic impact, sedentary lifestyle, and increased living cost, have the potential to seriously raise the risk of mental health issues among the population. Therefore, this study had the aim to assess the magnitude of mental health outcomes and risk factors among the general population in Morocco in times of the Covid-19 pandemic. This study consisted of a cross-sectional design and was survey-based and region-stratified by collecting demographic data and mental health measurements from 523 participants. The degree of depression, anxiety, and insomnia symptoms were assessed by using the 9-item Patient Health Questionnaire and the 7-items Generalized Anxiety Disorder. The survey was completed by 523 individuals. Results showed that 67.9% were women, and 58.6% were aged 18-30 years. 49% of participants reported depression issues, while 39.8% experienced anxiety. Being a married woman with children was associated with severe symptoms of depression and anxiety. Finally, our findings reported a significant mental health burden among the general population of Morocco, which needs to be tackled by specific co-created interventions and adapted strategies in order to prevent impacts on public health.

Keywords: anxiety, COVID-19, depression, mental health, Morocco, pandemic

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1817 Impact of Management and Development of Destination Attributes on Coastal Tourists' Visitor Experience, Negombo, Sri Lanka

Authors: M. S. R. Waas, S. G. U. S. Chandrarathne, U. A. Kumara

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The purpose of this quantitative study is to identify the impact of the destination attributes of Negombo on the coastal tourists’ visitor experience. As an island nation, Sri Lanka is identified and well renowned for its gold sandy beaches and natural scenic beauty. Among many tourist attractions, Negombo is identified as a developed beach centric tourist destination in the country. Yet, it is identified that there are low positive reviews on the internet for Negombo compared to other beach centric tourist attractions in Sri Lanka. Therefore, this study would help the policymakers and tourism service providers to identify the impact of destination attributes on international visitor satisfaction and to understand the visitors comprehensively so as to develop Negombo as a stable tourist destination while offering a memorable and satisfying experience for its visitors. In support, a self-administered questionnaire survey study was performed with 150 respondents (international tourists) in Negombo. The questions were designed based on the selected dimensions of destination attributes such as tourism service quality, infrastructure and superstructure developments, tourist information facilities and destination aesthetics and developments. The results showed that the overall satisfaction level of the international tourists who visit Sri Lanka is significantly affected by the destination attributes of Negombo. Yet, the dimensions of destination aesthetics and developments and tourist information facilities indicated a low level of mean satisfaction, paving the critique that Negombo as a beach centric tourist attraction is not serving well with its natural beauty and its destination management. Further, it is advocated that the policymakers and tourism service providers have a significant role in leading the way to attract more potential visitors to enhance their destination satisfaction and to encourage them to revisit Sri Lanka while recommending it to others. The survey was done during the off-peak season of the industry and it is suggested that the survey would have been conducted throughout a complete year.

Keywords: destination attributes, coastal tourism, tourism development, tourist satisfaction

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1816 Exploring the Role of Immune-Modulators in Pathogen Recognition Receptor NOD2 Mediated Protection against Visceral Leishmaniasis

Authors: Junaid Jibran Jawed, Prasanta Saini, Subrata Majumdar

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Background: Leishmania donovani infection causes severe host immune-suppression through the modulation of pathogen recognition receptors. Apart from TLRs (Toll Like Receptor), recent studies focus on the important contribution of NLR (NOD-Like Receptor) family member NOD1 and NOD2 as these receptors are capable of triggering host innate immunity. The aim of this study was to decipher the role of NOD1/NOD2 receptors during experimental visceral leishmaniasis (VL) and the important link between host failure and parasite evasion strategy. Method: The status of NOD1 and NOD2 receptors were analysed in uninfected and infected cells through western blotting and RT-PCR. The active contributions of these receptors in reducing parasite burden were confirmed by siRNA mediated silencing, and over-expression studies and the parasite numbers were calculated through microscopic examination of the Giemsa-stained slides. In-vivo studies were done by using non-toxic dose of Mw (Mycobacterium indicus pranii), Ara-LAM(Arabinoasylated lipoarabinomannan) along with MDP (Muramyl dipeptide) administration. Result: Leishmania donovani infection of the macrophages reduced the expression of NOD2 receptors whereas NOD1 remain unaffected. MDP, a NOD2-ligand, treatment during over-expression of NOD2, reduced the parasite burden effectively which was associated with increased pro-inflammatory cytokine generation and NO production. In experimental mouse model, Ara-LAM treatment increased the expression of NOD2 and in combination with MDP it showed active therapeutic potential against VL and found to be more effective than Mw which was already reported to be involved in NOD2 modulation. Conclusion: This work explores the essential contribution of NOD2 during experimental VL and mechanistic understanding of Ara-LAM + MDP combination therapy to work against this disease and highlighted NOD2 as an essential therapeutic target.

Keywords: Ara-LAM (Arabinoacylated Lipoarabinomannan), NOD2 (nucleotide binding oligomerization receptor 2), MDP (muramyl di peptide), visceral Leishmaniasis

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1815 The Long – Term Effects of a Prevention Program on the Number of Critical Incidents and Sick Leave Days: A Decade Perspective

Authors: Valerie Isaak

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Background: This study explores the effectiveness of refresher training sessions of an intervention program at reducing the employees’ risk of injury due to patient violence in a forensic psychiatric hospital. Methods: The original safety intervention program that consisted of a 3 days’ workshop was conducted in the maximum-security ward of a psychiatric hospital in Israel. Ever since the original intervention, annual refreshers were conducted, highlighting one of the safety elements covered in the original intervention. The study examines the effect of the intervention program along with the refreshers over a period of 10 years in four wards. Results: Analysis of the data demonstrates that beyond the initial reduction following the original intervention, refreshers seem to have an additional positive long-term effect, reducing both the number of violent incidents and the number of actual employee injuries in a forensic psychiatric hospital. Conclusions: We conclude that such an intervention program followed by refresher training would promote employees’ wellbeing. A healthy work environment is part of management’s commitment to improving employee wellbeing at the workplace.

Keywords: wellbeing, violence at work, intervention program refreshers, public sector mental healthcare

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1814 A Case Report on Therapeutic Approach in Cases of Anasarca in Neonates Dogs

Authors: Maria L. G. Lourenço, Keylla H. N. P. Pereira, Viviane Y. Hibaru, Fabiana F. Souza, Joao C. P. Ferreira, Simone B. Chiacchio, Luiz H. A. Machado

Abstract:

Anasarca is generalized congenital edema that is often lethal. The condition is transmitted hereditarily and is autosomal dominant, with a racial predisposition in French Bulldogs and English Bulldogs. This study aims at reporting a case of anasarca treatment in neonates. The fetuses of a one year and six months old, primiparous English Bulldog mother were diagnosed with anasarca during an ultrasound examination performed at the 55th day of pregnancy and, therefore, an elective cesarean section was scheduled to prevent fetal dystocia. At birth, all puppies presented anasarca, and one of the six was stillborn. The newborns presented cyanosis, dyspnea, bradycardia, absent reflexes, low vitality scores (3/10), and hypothermia ( < 32ºC). The weight of the puppies at the time of birth varied between 347 and 373 grams, about 100 grams above the average weight estimated for the breed. Immediate neonatal care was applied with oxygen therapy via a mask, aminophylline (0.2 ml/100 g/PV/sublingual), and slow heating. After 10 minutes, there was a significant improvement in the neonatal parameters. The anasarca was treated with the drug furosemide, administered subcutaneously, at a dose of 0.2 mg per 100 grams of weight, every three hours. The stimulation for urination of newborns was performed every 30 minutes, and weight loss was monitored every 30 minutes. Five grams of potassium chloride were administered orally for every 30 grams of weight loss to counterbalance the loss of potassium caused by the diuretic medication. After 15 hours, the neonates reached the ideal weight for the breed, around 209 to 230 grams. In total, four neonates received five doses of furosemide, while one received six doses. The puppies are currently ten months old, healthy and neutered. Anasarca should not be ignored and is considered potentially lethal and an indication for euthanasia in all cases. Early intervention is of utmost importance for the survival of these patients.

Keywords: Walrus syndrome, congenital edema, water puppy syndrome, puppies

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1813 Delivering Safer Clinical Trials; Using Electronic Healthcare Records (EHR) to Monitor, Detect and Report Adverse Events in Clinical Trials

Authors: Claire Williams

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Randomised controlled Trials (RCTs) of efficacy are still perceived as the gold standard for the generation of evidence, and whilst advances in data collection methods are well developed, this progress has not been matched for the reporting of adverse events (AEs). Assessment and reporting of AEs in clinical trials are fraught with human error and inefficiency and are extremely time and resource intensive. Recent research conducted into the quality of reporting of AEs during clinical trials concluded it is substandard and reporting is inconsistent. Investigators commonly send reports to sponsors who are incorrectly categorised and lacking in critical information, which can complicate the detection of valid safety signals. In our presentation, we will describe an electronic data capture system, which has been designed to support clinical trial processes by reducing the resource burden on investigators, improving overall trial efficiencies, and making trials safer for patients. This proprietary technology was developed using expertise proven in the delivery of the world’s first prospective, phase 3b real-world trial, ‘The Salford Lung Study, ’ which enabled robust safety monitoring and reporting processes to be accomplished by the remote monitoring of patients’ EHRs. This technology enables safety alerts that are pre-defined by the protocol to be detected from the data extracted directly from the patients EHR. Based on study-specific criteria, which are created from the standard definition of a serious adverse event (SAE) and the safety profile of the medicinal product, the system alerts the investigator or study team to the safety alert. Each safety alert will require a clinical review by the investigator or delegate; examples of the types of alerts include hospital admission, death, hepatotoxicity, neutropenia, and acute renal failure. This is achieved in near real-time; safety alerts can be reviewed along with any additional information available to determine whether they meet the protocol-defined criteria for reporting or withdrawal. This active surveillance technology helps reduce the resource burden of the more traditional methods of AE detection for the investigators and study teams and can help eliminate reporting bias. Integration of multiple healthcare data sources enables much more complete and accurate safety data to be collected as part of a trial and can also provide an opportunity to evaluate a drug’s safety profile long-term, in post-trial follow-up. By utilising this robust and proven method for safety monitoring and reporting, a much higher risk of patient cohorts can be enrolled into trials, thus promoting inclusivity and diversity. Broadening eligibility criteria and adopting more inclusive recruitment practices in the later stages of drug development will increase the ability to understand the medicinal products risk-benefit profile across the patient population that is likely to use the product in clinical practice. Furthermore, this ground-breaking approach to AE detection not only provides sponsors with better-quality safety data for their products, but it reduces the resource burden on the investigator and study teams. With the data taken directly from the source, trial costs are reduced, with minimal data validation required and near real-time reporting enables safety concerns and signals to be detected more quickly than in a traditional RCT.

Keywords: more comprehensive and accurate safety data, near real-time safety alerts, reduced resource burden, safer trials

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