Search results for: invasive procedure

Authors: Gamalath M. B. P. Abeysekara

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Primary objective of any organization is to enhance the bottom line profit. Strategic procurement is one of the prominent aspects in view of receiving this ultimate objective. Strategic procurement is an activity used in each and every organization in their operations. Pharmaceutical procurement is an especially significant task for any organizations, particularly state sector concerned. The whole pharmaceutical procurement requirement of the country is procured through the State Pharmaceutical Corporation (SPC) of Sri Lanka. They follow Pharmaceutical Procurement Guideline of 2006 as the procurement principle. The main objective of this project is to identify the importance of State Pharmaceutical Corporation supplier selection criteria and critical analysis of pharmaceutical procurement procedure. State Pharmaceutical Corporations applied net price, product quality, past performance, and delivery of suppliers’ as main criteria for the selection suppliers. Data collection for this study was taken place through a questionnaire, given to fifty doctors within the Colombo district attached to five main state hospitals. Data analysis is carried out with mean and standard deviation functions. The ultimate outcomes indicated product quality, net price, and delivery of suppliers’ are the most important criteria behind the selection of suppliers. Critical analysis proved State Pharmaceutical Corporation should focus on net price reduction, improving laboratory testing facilities and effective communication between up and down stream of supply chain.

Keywords: government procurement procedure, pharmaceutical procurement supplier selection criteria, importance of SPC supplier selection criteria

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Authors: Hankyu Lee, Seoung Bum Kim

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The issue with imbalance and overlapping in the class distribution becomes important in various applications of data mining. The imbalanced dataset is a special case in classification problems in which the number of observations of one class (i.e., major class) heavily exceeds the number of observations of the other class (i.e., minor class). Overlapped dataset is the case where many observations are shared together between the two classes. Imbalanced and overlapped data can be frequently found in many real examples including fraud and abuse patients in healthcare, quality prediction in manufacturing, text classification, oil spill detection, remote sensing, and so on. The class imbalance and overlap problem is the challenging issue because this situation degrades the performance of most of the standard classification algorithms. In this study, we propose a classification procedure that can effectively handle imbalanced and overlapped datasets by splitting data space into three parts: nonoverlapping, light overlapping, and severe overlapping and applying the classification algorithm in each part. These three parts were determined based on the Hausdorff distance and the margin of the modified support vector machine. An experiments study was conducted to examine the properties of the proposed method and compared it with other classification algorithms. The results showed that the proposed method outperformed the competitors under various imbalanced and overlapped situations. Moreover, the applicability of the proposed method was demonstrated through the experiment with real data.

Keywords: classification, imbalanced data with class overlap, split data space, support vector machine

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Authors: A. Haddick, A. Soltan

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Background: During the period of recovery from an operative obstetric procedure, a woman is not only at risk of the life-threatening complications accompanying labour but also those associated with surgery and anaesthesia. It is speculated that women in the recovery area may receive a lower standard of care over a night shift. Thus obstetric recovery room care should be evaluated regularly to ensure all women receive an equally high standard of care 24/7. Aim: The aim of this audit was to undertake an audit in the Liverpool Women’s Hospital on the care in recovery, and to ascertain the extent to which the standards were met. This audit included the full audit cycle. Method: Standards were taken from the AAGBI, RCOA, NICE and CNST guidelines. There were 12 standards including appropriate documentation of vital signs and appropriate length of stay after surgery. Notes from 100 patients were analysed from March 2011-March 2012. There were 52 day notes and 48 night notes; these were accessed to gain the relevant data. In the re audit 35 notes were accessed from March 14-September 14. Results: The Liverpool Women’s Hospital met in total 10 of these standards. 10 were met during the day shift (83%) and 0 met during the night shift. In the re audit, there was a significant improvement in the standards met at night. 9 of the standards were met during the day and 7 of the standards were met at night. Clearly there are still improvements to be made. Conclusions: In the original audit, an audit action plan was formulated. This was following discussion of the results of this audit in an MDT meeting and presentation with a consultant Obstetrician, the head of Midwifery, the head of Obstetrics theatres and a recovery nurse. This audit will be further discussed in the Liverpool Woman's Hospital in July 2015 for further implementation for improvement.

Keywords: care, recovery, room, women

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Authors: Mohammed Ibrahim Girei

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Adamawa state is one the major producers of both crop and animals in Nigeria. Agricultural production serves as the major means livelihood of the people in the state. However, the agricultural activities of the farmers in the state are at subsistence level. However integration of these small scale farmers in local, national and international market is paramount importance. The paper was designed to categorize farmers based on market participation among the cattle farmers in Adamawa state, Nigeria. The multistage sampling procedure was employed. To achieve this procedure, structured questionnaires were used to collect data from 400 respondents. The data were analyzed using the descriptive statistics. The result revealed that the majority of market participants were net sellers (78.51 %) (Sales greater than purchase), net buyers were (purchase greater than sales) 12.95 % and only 9% were autarkic (sales equal purchase). The study recommends that Government should provide more effective security services in cattle farming communities, which is very important as the market participants in the study area were net sellers (producers), it will help in addressing the problem of cattle rustling and promote more investment in cattle industry. There is a need to establish a standard cattle market, veterinary services and grazing reserves in the area so that to facilitate the cattle production and marketing system in the area and to meet up with the challenging of livestock development as a result of rapid human population growth in developing countries like Nigeria.

Keywords: categories, cattle, farmers, market, participation

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Authors: Arlinda Memetaj

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A sound system of administrative justice represents a vital element of democratic governance. The proper control of public administration consists not only of a sound civil service framework and legislative oversight, but empowerment of the public and courts to hold public officials accountable for their decision-making through the application of fair administrative procedural rules and the use of appropriate administrative appeals processes and judicial review. The establishment of effective public administration, has been since 1990s among the most 'important and urgent' final strategic objectives of the Republic of Macedonia. To this aim the country has so far adopted a huge series of legislative and strategic documents related to any aspects of the administrative justice system. The latter is designed to strengthen the legal position of citizens, businesses, civic organizations, and other societal subjects. 'Changes and reforms' in this field have been thus the most frequent terms being used in the country for the last more than 20 years. Several years ago the County established Administrative Courts, while permanently amending the Law on the General Administrative procedure (LGAP). The new LGAP was adopted in 2015 and it introduced considerable innovations concerned. The most recent inputs in this regard includes the National Public Administration Reform Strategy 2017 – 2022, one of the key expected result of which includes both providing effective protection of the citizens` rights. In doing the aforesaid however there is still a series of interrelated shortcomings in this regard, such as (just to mention few) the complex appeal procedure, delays in enforcing court rulings, etc. Against the above background, the paper firstly describes the Macedonian institutional and legislative framework in the above field, and then illustrates the shortcomings therein. It finally claims that the current status quo situation may be overcome only if there is a proper implementation of the administrative courts decisions and far stricter international monitoring process thereof. A new approach and strong political commitment from the highest political leadership is thus absolutely needed to ensure the principles of transparency, accountability and merit in public administration. The main method used in this paper is the descriptive, analytical and comparative one due to the very character of the paper itself.

Keywords: administrative justice, administrative procedure, administrative courts/disputes, European Human Rights Court, human rights, monitoring, reform, benefit.

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Authors: Peter J. Fusco, Dave M. Mathew, Chris Mathew, Kenneth H. Levy, Kathryn S. Varghese, Stephanie Salazar-Restrepo, Serena M. Mathew, Sofia Khaja, Eamon Vega, Mia Polizzi, Alyssa Mullane, Adham Ahmed

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Background: Laparoscopic (LS) removal of neuroblastomas in children has been reported to offer favorable outcomes compared to the conventional open thoracotomy (OT) procedure. Critical perioperative measures such as blood loss, operative time, length of stay, and time to postoperative chemotherapy have all supported laparoscopic use rather than its more invasive counterpart. Herein, a pairwise meta-analysis was performed comparing perioperative outcomes between LS and OT in thoracoabdominal neuroblastoma cases. Methods: A comprehensive literature search was performed on PubMed, Ovid EMBASE, and Scopus databases to identify studies comparing the outcomes of pediatric patients with thoracoabdominal neuroblastomas undergoing resection via OT or LS. After deduplication, 4,227 studies were identified and subjected to initial title screening with exclusion and inclusion criteria to ensure relevance. When studies contained overlapping cohorts, only the larger series were included. Primary outcomes include estimated blood loss (EBL), hospital length of stay (LOS), and mortality, while secondary outcomes were tumor recurrence, post-operative complications, and operation length. The “meta” and “metafor” packages were used in R, version 4.0.2, to pool risk ratios (RR) or standardized mean differences (SMD) in addition to their 95% confidence intervals in the random effects model via the Mantel-Haenszel method. Heterogeneity between studies was assessed using the I² test, while publication bias was assessed via funnel plot. Results: The pooled analysis included 209 patients from 5 studies (141 OT, 68 LS). Of the included studies, 2 originated from the United States, 1 from Toronto, 1 from China, and 1was from a Japanese center. Mean age between study cohorts ranged from 2.4 to 5.3 years old, with female patients occupying between 30.8% to 50% of the study populations. No statistically significant difference was found between the two groups for LOS (SMD -1.02; p=0.083), mortality (RR 0.30; p=0.251), recurrence(RR 0.31; p=0.162), post-operative complications (RR 0.73; p=0.732), or operation length (SMD -0.07; p=0.648). Of note, LS appeared to be protective in the analysis for EBL, although it did not reach statistical significance (SMD -0.4174; p= 0.051). Conclusion: Despite promising literature assessing LS removal of pediatric neuroblastomas, results showed it was non-superior to OT for any explored perioperative outcomes. Given the limited comparative data on the subject, it is evident that randomized trials are necessary to further the efficacy of the conclusions reached.

Keywords: laparoscopy, neuroblastoma, thoracoabdominal, thoracotomy

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Authors: Maxime A. J. Kuitche, Ruxandra M. Botez, Arthur Guillemin

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As the Unmanned Aerial Systems have found diverse utilities in both military and civil aviation, the necessity to obtain an accurate aerodynamic model has shown an enormous growth of interest. Recent modeling techniques are procedures using optimization algorithms and statistics that require many flight tests and are therefore extremely demanding in terms of costs. This paper presents a procedure to estimate the aerodynamic behavior of an unmanned aerial system from a numerical approach using computational fluid dynamic analysis. The study was performed using an unstructured mesh obtained from a grid convergence analysis at a Mach number of 0.14, and at an angle of attack of 0°. The flow around the aircraft was described using a standard k-ω turbulence model. Thus, the Reynold Averaged Navier-Stokes (RANS) equations were solved using ANSYS FLUENT software. The method was applied on the UAS-S45 designed and manufactured by Hydra Technologies in Mexico. The lift, the drag, and the pitching moment coefficients were obtained at different angles of attack for several flight conditions defined in terms of altitudes and Mach numbers. The results obtained from the Computational Fluid Dynamics analysis were compared with the results obtained by using the DATCOM semi-empirical procedure. This comparison has indicated that our approach is highly accurate and that the aerodynamic model obtained could be useful to estimate the flight dynamics of the UAS-S45.

Keywords: aerodynamic modelling, CFD Analysis, ANSYS FLUENT, UAS-S45

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Authors: T. Gomes, J. Manzi

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The inclusion of stirring systems in the calculation and optimization procedures has been undergone a significant lack of attention, what it can reflect in the results because such systems provide an additional energy to the process, besides promote a better distribution of mass and energy. This is meaningful for the reactive systems, particularly for the Continuous Stirred Tank Reactor (CSTR), for which the key variables and parameters, as well as the operating conditions of stirring systems, can play a pivotal role and it has been showed in the literature that neglect these factors can lead to sub-optimal results. It is also well known that the sole use of the First Law of Thermodynamics as an optimization tool cannot yield satisfactory results, since the joint use of the First and Second Laws condensed into a procedure so-called entropy generation minimization (EGM) has shown itself able to drive the system towards better results. Therefore, the main objective of this paper is to determine the effects of key parameters of the stirring system in the optimization procedures by means of EGM applied to the reactive systems. Such considerations have been possible by dimensional analysis according to Rayleigh and Buckingham's method, which takes into account the physical and geometric parameters and the variables of the reactive system. For the simulation purpose based on the production of propylene glycol, the results have shown a significant increase in the conversion rate from 36% (not-optimized system) to 95% (optimized system) with a consequent reduction of by-products. In addition, it has been possible to establish the influence of the work of the stirrer in the optimization procedure, in which can be described as a function of the fluid viscosity and consequently of the temperature. The conclusions to be drawn also indicate that the use of the entropic analysis as optimization tool has been proved to be simple, easy to apply and requiring low computational effort.

Keywords: stirring systems, entropy, reactive system, optimization

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Authors: G. C. Santini, C. Potrich, L. Lunelli, L. Vanzetti, S. Marasso, M. Cocuzza, C. Pederzolli

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The relevance of circulating miRNAs as non-invasive biomarkers for several pathologies is nowadays undoubtedly clear, as they have been found to have both diagnostic and prognostic value able to add fundamental information to patients’ clinical picture. The availability of these data, however, relies on a time-consuming process spanning from the sample collection and processing to the data analysis. In light of this, strategies which are able to ease this procedure are in high demand and considerable effort have been made in developing Lab-on-a-chip (LOC) devices able to speed up and standardise the bench work. In this context, a very promising polydimethylsiloxane (PDMS)-based microdevice which integrates the processing of the biological sample, i.e. purification of extracellular miRNAs, and reverse transcription was previously developed in our lab. In this study, we aimed at the improvement of the miRNA extraction performances of this micro device by increasing the ability of its surface to absorb extracellular miRNAs from biological samples. For this purpose, we focused on the modulation of two properties of the material: roughness and charge. PDMS surface roughness was modulated by casting with several templates (terminated with silicon oxide coated by a thin anti-adhesion aluminum layer), followed by a panel of curing conditions. Atomic force microscopy (AFM) was employed to estimate changes at the nanometric scale. To introduce modifications in surface charge we functionalized PDMS with different mixes of positively charged 3-aminopropyltrimethoxysilanes (APTMS) and neutral poly(ethylene glycol) silane (PEG). The surface chemical composition was characterized by X-ray photoelectron spectroscopy (XPS) and the number of exposed primary amines was quantified with the reagent sulfosuccinimidyl-4-o-(4,4-dimethoxytrityl) butyrate (s-SDTB). As our final end point, the adsorption rate of all these different conditions was assessed by fluorescence microscopy by incubating a synthetic fluorescently-labeled miRNA. Our preliminary analysis identified casting on thermally grown silicon oxide, followed by a curing step at 85°C for 1 hour, as the most efficient technique to obtain a PDMS surface roughness in the nanometric scaleable to trap miRNA. In addition, functionalisation with 0.1% APTMS and 0.9% PEG was found to be a necessary step to significantly increase the amount of microRNA adsorbed on the surface, therefore, available for further steps as on-chip reverse transcription. These findings show a substantial improvement in the extraction efficiency of our PDMS microdevice, ultimately leading to an important step forward in the development of an innovative, easy-to-use and integrated system for the direct purification of less abundant circulating microRNAs.

Keywords: circulating miRNAs, diagnostics, Lab-on-a-chip, polydimethylsiloxane (PDMS)

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Authors: Michelle Rippy

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Medicolegal death investigation historically is a field that does not receive much research attention or advancement, as all of the subjects are deceased. Public health threats, drug epidemics and contagious diseases are typically recognized in decedents first, with thorough and accurate death investigations able to assist in epidemiology research and prevention programs. One vital component of medicolegal death investigation is determining the decedent’s time of death. An accurate time of death can assist in corroborating alibies, determining sequence of death in multiple casualty circumstances and provide vital facts in civil situations. Popular television portrays an unrealistic forensic ability to provide the exact time of death to the minute for someone found deceased with no witnesses present. The actuality of unattended decedent time of death determination can generally only be narrowed to a 4-6 hour window. In the mid- to late-20th century, liver temperatures were an invasive action taken by death investigators to determine the decedent’s core temperature. The core temperature was programmed into an equation to determine an approximate time of death. Due to many inconsistencies with the placement of the thermometer and other variables, the accuracy of the liver temperatures was dispelled and this once common place action lost scientific support. Currently, medicolegal death investigators utilize three major after death or post-mortem changes at a death scene. Many factors are considered in the subjective determination as to the time of death, including the cooling of the decedent, stiffness of the muscles, release of blood internally, clothing, ambient temperature, disease and recent exercise. Current research is utilizing non-invasive hospital grade tympanic thermometers to measure the temperature in the each of the decedent’s ears. This tool can be used at the scene and in conjunction with scene indicators may provide a more accurate time of death. The research is significant and important to investigations and can provide an area of accuracy to a historically inaccurate area, considerably improving criminal and civil death investigations. The goal of the research is to provide a scientific basis to unwitnessed deaths, instead of the art that the determination currently is. The research is currently in progress with expected termination in December 2018. There are currently 15 completed case studies with vital information including the ambient temperature, decedent height/weight/sex/age, layers of clothing, found position, if medical intervention occurred and if the death was witnessed. This data will be analyzed with the multiple variables studied and available for presentation in January 2019.

Keywords: algor mortis, forensic pathology, investigations, medicolegal, time of death, tympanic

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Authors: Sushmita Roy Chowdhury, Steve Holding, Sujoy Khan

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The immunogenic responses of the lung towards the fungus Aspergillus fumigatus may range from invasive aspergillosis in the immunocompromised, fungal ball or infection within a cavity in the lung in those with structural lung lesions, or allergic bronchopulmonary aspergillosis (ABPA). Patients with asthma or cystic fibrosis are particularly predisposed to ABPA. There are consensus guidelines that have established criteria for diagnosis of ABPA, but uncertainty remains on the serologic cut-off values that would increase the diagnostic specificity of ABPA. We retrospectively analyzed 80 patients with severe asthma and evidence of peripheral blood eosinophilia ( > 500) over the last 3 years who underwent all serologic tests to exclude ABPA. Total IgE, specific IgE and specific IgG levels against Aspergillus fumigatus were measured using ImmunoCAP Phadia-100 (Thermo Fisher Scientific, Sweden). The Modified ISHAM working group 2013 criteria (obligate criteria: asthma or cystic fibrosis, total IgE > 1000 IU/ml or > 417 kU/L and positive specific IgE Aspergillus fumigatus or skin test positivity; with ≥ 2 of peripheral eosinophilia, positive specific IgG Aspergillus fumigatus and consistent radiographic opacities) was used in the clinical workup for the final diagnosis of ABPA. Patients were divided into 3 groups - definite, possible, and no evidence of ABPA. Specific IgG Aspergillus fumigatus levels were not used to assign the patients into any of the groups. Of 80 patients (males 48, females 32; mean age 53.9 years ± SD 15.8) selected for the analysis, there were 30 patients who had positive specific IgE against Aspergillus fumigatus (37.5%). 13 patients fulfilled the Modified ISHAM working group 2013 criteria of ABPA (‘definite’), while 15 patients were ‘possible’ ABPA and 52 did not fulfill the criteria (not ABPA). As IgE levels were not normally distributed, median levels were used in the analysis. Median total IgE levels of patients with definite and possible ABPA were 2144 kU/L and 2597 kU/L respectively (non-significant), while median specific IgE Aspergillus fumigatus at 4.35 kUA/L and 1.47 kUA/L respectively were significantly different (comparison of standard deviations F-statistic 3.2267, significance level p=0.040). Mean levels of IgG anti-Aspergillus fumigatus in the three groups (definite, possible and no evidence of ABPA) were compared using ANOVA (Statgraphics Centurion Professional XV, Statpoint Inc). Mean levels of IgG anti-Aspergillus fumigatus (Gm3) in definite ABPA was 125.17 mgA/L ( ± SD 54.84, with 95%CI 92.03-158.32), while mean Gm3 levels in possible and no ABPA were 18.61 mgA/L and 30.05 mgA/L respectively. ANOVA showed a significant difference between the definite group and the other groups (p < 0.001). This was confirmed using multiple range tests (Fisher's least significant difference procedure). There was no significant difference between the possible ABPA and not ABPA groups (p > 0.05). The study showed that a sizeable proportion of patients with asthma are sensitized to Aspergillus fumigatus in this part of India. A higher cut-off value of Gm3 ≥ 80 mgA/L provides a higher serologic specificity towards definite ABPA. Long-term studies would provide us more information if those patients with 'possible' APBA and positive Gm3 later develop clear ABPA, and are different from the Gm3 negative group in this respect. Serologic testing with clear defined cut-offs are a valuable adjunct in the diagnosis of ABPA.

Keywords: allergic bronchopulmonary aspergillosis, Aspergillus fumigatus, asthma, IgE level

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Authors: Mahdi Karimi

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One of the most basic standards of fair trial is the right to defense, hire an attorney and its presence in the hearing stages. On the one hand, based on the reason and justice, as the legal issues, particularly criminal affairs, become complicated, the accused must benefit from an attorney in the court in order to defend itself which requires legal knowledge. On the other hand, as the judicial system has jurists such as investigation judges at its disposal, the accused must enjoy the same right to defend itself and reject allegations so that the balance is maintained between the litigating parties based on the principle of "equality of arms". The right to adequate time and facilities for defense is cited among the principles and rights relevant to the proceedings in international regulations such as the International Covenant on Civil and Political Rights. The innovations made in the Code of Criminal Procedure in 2013 guaranteed the presence of the accused’s attorney in the proceedings. The present study aims at assessing the result of the aforementioned guarantee in practice and made attempts to investigate the effect of the presence of accused’s attorney on reducing the punishment by asking the question and addressing the statistical population of this study including 48 judges of lower courts and courts of appeal. It seems that in despite of guarantees provided in the new Code of Criminal Procedure, Iran's penal system, does not tolerate the presence of an attorney in practice.

Keywords: defense attorney, equality of arms, fair trial, reducing the penalty, right to defense

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Authors: Emma K. Sales

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Durian is the flagship fruit of Mindanao and there is an abundance of several cultivars with many confusing identities/ names. The project was conducted to develop procedure for reliable and rapid detection and sorting of durian planting materials. Moreover, it is also aimed to establish specific genetic or DNA markers for routine testing and authentication of durian cultivars in question. The project developed molecular procedures for routine testing. SSR primers were also screened and identified for their utility in discriminating durian cultivars collected. Results of the study showed the following accomplishments; 1. Twenty (29) SSR primers were selected and identified based on their ability to discriminate durian cultivars, 2. Optimized and established standard procedure for identification and authentication of Durian cultivars 3. Genetic profile of durian is now available at Biotech Unit. Our results demonstrate the relevance of using molecular techniques in evaluating and identifying durian clones. The most polymorphic primers tested in this study could be useful tools for detecting variation even at the early stage of the plant especially for commercial purposes. The process developed combines the efficiency of the microsatellites development process with the optimization of non-radioactive detection process resulting in a user-friendly protocol that can be performed in two (2) weeks and easily incorporated into laboratories about to start microsatellite development projects. This can be of great importance to extend microsatellite analyses to other crop species where minimal genetic information is currently available. With this, the University can now be a service laboratory for routine testing and authentication of durian clones.

Keywords: DNA, SSR analysis, genotype, genetic diversity, cultivars

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Authors: Alaa Al Hawari, Mohammad Khader, Tarek Zayed, Osama Moselhi

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In this paper, an effective non-destructive, non-invasive approach for leak detection was proposed. The process relies on analyzing thermal images collected by an IR viewer device that captures thermo-grams. In this study a statistical analysis of the collected thermal images of the ground surface along the expected leak location followed by a visual inspection of the thermo-grams was performed in order to locate the leak. In order to verify the applicability of the proposed approach the predicted leak location from the developed approach was compared with the real leak location. The results showed that the expected leak location was successfully identified with an accuracy of more than 95%.

Keywords: thermography, leakage, water pipelines, thermograms

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Authors: Ahmed Abdel Sattar Khalil, Hazem Omar

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Background: Image-guided hepatic interventions are integral to the management of infective and neoplastic liver lesions. Over the past decades, 2D ultrasound was used for guidance of hepatic interventions; with the recent advances in ultrasound technology, 3D ultrasound was used to guide hepatic interventions. The aim of this study was to illustrate the added value of 3D image guided hepatic interventions by x matrix technology. Patients and Methods: This prospective study was performed on 100 patients who were divided into two groups; group A included 50 patients who were managed by 2D ultrasonography probe guidance, and group B included 50 patients who were managed by 3D X matrix ultrasonography probe guidance. Thermal ablation was done for 70 patients, 40 RFA (20 by the 2D probe and 20 by the 3D x matrix probe), and 30 MWA (15 by the 2D probe and 15 by the 3D x matrix probe). Chemical ablation (PEI) was done on 20 patients (10 by the 2D probe and 10 by the 3D x matrix probe). Drainage of hepatic collections and biopsy from undiagnosed hepatic focal lesions was done on 10 patients (5 by the 2D probe and 5 by the 3D x matrix probe). Results: The efficacy of ultrasonography-guided hepatic interventions by 3D x matrix probe was higher than the 2D probe but not significantly higher, with a p-value of 0.705, 0.5428 for RFA, MWA respectively, 0.5312 for PEI, 0.2918 for drainage of hepatic collections and biopsy. The complications related to the use of the 3D X matrix probe were significantly lower than the 2D probe, with a p-value of 0.003. The timing of the procedure was shorter by the usage of 3D x matrix probe in comparison to the 2D probe with a p-value of 0.08,0.34 for RFA and PEI and significantly shorter for MWA, and drainage of hepatic collection, biopsy with a P-value of 0.02,0.001 respectively. Conclusions: 3D ultrasonography-guided hepatic interventions by  x matrix probe have better efficacy, less complication, and shorter time of procedure than the 2D ultrasonography-guided hepatic interventions.

Keywords: 3D, X matrix, 2D, ultrasonography, MWA, RFA, PEI, drainage of hepatic collections, biopsy

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Authors: Umer Malik, David Armstrong, Mark Ashworth, Alex Dregan, Veline L'Esperance, Lucy McDonnell, Mariam Molokhia, Patrick White

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Introduction: The microbiota lining epithelial surfaces is thought to play an important role in many human physiological functions including defense against pathogens and modulation of immune response. The microbiota is susceptible to disruption from external influences such as exposure to antibiotic medication. It is thought that antibiotic-induced disruption of the microbiota could predispose to pathogen overgrowth and invasion. We hypothesized that antibiotic use would be associated with increased risk of future infections. We carried out a systematic review of evidence of associations between antibiotic use and subsequent risk of community-acquired infections. Methods: We conducted a review of the literature for observational studies assessing the association between antibiotic use and subsequent community-acquired infection. Eligible studies were published before April 29th, 2016. We searched MEDLINE, EMBASE, and Web of Science and screened titles and abstracts using a predefined search strategy. Infections caused by Clostridium difficile, drug-resistant organisms and fungal organisms were excluded as their association with prior antibiotic use has been examined in previous systematic reviews. Results: Eighteen out of 21,518 retrieved studies met the inclusion criteria. The association between past antibiotic exposure and subsequent increased risk of infection was reported in 16 studies, including one study on Campylobacter jejuni infection (Odds Ratio [OR] 3.3), two on typhoid fever (ORs 5.7 and 12.2), one on Staphylococcus aureus skin infection (OR 2.9), one on invasive pneumococcal disease (OR 1.57), one on recurrent furunculosis (OR 16.6), one on recurrent boils and abscesses (Risk ratio 1.4), one on upper respiratory tract infection (OR 2.3) and urinary tract infection (OR 1.1), one on invasive Haemophilus influenzae type b (Hib) infection (OR 1.51), one on infectious mastitis (OR 5.38), one on meningitis (OR 2.04) and five on Salmonella enteric infection (ORs 1.4, 1.59, 1.9, 2.3 and 3.8). The effect size in three studies on Salmonella enteric infection was of marginal statistical significance. A further two studies on Salmonella infection did not demonstrate a statistically significant association between prior antibiotic exposure and subsequent infection. Conclusion: We have found an association between past antibiotic exposure and subsequent risk of a diverse range of infections in the community setting. Our findings provide evidence to support the hypothesis that prior antibiotic usage may predispose to future infection risk, possibly through antibiotic-induced alteration of the microbiota. The findings add further weight to calls to minimize inappropriate antibiotic prescriptions.

Keywords: antibiotic, infection, risk factor, side effect

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Authors: Irina Alexandra Paun, Mona Mihailescu, Marian Zamfirescu, Catalin Romeo Luculescu, Adriana Maria Acasandrei, Cosmin Catalin Mustaciosu, Roxana Cristina Popescu, Maria Dinescu

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A major concern in bone tissue engineering is to develop complex 3D architectures that mimic the natural cells environment, facilitate the cells growth in a defined manner and allow the flow transport of nutrients and metabolic waste. In particular, porous structures of controlled pore size and positioning are indispensable for growing human-like bone structures. Another concern is to monitor both the structures and the seeded cells with high spatial resolution and without interfering with the cells natural environment. The present approach relies on laser-based technologies employed for fabricating porous biomimetic structures that support the growth of osteoblast-like cells and for their non-invasive 3D imaging. Specifically, the porous structures were built by two photon polymerization –direct writing (2PP_DW) of the commercially available photoresists IL-L780, using the Photonic Professional 3D lithography system. The structures consist of vertical tubes with micrometer-sized heights and diameters, in a honeycomb-like spatial arrangement. These were fabricated by irradiating the IP-L780 photoresist with focused laser pulses with wavelength centered at 780 nm, 120 fs pulse duration and 80 MHz repetition rate. The samples were precisely scanned in 3D by piezo stages. The coarse positioning was done by XY motorized stages. The scanning path was programmed through a writing language (GWL) script developed by Nanoscribe. Following laser irradiation, the unexposed regions of the photoresist were washed out by immersing the samples in the Propylene Glycol Monomethyl Ether Acetate (PGMEA). The porous structures were seeded with osteoblast like MG-63 cells and their osteogenic potential was tested in vitro. The cell-seeded structures were analyzed in 3D using the digital holographic microscopy technique (DHM). DHM is a marker free and high spatial resolution imaging tool, where the hologram acquisition is performed non-invasively i.e. without interfering with the cells natural environment. Following hologram recording, a digital algorithm provided a 3D image of the sample, as well as information about its refractive index, which is correlated with the intracellular content. The axial resolution of the images went down to the nanoscale, while the temporal scales ranged from milliseconds up to hours. The hologram did not involve sample scanning and the whole image was available in one frame recorded going over 200μm field of view. The digital holograms processing provided 3D quantitative information on the porous structures and allowed a quantitative analysis of the cellular response in respect to the porous architectures. The cellular shape and dimensions were found to be influenced by the underlying micro relief. Furthermore, the intracellular content gave evidence on the beneficial role of the porous structures in promoting osteoblast differentiation. In all, the proposed laser-based protocol emerges as a promising tool for the fabrication and non-invasive imaging of porous constructs for bone tissue engineering. Acknowledgments: This work was supported by a grant of the Romanian Authority for Scientific Research and Innovation, CNCS-UEFISCDI, project PN-II-RU-TE-2014-4-2534 (contract 97 from 01/10/2015) and by UEFISCDI PN-II-PT-PCCA no. 6/2012. A part of this work was performed in the CETAL laser facility, supported by the National Program PN 16 47 - LAPLAS IV.

Keywords: biomimetic, holography, laser, osteoblast, two photon polymerization

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Authors: Shantha Kumari Muniyandi, Johan Sohaili, Siti Suhaila Mohamad

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The aim of this study was to investigate the suitability of reusing nonmetallic printed circuit boards (PCBs) waste in recycled HDPE (rHDPE) in terms of toxicity and mechanical properties. A series of X-ray Fluorescence Spectrometry (XRF) analysis tests have been conducted on raw nonmetallic PCBs waste to determine the chemical compositions. It can be seen that the nonmetallic PCBs approximately 72% of glass fiber reinforced epoxy resin materials such as SiO2, Al2O3, CaO, MgO, BaO, Na2O, and SrO, 9.4% of metallic materials such as CuO, SnO2, and Fe2O3, and 6.53% of Br. Total Threshold Limit Concentration (TTLC) and Toxicity Characteristic Leaching Procedure (TCLP) tests also have been done to study the toxicity characteristics of raw nonmetallic PCB powders, rHDPE/PCB and virgin HDPE for comparison purposes. For both of the testing, Cu was identified as the highest metal element contained in raw PCBs with the concentration of 905 mg/kg and 59.09 mg/L for TTLC and TCLP, respectively. However, once the nonmetallic PCB was filled in rHDPE composites, the concentrations of Cu were reduced to 134 mg/kg for TTLC and to 3 mg/L for TCLP testing. For mechanical properties testing, incorporation of 40 wt% nonmetallic PCB into rHDPE has increased the flexural modulus and flexural strength by 140% and 36%, respectively. While, Izod Impact strength decreased steadily with incorporation of 10 – 40 wt% nonmetallic PCBs.

Keywords: nonmetallic printed circuit board, recycled HDPE, composites, mechanical properties, total threshold limit concentration, toxicity characteristic leaching procedure

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Authors: S. M. Shahinul Islam, Israt Ara, Narendra Tuteja, Sreeramanan Subramaniam

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Through anther and microspore culture methods, complete homozygous plants can be produced within a year as compared to the long inbreeding method. Isolated microspore culture is one of the most important techniques for rapid development of haploid plants. The efficiency of this method is influenced by several factors such as cultural conditions, growth regulators, plant media, pretreatments, physical and growth conditions of the donor plants, pollen isolation procedure, etc. The main purpose of this study was to improve the isolated microspore culture protocol in order to increase the efficiency of embryoids, its regeneration and reducing albinisms. Under this study we have tested mainly three different microspore isolation procedures by glass rod, homozeniger and by blending and found the efficiency on gametic embryogenesis. There are three types of media viz. washing, pre-culture and induction was used. The induction medium as AMC (modified MS) supplemented by 2, 4-D (2.5 mg/l), kinetin (0.5 mg/l) and higher amount of D-Manitol (90 g/l) instead of sucrose and two types of amino acids (L-glutamine and L-serine) were used. Out of three main microspore isolation procedure by homogenizer isolation (P4) showed best performance on ELS induction (177%) and green plantlets (104%) compared with other techniques. For all cases albinisims occurred but microspore isolation from excised anthers by glass rod and homogenizer showed lesser numbers of albino plants that was also one of the important findings in this study.

Keywords: androgenesis, pretreatment, microspore culture, regeneration, albino plants, Oryza sativa

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Authors: Alok Madan, Arshad K. Hashmi

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Performance based design (PBD) is an iterative exercise in which a preliminary trial design of the building structure is selected and if the selected trial design of the building structure does not conform to the desired performance objective, the trial design is revised. In this context, development of a fundamental approach for performance based seismic design of masonry infilled frames with minimum number of trials is an important objective. The paper presents a plastic design procedure based on the energy balance concept for PBD of multi-story multi-bay masonry infilled reinforced concrete (R/C) frames subjected to near-field earthquakes. The proposed energy based plastic design procedure was implemented for trial performance based seismic design of representative masonry infilled reinforced concrete frames with various practically relevant distributions of masonry infill panels over the frame elevation. Non-linear dynamic analyses of the trial PBD of masonry infilled R/C frames was performed under the action of near-field earthquake ground motions. The results of non-linear dynamic analyses demonstrate that the proposed energy method is effective for performance based design of masonry infilled R/C frames under near-field as well as far-field earthquakes.

Keywords: masonry infilled frame, energy methods, near-fault ground motions, pushover analysis, nonlinear dynamic analysis, seismic demand

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Authors: Sarakorn Sukaviriya

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This paper describes the inspection procedure, root cause analysis, the rectification of crack, and how to apply the procedure with other similar plants. During the operation of the steam turbine (620MW), instruments such as speed sensor of steam turbine, the servo valve of main stop valve and electrical wires were malfunction caused by leakage steam from main steam governing valve. Therefore, the power plant decided to shutdown steam turbines for figuring out the cause of leakage steam. Inspection techniques to be applied in this problem were microstructure testing (SEM), pipe stress analysis (FEM) and non-destructive testing. The crack was initially found on main governing valve’s weldment by visual inspection. To analyze more precisely, pipe stress analysis and microstructure testing were applied and results indicated that the crack was intergranular and originated from the weld defect. This weld defect caused the notch with high-stress concentration which created crack and then propagated to steam leakage. The major root cause of this problem was an inappropriate welding process, which created a weld defect. To repair this joint from damage, we used a welding technique by producing refinement of coarse grain HAZ and eliminating stress concentration. After the weldment was completely repaired, other adjacent weldments still had risk. Hence, to prevent any future cracks, non-destructive testing (NDT) shall be applied to all joints in order to ensure that there will be no indication of crack.

Keywords: steam-pipe leakage, steam leakage, weld crack analysis, weld defect

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Authors: Julio C. Ferreira, Maria T. A. Steiner

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The aim of this work is to present a solution procedure referred to here as the Multi-objective Optimization for Green Vehicle Routing Problem (MOOGVRP) to provide solutions for a case study. The proposed methodology consists of three stages to resolve Scenario A. Stage 1 consists of the “treatment” of data; Stage 2 consists of applying mathematical models of the p-Median Capacitated Problem (with the objectives of minimization of distances and homogenization of demands between groups) and the Asymmetric Traveling Salesman Problem (with the objectives of minimizing distances and minimizing time). The weighted method was used as the multi-objective procedure. In Stage 3, an analysis of the results is conducted, taking into consideration the environmental aspects related to the case study, more specifically with regard to fuel consumption and air pollutant emission. This methodology was applied to a (partial) database that addresses newspaper distribution in the municipality of Curitiba, Paraná State, Brazil. The preliminary findings for Scenario A showed that it was possible to improve the distribution of the load, reduce the mileage and the greenhouse gas by 17.32% and the journey time by 22.58% in comparison with the current scenario. The intention for future works is to use other multi-objective techniques and an expanded version of the database and explore the triple bottom line of sustainability.

Keywords: Asymmetric Traveling Salesman Problem, Green Vehicle Routing Problem, Multi-objective Optimization, p-Median Capacitated Problem

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Authors: S. Bouhouche, R. Drai, J. Bast

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This paper is concerned with a method for uncertainty evaluation of steel sample content using X-Ray Fluorescence method. The considered method of analysis is a comparative technique based on the X-Ray Fluorescence; the calibration step assumes the adequate chemical composition of metallic analyzed sample. It is proposed in this work a new combined approach using the Kalman Filter and Markov Chain Monte Carlo (MCMC) for uncertainty estimation of steel content analysis. The Kalman filter algorithm is extended to the model identification of the chemical analysis process using the main factors affecting the analysis results; in this case, the estimated states are reduced to the model parameters. The MCMC is a stochastic method that computes the statistical properties of the considered states such as the probability distribution function (PDF) according to the initial state and the target distribution using Monte Carlo simulation algorithm. Conventional approach is based on the linear correlation, the uncertainty budget is established for steel Mn(wt%), Cr(wt%), Ni(wt%) and Mo(wt%) content respectively. A comparative study between the conventional procedure and the proposed method is given. This kind of approaches is applied for constructing an accurate computing procedure of uncertainty measurement.

Keywords: Kalman filter, Markov chain Monte Carlo, x-ray fluorescence calibration and testing, steel content measurement, uncertainty measurement

Procedia PDF Downloads 283

Authors: Md. Shams Razi Shopnil, Tanvir Imtiaz, Sabrina Mahjabin, Md. Sahadat Hossain

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Saturated hydraulic conductivity is one of the most significant attributes of pavement base course. Determination of hydraulic conductivity is a routine procedure for regular aggregate base courses. However, in many cases, a cement-stabilized base course is used with compromised drainage ability. Traditional hydraulic conductivity testing procedure is a readily available option which leads to two consequential drawbacks, i.e., the time required for the specimen to be saturated and extruding the sample after completion of the laboratory test. To overcome these complications, this study aims at formulating an empirical approach to predicting hydraulic conductivity based on Unconfined Compressive Strength test results. To do so, this study comprises two separate experiments (Constant Head Permeability test and Unconfined Compressive Strength test) conducted concurrently on a specimen having the same physical credentials. Data obtained from the two experiments were then used to devise a correlation between hydraulic conductivity and unconfined compressive strength. This correlation in the form of a polynomial equation helps to predict the hydraulic conductivity of cement-treated pavement base course, bypassing the cumbrous process of traditional permeability and less commonly used horizontal permeability tests. The correlation was further corroborated by a different set of data, and it has been found that the derived polynomial equation is deemed to be a viable tool to predict hydraulic conductivity.

Keywords: hydraulic conductivity, unconfined compressive strength, recycled plastics, recycled concrete aggregates

Procedia PDF Downloads 90

Authors: Kazem Shakouri, Alireza Pishgahi, Homayoun Sadeghi-bBazargani, Shahla Dareshiri

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Introduction: Carpal Tunnel Syndrome has numerous nonsurgical treatments including splint, physical therapy and corticosteroid injections. Aim: The purpose of this study was to evaluate the effectiveness of an ultrasound guided treatment procedure, for individuals with severe carpal tunnel syndrome. Materials and Method: 20 patients with an electrodiagnostic evidence of severe carpal tunnel syndrome were treated by an office-based ultrasound guided procedure (combination of percutaneous needle release of carpal tunnel and corticosteroid injection). Electrodiagnostic (nerve conduction study), clinical (Boston Carpal Tunnel Questionnaire, grip strength) and ultrasonic (median nerve and carpal tunnel cross-sectional area) measurements were recorded at baseline and one month after intervention. Results: Our preliminary data analysis showed that in one month follow up, patients had a significantly smaller cross-sectional area of the median nerve compared to pretreatment values (mean difference 0.06; 95%CI: 0.02-0.1; p < 0.001). In addition, patients had significantly less functional impairment (mean difference 35; 95% CI:28.7-43.4 ; p < 0.001), and an improved hand grip strength in one month follow up (mean difference 5.4; 95%CI: 3.1-7.8; p < 0.001;). There were no significant complications. Conclusion: Patients with severe carpal tunnel syndrome, who are candidates for surgical intervention, can consider office-based ultrasound guided needle release of carpal tunnel as an alternative safe treatment.

Keywords: Carpal Tunnel Syndrome, needle release, pain, ultrasound

Procedia PDF Downloads 247

Authors: Mohammad A. Khasawneh

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Asphalt concrete pavements gradually lose their skid resistance causing safety problems especially under wet conditions and high driving speeds. In order to enact the actual field polishing and wearing process of asphalt pavement surfaces in a laboratory setting, several laboratory-scale accelerated polishing devices were developed by different agencies. To mimic the actual process, friction and texture measuring devices are needed to quantify surface deterioration at different polishing intervals that reflect different stages of the pavement life. The test could still be considered lengthy and to some extent labor-intensive. Therefore, there is a need to come up with another method that can assist in investigating the bituminous pavement surface characteristics in a practical and time-efficient test procedure. The purpose of this paper is to utilize a well-developed image analysis technique to characterize asphalt pavement surfaces without the need to use conventional friction and texture measuring devices in an attempt to shorten and simplify the polishing procedure in the lab. Promising findings showed the possibility of using image analysis in lieu of the labor-sensitive-variable-in-nature friction and texture measurements. It was found that the exposed aggregate surface area of asphalt specimens made from limestone and gravel aggregates produced solid evidence of the validity of this method in describing asphalt pavement surfaces. Image analysis results correlated well with the British Pendulum Numbers (BPN), Polish Values (PV) and Mean Texture Depth (MTD) values.

Keywords: friction, image analysis, polishing, statistical analysis, texture

Procedia PDF Downloads 306

Authors: Melikulov A. A., Toshpulotov Sh. G., Akhmedova M. F., Beshimov A. S., Rakhimov M. K. Zokirov N. K.

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Postinfarction ventricular septal defect (PVSD) is a rare but life-threatening complication of acute myocardial infarction. Currently, an alternative direction of minimally invasive treatment of postinfarction ventricular septal defect (PVSD) is being developed - transcatheter closure of the defect using an occluder, but surgical closure of the defect remains the <> correction of post-infarction VSD. Our article presents a case of successful surgical treatment of a patient with a large post-infarction rupture of the interventricular septum (IVS) and post-infarction LV aneurysm under cardiopulmonary bypass and parallel perfusion.

Keywords: echocardiography, myocardial infarction, ventricular septal defect, parallel perfusion

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Authors: Khaled Harrar, Rachid Jennane

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The purpose of this study is the discrimination of 28 postmenopausal with osteoporotic femoral fractures from an age-matched control group of 28 women using texture analysis based on fractals. Two pre-processing approaches are applied on radiographic images; these techniques are compared to highlight the choice of the pre-processing method. Furthermore, the values of the fractal dimension are compared to those of the fractal signature in terms of the classification of the two populations. In a second analysis, the BMD measure at proximal femur was compared to the fractal analysis, the latter, which is a non-invasive technique, allowed a better discrimination; the results confirm that the fractal analysis of texture on calcaneus radiographs is able to discriminate osteoporotic patients with femoral fracture from controls. This discrimination was efficient compared to that obtained by BMD alone. It was also present in comparing subgroups with overlapping values of BMD.

Keywords: osteoporosis, fractal dimension, fractal signature, bone mineral density

Procedia PDF Downloads 425

Authors: Omid Ataei Nia, Karim Salahshoor

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In this paper, a new precise and reliable sensor network methodology is introduced for unit processes and operations using the Constriction Coefficient Particle Swarm Optimization (CPSO) method. CPSO is introduced as a new search engine for optimal sensor network design purposes. Furthermore, a Square Root Unscented Kalman Filter (SRUKF) algorithm is employed as a new data reconciliation technique to enhance the stability and accuracy of the filter. The proposed design procedure incorporates precision, cost, observability, reliability together with importance-of-variables (IVs) as a novel measure in Instrumentation Criteria (IC). To the best of our knowledge, no comprehensive approach has yet been proposed in the literature to take into account the importance of variables in the sensor network design procedure. In this paper, specific weight is assigned to each sensor, measuring a process variable in the sensor network to indicate the importance of that variable over the others to cater to the ultimate sensor network application requirements. A set of distinct scenarios has been conducted to evaluate the performance of the proposed methodology in a simulated Continuous Stirred Tank Reactor (CSTR) as a highly nonlinear process plant benchmark. The obtained results reveal the efficacy of the proposed method, leading to significant improvement in accuracy with respect to other alternative sensor network design approaches and securing the definite allocation of sensors to the most important process variables in sensor network design as a novel achievement.

Keywords: constriction coefficient PSO, importance of variable, MRMSE, reliability, sensor network design, square root unscented Kalman filter

Procedia PDF Downloads 160

Authors: G. Petruzzelli, F. Pedron, M. Grifoni, M. Barbafieri, I. Rosellini, B. Pezzarossa

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As a result of diverse industrial activities, pollution from numerous contaminant affects both groundwater and soils. Many contaminated sites have been discovered in industrialized countries and their remediation is a priority in environmental legislations. The aim of this paper is to provide the evolution of remediation from consolidated invasive technologies to environmental friendly green strategies. Many clean-up technologies have been used. Nowadays the technologies selection is no longer exclusively based on eliminating the source of pollution, but the aim of remediation includes also the recovery of soil quality. “Green remediation”, a strategy based on “soft technologies”, appears the key to tackle the issue of remediation of contaminated sites with the greatest attention to environmental quality, including the preservation of soil functionality.

Keywords: bioremediation, Green Remediation, phytoremediation, remediation technologies, soil

Procedia PDF Downloads 230