Search results for: poor outcome of delayed breast cancer treatment

Authors: Elmo Thiago Lins Cöuras Ford, Valentina Alessandra Carvalho do Vale

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It presents a heating system using low cost alternative solar collectors to promote the disinfection of water in low income communities that take water contaminated by bacteria. The system consists of two solar collectors, with total area of 4 m² and was built using PET bottles and cans of beer and soft drinks. Each collector is made up of 8 PVC tubes, connected in series and work in continuous flow. It will determine the flux the most appropriate to generate the temperature to promote the disinfection. Will be presented results of the efficiency and thermal loss of system and results of analysis of water after undergoing the process of heating.

Keywords: disinfection of water, solar heating system, poor communities, PVC

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Authors: Nassrin Badrkhani

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Current paper was designed aiming at finding the impacts of play therapy on the development of mentally retarded students in elementary school. The sample included 191 elementary students from 5 classes. Sixty students were chosen from each class, and based on their learning capabilities, they were further assigned into similar control and treatment groups. Then, five groups received treatments with special types of games, instruments, and methods for two months. The teacher-made instruments in literature, math, and science were adopted after their content validity had been confirmed by experienced teachers. The findings were analyzed in both descriptive, including mean, median, and standard deviation, and interpretive levels, using covariance analysis in SPSS. The results were indicative of the fact that play therapy (individual and group games) was positively effective in mentally retarded students’ educational development. Moreover, regarding P ˂0/001, it was found that group games were more influential than individual ones. It was also clear that the students’ gender played no role in this kind of treatment. Therefore, it is highly recommended to implement play therapy as a part of the educational curriculum for mentally retarded pupils.

Keywords: development, education, learning, play therapy, student, teacher

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Authors: Marco Frieslaar, Bing Chu, Eric Rogers

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Stroke is a devastating illness that is the second biggest cause of death in the world (after heart disease). Where it does not kill, it leaves survivors with debilitating sensory and physical impairments that not only seriously harm their quality of life, but also cause a high incidence of severe depression. It is widely accepted that early intervention is essential for recovery, but current rehabilitation techniques largely favor hospital-based therapies which have restricted access, expensive and specialist equipment and tend to side-step the emotional challenges. In addition, there is insufficient funding available to provide the long-term assistance that is required. As a consequence, recovery rates are poor. The relatively unexplored solution is to develop therapies that can be harnessed in the home and are formulated from technologies that already exist in everyday life. This would empower individuals to take control of their own improvement and provide choice in terms of when and where they feel best able to undertake their own healing. This research seeks to identify how effective post-stroke, rehabilitation therapy can be applied to upper limb mobility, within the physical context of a home rather than a hospital. This is being achieved through the design and construction of an automation scheme, based on iterative learning control and the Riener muscle model, that has the ability to adapt to the user and react to their level of fatigue and provide tangible physical recovery. It utilizes a SMART Phone and laptop to construct an iterative learning control (ILC) system, that monitors upper arm movement in three dimensions, as a series of exercises are undertaken. The equipment generates functional electrical stimulation to assist in muscle activation and thus improve directional accuracy. In addition, it monitors speed, accuracy, areas of motion weakness and similar parameters to create a performance index that can be compared over time and extrapolated to establish an independent and objective assessment scheme, plus an approximate estimation of predicted final outcome. To further extend its assessment capabilities, nerve conduction velocity readings are taken by the software, between the shoulder and hand muscles. This is utilized to measure the speed of response of neuron signal transfer along the arm and over time, an online indication of regeneration levels can be obtained. This will prove whether or not sufficient training intensity is being achieved even before perceivable movement dexterity is observed. The device also provides the option to connect to other users, via the internet, so that the patient can avoid feelings of isolation and can undertake movement exercises together with others in a similar position. This should create benefits not only for the encouragement of rehabilitation participation, but also an emotional support network potential. It is intended that this approach will extend the availability of stroke recovery options, enable ease of access at a low cost, reduce susceptibility to depression and through these endeavors, enhance the overall recovery success rate.

Keywords: home-based therapy, iterative learning control, Riener muscle model, SMART phone, stroke rehabilitation

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Authors: Shahram Naghizadeh Raeisi, Ali Alghooneh

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The application of whey protein in drink industry to enhance the nutritional value of the products is important. Furthermore, the gelification of protein during thermal treatment and shelf life makes some limitations in its application. So, the main goal of this research is manufacturing of high concentrate whey protein orange drink with appropriate shelf life. In this way, whey protein was 5 to 30% hydrolyzed ( in 5 percent intervals at six stages), then thermal stability of samples with 10% concentration of protein was tested in acidic condition (T= 90 °C, pH=4.2, 5 minutes ) and neutral condition (T=120° C, pH:6.7, 20 minutes.) Furthermore, to study the shelf life of heat treated samples in 4 months at 4 and 24 °C, the time sweep rheological test were done. At neutral conditions, 5 to 20% hydrolyzed sample showed gelling during thermal treatment, whereas at acidic condition, was happened only in 5 to 10 percent hydrolyzed samples. This phenomenon could be related to the difference in hydrodynamic radius and zeta potential of samples with different level of hydrolyzation at acidic and neutral conditions. To study the gelification of heat resistant protein solutions during shelf life, for 4 months with 7 days intervals, the time sweep analysis were performed. Cross over was observed for all heat resistant neutral samples at both storage temperature, while in heat resistant acidic samples with degree of hydrolysis, 25 and 30 percentage at 4 and 20 °C, it was not seen. It could be concluded that the former sample was stable during heat treatment and 4 months storage, which made them a good choice for manufacturing high protein drinks. The Scheffe polynomial model and numerical optimization were employed for modeling and high protein orange drink formula optimization. Scheffe model significantly predicted the overal acceptance index (Pvalue<0.05) of sensorial analysis. The coefficient of determination (R2) of 0.94, the adjusted coefficient of determination (R2Adj) of 0.90, insignificance of the lack-of-fit test and F value of 64.21 showed the accuracy of the model. Moreover, the coefficient of variable (C.V) was 6.8% which suggested the replicability of the experimental data. The desirability function had been achieved to be 0.89, which indicates the high accuracy of optimization. The optimum formulation was found as following: Modified whey protein solution (65.30%), natural orange juice (33.50%), stevia sweetener (0.05%), orange peel oil (0.15%) and citric acid (1 %), respectively. Its worth mentioning that this study made an appropriate model for application of whey protein in drink industry without bitter flavor and gelification during heat treatment and shelf life.

Keywords: croos over, orange beverage, protein modification, optimization

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

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

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

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Authors: Hanieh Sakha, Nader Nader, Haleh Farzin

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Introduction: Throughout history, pain theories have been supposed by biomedicine, especially regarding its diagnosis and treatment aspects. Therefore, the feeling of pain is not only a personal experience and is affected by social background; therefore, it involves extensive systems of signals. The challenges in emotional and sentimental dimensions of pain originate from scientific medicine (i.e., the dominant theory is also referred to as the specificity theory); however, this theory has accepted some alterations by emerging physiology. Then, Von Frey suggested the theory of cutaneous senses (i.e., Muller’s concept: the common sensation of combined four major skin receptors leading to a proper sensation) 50 years after the specificity theory. The pain pathway was composed of spinothalamic tracts and thalamus with an inhibitory effect on the cortex. Pain is referred to as a series of unique experiences with various reasons and qualities. Despite the gate control theory, the biological aspect overcomes the social aspect. Vrancken provided a more extensive definition of pain and found five approaches: Somatico-technical, dualistic body-oriented, behaviorist, phenomenological, and consciousness approaches. The Western model combined physical, emotional, and existential aspects of the human body. On the other hand, Kotarba felt confused about the basic origins of chronic pain. Freund demonstrated and argued with Durkhemian about the sociological approach to emotions. Lynch provided a piece of evidence about the correlation between cardiovascular disease and emotionally life-threatening occurrences. Helman supposed a distinction between private and public pain. Conclusion: The consideration of the emotional aspect of pain could lead to effective, emotional, and social responses to pain. On the contrary, the theory of embodiment is based on the sociological view of health and illness. Social epidemiology shows an imbalanced distribution of health, illness, and disability among various social groups. The social support and socio-cultural level can result in several types of pain. It means the status of athletes might define their pain experiences. Gender is one of the important contributing factors affecting the type of pain (i.e., females are more likely to seek health services for pain relief.) Chronic non-cancer pain (CNCP) has become a serious public health issue affecting more than 70 million people globally. CNCP is a serious public health issue which is caused by the lack of awareness about chronic pain management among the general population.

Keywords: pain, sociology, sociological, body

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Authors: Raju Singh, Shikha Singh

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This article is note for managing Autistic Child during the Corona time line. It becomes very critical for the primary caregiver as corona pandemic poses new challenges and completely variety of threats to line of treatment, growth, socialization, mental health for children with autism spectrum disorder (ASD), and, so for the family of the children. It is a highly distressful situation, where the line of treatment has shrunken, physical contact has reduced and therapies footprints reduced in several parts of the world. As children with ASD already face socialization challenges, isolation rules imposed by individuals (or social groups), government agencies have only made the situation worse for the children with ASD and their family. This note will try to touch the basics on understanding the ASD and related development disorders, challenges, impact, and suggest approaches to deal with such situation. This document also covers data analysis, deep dive into the increasing impact of ASD on children. This document can also act as a baseline for many researchers, psychiatrists, psychologists, therapists to view the problem statement and measure its impact.

Keywords: autism spectrum disorder, mental health, applied behavior therapy, occupational therapy, social anxiety

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Authors: Peri Harish Kumar, Rafique Umer Harvitkar

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Background: The emergency department mandates maximum efficacy in the utilization of the available resources. Non-urgent patient visits pose a serious concern to the treatment, patient triage, and resources available. Aims and Objectives: We conducted a retrospective case-control study of the emergency department patient list from October 2019 to November 2022. A total of 839 patients formed part of the study. Somatic complaints, vital signs, diagnostic test results, admission to the hospital, etc., were some of the criteria used for the categorization of patients. Results: The proportion of non-urgent visits varied from 7.2% to 43%, with a median of 21%. Somatic complaints were the least associated with further hospital admissions (n=28%), while diagnostic test results were the most significant indicator of further hospital admissions (n=74%). Effective triage helped minimize emergency department admissions by 36%. Conclusion: Our study shows that effective triaging, patient counselling, and round-the-clock consumable monitoring helped in the effective management of patients admitted and also significantly helped provide treatment to the patients most in need.

Keywords: urgent visits, non-urgent visits, traiging, emergency department admissions

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Authors: Leo Nnamdi Ozurumba-Dwight

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Single-cell genomic analytical systems have proved to be a platform to isolate bulk cells into selected single cells for genomic, proteomic, and related metabolomic studies. This is enabling systematic investigations of the level of heterogeneity in a diverse and wide pool of cell populations. Single cell technologies, embracing techniques such as high parameter flow cytometry, single-cell sequencing, and high-resolution images are playing vital roles in these investigations on messenger ribonucleic acid (mRNA) molecules and related gene expressions in tracking the nature and course of disease conditions. This entails targeted molecular investigations on unit cells that help us understand cell behavoiur and expressions, which can be examined for their health implications on the health state of patients. One of the vital good sides of single-cell RNA sequencing (scRNA seq) is its probing capacity to detect deranged or abnormal cell populations present within homogenously perceived pooled cells, which would have evaded cursory screening on the pooled cell populations of biological samples obtained as part of diagnostic procedures. Despite conduction of just single-cell transcriptome analysis, scRNAseq now permits comparison of the transcriptome of the individual cells, which can be evaluated for gene expressional patterns that depict areas of heterogeneity with pharmaceutical drug discovery and clinical treatment applications. It is vital to strictly work through the tools of investigations from wet lab to bioinformatics and computational tooled analyses. In the precise steps for scRNAseq, it is critical to do thorough and effective isolation of viable single cells from the tissues of interest using dependable techniques (such as FACS) before proceeding to lysis, as this enhances the appropriate picking of quality mRNA molecules for subsequent sequencing (such as by the use of Polymerase Chain Reaction machine). Interestingly, scRNAseq can be deployed to analyze various types of biological samples such as embryos, nervous systems, tumour cells, stem cells, lymphocytes, and haematopoietic cells. In haematopoietic cells, it can be used to stratify acute myeloid leukemia patterns in patients, sorting them out into cohorts that enable re-modeling of treatment regimens based on stratified presentations. In immunotherapy, it can furnish specialist clinician-immunologist with tools to re-model treatment for each patient, an attribute of precision medicine. Finally, the good predictive attribute of scRNAseq can help reduce the cost of treatment for patients, thus attracting more patients who would have otherwise been discouraged from seeking quality clinical consultation help due to perceived high cost. This is a positive paradigm shift for patients’ attitudes primed towards seeking treatment.

Keywords: immunotherapy, transcriptome, re-modeling, mRNA, scRNA-seq

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Authors: Smitha Yadav, Snehal Pathak

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Aggregate compositions in the construction and demolition (C&D) waste have potential to replace normal aggregates. However, to re-utilise these aggregates, the concrete produced with these recycled aggregates needs to provide the desired compressive strength and durability. This paper examines the performance of recycled aggregate concrete made up of 60% recycled aggregates of 20 mm size in terms of durability tests namely rapid chloride permeability, drying shrinkage, water permeability, modulus of elasticity and creep without compromising the compressive strength. The experimental outcome indicates that recycled aggregate concrete provides strength and durability same as controlled concrete when processed for removal of adhered mortar.

Keywords: compressive strength, recycled aggregate, shrinkage, rapid chloride permeation test, modulus of elasticity, water permeability

Procedia PDF Downloads 307

Authors: Reem Al-Garni

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Malnutrition is a global epidemic, but the under-weight or Failure-To-Thrive risk is increasing in rehabilitation setting and considered one of the contribution factor for developmental delay. Beside the consequences of malnutrition on children growth and development, there are other side-effects that might delay or hold the progress of rehabilitation. The awareness for malnutrition must be raised and discussed by the rehabilitation team, to promote the treatment and to optimize the client care. The solution can start from food supplements intake and / or Enteral Nutrition plan, depending on the malnutrition level and to reach the goal, the medical team should to work together in order to provide comprehensive treatment and to help the family to be able to manage their child condition. We have explore the outcomes of rehabilitation between the children with CP whose diagnosed with malnutrition and children with normal body Wight Over a period of 4 months who received 4-6 weeks of rehabilitation two hours daily by using WeeFIM score to measure rehabilitation outcomes. WeeFIM measures and covers various domains, such as: self-care, mobility, locomotion, communication and other psycho-social aspects. Our findings reported that children with normal body Wight has better outcomes and improvement comparing with children with malnutrition for the entire study sample.

Keywords: Cerebral Palsy (CP), pediatric Functional Independent Measure (WeeFIM), rehabilitation, malnutrition

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Authors: M. H. Rajikin, S. M. M. Syairah, A. R. Sharaniza

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Effects of nicotine on pre-partum body weight and preimplantation embryonic development has been reported previously. Present study was conducted to determine the effects of annatto (Bixa orellana)-derived delta-tocotrienol (TCT) (with presence of 10% gamma-TCT isomer) on the nicotine-induced reduction in body weight and 8-cell embryonic growth in mice. Twenty four 6-8 weeks old (23-25g) female balb/c mice were randomly divided into four groups (G1-G4; n=6). Those groups were subjected to the following treatments for 7 consecutive days: G1 (control) were gavaged with 0.1 ml tocopherol stripped corn oil, G2 was subcutaneously (s.c.) injected with 3 mg/kg/day of nicotine, G3 received concurrent treatment of nicotine (3 mg/kg/day) and 60 mg/kg/day of δ-TCT mixture (contains 90% delta & 10% gamma isomers) and G4 was given 60 mg/kg/day of δ-TCT mixture alone. Body weights were recorded daily during the treatment. On Day 8, females were superovulated with 5 IU Pregnant Mare’s Serum Gonadotropin (PMSG) for 48 hours followed with 5 IU human Chorionic Gonadotropin (hCG) before mated with males at the ratio of 1:1. Females were sacrificed by cervical dislocation for embryo collection 48 hours post-coitum. Collected embryos were cultured in vitro. Results showed that throughout Day 1 to Day 7, the body weight of nicotine treated group (G2) was significantly lower (p<0.05) than that of G1, G3 and G4. Intervention with δ-TCT mixture (G3) managed to increase the body weight close to the control group. This is also observed in the group treated with δ-TCT mixture alone (G4). The development of 8-cell embryos following in vitro culture (IVC) was totally inhibited in G2. Intervention with δ-TCT mixture (G3) resulted in the production of 8-cell embryos, although it was not up to that of the control group. Treatment with δ-TCT mixture alone (G4) caused significant increase in the average number of produced 8-cell embryo compared to G1. Present data indicated that δ-TCT mixture was able to reverse the body weight loss in nicotine treated mice and the development of 8-cell embryos was also improved.

Keywords: δ-tocotrienol, body weight, nicotine, preimplantation embryonic development

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Authors: Mohammad W. Dewan, Jahangir Alam, Khurshida Sharmin

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Synthetic fibers (carbon, glass, aramid, etc.) are generally utilized to make composite materials for better mechanical and thermal properties. However, they are expensive and non-biodegradable. In the perspective of Bangladesh, jute fibers are available, inexpensive, and comprising good mechanical properties. The improved properties (i.e., low cost, low density, eco-friendly) of natural fibers have made them a promising reinforcement in hybrid composites without sacrificing mechanical properties. In this study, jute and e-glass fiber reinforced hybrid composite materials are fabricated utilizing hand lay-up followed by a compression molding technique. Room temperature cured two-part epoxy resin is used as a matrix. Approximate 6-7 mm thick composite panels are fabricated utilizing 17 layers of woven glass and jute fibers with different fiber layering sequences- only jute, only glass, glass, and jute alternatively (g/j/g/j---) and 4 glass - 9 jute – 4 glass (4g-9j-4g). The fabricated composite panels are analyzed through fiber volume calculation, tensile test, bending test, and water absorption test. The hybridization of jute and glass fiber results in better tensile, bending, and water absorption properties than only jute fiber-reinforced composites, but inferior properties as compared to only glass fiber reinforced composites. Among different fiber layering sequences, 4g-9j-4g fibers layering sequence resulted in better tensile, bending, and water absorption properties. The effect of chemical treatment on the woven jute fiber and chopped glass microfiber infusion are also investigated in this study. Chemically treated jute fiber and 2 wt. % chopped glass microfiber infused hybrid composite shows about 12% improvements in flexural strength as compared to untreated and no micro-fiber infused hybrid composite panel. However, fiber chemical treatment and micro-filler do not have a significant effect on tensile strength.

Keywords: compression molding, chemical treatment, hybrid composites, mechanical properties

Procedia PDF Downloads 152

Authors: Rodrigo Fernandes da Silva, Daniela Maira Cardozo, Paulo Cesar Martins Alves, Sophie Françoise Derchain, Fernando Guimarães

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T-reg lymphocytes are important for the control of peripheral tolerance. They control the adaptive immune system and prevent autoimmunity through its suppressive action on CD4+ and CD8+ lymphocytes. The suppressive action also includes B lymphocytes, dendritic cells, monocytes/macrophages and recently, studies have shown that T-reg are also able to inhibit NK cells, therefore they exert their control of the immune response from innate to adaptive response. Most tumors express self-ligands, therefore it is believed that T-reg cells induce tolerance of the immune system, hindering the development of successful immunotherapies. T-reg cells have been linked to the suppression mechanisms of the immune response against tumors, including ovarian cancer. The goal of this study was to disclose the sub-population of the expanded CD3+ lymphocytes reported by previous studies, using the long-term culture model designed by Carlens et al 2001, to generate effector cell suspensions enriched with cytotoxic CD3-CD56+ NK cells, from PBMC of ovarian neoplasia patients. Methods and Results: Blood was collected from 12 patients with ovarian neoplasia after signed consent: 7 benign (Bng) and 5 malignant (Mlg). Mononuclear cells were separated by Ficoll-Paque gradient. Long-term culture was conducted by a 21 day culturing process with SCGM CellGro medium supplemented with anti-CD3 (10ng/ml, first 5 days), IL-2 (1000UI/ml) and FBS (10%). After 21 days of expansion, there was an increase in the population of CD3+ lymphocytes in the benign and malignant group. Within CD3+ population, there was a significant decrease in the population of CD4+ lymphocytes in the benign (median Bgn D-0=73.68%, D-21=21.05%) (p<0.05) and malignant (median Mlg D-0=64.00%, D-21=11.97%) (p < 0.01) group. Inversely, after 21 days of expansion, there was an increase in the population of CD8+ lymphocytes within the CD3+ population in the benign (median Bgn D-0=16.80%, D-21=38.56%) and malignant (median Mlg D-0=27.12%, D-21=72.58%) group. However, this increase was only significant on the malignant group (p<0.01). Within the CD3+CD4+ population, there was a significant increase (p < 0.05) in the population of T-reg lymphocytes in the benign (median Bgn D-0=9.84%, D-21=39.47%) and malignant (median Mlg D-0=3.56%, D-21=16.18%) group. Statistical analysis inter groups was performed by Kruskal-Wallis test and intra groups by Mann Whitney test. Conclusion: The CD4+ and CD8+ sub-population of CD3+ lymphocytes shifts with the culturing process. This might be due to the process of the immune system to produce a cytotoxic response. At the same time, T-reg lymphocytes increased within the CD4+ population, suggesting a modulation of the immune response towards cells of the immune system. The expansion of the T-reg population can hinder an immune response against cancer. Therefore, an immunotherapy using this expansion procedure should aim to halt the expansion of T-reg or its immunosuppresion capability.

Keywords: regulatory T cells, CD8+ T cells, CD4+ T cells, NK cell expansion

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Authors: Bryce Benson, Sooin Lee, Ashwin Belle

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Unrecognized or delayed identification of patient deterioration is a key cause of in-hospitals adverse events. Clinicians rely on vital signs monitoring to recognize patient deterioration. However, due to ever increasing nursing workloads and the manual effort required, vital signs tend to be measured and recorded intermittently, and inconsistently causing large gaps during patient monitoring. Additionally, during deterioration, the body’s autonomic nervous system activates compensatory mechanisms causing the vital signs to be lagging indicators of underlying hemodynamic decline. This study analyzes the predictive efficacy of the Analytic for Hemodynamic Instability (AHI) system, an automated tool that was designed to help clinicians in early identification of deteriorating patients. The lead time analysis in this retrospective observational study assesses how far in advance AHI predicted deterioration prior to the start of an episode of hemodynamic instability (HI) becoming evident through vital signs? Results indicate that of the 362 episodes of HI in this study, 308 episodes (85%) were correctly predicted by the AHI system with a median lead time of 57 minutes and an average of 4 hours (240.5 minutes). Of the 54 episodes not predicted, AHI detected 45 of them while the episode of HI was ongoing. Of the 9 undetected, 5 were not detected by AHI due to either missing or noisy input ECG data during the episode of HI. In total, AHI was able to either predict or detect 98.9% of all episodes of HI in this study. These results suggest that AHI could provide an additional ‘pair of eyes’ on patients, continuously filling the monitoring gaps and consequently giving the patient care team the ability to be far more proactive in patient monitoring and adverse event management.

Keywords: clinical deterioration prediction, decision support system, early warning system, hemodynamic status, physiologic monitoring

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Authors: Petros Gkotsis, Giorgos Stratidis, Manassis Mitrakas, Anastasios Zouboulis

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This study investigates the use of original and pre-polymerized iron (Fe) reagents compared to the commonly applied polyaluminum chloride (PACl) coagulant for surface water treatment. Applicable coagulants included both ferric chloride (FeCl₃) and ferric sulfate (Fe₂(SO₄)₃) and their pre-polymerized Fe reagents, such as polyferric sulfate (PFS) and polyferric chloride (PFCl). The efficiency of coagulants was evaluated by the removal of natural organic matter (NOM) and suspended solids (SS), which were determined in terms of reducing the UV absorption at 254 nm and turbidity, respectively. The residual metal concentration (Fe and Al) was also measured. Coagulants were added at five concentrations (1, 2, 3, 4 and 5 mg/L) and three pH values (7.0, 7.3 and 7.6). Experiments were conducted in a jar-test device, with two types of synthetic surface water (i.e., of high and low organic strength) which consisted of humic acid (HA) and kaolin at different concentrations (5 mg/L and 50 mg/L). After the coagulation/flocculation process, clean water was separated with filters of pore size 0.45 μm. Filtration was also conducted before the addition of coagulants in order to compare the ‘net’ effect of the coagulation/flocculation process on the examined parameters (UV at 254 nm, turbidity, and residual metal concentration). Results showed that the use of PACl resulted in the highest removal of humics for both types of surface water. For the surface water of high organic strength (humic acid-kaolin, 50 mg/L-50 mg/L), the highest removal of humics was observed at the highest coagulant dosage of 5 mg/L and at pH=7. On the contrary, turbidity was not significantly affected by the coagulant dosage. However, the use of PACl decreased turbidity the most, especially when the surface water of high organic strength was employed. As expected, the application of coagulation/flocculation prior to filtration improved NOM removal but slightly affected turbidity. Finally, the residual Fe concentration (0.01-0.1 mg/L) was much lower than the residual Al concentration (0.1-0.25 mg/L).

Keywords: coagulation/flocculation, iron and aluminum coagulants, metal salts, pre-polymerized coagulants, surface water treatment

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Authors: Izdihar Ismail, Alona C. Linatoc, Maryati Mohamed

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The tropical rainforest of Malaysia is known for its rich biological diversity and high endemicity. The potential for these forests to hold the cure for many diseases and illnesses is high and much is yet to be discovered. This study explores the richness of the tropical rainforest of Endau-Rompin National Park in Johor, Malaysia in search of plants traditionally used by the indigenous people in the treatment of malaria and malaria-like symptoms. Seven species of plants were evaluated and tested for antiplasmodial activities. Different plant parts were subjected to methanolic and aqueous extractions. A total of 24 extracts were evaluated by histidine-rich protein II (HRP2) assay against K1 strain of Plasmodium falciparum chloroquine-resistant. Ten extracts showed significant inhibition of the growth of P. falciparum. Phytochemical screening of the same extracts revealed the presence of alkaloids, flavonoids, terpenoids and anthraquinones. This study affirms that tropical rainforests may still hold undiscovered cures for many diseases and illnesses that have inflicted millions of people worldwide. The species studied herein have not known to have been studied elsewhere before.

Keywords: Endau-Rompin, malaria, Malaysia, tropical rainforest, traditional knowledge

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Authors: A. Kavandi, K. Goshtasbi, M. R. Hadei, H. Nejati

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In geothermal energy production, the method of liquid nitrogen (LN₂) fracturing in hot, dry rock is one of the most effective methods to increase the permeability of the reservoir. The geothermal reservoirs mainly consist of hard rocks such as granites and metamorphic rocks like gneiss with high temperatures. Gneiss, as a metamorphic rock, experiences a high level of inherent anisotropy. This type of anisotropy is considered as the nature of rocks, which affects the mechanical behavior of rocks. The aim of this study is to investigate the effects of heating-liquid nitrogen (LN₂) cooling treatment and rock anisotropy on the fracture toughness of gneiss. For this aim, a series of semi-circular bend (SCB) tests were carried out on specimens of gneiss with different anisotropy plane angles (0°, 30°, 60°, and 90°). In this study, gneiss specimens were exposed to heating–cooling treatment through gradual heating to 100°C followed by LN₂ cooling. Results indicate that the fracture toughness of treated samples is lower than that of untreated samples, and with increasing the anisotropy plane angle, the fracture toughness increases. The scanning electron microscope (SEM) technique is also implemented to evaluate the fracture process zone (FPZ) ahead of the crack tip.

Keywords: heating-cooling, anisotropic rock, fracture toughness, liquid nitrogen

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Authors: Ennus Tajuddin Tamboli, Madhukar Garg, Mohd. Mujeeb, Sayeed Ahmad

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An efficient protocol for simultaneous production of forskolin and rosmarinic acid in in vitro callus derived from the leaves of Coleus forskohlii Briq. has been developed. MS media was used for the establishment of cultures and NAA + 6-BA (1.0 ppm) was found best for callus growth. The callus was further subjected to treatment with various elicitor/precursors viz. chitosan, thidiazuron and methyl jasmonate to observe their effect on production of biomass and accumulation of secondary metabolites. The content of forskolin and rosmarinic acid were estimated by HPTLC, in comparison to natural explant which showed 2 fold and 10 fold rise in forskolin and rosmarinic acid content, respectively. Methy1 jasmonate 50 µM was found best for production of forskolin, whereas thidiazuron showed best results in the yield of rosmarinic acid, separately in static culture. However, combined treatment in suspension culture showed moderated effect for increase in secondary metabolites but the biomass increased significantly as compared to static culture.

Keywords: plant tissue culture, secondary metabolites, coleus, forskolin, rosmarinic acid, HPTLC

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Authors: Alhaji Musa Abdullahi, Usman Abdullahi, Adamu Adamu, Aminu Maidala

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One hundred and fifty (150) day old chicks were randomly allocated into five dietary treatments birds and each treatment where replicated twice in groups of fifteen birds in each replicate. Camel rumen content (CRC) was included in the diets of broiler at 0, 5, 10, 15, and 20% to replace maize and groundnut cake to evaluate the effect on the performance and hematological parameters at the starter and finisher phase. A completely randomized design was used and 600g of feed was given daily and water was given ad libitum. At the starter phase, the daily weight gain and feed conversion ratio were significantly affected by the test ingredients, although T1(0% CRC) which serve as a control, were similar with T2(5% CRC), T3(10% CRC), and T4(15% CRC), while the lowest value was recorded in T5(20% CRC). The result indicates that up to 15% (CRC) level can be included in the starter diet to replace maize and groundnut cake without any effect on the performance. However, at the finisher phase, the daily feed intake, daily weight gain and feed conversion ratio show no significant (F>0.05) difference among the dietary treatments. Similarly, Packed cell volume (PCV), Red Blood Cell (RBC), White Blood Cell (WBC), Mean Corpuscular Volume (MCV), and Mean Corpuscular Haemoglobin (MCH) also did not differ significantly (F>0.05) among the dietary treatments while hemoglobin (Hb) and Mean Corpuscular Haemoglobin Concentration (MCHC) differs significantly. The differential counts of eosinophils, heterophils, and lymphocytes differ significantly among the treatment groups, while that of basophils and monocytes shows no significant difference among the treatment groups. This means up to 20% CRC inclusion level can be used to replaced maize and groundnut cake in the finisher diet without any adverse effect on the performance and hematological parameters of the chickens.

Keywords: camel, rumen content, growth, hematology

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Authors: Muhammad Azeem Qureshi, Hammad Tahir, Fawwad Mahmood Butt

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Purpose: This study examines empirically the effect of brand satisfaction, brand trust and brand experience on brand loyalty which can be helpful to retain and increase customer base and satisfying customer needs as well. Methodology: Data has been collected on convenient sampling method and cause and effect among variables has been measured by applying regression analysis technique. Findings: Finding of this study have supported the proposed hypotheses and results show that brand loyalty is significantly explained by brand satisfaction, brand trust and brand experience. Practical Implications: The outcome of this study provides a useful framework and importance of brand loyalty culture in Pakistan. Marketers can be benefited trough the findings of this study.

Keywords: brand experience, brand satisfaction, brand trust, brand loyalty, hair-care products

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Authors: Kaouka Alaeddine, K. Benarous

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This study aims to obtain a surface of pure titanium and titanium alloy Ti-64Al with high performance by the diffusion process. Two agents metal alloy have been used in this treatment, niobium (Nb) and molybdenum (Mo), spread on elemental titanium and Ti-64Al alloy. Nb and Mo are used as powder form to increase the contact surface and to improve the distribution. Both Mo and Nb are distributed on samples of Ti and Ti-64Al at 1100 °C and 1200 °C for 3 h. They were performed to effect different experiments objectives. This work was achieved to improve some properties and microstructure of Ti and Ti-64Al surface, using optical microscopy and SEM and study some mechanical properties. The effects of temperature and the powder contents on the microstructure of Ti and Ti-64Al alloy, different phases and hardness value of Ti and Ti-64Al alloy were determined. Experimental results indicate that increasing the powder contents and/or the temperature, the α + β phases change to the equiaxed β lamellar structure. In particular, experiments in 1200 °C were created by diffusion α + β phases both equiaxed β phase laminar and α + β phase, thus meeting the objectives were established in the work. In addition, simulation results are used for comparison with the experimental results by DICTRA software.

Keywords: diffusion, powder metallurgy, titanium alloy, molybdenum, niobium

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Authors: Gladys Oppong, Saumya Singh, Pramod Pathak

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Women entrepreneurship has started establishing itself globally. Despite various social hurdles, Indian women have proved their strength in the area of entrepreneurship. Rising pattern of women entrepreneurship in Indian context make it significant to know the reason behind it. It’s a normal perception that women with financially strong backgrounds are highly motivated to progress in the area of entrepreneurship while lack of money becomes a major restraint for others. The proposed study attempts to identify the motivational factors for becoming women entrepreneur. The research work is to be conducted on women entrepreneurs. For this purpose, factor analysis will be used. The study has identified a set of motivational factors namely family business, social status, education and qualification, self-fulfillment and achievement among others that give momentum to the women to become an entrepreneur. The outcome of the study will be helpful in developing women entrepreneurship in India.

Keywords: women entrepreneurship, motivation, family business, social status

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Authors: Daniela Istrati, Camelia Vizireanu, Camelia Grozavu, Rodica Mihaela Dinica

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In last years, eating habits have changed, and snacking has become more common. Snacking habits, including eating whole fruit, vegetables and crackers, were found to contribute to better overall diet quality, while consuming snacks such as cookies, pastries, sweets, milk desserts and soft drinks was associated with poorer diet quality. The nutritional quality of the snack is very important and choosing nutritious foods as snacks can be beneficial for our health. For this reason, the development of functional snacks bars represents a necessity for this niche market. The aim of this work was to develop some formulations of energizing snack bars with high dietary fibers and antioxidant activity. Snack bars contain both fruits with antioxidant activity and components (cereals and seeds) rich in carbohydrates and polyunsaturated fats that provide energy during sports activities, physical and mental stress. Three types of samples were prepared and stored in refrigerated conditions at 40°C for 30 days. The first sample (S1) contains wheat germs, raw pumpkin seeds, toasted oat flakes, flaxseeds flour, cinnamon honey, raw sunflower seeds, sea buckthorn, amaranth flour, cinnamon and olive oil. The second sample (S2) has the same composition as the first, less flour and cinnamon flour and the honey used was ginger, honey. The third sample (S3) is like the first less amaranth flour and the honey used was buckthorn sea honey. The physicochemical, antioxidant activity, polyphenolic and flavonoid content and sensorial characteristics of the samples were investigated. Results showed that snacks bars had important level of extracted phenolics, flavonoids, fibers, proteins, carbohydrates and fats. Therefore, snack bars may be a convenient functional food, offering an important source of flavonoids and polyphenols, a healthy alternative to a poor diet quality, with balanced nutritional and sensory characteristics that recommend it in the diet of all consumers concerned with maintaining health. Acknowledgment: This study has been founded by the Francophone University Agency, Project Réseau régional dans le domaine de la santé, la nutrition et la sécurité alimentaire (SaIN), No. at Dunarea de Jos University of Galati 21899/ 06.09.2017

Keywords: antioxidant activity, functional food, sea buckthorn, snack bars

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Authors: Amer Elgerwi, Abdelrazzag El-Magdoub, Abubakr El-Mahmoudy

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There are many bacterial infections affecting sheep that necessitates antibiotic intervention. Amoxicillin is among commonly used antibiotics in such case for its broad spectrum of activity. However, the side alterations in blood and organ function that may be associated during or after treatment are questionable. Therefore, the aim of the present study was to assess the possible alterations in blood parameters and organ function bio markers of sheep that may occur following intramuscular injection of amoxicillin. Amoxicillin has been administered intramuscularly to 10 sheep at a dosage regimen of 7 mg/kg of body weight for 5 successive days. Two types of blood samples (with and without anticoagulant) were collected from the jugular vein pre- and post-administration of the drug. Amoxicillin significantly (P < 0.001) increased total leukocyte count and (P < 0.05) absolute eosinophilic count when compared with those of the control samples. Aspartate aminotransferase, alkaline phosphatase and cholesterol were significantly (P < 0.05) higher than the corresponding control values. In addition, amoxicillin significantly (P < 0.05) increased blood urea nitrogen and creatinine but decreased phosphorus level when compared with those of prior-administration samples. These data may indicate that although the side changes caused by amoxicillin are minor in sheep, yet the liver and kidney functions should be monitored during its usage in therapy and it should be used with care for treatment of sheep with renal and/or hepatic impairments.

Keywords: amoxicillin, biogram, haemogram, sheep

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Authors: Zeynep Busra Velioglu, Deniz Pulat, Beril Demirbakan, Burak Ozcan, Ece Bayrak, Cevat Erisken

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Bone tissue has the ability to perform a wide array of functions including providing posture, load-bearing capacity, protection for the internal organs, initiating hematopoiesis, and maintaining the homeostasis of key electrolytes via calcium/phosphate ion storage. The most common cause for bone defects is extensive trauma and subsequent infection. Bone tissue has the self-healing capability without a scar tissue formation for the majority of the injuries. However, some may result with delayed union or fracture non-union. Such cases include reconstruction of large bone defects or cases of compromised regenerative process as a result of avascular necrosis and osteoporosis. Several surgical methods exist to treat bone defects, including Ilizarov method, Masquelete technique, growth factor stimulation, and bone replacement. Unfortunately, these are technically demanding and come with noteworthy disadvantages such as lengthy treatment duration, adverse effects on the patient’s psychology, repeated surgical procedures, and often long hospitalization times. These limitations associated with surgical techniques make bone substitutes an attractive alternative. Here, it was hypothesized that a 3D printed scaffold will mimic trabecular bone in terms of biomechanical properties and that such scaffolds will support cell attachment and survival. To test this hypothesis, this study aimed at fabricating poly(lactic acid), PLA, structures using 3D printing technology for trabecular bone defects, characterizing the scaffolds and comparing with bovine trabecular bone. Capacity of scaffolds on human bone marrow stem cell (hBMSC) attachment and survival was also evaluated. Cubes with a volume of 1 cm³ having pore sizes of 0.50, 1.00 and 1.25 mm were printed. The scaffolds/grafts were characterized in terms of porosity, contact angle, compressive mechanical properties as well cell response. Porosities of the 3D printed scaffolds were calculated based on apparent densities. For contact angles, 50 µl distilled water was dropped over the surface of scaffolds, and contact angles were measured using ‘Image J’ software. Mechanical characterization under compression was performed on scaffolds and native trabecular bone (bovine, 15 months) specimens using a universal testing machine at a rate of 0.5mm/min. hBMSCs were seeded onto the 3D printed scaffolds. After 3 days of incubation with fully supplemented Dulbecco’s modified Eagle’s medium, the cells were fixed using 2% formaldehyde and glutaraldehyde mixture. The specimens were then imaged under scanning electron microscopy. Cell proliferation was determined by using EZQuant dsDNA Quantitation kit. Fluorescence was measured using microplate reader Spectramax M2 at the excitation and emission wavelengths of 485nm and 535nm, respectively. Findings suggested that porosity of scaffolds with pore dimensions of 0.5mm, 1.0mm and 1.25mm were not affected by pore size, while contact angle and compressive modulus decreased with increasing pore size. Biomechanical characterization of trabecular bone yielded higher modulus values as compared to scaffolds with all pore sizes studied. Cells attached and survived in all surfaces, demonstrating higher proliferation on scaffolds with 1.25mm pores as compared with those of 1mm. Collectively, given lower mechanical properties of scaffolds as compared to native bone, and biocompatibility of the scaffolds, the 3D printed PLA scaffolds of this study appear as candidate substitutes for bone repair and regeneration.

Keywords: 3D printing, biomechanics, bone repair, stem cell

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Authors: Liu Li, Kim Seng Lee, Li Lu

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The high-energy-density Li-rich layered materials are promising cathode materials for the next-generation high-performance lithium-ion batteries. They have attracted a lot of attentions due mainly to their high reversible capacity of more than 250 mAh•g-1 at low charge-discharge current. However several drawbacks still hinder their applications, such as voltage decay caused by an undesired phase transformation during cycling and poor rate capability. To conquer these issues, the authors applied F modification methods on the pristine Li1.2Mn0.54Ni0.13Co0.13O2 to enhance its electrochemical performance.

Keywords: Li-ion battery, Li-rich layered cathode material, phase transformation, cycling stability, rate capability

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Authors: Vasudha Govil, Suresh Singhal

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Introduction: Patients with oropharyngeal masses pose a challenge for an anaesthetist in terms of ventilation and tracheal intubation. Thus, preoperative assessment and preparation become an integral part of managing such anticipated difficult airway cases. Case report: A 45- year old female presented with growth in the oropharynx causing dysphagia and hoarseness of voice. Clinical examination and investigations predicted a difficult airway. It was managed with fibreoptic nasotracheal intubation with a successful perioperative outcome. Tracheostomy was kept as plan B in case of the CVCI situation. Conclusion: Careful preoperative examination and assessment is required to prepare oneself for difficult airway. Fibreoptic bronchoscope-guided nasotracheal intubation in a spontaneously breathing patient is a safe and successful airway management technique in difficult airway cases.

Keywords: airway, difficult, mass, oropharyngeal

Procedia PDF Downloads 191

Authors: Priya Kulkarni, Soumya Koppikar, Narendrakumar Wagh, Dhanshri Ingle, Onkar Lande, Abhay Harsulkar

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Cartilage is an extracellular matrix composed of aggrecan, which imparts it with a great tensile strength, stiffness and resilience. Disruption in cartilage metabolism leading to progressive degeneration is a characteristic feature of Osteoarthritis (OA). The process involves enzymatic depolymerisation of cartilage specific proteoglycan, releasing free glycosaminoglycan (GAG). This released GAG in synovial fluid (SF) of knee joint serves as a direct measure of cartilage loss, however, limited due to its invasive nature. Western Ontario and McMaster Universities Arthritis Index (WOMAC) is widely used for assessing pain, stiffness and physical-functions in OA patients. The scale is comprised of three subscales namely, pain, stiffness and physical-function, intends to measure patient’s perspective of disease severity as well as efficacy of prescribed treatment. Twenty SF samples obtained from OA patients were analysed for their GAG values in SF using DMMB based assay. LK 1.0 vernacular version was used to attain WOMAC scale. The results were evaluated using SAS University software (Edition 1.0) for statistical significance. All OA patients revealed higher GAG values compared to the control value of 78.4±30.1µg/ml (obtained from our non-OA patients). Average WOMAC calculated was 51.3 while pain, stiffness and function estimated were 9.7, 3.9 and 37.7, respectively. Interestingly, a strong statistical correlation was established between WOMAC function subscale and GAG (p = 0.0102). This subscale is based on day-to-day activities like stair-use, bending, walking, getting in/out of car, rising from bed. However, pain and stiffness subscale did not show correlation with any of the studied markers and endorsed the atypical inflammation in OA pathology. On one side, where knee pain showed poor correlation with GAG, it is often noted that radiography is insensitive to cartilage degenerative changes; thus OA remains undiagnosed for long. Moreover, active cartilage degradation phase remains elusive to both, patient and clinician. Through analysis of large number of OA patients we have established a close association of Kellgren-Lawrence grades and increased cartilage loss. A direct attempt to correlate WOMAC and radiographic progression of OA with various biomarkers has not been attempted so far. We found a good correlation in GAG levels in SF and the function subscale.

Keywords: cartilage, Glycosaminoglycan, synovial fluid, western ontario and McMaster Universities Arthritis Index

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Authors: Wisam H. Benamer, Ehab A. Elfallah, Mohamed A. Elshaari, Farag A. Elshaari

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A challenge for laboratories is to provide bacterial identification and antibiotic sensitivity results within a short time. Hence, advancement in the required technology is desirable to improve timing, accuracy and quality. Even with the current advances in methods used for both phenotypic and genotypic identification of bacteria the need is there to develop method(s) that enhance the outcome of bacteriology laboratories in accuracy and time. The hypothesis introduced here is based on the assumption that the chromosome of any bacteria contains unique sequences that can be used for its identification and typing. The outcome of a pilot study designed to test this hypothesis is reported in this manuscript. Methods: The complete chromosome sequences of several bacterial species were downloaded to use as search targets for unique sequences. Visual basic and SQL server (2014) were used to generate a complete set of 18-base long primers, a process started with reverse translation of randomly chosen 6 amino acids to limit the number of the generated primers. In addition, the software used to scan the downloaded chromosomes using the generated primers for similarities was designed, and the resulting hits were classified according to the number of similar chromosomal sequences, i.e., unique or otherwise. Results: All primers that had identical/similar sequences in the selected genome sequence(s) were classified according to the number of hits in the chromosomes search. Those that were identical to a single site on a single bacterial chromosome were referred to as unique. On the other hand, most generated primers sequences were identical to multiple sites on a single or multiple chromosomes. Following scanning, the generated primers were classified based on ability to differentiate between medically important bacterial and the initial results looks promising. Conclusion: A simple strategy that started by generating primers was introduced; the primers were used to screen bacterial genomes for match. Primer(s) that were uniquely identical to specific DNA sequence on a specific bacterial chromosome were selected. The identified unique sequence can be used in different molecular diagnostic techniques, possibly to identify bacteria. In addition, a single primer that can identify multiple sites in a single chromosome can be exploited for region or genome identification. Although genomes sequences draft of isolates of organism DNA enable high throughput primer design using alignment strategy, and this enhances diagnostic performance in comparison to traditional molecular assays. In this method the generated primers can be used to identify an organism before the draft sequence is completed. In addition, the generated primers can be used to build a bank for easy access of the primers that can be used to identify bacteria.

Keywords: bacteria chromosome, bacterial identification, sequence, primer generation

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