Search results for: weight gain prevention
1893 Pressure Relief in Prosthetic Sockets through Hole Implementation Using Different Materials
Authors: Gabi N. Nehme
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Below-knee amputees commonly experience asymmetrical gait patterns. It is generally believed that ischemia is related to the formation of pressure sores due to uneven distribution of forces. Micro-vascular responses can reveal local malnutrition. Changes in local skin blood supply under various external loading conditions have been studied for a number of years. Radionuclide clearance, photo-plethysmography, trans-cutaneous oxygen tension along with other studies showed that the blood supply would be influenced by the epidermal forces, and the rate and the amount of blood supply would decrease with increased epidermal loads being shear forces or normal forces. Several cases of socket designs were investigated using Finite Element Model (FEM) and Design of Experiment (DOE) to increase flexibility and minimize the pressure at the limb/socket interface using ultra high molecular weight polyethylene (UHMWPE) and polyamide 6 (PA6) or Duraform. The pressure reliefs at designated areas where reducing thickness is involved are seen to be critical in determination of amputees’ comfort and are very important to clinical applications. Implementing a hole between the Patellar Tendon (PT) and Distal Tibia (DT) would decrease stiffness and increase prosthesis range of motion where flexibility is needed. In addition, displacement and prosthetic energy storage increased without compromising mechanical efficiency and prosthetic design integrity.Keywords: patellar tendon, distal tibia, prosthetic socket relief areas, hole implementation
Procedia PDF Downloads 4141892 Sulforaphane Attenuates Fibrosis of Dystrophic Muscle in Mdx Mice via Nrf2-Mediated Inhibition of TGF-β/Smad Signaling
Authors: Chengcao Sun, Cuili Yang, Shujun Li, Ruilin Xue, Yongyong Xi, Liang Wang, Dejia Li
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Backgrounds: A few lines of evidence show that Sulforaphane (SFN) has anti-fibrosis effect in liver tissue via Nrf2-mediated inhibition of TGF-β/Smad signaling. However, its effects on muscular dystrophic fibrosis remain unknown. This work was undertaken to evaluate the effects of SFN on fibrosis in dystrophic muscle. Methods: 3-month-old male mdx mice were treated with SFN by gavage (2 mg/kg body weight per day) for 3 months. Gastrocnemius, tibial anterior and triceps brachii muscles were collected for related analysis. Fibrosis in skeletal muscles was analyzed by Sirius red staining. Histology and morphology of skeletal muscles were investigated by H&E staining. Moreover, the expressions of Nrf2, NQO1, HO-1, and TGF-β/Smad signaling pathway were detected by western blot, qRT-PCR, immunohistochemistry and immunofluorescence assays. Results: Our results demonstrated that SFN treatment significantly decreased and improved morphological features in mdx muscles. Moreover, SFN increased the expression of muscle phase II enzymes NQO1 and HO-1 and significantly decreased the expression of TGF-β1,p-smad2, p-smad3, α-SMA, fibronectin, collagen I, PAI-1, and TIMP-1 in Nrf2 dependent manner. Additionally, SFN significantly decreased the expression of CD45 and TNF-α. Conclusions: Collectively, these results show that SFN can ameliorate muscle fibrosis in mdx mice by Nrf2-induced inhibition of TGF-β/Smad signaling pathway, which indicate Nrf2 may be useful for the treatment of muscular dystrophy.Keywords: sulforaphane, Nrf2, TGF-β/smad signaling, duchenne muscular dystrophy, fibrosis
Procedia PDF Downloads 4411891 Development of LSM/YSZ Composite Anode Materials for Solid Oxide Electrolysis Cells
Authors: Christian C. Vaso, Rinlee Butch M. Cervera
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Solid oxide electrolysis cell (SOEC) is a promising technology for hydrogen production that will contribute to the sustainable energy of the future. An important component of this SOEC is the anode material and one of the promising anode material for such application is the Sr-doped LaMnO3 (LSM) and Yttrium-stabilized ZrO2 (YSZ) composite material. In this study, LSM/YSZ with different weight percent compositions of LSM and YSZ were synthesized using solid-state reaction method. The obtained samples, 60LSM/40YSZ, 50LSM/50YSZ, and 40LSM/60YSZ, were fully characterized for its microstructure using X-ray diffraction, FTIR, and SEM/EDS. EDS analysis confirmed the elemental composition and distribution of the synthesized samples. Surface morphology of the sample using SEM exhibited a well sintered and densified samples and revealed a beveled cube-like LSM morphology while the YSZ phase appeared to have a sphere-like microstructure. Density measurements using Archimedes principle showed relative densities greater than 90%. In addition, AC impedance measurement of the synthesized samples have been investigated at intermediate temperature range (400-700 °C) in an inert and oxygen gas flow environment. At pure states, LSM exhibited a high electronic conductivity while YSZ demonstrated an ionic conductivity of 3.25 x 10-4 S/cm at 700 °C under Oxygen gas environment with calculated activation energy of 0.85eV. The composite samples were also studied and revealed that as the YSZ content of the composite electrode increases, the total conductivity decreases.Keywords: ceramic composites, fuel cells, strontium lanthanum manganite, yttria partially-stabilized zirconia
Procedia PDF Downloads 3131890 Assessing the Applicability of Kevin Lynch’s Framework of ‘the Image of the City’ in the Case of a Walled City of Jaipur
Authors: Jay Patel
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This Research is about investigating the ‘image’ of the city, and asks whether this ‘image’ holds any significance that can be changed. Kevin Lynch in the book ‘The image of the city’ develops a framework that breaks down the city’s image into five physical elements. These elements (Paths, Edge, Nodes, Districts, and Landmarks), according to Lynch assess the legibility of the urbanscapes, that emerged from his perception-based study in 3 different cities (New Jersey, Los Angeles, and Boston) in the USA. The aim of this research is to investigate whether Lynch’s framework can be applied within an Indian context or not. If so, what are the possibilities and whether the imageability of Indian cities can be depicted through the Lynch’s physical elements or it demands an extension to the framework by either adding or subtracting a physical attribute. For this research project, the walled city of Jaipur was selected, as it is considered one of the futuristic designed cities of all time in India. The other significant reason for choosing Jaipur was that it is a historically planned city with solid historical, touristic and local importance; allowing an opportunity to understand the application of Lynch's elements to the city's image. In other words, it provides an opportunity to examine how the disadvantages of a city's implicit programme (its relics of bygone eras) can be converted into assets by improving the imageability of the city. To obtain data, a structured semi-open ended interview method was chosen. The reason for selecting this method explicitly was to gain qualitative data from the users rather than collecting quantitative data from closed-ended questions. This allowed in-depth understanding and applicability of Kevin Lynch’s framework while assessing what needs to be added. The interviews were conducted in Jaipur that yielded varied inferences that were different from the expected learning outcomes, highlighting the need for extension on Lynch’s physical elements to achieve city’s image. Whilst analyzing the data, there were few attributes found that defined the image of Jaipur. These were categorized into two: a Physical aspect (streets and arcade entities, natural features, temples and temporary/ informal activities) and Associational aspects (History, Culture and Tradition, Medium of help in wayfinding, and intangible aspects).Keywords: imageability, Kevin Lynch, people’s perception, assessment, associational aspects, physical aspects
Procedia PDF Downloads 1981889 Characterization and Selection of Phosphorus Deficiency Tolerant Genotypes in Nigeria Based on Morpho-Physiologic Traits
Authors: Umego Chukwudi T., Ntui Valentine O., Uyoh Edak A.
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Phosphorus (P) deficiency has been identified as a major hindrance to rice production the world over. Eleven (11) rice genotypes predominantly used by local farmers in Nigeria were studied for their responses to P deficient conditions. The characterization was based on morpho-physiologic parameters. The genotypes were screened using a hydroponic system in a modified Hoagland’s solution. Morphological and physiologic parameters, including Plant height (PH), number of tillers per plant, shoot dry weight (SDW), shoot phosphate concentration (SPC), and chlorophyll content, were recorded after exposure to three levels of phosphate concentration (0µM, 400 µM, and 800 µM). The data obtained were subjected to analysis of variance (ANOVA), and the means were separated using least significance difference tests. The results obtained showed that P starvation caused a significant (p≤0.05) reduction in PH, SDW, and tillering and also triggered a significant (p≤0.05) increase in root length among the genotypes. The Pearsons correlation coefficient was used to estimate the relationships among studied parameters, and a significant negative correlation was observed between plant height and root length. FARO63 was identified as a highly tolerant genotype to P deficiency with a low (0.24) SPC and higher (4.81) phosphate utilization efficiency (PUE). This study has identified FARO63 as a true tolerant genotype to Phosphate deficiency, which will be useful in breeding for phosphate deficiency tolerance in rice and thus combating food insecurity.Keywords: phosphate deficiency, rice genotypes, hydroponic system, food security
Procedia PDF Downloads 1091888 Cataract Surgery and Sustainability: Comparative Study of Single-Use Versus Reusable Cassettes in Phacoemulsification
Authors: Oscar Kallay
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Objective: This study compares the sustainability, financial implications, and surgical efficiency of two phacoemulsification cassette systems for cataract surgery: a machine with single-use cassettes and another with daily, reusable ones. Methods: The observational study involves retrospective cataract surgery data collection at the Centre Médical de l'Alliance, Braine-L’alleud, Belgium, a tertiary eye care center. Information on cassette weight, quantities, and transport volume was obtained from routine procedures and purchasing records. The costs for each machine were calculated by reviewing the invoices received from the accounting department. Results: We found significant differences across comparisons. The reusable cassette machine, when compared to the single-use machine, used 306.7 kg less plastic (75.3% reduction), required 2,494 cubic meters less storage per 1000 surgeries (67.7% decrease), and cost €54.16 less per 10 procedures (16.9% reduction). The machine with daily reusable cassettes also exhibited a 7-minute priming time advantage for 10 procedures, reducing downtime between cases. Conclusions: Our findings underscore the benefits of adopting reusable cassette systems: reduced plastic consumption, storage volume, and priming time, as well as enhanced efficiency and cost savings. Healthcare professionals and institutions are encouraged to embrace environmentally conscious initiatives. The use of reusable cassette systems for cataract surgeries offers a pathway to sustainable practices.Keywords: cataract, epidemiolog, surgery treatment, lens and zonules, public health
Procedia PDF Downloads 171887 Towards an Equitable Proprietary Regime: Property Rights Over Human Genes as a Case Study
Authors: Aileen Editha
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The legal recognition of property rights over human genes is a divisive topic to which there is no resolution. As a frequently discussed topic, scholars and practitioners often highlight the inadequacies of a proprietary regime. However, little has been said in regard to the nature of human genetic materials (HGMs). This paper proposes approaching the issue of property over HGMs from an alternative perspective that looks at the personal and social value and valuation of HGMs. This paper will highlight how the unique and unresolved status of HGMs is incompatible with the main tenets of property and, consequently, contributes to legal ambiguity and uncertainty in the regulation of property rights over human genes. HGMs are perceived as part of nature and a free-for-all while also being within an individual’s private sphere. Additionally, it is also considered to occupy a unique “not-private-nor-public” status. This limbo-like position clashes with property’s fundamental characteristic that relies heavily on a clear public/private dichotomy. Moreover, as property is intrinsically linked to the legal recognition of one’s personhood, this irresolution benefits some while disadvantages others. In particular, it demands the publicization of once-private genes for the “common good” but subsequently encourages privatization (through labor) of these now-public genes. This results in the gain of some (already privileged) individuals while enabling the disenfranchisement of members of minority groups, such as Indigenous communities. This paper will discuss real and intellectual property rights over human genes, such as the right to income or patent rights, in Canada and the US. This paper advocates for a sui generis approach to governing rights and interests over human genes that would not rely on having a strict public/private dichotomy. Not only would this improve legal certainty and clarity, but it would also alleviate—or, at the very least, minimize—the role that the current law plays in further entrenching existing systemic inequalities. Despite the specificity of this topic, this paper argues that there are broader lessons to be learned. This issue is an insightful case study on the interconnection of various principles in law, society, and property, and what must be done when discordance between one or more of those principles has detrimental societal outcomes. Ultimately, it must be remembered that property is an adaptable and malleable instrument that can be developed to ensure it contributes to equity and flourishing.Keywords: property rights, human genetic materials, critical legal scholarship, systemic inequalities
Procedia PDF Downloads 801886 Circulating Oxidized LDL and Insulin Resistance among Obese School Students
Authors: Nayera E. Hassan, Sahar A. El-Masry, Mones M. Abu Shady, Rokia A. El Banna, Muhammad Al-Tohamy, Mehrevan M. Abd El-Moniem, Mona Anwar
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Circulating oxidized LDL (ox-LDL) is associated with obesity, insulin resistance (HOMA), metabolic syndrome, and cardiovascular disease in adults. Little is known about relations in children. Aim: To assess association of ox-LDL with fat distribution and insulin resistance in a group of obese Egyptian children. Methods: Study is cross-sectional consisting of 68 obese children, with a mean age of 9.96 ± 1.32. Each underwent a complete physical examination; blood pressure (SBP, DBP) and anthropometric measurements (weight, height, BMI; waist, hip circumferences, waist/hip ratio), biochemical tests of fasting blood glucose (FBS), insulin levels; lipid profile (TC, LDL,HDL, TG) and ox-LDL; calculated HOMA. Sample was classified according to waist/hip ratio into: group I with and group II without central obesity. Results: ox-LDL showed significant positive correlation with LDL and TC in all groups of obesity. After adjustment for age and sex, significant positive correlation was detected between ox-LDL with SBP, DBP, TC, LDL, insulin, and HOMA in group II and with TC and FBS in group I. Insignificant association was detected between ox-LDL and other anthropometric parameters including BMI in any group of obese children (p > 0.05). Conclusions: ox-LDL, as a marker of oxidative stress is not correlated with BMI among all studied obese children (aged 6-12 years). Increased oxidative stress has causal effects on insulin resistance in obese children without central obesity and on fasting blood sugar in those with central obesity. These findings emphasize the importance of obesity during childhood and suggest that the metabolic complications of obesity and body fat distribution are detectable early in life.Keywords: ox-LDL, obesity, insulin resistance, children
Procedia PDF Downloads 3581885 Characterization and Modification of the Optical Properties of Zirconia Ceramics for Aesthetic Dental Restorations
Authors: R. A. Shahmiri, O. Standard, J. Hart, C. C. Sorrell
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Yttrium stabilized tetragonal zirconium polycrystalline (Y-TZP) has been used as a dental biomaterial. The strength and toughness of zirconia can be accounted for by its toughening mechanisms, such as crack deflection, zone shielding, contact shielding, and crack bridging. Prevention of crack propagation is of critical importance in high-fatigue situations, such as those encountered in mastication and para-function. However, the poor translucency of Y-TZP means that it may not meet the aesthetic requirements due to its white/grey appearance in polycrystalline form. To improve optical property of the Zirconia, precise evaluation of its refractive index is of significance. Zirconia`s optical properties need to be studied more in depth. Number of studies assumed, scattered light is isotropically distributed over all angles from biological media when defining optical parameters. Nevertheless, optical behaviour of real biological material depends on angular scattering of light by anisotropy material. Therefore, the average cosine of the scattering angle (which represent recovery phase function in the scattering angular distribution) usually characterized by anisotropy material. It has been identified that yttrium anti-sites present in the space charge layer have no significant role in the absorption of light in the visible range. Addition of cation dopant to polycrystalline zirconia results in segregate to grain boundaries and grain growth. Intrinsic and extrinsic properties of ZrO2 and their effect on optical properties need to be investigated. Intrinsic properties such as chemical composition, defect structure (oxygen vacancy), phase configuration (porosity, second phase) and distribution of phase need to be studied to comprehend their effect on refraction index, absorption/reflection and scattering. Extrinsic properties such as surface structure, thickness, underlying tooth structure, cement layer (type, thickness), and light source (natural, curing, artificial) of ZrO2 need to be studied to understand their effect on colour and translucency of material. This research reviewed effect of stabilization of tetragonal zirconia on optical property of zirconia for dental application.Keywords: optical properties, zirconia dental biomaterial, chemical composition, phase composition
Procedia PDF Downloads 3951884 Activated Carbon Content Influence in Mineral Barrier Performance
Authors: Raul Guerrero, Sandro Machado, Miriam Carvalho
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Soil and aquifer pollution, caused by hydrocarbon liquid spilling, is induced by misguided operational practices and inefficient safety guidelines. According to the Environmental Brazilian Institute (IBAMA), during 2013 alone, over 472.13 m3 of diesel oil leaked into the environment nationwide for those reported cases only. Regarding the aforementioned information, there’s an indisputable need to adopt appropriate environmental safeguards specially in those areas intended for the production, treatment, transportation and storage of hydrocarbon fluids. According to Brazilian norm, ABNT-NBR 7505-1:2000, compacted soil or mineral barriers used in structural contingency levees, such as storage tanks, are required to present a maximum water permeability coefficient, k, of 1x10-6 cm/s. However, as discussed by several authors, water can not be adopted as the reference fluid to determine the site’s containment performance against organic fluids. Mainly, due to the great discrepancy observed in polarity values (dielectric constant) between water and most organic fluids. Previous studies, within this same research group, proposed an optimal range of values for the soil’s index properties for mineral barrier composition focused on organic fluid containment. Unfortunately, in some circumstances, it is not possible to encounter a type of soil with the required geotechnical characteristics near the containment site, increasing prevention and construction costs, as well as environmental risks. For these specific cases, the use of an organic product or material as an additive to enhance mineral-barrier containment performance may be an attractive geotechnical solution. This paper evaluates the effect of activated carbon (AC) content additions into a clayey soil towards hydrocarbon fluid permeability. Variables such as compaction energy, carbon texture and addition content (0%, 10% and 20%) were analyzed through laboratory falling-head permeability tests using distilled water and commercial diesel as percolating fluids. The obtained results showed that the AC with smaller particle-size reduced k values significantly against diesel, indicating a direct relationship between particle-size reduction (surface area increase) of the organic product and organic fluid containment.Keywords: activated carbon, clayey soils, permeability, surface area
Procedia PDF Downloads 2561883 Optimum Design of Hybrid (Metal-Composite) Mechanical Power Transmission System under Uncertainty by Convex Modelling
Authors: Sfiso Radebe
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The design models dealing with flawless composite structures are in abundance, where the mechanical properties of composite structures are assumed to be known a priori. However, if the worst case scenario is assumed, where material defects combined with processing anomalies in composite structures are expected, a different solution is attained. Furthermore, if the system being designed combines in series hybrid elements, individually affected by material constant variations, it implies that a different approach needs to be taken. In the body of literature, there is a compendium of research that investigates different modes of failure affecting hybrid metal-composite structures. It covers areas pertaining to the failure of the hybrid joints, structural deformation, transverse displacement, the suppression of vibration and noise. In the present study a system employing a combination of two or more hybrid power transmitting elements will be explored for the least favourable dynamic loads as well as weight minimization, subject to uncertain material properties. Elastic constants are assumed to be uncertain-but-bounded quantities varying slightly around their nominal values where the solution is determined using convex models of uncertainty. Convex analysis of the problem leads to the computation of the least favourable solution and ultimately to a robust design. This approach contrasts with a deterministic analysis where the average values of elastic constants are employed in the calculations, neglecting the variations in the material properties.Keywords: convex modelling, hybrid, metal-composite, robust design
Procedia PDF Downloads 2111882 Active Packaging Films Based on Chitosan Incorporated with Thyme Essential Oil and Cross Linkers and Its Effect on the Quality Shelf Life of Food
Authors: Aiman Zehra, Sajad Mohd Wani
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Packaging has a vital role as it contains and protects the food that moves from the supply chain to the consumer. Chitosan (CH) has been extensively used in food packaging applications among the plentiful natural macromolecules, including all the polysaccharide class, owing to its easy film-forming capacity, biodegradability, better oxygen and water vapour barrier ability and good mechanical strength. Compared to synthetic films, the films produced from chitosan present poor barrier and mechanical properties. To overcome its deficient qualities, a number of modification procedures are required to enhance the mechanical and physical properties. Various additives such as plasticizers (e.g., glycerol and sorbitol), crosslinkers (e.g.,CaCl₂, ZnO), fillers (nanoclay), and antimicrobial agents (e.g. thyme essential oil) have been used to improve the mechanical, thermal, morphological, antimicrobial properties and emulsifying agents for the stability and elasticity of chitosan-based biodegradable films. Different novel biocomposite films based on chitosan incorporated with thyme essential oil and different additives (ZnO, CaCl₂, NC, and PEG) were successfully prepared and used as packaging material for carrot candy. The chitosan film incorporated with crosslinkers was capable of forming a protective barrier on the surface of the candy to maintain moisture content, water activity, TSS, total sugars, and titratable acidity. ZnO +PEG +NC +CaCl₂ remarkably promotes a synergistic effect on the barrier properties of the film. The combined use of ZnO +PEG +NC +CaCl₂ in CH-TO films was more effective in preventing the moisture gain in candies. The lowest a𝓌 (0.624) was also observed for the candies stored in treatment. The color values L*, a*, b* of the candies were also retained in the film containing all the additives during the 6th month of storage. The value for L*, a*, and b* observed for T was 42.72, 9.89, and 10.84, respectively. The candies packaged in film retained TSS and acidity. The packaging film significantly p≤0.05 conserved sensory qualities and inhibited microbial activity during storage. Carrot candy was found microbiologically safe for human consumption even after six months of storage in all the packaging materials.Keywords: chitosan, biodegradable films, antimicrobial activity, thyme essential oil, crosslinkers
Procedia PDF Downloads 951881 Prevalence and Correlates of Anemia in Adolescents in Riyadh City, Kingdom of Saudi Arabia
Authors: Aljohara M. Alquaiz, Tawfik A. M. Khoja, Abdullah Alsharif, Ambreen Kazi, Ashry Gad Mohamed, Hamad Al Mane, Abdullah Aldiris, Shaffi Ahamed Shaikh
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Objective: To determine the prevalence and correlates of anemia in male and female adolescents in Riyadh, Kingdom of Saudi Arabia. Design: A cross-sectional community based study setting: Five primary health care centers in Riyadh. Subjects: We invited 203 male and 292 female adolescents aged 13-18 years for interview, anthropometric measurements and complete blood count. Blood hemoglobin was measured with coulter cellular analysis system using light scatter method. Results: Using the WHO cut-off of Hb < 12gms/dl, 16.7%(34) males and 34%(100) females were suffering from anemia. The mean Hb (±SD) in males and females was 13.5(±1.4) and 12.3(±1.2) mg/dl, respectively. Mean(±SD) MCV, MCH, MCHC and RDW in male and female adolescents were 77.8(±6.2) vs76.4(±10.3)fL, 26.1(±2.7) vs25.5(±2.6)pg, 32.7(±2.4) vs32.2(±2.6)g/dL, 13.9(±1.4) vs13.6(±1.3)%, respectively. Multivariate logistic regression revealed that positive family history of iron deficiency anemia(IDA)(OR 4.7,95%CI 1.7–12.2), infrequent intake (OR 3.7,95%CI 1.3–10.0) and never intake of fresh juices(OR 3.5,95%CI 1.4–9.5), 13 to 14 years age (OR 3.1,95%CI 1.2–9.3) were significantly associated with anemia in male adolescents; whereas in females: family history of IDA (OR 3.4, 95%CI 1.5–7.6), being over-weight(OR 3.0,95%CI 1.4–6.1), no intake of fresh juice (OR 2.6,95%CI 1.4–5.1), living in an apartment (OR 2.0, 95%CI 1.1-3.8) or living in small house (OR 2.5, 95%CI 1.2-5.3) were significantly associated with anemia. Conclusion: Anemia is more prevalent among Saudi female adolescents as compared to males. Important factors like positive family history of IDA, overweight, lack of fresh juice intake and low socioeconomic status are significantly associated with anemia in adolescents.Keywords: adolescents, anemia, correlates, obesity
Procedia PDF Downloads 3501880 Tuberculosis and Associated Transient Hyperglycaemia in Peri-Urban South Africa: Implications for Diabetes Screening in High Tuberculosis/HIV Burden Settings
Authors: Mmamapudi Kubjane, Natacha Berkowitz, Rene Goliath, Naomi S. Levitt, Robert J. Wilkinson, Tolu Oni
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Background: South Africa remains a high tuberculosis (TB) burden country globally and the burden of diabetes – a TB risk factor is growing rapidly. As an infectious disease, TB also induces transient hyperglycaemia. Therefore, screening for diabetes in newly diagnosed tuberculosis patients may result in misclassification of transient hyperglycaemia as diabetes. Objective: The objective of this study was to determine and compare the prevalence of hyperglycaemia (diabetes and impaired glucose regulation (IGR)) in TB patients and to assess the cross-sectional association between TB and hyperglycaemia at enrolment and after three months of follow-up. Methods: Consecutive adult TB and non-TB participants presenting at a TB clinic in Cape Town were enrolled in this cross-sectional study and follow-up between July 2013 and August 2015. Diabetes was defined as self-reported diabetes, fasting plasma glucose (FPG) ≥ 7.0 mmol·L⁻¹ or glycated haemoglobin (HbA1c) ≥ 6.5%. IGR was defined as FPG 5.5– < 7.0 mmol·L⁻¹ or HbA1c 5.7– < 6.5%. TB patients initiated treatment. After three months, all participants were followed up and screened for diabetes again. The association between TB and hyperglycaemia was assessed using logistic regression adjusting for potential confounders including sex, age, income, hypertension, waist circumference, previous prisoner, marital status, work status, HIV status. Results: Diabetes screening was performed in 852 participants (414 TB and 438 non-TB) at enrolment and in 639 (304 TB and 335 non-TB) at three-month follow-up. The prevalence of HIV-1 infection was 69.6% (95% confidence interval (CI), 64.9–73.8 %) among TB patients, and 58.2% (95% CI, 53.5–62.8 %) among the non-TB participants. Glycaemic levels were much higher in TB patients than in the non-TB participants but decreased over time. Among TB patients, the prevalence of IGR was 65.2% (95% CI 60.1 - 69.9) at enrollment and 21.5% (95% CI 17.2-26.5) at follow-up; and was 50% (45.1 - 54.94) and 32% (95% CI 27.9 - 38.0) respectively, among non-TB participants. The prevalence of diabetes in TB patients was 12.5% (95% CI 9.69 – 16.12%) at enrolment and 9.2% (95% CI, 6.43–13.03%) at follow-up; and was 10.04% (95% CI, 7.55–13.24%) and 8.06% (95% CI, 5.58–11.51) respectively, among non-TB participants. The association between TB and IGT was significant at enrolment (adjusted odds ratio (OR) 2.26 (95% CI, 1.55-3.31) but disappeared at follow-up 0.84 (0.53 - 1.36). However, the TB-diabetes association remained positive and significant both at enrolment (2.41 (95% CI, 1.3-4.34)) and follow-up (OR 3.31 (95% CI, 1.5 - 7.25)). Conclusion: Transient hyperglycaemia exists during tuberculosis. This has implications on diabetes screening in TB patients and suggests a need for diabetes confirmation tests during or after TB treatment. Nonetheless, the association between TB and diabetes noted at enrolment persists at 3 months highlighting the importance of diabetes control and prevention for TB control. Further research is required to investigate the impact of hyperglycaemia (transient or otherwise) on TB outcomes to ascertain the clinical significance of hyperglycemia at enrolment.Keywords: diabetes, impaired glucose regulation, transient hyperglycaemia, tuberculosis
Procedia PDF Downloads 1641879 Aerodynamic Interaction between Two Speed Skaters Measured in a Closed Wind Tunnel
Authors: Ola Elfmark, Lars M. Bardal, Luca Oggiano, H˚avard Myklebust
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Team pursuit is a relatively new event in international long track speed skating. For a single speed skater the aerodynamic drag will account for up to 80% of the braking force, thus reducing the drag can greatly improve the performance. In a team pursuit the interactions between athletes in near proximity will also be essential, but is not well studied. In this study, systematic measurements of the aerodynamic drag, body posture and relative positioning of speed skaters have been performed in the low speed wind tunnel at the Norwegian University of Science and Technology, in order to investigate the aerodynamic interaction between two speed skaters. Drag measurements of static speed skaters drafting, leading, side-by-side, and dynamic drag measurements in a synchronized and unsynchronized movement at different distances, were performed. The projected frontal area was measured for all postures and movements and a blockage correction was performed, as the blockage ratio ranged from 5-15% in the different setups. The static drag measurements where performed on two test subjects in two different postures, a low posture and a high posture, and two different distances between the test subjects 1.5T and 3T where T being the length of the torso (T=0.63m). A drag reduction was observed for all distances and configurations, from 39% to 11.4%, for the drafting test subject. The drag of the leading test subject was only influenced at -1.5T, with the biggest drag reduction of 5.6%. An increase in drag was seen for all side-by-side measurements, the biggest increase was observed to be 25.7%, at the closest distance between the test subjects, and the lowest at 2.7% with ∼ 0.7 m between the test subjects. A clear aerodynamic interaction between the test subjects and their postures was observed for most measurements during static measurements, with results corresponding well to recent studies. For the dynamic measurements, the leading test subject had a drag reduction of 3% even at -3T. The drafting showed a drag reduction of 15% when being in a synchronized (sync) motion with the leading test subject at 4.5T. The maximal drag reduction for both the leading and the drafting test subject were observed when being as close as possible in sync, with a drag reduction of 8.5% and 25.7% respectively. This study emphasize the importance of keeping a synchronized movement by showing that the maximal gain for the leading and drafting dropped to 3.2% and 3.3% respectively when the skaters are in opposite phase. Individual differences in technique also appear to influence the drag of the other test subject.Keywords: aerodynamic interaction, drag force, frontal area, speed skating
Procedia PDF Downloads 1311878 An Application of Hip Arthroscopy after Acute Injury - A Case Report
Authors: Le Nguyen Binh, Luong Xuan Binh, Le Van Tuan, Tran Binh Duong, Truong Nguyen Khanh Hung, Do Le Hoang Son, Pham Quang Vinh, Hoang Quoc Huy, Nguyen Bach, Nguyen Quoc Khanh Le, Jiunn Horng Kang
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Introduction: Traumatic hip dislocation is an emergency in young adult which can cause avascular necrosis of femoral head or osteoarthritis of hip joint. The reasons for these may be the loose body of bony or chondral fragments, which are difficult to be detected on CT scan or MRI. In those cases, Hip arthroscopy may be the method of choice for diagnosis and treatment of loose bodies in hip joint after traumatic dislocation. Methods: A case report is performed. A 55-year-old male patient was under hip arthroscopy to retrieve the loose body in the right hip joint. Results: The patient’s hip was reduced under anesthesia in the opeation room. Xray and CT scan post-reduction showed that his right hip was wide and a small fragment of femoral head (< 5mm) locking inside the joint. A hip arthroscopy was done to take the fragment out. Post-operation, the patient went under rehabilition. After 6 months, he can walk with full-weight bearing; no further dislocaion was noted, and the Harris score was 84 points. Conclusions: Although acute traumatic injury of hip joint is usually treated with open surgeries, these methods have many drawbacks, such as soft tissue destruction, blood-loss,….Despite its technical requirement, hip arthroscopy is less invasive and effective treatment. Therefore, it may be an alternative treatment for a traumatic hip injury and can be applied frequently in the near future.Keywords: hip dislocation, hip arthroscopy, hip osteoarthritis, acute hip trauma
Procedia PDF Downloads 861877 Pathological Observations of Intestinal Coccidiosis in Camel (Camelus dromedarius)
Authors: Abhilasha Dadhich, Manisha Mathur, Sanjay Kumar, Hemant Dadhich
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The camel (Camelus dromedarius) is an important animal component of the fragile desert eco-system of India. Apart from others, impaired milk and meat production decrease in performance and even death are some of the major consequences of parasitic disease like coccidiosis in camel. Coccidiosis which is an acute invasion and destruction of intestinal mucosa by protozoa of the genera Eimeria or isospora spp. Post-Mortem examinations of 5 carcasses of dromedary of different age groups aged from 2 to 5 years were conducted. The history indicated that the camels were suffering from diarrhoea, dysentery, pyrexia, inappetence, weight loss, and emaciation. Post mortem examinations showed macroscopic and microscopic alterations in the small intestine, particularly in jejunum and ileum regions. The mucosae were congested, and haemorrhagic on which there were numerous whitish-grey nodular foci were observed. The affected intestinal tissue specimens were preserved in 10% formal saline and processed mechanically for paraffin embedding by acetone and benzene technique. The sections were stained with haematoxylin and eosin method of staining for histopathological examinations. Histologically, typical lesions such as congestion and haemorrhages were present. The intestinal villi were oedematous; mucosa degenerated and desquamated, along with infiltration of eosinophils and macrophages. Crypts of lieberkuhn were obliterated due to presence of schizonts in lamina propria. Older camels served as the source of spread of coccidial infection and were also predisposed to secondary infections.Keywords: camel, coccidiosis, Eimeria, histopathology
Procedia PDF Downloads 1901876 Improving the Growth, Biochemical Parameters and Content and Composition of Essential Oil of Mentha piperita L. through Soil-Applied N, P, and K
Authors: Bilal Bhat, M. Masroor A. Khan, Moin Uddin, M. Naeem
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Aromatic herb, peppermint (Mentha piperita L.), is a natural hybrid (M. aquatica × M. spicata) with immense therapeutic uses, apart from other potential uses. Peppermint oil is one of the most popular and widely used essential oil (EO), because of its main components menthol and menthone. In view of enhancing growth, yield and quality of this medicinally important herb, a pot experiment was conducted in the net-house of the department. The experiment was aimed at studying the effect of graded levels of N, P, and K on growth, biochemical characteristics, and content and composition of EO in Mentha piperita L. Six NPK treatments (viz. N0P0K0, N20P20K20, N40P40K40, N20+20 P20+20 K20+20, N60P60K60, and N30+30 P30+30 K30+30) were tested. The plants were harvested 150 days after transplanting. The crop performance was assessed in terms of growth attributes, physiological activities, herbage yield and content as well as yield of active constituents of Mentha piperita L. Biochemical parameters were analyzed spectrophotometrically. The EO was extracted using Clevenger’s apparatus and the active constituents of the oil were determined using Gas Chromatography. Split-dose application of N, P and K (N30+30 P30+30 K30+30) ameliorated most of the parameters significantly including, fresh and dry weight of plant, NPK content, chlorophyll and carotenoids content, and the activities of carbonic anhydrase and nitrate reductase in the leaves. It also enhanced the EO content (44.0%), EO yield (91.0%), menthol content (14.1%), menthone content (34.0%), menthyl acetate content (16.9%) and 1, 8-cineole content (43.7%) but decreased the pulegone content (36.8%). Conclusively, the fertilization proved useful in enhancing the EO content, yield and other EO components of the plant. Thus, the yield and quality of EO of peppermint may be improved by this agricultural strategy.Keywords: mentha piperita, menthol, menthone, EO
Procedia PDF Downloads 4981875 The Situation in Afghanistan as a Step Forward in Putting an End to Impunity
Authors: Jelena Radmanovic
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On 5 March 2020, the International Criminal Court has decided to authorize the investigation into the crimes allegedly committed on the territory of Afghanistan after 1 May 2003. The said determination has raised several controversies, including the recently imposed sanctions by the United States, furthering the United States' long-standing rejection of the authority of the International Criminal Court. The purpose of this research is to address the said investigation in light of its importance for the prevention of impunity in the cases where the perpetrators are nationals of Non-Party States to the Rome Statute. Difficulties that the International Criminal Court has been facing, concerning the establishment of its jurisdiction in those instances where an involved state is not a Party to the Rome Statute, have become the most significant stumbling block undermining the importance, integrity, and influence of the Court. The Situation in Afghanistan raises even further concern, bearing in mind that the Prosecutor’s Request for authorization of an investigation pursuant to article 15 from 20 November 2017 has initially been rejected with the ‘interests of justice’ as an applied rationale. The first method used for the present research is the description of the actual events regarding the aforementioned decisions and the following reactions in the international community, while with the second method – the method of conceptual analysis, the research will address the decisions pertaining to the International Criminal Court’s jurisdiction and will attempt to address the mentioned Decision of 5 March 2020 as an example of good practice and a precedent that should be followed in all similar situations. The research will attempt parsing the reasons used by the International Criminal Court, giving rather greater attention to the latter decision that has authorized the investigation and the points raised by the officials of the United States. It is a find of this research that the International Criminal Court, together with other similar judicial instances (Nuremberg and Tokyo Tribunals, The International Criminal Tribunal for the former Yugoslavia, The International Criminal Tribunal for Rwanda), has presented the world with the possibility of non-impunity, attempting to prosecute those responsible for the gravest of crimes known to the humanity and has shown that such persons should not enjoy the benefits of their immunities, with its focus primarily on the victims of such crimes. Whilst it is an issue that will most certainly be addressed further in the future, with the situations that will be brought before the International Criminal Court, the present research will make an attempt at pointing to the significance of the situation in Afghanistan, the International Criminal Court as such and the international criminal justice as a whole, for the purpose of putting an end to impunity.Keywords: Afghanistan, impunity, international criminal court, sanctions, United States
Procedia PDF Downloads 1271874 The Impact of Corruption on Exports and Innovation in Small and Medium-Sized Enterprises: The Case of Tunisia
Authors: Moujib Bahri, Rahim Kallel, Ouafa Sakka
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Corruption is a phenomenon that increases uncertainty and risk of SMEs as it undermines the quality of the business environment and the easy access to public services. Our research builds on existing research on corruption's effects on economic growth at the firm level. Several papers have analyzed the effect of firms’ payments of bribes on their performance; however, only limited research has investigated the link between corruption, innovation, and exports. Drawing on principal-agent theory, we explore how corruption weakens the institutional context and makes the business environment unsound and not conducive to innovation and exports. This study employs data from The Enterprise Surveys conducted in Tunisia between March 2013 and July 2014 by the World Bank, the European Bank for Reconstruction and Development (EBRD) and the European Investment Bank (EIB). The main objective of this survey was to gain a better understanding of Tunisian firms’ perception of the environment in which they operate. Since 2011, the country's political situation has become fragile and unstable, and public services are perceived as inefficient and corrupt. We test our hypotheses on a sample of 537 Tunisian manufacturing SMEs using structural equation modeling and path analysis. We find that political instability leads to higher level of corruption, and that excessive business licensing regulations create a fertile ground for bribery. Our findings do not support the greasing hypothesis suggesting that corruption can reduce the negative effect of bureaucratic delays and the hard access of companies to public services related to innovation and exports. Instead, our results support the sanding hypothesis according to which corruption hinders innovation activities and exports. Furthermore, corruption is found to, negatively and significantly, impact firms’ ownership of quality certificates. Our results suggest that, in an environment with a high level of corruption, governments and policymakers interested in assisting SMEs with their innovation and export activities should have a better control on corruption to allow them developing those activities without being forced to bribe government officers.Keywords: corruption, innovation, exports, SMEs
Procedia PDF Downloads 1801873 The Importance of Effectively Communicating Science and Economics to the Public (Layman)
Authors: Puran Prasad Adhikari
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Considering the fact that when we are able to communicate science and economics effectively to broader nonprofessional audiences, it promotes a great understanding of its wider relevance to society and encourages more informed and confident decision-making at all levels, from the government to communities to individuals. The study has been conducted. This study is aimed to examine the understanding of the general public of economics and the basic sciences functioning in our surroundings in our day-to-day life. Data was gathered through historical documents related to science communication and through interviews with the public. The statistical result shows that there is a great lack of knowledge in the general public about the basic sciences and how economics impacts their life daily. The difficulties faced by the public include the view that these things can only be understood by professionals and it is beyond their capacity to grasp these concepts, the use of technical words and jargon by the professionals, and the lack of the medium to understand even if they want to learn it. The result further indicates that the lack of this basic knowledge also leads to bad decision-making, which causes frustration and anxiety. The result shows the great correlation between the confidence level of a person and the knowledge of basic science and economics. The factor behind this was the right decision-making capacity of the individual, which boosts the happy hormones of the individual. So indirectly, we found the correlation between mental health and the understanding of science and economics. The public wants to have a basic understanding and concepts of these topics, but they complain that there is no effective medium through which they can gain the understanding; the medium which is available is full of jargon and technical terms directed to professional and highly educated which they consider is beyond their reach. So, communicating the basic concepts to the general public is of great importance in the 21st century for the overall progress of society. The professional one can make this possible by considering the level of public understanding and making the communication and the programs comprehensible to the layman. Various means can be used to make this successful and effective, e.g., cartoon guide books, Q&A with the layman, animations use, and daily life examples. This study’s implication will help educators of high-level institutions and policymakers improve general public [layman] access to comprehensible knowledge.Keywords: layman, comprehensible, decision making, frustration, confidence
Procedia PDF Downloads 741872 Corrosion Interaction Between Steel and Acid Mine Drainage: Use of AI Based on Fuzzy Logic
Authors: Maria Luisa de la Torre, Javier Aroba, Jose Miguel Davila, Aguasanta M. Sarmiento
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Steel is one of the most widely used materials in polymetallic sulfide mining installations. One of the main problems suffered by these facilities is the economic losses due to the corrosion of this material, which is accelerated and aggravated by the contact with acid waters generated in these mines when sulfides come into contact with oxygen and water. This generation of acidic water, in turn, is accelerated by the presence of acidophilic bacteria. In order to gain a more detailed understanding of this corrosion process and the interaction between steel and acidic water, a laboratory experiment was carried out in which carbon steel plates were introduced into four different solutions for 27 days: distilled water (BK), which tried to assimilate the effect produced by rain on this material, an acid solution from a mine with a high Fe2+/Fe3+ (PO) content, another acid solution of water from another mine with a high Fe3+/Fe2+ (PH) content and, finally, one that reproduced the acid mine water with a high Fe2+/Fe3+ content but in which there were no bacteria (ST). Every 24 hours, physicochemical parameters were measured, and water samples were taken to carry out an analysis of the dissolved elements. The results of these measurements were processed using an explainable AI model based on fuzzy logic. It could be seen that, in all cases, there was an increase in pH, as well as in the concentrations of Fe and, in particular, Fe(II), as a consequence of the oxidation of the steel plates. Proportionally, the increase in Fe concentration was higher in PO and ST than in PH because Fe precipitates were produced in the latter. The rise of Fe(II) was proportionally much higher in PH, especially in the first hours of exposure, because it started from a lower initial concentration of this ion. Although to a lesser extent than in PH, the greater increase in Fe(II) also occurred faster in PO than in ST, a consequence of the action of the catalytic bacteria. On the other hand, Cu concentrations decreased throughout the experiment (with the exception of distilled water, which initially had no Cu, as a result of an electrochemical process that generates a precipitation of Cu together with Fe hydroxides. This decrease is lower in PH because the high total acidity keeps it in solution for a longer time. With the application of an artificial intelligence tool, it has been possible to evaluate the effects of steel corrosion in mining environments, corroborating and extending what was obtained by means of classical statistics.Keywords: acid mine drainage, artificial intelligence, carbon steel, corrosion, fuzzy logic
Procedia PDF Downloads 81871 A Sensor Placement Methodology for Chemical Plants
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 1601870 Correlation Between Ore Mineralogy and the Dissolution Behavior of K-Feldspar
Authors: Adrian Keith Caamino, Sina Shakibania, Lena Sunqvist-Öqvist, Jan Rosenkranz, Yousef Ghorbani
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Feldspar minerals are one of the main components of the earth’s crust. They are tectosilicate, meaning that they mainly contain aluminum and silicon. Besides aluminum and silicon, they contain either potassium, sodium, or calcium. Accordingly, feldspar minerals are categorized into three main groups: K-feldspar, Na-feldspar, and Ca-feldspar. In recent years, the trend to use K-feldspar has grown tremendously, considering its potential to produce potash and alumina. However, the feldspar minerals, in general, are difficult to decompose for the dissolution of their metallic components. Several methods, including intensive milling, leaching under elevated pressure and temperature, thermal pretreatment, and the use of corrosive leaching reagents, have been proposed to improve its low dissolving efficiency. In this study, as part of the POTASSIAL EU project, to overcome the low dissolution efficiency of the K-feldspar components, mechanical activation using intensive milling followed by leaching using hydrochloric acid (HCl) was practiced. Grinding operational parameters, namely time, rotational speed, and ball-to-sample weight ratio, were studied using the Taguchi optimization method. Then, the mineralogy of the grinded samples was analyzed using a scanning electron microscope (SEM) equipped with automated quantitative mineralogy. After grinding, the prepared samples were subjected to HCl leaching. In the end, the dissolution efficiency of the main elements and impurities of different samples were correlated to the mineralogical characterization results. K-feldspar component dissolution is correlated with ore mineralogy, which provides insight into how to best optimize leaching conditions for selective dissolution. Further, it will have an effect on purifying steps taken afterward and the final value recovery proceduresKeywords: K-feldspar, grinding, automated mineralogy, impurity, leaching
Procedia PDF Downloads 761869 A Method To Assess Collaboration Using Perception of Risk from the Architectural Engineering Construction Industry
Authors: Sujesh F. Sujan, Steve W. Jones, Arto Kiviniemi
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The use of Building Information Modelling (BIM) in the Architectural-Engineering-Construction (AEC) industry is a form of systemic innovation. Unlike incremental innovation, (such as the technological development of CAD from hand based drawings to 2D electronically printed drawings) any form of systemic innovation in Project-Based Inter-Organisational Networks requires complete collaboration and results in numerous benefits if adopted and utilised properly. Proper use of BIM involves people collaborating with the use of interoperable BIM compliant tools. The AEC industry globally has been known for its adversarial and fragmented nature where firms take advantage of one another to increase their own profitability. Due to the industry’s nature, getting people to collaborate by unifying their goals is critical to successful BIM adoption. However, this form of innovation is often being forced artificially in the old ways of working which do not suit collaboration. This may be one of the reasons for its low global use even though the technology was developed more than 20 years ago. Therefore, there is a need to develop a metric/method to support and allow industry players to gain confidence in their investment into BIM software and workflow methods. This paper departs from defining systemic risk as a risk that affects all the project participants at a given stage of a project and defines categories of systemic risks. The need to generalise is to allow method applicability to any industry where the category will be the same, but the example of the risk will depend on the industry the study is done in. The method proposed seeks to use individual perception of an example of systemic risk as a key parameter. The significance of this study lies in relating the variance of individual perception of systemic risk to how much the team is collaborating. The method bases its notions on the claim that a more unified range of individual perceptions would mean a higher probability that the team is collaborating better. Since contracts and procurement devise how a project team operates, the method could also break the methodological barrier of highly subjective findings that case studies inflict, which has limited the possibility of generalising between global industries. Since human nature applies in all industries, the authors’ intuition is that perception can be a valuable parameter to study collaboration which is essential especially in projects that utilise systemic innovation such as BIM.Keywords: building information modelling, perception of risk, systemic innovation, team collaboration
Procedia PDF Downloads 1851868 Relatively High Heart-Rate Variability Predicts Greater Survival Chances in Patients with Covid-19
Authors: Yori Gidron, Maartje Mol, Norbert Foudraine, Frits Van Osch, Joop Van Den Bergh, Moshe Farchi, Maud Straus
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Background: The worldwide pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-COV2), which began in 2019, also known as Covid-19, has infected over 136 million people and tragically took the lives of over 2.9 million people worldwide. Many of the complications and deaths are predicted by the inflammatory “cytokine storm.” One way to progress in the prevention of death is by finding a predictive and protective factor that inhibits inflammation, on the one hand, and which also increases anti-viral immunity on the other hand. The vagal nerve does precisely both actions. This study examined whether vagal nerve activity, indexed by heart-rate variability (HRV), predicts survival in patients with Covid-19. Method: We performed a pseudo-prospective study, where we retroactively obtained ECGs of 271 Covid-19 patients arriving at a large regional hospital in The Netherlands. HRV was indexed by the standard deviation of the intervals between normal heartbeats (SDNN). We examined patients’ survival at 3 weeks and took into account multiple confounders and known prognostic factors (e.g., age, heart disease, diabetes, hypertension). Results: Patients’ mean age was 68 (range: 25-95) and nearly 22% of the patients had died by 3 weeks. Their mean SDNN (17.47msec) was far below the norm (50msec). Importantly, relatively higher HRV significantly predicted a higher chance of survival, after statistically controlling for patients’ age, cardiac diseases, hypertension and diabetes (relative risk, H.R, and 95% confidence interval (95%CI): H.R = 0.49, 95%CI: 0.26 – 0.95, p < 0.05). However, since HRV declines rapidly with age and since age is a profound predictor in Covid-19, we split the sample by median age (40). Subsequently, we found that higher HRV significantly predicted greater survival in patients older than 70 (H.R = 0.35, 95%CI: 0.16 – 0.78, p = 0.01), but HRV did not predict survival in patients below age 70 years (H.R = 1.11, 95%CI: 0.37 – 3.28, p > 0.05). Conclusions: To the best of our knowledge, this is the first study showing that higher vagal nerve activity, as indexed by HRV, is an independent predictor of higher chances for survival in Covid-19. The results are in line with the protective role of the vagal nerve in diseases and extend this to a severe infectious illness. Studies should replicate these findings and then test in controlled trials whether activating the vagus nerve may prevent mortality in Covid-19.Keywords: Covid-19, heart-rate Variability, prognosis, survival, vagal nerve
Procedia PDF Downloads 1751867 New Advanced Medical Software Technology Challenges and Evolution of the Regulatory Framework in Expert Software, Artificial Intelligence, and Machine Learning
Authors: Umamaheswari Shanmugam, Silvia Ronchi, Radu Vornicu
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Software, artificial intelligence, and machine learning can improve healthcare through innovative and advanced technologies that are able to use the large amount and variety of data generated during healthcare services every day. As we read the news, over 500 machine learning or other artificial intelligence medical devices have now received FDA clearance or approval, the first ones even preceding the year 2000. One of the big advantages of these new technologies is the ability to get experience and knowledge from real-world use and to continuously improve their performance. Healthcare systems and institutions can have a great benefit because the use of advanced technologies improves the same time efficiency and efficacy of healthcare. Software-defined as a medical device, is stand-alone software that is intended to be used for patients for one or more of these specific medical intended uses: - diagnosis, prevention, monitoring, prediction, prognosis, treatment or alleviation of a disease, any other health conditions, replacing or modifying any part of a physiological or pathological process–manage the received information from in vitro specimens derived from the human samples (body) and without principal main action of its principal intended use by pharmacological, immunological or metabolic definition. Software qualified as medical devices must comply with the general safety and performance requirements applicable to medical devices. These requirements are necessary to ensure high performance and quality and also to protect patients’ safety. The evolution and the continuous improvement of software used in healthcare must take into consideration the increase in regulatory requirements, which are becoming more complex in each market. The gap between these advanced technologies and the new regulations is the biggest challenge for medical device manufacturers. Regulatory requirements can be considered a market barrier, as they can delay or obstacle the device approval, but they are necessary to ensure performance, quality, and safety, and at the same time, they can be a business opportunity if the manufacturer is able to define in advance the appropriate regulatory strategy. The abstract will provide an overview of the current regulatory framework, the evolution of the international requirements, and the standards applicable to medical device software in the potential market all over the world.Keywords: artificial intelligence, machine learning, SaMD, regulatory, clinical evaluation, classification, international requirements, MDR, 510k, PMA, IMDRF, cyber security, health care systems.
Procedia PDF Downloads 901866 Doxorubicin and Cyclosporine Loaded PLGA Nanoparticles to Combat Multidrug Resistance
Authors: Senthil Rajan Dharmalingam, Shamala Nadaraju, Srinivasan Ramamurthy
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Doxorubicin is the most widely used anticancer drugs in chemotherapy treatment. However, problems related to the development of multidrug resistance (MDR) and acute cardiotoxicity have led researchers to investigate alternative forms of administering doxorubicin for cancer therapy. Several methods have been attempted to overcome MDR, including the co-administration of a chemosensitizer inhibiting the efflux caused by ATP binding cassette transporters with anticancer drugs, and the bypass of the efflux mechanism. Co encapsulation of doxorubicin (Dox) and cyclosporine A (CSA) into poly (DL-lactide-co-glycolide) nanoparticles was emulsification-solvent evaporation method using polyvinyl alcohol as emulsion stabilizers. The Dox-CSA loaded nanoparticles were evaluated for particle size, zeta potential and PDI by light scattering analysis and thermal characterizations by differential scanning calorimetry (DSC). Loading efficiency (LE %) and in-vitro dissolution samples were evaluated by developed and validated HPLC method. The optimum particle size obtained is 298.6.8±39.4 nm and polydispersity index (PDI) is 0.098±0.092. Zeta potential is found to be -29.9±4.23. Optimum pH to increase Dox LE% was found 7.1 which gave 42.5% and 58.9% increase of LE% for pH 6.6 and pH 8.6 compared respectively. LE% achieved for Dox is 0.07±0.01 % and CSA is 0.09±0.03%. Increased volume of PVA and weight of PLGA shows increase in size of nanoparticles. DSC thermograms showed shift in the melting peak for the nanoparticles compared to Dox and CSA indicating encapsulation of drugs. In conclusion, these preliminary studies showed the feasibility of PLGA nanoparticles to entrap Dox and CSA and require future in-vivo studies to be performed to establish its potential.Keywords: doxorubicin, cyclosporine, PLGA, nanoparticles
Procedia PDF Downloads 4601865 Self-Assembled ZnFeAl Layered Double Hydroxides as Highly Efficient Fenton-Like Catalysts
Authors: Marius Sebastian Secula, Mihaela Darie, Gabriela Carja
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Ibuprofen is a non-steroidal anti-inflammatory drug (NSAIDs) and is among the most frequently detected pharmaceuticals in environmental samples and among the most widespread drug in the world. Its concentration in the environment is reported to be between 10 and 160 ng L-1. In order to improve the abatement efficiency of this compound for water source prevention and reclamation, the development of innovative technologies is mandatory. AOPs (advanced oxidation processes) are known as highly efficient towards the oxidation of organic pollutants. Among the promising combined treatments, photo-Fenton processes using layered double hydroxides (LDHs) attracted significant consideration especially due to their composition flexibility, high surface area and tailored redox features. This work presents the self-supported Fe, Mn or Ti on ZnFeAl LDHs obtained by co-precipitation followed by reconstruction method as novel efficient photo-catalysts for Fenton-like catalysis. Fe, Mn or Ti/ZnFeAl LDHs nano-hybrids were tested for the degradation of a model pharmaceutical agent, the anti-inflammatory agent ibuprofen, by photocatalysis and photo-Fenton catalysis, respectively, by means of a lab-scale system consisting of a batch reactor equipped with an UV lamp (17 W). The present study presents comparatively the degradation of Ibuprofen in aqueous solution UV light irradiation using four different types of LDHs. The newly prepared Ti/ZnFeAl 4:1 catalyst results in the best degradation performance. After 60 minutes of light irradiation, the Ibuprofen removal efficiency reaches 95%. The slowest degradation of Ibuprofen solution occurs in case of Fe/ZnFeAl 4:1 LDH, (67% removal efficiency after 60 minutes of process). Evolution of Ibuprofen degradation during the photo Fenton process is also studied using Ti/ZnFeAl 2:1 and 4:1 LDHs in the presence and absence of H2O2. It is found that after 60 min the use of Ti/ZnFeAl 4:1 LDH in presence of 100 mg/L H2O2 leads to the fastest degradation of Ibuprofen molecule. After 120 min, both catalysts Ti/ZnFeAl 4:1 and 2:1 result in the same value of removal efficiency (98%). In the absence of H2O2, Ibuprofen degradation reaches only 73% removal efficiency after 120 min of degradation process. Acknowledgements: This work was supported by a grant of the Romanian National Authority for Scientific Research and Innovation, CNCS - UEFISCDI, project number PN-II-RU-TE-2014-4-0405.Keywords: layered double hydroxide, advanced oxidation process, micropollutant, heterogeneous Fenton
Procedia PDF Downloads 2291864 Risk Mapping of Road Traffic Incidents in Greater Kampala Metropolitan Area for Planning of Emergency Medical Services
Authors: Joseph Kimuli Balikuddembe
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Road traffic incidents (RTIs) continue to be a serious public health and development burden around the globe. Compared to high-income countries (HICs), the low and middle-income countries (LMICs) bear the heaviest brunt of RTIs. Like other LMICs, Uganda, a country located in Eastern Africa, has been experiencing a worryingly high burden of RTIs and their associated impacts. Over the years, the highest number of all the total registered RTIs in Uganda has taken place in the Greater Kampala Metropolitan Area (GKMA). This places a tremendous demand on the few existing emergency medical services (EMS) to adequately respond to those affected. In this regard, the overall objective of the study was to risk map RTIs in the GKMA so as to help in the better planning of EMS for the victims of RTIs. Other objectives included: (i) identifying the factors affecting the exposure, vulnerability and EMS capacity for the victims of RTIs; (ii) identifying the RTI prone-areas and estimating their associated risk factors; (iii) identifying the weaknesses and capacities which affect the EMS systems for RTIs; and (iv) determining the strategies and priority actions that can help to improve the EMS response for RTI victims in the GKMA. To achieve these objectives, a mixed methodological approach was used in four phrases for approximately 15 months. It employed a systematic review based on the preferred reporting items for systematic reviews and meta-data analysis guidelines; a Delphi panel technique; retrospective data analysis; and a cross-sectional method. With Uganda progressing forward as envisaged in its 'Vision 2040', the GKMA, which is the country’s political and socioeconomic epicenter, is experiencing significant changes in terms of population growth, urbanization, infrastructure development, rapid motorization and other factors. Unless appropriate actions are taken, these changes are likely to worsen the already alarming rate of RTIs in Uganda, and in turn also to put pressure on the few existing EMS and facilities to render care for those affected. Therefore, road safety vis-à-vis injury prevention measures, which are needed to reduce the burden of RTIs, should be multifaceted in nature so that they closely correlate with the ongoing dynamics that contribute to RTIs, particularly in the GKMA and Uganda as a whole.Keywords: emergency medical services, Kampala, risk mapping, road traffic incidents
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