Search results for: digital patient passport

Authors: Samhita Mummadi, Sree Divya Nagalli, Harshini Vemuri, Saketh Charan Nakka, Sumesh K. J.

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One of the most significant challenges faced by people in today’s digital era is an alarming increase in fraudulent activities on online platforms. The fascination with online shopping to avoid long queues in shopping malls, the availability of a variety of products, and home delivery of goods have paved the way for a rapid increase in vast online shopping platforms. This has had a major impact on increasing fraudulent activities as well. This loop of online shopping and transactions has paved the way for fraudulent users to commit fraud. For instance, consider a store that orders thousands of products all at once, but what’s fishy about this is the massive number of items purchased and their transactions turning out to be fraud, leading to a huge loss for the seller. Considering scenarios like these underscores the urgent need to introduce machine learning approaches to combat fraud in online shopping. By leveraging robust algorithms, namely KNN, Decision Trees, and Random Forest, which are highly effective in generating accurate results, this research endeavors to discern patterns indicative of fraudulent behavior within transactional data. Introducing a comprehensive solution to this problem in order to empower e-commerce administrators in timely fraud detection and prevention is the primary motive and the main focus. In addition to that, sentiment analysis is harnessed in the model so that the e-commerce admin can tailor to the customer’s and consumer’s concerns, feedback, and comments, allowing the admin to improve the user’s experience. The ultimate objective of this study is to ramp up online shopping platforms against fraud and ensure a safer shopping experience. This paper underscores a model accuracy of 84%. All the findings and observations that were noted during our work lay the groundwork for future advancements in the development of more resilient and adaptive fraud detection systems, which will become crucial as technologies continue to evolve.

Keywords: behavior analysis, feature selection, Fraudulent pattern recognition, imbalanced classification, transactional anomalies

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Authors: Nikolett Deutsch, Éva Pintér, Péter Bagó, Miklós Hetényi

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Strategic technology management has emerged and evolved parallelly with strategic management paradigms. It focuses on the opportunity for organizations operating mainly in technology-intensive industries to explore and exploit technological capabilities upon which competitive advantage can be obtained. As strategic technology management involves multifunction within an organization, requires broad and diversified knowledge, and must be developed and implemented with business objectives to enable a firm’s profitability and growth, excellence in strategic technology management provides unique opportunities for organizations in terms of building a successful future. Accordingly, a framework supporting the evaluation of the technological readiness level of management can significantly contribute to developing organizational competitiveness through a better understanding of strategic-level capabilities and deficiencies in operations. In the last decade, several innovation maturity assessment models have appeared and become designated management tools that can serve as references for future practical approaches expected to be used by corporate leaders, strategists, and technology managers to understand and manage technological capabilities and capacities. The aim of this paper is to provide a comprehensive review of the state-of-the-art innovation maturity frameworks, to investigate the critical lessons learned from their application, to identify the similarities and differences among the models, and identify the main aspects and elements valid for the field and critical functions of technology management. To this end, a systematic literature review was carried out considering the relevant papers and articles published in highly ranked international journals around the 27 most widely known innovation maturity models from four relevant digital sources. Key findings suggest that despite the diversity of the given models, there is still room for improvement regarding the common understanding of innovation typologies, the full coverage of innovation capabilities, and the generalist approach to the validation and practical applicability of the structure and content of the models. Furthermore, the paper proposes an initial structure by considering the maturity assessment of the technological capacities and capabilities - i.e., technology identification, technology selection, technology acquisition, technology exploitation, and technology protection - covered by strategic technology management.

Keywords: innovation capabilities, innovation maturity models, technology audit, technology management, technology management maturity models

Procedia PDF Downloads 56

Authors: C. Busuioc, I. Stancu, A. Nicoara, A. Zamfirescu, A. Evanghelidis

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The field of tissue engineering has expanded its potential due to the use of composite biomaterials belonging to increasingly complex systems, leading to bone substitutes with properties that are continuously improving to meet the patient's specific needs. Furthermore, the development of biomaterials based on ceramic and polymeric phases is an unlimited resource for future scientific research, with the final aim of restoring the original tissue functionality. Thus, in the first stage, composite scaffolds based on polycaprolactone (PCL) or polylactic acid (PLA) and inorganic powders were prepared by employing the electrospinning technique. The targeted powders were: commercial and laboratory synthesized hydroxyapatite (HAp), as well as barium titanate (BT). By controlling the concentration of the powder within the precursor solution, together with the processing parameters, different types of three-dimensional architectures were achieved. In the second stage, both the mineral powders and hybrid composites were investigated in terms of composition, crystalline structure, and microstructure so that to demonstrate their suitability for tissue engineering applications. Regarding the scaffolds, these were proven to be homogeneous on large areas and loaded with mineral particles in different proportions. The biological assays demonstrated that the addition of inorganic powders leads to modified responses in the presence of simulated body fluid (SBF) or cell cultures. Through SBF immersion, the biodegradability coupled with bioactivity were highlighted, with fiber fragmentation and surface degradation, as well as apatite layer formation within the testing period. Moreover, the final composites represent supports accepted by the cells, favoring implant integration. Concluding, the purposed fibrous materials based on bioresorbable polymers and mineral powders, produced by the electrospinning technique, represent candidates with considerable potential in the field of tissue engineering. Future improvements can be attained by optimizing the synthesis process or by simultaneous incorporation of multiple inorganic phases with well-defined biological action in order to fabricate multifunctional composites.

Keywords: barium titanate, electrospinning, fibre networks, hydroxyapatite, smart scaffolds

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Authors: Sarayu Vanga, Jorge Galeano-Cabral, Kaya Wei

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Cerebral hypoxia refers to a condition in which there is a decrease in oxygen supply to the brain. Patients suffering from this condition experience a decrease in their body temperature. While there isn't any cure to treat cerebral hypoxia as of date, certain procedures are utilized to help aid in the treatment of the condition. Regulating the body temperature is an example of one of those procedures. Hypoxia is well known to reduce the body temperature of mammals, although the neural origins of this response remain uncertain. In order to speed recovery from this condition, it is necessary to maintain a stable body temperature. In this study, we present an approach to regulating body temperature for patients who suffer from cerebral hypoxia or other similar conditions. After a thorough literature study, we propose the use of thermoelectric blankets, which are temperature-controlled thermal blankets based on thermoelectric devices. These blankets are capable of heating up and cooling down the patient to stabilize body temperature. This feature is possible through the reversible effect that thermoelectric devices offer while behaving as a thermal sensor, and it is an effective way to stabilize temperature. Thermoelectricity is the direct conversion of thermal to electrical energy and vice versa. This effect is now known as the Seebeck effect, and it is characterized by the Seebeck coefficient. In such a configuration, the device has cooling and heating sides with temperatures that can be interchanged by simply switching the direction of the current input in the system. This design integrates various aspects, including a humidifier, ventilation machine, IV-administered medication, air conditioning, circulation device, and a body temperature regulation system. The proposed design includes thermocouples that will trigger the blanket to increase or decrease a set temperature through a medical temperature sensor. Additionally, the proposed design allows an efficient way to control fluctuations in body temperature while being cost-friendly, with an expected cost of 150 dollars. We are currently working on developing a prototype of the design to collect thermal and electrical data under different conditions and also intend to perform an optimization analysis to improve the design even further. While this proposal was developed for treating cerebral hypoxia, it can also aid in the treatment of other related conditions, as fluctuations in body temperature appear to be a common symptom that patients have for many illnesses.

Keywords: body temperature regulation, cerebral hypoxia, thermoelectric, blanket design

Procedia PDF Downloads 151

Authors: Hussam Ashwi, Magbool Oraiby, Ali Muyidi, Hamad Al-Oufi, Mohammed Al-Oufi, Adel Al-Juhani, Salman Al-Zemaa, Saeed Al-Shahrani, Amal Abuallah, Wedad Sherwani, Mohammed Alattas, Ibraheem Attafi

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Ethanol must be accurately identified and quantified to establish their use and contribution in criminal cases and forensic medicine. In some situations, it may be necessary to reanalyze an old specimen; therefore, it is essential to comprehend the effect of storage conditions and how long the result of a reanalyzed specimen can be reliable and reproducible. Additionally, ethanol can be produced via multiple in vivo and in vitro processes, particularly in diabetic patients, and the results can be affected by storage conditions and time. In order to distinguish between in vivo and in vitro alcohol generation in diabetes patient urine samples, various factors should be considered. This study identifies and quantifies ethanol and EtG in diabetic patients' urine samples stored in two different settings over time. Ethanol levels were determined using gas chromatography-headspace (GC-HS), and ethyl glucuronide (EtG) levels were determined using the immunoassay (RANDOX) technique. Ten urine specimens were collected and placed in a standard container. Each specimen was separated into two containers. The specimens were divided into two groups: those kept at room temperature (25 °C) and those kept cold (2-8 °C). Ethanol and EtG levels were determined serially over a two-week period. Initial results showed that none of the specimens tested positive for ethanol or EtG. At room temperature (15-25 °C), 7 and 14 days after the sample was taken, the average concentration of ethanol increased from 1.7 mg/dL to 2 mg/dL, and the average concentration of EtG increased from 108 ng/mL to 186 ng/mL. At 2–8 °C, the average ethanol concentration was 0.4 and 0.5 mg/dL, and the average EtG concentration was 138 and 124 ng/mL seven and fourteen days after the sample was collected, respectively. When ethanol and EtG levels were determined 14 days post collection, they were considerably lower than when stored at room temperature. A considerable increase in EtG concentrations (14-day range 0–186 ng/mL) is produced during room-temperature storage, although negative initial results for all specimens. Because EtG might be produced after a sampling collection, it is not a reliable indicator of recent alcohol consumption. Given the possibility of misleading EtG results due to in vitro EtG production in the urine of diabetic patients.

Keywords: ethyl glucuronide, ethanol, forensic toxicology, diabetic

Procedia PDF Downloads 121

Authors: Idowu Olugbenga Adewumi, Foluke Iyabo Oluwatoyinbo

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Presently, there are several discussions on the food security with increase in yield of arable crop throughout the world. This article, briefly present research efforts to create digital interfaces to nature, in particular to area of crop production in agriculture with increase in yield with interest on pervasive computing. The approach goes beyond the use of sensor networks for environmental monitoring but also by emphasizing the development of a system architecture that detect intruder (Intrusion Process) which reduce the yield of the farmer at the end of the planting/harvesting period. The objective of the work is to set a model for setting up the hand held or portable device for increasing the quality and quantity of arable crop. This process incorporates the use of infrared motion image sensor with security alarm system which can send a noise signal to intruder on the farm. This model of the portable image sensing device in monitoring or scaring human, rodent, birds and even pests activities will reduce post harvest loss which will increase the yield on farm. The nano intelligence technology was proposed to combat and minimize intrusion process that usually leads to low quality and quantity of produce from farm. Intranet system will be in place with wireless radio (WLAN), router, server, and client computer system or hand held device e.g PDAs or mobile phone. This approach enables the development of hybrid systems which will be effective as a security measure on farm. Since, precision agriculture has developed with the computerization of agricultural production systems and the networking of computerized control systems. In the intelligent plant production system of controlled greenhouses, information on plant responses, measured by sensors, is used to optimize the system. Further work must be carry out on modeling using pervasive computing environment to solve problems of agriculture, as the use of electronics in agriculture will attracts more youth involvement in the industry.

Keywords: pervasive computing, intrusion detection, precision agriculture, security, arable crop

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Authors: Shinsuke Udagawa, Masato Yamagishi, Masanori Ota

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The Schlieren method, which has been conventionally used to visualize high-speed flows, has disadvantages such as the complexity of the experimental setup and the inability to quantitatively analyze the amount of refraction of light. The Background Oriented Schlieren (BOS) method proposed by Meier is one of the measurement methods that solves the problems, as mentioned above. The refraction of light is used for BOS method same as the Schlieren method. The BOS method is characterized using a digital camera to capture the images of the background behind the observation area. The images are later analyzed by a computer to quantitatively detect the amount of shift of the background image. The experimental setup for BOS does not require concave mirrors, pinholes, or color filters, which are necessary in the conventional Schlieren method, thus simplifying the experimental setup. However, the defocusing of the observation results is caused in case of using BOS method. Since the focus of camera on the background image leads to defocusing of the observed object. The defocusing of object becomes greater with increasing the distance between the background and the object. On the other hand, the higher sensitivity can be obtained. Therefore, it is necessary to adjust the distance between the background and the object to be appropriate for the experiment, considering the relation between the defocus and the sensitivity. The purpose of this study is to experimentally clarify the effect of defocus on density field reconstruction. In this study, the visualization experiment of underexpanded jet using BOS measurement system with ronchi ruling as the background that we constructed, have been performed. The reservoir pressure of the jet and the distance between camera and axis of jet is fixed, and the distance between background and axis of jet has been changed as the parameter. The images have been later analyzed by using personal computer to quantitatively detect the amount of shift of the background image from the comparison between the background pattern and the captured image of underexpanded jet. The quantitatively measured amount of shift have been reconstructed into a density flow field using the Abel transformation and the Gradstone-Dale equation. From the experimental results, it is found that the reconstructed density image becomes blurring, and noise becomes decreasing with increasing the distance between background and axis of underexpanded jet. Consequently, it is cralified that the sensitivity constant should be greater than 20, and the circle of confusion diameter should be less than 2.7mm at least in this experimental setup.

Keywords: BOS method, underexpanded jet, abel transformation, density field visualization

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Authors: Hossein Rassi, Marjan Moradi Fard, Samaneh Niko

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Human papillomavirus type 16 and 18 are closely associated with the development of human cervical carcinoma, which is one of the most common causes of cancer death in women worldwide. At present, HPV type 18 accounts for about 34 % of all HPV infections in Iran and the most promising vaccine against HPV infection is based on the L1 major capsid protein. The L1 protein of HPV18 has the capacity to self-assemble into capsomers or virus-like particles (VLPs) that are non-infectious, highly immunogenic and allowing their use in vaccine production. The methylotrophic yeast Pichia pastoris is an efficient and inexpensive expression system used to produce high levels of heterologous proteins. In this study we expressed HPV18 L1 VLPs in P. pastoris. The gene encoding the major capsid protein L1 of the high-risk HPV type 18 was isolated from Iranian patient by PCR and inserted into pTG19-T vector to obtain the recombinant expression vector pTG19-HPV18-L1. Then, the pTG19-HPV18-L1 was transformed into E. coli strain DH5α and the recombinant protein HPV18 L1 was expressed under IPTG induction in soluble form. The HPV18 L1 gene was excised from recombinant plasmid with XhoI and EcoRI enzymes and ligated into the yeast expression vector pPICZα linearized with the same enzymes, and transformed into P. pastoris. Induction and expression of HPV18 L1 protein was demonstrated by BMGY/BMMY and RT PCR. The parameters for induced cultivation for strain in P. pastoris KM71 with HPV16L1 were investigated in shaking flask cultures. After induced cultivation BMMY (pH 7.0) medium supplemented with methanol to a final concentration of 1.0% every 24 h at 37 degrees C for 96 h, the recombinant produced 78.6 mg/L of L1 protein. This work offers the possibility for the production of prophylactic vaccine for cervical carcinoma by P. pastoris for HPV-18 L1 gene. The VLP-based HPV vaccines can prevent persistent HPV18 infections and cervical cancer in Iran. The HPV-18 L1 gene was expressed successfully in E.coli, which provides necessary basis for preparing HPV-18 L1 vaccine in human. Also, HPV type 6 L1 proteins expressed in Pichia pastoris will facilitate the HPV vaccine development and structure-function study.

Keywords: Pichia pastoris, L1 virus-like particles, human papillomavirus type 18, biotechnology

Procedia PDF Downloads 402

Authors: Metin Özkan

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In the last decade, Turkish higher education has been expanded dramatically. With this expansion, Turkey has come a long way in establishing an efficient system of higher education which is moving into a ‘mass’ system with institutions spanning the whole country. This expansion as a quantitative target leads to questioning the quality of higher education services. Especially, the qualities of higher education services depend on mainly quality of educators. Qualities of educators are most important in Turkish higher education system due to rapid rise in the number of universities and students. Therefore, it is seen important that reveals the portrait of ideal university teacher from the point of view student enrolled in Turkish higher education system. The purpose of this current study is to determine the portrait of ideal university teacher according to the views of Turkish Students. This research is carried out with descriptive scanning method and combined and mixed of qualitative and quantitative methodologies. Research data of qualitative section were collected at Gaziantep University with the participation of 45 students enrolled in 15 different faculties. Quantitative section was performed on 217 students. The data were obtained through semi-structured interview and “Ideal University Teacher Assessment” form developed by the researcher. The interview form consists of basically two parts. The first part of the interview was about personal information, the second part included questions about the characteristic of ideal university teacher. The questions which constitute the second part of the interview are; "what is a good university teacher like?” and “What human qualities and professional skills should a university teacher have? ". Assessment form which was created from the qualitative data obtained from interviews was used to attain scaling values for pairwise comparison and ranking judgment. According to study results, it has been found that ideal university teacher characteristics include the features like patient, tolerant, comprehensive and tolerant. Ideal university teacher, besides, implement the teaching methods like encouraging the students’ critical thinking, accepting the students’ recommendations on how to conduct the lesson and making use of the new technologies etc. Motivating and respecting the students, adopting a participative style, adopting a sincere way of manner also constitute the ideal university features relationships with students.

Keywords: faculty, higher education, ideal university teacher, teacher behavior

Procedia PDF Downloads 207

Authors: Mohamed H. Khalil

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Water is one of the most crucial elements which influence human lives and development. Noteworthy, over the last few years, GIS plays a significant role in optimizing water management systems, especially after exponential developing in this sector. In this context, the Egyptian government initiated an advanced ‘GIS-Web Based System’. This system is efficiently designed to tangibly assist and optimize the complement and integration of data between departments of Call Center, Operation and Maintenance, and laboratory. The core of this system is a unified ‘Data Model’ for all the spatial and tabular data of the corresponding departments. The system is professionally built to provide advanced functionalities such as interactive data collection, dynamic monitoring, multi-user editing capabilities, enhancing data retrieval, integrated work-flow, different access levels, and correlative information record/track. Noteworthy, this cost-effective system contributes significantly not only in the completeness of the base-map (93%), the water network (87%) in high level of details GIS format, enhancement of the performance of the customer service, but also in reducing the operating costs/day-to-day operations (~ 5-10 %). In addition, the proposed system facilitates data exchange between different departments (Call Center, Operation and Maintenance, and laboratory), which allowed a better understanding/analyzing of complex situations. Furthermore, this system reflected tangibly on: (i) dynamic environmental monitor/water quality indicators (ammonia, turbidity, TDS, sulfate, iron, pH, etc.), (ii) improved effectiveness of the different water departments, (iii) efficient deep advanced analysis, (iv) advanced web-reporting tools (daily, weekly, monthly, quarterly, and annually), (v) tangible planning synthesizing spatial and tabular data; and finally, (vi) scalable decision support system. It is worth to highlight that the proposed future plan (second phase) of this system encompasses scalability will extend to include integration with departments of Billing and SCADA. This scalability will comprise advanced functionalities in association with the existing one to allow further sustainable contributions.

Keywords: GIS Web-Based, base-map, water network, decision support system

Procedia PDF Downloads 86

Authors: Hung-Yuan Chang, Wen-Lung Chiang, Kuo-Liang Wu, Chen-Tsung Lin

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National Space Organization (NSPO) has completed in 2014 the development of a space-borne GPS receiver, including design, manufacture, comprehensive functional test, environmental qualification test and so on. The main performance of this receiver include 8-meter positioning accuracy, 0.05 m/sec speed-accuracy, the longest 90 seconds of cold start time, and up to 15g high dynamic scenario. The receiver will be integrated in the autonomous FORMOSAT-7 NSPO-Built satellite scheduled to be launched in 2019 to execute pre-defined scientific missions. The flight model of this receiver manufactured in early 2015 will pass comprehensive functional tests and environmental acceptance tests, etc., which are expected to be completed by the end of 2015. The space-borne GPS receiver is a pure software design in which all GPS baseband signal processing are executed by a digital signal processor (DSP), currently only 50% of its throughput being used. In response to the booming global navigation satellite systems, NSPO will gradually expand this receiver to become a multi-mode, multi-band, high-precision navigation receiver, and even a science payload, such as the reflectometry receiver of a global navigation satellite system. The fundamental purpose of this extension study is to port some software algorithms such as signal acquisition and correlation, reused code and large amount of computation load to the FPGA whose processor is responsible for operational control, navigation solution, and orbit propagation and so on. Due to the development and evolution of the FPGA is pretty fast, the new system architecture upgraded via an FPGA should be able to achieve the goal of being a multi-mode, multi-band high-precision navigation receiver, or scientific receiver. Finally, the results of tests show that the new system architecture not only retains the original overall performance, but also sets aside more resources available for future expansion possibility. This paper will explain the detailed DSP/FPGA architecture, development, test results, and the goals of next development stage of this receiver.

Keywords: space-borne, GPS receiver, DSP, FPGA, multi-mode multi-band

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Authors: Li-Ching Lin, Yu-Tzu Dai

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Recurrent foot ulcers or foot amputation have a major impact on patients with diabetes mellitus (DM), medical professionals, and society. A critical procedure for foot care is foot self-monitoring. Medical professionals’ understanding of patients’ foot self-monitoring knowledge, attitude, and practice is beneficial for raising patients’ disease awareness. This study investigated these and related factors among patients with DM through a descriptive study of the correlations. A scale for measuring the foot self-monitoring knowledge, attitude, and practice of patients with DM was used. Purposive sampling was adopted, and 100 samples were collected from the respondents’ self-reports or from interviews. The statistical methods employed were an independent-sample t-test, one-way analysis of variance, Pearson correlation coefficient, and multivariate regression analysis. The findings were as follows: the respondents scored an average of 12.97 on foot self-monitoring knowledge, and the correct answer rate was 68.26%. The respondents performed relatively lower in foot health screenings and recording, and awareness of neuropathy in the foot. The respondents held a positive attitude toward self-monitoring their feet and a negative attitude toward having others check the soles of their feet. The respondents scored an average of 12.64 on foot self-monitoring practice. Their scores were lower in their frequency of self-monitoring their feet, recording their self-monitoring results, checking their pedal pulse, and examining if their soles were red immediately after taking off their shoes. Significant positive correlations were observed among foot self-monitoring knowledge, attitude, and practice. The correlation coefficient between self-monitoring knowledge and self-monitoring practice was 0.20, and that between self-monitoring attitude and self-monitoring practice was 0.44. Stepwise regression analysis revealed that the main predictive factors of the foot self-monitoring practice in patients with DM were foot self-monitoring attitude, prior experience in foot care, and an educational attainment of college or higher. These factors predicted 33% of the variance. This study concludes that patients with DM lacked foot self-monitoring practice and advises that the patients’ self-monitoring abilities be evaluated first, including whether patients have poor eyesight, difficulties in bending forward due to obesity, and people who can assist them in self-monitoring. In addition, patient education should emphasize self-monitoring knowledge and practice, such as perceptions regarding the symptoms of foot neurovascular lesions, pulse monitoring methods, and new foot self-monitoring equipment. By doing so, new or recurring ulcers may be discovered in their early stages.

Keywords: diabetic foot, foot self-monitoring attitude, foot self-monitoring knowledge, foot self-monitoring practice

Procedia PDF Downloads 192

Authors: Neslihan Demirci, Serdar Durdağı

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Mycobacterium tuberculosis is still a worldwide disease-causing agent that, according to WHO, led to the death of 1.5 million people from tuberculosis (TB) in 2020. The bacteria reside in macrophages located specifically in the lung. There is a known quadruple drug therapy regimen for TB consisting of isoniazid (INH), rifampin (RIF), pyrazinamide (PZA), and ethambutol (EMB). Over the past 60 years, there have been great contributions to treatment options, such as recently approved delamanid (OPC67683) and bedaquiline (TMC207/R207910), targeting mycolic acid and ATP synthesis, respectively. Also, there are natural compounds that can block the tryptophanyl-tRNA synthetase (TrpRS) enzyme, chuangxinmycin, and indolmycin. Yet, already the drug resistance is reported for those agents. In this study, the newly released TrpRS enzyme structure is investigated for potential inhibitor drugs from already synthesized molecules to help the treatment of resistant cases and to propose an alternative drug for the quadruple drug therapy of tuberculosis. Maestro, Schrodinger is used for docking and molecular dynamic simulations. In-house library containing ~8000 compounds among FDA-approved indole-containing compounds, a total of 57 obtained from the ChemBL were used for both ATP and tryptophan binding pocket docking. Best of indole-containing 57 compounds were subjected to hit expansion and compared later with virtual screening workflow (VSW) results. After docking, VSW was done. Glide-XP docking algorithm was chosen. When compared, VSW alone performed better than the hit expansion module. Best scored compounds were kept for ten ns molecular dynamic simulations by Desmond. Further, 100 ns molecular dynamic simulation was performed for elected molecules according to Z-score. The top three MMGBSA-scored compounds were subjected to steered molecular dynamic (SMD) simulations by Gromacs. While SMD simulations are still being conducted, ponesimod (for multiple sclerosis), vilanterol (β₂ adrenoreceptor agonist), and silodosin (for benign prostatic hyperplasia) were found to have a significant affinity for tuberculosis TrpRS, which is the propulsive force for the urge to expand the research with in vitro studies. Interestingly, top-scored ponesimod has been reported to have a side effect that makes the patient prone to upper respiratory tract infections.

Keywords: drug repurposing, molecular dynamics, tryptophanyl-tRNA synthetase, tuberculosis

Procedia PDF Downloads 118

Authors: Mohammed Al-Zubaidi, Katherine Ong, Pravin Viswambaram, Steve McCombie, Oliver Oey, Jeremy Ong, Richard Gauci, Ronny Low, Dickon Hayne

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Objective: Lymph node involvement along with distant metastasis in a patient with invasive bladder cancer determines the disease survival, therefeor, it is an essential determinant of the therapeutic management and outcome. This retrospective study aims to determine the accuracy of FDG PET scan in detecting lymphatic involvement and distant metastatic urothelial cancer compared to conventional CT staging. Method: A retrospective review of 76 patients with UC or BC who underwent surgery or confirmatory biopsy that was staged with both CT and 18F-FDG-PET (up to 8 weeks apart) between 2015 and 2020. Fifty-sevenpatients (75%) had formal pelvic LN dissection or biopsy of suspicious metastasis. 18F-FDG-PET reports for positive sites were qualitative depending on SUV Max. On the other hand, enlarged LN by RECIST criteria 1.1 (>10 mm) and other qualitative findings suggesting metastasis were considered positive in CT scan. Histopathological findings from surgical specimens or image-guided biopsies were considered the gold standard in comparison to imaging reports. 18F-FDG-avid or enlarged pelvic LNs with surgically proven nodal metastasis were considered true positives. Performance characteristics of 18F-FDG-PET and CT, including sensitivity, specificity, positive predictive value (PPV), and negative predictive value (PPV), were calculated. Results: Pelvic LN involvement was confirmed histologically in 10/57 (17.5%) patients. Sensitivity, specificity, PPV and NPV of CT for detecting pelvic LN metastases were 41.17% (95% CI:18-67%), 100% (95% CI:90-100%) 100% (95% CI:59-100%) and 78.26% (95% CI:64-89%) respectively. Sensitivity, specificity, PPV and NPV of 18F-FDG-PET for detecting pelvic LN metastases were 62.5% (95% CI:35-85%), 83.78% (95% CI:68-94%), 62.5% (95% CI:35-85%), and 83.78% (95% CI:68-94%) respectively. Pre-operative staging with 18F-FDG-PET identified the distant metastatic disease in 9/76 (11.8%) patients who were occult on CT. This retrospective study suggested that 18F-FDG-PET may be more sensitive than CT for detecting pelvic LN metastases. 7/76 (9.2%) patients avoided cystectomy due to 18F-FDG-PET diagnosed metastases that were not reported on CT. Conclusion: 18F-FDG-PET is more sensitive than CT for pelvic LN metastases, which can be used as the standard modality of bladder cancer staging, as it may change the treatment by detecting lymph node metastasis that was occult in CT. Further research involving randomised controlled trials comparing the diagnostic yield of 18F-FDG-PET and CT in detecting nodal and distant metastasis in UC or BC is warranted to confirm our findings.

Keywords: FDG PET, CT scan, urothelial cancer, bladder cancer

Procedia PDF Downloads 118

Authors: Gökçe Erdemir, İlhan Yaylım, Serap Erdem-Kuruca, Musa Mutlu Can

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It has been determined that the main reason for the death of cancer disease is caused by metastases rather than the primary tumor. The cells that leave the primary tumor and enter the circulation and cause metastasis in the secondary organs are called "circulating tumor cells" (CTCs). The presence and number of circulating tumor cells has been associated with poor prognosis in many major types of cancer, including breast, prostate, and colorectal cancer. It is thought that knowledge of circulating tumor cells, which are seen as the main cause of cancer-related deaths due to metastasis, plays a key role in the diagnosis and treatment of cancer. The fact that tissue biopsies used in cancer diagnosis and follow-up are an invasive method and are insufficient in understanding the risk of metastasis and the progression of the disease have led to new searches. Liquid biopsy tests performed with a small amount of blood sample taken from the patient for the detection of CTCs are easy and reliable, as well as allowing more than one sample to be taken over time to follow the prognosis. However, since these cells are found in very small amounts in the blood, it is very difficult to capture them and specially designed analytical techniques and devices are required. Methods based on the biological and physical properties of the cells are used to capture these cells in the blood. Early diagnosis is very important in following the prognosis of tumors of epithelial origin such as breast, lung, colon and prostate. Molecules such as EpCAM, vimentin, and cytokeratins are expressed on the surface of cells that pass into the circulation from very few primary tumors and reach secondary organs from the circulation, and are used in the diagnosis of cancer in the early stage. For example, increased EpCAM expression in breast and prostate cancer has been associated with prognosis. These molecules can be determined in some blood or body fluids to be taken from patients. However, more sensitive methods are required to be able to determine when they are at a low level according to the course of the disease. The aim is to detect these molecules found in very few cancer cells with the help of sensitive, fast-sensing biosensors, first in breast cancer cells reproduced in vitro and then in blood samples taken from breast cancer patients. In this way, cancer cells can be diagnosed early and easily and effectively treated.

Keywords: electrochemical biosensors, breast cancer, circulating tumor cells, EpCAM, Vimentin, Cytokeratins

Procedia PDF Downloads 256

Authors: Shraddha Acharya, Sharad Kumar Sharma, Ratna Bhattarai, Bhagwan Maharjan, Deepak Dahal, Serpahine Kaminsa

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Background: Drug-resistant (DR) tuberculosis (TB) continues to be a threat in Nepal, with an estimated 2800 new cases every year. The treatment of DR-TB with second line TB drugs is complex and takes longer time with comparatively lower treatment success rate than drug-susceptible TB. Delay in treatment initiation for DR-TB patients might further result in unfavorable treatment outcomes and increased transmission. This study thus aims to determine median time taken to initiate second-line treatment among Rifampicin Resistant (RR) diagnosed TB patients and to assess the proportion of treatment delays among various type of DR-TB cases. Method: A retrospective cohort study was done using national routine electronic data (DRTB and TB Laboratory Patient Tracking System-DHIS2) on drug resistant tuberculosis patients between January 2020 and December 2022. The time taken for treatment initiation was computed as– days from first diagnosis as RR TB through Xpert MTB/Rif test to enrollment on second-line treatment. The treatment delay (>7 days after diagnosis) was calculated. Results: Among total RR TB cases (N=954) diagnosed via Xpert nationwide, 61.4% were enrolled under shorter-treatment regimen (STR), 33.0% under longer treatment regimen (LTR), 5.1% for Pre-extensively drug resistant TB (Pre-XDR) and 0.4% for Extensively drug resistant TB (XDR) treatment. Among these cases, it was found that the median time from diagnosis to treatment initiation was 6 days (IQR:2-15.8). The median time was 5 days (IQR:2.0-13.3) among STR, 6 days (IQR:3.0-15.0) among LTR, 30 days (IQR:5.5-66.8) among Pre-XDR and 4 days (IQR:2.5-9.0) among XDR TB cases. The overall treatment delay (>7 days after diagnosis) was observed in 42.4% of the patients, among which, cases enrolled under Pre-XDR contributed substantially to treatment delay (72.0%), followed by LTR (43.6%), STR (39.1%) and XDR (33.3%). Conclusion: Timely diagnosis and prompt treatment initiation remain fundamental focus of the National TB program. The findings of the study, however suggest gaps in timeliness of treatment initiation for the drug-resistant TB patients, which could bring adverse treatment outcomes. Moreover, there is an alarming delay in second line treatment initiation for the Pre-XDR TB patients. Therefore, this study generates evidence to identify existing gaps in treatment initiation and highlights need for formulating specific policies and intervention in creating effective linkage between the RR TB diagnosis and enrollment on second line TB treatment with intensified efforts from health providers for follow-ups and expansion of more decentralized, adequate, and accessible diagnostic and treatment services for DR-TB, especially Pre-XDR TB cases, due to the observed long treatment delays.

Keywords: drug-resistant, tuberculosis, treatment initiation, Nepal, treatment delay

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Authors: Simiksha Balkissoon, Jerome Andrew, Bruce Sithole

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Approximately half of the wood processed in the Forestry, Timber, Pulp and Paper (FTPP) sector is accumulated as waste. The concept of a “green economy” encourages industries to employ revolutionary, transformative technologies to eliminate waste generation by exploring the development of new value chains. The transition towards an almost paperless world driven by the rise of digital media has resulted in a decline in traditional paper markets, prompting the FTTP sector to reposition itself and expand its product offerings by unlocking the potential of value-adding opportunities from renewable resources such as wood to generate revenue and mitigate its environmental impact. The production of valuable products from wood waste such as sawdust has been extensively explored in recent years. Wood components such as lignin, cellulose and hemicelluloses, which can be extracted selectively by chemical processing, are suitable candidates for producing numerous high-value products. In this study, a novel approach to produce high-value cellulose products, such as dissolving wood pulp (DWP), from sawdust was developed. DWP is a high purity cellulose product used in several applications such as pharmaceutical, textile, food, paint and coatings industries. The proposed approach demonstrates the potential to eliminate several complex processing stages, such as pulping and bleaching, which are associated with traditional commercial processes to produce high purity cellulose products such as DWP, making it less chemically energy and water-intensive. The developed process followed the path of experimentally designed lab tests evaluating typical processing conditions such as residence time, chemical concentrations, liquid-to-solid ratios and temperature, followed by the application of suitable purification steps. Characterization of the product from the initial stage was conducted using commercially available DWP grades as reference materials. The chemical characteristics of the products thus far have shown similar properties to commercial products, making the proposed process a promising and viable option for the production of DWP from sawdust.

Keywords: biomass, cellulose, chemical treatment, dissolving wood pulp

Procedia PDF Downloads 181

Authors: Joanna Maj, Awais Hussain, Lyndsey Vu, Catherine Roxas

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Background: Bone injuries in babies are common conditions that arise during delivery. Fractures of the clavicle, humerus, femur, and skull are the most common neonatal bone injuries sustained from labor and delivery. During operative deliveries, zealous tractions, ineffective delivery techniques, improper uterine incision, and inadequate relaxation of the uterus can lead to bone fractures in the newborn. Neonatal anatomy is unique. Just as children are not mini-adults, newborns are not mini children. A newborn’s anatomy and physiology are significantly different from a pediatric patient's. In this paper, we describe common orthopedic trauma in newborn babies. We provide a comprehensive overview of the different types of bone injuries in newborns. We hypothesize that the rate of bone fractures sustained at birth is higher in cases of operative deliveries. Methods: Relevant literature was selected by using the PubMed database. Search terms included orthopedic conditions in newborns, neonatal anatomy, and bone fractures in neonates during operative deliveries. Inclusion criteria included age, gender, race, type of bone injury and progression of bone injury. Exclusion criteria were limited in the medical history of cases reviewed and comorbidities. Results: This review finds that a clavicle fracture is the most common type of neonatal orthopedic injury sustained at birth in both operative and non-operative deliveries. We confirm the hypothesis that infants born via operative deliveries have a significantly higher rate of bone fractures than non-cesarean section deliveries. Conclusion: Newborn babies born via operative deliveries have a higher rate of bone fractures of the clavicle, humerus, and femur. A clavicle bone fracture in newborns is most common during emergency operative deliveries in new mothers. We conclude that infants born via an operative delivery sustained more bone injuries than infants born via non-cesarean section deliveries.

Keywords: clavicle fracture, humerus fracture, neonates, newborn orthopedics, orthopedic surgery, pediatrics, orthopedic trauma, orthopedic trauma during delivery, cesarean section, obstetrics, neonatal anatomy, neonatal fractures, operative deliveries, labor and delivery, bone injuries in neonates

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Authors: Shoukat Ali, Amjad Hussain, Latif-ur-Rehman, Sehrish Inam

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Radiotherapy plays an important role in the management of cancer patients. Approximately 50% of the cancer patients receive radiotherapy at one point or another during the course of treatment. The entire radiotherapy treatment of curative intent is divided into different phases, depending on the histology of the tumor. The established protocols are useful in deciding the total dose, fraction size, and numbers of phases. The objective of this study was to evaluate the dosimetric differences between the conventional treatment protocols and the three-dimensional conformal simultaneously integrated boost (SIB) plans for three different tumors sites (i.e. bladder, breast, and brain). A total of 30 patients with brain, breast and bladder cancers were selected in this retrospective study. All the patients were CT simulated initially. The primary physician contoured PTV1 and PTV2 in the axial slices. The conventional doses prescribed for brain and breast is 60Gy/30 fractions, and 64.8Gy/36 fractions for bladder treatment. For the SIB plans biological effective doses (BED) were calculated for 25 fractions. The two conventional (Phase I and Phase II) and a single SIB plan for each patient were generated on Eclipse™ treatment planning system. Treatment plans were compared and analyzed for coverage index, conformity index, homogeneity index, dose gradient and organs at risk doses.In both plans 95% of PTV volume received a minimum of 95% of the prescribe dose. Dose deviation in the optic chiasm was found to be less than 0.5%. There is no significant difference in lung V20 and heart V30 in the breast plans. In the rectum plans V75%, V50% and V25% were found to be less than 1.2% different. Deviation in the tumor coverage, conformity and homogeneity indices were found to be less than 1%. SIB plans with three dimensional conformal radiotherapy technique reduce the overall treatment time without compromising the target coverage and without increasing dose to the organs at risk. The higher dose per fraction may increase the late effects to some extent. Further studies are required to evaluate the late effects with the intention of standardizing the SIB technique for practical implementation.

Keywords: coverage index, conformity index, dose gradient, homogeneity index, simultaneously integrated boost

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Authors: Andrea Gatti, Federica Coppotelli, Ma Primavera, Laura Palmieri, Umberto Tarantino

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Aim of study: Scientific literature is scarce of studies and reviews valuing the pros and cons of the paratricipital approach for the treatment of humeral shaft fractures; the lateral paratricipital approach is a valid alternative to the classical posterior approach to the humeral shaft as it preserves both the triceps muscle and the elbow extensor mechanisms; based on our experience, this retrospective analysis aims at analyzing outcome, risks and benefits of the lateral paratricipital approach for humeral shaft fractures. Methods: Our study includes 14 patients treated between 2018 and 2019 for unilateral humeral shaft fractures: 13 with a B1 or B2 and a patient with a C fracture type (according to the AO/ATO Classification); 6 of our patients identified as male while 8 as female; age average was 57.8 years old (range 21-73 years old). A lateral paratricipital approach was performed on all 14 patients, sparing the triceps muscle by avoiding the olecranon osteotomy and by assessing the integrity and the preservation of the radial nerve; the humeral shaft fracture osteosynthesis was performed by means of plates and screws. After surgery all patients have started elbow functional rehabilitation with acceptable pain management. Post-operative follow-up has been carried out by assessing radiographs, MEPS (Mayo Elbow Performance Score) and DASH (Disability of Arm Shoulder and Hand) functional assessment and ROM of the affected joint. Results: All 14 patients had an optimal post-operative follow-up with an adequate osteosynthesis and functional rehabilitations by entirely preserving the operated elbow joint; the mean elbow ROM was 0-118.6 degree (range of 0-130) while the average MEPS score was 86 (range75-100) and 79.9 for the DASH (range 21.7-86.1). Just 2 patients suffered of temporary radial nerve apraxia, healed in the subsequent follow-ups. CONCLUSION: The lateral paratricipital approach preserve both the integrity of the triceps muscle and the elbow biomechanism but we do strongly recommend additional studies to be carried out to highlight differences between it and the classical posterior approach in treating humeral shaft fractures.

Keywords: paratricepital approach, humerus shaft fracture, posterior approach humeral shaft, paratricipital postero-lateral approach

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Authors: Yu-Wen Lin, Li-Ni Liu

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Introduction: Fatigue is the most common symptoms experienced by cancer patients undergoing chemotherapy. Patients receiving anticancer therapies develop a higher proportion of fatigue compared with patients who do not receive anticancer therapies. Fatigue has significant impacts on quality of life, daily activities, mood status, and social behaviors. A warm-water footbath (WWF) at 41℃ promotes circulation and removes metabolites resulting in improving sleep and relieving fatigue. The aim of this study is to determine the effectiveness of WWF for relieving fatigue with cancer patients undergoing chemotherapy. Materials and Methods: This is a single-center, prospective, quasi-experimental design study in the oncology ward in Taiwan. Participants in this study were assigned to WWF group as experimental group and standard care group as a control group by purposive sampling. In the WWF group, the participants were asked to soak their feet in 42-43℃ water 15 minutes for consecutive 6 days at one day before chemotherapy. Each participant was evaluated for fatigue level by the Taiwanese version of the Brief Fatigue Inventory (BFI-T). BFI-T was completed for consecutive 8 days of the study. The primary outcome was compared the BFI-T score of WWF group to the standard care group. Results: There were 60 participants enrolled in this study. Thirty participants were assigned to WWF group and 30 participants were assigned to standard care group. Both groups have comparable characteristic. The BFI-T scores of both groups were increased associated with the days of chemotherapy. The highest BFI-T scores of both groups were on the day 4 of chemotherapy. The BFI-T scores of both groups were decreased since day 5 and significantly decreased in WWF group on day 5 compared to standard care group (4.17 vs. 5.7, P ＜ .05). At the end of the study the fatigue at its worse were significantly decreased in WWF group (2.33 vs. 4.37, P ＜ .001). There was no adverse event reported in this study. Conclusion: WWF is an easy, safe, non-invasive, and relatively inexpensive nursing intervention for improving fatigue of cancer patients undergoing chemotherapy. In summary, this study shows the WWF is a simple complementary care method, and it is effective for improving and relieving fatigue in a short time. Through improving fatigue is a way to enhance the quality of life which is important for cancer patients undergoing chemotherapy. Larger prospective randomized controlled trial and long-term effectiveness and outcomes of WWF should be performed to confirm this study.

Keywords: chemotherapy, warm-water footbath, fatigue, Taiwanese version of the brief fatigue inventory

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Authors: S. Blanchard, D. Beladjine, K. Beddiar

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Since 2015, the arrival of BIM in the building sector in France has turned the corporation world upside down. Not only constructive practices have been impacted, but also the uses and the men who have undergone important changes. Thus, the new collaborative mode generated by the BIM and the digital model has challenged the supremacy of some construction actors because the process involves working together taking into account the needs of other contributors. New BIM tools have emerged and actors in the act of building must take ownership of them. It is in this context that under the impetus of a European directive and the French government's encouragement of new missions and job profiles have. Moreover, concurrent engineering requires that each actor can advance at the same time as the others, at the whim of the information that reaches him, and the information he has to transmit. However, in the French legal system around public procurement, things are not planned in this direction. Also, a consequent evolution must take place to adapt to the methodology. The new missions generated by the BIM in France require a good mastery of the tools and the process. Also, to meet the objectives of the BIM approach, it is possible to define a typical job profile around the BIM, adapted to the various sectors concerned. The multitude of job offers using the same terms with very different objectives and the complexity of the proposed missions motivated by our approach. In order to reinforce exchanges with professionals or specialists, we carried out a statistical study to answer this problem. Five topics are discussed around the business area: the BIM in the company, the function (business), software used and BIM missions practiced (39 items). About 1400 professionals were interviewed. These people work in companies (micro businesses, SMEs, and Groups) of construction, engineering offices or, architectural agencies. 77% of respondents have the status of employees. All participants are graduated in their trade, the majority having level 1. Most people have less than a year of experience in BIM, but some have 10 years. The results of our survey help to understand why it is not possible to define a single type of BIM Manager. Indeed, the specificities of the companies are so numerous and complex and the missions so varied, that there is not a single model for a function. On the other hand, it was possible to define 3 main professions around the BIM (Manager, Coordinator and Modeler) and 3 main missions for the BIM Manager (deployment of the method, assistance to project management and management of a project).

Keywords: BIM manager, BIM modeler, BIM coordinator, project management

Procedia PDF Downloads 161

Authors: Emel Sonmezer, Hayri Baran Yosmaoglu

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The negative impact of chronic pain syndromes on sexual function has been reported in several studies; however, the influences of treatment strategies on sexual dysfunction have not been evaluated widely. The aim of this study was to determine the effects of pelvic floor exercise on sexual dysfunction in female patients with chronic low back pain. Forty-two patient with chronic low back pain were enrolled this study. Subjects were divided into two groups. Group 1 received conventional physiotherapy consist of heat therapy, ergonomic education, William flexion exercise during 6 weeks. Group 2 received pelvic floor exercises in addition to conventional physiotherapy. Female Sexual Function Index (FSFI) was used for the assessment of sexual function. Pain intensity was assessed with Visual Analogue Scale. Quality of life was assessed with World Health Organization Quality of Life Scale. All measurements were taken before and after treatment. In conventional physiotherapy group; there were significant improvement in pain intensity (p= 0,003), physical health (p=0,011), psychological health (p=0,042) subscales of quality of life scale, arousal (p=0,042), lubrication (p=0,028) and pain (p= 0,034) subscales of FSFI. In additional pelvic floor exercise group; there were significant improvement in pain intensity (p= 0,005), physical health (p=0,012) psychological health (p=0,039) subscales of quality of life scale, arousal (p=0,024), lubrication (p=0,011), orgasm (p=0,035) and pain (p= 0,015) subscales and total score (p=0,016) of FSFI. Total FSFI score (p=0,025) and orgasm (p=0,017) subscale of FSFI were significantly higher for the additional pelvic floor exercise group than the conventional physiotherapy group.The outcome of this study suggested that conventional physiotherapy may contribute to improve pain, quality of life and some parameters of the sexual function in patients with low back pain. Although additional pelvic floor exercise did not reveal more treatment effect in terms of quality of life and pain intensity, it caused significant improvement in sexual function. It is recommended that pelvic floor exercise should be added to treatment programs in order to manage sexual dysfunction more effectively in patients with chronic low back pain.

Keywords: physiotherapy, chronic pain, sexual dysfunction, pelvic floor

Procedia PDF Downloads 265

Authors: Joyce K. Anastasi, Bernadette Capili

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Community Engagement Strategies to Assist with the Development of an RCT Among People Living with HIV Our research team focuses on developing and testing protocols to manage chronic symptoms. For many years, our team designed and implemented symptom management studies for people living with HIV (PLWH). We identify symptoms that are not curative and are not adequately controlled by conventional therapies. As an exemplar, we describe how we successfully engaged PLWH in developing and refining our research feasibility protocol for distal sensory peripheral neuropathy (DSP) associated with HIV. With input from PLWH with DSP, our research received National Institutes of Health (NIH) research funding support. Significance: DSP is one of the most common neurologic complications in HIV. It is estimated that DSP affects 21% to 50% of PLWH. The pathogenesis of DSP in HIV is complex and unclear. Proposed mechanisms include cytokine dysregulation, viral protein-produced neurotoxicity, and mitochondrial dysfunction associated with antiretroviral medications. There are no FDA-approved treatments for DSP in HIV. Purpose: Aims: 1) to explore the impact of DSP on the lives of PLWH, 2) to identify patients’ perspectives on successful treatments for DSP, 3) to identify interventions considered feasible and sensitive to the needs of PLWH with DSP, and 4) to obtain participant input for protocol/study design. Description of Process: We conducted a needs assessment with PLWH with DSP. From our needs assessment, we learned from the patients’ perspective detailed descriptions of their symptoms; physical functioning with DSP; self-care remedies tried, and desired interventions. We also asked about protocol scheduling, instrument clarity, study compensation, study-related burdens, and willingness to participate in a randomized controlled trial (RCT) with a placebo and a waitlist group. Implications: We incorporated many of the suggestions learned from the need assessment. We developed and completed a feasibility study that provided us with invaluable information that informed subsequent NIH-funded studies. In addition to our extensive clinical and research experience working with PLWH, learning from the patient perspective helped in developing our protocol and promoting a successful plan for recruitment and retention of study participants.

Keywords: clinical trial development, peripheral neuropathy, traditional medicine, HIV, AIDS

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Authors: Ayda Youssef, Tarek Rafaat, Iman zaky

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Purpose: Langerhans’ cell histiocytosis (LCH) is not uncommon pathology that implies aberrant proliferation of a specific dendritic (Langerhans) cell. These atypical but mature cells of monoclonal origin can infiltrate many sites of the body and may occur as localized lesions or as widespread systemic disease. Liver is one of the uncommon sites of affection. The twofold objective of this study is to illustrate the radiological presentation of this disease, and to compare these results with previously reported series. Methods and Materials: Between 2007 and 2012, 150 patients with biopsy-proven LCH were treated in our hospital, a paediatric cancer tertiary care center. A retrospective review of radiographic images and reports was performed. There were 33 patients with liver affection are stratified. All patients underwent imaging studies, mostly US and CT. A chart review was performed to obtain demographic, clinical and radiological data. They were analyzed and compared to other published series. Results: Retrospective assessment of 150 patients with LCH was performed, among them 33 patients were identified who had liver involvement. All these patients developed multisystemic disease; They were 12 females and 21 males with (n= 32), seven of them had marked hepatomegaly. Diffuse hypodense liver parenchyma was encountered in five cases, the periportal location has a certain predilection in cases of focal affection where three cases has a hypodense periportal soft tissue sheets, one of them associated with dilated biliary radicals, only one case has multiple focal lesions unrelated to portal tracts. On follow up of the patients, two cases show abnormal morphology of liver with bossy outline. Conclusion: LCH is a not infrequent disease. A high-index suspicion should be raised in the context of diagnosis of liver affection. A biopsy is recommended in the presence of radiological suspicion. Chemotherapy is the preferred therapeutic modality. Liver histiocytosis are not disease specific features but should be interpreted in conjunction with the clinical history and the results of biopsy. Clinical Relevance/Application: Radiologist should be aware of different patterns of hepatobiliary histiocytosis, Thus early diagnosis and proper management of patient can be conducted.

Keywords: langerhans’ cell histiocytosis, liver, medical and health sciences, radiology

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Authors: Annelyn Fatima Lopez, Ermenilda Avendano, Aileen Marie Vargas, Lara Baylon, Rorilee Angeles

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BACKGROUND: The COVID-19 resulted in a public health emergency and quarantine measures which may negatively impact psychosocial and environmental aspects of vulnerable populations. OBJECTIVES: This study intended to determine the quality of life, situations and emerging concerns of parents of children with neurodevelopmental disorders during the ongoing coronavirus pandemic. METHODOLOGY: Parents of patients seen in the PCMC Neurodevelopmental Pediatrics OPD clinic were recruited to fill out questionnaires on parent and child characteristics, survey on situations and emerging concerns during the coronavirus pandemic and WHOQOL-BREF (Filipino version) for parental quality of life. RESULTS: Data from 115 respondents showed a lower score in the environmental domain. The child characteristics that are statistically comparable with the QoL scores include sex, severity of ID and ADHD while the parent characteristics that are statistically comparable with the QoL scores include educational attainment, monthly family income, father’s employment status and family structure (P-value <0.05). Most respondents reported physical distancing (82.61%) and curfew (80.87%) as measures implemented due to the pandemic. Inability to access essential services (43.48-74.48%) were further compounded by limited financial resources (51.30%) and public transport (60%). Government responses received include quarantine pass (90.43%), food allowance or relief package (86.09%), disinfection (60.87%), DSWD-SAP (42.61%) and cash distribution (41.74%). Concerns encountered include socio-environmental issues (i.e. no available transportation, effect on the ability to earn, inadequate food/medicine rations, disruptions in basic social services) and patient concerns (i.e. access to education, medical, developmental and behavioral services, nutrition and sleep). RECOMMENDATIONS: Programs and policies should be planned accordingly to provide improvement of quality of life for both parents and the child with a neurodevelopmental disorder.

Keywords: covid-19, neurodevelopmental disorder, parental quality of life, whoqol-bref

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Authors: Joshua Chima Chizoba, Wisdom Izuchukwu Uzoma, Elizabeth Ifeyiwa Okoyeh

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Water cannot be optimally used and sustained unless the quality is periodically assessed. The study area Umunneochi and environs are located in south eastern part of Nigeria. It stretches geographically from latitudes 50501N to 60000N and longitudes 70201E to 70301. The major geologic formations in the area include the Asu River group, Nkporo Shale, and Ajali Sandstone. The aim of this study is to evaluate the hydrochemical characteristics of surface and ground water sources in parts of Umunneochi and environs in order to establish portability of the water sources for drinking, domestic and irrigation purposes. A total of 15 samples were collected randomly from streams, springs and wells. The samples were analyzed for physicochemical parameters and heavy metals using handheld digital kits, photometer, titration method and Atomic Absorption Spectrophotometer (AAS) following acceptable standards. The obtained analytical data were interpreted, and results were compared with World Health Organization (WHO) standard. The concentration of pH, SO42-and Cl- range from 5.81 mg/l – 6.07 mg/l, 41.93 mg/l – 142.95 mg/l and 20.00 mg/l – 111 mg/l respectively, while Pb and Zn revealed a relative low mean concentration of 0.14 mg/l and 0.40 mg/l, which are all within (WHO) permissible limits except pH. About 27% of the samples are moderately hard. This is attributed to the mining activities in the areas. The abundance of cations and anions in the area are in the order of K+>Na+>Mg2+>Ca2+ and SO4->Cl->HCO3->NO3-, respectively. Chloride, bicarbonate, and nitrate are all within the permissible limits. 13.33% of the total samples contain Sulphate above the standard permissible limits. The values of calculated Water Quality Index (WQI) are less than 50 indicating excellent water. The predominant water-type in the study area is Na-Cl water type and mixed Ca-Mg-Cl water type based on the sample plots on the Piper diagram. The Sodium Absorption Ratio (SAR) calculations showed excellent water for consumption and also good water for irrigation purpose with low sodium and alkalinity ratio respectively. Government water projects are recommended in the area for sustainable domestic and agricultural water supply to ease the stress of water supply problems.

Keywords: groundwater, hydrochemical, physichochemical, water-type, sodium adsorption ratio

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Authors: Gulseren Kirbas, Mushap Kuru, Buket Bakir, Ebru Karadag Sari

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Capra (mountain goat) is a genus comprising nine species. The domestic goat (C. aegagrus hircus) is a subspecies of the wild goat that is domesticated. This study aimed to determine the anatomical structure of the salpinx and ovary of the Anatolian wild goat (C. aegagrus aegagrus). Animals that were taken to the Kafkas University Wildlife Rescue and Rehabilitation Center, Kars, Turkey, because of various reasons, such as traffic accidents and firearm injuries, were used in this study. The salpinges and ovaries of four wild goats of similar ages, which could not be rescued by the Center despite all interventions, were dissected. Measurements were taken from the right-left salpinx and ovary using digital calipers. The weights of each ovary and salpinx were measured using a precision scale (min: 0.0001 g − max: 220 g, code: XB220A; Precisa, Swiss). The histological structure of the tissues was examined after weighing the organs. The tissue samples were fixed in 10% formaldehyde for 24 h. Then a routine procedure was applied, and the tissues were embedded in paraffin. Mallory’s modified triple staining was used to demonstrate the general structure of the salpinx. The salpinx was found to consist of three different regions (infundibulum, ampulla, and isthmus). These regions consisted of tunica mucosa, tunica muscularis, and tunica serosa. The prismatic epithelial cells were observed in the lamina epithelialis of tunica mucosa in every region, but the prismatic fimbrae cells occurred most in the infundibulum. The ampulla was distinguished by its many mucosal folds. It was the longest region of the salpinx and was joined to the isthmus via the ampullary–isthmus junction. Isthmus was the caudal end of the salpinx joined to the uterus and had the thickest tunica muscularis compared with the other regions. The mean length of the ovary was 13.22 ± 1.27 mm, width was 8.46 ± 0.88 mm, the thickness was 5.67 ± 0.79 mm, and weight was 0.59 ± 0.17 g. The average length of the salpinx was 58.11 ± 14.02 mm, width was 0.80 ± 0.22 mm, the thickness was 0.41 ± 0.01 mm, and weight was 0.30 ± 0.08 g. In conclusion, the Anatolian wild goat, which is included in wildlife diversity in Turkey, has been disappearing due to illegal and uncontrolled hunting as well as traffic accidents in recent years. These findings are believed to contribute to the literature.

Keywords: Anatolian wild goat, anatomy, ovary, salpinx

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Authors: Novita Linda Akbar, Elmeida Effendy, Mustafa M. Amin

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Background: The most common of psychotic disorders is schizophrenia. Vitamin D is made from sunlight, and in the skin from UVB radiation from sunlight. If people with Vitamin D deficiency is common severe mental illness such as schizophrenia.Schizophrenia is a chronic mental illness characterised by positive symptoms and negatives symptoms, such as hallucinations and delusions, flat affect and lack of motivation we can found. In patients with Schizophrenia maybe have several environmental risk factors for schizophrenia, such as season of birth, latitude, and climate has been linked to vitamin D deficiency. There is also relationship between the risk of schizophrenia and latitude, and with an increased incidence rate of schizophrenia seen at a higher latitude. Methods: This study was an analytical study, conducted in BLUD RS Jiwa Propinsi Sumatera Utara and RSUD Deli Serdang, the period in May 2016 and ended in June 2016 with a sample of the study 60 sample (20 patients live in the Highland and Lowland, 20 healthy controls). Inclusion criteria were schizophrenic patients both men and women, aged between 18 to 60 years old, acute phase no agitation or abstinence antipsychotic drugs for two weeks, live in the Highland and Lowland, and willing to participate this study. Exclusion criteria were history of other psychotic disorders, comorbidities with other common medical condition, a history of substance abuse. Sample inspection for serum vitamin D using ELFA method. Statistical analysis using numeric comparative T-independent test. Results: The results showed that average levels of vitamin D for a group of subjects living in areas of high land was 227.6 ng / mL with a standard deviation of 86.78 ng / mL, the lowest levels of vitamin D is 138 ng / mL and the highest 482 ng / mL. In the group of subjects who settled in the low lands seem mean vitamin D levels higher than the mountainous area with an average 237.8 ng / mL with a standard deviation of 100.16 ng / mL. Vitamin D levels are lowest and the highest 138-585 ng / mL. Conclusion and Suggestion: The results of the analysis using the Mann Whitney test showed that there were no significant differences between the mean for the levels of vitamin D based on residence subject with a value of p = 0.652.

Keywords: latitude, schizophrenia, Vitamin D, Sumatera Utara

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Authors: Chang Yu Chuan

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Background and Aim: Pressure sore is not only the consequence of any gradual damage of the skin leading to tissue defects but also an important indicator of clinical care. If hospitalized patients develop pressure sores without proper care, it would result in delayed healing, wound infection, increase patient physical pain, prolonged hospital stay and even death, which would have a negative impact on the quality of care and also increase nursing manpower and medical costs. This project is aimed at decreasing the incidence of pressure sore in one ward of internal medicine. Our data showed 53 cases (0.61%) of pressure sore in 2015, which exceeded the average (0.5%) of Taiwan Clinical Performance Indicator (TCPI) for medical centers. The purpose of this project is to reduce the incidence rate of pressure sore in the ward. After data collection and analysis from January to December 2016, the reasons of developing pressure sore were found: 1. Lack of knowledge to prevent pressure among nursing staffs; 2. No relevant courses about preventing pressure ulcers and pressure wound care being held in this unit; 3. Low complete rate of pressure sore care education that family members should receive from nursing staffs; 4. Decompression equipment is not enough; 5. Lack of standard procedures for body-turning and positioning care. After team members brainstorming, several strategies were proposed, including holding in-service education, pressure sore care seed training, purchasing decompression mattress and memory pillows, designing more elements of health education tools, such as health education pamphlet, posters and multimedia films of body-turning and positioning demonstration, formulation and promotion of standard operating procedures. In this way, nursing staffs can understand the body-turning and positioning guidelines for pressure sore prevention and enhance the quality of care. After the implementation of this project, the pressure sore density significantly decreased from 0.61%(53 cases) to 0.45%(28 cases) in this ward. The project shows good results and good example for nurses working at the ward and helps to enhance quality of care.

Keywords: body-turning and positioning, incidence density, nursing, pressure sore

Procedia PDF Downloads 264