Search results for: clinical trial optimization
2271 Purification, Extraction and Visualization of Lipopolysaccharide of Escherichia coli from Urine Samples of Patients with Urinary Tract Infection
Authors: Fariha Akhter Chowdhury, Mohammad Nurul Islam, Anamika Saha, Sabrina Mahboob, Abu Syed Md. Mosaddek, Md. Omar Faruque, Most. Fahmida Begum, Rajib Bhattacharjee
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Urinary tract infection (UTI) is one of the most common infectious diseases in Bangladesh where Escherichia coli is the prevalent organism and responsible for most of the infections. Lipopolysaccharide (LPS) is known to act as a major virulence factor of E. coli. The present study aimed to purify, extract and visualize LPS of E. coli clinical isolates from urine samples of patients with UTI. The E. coli strain was isolated from the urine samples of 10 patients with UTI and then the antibiotic sensitivity pattern of the isolates was determined. The purification of LPS was carried out using the hot aqueous-phenol method and separated by sodium dodecyl sulfate polyacrylamide gel electrophoresis, which was directly stained using the modified silver staining method and Coomassie blue. The silver-stained gel demonstrated both smooth and rough type LPS by showing trail-like band patterns with the presence and lacking O-antigen region, respectively. Coomassie blue staining showed no band assuring the absence of any contaminating protein. Our successful extraction of purified LPS from E. coli isolates of UTI patients’ urine samples can be an important step to understand the UTI disease conditions.Keywords: Escherichia coli, electrophoresis, polyacrylamide gel, silver staining, sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE)
Procedia PDF Downloads 3882270 Challenges and Insights by Electrical Characterization of Large Area Graphene Layers
Authors: Marcus Klein, Martina GrießBach, Richard Kupke
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The current advances in the research and manufacturing of large area graphene layers are promising towards the introduction of this exciting material in the display industry and other applications that benefit from excellent electrical and optical characteristics. New production technologies in the fabrication of flexible displays, touch screens or printed electronics apply graphene layers on non-metal substrates and bring new challenges to the required metrology. Traditional measurement concepts of layer thickness, sheet resistance, and layer uniformity, are difficult to apply to graphene production processes and are often harmful to the product layer. New non-contact sensor concepts are required to adapt to the challenges and even the foreseeable inline production of large area graphene. Dedicated non-contact measurement sensors are a pioneering method to leverage these issues in a large variety of applications, while significantly lowering the costs of development and process setup. Transferred and printed graphene layers can be characterized with high accuracy in a huge measurement range using a very high resolution. Large area graphene mappings are applied for process optimization and for efficient quality control for transfer, doping, annealing and stacking processes. Examples of doped, defected and excellent Graphene are presented as quality images and implications for manufacturers are explained.Keywords: graphene, doping and defect testing, non-contact sheet resistance measurement, inline metrology
Procedia PDF Downloads 3062269 Optimizing Agricultural Packaging in Fiji: Strategic Barrier Analysis Using Interpretive Structural Modeling and Cross-Impact Matrix Multiplication Applied to Classification
Authors: R. Ananthanarayanan, S. B. Nakula, D. R. Seenivasagam, J. Naua, B. Sharma
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Product packaging is a critical component of production, trade, and marketing, playing numerous vital roles that often go unnoticed by consumers. Packaging is essential for maintaining the shelf life, quality assurance, and safety of both manufactured and agricultural products. For example, harvested produce or processed foods can quickly lose quality and freshness, making secure packaging crucial for preservation and safety throughout the food supply chain. In Fiji, agricultural packaging has primarily been managed by local companies for international trade, with gradual advancements in these practices. To further enhance the industry’s performance, this study examines the challenges and constraints hindering the optimization of agricultural packaging practices in Fiji. The study utilizes Multi-Criteria Decision Making (MCDM) tools, specifically Interpretive Structural Modeling (ISM) and Cross-Impact Matrix Multiplication Applied to Classification (MICMAC). ISM analyzes the hierarchical structure of barriers, categorizing them from the least to the most influential, while MICMAC classifies barriers based on their driving and dependence power. This approach helps identify the interrelationships between barriers, providing valuable insights for policymakers and decision-makers to propose innovative solutions for sustainable development in the agricultural packaging sector, ultimately shaping the future of packaging practices in Fiji.Keywords: agricultural packaging, barriers, ISM, MICMAC
Procedia PDF Downloads 262268 Bacteriological Culture Methods and its Uses in Clinical Pathology
Authors: Prachi Choudhary, Jai Gopal Sharma
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Microbial cultures determine the type of organism, its abundance in the tested sample, or both. It is one of the primary diagnostic methods of microbiology. It is used to determine the cause of infectious disease by letting the agent multiply in a predetermined medium. Different bacteria produce colonies that may be very distinct from the bacterial species that produced them. To culture any pathogen or microorganism, we should first know about the types of media used in microbiology for culturing. Sometimes sub culturing is also done in various microorganisms if some mixed growth is seen in culture. Nearly 3 types of culture media based on consistency – solid, semi-solid, and liquid (broth) media; are further explained in the report. Then, The Five I's approach is a method for locating, growing, observing, and characterizing microorganisms, including inoculation and incubation. Isolation, inspection, and identification. For identification of bacteria, we have to culture the sample like urine, sputum, blood, etc., on suitable media; there are different methods of culturing the bacteria or microbe like pour plate method, streak plate method, swabbing by needle, pipetting, inoculation by loop, spreading by spreader, etc. After this, we see the bacterial growth after incubation of 24 hours, then according to the growth of bacteria antibiotics susceptibility test is conducted; this is done for sensitive antibiotics or resistance to that bacteria, and also for knowing the name of bacteria. Various methods like the dilution method, disk diffusion method, E test, etc., do antibiotics susceptibility tests. After that, various medicines are provided to the patients according to antibiotic sensitivity and resistance.Keywords: inoculation, incubation, isolation, antibiotics suspectibility test, characterizing
Procedia PDF Downloads 802267 Salter Pelvic Osteotomy for the Treatment of Developmental Dysplasia of the Hip: Assessment of Postoperative Results and Risk Factors
Authors: Suvorov Vasyl, Filipchuk Viktor
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Background: If non-surgical treatment of developmental dysplasia of the hip (DDH) fails or if DDH is late-detected, surgery is necessary. Salter pelvic osteotomy (SPO) is an effective surgical option for such cases. The objectives of this study were to assess the results after SPO, evaluate risk factors, and reveal those radiological parameters that may correlate with the results. Mid- and long-term postoperative results after SPO in 17 patients (22 hip joints) were analyzed. Risk factors included those that do not depend on the surgeon (patient's age, value of the acetabular index (AI) preoperatively, DDH Tonnis grade) and those that depend on the surgeon (amount of AI correction). To radiological parameters which may correlate with the amount of AI correction, we referred distance "d" and the lateral rotation angle. Results: SPO allows performing AI correction in ranges 24.1 ± 6.5°. Excellent and good clinical results were obtained in 95.5% of patients; excellent and good radiological results in 86.4% of patients. Risk factors that do not depend on the surgeon were older patient’s age and higher preoperative AI values (p < 0.05). The risk factor that depends on the surgeon was the amount of AI correction (p < 0.05). The distance "d" was recognized as a radiological parameter that may indicate sufficient AI correction (p < 0.05). Conclusion: In older patients with a higher preoperative AI value, the results will be predictably worse. The surgeon may influence the result with a greater amount of AI correction (which may also be indicated radiologically by the distance "d" values).Keywords: developmental dysplasia of the hip, results, risk factor, pelvic osteotomy, salter osteotomy
Procedia PDF Downloads 1272266 The Effect of Body Positioning on Upper-Limb Arterial Occlusion Pressure and the Reliability of the Method during Blood Flow Restriction Training
Authors: Stefanos Karanasios, Charkleia Koutri, Maria Moutzouri, Sofia A. Xergia, Vasiliki Sakellari, George Gioftsos
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The precise calculation of arterial occlusive pressure (AOP) is a critical step to accurately prescribe individualized pressures during blood flow restriction training (BFRT). AOP is usually measured in a supine position before training; however, previous reports suggested a significant influence in lower limb AOP across different body positions. The aim of the study was to investigate the effect of three different body positions on upper limb AOP and the reliability of the method for its standardization in clinical practice. Forty-two healthy participants (Mean age: 28.1, SD: ±7.7) underwent measurements of upper limb AOP in supine, seated, and standing positions by three blinded raters. A cuff with a manual pump and a pocket doppler ultrasound were used. A significantly higher upper limb AOP was found in seated compared with supine position (p < 0.031) and in supine compared with standing position (p < 0.031) by all raters. An excellent intraclass correlation coefficient (0.858- 0.984, p < 0.001) was found in all positions. Upper limb AOP is strongly dependent on body position changes. The appropriate measurement position should be selected to accurately calculate AOP before BFRT. The excellent inter-rater reliability and repeatability of the method suggest reliable and consistent results across repeated measurements.Keywords: Kaatsu training, blood flow restriction training, arterial occlusion, reliability
Procedia PDF Downloads 2102265 Big Data in Construction Project Management: The Colombian Northeast Case
Authors: Sergio Zabala-Vargas, Miguel Jiménez-Barrera, Luz VArgas-Sánchez
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In recent years, information related to project management in organizations has been increasing exponentially. Performance data, management statistics, indicator results have forced the collection, analysis, traceability, and dissemination of project managers to be essential. In this sense, there are current trends to facilitate efficient decision-making in emerging technology projects, such as: Machine Learning, Data Analytics, Data Mining, and Big Data. The latter is the most interesting in this project. This research is part of the thematic line Construction methods and project management. Many authors present the relevance that the use of emerging technologies, such as Big Data, has taken in recent years in project management in the construction sector. The main focus is the optimization of time, scope, budget, and in general mitigating risks. This research was developed in the northeastern region of Colombia-South America. The first phase was aimed at diagnosing the use of emerging technologies (Big-Data) in the construction sector. In Colombia, the construction sector represents more than 50% of the productive system, and more than 2 million people participate in this economic segment. The quantitative approach was used. A survey was applied to a sample of 91 companies in the construction sector. Preliminary results indicate that the use of Big Data and other emerging technologies is very low and also that there is interest in modernizing project management. There is evidence of a correlation between the interest in using new data management technologies and the incorporation of Building Information Modeling BIM. The next phase of the research will allow the generation of guidelines and strategies for the incorporation of technological tools in the construction sector in Colombia.Keywords: big data, building information modeling, tecnology, project manamegent
Procedia PDF Downloads 1262264 Mapping of Adrenal Gland Diseases Research in Middle East Countries: A Scientometric Analysis, 2007-2013
Authors: Zahra Emami, Mohammad Ebrahim Khamseh, Nahid Hashemi Madani, Iman Kermani
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The aim of the study was to map scientific research on adrenal gland diseases in the Middle East countries through the Web of Science database using scientometric analysis. Data were analyzed with Excel software; and HistCite was used for mapping of the scientific texts. In this study, from a total of 268 retrieved records, 1125 authors from 328 institutions published their texts in 138 journals. Among 17 Middle East countries, Turkey ranked first with 164 documents (61.19%), Israel ranked second with 47 documents (15.53%) and Iran came in the third place with 26 documents. Most of the publications (185 documents, 69.2%) were articles. Among the universities of the Middle East, Istanbul University had the highest science production rate (9.7%). The Journal of Clinical Endocrinology & Metabolism had the highest TGCS (243 citations). In the scientific mapping, 7 clusters were formed based on TLCS (Total Local Citation Score) & TGCS (Total Global Citation Score). considering the study results, establishment of scientific connections and collaboration with other countries and use of publications on adrenal gland diseases from high ranking universities can help in the development of this field and promote the medical practice in this regard. Moreover, investigation of the formed clusters in relation to Congenital Hyperplasia and puberty related disorders can be research priorities for investigators.Keywords: mapping, scientific research, adrenal gland diseases, scientometric
Procedia PDF Downloads 2722263 Paramedic Strength and Flexibility: Findings of a 6-Month Workplace Exercise Randomised Controlled Trial
Authors: Jayden R. Hunter, Alexander J. MacQuarrie, Samantha C. Sheridan, Richard High, Carolyn Waite
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Workplace exercise programs have been recommended to improve the musculoskeletal fitness of paramedics with the aim of reducing injury rates, and while they have shown efficacy in other occupations, they have not been delivered and evaluated in Australian paramedics to our best knowledge. This study investigated the effectiveness of a 6-month workplace exercise program (MedicFit; MF) to improve paramedic fitness with or without health coach (HC) support. A group of regional Australian paramedics (n=76; 43 male; mean ± SD 36.5 ± 9.1 years; BMI 28.0 ± 5.4 kg/m²) were randomised at the station level to either exercise with remote health coach support (MFHC; n=30), exercise without health coach support (MF; n=23), or no-exercise control (CON; n=23) groups. MFHC and MF participants received a 6-month, low-moderate intensity resistance and flexibility exercise program to be performed ƒ on station without direct supervision. Available exercise equipment included dumbbells, resistance bands, Swiss balls, medicine balls, kettlebells, BOSU balls, yoga mats, and foam rollers. MFHC and MF participants were also provided with a comprehensive exercise manual including sample exercise sessions aimed at improving musculoskeletal strength and flexibility which included exercise prescription (i.e. sets, reps, duration, load). Changes to upper-body (push-ups), lower-body (wall squat) and core (plank hold) strength and flexibility (back scratch and sit-reach tests) after the 6-month intervention were analysed using repeated measures ANOVA to compare changes between groups and over time. Upper-body (+20.6%; p < 0.01; partial eta squared = 0.34 [large effect]) and lower-body (+40.8%; p < 0.05; partial eta squared = 0.08 (moderate effect)) strength increased significantly with no interaction or group effects. Changes to core strength (+1.4%; p=0.17) and both upper-body (+19.5%; p=0.56) and lower-body (+3.3%; p=0.15) flexibility were non-significant with no interaction or group effects observed. While upper- and lower-body strength improved over the course of the intervention, providing a 6-month workplace exercise program with or without health coach support did not confer any greater strength or flexibility benefits than exercise testing alone (CON). Although exercise adherence was not measured, it is possible that participants require additional methods of support such as face-to-face exercise instruction and guidance and individually-tailored exercise programs to achieve adequate participation and improvements in musculoskeletal fitness. This presents challenges for more remote paramedic stations without regular face-to-face access to suitably qualified exercise professionals, and future research should investigate the effectiveness of other forms of exercise delivery and guidance for these paramedic officers such as remotely-facilitated digital exercise prescription and monitoring.Keywords: workplace exercise, paramedic health, strength training, flexibility training
Procedia PDF Downloads 1382262 Food Safety in Wine: Removal of Ochratoxin a in Contaminated White Wine Using Commercial Fining Agents
Authors: Antònio Inês, Davide Silva, Filipa Carvalho, Luís Filipe-Riberiro, Fernando M. Nunes, Luís Abrunhosa, Fernanda Cosme
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The presence of mycotoxins in foodstuff is a matter of concern for food safety. Mycotoxins are toxic secondary metabolites produced by certain molds, being ochratoxin A (OTA) one of the most relevant. Wines can also be contaminated with these toxicants. Several authors have demonstrated the presence of mycotoxins in wine, especially ochratoxin A. Its chemical structure is a dihydro-isocoumarin connected at the 7-carboxy group to a molecule of L-β-phenylalanine via an amide bond. As these toxicants can never be completely removed from the food chain, many countries have defined levels in food in order to attend health concerns. OTA contamination of wines might be a risk to consumer health, thus requiring treatments to achieve acceptable standards for human consumption. The maximum acceptable level of OTA in wines is 2.0 μg/kg according to the Commission regulation No. 1881/2006. Therefore, the aim of this work was to reduce OTA to safer levels using different fining agents, as well as their impact on white wine physicochemical characteristics. To evaluate their efficiency, 11 commercial fining agents (mineral, synthetic, animal and vegetable proteins) were used to get new approaches on OTA removal from white wine. Trials (including a control without addition of a fining agent) were performed in white wine artificially supplemented with OTA (10 µg/L). OTA analyses were performed after wine fining. Wine was centrifuged at 4000 rpm for 10 min and 1 mL of the supernatant was collected and added of an equal volume of acetonitrile/methanol/acetic acid (78:20:2 v/v/v). Also, the solid fractions obtained after fining, were centrifuged (4000 rpm, 15 min), the resulting supernatant discarded, and the pellet extracted with 1 mL of the above solution and 1 mL of H2O. OTA analysis was performed by HPLC with fluorescence detection. The most effective fining agent in removing OTA (80%) from white wine was a commercial formulation that contains gelatin, bentonite and activated carbon. Removals between 10-30% were obtained with potassium caseinate, yeast cell walls and pea protein. With bentonites, carboxymethylcellulose, polyvinylpolypyrrolidone and chitosan no considerable OTA removal was verified. Following, the effectiveness of seven commercial activated carbons was also evaluated and compared with the commercial formulation that contains gelatin, bentonite and activated carbon. The different activated carbons were applied at the concentration recommended by the manufacturer in order to evaluate their efficiency in reducing OTA levels. Trial and OTA analysis were performed as explained previously. The results showed that in white wine all activated carbons except one reduced 100% of OTA. The commercial formulation that contains gelatin, bentonite and activated carbon reduced only 73% of OTA concentration. These results may provide useful information for winemakers, namely for the selection of the most appropriate oenological product for OTA removal, reducing wine toxicity and simultaneously enhancing food safety and wine quality.Keywords: wine, ota removal, food safety, fining
Procedia PDF Downloads 5372261 The Effects of Logistical Centers Realization on Society and Economy
Authors: Anna Dolinayova, Juraj Camaj, Martin Loch
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Presently it is necessary to ensure the sustainable development of passenger and freight transport. Increasing performance of road freight have been a negative impact to environment and society. It is therefore necessary to increase the competitiveness of intermodal transport, which is more environmentally friendly. The study describe the effectiveness of logistical centers realization for companies and society and research how the partial internalization of external costs reflected in the efficient use of these centers and increase the competitiveness of intermodal transport to road freight. In our research, we use the method of comparative analysis and market research to describe the advantages of logistic centers for their users as well as for society as a whole. Method normal costing is used for calculation infrastructure and total costs, method of conversion costing for determine the external costs. We modelling of total society costs for road freight transport and inter modal transport chain (we assumed that most of the traffic is carried by rail) with different loading schemes for condition in the Slovak Republic. Our research has shown that higher utilization of inter modal transport chain do good not only for society, but for companies providing freight services too. Increase in use of inter modal transport chain can bring many benefits to society that do not bring direct immediate financial return. They often bring the multiplier effects, such as greater use of environmentally friendly transport mode and reduce the total society costs.Keywords: delivery time, economy effectiveness, logistical centers, ecological efficiency, optimization, society
Procedia PDF Downloads 4432260 Protective Role of CoQ10 or L-Carnitine on the Integrity of the Myocardium in Doxorubicin Induced Toxicity
Authors: Gehan A. Hegazy, Hesham N. Mustafa, Sally A. El Awdan, Marawan AbdelBaset
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Doxorubicin (DOX) is a chemotherapeutic agent used for the treatment of different cancers and its clinical usage is hindered by the oxidative injury-related cardiotoxicity. This work aims to declare if the harmful effects of DOX on the heart can be alleviated with the use of Coenzyme Q10 (CoQ10) or L-carnitine. The study was performed on seventy-two female Wistar albino rats divided into six groups, 12 animals each: Control group; DOX group (10 mg/kg); CoQ10 group (200 mg/kg); L-carnitine group (100 mg/kg); DOX + CoQ10 group; DOX + L-carnitine group. CoQ10 and L-carnitine treatment orally started five days before a single dose of 10 mg/kg DOX that injected intraperitoneally (IP) then the treatment continued for ten days. At the end of the study, serum biochemical parameters of cardiac damage, oxidative stress indices, and histopathological changes were investigated. CoQ10 or L-carnitine showed noticeable effects in improving cardiac functions evidenced reducing serum enzymes as serum interleukin-1 beta (IL-1), tumor necrosis factor alpha (TNF-), leptin, lactate dehydrogenase (LDH), Cardiotrophin-1, Troponin-I and Troponin-T. Also, alleviate oxidative stress, decrease of cardiac Malondialdehyde (MDA), Nitric oxide (NO) and restoring cardiac reduced glutathione levels to normal levels. Both corrected the cardiac alterations histologically and ultrastructurally. With visible improvements in -SMA, vimentin and eNOS immunohistochemical markers. CoQ10 or L-carnitine supplementation improves the functional and structural integrity of the myocardium.Keywords: CoQ10, doxorubicin, L-Carnitine, cardiotoxicity
Procedia PDF Downloads 1682259 Sheathed Cotton Fibers: Material for Oil-Spill Cleanup
Authors: Benjamin M Dauda, Esther Ibrahim, Sylvester Gadimoh, Asabe Mustapha, Jiyah Mohammed
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Despite diverse optimization techniques on natural hydrophilic fibers, hydrophobic synthetic fibers are still the best oil sorption materials. However, these hydrophobic fibers are not biodegradable, making their disposal problematic. To this end, this work sets out to develop Nonwoven sorbents from epoxy-coated Cotton fibers. As a way of improving the compatibility of the crude oil and reduction of moisture absorption, cotton fibers were coated with epoxy resin by immersion in acetone-thinned epoxy solution. A needle-punching machine was used to convert the fibers into coherent nonwoven sheets. An oil sorption experiment was then carried out. The result indicates that the developed epoxy-modified sorbent has a higher crude oil-sorption capacity compared with those of untreated cotton and commercial polypropylene sorbents. Absorption Curves show that the coated fiber and polypropylene sorbent saturated faster than the uncoated cotton fiber pad. The result also shows that the coated cotton sorbent adsorbed crude faster than the polypropylene sorbent, and the equilibrium exhaustion was also higher. After a simple mechanical squeezing process, the Nonwoven pads could be restored to their original form and repeatedly recycled for oil/water separation. The results indicate that the cotton-coated non-woven pads hold promise for the cleanup of oil spills. Our data suggests that the sorption behaviors of the epoxy-coated Nonwoven pads and their crude oil sorption capacity are relatively stable under various environmental conditions compared to the commercial sheet.Keywords: oil spill, adsorption, cotton, epoxy, nonwoven
Procedia PDF Downloads 542258 Therapeutic Application of Light and Electromagnetic Fields to Reduce Hyper-Inflammation Triggered by COVID-19
Authors: Blanche Aguida, Marootpong Pooam, Nathalie Jourdan, Margaret Ahmad
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COVID-19-related morbidity is associated with exaggerated inflammation and cytokine production in the lungs, leading to acute respiratory failure. The cellular mechanisms underlying these so-called ‘cytokine storms’ are regulated through the Toll-like receptor 4 (TLR4) signaling pathway and by reactive oxygen species (ROS). Both light (photobiomodulation) and magnetic fields (e.g., pulsed electromagnetic field) stimulation are non-invasive therapies known to confer anti-inflammatory effects and regulate ROS signaling pathways. Here we show that daily exposure to two 10-minute intervals of moderate-intensity infra-red light significantly lowered the inflammatory response induced via the TLR4 receptor signaling pathway in human cell cultures. Anti-inflammatory effects were likewise achieved by electromagnetic field exposure of cells to daily 10-minute intervals of either pulsed electromagnetic fields (PEMF) or to low-level static magnetic fields. Because current illumination and electromagnetic field therapies have no known side effects and are already approved for some medical uses, we have here developed protocols for verification in clinical trials of COVID 19 infection. These treatments are affordable, simple to implement, and may help to resolve the acute respiratory distress of COVID 19 patients both in the home and in the hospital.Keywords: COVID 19, electromagnetic fields therapy, inflammation, photobiomodulation therapy
Procedia PDF Downloads 1432257 Evaluation of the Practice of Veterinary Pharmacy
Authors: Maria Magdy Danial Riad
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Background: In the United Kingdom (UK), pharmacists' roles have expanded considerably in recent decades to encompass clinical practice through more direct patient care. However, dispensing and compounding remain core activities for pharmacists. A lack of marketed preparations for species-specific animal use results in veterinary pharmacy practice compounding, retaining its prominence. Current participation by pharmacists to support this sphere of practice would appear to be minimal. Objectives: This study was undertaken to determine the opinions and views toward the practice of veterinary pharmacy by a cross-sectional group of pharmacists. Methods: Research data were collected via a self-administered survey questionnaire distributed at the 2012 annual conference of the Royal Pharmaceutical Society. Sampling was purposive, with a random distribution of the questionnaire to pharmacists during the conference sessions. Key findings: Interaction by pharmacists with veterinary pharmacies is currently minimal, primarily due to a lack of knowledge of veterinary medicines. Respondents revealed a lack of veterinary pharmacy courses during their undergraduate studies. This has led to situations where some veterinary prescriptions are dispensed without adequate checks being performed by the pharmacist. Pharmacists, on occasion, do not dispense veterinary prescriptions presented to them due to insufficient knowledge of veterinary medicines and/or a lack of consultable reference sources. The effect on practice is that pharmacists do not always participate as fully as would seem logical. Conclusions: Pharmacists' participation in veterinary pharmacy is limited by a lack of knowledge of veterinary medicines, mostly resulting from inadequate tuition on veterinary pharmacy during their initial education.Keywords: veterinary pharmacy, veterinary medicines, pharmacy education, pharmacists continuing professional development
Procedia PDF Downloads 802256 Yield Loss in Maize Due to Stem Borers and Their Integrated Management
Authors: C. P. Mallapur, U. K. Hulihalli, D. N. Kambrekar
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Maize (Zea mays L.) an important cereal crop in the world has diversified uses including human consumption, animal feed, and industrial uses. A major constraint in low productivity of maize in India is undoubtedly insect pests particularly two species of stem borers, Chilo partellus (Swinhoe) and Sesamia inferens (Walker). The stem borers cause varying level of yield losses in different agro-climate regions (25.7 to 80.4%) resulting in a huge economic loss to the farmers. Although these pests are rather difficult to manage, efforts have been made to combat the menace by using effective insecticides. However, efforts have been made in the present study to integrate various possible approaches for sustainable management of these borers. Two field experiments were conducted separately during 2016-17 at Main Agricultural Research Station, University of Agricultural Sciences, Dharwad, Karnataka, India. In the first experiment, six treatments were randomized in RBD. The insect eggs at pinhead stage (@ 40 eggs/plant) were stapled to the under surface of leaves covering 15-20 % of plants in each plot after 15 days of sowing. The second experiment was planned with nine treatments replicated thrice. The border crop with NB -21 grass was planted all around the plots in the specific treatments while, cowpea intercrop (@6:1-row proportion) was sown along with the main crop and later, the insecticidal spray with chlorantraniliprole and nimbecidine was taken upon need basis in the specific treatments. The results indicated that the leaf injury and dead heart incidence were relatively more in the treatments T₂ and T₄ wherein, no insect control measures were made after the insect release (58.30 & 40.0 % leaf injury and 33.42 and 25.74% dead heart). On the contrary, these treatments recorded higher stem tunneling (32.4 and 24.8%) and resulted in lower grain yield (17.49 and 26.79 q/ha) compared to 29.04, 32.68, 40.93 and 46.38 q/ha recorded in T₁, T₃, T₅ and T₆ treatments, respectively. A maximum yield loss of 28.89 percent was noticed in T₂ followed by 19.59 percent in T₄ where no sprays were imposed. The data on integrated management trial revealed the lowest stem borer damage (19.28% leaf injury and 1.21% dead heart) in T₅ (seed treatment with thiamethoxam 70FS @ 8ml/kg seed + cow intercrop along with nimbecidine 0.03EC @ 5.0 ml/l and chlorantraniliprole 18.5SC spray @ 0.2 ml/l). The next best treatment was T₆ (ST+ NB-21 borer with nimbecidine and chlorantraniliprole spray) with 21.3 and 1.99 percent leaf injury and dead heart incidence, respectively. These treatments resulted in highest grain yield (77.71 and 75.53 q/ha in T₅ and T₆, respectively) compared to the standard check, T₁ (ST+ chlorantraniliprole spray) wherein, 27.63 percent leaf injury and 3.68 percent dead heart were noticed with 60.14 q/ha grain yield. The stem borers can cause yield loss up to 25-30 percent in maize which can be well tackled by seed treatment with thiamethoxam 70FS @ 8ml/kg seed and sowing the crop along with cowpea as intercrop (6:1 row proportion) or NB-21 grass as border crop followed by application of nimbecidine 0.03EC @ 5.0 ml/l and chlorantraniliprole 18.5SC @ 0.2 ml/l on need basis.Keywords: Maize stem borers, Chilo partellus, Sesamia inferens, crop loss, integrated management
Procedia PDF Downloads 1762255 Optimizing Microwave Assisted Extraction of Anti-Diabetic Plant Tinospora cordifolia Used in Ayush System for Estimation of Berberine Using Taguchi L-9 Orthogonal Design
Authors: Saurabh Satija, Munish Garg
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Present work reports an efficient extraction method using microwaves based solvent–sample duo-heating mechanism, for the extraction of an important anti-diabetic plant Tinospora cordifolia from AYUSH system for estimation of berberine content. The process is based on simultaneous heating of sample matrix and extracting solvent under microwave energy. Methanol was used as the extracting solvent, which has excellent berberine solubilizing power and warms up under microwave attributable to its great dispersal factor. Extraction conditions like time of irradition, microwave power, solute-solvent ratio and temperature were optimized using Taguchi design and berberine was quantified using high performance thin layer chromatography. The ranked optimized parameters were microwave power (rank 1), irradiation time (rank 2) and temperature (rank 3). This kind of extraction mechanism under dual heating provided choice of extraction parameters for better precision and higher yield with significant reduction in extraction time under optimum extraction conditions. This developed extraction protocol will lead to extract higher amounts of berberine which is a major anti-diabetic moiety in Tinospora cordifolia which can lead to development of cheaper formulations of the plant Tinospora cordifolia and can help in rapid prevention of diabetes in the world.Keywords: berberine, microwave, optimization, Taguchi
Procedia PDF Downloads 3432254 Numerical Modal Analysis of a Multi-Material 3D-Printed Composite Bushing and Its Application
Authors: Paweł Żur, Alicja Żur, Andrzej Baier
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Modal analysis is a crucial tool in the field of engineering for understanding the dynamic behavior of structures. In this study, numerical modal analysis was conducted on a multi-material 3D-printed composite bushing, which comprised a polylactic acid (PLA) outer shell and a thermoplastic polyurethane (TPU) flexible filling. The objective was to investigate the modal characteristics of the bushing and assess its potential for practical applications. The analysis involved the development of a finite element model of the bushing, which was subsequently subjected to modal analysis techniques. Natural frequencies, mode shapes, and damping ratios were determined to identify the dominant vibration modes and their corresponding responses. The numerical modal analysis provided valuable insights into the dynamic behavior of the bushing, enabling a comprehensive understanding of its structural integrity and performance. Furthermore, the study expanded its scope by investigating the entire shaft mounting of a small electric car, incorporating the 3D-printed composite bushing. The shaft mounting system was subjected to numerical modal analysis to evaluate its dynamic characteristics and potential vibrational issues. The results of the modal analysis highlighted the effectiveness of the 3D-printed composite bushing in minimizing vibrations and optimizing the performance of the shaft mounting system. The findings contribute to the broader field of composite material applications in automotive engineering and provide valuable insights for the design and optimization of similar components.Keywords: 3D printing, composite bushing, modal analysis, multi-material
Procedia PDF Downloads 1072253 Binding Studies of Complexes of Anticancer Drugs with DNA and Enzymes Involved in DNA Replication Using Molecular Docking and Cell Culture Techniques
Authors: Fouzia Perveen, Rumana Qureshi
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The presently studied twelve anticancer drugs are the cytotoxic agents which inhibit the replication of DNA and activity of enzymes involved in DNA replication namely topoisomerase-II, polymerase and helicase and have shown remarkable anticancer activity in clinical trials. In this study, we performed molecular docking studies of twelve antitumor drugs against DNA and DNA enzymes in the presence and absence of ascorbic acid (AA) and developed the quantitative structure-activity relationship (QSAR) model for anticancer activity screening. A number of electronic and steric descriptors were calculated using MOE software package. QSAR was established showing a correlation of binding strength with various physicochemical descriptors. Out of these twelve, eight cytotoxic drugs were tested on Non-Small Cell Lung Cancer cell lines (H-157 and H-1299) in the absence and presence of ascorbic acid and experimental IC50 values were calculated. From the docking studies, binding constants were calculated indicating the strength of drug-DNA and drug-enzyme complex formation and it was correlated to the IC50 values (both experimental and theoretical). These results can offer useful references for directing the molecular design of DNA enzyme inhibitor with improved anticancer activity.Keywords: ascorbic acid, binding constant, cytotoxic agents, cell culture, DNA, DNA enzymes, molecular docking
Procedia PDF Downloads 4252252 Adherence of Trauma and Orthopaedics Surgery Operative Notes to the RCS Good Surgical Practice Guidelines in Ashford and St. Peter's Hospital
Authors: Maryam Risla Shahul Hameed, Tharsiga Yogarajah, Fritzy Mathew, Tayyaba Syed, Shalin Shaunak
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Aim: Auditing the adherence of Trauma and Orthopaedics Operative notes to the RCS Good Surgical Practice Guidelines. Method: Clinical audit conducted on 150 operative notes over a period of 2 months April- May 2023, including emergency and elective surgeries performed in Ashford and St. Peter’s Hospital. The RCS Good Practice Surgical Guidelines for an ideal operative note were used to compare.Results: Date of the procedure and signature of the surgeon were mentioned in all the notes by default in the electronic template being used. Title of the operation performed and whether elective or emergency were mentioned by 92% and 45%, respectively. Name of theatre anaesthetist and operating surgeons were mentioned by 73% and 93% respectively. Time of surgery mentioned by 26%. Operative findings and operative diagnosis mentioned by 83% and 53% respectively. Incision and complications of surgery mentioned in 80% and 53%, respectively. Details of tissue added/ altered/ removed mentioned by 46%. Information on prosthesis or implant used is mentioned by 54%. Details of closure and anticipated blood loss mentioned in 91% and 45% respectively. Antibiotic prophylaxis was mentioned by 63%, out of which only 23% mentioned the name and duration of the antibiotic. VTE prophylaxis was mentioned by 84%, out of which only 23% and 29% mentioned the name and duration of the prophylaxis, respectively. Conclusion: There is more for improvement in the operative notes for better continuity of care between the operating surgeons and other doctors in the wards taking care of the patients post operatively. We recommend to follow a standardized guidelines by all the nationwide and a standard template to be followed by all.Keywords: surgery, notes, RCS, guidelines
Procedia PDF Downloads 1622251 Resilience Assessment of Mountain Cities from the Perspective of Disaster Prevention: Taking Chongqing as an Example
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President Xi Jinping has clearly stated the need to more effectively advance the process of urbanization centered on people, striving to shape cities into spaces that are healthier, safer, and more livable. However, during the development and construction of mountainous cities, numerous uncertain disruptive factors have emerged one after another, posing severe challenges to the city's overall development. Therefore, building resilient cities and creating high-quality urban ecosystems and safety systems have become the core and crux of achieving sustainable urban development. This paper takes the central urban area of Chongqing as the research object and establishes an urban resilience assessment indicator system from four dimensions: society, economy, ecology, and infrastructure. It employs the entropy weight method and TOPSIS model to assess the urban resilience level of the central urban area of Chongqing from 2019 to 2022. The results indicate that ① the resilience level of the central urban area of Chongqing is unevenly distributed, showing a spatial pattern of "high in the middle and low around"; it also demonstrates differentiation across different dimensions; ② due to the impact of the COVID-19 pandemic, the overall resilience level of the central urban area of Chongqing has declined significantly, with low recovery capacity and slow improvement in urban resilience. Finally, based on the four selected dimensions, this paper proposes optimization strategies for urban resilience in mountainous cities, providing a basis for Chongqing to build a safe and livable new city.Keywords: mountainous urban areas, central urban area of Chongqing, entropy weight method, TOPSIS model, ArcGIS
Procedia PDF Downloads 12250 Comet Assay: A Promising Tool for the Risk Assessment and Clinical Management of Head and Neck Tumors
Authors: Sarim Ahmad
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The Single Cell Gel Electrophoresis Assay (SCGE, known as comet assay) is a potential, uncomplicated, sensitive and state-of-the-art technique for quantitating DNA damage at individual cell level and repair from in vivo and in vitro samples of eukaryotic cells and some prokaryotic cells, being popular in its widespread use in various areas including human biomonitoring, genotoxicology, ecological monitoring and as a tool for research into DNA damage or repair in different cell types in response to a range of DNA damaging agents, cancer risk and therapy. The method involves the encapsulation of cells in a low-melting-point agarose suspension, lysis of the cells in neutral or alkaline (pH > 13) conditions, and electrophoresis of the suspended lysed cells, resulting in structures resembling comets as observed by fluorescence microscopy; the intensity of the comet tail relative to the head reflects the number of DNA breaks. The likely basis for this is that loops containing a break lose their supercoiling and become free to extend towards the anode. This is followed by visual analysis with staining of DNA and calculating fluorescence to determine the extent of DNA damage. This can be performed by manual scoring or automatically by imaging software. The assay can, therefore, predict an individual’s tumor sensitivity to radiation and various chemotherapeutic drugs and further assess the oxidative stress within tumors and to detect the extent of DNA damage in various cancerous and precancerous lesions of oral cavity.Keywords: comet assay, single cell gel electrophoresis, DNA damage, early detection test
Procedia PDF Downloads 2912249 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 1582248 Phonological Characteristics of Severe to Profound Hearing Impaired Children
Authors: Akbar Darouie, Mamak Joulaie
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In regard of phonological skills development importance and its influence on other aspects of language, this study has been performed. Determination of some phonological indexes in children with hearing impairment and comparison with hearing children was the objective. A sample of convenience was selected from a rehabilitation center and a kindergarten in Karaj, Iran. Participants consisted of 12 hearing impaired and 12 hearing children (age range: 5 years and 6 months to 6 years and 6 months old). Hearing impaired children suffered from severe to profound hearing loss while three of them were cochlear implanted and the others were wearing hearing aids. Conversational speech of these children was recorded and 50 first utterances were selected to analyze. Percentage of consonant correct (PCC) and vowel correct (PVC), initial and final consonant omission error, cluster consonant omission error and syllabic structure variety were compared in two groups. Data were analyzed with t test (version 16th SPSS). Comparison between PCC and PVC averages in two groups showed a significant difference (P< 0/01). There was a significant difference about final consonant emission error (P<0/001) and initial consonant emission error (P<0/01) too. Also, the differences between two groups on cluster consonant omission were significant (P<0/001). Therefore, some changes were seen in syllabic structures in children with hearing impairment compared to typical group. This study demonstrates some phonological differences in Farsi language between two groups of children. Therefore, it seems, in clinical practices we must notice this issue.Keywords: hearing impairment, phonology, vowel, consonant
Procedia PDF Downloads 2422247 Gradient-Based Reliability Optimization of Integrated Energy Systems Under Extreme Weather Conditions: A Case Study in Ningbo, China
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Recent extreme weather events, such as the 2021 European floods and North American heatwaves, have exposed the vulnerability of energy systems to both extreme demand scenarios and potential physical damage. Current integrated energy system designs often overlook performance under these challenging conditions. This research, focusing on a regional integrated energy system in Ningbo, China, proposes a distinct design method to optimize system reliability during extreme events. A multi-scenario model was developed, encompassing various extreme load conditions and potential system damages caused by severe weather. Based on this model, a comprehensive reliability improvement scheme was designed, incorporating a gradient approach to address different levels of disaster severity through the integration of advanced technologies like distributed energy storage. The scheme's effectiveness was validated through Monte Carlo simulations. Results demonstrate significant enhancements in energy supply reliability and peak load reduction capability under extreme scenarios. The findings provide several insights for improving energy system adaptability in the face of climate-induced challenges, offering valuable references for building reliable energy infrastructure capable of withstanding both extreme demands and physical threats across a spectrum of disaster intensities.Keywords: extreme weather events, integrated energy systems, reliability improvement, climate change adaptation
Procedia PDF Downloads 222246 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 752245 The MTHFR C677T Polymorphism Screening: A Challenge in Recurrent Pregnancy Loss
Authors: Rim Frikha, Nouha Bouayed, Afifa Sellami, Nozha Chakroun, Salima Daoud, Leila Keskes, Tarek Rebai
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Introduction: Recurrent pregnancy loss (RPL) defined as two or more pregnancy losses, is a serious clinical problem. Methylene-tetrahydro-folate-reductase (MTHFR) polymorphisms, commonly the variant C677T is recognized as an inherited thrombophilia which might affect embryonic development and pregnancy success and cause pregnancy complications as RPL. Material and Methods DNA was extracted from peripheral blood samples and PCR-RFLP was performed for the molecular diagnosis of the C677T MTHFR polymorphism among 70 patients (35 couples) with more than 2 fetal losses. Aims and Objective: The aim of this study is to determine the frequency of MTHFR C677T among Tunisian couples with RPL and to critically analyze the available literature on the importance of MTHFR polymorphism testing in the management of RPL. Result and comments: No C677T mutation was detected in the carriers of RPL. This result would be related to sample size and to different criteria (number of abortion), - The association between MTHFR polymorphisms and pregnancy complications has been reported but with controversial results. - A lack of evidence for MTHFR polymorphism testing previously recommended by ACMG (American College of Medical medicine). Our study highlights the importance of screening of MTHFR polymorphism since the real impact of such thrombotic molecular defect on the pregnancy outcome is evident. - Folic supplementation of these patients during pregnancy can prevent such complications and lead to a successful pregnancy outcome.Keywords: methylenetetrahydrofolate reductase, C677T, recurrent pregnancy loss, genetic testing
Procedia PDF Downloads 3042244 Synergistic Effect of Platelet-Rich Plasma with Hyaluronic Acid Injection Following Arthrocentesis to Reduce Pain and Improve Function in Temporomandibular joint (TMJ) Osteoarthritis
Authors: Ayman Hegab
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Increasing evidence supports the use of platelet-rich plasma (PRP) combined with hyaluronic acid (HA) for the treatment of knee osteoarthritis, which effectively promotes cartilage repair. This study aimed to determine whether injection of PRP+HA following arthrocentesis reduces pain and improves maximum incisal opening. This was a single-blind, prospective, randomized control study. The patients were selected based on the Hegab classification: Group I: patients treated with arthrocentesis followed by a single PRP injection; Group II (Control): patients treated with arthrocentesis followed by a single HA injection; and Group III: patients treated with arthrocentesis followed by a single PRP+HA combination injection. The primary predictor variable was the medication used for injection. The primary outcome variables were the maximum voluntary mouth opening and pain index scores. The secondary outcome variable was joint sounds. All outcome variables were assessed and compared among the three groups at baseline and at 1-, 3-, 6-, and 12-month intervals. Other variables, including patients’ age and sex, were evaluated in relation to the patient outcomes. Injecting PRP+HA showed statistically significant improvement in the primary and secondary treatment outcomes over PRP or HA injection throughout the study period (P<0.005). Injection of PRP+HA following arthrocentesis had significant long-term clinical efficacy regarding pain relief that was considered the main concern of both the patient and clinician.Keywords: TMJ, HA, PRP, osteoarthritis
Procedia PDF Downloads 62243 Avidity and IgE versus IgG and IgM in Diagnosis of Maternal Toxoplasmosis
Authors: Ghada A. Gamea, Nabila A. Yaseen, Ahmed A. Othman, Ahmed S. Tawfik
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Infection with Toxoplasma gondii can cause serious complications in pregnant women, leading to abortion, stillbirth, and congenital anomalies in the fetus. Definitive diagnosis of T. gondii acute infection is therefore critical for the clinical management of a mother and her fetus. This study was conducted on 250 pregnant females in the first trimester who were inpatients or outpatients at Obstetrics and Gynaecology Department at Tanta University Hospital. Screening of the selected females was done for the detection of immunoglobulin (IgG and IgM), and all subjects were submitted to history taking through a questionnaire including personal data, risk factors for Toxoplasma, complaint and history of the present illness. Thirty-eight samples, including 18 IgM +ve and 20 IgM-ve cases were further investigated by the avidity and IgE ELISA tests. The seroprevalence of toxoplasmosis in pregnant women was (42.8%) based on the presence of IgG antibodies in their sera. Contact with cats and consumption of raw or undercooked meat are important risk factors that were associated with toxoplasmosis in pregnant women. By serology, it could be observed that in the IgM +ve group, only one case (5.6%) showed an acute pattern by using the avidity test, though 10 (55.6%) cases were found to be acute by the IgE assay. On the other hand, in the IgM –ve group, 3 (15%) showed low avidity, but none of them was positive by using the IgE assay. In conclusion, there is no single serological test that can be used to confirm whether T. gondii infection is recent or was acquired in the distant past. A panel of tests for detection of toxoplasmosis will certainly have higher discriminatory power than any test alone.Keywords: diagnosis, serology, seroprevalence, toxoplasmosis
Procedia PDF Downloads 1512242 Incidence of Post Endoscopic Retrograde Cholangiopancreatography Biliary Ascariasis Diagnosed on Ultrasound
Authors: Shehzad Khan, Jehangir Khan, Shah Babar, Rashid Mahmood, Rizwan Khan, Sanya Hadi
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Ascaris lumbricoides are familiar with the roundworm that causes biliary infections in humans. Nevertheless, ascariasis is primarily found in the jejunum and transferred in numerous body parts with the intake of Ascaris lumbricoides present in food and water. These study methods were implemented at the Saidu Teaching Hospital Radiology Department from December 2021 to January 2023. This study includes the participants suffering from biliary ascariasis admitted or visited Saidu Teaching Hospital in that time frame. Clinical assessment of the participants was done based on the appearance of signs and symptoms present in them. The participant's laboratory test was done to determine the level of basic body parameters. After that ultrasonography was used to diagnose the presence and appearance of worms. Endoscopic retrograde cholangiopancreatography (ERCP) was used to extract worms from biliary channels, and the incidence of post-ERCP biliary ascariasis was accessed with ultrasonography. This study's results show the presence of numerous types of worms in the biliary channels of patients. Also, the level of body parameters, for instance, neutrophil, hemoglobin, and others, were compared at the time of admission and at the time of discharge from the hospital. Furthermore, the incidence of post-ERCP biliary ascariasis was reported as 4% in females, and 1% in males, respectively.Keywords: Ascaris, biliary, ERCP, ultrasound
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