Search results for: clinical chemistry values

Authors: Fakhrosadat Sajjadian, Ramin Ghasemi Shayan

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The tumor microenvironment plays an fundamental part in tumor start, movement, metastasis, and treatment resistance. It varies from ordinary tissue in terms of its extracellular network, vascular and lymphatic arrange, as well as physiological conditions. The clinical application of atomic cancer imaging is regularly prevented by the tall commercialization costs of focused on imaging operators as well as the constrained clinical applications and little showcase measure of a few operators. . Since numerous cancer types share comparable characteristics of the tumor microenvironment, the capacity to target these biomarkers has the potential to supply clinically translatable atomic imaging advances for numerous types encompassing cancer and broad clinical applications. Noteworthy advance has been made in focusing on the tumor microenvironment for atomic cancer imaging. In this survey, we summarize the standards and methodologies of later progresses in atomic imaging of the tumor microenvironment, utilizing distinctive imaging modalities for early discovery and conclusion of cancer. To conclude, The tumor microenvironment (TME) encompassing tumor cells could be a profoundly energetic and heterogeneous composition of safe cells, fibroblasts, forerunner cells, endothelial cells, flagging atoms and extracellular network (ECM) components.

Keywords: molecular, imaging, TME, medicine

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Authors: Fernando Maass, Pablo Martin, Jorge Olivares

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Fractional derivatives have become very important in several areas of Engineering, however, the solutions of simple differential equations are not known. Here we are considering the simplest first order nonhomogeneous differential equations with Bessel regular functions of the first kind, in this way the solutions have been found which are hypergeometric solutions for any fractional derivative of order α, where α is rational number α=m/p, between zero and one. The way to find this result is by using Laplace transform and the Caputo definitions of fractional derivatives. This method is for values longer than one. However for α entire number the hypergeometric functions are Kumer type, no integer values of alpha, the hypergeometric function is more complicated is type ₂F₃(a,b,c, t2/2). The argument of the hypergeometric changes sign when we go from the regular Bessel functions to the modified Bessel functions of the first kind, however it integer seems that using precise values of α and considering no integers values of α, a solution can be obtained in terms of two hypergeometric functions. Further research is required for future papers in order to obtain the general solution for any rational value of α.

Keywords: Caputo, fractional calculation, hypergeometric, linear differential equations

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Authors: Aniruddha Kulkarni

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In very few cases of external hernias we require imaging modalities as on most occasions clinical examination tests are good enough. Ultrasound will help in chronic abdominal or groin pain, equivocal clinical results & complicated hernias. Ultrasound is useful in assessment of cause of raised intrabdominal pressure. In certain cases will comment about etiology, complications and chronicicty of lesion. Screening of rest of abdominal organs too is important advantage being real time modality. Cost effectiveness, no radiation allows modality be used repeatedly in indicated cases. Sonography is better accepted by patients too as it is cost effective. Best advanced tissue harmonic equipment and increasing expertise making it popular. Ultrasound can define surgical anatomy, rent size, contents, etiological /recurrence factors in great detail and with authority hence accidental findings in a planned surgical procedure can be easily avoided. Clinical dynamic valselva and reducibility test can better documented by real time ultrasound study. In case of recurrence, Sonography will help in assessing the hernia details better as being dynamic real time investigation. Ultrasound signs in case of internal hernias are well comparable with CT findings.

Keywords: laparoscopic repair, Hernia, CT findings, chronic pain

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Authors: Urszula Stachewicz

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Surface properties of materials are the key parameter in many applications, especially in the biomedical field, to control cell-material interactions. In our work, we want to achieve the controllability of surface properties of polymer fibers via a single-step electrospinning process by alternating voltage polarities. Voltage polarity defines the charge accumulated on the surface of the liquid jet and the surface of the fibers. Positive polarity attracts negatively charged groups to fibers’ surface, whereas negative polarity moves the negatively charged functional groups away from the surface. This way, we can control the surface chemistry, wettability, and additionally surface potential of electrospun fibers. Within our research, we characterized surface chemistry using X-ray photoelectron microscopy (XPS) and surface potential with Kelvin probe force microscopy (KPFM) on electrospun fibers of commonly used polymers such as PCL, PVDF, and PMMA, often used as biomaterials. We proved the significant effect of fibers' surface potential on cell integration with the scaffolds and further cells development for the regeneration processes based on the osteoblast and fibroblast culture studies. Acknowledgments: The study was conducted within ‘Nanofiber-based sponges for atopic skin treatment’ project, which is carried out within the First TEAM programme of the Foundation for Polish Science co-financed by the European Union under the European Regional Development Fund, project no POIR.04.04.00-00- 4571/18-00.

Keywords: cell attachment, fibers, fibroblasts, osteoblast, proliferation, surface potential

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Authors: Odukunle Adebayo Atewolara-Odule

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Music is an electronic medium and an integral content of the broadcast media, which has communicative values even in the process of entertaining listeners. The communicative values of music could have implications on what adults learn about culture and society. This study aimed at examining the communicative values of Yoruba traditional music and adulthood socialisation by comparing the situation of the late 20th with early 21st centuries. From the population of literate adults of between the ages of 30 years and 65 years in Ijebu North Local Government area of Ogun state, a sample of 200 respondents was drawn into the study through the stratified technique. A descriptive survey was conducted on the sample with the use of a structured questionnaire as the research instrument. Findings showed a significant relationship between what adults learned about the society and its culture from this category of music (p=0.000<0.05) but there was a higher significant relationship between Yoruba traditional music and adulthood socialisation in the late 20th than in early 21st centuries. Results also showed a significant communicative influence of Yoruba traditional music of the late 20th and early 21st centuries on adulthood socialisation (p=0.000<0.05). Respondents’ demographic characteristics were observed to play significant intervening roles on the communicative influence of Yoruba traditional music on socialisation among the adults between the late 20th and early 21st centuries (p=0.000<0.05). The study recommends that stakeholders should take cognisance of the lyrical contents of Yoruba traditional music due to its implications to inculcate values into people and shape their behaviour.

Keywords: adulthood socialisation, communicative values, traditional music, Voruba

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Authors: Chamtouri I., Kechida M.

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Background: Evaluation has a prominent role in medical education and graduation. This evaluation has usually done in face-to-face, by written or oral questions. Simulation is increasingly taking a part as a method of evaluation. Due to the Covid-19 pandemic, which disrupted face-to-face evaluation, simulation using serious games (SG) is emerging in the field of training and assessment of medical students. The aim of our study is to compare the results of the evaluation of medical students by virtual simulation by online serious games versus clinical case-multiple choice questions (MCQ) and to assess the degree of satisfaction from these two evaluation methods. Methods: Medical students from the same study level were voluntarily participated in this study. Groupe 1 had an evaluation by SG dealing with “diagnosis and management of ST-segment elevationmyocardialinfarction (STEMI)alreadyprepared on the website www.Mediactiv.com. Groupe 2 were evaluated by clinical case-MCQ having thes same topic as SG. Results of the two groups were compared. Satisfaction questionnaire was filled by the two groups. Satisfaction degree was compared between the two groups. Results. In this study, 64 medical students (G1:31 and G2: 33) were enrolled. Obtaining complete notes in the "questioning" and "clinical examination" parts is significantly more important in-group 1 compared to group 2. No significant difference detected between the two groups in terms of “ECG interpretation” and “diagnosis of STEMI” parts. A greater number of students of group 1 obtained the full note compared to group 2 in “the initial treatment part” (54.8% vs. 39.4%; p = 0.04). Thirty learners (96.8%) in-group 1 obtained a total score ≥ 50% versus 69.7% in-group 2 (p = 0.004). The full score of 100% was obtained in three learners in-group1, while no student scored 100% in-group2 (p = 0.027). Medical evaluation using SG was reported as more innovative, fun, and realistic compared to evaluation by clinical case-MCQ. No significant difference detected between the two methods in terms of stress. Conclusion: Simulation by SG can be considered as an innovative and effective method in evaluating medical students with a higher degree of satisfaction.

Keywords: evaluation, serious games, medical students, satisfaction

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Authors: Shanza Akram, Sameen Toor, Heba Harb Abu Alkass, Zainab Abdulsalam Altaha, Sara Taha Abdulla, Saleem Imran

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Acute pulmonary embolism (PE) is a common disease and can be fatal. The clinical presentation is variable and nonspecific, making accurate diagnosis difficult. Testing patients with suspected acute PE has increased dramatically. However, the overuse of some tests, particularly CT and D-dimer measurement, may not improve care while potentially leading to patient harm and unnecessary expense. CTPA is the investigation of choice for PE. Its easy availability, accuracy and ability to provide alternative diagnosis has lowered the threshold for performing it, resulting in its overuse. Guidelines have recommended the use of clinical pretest probability tools such as ‘Wells score’ to assess risk of suspected PE. Unfortunately, implementation of guidelines in clinical practice is inconsistent. This has led to low risk patients being subjected to unnecessary imaging, exposure to radiation and possible contrast related complications. Aim: To study the diagnostic yield of CT PA, clinical pretest probability of patients according to wells score and to determine whether or not there was an overuse of CTPA in our service. Methods: CT scans done on patients with suspected P.E in our hospital from 1st January 2014 to 31st December 2014 were retrospectively reviewed. Medical records were reviewed to study demographics, clinical presentation, final diagnosis, and to establish if Wells score and D-Dimer were used correctly in predicting the probability of PE and the need for subsequent CTPA. Results: 100 patients (51male) underwent CT PA in the time period. Mean age was 57 years (24-91 years). Majority of patients presented with shortness of breath (52%). Other presenting symptoms included chest pain 34%, palpitations 6%, collapse 5% and haemoptysis 5%. D Dimer test was done in 69%. Overall Wells score was low (<2) in 28 %, moderate (>2 - < 6) in 47% and high (> 6) in 15% of patients. Wells score was documented in medical notes of only 20% patients. PE was confirmed in 12% (8 male) patients. 4 had bilateral PE’s. In high-risk group (Wells > 6) (n=15), there were 5 diagnosed PEs. In moderate risk group (Wells >2 - < 6) (n=47), there were 6 and in low risk group (Wells <2) (n=28), one case of PE was confirmed. CT scans negative for PE showed pleural effusion in 30, Consolidation in 20, atelactasis in 15 and pulmonary nodule in 4 patients. 31 scans were completely normal. Conclusion: Yield of CT for pulmonary embolism was low in our cohort at 12%. A significant number of our patients who underwent CT PA had low Wells score. This suggests that CT PA is over utilized in our institution. Wells score was poorly documented in medical notes. CT-PA was able to detect alternative pulmonary abnormalities explaining the patient's clinical presentation. CT-PA requires concomitant pretest clinical probability assessment to be an effective diagnostic tool for confirming or excluding PE. . Clinicians should use validated clinical prediction rules to estimate pretest probability in patients in whom acute PE is being considered. Combining Wells scores with clinical and laboratory assessment may reduce the need for CTPA.

Keywords: CT PA, D dimer, pulmonary embolism, wells score

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Authors: Marthese Azzopardi, Liberato Camilleri

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This research was performed to investigate the study habits and level of difficulty perceived by post-secondary students in Biology at Advanced-level topics after completing their first year of study. At the end of a two-year ‘sixth form’ course, Maltese students sit for the Matriculation and Secondary Education Certificate (MATSEC) Advanced-level biology exam as a requirement to pursue science-related studies at the University of Malta. The sample was composed of 23 students (16 taking Chemistry and seven taking some ‘Other’ subject at the Advanced Level). The cohort comprised seven males and 16 females. A questionnaire constructed by the authors, was answered anonymously during the last lecture at the end of the first year of study, in May 2016. The Chi square test revealed that gender plays no effect on the various study habits (c² (6) = 5.873, p = 0.438). ‘Reading both notes and textbooks’ was the most common method adopted by males (71.4%), whereas ‘Writing notes on each topic’ was that mostly used by females (81.3%). The Mann-Whitney U test showed no significant difference in the study habits of students and the mean assessment mark obtained at the end of the first year course (p = 0.231). Statistical difference was found with the One-ANOVA test when comparing the mean assessment mark obtained at the end of the first year course when students are clustered by their Secondary Education Certificate (SEC) grade (p < 0.001). Those obtaining a SEC grade of 2 and 3 got the highest mean assessment of 68.33% and 66.9%, respectively [SEC grading is 1-7, where 1 is the highest]. The Friedman test was used to compare the mean difficulty rating scores provided for the difficulty of each topic. The mean difficulty rating score ranges from 1 to 4, where the larger the mean rating score, the higher the difficulty. When considering the whole group of students, nine topics out of 21 were perceived as significantly more difficult than the other topics. Protein synthesis, DNA Replication and Biomolecules were the most difficult, in that order. The Mann-Whitney U test revealed that the perceived level of difficulty in comprehending Biomolecules is significantly lower for students taking Chemistry compared to those not choosing the subject (p = 0.018). Protein Synthesis was claimed as the most difficult by Chemistry students and Biomolecules by those not studying Chemistry. DNA Replication was the second most difficult topic perceived by both groups. The Mann-Whitney U test was used to examine the effect of gender on the perceived level of difficulty in comprehending various topics. It was found that females have significantly more difficulty in comprehending Biomolecules than males (p=0.039). Protein synthesis was perceived as the most difficult topic by males (mean difficulty rating score = 3.14), while Biomolecules, DNA Replication and Protein synthesis were of equal difficulty for females (mean difficulty rating score = 3.00). Males and females perceived DNA Replication as equally difficult (mean difficulty rating score = 3.00). Discovering the students’ study habits and perceived level of difficulty of specific topics is vital for the lecturer to offer guidance that leads to higher academic achievement.

Keywords: biology, perceived difficulty, post-secondary, study habits

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Authors: M. I. A. Adziz, J. Sharib Sarip, M. T. Ishak, D. N. A. Tugi

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Radiation exposure to humans and the environment is caused by natural radioactive material sources. Given that exposure to people and communities can occur through several pathways, it is necessary to pay attention to the increase in naturally radioactive material, particularly in the soil. Continuous research and monitoring on the distribution and determination of these natural radionuclides' activity as a guide and reference are beneficial, especially in an accidental exposure. Surface soil/sediment samples from several locations identified around the Sembrong catchment area were taken for the study. After 30 days of secular equilibrium with their daughters, the activity concentrations of the naturally occurring radioactive material (NORM) members, i.e. ²²⁶Ra, ²²⁸Ra, ²³⁸U, ²³²Th, and ⁴⁰K, were measured using high purity germanium (HPGe) gamma spectrometer. The results obtained showed that the radioactivity concentration of ²³⁸U ranged between 17.13 - 30.13 Bq/kg, ²³²Th ranged between 22.90 - 40.05 Bq/kg, ²²⁶Ra ranged between 19.19 - 32.10 Bq/kg, ²²⁸Ra ranged between 21.08 - 39.11 Bq/kg and ⁴⁰K ranged between 9.22 - 51.07 Bq/kg with average values of 20.98 Bq/kg, 27.39 Bq/kg, 23.55 Bq/kg, 26.93 Bq/kg and 23.55 Bq/kg respectively. The values obtained from this study were low or equivalent to previously reported in previous studies. It was also found that the mean/mean values obtained for the four parameters of the Radiation Hazard Index, namely radium equivalent activity (Raeq), external dose rate (D), annual effective dose and external hazard index (Hₑₓ), were 65.40 Bq/kg, 29.33 nGy/h, 19.18 ¹⁰⁻⁶Sv and 0.19 respectively. These obtained values are low compared to the world average values and the values of globally applied standards. Comparison with previous studies (dry season) also found that the values for all four parameters were low and equivalent. This indicates the level of radiation hazard in the area around the study is safe for the public.

Keywords: catchment area, gamma spectrometry, naturally occurring radioactive material (NORM), soil

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Authors: Heshalini Rajagopal, Li Sze Chow, Raveendran Paramesran

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Magnetic Resonance Imaging (MRI) is one of the most important medical imaging modality. Subjective assessment of the image quality is regarded as the gold standard to evaluate MR images. In this study, a database of 210 MR images which contains ten reference images and 200 distorted images is presented. The reference images were distorted with four types of distortions: Rician Noise, Gaussian White Noise, Gaussian Blur and DCT compression. The 210 images were assessed by ten subjects. The subjective scores were presented in Difference Mean Opinion Score (DMOS). The DMOS values were compared with four FR-IQA metrics. We have used Pearson Linear Coefficient (PLCC) and Spearman Rank Order Correlation Coefficient (SROCC) to validate the DMOS values. The high correlation values of PLCC and SROCC shows that the DMOS values are close to the objective FR-IQA metrics.

Keywords: medical resonance (MR) images, difference mean opinion score (DMOS), full reference image quality assessment (FR-IQA)

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Authors: Christian T. Lystbaek

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Background: The importance of innovation management has traditionally been ascribed to private production companies, however, there is an increasing interest in public services innovation management. One of the major theoretical challenges arising from this situation is to understand public values justifying public services innovation management. However, there is not single and stable definition of public value in the literature. The research question guiding this paper is: What is the supposed added value operating in the public sphere? Methodology: The study takes an action research strategy. This is highly contextualized methodology, which is enacted within a particular set of social relations into which on expects to integrate the results. As such, this research strategy is particularly well suited for its potential to generate results that can be applied by managers. The aim of action research is to produce proposals with a creative dimension capable of compelling actors to act in a new and pertinent way in relation to the situations they encounter. The context of the study is a workshop on public services innovation within elderly care. The workshop brought together different actors, such as managers, personnel and two groups of users-citizens (elderly clients and their relatives). The process was designed as an extension of the co-construction methods inherent in action research. Scenario methods and focus groups were applied to generate dialogue. The main strength of these techniques is to gather and exploit as much data as possible by exposing the discourse of justification used by the actors to explain or justify their points of view when interacting with others on a given subject. The approach does not directly interrogate the actors on their values, but allows their values to emerge through debate and dialogue. Findings: The public values related to public services innovation management in elderly care were identified in two steps. In the first step, identification of values, values were identified in the discussions. Through continuous analysis of the data, a network of interrelated values was developed. In the second step, tracking group consensus, we then ascertained the degree to which the meaning attributed to the value was common to the participants, classifying the degree of consensus as high, intermediate or low. High consensus corresponds to strong convergence in meaning, intermediate to generally shared meanings between participants, and low to divergences regarding the meaning between participants. Only values with high or intermediate degree of consensus were retained in the analysis. Conclusion: The study shows that the fundamental criterion for justifying public services innovation management is the capacity for actors to enact public values in their work. In the workshop, we identified two categories of public values, intrinsic value and behavioural values, and a list of more specific values.

Keywords: public services innovation management, public value, co-creation, action research

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Authors: Ashwin Belle, Bryce Benson, Mark Salamango, Fadi Islim, Rodney Daniels, Kevin Ward

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A reliable, real-time, and non-invasive system that can identify patients at risk for hemodynamic instability is needed to aid clinicians in their efforts to anticipate patient deterioration and initiate early interventions. The purpose of this pilot study was to explore the clinical capabilities of a real-time analytic from a single lead of an electrocardiograph to correctly distinguish between rapid response team (RRT) activations due to hemodynamic (H-RRT) and non-hemodynamic (NH-RRT) causes, as well as predict H-RRT cases with actionable lead times. The study consisted of a single center, retrospective cohort of 21 patients with RRT activations from step-down and telemetry units. Through electronic health record review and blinded to the analytic’s output, each patient was categorized by clinicians into H-RRT and NH-RRT cases. The analytic output and the categorization were compared. The prediction lead time prior to the RRT call was calculated. The analytic correctly distinguished between H-RRT and NH-RRT cases with 100% accuracy, demonstrating 100% positive and negative predictive values, and 100% sensitivity and specificity. In H-RRT cases, the analytic detected hemodynamic deterioration with a median lead time of 9.5 hours prior to the RRT call (range 14 minutes to 52 hours). The study demonstrates that an electrocardiogram (ECG) based analytic has the potential for providing clinical decision and monitoring support for caregivers to identify at risk patients within a clinically relevant timeframe allowing for increased vigilance and early interventional support to reduce the chances of continued patient deterioration.

Keywords: critical care, early warning systems, emergency medicine, heart rate variability, hemodynamic instability, rapid response team

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Authors: S. Pooja Pragati, B. Sudarsan, S. Rajkumar

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Silver nanoparticles (AgNP) are known for their excellent antimicrobial agents, and thus can be used as alternative disinfectant agents. However, released silver nanoparticles is a threat to naturally occurring microorganisms. This paper exhibits information on the environmental fate, toxicological effects, and application of AgNP and the current estimate on the physicochemical and antimicrobial properties of AgNP in different aqueous solutions, as well as their application as alternative disinfectants in water-treatment systems. It also gives a better approximation and experimental data of AgNP’s antimicrobial properties at different water chemistry conditions. A saturation-type fitting curve was established, showing the survival of bacteria under different water chemistry conditions as a function of the size of the nanoparticles. The results obtained show that silver nanoparticles in surface water, ground water, and brackish water are stable. The paper demonstrates the comparative study of AgNP-impregnated point-of-use ceramic water filters and ceramic filters impregnated with silver nitrate. It is observed that AgNP-impregnated ceramic water filters are more appropriate for this application due to the lesser amount of silver desorbed. Experimental data of the comparison of a polymer-based quaternary amine functionalized silsesquioxanes compound and AgNP are also tabulated and conclusions are analysed with the goal of optimizing. The simplicity of synthesis and application of Silver nanoparticles enables us to consider its effective modified version for the purification of water.

Keywords: disinfectant agent, purification of water, nano particles, water treatment

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Authors: R. Sudhesh Solomon, P. Y. K. L. Srinivas, Abhay Narayan, Amitava Das

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Users in social networks either unicast or broadcast their messages. At mention is the popular way of unicasting for Twitter whereas general tweeting could be considered as broadcasting method. Understanding the information flow and dynamics within a Social Network and modeling the same is a promising and an open research area called Information Diffusion. This paper seeks an answer to a fundamental question - understanding if the at-mention network or the unicasting pattern in social media is purely random in nature or is there any user specific selectional preference? To answer the question we present an empirical analysis to understand the sociological aspects of Twitter mentions network within a social network community. To understand the sociological behavior we analyze the values (Schwartz model: Achievement, Benevolence, Conformity, Hedonism, Power, Security, Self-Direction, Stimulation, Traditional and Universalism) of all the users. Empirical results suggest that values traits are indeed salient cue to understand how the mention-based communication network functions. For example, we notice that individuals possessing similar values unicast among themselves more often than with other value type people. We also observe that traditional and self-directed people do not maintain very close relationship in the network with the people of different values traits.

Keywords: information diffusion, personality and values, social network analysis, twitter mentions network

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Authors: Don Buddika Oshadi Malaweera, Lora Harris, Bruce Rathgeber, Chibuike C. Udenigwe, Kirsti Rouvinen-Watt

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Fatty liver disease is among the three most severe health concerns for mink and believed to occur through the same mechanism as nursing sickness. In North America, nursing sickness affects about 45% of mink farms and in Canada, approximately 50,000 mink females is affected annually. Orotic acid (OA) plays a critical role in lipid metabolism and can increase hepatic lipids by enhancing Sterol regulatory element binding protein-1c expression and decreasing Carnitine palmitoyl transferase I activity. This study was conducted to identify particular pathways and regulatory control points involved in fatty liver development, and evaluate the effectiveness of arginine and bioactive peptides for prevention and treatment of fatty liver disease in mink. A total of 45 mink were used in 9 treatments. The experimental diets consisted of 1% OA, 2% L-arginine and 5% of whey protein hydrolysates. At the end of 10 days of experimental period, the mink were anaesthetized, sampled for blood and euthanized, samples were obtained for histological, biochemical and molecular assays. The blood samples will be analyzed for clinical chemistry and triacylglycerol. The liver samples will be analyzed for total lipid content and analyzed for 6 genes of interest involved in adipogenic transformation, ER stress, and liver inflammation.

Keywords: fatty liver, L-arginine, mink, orotic acid, whey protein hydrolysates

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Authors: Siriporn Sikkaphun

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Food is essential for living, and receiving correct, suitable, and adequate food is advantageous to the body, especially for patients because it can enable good recovery. Feeding through a gastrostomy tube is one useful way that is widely used because it is easy, convenient, and economical.To compare the effectiveness of using the clinical guidelines for feeding through a gastrostomy tube in critically ill surgical patients.This is a pre-post quasi-experimental study on 15 critically ill surgical or accident patients who needed intubation and the gastrostomy tube from August 2011 to November 2012. The data were collected using the guidelines, and an evaluation form for effectiveness of guidelines for feeding through a gastrostomy tube in critically ill surgical patients. After using the guidelines for feeding through a gastrostomy tube in critically ill surgical patients, it was found that The average number of days from the admission date to the day the patients received food through the G-tube significantly reduced at the level .05. The number of personnel who practiced nursing activities correctly and suitably for patients with complications during feeding significantly increased at the level .05.The number of patients receiving energy to the target level significantly increased at the level .05. The results of this study indicated that the use of the guidelines for feeding through a gastrostomy tube in critically ill surgical patients was feasible in practice, and the outcomes were beneficial to the patients.

Keywords: clinical guidelines, feeding, gastrostomy tube, critically ill, surgical patients

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Authors: Xin Wu, Yongfeng Zhao, Qingxiang Meng

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In China, quite low proportion of crop residues were used as feedstuff because of its poor palatability and low digestibility. Steam explosion is a physical and chemical feed processing technology which has great potential to improve sapidity and digestibility of crop residues. To investigate the effect of the steam explosion on chemical compositions and efficient energy values, crop residues (rice straw, wheat straw and maize stover) were processed by steam explosion (steam temperature 120-230°C, steam pressure 2-26kg/cm², 40min). Steam-exploded crop residues were regarded as treatment groups and untreated ones as control groups, nutritive compositions were analyzed and effective energy values were calculated by prediction model in INRA (1988, 2010) for both groups. Results indicated that the interaction between treatment and variety has a significant effect on chemical compositions of crop residues. Steam explosion treatment of crop residues decreased neutral detergent fiber (NDF) significantly (P < 0.01), and compared with untreated material, NDF content of rice straw, wheat straw, and maize stover lowered 21.46%, 32.11%, 28.34% respectively. Acid detergent lignin (ADL) of crop residues increased significantly after the steam explosion (P < 0.05). The content of crude protein (CP), ether extract (EE) and Ash increased significantly after steam explosion (P < 0.05). Moreover, predicted effective energy values of each steam-exploded residue were higher than that of untreated ones. The digestible energy (DE), metabolizable energy (ME), net energy for maintenance (NEm) and net energy for gain (NEg)of steam-exploded rice straw were 3.06, 2.48, 1.48and 0.29 MJ/kg respectively and increased 46.21%, 46.25%, 49.56% and 110.92% compared with untreated ones(P < 0.05). Correspondingly, the energy values of steam-exploded wheat straw were 2.18, 1.76, 1.03 and 0.15 MJ/kg, which were 261.78%, 261.29%, 274.59% and 1014.69% greater than that of wheat straw (P < 0.05). The above predicted energy values of steam exploded maize stover were 5.28, 4.30, 2.67 and 0.82 MJ/kg and raised 109.58%, 107.71%, 122.57% and 332.64% compared with the raw material(P < 0.05). In conclusion, steam explosion treatment could significantly decrease NDF content, increase ADL, CP, EE, Ash content and effective energy values of crop residues. The effect of steam explosion was much more obvious for wheat straw than the other two kinds of residues under the same condition.

Keywords: chemical compositions, crop residues, efficient energy values, steam explosion

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Authors: Vipan Kumar Sohpal

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Temperature effect on the adsorption of crystal violet dye (CVD) was investigated using a castor leaf powder (CLP) that was prepared from the mature leaves of castor trees, through chemical reaction. The optimum values of pH (8), adsorbent dose (10g/L), initial dye concentration (10g/L), time (2hrs), and stirrer speed (120 rpm) were fixed to investigate the influence of temperature on adsorption capacity, percentage of removal of dye and free energy. A central composite design (CCD) was successfully employed for experimental design and analysis of the results. The combined effect of temperature, absorbance, and concentration on the dye adsorption was studied and optimized using response surface methodology. The optimum values of adsorption capacity, percentage of removal of dye and free energy were found to be 0.965(mg/g), 93.38 %, -8202.7(J/mol) at temperature 55.97 °C having desirability > 90% for removal of crystal violet dye respectively. The experimental values were in good agreement with predicted values.

Keywords: crystal violet dye, CVD, castor leaf powder, CLP, response surface methodology, temperature, optimization

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Authors: Yuliya Markava

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The laser in situ keratomileusis (LASIK) is widely common surgical procedure, which has become an alternative for patients who are not satisfied with the performance of other correction methods. A high level of patient satisfaction functional outcomes after refractive surgery confirms the high reliability and safety of LASIK and provides a significant improvement in the quality of life and social adaptation. Purpose: To perform clinical analysis of the results of correction made to the excimer laser system SCHWIND AMARIS 500E in patients with different types of refractive anomalies. Materials and Methods: This was a retrospective analysis of 1581 operations (812 patients): 413 males (50.86%) and 399 females (49.14%) at the age from 18 to 47 years with different types of ametropia. All operations were performed on excimer laser SCHWIND AMARIS 500E in the LASIK procedure. Formation of the corneal flap was made by mechanical microkeratome SCHWIND. Results: Analyzing the structure of refractive anomalies: The largest number of interventions accounted for myopia: 1505 eyes (95.2%), of which about a low myopia: 706 eyes (44.7%), moderate myopia: 562 eyes (35.5 %), high myopia: eyes 217 (13.7%) and supermyopia: 20 eyes (1.3%). Hyperopia was 0.7% (11 eyes), mixed astigmatism: 4.1% (65 eyes). The efficiency was 80% (in patients with supermyopia) to 91.6% and 95.4% (in groups with myopia low and moderate, respectively). Uncorrected visual acuity average values before and after laser operation was in groups: a low myopia 0.18 (up 0.05 to 0.31) and 0.80 (up 0.60 to 1.0); moderate myopia 0.08 (up 0.03 to 0.13) and 0.87 ( up 0.74 to 1.0); high myopia 0.05 (up 0.02 to 0.08) and 0.83 (up 0.66 to 1.0); supermyopia 0.03 (up 0.02 to 0.04) and 0.59 ( up 0.34 to 0.84); hyperopia 0.27 (up 0.16 to 0.38) and 0.57 (up 0.27 to 0.87); mixed astigmatism of 0.35 (up 0.19 to 0.51) and 0.69 (up 0.44 to 0.94). In all cases, after LASIK indicators uncorrected visual acuity significantly increased. Reoperation was 4.43%. Significance: Clinical results of refractive surgery at the excimer laser system SCHWIND AMARIS 500E in different ametropia correction is characterized by high efficiency.

Keywords: effectiveness of laser correction, LASIK, refractive anomalies, surgical treatment

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Authors: Caixiu Pu, Zhen Chen

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We present the rare case of umbilical arterial atresia, leading to a good outcome and provide clinical and pathological findings. A 27-year-old nulliparous first gravida with PGDM was found single umbilical artery(SUA) by routine ultrasound san at 30 weeeks of gestation. Fetal status was monitored weekly. A healthy male newborn was delivered by cesarean section at 39 weeks. The umbilical cord was overly twisted and no thrombus was found along the whole diseased vessel. The cause of umbilical arterial atresia was unclear, and the correct diagnosis was a challenge. Expected clinical management was recommended, in which sonographic diagnosis may play a very important part.

Keywords: pregnancy, single umbilical artery, umbilical arterial atresia, prenatal diagnosis

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Authors: Khalifa Alatresh, Mirac Aydin

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This research explores the impacts of irrigation by treated wastewater (TWW) on the mineralogical and chemical attributes of sandy calcareous soils in the Southern region of Misurata. Soil samples obtained from three horizons (A, B, and C) of six TWW-irrigated pedons (29years) and six other pedons from nearby non-irrigated areas (dry-control). The results demonstrated that the TWW-irrigated pedons had significantly higher salinity (EC), sodium adsorption ratio (SAR), exchangeable sodium percentage (ESP), cation exchange capacity (CEC), available phosphor (AP), total nitrogen (TN), and organic matter (OM) relative to the control pedons. Nonetheless, all the values of interest (EC < 4000 µs/cm < SAR < 13, pH < 8.5 and ESP < 15) remained lower than the thresholds, showing no issues with sodicity or salinity. Irrigated pedons contained significantly higher amounts of total clay and showed an altered distribution of particle sizes and minerals identified (quartz, calcite, microcline, albite, anorthite, and dolomite) within the profile. The observed results included the occurrence of Margarite, Anorthite, Chabazite, and Tridymite minerals after the application of TWW in small quantities that are not enough to influence soil genesis and classification.0,51 cm.

Keywords: treated wastewater, sandy calcareous soils, soil mineralogy, and chemistry

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Authors: Ilana Margalith, Yaron Niv

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One of the most important factors of professional health treatment is teamwork, in which each discipline contributes its expert knowledge, thus ensuring quality and a high standard of care as well as efficient communication (one of the International Patient Safety Goals). However, in most countries, students are educated separately by each health discipline. They are exposed to teamwork only during their clinical experience, which in some cases is short and skill-oriented. In addition, health organizations in most countries are hierarchical and although changes have occurred in the hierarchy of the medical system, there are still disciplines that underrate the unique contributions of other health professionals, thus, young graduates of health professions develop and base their perception of their peers from other disciplines on insufficient knowledge. In order to establish a wide-ranging perception among nursing students as to the contribution of different health professionals to the health of their patients, students at the Clalit Nursing Academy, Rabin Campus (Dina), Israel, participated in an interdisciplinary clinical discussion with students from several different professions, other than nursing, who were completing their clinical experience at Rabin Medical Center in medicine, health psychology, social work, audiology, physiotherapy and occupational therapy. The discussion was led by a medical-surgical nursing instructor. Their tutors received in advance, a case report enabling them to prepare the students as to how to present their professional theories and interventions regarding the case. Mutual stimulation and acknowledgment of the unique contribution of each part of the team enriched the nursing students' understanding as to how their own nursing interventions could be integrated into the entire process towards a safe and speedy recovery of the patient.

Keywords: health professions' students, interdisciplinary clinical discussion, nursing education, patient safety

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Authors: Salahud Din, Saima Masood, Hafsa Zaneb, Habib Ur Rehman, Saima Ashraf, Imad Khan, Muqader Shah

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The objective of this study was (1) to study gross morphological, osteometric and clinical important landmarks in the skull of adult Chinkara to obtain baseline data and (2) to study sexual dimorphism in male and female adult Chinkara through osteometry. For this purpose, after performing postmortem examination, the carcass of adult Chinkara of known sex and age was buried in the locality of the Manglot Wildlife Park and Ungulate Breeding Centre, Nizampur, Pakistan; after a specific period of time, the bones were unearthed. Gross morphological features and various osteometric parameters of the skull were studied in the University of Veterinary and Animal Sciences, Lahore, Pakistan. The shape of the Chinkara skull was elongated and had thirty-two bones. The skull was comprised of the cranial and the facial part. The facial region of the skull was formed by maxilla, incisive, palatine, vomar, pterygoid, frontal, parietal, nasal, incisive, turbinates, mandible and hyoid apparatus. The bony region of the cranium of Chinkara was comprised of occipital, ethmoid, sphenoid, interparietal, parietal, temporal, and frontal bone. The foramina identified in the facial region of the skull of Chinkara were infraorbital, supraorbital foramen, lacrimal, sphenopalatine, maxillary and caudal palatine foramina. The foramina of the cranium of the skull of the Chinkara were the internal acoustic meatus, external acoustic meatus, hypoglossal canal, transverse canal, sphenorbital fissure, carotid canal, foramen magnum, stylomastoid foramen, foramen rotundum, foramen ovale and jugular foramen, and the rostral and the caudal foramina that formed the pterygoid canal. The measured craniometric parameters did not show statistically significant differences (p > 0.05) between male and female adult Chinkara except Palatine bone, OI, DO, IOCDE, OCT, ICW, IPCW, and PCPL were significantly higher (p > 0.05) in male than female Chinkara and mean values of the mandibular parameters except b and h were significantly (p < 0.5) higher in male Chinkara than female Chinkara. Sexual dimorphism exists in some of the orbital and foramen magnum parameters, while high levels of sexual dimorphism identified in mandible. In conclusion, morphocraniometric studies of Chinkara skull made it possible to identify species-specific skull and use clinical measurements during practical application.

Keywords: Chinkara, skull, morphology, morphometrics, sexual dimorphism

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Authors: C. Han, H. Kim, S. Park

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The purpose of the present study is to analyze the effect of surface roughness on fatigue life of SCM440 steel. Two groups of specimens were made from SCM440 steel with and without surface polished after forging process and resulted in different values of surface roughness. The difference of the surface roughness between two groups was clearly distinguished even to the naked eye. Surface roughness of both groups of the specimens was quantitatively measured by a roughness measuring device, Talysurf series2 (Taylor-Hobson Co., USA). Average roughness (Ra) and maximum roughness depth (Rmax) values were obtained by scanning 45 mm with a speed of 0.25 mm/s. Fatigue tests were conducted using a three-point bending method with a cyclic sinusoidal profile of 5 Hz, stress ratio of R = 0.1 and reference life for fatigue limit of 1 × 106 cycles. Ra and Rmax without surface polished were 10.497 ± 1.721 μm and 87.936 ± 16.210 μm, respectively while those values with surface polished were much smaller (ongoing measurements). Fatigue lives of the surface-polished specimens achieved approximately 1 × 106 cycles under the maximum stress of 900 MPa, which was 10 times longer than those of the surface-untreated specimens with an average roughness of 10.082 μm. The results showed that an increase in surface roughness values led to a decrease in fatigue lives.

Keywords: surface roughness, fatigue test, fatigue life, SCM440 steel

Procedia PDF Downloads 353

Authors: Malik Sajjad Mehmood, Aisha Ali, Hamna Khan, Tariq Yasin, Masroor Ikram

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Ultra-high molecular weight polyethylene (UHMWPE) is one of the polymers belongs to polyethylene (PE) family having monomer –CH2– and average molecular weight is approximately 3-6 million g/mol. Due its chemical, mechanical, physical and biocompatible properties, it has been extensively used in the field of electrical insulation, medicine, orthopedic, microelectronics, engineering, chemistry and the food industry etc. In order to alter/modify the properties of UHMWPE for particular application of interest, certain various procedures are in practice e.g. treating the material with high energy irradiations like gamma ray, e-beam, and ion bombardment. Radiation treatment of UHMWPE induces free radicals within its matrix, and these free radicals are the precursors of chain scission, chain accumulation, formation of double bonds, molecular emission, crosslinking etc. All the aforementioned physical and chemical processes are mainly responsible for the modification of polymers properties to use them in any particular application of our interest e.g. to fabricate LEDs, optical sensors, antireflective coatings, polymeric optical fibers, and most importantly for radiation dosimetry applications. It is therefore, to check the feasibility of using UHMWPE for radiation dosimetery applications, the compressed sheets of UHMWPE were irradiated at room temperature (~25°C) for total dose values of 30 kGy and 100 kGy, respectively while one were kept un-irradiated as reference. Transmittance data (from 400 nm to 800 nm) of e-beam irradiated UHMWPE and its hybrids were measured by using Muller matrix spectro-polarimeter. As a result significant changes occur in the absorption behavior of irradiated samples. To analyze these (radiation induced) changes in polymer matrix Urbach edge method and modified Tauc’s equation has been used. The results reveal that optical activation energy decreases with irradiation. The values of activation energies are 2.85 meV, 2.48 meV, and 2.40 meV for control, 30 kGy, and 100 kGy samples, respectively. Direct and indirect energy band gaps were also found to decrease with irradiation due to variation of C=C unsaturation in clusters. We believe that the reported results would open new horizons for radiation dosimetery applications.

Keywords: electron beam, radiation dosimetry, Tauc’s equation, UHMWPE, Urbach method

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Authors: Olajide Emmanuel Adedeji, Olufunke O. Ezekiel

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Moringa seed (20%) was incorporated into ogi (80%) at different stages in the flow line of ogi flour. Functional, pasting and L*a*b* colour characteristics of the samples were determined using standard methods. Loose and packed bulk densities ranged from 0.32 to 0.39 g/cm3 and 0.57 to 0.70 g/cm3 respectively. 100% ogi flour had the lowest values in both parameters. Water absorption and swelling capacities of the samples ranged from 0.89 to 1.80 ml/g and from 5.81 to 6.99 respectively. Pasting viscosity ranged from 870.33 RVU to 4660.67 RVU with the sample produced through the incorporation of full fat moringa seed flour during souring stage and 100% ogi flour having the least and highest values respectively. Stage of moringa seed inclusion also had effect on the trough, breakdown and final viscosity of the samples. The range of values obtained for these pasting parameters were 599.33-2940.00 RVU, 271.00-1720.67 RVU and 840.00-5451.67 RVU respectively. There was no significant difference (p≥ 0.05) in L*(a measure of whiteness) among the co fermented, blend of ogi and full fat moringa flours, blend of ogi and defatted moringa flour and 100% ogi flour samples. Low values were recorded for these samples in a* (measure of redness), b* (measure of yellowness) and colour intensity.

Keywords: stage of inclusion, functional property, ogi, moringa seed

Procedia PDF Downloads 487

Authors: Siddharth Jain, Abhenil Mittal, Surendra Kumar Sharma

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Background: With its recent emergence and re-emergence, dengue has become a major international public health concern, imposing significant financial burden especially in developing countries. Despite aggressive control measures in place, India experienced one of its largest outbreaks in 2015 with Delhi being most severely affected. There is a lack of reliable predictors of disease severity and mortality in dengue. The present study was carried out to identify these predictors during the 2015 outbreak. Methods: This prospective observational study conducted at an apex tertiary care center in Delhi, India included confirmed adult dengue patients admitted between August-November 2015. Patient demographics, clinical details, and laboratory findings were recorded in a predesigned proforma. Appropriate statistical tests were used to summarize and compare the clinical and laboratory characteristics and derive predictors of mortality and severe disease, while developing a clinical risk score for mortality. Serotype analysis was also done for 75 representative samples to identify the dominant serotypes. Results: Data of 369 patients were analyzed (mean age 30.9 years; 67% males). Of these, 198 (54%) patients had dengue fever, 125 (34%) had dengue hemorrhagic fever (DHF Grade 1,2)and 46 (12%) developed dengue shock syndrome (DSS). Twenty two (6%) patients died. Late presentation to the hospital (≥5 days after onset) and dyspnoea at rest were identified as independent predictors of severe disease. Age ≥ 24 years, dyspnoea at rest and altered sensorium were identified as independent predictors of mortality. A clinical risk score was developed (12*age + 14*sensorium + 10*dyspnoea) which, if ≥ 22, predicted mortality with a high sensitivity (81.8%) and specificity (79.2%). The predominant serotypes in Delhi (2015) were DENV-2 and DENV-4. Conclusion: Age ≥ 24 years, dyspnoea at rest and altered sensorium were identified as independent predictors of mortality. Platelet counts did not determine the outcome in dengue patients. Timely referral/access to health care is important. Development and use of validated predictors of disease severity and simple clinical risk scores, which can be applied in all healthcare settings, can help minimize mortality and morbidity, especially in resource limited settings.

Keywords: dengue, mortality, predictors, severity

Procedia PDF Downloads 307

Authors: Vesile Unver, Tulay Basak, Hatice Ayhan, Ilknur Cinar, Emine Iyigun, Nuran Tosun

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The aim of this study is to analyze the effects of the hybrid simulation. In this simulation, types standardized patients and task trainers are employed simultaneously. For instance, in order to teach the IV activities standardized patients and IV arm models are used. The study was designed as a quasi-experimental research. Before the implementation an ethical permission was taken from the local ethical commission and administrative permission was granted from the nursing school. The universe of the study included second-grade nursing students (n=77). The participants were selected through simple random sample technique and total of 39 nursing students were included. The views of the participants were collected through a feedback form with 12 items. The form was developed by the authors and “Patient intervention self-confidence/competence scale”. Participants reported advantages of the hybrid simulation practice. Such advantages include the following: developing connections between the simulated scenario and real life situations in clinical conditions; recognition of the need for learning more about clinical practice. They all stated that the implementation was very useful for them. They also added three major gains; improvement of critical thinking skills (94.7%) and the skill of making decisions (97.3%); and feeling as if a nurse (92.1%). In regard to the mean scores of the participants in the patient intervention self-confidence/competence scale, it was found that the total mean score for the scale was 75.23±7.76. The findings obtained in the study suggest that the hybrid simulation has positive effects on the integration of theoretical and practical activities before clinical activities for the nursing students.

Keywords: hybrid simulation, clinical practice, nursing education, nursing students

Procedia PDF Downloads 290

Authors: Mei Xuan Tan, Eng Ying Bong

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Academic discussion during and after instructional teaching is an integral part of learning. Such discussion between the instructor and student or peer-to-peer discussion can be in several different forms. It could be face-to-face discussion, via email and use of online discussion forum. In this study, the effectiveness of using WhatsApp for academic discussion for a first year half-credit Chemistry course was examined. This study was run over two years with two different batches of students. Participation in the study was voluntary and student volunteers were recruited within the first week of the term. The activity in the WhatsApp group was monitored by two instructors teaching the course. At the end of the course, the students participated in an online survey to evaluate their experience of using WhatsApp for academic discussion. There were a total of 26 questions. The survey had a total of 4 sections with regards to the use of WhatsApp for academic discussion: 1) Familiarity with WhatsApp, 2) Effectiveness of using WhatsApp for discussion, 3) Challenges and 4) Overall experience. The main purpose of using an IM platform for academic discussion was to encourage after-class discussion amongst the students. 32% of the participants had used other online platform, such as Piazza and forums in Learning Management System (LMS), for after-class academic discussion with their instructors and peers. This was a low percentage considering that some courses use such online platform as their main forum amongst instructors and students. At the end of our study, over 83% of the participants felt that WhatsApp was a more effective platform compared to other online forum. One interesting finding was the effect of WhatsApp discussion on face-to-face interaction with instructors. 28% of the students agreed that the use of WhatsApp as a discussion forum had encouraged them to approach their instructors during or after class. 51% of students answered neutral. This could be interpreted that the use of WhatsApp had not affected the frequent (or lack of) face-to-face interaction with their instructors. A second survey question, similar but phrased differently from the first, was also asked to evaluate the aspect of face-to-face interaction with instructors. 34% disagreed that the use of WhatsApp had reduced the frequency of face-to-face interaction. This could imply that the frequency remained the same or might have increased. The 38% who agreed to a decrease in face-to-face interaction have either asked the questions in WhatsApp or had their questions answered by a query from another student in the group chat. These outcomes suggested that the use of technology aided and complemented face-to-face interaction between instructors and students. The study also looked at the challenges of using WhatsApp for academic discussion. Some challenges included difficulty in referring back to previous discussion and students finding some discussions irrelevant to them. In conclusion, the use of IM platform for academic discussion was desirable for the students, but it should not be the only channel as face-to-face consultation and online forum for lengthy discussion are still important for after-class learning of students.

Keywords: chemistry, pedogogy, technological tools, undergraduate

Procedia PDF Downloads 136

Authors: S. J. Yune, S. Y. Lee, S. J. Im, B. S. Kam, S. Y. Baek

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This study aimed to determine the reliability of clinical performance assessments, having been emphasized by ability-based education, and professors overall assessment methods. We addressed the following problems: First, we try to find out whether there is a difference in what we consider to be the main variables affecting the clinical performance test according to the evaluator’s working period and the number of evaluation experience. Second, we examined the relationship among the global rating score (G), analytic global rating score (Gc), and the sum of the analytical checklists (C). What are the main factors affecting clinical performance assessments in relation to the numbers of times the evaluator had administered evaluations and the length of their working period service? What is the relationship between overall assessment score and analytic checklist score? How does analytic global rating with 6 components in OSCE and 4 components in sub-domains (Gc) CPX: aseptic practice, precision, systemic approach, proficiency, successfulness, and attitude overall assessment score and task-specific analytic checklist score sum (C) affect the professor’s overall global rating assessment score (G)? We studied 75 professors who attended a 2016 Bugyeoung Consortium clinical skills performances test evaluating third and fourth year medical students at the Pusan National University Medical school in South Korea (39 prof. in OSCE, 36 prof. in CPX; all consented to participate in our study). Each evaluator used 3 forms; a task-specific analytic checklist, subsequent analytic global rating scale with sub-6 domains, and overall global scale. After the evaluation, the professors responded to the questionnaire on the important factors of clinical performance assessment. The data were analyzed by frequency analysis, correlation analysis, and hierarchical regression analysis using SPSS 21.0. Their understanding of overall assessment was analyzed by dividing the subjects into groups based on experiences. As a result, they considered ‘precision’ most important in overall OSCE assessment, and ‘precise accuracy physical examination’, ‘systemic approaches to taking patient history’, and ‘diagnostic skill capability’ in overall CPX assessment. For OSCE, there was no clear difference of opinion about the main factors, but there was for CPX. Analytic global rating scale score, overall rating scale score, and analytic checklist score had meaningful mutual correlations. According to the regression analysis results, task-specific checklist score sum had the greatest effect on overall global rating. professors regarded task-specific analytic checklist total score sum as best reflecting overall OSCE test score, followed by aseptic practice, precision, systemic approach, proficiency, successfulness, and attitude on a subsequent analytic global rating scale. For CPX, subsequent analytic global rating scale score, overall global rating scale score, and task-specific checklist score had meaningful mutual correlations. These findings support explanations for validity of professors’ global rating in clinical performance assessment.

Keywords: global rating, clinical performance assessment, medical education, analytic checklist

Procedia PDF Downloads 235