Search results for: clinical profile

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

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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

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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

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Authors: Amel Hannech, Mehdi Adda, Hamid Mcheick

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In this paper, we propose a generic model of user profile integrating several elements that may positively impact the research process. We exploit the classical behavior of users and integrate a delimitation process of their research activities into several research sessions enriched with contextual and temporal information, which allows reflecting the current interests of these users in every period of time and infer data freshness. We argue that the annotation of resources gives more transparency on users' needs. It also strengthens social links among resources and users, and can so increase the scope of the user profile. Based on this idea, we integrate the social tagging practice in order to exploit the social users' behavior to enrich their profiles. These profiles are then integrated into a recommendation system in order to predict the interesting personalized items of users allowing to assist them in their researches and further enrich their profiles. In this recommendation, we provide users new research experiences.

Keywords: user profiles, topical ontology, contextual information, folksonomies, tags' clusters, data freshness, association rules, data recommendation

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Authors: Ian McCulloh, Andrew Placona, Darren Stewart, Daniel Gause, Kevin Kiernan, Morgan Stuart, Christopher Zinner, Laura Cartwright

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An estimated 22-25% of viable deceased donor kidneys are discarded every year in the US, while waitlisted candidates are dying every day. As many as 85% of transplanted organs are refused at least once for a patient that scored higher on the match list. There are hundreds of clinical variables involved in making a clinical transplant decision and there is rarely an ideal match. Decision makers exhibit an optimism bias where they may refuse an organ offer assuming a better match is imminent. We propose a semi-parametric Cox proportional hazard model, augmented by an accelerated failure time model based on patient specific suitable organ supply and demand to estimate a time-to-next-offer. Performance is assessed with Cox-Snell residuals and decision curve analysis, demonstrating improved decision support for up to a 5-year outlook. Providing clinical decision makers with quantitative evidence of likely patient outcomes (e.g., time to next offer and the mortality associated with waiting) may improve decisions and reduce optimism bias, thus reducing discarded organs and matching more patients on the waitlist.

Keywords: decision science, KDPI, optimism bias, organ transplant

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Authors: Soon Young Choi, Chan Hwan Kim, Chan Hong Park, Hyung Rae Kim, Myoung Hoon Lee, Hyeon-Yeong Park

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We performed the marine magnetic, bathymetry and seismic survey at the TA22 seamount (in the Lau basin, SW Pacific) for finding the submarine hydrothermal deposits in October 2009. We acquired magnetic and bathymetry data sets by suing Overhouser Proton Magnetometer SeaSPY (Marine Magnetics Co.), Multi-beam Echo Sounder EM120 (Kongsberg Co.). We conducted the data processing to obtain detailed seabed topography, magnetic anomaly, reduction to the pole (RTP) and magnetization. Based on the magnetic properties result, we analyzed submarine geology structure of TA22 seamount with post-processed seismic profile. The detailed bathymetry of the TA22 seamount showed the left and right crest parts that have caldera features in each crest central part. The magnetic anomaly distribution of the TA22 seamount regionally displayed high magnetic anomalies in northern part and the low magnetic anomalies in southern part around the caldera features. The RTP magnetic anomaly distribution of the TA22 seamount presented commonly high magnetic anomalies in the each caldera central part. Also, it represented strong anomalies at the inside of caldera rather than outside flank of the caldera. The magnetization distribution of the TA22 seamount showed the low magnetization zone in the center of each caldera, high magnetization zone in the southern and northern east part. From analyzed the seismic profile map, The TA22 seamount area is showed for the inferred small mounds inside each caldera central part and it assumes to make possibility of sills by the magma in cases of the right caldera. Taking into account all results of this study (bathymetry, magnetic anomaly, RTP, magnetization, seismic profile) with rock samples at the left caldera area in 2009 survey, we suppose the possibility of hydrothermal deposits at mounds in each caldera central part and at outside flank of the caldera representing the low magnetization zone. We expect to have the better results by combined modeling from this study data with the other geological data (ex. detailed gravity, 3D seismic, petrologic study results and etc).

Keywords: detailed bathymetry, magnetic anomaly, seamounts, seismic profile, SW Pacific

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Authors: C. E. Chinma, S. O. Azeez, J. C. Anuonye, O. B. Ocheme, C. M. Yakubu, S. James, E. U. Ohuoba, I. A. Baba

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There is growing interest in the use of rice bran protein in food formulation due to its hypoallergenic protein, high nutritional value and health promoting potentials. For the first time, the amino acid profile, protein digestibility, antioxidant, and functional properties of protein concentrate from some local varieties of rice bran from Nigeria were studied for possible food applications. Protein concentrates were prepared from rice bran and analysed using standard methods. Results showed that protein content of Kwandala, Yardass, Jeep, and Jamila were 69.24%, 69.97%, 68.73%, and 71.62%, respectively while total essential amino acid were 52.71, 53.03, 51.86, and 55.75g/100g protein, respectively. In vitro protein digestibility of protein concentrate from Kwandala, Yardass, Jeep and Jamila were 90.70%, 91.39%, 90.57% and 91.63% respectively. DPPH radical inhibition of protein from Kwandala, Yardass, Jeep, and Jamila were 48.15%, 48.90%, 47.56%, and 53.29%, respectively while ferric reducing ability power were 0.52, 0.55, 0.47 and 0.67mmol TE per gram, respectively. Protein concentrate from Jamila had higher onset (92.57oC) and denaturation temperature (102.13oC), and enthalpy (0.72J/g) than Jeep (91.46oC, 101.76oC, and 0.68J/g, respectively), Kwandala (90.32oC, 100.54oC and 0.57J/g, respectively), and Yardass (88.94oC, 99.45oC, and 0.51J/g, respectively). In vitro digestibility of protein from Kwandala, Yardas, Jeep, and Jamila were 90.70%, 91.39%, 90.57% and 91.63% respectively. Oil absorption capacity of Kwandala, Yardass, Jeep, and Jamila were 3.61, 3.73, 3.40, and 4.23g oil/g sample respectively, while water absorption capacity were 4.19, 4.32, 3.55 and 4.48g water/g sample, respectively. Protein concentrates had low bulk density (0.37-0.43g/ml). Protein concentrate from Jamila rice bran had the highest foam capacity (37.25%), followed by Yardass (34.20%), Kwandala (30.14%) and Jeep (28.90%). Protein concentrates showed low emulsifying and gelling capacities. In conclusion, protein concentrate prepared from these local rice bran varieties could serve as functional ingredients in food formulations and for enriching low protein foods.

Keywords: rice bran protein, amino acid profile, protein digestibility, antioxidant and functional properties

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Authors: M. Testa, L. Peotta, S. Giusiano, B. Lazzolino, U. Manera, A. Canosa, M. Grassano, F. Palumbo, A. Bombaci, S. Cabras, F. Di Pede, L. Solero, E. Matteoni, C. Moglia, A. Calvo, A. Chio

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Amyotrophic Lateral Sclerosis (ALS) is a neurodegenerative disease of adulthood, which primarily affects the central nervous system and is characterized by progressive bilateral degeneration of motor neurons. The degeneration processes in ALS extend far beyond the neurons of the motor system, and affects cognition, behaviour and language. To outline the prevalence of language deficits in an ALS cohort and explore their profile along with demographic and neuropsychological data. A full neuropsychological battery and language assessment was administered to 56 ALS patients. Neuropsychological assessment included tests of executive functioning, verbal fluency, social cognition and memory. Language was assessed using tests for verbal comprehension, production and pragmatics. Patients were cognitively classified following the Revised Consensus Criteria and divided in three groups showing different levels of language deficits: group 1 - no language deficit; group 2 - one language deficit; group 3 - two or more language deficits. Chi-square for independence and non-parametric measures to compare groups were applied. Nearly half of ALS-CN patients (48%) reported one language test under the clinical cut-off, and only 13% of patents classified as ALS-CI showed no language deficits, while the rest 87% of ALS-CI reported two or more language deficits. ALS-BI and ALS-CBI cases all reported two or more language deficits. Deficits in production and in comprehension appeared more frequent in ALS-CI patients (p=0.011, p=0.003 respectively), with a higher percentage of comprehension deficits (83%). Nearly all ALS-CI reported at least one deficit in pragmatic abilities (96%) and all ALS-BI and ALS-CBI patients showed pragmatic deficits. Males showed higher percentage of pragmatic deficits (97%, p=0.007). No significant differences in language deficits have been found between bulbar and spinal onset. Months from onset and level of impairment at testing (ALS-FRS total score) were not significantly different between levels and type of language impairment. Age and education were significantly higher for cases showing no deficits in comprehension and pragmatics and in the group showing no language deficits. Comparing performances at neuropsychological tests among the three levels of language deficits, no significant differences in neuropsychological performances were found between group 1 and 2; compared to group 1, group 3 appeared to decay specifically on executive testing, verbal/visuospatial learning, and social cognition. Compared to group 2, group 3 showed worse performances specifically in tests of working memory and attention. Language deficits have found to be spread in our sample, encompassing verbal comprehension, production and pragmatics. Our study reveals that also cognitive intact patients (ALS-CN) showed at least one language deficit in 48% of cases. Pragmatic domain is the most compromised (84% of the total sample), present in nearly all ALS-CI (96%), likely due to the influence of executive impairment. Lower age and higher education seem to preserve comprehension, pragmatics and presence of language deficits. Finally, executive functions, verbal/visuospatial learning and social cognition differentiate the group with no language deficits from the group with a clinical language impairment (group 3), while attention and working memory differentiate the group with one language deficit from the clinical impaired group.

Keywords: amyotrophic lateral sclerosis, language assessment, neuropsychological assessment, language deficit

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Authors: Showkat Ahmad Bhat, Iqra Reyaz, Falaque ul Afshan, Ahmad Arif Reshi, Muneeb U. Rehman, Manzoor R. Mir, Sabhiya Majid, Sonallah, Sheikh Bilal, Ishraq Hussain

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Background: Gastric cancer is the fourth most common cancer and the second leading cause of worldwide cancer-related deaths, with a wide variation in incidence rates across different geographical areas. The current view of cancer is that a malignancy arises from a transformation of the genetic material of a normal cell, followed by successive mutations and by chain of alterations in genes such as DNA repair genes, oncogenes, Tumor suppressor genes. Minerals are necessary for the functioning of several transcriptional factors, proteins that recognize certain DNA sequences and have been found to play a role in gastric cancer. Material Methods:The present work was a case control study and its aim was to ascertain the role of minerals and promoter hypermethylation of CpG islands of DAP-K gene in Gastric cancer patients among the Kashmiri population. Serum was extracted from all the samples and mineral estimation was done by AAS from serum, DNA was also extracted and was modified using bisulphite modification kit. Methylation-specific PCR was used for the analysis of the promoter hypermethylation status of DAP-K gene. The epigenetic analysis revealed that unlike other high risk regions, Kashmiri population has a different promoter hypermethylation profile of DAP-K gene and has different mineral profile. Results: In our study mean serum copper levels were significantly different for the two genders (p<0.05), while as no significant differences were observed for iron and zinc levels. In Methylation-specific PCR the methylation status of the promoter region of DAP-K gene was as 67.50% (27/40) of the gastric cancer tissues showed methylated DAP-K promoter and 32.50% (13/40) of the cases however showed unmethylated DAP-K promoter. Almost all 85% (17/20) of the histopathologically confirmed normal tissues showed unmethylated DAP-K promoter except only in 3 cases where DAP-K promoter was found to be methylated. The association of promoter hypermethylation with gastric cancer was evaluated by χ2 (Chi square) test and was found to be significant (P=0.0006). Occurrence of DAP-K methylation was found to be unequally distributed in males and females with more frequency in males than in females but the difference was not statistically significant (P =0.7635, Odds ratio=1.368 and 95% C.I=0.4197 to 4.456). When the frequency of DAP-K promoter methylation was compared with clinical staging of the disease, DAP-K promoter methylation was found to be certainly higher in Stage III/IV (85.71%) compared to Stage I/ II (57.69%) but the difference was not statistically significant (P =0.0673). These results suggest that DAP-K aberrant promoter hypermethylation in Kashmiri population contributes to the process of carcinogenesis in Gastric cancer and is reportedly one of the commonest epigenetic changes in the development of Gastric cancer.

Keywords: gastric cancer, minerals, AAS, hypermethylation, CpG islands, DAP-K gene

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Authors: M. R. Ahmad, I. Musirin, M. M. Othman, N. A. Rahmat

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Plug-in Hybrid-Electric Vehicle (PHEV) has gained immense popularity in recent years. PHEV offers numerous advantages compared to the conventional internal-combustion engine (ICE) vehicle. Millions of PHEVs are estimated to be on the road in the USA by 2020. Uncoordinated PHEV charging is believed to cause severe impacts to the power grid; i.e. feeders, lines and transformers overload and voltage drop. Nevertheless, improper PHEV data model used in such studies may cause the findings of their works is in appropriated. Although smart charging is more attractive to researchers in recent years, its implementation is not yet attainable on the street due to its requirement for physical infrastructure readiness and technology advancement. As the first step, it is finest to study the impact of charging PHEV based on real vehicle travel data from National Household Travel Survey (NHTS) and at present charging rate. Due to the lack of charging station on the street at the moment, charging PHEV at home is the best option and has been considered in this work. This paper proposed a technique that comprehensively presents the impact of charging PHEV on power system networks considering huge numbers of PHEV samples with its traveling data pattern. Vehicles Charging Load Profile (VCLP) is developed and implemented in IEEE 30-bus test system that represents a portion of American Electric Power System (Midwestern US). Normalization technique is used to correspond to real time loads at all buses. Results from the study indicated that charging PHEV using opportunity charging will have significant impacts on power system networks, especially whereas bigger battery capacity (kWh) is used as well as for higher penetration level.

Keywords: plug-in hybrid electric vehicle, transportation electrification, impact of charging PHEV, electricity demand profile, load profile

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Authors: Beghdadi Lotfi, Belkacem Abdellah

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In this work, a numerical method is proposed in order to solve the thermal performance problems of heat transfer of fins surfaces. The bidimensional temperature distribution on the longitudinal section of the fin is calculated by restoring to the finite volumes method. The heat flux dissipated by a generic profile fin is compared with the heat flux removed by the rectangular profile fin with the same length and volume. In this study, it is shown that a finite volume method for quadrilaterals unstructured mesh is developed to predict the two dimensional steady-state solutions of conduction equation, in order to determine the sinusoidal parameter values which optimize the fin effectiveness. In this scheme, based on the integration around the polygonal control volume, the derivatives of conduction equation must be converted into closed line integrals using same formulation of the Stokes theorem. The numerical results show good agreement with analytical results. To demonstrate the accuracy of the method, the absolute and root-mean square errors versus the grid size are examined quantitatively.

Keywords: Stokes theorem, unstructured grid, heat transfer, complex geometry

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Authors: Asma A. Parlin, K. Nakamura, N. Watanabe, T. Komai

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Understanding the effective diffusion of benzene vapor in the soil-atmosphere interface is important as an intrusion of benzene into the atmosphere from the soil is largely driven by diffusion. To analyze the vertical one dimensional effective diffusion of benzene vapor in porous medium with high water content, diffusion experiments were conducted in soil columns using Andosol soil and Toyoura silica sand with different water content; for soil water content was from 0 to 30 wt.% and for sand it was from 0.06 to 10 wt.%. In soil, a linear relation was found between water content and effective diffusion coefficient while the effective diffusion coefficient didn’t change in the sand with increasing water. A numerical transport model following unsteady-state approaches based on Fick’s second law was used to match the required time for a steady state of the gas phase concentration profile of benzene to the experimentally measured concentration profile gas phase in the column. The result highlighted that both the water content and porosity might increase vertical diffusion of benzene vapor in soil.

Keywords: benzene vapor-phase, effective diffusion, subsurface soil medium, unsteady state

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Authors: Reini S. Ilmiaty, Muhammad B. Al Amin, Sarino, Muzamil Jariski

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Kedukan River is an artificial river which serves as a Watershed Boang drainage channel in Palembang. The river has upstream and downstream connected to Musi River, that often overflowing and flooding caused by the huge runoff discharge and high tide water level of Musi River. This study aimed to analyze the flood water surface profile on Kedukan River continued with flood inundation simulation to determine flooding prone areas in research area. The analysis starts from the peak runoff discharge calculations using rational method followed by water surface profile analysis using HEC-RAS program controlled by manual calculations using standard stages. The analysis followed by running flood inundation simulation using ArcGIS program that has been integrated with HEC-GeoRAS. Flood inundation simulation on Kedukan River creates inundation characteristic maps with depth, area, and circumference of inundation as the parameters. The inundation maps are very useful in providing an overview of flood prone areas in Kedukan River.

Keywords: flood modelling, HEC-GeoRAS, HEC-RAS, inundation map

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Authors: Essia Sebai, Amel Abidi, Hayet benyeddem, Akkari Hafidh

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Herbal extracts are of particular interest to the drug industry; essential oil with significant anthelmintic activity has the potential to be used as an alternative to conventional chemical drugs. In the present study, we describe the chemical profile of Laurus nobilis essential oil (EO), the in vitro anthelmintic activity of laurel oil against Haemonchus contortus and its in vivo anthelmintic effect against the murine helminth parasite model Heligmosomoides polygyrus. The chromatographic profile of L. nobilis (EO) extracted from the leaves of L. nobilis has shown the presence of monoterpenes 1,8-cineol (Eucalyptol) (29.47%), D-Limonène (18.51%) and Linalool (10.84%) in high fractions. The in vitro anthelmintic potential was expressed by an ovicidal effect against H. contortus egg hatching with an inhibition value of 3.23 mg/mL and 87.5% of immobility of adult worms after 8 hours of exposure to 8 mg/mL of L. nobilis EO. Regarding the in vivo anthelmintic potential, L. nobilis (EO) at 2400 mg/kg completely eliminated the egg output of H. polygyrus after seven days of oral treatment, together with a 79.2% of reduction in total worm counts. Based on the obtained funding, L. nobilis EO showed promising in vitro and in vivo anthelmintic capacities against gastrointestinal parasites.

Keywords: lauris nobilis, anthelmintic, haemonchus, pylogyrus

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Authors: Shi-xia Xu, Zai-wen Zhang, Ru-xue Chen, Shan Zhou, Xiang-feng Tang

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Objective: The clinical influence of HLA-DPB1 mismatches on clinical outcome of HSCT is less clear. This is the first meta-analysis to study the HLA-DPB1 matching statues on clinical outcomes after unrelated donor HSCT. Methods: We searched the CIBMTR, Cochrane Central Register of Controlled Trials (CENTRAL) and related databases (1995.01–2017.06) for all relevant articles. Comparative studies were used to investigate the HLA-DPB1 loci mismatches on clinical outcomes after unrelated donor HSCT, such as the disease-free survival (DFS), overall survival, GVHD, relapse, and transplant-related mortality (TRM). We performed meta-analysis using Review Manager 5.2 software and funnel plot to assess the bias. Results: At first, 1246 articles were retrieved, and 18 studies totaling 26368 patients analyzed. Pooled comparisons of studies found that the HLA-DPB1 mismatched group had a lower rate of DFS than the DPB1-matched group, and lower OS in non-T cell depleted transplantation. The DPB1 mismatched group has a higher incidence of aGVHD and more severe ( ≥ III degree) aGvHD, lower rate of relapse and higher TRM. Moreover, compared with 1-antigen mismatch, 2-antigen mismatched led to a higher risk of TRM and lower relapse rate. Conclusions: This meta-analysis indicated HLA-DPB1 has important influence on survival and transplant-related complications during unrelated donor HSCT and HLA-DPB1 donor selection strategies have been proposed based on a personalized algorithm.

Keywords: human leukocyte antigen, DPB1, transplant, meta-analysis, outcome

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Authors: Abbasali Abouei Mehrizi, Hao Wang

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The thin film region is so important in heat transfer process due to its low thermal resistance. On the other hand, the dynamic contact angle is crucial boundary condition in numerical simulations. While different modeling contains different assumption of the microscopic contact angle, none of them has experimental evidence for their assumption, and the contact line movement mechanism still remains vague. The experimental investigation in complete wetting is more popular than partial wetting, especially in nanoscale resolution when there is sharp variation in thin film profile in partial wetting. In the present study, an experimental investigation of water film morphology near the triple phase contact line during the condensation is performed. The state-of-the-art tapping-mode atomic force microscopy (TM-AFM) was used to get the high-resolution film profile goes down to 2 nm from the contact line. The droplet was put in saturated chamber. The pristine silicon wafer was used as a smooth substrate. The substrate was heated by PI film heater. So the chamber would be over saturated by droplet evaporation. By turning off the heater, water vapor gradually started condensing on the droplet and the droplet advanced. The advancing speed was less than 20 nm/s. The dominant results indicate that in contrast to nonvolatile liquid, the film profile goes down straightly to the surface till 2 nm from the substrate. However, small bending has been observed below 20 nm, occasionally. So, it can be claimed that for the low condensation rate the microscopic contact angle equals to the optically detectable macroscopic contact angle. This result can be used to simplify the heat transfer modeling in partial wetting. The experimental result of the equality of microscopic and macroscopic contact angle can be used as a solid evidence for using this boundary condition in numerical simulation.

Keywords: advancing, condensation, microscopic contact angle, partial wetting

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Authors: P. Sathyathas, H. M. I. S. W. Herath, T. Amalraj, U. J. M. A. L. Jayasinghe

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Over two thirds of medical radiation can now be attributed to Computed Tomography (CT). There is little information on amount of radiation received from multiphase CT scan of abdomen- pelvic region in clinical practice. We sought to estimate the radiation dose and associated exposure parameters in the multiphase abdomen - pelvic scan of Multideteror Computed Tomography (MDCT) studies in clinical practice. This was a retrospective cross sectional studies describing radiation dose associated with main exposure parameters in diagnostic multiphase abdomen - pelvic scans performed on 152 consecutive patients by two different sixteen slice CT scanners. Patient information, exposure parameters of CTDI (volume), DLP, kVp, mAs and pitch were recorded for every phases of abdomen- a pelvic study from dose report of MDCT scanners (MDCTs). Age of patients range from 14 years to 87 years in both MDCT scanners. Overall CTDI (volume) median was 63.8 (±10.4) mGy for a multiphase abdominal-pelvic scan with scanner A while it was 35.4 (±15.6) mGy for scanner B. Patients' effective dose for multiphase abdomen - pelvic CT scan range from 8.2 mSv to 58 mSv. Median effective dose for patients, who underwent multiphase abdomen- pelvis scan with scanner A and B were 38.5 (± 8.2) mSv and 21.3 (± 8.6) mSv respectively. Median value of exposure parameters of mAs, kVp and pitch, were 150 (±29.7), 130 (±15.3) and 1.3 (±0.1) respectively in scanner A. In scanner B; they were 60 (±14.5), 120 and 1. The median effective dose for patients between multiphase abdomen-pelvic scan of both MDCT, a significant different (P<0.05) was observed. Multiphase abdomen – pelvic scan of clinical study shows significant different of effective dose with reference level of phantom studies (8-14mSv) and it depends on the type of vendors.

Keywords: abdomen-pelvic region, computed tomography, exposure parameters, radiation dose

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Authors: H. K. Sachidananda, K. Raghunandana, B. Shivamurthy

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The estimation of gear tooth stiffness is important for finding the load distribution between the gear teeth when two consecutive sets of teeth are in contact. Based on dynamic model a C-program has been developed to compute mesh stiffness. By using this program position dependent mesh stiffness of spur gear tooth for various profile shifts have been computed for a fixed center distance and altering tooth-sum gearing (100 by ± 4%). It is found that the C-program using dynamic model is one of the rapid soft computing technique which helps in design of gears. The mesh tooth stiffness along the path of contact is studied for both 20° and 25° pressure angle gears at various profile shifts. Better tooth stiffness is noticed in case of negative alteration tooth-sum gears compared to standard and positive alteration tooth-sum gears. Also, in case of negative alteration tooth-sum gearing better mesh stiffness is noticed in 20° pressure angle when compared to 25°.

Keywords: altered tooth-sum gearing, bending fatigue, mesh stiffness, spur gear

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Authors: Kyoko Ito, Shinya Furuta, Daisuke Kamihigashi, Kimi Ueda, Hirotake Ishii, Hiroshi Shimoda, Fumiaki Obayashi, Kazuhiro Taniguchi

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In order to improve intellectual concentration, few studies have verified the effect of indoor airflow among the thermal environment conditions, and the differences of the season in effects have not been studied. In this study, in order to investigate the influence of the airflow in winter on the intellectual concentration, an evaluation experiment was conducted. In the previous study, an effective airflow in summer was proposed and the improvement of intellectual concentration by evaluation experiment was confirmed. Therefore, an airflow profile in winter was proposed with reference to the airflow profile in summer. The airflows are a combination of a simulative airflow and mild airflow. An experiment has been conducted to investigate the influence of a room airflow in winter on intellectual concentration. As a result of comparison with no airflow condition, no significant difference was found. Based on the results, it is a future task to ask preliminary preference in advance and to establish a mechanism that can provide controllable airflow for each individual, taking into account the preference for airflow to be different for each individual.

Keywords: concentration time ratio, CTR, indoor airflow, intellectual concentration, workplace environment

Procedia PDF Downloads 227

Authors: Sepehr Moradi

Abstract:

The physical and mechanical property parameters, inter-relation of key dimensional and distribution profile of raw Australia Superfine Merino Wool (ASFW) and Inner Mongolia Cashmere (IMC) fibres have been studied. The relationship between the properties of these fibres is assessed using fit transformation functions obtained through correlation coefficient analysis. ASFW and IMC fibre properties are found to be both positively skewed and asymmetric in nature. Whilst fibre diameter varies along its length and both ends have a tapering shape. The basic physical features, namely linear density, true local diameter, true length and breaking load are positively correlated while their tenacity is negatively correlated. The tenacity and true length follow a second order polynomial while the true local diameter is linearly correlated. Assessment of the diameter and length is sufficient to estimate the evaluation of quality for commercial grade ASFW and IMC fibres.

Keywords: Australia Superfine Merino Wool fibre, Inner Mongolia Cashmere fibre, distribution profile, physical properties

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Authors: Meity Sompie, Agnes Triasih, Wisje Ponto

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Edible coating is thin layers that act as a barrier to the external factors and protect the food products. The addition of the plasticizer to the edible coating is required to overcome film caused by extensive intermolecular forces. The potential development of pigskin with different ages as a raw material for the manufacture of edible films had not been widely publicized. This research was aimed to determine the influence of gelatin concentration and different type of plasticizer on the edible coating characteristics extracted from pigskin gelatin. This study used Completely Randomized Design (CRD) with two factors and three replicates of treatments. The first factor was consisted of pigskin gelatin concentration ( 10, 20, and 30 %) and the second factor was different type of plasticizer (glycerol, sorbitol and PEG). The results show that the interaction between the use of gelatin concentrations and type of plasticizer had significant effect (P< 0.05) on the thickness, tensile strength, elongation, water vapor transmission rate (WVTR), water content and amino acid profile of edible coating. It was concluded that the edible coating from pigskin gelatin with plasticizer gliserol had the best film characteristics, and it can be applied as an edible coating.

Keywords: edible coating, edible film, pigskin gelatin, plasticizer

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Authors: Hamza Ikhlaq, Stephen Franks

Abstract:

Background: Polycystic ovarian syndrome (PCOS) is one of the most common endocrine disorders affecting women of reproductive age. The aetiology behind PCOS is poorly understood but influencing ethnic, environmental, and genetic factors have been recognised. However, literature examining the impact of ethnicity is scarce. We hypothesised Body Mass Index (BMI) and ethnicity influence the clinical, metabolic, and biochemical presentations of PCOS, with an interaction between these factors. Methods: A database of 1081 women with PCOS and a control group of 72 women were analysed. BMIs were grouped using the World Health Organisation classification into normal weight, overweight and obese groups. Ethnicities were classified into European, South Asian, and Afro-Caribbean groups. Biochemical and clinical presentations were compared amongst these groups, and statistical analyses were performed to assess significance. Results: This study revealed ethnicity significantly influences biochemical and clinical presentations of PCOS. A greater proportion of South Asian women are impacted by menstrual cycle disturbances and hirsutism than European and Afro-Caribbean women. South Asian and Afro-Caribbean women show greater measures of insulin resistance and weight gain when compared to their European peers. Women with increased BMI are shown to have an increased prevalence of PCOS phenotypes alongside increased levels of insulin resistance and testosterone. Furthermore, significantly different relationships between the waist-hip ratio and measures of insulin and glucose control for Afro-Caribbean women were identified compared to other ethnic groups. Conclusions: The findings of this study show ethnicity significantly influence the phenotypic and biochemical presentations of PCOS, with an interaction between body habitus and ethnicity found. Furthermore, we provide further data on the influences of BMI on the manifestations of PCOS. Therefore, we highlight the need to consider these factors when reviewing diagnostic criteria and delivering clinical care for these groups.

Keywords: PCOS, ethnicity, BMI, clinical

Procedia PDF Downloads 96

Authors: Swati Kishor Zode, Rahul Ambekar

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Data mining is the extraction of fascinating examples on the other hand information from enormous measure of information and choice is made as indicated by the applicable information extracted. As of late, with the dangerous advancement in internet, stockpiling of information and handling procedures, privacy preservation has been one of the major (higher) concerns in data mining. Various techniques and methods have been produced for protection saving data mining. In the situation of Clinical Decision Support System, the choice is to be made on the premise of the data separated from the remote servers by means of Internet to diagnose the patient. In this paper, the fundamental thought is to build the precision of Decision Support System for multiple diseases for different maladies and in addition protect persistent information while correspondence between Clinician side (Client side) also, the Server side. A privacy preserving protocol for clinical decision support network is proposed so that patients information dependably stay scrambled amid diagnose prepare by looking after the accuracy. To enhance the precision of Decision Support System for various malady C5.0 classifiers and to save security, a Homomorphism encryption algorithm Paillier cryptosystem is being utilized.

Keywords: classification, homomorphic encryption, clinical decision support, privacy

Procedia PDF Downloads 322

Authors: Mehmet Bulent Ozdemir, Sultan Çagirici, Sahika Pinar Akyer, Fikri Turk

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Neuroanatomical appearance can be correlated with clinical or other characteristics of illness. With the introduction of diagnostic imaging machines, producing 3D images of anatomic structures, calculating the correlation between subjects and pattern of the structures have become possible. The aim of this study is to examine the 3D structure of hippocampus in cases with Alzheimer disease in different dementia severity. For this purpose, 62 female and 38 male- 68 patients’s (age range between 52 and 88) MR scanning were imported to the computer. 3D model of each right and left hippocampus were developed by a computer aided propramme-Surf Driver 3.5. Every reconstruction was taken by the same investigator. There were different apperance of hippocampus from normal to abnormal. In conclusion, These results might improve the understanding of the correlation between the morphological changes in hippocampus and clinical staging in Alzheimer disease.

Keywords: Alzheimer disease, hippocampus, computer-assisted anatomy, 3D

Procedia PDF Downloads 470

Authors: Marlin Mubarak

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Background: Endometriosis is a complex disabling disease affecting young females in the reproductive period mainly. The aim of this project is to generate a diagnostic model to predict severity and stage of endometriosis prior to Laparoscopic surgery. This will help to improve the pre-operative diagnostic accuracy of stage 3 & 4 endometriosis and as a result, refer relevant women to a specialist centre for complex Laparoscopic surgery. The model is based on the British Society of Gynaecological Endoscopy (BSGE) pain questionnaire, clinical examination and ultrasound scan. Design: This is a prospective, observational, study, in which women completed the BSGE pain questionnaire, a BSGE requirement. Also, as part of the routine preoperative assessment patient had a routine ultrasound scan and when recto-vaginal and deep infiltrating endometriosis was suspected an MRI was performed. Setting: Luton & Dunstable University Hospital. Patients: Symptomatic women (n = 56) scheduled for laparoscopy due to pelvic pain. The age ranged between 17 – 52 years of age (mean 33.8 years, SD 8.7 years). Interventions: None outside the recognised and established endometriosis centre protocol set up by BSGE. Main Outcome Measure(s): Sensitivity and specificity of endometriosis diagnosis predicted by symptoms based on BSGE pain questionnaire, clinical examinations and imaging. Findings: The prevalence of diagnosed endometriosis was calculated to be 76.8% and the prevalence of advanced stage was 55.4%. Deep infiltrating endometriosis in various locations was diagnosed in 32/56 women (57.1%) and some had DIE involving several locations. Logistic regression analysis was performed on 36 clinical variables to create a simple clinical prediction model. After creating the scoring system using variables with P < 0.05, the model was applied to the whole dataset. The sensitivity was 83.87% and specificity 96%. The positive likelihood ratio was 20.97 and the negative likelihood ratio was 0.17, indicating that the model has a good predictive value and could be useful in predicting advanced stage endometriosis. Conclusions: This is a hypothesis-generating project with one operator, but future proposed research would provide validation of the model and establish its usefulness in the general setting. Predictive tools based on such model could help organise the appropriate investigation in clinical practice, reduce risks associated with surgery and improve outcome. It could be of value for future research to standardise the assessment of women presenting with pelvic pain. The model needs further testing in a general setting to assess if the initial results are reproducible.

Keywords: deep endometriosis, endometriosis, minimally invasive, MRI, ultrasound.

Procedia PDF Downloads 339

Authors: Kobus-Cisowska Joanna, Flaczyk Ewa, Gramza-Michalowska Anna, Kmiecik Dominik, Przeor Monika, Marcinkowska Agata, Korczak Józef

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The object of this study was to develop recipes and technology of production of functional bread with morus alba fruit addition. There were prepared four samples of functional breads and the control sample also. Bread recipe was designed for supporting the treatment of anemia, diabetes, obesity and cardiovascular diseases. Samples of bread were baked with mixes directly after preparation and after three months' storage, each time preparing the water and methanol extracts. The sensory analysis and nutritional value were estimated. The antioxidant activity were estimated used tests such as the ability to scavenge free radical DPPH, the ability to scavenge the ABTS cation, chelating properties and the total content of polyphenols. The study results showed that the prepared sample of functional breads were characterized by a high nutritional value with high concentration of biologically active compounds which showed antioxidant activity. In addition, the profile sensory of bread samples was highly rated. However, to determine whether they can be considered as a new product preset pro-health properties require additional nutritional studies - clinical trials.

Keywords: functional food, breads, white mulberry, bioactive components

Procedia PDF Downloads 291

Authors: Paria Baharvand, Mohammad Reza Abbasi, Soha Namazi

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Introduction: Uremic pruritus (UP) is one of the major complaints in hemodialysis patients. The aim of this randomized clinical trial study was the evaluation of the anti-pruritus effect of Melatonin on hemodialysis patients with UP. Methods: This multi-centered double, blinded randomized clinical trial study was conducted on hemodialysis patients with UP that referred to the dialysis department of Imam Khomeini Hospital, Labbafinezhad Hospital and Ghiasi Hospital in Tehran, Iran, in 2018. Forty participants were enrolled and block randomization was performed by using a randomized list and divided into 2 groups of twenty patients. Evaluation of the 12-Item Pruritus Severity Scale (12-PSS), Visual analog scale (VAS), and Calculation of the affected body surface area for pruritus extent (BSA %) was performed every week. The Melatonin group received a 10 mg soft gel capsule, and the placebo group received a soft gel capsule placebo after dinner. For statistical analysis used by SPSS version 21(IRCT20180714040462N1). Results: 38 hemodialysis patients enrolled in this study. The mean age in the placebo group and in the Melatonin group was 55.88 ± 11.70 and 54.52 ± 13.00 years (p> 0.05). Also, 46% of all participants were female. Aspartate transaminase, alanine transaminase and C-reactive protein have significant differences between the two groups (p< 0.05). VAS score reduction in the two groups had a statistically significant (CI 95% = -1.71, P= 0.015(.The results of BSA% showed Melatonin had a significant effect on the decrease of the pruritus extent compared to placebo (CI 95% = -22.82, P= 0.001(. Conclusion: According to the results of this study and the preliminary effects of Melatonin on uremic pruritus, we suggest performing advanced clinical trials studies.

Keywords: Melatonin, Uremic Pruritus, hemodialysis, anti-pruritus

Procedia PDF Downloads 66

Authors: Ezedin Geta Seid

Abstract:

Slope failures are among the common geo-environmental natural hazards in the hilly and mountainous terrain of the world causing damages to human life and destruction of infrastructures. In Ethiopia, the demand for the construction of infrastructures, especially highways and railways, has increased to connect the developmental centers. However, the failure of roadside slopes formed due to the difficulty of geographical locations is the major difficulty for this development. As a result, a comprehensive site-specific investigation of destabilizing agents and a suitable selection of slope profiles are needed during design. Hence, this study emphasized the stability analysis and performance evaluation of slope profiles (single slope, multi-slope, and benched slope). The analysis was conducted for static and dynamic loading conditions using limit equilibrium (slide software) and finite element method (Praxis software). The analysis results in selected critical sections show that the slope is marginally stable, with FS varying from 1.2 to 1.5 in static conditions, and unstable with FS below 1 in dynamic conditions. From the comparison of analysis methods, the finite element method provides more valuable information about the failure surface of a slope than limit equilibrium analysis. Performance evaluation of geometric profiles shows that geometric modification provides better and more economical slope stability. Benching provides significant stability for cut slopes (i.e., the use of 2m and 3m bench improves the factor of safety by 7.5% and 12% from a single slope profile). The method is more effective on steep slopes. Similarly, the use of a multi-slope profile improves the stability of the slope in stratified soil with varied strength. The performance is more significant when it is used in combination with benches. The study also recommends drainage control and slope reinforcement as a remedial measure for cut slopes.

Keywords: slope failure, slope profile, bench slope, multi slope

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Authors: Zahra Salehi Shahrbabaki, Zahra Chavoshzadeh, Fahimeh Abdollahimajd, Samin Sharafian, Tolue Mahdavi, Mahnaz Jamee

Abstract:

Background: Inborn errors of immunity (IEIs) are monogenic diseases of the immune the system with broad clinical manifestations. Despite the increasing genetic advancements, the diagnosis of IEIs still leans on clinical diagnosis. Dermatologic manifestations are observed in a large number of IEI patients and can lead to proper approach, prompt intervention and improved prognosis. Methods: This cross-sectional study was carried out between 2018 and 2020 on IEIs at a Children's tertiary care center in Tehran, Iran. Demographic details (including age, sex, and parental consanguinity), age at onset of symptoms and family history of IEI with were recorded. Results :212 patients were included. Cutaneous findings were reported in (95 ,44.8%) patients. and 61 of 95 (64.2%) reported skin lesions as the first clinical presentation. Skin infection (69, 72.6%) was the most frequent cutaneous manifestation, followed by an eczematous rash (24, 25 %). Conclusions: Skin manifestations are common feature in IEI patients and can be readily recognizable by healthcare providers. This study tried to provide information on prognostic consequences.

Keywords: primary immuno deficiency, inborn errror of metabolism, skin manifestation, skin infection

Procedia PDF Downloads 83

Authors: Ali Asghar Memon

Abstract:

The simulation modeling of switched reluctance (SR) machine often relies and uses the three data tables identified as static torque characteristics that include flux linkage characteristics, co energy characteristics and static torque characteristics separately. It has been noticed from the literature that the data of static torque used in the simulation model is often calculated so far the literature is concerned. This paper presents the simulation model that include the data of measured and calculated static torque separately to see its effect on instantaneous torque profile of the machine. This is probably for the first time so far the literature review is concerned that static torque from co energy information, and measured static torque directly from experiments are separately used in the model. This research is helpful for accurate modeling of switched reluctance drive.

Keywords: static characteristics, current chopping, flux linkage characteristics, switched reluctance motor

Procedia PDF Downloads 282