Search results for: fiscal reaction function

Authors: Yi Xiong, Tao Kong

Abstract:

Traditional safety, risk and reliability analysis approaches are problem-oriented, which make it great workload when analyzing complicated and huge system, besides, too much repetitive work would to do if the analyzed system composed by many similar components. It is pressing need an object and function oriented approach to maintain high consistency with problem domain. A new approach is proposed to overcome these shortcomings of traditional approaches, the concepts: class, abstract, inheritance, polymorphism and encapsulation are introduced into FTA and establish the professional class library that the abstractions of physical objects in real word, four areas relevant information also be proposed as the establish help guide. The interaction between classes is completed by the inside or external methods that mapping the attributes to base events through fully search the knowledge base, which forms good encapsulation. The object oriented fault tree analysis system that analyze and evaluate the system safety and reliability according to the original appearance of the problem is set up, where could mapped directly from the class and object to the problem domain of the fault tree analysis. All the system failure situations can be analyzed through this bottom-up fault tree construction approach. Under this approach architecture, FTA approach is developed, which avoids the human influence of the analyst on analysis results. It reveals the inherent safety problems of analyzed system itself and provides a new way of thinking and development for safety analysis. So that object oriented technology in the field of safety applications and development, safety theory is conducive to innovation.

Keywords: FTA, knowledge base, object-oriented technology, reliability analysis

Procedia PDF Downloads 251

Authors: Nuralam Sam, Irawan Yusuf, Irfan Idris, Endi Adnan

Abstract:

The most case in the shoulder in the the adult is the frozen shoulder. It make an uncomfortable sensation which disturbance daily activity. The studies of frozen shoulder are still limited. This study used a true experimental pre and post test design with a group design. The participant underwent dextrose prolotherapy injection in the rotator cuff, intraarticular glenohumeral joint, long head tendon biceps, and acromioclavicular joint injections with 15% dextrose, respectively, at week 2, week 4, and week 6. Participants were followed for 12 weeks. The specific biomarker MMP and TIMP, ROM, DASH score were measured at baseline, at week 6, and week 12. The data were analyzed by multivariate analysis (repeated measurement ANOVA, Paired T-Test, and Wilcoxon) to determine the effect of the intervention. The result showed a significant decrease in The Disability of the Arm, Shoulder, and Hand (DASH) score in prolo injection patients in each measurement week (p < 0.05). While the measurement of Range of Motion (ROM), each direction of shoulder motion showed a significant difference in average each week, from week 0 to week 6 (p <0.05).Dextrose prolotherapy injection results give a significant improvement in functional outcome of the shoulder joint, and ROMand did not show significant results in assessing the specific biomarker, MMP-1, and TIMP-1 in tissue repair. This study suggestion an alternative to the use of injection prolotherapy in Frozen shoulder patients, which has fewer side effects and better effectiveness than the use of corticosteroid injections.

Keywords: frozen shoulder, ROM, DASH score, prolotherapy, MMP-1, TIMP-1

Procedia PDF Downloads 122

Authors: Marine Kobalava, Eter Narimanishvili, Nino Grigolaia

Abstract:

The paper analyzes the contemporary problems of public relations in Georgia. The approaches to public attitudes towards the relationship with the population of the country are studied on a global scale, the importance of forming the concept of public relations in Georgia in terms of globalization is justified. The basic components of public relations are characterized by the RACE system, namely analyzing research, action, communication, evaluation. The main challenges of public relations are identified in the research process; taking into consideration the scope of globalization, the influence of social, economic, and political changes in Georgia on PR development are identified. The article discusses the public relations as the strategic management function that facilitates communication with the society, recognition of public interests, and their prediction. In addition, the feminization of the sector is considered to be the most important achievement of public relations in the modern world. The conclusion is that the feminization indicator of the field is an unconditional increase in the employment rates of women. In the paper, the problems of globalization and public relations in the industrial countries are studied, the directions of improvement of public relations with the background of peculiarities of different countries and globalization process are proposed. Public relations under globalization are assessed in accordance with the theory of benefits and requirements, and the requirements are classified according to informational, self-identification, integration, social interaction, and other types of signs. In the article, conclusions on the current challenges of public relations in Georgia are made, and the recommendations for their solution, taking into consideration globalization processes in the world, are proposed.

Keywords: public relations, globalization, RACE system, public relationship concept, feminization

Procedia PDF Downloads 177

Authors: Shyam Sunder Gupta

Abstract:

GOD is an infinite source of knowledge. From time to time, as per the need of mankind, GOD keeps revealing, some small, selected part of HIS knowledge as WORDS, to a chosen entity whose responsibility is to function as Messenger and share WORDS, in the form of verses, with common masses. GOD has confirmed that Messenger may not understand every WORD revealed to him, and HE directs Messenger to learn from persons who have knowledge of WORDS revealed in earlier times, as some revealed content is identical and some different by design. In due course of time, Verses, as communicated orally, are collected, and edited by an individual in a planned manner or by a group of individuals and get edited unintentionally and converted in the form of Scripture. Whatever gets collected, depending on the knowledge of the Editor(s), some errors, scientific and other forms, get into Scripture. In the present world, there are three major religions: Christianity, Islam and Hinduism, accounting for more than two-thirds of the world’s population. Each of the religions has its own Scripture, namely the Bible, Quran, and Veda. Since the source of WORDS for each of these Scriptures is the same, there is ONENESS of all Scriptures. There are amazing similarities between the events described, like the flood during the time of Noah and King Satyavara. The description of the creation of man and woman is identical. Description of Last Day, categorization of human beings, identical names, etc., have remarkable similarities. Ram, the hero of Ramayana, is a common name in Hinduism and two of Jesus’ ancestors’ names were Ram and many names in the Bible are derived from Ram. Attributes of GOD are common in all Scriptures, namely, GOD is Eternal, Unborn, Immortal, Creator of Universe(s) and everything that exists within the Universe, Omnipotent, Omnipresent, Omniscient, Subtlest of all, Unchangeable, Unique, Always Works, Source of Eternal Bliss, etc. There is the Oneness of GOD.

Keywords: GOD, scriptures, oneness, WORDS, Jesus, Ram

Procedia PDF Downloads 68

Authors: Makhlouf Sandy, Adem Ziad, Taher Fadia, Magnier Sylvie

Abstract:

The electronic structure of 90ZrS has been investigated using Ab-initio methods based on Complete Active Space Self Consistent Field and Multi-reference Configuration Interaction (CASSCF/MRCI). The number of predicted states has been extended to 14 singlet and 12 triplet lowest-lying states situated below 36000cm-1. The equilibrium energies of these 26 lowest-lying electronic states have been calculated in the 2S+1Λ(±) representation. The potential energy curves have been plotted in function of the inter-nuclear distances in a range of 1.5 to 4.5Å. Spectroscopic constants, permanent electric dipole moments and transition dipole moments between the different electronic states have also been determined. A discrepancy error of utmost 5% for the majority of values shows a good agreement with available experimental data. The ground state is found to be of symmetry X1Σ+ with an equilibrium inter-nuclear distance Re= 2.16Å. However, the (1)3Δ is the closest state to X1Σ+ and is situated at 514 cm-1. To the best of our knowledge, this is the first time that the spin-orbit coupling has been investigated for all the predicted states of ZrS. 52 electronic components in the Ω(±) representation have been predicted. The energies of these components, the spectroscopic constants ωe, ωeχe, βe and the equilibrium inter-nuclear distances have been also obtained. The percentage composition of the Ω state wave-functions in terms of S-Λ states was calculated to identify their corresponding main parents. These (SOC) calculations have determined the shift between (1)3Δ1 and X1Σ+ states and confirmed the ground state type being 1Σ+.

Keywords: CASSCF/MRCI, electronic structure, spin-orbit effect, zirconium monosulfide

Procedia PDF Downloads 169

Authors: S. Mamoucha, J. Rahul, N. Christodoulakis

Abstract:

Introduction: Nature has been the source of medicinal agents since the dawn of the human existence on Earth. Currently, millions of people, in the developing world, rely on medicinal plants for primary health care, income generation and lifespan improvement. In Greece, more than 5500 plant taxa are reported while about 250 of them are considered to be of great pharmaceutical importance. Among the plants used for medical purposes, Vitex agnus-castus L. (Verbenaceae) is known since ancient times. It is a small tree or shrub, widely distributed in the Mediterranean basin up to the Central Asia. It is also known as chaste tree or monks pepper. Theophrastus mentioned the shrub several times, as ‘agnos’ in his ‘Enquiry into Plants’. Dioscorides mentioned the use of V. agnus-castus for the stimulation of lactation in nursing mothers and the treatment of several female disorders. The plant has important medicinal properties and a long tradition in folk medicine as an antimicrobial, diuretic, digestive and insecticidal agent. Materials and methods: Leaves were cleaned, detached, fixed, sectioned and investigated with light and Scanning Electron Microscopy (SEM). Histochemical tests were executed as well. Specific histochemical reagents (osmium tetroxide, H2SO4, vanillin/HCl, antimony trichloride, Wagner’ s reagent, Dittmar’ s reagent, potassium bichromate, nitroso reaction, ferric chloride and di methoxy benzaldehyde) were used for the sub cellular localization of secondary metabolites. Results: Light microscopical investigations of the elongated leaves of V. agnus-castus revealed three layers of palisade parenchyma, just below the single layered adaxial epidermis. The spongy parenchyma is rather loose. Adaxial epidermal cells are larger in magnitude, compared to those of the abaxial epidermis. Four different types of capitate, secreting trichomes, were localized among the abaxial epidermal cells. Stomata were observed at the abaxial epidermis as well. SEM revealed the interesting arrangement of trichomes. Histochemical treatment on fresh and plastic embedded tissue sections revealed the nature and the sites of secondary metabolites accumulation (flavonoids, steroids, terpenes). Acknowledgment: This work was supported by IKY - State Scholarship Foundation, Athens, Greece.

Keywords: Vitex agnus-castus, leaf anatomy, histochemical reagents, secondary metabolites

Procedia PDF Downloads 388

Authors: Y. Mateyshina, A.Ulihin, N.Uvarov

Abstract:

Electrolytes with different type of charge carrier can find widely application in different using, e.g. sensors, electrochemical equipments, batteries and others. One of important components ensuring stable functioning of the equipment is electrolyte. Electrolyte has to be characterized by high conductivity, thermal stability, and wide electrochemical window. In addition to many advantageous characteristic for liquid electrolytes, the solid state electrolytes have good mechanical stability, wide working range of temperature range. Thus search of new system of solid electrolytes with high conductivity is an actual task of solid state chemistry. Families of alkali perchlorates and nitrates have been investigated by us earlier. In literature data about transport properties of alkali nitrites are absent. Nevertheless, alkali nitrites MeNO2 (Me= Li+, Na+, K+, Rb+ and Cs+), except for the lithium salt, have high-temperature phases with crystal structure of the NaCl-type. High-temperature phases of nitrites are orientationally disordered, i.e. non-spherical anions are reoriented over several equivalents directions in the crystal lattice. Pure lithium nitrite LiNO2 is characterized by ionic conductivity near 10-4 S/cm at 180°C and more stable as compared with lithium nitrate and can be used as a component for synthesis of composite electrolytes. In this work composite solid electrolytes in the binary system LiNO2 - A (A= MgO, -Al2O3, Fe2O3, CeO2, SnO2, SiO2) were synthesized and their structural, thermodynamic and electrical properties investigated. Alkali nitrite was obtained by exchange reaction from water solutions of barium nitrite and alkali sulfate. The synthesized salt was characterized by X-ray powder diffraction technique using D8 Advance X-Ray Diffractometer with Cu K radiation. Using thermal analysis, the temperatures of dehydration and thermal decomposition of salt were determined.. The conductivity was measured using a two electrode scheme in a forevacuum (6.7 Pa) with an HP 4284A (Precision LCR meter) in a frequency range 20 Hz < ν < 1 MHz. Solid composite electrolytes LiNO2 - A A (A= MgO, -Al2O3, Fe2O3, CeO2, SnO2, SiO2) have been synthesized by mixing of preliminary dehydrated components followed by sintering at 250°C. In the series of nitrite of alkaline metals Li+-Cs+, the conductivity varies not monotonically with increasing radius of cation. The minimum conductivity is observed for KNO2; however, with further increase in the radius of cation in the series, the conductivity tends to increase. The work was supported by the Russian Foundation for Basic research, grant #14-03-31442.

Keywords: conductivity, alkali nitrites, composite electrolytes, transport properties

Procedia PDF Downloads 325

Authors: Chang-Hwan Oh, Young-Jong Lee

Abstract:

In April, 2015, the Ministry of Food and Drug Safety’s announcement that only 10 of the 207 products that list Cynanchum Wilfordii Radix among their ingredients were confirmed to actually contain “iyeobupiso” the counterfeit version of the “baeksuo” raised a fog to consumers who purchased health/functional foods supposedly containing the herbal medicinal material, “baeksuo” in Korean. Baeksuo is the main ingredient of the product “EstroG-100” that contain Phlomis umbrosa and Angelica gigas too (NaturalEndoTech, S.Korea). The hot water extract of the herbal medicinal materials (HMM) was approved as a product specific Health/Functional Food (HFF) having a helpful function to women reaching menopause by Korea Food & Drug Administration (Ministry of Food & Drug Safety at present). The origin of “baeksuo” is the root of Cynanchum wilfordii Hemsley in Korea (But “iyeobupiso, the root of Cynanchum auriculatum Royle ex Wight is considered as the origin of “baeksuo” in China). In Korea, about 116 HMMs are listed as the food materials in Korea Food Code among the total 187 HMMs could be used for food and medicine purpose simultaneously. But there are some chances of the HMMs (shared use for food and medicine purpose) could be misused by the part and HMMs not permitted for HFF such as the “baeksuo” case. In this study, some of HMMs (shared use for food and medicine purpose) are examined to alleviate the misuse chance of HMMs for HFFs in Korea. For the purpose of this study, the origin, shape, edible parts, efficacy and the side effects of the similar HMMs to be misused for HFF are investigated.

Keywords: herbal medicinal materials, healthy/functional foods, misuse, shared use

Procedia PDF Downloads 297

Authors: Lisa Shambare, Jean Mulopo, Sehliselo Ndlovu

Abstract:

One of the major challenges of sustainable development is promoting an industry which is both ecologically durable and economically viable. This requires processes that are material and energy efficient whilst also being able to limit the production of waste and toxic effluents through effective methods of process synthesis and intensification. In South Africa and globally, both miniaturisation and technological advances have substantially increased the amount of electronic wastes (e-waste) generated annually. Vast amounts of e-waste are being generated yearly with only a minute quantity being recycled officially. The passion for electronic devices cannot ignore the scarcity and cost of mining the noble metal resources which contribute significantly to the efficiency of most electronic devices. It has hence become imperative especially in an African context that sustainable strategies which are environmentally friendly be developed for recycling of the noble metals from e-waste. This paper investigates the recovery of gold, silver and palladium from electronic wastes, which consists of a vast array of metals, using ionic liquids which have the potential of reducing the gaseous and aqueous emissions associated with existing hydrometallurgical and pyrometallurgical technologies while also maintaining the economy of the overall recycling scheme through solvent recovery. The ionic liquids 1-butyl-3-methyl imidazolium hydrogen sulphate (BmimHSO4) which behaves like a protic acid and was used in the present research for the selective leaching of gold and silver from e-waste. Different concentrations of the aqueous ionic liquid were used in the experiments ranging from 10% to 50%. Thiourea was used as the complexing agent in the investigation with Fe3+ as the oxidant. The pH of the reaction was maintained in the range of 0.8 to 1.5. The preliminary investigations conducted were successful in the leaching of silver and palladium at room temperature with optimum results being at 48hrs. The leaching results could not be explained because of the leaching of palladium with the absence of gold. Hence a conclusion could not be drawn and there was the need for further experiments to be run. The leaching of palladium was carried out with hydrogen peroxide as oxidant and 1-butyl-3-methyl imidazolium chloride (BmimCl) as the solvent. The experiments at carried out at a temperature of 60 degrees celsius and a very low pH. The chloride ion was used to complex with palladium metal. From the preliminary results, it could be concluded that pretreatment of the treatment e-waste was necessary to improve the efficiency of the metal recovery process. A conclusion could not be drawn for the leaching experiments.

Keywords: BmimCl, BmimHSO4, gold, palladium, silver

Procedia PDF Downloads 293

Authors: Rosmini Yanti, Safira Aviolita, Marsetio

Abstract:

Indonesia has several straits that are very important as a shipping lane, including the Sunda Strait and the Lombok Strait, which are the part of the Indonesian Archipelagic Sea Lane (IASL). An increase in traffic on the Marine Archipelago makes the task of monitoring sea routes increasingly difficult. Indonesia has proposed the establishment of a Traffic Separation Scheme (TSS) in the Sunda Strait and the Lombok Strait and the country now has the right to be able to conceptualize the TSS as well as the obligation to regulate it. Indonesia has the right to maintain national safety and sovereignty. In setting the TSS, Indonesia needs to issue national regulations that are in accordance with international law and the general provisions of the IMO (International Maritime Organization) can then be used as guidelines for maritime safety and security in the Sunda Strait and the Lombok Strait. The research method used is a qualitative method with the concept of linguistic and visual data collection. The source of the data is the analysis of documents and regulations. The results show that the determination of TSS was justified by International Law, in accordance with article 22, article 41, and article 53 of the United Nations Convention on the Law of the Sea (UNCLOS) 1982. The determination of TSS by the Indonesian government would be in accordance with COLREG (International Convention on Preventing Collisions at Sea) 10, which has been designed to follow IASL. Thus, TSS can provide a function as a safety and monitoring medium to minimize ship accidents or collisions, including the warship and aircraft of other countries that cross the IASL.

Keywords: archipelago state, maritime law, maritime security, traffic separation scheme

Procedia PDF Downloads 133

Authors: Ozan Ozkan, Hilal Turkoglu Sasmazel

Abstract:

Natural polymers are widely used in tissue engineering applications, because of their biocompatibility, biodegradability and solubility in the physiological medium. On the other hand, synthetic polymers are also widely utilized in tissue engineering applications, because they carry no risk of infectious diseases and do not cause immune system reaction. However, the disadvantages of both polymer types block their individual usages as tissue scaffolds efficiently. Therefore, the idea of usage of natural and synthetic polymers together as a single 3D hybrid scaffold which has the advantages of both and the disadvantages of none has been entered to the literature. On the other hand, even though these hybrid structures support the cell adhesion and/or proliferation, various surface modification techniques applied to the surfaces of them to create topographical changes on the surfaces and to obtain reactive functional groups required for the immobilization of biomolecules, especially on the surfaces of synthetic polymers in order to improve cell adhesion and proliferation. In a study presented here, to improve the surface functionality and topography of the layer by layer electrospun 3D poly-epsilon-caprolactone/chitosan/poly-epsilon-caprolactone hybrid tissue scaffolds by using atmospheric pressure plasma method, thus to improve cell adhesion and proliferation of these tissue scaffolds were aimed. The formation/creation of the functional hydroxyl and amine groups and topographical changes on the surfaces of scaffolds were realized by using two different atmospheric pressure plasma systems (nozzle type and dielectric barrier discharge (DBD) type) carried out under different gas medium (air, Ar+O2, Ar+N2). The plasma modification time and distance for the nozzle type plasma system as well as the plasma modification time and the gas flow rate for DBD type plasma system were optimized with monitoring the changes in surface hydrophilicity by using contact angle measurements. The topographical and chemical characterizations of these modified biomaterials’ surfaces were carried out with SEM and ESCA, respectively. The results showed that the atmospheric pressure plasma modifications carried out with both nozzle type plasma and DBD plasma caused topographical and functionality changes on the surfaces of the layer by layer electrospun tissue scaffolds. However, the shelf life studies indicated that the hydrophilicity introduced to the surfaces was mainly because of the functionality changes. Therefore, according to the optimized results, samples treated with nozzle type air plasma modification applied for 9 minutes from a distance of 17 cm and Ar+O2 DBD plasma modification applied for 1 minute under 70 cm3/min O2 flow rate were found to have the highest hydrophilicity compared to pristine samples.

Keywords: biomaterial, chitosan, hybrid, plasma

Procedia PDF Downloads 277

Authors: Shuchi Bharti

Abstract:

This article intends to analyse the transforming nature of state and corporate sector relationship in the light of evolving regulatory and institutional aspects pertaining to Corporate Social Responsibility (CSR) in India. The focus is on evaluating the accounts of law and decentred discourses, relevant within the changing regulatory and institutional paradigm that substantially goes ahead of formal legal control of state towards corporate actors. At this vantage point, it is important to understand the state’s posture towards a changing scenario particularly as the tone is set by regulatory parameters pertaining to CSR to drive process of engagement with the stakeholders. The tripartite framework of the article intends to focus on finding on the vital interconnected aspects of the CSR provisions (Section 135) of The Companies Act 2013 (The Act), rise of new institutions and the emergence of the decentred regulatory space. Thus is earmarked in a neo-liberal paradigm; state is witnessed to perform a responsive function in engendering enhanced public role for the corporate sector. In this overarching framework the aim is to undertake a causal, exploratory and relational analysis of aspects pertaining law, regulation and institutional transformations. Firstly, focus is drawn on to investigate the relational facets of the advent of law and regulatory framework of CSR. Secondly, in the light of the historical evolution, a causal connection is attempted between globalization, emergence of international soft law framework and the Indian case of CSR. Finally, I look into how the new Companies Act mandates CSR expenditure vis- a -vis multiple parameters and guidelines.

Keywords: corporate social responsibility, stakeholders, soft law, decentred regulation

Procedia PDF Downloads 306

Authors: Mia I. Allen, Bernard N. Johnson, Gagan Deep, Yixin Su, Sangeeta Singth, Ashish Kumar, , Michael A. Nader

Abstract:

With no FDA-approved treatments for cocaine use disorders (CUD), research has focused on the behavioral and neuropharmacological effects of cocaine in animal models, with the goal of identifying novel interventions. While the majority of people with CUD also use tobacco/nicotine, the majority of preclinical cocaine research does not include the co-use of nicotine. The present study examined nicotine and cocaine co-use under several conditions of intravenous drug self-administration in monkeys. In Experiment 1, male rhesus monkeys (N=3) self-administered cocaine (0.001-0.1 mg/kg/injection) alone and cocaine+nicotine (0.01-0.03 mg/kg/injection) under a progressive-ratio schedule of reinforcement. When nicotine was added to cocaine, there was a significant leftward shift and significant increase in peak break point. In Experiment 2, socially housed female and male cynomolgus monkeys (N=14) self-administered cocaine under a concurrent drug-vs-food choice schedule. Combining nicotine significantly decreased cocaine choice ED50 values (i.e., shifted the cocaine dose-response curve to the left) in females but not in males. There was no evidence of social rank differences. In delay discounting studies, the co-use of nicotine and cocaine required significantly larger delays to the preferred drug reinforcer to reallocate choice compared with cocaine alone. Overall, these results suggest drug interactions of nicotine and cocaine co-use is not simply a function of potency but rather a fundamentally distinctive condition that should be utilized to better understand the neuropharmacology of CUD and the evaluation of potential treatments.

Keywords: polydrug use, animal models, nonhuman primates, behavioral pharmacology, drug self-administration

Procedia PDF Downloads 90

Authors: Mohammed N. Al Kindi, Mazin Al Khabouri, Khalsa Al Lamki, Tommasso Pappuci, Giovani Romeo, Nadia Al Wardy

Abstract:

Hereditary hearing loss is a heterogeneous group of complex disorders with an overall incidence of one in every five hundred newborns presented as syndromic and non-syndromic forms. Cadherin-related 23 (CDH23) is one of the listed deafness causative genes. CDH23 is found to be expressed in the stereocilia of hair cells and the retina photoreceptor cells. Defective CDH23 has been associated mostly with prelingual severe-to-profound sensorineural hearing loss (SNHL) in either syndromic (USH1D) or non-syndromic SNHL (DFNB12). An Omani family diagnosed clinically with severe-profound sensorineural hearing loss was genetically analysed by whole exome sequencing technique. A novel homozygous missense variant, c.A7451C (p.D2484A), in exon 53 of CDH23 was detected. One hundred and thirty control samples were analysed where all were negative for the detected variant. The variant was analysed in silico for pathogenicity verification using several mutation prediction software. The variant proved to be a pathogenic mutation and is reported for the first time in Oman and worldwide. It is concluded that in silico mutation prediction analysis might be used as a useful molecular diagnostics tool benefiting both genetic counseling and mutation verification. The aspartic acid 2484 alanine missense substitution might be the main disease-causing mutation that damages CDH23 function and could be used as a genetic hearing loss marker for this particular Omani family.

Keywords: Cdh23, d2484a, in silico, Oman

Procedia PDF Downloads 220

Authors: Jiashu Shen

Abstract:

Objectives: Spirometry is a basic reference for health evaluation which is widely used in clinical. Previous reference of spirometry is not applicable because of drastic changes of social and natural circumstance in China. A new reference values for the spirometry of the Chinese population is extremely needed. Method: Spirometric reference value was established using the statistical modeling method Generalized Additive Models for Location, Scale and Shape for forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), FEV1/FVC, and maximal mid-expiratory flow (MMEF). Results: Data from 236,606 healthy non-smokers aged 4–90 years was collected from the MJ Health Check database. Spirometry equations for FEV1, FVC, MMEF, and FEV1/FVC were established, including the predicted values and lower limits of normal (LLNs) by sex. The predictive equations that were developed for the spirometric results elaborated the relationship between spirometry and age, and they eliminated the effects of height as a variable. Most previous predictive equations for Chinese spirometry were significantly overestimated (to be exact, with mean differences of 22.21% in FEV1 and 31.39% in FVC for males, along with differences of 26.93% in FEV1 and 35.76% in FVC for females) or underestimated (with mean differences of -5.81% in MMEF and -14.56% in FEV1/FVC for males, along with a difference of -14.54% in FEV1/FVC for females) the results of lung function measurements as found in this study. Through cross-validation, our equations were established as having good fit, and the means of the measured value and the estimated value were compared, with good results. Conclusions: Our study updates the spirometric reference equations for Chinese people of all ages and provides comprehensive values for both physical examination and clinical diagnosis.

Keywords: Chinese, GAMLSS model, reference values, spirometry

Procedia PDF Downloads 138

Authors: Satoko Fujiwara, Kiyotaka Obunai, Kazuya Okubo

Abstract:

A skew is one of important problems for designing the conveyor and transmission with frictional flat belt, in which running belt is deviated in width direction due to the transverse force applied to the belt. The skew often not only degrades the stability of the path of belt but also causes some damages of the belt and auxiliary machines. However, the transverse behavior such as the skew has not been discussed quantitatively in detail for frictional belts. The objective of this study is to clarify the transverse behavior of frictional flat belt driven by tapered pulley. Commercially available rubber flat belt reinforced by polyamide film was prepared as the test belt where the thickness and length were 1.25 mm and 630 mm, respectively. Test belt was driven between two pulleys made of aluminum alloy, where diameter and inter-axial length were 50 mm and 150 mm, respectively. Some tapered pulleys were applied where tapered angles were 0 deg (for comparison), 2 deg, 4 deg, and 6 deg. In order to alternatively investigate the transverse behavior, the transverse force applied to the belt was measured when the skew was constrained at the string under driving state. The transverse force was measured by a load cell having free rollers contacting on the side surface of the belt when the displacement in the belt width direction was constrained. The conditions of observed bending stiffness in-plane of the belt were changed by preparing three types of belts (the width of the belt was 20, 30, and 40 mm) where their observed stiffnesses were changed. The contributions of the bending stiffness in-plane of belt and initial inter-axial force to the transverse were discussed in experiments. The inter-axial force was also changed by setting a distance (about 240 mm) between the two pulleys. Influence of observed bending stiffness in-plane of the belt and initial inter-axial force on the transverse force were investigated. The experimental results showed that the transverse force was increased with an increase of observed bending stiffness in-plane of the belt and initial inter-axial force. The transverse force acting on the belt running on the tapered pulley was classified into multiple components. Those were components of forces applied with the deflection of the inter-axial force according to the change of taper angle, the resultant force by the bending moment applied on the belt winding around the tapered pulley, and the reaction force applied due to the shearing deformation. The calculation result of the transverse force was almost agreed with experimental data when those components were formulated. It was also shown that the most contribution was specified to be the shearing deformation, regardless of the test conditions. This study found that transverse behavior of frictional flat belt driven by tapered pulley was explained by the summation of those components of forces.

Keywords: skew, frictional flat belt, transverse force, tapered pulley

Procedia PDF Downloads 151

Authors: Ahmed H. Elkholy

Abstract:

An elastic analysis is developed to obtain the distribution of stresses, strains, bending moment and deformation for a thin hollow, variable thickness cylindrical specimen when subjected to different biaxial loadings. The specimen was subjected to a combination of internal pressure, axial tensile loading and external pressure. Several axial to circumferential stress ratios were investigated in detail. The analytical model was then validated using experimental results obtained from a test rig using several biaxial loadings. Based on the preliminary results obtained, the specimen was then modified geometrically to ensure uniform strain distribution through its wall thickness and along its gauge length. The new design of the specimen has a higher buckling strength and a maximum value of equivalent stress according to the maximum distortion energy theory. A cyclic function generator of the standard servo-controlled, electro-hydraulic testing machine is used to generate a specific signal shape (sine, square,…) at a certain frequency. The two independent controllers of the electronic circuit cause an independent movement to each servo-valve piston. The movement of each piston pressurizes the upper and lower sides of the actuators alternately. So, the specimen will be subjected to axial and diametral loads independent of each other. The hydraulic system has two different pressures: one pressure will be responsible for axial stress produced in the specimen and the other will be responsible for the tangential stress. Changing the two pressure ratios will change the stress ratios accordingly. The only restriction on the maximum stress obtained is the capacity of the testing system and specimen instability due to buckling.

Keywords: biaxial, fatigue, stress, testing

Procedia PDF Downloads 133

Authors: B. B. Siswanto, A. Halimi, K. M. H. J. Tandayu, C. Abdillah, F. Nanda , E. Chandra

Abstract:

Nowadays, modern cardiac biomarkers, such as ST2 and NT-proBNP, have important roles in predicting morbidity and mortality in heart failure patients. Abnormalities of serum electrolytes, sepsis or infection, and deteriorating renal function will worsen the conditions of patients with heart failure. It is intriguing to know whether cardiac biomarkers elevations are affected by laboratory findings in heart failure patients. We recruited 65 patients from the heart failure clinic in NCVC Harapan Kita in 2014-2015. All of them have consented for laboratory examination, including cardiac biomarkers. The findings were recorded in our Research and Development Centre and analyzed using linear regression to find whether there is a relationship between laboratory findings (sodium, potassium, creatinine, and leukocytes) and ST2 or NT-proBNP. From 65 patients, 26.9% of them are female, and 73.1% are male, 69.4% patients classified as NYHA I-II and 31.6% as NYHA III-IV. The mean age is 55.7+11.4 years old; mean sodium level is 136.1+6.5 mmol/l; mean potassium level is 4.7+1.9 mmol/l; mean leukocyte count is 9184.7+3622.4 /ul; mean creatinine level is 1.2+0.5 mg/dl. From linear regression logistics, the relationship between NT-proBNP and sodium level (p<0.001), as well as leukocyte count (p=0.002) are significant, while NT-proBNP and potassium level (p=0.05), as well as creatinine level (p=0.534) are not significant. The relationship between ST2 and sodium level (p=0.501), potassium level (p=0.76), leukocyte level (p=0.897), and creatinine level (p=0.817) are not significant. To conclude, laboratory findings are more sensitive in predicting NT-proBNP elevation than ST2 elevation. Larger studies are needed to prove that NT-proBNP correlation with laboratory findings is more superior than ST2.

Keywords: heart failure, laboratory, NT-proBNP, ST2

Procedia PDF Downloads 344

Authors: Jiandong Ren, Lijun Zhao, Peng Chen

Abstract:

Nafamostat (NA), a synthetic broad-spectrum serine protease inhibitor, has been routinely employed for the treatment of acute pancreatitis (AP) and other inflammatory-associated diseases in some East Asia countries. Although the potent inhibitory activity against inflammation-related proteases such as thrombin, trypsin, kallikrein, plasmin, coagulation factors and complement factors is generally considered to be responsible for the anti-inflammatory effects of NA, precise target and molecular mechanism underlying the anti-inflammatory activity in the treatment of AP remain largely unknown yet. As an intracellular inflammatory signaling platform, the NOD-like receptor protein 3 (NLRP3) inflammasome is recently identified to be involved in the development of AP. In present study, we have revealed that NA alleviated pancreatic injury in a caerulein-induced AP model by inhibiting the NLRP3 inflammasome activation in pancreas. Mechanistically, NA interacted with HDAC6, a cytoplasmic deacetylase implicated in the NLRP3 inflammasome pathway, and efficiently abrogated the function of HDAC6. This property enabled NA to influence HDAC6 dependent NF-κB transcriptional activity and thus block NF-κB-driven transcriptional priming of NLRP3 inflammasome. Moreover, NA exerted the potential to interfere HDAC6-mediated intracellular transport of NLRP3, thereby leading to the failure of NLRP3 inflammasome activation. Our current work has provided valuable insight into the molecular mechanism underlying the immunomodulatory effect of NA in treatment of AP, highlighting its promising application in prevention of NLRP3 inflammasome-associated inflammatory pathological damage.

Keywords: acute pancreatitis, HDAC6, nafamostat, NLRP3 inflammasome

Procedia PDF Downloads 76

Authors: Luis Prada, Jose Gomez, Arlex Chaves, Julio Pedraza

Abstract:

Polymeric liquids have been used in the oil industry, especially at enhanced oil recovery (EOR). From the rheological point of view, polymers have the particularity of being viscoelastic liquids. One of the most common and useful models to describe that behavior is the Upper Convected Maxwell model (UCM). The main characteristic of the polymer used in EOR process is the increase in viscosity which pushes the oil outside of the reservoir. The elasticity could contribute in the drag of the oil that stays in the reservoir. Studying the elastic effect on the oil drop at the pore scale, bring an explanation if the addition of elastic force could mobilize the oil. This research explores if the contraction and expansion of the polymer in the pore scale may increase the elastic behavior of this kind of fluid. For that reason, this work simplified the pore geometry and build two simple geometries with micrometer lengths. Using source terms with the user define a function this work introduces the UCM model in the ANSYS fluent simulator with the purpose of evaluating the elastic effect of the polymer in a contraction and expansion geometry. Also, using the Eulerian multiphase model, this research considers the possibility that extra elastic force will show a deformation effect on the oil; for that reason, this work considers an oil drop on the upper wall of the geometry. Finally, all the simulations exhibit that at the pore scale conditions exist extra vortices at UCM model but is not possible to deform the oil completely and push it outside of the restrictions, also this research find the conditions for the oil displacement.

Keywords: ANSYS fluent, interfacial fluids mechanics, polymers, pore scale, viscoelasticity

Procedia PDF Downloads 135

Authors: Abhimanyu Pati, Prabir K. Bandyopadhyay

Abstract:

The paper intends to highlight the significance of Digital Manufacturing (DM) strategy in support and achievement of business strategy and goals of any manufacturing organization. Towards this end, DM initiatives have been given a process perspective, while not undermining its technological significance, with a view to link its benefits directly with fulfilment of customer needs and expectations in a responsive and cost-effective manner. A digital process model has been proposed to categorize digitally enabled organizational processes with a view to create synergistic groups, which adopt and use digital tools having similar characteristics and functionalities. This will throw future opportunities for researchers and developers to create a unified technology environment for integration and orchestration of processes. Secondly, an effort has been made to apply “what” and “how” features of Quality Function Deployment (QFD) framework to establish the relationship between customers’ needs – both for external and internal customers, and the features of various digital processes, which support for the achievement of these customer expectations. The paper finally concludes that in the present highly competitive environment, business organizations cannot thrive to sustain unless they understand the significance of digital strategy and integrate it with their business strategy with a clearly defined implementation roadmap. A process-oriented approach to DM strategy will help business executives and leaders to appreciate its value propositions and its direct link to organization’s competitiveness.

Keywords: knowledge management, cloud computing, knowledge management approaches, cloud-based knowledge management

Procedia PDF Downloads 314

Authors: K. Mondal, S. Talapatra, M. Terrones, S. Pokhrel, C. Frizzel, B. Sumpter, V. Meunier, A. L. Elias

Abstract:

Worldwide energy independence is reliant on the ability to leverage locally available resources for fuel production. Recently, syngas produced through gasification of carbonaceous materials provided a gateway to a host of processes for the production of various chemicals including transportation fuels. The basis of the production of gasoline and diesel-like fuels is the Fischer Tropsch Synthesis (FTS) process: A catalyzed chemical reaction that converts a mixture of carbon monoxide (CO) and hydrogen (H₂) into long chain hydrocarbons. Until now, it has been argued that only transition metal catalysts (usually Co or Fe) are active toward the CO hydrogenation and subsequent chain growth in the presence of hydrogen. In this paper, we demonstrate that carbon nanotube (CNT) surfaces are also capable of hydro-deoxygenating CO and producing long chain hydrocarbons similar to that obtained through the FTS but with orders of magnitude higher conversion efficiencies than the present state-of-the-art FTS catalysts. We have used advanced experimental tools such as XPS and microscopy techniques to characterize CNTs and identify C-O functional groups as the active sites for the enhanced catalytic activity. Furthermore, we have conducted quantum Density Functional Theory (DFT) calculations to confirm that C-O groups (inherent on CNT surfaces) could indeed be catalytically active towards reduction of CO with H₂, and capable of sustaining chain growth. The DFT calculations have shown that the kinetically and thermodynamically feasible route for CO insertion and hydro-deoxygenation are different from that on transition metal catalysts. Experiments on a continuous flow tubular reactor with various nearly metal-free CNTs have been carried out and the products have been analyzed. CNTs functionalized by various methods were evaluated under different conditions. Reactor tests revealed that the hydrogen pre-treatment reduced the activity of the catalysts to negligible levels. Without the pretreatment, the activity for CO conversion as found to be 7 µmol CO/g CNT/s. The O-functionalized samples showed very activities greater than 85 µmol CO/g CNT/s with nearly 100% conversion. Analyses show that CO hydro-deoxygenation occurred at the C-O/O-H functional groups. It was found that while the products were similar to FT products, differences in selectivities were observed which, in turn, was a result of a different catalytic mechanism. These findings now open a new paradigm for CNT-based hydrogenation catalysts and constitute a defining point for obtaining clean, earth abundant, alternative fuels through the use of efficient and renewable catalyst.

Keywords: CNT, CO Hydrodeoxygenation, DFT, liquid fuels, XPS, XTL

Procedia PDF Downloads 351

Authors: Lista Andriyati, Nurpudji A Taslim

Abstract:

The human immunodeficiency virus (HIV) patients have potential nutritional and metabolic problems. HIV is a virus that attacks cells T helper and impairs the function of immune cells. Infected individuals gradually become immunodeficient, results in increased susceptibility to a wide range of infections such as tuberculosis (TB). Malnutrition has destructive effects on the immune system and host defense mechanisms. Effective and proper nutritional therapies are important to improve medical outcomes and quality of life, which is associated with functional improvement. A case of 38-years old man admitted to hospital with loss of consciousness and was diagnosed HIV infection and relapse lung TB with severe malnutrition, fever, oral candidiasis, anemia (6.3 g/dL), severe hypoalbuminemia (1.9 g/dL), severe hypokalemia (2.2 mmol/L), immune depletion (1085 /µL) and elevated liver enzyme (ALT 1198/AST 375 U/L). Nutritional intervention by giving 2300 kcal of energy, protein 2 g/IBW/day, carbohydrate 350 g, fat 104 g through enteral and parenteral nutrition. Supplementations administered are zinc, vitamin A, vitamin B1, vitamin B6, vitamin B12, vitamin C, vitamin D, and snakehead fish extract high content of protein albumin (Pujimin®). After 46 days, there are clinical and metabolic improvement in Hb (6.3 to 11.2 g/dL), potassium (2.2 to 3.4 mmol/L), albumin (1.9 to 2.3 g/dL), ALT 1198 to 47/AST 375 to 68 U/L) and improved awareness. In conclusion, nutritional therapy in HIV infection with adequate macronutrients and micronutrients fulfillment and immunonutrition is very important to avoid cachexia and to improve nutritional status and immune disfunction.

Keywords: HIV, hypoalbuminemia, malnutrition, tuberculosis

Procedia PDF Downloads 134

Authors: Mirjana Ruppel, Rajendra Persad, Amit Bahl, Sanja Dogramadzi, Chris Melhuish, Lyndon Smith

Abstract:

Multimodal image registration is a profoundly complex task which is why deep learning has been used widely to address it in recent years. However, two main challenges remain: Firstly, the lack of ground truth data calls for an unsupervised learning approach, which leads to the second challenge of defining a feasible loss function that can compare two images of different modalities to judge their level of alignment. To avoid this issue altogether we implement a generative adversarial network consisting of two registration networks GAB, GBA and two discrimination networks DA, DB connected by spatial transformation layers. GAB learns to generate a deformation field which registers an image of the modality B to an image of the modality A. To do that, it uses the feedback of the discriminator DB which is learning to judge the quality of alignment of the registered image B. GBA and DA learn a mapping from modality A to modality B. Additionally, a cycle-consistency loss is implemented. For this, both registration networks are employed twice, therefore resulting in images ˆA, ˆB which were registered to ˜B, ˜A which were registered to the initial image pair A, B. Thus the resulting and initial images of the same modality can be easily compared. A dataset of liver CT and MRI was used to evaluate the quality of our approach and to compare it against learning and non-learning based registration algorithms. Our approach leads to dice scores of up to 0.80 ± 0.01 and is therefore comparable to and slightly more successful than algorithms like SimpleElastix and VoxelMorph.

Keywords: cycle consistency, deformable multimodal image registration, deep learning, GAN

Procedia PDF Downloads 138

Authors: Sandeep, A. Joshi, Kamal, Piu Dhibar, Parveen Kumar

Abstract:

In the present work strong ground motion has been simulated using a modified semi-empirical technique (MSET), with frequency dependent radiation pattern model. Joshi et al. (2014) have modified the semi-empirical technique to incorporate the modeling of strong motion generation areas (SMGAs). A frequency dependent radiation pattern model is applied to simulate high frequency ground motion more precisely. Identified SMGAs (Kurahashi and Irikura 2012) of the 2011 Tohoku earthquake (Mw 9.0) were modeled using this modified technique. Records are simulated for both frequency dependent and constant radiation pattern function. Simulated records for both cases are compared with observed records in terms of peak ground acceleration and pseudo acceleration response spectra at different stations. Comparison of simulated and observed records in terms of root mean square error suggests that the method is capable of simulating record which matches in a wide frequency range for this earthquake and bears realistic appearance in terms of shape and strong motion parameters. The results confirm the efficacy and suitability of rupture model defined by five SMGAs for the developed modified technique.

Keywords: strong ground motion, semi-empirical, strong motion generation area, frequency dependent radiation pattern, 2011 Tohoku Earthquake

Procedia PDF Downloads 542

Authors: Omid Khaiyat, David Hawkes

Abstract:

Introduction: There remains a lack of information on sophisticated coordination patterns across shoulder girdle muscles. Considering the stability of the shoulder being heavily dependent on coordinated muscle activity during its wide-ranging movements, it is important that key intermuscular relationships are well-defined for a better understanding of underlying pathology. This study investigated shoulder intermuscular coordination during different planes of shoulder elevation. Materials and Methods: EMG was recorded from 14 shoulder muscles in 20 healthy participants during shoulder flexion, scapula plane elevation, abduction, and extension. Cross-correlation by means of Pearson Correlation Coefficient (PCC) was used to examine the coordination between different muscles and muscle groups. Results: Coordination between rotator cuff and deltoid muscle groups was significantly higher (p =0.020-0.035) during the initial (PCC) = 0.79) and final (PCC = 0.74) phases of elevation compared to the mid-range (PCC = 0.34). Furthermore, a high level of coordination (PCC = 0.89) was noted between the deltoid group and the adductor group (latissimus dorsi and teres major) during the initial stage of shoulder elevation. Conclusion: The destabilising force of the deltoid during the initial stage of shoulder elevation is balanced by coordinated activity of rotator cuff, latissimus dorsi, and teres major. This is also the case for the end-range of movement, where increased demand for stability again leads to higher coordination between the deltoid and rotator cuff muscle groups. Appreciation of the sophistication of normal shoulder function evidence-based rehabilitation strategies for conditions such as subacromial impingement syndrome or shoulder instability can be developed.

Keywords: shoulder, coordination, EMG, muscle activity, upper limb

Procedia PDF Downloads 171

Authors: Christina Van Wingerden

Abstract:

This paper focuses on a sense of belonging, isolation, and the use of a learning management system as a “third space” for connection and community. Given student use of learning management systems (LMS) for courses on campuses, moderate to high use of social media and hand-held devices, the author explores the possibilities of LMS as a third space. The COVID-19 pandemic has exacerbated student experiences of isolation, and research indicates that students who experience a sense of belonging have a greater likelihood for academic retention and success. The impacts on students of an LMS designed for student employee orientation and training were examined through a mixed methods approach, including a survey, individual interviews, and focus groups. The sample involved 250-450 undergraduate student employees at a US northwestern university. The goal of the study was to find out the efficiency and effectiveness of the orientation information for a wide range of student employees from multiple student affairs departments. And unexpected finding emerged within the study in 2015 and was noted again as a finding in the 2017 study. Students reported feeling like they individually connected to the department, and further to the university because of the LMS orientation. They stated they could see themselves as part of the university community and like they belonged. The orientation, through the LMS, was designed for and occurred online (asynchronous), prior to students traveling and beginning university life for the academic year. The students indicated connection and belonging resulting from some of the design features. With the onset of COVID-19 and prolonged sheltering in place in North America, as well as other parts of the world, students have been precluded from physically gathering to educate and learn. COVID-19 essentially paused face-to-face education in 2020. Media, governments, and higher education outlets have been reporting on widespread college student stress, isolation, loneliness, and sadness. In this context, the author conducted a current mixed methods study (online survey, online interviews) of students in advanced degree programs, like Ph.D. and Ed.D. specifically investigating isolation and sense of belonging. As a part of the study a prototype of a Canvas site was experienced by student interviewees for their reaction of this Canvas site prototype as a “third” space. Some preliminary findings of this study are presented. Doctoral students in the study affirmed the potential of LMS as a third space for community and social academic connection.

Keywords: COVID-19, isolation, learning management system, sense of belonging

Procedia PDF Downloads 114

Authors: Dileep Kumar Gupta, Rajendra Prasad, Pradeep Kumar, Varun Narayan Mishra, Ajeet Kumar Vishwakarma, Prashant K. Srivastava

Abstract:

An approach was evaluated for the retrieval of soil moisture of bare soil surface using bistatic scatterometer data in the angular range of 200 to 700 at VV- and HH- polarization. The microwave data was acquired by specially designed X-band (10 GHz) bistatic scatterometer. The linear regression analysis was done between scattering coefficients and soil moisture content to select the suitable incidence angle for retrieval of soil moisture content. The 250 incidence angle was found more suitable. The support vector regression analysis was used to approximate the function described by the input-output relationship between the scattering coefficient and corresponding measured values of the soil moisture content. The performance of support vector regression algorithm was evaluated by comparing the observed and the estimated soil moisture content by statistical performance indices %Bias, root mean squared error (RMSE) and Nash-Sutcliffe Efficiency (NSE). The values of %Bias, root mean squared error (RMSE) and Nash-Sutcliffe Efficiency (NSE) were found 2.9451, 1.0986, and 0.9214, respectively at HH-polarization. At VV- polarization, the values of %Bias, root mean squared error (RMSE) and Nash-Sutcliffe Efficiency (NSE) were found 3.6186, 0.9373, and 0.9428, respectively.

Keywords: bistatic scatterometer, soil moisture, support vector regression, RMSE, %Bias, NSE

Procedia PDF Downloads 430

Authors: Elham Mansouri, Asghar Mesbahi

Abstract:

Purpose: In the current study, we aimed to investigate the macroscopic and microscopic dose enhancement effect of metallic nanoparticles in interstitial brachytherapy of uterus cancer by Iodin-125 source using a nano-lattice model in MCNPX (5) and MCNP6.1 codes. Materials and methods: Based on a nano-lattice simulation model containing a radiation source and a tumor tissue with cellular compartments loaded with 7mg/g spherical nanoparticles (bismuth, gold, and gadolinium), the energy deposited by the secondary electrons in microscopic and macroscopic level was estimated. Results: The results show that the values of macroscopic DEF is higher than microscopic DEF values and the macroscopic DEF values decreases as a function of distance from the brachytherapy source surface. Also, the results revealed a remarkable discrepancy between the DEF and secondary electron spectra calculated by MCNPX (5) and MCNP6.1 codes, which could be justified by the difference in energy cut-off and electron transport algorithms of two codes. Conclusion: According to the both MCNPX (5) and MCNP6.1 outputs, it could be concluded that the presence of metallic nanoparticles in the tumor tissue of uteruscancer increases the physical effectiveness of brachytherapy by I-125 source. The results presented herein give a physical view of radiosensitization potential of different metallic nanoparticles and could be considered in design of analytical and experimental radiosensitization studies in tumor regions using various radiotherapy modalities in the presence of heavy nanomaterials.

Keywords: MCNPX, MCNP6, nanoparticle, brachytherapy

Procedia PDF Downloads 108

Authors: Babu Shersad, Partha Banerjee

Abstract:

Reduction in haemoglobin levels has been implicated to be a cause for reduced exercise tolerance and cardiovascular complications of chronic renal diseases. Trends of hemoglobin levels in patients on haemodialysis could be an indicator of efficacy of hemodialysis and an indicator of quality of life in haemodialysis patients. In the UAE, the rate of growth (of patients on dialysis) is 10 to 15 per cent per year. The primary mode of haemodialysis in the region is based on in-patient hospital-based hemodialysis units. The increase in risk of cardiovascular and cerebrovascular morbidity as well as mortality in pre-dialysis Chronic Renal Disease has been reported. However, data on the health burden on haemodialysis in standalone dialysis facilities is very scarce. This is mainly due to the paucity of ambulatory centres for haemodialysis in the region. AMSA is the first center to offer standalone dialysis in the UAE and a study over a one year period was performed. Patient data was analyzed using a questionnaire for 45 patients with an average of 2.5 dialysis sessions per week. All patients were on chronic haemodialysis as outpatients. The trends of haemoglobin levels as an independent variable were evaluated. These trends were interpreted in comparison with other parameters of renal function (creatinine, uric acid, blood pressure and ferritin). Trends indicate an increase in hemoglobin levels with increased supplementation of iron and erythropoietin over time. The adequacy of hemodialysis shows improvement concomitantly. This, in turn, correlates with better patient outcomes and has a direct impact on morbidity and mortality. This study is a pilot study and further studies are indicated so that objective parameters can be studied and validated for hemodialysis in the region.

Keywords: haemodialysis, haemoglobin in haemodialysis, haemodialysis parameters, erythropoietic agents in haemodialysis

Procedia PDF Downloads 289