Search results for: healthcare evaluation
2326 A Fuzzy Hybrıd Decısıon Support System for Naval Base Place Selectıon in a Foreıgn Country
Authors: Latif Yanar, Muharrem Kaçan
Abstract:
In this study, an Analytic Hierarchy Process and Analytic Network Process Decision Support System (DSS) model for determination of a navy base place in another country is proposed together with a decision support software (DESTEC 1.0) developed using C Sharp programming language. The proposed software also has the ability of performing the fuzzy models (Fuzzy AHP and Fuzzy ANP) of the proposed DSS to cope with the ambiguous and linguistic nature of the model. The AHP and ANP model, for a decision support for selecting the best place among the alternatives, including the criteria and alternatives, is developed and solved by the experts from Turkish Navy and Turkish academicians related to international relations branches of the universities in Turkey. Also, the questionnaires used for weighting of the criteria and the alternatives are filled by these experts.Some of our alternatives are: economic and political stability of the third country, the effect of another super power in that country, historical relations, security in that country, social facilities in the city in which the base will be built, the transportation security and difficulty from a main city that have an airport to the city will have the base etc. Over 20 criteria like these are determined which are categorized in social, political, economic and military aspects. As a result all the criteria and three alternatives are evaluated by different people who have background and experience to weight the criteria and alternatives as it must be in AHP and ANP evaluation system. The alternatives got their degrees all between 0 – 1 and the total is 1. At the end the DSS advices one of the alternatives as the best one to the decision maker according to the developed model and the evaluations of the experts.Keywords: analytic hierarchical process, analytic network process, fuzzy logic, naval base place selection, multiple criteria decision making
Procedia PDF Downloads 3912325 The Effect of Salinity on Symbiotic Nitrogen Fixation in Alfalfa and Faba Bean
Authors: Mouffok Ahlem, Belhamra Mohamed, Mouffok Sihem
Abstract:
The use of nitrogen fertilizers inevitable consequence, the increase in the nitrate content of water, which may contribute to the production of nitrite and the formation of carcinogenic nitrosamines. The nitrogen fertilizer may also affect the structure and function of the microbial community. And the fight against eutrophication of aquatic environments represents a cost to the student statements. The agronomic, ecological and economic legumes such as faba beans and alfalfa are not demonstrated, especially in the case of semi-arid and arid areas. Osmotic stress due to drought and / or salinity deficit, nutritional deficiencies is the major factors limiting symbiotic nitrogen fixation and productivity of pulses. To study the symbiotic nitrogen fixation in faba bean (Vicia faba L.) and alfalfa (Medicago sativa L.) in the region of Biskra, we used soil samples collected from 30 locations. This work has identified several issues of ecological and agronomic interest. Evaluation of symbiotic potential of soils in the region of Biskra; by trapping technique, show different levels of susceptibility to rhizobial microflora. The effectiveness of the rhizobial symbiosis in both legumes indicates that air dry biomass and the amount of nitrogen accumulated in the aerial part, depends mainly on the rate of nodulation and regardless of the species and locality. The correlation between symbiotic nitrogen fixation and some physico-chemical properties of soils shows that symbiotic nitrogen fixation in both legumes is strongly related to soil conditions of the soil. Salinity disrupts the physiological process of growth, development and more particularly that of the symbiotic fixation of atmospheric nitrogen. Against by phosphorus promotes rhizobial symbiosis.Keywords: rhizobia, faba bean, alfalfa, salinity
Procedia PDF Downloads 4602324 Predicting Provider Service Time in Outpatient Clinics Using Artificial Intelligence-Based Models
Authors: Haya Salah, Srinivas Sharan
Abstract:
Healthcare facilities use appointment systems to schedule their appointments and to manage access to their medical services. With the growing demand for outpatient care, it is now imperative to manage physician's time effectively. However, high variation in consultation duration affects the clinical scheduler's ability to estimate the appointment duration and allocate provider time appropriately. Underestimating consultation times can lead to physician's burnout, misdiagnosis, and patient dissatisfaction. On the other hand, appointment durations that are longer than required lead to doctor idle time and fewer patient visits. Therefore, a good estimation of consultation duration has the potential to improve timely access to care, resource utilization, quality of care, and patient satisfaction. Although the literature on factors influencing consultation length abound, little work has done to predict it using based data-driven approaches. Therefore, this study aims to predict consultation duration using supervised machine learning algorithms (ML), which predicts an outcome variable (e.g., consultation) based on potential features that influence the outcome. In particular, ML algorithms learn from a historical dataset without explicitly being programmed and uncover the relationship between the features and outcome variable. A subset of the data used in this study has been obtained from the electronic medical records (EMR) of four different outpatient clinics located in central Pennsylvania, USA. Also, publicly available information on doctor's characteristics such as gender and experience has been extracted from online sources. This research develops three popular ML algorithms (deep learning, random forest, gradient boosting machine) to predict the treatment time required for a patient and conducts a comparative analysis of these algorithms with respect to predictive performance. The findings of this study indicate that ML algorithms have the potential to predict the provider service time with superior accuracy. While the current approach of experience-based appointment duration estimation adopted by the clinic resulted in a mean absolute percentage error of 25.8%, the Deep learning algorithm developed in this study yielded the best performance with a MAPE of 12.24%, followed by gradient boosting machine (13.26%) and random forests (14.71%). Besides, this research also identified the critical variables affecting consultation duration to be patient type (new vs. established), doctor's experience, zip code, appointment day, and doctor's specialty. Moreover, several practical insights are obtained based on the comparative analysis of the ML algorithms. The machine learning approach presented in this study can serve as a decision support tool and could be integrated into the appointment system for effectively managing patient scheduling.Keywords: clinical decision support system, machine learning algorithms, patient scheduling, prediction models, provider service time
Procedia PDF Downloads 1212323 Automated Natural Hazard Zonation System with Internet-SMS Warning: Distributed GIS for Sustainable Societies Creating Schema and Interface for Mapping and Communication
Authors: Devanjan Bhattacharya, Jitka Komarkova
Abstract:
The research describes the implementation of a novel and stand-alone system for dynamic hazard warning. The system uses all existing infrastructure already in place like mobile networks, a laptop/PC and the small installation software. The geospatial dataset are the maps of a region which are again frugal. Hence there is no need to invest and it reaches everyone with a mobile. A novel architecture of hazard assessment and warning introduced where major technologies in ICT interfaced to give a unique WebGIS based dynamic real time geohazard warning communication system. A never before architecture introduced for integrating WebGIS with telecommunication technology. Existing technologies interfaced in a novel architectural design to address a neglected domain in a way never done before–through dynamically updatable WebGIS based warning communication. The work publishes new architecture and novelty in addressing hazard warning techniques in sustainable way and user friendly manner. Coupling of hazard zonation and hazard warning procedures into a single system has been shown. Generalized architecture for deciphering a range of geo-hazards has been developed. Hence the developmental work presented here can be summarized as the development of internet-SMS based automated geo-hazard warning communication system; integrating a warning communication system with a hazard evaluation system; interfacing different open-source technologies towards design and development of a warning system; modularization of different technologies towards development of a warning communication system; automated data creation, transformation and dissemination over different interfaces. The architecture of the developed warning system has been functionally automated as well as generalized enough that can be used for any hazard and setup requirement has been kept to a minimum.Keywords: geospatial, web-based GIS, geohazard, warning system
Procedia PDF Downloads 4082322 Predictive Analytics in Oil and Gas Industry
Authors: Suchitra Chnadrashekhar
Abstract:
Earlier looked as a support function in an organization information technology has now become a critical utility to manage their daily operations. Organizations are processing huge amount of data which was unimaginable few decades before. This has opened the opportunity for IT sector to help industries across domains to handle the data in the most intelligent manner. Presence of IT has been a leverage for the Oil & Gas industry to store, manage and process the data in most efficient way possible thus deriving the economic value in their day-to-day operations. Proper synchronization between Operational data system and Information Technology system is the need of the hour. Predictive analytics supports oil and gas companies by addressing the challenge of critical equipment performance, life cycle, integrity, security, and increase their utilization. Predictive analytics go beyond early warning by providing insights into the roots of problems. To reach their full potential, oil and gas companies need to take a holistic or systems approach towards asset optimization and thus have the functional information at all levels of the organization in order to make the right decisions. This paper discusses how the use of predictive analysis in oil and gas industry is redefining the dynamics of this sector. Also, the paper will be supported by real time data and evaluation of the data for a given oil production asset on an application tool, SAS. The reason for using SAS as an application for our analysis is that SAS provides an analytics-based framework to improve uptimes, performance and availability of crucial assets while reducing the amount of unscheduled maintenance, thus minimizing maintenance-related costs and operation disruptions. With state-of-the-art analytics and reporting, we can predict maintenance problems before they happen and determine root causes in order to update processes for future prevention.Keywords: hydrocarbon, information technology, SAS, predictive analytics
Procedia PDF Downloads 3602321 Early Evaluation of Long-Span Suspension Bridges Using Smartphone Accelerometers
Authors: Ekin Ozer, Maria Q. Feng, Rupa Purasinghe
Abstract:
Structural deterioration of bridge systems possesses an ongoing threat to the transportation networks. Besides, landmark bridges’ integrity and safety are more than sole functionality, since they provide a strong presence for the society and nations. Therefore, an innovative and sustainable method to inspect landmark bridges is essential to ensure their resiliency in the long run. In this paper, a recently introduced concept, smartphone-based modal frequency estimation is addressed, and this paper targets to authenticate the fidelity of smartphone-based vibration measurements gathered from three landmark suspension bridges. Firstly, smartphones located at the bridge mid-span are adopted as portable and standalone vibration measurement devices. Then, their embedded accelerometers are utilized to gather vibration response under operational loads, and eventually frequency domain characteristics are deduced. The preliminary analysis results are compared with the reference publications and high-quality monitoring data to validate the usability of smartphones on long-span landmark suspension bridges. If the technical challenges such as high period of vibration, low amplitude excitation, embedded smartphone sensor features, sampling, and citizen engagement are tackled, smartphones can provide a novel and cost-free crowdsourcing tool for maintenance of these landmark structures. This study presents the early phase findings from three signature structures located in the United States.Keywords: smart and mobile sensing, structural health monitoring, suspension bridges, vibration analysis
Procedia PDF Downloads 2922320 The Potential Impact of Big Data Analytics on Pharmaceutical Supply Chain Management
Authors: Maryam Ziaee, Himanshu Shee, Amrik Sohal
Abstract:
Big Data Analytics (BDA) in supply chain management has recently drawn the attention of academics and practitioners. Big data refers to a massive amount of data from different sources, in different formats, generated at high speed through transactions in business environments and supply chain networks. Traditional statistical tools and techniques find it difficult to analyse this massive data. BDA can assist organisations to capture, store, and analyse data specifically in the field of supply chain. Currently, there is a paucity of research on BDA in the pharmaceutical supply chain context. In this research, the Australian pharmaceutical supply chain was selected as the case study. This industry is highly significant since the right medicine must reach the right patients, at the right time, in right quantity, in good condition, and at the right price to save lives. However, drug shortages remain a substantial problem for hospitals across Australia with implications on patient care, staff resourcing, and expenditure. Furthermore, a massive volume and variety of data is generated at fast speed from multiple sources in pharmaceutical supply chain, which needs to be captured and analysed to benefit operational decisions at every stage of supply chain processes. As the pharmaceutical industry lags behind other industries in using BDA, it raises the question of whether the use of BDA can improve transparency among pharmaceutical supply chain by enabling the partners to make informed-decisions across their operational activities. This presentation explores the impacts of BDA on supply chain management. An exploratory qualitative approach was adopted to analyse data collected through interviews. This study also explores the BDA potential in the whole pharmaceutical supply chain rather than focusing on a single entity. Twenty semi-structured interviews were undertaken with top managers in fifteen organisations (five pharmaceutical manufacturers, five wholesalers/distributors, and five public hospital pharmacies) to investigate their views on the use of BDA. The findings revealed that BDA can enable pharmaceutical entities to have improved visibility over the whole supply chain and also the market; it enables entities, especially manufacturers, to monitor consumption and the demand rate in real-time and make accurate demand forecasts which reduce drug shortages. Timely and precise decision-making can allow the entities to source and manage their stocks more effectively. This can likely address the drug demand at hospitals and respond to unanticipated issues such as drug shortages. Earlier studies explore BDA in the context of clinical healthcare; however, this presentation investigates the benefits of BDA in the Australian pharmaceutical supply chain. Furthermore, this research enhances managers’ insight into the potentials of BDA at every stage of supply chain processes and helps to improve decision-making in their supply chain operations. The findings will turn the rhetoric of data-driven decision into a reality where the managers may opt for analytics for improved decision-making in the supply chain processes.Keywords: big data analytics, data-driven decision, pharmaceutical industry, supply chain management
Procedia PDF Downloads 1062319 The Impact of Ozone on the Sensory Perception of Pumpkin Seeds and its Toxicity against Plodia interpunctella (Lepidoptera: Pyralidae)
Authors: Saba Goudarzi Dehrizifar, Aysan Afradi
Abstract:
The utilization of ozone treatment as a potential technique for storage pest control has gained significant attention. This approach presents an alternative to traditional chemical methods. In the current study, the mortality rates of Plodia interpunctella as a primary pest found in stored products particularly nuts, were examined after being exposed to different O3 concentration (minimum, half, and maximum) in three replicates and within 24 hours. As the concentration of O3 increased, the mortality rates of P. interpunctella also experienced a dramatic growth. A 20-member panel (men and women in different ages), formed from the society community, was selected for sensory evaluation. The pumpkin seeds samples were coded and presented randomly in identical containers. The panelists were asked to evaluate their degree of liking or disliking on a seven-point hedonic scale using descriptive categories, ranging 1-7 (1: extremely dislike, 2: very dislike, 3: dislike, 4: no difference, 5: like, 6: very like, and 7: extremely like). The results obtained from experiments on the qualitative characteristics of the studied dates through the sensory test revealed that O3 concentration did not affect their color, crispness, firmness, and overall acceptance and the half concentration of ozone on pumpkin seed had the highest consumption interest. Moreover, minimal alterations were observed in the aroma of the pumpkin seeds, which could be resolved with a short period of air exposure. Therefore, it could be concluded that the atmospheric O3 gas provided a cost-effective and environmentally friendly way for controlling the insect pests in pumpkin seeds, besides preserving their sensory and quality properties.Keywords: zone, control, pumpkin seeds, qualitative characteristics
Procedia PDF Downloads 542318 The Influence of Guided and Independent Training Toward Teachers’ Competence to Plan Early Childhood Education Learning Program
Authors: Sofia Hartati
Abstract:
This research is aimed at describing training in early childhood education program empirically, describing teachers ability to plan lessons empirically, and acquiring empirical data as well as analyzing the influence of guided and independent training toward teachers competence in planning early childhood learning program. The method used is an experiment. It collected data with a population of 76 early childhood educators in Tunjung Teja Sub District area through random sampling technique and grouped into two namely 38 people in an experiment class and 38 people in a controlled class. The technique used for data collections is a test. The result of the research shows that there is a significant influence between training for guided educators toward Teachers Ability toward Planning Early Childhood Learning Program. Guided training has been proven to improve the ability to comprehend planning a learning program. The ability to comprehend planning a learning program owned by teachers of early childhood program comprises of 1) determining the characteristics and competence of students prior to learning; 2) formulating the objective of the learning; 3) selecting materials and its sequences; 4) selecting teaching methods; 5) determining the means or learning media; 6) selecting evaluation strategy as a part of teachers pedagogic competence. The result of this research describes a difference in the competence level of teachers who have joined guided training which is relatively higher than the teachers who joined the independent training. Guided training is one of an effective way to improve the knowledge and competence of early childhood educators.Keywords: competence, planning, teachers, training
Procedia PDF Downloads 2642317 A Numerical Study on Semi-Active Control of a Bridge Deck under Seismic Excitation
Authors: A. Yanik, U. Aldemir
Abstract:
This study investigates the benefits of implementing the semi-active devices in relation to passive viscous damping in the context of seismically isolated bridge structures. Since the intrinsically nonlinear nature of semi-active devices prevents the direct evaluation of Laplace transforms, frequency response functions are compiled from the computed time history response to sinusoidal and pulse-like seismic excitation. A simple semi-active control policy is used in regard to passive linear viscous damping and an optimal non-causal semi-active control strategy. The control strategy requires optimization. Euler-Lagrange equations are solved numerically during this procedure. The optimal closed-loop performance is evaluated for an idealized controllable dash-pot. A simplified single-degree-of-freedom model of an isolated bridge is used as numerical example. Two bridge cases are investigated. These cases are; bridge deck without the isolation bearing and bridge deck with the isolation bearing. To compare the performances of the passive and semi-active control cases, frequency dependent acceleration, velocity and displacement response transmissibility ratios Ta(w), Tv(w), and Td(w) are defined. To fully investigate the behavior of the structure subjected to the sinusoidal and pulse type excitations, different damping levels are considered. Numerical results showed that, under the effect of external excitation, bridge deck with semi-active control showed better structural performance than the passive bridge deck case.Keywords: bridge structures, passive control, seismic, semi-active control, viscous damping
Procedia PDF Downloads 2422316 Collagen Scaffold Incorporated with Macrotyloma uniflorum Plant Extracts as a–Burn/Wound Dressing Material, in Vitro and in Vivo Evaluation
Authors: Thangavelu Muthukumar, Thotapalli Parvathaleswara Sastry
Abstract:
Collagen is the most abundantly available connective tissue protein, which is being used as a biomaterial for various biomedical applications. Presently, fish wastes are disposed improperly which is causing serious environmental pollution resulting in offensive odour. Fish scales are promising source of Type I collagen. Medicinal plants have been used since time immemorial for treatment of various ailments of skin and dermatological disorders especially cuts, wounds, and burns. Developing biomaterials from the natural sources which are having wound healing properties within the search of a common man is the need of hour, particularly in developing and third world countries. With these objectives in view we have developed a wound dressing material containing fish scale collagen (FSC) incorporated with Macrotyloma uniflorum plant extract (PE). The wound dressing composite was characterized for its physiochemical properties using conventional methods. SEM image revealed that the composite has fibrous and porous surface which helps in transportation of oxygen as well as absorbing wound fluids. The biomaterial has shown 95% biocompatibility with required mechanical strength and has exhibited antimicrobial properties. This biomaterial has been used as a wound dressing material in experimental wounds of rats. The healing pattern was evaluated by macroscopic observations, panimetric studies, biochemical, histopathological observations. The results showed faster healing pattern in the wounds treated with CSPE compared to the other composites used in this study and untreated control. These experiments clearly suggest that CSPE can be used as wound/burn dressing materials.Keywords: collagen, wound dressing, Macrotyloma uniflorum, burn dressing
Procedia PDF Downloads 4172315 Evaluation of Newly Synthesized Steroid Derivatives Using In silico Molecular Descriptors and Chemometric Techniques
Authors: Milica Ž. Karadžić, Lidija R. Jevrić, Sanja Podunavac-Kuzmanović, Strahinja Z. Kovačević, Anamarija I. Mandić, Katarina Penov-Gaši, Andrea R. Nikolić, Aleksandar M. Oklješa
Abstract:
This study considered selection of the in silico molecular descriptors and the models for newly synthesized steroid derivatives description and their characterization using chemometric techniques. Multiple linear regression (MLR) models were established and gave the best molecular descriptors for quantitative structure-retention relationship (QSRR) modeling of the retention of the investigated molecules. MLR models were without multicollinearity among the selected molecular descriptors according to the variance inflation factor (VIF) values. Used molecular descriptors were ranked using generalized pair correlation method (GPCM). In this method, the significant difference between independent variables can be noticed regardless almost equal correlation between dependent variable. Generated MLR models were statistically and cross-validated and the best models were kept. Models were ranked using sum of ranking differences (SRD) method. According to this method, the most consistent QSRR model can be found and similarity or dissimilarity between the models could be noticed. In this study, SRD was performed using average values of experimentally observed data as a golden standard. Chemometric analysis was conducted in order to characterize newly synthesized steroid derivatives for further investigation regarding their potential biological activity and further synthesis. This article is based upon work from COST Action (CM1105), supported by COST (European Cooperation in Science and Technology).Keywords: generalized pair correlation method, molecular descriptors, regression analysis, steroids, sum of ranking differences
Procedia PDF Downloads 3472314 Comparative Evaluation of Vanishing Interfacial Tension Approach for Minimum Miscibility Pressure Determination
Authors: Waqar Ahmad Butt, Gholamreza Vakili Nezhaad, Ali Soud Al Bemani, Yahya Al Wahaibi
Abstract:
Minimum miscibility pressure (MMP) plays a great role in determining the displacement efficiency of different gas injection processes. Experimental techniques for MMP determination include industrially recommended slim tube, vanishing interfacial tension (VIT) and rising bubble apparatus (RBA). In this paper, MMP measurement study using slim tube and VIT experimental techniques for two different crude oil samples (M and N) both in live and stock tank oil forms is being presented. VIT measured MMP values for both 'M' and 'N' live crude oils were close to slim tube determined MMP values with 6.4 and 5 % deviation respectively. Whereas for both oil samples in stock tank oil form, VIT measured MMP showed a higher unacceptable deviation from slim tube determined MMP. This higher difference appears to be related to high stabilized crude oil heavier fraction and lack of multiple contacts miscibility. None of the different nine deployed crude oil and CO2 MMP computing correlations could result in reliable MMP, close to slim tube determined MMP. Since VIT determined MMP values for both considered live crude oils are in close match with slim tube determined MMP values, it confirms reliable, reproducible, rapid and cheap alternative for live crude oil MMP determination. Whereas VIT MMP determination for stock tank oil case needed further investigation about stabilization / destabilization mechanism of oil heavier ends and multiple contacts miscibility development issues.Keywords: minimum miscibility pressure, interfacial tension, multiple contacts miscibility, heavier ends
Procedia PDF Downloads 2682313 Evaluation of Virtual Reality for the Rehabilitation of Athlete Lower Limb Musculoskeletal Injury: A Method for Obtaining Practitioner’s Viewpoints through Observation and Interview
Authors: Hannah K. M. Tang, Muhammad Ateeq, Mark J. Lake, Badr Abdullah, Frederic A. Bezombes
Abstract:
Based on a theoretical assessment of current literature, virtual reality (VR) could help to treat sporting injuries in a number of ways. However, it is important to obtain rehabilitation specialists’ perspectives in order to design, develop and validate suitable content for a VR application focused on treatment. Subsequently, a one-day observation and interview study focused on the use of VR for the treatment of lower limb musculoskeletal conditions in athletes was conducted at St George’s Park England National Football Centre with rehabilitation specialists. The current paper established the methods suitable for obtaining practitioner’s viewpoints through observation and interview in this context. Particular detail was provided regarding the method of qualitatively processing interview results using the qualitative data analysis software tool NVivo, in order to produce a narrative of overarching themes. The observations and overarching themes identified could be used as a framework and success criteria of a VR application developed in future research. In conclusion, this work explained the methods deemed suitable for obtaining practitioner’s viewpoints through observation and interview. This was required in order to highlight characteristics and features of a VR application designed to treat lower limb musculoskeletal injury of athletes and could be built upon to direct future work.Keywords: athletes, lower-limb musculoskeletal injury, rehabilitation, return-to-sport, virtual reality
Procedia PDF Downloads 2572312 Formulation and in vitro Evaluation of Transdermal Delivery of Articaine
Authors: Dinakaran Venkatachalam, Paul Chambers, Kavitha Kongara, Preet Singh
Abstract:
The objective of this study is to formulate different topical preparations containing articaine and to investigate their permeation through goat skin. Initially, articaine and its hydrochloride salt were compared for in vitro permeation using Franz cell model. Goat skin samples were collected after euthanizing male goat kids purchased from the dairy goat farmers. Subcutaneous fat was removed and the skin was mounted on the donor chamber (orifice area 1.00 cm²) and drugs were applied onto the epidermis. Phosphate buffer saline (pH 7.4) was used to maintain sink condition in the receptor chamber (8 ml) of the Franz cell. Samples (0.4 ml) were collected at various intervals over 24 hours after each sampling equal volume of PBS was replaced in the receptor chamber. Articaine in the collected samples were quantified using LC/MS. The results suggested that articaine free base permeates better than its hydrochloride salt through goat skin. This study results support the fact that local anesthetics in its base form are lipophilic and thus penetrates faster through cell membranes than their salts. Later, articaine free base was formulated either using ethanol and octyl salicylate or dimethyl sulfoxide (DMSO) as penetration enhancers and was compared for in vitro permeation. The transdermal flux of articaine in the formulation containing DMSO was approximately 3.8 times higher than that of the formulation containing ethanol and octyl salicylate. Further studies to evaluate the local anesthetic efficacy of the topical formulation containing articaine for dermal anesthesia in animals have been planned.Keywords: articaine, dermal anesthesia, local anesthetic, transdermal
Procedia PDF Downloads 2372311 Outcome Analysis of Surgical and Nonsurgical Treatment on Indicated Operative Chronic Subdural Hematoma: Serial Case in Cipto Mangunkusumo Hospital Indonesia
Authors: Novie Nuraini, Sari Hanifa, Yetty Ramli
Abstract:
Chronic subdural hematoma (cSDH) is a common condition after head trauma. Although the size of the thickness of cSDH has an important role in the decision to perform surgery, but the size limit of the thickness is not absolute. In this serial case report, we evaluate three case report of cSDH that indicated to get the surgical procedure because of deficit neurologic and neuroimaging finding with subfalcine herniation more than 0.5 cm and hematoma thickness more than one cm. On the first case, the patient got evacuation hematoma procedure, but the second and third case, we did nonsurgical treatment because the patient and family refused to do the operation. We did the conservative treatment with bed rest and mannitol. Serial radiologic evaluation is done when we found worsening condition. We also reevaluated radiologic examination two weeks after the treatment. The results in this serial case report, the first and second case have a good outcome. On the third case, there was a worsening condition, which in this patient there was a comorbid with type two diabetic mellitus, pneumonie and chronic kidney disease. Some conservative treatment such as bed rest, corticosteroid, mannitol or the other hyperosmolar has a good outcome in patient without neurologic deficits, small hematoma, and or patient without comorbid disease. Evacuate hematome is the best choice in cSDH treatment with deficit neurologic finding. Afterall, there is some condition that we can not do the surgical procedure. Serial radiologic examination needed after two weeks to evaluate the treatment or if there is any worsening condition.Keywords: chronic subdural hematoma, traumatic brain injury, surgical treatment, nonsurgical treatment, outcome
Procedia PDF Downloads 3322310 Evaluation of the Biological Activities of Chrysin as an Important Perspective in the Treatment of Infectious and Cancer Diseases
Authors: Sajjad Jafari, Reza Akbari
Abstract:
Background and Aim: Chrysin, a flavonoid compound found in medicinal plants, honey, and propolis, has potential biological activities that make it an important perspective in the treatment of infectious and cancer diseases. The aim of this review study is to evaluate the biological activities of chrysin in the treatment of infectious and cancer diseases. Material and Methods: The present study is a review study that searched reputable scientific databases such as PubMed, Google Scholar, Scopus, and Web of Science from 2000 to 2023 using keywords such as antimicrobial, antifungal, chrysin, anticancer, antioxidants, and infectious diseases. The researchers examined 25 articles to determine the biological activities of chrysin. Results: Chrysin has high inhibitory or lethal activities on gram-positive and gram-negative bacteria, including Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, Bacillus subtilis, and Enterococcus faeces. It also has anti-biofilm effects and antifungal effects on strains such as Aspergillus niger and Candida albicans. Chrysin also has anticancer effects on various cancers, including colorectal cancer, pancreatic cancer, breast cancer, and MCF-7 cancer, which have been confirmed in vitro and in vivo. Conclusion: Chrysin has the potential as an important therapeutic option in the treatment of infectious and cancer diseases. Its high antimicrobial and anticancer activities, combined with its low toxicity in nanoparticle form, make it a promising candidate for further clinical trials. The production of anti-microbial and anti-cancer drugs from natural substances, such as chrysin, is a valuable contribution to the field of medicine.Keywords: chrysin, antimicrobial, anticancer, infectious diseases
Procedia PDF Downloads 1162309 Performance Evaluation of Filtration System for Groundwater Recharging Well in the Presence of Medium Sand-Mixed Storm Water
Authors: Krishna Kumar Singh, Praveen Jain
Abstract:
The collection of storm water runoff and forcing it into the groundwater is the need of the hour to sustain the ground water table. However, the runoff entraps various types of sediments and other floating objects whose removal are essential to avoid pollution of ground water and blocking of pores of aquifer. However, it requires regular cleaning and maintenance due to the problem of clogging. To evaluate the performance of filter system consisting of coarse sand (CS), gravel (G) and pebble (P) layers, a laboratory experiment was conducted in a rectangular column. The effect of variable thickness of CS, G and P layers of the filtration unit of the recharge shaft on the recharge rate and the sediment concentration of effluent water were evaluated. Medium sand (MS) of three particle sizes, viz. 0.150–0.300 mm (T1), 0.300–0.425 mm (T2) and 0.425–0.600 mm of thickness 25 cm, 30 cm, and 35 cm respectively in the top layer of the filter system and having seven influent sediment concentrations of 250–3,000 mg/l were used for the experimental study. The performance was evaluated in terms of recharge rates and clogging time. The results indicated that 100 % suspended solids were entrapped in the upper 10 cm layer of MS, the recharge rates declined sharply for influent concentrations of more than 1,000 mg/l. All treatments with a higher thickness of MS media indicated recharge rate slightly more than that of all treatment with a lower thickness of MS media respectively. The performance of storm water infiltration systems was highly dependent on the formation of a clogging layer at the filter. An empirical relationship has been derived between recharge rates, inflow sediment load, size of MS and thickness of MS with using MLR.Keywords: groundwater, medium sand-mixed storm water filter, inflow sediment load
Procedia PDF Downloads 3922308 Detection and Identification of Antibiotic Resistant UPEC Using FTIR-Microscopy and Advanced Multivariate Analysis
Authors: Uraib Sharaha, Ahmad Salman, Eladio Rodriguez-Diaz, Elad Shufan, Klaris Riesenberg, Irving J. Bigio, Mahmoud Huleihel
Abstract:
Antimicrobial drugs have played an indispensable role in controlling illness and death associated with infectious diseases in animals and humans. However, the increasing resistance of bacteria to a broad spectrum of commonly used antibiotics has become a global healthcare problem. Many antibiotics had lost their effectiveness since the beginning of the antibiotic era because many bacteria have adapted defenses against these antibiotics. Rapid determination of antimicrobial susceptibility of a clinical isolate is often crucial for the optimal antimicrobial therapy of infected patients and in many cases can save lives. The conventional methods for susceptibility testing require the isolation of the pathogen from a clinical specimen by culturing on the appropriate media (this culturing stage lasts 24 h-first culturing). Then, chosen colonies are grown on media containing antibiotic(s), using micro-diffusion discs (second culturing time is also 24 h) in order to determine its bacterial susceptibility. Other methods, genotyping methods, E-test and automated methods were also developed for testing antimicrobial susceptibility. Most of these methods are expensive and time-consuming. Fourier transform infrared (FTIR) microscopy is rapid, safe, effective and low cost method that was widely and successfully used in different studies for the identification of various biological samples including bacteria; nonetheless, its true potential in routine clinical diagnosis has not yet been established. The new modern infrared (IR) spectrometers with high spectral resolution enable measuring unprecedented biochemical information from cells at the molecular level. Moreover, the development of new bioinformatics analyses combined with IR spectroscopy becomes a powerful technique, which enables the detection of structural changes associated with resistivity. The main goal of this study is to evaluate the potential of the FTIR microscopy in tandem with machine learning algorithms for rapid and reliable identification of bacterial susceptibility to antibiotics in time span of few minutes. The UTI E.coli bacterial samples, which were identified at the species level by MALDI-TOF and examined for their susceptibility by the routine assay (micro-diffusion discs), are obtained from the bacteriology laboratories in Soroka University Medical Center (SUMC). These samples were examined by FTIR microscopy and analyzed by advanced statistical methods. Our results, based on 700 E.coli samples, were promising and showed that by using infrared spectroscopic technique together with multivariate analysis, it is possible to classify the tested bacteria into sensitive and resistant with success rate higher than 90% for eight different antibiotics. Based on these preliminary results, it is worthwhile to continue developing the FTIR microscopy technique as a rapid and reliable method for identification antibiotic susceptibility.Keywords: antibiotics, E.coli, FTIR, multivariate analysis, susceptibility, UTI
Procedia PDF Downloads 1722307 Evaluation of Produced Water Treatment Using Advanced Oxidation Processes and Sodium Ferrate(VI)
Authors: Erica T. R. Mendonça, Caroline M. B. de Araujo, Filho, Osvaldo Chiavone, Sobrinho, Maurício A. da Motta
Abstract:
Oil and gas exploration is an essential activity for modern society, although the supply of its global demand has caused enough damage to the environment, mainly due to produced water generation, which is an effluent associated with the oil and gas produced during oil extraction. It is the aim of this study to evaluate the treatment of produced water, in order to reduce its oils and greases content (OG), by using flotation as a pre-treatment, combined with oxidation for the remaining organic load degradation. Thus, there has been tested Advanced Oxidation Process (AOP) using both Fenton and photo-Fenton reactions, as well as a chemical oxidation treatment using sodium ferrate(VI), Na2[FeO4], as a strong oxidant. All the studies were carried out using real samples of produced water from petroleum industry. The oxidation process using ferrate(VI) ion was studied based on factorial experimental designs. The factorial design was used in order to study how the variables pH, temperature and concentration of Na2[FeO4] influences the O&G levels. For the treatment using ferrate(VI) ion, the results showed that the best operating point is obtained when the temperature is 28 °C, pH 3, and a 2000 mg.L-1 solution of Na2[FeO4] is used. This experiment has achieved a final O&G level of 4.7 mg.L-1, which means 94% percentage removal efficiency of oils and greases. Comparing Fenton and photo-Fenton processes, it was observed that the Fenton reaction did not provide good reduction of O&G (around 20% only). On the other hand, a degradation of approximately 80.5% of oil and grease was obtained after a period of seven hours of treatment using photo-Fenton process, which indicates that the best process combination has occurred between the flotation and the photo-Fenton reaction using solar radiation, with an overall removal efficiency of O&G of approximately 89%.Keywords: advanced oxidation process, ferrate (VI) ion, oils and greases removal, produced water treatment
Procedia PDF Downloads 3192306 Rethink Urban Resilience: An Introductory Study Towards Resilient Spatial Structure of Refugees Neighborhoods
Authors: Salwa Mohammad Alawneh
Abstract:
The ongoing humanitarian crises spur rapid and unpredicted refugee influxes resulting in demographic changes in cities. Regarding different urban systems are vulnerable in refugee neighborhoods. With the consequent social, economic, and spatial challenges, cities must respond with a more durable and sustainable approach based on urban resilience. The paper systematically approaches urban resilience to contribute to refugee spaces by reflecting on the overall urban systems of their neighborhoods. The research will review the urban resilience literature to develop an evaluation framework. The developed framework applies urban resilience more holistically in refugee neighborhoods and expands to the urban systems of social, economic, and spatial. However, the main highlight of this paper is the resilient spatial structure in refugee neighborhoods to face the internal and complex stress of refugee waves and their demographic changes. Finding a set of resilient spatial measurements and focusing on urban forms at a neighborhood scale provide vulnerability reduction and enhance adaptation capacity. As a model example, the paper applies these measurements and facilitates geospatial technologies to one of the refugee neighborhoods in Amman, Jordan, namely Al-Jubilee. The application in Al-Jubilee helps to demonstrate a road map towards a developmental pattern in design and planning by different decision-makers of inter-governmental and humanitarian organizations. In this regard, urban resilience improves the humanitarian assistantship of refugee settings beyond providing the essential needs. In conclusion, urban resilience responds to the different challenges of refugee neighborhoods by supporting urban stability, improving livability, and maintaining both urban functions and security.Keywords: urban resilience of refugee, resilient urban form, refugee neighborhoods, humanitarian assistantship, refugee in Jordan
Procedia PDF Downloads 1602305 Implementing Service Learning in the Health Education Curriculum
Authors: Karen Butler
Abstract:
Johnson C. Smith University, one of the nation’s oldest Historically Black Colleges and Universities, has a strong history of service learning and community service. We first integrated service learning and peer education into health education courses in the spring of 2000. Students enrolled in the classes served as peer educators for the semester. Since then, the program has evolved and expanded but remains an integral part of several courses. The purpose of this session is to describe our program in terms of development, successes, and obstacles, and feedback received. A detailed description of the service learning component in HED 235: Drugs and Drug Education and HED 337: Environmental Health will be provided. These classes are required of our Community Health majors but are also popular electives for students in other disciplines. Three sources of student feedback were used to evaluate and continually modify the component: the SIR II course evaluation, service learning reflection papers, and focus group interviews. Student feedback has been largely positive. When criticism was given, it was thoughtful and constructive – given in the spirit of making it better for the next group. Students consistently agreed that the service learning program increased their awareness of pertinent health issues; that both the service providers and service recipients benefited from the project; and that the goals/issues targeted by the service learning component fit the objectives of the course. Also, evidence of curriculum and learning enhancement was found in the reflection papers and focus group sessions. Service learning sets up a win-win situation. It provides a way to respond to campus and community health needs while enhancing the curriculum, as students learn more by doing things that benefit the health and wellness of others. Service learning is suitable for any health education course and any target audience would welcome the effort.Keywords: black colleges, community health, health education, service learning
Procedia PDF Downloads 3402304 Estimation of Constant Coefficients of Bourgoyne and Young Drilling Rate Model for Drill Bit Wear Prediction
Authors: Ahmed Z. Mazen, Nejat Rahmanian, Iqbal Mujtaba, Ali Hassanpour
Abstract:
In oil and gas well drilling, the drill bit is an important part of the Bottom Hole Assembly (BHA), which is installed and designed to drill and produce a hole by several mechanisms. The efficiency of the bit depends on many drilling parameters such as weight on bit, rotary speed, and mud properties. When the bit is pulled out of the hole, the evaluation of the bit damage must be recorded very carefully to guide engineers in order to select the bits for further planned wells. Having a worn bit for hole drilling may cause severe damage to bit leading to cutter or cone losses in the bottom of hole, where a fishing job will have to take place, and all of these will increase the operating cost. The main factor to reduce the cost of drilling operation is to maximize the rate of penetration by analyzing real-time data to predict the drill bit wear while drilling. There are numerous models in the literature for prediction of the rate of penetration based on drilling parameters, mostly based on empirical approaches. One of the most commonly used approaches is Bourgoyne and Young model, where the rate of penetration can be estimated by the drilling parameters as well as a wear index using an empirical correlation, provided all the constants and coefficients are accurately determined. This paper introduces a new methodology to estimate the eight coefficients for Bourgoyne and Young model using the gPROMS parameters estimation GPE (Version 4.2.0). Real data collected form similar formations (12 ¼’ sections) in two different fields in Libya are used to estimate the coefficients. The estimated coefficients are then used in the equations and applied to nearby wells in the same field to predict the bit wear.Keywords: Bourgoyne and Young model, bit wear, gPROMS, rate of penetration
Procedia PDF Downloads 1542303 Pattern of Biopsy Proven Renal Disease and Association between the Clinical Findings with Renal Pathology in Eastern Nepal
Authors: Manish Subedi, Bijay Bartaula, Ashok R. Pant, Purbesh Adhikari, Sanjib K. Sharma
Abstract:
Background: The pattern of glomerular disease varies worldwide. In absence of kidney disease/Kidney biopsy registry in Nepal, the exact etiology of different forms of glomerular disease is primarily unknown in our country. Method: We retrospectively analyzed 175 cases of renal biopsies performed from dated September 2014 to August 2016 at B. P. Koirala Institute of Health Sciences, Dharan, Nepal. Results: The commonest indication for renal biopsy was nephrotic syndrome (34.9%), followed by Systemic lupus erythematosus with suspected renal involvement (22.3%). Majority of patients were in the 30-60 year bracket (57.2%), with the mean age of the patients being 35.37 years. The average number of glomeruli per core was 13, with inadequate sampling in 5.1%. IgA nephropathy (17%) was found to be the most common primary glomerular disease, followed by membranous nephropathy (14.6%) and FSGS (14.6%). The commonest secondary glomerular disease was lupus nephritis. Complications associated with renal biopsy were pain at biopsy site in 18% of cases, hematuria in 6% and perinephric hematoma in 4% cases. Conclusion: The commonest primary and secondary glomerular disease was IgA nephropathy and lupus nephritis respectively. The high prevalence of Systemic lupus erythematosus with lupus nephritis among Nepalese in comparison with other developing countries warrants further evaluation. As an initial attempt towards documentation of glomerular diseases in the national context, this study should serve as a stepping stone towards the eventual establishment of a full-fledged national registry of glomerular diseases in Nepal.Keywords: glomerular, Nepal, renal biopsy, systemic lupus erythematoses
Procedia PDF Downloads 2292302 Immunohistochemical Evaluation of Moringa oleifera Seed Oil in Cadmium Induced Frontal Cortex Damage in Wistar Rats
Authors: Olusegun D. Omotoso
Abstract:
The use of Moringa oleifera seed oil in the prevention and cure of many ailments particularly, neurodegenerative diseases have been on increasing trend in Nigeria. The study was aimed at investigating the ameliorative or reversal effects by the intervention of Moringa oleifera seed oil on the damage to frontal cortex of Wistar rats by cadmium. Twenty-eight Wistar rats of both sexes weighed between 73g-151g were used. The animals were acclimatized and were fed on rat chow and water ad libitum. The rats were randomly divided into four groups A, B, C and D of 7 rats each. Group A served as control which received 2.5mg/kgbw phosphate buffer intra-peritoneally, while group D served as Moringa-treated control and received oral administration of 2.0 mg/kgbw Moringa oleifera oil. Groups B and C were injected intra-peritoneally with 3.5mg/kgbw CdSO₄.8H₂O single dose. Group C received orally administration of 2.0mg/kgbw Moringa oleifera oil. The intervention lasted for four weeks after which the animals were sacrificed by cervical dislocation and the tissues processed histologically. The immuno-histoarchitecture of the frontal cortex was characterized by pyknosis of nuclei as well as activation of astrocytes which was evidence in group B rats, while those animals in group C showed ameliorative effect that were evidence in reduction in the number of pyknotic nuclei and reduction of activated astrocytes as compared with control group A and Moringa-treated group D. It can be deduced that Moringa oleifera seed oil has natural antioxidant constituents that might have ameliorated the immuno-histoarchitectural damage caused by cadmium.Keywords: cadmium, immuno-histoarchitecture, Moringa oleifera, pyknotic nuclei
Procedia PDF Downloads 2112301 Translation and Validation of the Thai Version of the Japanese Sleep Questionnaire for Preschoolers
Authors: Natcha Lueangapapong, Chariya Chuthapisith, Lunliya Thampratankul
Abstract:
Background: There is a need to find an appropriate tool to help healthcare providers determine sleep problems in children for early diagnosis and management. The Japanese Sleep Questionnaire for Preschoolers (JSQ-P) is a parent-reported sleep questionnaire that has good psychometric properties and can be used in the context of Asian culture, which is likely suitable for Thai children. Objectives: This study aimed to translate and validate the Japanese Sleep Questionnaire for Preschoolers (JSQ-P) into a Thai version and to evaluate factors associated with sleep disorders in preschoolers. Methods: After approval by the original developer, the cross-cultural adaptation process of JSQ-P was performed, including forward translation, reconciliation, backward translation, and final approval of the Thai version of JSQ-P (TH-JSQ-P) by the original creator. This study was conducted between March 2021 and February 2022. The TH-JSQ-P was completed by 2,613 guardians whose children were aged 2-6 years twice in 10-14 days to assess its reliability and validity. Content validity was measured by an index of item-objective congruence (IOC) and a content validity index (CVI). Face validity, content validity, structural validity, construct validity (discriminant validity), criterion validity and predictive validity were assessed. The sensitivity and specificity of the TH-JSQ-P were also measured by using a total JSQ-P score cutoff point 84, recommended by the original JSQ-P and each subscale score among the clinical samples of obstructive sleep apnea syndrome. Results: Internal consistency reliability, evaluated by Cronbach’s α coefficient, showed acceptable reliability in all subscales of JSQ-P. It also had good test-retest reliability, as the intraclass correlation coefficient (ICC) for all items ranged between 0.42-0.84. The content validity was acceptable. For structural validity, our results indicated that the final factor solution for the Th-JSQ-P was comparable to the original JSQ-P. For construct validity, age group was one of the clinical parameters associated with some sleep problems. In detail, parasomnias, insomnia, daytime excessive sleepiness and sleep habits significantly decreased when the children got older; on the other hand, insufficient sleep was significantly increased with age. For criterion validity, all subscales showed a correlation with the Epworth Sleepiness Scale (r = -0.049-0.349). In predictive validity, the Epworth Sleepiness Scale was significantly a strong factor that correlated to sleep problems in all subscales of JSQ-P except in the subscale of sleep habit. The sensitivity and specificity of the total JSQ-P score were 0.72 and 0.66, respectively. Conclusion: The Thai version of JSQ-P has good internal consistency reliability and test-retest reliability. It passed 6 validity tests, and this can be used to evaluate sleep problems in preschool children in Thailand. Furthermore, it has satisfactory general psychometric properties and good reliability and validity. The data collected in examining the sensitivity of the Thai version revealed that the JSQ-P could detect differences in sleep problems among children with obstructive sleep apnea syndrome. This confirmed that the measure is sensitive and can be used to discriminate sleep problems among different children.Keywords: preschooler, questionnaire, validation, Thai version
Procedia PDF Downloads 1042300 Moving from Practice to Theory
Authors: Maria Lina Garrido
Abstract:
This paper aims to reflect upon instruction in English classes with the specific purpose of reading comprehension development, having as its paradigm the considerations presented by William Grabe, in his book Reading in a Second Language: Moving from theory to practice. His concerns regarding the connection between research findings and instructional practices have stimulated the present author to re-evaluate both her long practice as an English reading teacher and as the author of two reading textbooks for graduate students. Elements of the reading process such as linguistic issues, prior knowledge, reading strategies, critical evaluation, and motivation are the main foci of this analysis as far as the activities developed in the classroom are concerned. The experience with university candidates on postgraduate courses with different levels of English knowledge in Bahia, Brazil, has definitely demanded certain adjustments to this author`s classroom setting. Word recognition based on cognates, for example, has been emphasized given the fact that academic texts use many Latin words which have the same roots as the Brazilian Portuguese lexicon. Concerning syntactic parsing, the tenses/verbal aspects, modality and linking words are included in the curriculum, but not with the same depth as the general English curricula. Reading strategies, another essential predictor for developing reading skills, have been largely stimulated in L2 classes in order to compensate for a lack of the appropriate knowledge of the foreign language. This paper presents results that demonstrate that this author`s teaching practice is compatible with the implications and instruction concerning the reading process outlined by Grabe, however, it admits that each class demands specific instructions to meet the needs of that particular group.Keywords: classroom practice, instructional activities, reading comprehension, reading skills
Procedia PDF Downloads 4622299 Evaluation of Pile Performance in Different Layers of Soil
Authors: Orod Zarrin, Mohesn Ramezan Shirazi, Hassan Moniri
Abstract:
The use of pile foundations technique is developed to support structures and buildings on soft soil. The most important dynamic load that can affect the pile structure is earthquake vibrations. Pile foundations during earthquake excitation indicate that piles are subject to damage by affecting the superstructure integrity and serviceability. During an earthquake, two types of stresses can damage the pile head, inertial load that is caused by superstructure and deformation which caused by the surrounding soil. Soil deformation and inertial load are associated with the acceleration developed in an earthquake. The acceleration amplitude at the ground surface depends on the magnitude of earthquakes, soil properties and seismic source distance. According to the investigation, the damage is between the liquefiable and non-liquefiable layers and also soft and stiff layers. This damage crushes the pile head by increasing the inertial load which is applied by the superstructure. On the other hand, the cracks on the piles due to the surrounding soil are directly related to the soil profile and causes cracks from small to large. However, the large cracks reason have been listed such as liquefaction, lateral spreading, and inertial load. In the field of designing, elastic response of piles is always a challenge for designer in liquefaction soil, by allowing deflection at top of piles. Moreover, absence of plastic hinges in piles should be insured, because the damage in the piles is not observed directly. In this study, the performance and behavior of pile foundations during liquefaction and lateral spreading are investigated. In addition, emphasize on the soil behavior in the liquefiable and non-liquefiable layers by different aspect of piles damage such as ranking, location and degree of damage are going to discuss.Keywords: pile, earthquake, liquefaction, non-liquefiable, damage
Procedia PDF Downloads 3012298 Innovative Strategies for Chest Wall Reconstruction Following Resection of Recurrent Breast Carcinoma
Authors: Sean Yao Zu Kong, Khong Yik Chew
Abstract:
Introduction: We described a case report of the successful use of advanced surgical techniques in a patient with recurrent breast cancer who underwent a wide resection including the hemi-sternum, clavicle, multiple ribs, and a lobe of the lung due to tumor involvement. This extensive resection exposed critical structures, requiring a creative approach to reconstruction. To address this complex chest wall reconstruction, a free fibula flap and a 4-zone rectus abdominis musculocutaneous flap were successfully utilized. The use of a free vascularized bone flap allowed for rapid osteointegration and resistance against osteoradionecrosis after adjuvant radiation, while a four-zone tram flap allowed for reconstruction of both the chest wall and breast mound. Although limited recipient vessels made free flaps challenging, the free fibula flap served as both a bony reconstruction and vascular conduit, supercharged with the distal peroneal artery and veins of the peroneal artery from the fibula graft. Our approach highlights the potential of advanced surgical techniques to improve outcomes in complex cases of chest wall reconstruction in patients with recurrent breast cancer, which is becoming increasingly relevant as breast cancer incidence rates increases. Case presentation: This report describes a successful reconstruction of a patient with recurrent breast cancer who required extensive resection, including the anterior chest wall, clavicle, and sternoclavicular joint. Challenges arose due to the loss of accessory muscles and the non-rigid rib cage, which could lead to compromised ventilation and instability. A free fibula osteocutaneous flap and a four-zone TRAM flap with vascular supercharging were utilized to achieve long-term stability and function. The patient has since fully recovered, and during the review, both flaps remained viable, and chest mound reconstruction was satisfactory. A planned nipple/areolar reconstruction was offered pending the patient’s decision after adjuvant radiotherapy. Conclusion: In conclusion, this case report highlights the successful use of innovative surgical techniques in addressing a complex case of recurrent breast cancer requiring extensive resection and radical reconstruction. Our approach, utilized a combination of a free fibula flap and a 4-zone rectus abdominis musculocutaneous flap, demonstrates the potential for advanced techniques in chest wall reconstruction to minimize complications and ensure long-term stability and function. As the incidence of breast cancer continues to rise, it is crucial that healthcare professionals explore and utilize innovative techniques to improve patient outcomes and quality of life.Keywords: free fibula flap, rectus abdominis musculocutaneous flap, post-adjuvant radiotherapy, reconstructive surgery, malignancy
Procedia PDF Downloads 622297 Extraction of Cellulose Nanofibrils from Pulp Using Enzymatic Pretreatment and Evaluation of Their Papermaking Potential
Authors: Ajay Kumar Singh, Arvind Kumar, S. P. Singh
Abstract:
Cellulose nanofibrils (CNF) have shown potential of their extensive use in various fields, including papermaking, due to their unique characteristics. In this study, CNF’s were prepared by fibrillating the pulp obtained from raw materials e.g. bagasse, hardwood and softwood using enzymatic pretreatment followed by mechanical refining. These nanofibrils, when examined under FE-SEM, show that partial fibrillation on fiber surface has resulted in production of nanofibers. Mixing these nanofibers with the unrefined and normally refined fibers show their reinforcing effect. This effect is manifested in observing the improvement in the physical and mechanical properties e.g. tensile index and burst index of paper. Tear index, however, was observed to decrease on blending with nanofibers. The optical properties of paper sheets made from blended fibers showed no significant change in comparison to those made from only mechanically refined pulp. Mixing of normal pulp fibers with nanofibers show increase in ºSR and consequent decrease in drainage rate. These changes observed in mechanical, optical and other physical properties of the paper sheets made from nanofibrils blended pulp have been tried to explain considering the distribution of the nanofibrils alongside microfibrils in the fibrous network. Since usually, paper/boards with higher strength are observed to have diminished optical properties which is a drawback in their quality, the present work has the potential for developing paper/boards having improved strength alongwith undiminished optical properties utilising the concepts of nanoscience and nanotechnology.Keywords: enzymatic pretreatment, mechanical refining, nanofibrils, paper properties
Procedia PDF Downloads 353