Search results for: patient safety in home hemodialysis

Authors: Kang Shuo-Shuo, Li Jian-Nan, Yang Shiming

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Purpose: The three-dimensional anatomical structure of the facial nerve recess and its relationship were measured by high-resolution temporal bone CT to provide imaging reference for cochlear implant operation. Materials and Methods: By analyzing the high-resolution CT of 160 cases (320 pleural ears) of the temporal bone, the following parameters were measured at the axial window niche level: 1. The distance between the facial nerve and chordae tympani nerve d1; 2. Distance between the facial nerve and circular window niche d2; 3. The relative Angle between the facial nerve and the circular window niche a; 4. Distance between the middle point of the face recess and the circular window niche d3; 5. The relative angle between the middle point of the face recess and the circular window niche b. Factors that might influence the anatomy of the facial recess were recorded, including the patient's sex, age, and anatomical variation (e.g., vestibular duct dilation, mastoid gas type, mothoid sinus advancement, jugular bulbar elevation, etc.), and the correlation between these factors and the measured facial recess parameters was analyzed. Result: The mean value of face-drum distance d1 is (3.92 ± 0.26) mm, the mean value of face-niche distance d2 is (5.95 ± 0.62) mm, the mean value of face-niche Angle a is (94.61 ± 9.04) °, and the mean value of fossa - niche distance d3 is (6.46 ± 0.63) mm. The average fossa-niche Angle b was (113.47 ± 7.83) °. Gender, age, and anterior sigmoid sinus were the three factors affecting the width of the opposite recess d1, the Angle of the opposite nerve relative to the circular window niche a, and the Angle of the facial recess relative to the circular window niche b. Conclusion: High-resolution temporal bone CT before cochlear implantation can show the important anatomical relationship of the facial nerve recess, and the measurement results have clinical reference value for the operation of cochlear implantation.

Keywords: cochlear implantation, recess of facial nerve, temporal bone CT, three-dimensional measurement

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Authors: E. A. Alaswad, H. M. Choudhry, F. Z. Filimban

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Sickle Cell Anemia (SCA) is one type of blood diseases related to autosomal disorder. The sickle shaped red blood cells are the main cause of many problems in the blood vessels and capillaries. Aerva Javanica (J) and Ficus Palmata (P) are medicinal plants that have many popular uses and have been proved their efficacy. The aim of this study was to assess the antioxidants activity and the antisickling effect of J and P extractions. The period of this study, air-dried leaves of J, and P plants were ground and the active components were extracted by maceration in water (W) and methanol (M) as solvents. The antioxidants activity of JW, PW, JM, and PM were assessed by way of the radical scavenging method using 2,2-diphenyl-1-picrylhydrazyl (DPPH). To determine the antisickling effect of J and P extracts. 20 samples were collected from sickle cell anemia patients. Different concentrations of J and P extracts (200 and 110 μg/mL) were added on the sample and incubated. A drop of each sample was examined with light microscope. Normal and sickled RBCs were calculated and expressed as the percent of sickling. The stabilization effect of the extracts was measured by the osmotic fragility test for erythrocytes. The finding suggests as estimated by DPPH method, all the extracts showed an antioxidant activity with a significant inhibition of the DPPH radicals. PM has the least IC50% with 71.49 μg/ml while JM was the most with 408.49 μg/ml. Sickle cells treated with extracts at different concentrations significantly reduced the percentage of sickling compering to control samples. However, JM 200 μg/mL give the highest anti-sickling affect with 17.4% of sickling compared to control 67.5 of sickling while PM at 200 μg/mL showed the highest membrane cell stability. In a conclusion, the results showed that J and P extracts have antisickling effects. Therefore, the Aerva javanica and Ficus palmata may have a role in SCA management and a good impact on the patient's lives.

Keywords: Aerva javanica, antioxidant, antisickling, Ficus palmata, sickle cell anemia

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Authors: Naser Shagerdi Esmaeli, Mohsen Hamidpour, Parisa Hasankhani Tehrani

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Background And Objective: Haematopoietic stem cell transplant is a potentially curative treatment option in various benign and malignant haematological diseases. Patients undergoing stem cell transplant procedure require blood transfusion on a daily basis. Currently, there is paucity of data from developing countries on transfusion practices. This audit was undertaken to determine the consumption of packed red blood cells (PRBCs) transfusion in the bone marrow transplant unit of the Shahid Ghazi Tabatabaei Hospital, Tabriz, Iran. Subjects And Methods: A retrospective audit was conducted for packed red cell transfusion ordering practice over a period from March 2017 to march 2018. All consecutive patients admitted for stem cell transplant procedure for various underlying diseases were included. Outcome measures used in this study were (i) cross match to transfusion (C: T) ratio and (ii) transfusion trigger. Results: During the study period, n=13 patients underwent a haematopoietic stem cell transplant. There were n=10 males and n=3 females. One patient was less than 15 years of age, while rests were adults. Median age±SD was 26.5±14.5 years (12∼54 years). The underlying diagnosis included Aplastic anemia (n=4), Thalassemia major (n=1), Multiple Myeloma (n=3), Acute leukemia (n=3), Hodgkin's lymphoma (n=1), PRCA (n=1). Grand total consumption of PRBCs during the study period was 204, while 258 products were crossmatch. The C:T ratio was 1.26. The transfusion trigger was Hb level of less than 8 gr/dl. Conclusion: The results of our BMT unit indicate that the C:T ratio and transfusion trigger is comparable to the international criteria and pioneer country in BMT transplantation. Also, we hope that our blood consumption become less than it is now.

Keywords: blood consumption, C: T ratio, PRBCs, stem cell transplant, tabriz, Iran

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Authors: Richard Krijnen, Alan Wang

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As the world is aiming to reach net zero around 2050, structural engineers must begin finding solutions to contribute to this global initiative. Approximately 40% of global energy-related emissions are due to buildings and construction, and a building’s structure accounts for 50% of its embodied carbon, which indicates that structural engineers are key contributors to finding solutions to reach carbon neutrality. However, this task presents a multifaceted challenge as structural engineers must navigate technical, safety and economic considerations while striving to reduce emissions. This study reviews several options and considerations to reduce carbon emissions that structural engineers can use in their future designs without compromising the structural integrity of their proposed design. Low-carbon structures should adhere to several guiding principles. Firstly, prioritize the selection of materials with low carbon footprints, such as recyclable or alternative materials. Optimization of design and engineering methods is crucial to minimize material usage. Encouraging the use of recyclable and renewable materials reduces dependency on natural resources. Energy efficiency is another key consideration involving the design of structures to minimize energy consumption across various systems. Choosing local materials and minimizing transportation distances help in reducing carbon emissions during transport. Innovation, such as pre-fabrication and modular design or low-carbon concrete, can further cut down carbon emissions during manufacturing and construction. Collaboration among stakeholders and sharing experiences and resources are essential for advancing the development and application of low-carbon structures. This paper identifies current available tools and solutions to reduce embodied carbon in structures, which can be used as part of daily structural engineering practice.

Keywords: efficient structural design, embodied carbon, low-carbon material, sustainable structural design

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Authors: Ivelise M. Strozberg, Juliana Sales Frota, Lucas de Oliveira Vale

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The state of Ceara, located in the northeast region of Brazil, is abundant in lateritic soil which has been usually discarded due to its lack of agricultural potential while materials of similar nature have been used as constituents of housing constructive elements in many parts of the world, such as India and Portugal, for decades. Since many of the semi-arid housing conditions in the state of Ceara fail to meet the minimum criteria regarding comfort and safety requirements, this research proposed to study the Ceara lateritic soil and the possibility of its use as a sustainable building block constituent for social housings, collaborating to the improvement of the region living conditions. In order to achieve this objective, soil samples were collected from five different locations within the specific region, three of which presented lateritic nature, being characterized according to the Unified Soil Classification System and the MCT methodology, which is a Brazilian methodology developed during the 80’s that aimed to better describe and approach tropical soils, its characterization and behavior. Two of these samples were used to build two different miniature block prototypes, which were manually molded, heated at low temperatures -( < 300 ºC) in order to save energy and lessen the CO₂ high emission rate common in traditional burning methods- and then submitted to load tests. Among the soils tested, the one with the highest degree of laterization and greater presence of fines constituted the block with the best performance in terms of flexural strength tensions, presenting resistance gains when heated at increasing temperatures, which can indicate that this type of soil has potential towards being used as constructing material.

Keywords: constructive blocks, lateritic soil, MCT methodology, sustainability

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Authors: Peng Guo

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Objective To investigate the clinical characteristics and changes of video-polysomnography (v-PSG) in Parkinson disease (PD) patients accompanied with cognitive impairment. Methods Three hundred and ninety-four patients with PD were enrolled in Beijing Tiantan Hospital, according to CI level, the patients were divided into PD without cognitive impairment (PD-NCI), PD with mild cognitive impairment (PD-MCI), and PD with dementia (PDD) group. Collect patient's demographic data, including gender, onset age, education level and duration. The cognitive function of PD patients was evaluated by Montreal cognitive assessment (MoCA) scale, and the overall cognitive function and cognitive domains of the three groups were compared.Using v-PSG to assess the sleep status of patients. Correlation analysis of MoCA Scale and v-PSG results in PD-CI group. Results 1. In 394 cases of PD, 94 cases (23.86%) in PD-NCI group , 177 cases(44.92%) in PD-MCI group , 123 cases (31.22%) in PDD group. 2.There was no significant difference in gender, age of onset, education level and duration in PD-NCI group, PD-MCI group and PDD group （P＞0.05）. 3. The total score of MoCA scale in PD-NCI group, PD-MCI group and PDD group decreased one by one. In PD-NCI group, PD-MCI group and PDD group, the scores of each cognitive domain in MoCA scale decreased significantly（P<0.05）. 4.Compared with the PD-MCI group, PDD group had lower total sleep time, lower sleep efficiency （P<0.05）. Compared with PD-NCI group, PDD group had lower total sleep time and lower sleep efficiency （P<0.05）.5. The sleep efficiency of PD-CI patients is positively correlated with the total score of MoCA scale, visual spatial function, executive function, delayed recall and attention score（P<0.05). Conclusions The incidence of CI in PD patients was high; The cognitive function and cognitive domains of PD-CI patients were significantly impaired; In patients with PD-CI, total sleep time decreased, sleep efficiency decreased, and it was related to overall cognitive function and partial cognitive impairment.

Keywords: Parkinson disease, cognitive impairment, clinical characteristics, sleep disorders, video-polysomnography

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Authors: Xvelian Qin

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Urban "organic renewal" based on the development of existing resources in high-density urban areas has become the mainstream of urban development in the new era. As an important stock resource of public space in high-density urban areas, promoting its value remodeling is an effective way to alleviate the shortage of public space resources. However, due to the lack of evaluation links in the process of underpass space renewal, a large number of underpass space resources have been left idle, facing the problems of low space conversion efficiency, lack of accuracy in development decision-making, and low adaptability of functional positioning to citizens' needs. Therefore, it is of great practical significance to construct the evaluation system of under-bridge space renewal potential and explore the renewal mode. In this paper, some of the under-bridge spaces in the main urban area of Chongqing are selected as the research object. Through the questionnaire interviews with the users of the built excellent space under the bridge, three types of six levels and twenty-two potential evaluation indexes of "objective demand factor, construction feasibility factor and construction suitability factor" are selected, including six levels of land resources, infrastructure, accessibility, safety, space quality and ecological environment. The analytical hierarchy process and expert scoring method are used to determine the index weight, construct the potential evaluation system of the space under the bridge in high-density urban areas of Chongqing, and explore the direction of renewal and utilization of its suitability.

Keywords: space under bridge, potential evaluation, high density urban area, updated using

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Authors: M. Karimpour, L. Hitihamillage, N. Elkhoury, S. Moridpour, R. Hesami

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Rail transport authorities around the world have been facing a significant challenge when predicting rail infrastructure maintenance work for a long period of time. Generally, maintenance monitoring and prediction is conducted manually. With the restrictions in economy, the rail transport authorities are in pursuit of improved modern methods, which can provide precise prediction of rail maintenance time and location. The expectation from such a method is to develop models to minimize the human error that is strongly related to manual prediction. Such models will help them in understanding how the track degradation occurs overtime under the change in different conditions (e.g. rail load, rail type, rail profile). They need a well-structured technique to identify the precise time that rail tracks fail in order to minimize the maintenance cost/time and secure the vehicles. The rail track characteristics that have been collected over the years will be used in developing rail track degradation prediction models. Since these data have been collected in large volumes and the data collection is done both electronically and manually, it is possible to have some errors. Sometimes these errors make it impossible to use them in prediction model development. This is one of the major drawbacks in rail track degradation prediction. An accurate model can play a key role in the estimation of the long-term behavior of rail tracks. Accurate models increase the track safety and decrease the cost of maintenance in long term. In this research, a short review of rail track degradation prediction models has been discussed before estimating rail track degradation for the curve sections of Melbourne tram track system using Adaptive Network-based Fuzzy Inference System (ANFIS) model.

Keywords: ANFIS, MGT, prediction modeling, rail track degradation

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Authors: Shaista Meghani, Rozina Karmaliani, Khairulnissa Ajani, Shireen Shahzad, Nadeem Ullah Khan

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Background: The concept of Family Presence During Resuscitation (FPDR) is gradually gaining recognition in western countries, however, it is rarely considered in South Asian countries including Pakistan. Over time, patients’ and families’ rights have gained recognition and healthcare has progressed to become more patient-family centered. Objectives: The objective of this study was to evaluate the impact of an educational program on the Knowledge, Attitude, and Practices (KAP) of healthcare professionals (HCPs) towards FPDR in Emergency Department (ED), at a tertiary care setting, in Karachi, Pakistan. Methods: This was a Pre-test and Post-test study design. A convenient universal sampling was done, and all ED nurses and physicians with more than one year of experience were eligible. The intervention included one-hour training sessions for physicians (three sessions) and nurses (eight sessions), The KAP of nurses and physicians were assessed immediately after (post-test I), and two weeks(post-test II) after the intervention using a pretested questionnaire. Results: The findings of the study revealed that the mean scores of knowledge and attitude of HCPs at both time points were statistically significant (p-value=<0.001), however, an insignificant difference was found on practice of FPDR (p-value=>0.05). Conclusion: The study findings recommend that the educational program on FPDR for HCPs needs to be offered on an ongoing basis. Moreover, training modules need to be developed for the staff, and formal guidelines need to be proposed for FPDR, through a multidisciplinary team approach.

Keywords: family presence, cardiopulmonary resuscitation, attitude, education, practices, health care professionals

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Authors: Hela Gargouri, Nizar Moalla, Hassen Hadj Kacem

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Meat adulteration affecting the safety and quality of food is becoming one of the main concerns of public interest across the world. The drastic consequences on the meat industry highlighted the urgent necessity to control the products' quality and to point out the complexity of both supply and processing circuits. Due to the expansion of this problem, the authentic testing of foods, particularly meat and its products, is deemed crucial to avoid unfair market competition and to protect consumers from fraudulent practices of meat adulteration. The adoption of authentication methods by the food quality-control laboratories is becoming a priority issue. However, in some developing countries, the number of food tests is still insignificant, although a variety of processed and traditional meat products are widely consumed. Little attention has been paid to provide an easy, fast, reproducible, and low-cost molecular test, which could be conducted in a basic laboratory. In the current study, the 359 bp fragment of the cytochrome-b gene was mapped by PCR-RFLP using firstly fresh biological supports (DNA and meat) and then turkey salami as an example of commercial processed meat. This technique has been established through several optimizations, namely: the selection of restriction enzymes. The digestion with BsmAI, SspI, and TaaI succeed to identify the seven included animal species when meat is formed by individual species and when the meat is a mixture of different origin. In this study, the PCR-RFLP technique using universal primer succeed to meet our needs by providing an indirect sequencing method identifying by restriction enzymes the specificities characterizing different species on the same amplicon reducing the number of potential tests.

Keywords: adulteration, animal species, authentication, meat, mtDNA, PCR-RFLP

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Authors: M. Abuqebitah, H. Tanyildizi, N. Yeyin, I. Cavdar, M. Demir, L. Kabasakal

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Aim: Targeted radionuclide therapy (TRT) is an increasingly used treatment modality for wide range of cancers. Presently dosimetry is highly required either to plan treatment or to ascertain the absorbed dose delivered to critical organs during treatment. Methods and Materials: The study comprised 7 patients suffered from prostate cancer with progressive disease and candidate to undergo Lu-177-DOTA-617 therapy following to PSMA- PET/CT imaging for all patients. (5.2±0.3 mCi) was intravenously injected. To evaluate bone marrow absorbed dose 2 cc blood samples were withdrawn in short variable times (3, 15, 30, 60, 180 minutes) after injection. Furthermore, whole body scans were performed using scintillation gama camera in 4, 24, 48, and 120 hours after injection and in order to quantify the activity taken up in the body, kidneys , liver, right parotid, and left parotid the geometric mean of anterior and posterior counts were determined through ROI analysis, after that background subtraction and attenuation correction were applied using patients PSMA- PET/CT images taking in a consideration: organ thickness, body thickness, and Hounsfield unites from CT scan. OLINDA/EXM dosimetry program was used for curve fitting, residence time calculation, and absorbed dose calculations. Findings: Absorbed doses of bone marrow, left kidney, right kidney, liver, left parotid, right parotid, total body were 1.28±0.52, 32.36±16.36, 32.7±13.68, 10.35±3.45, 38.67±21.29, 37.55±19.77, 2.25±0.95 (mGy/mCi), respectively. Conclusion: Our first results clarify that Lu-177-DOTA-617 is safe and reliable therapy as there were no complications seen. In the other hand, the observable variation in the absorbed dose of the critical organs among the patients necessitate patient-specific dosimetry approach to save body organs and particularly highly exposed kidneys and parotid gland.

Keywords: Lu-177-PSMA, prostate cancer, radionuclide therapy

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Authors: Huiling Feng, Xiaoshuang Jia, Jihong Liang, Li Niu

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Beijing, formerly romanized as Peking, is the capital of the People's Republic of China and the world's second most populous city proper and most populous capital city. Beijing is a noted historical and cultural whose city history dates back three millennia which is extremely rich in terms of cultural heritage. In 2012, a digital memory project led by Humanistic Beijing Studies Center in Renmin University of China started with the goal to build a total digital collection of knowledge assets about Beijing and represent Beijing memories in new fresh ways. The title of the entire project is ‘Peking Memory Project(PMP)’. The main goal is for safeguarding the documentary heritage and intellectual memory of Beijing, more specifically speaking, from the perspective of historical humanities and public participation, PMP will comprehensively applied digital technologies like digital capture, digital storage, digital process, digital presentation and digital communication to transform different kinds of cultural heritage of Beijing into digital formats that can be stored, re-organized and shared. These digital memories can be interpreted with a new perspective, be organized with a new theme, be presented in a new way and be utilized with a new need. Taking social memory as theoretical basis and digital technologies as tools, PMP is framed with ‘Two Sites and A Repository’. Two sites mean the special website(s) characterized by ‘professional’ and an interactive website characterized by ‘crowdsourcing’. A Repository means the storage pool used for safety long-time preservation of the digital memories. The work of PMP has ultimately helped to highlight the important role in safeguarding the documentary heritage and intellectual memory of Beijing.

Keywords: digital memory, cultural heritage, digital technologies, peking memory project

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Authors: Denise Levy

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Nuclear technology is part of our everyday life and its beneficial applications help to improve the quality of our lives. Nevertheless, in Brazil, most often the media and social networks tend to associate radiation to nuclear weapons and major accidents, and there is still great misunderstanding about the peaceful applications of nuclear science. The Educational Portal Radioatividades (Radioactivities) is a corporate social responsibility initiative that takes advantage of the growing impact of Internet to offer high quality scientific information for teachers and students throughout Brazil. This web-based initiative focusses on the positive applications of nuclear technology, presenting the several contributions of ionizing radiation in different contexts, such as nuclear medicine, agriculture techniques, food safety and electric power generation, proving nuclear technology as part of modern life and a must to improve the quality of our lifestyle. This educational project aims to contribute for democratization of scientific education and social inclusion, approaching society to scientific knowledge, promoting critical thinking and inspiring further reflections. The website offers a wide variety of ludic activities such as curiosities, interactive exercises and short courses. Moreover, teachers are offered free web-based material with full instructions to be developed in class. Since year 2013, the project has been developed and improved according to a comprehensive study about the realistic scenario of ICTs infrastructure in Brazilian schools and in full compliance with the best e-learning national and international recommendations.

Keywords: information and communication technologies, nuclear technology, science communication, society and education

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Authors: Daniele Zullino, Gabriel Thorens, Léonice Furtado, Federico Seragnoli, Radu Iuga, Louise Penzenstadler

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Context: Since the start of the 21st century, there has been a resurgence of interest in psychedelics, marked by a renewed focus on scientific investigations into their therapeutic potential. While psychedelic therapy has gained recognition for effectively treating depression and anxiety disorders, notable progress has been made in the clinical development of substances like psilocybin. Moreover, mounting evidence suggests promising applications of Lysergic acid diethylamide (LSD) and psilocybin in the field of addiction medicine. In Switzerland, compassionate treatment with LSD and psilocybin has been permitted since 2014 through exceptional licenses granted by the Federal Office of Public Health. This treatment approach is also available within the Geneva treatment program, extending its accessibility to patients undergoing opioid-assisted treatment involving substances like morphine and diacetylmorphine. The aim of this study is to assess the feasibility of psychedelic-assisted therapy in patients with opioid use disorder who are undergoing opioid-assisted treatment. This study addresses the question of whether psychedelic-assisted therapy can be successfully implemented in patients with opioid use disorder. It also explores the effects of psychedelic therapy on the patient's experiences and outcomes. Methodology: This is an open case series on six patients who have undergone at least one session with either LSD (100-200 micrograms) or psilocybin (20-40 mg). The patients were assessed using the Five Dimensional Altered States of Consciousness (5D-ASC)-Scale. The data were analyzed descriptively to identify patterns and trends in the patients' experiences. Results: The patients experienced substantial positive psychedelic effects during the psychedelic sessions without significant adverse effects. The patients reported positive experiences and improvements in their condition. Conclusion: The findings of this study support the feasibility and potential efficacy of psychedelic-assisted therapy in patients undergoing opioid-assisted treatment.

Keywords: psychedelics, psychedelic-assisted treatment, opioid use disorder, addiction, LSD, psilocybin

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Authors: A. D. Zikiryahodjaev, L. V. Bolotina, A. S. Sukhotko

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Purpose. To evaluate the expediency and timeliness of performance of surgical treatment as a component of multi-therapy treatment of patients with stage IV breast cancers. Materials and Methods. This investigation comparatively analyzed the results of complex treatment with or without surgery in patients with metastatic breast cancer. We analyzed retrospectively treatment experience of 196 patients with generalized breast cancer in the department of oncology and breast reconstructive surgery of P.A. Herzen Moscow Cancer Research Institute from 2000 to 2012. The average age was (58±1,1) years. Invasive ductul carcinoma was verified in128 patients (65,3%), invasive lobular carcinoma-33 (16,8%), complex form - 19 (9,7%). Complex palliative care involving drug and radiation therapies was performed in two patient groups. The first group includes 124 patients who underwent surgical intervention as complex treatment, the second group includes 72 patients with only medical therapy. Standard systemic therapy was given to all patients. Results. Overall, 3-and 5-year survival in fist group was 43,8 and 21%, in second - 15,1 and 9,3% respectively [p=0,00002 log-rank]. Median survival in patients with surgical treatment composed 32 months, in patients with only systemic therapy-21. The factors having influencing an influence on the prognosis and the quality of life outcomes for of patients with generalized breast cancer were are also studied: hormone-dependent tumor, Her2/neu hyper-expression, reproductive function status (age, menopause existence). Conclusion.Removing primary breast tumor in patients with generalized breast cancer improve long-term outcomes. Three- and five-year survival increased by 28,7 and 16,3% respectively, and median survival–for 11 months. These patients may benefit from resection of the breast tumor. One explanation for the effect of this resection is that reducing the tumor load influences metastatic growth.

Keywords: breast cancer, combination therapy, factors of prognosis, primary tumor

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Authors: Patience Manjengwa-Hungwe, Carmen White

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Background: Odyssean malaria refers to malaria acquired by infected mosquito bites from malaria endemic to non-endemic regions by mechanical modes of transport, such as airplanes, water vessels, trains and vehicles. Odyssean Malaria is rare and is characterised by absence of travel history to malaria endemic areas. As not anticipated in non-endemic areas, late diagnosis and treatment lead to a high case fatality rate. On 26 September 2014, the Outbreak Response Unit at the National Institute of Communicable Diseases was notified of a suspected death from Odyssean Malaria in Johannesburg, Gauteng Province, a non-endemic area. The main objective of this investigation was to identify the etiological agent's mode and source of transmission. Methods: Epidemiological surveys were conducted with the deceased’s family and clinical details were obtained from doctors who treated the victim in Southrand, Johannesburg. Blood samples were collected prior to death and sent to the National Health Laboratory Services, Johannesburg laboratory for a full blood count, urea electrolytes, creatinine, and C-reactive protein. Environmental assessments and entomological investigations, including collection of mosquito and larvae, were conducted at the deceased’s home and surrounding areas and sent to the laboratory for analysis. Results: Epidemiological surveys revealed no travel history, no mechanical transmission through blood transfusion and no previous possible exposure of the victim to malaria mosquitoes. Laboratory findings indicated that the platelet count was low. A further smear revealed that the malaria parasite was present and malaria antigen for P. falciparum was positive. Entomological findings revealed that none of the six adult or larval mosquitoes collected on site were malaria vectors. Dumping sites found at the back of the house were identified as possible sites where mosquitoes from endemic places could possibly breed. Conclusion: Given that there was no travel history or the possibility of mechanical transmission (blood transfusion or needle), the research team concluded that it is highly probable that the infection was acquired through an infective Anopheles mosquito inadvertently translocated from a Malaria endemic area by mechanical modes of transport. We recommend that clinicians in non-endemic malaria areas be aware of this type of malaria and test for malaria in patients showing malaria-like symptoms.

Keywords: Odyssean Malaria, vector Bourne, malaria, epidemiological surveys

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Authors: Amit Syal, Madeline Grade, Alister Martin

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Background: Cross-sectional and longitudinal studies demonstrate an association between health and voting. Furthermore, voting enables populations to support policies that impact their health via social determinants like income, education, housing, and healthcare access. Unfortunately, many barriers exist which disproportionately affect the civic participation of certain minority groups. Health professionals have an important role to play in addressing the civic health of all patients and empowering underrepresented communities. Description: Vot-ER is a non-partisan, nonprofit organization that aims to reduce barriers to civic participation by helping patients register to vote while in healthcare settings. The initial approach involved iPad-based kiosks in the emergency department waiting rooms, allowing patients to register themselves while waiting. After the COVID-19 pandemic began, Vot-ER expanded its touchless digital approaches. Vot-ER provides healthcare workers across the country with “Healthy Democracy Kits” consisting of badge backers, posters, discharge paperwork, and other resources. These contain QR and text codes that direct users to an online platform for registering to vote or requesting a mail-in ballot, available in English or Spanish. Outcomes: From May to November 2020, Vot-ER helped prepare 46,320 people to vote. 13,192 individual healthcare providers across all 50 states signed up for and received Healthy Democracy Kits. 80 medical schools participated in the Healthy Democracy Campaign competition. Over 500 institutions ordered site-based materials. Conclusions: A healthy democracy is one in which all individuals in a community have equal and fair opportunities for their voices to be heard. Healthcare settings, such as hospitals, are appropriate and effective venues for increasing both voter registration and education.

Keywords: civic health, enfranchisement, physician, voting

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Authors: Michael Vieth, Aric Schadler, Hubert Ballard, J. A. Bauer, Pratibha Thakkar

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Introduction: Congenital diaphragmatic hernia (CDH) is a condition characterized by the herniation of abdominal contents into the thoracic cavity requiring postnatal surgical repair. Previous literature suggests improved CDH outcomes at high-volume regional referral centers compared to low-volume centers. The purpose of this study was to examine CDH outcomes at Kentucky Children’s Hospital (KCH), a low-volume center, compared to the Congenital Diaphragmatic Hernia Study Group (CDHSG). Methods: A retrospective chart review was performed at KCH from 2007-2019 for neonates with CDH, and then subdivided into two cohorts: those requiring ECMO therapy and those not requiring ECMO therapy. Basic demographic data and measures of mortality and morbidity including ventilator days and length of stay were compared to the CDHSG. Measures of morbidity for the ECMO cohort including duration of ECMO, clinical bleeding, intracranial hemorrhage, sepsis, need for continuous renal replacement therapy (CRRT), need for sildenafil at discharge, timing of surgical repair, and total ventilator days were collected. Statistical analysis was performed using IBM SPSS Statistics version 28. One-sample t-tests and one-sample Wilcoxon Signed Rank test were utilized as appropriate.Results: There were a total of 27 neonatal patients with CDH at KCH from 2007-2019; 9 of the 27 required ECMO therapy. The birth weight and gestational age were similar between KCH and the CDHSG (2.99 kg vs 2.92 kg, p =0.655; 37.0 weeks vs 37.4 weeks, p =0.51). About half of the patients were inborn in both cohorts (52% vs 56%, p =0.676). KCH cohort had significantly more Caucasian patients (96% vs 55%, p=<0.001). Unadjusted mortality was similar in both groups (KCH 70% vs CDHSG 72%, p =0.857). Using ECMO utilization (KCH 78% vs CDHSG 52%, p =0.118) and need for surgical repair (KCH 95% vs CDHSG 85%, p =0.060) as proxy for severity, both groups’ mortality were comparable. No significant difference was noted for pulmonary outcomes such as average ventilator days (KCH 43.2 vs. CDHSG 17.3, p =0.078) and home oxygen dependency (KCH 44% vs. CDHSG 24%, p =0.108). Average length of hospital stay for patients treated at KCH was similar to CDHSG (64.4 vs 49.2, p=1.000). Conclusion: Our study demonstrates that outcome in CDH patients is independent of center’s case volume status. Management of CDH with a standardized approach in a low-volume center can yield similar outcomes. This data supports the treatment of patients with CDH at low-volume centers as opposed to transferring to higher-volume centers.

Keywords: ECMO, case volume, congenital diaphragmatic hernia, congenital diaphragmatic hernia study group, neonate

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Authors: Helena M. Wilhelm, Paulo O. Fernandes, Laís P. Dill, Kethlyn G. Moscon

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The use of vegetable oil (or natural ester) as an insulating fluid in electrical transformers is a trend that aims to contribute to environmental preservation since it is biodegradable and non-toxic. Besides, vegetable oil has high flash and combustion points, being considered a fire safety fluid. However, vegetable oil is usually less stable towards oxidation than mineral oil. Both insulating fluids, mineral and vegetable oils, need to be tested periodically according to specific standards. Oxidation stability can be determined by the induction period measured by conductivity method (Rancimat) by monitoring the effectivity of oil’s antioxidant additives, a methodology already developed for food application and biodiesel but still not standardized for insulating fluids. Besides adequate oxidation stability, fluids must be compatible with transformer's construction materials under normal operating conditions to ensure that damage to the oil and parts of the transformer does not occur. ASTM standard and Brazilian normative differ in parameters evaluated, which reveals the need to regulate tests for each oil type. The aim of this study was to assess oxidation stability and compatibility of vegetable oils to suggest the best way to assure a viable performance of vegetable oil as transformer insulating fluid. The determination of the induction period for several vegetable insulating oils from the local market by using Rancimat was carried out according to BS EN 14112 standard, at different temperatures (110, 120, and 130 °C). Also, the compatibility of vegetable oil was assessed according to ASTM and ABNT NBR standards. The main results showed that the best temperature for use in the Rancimat test is 130 °C, which allows a better observation of conductivity change. The compatibility test results presented differences between vegetable and mineral oil standards that should be taken into account in oil testing since materials compatibility and oxidation stability are essential for equipment reliability.

Keywords: compatibility, Rancimat, natural ester, vegetable oil

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Authors: Engida Yisma, Berhanu Dessalegn, Ayalew Astatkie, Nebreed Fesseha

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Background: The use of the partograph is a well-known best practice for quality monitoring of labour and subsequent prevention of obstructed and prolonged labour. However, a number of cases of obstructed labour do happen in health facilities due to poor quality of intrapartum care. Methods: A cross-sectional quantitative study assessed knowledge and utilization of partograph among obstetric care givers in public health institutions of Addis Ababa, Ethiopia using a structured interviewer administered questionnaire. The collected data was analyzed using SPSS version 16.0. Logistic regression analysis was used to identify factors associated with knowledge and use of partograph among obstetric care givers. Results: Knowledge about the partograph was fair: 189 (96.6%) of all the respondents correctly mentioned at least one component of the partograph, 104 (53.3%) correctly explained the function of alert line and 161 (82.6%) correctly explained the function of action line. The study showed that 112 (57.3%) of the obstetric care givers at public health institutions reportedly utilized partograph to monitor mothers in labour. The utilization of the partograph was significantly higher among obstetric care givers working in health centres (67.9%) compared to those working in hospitals (34.4%) [Adjusted OR = 3.63(95%CI: 1.81, 7.28)]. Conclusions: A significant percentage of obstetric care givers had fair knowledge of the partograph and why it is necessary to use it in the management of labour and over half of obstetric care givers reported use of the partograph to monitor mothers in labour. Pre-service and on-job training of obstetric care givers on the use of the partograph should be given emphasis. Mandatory health facility policy is also recommended to ensure safety of women in labour in public health facilities in Addis Ababa, Ethiopia.

Keywords: partograph, knowledge, utilization, obstetric care givers, public health institutions

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Authors: Eunkyo Kang, Jihye Lee, Jiyeon Choo

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Background: Pediatric palliative care has been increasing, and the number of studies has focused on the age at which pediatric patient can be notified their terminal illness, pediatric advanced care planning (ACP) and palliative care. However, there is a lack of research on health professionals’ perception. Aim: We aimed to investigate the perceptions of healthcare professionals about appropriate age disclosing terminal illness, awareness of ACP, and the relationship between ACP knowledge and the preference for palliative care for children. Methods: We administered nationwide questionnaires to 928 physicians from the 12 hospitals and the Korean Medical Association and 1,241 individuals of the general Korean population. We asked about the age at which the pediatric patients could be notified of their terminal illness, by 4 groups; 4 years old or older, 12 years old or older, 15 years old or older, or not. In addition, we surveyed the questionnaires about the knowledge of ACP of the medical staff, the preference of the pediatric hospice palliative care, aggressive treatment, and life-sustaining treatment preference. Results: In the appropriate age disclosing terminal illness, there were more respondents in the physicians than in the general population who thought that it was possible even at a younger age. Palliative care preference in pediatric patients who were expected to expire within months was higher when health care professionals had knowledge of ACPs compared to those without knowledge. The same results were obtained when deaths were expected within weeks or days. The age of the terminal status notification, the health care professionals who thought to be available at a lower age have a higher preference for palliative care and has less preference for aggressive treatment and life-sustaining treatment. Conclusion: Despite the importance of pediatric palliative care, our study confirmed that there is a difference in the preference of the health care professionals for pediatric palliative care according to the ACP knowledge of the medical staff or the appropriate age disclosing terminal illness. Future research should focus on strategies for inducing changes in perceptions of health care professionals and identifying other obstacles for the pediatric palliative care.

Keywords: pediatric palliative care, disclosing terminal illness, palliative care, advanced care planning

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Authors: P. Moskal, T. Bednarski, P. Bialas, E. Czerwinski, A. Gajos, A. Gruntowski, D. Kaminska, L. Kaplon, G. Korcyl, P. Kowalski, T. Kozik, W. Krzemien, E. Kubicz, Sz. Niedzwiecki, M. Palka, L. Raczynski, Z. Rudy, P. Salabura, N. G. Sharma, M. Silarski, A. Slomski, J. Smyrski, A. Strzelecki, A. Wieczorek, W. Wislicki, M. Zielinski, N. Zon

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A new concept and results of the performance tests of the TOF-PET detection system developed at the Jagiellonian University will be presented. The novelty of the concept lies in employing long strips of polymer scintillators instead of crystals as detectors of annihilation quanta, and in using predominantly the timing of signals instead of their amplitudes for the reconstruction of Lines-of-Response. The diagnostic chamber consists of plastic scintillator strips readout by pairs of photo multipliers arranged axially around a cylindrical surface. To take advantage of the superior timing properties of plastic scintillators the signals are probed in the voltage domain with the accuracy of 20 ps by a newly developed electronics, and the data are collected by the novel trigger-less and reconfigurable data acquisition system. The hit-position and hit-time are reconstructed by the dedicated reconstruction methods based on the compressing sensing theory and the library of synchronized model signals. The solutions are subject to twelve patent applications. So far a time-of-flight resolution of ~120 ps (sigma) was achieved for a double-strip prototype with 30 cm field-of-view (FOV). It is by more than a factor of two better than TOF resolution achievable in current TOF-PET modalities and at the same time the FOV of 30 cm long prototype is significantly larger with respect to typical commercial PET devices. The Jagiellonian PET (J-PET) detector with plastic scintillators arranged axially possesses also another advantage. Its diagnostic chamber is free of any electronic devices and magnetic materials thus giving unique possibilities of combining J-PET with CT and J-PET with MRI for scanning the same part of a patient at the same time with both methods.

Keywords: PET-CT, PET-MRI, TOF-PET, scintillator

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Authors: Ali Asgary, Haopeng Zhou, Ghassem Tofighi

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Use of virtual (VR), augmented reality (AR), and extended reality technologies for training and education has increased in recent years as more hardware and software tools have become available and accessible to larger groups of users. Similarly, the applications of these technologies in earthquake related training and education are on the rise. Several studies have reported promising results for the use of VR and AR for evacuation behaviour and training under earthquake situations. They simulate the impacts that earthquake has on buildings, buildings’ contents, and how building occupants and users can find safe spots or open paths to outside. Considering that considerable number of earthquake injuries and fatalities are linked to the behaviour, our goal is to use these technologies to reduce the impacts of building contents on people. Building on our artificial intelligence (AI) based indoor earthquake risk assessment application that enables users to use their mobile device to assess the risks associated with building contents during earthquakes, we develop a virtual reality application to demonstrate the behavior of different building contents during earthquakes, their associate moving, spreading, falling, and collapsing risks, and their risk mitigation methods. We integrate realistic seismic models, building contents behavior with and without risk mitigation measures in virtual reality environment. The application can be used for training of architects, interior design experts, and building users to enhance indoor safety of the buildings that can sustain earthquakes. This paper describes and demonstrates the application development background, structure, components, and usage.

Keywords: virtual reality, earthquake damage, building content, indoor risks, earthquake risk mitigation, interior design, unity game engine, oculus

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Authors: V. Veeraprathap, G. S. Harish, G. Narendra Kumar

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Uncontrolled growth of abnormal cells in the lung in the form of tumor can be either benign (non-cancerous) or malignant (cancerous). Patients with Lung Cancer (LC) have an average of five years life span expectancy provided diagnosis, detection and prediction, which reduces many treatment options to risk of invasive surgery increasing survival rate. Computed Tomography (CT), Positron Emission Tomography (PET), and Magnetic Resonance Imaging (MRI) for earlier detection of cancer are common. Gaussian filter along with median filter used for smoothing and noise removal, Histogram Equalization (HE) for image enhancement gives the best results without inviting further opinions. Lung cavities are extracted and the background portion other than two lung cavities is completely removed with right and left lungs segmented separately. Region properties measurements area, perimeter, diameter, centroid and eccentricity measured for the tumor segmented image, while texture is characterized by Gray-Level Co-occurrence Matrix (GLCM) functions, feature extraction provides Region of Interest (ROI) given as input to classifier. Two levels of classifications, K-Nearest Neighbor (KNN) is used for determining patient condition as normal or abnormal, while Artificial Neural Networks (ANN) is used for identifying the cancer stage is employed. Discrete Wavelet Transform (DWT) algorithm is used for the main feature extraction leading to best efficiency. The developed technology finds encouraging results for real time information and on line detection for future research.

Keywords: artificial neural networks, ANN, discrete wavelet transform, DWT, gray-level co-occurrence matrix, GLCM, k-nearest neighbor, KNN, region of interest, ROI

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Authors: Mirco Tarozzi, Giacomo Pignagnoli, Andrea Benedetti

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Structural systems are often subjected to degradation processes due to different kind of phenomena like unexpected loadings, ageing of the materials and fatigue cycles. This is true especially for bridges, in which their safety evaluation is crucial for the purpose of a design of planning maintenance. This paper discusses the experimental evaluation of the stiffness reduction from frequency changes due to uniform damage scenario. For this purpose, a 1:4 scaled bridge has been built in the laboratory of the University of Bologna. It is made of concrete and its cross section is composed by a slab linked to four beams. This concrete deck is 6 m long and 3 m wide, and its natural frequencies have been identified dynamically by exciting it with an impact hammer, a dropping weight, or by walking on it randomly. After that, a set of loading cycles has been applied to this bridge in order to produce a uniformly distributed crack pattern. During the loading phase, either cracking moment and yielding moment has been reached. In order to define the relationship between frequency variation and loss in stiffness, the identification of the natural frequencies of the bridge has been performed, before and after the occurrence of the damage, corresponding to each load step. The behavior of breathing cracks and its effect on the natural frequencies has been taken into account in the analytical calculations. By using a sort of exponential function given from the study of lot of experimental tests in the literature, it has been possible to predict the stiffness reduction through the frequency variation measurements. During the load test also crack opening and middle span vertical displacement has been monitored.

Keywords: concrete bridge, damage detection, dynamic test, frequency shifts, operational modal analysis

Procedia PDF Downloads 184

Authors: Ya-Ching Fu, An-Kuo Chou, Boon-Fatt Tan, Chi-Nien Chen, Wen-Chien Yang, Pou-Leng Cheong

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Blind oro-/naso-pharyngeal suction and feeding tube placement are very common practices in neonatal intensive care unit. Though esophageal perforation is a rare complication of these instrumentations, its prevalence is highest in extremely premature neonates. Due to its association with significant morbidity (including respiratory deterioration, pneumothorax, and sepsis) and even mortality, it is an important issue to prevent this iatrogenic complication in the field of premature care. We demonstrate an esophageal perforation in an extreme-low-birth-weight neonate after oro-gastric tube placement. This female baby weighing 680 grams was delivered by caesarean section at 25 weeks of gestational age. She initially received oro-tracheal intubation with mechanical ventilation which was smoothly weaned to non-invasive positive-pressure ventilation at 7-day-old. However, after insertion of a 5-French oro-gastric tube, the baby’s condition suddenly worsened with apnea requiring mechanical ventilation. Her chest radiogram showed the oro-gastric tube in right pleural space, and thus another oro-gastric tube was replaced, and its position was radiographically confirmed. The malpositioned tube was then removed. The baby received 2-week course of intravenous antibiotics for her esophageal perforation. Feeding was then reintroduced and increased to full feeds in a smooth course. She was discharged at 107-day-old. Esophageal perforation in newborn is very rare. Sudden respiratory deterioration in a neonate after naso-/oro-gastric tube placement should alarm us to consider esophageal perforation, and further radiological investigation is required for the diagnosis. Tube materials, patient condition, and age are major risk factors of esophageal perforation. The use of softer tube material, such as silicone, in extreme premature baby might prevent this fetal complication.

Keywords: esophageal perforation, preterm, newborn, feeding tube

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Authors: Mohammadreza Vafaei, Amirali Moradi, Sophia C. Alih

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The method selected for the design of structures not only can affect their seismic vulnerability but also can affect their construction cost. For the design of steel structures, two distinct methods have been introduced by existing codes, namely allowable stress design (ASD) and load resistant factor design (LRFD). This study investigates the effect of using the aforementioned design methods on the seismic vulnerability and construction cost of steel structures. Specifically, a 20-story building equipped with special moment resisting frame and an eccentrically braced system was selected for this study. The building was designed for three different intensities of peak ground acceleration including 0.2 g, 0.25 g, and 0.3 g using the ASD and LRFD methods. The required sizes of beams, columns, and braces were obtained using response spectrum analysis. Then, the designed frames were subjected to nine natural earthquake records which were scaled to the designed response spectrum. For each frame, the base shear, story shears, and inter-story drifts were calculated and then were compared. Results indicated that the LRFD method led to a more economical design for the frames. In addition, the LRFD method resulted in lower base shears and larger inter-story drifts when compared with the ASD method. It was concluded that the application of the LRFD method not only reduced the weights of structural elements but also provided a higher safety margin against seismic actions when compared with the ASD method.

Keywords: allowable stress design, load resistant factor design, nonlinear time history analysis, seismic vulnerability, steel structures

Procedia PDF Downloads 269

Authors: Swati Kapoor, Rajeev Upreti, Monica Mahajan, Abhaya Indrayan, Dinesh Srivastava

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Enteric Fever is caused by gram negative bacilli Salmonella typhi and paratyphi. It is associated with high morbidity and mortality worldwide. Timely initiation of treatment is a crucial step for prevention of any complications. Cultures of body fluids are diagnostic, but not always conclusive or practically feasible in most centers. Moreover, the results of cultures delay the treatment initiation. Serological tests lack diagnostic value. The blood counts can offer a promising option in diagnosis. A retrospective study to find out the relevance of leucopenia and eosinopenia was conducted on 203 culture proven enteric fever patients and 159 culture proven non-enteric fever patients in a tertiary care hospital in New Delhi. The patient details were retrieved from the electronic medical records section of the hospital. Absolute eosinopenia was considered as absolute eosinophil count (AEC) of less than 40/mm³ (normal level: 40-400/mm³) using LH-750 Beckman Coulter Automated machine. Leucopoenia was defined as total leucocyte count (TLC) of less than 4 X 10⁹/l. Blood cultures were done using BacT/ALERT FA plus automated blood culture system before first antibiotic dose was given. Case and control groups were compared using Pearson Chi square test. It was observed that absolute eosinophil count (AEC) of 0-19/mm³ was a significant finding (p < 0.001) in enteric fever patients, whereas leucopenia was not a significant finding (p=0.096). Using Receiving Operating Characteristic (ROC) curves, it was observed that patients with both AEC < 14/mm³ and TCL < 8 x 10⁹/l had 95.6% chance of being diagnosed as enteric fever and only 4.4% chance of being diagnosed as non-enteric fever. This result was highly significant with p < 0.001. This is a very useful association of AEC and TLC found in enteric fever patients of this study which can be used for the early initiation of treatment in clinically suspected enteric fever patients.

Keywords: absolute eosinopenia, absolute eosinophil count, enteric fever, leucopenia, total leucocyte count

Procedia PDF Downloads 172

Authors: P. V. S. Mascarenhas, B. C. P. Albuquerque, D. J. F. Campos, L. L. Almeida, V. R. Domingues, L. C. S. M. Ozelim

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Retaining slope structures are increasingly considered in geotechnical engineering projects due to extensive urban cities growth. These kinds of engineering constructions may present instabilities over the time and may require reinforcement or even rebuilding of the structure. In this context, statistical analysis is an important tool for decision making regarding retaining structures. This study approaches the failure probability of the construction of a retaining wall over the debris of an old and collapsed one. The new solution’s extension length will be of approximately 350 m and will be located over the margins of the Lake Paranoá, Brasilia, in the capital of Brazil. The building process must also account for the utilization of the ruins as a caisson. A series of in situ and laboratory experiments defined local soil strength parameters. A Standard Penetration Test (SPT) defined the in situ soil stratigraphy. Also, the parameters obtained were verified using soil data from a collection of masters and doctoral works from the University of Brasília, which is similar to the local soil. Initial studies show that the concrete wall is the proper solution for this case, taking into account the technical, economic and deterministic analysis. On the other hand, in order to better analyze the statistical significance of the factor-of-safety factors obtained, a Monte Carlo analysis was performed for the concrete wall and two more initial solutions. A comparison between the statistical and risk results generated for the different solutions indicated that a Gabion solution would better fit the financial and technical feasibility of the project.

Keywords: economical analysis, probability of failure, retaining walls, statistical analysis

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Authors: Ekere E. Kokonne, Isimi C. Yetunde, Okoh E. Judith, Okafor E. Ijeoma, Ajeh J. Isaac, Olobayo O. Kunle, Emeje O. Martins

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NIPRIMAL® is a mono herbal formulation of Nauclea latifolia used in the treatment of malaria. The stability of extracts made from plant material is essential to ensure the quality, safety and efficacy of the finished product. This study assessed the stability of the formulation under three different storage conditions; normal room temperature, infrared and under refrigeration. Differential Scanning Calorimetry (DSC) and Thin Layer Chromatography (TLC) were used to monitor the formulations. The DSC analysis was done from 0oC to 350oC under the three storage conditions. Results obtained indicate that NIPRIMAL® was stable at all the storage conditions investigated. Thin layer chromatography (TLC) after 6 months showed there was no significant difference between retention factor (RF) values for the various storage conditions. The reference sample had four spots with RF values of 0.47, 0.68, 0.76, 0.82 respectively and these spots were retained in the test formulations with corresponding RF values were after 6 months at room temperature and refrigerated temperature been 0.56, 0.73, 0.80, 0.92 and 0.47, 0.68, 0.76, 0.82 respectively. On the other hand, the RF values (0.55, 0.74, 0.77, 0.93) obtained under infrared after 1 month varied slightly from the reference. The sample exposed to infrared had a lower heat capacity compared to that stored under room temperature or refrigeration. A combination of TLC and DSC measurements has been applied for assessing the stability of NIPRIMAL®. Both methods were found to be rapid, sensitive and reliable in determining its stability. It is concluded that NIPRIMAL® can be stored under any of the tested conditions without degradation. This study is a major contribution towards developing appropriate stability monitoring parameters for herbal products.

Keywords: differential scanning calorimetry, formulation, NIPRIMAL®, stability, thin layer hromatography

Procedia PDF Downloads 257