Search results for: small cell carcinoma of gall bladder
2506 Prevalence, Isolation and Identification of Feline Panleukopaenia Virus from Wild Felids in Nandankanan Zoo, Odisha
Authors: Arun Kharate, Sarata Kumar Sahu, Susen Kumar Panda, Niranjan Sahoo, H. K. Panda
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In the present study, an attempt has been made for isolation and identification of feline panleukopaenia virus (FPLV) from wild felids of Nandankanan zoo, Odisha, India, along with prevalence study of FPLV. Fecal samples collected from wild felids (26 tigers, 22 lions, 5 leopards, 3 hyenas, 1 jaguar, 2 foxes and 1 wild cat) were subjected to hemagglutinnation test and fluorescent antibody test. In hemagglutinnation test 13 (50%) samples from tiger, 14 (63.63%) samples from lions, 1 (20%) sample from leopards, 1 (50%) from fox, 3 (100%) samples from hyenas and 1 (100%) sample from wild cat were positive. On fluorescent antibody test (FAT), 15 (57.69%) samples from tiger, 18 (81.81%) from lions, 2 (40%) from leopards, 1 (50%) from fox, 3 (100%) from hyenas and 1 (100%) from wild cat were positive. FPLV was isolated using MDBK cell line and preliminary characterization was done on the basis of characteristic cytopathic effect. The virus samples were quantified through titration in MDBK cells. Serological confirmation of FPLV isolates was carried out by HI test, micro-SNT and indirect-ELISA. Physico-chemical characters like pH and temperature resistance along molecular identification using specific FPLV primers was carried out. Seroprevalence study of 36 serum samples employing HI test, micro SNT and indirect-ELISA revealed prevalence of 38.8, 44.4 and 72.2% respectively. During study period an adult tigress and a tiger cub died suspected of feline panleukopenia. The necropsy findings in both animals showed hemorrhagic gastroenteritis. The cytological examination revealed presence of intranuclear inclusion bodies in the intestinal epithelial cells. Spleen, mesenteric lymph node and intestine were positive for feline panleukopenia by FAT. The investigation revealed that feline panleukopenia was prevalent in wild felines of Nandankanan zoo.Keywords: Feline panleukopenia, fluorescent antibody test, hemagglutination test, indirect-ELISA, Nandankanan zoo
Procedia PDF Downloads 3252505 Development of Latent Fingerprints on Non-Porous Surfaces Recovered from Fresh and Sea Water
Authors: A. Somaya Madkour, B. Abeer sheta, C. Fatma Badr El Dine, D. Yasser Elwakeel, E. Nermine AbdAllah
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Criminal offenders have a fundamental goal not to leave any traces at the crime scene. Some may suppose that items recovered underwater will have no forensic value, therefore, they try to destroy the traces by throwing items in water. These traces are subjected to the destructive environmental effects. This can represent a challenge for Forensic experts investigating finger marks. Accordingly, the present study was conducted to determine the optimal method for latent fingerprints development on non-porous surfaces submerged in aquatic environments at different time interval. The two factors analyzed in this study were the nature of aquatic environment and length of submerged time. In addition, the quality of developed finger marks depending on the used method was also assessed. Therefore, latent fingerprints were deposited on metallic, plastic and glass objects and submerged in fresh or sea water for one, two, and ten days. After recovery, the items were subjected to cyanoacrylate fuming, black powder and small particle reagent processing and the prints were examined. Each print was evaluated according to fingerprint quality assessment scale. The present study demonstrated that the duration of submersion affects the quality of finger marks; the longer the duration, the worse the quality.The best results of visualization were achieved using cyanoacrylate either in fresh or sea water. This study has also revealed that the exposure to sea water had more destructive influence on the quality of detected finger marks.Keywords: fingerprints, fresh water, sea, non-porous
Procedia PDF Downloads 4532504 Health Hazards in SME Garment Industries in India
Authors: Pranab Kumar Goswami
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According to WHO, over 1000 million people worldwide are employed in small-scale industries. The ‘garment’ industry’ is one such industry in developing countries. These garment SMEs are mostly run by private establishments in the unorganized sector to avoid legal obligations of OSH provisions. The OSH standards are very poor and even basic health and safety provisions are not provided in such units. The study has been conducted in India among workers employed in the ‘garment’ industry with the objectives to analyze the types and extent of occupational health hazards of the garment workers and to assess the relationship of sociodemographic and occupational factors with various health hazards. The survey method, the tabular method followed by applying simple statistical technique, has been taken into account to analyze the data collected from three SME garment industries in Delhi (India-Asia). The study was conducted in Delhi from August-2019 to October-2020. A random sampling of 70 workers from three factories has been chosen for this study. The study shows that most of the workers were males (82%) and were in the 18-50 age group (78%), with none below 18 years of age. It was found that 26% of the workers were illiterate and most of them belonged to poor socioeconomic status. The study revealed that the nature of the hazards in garment industries in India is mostly physical and mechanical. We found that musculoskeletal problems (54%) were the commonest health problem. The body areas commonly affected were neck, low back, hand, wrist, finger, and shoulder. If garment workers’ health is affected by occupational hazards, it will impact on national health and economic growth of developing countries. Health is a joint responsibility of both government and employing authority.Keywords: garment, MSD, health hazard, social factor
Procedia PDF Downloads 1972503 Study of Acoustic Resonance of Model Liquid Rocket Combustion Chamber and Its Suppression
Authors: Vimal O. Kumar, C. K. Muthukumaran, P. Rakesh
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Liquid rocket engine (LRE) combustion chamber is subjected to pressure oscillation during the combustion process. The combustion noise (acoustic noise) is a broad band, small amplitude, high frequency component pressure oscillation. They constitute only a minor fraction ( < 1%) of the entire combustion process. However, this high frequency oscillation is huge concern during the design phase of LRE combustion chamber as it would cause catastrophic failure of the chamber. Depends on the chamber geometry, certain frequencies form standing wave pattern, and they resonate with high amplitude and are known as Eigen modes. These Eigen modes could cause failures unless it is suppressed to be within safe limits. These modes are categorized into radial, tangential, and azimuthal modes, and their structure inside the combustion chamber is of interest to the researchers. In the present proposal, experimental as well as numerical simulation will be performed to obtain the frequency-amplitude characteristics of the model combustion chamber for different baffle configuration. The main objective of this study is to find effect of baffle configuration that would provide better suppression of acoustic modes. The experimental study aims at measuring the frequency amplitude characteristics at certain points in the chamber wall. The experimental measurement will be also used for scheme used in numerical simulation. In addition to experiments, numerical simulation would provide detailed structure of the Eigenmodes exhibited and their level of suppression with the aid of different baffle configurations.Keywords: baffle, instability, liquid rocket engine, pressure response of chamber
Procedia PDF Downloads 1192502 Age and Gender Differences in the Language Deficits of Individuals with Asperger Syndrome (AS) and High Functioning Autism (HFA): Systematic Literature Review (SLR) and Meta-Analysis (MA)
Authors: Sadeq Al Yaari, Muhammad Alkhunayn, Montaha Al Yaari, Ayman Al Yaari, Aayah Al Yaari, Adham Al Yaari, Sajedah Al Yaari, Fatehi Eissa
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Background: In spite of the fact that several language deficits, both internalizing and externalizing, have been documented in comorbidity with Asperger Syndrome (AS) and High Functioning Autism (HFA), there is a paucity of the continuity of these deficits in these individuals’ life span. Furthermore, findings regarding differences in the occurrence of these language deficits both in HFA and AS males and females are mixed. Aims: Systematic Literature Review and meta-analysis (SLR & Meta-analysis) provides a more valid indicator; that is why it has been used here to distinguish HFA and AS individuals in terms of (a) When does language deficits prevails in these individuals’ life and (b) in which gender the prevalence of these language deficits is seen more. Materials and Method: In this SLR & Meta-analysis, PubMed, ScienceDirect, SpringerLink, SAGE journals online, WILEY online library, Google Scholar, CINAHL, EMBASE, Scopus, and ERIC databases in addition to unpublished literature were systematically searched between 1st of January 1980 and 30th of May 2022. Interpretations: Although overall sample sizes were small, the combined results do permit the tentative conclusion that prevalence of language deficits both in AS and HFA children and adults with more prevalence of phonological deficit in HFA male children and pragmatic deficits in AS male children. Further research should be separately undertaken in each linguistic branch to verify the occlusions of this study.Keywords: high-functioning autism, Asperger syndrome, systematic literature review, meta-analysis
Procedia PDF Downloads 502501 Sustainability of Ecotourism Related Activities in the Town of Yercaud: A Modeling Study
Authors: Manoj Gupta Charan Pushparaj
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Tourism related activities are getting popular day by day and tourism has become an integral part of everyone’s life. Ecotourism initiatives have grown enormously in the past decade, and the concept of ecotourism has shown to bring great benefits in terms of environment conservation and to improve the livelihood of local people. However, the potential of ecotourism to sustain improving the livelihood of the local population in the remote future is a topic of active debate. A primary challenge that exists in this regard is the enormous costs of limiting the impacts of tourism related activities on the environment. Here we employed systems modeling approach using computer simulations to determine if ecotourism activities in the small hill town of Yercaud (Tamil Nadu, India) can be sustained over years in improving the livelihood of the local population. Increasing damage to the natural environment as a result of tourism-related activities have plagued the pristine hill station of Yercaud. Though ecotourism efforts can help conserve the environment and enrich local population, questions remain if this can be sustained in the distant future. The vital state variables in the model are the existing tourism foundation (labor, services available to tourists, etc.,) in the town of Yercaud and its natural environment (water, flora and fauna). Another state variable is the textile industry that drives the local economy. Our results would help to understand if environment conservation efforts are sustainable in Yercaud and would also offer suggestions to make it sustainable over the course of several years.Keywords: ecotourism, simulations, modeling, Yercaud
Procedia PDF Downloads 2732500 Antimicrobial, Antioxidant and Cytotoxic Activities of Cleoma viscosa Linn. Crude Extracts
Authors: Suttijit Sriwatcharakul
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The bioactivity studies from the weed ethanolic crude extracts from leaf, stem, pod and root of wild spider flower; Cleoma viscosa Linn. were analyzed for the growth inhibition of 6 bacterial species; Salmonella typhimurium TISTR 5562, Pseudomonas aeruginosa ATCC 27853, Staphylococcus aureus TISTR 1466, Streptococcus epidermidis ATCC 1228, Escherichia coli DMST 4212 and Bacillus subtilis ATCC 6633 with initial concentration crude extract of 50 mg/ml. The agar well diffusion results found that the extracts inhibit only gram positive bacteria species; S. aureus, S. epidermidis and B. subtilis. The minimum inhibition concentration study with gram positive strains revealed that leaf crude extract give the best result of the lowest concentration compared with other plant parts to inhibit the growth of S. aureus, S. epidermidis and B. subtilis at 0.78, 0.39 and lower than 0.39 mg/ml, respectively. The determination of total phenolic compounds in the crude extracts exhibited the highest phenolic content was 10.41 mg GAE/g dry weight in leaf crude extract. Analyzed the efficacy of free radical scavenging by using DPPH radical scavenging assay with all crude extracts showed value of IC50 of leaf, stem, pod and root crude extracts were 8.32, 12.26, 21.62 and 35.99 mg/ml, respectively. Studied cytotoxicity of crude extracts on human breast adenocarcinoma cell line by MTT assay found that pod extract had the most cytotoxicity CC50 value, 32.41 µg/ml. Antioxidant activity and cytotoxicity of crude extracts exhibited that the more increase of extract concentration, the more activities indicated. According to the bioactivities results, the leaf crude extract of Cleoma viscosa Linn. is the most interesting plant part for further work to search the beneficial of this weed.Keywords: antimicrobial, antioxidant activity, Cleoma viscosa Linn., cytotoxicity test, total phenolic compound
Procedia PDF Downloads 2702499 Assessment of Tidal Current Energy Potential at LAMU and Mombasa in Kenya
Authors: Lucy Patricia Onundo, Wilfred Njoroge Mwema
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The tidal power potential available for electricity generation from Mombasa and Lamu sites in Kenya will be examined. Several African countries in the Western Indian Ocean endure insufficiencies in the power sector, including both generation and distribution. One important step towards increasing energy security and availability is to intensify the use of renewable energy sources. The access to cost-efficient hydropower is low in Mombasa and Lamu hence Ocean energy will play an important role. Global-Level resource assessments and oceanographic literature and data have been compiled in an analysis between technology-specific requirements for ocean energy technologies (salinity, tide, tidal current, wave, Ocean thermal energy conversion, wind and solar) and the physical resources in Lamu and Mombasa. The potential for tide and tidal current power is more restricted but may be of interest at some locations. The theoretical maximum power produced over a tidal cycle is determined by the product of the forcing tide and the undisturbed volumetric flow-rate. The extraction of the maximum power reduces the flow-rate, but a significant portion of the maximum power can be extracted with little change to the tidal dynamics. Two-dimensional finite-element, numerical simulations designed and developed agree with the theory. Temporal variations in resource intensity, as well as the differences between small-scale and large-scale applications, are considered.Keywords: energy assessment, marine tidal power, renewable energy, tidal dynamics
Procedia PDF Downloads 5762498 Elaboration and Investigation of the New Ecologically Clean Friction Composite Materials on the Basis of Nanoporous Raw Materials
Authors: Lia Gventsadze, Elguja Kutelia, David Gventsadze
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The purpose of the article is to show the possibility for the development of a new generation, eco-friendly (asbestos free) nano-porous friction materials on the basis of Georgian raw materials, along with the determination of technological parameters for their production, as well as the optimization of tribological properties and the investigation of structural aspects of wear peculiarities of elaborated materials using the scanning electron microscopy (SEM) and Auger electron spectroscopy (AES) methods. The study investigated the tribological properties of the polymer friction materials on the basis of the phenol-formaldehyde resin using the porous diatomite filler modified by silane with the aim to improve the thermal stability, while the composition was modified by iron phosphate, technical carbon and basalt fibre. As a result of testing the stable values of friction factor (0.3-0,45) were reached, both in dry and wet friction conditions, the friction working parameters (friction factor and wear stability) remained stable up to 500 OC temperatures, the wear stability of gray cast-iron disk increased 3-4 times, the soundless operation of materials without squeaking were achieved. Herewith it was proved that small amount of ingredients (5-6) are enough to compose the nano-porous friction materials. The study explains the mechanism of the action of nano-porous composition base brake lining materials and its tribological efficiency on the basis of the triple phase model of the tribo-pair.Keywords: brake lining, friction coefficient, wear, nanoporous composite, phenolic resin
Procedia PDF Downloads 3922497 A Case Report of Aberrant Vascular Anatomy of the Deep Inferior Epigastric Artery Flap
Authors: Karissa Graham, Andrew Campbell-Lloyd
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The deep inferior epigastric artery perforator flap (DIEP) is used to reconstruct large volumes of tissue. The DIEP flap is based on the deep inferior epigastric artery (DIEA) and vein. Accurate knowledge of the anatomy of these vessels allows for efficient dissection of the flap, minimal damage to surrounding tissue, and a well vascularized flap. A 54 year old lady was assessed for bilateral delayed autologous reconstruction with DIEP free flaps. The right DIEA was consistent with the described anatomy. The left DIEA had a vessel branching shortly after leaving the external iliac artery and before entering the muscle. This independent branch entered the muscle and had a long intramuscular course to the largest perforator. The main DIEA vessel demonstrated a type II branching pattern but had perforators that were too small to have a viable DIEP flap. There were no communicating arterial branches between the independent vessel and DIEA, however, there was one venous communication between them. A muscle sparing transverse rectus abdominis muscle flap was raised using the main periumbilical perforator from the independent vessel. Our case report demonstrated an unreported anatomical variant of the DIEA. A few anatomical variants have been described in the literature, including a unilateral absent DIEA and peritoneal-cutaneous perforators that had no connection to the DIEA. Doing a pre-operative CTA helps to identify these rare anatomical variations, which leads to safer, more efficient, and effective operating.Keywords: aberrant anatomy, CT angiography, DIEP anatomy, free flap
Procedia PDF Downloads 1312496 Effect of Insulin versus Green Tea on the Parotid Gland of Streptozotocin Induced Diabetic Rats
Authors: H. El-Messiry, M. El-Zainy, D. Ghazy
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Diabetes is a metabolic disease that results in a variety of oral health complications. Green tea is a natural antioxidant proved to have powerful effects against diabetes. The aim of this study was to compare between the effect of insulin and green tea on the Parotid gland of streptozotocin induced diabetic Albino rats by using light and transmission electron microscopy. Forty male Albino rats were divided into control group and diabetic groups. The diabetic group received a single injection of 40 mg/kg of streptozotocin intra-peritoneal under anesthesia and was further subdivided into three subgroups: The diabetic untreated subgroup which was untreated for two weeks, the insulin treated subgroup which has received insulin subcutaneously in a daily dose of 5 IU/kg body weight/day for two weeks and a green tea treated subgroup received a daily dose of 1 ml/ 100 gm body weight intragastrically for two weeks. Rats were terminated and parotid glands were dissected and processed for light and transmission electron microscopic examination. Histological examination of the diabetic untreated subgroup revealed acinar cells with pyknotic and hyperchromatic nuclei with cytoplasmic vacuolations. Ultrastructurally, acinar cells showed nuclear pleomorphism, dilated rough endoplasmic reticulum and swollen mitochondria with damaged cristae. Inflammatory cell infiltration was detected both histologically and ultrastructurally. Ducts showed signs of degeneration with loss of their normal outline and stagnated secretion within the lumen. However, insulin and green tea treated subgroups showed minimal degenerative damage and were almost similar to the control with minimal changes. Treatment of the parotid gland of the streptozotocin induced diabetic rats with GT was closely comparable to the traditional insulin therapy in reducing signs of histological and ultrastructural damage.Keywords: diabetes, green tea, insulin, parotid
Procedia PDF Downloads 1762495 Nonlinear Passive Shunt for Electroacoustic Absorbers Using Nonlinear Energy Sink
Authors: Diala Bitar, Emmanuel Gourdon, Claude H. Lamarque, Manuel Collet
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Acoustic absorber devices play an important role reducing the noise at the propagation and reception paths. An electroacoustic absorber consists of a loudspeaker coupled to an electric shunt circuit, where the membrane is playing the role of an absorber/reflector of sound. Although the use of linear shunt resistors at the transducer terminals, has shown to improve the performances of the dynamical absorbers, it is nearly efficient in a narrow frequency band. Therefore, and since nonlinear phenomena are promising for their ability to absorb the vibrations and sound on a larger frequency range, we propose to couple a nonlinear electric shunt circuit at the loudspeaker terminals. Then, the equivalent model can be described by a 2 degrees of freedom system, consisting of a primary linear oscillator describing the dynamics of the loudspeaker membrane, linearly coupled to a cubic nonlinear energy sink (NES). The system is analytically treated for the case of 1:1 resonance, using an invariant manifold approach at different time scales. The proposed methodology enables us to detect the equilibrium points and fold singularities at the first slow time scales, providing a predictive tool to design the nonlinear circuit shunt during the energy exchange process. The preliminary results are promising; a significant improvement of acoustic absorption performances are obtained.Keywords: electroacoustic absorber, multiple-time-scale with small finite parameter, nonlinear energy sink, nonlinear passive shunt
Procedia PDF Downloads 2182494 Radial Variation of Anatomical Characteristics in Three Native Fast-Growing Species Growing in South Kalimantan, Indonesia
Authors: Wiwin Tyas Istikowati, Futoshi Ishiguri, Haruna Aisho, Budi Sutiya, Imam Wahyudi, Kazuya Iizuka, Shinso Yokota
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The objective of this study was to investigate the anatomical characteristics of three native fast-growing species, terap (Artocarpus elasticus Reinw. ex Blume), medang (Neolitsea latifolia (Blume) S. Moore), and balik angin (Alphitonia excelsa (Fenzel) Reissek ex Benth) growing in the secondary forest in South Kalimantan, Indonesia for evaluating the possibility of tree breeding for wood quality. Cell lengths were investigated for 5 trees in each species at several different height positions (1.0, 3.0, 5.0, 7.0, 9.0, and 11.0 m above the ground). The mean values of fiber and vessel element lengths in terap, medang, and balik angin were 1.52 and 0.44, 1.16 and 0.53, and 1.02 and 0.49 mm, respectively. Fiber length in terap and balik angin gradually increased from pith to bark, whereas it increased up to 2 cm and then became nearly constant to the bark in medang. Vessel element length was almost constant from pith to bark in terap and balik angin, while slightly increased from pith to bark in medang. Fiber length in terap has a fluctuation pattern from ground level to top of the tree. It decreased up to 3 m above the ground, increased up to 5 m, and then decreased to the top of the tree. On the other hand, vessel element length slightly increased up to 5 m above the ground, and then decreased to the top of the tree. Both fiber and vessel element lengths in medang were almost constant from ground level to top of the tree, whereas decreased from ground level to top of the tree in balik angin. Significant difference at 1% level among trees was found in both fiber and vessel element length in both radial and longitudinal directions for terap and medang. Based on obtained results, it is concluded that the wood quality in fiber and vessel element lengths of terap and medang can be improved by tree breeding programs.Keywords: anatomical properties, fiber length, vessel elements length, fast-growing species
Procedia PDF Downloads 3472493 Characteristics and Flight Test Analysis of a Fixed-Wing UAV with Hover Capability
Authors: Ferit Çakıcı, M. Kemal Leblebicioğlu
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In this study, characteristics and flight test analysis of a fixed-wing unmanned aerial vehicle (UAV) with hover capability is analyzed. The base platform is chosen as a conventional airplane with throttle, ailerons, elevator and rudder control surfaces, that inherently allows level flight. Then this aircraft is mechanically modified by the integration of vertical propellers as in multi rotors in order to provide hover capability. The aircraft is modeled using basic aerodynamical principles and linear models are constructed utilizing small perturbation theory for trim conditions. Flight characteristics are analyzed by benefiting from linear control theory’s state space approach. Distinctive features of the aircraft are discussed based on analysis results with comparison to conventional aircraft platform types. A hybrid control system is proposed in order to reveal unique flight characteristics. The main approach includes design of different controllers for different modes of operation and a hand-over logic that makes flight in an enlarged flight envelope viable. Simulation tests are performed on mathematical models that verify asserted algorithms. Flight tests conducted in real world revealed the applicability of the proposed methods in exploiting fixed-wing and rotary wing characteristics of the aircraft, which provide agility, survivability and functionality.Keywords: flight test, flight characteristics, hybrid aircraft, unmanned aerial vehicle
Procedia PDF Downloads 3272492 Design and Implementation Wireless System by Using Microcontrollers.Application for Drive Acquisition System with Multiple Sensors
Authors: H. Fekhar
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Design and implementation acquisition system using radio frequency (RF) ASK module and micro controllers PIC is proposed in this work. The paper includes hardware and software design. The design tools are divided into two units , namely the sender MCU and receiver.The system was designed to measure temperatures of two furnaces and pressure pneumatic process. The wireless transmitter unit use the 433.95 MHz band directly interfaced to micro controller PIC18F4620. The sender unit consists of temperatures-pressure sensors , conditioning circuits , keypad GLCD display and RF module.Signal conditioner converts the output of the sensors into an electric quantity suitable for operation of the display and recording system.The measurements circuits are connected directly to 10 bits multiplexed A/D converter.The graphic liquid crystal display (GLCD) is used . The receiver (RF) module connected to a second microcontroller ,receive the signal via RF receiver , decode the Address/data and reproduces the original data . The strategy adopted for establishing communication between the sender MCU and receiver uses the specific protocol “Header, Address and data”.The communication protocol dealing with transmission and reception have been successfully implemented . Some experimental results are provided to demonstrate the effectiveness of the proposed wireless system. This embedded system track temperatures – pressure signal reasonably well with a small error.Keywords: microcontrollers, sensors, graphic liquid cristal display, protocol, temperature, pressure
Procedia PDF Downloads 4572491 Towards Printed Green Time-Temperature Indicator
Authors: Mariia Zhuldybina, Ahmed Moulay, Mirko Torres, Mike Rozel, Ngoc-Duc Trinh, Chloé Bois
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To reduce the global waste of perishable goods, a solution for monitoring and traceability of their environmental conditions is needed. Temperature is the most controllable environmental parameter determining the kinetics of physical, chemical, and microbial spoilage in food products. To store the time-temperature information, time-temperature indicator (TTI) is a promising solution. Printed electronics (PE) has shown a great potential to produce customized electronic devices using flexible substrates and inks with different functionalities. We propose to fabricate a hybrid printed TTI using environmentally friendly materials. The real-time TTI profile can be stored and transmitted to the smartphone via Near Field Communication (NFC). To ensure environmental performance, Canadian Green Electronics NSERC Network is developing green materials for the ink formulation with different functionalities. In terms of substrate, paper-based electronics has gained the great interest for utilization in a wide area of electronic systems because of their low costs in setup and methodology, as well as their eco-friendly fabrication technologies. The main objective is to deliver a prototype of TTI using small-scale printed techniques under typical printing conditions. All sub-components of the smart labels, including a memristor, a battery, an antenna compatible with NFC protocol, and a circuit compatible with integration performed by an offsite supplier will be fully printed with flexography or flat-bed screen printing.Keywords: NFC, printed electronics, time-temperature indicator, hybrid electronics
Procedia PDF Downloads 1632490 Evaluation of Corrosion Behaviour of Austenitic Steel 08Cr18Ni10Ti Exposed to Supercritical Water
Authors: Monika Šípová, Daniela Marušáková, Claudia Aparicio
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New sources and ways of producing energy are still seeking, and one of the sustainable ways is Generation IV nuclear reactors. The supercritical water-cooled reactor is one of the six nuclear reactors of Generation IV, and as a consequence of the development of light water, reactors seem to be the most perspective. Thus, materials usually used in light water reactors are also tested under the expected operating conditions of the supercritical water-cooled reactor. Austenitic stainless steel 08Cr18Ni10Ti is widely used in the eastern types of light water nuclear power plants. Therefore, specimens of 08Cr18Ni10Ti were exposed to conditions close to the pseudo-critical point of water and high-temperature supercritical water. The description and evaluation of the corrosion behaviour of austenitic stainless steel have been done based on the results of X-ray diffraction in combination with energy dispersive spectroscopy and electron backscatter diffraction. Thus, significant differences have been found in the structure and composition of oxides formed depending on the temperature of exposure. The high temperature of supercritical water resulted in localised form of corrosion in contrast to the thin oxide layer of 1 µm present on the surface of specimens exposed close to the pseudo-critical point of water. The obtained results are important for further research as the supercritical water can be successfully used as a coolant for small modular reactors, which are currently of interest.Keywords: localised corrosion, supercritical water, stainless steel, electron backscatter diffraction
Procedia PDF Downloads 762489 Use of Giant Magneto Resistance Sensors to Detect Micron to Submicron Biologic Objects
Authors: Manon Giraud, Francois-Damien Delapierre, Guenaelle Jasmin-Lebras, Cecile Feraudet-Tarisse, Stephanie Simon, Claude Fermon
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Early diagnosis or detection of harmful substances at low level is a growing field of high interest. The ideal test should be cheap, easy to use, quick, reliable, specific, and with very low detection limit. Combining the high specificity of antibodies-functionalized magnetic beads used to immune-capture biologic objects and the high sensitivity of a GMR-based sensors, it is possible to even detect these biologic objects one by one, such as a cancerous cell, a bacteria or a disease biomarker. The simplicity of the detection process makes its use possible even for untrained staff. Giant Magneto Resistance (GMR) is a recently discovered effect consisting in the electrical resistance modification of some conductive layers when exposed to a magnetic field. This effect allows the detection of very low variations of magnetic field (typically a few tens of nanoTesla). Magnetic nanobeads coated with antibodies targeting the analytes are mixed with a biological sample (blood, saliva) and incubated for 45 min. Then the mixture is injected in a very simple microfluidic chip and circulates above a GMR sensor that detects changes in the surrounding magnetic field. Magnetic particles do not create a field sufficient to be detected. Therefore, only the biological objects surrounded by several antibodies-functionalized magnetic beads (that have been captured by the complementary antigens) are detected when they move above the sensor. Proof of concept has been carried out on NS1 mouse cancerous cells diluted in PBS which have been bonded to magnetic 200nm particles. Signals were detected in cells-containing samples while none were recorded for negative controls. Binary response was hence assessed for this first biological model. The precise quantification of the analytes and its detection in highly diluted solution is the step now in progress.Keywords: early diagnosis, giant magnetoresistance, lab-on-a-chip, submicron particle
Procedia PDF Downloads 2472488 Effect of Manganese Doping on Ferrroelectric Properties of (K0.485Na0.5Li0.015)(Nb0.98V0.02)O3 Lead-Free Piezoceramic
Authors: Chongtham Jiten, Radhapiyari Laishram, K. Chandramani Singh
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Alkaline niobate (Na0.5K0.5)NbO3 ceramic system has attracted major attention in view of its potential for replacing the highly toxic but superior lead zirconate titanate (PZT) system for piezoelectric applications. Recently, a more detailed study of this system reveals that the ferroelectric and piezoelectric properties are optimized in the Li- and V-modified system having the composition (K0.485Na0.5Li0.015)(Nb0.98V0.02)O3. In the present work, we further study the pyroelectric behaviour of this composition along with another doped with Mn4+. So, (K0.485Na0.5Li0.015)(Nb0.98V0.02)O3 + x MnO2 (x = 0, and 0.01 wt. %) ceramic compositions were synthesized by conventional ceramic processing route. X-ray diffraction study reveals that both the undoped and Mn4+-doped ceramic samples prepared crystallize into a perovskite structure having orthorhombic symmetry. Dielectric study indicates that Mn4+ doping has little effect on both the Curie temperature (Tc) and tetragonal-orthorhombic phase transition temperature (Tot). The bulk density, room-temperature dielectric constant (εRT), and room-c The room-temperature coercive field (Ec) is observed to be lower in Mn4+ doped sample. The detailed analysis of the P-E hysteresis loops over the range of temperature from about room temperature to Tot points out that enhanced ferroelectric properties exist in this temperature range with better thermal stability for the Mn4+ doped ceramic. The study reveals that small traces of Mn4+ can modify (K0.485Na0.5Li0.015)(Nb0.98V0.02)O3 system so as to improve its ferroelectric properties with good thermal stability over a wide range of temperature.Keywords: ceramics, dielectric properties, ferroelectric properties, lead-free, sintering, thermal stability
Procedia PDF Downloads 2372487 Encapsulation and Protection of Bioactive Nutrients Based on Ligand-Binding Property of Milk Proteins
Authors: Hao Cheng, Yingzhou Ni, Amr M. Bakry, Li Liang
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Functional foods containing bioactive nutrients offer benefits beyond basic nutrition and hence the possibility of delaying and preventing chronic diseases. However, many bioactive nutrients degrade rapidly under food processing and storage conditions. Encapsulation can be used to overcome these limitations. Food proteins have been widely used as carrier materials for the preparation of nano/micro-particles because of their ability to form gels and emulsions and to interact with polysaccharides. The mechanisms of interaction between bioactive nutrients and proteins must be understood in order to develop protein-based lipid-free delivery systems. Beta-lactoglobulin, a small globular protein in milk whey, exhibits an affinity to a wide range of compounds. Alfa-tocopherol, resveratrol and folic acid were respectively bound to the central cavity, the outer surface near Trp19–Arg124 and the hydrophobic pocket in the groove between the alfa-helix and the beta-barrel of the protein. Beta-lactoglobulin could thus bind the three bioactive nutrients simultaneously to form protein-multi-ligand complexes. Beta-casein, an intrinsically unstructured but major milk protein, could also interact with resveratrol and folic acid to form complexes. These results suggest the potential to develop milk-protein-based complex carrier systems for encapsulation of multiple bioactive nutrients for functional food application and also pharmaceutical and medical uses.Keywords: milk protein, bioactive nutrient, interaction, protection
Procedia PDF Downloads 4102486 Preparation of Pegylated Interferon Alpha-2b with High Antiviral Activity Using Linear 20 KDa Polyethylene Glycol Derivative
Authors: Ehab El-Dabaa, Omnia Ali, Mohamed Abd El-Hady, Ahmed Osman
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Recombinant human interferon alpha 2 (rhIFN-α2) is FDA approved for treatment of some viral and malignant diseases. Approved pegylated rhIFN-α2 drugs have highly improved pharmacokinetics, pharmacodynamics and therapeutic efficiency compared to native protein. In this work, we studied the pegylation of purified properly refolded rhIFN-α2b using linear 20kDa PEG-NHS (polyethylene glycol- N-hydroxysuccinimidyl ester) to prepare pegylated rhIFN-α2b with high stability and activity. The effect of different parameters like rhIFN-α2b final concentration, pH, rhIFN-α2b/PEG molar ratios and reaction time on the efficiency of pegylation (high percentage of monopegylated rhIFN-α2b) have been studied in small scale (100µl) pegylation reaction trials. Study of the percentages of different components of these reactions (mono, di, polypegylated rhIFN-α2b and unpegylated rhIFN-α2b) indicated that 2h is optimum time to complete the reaction. The pegylation efficiency increased at pH 8 (57.9%) by reducing the protein concentration to 1mg/ml and reducing the rhIFN-α2b/PEG ratio to 1:2. Using larger scale pegylation reaction (65% pegylation efficiency), ion exchange chromatography method has been optimized to prepare and purify the monopegylated rhIFN-α2b with high purity (96%). The prepared monopegylated rhIFN-α2b had apparent Mwt of approximately 65 kDa and high in vitro antiviral activity (2.1x10⁷ ± 0.8 x10⁷ IU/mg). Although it retained approximately 8.4 % of the antiviral activity of the unpegylated rhIFN-α2b, its activity is high compared to other pegylated rhIFN-α2 developed by using similar approach or higher molecular weight branched PEG.Keywords: antiviral activity, rhIFN-α2b, pegylation, pegylation efficiency
Procedia PDF Downloads 1762485 Generation of Medical Waste in Hospitals in Interior of São Paulo, Brazil
Authors: Silvia Carla Da Silva André, Angela Maria Magosso Takayanagui
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Introduction: The Medical Waste (MW) are responsible per 2% of total waste generated for a city and has merited attention due the risks that offers to the public health and environment, representing an important aspect in waste management. In Brazil, the Resolution 306/04 of the National Health Surveillance Agency classifies the MW into 5 groups as follows: Group A (GA) biological, Group B (GB) chemical, Group C (GC) radioactive waste, Group D (GD) common, and Group E (GE) sharps. Objective: This study aimed to determine the amount of waste generated in hospitals of Ribeirão Preto, São Paulo, Brazil. Material and Methods: This is a field research, exploratory, using quantitative variables. The survey was conducted in 11 hospitals in Ribeirão Preto, located in the State of São Paulo, Brazil. It is noted that the study sample included general hospitals, skilled, university, maternity, and psychiatric; public, private, and philanthropic; and large, medium, and small. To quantify the MW, the weighing of the waste was held for six days, following methodology adapted from PAHO. Data were analyzed using descriptive statistics, determining the average global generation of MW and for each group. This research was carried out after approval by the Ethics in Research of the University of São Paulo. Thus, in order to comply with the ethical principles of research, to present the results hospitals were numbered from 1 to 11. Results: The data revealed a greater generation of biological waste among teaching hospitals, which can be justified by the use of materials for the realization of techniques.Keywords: environmental health, management of medical waste, medical waste, public health
Procedia PDF Downloads 3692484 Differentiating Morphological Patterns of the Common Benthic Anglerfishes from the Indian Waters
Authors: M. P. Rajeeshkumar, K. V. Aneesh Kumar, J. L. Otero-Ferrer, A. Lombarte, M. Hashim, N. Saravanane, V. N.Sanjeevan, V. M. Tuset
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The anglerfishes are widely distributed from shallow to deep-water habitats and are highly diverse in morphology, behaviour, and niche occupancy patterns. To understand this interspecific variability and degree of niche overlap, we performed a functional analysis of five species inhabiting Indian waters where diversity of deep-sea anglerfishes is very high. The sensory capacities (otolith shape and eye size) were also studied to improve the understanding of coexistence of species. The analyses of fish body and otolith shape clustered species in two morphotypes related to phylogenetic lineages: i) Malthopsis lutea, Lophiodes lugubri and Halieutea coccinea were characterized by a dorso-ventrally flattened body with high swimming ability and relative small otoliths, and ii) Chaunax spp. were distinguished by their higher body depth, lower swimming efficiency, and relative big otoliths. The sensory organs did not show a pattern linked to depth distribution of species. However, the larger eye size in M. lutea suggested a nocturnal feeding activity, whereas Chaunax spp. had a large mouth and deeper body in response to different ecological niches. Therefore, the present study supports the hypothesis of spatial and temporal segregation of anglerfishes in the Indian waters, which can be explained from a functional approach and understanding from sensory capabilities.Keywords: functional traits, otoliths, niche overlap, fishes, Indian waters
Procedia PDF Downloads 1312483 Community Based Landslide Investigation and Treatment in the Earthquake Affected Areas, Nepal
Authors: Basanta Raj Adhikari
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Large and small scale earthquakes are frequent in the Nepal, Himalaya, and many co-seismic landslides are resulted out of it. Recently, Gorkha earthquake-2015 has triggered many co-seismic landslides destroying many lives and properties. People have displaced their original places due to having many cracks and unstable ground. Therefore, Nepal has been adopting a pronged development strategy to address the earthquake issues through reconstruction and rehabilitation policy, plans and budgets. Landslides are major threat for the mountain livelihood, and it is very important to investigate and mitigate to improve human wellbeing factoring in considerations of economic growth, environmental safety, and sustainable development. Community based landslide investigation was carried with the involvement of the local community in the Sindhupalchowk District of Central Nepal. Landslide training and field orientation were the major methodological approach of this study. Combination of indigenous and modern scientific knowledge has created unique working environment which enhanced the local capacity and trained people for replication. Local topography of the landslide was created with the help of Total Station and bill of quantity was derived based on it. River training works, plantation of trees and grasses, support structures, surface and sub-surface drainage management are the recommended mitigative measures. This is a very unique example of how academia and local community can work together for sustainable development by reducing disaster risk at the local level with very low-cost technology.Keywords: community, earthquake, landslides, Nepal
Procedia PDF Downloads 1562482 Numerical Modeling and Prediction of Nanoscale Transport Phenomena in Vertically Aligned Carbon Nanotube Catalyst Layers by the Lattice Boltzmann Simulation
Authors: Seungho Shin, Keunwoo Choi, Ali Akbar, Sukkee Um
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In this study, the nanoscale transport properties and catalyst utilization of vertically aligned carbon nanotube (VACNT) catalyst layers are computationally predicted by the three-dimensional lattice Boltzmann simulation based on the quasi-random nanostructural model in pursuance of fuel cell catalyst performance improvement. A series of catalyst layers are randomly generated with statistical significance at the 95% confidence level to reflect the heterogeneity of the catalyst layer nanostructures. The nanoscale gas transport phenomena inside the catalyst layers are simulated by the D3Q19 (i.e., three-dimensional, 19 velocities) lattice Boltzmann method, and the corresponding mass transport characteristics are mathematically modeled in terms of structural properties. Considering the nanoscale reactant transport phenomena, a transport-based effective catalyst utilization factor is defined and statistically analyzed to determine the structure-transport influence on catalyst utilization. The tortuosity of the reactant mass transport path of VACNT catalyst layers is directly calculated from the streaklines. Subsequently, the corresponding effective mass diffusion coefficient is statistically predicted by applying the pre-estimated tortuosity factors to the Knudsen diffusion coefficient in the VACNT catalyst layers. The statistical estimation results clearly indicate that the morphological structures of VACNT catalyst layers reduce the tortuosity of reactant mass transport path when compared to conventional catalyst layer and significantly improve consequential effective mass diffusion coefficient of VACNT catalyst layer. Furthermore, catalyst utilization of the VACNT catalyst layer is substantially improved by enhanced mass diffusion and electric current paths despite the relatively poor interconnections of the ion transport paths.Keywords: Lattice Boltzmann method, nano transport phenomena, polymer electrolyte fuel cells, vertically aligned carbon nanotube
Procedia PDF Downloads 1982481 Identifying the Traditional Color Scheme in Decorative Patterns Used by the Bahnar Ethnic Group in the Central Highlands of Vietnam
Authors: Nguyen Viet Tan
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The Bahnar is one of 11 indigenous groups living in the Central Highlands of Vietnam. It is one among the four most popular groups in this area, including the Mnong who speak the same language of Mon Khmer family, while both groups of the Jrai and the Rhade belong to the Malayo-Polynesian language family. These groups once captured fertile plateaus, left their cultural and artistic heritage which affected the remaining small groups. Despite the difference in ethnic origins, these groups seem to share similar beliefs, customs and related folk arts after a very long time living beside each other. However, through an in-depth study, this paper points out the fact that the decorative patterns used by the Bahnar are different from the other ethnic groups, especially in color. Based on historical materials from the local museums and some studies in 1980s when all of the ethnic groups in this area had still lived in self-sufficient condition, this paper characterizes the traditional color scheme used by the Bahnar and identifies the difference in decorative motifs of this group compared to the others by pointing out they do not use green in their usual decorative patterns. Moreover, combined with some field surveys recently, through comparative analysis, it also discovers stylistic variations of these patterns in the process of cultural exchange with the other ethnic groups, both in and out of the region, in modern living conditions. This study helps to preserve and promote the traditional values and cultural identity of the Bahnar people in the Central Highlands of Vietnam, avoiding the fusion of styles among groups during the cultural exchange.Keywords: Bahnar ethnic group, decorative patterns, the central highlands of Vietnam, the traditional color scheme
Procedia PDF Downloads 1242480 Drought Alters the Expression of a Candidate Zea Mays P-Coumarate 3-Hydroxylase Gene and Caffeic Acid Biosynthesis
Authors: Zintle Kolo, Ndiko Ludidi
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The enzymatic activity of p-coumarate 3-hydroxylase (C3H) synthesize caffeic acid from p-coumaric acid. We recently showed that exogenously applied caffeic acid confers salinity tolerance in soybean (Glycine max) by inducing antioxidant enzymatic activity to promote enhanced scavenging or reactive oxygen species, thus limiting salinity-induced oxidative stress. Recent evidence also establishes that pre-treatment of plants with exogenously supplied caffeic acid improves plant tolerance to osmotic stress by improving plant antioxidant capacity and enhancing biosynthesis of compatible solutes. We aimed to identify a C3H in maize (Zea mays) and evaluate the effect of drought on the spatial and temporal expression of the gene encoding the candidate maize C3H (ZmC3H). Primary sequence analysis shows that ZmC3H shares 71% identity with an Arabidopsis thaliana C3H that is implicated in the control of Arabidopsis cell expansion, growth, and responses to stress. In silico ZmC3H promoter analysis reveals the presence of cis-acting elements that interact with transcription factors implicated in plant responses to drought. Spatial expression analysis by semi-quantitative RT-PCR shows that ZmC3H is expressed in both leaves and roots under normal conditions. However, drought represses the expression of ZmC3H in leaves whereas it up-regulates its expression in roots. These changes in ZmC3H expression correlate with the changes in the content of caffeic acid in maize in response to drought. We illustrate the implications of these changes in the expression of the gene in relation to maize responses to drought and discuss the potential of regulating caffeic acid biosynthesis towards genetic improvement of maize tolerance to drought stress. These findings have implications for food security because of the potential of the implications of the study for drought tolerance in maize.Keywords: caffeic acid, drought-responsive expression, maize drought tolerance, p-coumarate 3-hydroxylase
Procedia PDF Downloads 4722479 Seroprevalence of Toxoplasmosis among Hemato-Oncology Patients in Tertiary Hospital of East Cost Malaysia
Authors: Aisha Khodijah Kholib Jati, Suharni Mohamad, Azlan Husin, Wan Suriana Wan Ab Rahman
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Introduction: Toxoplasmosis is caused by an obligate intracellular parasite, Toxoplasma gondii (T. gondii). It is commonly asymptomatic in normal individual, but it can be fatal to immunocompromised patients as it can lead to severe complications such as encephalitis, chorioetinitis and myocarditis. Objective: The aim of the study was to determine the seroprevalence of toxoplasmosis and its association with socio-demographic and behavioral characteristics among hemato-oncology patients in Hospital USM. Methods: In this cross-sectional study, 56 hemato-oncology patients were screened for immunoglobulin M (IgM) antibodies, immunoglobulin G (IgG) antibodies, and IgG avidity of T. gondii by using ELISA Kit (BioRad, USA). For anti-T. gondii IgG antibody, titer ≥ 9 IU/ml was considered as recent infection, while for IgM, ratio ≥ 1.00 was considered as reactive for the anti-T. gondii IgM antibodies. Low avidity index is considered as recent infection within 20 weeks while high avidity considered as past infection. T. gondii exposure, socio-demographic and behavioral characteristics was assessed by a questionnaire and interview. Results: A total of 28 (50.0%) hemato-oncology patients were seropositive for T. gondii antibodies. Out of that total, 27 (48.21%) patients were IgG+/IgM- and one patient (1.79%) was IgG+/IgM+ with high avidity index. Univariate analysis showed that age, gender, ethnicity, marital status, educational level, employment status, stem cell transplant, blood transfusion, close contact with cats, water supply, and consumption of undercooked meat were not significantly associated with Toxoplasma seropositivity rate. Discussion: The seropositivity rate of IgG anti-T. gondii was high among hemato-oncology patients in Hospital USM. With impaired immune system, these patients might have a severe consequence if the infection reactivated. Therefore, screening for anti-T. gondii may be considered in the future. Moreover, health programme towards healthy food and good hygiene practice need to be implemented.Keywords: immunocompromised, seroprevalence, socio-demographic, toxoplasmosis
Procedia PDF Downloads 1492478 Risk Assessment in Construction of K-Span Buildings in United Arab Emirates (UAE)
Authors: Imtiaz Ali, Imam Mansoor
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Investigations as a part of the academic study were undertaken to identify and evaluate the significant risks associated with the construction of K-span buildings in the region of UAE. Primary field data was collected through questionnaires obtaining specific open and close-ended questions from carefully selected construction firms, civil engineers and, construction manager regarding risks associated to K-span building construction. Historical data available for other regions of the same construction technique was available which was compared for identifying various non-critical and critical risk parameters by comparative evaluation techniques to come up with important risks and potential sources for their control and minimization in K-Span buildings that is increasing in the region. The associated risks have been determined with their Relative Importance Index (RII) values of which Risk involved in Change of Design required by Owners carries the highest value (RII=0.79) whereas, Delayed Payment by Owner to Contractor is one of the least (RII=0.42) value. The overall findings suggest that most relative risks as quantified originate or associated with the contractors. It may be concluded that project proponents undertaking K-span projects in planning and budgeting the cost and delays should take into account of risks on high account if changes in design are also required any delays in the material by the supplier would then be a major risk in K-span project delay. Since projects are, less costly, so owners have limited budgets, then they hire small contractors, which are not highly competent contractors. So study suggests that owner should be aware of these types of risks associated with the construction of K-span buildings in order to make it cost effective.Keywords: k-span buildings, k-span construction, risk management, relative improvement index (RII)
Procedia PDF Downloads 3732477 Clinical Efficacy of Nivolumab and Ipilimumab Combination Therapy for the Treatment of Advanced Melanoma: A Systematic Review and Meta-Analysis of Clinical Trials
Authors: Zhipeng Yan, Janice Wing-Tung Kwong, Ching-Lung Lai
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Background: Advanced melanoma accounts for the majority of skin cancer death due to its poor prognosis. Nivolumab and ipilimumab are monoclonal antibodies targeting programmed cell death protein 1 (PD-1) and cytotoxic T-lymphocytes antigen 4 (CTLA-4). Nivolumab and ipilimumab combination therapy has been proven to be effective for advanced melanoma. This systematic review and meta-analysis are to evaluate its clinical efficacy and adverse events. Method: A systematic search was done on databases (Pubmed, Embase, Medline, Cochrane) on 21 June 2020. Search keywords were nivolumab, ipilimumab, melanoma, and randomised controlled trials. Clinical trials fulfilling the inclusion criteria were selected to evaluate the efficacy of combination therapy in terms of prolongation of progression-free survival (PFS), overall survival (OS), and objective response rate (ORR). The odd ratios and distributions of grade 3 or above adverse events were documented. Subgroup analysis was performed based on PD-L1 expression-status and BRAF-mutation status. Results: Compared with nivolumab monotherapy, the hazard ratios of PFS, OS and odd ratio of ORR in combination therapy were 0.64 (95% CI, 0.48-0.85; p=0.002), 0.84 (95% CI, 0.74-0.95; p=0.007) and 1.76 (95% CI, 1.51-2.06; p < 0.001), respectively. Compared with ipilimumab monotherapy, the hazard ratios of PFS, OS and odd ratio of ORR were 0.46 (95% CI, 0.37-0.57; p < 0.001), 0.54 (95% CI, 0.48-0.61; p < 0.001) and 6.18 (95% CI, 5.19-7.36; p < 0.001), respectively. In combination therapy, the odds ratios of grade 3 or above adverse events were 4.71 (95% CI, 3.57-6.22; p < 0.001) compared with nivolumab monotherapy, and 3.44 (95% CI, 2.49-4.74; p < 0.001) compared with ipilimumab monotherapy, respectively. High PD-L1 expression level and BRAF mutation were associated with better clinical outcomes in patients receiving combination therapy. Conclusion: Combination therapy is effective for the treatment of advanced melanoma. Adverse events were common but manageable. Better clinical outcomes were observed in patients with high PD-L1 expression levels and positive BRAF-mutation.Keywords: nivolumab, ipilimumab, advanced melanoma, systematic review, meta-analysis
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