Search results for: infusion
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 144

Search results for: infusion

114 Numerical Simulation of Phase Transfer during Cryosurgery for an Irregular Tumor Using Hybrid Approach

Authors: Rama Bhargava, Surabhi Nishad

Abstract:

The infusion of nanofluids has dramatically enhanced the heat-carrying capacity of the fluids, applicable to many engineering and medical process where the temperature below freezing is required. Cryosurgery is an efficient therapy for the treatment of cancer, but sometimes the excessive cooling may harm the nearby healthy cells. Efforts are therefore done to develop a model which can cause to generate the low temperature as required. In the present study, a mathematical model is developed based on the bioheat transfer equation to simulate the heat transfer from the probe on a tumor (with irregular domain) using the hybrid technique consisting of element free Galerkin method with αα-family of approximation. The probe is loaded will nano-particles. The effects of different nanoparticles, namely Al₂O₃, Fe₃O₄, Au on the heat-producing rate, is obtained. It is observed that the temperature can be brought to (60°C)-(-30°C) at a faster freezing rate on the infusion of different nanoparticles. Besides increasing the freezing rate, the volume of the nanoparticle can also control the size and growth of ice crystals formed during the freezing process. The study is also made to find the time required to achieve the desired temperature. The problem is further extended for multi tumors of different shapes and sizes. The irregular shape of the frozen domain and the direction of ice growth are very sensitive issues, posing a challenge for simulation. The Meshfree method has been one of the accurate methods in such problems as a domain is naturally irregular. The discretization is done using the nodes only. MLS approximation is taken in order to generate the shape functions. Sufficiently accurate results are obtained.

Keywords: cryosurgery, EFGM, hybrid, nanoparticles

Procedia PDF Downloads 123
113 Using Crude Actinidin Protease Extract of Kiwifruit to Improve Some Quality Attributes of Awassi Rams Meats

Authors: Hatem H.Saleh

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The aim of the study was to examine the effect of different concentrations of crude actinidin enzyme extract from kiwifruit juice and distilled water on some quality attributes of Awassi rams meats. Twelve Awassi rams were divided into four groups, After exsanguinations of rams carcasses they were infused (10% body weight) with crude of actinidin enzyme extract of kiwifruit juice with 10 and 15% of extract, and other group was infused with distilled water and were compared with other groups a non infusion treatment which were acted as a control. Thereafter samples from two main muscles, namely longissimus dorsi (LD) and Semimembranosus (SM) of the carcasses was chilled then stored in freezing, until testing time . The results showed a decrease in the rate pH decline on LD and SM muscle which was measured at time (0, 3, 6, 9, 12, 24 hours) postmortem among different treatments, It also reported lower values of the rate pH on the LD and SM muscle during the first of 12 hrs postmortem. No significant differences of the rate internal meat temperature in LD and SM muscle were observed among treatments postmortem except decreased of internal meat temperature during 3 hours postmortem when treated with enzyme extract. The results recorded higher values of glycolysis rate (R-value) in LD and SM muscle when treated with enzyme extract. Treated LD and LM muscle samples with 10 and 15% of crude actinidin enzyme extract of kiwifruit juice led to improve water holding capacity and higher significant differences in total tyrosine/ tryptophan index (T.T/T) in LD and SM muscles comparison with treatment control. It could be concluded that extract of kiwifruit juice infusion is could be used to improve of meat tenderization.

Keywords: extract of kiwifruit, decline of pH and Temperature , R-value, tyrosine / tryptophan index, sheep meat

Procedia PDF Downloads 543
112 Comparison of Analgesic Efficacy of Paracetamol and Tramadol for Pain Relief in Active Labor

Authors: Krishna Dahiya

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Introduction: Labour pain has been described as the most severe pain experienced by women in their lives. Pain management in labour is one of the most important challenges faced by the obstetrician. The opioids are the primary treatment for patients with moderate and severe pain but these drugs are not always tolerated and are associated with dose-dependent side effects. Nonsteroidal anti-inflammatory drugs, too, are associated with variable adverse effects. Considering these factors, our study compared the efficacy and side effect of intravenous tramadol and paracetamol. Objective: To evaluate the efficacy and adverse effects of an intravenous infusion of 1000 mg of paracetamol as compared with an intravenous injection of 50mg of tramadol for intrapartum analgesia. Methods: In a randomized prospective study at Pt. BDS PGIMS, 200 women in active labor were allocated to received either paracetamol (n=100) or tramadol (n=100). The primary outcome was the efficacy of the drug to supply adequate analgesia as measured by a change in the visual analog scale (VAS) pain intensity score at various times after drug administration. The secondary outcomes included the need for additional rescue analgesia and the presence of adverse maternal or fetal events. Results: The mean age of cases were 25.55 ± 3.849 years and 25.60 ± 3.655 years respectively As recorded by the VAS score, there was significant pain reduction at 30 minutes, and at 1 and 2 hours in both groups (P<0.01). In comparison, between group I and II, a significantly higher rate of nausea and vomiting in tramadol group (14% vs 8%; P < 0.03) patients. Similarly, drowsiness (0% vs 11%; P<0.01), dry mouth (0% vs 8%; P<0.04) and dizziness (0% vs 9%; P<0.02) was also significant in group II. Conclusion: Due to difficulty in administering epidural analgesia to all parturients, administration of paracetamol and tramadol infusion for analgesia is simple and less invasive alternative. In the present study, both paracetamol and tramadol were equally effective for labour analgesia but paracetamol has emerged as safe alternative as compared to tramadol due to a low incidence of side effects.

Keywords: paracetamol, tramadol, labor, analgesia

Procedia PDF Downloads 291
111 Trace Elements in Yerba Mate from Brazil and Argentina by Inductively Coupled Plasma Mass Spectrometry

Authors: F. V. Matta, C. M. Donnelly, M. B. Jaafar, N. I. Ward

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‘Yerba Mate’ (Ilex paraguariensis) is a native plant from South America with the main producers being Argentina and Brazil. ‘Mate’ is widely consumed in Argentina, Brazil, Uruguay and Paraguay. The most popular format is as an infusion made from dried leaves of a traditional cup, roasted material in tea bags or iced tea infusions. There are many alleged health benefits resulted from mate consumption, even though there is a lack of conclusive research published in the international literature. The main objective of this study was to develop and evaluate the sample preparation and instrumental analysis stages involved in the determination of trace elements in yerba mate using inductively coupled plasma mass spectrometry (ICP-MS). Specific details on the methods of sample digestion, validation of the ICP-MS analysis especially for polyatomic ion correction and matrix effects associated with the complex medium of mate will be presented. More importantly, mate produced in Brazil and Argentina, is subject to different soil conditions, methods of cultivation and production, especially for loose leaves and tea bags. The highest concentrations for loose mate leaf were for (mg/kg, dry weight): aluminium (253.6 – 506.9 for Brazil (Bra), 230.0 – 541.8 for Argentina (Arg), respectively), manganese (378.3 – 762.6 Bra; 440.8 – 879.9 Arg), iron (32.5 – 85.7 Bra; 28.2 – 132.9 Arg), zinc (28.2 – 91.1 Bra; 39.1 – 92.3 Arg), nickel (2.2 – 4.3 Bra; 2.9 – 10.8 Arg) and copper (4.8 – 9.1 Bra; 4.3 – 9.2 Arg), with lower levels of chromium, cobalt, selenium, molybdenum, cadmium, lead and arsenic. Elemental levels of mate leaf consumed in tea bags were found to be higher, mainly due to only using leaf material (as opposed to leaf and twig for loose packed product). Further implications of the way of consuming yerba mate will be presented, including different infusion methods in Brazil and Argentina. This research provides for the first time an extensive evaluation of mate products from both countries and the possible implications of specific trace elements, especially Mn, Fe, Se, Cu and Zn and the various health claims of consuming yerba mate.

Keywords: beverage analysis, ICP-MS, trace elements, yerba mate

Procedia PDF Downloads 226
110 Analysis of Expression of SP and NOS in the Porcine Nodose Ganglion (NG) Sensory Neurons Supplying Prepyloric Stomach Region after Intragastric Hydrochloric Acid Infusion

Authors: Liliana Rytel, Jarosław Całka

Abstract:

One of the diseases that are very common health problem of modern man is the stomach hyperacidity. It is well known that this pathological state, during which gastric glands secrete too much of hydrochloric acid can be caused due to various factors such as stress, eating habits, alcohol, smoking and some, especially anti-inflammatory drugs. Moreover, hyperacidity is recognized as one of factors leading to development of peptic ulcer disease. Therefore, we analyzed expression of substance P (SP) and neuronal isoform of nitric oxide synthase (nNOS) in the porcine nodose ganglion sensory neurons innervating prepyloric stomach region in physiological state and following intragastric infusion of hydrochloric acid. The study was performed on 8 immature gilts of the Large White Polish breed. All animals were injected retrograde marker Fast Blue (FB) into the anterior prepyloric stomach wall. After injections of FB, pigs were divided into two groups: control (group C; n = 4) and experimental (HCL group, n = 4) and after convalescence period of 23 days, animals of HCL group were subjected to renewed anaesthesia. Then, 0.25 M aqueous solution of hydrochloric acid with a dose of 5 ml/kg body weight was administered intragastrically with use of a stomach tube. On 28th day, all control and HCL pigs were euthanized and bilateral reght (rNG) and left (lNG) were collected. Cryostat sections were processed for double immunofluorescence using anibodies against SP and NOS. Immunofluorescence staining in the even-numbered ganglia nodes showed the presence of FB-positive cells expressing SP (45,9 ± 3,38% in rNG and 60,4 ± 1,71% in lNG), and nNOS (34,9 ± 6,83% in rNG and 49,9 ± 9,32% in lNG). In HCL group increased expression of both SP (54,8 ± 5,34% in rNG and 56,9 ± 3,28 % in lNG) as well as nNOS (54,9 ± 4,45% in rNG and 52,5 ± 2,17 % in lNG) in FB+ perikaria was found. The acquired results suggest that SP and nNOS are neurotransmitters and/ or neuromodulators participating in the sensory regulation of the prepyloric region of porcine stomach function as well as their potential role in development of the stomach inflamatory state.

Keywords: nNOS, nodose ganglion, pig, SP

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109 Case Report: Opioid Sparing Anaesthesia with Dexmedetomidine in General Surgery

Authors: Shang Yee Chong

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Perioperative pain is a complex mechanism activated by various nociceptive, neuropathic, and inflammatory pathways. Opioids have long been a mainstay for analgesia in this period, even as we are continuously moving towards a multimodal model to improve pain control while minimising side effects. Dexmedetomidine, a potent alpha-2 agonist, is a useful sedative and hypnotic agent. Its use in the intensive care unit has been well described, and it is increasingly an adjunct intraoperatively for its opioid sparing effects and to decrease pain scores. We describe a case of a general surgical patient in whom minimal opioids was required with dexmedetomidine use. The patient was a 61-year-old Indian gentleman with a history of hyperlipidaemia and type 2 diabetes mellitus, presenting with rectal adenocarcinoma detected on colonoscopy. He was scheduled for a robotic ultra-low anterior resection. The patient was induced with intravenous fentanyl 75mcg, propofol 160mg and atracurium 40mg. He was intubated conventionally and mechanically ventilated. Anaesthesia was maintained with inhalational desflurane and anaesthetic depth was measured with the Masimo EEG Sedline brain function monitor. An initial intravenous dexmedetomidine dose (bolus) of 1ug/kg for 10 minutes was given prior to anaesthetic induction and thereafter, an infusion of 0.2-0.4ug/kg/hr to the end of surgery. In addition, a bolus dose of intravenous lignocaine 1.5mg/kg followed by an infusion at 1mg/kg/hr throughout the surgery was administered. A total of 10mmol of magnesium sulphate and intravenous paracetamol 1000mg were also given for analgesia. There were no significant episodes of bradycardia or hypotension. A total of intravenous phenylephrine 650mcg was given throughout to maintain the patient’s mean arterial pressure within 10-15mmHg of baseline. The surgical time lasted for 5 hours and 40minutes. Postoperatively the patient was reversed and extubated successfully. He was alert and comfortable and pain scores were minimal in the immediate post op period in the postoperative recovery unit. Time to first analgesia was 4 hours postoperatively – with paracetamol 1g administered. This was given at 6 hourly intervals strictly for 5 days post surgery, along with celecoxib 200mg BD as prescribed by the surgeon regardless of pain scores. Oral oxycodone was prescribed as a rescue analgesic for pain scores > 3/10, but the patient did not require any dose. Neither was there nausea or vomiting. The patient was discharged on postoperative day 5. This case has reinforced the use of dexmedetomidine as an adjunct in general surgery cases, highlighting its excellent opioid-sparing effects. In the entire patient’s hospital stay, the only dose of opioid he received was 75mcg of fentanyl at the time of anaesthetic induction. The patient suffered no opioid adverse effects such as nausea, vomiting or postoperative ileus, and pain scores varied from 0-2/10. However, intravenous lignocaine infusion was also used in this instance, which would have helped improve pain scores. Paracetamol, lignocaine, and dexmedetomidine is thus an effective, opioid-sparing combination of multi-modal analgesia for major abdominal surgery cases.

Keywords: analgesia, dexmedetomidine, general surgery, opioid sparing

Procedia PDF Downloads 135
108 Efficacy of In-Situ Surgical vs. Needle Revision on Late Failed Trabeculectomy Blebs

Authors: Xie Xiaobin, Zhang Yan, Shi Yipeng, Sun Wenying, Chen Shuang, Cai Zhipeng, Zhang Hong, Zhang Lixia, Xie Like

Abstract:

Objective: The objective of this research is to compare the efficacy of the late in-situ surgical revision augmented with continuous infusion and needle revision on failed trabeculectomy blebs. Methods From December 2018 to December 2021, a prospective randomized controlled trial was performed on 44 glaucoma patients with failed bleb ≥ 6months with medically uncontrolled in Eye Hospital, China Academy of Chinese Medical Sciences. They were randomly divided into two groups. 22 eyes of 22 patients underwent the late in-situ surgical revision with continuous anterior chamber infusion in the study group, and 22 of 22 patients were treated with needle revision in the control group. Main outcome measures include preoperative and postoperative intraocular pressure (IOP), the number of anti-glaucoma medicines, the operation success rate, and the postoperative complications. Results The postoperative IOP values decreased significantly from the baseline in both groups (both P<0.05). IOP was significantly lower in the study group than in the control group at one week, 1, and 3 months postoperatively (all P<0.05). IOP reductions in the study group were substantially more prominent than in the control group at all postoperative time points (all P<0.05). The complete success rate in the study group was significantly higher than in the control group (71.4% vs. 33.3%, P<0.05), while the complete failure rate was significantly lower in the study group (0% vs. 28.5%, P<0.05). According to Cox’s proportional hazards regression analysis, high IOP at baseline was independently associated with increased risks of complete failure (adjusted hazard ratio=1.141, 95% confidence interval=1.021-1.276, P<0.05). There was no significant difference in the incidence of postoperative complications between the two groups (P>0.05). Conclusion: Both in-situ surgical and needle revision have acceptable success rates and safety for the late failed trabeculectomy blebs, while the former is likely to have a higher level of efficacy over the latter. Needle revision may be insufficient for eyes with low target IOP.

Keywords: glaucoma, trabeculectomy blebs, in-situ surgical revision, needle revision

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107 Management of Hypoglycemia in Von Gierke’s Disease

Authors: Makda Aamir, Sood Aayushi, Syed Omar, Nihan Khuld, Iskander Peter, Ijaz Naeem, Sharma Nishant

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Introduction:Glycogen Storage Disease Type-1 (GSD-1) is a rare phenomenon primarily affecting the liver and kidney. Excessive accumulation of glycogen and fat in liver, kidney, and intestinal mucosa is noted in patients with deficiency of Glucose-6-phosphatase deficiency. Patients with GSD-1 have a wide spectrum of symptoms, including hepatomegaly, hypoglycemia, lactic acidemia, hyperlipidemia, hyperuricemia, and growth retardation. Age of onset, rate of disease progression and its severity is variable in this disease.Case:An 18-year-old male with GSD-1a, Von Gierke’s disease, hyperuricemia, and hypertension presented to the hospital with nausea and vomiting. The patient followed an hourly cornstarch regimen during the day and overnight through infusion via a PEG tube. The complaints started at work, where he was unable to tolerate oral cornstarch. He washemodynamically stable on arrival. ABG showed pH 7.372, PaCO2 30.3, and PaO2 92.2. WBC 16.80, K+ 5.8, HCO3 13, BUN 28, Cr 2.2, Glucose 60, AST 115, ALT 128, Cholesterol 352, Triglycerides >1000, Uric Acid 10.6, Lactic Acid 11.8 which trended down to 8.0. CT abdomen showed hepatomegaly and fatty infiltration with the PEG tube in place.He was admitted to the ICU and started on D5NS for hypoglycemia and lactic acidosis. Per request by the patient’s pediatrician, he was transitioned to IV D10/0.45NS at 110mL/Hr to maintain blood glucose above 75 mg/L. Frequent accuchecks were done till he could tolerate his dietary regimen with cornstarch. Lactic acid downtrend to 2.9, and accuchecks ranged between 100-110. Cr improved to 1.3, and his home medications (Allopurinol and Lisinopril) were resumed. He was discharged in stable condition with plans for further genetic therapy work up.Discussion:Mainstay therapy for Von Gierke’s Disease is the prevention of metabolic derangements for which dietary and lifestyle changes are recommended. A low fructose and sucrose diet is recommended by limiting the intake of galactose and lactose to one serving per day. Hypoglycemia treatment in such patients is two-fold, utilizing both quick and stable release sources. Cornstarch has been one such therapy since the 1980s; its slow digestion provides a steady release of glucose over a longer period of time as compared with other sources of carbohydrates. Dosing guidelines vary from age to age and person to person, but it is highly recommended to check BG levels frequently to maintain a BG > 70 mg/dL. Associated high levels of triglycerides and cholesterol can be treated with statins, fibrates, etc. Conclusion:The management of hypoglycemia in GSD 1 disease presents various obstacles which could prove to be fatal. Due to the deficiency of G6P, treatment with a specialized hypoglycemic regimen is warranted. A D10 ½ NS infusion can be used to maintain blood sugar levels as well as correct metabolic or lactate imbalances. Infusion should be gradually weaned off after the patient can tolerate oral feeds as this can help prevent the risk of hypoglycemia and other derangements. Further research is needed in regards to these patients for more sustainable regimens.

Keywords: von gierke, glycogen storage disease, hypoglycemia, genetic disease

Procedia PDF Downloads 107
106 Changes in Expression of Galanin in the CSMG Neurons Supplying the Prepyloric Area of the Porcine Stomach Induced by Intragastric Infusion of Hydrochloric Acid

Authors: Katarzyna Palus, Jarosław Całka

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Gastrointestinal disorders, especially acid-related diseases, including peptic and duodenal ulcers, gastroesophageal reflux disease, upper GI bleeding or stress-related mucosal disease, are currently serious health issues encountered very frequently in patients worldwide. However, to date, the response of sympathetic neurons to gastric mucosal injury and local inflammation following hyperacidity is unknown. Thus, the present study was designed to determine possible changes in expression of galanin (GAL) in the CSMG neurons supplying the prepyloric area of the porcine stomach in a physiological state and following experimentally-induced hyperacidity by using combined retrograde tracing and double-labelling immunohistochemistry. The choice of the domestic pig as an experimental model in the present study is not accidental and is justified by the high degree of physiological and anatomical similarity to human digestive system functions. In this experiment ten juvenile female pigs of the Large White Polish breed were used. The animals were divided into two groups: control and animals with hydrochloric acid infusion (HCl). The neuronal retrograde marker Fast Blue (FB) was injected into the anterior prepyloric wall of the stomach of all animals. After 23 days, animals of the HCl-group were reintroduced into a state of general anesthesia and intragastrically given 5 ml/kg of body weight of 0.25 M aqueous solution of hydrochloric acid. On the 28th day, all animals were euthanized. The CSMG complexes were then collected and the CSMG cryostat sections were stained immunocytochemically for GAL and TH (tyrosine hydroxylase). Immunohistochemistry revealed that in the control group 8.40 ± 0.53 % out of 200 FB-positive CSMG neurons contained GAL. In HCl group upregulation of the GAL-IR neurons to 22.52 ± 1.18 % were observed. All GAL-IR neurons in both groups showed the simultaneously TH immunoreactivity. Increase in the expression of GAL in FB-positive neurons of the HCL group may suggest its participation in the protective mechanisms of neurons in different pathological processes, such as gastric hyperacidity.

Keywords: coeliac-superior mesenteric ganglion complex, gastric innervation, hyperacidity, immunohistochemistry

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105 The Effect of Sodium Bicarbonate on the Mg and P Concentrations in Turkish Black and Green Tea

Authors: E. Moroydor Derun, T. Yalcin, O. Dere Ozdemir, S. Kipcak, N. Tugrul, S. Piskin

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Tea is one of the most consumed beverages all over the world. Especially, black and green teas are preferred to consume. In Turkey, some local tea houses use sodium bicarbonate (SB) to obtain more infusion by using less amount of tea. Therefore, the addition of SB to black and green teas affects element concentrations of these teas. In this study, determination of magnesium (Mg) and phosphorus (P) contents in black and green teas is aimed for conscious consumption, after the addition of SB. Inductively coupled plasma optical emission spectrometry (ICP-OES) was used for these analysis. The results of this study showed that the concentrations of Mg and P decreased by adding SB from 11.020, 21.915 to 10.009, 17.520 in black tea and from 12.605, 14.550 to 8.118, 9.425 in green tea, respectively. The addition of SB on analyzed teas is not recommended as it reduces intake percentages of Mg and P from the essential elements.

Keywords: elements, ICP-OES, sodium bicarbonate, tea

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104 The Effect of Sea Buckthorn (Hippophae rhamnoides L.) Berries on Some Quality Characteristics of Cooked Pork Sausages

Authors: Anna M. Salejda, Urszula Tril, Grażyna Krasnowska

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The aim of this study was to analyze selected quality characteristics of cooked pork sausages manufactured with the addition of Sea buckthorn (Hippophae rhamnoides L.) berries preparations. Stuffings of model sausages consisted of pork, backfat, water and additives such a curing salt and sodium isoascorbate. Functional additives used in production process were two preparations obtained from dried Sea buckthorn berries in form of powder and brew. Powder of dried berries was added in amount of 1 and 3 g, while water infusion as a replacement of 50 and 100% ice water included in meat products formula. Control samples were produced without functional additives. Experimental stuffings were heat treated in water bath and stored for 4 weeks under cooled conditions (4±1ºC). Physical parameters of colour, texture profile and technological parameters as acidity, weight losses and water activity were estimated. The effect of Sea buckthorn berries preparations on lipid oxidation during storage of final products was determine by TBARS method. Studies have shown that addition of Sea buckthorn preparations to meat-fatty batters significant (P≤0.05) reduced the pH values of sausages samples after thermal treatment. Moreover, the addition of berries powder caused significant differences (P ≤ 0.05) in weight losses after cooking process. Analysis of results of texture profile analysis indicated, that utilization of infusion prepared from Sea buckthorn dried berries caused increase of springiness, gumminess and chewiness of final meat products. At the same time, the highest amount of Sea buckthorn berries powder in recipe caused the decrease of all measured texture parameters. Utilization of experimental preparations significantly decreased (P≤0.05) lightness (L* parameter of color) of meat products. Simultaneously, introduction of 1 and 3 grams of Sea buckthorn berries powder to meat-fatty batter increased redness (a* parameter) of samples under investigation. Higher content of substances reacting with thiobarbituric acid was observed in meat products produced without functional additives. It was observed that powder of Sea buckthorn berries added to meat-fatty batters caused higher protection against lipid oxidation in cooked sausages.

Keywords: sea buckthorn, meat products, texture, color parameters, lipid oxidation

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103 Metabolites of Polygonum L. Plants Having Antitumor Properties

Authors: Dmitriy Yu. Korulkin, Raissa A. Muzychkina

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The article represents the results of research of antitumor activity of different structural types of plant flavonoids extracted by authors from Polygonum L. plants in commercial reserves at the territory of the Republic of Kazakhstan. For the first time ever the results comparative research of antitumor activity of plant flavonoids of different structural groups and their synthetic derivatives have been represented. The results of determination of toxicity of flavonoids in single parenteral infusion conditions have been represented. Experimental substantiation of possible mechanisms of antiproliferative and cytotoxic action of flavonoids has been suggested. The perspectives of usage of plant flavonoids as medications and creation of effective dosage forms of antitumor medicines on their basis have been substantiated.

Keywords: antitumor activity, cytotoxicity, flavonoids, Polygonum L., secondary metabolites

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102 Determination of Cadmium , Lead, Nickel, and Zinc in Some Green Tea Samples Collected from Libyan Markets

Authors: Jamal A. Mayouf, Hashim Salih Al Bayati

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Green tea is one of the most common drinks in all cities of Libyan. Heavy metal contents such as cadmium (Cd), lead (Pb), nickel (Ni) and zinc (Zn) were determined in four green tea samples collected from Libyan market and their tea infusions by using atomic emission spectrophotometry after acid digestion. The results obtained indicate that the concentrations of Cd, Pb, Ni, and Zn in tea infusions samples ranged from 0.07-0.12, 0.19-0.28, 0.09-0.15, 0.18-0.43 mg/l after boiling for 5 min., 0.06-0.08, 0.18-0.23, 0.08-0.14, 0.17-0.27 mg/l after boiling for 10 min., 0.07-0.11, 0.18-0.24, 0.08-0.14, 0.21-0.34 mg/l after boiling for 15 min. respectively. On the other hand, the concentrations of the same element mentioned above obtained in tea leaves ranged from 6.0-18.0, 36.0-42.0, 16.0-20.0, 44.0-132.0 mg/kg respectively. The concentrations of Cd, Pb, Ni and Zn in tea leaves samples were higher than Prevention of Food Adulteration (PFA) limit and World Health Organization(WHO) permissible limit.

Keywords: tea, infusion, metals, Libya

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101 Determination of Lead , Cadmium, Nickel and Zinc in Some Green Tea Samples Collected from Libyan Markets

Authors: Jamal A. Mayouf, Hashim Salih Al Bayati, Eltayeb M. Emmima

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Green tea is one of the most common drinks in all cities of Libyan. Heavy metal contents such as cadmium (Cd), lead (Pb), nickel (Ni) and zinc (Zn) were determined in four green tea samples collected from Libyan market and their tea infusions by using atomic emission spectrophotometry after acid digestion. The results obtained indicate that the concentrations of Cd, Pb, Ni and Zn in tea infusions samples ranged from 0.07-0.12, 0.19-0.28, 0.09-0.15, 0.18-0.43 mg/l after boiling for 5 min., 0.06-0.08, 0.18-0.23, 0.08-0.14, 0.17-0.27 mg/l after boiling for 10 min., 0.07-0.11, 0.18-0.24, 0.08-0.14, 0.21-0.34 mg/l after boiling for 15 min. respectively. On the other hand, the concentrations of the same element mentioned above obtained in tea leaves ranged from 6.0-18.0, 36.0-42.0, 16.0-20.0, 44.0-132.0 mg/kg respectively. The concentrations of Cd, Pb, Ni and Zn in tea leaves samples were higher than Prevention of Food Adulteration (PFA) limit and World Health Organization(WHO) permissible limit.

Keywords: boiling, infusion, metals, tea

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100 A Rare Case of Clinically Amyopathic Dermatomyositis in a Filipino Female

Authors: Rene A. Amadore Jr., Ramar John Bangayan, Therese Eileen L. Natividad

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This is a case of a 59-year-old female who presented with a two-year history of heliotrope rash, Gottron's papules, shawl sign, V-neck sign, and muscle weakness. She was previously managed as a case of systemic lupus erythematosus, who initially responded to unrecalled corticosteroids. She was, however, admitted due to a one-month progressively enlarging sacral mass, which eventually turned out to be an abscess. While the abscess was being treated, her autoimmune condition was worked up, and she was then managed as a case of clinically amyopathic dermatomyositis (CADM) with interstitial lung disease (ILD). She received corticosteroids and underwent the first cycle of cyclophosphamide infusion prior to discharge.

Keywords: clinically amyopathic dermatomyositis, interstitial lung disease, corticosteroids, sacral abscess

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99 Bacterial Decontamination of Nurses' White Coats by Application of Antimicrobial Finish

Authors: Priyanka Gupta, Nilanjana Bairagi, Deepti Gupta

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New pathogenic strains of microbes are continually emerging and resistance of bacteria to antibiotics is growing. Hospitals in India have a high burden of infections in their intensive care units and general wards. Rising incidence of hospital infections is a matter of great concern in India. This growth is often attributed to the absence of effective infection control strategies in healthcare facilities. Government, therefore, is looking for cost effective strategies that are effective against HAIs. One possible method is by application of an antimicrobial finish on the uniform. But there are limited studies to show the effect of antimicrobial activity of antimicrobial finish treated nurses’ uniforms in a real hospital set up. This paper proposes a prospective non-destructive sampling technique, based on the use of a detachable fabric patch, to assess the effectiveness of silver based antimicrobial agent across five wards in a tertiary care government hospital in Delhi, India. Fabrics like polyester and polyester cotton blend fabric which are more prevalent for making coats were selected for the study. Polyester and polyester cotton blend fabric was treated with silver based antimicrobial (AM) finish. At the beginning of shift, a composite patch of untreated and treated fabric respectively was stitched on the abdominal region on the left and right side of the washed white coat of participating nurse. At the end of the shift, the patch was removed and taken for bacterial sampling on Brain Heart Infusion (BHI) plates. Microbial contamination on polyester and blend fabrics after 6 hours shift was compared in Brain Heart Infusion broth (BHI). All patches treated with silver based antimicrobial agent showed decreased bacterial counts. Percent reduction in the bacterial colonies after the antimicrobial treatment in both fabrics was 81.0 %. Antimicrobial finish was equally effective in reducing microbial adhesion on both fabric types. White coats of nurses become progressively contaminated during clinical care. Type of fabric used to make the coat can affect the extent of contamination which is higher on polyester cotton blend as compared to 100% polyester. The study highlights the importance of silver based antimicrobial finish in the area of uniform hygiene. Bacterial load can be reduced by using antimicrobial finish on hospital uniforms. Hospital staff uniforms endowed with antimicrobial properties may be of great help in reducing the occurrence and spread of infections.

Keywords: antimicrobial finish, bacteria, infection control, silver, white coat

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98 Effect of Ageing of Laser-Treated Surfaces on Corrosion Resistance of Fusion-bonded Al Joints

Authors: Rio Hirakawa, Christian Gundlach, Sven Hartwig

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Aluminium has been used in a wide range of industrial applications due to its numerous advantages, including excellent specific strength, thermal conductivity, corrosion resistance, workability and recyclability. The automotive industry is increasingly adopting multi-materials, including aluminium in structures and components to improve the mechanical usability and performance of individual components. A common method for assembling dissimilar materials is mechanical joining, but mechanical joining requires multiple manufacturing steps, affects the mechanical properties of the base material and increases the weight due to additional metal parts. Fusion bonding is being used in more and more industries as a way of avoiding the above drawbacks. Infusion bonding, and surface pre-treatment of the base material is essential to ensure the long-life durability of the joint. Laser surface treatment of aluminium has been shown to improve the durability of the joint by forming a passive oxide film and roughening the substrate surface. Infusion bonding, the polymer bonds directly to the metal instead of the adhesive, but the sensitivity to interfacial contamination is higher due to the chemical activity and molecular size of the polymer. Laser-treated surfaces are expected to absorb impurities from the storage atmosphere over time, but the effect of such changes in the treated surface over time on the durability of fusion-bonded joints has not yet been fully investigated. In this paper, the effect of the ageing of laser-treated surfaces of aluminum alloys on the corrosion resistance of fusion-bonded joints is therefore investigated. AlMg3 of 1.5 mm thickness was cut using a water-jet cutting machine, cleaned and degreased with isopropanol and surface pre-treated with a pulsed fiber laser at a wavelength of 1060 nm, maximum power of 70 W and repetition rate of 55 kHz. The aluminum surfaces were then stored in air for various periods of time and their corrosion resistance was assessed by cyclic voltammetry (CV) and electrochemical impedance spectroscopy (EIS). For the aluminum joints, induction heating was employed as the fusion bonding method and single-lap shear specimens were prepared. The corrosion resistance of the joints was assessed by measuring the lap shear strength before and after neutral salt spray. Cross-sectional observations by scanning electron microscopy (SEM) were also carried out to investigate changes in the microstructure of the bonded interface. Finally, the corrosion resistance of the surface and the joint were compared and the differences in the mechanisms of corrosion resistance enhancement between the two were discussed.

Keywords: laser surface treatment, pre-treatment, bonding, corrosion, durability, interface, automotive, aluminium alloys, joint, fusion bonding

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97 Causal Modeling of the Glucose-Insulin System in Type-I Diabetic Patients

Authors: J. Fernandez, N. Aguilar, R. Fernandez de Canete, J. C. Ramos-Diaz

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In this paper, a simulation model of the glucose-insulin system for a patient undergoing diabetes Type 1 is developed by using a causal modeling approach under system dynamics. The OpenModelica simulation environment has been employed to build the so called causal model, while the glucose-insulin model parameters were adjusted to fit recorded mean data of a diabetic patient database. Model results under different conditions of a three-meal glucose and exogenous insulin ingestion patterns have been obtained. This simulation model can be useful to evaluate glucose-insulin performance in several circumstances, including insulin infusion algorithms in open-loop and decision support systems in closed-loop.

Keywords: causal modeling, diabetes, glucose-insulin system, diabetes, causal modeling, OpenModelica software

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96 Comparison of Microstructure, Mechanical Properties and Residual Stresses in Laser and Electron Beam Welded Ti–5Al–2.5Sn Titanium Alloy

Authors: M. N. Baig, F. N. Khan, M. Junaid

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Titanium alloys are widely employed in aerospace, medical, chemical, and marine applications. These alloys offer many advantages such as low specific weight, high strength to weight ratio, excellent corrosion resistance, high melting point and good fatigue behavior. These attractive properties make titanium alloys very unique and therefore they require special attention in all areas of processing, especially welding. In this work, 1.6 mm thick sheets of Ti-5Al-2,5Sn, an alpha titanium (α-Ti) alloy, were welded using electron beam (EBW) and laser beam (LBW) welding processes to achieve a full penetration Bead-on Plate (BoP) configuration. The weldments were studied using polarized optical microscope, SEM, EDS and XRD. Microhardness distribution across the weld zone and smooth and notch tensile strengths of the weldments were also recorded. Residual stresses using Hole-drill Strain Measurement (HDSM) method and deformation patterns of the weldments were measured for the purpose of comparison of the two welding processes. Fusion zone widths of both EBW and LBW weldments were found to be approximately equivalent owing to fairly similar high power densities of both the processes. Relatively less oxide content and consequently high joint quality were achieved in EBW weldment as compared to LBW due to vacuum environment and absence of any shielding gas. However, an increase in heat-affected zone width and partial ά-martensitic transformation infusion zone of EBW weldment were observed because of lesser cooling rates associated with EBW as compared with LBW. The microstructure infusion zone of EBW weldment comprised both acicular α and ά martensite within the prior β grains whereas complete ά martensitic transformation was observed within the fusion zone of LBW weldment. Hardness of the fusion zone in EBW weldment was found to be lower than the fusion zone of LBW weldment due to the observed microstructural differences. Notch tensile specimen of LBW exhibited higher load capacity, ductility, and absorbed energy as compared with EBW specimen due to the presence of high strength ά martensitic phase. It was observed that the sheet deformation and deformation angle in EBW weldment were more than LBW weldment due to relatively more heat retention in EBW which led to more thermal strains and hence higher deformations and deformation angle. The lowest residual stresses were found in LBW weldments which were tensile in nature. This was owing to high power density and higher cooling rates associated with LBW process. EBW weldment exhibited highest compressive residual stresses due to which the service life of EBW weldment is expected to improve.

Keywords: Laser and electron beam welding, Microstructure and mechanical properties, Residual stress and distortions, Titanium alloys

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95 Multi-Institutional Report on Toxicities of Concurrent Nivolumab and Radiation Therapy

Authors: Neha P. Amin, Maliha Zainib, Sean Parker, Malcolm Mattes

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Purpose/Objectives: Combination immunotherapy (IT) and radiation therapy (RT) is an actively growing field of clinical investigation due to promising findings of synergistic effects from immune-mediated mechanisms observed in preclinical studies and clinical data from case reports of abscopal effects. While there are many ongoing trials of combined IT-RT, there are still limited data on toxicity and outcome optimization regarding RT dose, fractionation, and sequencing of RT with IT. Nivolumab (NIVO), an anti-PD-1 monoclonal antibody, has been rapidly adopted in the clinic over the past 2 years, resulting in more patients being considered for concurrent RT-NIVO. Knowledge about the toxicity profile of combined RT-NIVO is important for both the patient and physician when making educated treatment decisions. The acute toxicity profile of concurrent RT-NIVO was analyzed in this study. Materials/Methods: A retrospective review of all consecutive patients who received NIVO from 1/2015 to 5/2017 at 4 separate centers within two separate institutions was performed. Those patients who completed a course of RT from 1 day prior to initial NIVO infusion through 1 month after last NIVO infusion were considered to have received concurrent therapy and included in the subsequent analysis. Descriptive statistics are reported for patient/tumor/treatment characteristics and observed acute toxicities within 3 months of RT completion. Results: Among 261 patients who received NIVO, 46 (17.6%) received concurrent RT to 67 different sites. The median f/u was 3.3 (.1-19.8) months, and 11/46 (24%) were still alive at last analysis. The most common histology, RT prescription, and treatment site included non-small cell lung cancer (23/46, 50%), 30 Gy in 10 fractions (16/67, 24%), and central thorax/abdomen (26/67, 39%), respectively. 79% (53/67) of irradiated sites were treated with 3D-conformal technique and palliative dose-fractionation. Grade 3, 4, and 5 toxicities were experienced by 11, 1, and 2 patients, respectively. However all grade 4 and 5 toxicities were outside of the irradiated area and attributed to the NIVO alone, and only 4/11 (36%) of the grade 3 toxicities were attributed to the RT-NIVO. The irradiated site in these cases included the brain [2/10 (20%)] and central thorax/abdomen [2/19 (10.5%)], including one unexpected grade 3 pancreatitides following stereotactic body RT to the left adrenal gland. Conclusions: Concurrent RT-NIVO is generally well tolerated, though with potentially increased rates of severe toxicity when irradiating the lung, abdomen, or brain. Pending more definitive data, we recommend counseling patients on the potentially increased rates of side effects from combined immunotherapy and radiotherapy to these locations. Future prospective trials assessing fractionation and sequencing of RT with IT will help inform combined therapy recommendations.

Keywords: combined immunotherapy and radiation, immunotherapy, Nivolumab, toxicity of concurrent immunotherapy and radiation

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94 An Algorithm of Regulation of Glucose-Insulin Concentration in the Blood

Authors: B. Selma, S. Chouraqui

Abstract:

The pancreas is an elongated organ that extends across the abdomen, below the stomach. In addition, it secretes certain enzymes that aid in food digestion. The pancreas also manufactures hormones responsible for regulating blood glucose levels. In the present paper, we propose a mathematical model to study the homeostasis of glucose and insulin in healthy human, and a simulation of this model, which depicts the physiological events after a meal, will be represented in ordinary humans. The aim of this paper is to design an algorithm which regulates the level of glucose in the blood. The algorithm applied the concept of expert system for performing an algorithm control in the form of an "active" used to prescribe the rate of insulin infusion. By decomposing the system into subsystems, we have developed parametric models of each subsystem by using a forcing function strategy. The results showed a performance of the control system.

Keywords: modeling, algorithm, regulation, glucose-insulin, blood, control system

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93 Synthesis of Microporous Interconnected Polymeric Foam of Poly (Glycidyl Methacrylate-Co-Divinylbenzene-Co-Butyl Acrylate) by Using Aqueous Foam as a Template

Authors: A. A. Gadgeel, S. T. Mhaske

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Hexadecyltrimethylammonium bromide (HTAB) modified nano silica were used as pore stabilizer for the preparation of interconnected macroporous copolymer foam of glycidyl methacrylate (GMA), divinylbenzene (DVB) and tert-butyl acrylate (BA). The polymerization of air infused aqueous foam is carried out through free radical thermal initiator. The porosity of the polymerized foam depends on the concentration of HTAB used to control the hydrophobic and hydrophilic behavior of silica nanoparticle. Modified silica particle results to form closed cell foam with 74% of porosity for 60% of air infusion during aqueous foaming. The preliminary structure of microfoam was observed through optical microscopy, whereas for a better understanding of morphology SEM was used. The proposed route is an eco-friendly route for synthesizing polymeric microporous polymer as compared to other chemical and additive-based routes available.

Keywords: air-infused, interconnected microporous, porosity, aqueous foam

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92 Lubricant-Impregnated Nanoporous Surfaces for Biofilm Prevention

Authors: Yuen Yee Li Sip, Lei Zhai

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Biofilms are formed by the attachment of microorganisms onto substrates via self-synthesized extracellular polymeric substances. They have been observed in the International Space Stations (ISS), in which biofilms can jeopardize the performance of key equipment and can pose health threats to the astronauts. This project aims at building conformal nanoporous surfaces that are infused with lubricant and decorated with antimicrobial nanoparticles while simultaneously evaluating their efficacy in preventing biofilm formation. Lubricant-impregnated surfaces (LIS) are fabricated by using a layer-by-layer assembly of silica nanoparticles to generate conformal nanoporous coatings on substrates and fill the films with fluorinated fluids. LIS has demonstrated excellent repellency to a broad range of liquids, preventing microbe adhesion (anti-biofouling). Silver or copper nanoparticles were deposited on the coatings prior to lubricant infusion in order to provide antimicrobial characteristics to the coating. Surface morphology and biofilm growth were characterized to understand how the coating morphology affects the LIS stability and anti-biofouling behaviors (stationary and in a flow).

Keywords: biofilm, coatings, nanoporous, antifouling

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91 Experimental Assessment of Micromechanical Models for Mechanical Properties of Recycled Short Fiber Composites

Authors: Mohammad S. Rouhi, Magdalena Juntikka

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Processing of polymer fiber composites has a remarkable influence on their mechanical performance. These mechanical properties are even more influenced when using recycled reinforcement. Therefore, we place particular attention on the evaluation of micromechanical models to estimate the mechanical properties and compare them against the experimental results of the manufactured composites. For the manufacturing process, an epoxy matrix and carbon fiber production cut-offs as reinforcing material are incorporated using a vacuum infusion process. In addition, continuous textile reinforcement in combination with the epoxy matrix is used as reference material to evaluate the kick-down in mechanical performance of the recycled composite. The experimental results show less degradation of the composite stiffness compared to the strength properties. Observations from the modeling also show the same trend as the error between the theoretical and experimental results is lower for stiffness comparisons than the strength calculations. Yet still, good mechanical performance for specific applications can be expected from these materials.

Keywords: composite recycling, carbon fibers, mechanical properties, micromechanics

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90 Enframing the Smart City: Utilizing Heidegger's 'The Question Concerning Technology' as a Framework to Interpret Smart Urbanism

Authors: Will Brown

Abstract:

Martin Heidegger is considered to be one of the leading philosophical lights of the 20th century with his lecture/essay 'The Question Concerning Technology' proving to be an invaluable text in the study of technology and the understanding of how technology influences the world it is set upon. However, this text has not as of yet been applied to the rapid rise and proliferation of ‘smart’ cities. This article is premised upon the application of the aforementioned text and the smart city in order to provide a fresh, if not critical analysis and interpretation of this phenomena. The first section below provides a brief literature review of smart urbanism in order to lay the groundwork necessary to apply Heidegger’s work to the smart city, from which a framework is developed to interpret the infusion of digital sensing technologies and the urban milieu. This framework is comprised of four concepts put forward in Heidegger’s text: circumscribing, bringing-forth, challenging, and standing-reserve. A concluding chapter is based upon the notion of enframement, arguing that once the rubric of data collection is placed within the urban system, future systems will require the capability to harvest data, resulting in an ever-renewing smart city.

Keywords: air quality sensing, big data, Martin Heidegger, smart city

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89 A Multi-criteria Decision Support System for Migrating Legacies into Open Systems

Authors: Nasser Almonawer

Abstract:

Timely reaction to an evolving global business environment and volatile market conditions necessitates system and process flexibility, which in turn demands agile and adaptable architecture and a steady infusion of affordable new technologies. On the contrary, a large number of organizations utilize systems characterized by inflexible and obsolete legacy architectures. To effectively respond to the dynamic contemporary business environments, such architectures must be migrated to robust and modular open architectures. To this end, this paper proposes an integrated decision support system for a seamless migration to open systems. The proposed decision support system (DSS) integrates three well-established quantitative and qualitative decision-making models—namely, the Delphi method, Analytic Hierarchy Process (AHP) and Goal Programming (GP) to (1) assess risks and establish evaluation criteria; (2) formulate migration strategy and rank candidate systems; and (3) allocate resources among the selected systems.

Keywords: decision support systems, open systems architecture, analytic hierarchy process (AHP), goal programming (GP), delphi method

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88 Study of Reporting System for Adverse Events Related to Common Medical Devices at a Tertiary Care Public Sector Hospital in India

Authors: S. Kurian, S. Satpathy, S. K. Gupta, S. Arya, D. K. Sharma

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Advances in the use of health care technology have resulted in increased adverse events (AEs) related to the use of medical devices. The study focused on the existing reporting systems. This study was conducted in a tertiary care public sector hospital. Devices included Syringe infusion pumps, Cardiac monitors, Pulse oximeters, Ventilators and Defibrillators. A total of 211 respondents were recruited. Interviews were held with 30 key informants. Medical records were scrutinized. Relevant statistical tests were used. Resident doctors reported maximum frequency of AEs, followed by nurses; and least by consultants. A significant association was found between the cadre of health care personnel and awareness that the patients and bystanders have a risk of sustaining AE. Awareness regarding reporting of AEs was low, and it was generally done verbally. Other critical findings are discussed in the light of the barriers to reporting, reasons for non-compliance, recording system, and so on.

Keywords: adverse events, health care technology, medical devices, public sector hospital, reporting systems

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87 Determination of LS-DYNA MAT162 Material input Parameters for Low Velocity Impact Analysis of Layered Composites

Authors: Mustafa Albayrak, Mete Onur Kaman, Ilyas Bozkurt

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In this study, the necessary material parameters were determined to be able to conduct progressive damage analysis of layered composites under low velocity impact by using the MAT162 material module in the LS-DYNA program. The material module MAT162 based on Hashin failure criterion requires 34 parameters in total. Some of these parameters were obtained directly as a result of dynamic and quasi-static mechanical tests, and the remaining part was calibrated and determined by comparing numerical and experimental results. Woven glass/epoxy was used as the composite material and it was produced by vacuum infusion method. In the numerical model, composites are modeled as three-dimensional and layered. As a result, the acquisition of MAT162 material module parameters, which will enable progressive damage analysis, is given in detail and step by step, and the selection methods of the parameters are explained. Numerical data consistent with the experimental results are given in graphics.

Keywords: Composite Impact, Finite Element Simulation, Progressive Damage Analyze, LS-DYNA, MAT162

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86 Ammonia and Biogenic Amine Production of Fish Spoilage Bacteria: Affected by Olive Leaf, Olive Cake and Black Water

Authors: E. Kuley, M. Durmuş, E. Balikci, G. Ozyurt, Y. Uçar, F. Kuley, F. Ozogul, Y. Ozogul

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Ammonia and biogenic amine production of fish spoilage bacteria in sardine infusion decarboxylase broth and antimicrobial effect of olive by products (olive leaf extract:OL, olive cake: OC and black water:BW) was monitored using HPLC method. Fish spoilage bacteria produced all biogenic amine tested, mainly histamine and serotonin. Ammonia was accumulated more than 13.60 mg/L. Histamine production was in range 37.50 mg/L by Ser. liquefaciens and 86.71 mg/L by Ent. cloacae. The highest putrescine and cadaverine production was observed by Ent. cloacae (17.80 vs. 17.69 mg/L). The presence of OL, OC and BW in the broth significantly affected biogenic amine accumulation by bacteria. The antibacterial effect of olive by products depended on bacterial strains. OL and OC resulted in significant inhibition effect on HIS accumulation by bacteria apart from Ser. liquefaciens and Prot. mirabilis. The study result revealed that usefulness of OL and OC to prevent the accumulation of this amine which may affect human health.

Keywords: Antimicrobials, biogenic amine, fish spoilage bacteria, olive-by products

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85 The Effect of a Computer-Assisted Glycemic Surveillance Protocol on Nursing Workload

Authors: Özlem Canbolat, Sevgisun Kapucu

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The aim of this study was to determine the effect of a computer-assisted glycemic surveillance protocol on nursing workload in intensive care unit. The study is completed in an Education and Research Hospital in Ankara with the attendance of volunteered 19 nurse who had been worked in reanimation unit. Nurses used the written protocol and computer-assisted glycemic surveillance protocol for glycemic follow-up approach of the intensive care patients. Nurses used the written protocol first in the glycemic follow-up of the patient, then used the computer-assisted protocol. (Nurses used the written protocol first, then the computer-assisted protocol in the glycemic follow-up of the patient). Less time was spent in glycemic control with computerized protocol than written protocol and this difference is statistically significant (p < 0.001). It was determined that the computerized protocol application was completed in about 10 seconds (25% shorter) than the written protocol implementation. The computer-assisted glycemic surveillance protocol was found to be more easy and appropriate by nurses and the satisfaction level of the users was higher than with written protocol. While 79% of the nurses find it confusing to implement the written protocol, 79% were satisfied with the use of computerized protocol.

Keywords: computer-assisted protocol, glycemic control, insulin infusion protocol, intensive care, nursing workload

Procedia PDF Downloads 221