Search results for: integrated care delivery
2135 Bioefficiency of Cinnamomum verum Loaded Niosomes and Its Microbicidal and Mosquito Larvicidal Activity against Aedes aegypti, Anopheles stephensi and Culex quinquefasciatus
Authors: Aasaithambi Kalaiselvi, Michael Gabriel Paulraj, Ekambaram Nakkeeran
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Emergences of mosquito vector-borne diseases are considered as a perpetual problem globally in tropical countries. The outbreak of several diseases such as chikungunya, zika virus infection and dengue fever has created a massive threat towards the living population. Frequent usage of synthetic insecticides like Dichloro Diphenyl Trichloroethane (DDT) eventually had its adverse harmful effects on humans as well as the environment. Since there are no perennial vaccines, prevention, treatment or drugs available for these pathogenic vectors, WHO is more concerned in eradicating their breeding sites effectively without any side effects on humans and environment by approaching plant-derived natural eco-friendly bio-insecticides. The aim of this study is to investigate the larvicidal potency of Cinnamomum verum essential oil (CEO) loaded niosomes. Cholesterol and surfactant variants of Span 20, 60 and 80 were used in synthesizing CEO loaded niosomes using Transmembrane pH gradient method. The synthesized CEO loaded niosomes were characterized by Zeta potential, particle size, Fourier Transform Infrared Spectroscopy (FT-IR), GC-MS and SEM analysis to evaluate charge, size, functional properties, the composition of secondary metabolites and morphology. The Z-average size of the formed niosomes was 1870.84 nm and had good stability with zeta potential -85.3 meV. The entrapment efficiency of the CEO loaded niosomes was determined by UV-Visible Spectrophotometry. The bio-potency of CEO loaded niosomes was treated and assessed against gram-positive (Bacillus subtilis) and gram-negative (Escherichia coli) bacteria and fungi (Aspergillus fumigatus and Candida albicans) at various concentrations. The larvicidal activity was evaluated against II to IV instar larvae of Aedes aegypti, Anopheles stephensi and Culex quinquefasciatus at various concentrations for 24 h. The mortality rate of LC₅₀ and LC₉₀ values were calculated. The results exhibited that CEO loaded niosomes have greater efficiency against mosquito larvicidal activity. The results suggest that niosomes could be used in various applications of biotechnology and drug delivery systems with greater stability by altering the drug of interest.Keywords: Cinnamomum verum, niosomes, entrapment efficiency, bactericidal and fungicidal, mosquito larvicidal activity
Procedia PDF Downloads 1642134 Breeding for Hygienic Behavior in Honey Bees
Authors: Michael Eickermann, Juergen Junk
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The Western honey (Apis mellifera) is threatened by a number of parasites, especially the devastating Varroa mite (Varroa destructor) is responsible for a high level of mortality over winter, e.g., in Europe and USA. While the use of synthetic pesticides or organic acids has been preferred so far to control this parasite, breeding strategies for less susceptible honey bees are in early stages. Hygienic behavior can be an important tool for controlling Varroa destructor. Worker bees with a high level of this behavior are able to detect infested brood in the cells under the wax lid during pupation and remove them out of the hive. The underlying processes of this behavior are only partly investigated, but it is for sure that hygienic behavior is heritable and therefore, can be integrated into commercial breeding lines. In a first step, breeding lines with a high level of phenotypic hygienic behavior have been identified by using a bioassay for accurate assessment of this trait in a long-term national breeding program in Luxembourg since 2015. Based on the artificial infestation of nucleus colonies with 150 phoretic Varroa destructor mites, the level of phenotypic hygienic behavior was detected by counting the number of mites in all stages, twelve days after infestation. A nucleus with a high level of hygienic behavior was overwintered and used for breeding activities in the following years. Artificial insemination was used to combine different breeding lines. Buckfast lines, as well as Carnica lines, were used. While Carnica lines offered only a low increase of hygienic behavior up to maximum 62.5%, Buckfast lines performed much better with mean levels of more than 87.5%. Some mating ends up with a level of 100%. But even with a level of 82.5% Varroa mites are not able to reproduce in the colony anymore. In a final step, a nucleus with a high level of hygienic behavior were build up to full colonies and located at two places in Luxembourg to build up a drone congregation area. Local beekeepers can bring their nucleus to this location for mating the queens with drones offering a high level of hygienic behavior.Keywords: agiculture, artificial insemination, honey bee, varroa destructor
Procedia PDF Downloads 1362133 Human Factors Considerations in New Generation Fighter Planes to Enhance Combat Effectiveness
Authors: Chitra Rajagopal, Indra Deo Kumar, Ruchi Joshi, Binoy Bhargavan
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Role of fighter planes in modern network centric military warfare scenarios has changed significantly in the recent past. New generation fighter planes have multirole capability of engaging both air and ground targets with high precision. Multirole aircraft undertakes missions such as Air to Air combat, Air defense, Air to Surface role (including Air interdiction, Close air support, Maritime attack, Suppression and Destruction of enemy air defense), Reconnaissance, Electronic warfare missions, etc. Designers have primarily focused on development of technologies to enhance the combat performance of the fighter planes and very little attention is given to human factor aspects of technologies. Unique physical and psychological challenges are imposed on the pilots to meet operational requirements during these missions. Newly evolved technologies have enhanced aircraft performance in terms of its speed, firepower, stealth, electronic warfare, situational awareness, and vulnerability reduction capabilities. This paper highlights the impact of emerging technologies on human factors for various military operations and missions. Technologies such as ‘cooperative knowledge-based systems’ to aid pilot’s decision making in military conflict scenarios as well as simulation technologies to enhance human performance is also studied as a part of research work. Current and emerging pilot protection technologies and systems which form part of the integrated life support systems in new generation fighter planes is discussed. System safety analysis application to quantify the human reliability in military operations is also studied.Keywords: combat effectiveness, emerging technologies, human factors, systems safety analysis
Procedia PDF Downloads 1422132 Heat Transfer and Trajectory Models for a Cloud of Spray over a Marine Vessel
Authors: S. R. Dehghani, G. F. Naterer, Y. S. Muzychka
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Wave-impact sea spray creates many droplets which form a spray cloud traveling over marine objects same as marine vessels and offshore structures. In cold climates such as Arctic reigns, sea spray icing, which is ice accretion on cold substrates, is strongly dependent on the wave-impact sea spray. The rate of cooling of droplets affects the process of icing that can yield to dry or wet ice accretion. Trajectories of droplets determine the potential places for ice accretion. Combining two models of trajectories and heat transfer for droplets can predict the risk of ice accretion reasonably. The majority of the cooling of droplets is because of droplet evaporations. In this study, a combined model using trajectory and heat transfer evaluate the situation of a cloud of spray from the generation to impingement. The model uses some known geometry and initial information from the previous case studies. The 3D model is solved numerically using a standard numerical scheme. Droplets are generated in various size ranges from 7 mm to 0.07 mm which is a suggested range for sea spray icing. The initial temperature of droplets is considered to be the sea water temperature. Wind velocities are assumed same as that of the field observations. Evaluations are conducted using some important heading angles and wind velocities. The characteristic of size-velocity dependence is used to establish a relation between initial sizes and velocities of droplets. Time intervals are chosen properly to maintain a stable and fast numerical solution. A statistical process is conducted to evaluate the probability of expected occurrences. The medium size droplets can reach the highest heights. Very small and very large droplets are limited to lower heights. Results show that higher initial velocities create the most expanded cloud of spray. Wind velocities affect the extent of the spray cloud. The rate of droplet cooling at the start of spray formation is higher than the rest of the process. This is because of higher relative velocities and also higher temperature differences. The amount of water delivery and overall temperature for some sample surfaces over a marine vessel are calculated. Comparing results and some field observations show that the model works accurately. This model is suggested as a primary model for ice accretion on marine vessels.Keywords: evaporation, sea spray, marine icing, numerical solution, trajectory
Procedia PDF Downloads 2202131 A Rare Cause of Abdominal Pain Post Caesarean Section
Authors: Madeleine Cox
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Objective: discussion of diagnosis of vernix caseosa peritonitis, recovery and subsequent caesarean seciton Case: 30 year old G4P1 presented in labour at 40 weeks, planning a vaginal birth afterprevious caesarean section. She underwent an emergency caesarean section due to concerns for fetal wellbeing on CTG. She was found to have a thin lower segment with a very small area of dehiscence centrally. The operation was uncomplicated, and she recovered and went home 2 days later. She then represented to the emergency department day 6 post partum feeling very unwell, with significant abdominal pain, tachycardia as well as urinary retention. Raised white cell count of 13.7 with neutrophils of 11.64, CRP of 153. An abdominal ultrasound was poorly tolerated by the patient and did not aide in the diagnosis. Chest and abdominal xray were normal. She underwent a CT chest and abdomen, which found a small volume of free fluid with no apparent collection. Given no obvious cause of her symptoms were found and the patient did not improve, she had a repeat CT 2 days later, which showed progression of free fluid. A diagnostic laparoscopy was performed with general surgeons, which reveled turbid fluid, an inflamed appendix which was removed. The patient improved remarkably post operatively. The histology showed periappendicitis with acute appendicitis with marked serosal inflammatory reaction to vernix caseosa. Following this, the patient went on to recover well. 4 years later, the patient was booked for an elective caesarean section, on entry into the abdomen, there were very minimal adhesions, and the surgery and her subsequent recovery was uncomplicated. Discussion: this case represents the diagnostic dilemma of a patient who presents unwell without a clear cause. In this circumstance, multiple modes of imaging did not aide in her diagnosis, and so she underwent diagnostic surgery. It is important to evaluate if a patient is or is not responding to the typical causes of post operative pain and adjust management accordingly. A multiteam approach can help to provide a diagnosis for these patients. Conclusion: Vernix caseosa peritonitis is a rare cause of acute abdomen post partum. There are few reports in the literature of the initial presentation and no reports on the possible effects on future pregnancies. This patient did not have any complications in her following pregnancy or delivery secondary to her diagnosis of vernix caseosa peritonitis. This may assist in counselling other women who have had this uncommon diagnosis.Keywords: peritonitis, obstetrics, caesarean section, pain
Procedia PDF Downloads 1042130 A Study from Language and Culture Perspective of Human Needs in Chinese and Vietnamese Euphemism Languages
Authors: Quoc Hung Le Pham
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Human beings are motivated to satisfy the physiological needs and psychological needs. In the fundamental needs, bodily excretion is the most basic one, while physiological excretion refers to the final products produced in the process of discharging the body. This physiological process is a common human phenomenon. For instance, bodily secretion is totally natural, but people of various nationalities through the times avoid saying it directly. Terms like ‘shit’ are often negatively regarded as dirty, smelly and vulgar; it will lead people to negative thinking. In fact, it is in the psychology of human beings to avoid such unsightly terms. Especially in social situations where you have to take care of your image, and you have to release. The best way to solve this is to approach the use of euphemism. People prefer to say it as ‘answering nature's call’ or ‘to pass a motion’ instead. Chinese and Vietnamese nations are referring to use euphemisms to replace bodily secretions, so this research will take this phenomenon as the object aims to explore the similarities and dissimilarities between two languages euphemism. The basic of the niche of this paper is human physiological phenomenon excretion. As the preliminary results show, in expressing bodily secretions the deeply impacting factor is language and cultural factors. On language factor terms, two languages are using assonance to replace human nature discharge, whilst the dissimilarities are metonymy, loan word and personification. On culture factor terms, the convergences are metonymy and application of the semantically-contrary-word-euphemism, whilst the difference is Chinese euphemism using allusion but Vietnamese euphemism does not.Keywords: cultural factors, euphemism, human needs, language factors
Procedia PDF Downloads 3012129 Efficiency Validation of Hybrid Cooling Application in Hot and Humid Climate Houses of KSA
Authors: Jamil Hijazi, Stirling Howieson
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Reducing energy consumption and CO2 emissions are probably the greatest challenge now facing mankind. From considerations surrounding global warming and CO2 production, it has to be recognized that oil is a finite resource and the KSA like many other oil-rich countries will have to start to consider a horizon where hydro-carbons are not the dominant energy resource. The employment of hybrid ground-cooling pipes in combination with the black body solar collection and radiant night cooling systems may have the potential to displace a significant proportion of oil currently used to run conventional air conditioning plant. This paper presents an investigation into the viability of such hybrid systems with the specific aim of reducing cooling load and carbon emissions while providing all year-round thermal comfort in a typical Saudi Arabian urban housing block. Soil temperatures were measured in the city of Jeddah. A parametric study then was carried out by computational simulation software (DesignBuilder) that utilized the field measurements and predicted the cooling energy consumption of both a base case and an ideal scenario (typical block retro-fitted with insulation, solar shading, ground pipes integrated with hypocaust floor slabs/stack ventilation and radiant cooling pipes embed in floor). Initial simulation results suggest that careful ‘ecological design’ combined with hybrid radiant and ground pipe cooling techniques can displace air conditioning systems, producing significant cost and carbon savings (both capital and running) without appreciable deprivation of amenity.Keywords: cooling load, energy efficiency, ground pipe cooling, hybrid cooling strategy, hydronic radiant systems, low carbon emission, passive designs, thermal comfort
Procedia PDF Downloads 2312128 Elucidating Microstructural Evolution Mechanisms in Tungsten via Layerwise Rolling in Additive Manufacturing: An Integrated Simulation and Experimental Approach
Authors: Sadman Durlov, Aditya Ganesh-Ram, Hamidreza Hekmatjou, Md Najmus Salehin, Nora Shayesteh Ameri
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In the field of additive manufacturing, tungsten stands out for its exceptional resistance to high temperatures, making it an ideal candidate for use in extreme conditions. However, its inherent brittleness and vulnerability to thermal cracking pose significant challenges to its manufacturability. This study explores the microstructural evolution of tungsten processed through layer-wise rolling in laser powder bed fusion additive manufacturing, utilizing a comprehensive approach that combines advanced simulation techniques with empirical research. We aim to uncover the complex processes of plastic deformation and microstructural transformations, with a particular focus on the dynamics of grain size, boundary evolution, and phase distribution. Our methodology employs a combination of simulation and experimental data, allowing for a detailed comparison that elucidates the key mechanisms influencing microstructural alterations during the rolling process. This approach facilitates a deeper understanding of the material's behavior under additive manufacturing conditions, specifically in terms of deformation and recrystallization. The insights derived from this research not only deepen our theoretical knowledge but also provide actionable strategies for refining manufacturing parameters to improve the tungsten components' mechanical properties and functional performance. By integrating simulation with practical experimentation, this study significantly enhances the field of materials science, offering a robust framework for the development of durable materials suited for challenging operational environments. Our findings pave the way for optimizing additive manufacturing techniques and expanding the use of tungsten across various demanding sectors.Keywords: additive manufacturing, layer wise rolling, refractory materials, in-situ microstructure modifications
Procedia PDF Downloads 612127 The Design of Safe Spaces in Healthcare Facilities Vulnerable to Tornado Impact in Central US
Authors: Lucy Ampaw-Asiedu, Terri R. Norton
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In the wake of recent disasters happening around the world such as earthquake in Italy (January, 2017); hurricanes in the United States (US) (September 2016 and September 2017); and compounding disasters in Haiti (September 2010 and September 2016); to our best knowledge, never has the world seen the need to work on preemptive rather than reactionary measures to salvage this situation than now. Tornadoes are natural hazards that mostly affect mid-western and central states in the US. Tornadoes, like all natural hazards such as hurricanes, earthquakes, floods and others, are very destructive and result in massive destruction to homes, cause billions of dollars in damage and claims many lives. Healthcare facilities in general are vulnerable to disasters, and therefore, the safety of patients, health workers and those who come in to seek shelter should be a priority. The focus of this study is to assess disaster management measures instituted by healthcare facilities. Thus, the sole aim of the study is to examine the vulnerabilities and the design of safe spaces in healthcare facilities in Central US. Objectives that guide the study are to primarily identify the impacts of tornadoes in hospitals and to assess the structural design or specifications of safe spaces. St. John’s Regional Medical Center, now Mercy Hospital in Joplin, is used as a case study. Preliminary results show that the lateral base shear of the proposed design to be 684.24 ton (1508.49kip) for the safe space. Findings from this work will be used to make recommendations about the design of safe spaces for health care facilities in Central US.Keywords: disaster management, safe spaces, structural design, tornado, vulnerability
Procedia PDF Downloads 2152126 Low Enrollment in Civil Engineering Departments: Challenges and Opportunities
Authors: Alaa Yehia, Ayatollah Yehia, Sherif Yehia
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There is a recurring issue of low enrollments across many civil engineering departments in postsecondary institutions. While there have been moments where enrollments begin to increase, civil engineering departments find themselves facing low enrollments at around 60% over the last five years across the Middle East. There are many reasons that could be attributed to this decline, such as low entry-level salaries, over-saturation of civil engineering graduates in the job market, and a lack of construction projects due to the impending or current recession. However, this recurring problem alludes to an intrinsic issue of the curriculum. The societal shift to the usage of high technology such as machine learning (ML) and artificial intelligence (AI) demands individuals who are proficient at utilizing it. Therefore, existing curriculums must adapt to this change in order to provide an education that is suitable for potential and current students. In this paper, In order to provide potential solutions for this issue, the analysis considers two possible implementations of high technology into the civil engineering curriculum. The first approach is to implement a course that introduces applications of high technology in Civil Engineering contexts. While the other approach is to intertwine applications of high technology throughout the degree. Both approaches, however, should meet requirements of accreditation agencies. In addition to the proposed improvement in civil engineering curriculum, a different pedagogical practice must be adapted as well. The passive learning approach might not be appropriate for Gen Z students; current students, now more than ever, need to be introduced to engineering topics and practice following different learning methods to ensure they will have the necessary skills for the job market. Different learning methods that incorporate high technology applications, like AI, must be integrated throughout the curriculum to make the civil engineering degree more attractive to prospective students. Moreover, the paper provides insight on the importance and approach of adapting the Civil Engineering curriculum to address the current low enrollment crisis that civil engineering departments globally, but specifically in the Middle East, are facing.Keywords: artificial intelligence (AI), civil engineering curriculum, high technology, low enrollment, pedagogy
Procedia PDF Downloads 1662125 Surface Deformation Studies in South of Johor Using the Integration of InSAR and Resistivity Methods
Authors: Sirajo Abubakar, Ismail Ahmad Abir, Muhammad Sabiu Bala, Muhammad Mustapha Adejo, Aravind Shanmugaveloo
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Over the years, land subsidence has been a serious threat mostly to urban areas. Land subsidence is the sudden sinking or gradual downward settling of the ground’s surface with little or no horizontal motion. In most areas, land subsidence is a slow process that covers a large area; therefore, it is sometimes left unnoticed. South of Johor is the area of interest for this project because it is going through rapid urbanization. The objective of this research is to evaluate and identify potential deformations in the south of Johor using integrated remote sensing and 2D resistivity methods. Synthetic aperture radar interferometry (InSAR) which is a remote sensing technique has the potential to map coherent displacements at centimeter to millimeter resolutions. Persistent scatterer interferometry (PSI) stacking technique was applied to Sentinel-1 data to detect the earth deformation in the study area. A dipole-dipole configuration resistivity profiling was conducted in three areas to determine the subsurface features in that area. This subsurface features interpreted were then correlated with the remote sensing technique to predict the possible causes of subsidence and uplifts in the south of Johor. Based on the results obtained, West Johor Bahru (0.63mm/year) and Ulu Tiram (1.61mm/year) are going through uplift due to possible geological uplift. On the other end, East Johor Bahru (-0.26mm/year) and Senai (-1.16mm/year) undergo subsidence due to possible fracture and granitic boulders loading. Land subsidence must be taken seriously as it can cause serious damages to infrastructures and human life. Monitoring land subsidence and taking preventive actions must be done to prevent any disasters.Keywords: interferometric synthetic aperture radar, persistent scatter, minimum spanning tree, resistivity, subsidence
Procedia PDF Downloads 1472124 Analysis on the Importance and Direction of Change in Residential Environment of Apartment with the Change of Population Structure
Authors: Jo, Eui Chang, Shin, Heekang, Mun, A. Young , Kim, Hong Kyu
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Regarding change on population and family structure in Korea after the 1980s, there has been a rapid change of low fertility, graying and increase of single household that cannot be found in any other parts of the world. With the result of total population residence by the National Statistical Office, Korea will hold 52,160,065 people in 2030 and reduction is predicted and from 2025 people above the age of 65 will take 20% of the total population, which means the entry of a super aging society. Also, average number in a family will be 2.71 in 2015 and decrease to 2.33 in 2035. On the other hand, proportion of single and two person household will be 53.7% in 2015 and it will increase up to 68.4% in 2035. Old population will increase greatly, single and two person household will take 2/3 of the total households. Delphi research was processed in 3 steps on 40 professionals about the importance and changing factors of residential environment of apartment followed by the change of population structure. For interior plan, space variety, variability, safety, convenient installation, eco-friendly installation, and IT installation were important factors for construction plan, plan on aged and single households, convenient installation, safety installation, eco-friendly installation for subdivision plan, education/child care facility, parks/gymnasium facility, community facility, and accessibility of transportation were predicted as important factors.Keywords: change of population structure, super-graying, change of residential environment of apartment, single household, interior plan, construction plan, subdivision plan, Delphi research
Procedia PDF Downloads 4362123 Vertebral Pain Features in Women of Different Age Depending on Body Mass Index
Authors: Vladyslav Povoroznyuk, Tetiana Orlуk, Nataliia Dzerovych
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Introduction: Back pain is an extremely common health care problem worldwide. Many studies show a link between an obesity and risk of lower back pain. The aim is to study correlation and peculiarities of vertebral pain in women of different age depending on their anthropometric indicators. Materials: 1886 women aged 25-89 years were examined. The patients were divided into groups according to age (25-44, 45-59, 60-74, 75-89 years old) and body mass index (BMI: to 18.4 kg/m2 (underweight), 18.5-24.9 kg/m2 (normal), 25-30 kg/m2 (overweight) and more than 30.1 kg/m2 (obese). Methods: The presence and intensity of pain was evaluated in the thoracic and lumbar spine using a visual analogue scale (VAS). BMI is calculated by the standard formula based on body weight and height measurements. Statistical analysis was performed using parametric and nonparametric methods. Significant changes were considered as p <0.05. Results: The intensity of pain in the thoracic spine was significantly higher in the underweight women in the age groups of 25-44 years (p = 0.04) and 60-74 years (p=0.005). The intensity of pain in the lumbar spine was significantly higher in the women of 45-59 years (p = 0.001) and 60-74 years (p = 0.0003) with obesity. In the women of 45-74 years BMI was significantly positively correlated with the level of pain in the lumbar spine. Obesity significantly increases the relative risk of pain in the lumbar region (RR=0.07 (95% CI: 1.03-1.12; p=0.002)), while underweight significantly increases the risk of pain in the thoracic region (RR=1.21 (95% CI: 1.00-1.46; p=0.05)). Conclusion: In women, vertebral pain syndrome may be related to the anthropometric characteristics (e.g., BMI). Underweight may indirectly influence the development of pain in the thoracic spine and increase the risk of pain in this part by 1.21 times. Obesity influences the development of pain in the lumbar spine increasing the risk by 1.07 times.Keywords: body mass index, age, pain in thoracic and lumbar spine, women
Procedia PDF Downloads 3652122 Enhancing the Resilience of Combat System-Of-Systems Under Certainty and Uncertainty: Two-Phase Resilience Optimization Model and Deep Reinforcement Learning-Based Recovery Optimization Method
Authors: Xueming Xu, Jiahao Liu, Jichao Li, Kewei Yang, Minghao Li, Bingfeng Ge
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A combat system-of-systems (CSoS) comprises various types of functional combat entities that interact to meet corresponding task requirements in the present and future. Enhancing the resilience of CSoS holds significant military value in optimizing the operational planning process, improving military survivability, and ensuring the successful completion of operational tasks. Accordingly, this research proposes an integrated framework called CSoS resilience enhancement (CSoSRE) to enhance the resilience of CSoS from a recovery perspective. Specifically, this research presents a two-phase resilience optimization model to define a resilience optimization objective for CSoS. This model considers not only task baseline, recovery cost, and recovery time limit but also the characteristics of emergency recovery and comprehensive recovery. Moreover, the research extends it from the deterministic case to the stochastic case to describe the uncertainty in the recovery process. Based on this, a resilience-oriented recovery optimization method based on deep reinforcement learning (RRODRL) is proposed to determine a set of entities requiring restoration and their recovery sequence, thereby enhancing the resilience of CSoS. This method improves the deep Q-learning algorithm by designing a discount factor that adapts to changes in CSoS state at different phases, simultaneously considering the network’s structural and functional characteristics within CSoS. Finally, extensive experiments are conducted to test the feasibility, effectiveness and superiority of the proposed framework. The obtained results offer useful insights for guiding operational recovery activity and designing a more resilient CSoS.Keywords: combat system-of-systems, resilience optimization model, recovery optimization method, deep reinforcement learning, certainty and uncertainty
Procedia PDF Downloads 162121 Psychosocial Determinants of Quality of Life After Treatment for Breast Cancer - A Systematic Review
Authors: Lakmali Anthony, Madeline Gillies
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Purpose: Decreasing mortality has led to increased focus on patient-reported outcomes such as quality of life (QoL) in breast cancer. Breast cancer patients often have decreased QoL even after treatment is complete. This systematic review of the literature aims to identify psychosocial factors associated with decreased QoL in post-treatment breast cancer patients. Methodology: This systematic review was performed in accordance with the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations. The search was conducted in MEDLINE, EMBASE, and PsychINFO using MeSH headings. The two authors screened studies for relevance and extracted data. Results: Seventeen studies were identified, including 3,150 total participants (mean = 197) with a mean age of 51.9 years. There was substantial heterogeneity in measures of QoL. The most common was the European Organisation for Research and Treatment of Cancer QLQ-C30 (n=7, 41.1%). Most studies (n=12, 70.5%) found that emotional distress correlated with poor QoL, while 3 found no significant association. The most common measure of emotional distress was the Hospital Anxiety and Depression Scale (n=12, 70.5%). Other psychosocial factors associated with QoL were unmet needs, problematic social support, and negative affect. Clinicopathologic determinants included mastectomy without reconstruction, stage IV disease, and adjuvant chemotherapy. Conclusion: This systematic review provides a summary of the psychosocial determinants of poor QoL in post-treatment breast cancer patients, as well as the most commonly reported measures of these. An understanding of these potentially modifiable determinants of poor outcome is pivotal to the provision of quality, patient-centred care in surgical oncology.Keywords: breast cancer, quality of life, psychosocial determinants, cancer surgery
Procedia PDF Downloads 772120 Peer Instruction, Technology, Education for Textile and Fashion Students
Authors: Jimmy K. C. Lam, Carrie Wong
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One of the key goals on Learning and Teaching as documented in the University strategic plan 2012/13 – 2017/18 is to encourage active learning, the use of innovative teaching approaches and technology, and promoting the adoption of flexible and varied teaching delivery methods. This research reported the recent visited to Prof Eric Mazur at Harvard University on Peer Instruction: Collaborative learning in large class and innovative use of technology to enable new mode of learning. Peer Instruction is a research-based, interactive teaching method developed by Prof. Eric Mazur at Harvard University in the 1990s. It has been adopted across the disciplines, institutional type and throughout the world. One problem with conventional teaching lies in the presentation of the material. Frequently, it comes straight out of textbook/notes, giving students little incentive to attend class. This traditional presentation is always delivered as monologue in front of passive audience. Only exceptional lecturers are capable of holding students’ attention for an entire lecture period. Consequently, lectures simply reinforce students’ feelings that the most important step in mastering the material is memorizing a zoo of unrelated examples. In order to address these misconceptions about learning, Prof Mazur’s Team developed “Peer Instruction”, a method which involves students in their own learning during lectures and focuses their attention on underling concepts. Lectures are interspersed with conceptual questions called Concept Tests, designed to expose common difficulties in understanding the material. The students are given one or two minutes to think about the question and formulate their own answers; they then spend two or three minutes discussing their answers in a group of three or four, attempting to reach consensus on the correct answer. This process forces the students to think through the arguments being developed, and enable them to assess their understanding concepts before they leave the classroom. The findings from Peer Instruction and innovative use of technology on teaching at Harvard University were applied to the first year Textiles and Fashion students in Hong Kong. Survey conducted from 100 students showed that over 80% students enjoyed the flexibility of peer instruction and 70% of them enjoyed the instant feedback from the Clicker system (Student Response System used at Harvard University). Further work will continue to explore the possibility of peer instruction to art and fashion students.Keywords: peer instruction, education, technology, fashion
Procedia PDF Downloads 3162119 Locating Potential Site for Biomass Power Plant Development in Central Luzon Philippines Using GIS-Based Suitability Analysis
Authors: Bryan M. Baltazar, Marjorie V. Remolador, Klathea H. Sevilla, Imee Saladaga, Loureal Camille Inocencio, Ma. Rosario Concepcion O. Ang
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Biomass energy is a traditional source of sustainable energy, which has been widely used in developing countries. The Philippines, specifically Central Luzon, has an abundant source of biomass. Hence, it could supply abundant agricultural residues (rice husks), as feedstock in a biomass power plant. However, locating a potential site for biomass development is a complex process which involves different factors, such as physical, environmental, socio-economic, and risks that are usually diverse and conflicting. Moreover, biomass distribution is highly dispersed geographically. Thus, this study develops an integrated method combining Geographical Information Systems (GIS) and methods for energy planning; Multi-Criteria Decision Analysis (MCDA) and Analytical Hierarchy Process (AHP), for locating suitable site for biomass power plant development in Central Luzon, Philippines by considering different constraints and factors. Using MCDA, a three level hierarchy of factors and constraints was produced, with corresponding weights determined by experts by using AHP. Applying the results, a suitability map for Biomass power plant development in Central Luzon was generated. It showed that the central part of the region has the highest potential for biomass power plant development. It is because of the characteristics of the area such as the abundance of rice fields, with generally flat land surfaces, accessible roads and grid networks, and low risks to flooding and landslide. This study recommends the use of higher accuracy resource maps, and further analysis in selecting the optimum site for biomass power plant development that would account for the cost and transportation of biomass residues.Keywords: analytic hierarchy process, biomass energy, GIS, multi-criteria decision analysis, site suitability analysis
Procedia PDF Downloads 4252118 Understanding the Issue of Reproductive Matters among Urban Women: A Study of Four Cities in India from National Family Health Survey-4
Authors: Priyanka Dixit
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Reproductive health problem is an important public health issue in most of the developing countries like India. It is a common problem in India for women in the reproductive age group to suffer from reproductive illnesses and not seek care. Existing literatures tell us very little about the several dimensions of reproductive morbidity. In addition the general perception says, metros have better medical infrastructure, so its residents should lead a healthier life. However some of the studies reveal a very different picture. Therefore, the present study is conducted with the specific objectives to find out the prevalence of reproductive health problem and treatment seeking behavior of currently married women in four metro cities in India namely; Mumbai, Delhi, Chennai and Kolkata. In addition, this paper also examines the effect of socio-economic and demographic factors on self-reported reproductive health problems. Bi-variate and multivariate regression have been applied to achieve the proposed objectives. Study is based on National Family Health Survey 2015-16 data. The analysis shows that the prevalence of any reproductive health problem among women is the highest in Mumbai followed by Delhi, Chennai, and Kolkata. A bulk of women in all four metro cities has reported abdominal pain, itching and burning sensation as the major problems while urinating. However, in spite of the high prevalence of reproductive health problems, a huge proportion of such women in all these cities do not seek any advice or treatment for these problems. This study also investigates determinants that affect the prevalence of reproductive health problem to policy makers plan for proper interventions for improving women’s reproductive health.Keywords: reproductive health, India, national family health survey-4, city
Procedia PDF Downloads 2112117 Surgical Outcomes of Lung Cancer Surgery in Tasmania
Authors: Ayeshmanthe Rathnayake, Ashutosh Hardikar
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Introduction: Lung cancer is the most common cause of cancer death in Australia, with more than 13000 cases per year. Until now, there has been a major deficiency of national comprehensive thoracic surgery data. The thoracic workload for surgeons as well as caseload per unit, is highly variable, with some centres performing less than 15 cases per annum, thus raising concerns about optimal care at low-volume sites. This is an attempt to review the outcomes of lung cancer surgery in Tasmania. Method: The objective of this study is to determine the surgical outcomes of lung cancer surgery at Royal Hobart Hospital (RHH) with the primary outcome of surgical mortality. Four hundred fifty-one cases were analysed retrospectively from 2010 to May 2022. Results: A total of 451 patients underwent thoracic surgery with a primary diagnosis of lung cancer. The primary outcome of 30-day mortality was <0.5%. The mean age was 65.3 years, with male predominance and a 4.2% prevalence of Indigenous Australians. The mean LOS was 7.5 days. The surgical approach was either VATS (50.3%) or Thoracotomy (49.7%), with a trend towards the former in recent years with an increase in the proportion of VATS from 18.2% to 51% (p<0.05) in complex resections since 2019. A corresponding reduction in conversion rate to open was observed (18% vs. 5.5%), and there were no deaths within this subgroup. Lung resections were divided into lobectomy (55.4%), wedge resection (36.8%), segmentectomy (2.9%) and pneumonectomy (4.9%). The RHH demonstrates good surgical outcomes for lung cancer and provides a sustainable service for Tasmania. Conclusion: This retrospective study reports the surgical outcomes of lung cancer surgery at the Royal Hobart Hospital, thereby providing insight into the surgical management of lung cancer in the state thus far. The state has been slow to catch up on the minimally invasive program, but the overall results have been comparable to most peers.Keywords: lung cancer, thoracic surgery, lung resection, surgical outcomes
Procedia PDF Downloads 972116 Modeling Waiting and Service Time for Patients: A Case Study of Matawale Health Centre, Zomba, Malawi
Authors: Moses Aron, Elias Mwakilama, Jimmy Namangale
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Spending more time on long queues for a basic service remains a common challenge to most developing countries, including Malawi. For health sector in particular, Out-Patient Department (OPD) experiences long queues. This puts the lives of patients at risk. However, using queuing analysis to under the nature of the problems and efficiency of service systems, such problems can be abated. Based on a kind of service, literature proposes different possible queuing models. However, unlike using generalized assumed models proposed by literature, use of real time case study data can help in deeper understanding the particular problem model and how such a model can vary from one day to the other and also from each case to another. As such, this study uses data obtained from one urban HC for BP, Pediatric and General OPD cases to investigate an average queuing time for patients within the system. It seeks to highlight the proper queuing model by investigating the kind of distributions functions over patient’s arrival time, inter-arrival time, waiting time and service time. Comparable with the standard set values by WHO, the study found that patients at this HC spend more waiting times than service times. On model investigation, different days presented different models ranging from an assumed M/M/1, M/M/2 to M/Er/2. As such, through sensitivity analysis, in general, a commonly assumed M/M/1 model failed to fit the data but rather an M/Er/2 demonstrated to fit well. An M/Er/3 model seemed to be good in terms of measuring resource utilization, proposing a need to increase medical personnel at this HC. However, an M/Er/4 showed to cause more idleness of human resources.Keywords: health care, out-patient department, queuing model, sensitivity analysis
Procedia PDF Downloads 4352115 A Refrigerated Condition for the Storage of Glucose Test Strips at Health Promoting Hospitals: An Implication for Hospitals with Limited Air Conditioners
Authors: Wanutchaya Duanginta, Napaporn Apiratmateekul, Tippawan Sangkaew, Sunaree Wekinhirun, Kunchit Kongros, Wanvisa Treebuphachatsakul
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Thailand has a tropical climate with an average outdoor ambient air temperature of over 30°C, which can exceed manufacturer recommendations for the storage of glucose test strips. This study monitored temperature and humidity at actual sites of five sub-district health promoting hospitals (HPH) in Phitsanulok Province for the storage of glucose test strips in refrigerated conditions. Five calibrated data loggers were placed at the actual sites for glucose test strip storage at five HPHs for 8 weeks between April and June. For the stress test, two lot numbers of glucose test strips, each with two glucose meters, were kept in a plastic box with desiccants and placed in a refrigerator with the temperature calibrated to 4°C and at room temperature (RT). Temperature and humidity in the refrigerator and at RT were measured every hour for 30 days. The mean temperature for storing test strips at the five HPHs ranged from 29°C to 33°C, and three of the five HPHs (60%) had a mean temperature above 30°C. The refrigerator temperatures were 3.8 ± 2.0°C (2.0°C to 6.5°C), and relative humidity was 51 ± 2% (42 to 54%). The maximum of blood glucose testing by glucose meters when the test strips were stored in a refrigerator were not significantly different (p > 0.05) from unstressed test strips for both glucose meters using amperometry-GDH-PQQ and amperometry-GDH-FAD principles. Opening the test strip vial daily resulted in higher variation than when refrigerated after a single-use. However, the variations were still within an acceptable range. This study concludes that glucose tested strips can be stored in plastic boxes in a refrigerator if it is well-controlled for temperature and humidity. Storage of glucose-tested strips in the refrigerator during hot and humid weather may be useful for HPHs with limited air conditioners.Keywords: environmental stressed test, thermal stressed test, quality control, point-of-care testing
Procedia PDF Downloads 1942114 Influence of Temperature on the Development and Feeding Activity of Southern Green Stink Bug Nezara viridula (Heteroptera: Pentatomidae)
Authors: Pavitra Sharma, A. K. Singh
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The establishment of pest population in a habitat is greatly influenced by abiotic factors, such as temperature, photoperiod, and humidity. These factors influence the biology and behavior of insects and their pest status. Nezara viridula (Heteroptera: Pentatomidae), commonly known as southern green stink bug, is economically important pest of legumes. Both nymphs and adult suck the sap from different part of the plant and deteriorate the standing crop. Present study involves effects of temperature on incubation, hatching success and nymphal duration of N. viridula. The results indicated that the development of eggs requires optimal temperature range. Temperature conditions above and below the optimum range affect the incubation period as well as the percent hatchability of eggs. At 19°C, the egg incubation period was longest whereas it was shortest at 27°C. The change in temperature from the optimum condition also affected the hatchability of eggs in N. viridula. Decrease in the hatchability was observed with the decrease in temperature. However, the results were not statistically significant. Decrease in temperature from the optimum temperature to 19°C, also resulted in an increase in nymphal duration of N. viridula. However, no such effect of temperature within the studied range was observed on the morphology of nymphs or adults. Variation in temperature also had no adverse effects on the survival of laboratory bred population of Nezara nymphs. The feeding activity of the bug in relation to photoperiod was assessed by counting the number of punctures on the food surface. The results indicated that day-night regime did not affect the feeding activity of the bug significantly. The present study enhances our knowledge about the effect of environmental factors on the biology of insects and developing the strategy for ‘Integrated Pest Management’ of hemipteran insects by management of the physical factors.Keywords: development, feeding, hatchability, Nezara viridula
Procedia PDF Downloads 1782113 COVID-19, The Black Lives Matter Movement, and Race-Based Traumatic Stress
Authors: Claire Stafford, John Lewis, Ashley Stripling
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The aim of this study is to examine the relationship between both the independent effects and intersection between COVID-19 and the Black Lives Matter (BLM) movement simultaneously to investigate how the two events have coincided with impacting race-based traumatic stress in Black Americans. Four groups will be surveyed: Black Americans who participated in BLM-related activism, Black Americans who did not participate in BLM-related activism, White Americans who participated in BLM-related activism, and White Americans who did not participate in BLM-related activism. Participants are between the ages of 30 and 50. All participants will be administered a Brief Trauma Questionnaire with an additional question asking whether or not they have ever tested positive for COVID-19. Based on prior findings, it is expected that Black Americans will have significantly higher levels of COVID-19 contraction, with Black Americans who participated in BLM-related activism having the highest levels of contractions. Additionally, Black Americans who participated in BLM-related activism will likely have the highest self-reported rates of traumatic experiences due to the compounding effect of both the pandemic and the BLM movement. With the development of the COVID-19 pandemic, stark racial disparities between Black and White Americans have become more defined. Compared to White Americans, Black Americans have more COVID-19-related cases and hospitalizations. Researchers must investigate and attempt to mitigate these disparities while simultaneously critically questioning the structure of our national health care system and how it serves our marginalized communities. Further, a critical gaze must be directed at the geopolitical climate of the United States in order to holistically look at how both the COVID-19 pandemic and the Black Lives Matter (BLM) movement have interacted and impacted race-based stress and trauma in African Americans.Keywords: COVID-19, black lives matter movement, race-based traumatic stress, activism
Procedia PDF Downloads 1002112 Effectiveness of a Communication Training on Workplace Bullying Using Mobile Phone Application for Nurses
Authors: Jiyeon Kang, Yeon Jin Jeong, Hoon Heo
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Purpose: Bullying in nursing workplace has been a serious problem that increases the turnover of nurses. Few studies have examined the effects of communication training on workplace bullying for nurses, and all used a single-group design and a small sample size. Thus, more rigorous research has been needed to evaluate the effects properly. This research was aimed to identify the effects of the mobile type communication training of responses on bullying behaviors among nurses. Methods: A randomized controlled trial was performed. Subjects were 62 critical care nurses working in university hospitals in Busan, South Korea. We developed a mobile phone application to train nurses to deal with bullying situation. This application includes 6 common bullying situations and appropriate empathetic communication (non-violent communication) samples in the form of webtoons. The experimental group used this application for 4 weeks, and we measured interpersonal relationship, workplace bullying, symptom experience, and intention to leave before, post, and 8 weeks after the intervention from both experimental and control groups. The effect of the intervention was analyzed using repeated measures ANOVA. Results: The mobile type communication training developed in this study was effective for decreasing nurses’ intention to leave workplace (F = 5.11, p = .027). However, it had no effect on interpersonal relationship (F = 2.54, p = .116), workplace bullying (F = 2.99, p = .089) or symptom experience (F = 2.81, p = .099). The beneficial effects on intention to leave lasted at least up to 4 weeks after the training. Conclusion: The mobile type communication training can be utilized as an effective personal coping strategy for workplace bullying among nurses. Further studies on the long-term effects of the communication training are necessary.Keywords: bullying, communication, mobile applications, nurses, training, workplace
Procedia PDF Downloads 3312111 A Thematic Analysis on the Drivers of Community Participation for River Restoration Projects, the Case of Kerala, India
Authors: Alvin Manuel Vazhayil, Chaozhong Tan, Karl M. Wantzen
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As local community participation in river restoration projects is increasingly recognized to be crucial for sustainable outcomes, researchers are exploring factors that motivate community participation globally. In India, while there is consensus in literature on the importance of community engagement in river restoration projects, research on what drives local communities to participate is limited, especially given the societal and economic challenges common in the Global South. This study addresses this gap by exploring the drivers of community participation in the local river restoration initiatives of the "Now Let Me Flow" campaign in Kerala, India. The project aimed to restore 87,000 kilometers of streams through the middle-ground governance approach that integrated bottom-up community efforts with top-down governmental support. The fieldwork involved interviews with 26 key agents, including local leaders, policy practitioners, politicians, and environmental activists associated with the project, and the collection of secondary data from 12 documents including project reports and news articles. The data was analyzed in NVivo (NVivo 11 Plus for Windows, version 11.3.0.773) using thematic analysis which included two cycles of systematic coding. The findings reveal two main drivers influencing community participation: top-down actions from local governments, and bottom-up drivers within the community. The study highlights the importance of local stakeholder collaboration, support of local governments, and local community engagement in successful river restoration projects. These findings are consistent with other empirical studies on participatory environmental problem-solving globally. The results offer crucial insights for policymakers and governments to better design and implement effective and sustainable participatory river restoration projects.Keywords: community initiatives, drivers of participation, environmental governance, river restoration
Procedia PDF Downloads 272110 Reality Shock Affecting the Motivation to Work of New Flight Attendants: An Exploratory Qualitative Study of Flight Attendants Who Left Their Jobs Early
Authors: Hiromi Takafuji
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Flight attendant:FA is one of popular occupation, especially in Asian countries, and the decision to be hired is made after clearing a high multiplier. On the other hand, immediately after joining the company, they experience unique stress due to the fact that the organization requires them to perform security and customer service duties in a highly specialized and limited space and time. As a result, despite the high level of difficulty in joining the company, many new recruits retire early at a high rate. It is commonly said that 30% of new graduates leave the company within three years in Japan and speculated that Reality Shock:RS is one of the causes of this. RS is that newcomers experience refers to the stress caused by the difference between pre-employment expectations and post-employment reality. The purpose of this study was to elucidate the mechanism by which the expertise required of new FA and the expectation of expertise held by each of them cause reality shock, which affects motivation and the decision to leave. This study identified the professionalism required of new FA and the impact of that expectation for professionalism on RS through an exploratory study of the experiences and psychological processes of FA who left within three years. Semi-structured in-depth interviews were conducted with five FA who left a major Japanese airline at an early stage, and their experiences were categorized, integrated, and classified by qualitative content analysis. They were chosen under a number of controlled conditions. Then two major findings emerged: first, that pre-employment expectations defining RS were hierarchical, and second, that training amplified expectations of professionalism, which strongly influenced early turnover. From these, this study generated a model of RS generative process model of FA that expectations are hierarchical and influential. This could contribute to the prevention of mental health deterioration by reality shock among new FA.Keywords: reality shock, flight attendant, early turnover, qualitative study
Procedia PDF Downloads 822109 Social Participation and Associated Life Satisfaction among Older Adults in India: Moderating Role of Marital Status and Living Arrangements
Authors: Varsha Pandurang Nagargoje, K. S. James
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Background: Social participation is considered as one of the central components of successful and healthy aging. This study aimed to examine the moderating role of marital status and living arrangement in the relationship between social participation and life satisfaction and other potential factors associated with life satisfaction of Indian older adults. Method: For analyses, the nationally representative study sample of 31,464 adults aged ≥60 years old was extracted from the Longitudinal Ageing Study in India (LASI) wave 1, 2017-18. Descriptive statistics and bivariate analysis have been performed to determine the proportion of life satisfaction. The first set of multivariable linear regression analyses examined Diener’s Satisfaction with Life Scale and its association with various predictor variables, including social participation, marital status, living arrangements, socio-demographic, economic, and health-related variables. Further, the second and third sets of regression investigated the moderating role of marital status and living arrangements respectively in the association of social participation and level of life satisfaction among Indian older adults. Results: Overall, the proportion of life satisfaction among older men was relatively higher than women counterparts in most background characteristics. Regression results stressed the importance of older adults’ involvement in social participation [β = 0.39, p < 0.05], being in marital union [β = 0.68, p < 0.001] and co-residential living arrangements either only with spouse [β = 1.73, p < 0.001] or with other family members [β = 2.18, p < 0.001] for the improvement of life satisfaction. Results also showed that some factors were significant for life satisfaction: in particular, increased age, having a higher level of educational status, MPCE quintile, and caste category. Higher risk of life dissatisfaction found among Indian older adults who were exposed to vulnerabilities like consuming tobacco, poor self-rated health, having difficulty in performing ADL and IADL were of major concern. The interaction effect of social participation with marital status or with living arrangements explained that currently married older individuals, and those older adults who were either co-residing with their spouse only or with other family members irrespective of their involvement in social participation remained an important modifiable factor for life satisfaction. Conclusion: It would be crucial for policymakers and practitioners to advocate social policy programs and service delivery oriented towards meaningful social connections, especially for those Indian older adults who were staying alone or currently not in the marital union to enhance their overall life satisfaction.Keywords: Indian, older adults, social participation, life satisfaction, marital status, living arrangement
Procedia PDF Downloads 1292108 Aerosol - Cloud Interaction with Summer Precipitation over Major Cities in Eritrea
Authors: Samuel Abraham Berhane, Lingbing Bu
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This paper presents the spatiotemporal variability of aerosols, clouds, and precipitation within the major cities in Eritrea and it investigates the relationship between aerosols, clouds, and precipitation concerning the presence of aerosols over the study region. In Eritrea, inadequate water supplies will have both direct and indirect adverse impacts on sustainable development in areas such as health, agriculture, energy, communication, and transport. Besides, there exists a gap in the knowledge on suitable and potential areas for cloud seeding. Further, the inadequate understanding of aerosol-cloud-precipitation (ACP) interactions limits the success of weather modification aimed at improving freshwater sources, storage, and recycling. Spatiotemporal variability of aerosols, clouds, and precipitation involve spatial and time series analysis based on trend and anomaly analysis. To find the relationship between aerosols and clouds, a correlation coefficient is used. The spatiotemporal analysis showed larger variations of aerosols within the last two decades, especially in Assab, indicating that aerosol optical depth (AOD) has increased over the surrounding Red Sea region. Rainfall was significantly low but AOD was significantly high during the 2011 monsoon season. Precipitation was high during 2007 over most parts of Eritrea. The correlation coefficient between AOD and rainfall was negative over Asmara and Nakfa. Cloud effective radius (CER) and cloud optical thickness (COT) exhibited a negative correlation with AOD over Nakfa within the June–July–August (JJA) season. The hybrid single-particle Lagrangian integrated trajectory (HYSPLIT) model that is used to find the path and origin of the air mass of the study region showed that the majority of aerosols made their way to the study region via the westerly and the southwesterly winds.Keywords: aerosol-cloud-precipitation, aerosol optical depth, cloud effective radius, cloud optical thickness, HYSPLIT
Procedia PDF Downloads 1332107 Factors Contributing to Delayed Diagnosis and Treatment of Breast Cancer and Its Outcome in Jamhoriat Hospital Kabul, Afghanistan
Authors: Ahmad Jawad Fardin
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Over 60% of patients with breast cancer in Afghanistan present late with advanced stage III and IV, a major cause for the poor survival rate. The objectives of this study were to identify the contributing factors for the diagnosis and treatment delay and its outcome. This cross-sectional study was conducted on 318 patients with histologically confirmed breast cancer in the oncology department of Jamhoriat hospital, which is the first and only national cancer center in Afghanistan; data were collected from medical records and interviews conducted with women diagnosed with breast cancer, linear regression and logistic regression were used for analysis. Patient delay was defined as the time from first recognition of symptoms until first medical consultation and doctor form first consultation with a health care provider until histological confirmation of breast cancer. The mean age of patients was 49.2+_ 11.5years. The average time for the final diagnosis of breast cancer was 8.5 months; most patients had ductal carcinoma 260.7 (82%). Factors associated with delay were low education level 76% poor socioeconomic and cultural conditions 81% lack of cancer center 73% lack of screening 19%. The stage distribution was as follows stage IV 4 22% stage III 44.4% stage II 29.3% stage I 4.3%. Complex associated factors were identified to delayed the diagnosis of breast cancer and increased adverse outcomes consequently. Raising awareness and education in women, the establishment of cancer centers and providing accessible diagnosis service and screening, training of general practitioners; required to promote early detection, diagnosis and treatment.Keywords: delayed diagnosis and poor outcome, breast cancer in Afghanistan, poor outcome of delayed breast cancer treatment, breast cancer delayed diagnosis and treatment in Afghanistan
Procedia PDF Downloads 1822106 Effects of Nanoencapsulated Echinacea purpurea Ethanol Extract on the Male Reproductive Function in Streptozotocin-Induced Diabetic Rats
Authors: Jia-Ling Ho, Xiu-Ru Zhang, Zwe-Ling Kong
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Diabetes mellitus (DM) is a major health problem that affects patients’ life quality throughout the world due to its many complications. It characterized by chronic hyperglycemia with oxidative stress, which impaired male reproductive function. Fibroblast growth factor 21 (FGF21) is a metabolic regulator that is required for normal spermatogenesis and protects against diabetes-induced germ cell apoptosis. Echinacea purpurea ethanol extract (EE), which contain phenolic acid and isobutylamide, had been proven to have antidiabetic property. Silica-chitosan nanoparticles (Nano-CS) has drug delivery and controlled release properties. This study aims to investigate whether silica-chitosan nanoparticles encapsulated EE (Nano-EE) had more ameliorating male infertility by analyzing the effect of testicular FGF21. The Nano-EE was characterized before used to treatment the diabetic rat model. Male Sprague-Dawley (SD) rats were obtained and divided into seven groups. A group was no induced Streptozotocin (STZ), marked as normal group. Diabetic rats were induced into diabetes by STZ (33 mg/kg). A diabetic group was no treatment with sample (diabetic control group), and other groups were treatment by Nano-CS (465 mg/kg), Nano-EE (93, 279, 465 mg/kg), and metformin (Met) (200 mg/kg) used as reference drug for 7 weeks. Our results indicated that the average nanoparticle size and zeta potential of Nano-EE were 2630 nm and -21.3 mV, respectively. The encapsulation ratio of Nano-EE was about 70%. It also confirmed the antioxidative activity was unchanged by comparing the DPPH and ABTS scavenging of Nano-EE and EE. In vivo test, Nano-EE can improve the STZ induced hyperglycemia, insulin resistance, and plasma FGF21 levels. Nano-EE has increased sperm motility, mitochondria membrane potential (MMP), plasma testosterone level, and reduction of abnormal sperm, nitric oxide (NO), superoxide production as well as reactive oxygen species (ROS). In addition, in plasma antioxidant enzymes glutathione peroxidase (GPx) and superoxide dismutase (SOD) was increased whereas pro-inflammatory cytokines TNF-α, and IL-1β were decreased. Further, in testis, protein content of FGF21, PGC-1α, and SIRT1 were improved. Nano-EE might improve diabetes-induced down-regulation of testicular FGF21 and SIRT1/PGC-1α signaling hence maintain spermatogenesis.Keywords: diabetes mellitus, Echinacea purpurea, reproductive dysfunction, silica-chitosan nanoparticles
Procedia PDF Downloads 192