Search results for: high alert medication

Authors: Makan Cheraghpour, Seyed Ahmad Hosseini, Damoon Ashtary-Larky, Saeed Shirali, Matin Ghanavati, Meysam Alipour

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Background: In addition to reducing body weight, the low-calorie diets can reduce the lean body mass. It is hypothesized that in addition to reducing the body weight, the low-calorie diets can maintain the lean body mass. So, the current study aimed at evaluating the effects of high-protein diet with calorie restriction on body composition in overweight and obese individuals. Methods: 36 obese and overweight subjects were divided randomly into two groups. The first group received a normal-protein, low-energy diet (RDA), and the second group received a high-protein, low-energy diet (2×RDA). The anthropometric indices including height, weight, body mass index, body fat mass, fat free mass, and body fat percentage were evaluated before and after the study. Results: A significant reduction was observed in anthropometric indices in both groups (high-protein, low-energy diets and normal-protein, low-energy diets). In addition, more reduction in fat free mass was observed in the normal-protein, low-energy diet group compared to the high -protein, low-energy diet group. In other the anthropometric indices, significant differences were not observed between the two groups. Conclusion: Independently of the type of diet, low-calorie diet can improve the anthropometric indices, but during a weight loss, high-protein diet can help the fat free mass to be maintained.

Keywords: diet, high-protein, body mass index, body fat percentage

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Authors: Kai-Chee Loh, Jingxin Zhang, Yen-Wah Tong

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Hydrolysis and acidogenesis are the rate-controlling steps in an anaerobic digestion (AD) process. Considering that the optimum conditions for each stage can be diverse diverse, the development of a multi-stage AD system is likely to the AD efficiency through individual optimization. In this research, we developed a highly integrate three-stage anaerobic digester (HM3) to combine the advantages of dry AD and wet AD for anaerobic co-digestion of food waste and horse manure. The digester design comprised mainly of three chambers - high-solids hydrolysis, high-solids acidogenesis and wet methanogensis. Through comparing the treatment performance with other two control digesters, HM3 presented 11.2 ~22.7% higher methane yield. The improved methane yield was mainly attributed to the functionalized partitioning in the integrated digester, which significantly accelerated the solubilization of solid organic matters and the formation of organic acids, as well as ammonia in the high-solids hydrolytic and acidogenic stage respectively. Additionally, HM3 also showed the highest volatile solids reduction rate among the three digesters. Real-time PCR and pyrosequencing analysis indicated that the abundance and biodiversity of microorganisms including bacteria and archaea in HM3 was much higher than that in the control reactors.

Keywords: anaerobic digestion, high-solids, food waste and horse manure, microbial community

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Authors: Robert Jacobsen

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Flood inundation maps (FIMs) are an essential tool in communicating flood threat scenarios to the public as well as in floodplain governance. With an increasing demand for online raster FIMs, the FIM State-of-the-Practice (SOP) is rapidly advancing to meet the dual requirements for high-resolution and high-accuracy—or High-Definition. Importantly, today’s technology also enables the resolution of problems of local—neighborhood-scale—bias errors that often occur in FIMs, even with the use of SOP two-dimensional flood modeling. To facilitate the development of HD-FIMs, a new GIS method--Raster Adjustment with Scenario Profiles, RASPTM—is described for adjusting kernel raster FIMs to match refined scenario profiles. With RASPTM, flood professionals can prepare HD-FIMs for a wide range of scenarios with available kernel rasters, including kernel rasters prepared from vector FIMs. The paper provides detailed procedures for RASPTM, along with an example of applying RASPTM to prepare an HD-FIM for the August 2016 Flood in Louisiana using both an SOP kernel raster and a kernel raster derived from an older vector-based flood insurance rate map. The accuracy of the HD-FIMs achieved with the application of RASPTM to the two kernel rasters is evaluated.

Keywords: hydrology, mapping, high-definition, inundation

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Authors: Ali H. Mahfouz, Hossam E. M. Sallam, Abdulwali Wazir, Hamod H. Kharezi

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The soil profile at site of the bridge project includes soft fine grained soil layer located between 5.0 m to 11.0 m in depth, it has high water content, low SPT no., and low bearing capacity. The clay layer induces high settlement due to surcharge application of earth embankment at ramp T1, ramp T2, and ramp T3 especially at heights from 9m right 3m. Calculated settlement for embankment heights less than 3m may be accepted regarding Saudi Code for soil and foundation. The soil and groundwater at the project site comprise high contents of sulfates and chlorides of high aggressively on concrete and steel bars, respectively. Regarding results of the study, it has been recommended to use stone column piles or new technology named PCC piles as soil improvement to improve the bearing capacity of the weak layer. The new technology is cast in-situ thin wall concrete pipe piles (PCC piles), it has economically advantageous and high workability. The technology can save time of implementation and cost of application is almost 30% of other types of piles.

Keywords: soft foundation soil, bearing capacity, bridge ramps, soil improvement, geogrid, PCC piles

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Authors: Shannon Hearney, Jeffrey Hoch

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While all cancers are costly to treat, pancreatic cancer is a notoriously costly and deadly form of cancer. Across the world there are a variety of treatment centers ranging from small clinics to large, high-volume hospitals as well as differing structures of payment and access. It has been noted that centers that treat a high volume of pancreatic cancer patients have higher quality of care, it is unclear if that care is cost-effective. In the US there is no clear consensus on the cost-effectiveness of high-volume centers for the surgical care of pancreatic cancer. Other European countries, like Finland and Italy have shown that high-volume centers have lower mortality rates and can have lower costs, there however, is still a gap in knowledge about these centers cost-effectiveness globally. This paper seeks to review the current literature in Europe and the US to gain a better understanding of the state of high-volume pancreatic surgical centers cost-effectiveness while considering the contextual differences in health system structure. A review of major reference databases such as Medline, Embase and PubMed will be conducted for cost-effectiveness studies on the surgical treatment of pancreatic cancer at high-volume centers. Possible MeSH terms to be included, but not limited to, are: “pancreatic cancer”, “cost analysis”, “cost-effectiveness”, “economic evaluation”, “pancreatic neoplasms”, “surgical”, “Europe” “socialized medicine”, “privatized medicine”, “for-profit”, and “high-volume”. Studies must also have been available in the English language. This review will encompass European scientific literature, as well as those in the US. Based on our preliminary findings, we anticipate high-volume hospitals to provide better care at greater costs. We anticipate that high-volume hospitals may be cost-effective in different contexts depending on the national structure of a healthcare system. Countries with more centralized and socialized healthcare may yield results that are more cost-effective. High-volume centers may differ in their cost-effectiveness of the surgical care of pancreatic cancer internationally especially when comparing those in the United States to others throughout Europe.

Keywords: cost-effectiveness analysis, economic evaluation, pancreatic cancer, scientific literature review

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Authors: Sadia Suri Kashif, Raheeda Fatima, Maqsood Ahmed Khan

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Purpose of the study: The objective of this research was to determine the perception of Pakistani physicians (whether primary care, specialists or residents) in Karachi, being one of the largest and highly populated cities of Pakistan, regarding clinical approaches towards diet, exercise, and therapy in obese patients. This research determines their understanding of obesity and employability of obesity management in their daily practices. Research methodology: This is a questionnaire-based survey. A minimum of 300 questionnaires (N=300) were distributed and filled by practicing physicians in a random selection of medical setups in Karachi. Randomly 246 physicians responded to the survey. The survey tested their views regarding weight management, importance of general awareness and their strategies to control weight. Results: In the first part of survey the physicians responded to almost 66% regarding the seriousness of obesity management with advising diet modification, physical exercise and decreasing calorie intake; 57% failed to employ Body Mass Index and Waist Hip Ratio as weight measurement tools in their daily practice; 50% disagreed on using pharmacotherapy as an option; 67% were not sure about the proper dosage and indication of anti-obesity medication while almost same disagreed on using surgical options for management of obesity; 83.3% physicians agreed on the increased obesity pandemic in Pakistan. Conclusion: The findings indicate that there is a gap between awareness and knowledge among Pakistani practicing physicians regarding pharmacotherapy for obesity. There is a need to frequently update latest guidelines to help manage this condition, which is becoming more prevalent in our country day by day. Physicians should be obligated to use updated knowledge for managing obesity.

Keywords: obesity, physicians, BMI, weight management, obesity awareness

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Authors: Hossein Ilanloo, Sedigheh Ahmadi, Kianoosh Zahrakar

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The present study aims at investigating the effectiveness of group counseling of mindfulness-based cognitive therapy on cognitive emotion regulation in high school students. The research design was quasi-experimental and pre-test-post-test type and a two-month follow-up with a control group. The statistical population of the study consisted of all-male high school students in Takestan city in the Academic Year 2020-2021. The sample comprised 30 high school male students selected through the convenience sampling method and randomly assigned to experimental (n=15) and control (n=15) groups. The experimental group then received ten sessions of 90-minute group counseling of mindfulness-based cognitive therapy, and the control group did not receive any intervention. In order to collect data, the author used the Cognitive Emotion Regulation Questionnaire (CERQ). The researcher also used multivariate analysis of covariance, repeated measures, LSD post hoc test, and SPSS-26 software for data analysis.

Keywords: mindfulness-based cognitive therapy, cognitive emotion regulation, students, high schools

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Authors: Ravid Yinon

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Introduction: Pelvic trauma causes high mortality, particularly among the elderly population. Pelvic injury ranges from low-energy incidents such as falls to high-energy trauma like motor vehicle accidents. The mortality rate among high-energy trauma patients is higher, as can be expected. The elderly population is more vulnerable to pelvic trauma even at low energy mechanisms due to the fragility and diminished physiological reserve of these patients. The aim of this study is to examine whether there is a higher long-term mortality in pelvic injuries in the elderly from the low-energy mechanism than those injured in high energy. Methods: A retrospective cohort study was conducted in a level 1 trauma center with injured patients aged 65 years and over with pelvic trauma. The patients were divided into two groups of low and high-energy mechanisms of injury. Multivariate analysis was conducted to characterize the differences between the groups. Results: There were 585 consecutive injured patients over the age of 65 with a documented pelvic injury who were treated at the primary trauma center between 2008-2020. The injured in the high energy group were younger (mean HE- 75.18, LE-80.73), with fewer comorbidities (mean 0.78 comorbidities at HE and 1.28 at LE), more men (52.6% at HE and 27.4% at LE), were consumed more treatments facilities such as angioembolization, ICU admission, emergency surgeries and blood products transfusion and higher mortality rate at admission (HE- 19/133, 14.28%, LE- 10/452, 2.21%) compared to the low energy group. However, in a long-term follow-up of one year after the injury, mortality in the low-energy group was significantly higher (HE- 14/114, 12.28%, LE- 155/442, 35.06%). Discussion: Although it can be expected that in the mechanism of high energy, the mortality rate in the long term would be higher, it was found that mortality at the low energy patient was higher. Apparently, low-energy pelvic injury in geriatric patients is a measure of frailty in these patients, causes injury to more frail and morbid patients, and is a predictor of mortality in this population in the long term. Conclusion: The long-term follow-up of injured elderly with pelvic trauma should be more intense, and the healthcare provider should put more emphasis on the rehabilitation of these special patient populations in an attempt to prevent long-term mortality.

Keywords: pelvic trauma, elderly trauma, high energy trauma, low energy trauma

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Authors: Hyo-In Koh, Anders Nordborg, Alex Sievi, Chun-Kwon Park

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The noise source for the interior room of the high speed train is constituted by the rolling contact between the wheel and the rail, aerodynamic noise and structure-borne sound generated through the vibrations of bogie, connection points to the carbody. Air-borne sound is radiated through the panels and structures into the interior room of the trains. The high-speed lines are constructed with slab track systems and many tunnels. The interior noise level and the frequency characteristics vary according to types of the track structure and the infrastructure. In this paper the main sound sources and the transfer paths are studied to find out the contribution characteristics of the sources to the interior noise of a high-speed rail vehicle. For the identification of the acoustic power of each parts of the rolling noise sources a calculation model of wheel/rail noise is developed and used. For the analysis of the transmission of the sources to the interior noise noise and vibration are measured during the operation of the vehicle. According to operation speeds, the mainly contributed sources and the paths could be analyzed. Results of the calculations on the source generation and the results of the measurement with a high-speed train are shown and discussed.

Keywords: rail vehicle, high-speed, interior noise, noise source

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Authors: Ioannis Panagiotopoulos, Aristidis Anastasakis, Konstantinos Toutouzas, Ioannis Iakovou, Charalampos Vlachopoulos, Vasilis Voudris, Georgios Tziomalos, Konstantinos Tsioufis, Efstathios Kastritis, Alexandros Briassoulis, Kimon Stamatelopoulos, Alexios Antonopoulos, Paraskevi Exadaktylou, Evanthia Giannoula, Anastasia Katinioti, Maria Kalantzi, Evangelos Leontiadis, Eftychia Smparouni, Ioannis Malakos, Nikolaos Aravanis, Argyrios Doumas, Maria Koutelou

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Introduction: Cardiac amyloidosis from Transthyretin (ATTR-CA) is an infiltrative disease characterized by the deposition of pathological transthyretin complexes in the myocardium. This study describes the characteristics of patients diagnosed with ATTR-CA from 2019 until present at the Nuclear Medicine Department of Onassis Cardiac Surgery Center and AHEPA Hospital. These centers have extensive experience in amyloidosis and modern technological equipment for its diagnosis. Materials and Methods: Records of consecutive patients (N=73) diagnosed with any type of amyloidosis were collected, analyzed, and prospectively followed. The diagnosis of amyloidosis was made using specific myocardial scintigraphy with Tc-99m DPD. Demographic characteristics, including age, gender, marital status, height, and weight, were collected in a database. Clinical characteristics, such as amyloidosis type (ATTR and AL), serum biomarkers (BNP, troponin), electrocardiographic findings, ultrasound findings, NYHA class, aortic valve replacement, device implants, and medication history, were also collected. Some of the most significant results are presented. Results: A total of 73 cases (86% male) were diagnosed with amyloidosis over four years. The mean age at diagnosis was 82 years, and the main symptom was dyspnea. Most patients suffered from ATTR-CA (65 vs. 8 with AL). Out of all the ATTR-CA patients, 61 were diagnosed with wild-type and 2 with two rare mutations. Twenty-eight patients had systemic amyloidosis with extracardiac involvement, and 32 patients had a history of bilateral carpal tunnel syndrome. Four patients had already developed polyneuropathy, and the diagnosis was confirmed by DPD scintigraphy, which is known for its high sensitivity. Among patients with isolated cardiac involvement, only 6 had left ventricular ejection fraction below 40%. The majority of ATTR patients underwent tafamidis treatment immediately after diagnosis. Conclusion: In conclusion, the experiences shared by the two centers and the continuous exchange of information provide valuable insights into the diagnosis and management of cardiac amyloidosis. Clinical suspicion of amyloidosis and early diagnostic approach are crucial, given the availability of non-invasive techniques. Cardiac scintigraphy with DPD can confirm the presence of the disease without the need for a biopsy. The ultimate goal still remains continuous education and awareness of clinical cardiologists so that this systemic and treatable disease can be diagnosed and certified promptly and treatment can begin as soon as possible.

Keywords: amyloidosis, diagnosis, myocardial scintigraphy, Tc-99m DPD, transthyretin

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Authors: Dong Zhang, Kang Hai Tan, Aravind Dasari

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Increasing concern on environmental sustainability and waste management has driven the construction and building sector towards renewable materials. In this work, we have explored the usage of natural fibers as an alternative to synthetic fibers like polypropylene (PP) in ultra-high performance concrete (UHPC). PP fibers are incorporated into concrete to resist explosive thermal spalling of UHPC during a fire exposure scenario. Experimental studies on the effect of natural fiber on the mechanical properties and spalling resistance of UHCP were conducted. The residual mechanical properties of UHPC with natural fibers were tested after heating to different temperatures. Spalling behavior of UHPC with natural fibers is also assessed by heating the samples according to ISO 834 fire curve. A range of analytical, physical and microscopic characterization techniques was also used on the concrete samples before and after being subjected to elevated temperature to investigate the phase and microstructural change of the sample. The findings show that natural fibers are able to improve fire resistance of UHPC. Adding natural fibers can prevent UHPC from spalling at high temperature. This study provides an alternative, which is at low cost and environmentally friendly, to prevent spalling of UHPC.

Keywords: high temperature, natural fiber, spalling, ultra-high performance concrete

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Authors: Kyu Bum Han, Eunjin Jeon, Kimberly Watts, Brenda Payan Medina

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Gen3 Concentrating Solar Power (CSP) high-temperature thermal systems have the potential to lower the cost of a CSP system. When compared to the other systems (chloride salt blends and supercritical fluids), the particle transport system can avoid many of the issues associated with high fluid temperature systems at high temperature because of its ability to operate at ambient pressure with limited corrosion or thermal stability risk. Furthermore, identifying and demonstrating low-cost particles that have excellent optical properties and durability can significantly reduce the levelized cost of electricity (LCOE) of particle receivers. The currently available thermal transfer particle in the study and market is oxidized at about 700oC, which reduces its durability, generates particle loss by high friction loads, and causes the color change. To meet the CSP SunShot goal, the durability of particles must be improved by identifying particles that are less abrasive to other structural materials. Furthermore, the particles must be economically affordable and the solar absorptance of the particles must be increased while minimizing thermal emittance. We are studying a novel thermal transfer particle, which has low cost, high durability, and high solar absorptance at high temperatures. The particle minimizes thermal emittance and will be less abrasive to other structural materials. Additionally, the particle demonstrates reusability, which significantly lowers the LCOE. This study will contribute to two principal disciplines of energy science: materials synthesis and manufacturing. Developing this particle for thermal transfer will have a positive impact on the ceramic study and industry as well as the society.

Keywords: concentrating solar power, thermal energy storage, particle, reusability, economics

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Authors: Kadeejah Alsolami, Zainab Alrefay, Husaam Awad

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Obesity and vitamin D deficiency have both been related to cardiovascular disease. The present work aimed to investigate the possible protective effect of vitamin D on cardiac apoptosis in a rat model of dietary-induced obesity. Methods: 30 male Wistar rats included in this study. They were allocated into 4 groups: Control (n=5), animal were fed standard diet for 3 months: Control + vitamin D (VD) (n=5),animals were fed a standard diet with 400IU VD/kg for 3 months: hypercaloric diets group (n=10), animals were fed a high fat diet for 3 months: hypercaloric diet with VD group (n=10), animals were fed a high fat diet with 400IU VD/kg for 3 months. At the beginning of the experiment, the weight and length were measured to assess body mass index (BMI) and repeated every 45 days. Food intake and body weight were monitored throughout the study period. Then rats were sacrificed and heart tissues collected for Quantitative Real-time polymerase chain reaction (qRT-PCR). qRT-PCR used to detect different genetic markers of apoptosis (anti-apoptotic gene (BCL2), a pro-apoptotic gene(BAX), pro-apoptotic genes (FAS, FAS-L), tumour necrosis factor (TNF), mitogen-activated protein kinases (MAPK). Results: FAS and FAS-L gene expression were significantly upregulated in rats fed with high fat diet. And FAS-L gene expression was significantly upregulated in all groups on comparison with control. Whereas Bax gene expression was significantly downregulated in rats fed with high-fat diet supplied with vitamin D. TNF was significantly upregulated in rats fed with high-fat diet treated with vitamin D. MAPK was significantly upregulated in rats fed with high fat diet group, and in rats fed with high-fat diet supplied with vitamin D. Conclusion: The cardiac apoptotic pathways were more activated in rats fed with high-fat than lean rats. And vitamin D protect the heart from the cardiac mitochondrial-dependent apoptotic pathway.

Keywords: apoptosis, heart, obesity, Vitamin D

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Authors: Melissa K. Hord, Stephen P. Whiteside

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With lifetime prevalence rates ranging from 6% to 15%, anxiety disorders are among the most common childhood mental health diagnoses. Anxiety disorders diagnosed in childhood generally show an unremitting course, lead to additional psychopathology and interfere with social, emotional, and academic development. Effective evidence-based treatments include cognitive-behavioral therapy (CBT) and selective serotonin reuptake inhibitors (SSRI’s). However, if anxious children receive any treatment, it is usually through primary care, typically consists of medication, and very rarely includes evidence-based psychotherapy. Despite the high prevalence of anxiety disorders, there have only been two independent research labs that have investigated long-term results for CBT treatment for all childhood anxiety disorders and two for specific anxiety disorders. Generally, the studies indicate that the majority of youth maintain gains up to 7.4 years after treatment. These studies have not been replicated. In addition, little is known about the additional mental health care received by these patients in the intervening years after anxiety treatment, which seems likely to influence maintenance of gains for anxiety symptoms as well as the development of additional psychopathology during the subsequent years. The original sample consisted of 335 children ages 7 to 17 years (mean 13.09, 53% female) diagnosed with an anxiety disorder in 2010. Medical record review included provider billing records for mental health appointments during the five years after anxiety treatment. The subsample for this study was classified into three groups: 64 children who received CBT in an anxiety disorders clinic, 56 who received treatment from a psychiatrist, and 10 who were seen in a primary care setting. Chi-square analyses resulted in significant differences in mental health care utilization across the five years after treatment. Youth receiving treatment in primary care averaged less than one appointment each year and the appointments continued at the same rate across time. Children treated by a psychiatrist averaged approximately 3 appointments in the first two years and 2 in the subsequent three years. Importantly, youth treated in the anxiety clinic demonstrated a gradual decrease in mental health appointments across time. The nuanced differences will be presented in greater detail. The results of the current study have important implications for developing dissemination materials to help guide parents when they are selecting treatment for their children. By including all mental health appointments, this study recognizes that anxiety is often comorbid with additional diagnoses and that receiving evidence-based treatment may have long-term benefits that are associated with improvements in broader mental health. One important caveat might be that the acuity of mental health influenced the level of care sought by patients included in this study; however, taking this possibility into account, it seems those seeking care in a primary care setting continued to require similar care at the end of the study, indicating little improvement in symptoms was experienced.

Keywords: anxiety, children, mental health, outcomes

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Authors: Amira Zouaoui, Hamed Belloumi, Ferid Kourda

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This paper presents the analysis and design of a DC–AC resonant converter applied to induction heating. The proposed topology based on the series-parallel half-bridge resonant inverter is described. It can operate with Zero-Voltage Switching (ZVS). At the resonant frequency, the secondary current is amplified over the heating coil with small switching angle, which keeps the reactive power low and permits heating with small current through the resonant inductor and the transformer. The operation and control principle of the proposed high frequency inverter is described and verified through simulated and experimental results.

Keywords: induction heating, inverter, high frequency, resonant

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Authors: Ping Li, Bing Feng, Junpu Zhao, Xudong Xie, Dangpeng Xu, Kuixing Zheng, Qihua Zhu, Xiaofeng Wei

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In laser driven inertial confinement fusion (ICF), the control of the temporal shape of the laser pulse is a key point to ensure an optimal interaction of laser-target. One of the main difficulties in controlling the temporal shape is the foot part control accuracy of high contrast pulse. Based on the analysis of pulse perturbation in the process of amplification and frequency conversion in high power lasers, an approach of beam spatio-temporal multiplexing is proposed to improve the control precision of high contrast pulse. In the approach, the foot and peak part of high contrast pulse are controlled independently, which propagate separately in the near field, and combine together in the far field to form the required pulse shape. For high contrast pulse, the beam area ratio of the two parts is optimized, and then beam fluence and intensity of the foot part are increased, which brings great convenience to the control of pulse. Meanwhile, the near field distribution of the two parts is also carefully designed to make sure their F-numbers are the same, which is another important parameter for laser-target interaction. The integrated calculation results show that for a pulse with a contrast of up to 500, the deviation of foot part can be improved from 20% to 5% by using beam spatio-temporal multiplexing approach with beam area ratio of 1/20, which is almost the same as that of peak part. The research results are expected to bring a breakthrough in power balance of high power laser facility.

Keywords: inertial confinement fusion, laser pulse control, beam spatio-temporal multiplexing, power balance

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Authors: Amina Aquil, Abdeljalil El Got

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Background: Sleep quality is one of the most important indicators related to the quality of life of patients suffering from cancer. Many factors could affect this quality of sleep and then be considered as associated predictors. Methods: The aim of this study was to assess the prevalence of sleep disorders and the associated factors with impaired sleep quality in Moroccan women with gynecological cancer. A cross-sectional study was carried out within the oncology department of the Ibn Rochd University Hospital, Casablanca, on Moroccan women who had undergone radical surgery for gynecological cancer (n=100). Translated and validated Arabic versions of the following international scales were used: Pittsburgh sleep quality index (PSQI), Hospital Anxiety and Depression Scale (HADS), Rosenberg's self-esteem scale (RSES), and Body image scale (BIS). Results: 78% of participants were considered poor sleepers. Most of the patients exhibited very poor subjective quality, low sleep latency, a short period of sleep, and a low rate of usual sleep efficiency. The vast majority of these patients were in poor shape during the day and did not use sleep medication. Waking up in the middle of the night or early in the morning and getting up to use the bathroom were the main reasons for poor sleep quality. PSQI scores were positively correlated with anxiety, depression, body image dissatisfaction, and lower self-esteem (p < 0.001). Conclusion: Sleep quality and its predictors require a systematic evaluation and adequate management to prevent sleep disturbances and mental distress as well as to improve the quality of life of these patients.

Keywords: body image, gynecological cancer, self esteem, sleep quality

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Authors: Tlotlollo Sidwell Hlalele, Shengzhi Du

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High voltage transmission is the most pivotal process in the electrical power industry. It requires a robust infrastructure that can last for decades without causing impairment in human life. Due to the so-called global warming, power transmission system has started to experience some challenges which could presumably escalate more in future. These challenges are earthquake resistance, transmission power losses, and high electromagnetic field. In this paper, research efforts aim to address these challenges are discussed. We focus in particular on the research in regenerative electric energy such as: wind, hydropower, biomass and sea-waves based on the energy storage and transmission possibility. We conclude by drawing attention to specific areas that we believe need more research.

Keywords: power transmission, regenerative energy, power quality, energy storage

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Authors: Pedro M. Abreu, Bruno R. Mendes

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The management of pharmacotherapy and the process of dispensing medicines is becoming critical in clinical pharmacy due to the increase of incidence and prevalence of chronic diseases, the complexity and customization of therapeutic regimens, the introduction of innovative and more expensive medicines, the unbalanced relation between expenditure and revenue as well as due to the lack of rationalization associated with medication use. For these reasons, co-payments emerged in Europe in the 70s and have been applied over the past few years in healthcare. Co-payments lead to a rationing and rationalization of user’s access under healthcare services and products, and simultaneously, to a qualification and improvement of the services and products for the end-user. This analysis, under hospital practices particularly and co-payment strategies in general, was carried out on all the European regions and identified four reference countries, that apply repeatedly this tool and with different approaches. The structure, content and adaptation of European co-payments were analyzed through 7 qualitative attributes and 19 performance indicators, and the results expressed in a scorecard, allowing to conclude that the German models (total score of 68,2% and 63,6% in both elected co-payments) can collect more compliance and effectiveness, the English models (total score of 50%) can be more accessible, and the French models (total score of 50%) can be more adequate to the socio-economic and legal framework. Other European models did not show the same quality and/or performance, so were not taken as a standard in the future design of co-payments strategies. In this sense, we can see in the co-payments a strategy not only to moderate the consumption of healthcare products and services, but especially to improve them, as well as a strategy to increment the value that the end-user assigns to these services and products, such as medicines.

Keywords: clinical pharmacy, co-payments, healthcare, medicines

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Authors: Gobinda Gopal Khan, Ashutosh K. Singh, Debasish Sarkar

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Unique one-dimensional (1D) Ni-NiO and Co-Ni/Co3O4-NiO core/shell nano-heterostructures are fabricated by combining the electrochemical deposition and annealing. The high-performance pseudo-capacitor electrode based on the Ni-NiO and Co-Ni/Co3O4-NiO core/shell nano-heterostructures is designed and demonstrated. The Co-Ni/Co3O4-NiO core/shell nano-heterostructures exhibit high specific capacitance (2013 Fg-1 at 2.5 Ag-1), high energy and power density (23 Wh kg-1 and 5.5 kW kg-1, at the discharge current density of 20.8 A g-1.), good capacitance retention, and long cyclicality. The remarkable electrochemical property of the large surface area nano-heterostructures is demonstrated based on the novel nano-architectural design of the electrode with the coexistence of the two highly redox active materials at the surface supported by highly conducting metal alloy channel at the core for faster charge transport.

Keywords: nano-heterostructures, energy storage, supercapacitors, electrochemical deposition

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Authors: Swati Srivastava, Mattia Lauriola, Yuval Gilad, Adi Kimchi, Yosef Yarden

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The glucocorticoid receptor (GR) has been proposed to play important, but incompletely understood roles in cancer. Glucocorticoids (GCs) are widely used as co-medication of various carcinomas, due to their ability to reduce the toxicity of chemotherapy. Furthermore, GR antagonism has proven to be a strategy to treat triple negative breast cancer and castration-resistant prostate cancer. These observations suggest differential GR involvement in cancer subtypes. The goal of our study has been to elaborate the current understanding of GR signaling in tumor progression and metastasis. Our study involves two cellular models, non-tumorigenic breast epithelial cells (MCF10A) and Ewing sarcoma cells (CHLA9). In our breast cell model, the results indicated that the GR agonist dexamethasone inhibits EGF-induced mammary cell migration, and this effect was blocked when cells were stimulated with a GR antagonist, namely RU486. Microarray analysis for gene expression revealed that the mechanism underlying inhibition involves dexamenthasone-mediated repression of well-known activators of EGFR signaling, alongside with enhancement of several EGFR’s negative feedback loops. Because GR mainly acts primarily through composite response elements (GREs), or via a tethering mechanism, our next aim has been to find the transcription factors (TFs) which can interact with GR in MCF10A cells.The TF-binding motif overrepresented at the promoter of dexamethasone-regulated genes was predicted by using bioinformatics. To validate the prediction, we performed high-throughput Protein Complementation Assays (PCA). For this, we utilized the Gaussia Luciferase PCA strategy, which enabled analysis of protein-protein interactions between GR and predicted TFs of mammary cells. A library comprising both nuclear receptors (estrogen receptor, mineralocorticoid receptor, GR) and TFs was fused to fragments of GLuc, namely GLuc(1)-X, X-GLuc(1), and X-GLuc(2), where GLuc(1) and GLuc(2) correspond to the N-terminal and C-terminal fragments of the luciferase gene.The resulting library was screened, in human embryonic kidney 293T (HEK293T) cells, for all possible interactions between nuclear receptors and TFs. By screening all of the combinations between TFs and nuclear receptors, we identified several positive interactions, which were strengthened in response to dexamethasone and abolished in response to RU486. Furthermore, the interactions between GR and the candidate TFs were validated by co-immunoprecipitation in MCF10A and in CHLA9 cells. Currently, the roles played by the uncovered interactions are being evaluated in various cellular processes, such as cellular proliferation, migration, and invasion. In conclusion, our assay provides an unbiased network analysis between nuclear receptors and other TFs, which can lead to important insights into transcriptional regulation by nuclear receptors in various diseases, in this case of cancer.

Keywords: epidermal growth factor, glucocorticoid receptor, protein complementation assay, transcription factor

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Authors: Sadia Roshan, Kulsoom Sughra, Shazia Shamas, Shamaila Irum, Haleema Sadia

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To evaluate synergistic medicinal effects of Withania somnifera (Ashwaghandha) and Murraya koenigii (Curry pata) in vitro. Antimicrobial activity was determined using the disc diffusion method against five bacterial and two fungal strains. The antioxidant activity was evaluated by the DPPH assay. The antidiabetic activity was evaluated by alpha-glucosidase inhibition assay and alpha-amylase inhibition assay. Synergistic antibacterial activity was observed against all the strains of bacteria, either Gram-positive or Gram-negative and fungi under study conditions. The maximum antibacterial activity was displayed by combined extract against E. coli i.e. 26±0.4mm. Maximum antifungal activity was shown by combined extract against Aspergillus niger, i.e., 17.3±0.5mm. The antioxidant activity of the combined extract was also significant. Alpha-glucosidase inhibition and alpha-amylase inhibition assays also showed synergism. Results indicate that Withania somnifera and Murraya koengii have medicinal properties. The combined extract of both plants is more potent than their individual extracts, suggesting that these can work in synergism. The research suggests that different plant extracts could be used in combination to increase their medicinal activities by many folds, thus giving an insight into future use of herbal medication.

Keywords: withania somnifera, murraya koenigii, antimicrobial activity, gram-positive bacetria, gram-negative bacteria

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Authors: Saifon Chongthub

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The purpose of this research is to synthesize adsorbent foam for CO2 adsorption. The polymer was prepared from poly High Internal Phase Emulsion (PolyHIPE) using styrene as monomer and divinylbenzene as comonomer. Its morphology was determined by Scanning Electron Microscopy (SEM). To further increased CO2 adsorption of the prepared polyHIPE, the layer by layer (LbL) technique was applied, which alternated polyelectrolyte injection between layers of Poly(styrenesulfonate) (PSS) and Poly(diallyldimetyl-ammonium chloride)(PDADMAC) as primary layer, and layers of PSS and polyetyleneimine (PEI) as secondary layer.

Keywords: high internal phase emulsion, polyHIPE, surface modification, layer by layer technique, CO2 adsorption

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Authors: Fahad Aljasass, Hamza Abu-Tarboush, Salah Aleid, Siddig Hamad

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The effects of different high hydrostatic pressure treatments on the shelf life of camel’s milk were studied. Treatments at 300 to 350 MPa for 5 minutes at 40°C reduced microbial contamination to levels that prolonged the shelf life of refrigerated (3° C) milk up to 28 days. The treatment resulted in a decrease in the proteolytic activity of the milk. The content of proteolytic enzymes in the untreated milk sample was 4.23 µM/ml. This content decreased significantly to 3.61 µM/ml when the sample was treated at 250 MPa. Treatment at 300 MPa decreased the content to 3.90 which was not significantly different from the content of the untreated sample. The content of the sample treated at 350 MPa dropped to 2.98 µM/ml which was significantly lower than the contents of all other treated and untreated samples. High pressure treatment caused a slight but statistically significant increase in the pH of camel’s milk. The pH of the untreated sample was 6.63, which increased significantly to 6.70, in the samples treated at 250 and 350 MPa, but insignificantly in the sample treated at 300 MPa. High pressure treatment resulted in some degree of milk fat oxidation. The thiobarbituric acid (TBA) value of the untreated sample was 0.86 mg malonaldehyde/kg milk. This value remained unchanged in the sample treated at 250 MPa, but then it increased significantly to 1.25 and 1.33 mg/kg in the samples treated at 300 and 350 MPa, respectively. High pressure treatment caused a small increase in the greenness (a* value) of camel’s milk. The value of a* was reduced from -1.17 for the untreated sample to -1.26, -1.21 and -1.30 for the samples treated at 250, 300 and 350 MPa, respectively. Δa* at the 250 MPa treatment was -0.09, which then decreased to -0.04 at the 300 MPa treatment to increase again to -0.13 at the 350 MPa treatment. The yellowness (b* value) of camel’s milk increased significantly as a result of high pressure treatment. The b* value of the untreated sample was 1.40, this value increased to 2.73, 2.31 and 2.18 after treatments at 250, 300 and 350 MPa, respectively. The Δb* value was +1.33 at the treatment 250 MPa, decreased to +0.91 at 300 MPa and further to +0.78 at 350 MPa. The pressure treatment caused slight effect on color, slight decrease in protease activity and a slight increase in the oxidation products of lipids.

Keywords: high hydrostatic pressure, camel’s milk, mesophilic aerobic bacteria, clotting, protease

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Authors: Florge Francis A. Sy

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Physicians develop emotional and psychological distress after facing a patient’s death. This can result in stress or burnout. Coping mechanisms in dealing with these deaths may be maladaptive. Determining grief, emotional impact, and coping strategies in physicians is necessary to identify those needing intervention. This can be done by employing validated assessment tools such as the Texas Revised Inventory of Grief (TRIG) scale, Impact of Events Scale (IES), and BriefCOPE tool, respectively. This prospective, observational study was done in a private hospital in Cebu City. Fifty-five internal medicine residents were included and tasked to answer a survey based on their most memorable patient death encounter. The TRIG, IES, and BriefCOPE scores were determined. Participants were divided into severe grief and non-severe grief based on TRIG scores, low-impact, moderate-impact, and high-impact based on IES, and low-use, moderate-use, and high-use based on the BriefCOPE. The differences in the groups’ characteristics were statistically determined, and a p-value of < 0.05 was significant. The participants’ average age was 28.45 years. Most were female and single. Most belonged to the non-severe group based on TRIG, a moderate-impact group based on the IES, and high-use group based on the BriefCOPE. However, 21.8% reported severe grief, 27.3% reported high-impact, and 10.9% had low use of coping strategies. The proportion of residents who encountered CPR prior to the patient’s death was greater in the severe group. Proportions of both high-impact and non-high impact groups were comparable. The proportion of female residents was higher in the high-use group. There were a number of residents who reported severe grief, high emotional impact, and low coping strategies. This highlights the need for interventions such as debriefing after CPR or formal training in residency programs in dealing with emotional burden to counteract maladaptive coping behaviors and prevent negative outcomes.

Keywords: residents, grief, emotional impact, coping, patient death

Procedia PDF Downloads 94

Authors: Sarah Triller, Ferdi Schüth

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The challenges encountered in upscaling the mechanochemical synthesis of high surface area α-alumina are investigated in this study. After lab-scale experiments in shaker mills and planetary ball mills, the optimization of reaction parameters of the conversion in the smallest vessel of a scalable mill, named Simoloyer, was developed. Furthermore, the future perspectives by scaling up the conversion in several steps are described. Since abrasion from the steel equipment can be problematic, the process was transferred to a ceramically lined mill, which solved the contamination problem. The recovered alpha-alumina shows a high specific surface area in all investigated scales.

Keywords: mechanochemistry, scale-up, ball milling, ceramic lining

Procedia PDF Downloads 49

Authors: Mahzabin Afroz, Indubhushan Patnaikuni, Srikanth Venkatesan

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It is well-known that fly ash can be used in high volume as a partial replacement of cement to get beneficial effects on concrete. High volume fly ash (HVFA) concrete is currently emerging as a popular option to strengthen by fiber. Although studies have supported the use of fibers with fly ash, a unified model along with the incorporation into finite element software package to estimate the maximum flexural loads need to be developed. In this study, nonlinear finite element analysis of steel fiber reinforced high strength HVFA concrete beam under static loadings was conducted to investigate their failure modes in terms of ultimate load. First of all, the experimental investigation of mechanical properties of high strength HVFA concrete was done and validates with developed numerical model with the appropriate modeling of element size and mesh by ANSYS 16.2. To model the fiber within the concrete, three-dimensional random fiber distribution was simulated by spherical coordinate system. Three types of high strength HVFA concrete beams were analyzed reinforced with 0.5, 1 and 1.5% volume fractions of steel fibers with specific mechanical and physical properties. The result reveals that the use of nonlinear finite element analysis technique and three-dimensional random fiber orientation exhibited fairly good agreement with the experimental results of flexural strength, load deflection and crack propagation mechanism. By utilizing this improved model, it is possible to determine the flexural behavior of different types and proportions of steel fiber reinforced HVFA concrete beam under static load. So, this paper has the originality to predict the flexural properties of steel fiber reinforced high strength HVFA concrete by numerical simulations.

Keywords: finite element analysis, high volume fly ash, steel fibers, spherical coordinate system

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Authors: Boikanyego Sebina

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The present study investigates the effects of socioeconomic status (SES) and bilingualism on the Setswana speech rhythm of Batswana (citizens) children aged 6-7 years with typical development born and residing in Botswana. Botswana is a country in which there is a diglossic Setswana/English language setting, where English is the dominant high-status language in educational and public contexts. Generally, children from low SES have lower linguistic and cognitive profiles than their age-matched peers from high SES. A greater understanding of these variables would allow educators to distinguish between underdeveloped language skills in children due to impairment and environmental issues for them to successfully enroll children in language development enhancement programs specific to the child’s needs. There are 20 participants: 10 high SES private English-medium educated early sequential Setswana-English bilingual children, taught full-time in English (L2) from the age of 3 years, and for whom English has become dominant; and 10 low SES children who are educated in public schools for whom English is considered a learner language, i.e., L1 Setswana is dominant. The aim is to see whether SES and bilingualism, have had an effect on the Setswana speech rhythm of children in either group. The study primarily uses semi-spontaneous speech based on the telling of the wordless picture storybook. A questionnaire is used to elicit the language use pattern of the children and that of their parents, as well as the education level of the parents and the school the children attend. A comparison of the rhythm shows that children from high SES have a lower durational variability than those from low SES. The findings of the study are that the low durational variability by children from high SES may suggest an underdeveloped rhythm. In conclusion, the results of the present study are against the notion that children from high SES outperform those from low SES in linguistic development.

Keywords: bilingualism, Setswana English, socio-economic status, speech-rhythm

Procedia PDF Downloads 38

Authors: Sara Ataei, Molouk Hadjibabaie, Shirinsadat Badri, Amirhossein Moslehi, Iman Karimzadeh, Ardeshir Ghavamzadeh

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Purpose: To assess the pattern and probable risk factors for moderate and major drug–drug interactions in a referral hematology-oncology ward in Iran. Methods: All patients admitted to hematology–oncology ward of Dr. Shariati Hospital during a 6-month period and received at least two anti-cancer or non-anti-cancer medications simultaneously were included. All being scheduled anti-cancer and non-anti-cancer medications both prescribed and administered during ward stay were considered for drug–drug interaction screening by Lexi-Interact On- Desktop software. Results: One hundred and eighty-five drug–drug interactions with moderate or major severity were detected from 83 patients. Most of drug–drug interactions (69.73 %) were classified as pharmacokinetics. Fluconazole (25.95 %) was the most commonly offending medication in drug–drug interactions. Interaction of sulfamethoxazole-trimethoprim with fluconazole was the most common drug–drug interaction (27.27 %). Vincristine with imatinib was the only identified interaction between two anti-cancer agents. The number of administered medications during ward stay was considered as an independent risk factor for developing a drug–drug interaction. Conclusions: Potential moderate or major drug–drug interactions occur frequently in patients with hematological malignancies or related diseases. Performing larger standard studies are required to assess the real clinical and economical effects of drug–drug interactions on patients with hematological and non-hematological malignancies.

Keywords: drug–drug interactions, hematology–oncology ward, hematological malignancies

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Authors: Thomas Bryan, Veton Kepuska, Ivica Kostanic

Abstract:

A simple adaptive voice activity detector (VAD) is implemented using Gabor and gammatone atomic decomposition of speech for high Gaussian noise environments. Matching pursuit is used for atomic decomposition, and is shown to achieve optimal speech detection capability at high data compression rates for low signal to noise ratios. The most active dictionary elements found by matching pursuit are used for the signal reconstruction so that the algorithm adapts to the individual speakers dominant time-frequency characteristics. Speech has a high peak to average ratio enabling matching pursuit greedy heuristic of highest inner products to isolate high energy speech components in high noise environments. Gabor and gammatone atoms are both investigated with identical logarithmically spaced center frequencies, and similar bandwidths. The algorithm performs equally well for both Gabor and gammatone atoms with no significant statistical differences. The algorithm achieves 70% accuracy at a 0 dB SNR, 90% accuracy at a 5 dB SNR and 98% accuracy at a 20dB SNR using 30dB SNR as a reference for voice activity.

Keywords: atomic decomposition, gabor, gammatone, matching pursuit, voice activity detection

Procedia PDF Downloads 275