Search results for: plant disease identification
2979 Mutational and Evolutionary Analysis of Interleukin-2 Gene in Four Pakistani Goat Breeds
Authors: Tanveer Hussain, Misbah Hussain, Masroor Ellahi Babar, Muhammad Traiq Pervez, Fiaz Hussain, Sana Zahoor, Rashid Saif
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Interleukin 2 (IL-2) is a cytokine which is produced by activated T cells, play important role in immune response against antigen. It act in both autocrine and paracrine manner. It can stimulate B cells and various other phagocytic cells like monocytes, lymphokine-activated killer cells and natural killer cells. Acting in autocrine fashion, IL-2 protein plays a crucial role in proliferation of T cells. IL-2 triggers the release of pro and anti- inflammatory cytokines by activating several pathways. In present study, exon 1 of IL-2 gene of four local Pakistani breeds (Dera Din Panah, Beetal, Nachi and Kamori) from two provinces was amplified by using reported Ovine IL-2 primers, yielding PCR product of 501 bp. The sequencing of all samples was done to identify the polymorphisms in amplified region of IL-2 gene. Analysis of sequencing data resulted in identification of one novel nucleotide substitution (T→A) in amplified non-coding region of IL-2 gene. Comparison of IL-2 gene sequence of all four breeds with other goat breeds showed high similarity in sequence. While phylogenetic analysis of our local breeds with other mammals showed that IL-2 is a variable gene which has undergone many substitutions. This high substitution rate can be due to the decreased or increased changed selective pressure. These rapid changes can also lead to the change in function of immune system. This pioneering study of Pakistani goat breeds urge for further studies on immune system of each targeted breed for fully understanding the functional role of IL-2 in goat immunity.Keywords: interleukin 2, mutational analysis, phylogeny, goat breeds, Pakistan
Procedia PDF Downloads 6112978 Fixed Point Iteration of a Damped and Unforced Duffing's Equation
Authors: Paschal A. Ochang, Emmanuel C. Oji
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The Duffing’s Equation is a second order system that is very important because they are fundamental to the behaviour of higher order systems and they have applications in almost all fields of science and engineering. In the biological area, it is useful in plant stem dependence and natural frequency and model of the Brain Crash Analysis (BCA). In Engineering, it is useful in the study of Damping indoor construction and Traffic lights and to the meteorologist it is used in the prediction of weather conditions. However, most Problems in real life that occur are non-linear in nature and may not have analytical solutions except approximations or simulations, so trying to find an exact explicit solution may in general be complicated and sometimes impossible. Therefore we aim to find out if it is possible to obtain one analytical fixed point to the non-linear ordinary equation using fixed point analytical method. We started by exposing the scope of the Duffing’s equation and other related works on it. With a major focus on the fixed point and fixed point iterative scheme, we tried different iterative schemes on the Duffing’s Equation. We were able to identify that one can only see the fixed points to a Damped Duffing’s Equation and not to the Undamped Duffing’s Equation. This is because the cubic nonlinearity term is the determining factor to the Duffing’s Equation. We finally came to the results where we identified the stability of an equation that is damped, forced and second order in nature. Generally, in this research, we approximate the solution of Duffing’s Equation by converting it to a system of First and Second Order Ordinary Differential Equation and using Fixed Point Iterative approach. This approach shows that for different versions of Duffing’s Equations (damped), we find fixed points, therefore the order of computations and running time of applied software in all fields using the Duffing’s equation will be reduced.Keywords: damping, Duffing's equation, fixed point analysis, second order differential, stability analysis
Procedia PDF Downloads 2922977 Assessment of Water Quality of Selected Lakes of Coimbatore District, Tamil Nadu, India
Authors: K. P. Ganesh, T. Gomathi, L. Arul Pragasan
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Degradation of lake water quality is one of the serious environmental threats for the last few decades, particularly, the lakes situated in and around urban and industrial areas. The present study aimed to analyze the physicochemical and biological parameters, and metal elements to determine the water quality of Krishnampathi, Ukkadam, Kurichi, Sulur and Singanallur Lakes. Of the 23 physicochemical parameters analyzed in the five lakes, except TDS, Chloride and Total hardness values all the 20 parameters were found within the prescribed limit as recommended by World Health Organization (WHO) and Bureau of Indian Standards (BIS). In case of biological parameter, both Total Coliform and Fecal Coliform bacteria (Escherichia coli) were identified. This indicates the contamination of lakes by fecal matter, and warns of potential of disease causing by viruses, bacteria and other organisms. Among the twelve metal elements (Al, Cr, Mn, Fe, Ni, Cu, Zn, As, Se, Mo, Cd and Pb) determined by inductively coupled plasma-mass spectroscopy, except Cd (for all lakes), and Pb (for Ukkadam, Kurichi, Sulur & Singanallur), all the elements were found above the prescribed limits of BIS. The results of the present study revealed that all the five major lakes of Coimbatore were contaminated. It is recommended that proper implementation of the new wetland waste management system and monitoring of water quality be of the urgent need to sustain the water bodies for future generations.Keywords: heavy metals, inductively coupled plasma-mass spectroscopy, physicochemical and biological parameters, water quality
Procedia PDF Downloads 1792976 Barriers to Marital Expectation among Individuals with Hearing Impairment in Oyo State
Authors: Adebomi M. Oyewumi, Sunday Amaize
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The study was designed to examine the barriers to marital expectations among unmarried persons with hearing impairment in Oyo State, Nigeria. Descriptive survey research design was adopted. Purposive sampling technique was used to select one hundred participants made up forty-four (44) males and fifty-six (56) females, all with varying degrees of hearing impairment. Eight research questions were raised and answered. The instrument used was Marital Expectations Scale with reliability coefficient of 0.86. Data was analyzed using descriptive statistics tools of frequency count and simple percentage as well as inferential statistics tools of T-TEST and ANOVA. The findings revealed that there was a significant relationship existing among the main identified barriers (environmental barrier, communication barrier, hearing loss, unemployment and poor sexuality education) to the marital expectations of unmarried persons with hearing impairment. The joint contribution of the independent variables (identified barriers) to the dependent variable (marital expectations) was significant, F = 5.842, P < 0.05, accounting for about 89% of the variance. The relative contribution of the identified barriers to marital expectations of unmarried persons with hearing impairment is as follows: environmental barrier (β = 0.808, t = 5.176, P < 0.05), communication barrier (β = 0.533, t = 3.305, P < 0.05), hearing loss (β = 0.550, t = 2.233, P < 0.05), unemployment (β = 0.431, t = 2.102, P < 0.05), poor sexuality education (β = 0.361, t = 1.985, P < 0.05). Environmental barrier proved to be the most potent contributor to the poor marital expectations among unmarried persons with hearing impairment. Therefore, it is recommended that society dismantles the nagging environmental barrier through positive identification with individuals suffering from hearing impairment. In this connection, members of society should change their negative attitudes and do away with all the wrong notions about the marital ability of individuals with hearing impairment.Keywords: environmental barrier, hearing impairment, marriage, marital expectations
Procedia PDF Downloads 3702975 Investigating the Combined Medicinal Effects of Withania Somnifera (Ashwaghandha) and Murraya Koenigii (Curry Pata) in Vitro
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
Procedia PDF Downloads 802974 Review of State Anti-Trafficking Laws in the United States of America and Their Success in Combating Human Trafficking and Protecting the Victims
Authors: Andrea Marcela Morales Reyes
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In the year 2000, the federal government of the United States of America enacted anti-trafficking legislation to prevent human trafficking, prosecute traffickers, and protect the victims. Since then, all 50 states have followed the federal government's example by enacting state-level anti-trafficking legislation. In order to fight human trafficking in the United States, it is paramount that this legislation is not only comprehensively enacted but also enforced. This study reviewed the anti-trafficking laws enacted in each of the 50 states and investigated the success of such laws by reporting the number of trafficking related prosecutions, cases identified, and victims protected. This study reviewed human trafficking reports issued by nonprofits, and state and federal level agencies. An increase in the number of cases investigated since the state laws have been passed reflects a moderate success in the fight against human trafficking in the U.S. This review also found that although every state has passed anti-trafficking legislation, many still lack a comprehensive approach to combat human trafficking; some states lack key provisions to prevent human trafficking, prosecute traffickers, and protect it victims. This, along with the lack of enforcement of the anti-trafficking plans included in each of the state legislations, has meant that the human trafficking cases investigated in fiscal year 2016 are not near the estimated numbers; which in turn suggests that this crime is still greatly unaccounted for. This study concludes that although important steps have been taken at the national and state level to combat human trafficking, the identification and prosecution of human trafficking cases still proves challenging in the United States.Keywords: enforcement of laws, human trafficking, anti-trafficking legislation, United States
Procedia PDF Downloads 1652973 Synergistic Effect of Zr-Modified Cu-ZnO-Al₂O₃ and Bio-Templated HZSM-5 Catalysts in CO₂ Hydrogenation to Methanol and DME
Authors: Abrar Hussain, Kuen-Song Lin, Sayed Maeen Badshah, Jamshid Hussain
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The conversion of CO₂ into versatile, useful compounds such as fuels and other chemicals remains a challenging frontier in research, demanding the innovation of increasingly effective catalysts. In the present work, a catalyst-incorporating zirconium (Zr) modification within CuO–ZnO–Al₂O₃ (CZA) was synthesized via a co-precipitation method to convert CO₂ into methanol. Furthermore, bio-HZSM-5 was used to promote methanol dehydration to produce dimethyl ether (DME). We prepared the porous hierarchy bio-HZSM-5 with remarkable pore connectivity by utilizing an economical loofah sponge and rice husks as biotemplates. The synthesized catalysts were characterized using Field Emission Scanning Electron Microscopy (FE-SEM), X–ray diffraction (XRD), N₂ adsorption (BET), temperature-programmed desorption (NH₃-TPD) and thermogravimetric analysis (TGA). The Zr addition improved the performance of the CZZA catalyst as a structural promoter, leading to increased DME selectivity and total carbon conversion by enhancing active sites, surface area, and the synergistic interfaces between CuO and ZnO. The presence of silicon in the biomass, notably from the loofah sponge (0.016 wt %) and rice husks (8.3 wt %), also performed a pivotal role in the preparation of bio-HZSM-5. Furthermore, contrasted to the CZZA/com-ZSM-5 catalyst, the integration of CZZA with bio-HZSM-5-L bifunctional catalyst achieved the highest DME yield (12.1 %), DME selectivity (58.6%), CO₂ conversion (22.5%) at 280 °C and 30 bar. The payback time for 5 and 10-tons per day (5 and10-TPD) DME formation using the catalytic process of CO₂ from petrochemical refinery plant waste gas emissions was 2.98 and 2.44 years, respectively.Keywords: Cost assessment, Dimethyl ether, low-cost bio-HZSM-5, CZZA catalyst, CO₂ hydrogenation
Procedia PDF Downloads 112972 Classification of Small Towns: Three Methodological Approaches and Their Results
Authors: Jerzy Banski
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Small towns represent a key element of settlement structure and serve a number of important functions associated with the servicing of rural areas that surround them. It is in light of this that scientific studies have paid considerable attention to the functional structure of centers of this kind, as well as the relationships with both surrounding rural areas and other urban centers. But a preliminary to such research has typically involved attempts at classifying the urban centers themselves, with this also assisting with the planning and shaping of development policy on different spatial scales. The purpose of the work is to test out the methods underpinning three different classifications of small urban centers, as well as to offer a preliminary interpretation of the outcomes obtained. Research took in 722 settlement units in Poland, granted town rights and populated by fewer than 20,000 inhabitants. A morphologically-based classification making reference to the database of topographic objects as regards land cover within the administrative boundaries of towns and cities was carried out, and it proved possible to distinguish the categories of “housing-estate”, industrial and R&R towns, as well as towns characterized by dichotomy. Equally, a functional/morphological approach taken with the same database allowed for the identification – via an alternative method – of three main categories of small towns (i.e., the monofunctional, multifunctional or oligo functional), which could then be described in far greater detail. A third, multi-criterion classification made simultaneous reference to the conditioning of a structural, a location-related, and an administrative hierarchy-related nature, allowing for distinctions to be drawn between small towns in 9 different categories. The results obtained allow for multifaceted analysis and interpretation of the geographical differentiation characterizing the distribution of Poland’s urban centers across space in the country.Keywords: small towns, classification, local planning, Poland
Procedia PDF Downloads 872971 Effect of Cellular Water Transport on Deformation of Food Material during Drying
Authors: M. Imran Hossen Khan, M. Mahiuddin, M. A. Karim
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Drying is a food processing technique where simultaneous heat and mass transfer take place from surface to the center of the sample. Deformation of food materials during drying is a common physical phenomenon which affects the textural quality and taste of the dried product. Most of the plant-based food materials are porous and hygroscopic in nature that contains about 80-90% water in different cellular environments: intercellular environment and intracellular environment. Transport of this cellular water has a significant effect on material deformation during drying. However, understanding of the scale of deformation is very complex due to diverse nature and structural heterogeneity of food material. Knowledge about the effect of transport of cellular water on deformation of material during drying is crucial for increasing the energy efficiency and obtaining better quality dried foods. Therefore, the primary aim of this work is to investigate the effect of intracellular water transport on material deformation during drying. In this study, apple tissue was taken for the investigation. The experiment was carried out using 1H-NMR T2 relaxometry with a conventional dryer. The experimental results are consistent with the understanding that transport of intracellular water causes cellular shrinkage associated with the anisotropic deformation of whole apple tissue. Interestingly, it is found that the deformation of apple tissue takes place at different stages of drying rather than deforming at one time. Moreover, it is found that the penetration rate of heat energy together with the pressure gradient between intracellular and intercellular environments is the responsible force to rupture the cell membrane.Keywords: heat and mass transfer, food material, intracellular water, cell rupture, deformation
Procedia PDF Downloads 2212970 Project Time and Quality Management during Construction
Authors: Nahed Al-Hajeri
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Time and cost is an integral part of every construction plan and can affect each party’s contractual obligations. The performance of both time and cost are usually important to the client and contractor during the project. Almost all construction projects are experiencing time overrun. These time overruns always contributed as expensive to both client and contractor. Construction of any project inside the gathering centers involves complex management skills related to work force, materials, plant, machineries, new technologies etc. It also involves many agencies interdependent on each other like the vendors, structural and functional designers including various types of specialized engineers and it includes support of contractors and specialized contractors. This paper mainly highlights the types of construction delays due to which project suffer time and cost overrun. This paper also speaks about the delay causes and factors that contribute to the construction sequence delay for the oil and gas projects. Construction delay is supposed to be one of the repeated problems in the construction projects and it has an opposing effect on project success in terms of time, cost and quality. Some effective methods are identified to minimize delays in construction projects such as: 1. Site management and supervision, 2. Effective strategic planning, 3. Clear information and communication channel. Our research paper studies the types of delay with some real examples with statistic results and suggests solutions to overcome this problem.Keywords: non-compensable delay, delays caused by force majeure, compensable delay, delays caused by the owner or the owner’s representative, non-excusable delay, delay caused by the contractor or the contractor’s representative, concurrent delay, delays resulting from two separate causes at the same time
Procedia PDF Downloads 2422969 Challenges in Early Diagnosis of Enlarged Vestibular Aqueduct (EVA) in Pediatric Population: A Single Case Report
Authors: Asha Manoharan, Sooraj A. O, Anju K. G
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Enlarged vestibular aqueduct (EVA) refers to the presence of congenital sensorineural hearing loss with an enlarged vestibular aqueduct. The Audiological symptoms of EVA are fluctuating and progressive in nature and the diagnosis of EVAS can be confirmed only with radiological evaluation. Hence it is difficult to differentiate EVA from conditions like Meniere’s disease, semi-circular dehiscence, etc based on audiological findings alone. EVA in adults is easy to identify due to distinct vestibular symptoms. In children, EVA can remain either unidentified or misdiagnosed until the vestibular symptoms are evident. Motor developmental delay, especially the ones involving a change of body alignment, has been reported in the pediatric population with EVA. So, it should be made mandatory to recommend radiological evaluation in young children with fluctuating hearing loss reporting with motor developmental delay. This single case study of a baby with Enlarged Vestibular Aqueduct (EVA) primarily aimed to address the following: a) Challenges while diagnosing young patients with EVA and fluctuating hearing loss, b) Importance of radiological evaluation in audiological diagnosis in the pediatric population, c) Need for regular monitoring of hearing, hearing aid performance, and cochlear implant mapping closely for potential fluctuations in such populations, d) Importance of reviewing developmental, language milestones in very young children with fluctuating hearing loss.Keywords: enlarged vestibular aqueduct (EVA), motor delay, radiological evaluation, fluctuating hearing loss, cochlear implant
Procedia PDF Downloads 1672968 Experimental Study of Unconfined and Confined Isothermal Swirling Jets
Authors: Rohit Sharma, Fabio Cozzi
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A 3C-2D PIV technique was applied to investigate the swirling flow generated by an axial plus tangential type swirl generator. This work is focused on the near-exit region of an isothermal swirling jet to characterize the effect of swirl on the flow field and to identify the large coherent structures both in unconfined and confined conditions for geometrical swirl number, Sg = 4.6. Effects of the Reynolds number on the flow structure were also studied. The experimental results show significant effects of the confinement on the mean velocity fields and its fluctuations. The size of the recirculation zone was significantly enlarged upon confinement compared to the free swirling jet. Increasing in the Reynolds number further enhanced the recirculation zone. The frequency characteristics have been measured with a capacitive microphone which indicates the presence of periodic oscillation related to the existence of precessing vortex core, PVC. Proper orthogonal decomposition of the jet velocity field was carried out, enabling the identification of coherent structures. The time coefficients of the first two most energetic POD modes were used to reconstruct the phase-averaged velocity field of the oscillatory motion in the swirling flow. The instantaneous minima of negative swirl strength values calculated from the instantaneous velocity field revealed the presence of two helical structures located in the inner and outer shear layers and this structure fade out at an axial location of approximately z/D = 1.5 for unconfined case and z/D = 1.2 for confined case. By phase averaging the instantaneous swirling strength maps, the 3D helical vortex structure was reconstructed.Keywords: acoustic probes, 3C-2D particle image velocimetry (PIV), precessing vortex core (PVC), recirculation zone (RZ)
Procedia PDF Downloads 2332967 Barriers and Enablers to Public Innovation in the Central Region of Colombia: A Characterization from Measurement through the Item Response Methodology and Comparative Analysis
Authors: Yessenia Parrado, Ana Barbosa, Daniela Mahe, Sebastian Toro, Jhon Garcia
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The purpose of this work is to present the identification and characterization of the barriers and enablers to public innovation in the Central Region of Colombia from a mixed methodology in a research carried out in 2020 by the Laboratory of Innovation, Creativity and New Technologies of the National University of Colombia in alliance with the National Planning Department. Based on the research, the index of barriers to regional and departmental public innovation was built, which reflects the level of difficulty of the territorial entities to overcome the barriers present around three dimensions: organizational structure of the entity, generation of public value, and governance processes. The index was built from the item response methodology and the multiple correspondence analysis from the application of an institutional information form for public entities and a perception form for public servants. This investigation had the participation of 36 entities and 1038 servers and servants from the departments of Huila, Meta, Boyacá, Cundinamarca, Tolima, and the Capital District. In this exercise, it was identified that the departmental indices range between 13 and 44 and that the regional index was 30 out of 100. From the analysis of the information, it was possible to establish that the main barriers are the lack of specialized agencies for public innovation exercises, lack of qualified personnel and work methodologies for public innovation, inadequate information management, lack of feedback between the learning from governmental and non-governmental entities, the inability of the initiatives to generate binding participation mechanisms and the lack of qualification of citizens to participate in these processes.Keywords: item response, public innovation, quantitative analysis, compared analysis
Procedia PDF Downloads 1252966 Statistical Time-Series and Neural Architecture of Malaria Patients Records in Lagos, Nigeria
Authors: Akinbo Razak Yinka, Adesanya Kehinde Kazeem, Oladokun Oluwagbenga Peter
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Time series data are sequences of observations collected over a period of time. Such data can be used to predict health outcomes, such as disease progression, mortality, hospitalization, etc. The Statistical approach is based on mathematical models that capture the patterns and trends of the data, such as autocorrelation, seasonality, and noise, while Neural methods are based on artificial neural networks, which are computational models that mimic the structure and function of biological neurons. This paper compared both parametric and non-parametric time series models of patients treated for malaria in Maternal and Child Health Centres in Lagos State, Nigeria. The forecast methods considered linear regression, Integrated Moving Average, ARIMA and SARIMA Modeling for the parametric approach, while Multilayer Perceptron (MLP) and Long Short-Term Memory (LSTM) Network were used for the non-parametric model. The performance of each method is evaluated using the Mean Absolute Error (MAE), R-squared (R2) and Root Mean Square Error (RMSE) as criteria to determine the accuracy of each model. The study revealed that the best performance in terms of error was found in MLP, followed by the LSTM and ARIMA models. In addition, the Bootstrap Aggregating technique was used to make robust forecasts when there are uncertainties in the data.Keywords: ARIMA, bootstrap aggregation, MLP, LSTM, SARIMA, time-series analysis
Procedia PDF Downloads 752965 Quinazoline Analogue as a Pet Tracer for Imaging PDE10A: Radiosynthesis and Biological Evaluation
Authors: Anjani Kumar Tiwari, Neelam Kumari, Anil Mishra
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The family of phosphodiesterases (PDEs) plays a critical role in control of the level, localization, and duration of intracellular 3’-5’-cyclic adenosine monophosphate (cAMP) and 3’-5’-cyclic guanosine monophosphate (cGMP) signals by specifically hydrolyzing these cyclic nucleotides. As the involvement of cyclic nucleotide second messengers in cell signaling and homeostasis is established, the regulation of these pathways in the brain by various PDE isoforms is an area of considerable interest, as they are involved in nearly all brain functions and in the etiology of neuropsychiatric diseases. The PDE10A isoform, isolated from different species and characterized regarding structure and function, has received much attention in recent years, particularly in the context of schizophrenia and Huntington’s disease, which are both related to a role of PDE10A in the regulation of striatal dopaminergic neurotransmission. Quinazoline analogue 1-(4-methoxyphenyl)-6,7-dimethoxyquinazoline, was evaluated as specific PET marker for phosphodiesterase (PDE) 10A. Here, we report the radiosynthesis of [11C]2 and the in vitro and in vivo evaluation of [11C]2 as a potential positron emission tomography (PET) radiotracer for imaging PDE10A in the central nervous system (CNS). The radiosynthesis of [11C]2 was achieved by O-methylation of the corresponding des-methyl precursor with [11C]methyl iodide. [11C]2 was obtained with ∼50% radiochemical yield. PET imaging studies in rat brain displayed initial specific uptake with very rapid clearance of [11C]2 from brain. Though [11C]2 is not an ideal radioligand for clinical imaging of PDE10A in the CNS. Modified analogue of quinazoline having a higher potency for inhibiting PDE10A and improved pharmacokinetic properties will be necessary for imaging this enzyme with PET.Keywords: PDE10A, PET, radiotracer, quinazoline
Procedia PDF Downloads 1862964 Use of Selected Cytokines in the Early SIRS/MODS Diagnostic Testing at Patients after Trauma
Authors: Aneta Binkowska, Grzegorz Michalak, Slawomir Pilip, Lukasz Bondaruk, Daniel Celinski, Robert Slotwinski
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Post-traumatic mortality rates are still very high and show an increasing tendency. Early identification of patients at high risk of severe complications has a significant impact on treatment outcomes. The aim of the study was to better understand the early pathological inflammatory response to injury and infection and to determine the usefulness of the assessment of TNF-α and sTNFR1 concentrations in the peripheral blood as early indicators of severe post-traumatic complications. The study was carried out in a group of 51 patients after trauma treated in the ED, including 32 patients that met inclusion criteria for immunological analysis. Patients were divided into two groups using the ISS scale (group A with ISS ≥20, group B with ISS <20). Serum levels of TNF-α and sTNFR1 were determined after admission to the ED and after 3, 6, 12 and 24 hours. The highest TNF-α and sTNFR1 concentrations in both groups were recorded at admission and were significantly higher in group A compared to group B (A vs B TNF-α 2.46 pg/ml vs 1.78 pg/ml; sTNFR1 1667.5 pg/ml vs 875.2 p<0.005). The concentration of sTNFR1 in patients with severe complications was significantly higher compared to patients without complications and preceded clinical symptoms of complications ( C+ vs C- 1561.5 pg/ml vs 930.6 pg/ml). Spearman's correlation showed a statistically significant positive correlation between the baseline concentrations of IL-6 (r=0.38, p<0.043) and sTNFR1 (r=0.59, p=0.001) and the ISS scores. The high diagnostic sensitivity calculated from the ROC (receiver operating characteristic) curves was found for the concentrations of both cytokines: TNF α (AUC=0.91, p=0.004) and sTNFR1 (AUC=0.86, p=0.011). Elevated levels of sTNFR1, determined in the peripheral blood shortly after injury, is significantly associated with the occurrence of later complications, which in some patients lead to death. In contrast, high levels of TNF-α shortly after injury are associated with high mortality.Keywords: cytokine, SIRS, MODS, trauma
Procedia PDF Downloads 1632963 User Requirements Study in Order to Improve the Quality of Social Robots for Dementia Patients
Authors: Konrad Rejdak
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Introduction: Neurodegenerative diseases are frequently accompanied by loss and unwanted change in functional independence, social relationships, and economic circumstances. Currently, the achievements of social robots to date is being projected to improve multidimensional quality of life among people with cognitive impairment and others. Objectives: Identification of particular human needs in the context of the changes occurring in course of neurodegenerative diseases. Methods: Based on the 110 surveys performed in the Medical University of Lublin from medical staff, patients, and caregivers we made prioritization of the users' needs as high, medium, and low. The issues included in the surveys concerned four aspects: user acceptance, functional requirements, the design of the robotic assistant and preferred types of human-robot interaction. Results: We received completed questionnaires; 50 from medical staff, 30 from caregivers and 30 from potential users. Above 90% of the respondents from each of the three groups, accepted a robotic assistant as a potential caregiver. High priority functional capability of assistive technology was to handle emergencies in a private home-like recognizing life-threatening situations and reminding about medication intake. With reference to the design of the robotic assistant, the majority of the respondent would like to have an anthropomorphic appearance with a positive emotionally expressive face. The most important type of human-robot interaction was a voice-operated system and by touchscreen. Conclusion: The results from our study might contribute to a better understanding of the system and users’ requirements for the development of a service robot intended to support patients with dementia.Keywords: assistant robot, dementia, long term care, patients
Procedia PDF Downloads 1542962 Effects of Tomato-Crispy Salad Intercropping on Diameter of Tomato Fruits under Greenhouse Conditions
Authors: Halil Demir, Ersin Polat
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This study, in which crispy salad plants was cultivated between the two rows of tomato, was conducted in Spring 2007 in a research glasshouse at Akdeniz University. Crispy salad (Lactuca sativa var. crispa cv. Bohemia) plants were intercropped with tomato (Solanum lycopersicon cv. Selin F1) plants as the main crop. Tomato seedlings were planted according to double line plantation system with 100 cm large spacing, 50 cm narrow spacing and 50 cm within row plant spacing. In both control and intercropping applications, each plot was 9.75 m2 according to plantation distances and there were 26 plants per each plot for tomato. Crispy salad seedlings were planted with 30 cm spacing as one row in the middle of tomato plants and with 30x30 spacing as two rows between plants rows. Moreover, salad seedlings were transplanted between tomato plants above the tomato rows that were planted in two rows with intervals of 50 cm and also with 25x25 cm spacing as the third row in the middle of tomato rows. While tomato plants were growing during the research, fruit width and height were measured periodically with 15 days in the tomato fruits of the third cluster from the formation of fruit to fruit ripening. According to results, while there were no differences between cropping systems in terms of fruit width, the highest fruit height was found in Control trial in the first measurement. In the second measurement while the highest fruit width was determined with 64.39 mm in Control, there were no differences between cropping systems. In the third measurement, the highest fruit width and height were obtained from Control with 68.47 mm and 55.52 mm, respectively. As a conclusion the trial, which crispy salad seedlings were planted with 30x30 cm spacing as two rows between tomato plants rows, was determined as a best intercropping application.Keywords: crispy salad, glasshouse, intercropping, tomato
Procedia PDF Downloads 3212961 Genomic and Evolutionary Diversity of Long Terminal Repeat (LTR) Retrotransposons in Date Palm (Phoenix dactylifera)
Authors: Faisal Nouroz, Mukaramin Mukaramin
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Of the transposable elements (TEs), the retrotransposons are the most copious elements identified from many sequenced genomes. They have played a major role in genome evolution, rearrangement, and expansions based on their copy and paste mode of proliferation. They are further divided into LTR and Non-LTR retrotransposons. The purpose of the current study was to identify the LTR REs in sequenced Phoenix dactylifera genome and to study their structural diversity. A total of 150 P. dactylifera BAC sequences with > 60kb sizes were randomly retrieved from National Center for Biotechnology Information (NCBI) database and screened for the presence of LTR retrotransposons. Seven bacterial artificial chromosomes (BAC) sequences showed full-length LTR Retrotransposons with 4 Copia and 3 Gypsy families having variable copy numbers in respective families. Reverse transcriptase (RT) domain was found as the most conserved domain among Copia and Gypsy superfamilies and was used to deduce evolutionary analysis. The amino acid residues among various RT sequences showed variability in their percentages indicating post divergence evolution. Amino acid Leucine was found in highest proportions followed by Lysine, while Methionine and Tryptophan were in lowest percentages. The phylogenetic analysis based on RT domains confirmed that although having most conserved RT regions, several evolutionary events occurred causing nucleotide polymorphisms and hence clustering of Gypsy and Copia superfamilies into their respective lineages. The study will be helpful in identification and annotation of these elements in other species and genera and their distribution patterns on chromosomes by fluorescent in situ hybridization techniques.Keywords: transposable elements, Phoenix dactylifera, retrotransposons, phylogenetic analysis
Procedia PDF Downloads 1282960 Distribution of Spotted Fever Group in Ixodid Ticks, Domestic Cattle and Buffalos of Faisalabad District, Punjab, Pakistan
Authors: Muhammad Sohail Sajid, Qurat-ul-Ain, Zafar Iqbal, Muhammad Nisar Khan, Asma Kausar, Adil Ejaz
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Rickettsiosis, caused by a Spotted Fever Group Rickettsiae (SFGR), is considered as an emerging infectious disease from public and veterinary perspective. The present study reports distribution of SFGR in the host (buffalo and cattle) and vector (ticks) population determined through gene specific amplification through PCR targeting outer membrane protein (ompA). Tick and blood samples were collected using standard protocols through convenient sampling from district Faisalabad. Ticks were dissected to extract salivary glands (SG). Blood and tick SG pools were subjected to DNA extraction and amplification of ompA using PCR. Overall prevalence of SFGR was reported as 21.5% and 33.6 % from blood and ticks, respectively. Hyalomma anatolicum was more prevalent tick associated with SFGR as compared to Rhipicephalus sp. Higher prevalence of SFGR was reported in cattle (25%) population as compared to that of buffalo (17.07%). On seasonal basis, high SFGR prevalence was recorded during spring season (48.1%, 26.32%, 17.76%) as compared to winter (27.9%, 21.43%, 15.38%) in vector and host (cattle and buffalo respectively) population. Sequencing analysis indicated that rickettsial endo-symbionts were associated with ticks of the study area. These results provided baseline information about the prevalence of SFGR in vector and host population.Keywords: Rickettsia, livestock, polymerase chain reaction, sequencing, ticks, vectors
Procedia PDF Downloads 2702959 Detection and Dissemination of Putative Virulence Genes from Brucella Species Isolated from Livestock in Eastern Cape Province of South Africa
Authors: Rudzani Manafe, Ezekiel Green
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Brucella, has many different virulence factors that act as a causative agent of brucellosis, depending on the environment and other factors, some factors may play a role more than others during infection and as a result, play a role in becoming a causative agent for pathogenesis. Brucella melitensis and Brucella abortus are considered to be pathogenic to humans. The genetic regularity of nine potential causes of virulence of two Brucella species in Eastern Cape livestock have been examined. A hundred and twenty isolates obtained from Molecular Pathogenesis and Molecular Epidemiology Research Group (MPMERG) were used for this study. All isolates were grown on Brucella agar medium. Nine primer pairs were used for the detection of virB2, virB5, vceC, btpA, btpB, prpA, betB, bpe275, and bspB virulence factors using Polymerase chain reaction (PCR). Approximately 100% was observed for genes BecC and BetB from B. arbotus. While the lowest gene observed was PrpA at 4.6% from B. arbotus. BetB was detected in 34.7%, while virB2 and prpA (0%) were not detected in B. melitensis. The results from this research suggest that most isolates of Brucella have virulence-related genes associated with disease pathogenesis. Finally, our findings showed that Brucella strains in the Eastern Cape Province are extremely virulent as virulence characteristics exist in most strains investigated.Keywords: putative virulence genes, brucella, polymerase chain reaction, milk
Procedia PDF Downloads 1392958 Water Quality, Safety and Drowning Prevention to Preschool Children in Sub-Saharan Africa
Authors: Amos King'ori Githu
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Water safety is crucial for all ages, but particularly for children. In the past decade, preschool institutions in Sub-Saharan Africa have seen the inclusion of swimming as one of the co-curricular activities. However, these countries face challenges in adopting frameworks, staffing, and resources to heighten water safety, quality, and drowning prevention, hence the focus of this research. It is worth noting that drowning is a leading cause of injury-related deaths among children. Universally, the highest drowning rates occur among children aged 1-4 years and 5-9 years. Preschool children even stand a higher risk of drowning as they are active, eager, and curious to explore their environment. If not supervised closely around or in water, these children can drown quickly in just a few inches of water. Thus, this empirical review focuses on the identification, assessment, and analysis of water safety efforts to curb drowning among children and assess the quality of water to mitigate contamination that may eventually pose infection risks to the children. In addition, it outlines the use of behavioral theories and evaluation frameworks to guide the above. Notably, a search on ten databases was adopted for crucial peer-reviewed articles, and five were selected in the eventual review. This research relied extensively on secondary data to curb water infections and drowning-inflicted deaths among children. It suffices to say that interventions must be supported that adopt an array of strategies, are guided by planning and theory as well as evaluation frameworks, and are vast in intervention design, evaluation, and delivery methodology. Finally, this approach will offer solid evidence that can be shared to guide future practices and policies in preschools on child safety and drowning prevention.Keywords: water quality and safety, drowning prevention, preschool children, sub-saharan Africa, supervision
Procedia PDF Downloads 602957 Creating Systems Change: Implementing Cross-Sector Initiatives within the Justice System to Support Ontarians with Mental Health and Addictions Needs
Authors: Tania Breton, Dorina Simeonov, Shauna MacEachern
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Ontario’s 10 Year Mental Health and Addictions Strategy has included the establishment of 18 Service Collaborative across the province; cross-sector tables in a specific region coming together to explore mental health and addiction system needs and adopting an intervention to address that need. The process is community led and supported by implementation teams from the Centre for Addiction and Mental Health (CAMH), using the framework of implementation science (IS) to enable evidence-based and sustained change. These justice initiatives are focused on the intersection of the justice system and the mental health and addiction systems. In this presentation, we will share the learnings, achievements and challenges of implementing innovative practices to the mental health and addictions needs of Ontarians within the justice system. Specifically, we will focus on the key points across the justice system - from early intervention and trauma-informed, culturally appropriate services to post-sentence support and community reintegration. Our approach to this work involves external implementation support from the CAMH team including coaching, knowledge exchange, evaluation, Aboriginal engagement and health equity expertise. Agencies supported the implementation of tools and processes which changed practice at the local level. These practices are being scaled up across Ontario and community agencies have come together in an unprecedented collaboration and there is a shared vision of the issues overlapping between the mental health, addictions and justice systems. Working with ministry partners has allowed space for innovation and created an environment where better approaches can be nurtured and spread.Keywords: implementation, innovation, early identification, mental health and addictions, prevention, systems
Procedia PDF Downloads 3632956 Effect of Satureja khuzestanica Jamzad Supplementation on Inflammatory and Antioxidant Indicators in Type 2 Diabetes Patients: A Randomized Controlled Clinical Trial Study
Authors: Maryam Bordbar, Yaser Mokhayeri, Sajjad Roosta, Fatemeh Ghasemi, Saeed Choobkar, Hamidreza Nikbakht, Ebrahim Falahi
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Objective: Diabetes mellitus type 2 is the most common metabolic disorder that is growing exponentially worldwide. Satureja Khuzestanica Jamzad is a native plant of Iran that grows widely in the south of Iran. Its antimicrobial, antioxidant, anti-inflammatory and pain-relieving effects have been documented in animal studies. The purpose of this study is to investigate the effect of consumption daily S. khuzestanica on inflammatory and antioxidant indicators in type 2 diabetic patients. Methods and Materials: In a double-blind, placebo-controlled clinical trial, 67 patients with type 2 diabetes were included and divided into two groups. One group received S. khuzestanica (capsule containing 500 mg) and the other group received placebo (500 mg talcum powder) once a day for 12 weeks. After the intervention, the inflammatory and antioxidant indicators of the two groups were compared. Results: In comparison to placebo groups, there was a significant difference in levels of total antioxidant capacity, superoxide dismutase, catalase, glutathione reductase, and glutathione peroxidase; these antioxidant indicators were higher in the intervention group (P<0.05). Moreover, a considerable decrease in weight, CRP and IL-6 levels were observed in patients in the S.Khuzestanica group. Conclusion: Our findings may provide novel complementary treatments without adverse effects for diabetes complications.Keywords: Satureja khuzestanica Jamzad, diabetes mellitus, antioxidant indicators, IL-6, C-reactive protein
Procedia PDF Downloads 702955 Perceptual and Ultrasound Articulatory Training Effects on English L2 Vowels Production by Italian Learners
Authors: I. Sonia d’Apolito, Bianca Sisinni, Mirko Grimaldi, Barbara Gili Fivela
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The American English contrast /ɑ-ʌ/ (cop-cup) is difficult to be produced by Italian learners since they realize L2-/ɑ-ʌ/ as L1-/ɔ-a/ respectively, due to differences in phonetic-phonological systems and also in grapheme-to-phoneme conversion rules. In this paper, we try to answer the following research questions: Can a short training improve the production of English /ɑ-ʌ/ by Italian learners? Is a perceptual training better than an articulatory (ultrasound - US) training? Thus, we compare a perceptual training with an US articulatory one to observe: 1) the effects of short trainings on L2-/ɑ-ʌ/ productions; 2) if the US articulatory training improves the pronunciation better than the perceptual training. In this pilot study, 9 Salento-Italian monolingual adults participated: 3 subjects performed a 1-hour perceptual training (ES-P); 3 subjects performed a 1-hour US training (ES-US); and 3 control subjects did not receive any training (CS). Verbal instructions about the phonetic properties of L2-/ɑ-ʌ/ and L1-/ɔ-a/ and their differences (representation on F1-F2 plane) were provided during both trainings. After these instructions, the ES-P group performed an identification training based on the High Variability Phonetic Training procedure, while the ES-US group performed the articulatory training, by means of US video of tongue gestures in L2-/ɑ-ʌ/ production and dynamic view of their own tongue movements and position using a probe under their chin. The acoustic data were analyzed and the first three formants were calculated. Independent t-tests were run to compare: 1) /ɑ-ʌ/ in pre- vs. post-test respectively; /ɑ-ʌ/ in pre- and post-test vs. L1-/a-ɔ/ respectively. Results show that in the pre-test all speakers realize L2-/ɑ-ʌ/ as L1-/ɔ-a/ respectively. Contrary to CS and ES-P groups, the ES-US group in the post-test differentiates the L2 vowels from those produced in the pre-test as well as from the L1 vowels, although only one ES-US subject produces both L2 vowels accurately. The articulatory training seems more effective than the perceptual one since it favors the production of vowels in the correct direction of L2 vowels and differently from the similar L1 vowels.Keywords: L2 vowel production, perceptual training, articulatory training, ultrasound
Procedia PDF Downloads 2562954 Chemical Composition and Biological Investigation of Halpophyllum tuberculatum A. Juss (Rutaceae) Essential Oils Growing in Libya
Authors: O. M. M. Sabry, Abeer M. El Sayed
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The essential oils from the aerial parts and flowers of Haplophyllum tuberculatum (Forsskal) Adr. Juss (Rutaceae) growing in Libya were obtained separately by hydro-distillation using a Clevenger-type apparatus. The essential oils yield were (0.4, 1.5w/w%) respectively based on the dry weight of the plant. The oils were analyzed by GC-MS. Twenty four constituents, amounting to 96.6%, were identified in the oil of the aerial parts. The predominant compounds were among the non oxygenated terpenoids (82.4%) as monoterpene hydrocarbons, represented by sabinen (26.4 %), δ-terpinen (26 %), β-phellandrene (10.4%) and 3-carene (3.86%). Zingiberine (0.4%) and β-sesquiphellandrene (0.12%) were the major sesquiterpene hydrocarbons identified. Oxygenated monoterpenes were represented by eucalyptol (5.5%) and piperitone (5.55%). Twenty six constituents, equivalent to 99.5%, were identified in the oil of the flowers. The dominance of monoterpene hydrocarbons in the flowers oil can be attributed to the high percentage of γ-terpinen (38.44%), β-phellandrene (10.0%), α- phellandrene (2.33%), 3,4-dimethyl-1,5-cyclooctadiene (6.67%), β-myrecene (6.04%), 3-carene (5.43%) and α-pinene (1.3%).While the oxygenated monoterpenes can be contributed to the trans-piperitol (4.67%) and piperitone (2.07%). Sesquiterpene hydrocarbons were not identified in the oil of the flower of H. tuberculatum. Variation in constitution between oils of Libyan H. tuberculatum and that obtained from other countries can be due to both environmental and genetic factors. The essential oils have demonstrated variable antimicrobial activities against certain micro-organisms. Also have revealed marked in vitro cytotoxicity against lung (H1299), liver (HEPG2) carcinoma cell line and variably effective as anti-inflammatory and antioxidant.Keywords: Halpophyllum tuberculatum, rutaceae, essential oil, antimicrobial, anti-inflammatory, antitumor, antioxidant, Libya
Procedia PDF Downloads 4782953 Biopsy Proven Polyoma (BK) Virus in Saudi Kidney Recipients – Prevalence, Clinicopathological Features and Clinico-Pathological Correlations
Authors: Sarah Hamdan Al-Jahdali, Khaled Alsaad, Abdullah Al-Sayyari
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Objectives: To study the prevalence, clinicopathological features, risk factors and outcome of biopsy proven polyoma (BK) virus infection among Saudi kidney transplant recipients and compare them to negative BK virus group. Methods: We retrospectively reviewed the charts of all the patients with biopsy-proven polyoma (BK) virus infection in King Abdulaziz Medical City in Riyadh between 2005 and 2011. The details of clinical presentation, the indication for kidney biopsy, the laboratory findings at presentation, the natural history of the disease, thepathological findings, the prognosis as well as the response to therapy were all recorded. Results: Kidney biopsy was performed in 37 cases of unexplained graft dysfunction. BK virus was found in 10 (27%). Out of those 10, 3 (30%) ended with graft failure. BK virus occurred in all patients who received ATG induction therapy 100% versus 59.3% in the non BK virus patients (p=0.06). Furthermore, the risk of BK virus was much less in those who received acyclovir as an anti-viral prophylaxis as compared to those who did not receive it (p=0.01). Also, patients with BK virus weighed much less (mean 46.7±20.6 Kgs) than those without BK virus at time of transplantation (mean 64.3±12.1). Graft survival was better among deceased donor kidneys compared to living ones (P=0.016) and with older age (P=0.005). Conclusion: Our findings suggest the involvement of ATG induction therapy, the lack of antiviral prophylaxis therapy and lower weight at transplant as significant risk factors for the development of BK virus infection.Keywords: BKVAN, BKV, kidney transpant, Saudi Arabia
Procedia PDF Downloads 2842952 A Visual Analytics Tool for the Structural Health Monitoring of an Aircraft Panel
Authors: F. M. Pisano, M. Ciminello
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Aerospace, mechanical, and civil engineering infrastructures can take advantages from damage detection and identification strategies in terms of maintenance cost reduction and operational life improvements, as well for safety scopes. The challenge is to detect so called “barely visible impact damage” (BVID), due to low/medium energy impacts, that can progressively compromise the structure integrity. The occurrence of any local change in material properties, that can degrade the structure performance, is to be monitored using so called Structural Health Monitoring (SHM) systems, in charge of comparing the structure states before and after damage occurs. SHM seeks for any "anomalous" response collected by means of sensor networks and then analyzed using appropriate algorithms. Independently of the specific analysis approach adopted for structural damage detection and localization, textual reports, tables and graphs describing possible outlier coordinates and damage severity are usually provided as artifacts to be elaborated for information extraction about the current health conditions of the structure under investigation. Visual Analytics can support the processing of monitored measurements offering data navigation and exploration tools leveraging the native human capabilities of understanding images faster than texts and tables. Herein, a SHM system enrichment by integration of a Visual Analytics component is investigated. Analytical dashboards have been created by combining worksheets, so that a useful Visual Analytics tool is provided to structural analysts for exploring the structure health conditions examined by a Principal Component Analysis based algorithm.Keywords: interactive dashboards, optical fibers, structural health monitoring, visual analytics
Procedia PDF Downloads 1242951 Trehalose-Based Nanocarriers for Alleviation of Inflammation in Colitis
Authors: Wessam H. Abd-Elsalam, Mona M. Saber, Samar M. Abouelatta
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Non-steroidal anti-inflammatory drugs (NSAIDs) are considered a double edged sword in inflammatory bowel diseases (IBDs). Some studies reported their advantageous effect in decreasing inflammation, and other studies reported that their use is associated with colitis aggravation. This study aimed to use specifically formulated trehalose-based nano-carriers that targets the colon in an attempt to alleviate inflammation caused by NSAIDs. L-α-phosphatidylcholine (PL), trehalose, and transcutol were used to prepare the trehalosomes (THs), which were also loaded with Tenoxicam(TXM) as a model NSAID. To optimize the formulation variables, a full 23 factorial design, using Design-Expert® software, was performed. The optimized formulation composed of trehalose: PL at a weight ratio of 1:1, 377.72 mg transcutol, and sonicated for 4 min, possessed a spherical shape with a size of 268.61 nm and EE% of 97.83% and released 70.22% of its drug content over 24 h. The superior protective action of TXM loaded THs compared to TXM suspension and drug-free THs was shown by the inhibition of the inflammatory biomarkers, namely; IL-1ß, IL-6, and TNF-alpha levels, as well as oxidative stress markers, measured as GSH and MDA. Improved histopathology of the colonic tissue in male New Zealand rabbits also confirmed the superiority of the TXM loaded THs compared to the unformulated drug or the drug free nano-carriers. Our findings highlight the prosperous role of THs in colon targeting and its anti-inflammatory characteristics in guarding against possible NSAIDs-driven exacerbation of colitis.Keywords: inflammatory bowel disease, trehalose, trehalosomes, colon targeting
Procedia PDF Downloads 1382950 Improving Access to Palliative Care for Heart Failure Patients in England Using a Health Systems Approach
Authors: Alex Hughes
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Patients with advanced heart failure develop specific palliative care needs due to the progressive symptom burden and unpredictable disease trajectory. NICE guidance advises that palliative care should be provided to patients with both cancer and non-cancer conditions as and when required. However, there is some way to go before this guidance is consistently and effectively implemented nationwide in conditions such as heart failure. The Ambitions for Palliative and End of Life Care: A national framework for local action in England provides a set of foundations and ambitions which outline a vision for what high-quality palliative and end-of-life care look like in England. This poster aims to critically consider how to improve access to palliative care for heart failure patients in England by analysing the foundations taken from this framework to generate specific recommendations using Soft Systems Methodology (SSM). The eight foundations analysed are: ‘Personalised care planning’, ‘Shared records’, ‘Evidence and information’, ‘Involving, supporting and caring for those important to the dying Person’, ‘Education and training’, ‘24/7 access’, ‘Co-design’ and ‘Leadership.’ A number of specific recommendations have been generated which highlight a need to close the evidence-policy gap and implement policy with sufficient evidence. These recommendations, alongside the creation of an evidence-based national strategy for palliative care and heart failure, should improve access to palliative care for heart failure patients in England. Once implemented, it will be necessary to evaluate the effect of these proposals to understand if access to palliative care for heart failure patients actually improves.Keywords: access, health systems, heart failure, palliative care
Procedia PDF Downloads 128