Search results for: Tabriz wastewater treatment plant
4269 Mayan Culture and Attitudes towards Sustainability
Authors: Sarah Ryu
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Agricultural methods and ecological approaches employed by the pre-colonial Mayans may provide valuable insights into forest management and viable alternatives for resource sustainability in the face of major deforestation across Central and South America.Using a combination of observation data collected from the modern indigenous inhabitants near Mixco in Guatemala and historical data, this study was able to create a holistic picture of how the Maya maintained their ecosystems. Surveys and observations were conducted in the field, over a period of twelve weeks across two years. Geographic and archaeological data for this area was provided by Guatemalan organizations such as the Universidad de San Carlos de Guatemala. Observations of current indigenous populations around Mixco showed that they adhered to traditional Mayan methods of agriculture, such as terrace construction and arboriculture. Rather than planting one cash crop as was done by the Spanish, indigenous peoples practice agroforestry, cultivating forests that would provide trees for construction material, wild plant foods, habitat for game, and medicinal herbs. The emphasis on biodiversity prevented deforestation and created a sustainable balance between human consumption and forest regrowth. Historical data provided by MayaSim showed that the Mayans successfully maintained their ecosystems from about 800BCE to 700CE. When the Mayans practiced natural resource conservation and cultivated a harmonious relationship with the forest around them, they were able to thrive and prosper alongside nature. Having lasted over a thousand years, the Mayan empire provides a valuable lesson in sustainability and human attitudes towards the environment.Keywords: biodiversity, forestry, mayan, sustainability
Procedia PDF Downloads 1784268 Green Synthesis of Nicotine Analogues via Cycloaddition Reactions
Authors: Agnieszka Fryźlewicz, Jowita Kras, Mikołaj Sadowski, Agnieszka Łapczuk-Krygier, Agnieszka Kącka-Zych Radomir Jasiński
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Nicotines are a group of compounds containing conjugated pyridine and pyrrolidine molecular segments. They are widely applied in medicine, pharmacy, and agriculture. Namely as researched treatment of Alzheimer, depression, Parkinson's, Tourette syndrome, general nervous and mental disorders. Furthermore, nicotine itself is used as a stimulant, animal repellent and was widely applied as an insecticide. In our work, we obtained nicotine analogues with possible applications in agriculture. The synthesis employed [3+2] cycloaddition (32CA) reactions, occurring between pirydyl-functionalised nitrones and conjugated nitroalkenes, that allowed us to fully regio- and stereoselectively obtain product. Moreover, cycloaddition reaction realizes rapidly in mild conditions with the full atomic economy, thus fitting into “green chemistry” trends.Keywords: nicotine, isoxazolidine, 1-3-dipolar cycloaddition, green chemistry, biological and pharmacological activity
Procedia PDF Downloads 944267 Consumption Insurance against the Chronic Illness: Evidence from Thailand
Authors: Yuthapoom Thanakijborisut
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This paper studies consumption insurance against the chronic illness in Thailand. The study estimates the impact of household consumption in the chronic illness on consumption growth. Chronic illness is the health care costs of a person or a household’s decision in treatment for the long term; the causes and effects of the household’s ability for smooth consumption. The chronic illnesses are measured in health status when at least one member within the household faces the chronic illness. The data used is from the Household Social Economic Panel Survey conducted during 2007 and 2012. The survey collected data from approximately 6,000 households from every province, both inside and outside municipal areas in Thailand. The study estimates the change in household consumption by using an ordinary least squares (OLS) regression model. The result shows that the members within the household facing the chronic illness would reduce the consumption by around 4%. This case indicates that consumption insurance in Thailand is quite sufficient against chronic illness.Keywords: consumption insurance, chronic illness, health care, Thailand
Procedia PDF Downloads 2424266 Remote Patient Monitoring for Covid-19
Authors: Launcelot McGrath
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The Coronavirus disease 2019 (COVID-19) has spread rapidly around the world, resulting in high mortality rates and very large numbers of people requiring medical treatment in ICU. Management of patient hospitalisation is a critical aspect to control this disease and reduce chaos in the healthcare systems. Remote monitoring provides a solution to protect vulnerable and elderly high-risk patients. Continuous remote monitoring of oxygen saturation, respiratory rate, heart rate, and temperature, etc., provides medical systems with up-to-the-minute information about their patients' statuses. Remote monitoring also limits the spread of infection by reducing hospital overcrowding. This paper examines the potential of remote monitoring for Covid-19 to assist in the rapid identification of patients at risk, facilitate the detection of patient deterioration, and enable early interventions.Keywords: remote monitoring, patient care, oxygen saturation, Covid-19, hospital management
Procedia PDF Downloads 1124265 The Relationship between Wasting and Stunting in Young Children: A Systematic Review
Authors: Susan Thurstans, Natalie Sessions, Carmel Dolan, Kate Sadler, Bernardette Cichon, Shelia Isanaka, Dominique Roberfroid, Heather Stobagh, Patrick Webb, Tanya Khara
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For many years, wasting and stunting have been viewed as separate conditions without clear evidence supporting this distinction. In 2014, the Emergency Nutrition Network (ENN) examined the relationship between wasting and stunting and published a report highlighting the evidence for linkages between the two forms of undernutrition. This systematic review aimed to update the evidence generated since this 2014 report to better understand the implications for improving child nutrition, health and survival. Following PRISMA guidelines, this review was conducted using search terms to describe the relationship between wasting and stunting. Studies related to children under five from low- and middle-income countries that assessed both ponderal growth/wasting and linear growth/stunting, as well as the association between the two, were included. Risk of bias was assessed in all included studies using SIGN checklists. 45 studies met the inclusion criteria- 39 peer reviewed studies, 1 manual chapter, 3 pre-print publications and 2 published reports. The review found that there is a strong association between the two conditions whereby episodes of wasting contribute to stunting and, to a lesser extent, stunting leads to wasting. Possible interconnected physiological processes and common risk factors drive an accumulation of vulnerabilities. Peak incidence of both wasting and stunting was found to be between birth and three months. A significant proportion of children experience concurrent wasting and stunting- Country level data suggests that up to 8% of children under 5 may be both wasted and stunted at the same time, global estimates translate to around 16 million children. Children with concurrent wasting and stunting have an elevated risk of mortality when compared to children with one deficit alone. These children should therefore be considered a high-risk group in the targeting of treatment. Wasting, stunting and concurrent wasting and stunting appear to be more prevalent in boys than girls and it appears that concurrent wasting and stunting peaks between 12- 30 months of age with younger children being the most affected. Seasonal patterns in prevalence of both wasting and stunting are seen in longitudinal and cross sectional data and in particular season of birth has been shown to have an impact on a child’s subsequent experience of wasting and stunting. Evidence suggests that the use of mid-upper-arm circumference combined with weight-for-age Z-score might effectively identify children most at risk of near-term mortality, including those concurrently wasted and stunted. Wasting and stunting frequently occur in the same child, either simultaneously or at different moments through their life course. Evidence suggests there is a process of accumulation of nutritional deficits and therefore risk over the life course of a child demonstrates the need for a more integrated approach to prevention and treatment strategies to interrupt this process. To achieve this, undernutrition policies, programmes, financing and research must become more unified.Keywords: Concurrent wasting and stunting, Review, Risk factors, Undernutrition
Procedia PDF Downloads 1304264 Screening of Nickel-Tolerant Genotype of Mung Bean (Vigna radiata) Based on Photosynthesis and Antioxidant System
Authors: Mohammad Yusuf, Qazi Fariduddin
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The main aim of this study was to explore the different cultivars of Vigna radiata on basis of photosynthesis, antioxidants and proline to assess Ni-sensitive and Ni-tolerant cultivar. Seeds of five different cultivars were sown in soil amended with different levels of Ni (0, 50, 100, or 150 mg kg 1). At 30 d stage, plants were harvested to assess the various parameters. The Ni treatment diminished growth, leaf water potential, chlorophyll content and net photosynthesis along with nitrate reductase and carbonic anhydrase activities in the concentration dependent manner whereas, it enhanced proline content and various antioxidant enzymes. The varieties T-44 found least affected, whereas PDM-139 experienced maximum damage at 150 mg kg-1 of Ni. Moreover, T-44 possessed maximum activity of antioxidant enzymes and proline content at all the levels of metal whereas PDM-139 possessed minimum values. Therefore, T-44 and PDM-139 were established as the most resistant and sensitive varieties, respectively.Keywords: Vigna radiata, antioxidants, nickel, photosynthesis, proline
Procedia PDF Downloads 2264263 Effective Microorganisms as a Sustainable Environment Product and Their Application: A Study in Pakistan
Authors: Jaffar Hussain, Farman Ali Shah
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As we know that Pakistan is the developing country so it adopts new technologies for progress. In last three decays, some new technologies were introduced in the world in which Effective Microorganism was one of them. Microorganisms are one of the most power full living forces on earth. Originally, EM was developed as an odor control, farm, and animal health, human health many industrial treatments. Effective Microorganism is an organic fertilizer that contains a mixture of co-existing valuable microorganism composed from the environment. There are vast application of the EM in the world in which the researchers are explained in literature .In Pakistan work on EM technologies are under process, researcher are doing work to make them most valuable. At that time the application of EM are in agriculture, water treatment, to increase Cement strength, improving saline soil etc. Effective microorganisms are environmentally friendly , not-naturally organized, not chemically synthesized, not dangerous and not pathogenic.Keywords: developing country, technologies, effective microorganism, researchers, Pakistan, agriculture
Procedia PDF Downloads 4874262 Outcome Evaluation of a Blended-Learning Mental Health Training Course in South African Public Health Facilities
Authors: F. Slaven, M. Uys, Y. Erasmus
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The South African National Mental Health Education Programme (SANMHEP) was a National Department of Health (NDoH) initiative to strengthen mental health services in South Africa in collaboration with the Foundation for Professional Development (FPD), SANOFI and the various provincial departments of health. The programme was implemented against the backdrop of a number of challenges in the management of mental health in the country related to staff shortages and infrastructure, the intersection of mental health with the growing burden of non-communicable diseases and various forms of violence, and challenges around substance abuse and its relationship with mental health. The Mental Health Care Act (No. 17 of 2002) prescribes that mental health should be integrated into general health services including primary, secondary and tertiary levels to improve access to services and reduce stigma associated with mental illness. In order for the provisions of the Act to become a reality, and for the journey of mental health patients through the system to improve, sufficient and skilled health care providers are critical. SANMHEP specifically targeted Medical Doctors and Professional Nurses working within the facilities that are listed to conduct 72-hour assessments, as well as District Hospitals. The aim of the programme was to improve the clinical diagnosis and management of mental disorders/conditions and the understanding of and compliance with the Mental Health Care Act and related Regulations and Guidelines in the care, treatment and rehabilitation of mental health care users. The course used a blended-learning approach and trained 1 120 health care providers through 36 workshops between February and November 2019. Of those trained, 689 (61.52%) were Professional Nurses, 337 (30.09%) were Medical Doctors, and 91 (8.13%) indicated their occupation as ‘other’ (of these more than half were psychologists). The pre- and post-evaluation of the face-to-face training sessions indicated a marked improvement in knowledge and confidence level scores (both clinical and legislative) in the care, treatment and rehabilitation of mental health care users by participants in all the training sessions. There was a marked improvement in the knowledge and confidence of participants in performing certain mental health activities (on average the ratings increased by 2.72; or 27%) and in managing certain mental health conditions (on average the ratings increased by 2.55; or 25%). The course also required that participants obtain 70% or higher in their formal assessments as part of the online component. The 337 participants who completed and passed the course scored 90% on average. This illustrates that when participants attempted and completed the course, they did very well. To further assess the effect of the course on the knowledge and behaviour of the trained mental health care practitioners a mixed-method outcome evaluation is currently underway consisting of a survey with participants three months after completion, follow-up interviews with participants, and key informant interviews with department of health officials and course facilitators. This will enable a more detailed assessment of the impact of the training on participants' perceived ability to manage and treat mental health patients.Keywords: mental health, public health facilities, South Africa, training
Procedia PDF Downloads 1234261 Isolation and Characterization of Actinophages Infecting Streptomyces scabies in Egypt
Authors: D. Zahran, M. AlKhazindar, M. Khalil, E. T. A. Sayed
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Streptomyces scabies is a pathogenic actinomycete that infects potato crop causing severe production losses. Actinophages affect the composition and diversity of the bacterial population, thereby, can be used as a biological control. Samples of actinomycetes and phages were collected from different cultivated soils including farms of Faculty of Science, Faculty of Agriculture and different locations in Giza, Egypt. Actinomycetes were identified by using biochemical, morphological tests and molecular studies using 16S rRNA sequencing. Two specific phages (E1 and E2) against Streptomyces scabies and other hosts were isolated. Phages were identified using dilution end point (DEP), longevity in vitro (LIV), thermal inactivation point (TIP), host range and electron microscopy. PhageE1 was characterized by 10-8 (DEP),180 days(LIV), 95°C(TIP), narrow host range and electron microscopy showed ahead (59.9 nm) and neck (10.4nm). On the other hand phageE2 had 10-20 (DEP),180 days(LIV), 90°C(TIP), and the size of head was (67.2 nm) and tail (114nm). Antiviral activity was also studied using different chemicals (NaCL, KCL, CaCL2, BaCL2, CoCL2, AgNO3, ALCL3and HgCL2) with different concentrations and different plant extracts with different concentrations (star anise, tea, tillia, peppermint, ginger, cumin, chamomile, turmeric cinnamon, marjoram and black cumin). Both Phage E1and phage E2 were vulnerable to (cumin, ginger, chamomile, guavas leaves and star anise) but resistant to (Tillie, marjoram, fennelflower seeds, peppermint, and cinnamon).Keywords: potato scab, actinophages, biological control, electron microscopy, TIP, DEP, LIV, antiviral activity
Procedia PDF Downloads 4344260 Implant Guided Surgery and Immediate Loading
Authors: Omid Tavakol, Mahnaz Gholami
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Introduction : In this oral presentation the main goal is discussing immediate loading in dental implants , from treatment planning and surgical guide designing to delivery , follow up and occlusal consideration . Methods and materials : first of all systematic reviews about immediate loading will be considered . besides , a comparison will be made between immediate loading and conventional loading in terms of success rate and complications . After that different methods , prosthetic options and materials best used in immediate loading will be explained. Particularly multi unit abutments and their mechanism of function will be explained .Digital impressions and designing the temporaries is the next topic we are to explicate .Next issue is the differences between single unit , multiple unit and full arch implantation in immediate loading .Following we are going to describe methods for tissue engineering and papilla formation after extraction . Last slides are about a full mouth rehabilitation via immediate loading technique from surgical designing to follow up .At the end we would talk about potential complications , how to prevent from occurrence and what to do if we face up with .Keywords: guided surgery, digital implantology, immediate loading, digital dentistry
Procedia PDF Downloads 514259 Economic Determinants of Maize Production in 2013-2014 in the Individual Farm
Authors: Ewa Krasnodębska
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The article presents the costs and income maize cultivation for grain four selected varieties with different numbers of FAO in 2013-2014. Results of the experiments are derived from a field experiment conducted in indywidulnym farm specializing in the production plant located in the eastern part of Mazowieckie voivodship. The experiment examined the profitability of four varieties of maize cultivation: medium early: P8400 (FAO 240) and P8589 (FAO 250), and an average of late: PR38N86 (FAO 270) and P9027 (FAO 260). In order to evaluate the profitability of grain maize production was calculated income from 1 ha of crops in zł and profitability index taking into account the direct payments up to 1 ha. Analyzing the value of crop production can be concluded that the value of the total production of each variety was very much varied and very much depend on the sales price and yield of maize obtained from 1 ha of cultivation. The largest average seed yield of two years at a moisture content of 15% was achieved in a variety PR38N86, which amounted to 12.1 t / ha and the lowest in the variety P8400 - 9.8 t / ha. Income from 1 ha of crops including EU subsidies ranged from 4916.4 zł / ha in 2013 for variety and only 528.7 PR38N86 zł / ha for a variety of P8400 in 2014. Profitability index reached the highest average late PR38N86 variety of FAO 290 over the entire two-year period under study, and the lowest rate of profitability achieved P8400 medium early variety of FAO 240. The profitability of production ranged from 8964.0 zł / ha in 2013 for a variety of PR38N86 to 5616.0 zł / ha for a variety of P8400 in 2014. Cultivation of maize for grain production is attractive and does not require large amounts of work, but its economic rationale is based primarily on the resulting yield and the price of buying.Keywords: corn, grain, income, profitability
Procedia PDF Downloads 3964258 Anaerobic Co-Digestion of Duckweed (Lemna gibba) and Waste Activated Sludge in Batch Mode
Authors: Rubia Gaur, Surindra Suthar
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The present study investigates the anaerobic co-digestion of duckweed (Lemna gibba) and waste activated sludge (WAS) of different proportions with acclimatized anaerobic granular sludge (AAGS) as inoculum in mesophilic conditions. Batch experiments were performed in 500 mL capacity reagent bottles at 300C temperature. Varied combinations of pre-treated duckweed biomass with constant volume of anaerobic inoculum (AAGS - 100 mL) and waste activated sludge (WAS - 22.5 mL) were devised into five batch tests. The highest methane generation was observed with batch study, T4. The Gompertz model fits well on the experimental data of the batch study, T4. The values of correlation coefficient were achieved relatively higher (R2 ≥ 0.99). The co-digestion without pre-treatment of both duckweed and WAS shows poor generation of methane gas.Keywords: aquatic weed, biogas, biomass, Gompertz equation, waste activated sludge
Procedia PDF Downloads 2874257 MicroRNA 200c-3p Regulates Autophagy Mediated Upregulation of Endoplasmic Reticulum Stress in PC-3 Cells
Authors: Eun Jung Sohn, Hwan Tae Park
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Autophagy is a cellular response to stress or environment on cell survival. Here, we investigated the role of ectopic expression of miR 200c-3p in autophagy. Ectopic expression of miR 200c-3p increased the expression of IRE1alpha, ATF6 and CHOP by western blot and RT-qPCR. Furthermore, the level of microRNA 200c-3p was enhanced by treatment of TG or overexpression of GRP 78. Also, ectopic expression of miR200c-3p increased the LC3 II expression by western blot and RT-qPCR. Also, we found that western blot assay showed that miR200c-3p inhibitor was blocked the starvation–induced LC3II levels. Furthermore, starvation stress increased the level of miR200c-3p in different kinetics. Ectopic expression of miR200c-3p attenuated LC3II expression in IRE1 siRNA transfected PC3 cells. Here, we first demonstrate that miR200c-3p regulates autophagy via ER stress pathway.Keywords: Autophagy, ER stress, LC3II, miR200c-3p
Procedia PDF Downloads 2884256 MXene Mediated Layered 2D-3D-2D g-C3N4@WO3@Ti3C2 Multijunctional Heterostructure with Enhanced Photoelectrochemical and Photocatalytic Properties
Authors: Lekgowa Collen Makola, Cecil Naphtaly Moro Ouma, Sharon Moeno, Langelihle Dlamini
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In recent years, advancement in the field of nanotechnology has evolved new strategies to address energy and environmental issues. Amongst the developing technologies, visible-light-driven photocatalysis is regarded as a sustainable approach for energy production and environmental detoxifications, where transition metal oxides (TMOs) and metal-free carbon-based semiconductors such as graphitic carbon nitride (CN) evidenced notable potential in this matter. Herein, g-C₃N₄@WO₃@Ti₃C₂Tx three-component multijunction photocatalyst was fabricated via facile ultrasonic-assisted self-assembly, followed by calcination to facilitate extensive integrations of the materials. A series of different Ti₃C₂ wt% loading in the g-C₃N4@WO₃@Ti₃C₂Tx were prepared and represented as 1-CWT, 3-CWT, 5-CWT, and 7-CWT corresponding to 1, 3, 5, and 7wt%, respectively. Systematic characterization using spectroscopic and microscopic techniques were employed to validate the successful preparation of the photocatalysts. Enhanced optoelectronic and photoelectrochemical properties were observed for the WO₃@Ti₃C2@g-C₃N4 heterostructure with respect to the individual materials. Photoluminescence spectra and Nyquist plots show restrained recombination rates and improved photocarrier conductivities, respectively, and this was credited to the synergistic coupling effect and the presence of highly conductive Ti₃C2 MXene. The strong interfacial contact surfaces upon the formation of the composite were confirmed using XPS. Multiple charge transfer mechanisms were proposed for the WO3@Ti3C₂@g-C3N4, which couples Z-scheme and Schottky-junction mediated with Ti3C2 MXene. Bode phase plots show improved charge carrier life-times upon the formation of the multijunctional photocatalyst. Moreover, transient photocurrent density of 7-CWT is 40 and seven (7) times higher compared to that of g-C₃N4 and WO3, correspondingly. Unlike in the traditional Z-Scheme, the formed ternary heterostructure possesses interfaces through the metallic 2D Ti₃C₂ MXene, which provided charge transfer channels for efficient photocarrier transfers with carrier concentrations (ND) of 17.49×1021 cm-3 and 4.86% photo-to-chemical conversion efficiency. The as-prepared ternary g-C₃N₄@WO₃@Ti₃C₂Tx exhibited excellent photoelectrochemical properties with reserved redox band potential potencies to facilitate efficient photo-oxidation and -reduction reactions. The fabricated multijunction photocatalyst exhibits potentials to be used in an extensive range of photocatalytic process vis., production of valuable hydrocarbons from CO₂, production of H₂, and degradation of a plethora of pollutants from wastewater.Keywords: photocatalysis, Z-scheme, multijunction heterostructure, Ti₃C₂ MXene, g-C₃N₄
Procedia PDF Downloads 1304255 Prevention of Preterm Birth and Management of Uterine Contractions with Traditional Korean Medicine: Integrative Approach
Authors: Eun-Seop Kim, Eun-Ha Jang, Rana R. Kim, Sae-Byul Jang
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Objective: Preterm labor is the most common antecedent of preterm birth(PTB), which is characterized by regular uterine contraction before 37 weeks of pregnancy and cervical change. In acute preterm labor, tocolytics are administered as the first-line medication to suppress uterine contractions but rarely delay pregnancy to 37 weeks of gestation. On the other hand, according to the Korean Traditional Medicine, PTB is caused by the deficiency of Qi and unnecessary energy in the body of the mother. The aim of this study was to demonstrate the benefit of Traditional Korean Medicine as an adjuvant therapy in management of early uterine contractions and the prevention of PTB. Methods: It is a case report of a 38-year-old woman (0-0-6-0) hospitalized for irregular uterine contractions and cervical change at 33+3/7 weeks of gestation. Past history includes chemical pregnancies achieved by Artificial Rroductive Technology(ART), one stillbirth (at 7 weeks) and a laparoscopic surgery for endometriosis. After seven trials of IVF and articificial insemination, she had succeeded in conception via in-vitro fertilization (IVF) with help of Traditional Korean Medicine (TKM) treatments. Due to irregular uterine contractions and cervical changes, 2 TKM were prescribed: Gami-Dangguisan, and Antae-eum, known to nourish blood and clear away heat. 120ml of Gami-Dangguisan was given twice a day monring and evening along with same amount of Antae-eum once a day from 31 August 2013 to 28 November 2013. Tocolytics (Ritodrine) was administered as a first aid for maintenance of pregnancy. Information regarding progress until the delivery was collected during the patient’s visit. Results: On admission, the cervix of 15mm in length and cervical os with 0.5cm-dilated were observed via ultrasonography. 50% cervical effacement was also detected in physical examination. Tocolysis had been temporarily maintained. As a supportive therapy, TKM herbal preparations(gami-dangguisan and Antae-eum) were concomitantly given. As of 34+2/7 weeks of gestation, however intermittent uterine contractions appeared (5-12min) on cardiotocography and vaginal bleeding was also smeared at 34+3/7 weeks. However, enhanced tocolytics and continuous administration of herbal medicine sustained the pregnancy to term. At 37+2/7 weeks, no sign of labor with restored cervical length was confirmed. The woman gave a term birth to a healthy infant via vaginal delivery at 39+3/7 gestational weeks. Conclusions: This is the first successful case report about a preter labor patient administered with conventional tocolytic agents as well as TKM herbal decoctions, delaying delivery to term. This case deserves attention considering it is rare to maintain gestation to term only with tocolytic intervention. Our report implies the potential of herbal medicine as an adjuvant therapy for preterm labor treatment. Further studies are needed to assess the safety and efficacy of TKM herbal medicine as a therapeutic alternative for curing preterm birth.Keywords: preterm labor, traditional Korean medicine, herbal medicine, integrative treatment, complementary and alternative medicine
Procedia PDF Downloads 3784254 Designing Web Application to Simulate Agricultural Management for Smart Farmer: Land Development Department’s Integrated Management Farm
Authors: Panasbodee Thachaopas, Duangdorm Gamnerdsap, Waraporn Inthip, Arissara Pungpa
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LDD’s IM Farm or Land Development Department’s Integrated Management Farm is the agricultural simulation application developed by Land Development Department relies on actual data in simulation game to grow 12 cash crops which are rice, corn, cassava, sugarcane, soybean, rubber tree, oil palm, pineapple, longan, rambutan, durian, and mangosteen. Launching in simulation game, players could select preferable areas for cropping from base map or Orthophoto map scale 1:4,000. Farm management is simulated from field preparation to harvesting. The system uses soil group, and present land use database to facilitate player to know whether what kind of crop is suitable to grow in each soil groups and integrate LDD’s data with other agencies which are soil types, soil properties, soil problems, climate, cultivation cost, fertilizer use, fertilizer price, socio-economic data, plant diseases, weed, pest, interest rate for taking on loan from Bank for Agriculture and Agricultural Cooperatives (BAAC), labor cost, market prices. These mentioned data affect the cost and yield differently to each crop. After completing, the player will know the yield, income and expense, profit/loss. The player could change to other crops that are more suitable to soil groups for optimal yields and profits.Keywords: agricultural simulation, smart farmer, web application, factors of agricultural production
Procedia PDF Downloads 2014253 Optimization of Municipal Solid Waste Management in Peshawar Using Mathematical Modelling and GIS with Focus on Incineration
Authors: Usman Jilani, Ibad Khurram, Irshad Hussain
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Environmentally sustainable waste management is a challenging task as it involves multiple and diverse economic, environmental, technical and regulatory issues. Municipal Solid Waste Management (MSWM) is more challenging in developing countries like Pakistan due to lack of awareness, technology and human resources, insufficient funding, inefficient collection and transport mechanism resulting in the lack of a comprehensive waste management system. This work presents an overview of current MSWM practices in Peshawar, the provincial capital of Khyber Pakhtunkhwa, Pakistan and proposes a better and sustainable integrated solid waste management system with incineration (Waste to Energy) option. The diverted waste would otherwise generate revenue; minimize land fill requirement and negative impact on the environment. The proposed optimized solution utilizing scientific techniques (like mathematical modeling, optimization algorithms and GIS) as decision support tools enhances the technical & institutional efficiency leading towards a more sustainable waste management system through incorporating: - Improved collection mechanisms through optimized transportation / routing and, - Resource recovery through incineration and selection of most feasible sites for transfer stations, landfills and incineration plant. These proposed methods shift the linear waste management system towards a cyclic system and can also be used as a decision support tool by the WSSP (Water and Sanitation Services Peshawar), agency responsible for the MSWM in Peshawar.Keywords: municipal solid waste management, incineration, mathematical modeling, optimization, GIS, Peshawar
Procedia PDF Downloads 3794252 Determination of in vitro Antioxidative Activity of Aster yomena (Kitam.) Honda
Authors: Hyun Young Kim, Min Jung Kim, Ji Hyun Kim, Sanghyun Lee, Eun Ju Cho
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Oxidative stress that results from overproduction of free radicals can lead to pathogenesis of human diseases including cancer, neurodegenerative diseases, and cardiovascular disease. Aster yomena (Kitam.) Honda (A. yomena) belonging to Compositae family is a perennial plant, and it has anti-inflammatory, anti-asthmatic and anti-obesity effects. In this study, we investigated the antioxidative effect of A. yomena by measuring 2, 2-diphenyl-1-picrylhydrazyl (DPPH), hydroxyl radical (˙OH) and superoxide radical (O₂⁻) scavenging activities in vitro. A. yomena was extracted with ethanol and then partitioned with n-hexane, methylene chloride (CH₂Cl₂), ethyl acetate (EtOAc) and n-butanol (n-BuOH). In DPPH radical scavenging assay, the concentration of A. yomena from 10 to 100μg/mL dose-dependently raised the inhibition of DPPH oxidation. Especially, EtOAc fraction of A. yomena showed the highest DPPH radical scavenging activity among other fractions. The ˙OH radical scavenging activities of the extract and four fractions of A. yomena were increased by over 80% at a concentration of 50μg/mL. Especially, the IC50 value of EtOAc fraction was 0.03 μg/mL that is the lowest value compared with the values of other fractions. In addition, we found that the EtOAc fraction of A. yomena was showed to be better at O₂⁻ radical scavenging than other fractions. Taken together these results, we suggested that A. yomena, especially EtOAc fraction, can be used as a natural antioxidant against free radicals. Acknowledgements: This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology (NRF-2016R1D1A1B03931593).Keywords: Aster yomena (Kitam.) Honda (A. yomena), free radicals, antioxidant, EtOAc fraction
Procedia PDF Downloads 2944251 Experimental Study on Two-Step Pyrolysis of Automotive Shredder Residue
Authors: Letizia Marchetti, Federica Annunzi, Federico Fiorini, Cristiano Nicolella
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Automotive shredder residue (ASR) is a mixture of waste that makes up 20-25% of end-of-life vehicles. For many years, ASR was commonly disposed of in landfills or incinerated, causing serious environmental problems. Nowadays, thermochemical treatments are a promising alternative, although the heterogeneity of ASR still poses some challenges. One of the emerging thermochemical treatments for ASR is pyrolysis, which promotes the decomposition of long polymeric chains by providing heat in the absence of an oxidizing agent. In this way, pyrolysis promotes the conversion of ASR into solid, liquid, and gaseous phases. This work aims to improve the performance of a two-step pyrolysis process. After the characterization of the analysed ASR, the focus is on determining the effects of residence time on product yields and gas composition. A batch experimental setup that reproduces the entire process was used. The setup consists of three sections: the pyrolysis section (made of two reactors), the separation section, and the analysis section. Two different residence times were investigated to find suitable conditions for the first sample of ASR. These first tests showed that the products obtained were more sensitive to residence time in the second reactor. Indeed, slightly increasing residence time in the second reactor managed to raise the yield of gas and carbon residue and decrease the yield of liquid fraction. Then, to test the versatility of the setup, the same conditions were applied to a different sample of ASR coming from a different chemical plant. The comparison between the two ASR samples shows that similar product yields and compositions are obtained using the same setup.Keywords: automotive shredder residue, experimental tests, heterogeneity, product yields, two-step pyrolysis
Procedia PDF Downloads 1324250 Treatment and Diagnostic Imaging Methods of Fetal Heart Function in Radiology
Authors: Mahdi Farajzadeh Ajirlou
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Prior evidence of normal cardiac anatomy is desirable to relieve the anxiety of cases with a family history of congenital heart disease or to offer the option of early gestation termination or close follow-up should a cardiac anomaly be proved. Fetal heart discovery plays an important part in the opinion of the fetus, and it can reflect the fetal heart function of the fetus, which is regulated by the central nervous system. Acquisition of ventricular volume and inflow data would be useful to quantify more valve regurgitation and ventricular function to determine the degree of cardiovascular concession in fetal conditions at threat for hydrops fetalis. This study discusses imaging the fetal heart with transvaginal ultrasound, Doppler ultrasound, three-dimensional ultrasound (3DUS) and four-dimensional (4D) ultrasound, spatiotemporal image correlation (STIC), glamorous resonance imaging and cardiac catheterization. Doppler ultrasound (DUS) image is a kind of real- time image with a better imaging effect on blood vessels and soft tissues. DUS imaging can observe the shape of the fetus, but it cannot show whether the fetus is hypoxic or distressed. Spatiotemporal image correlation (STIC) enables the acquisition of a volume of data concomitant with the beating heart. The automated volume accession is made possible by the array in the transducer performing a slow single reach, recording a single 3D data set conforming to numerous 2D frames one behind the other. The volume accession can be done in a stationary 3D, either online 4D (direct volume scan, live 3D ultrasound or a so-called 4D (3D/ 4D)), or either spatiotemporal image correlation-STIC (off-line 4D, which is a circular volume check-up). Fetal cardiovascular MRI would appear to be an ideal approach to the noninvasive disquisition of the impact of abnormal cardiovascular hemodynamics on antenatal brain growth and development. Still, there are practical limitations to the use of conventional MRI for fetal cardiovascular assessment, including the small size and high heart rate of the mortal fetus, the lack of conventional cardiac gating styles to attend data accession, and the implicit corruption of MRI data due to motherly respiration and unpredictable fetal movements. Fetal cardiac MRI has the implicit to complement ultrasound in detecting cardiovascular deformations and extracardiac lesions. Fetal cardiac intervention (FCI), minimally invasive catheter interventions, is a new and evolving fashion that allows for in-utero treatment of a subset of severe forms of congenital heart deficiency. In special cases, it may be possible to modify the natural history of congenital heart disorders. It's entirely possible that future generations will ‘repair’ congenital heart deficiency in utero using nanotechnologies or remote computer-guided micro-robots that work in the cellular layer.Keywords: fetal, cardiac MRI, ultrasound, 3D, 4D, heart disease, invasive, noninvasive, catheter
Procedia PDF Downloads 454249 A Time since of Injection Model for Hepatitis C Amongst People Who Inject Drugs
Authors: Nader Al-Rashidi, David Greenhalgh
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Mathematical modelling techniques are now being used by health organizations worldwide to help understand the likely impact that intervention strategies treatment options and combinations of these have on the prevalence and incidence of hepatitis C virus (HCV) in the people who inject drugs (PWID) population. In this poster, we develop a deterministic, compartmental mathematical model to approximate the spread of the HCV in a PWID population that has been divided into two groups by time since onset of injection. The model assumes that after injection needles adopt the most infectious state of their previous state or that of the PWID who last injected with them. Using analytical techniques, we find that the model behaviour is determined by the basic reproductive number R₀, where R₀ = 1 is a critical threshold separating two different outcomes. The disease-free equilibrium is globally stable if R₀ ≤ 1 and unstable if R₀ > 1. Additionally, we make some simulations where have confirmed that the model tends to this endemic equilibrium value with realistic parameter values giving an HCV prevalence.Keywords: hepatitis C, people who inject drugs, HCV, PWID
Procedia PDF Downloads 1504248 Effect of Ocimum americanum Water Extract on Antioxidant System in Rat
Authors: Pornrut Rabintossaporn, Suphaket Saenthaweesuk, Amornnat Thuppia, Nuntiya Somparn
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Several dietary and herbal plants have been shown to possess cytoprotective and antioxidant effects with various mechanisms of action. The aim of this study was to determine the antioxidant effects and its mechanism of aqueous leaves extract of Ocimum americanum (OA), commonly known as American basil or 'hoary basil', in rat. The extract was screened for its phytochemical contents and antioxidant activity in vitro. Moreover, the extract was studied in rats to evaluate its effects in vivo. Rats were orally administered with the extract at the dose of 100, 200 and 400 mg/kg for 28 days. Phytochemical screening of plant extracts revealed the presence of alkaloid, cardiac glycosides, tannin and steroid compounds. The extract contained phenolic compounds 36.91 ± 0.66 mg of gallic acid equivalents per gram OA extract. The free radical scavenging activity assessed by DPPH assay gave IC50 of 41.27 ± 1.86 µg/mL, which is relatively lower than that of BHT with IC50 of 12.34 ± 1.14µg/mL. In the animals, the extract was well tolerated by the animals throughout the 28 days of study as shown by normal serum levels AST, ALP, ALT, BUN and Cr as well as normal histology of liver and pancreatic and kidney tissue. The protein expression of antioxidant enzymes, γ-glutamylcysteine ligase (γ-GCL) in liver was significantly increased compared with normal control. Consistent with the induction of γ-GCL protein expression significantly reduction of serum oxidative stress marker malondialdehyde (MDA) was found in rat treated with OA extract compared with control. Taken together, this study provides evidence that Ocimum americanum exhibits direct antioxidant properties and can induce cytoprotective enzyme in vivo.Keywords: antioxidant, γ-glutamylcysteine ligase, MDA, Ocimum americanum
Procedia PDF Downloads 2474247 Prediction of Solanum Lycopersicum Genome Encoded microRNAs Targeting Tomato Spotted Wilt Virus
Authors: Muhammad Shahzad Iqbal, Zobia Sarwar, Salah-ud-Din
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Tomato spotted wilt virus (TSWV) belongs to the genus Tospoviruses (family Bunyaviridae). It is one of the most devastating pathogens of tomato (Solanum Lycopersicum) and heavily damages the crop yield each year around the globe. In this study, we retrieved 329 mature miRNA sequences from two microRNA databases (miRBase and miRSoldb) and checked the putative target sites in the downloaded-genome sequence of TSWV. A consensus of three miRNA target prediction tools (RNA22, miRanda and psRNATarget) was used to screen the false-positive microRNAs targeting sites in the TSWV genome. These tools calculated different target sites by calculating minimum free energy (mfe), site-complementarity, minimum folding energy and other microRNA-mRNA binding factors. R language was used to plot the predicted target-site data. All the genes having possible target sites for different miRNAs were screened by building a consensus table. Out of these 329 mature miRNAs predicted by three algorithms, only eight miRNAs met all the criteria/threshold specifications. MC-Fold and MC-Sym were used to predict three-dimensional structures of miRNAs and further analyzed in USCF chimera to visualize the structural and conformational changes before and after microRNA-mRNA interactions. The results of the current study show that the predicted eight miRNAs could further be evaluated by in vitro experiments to develop TSWV-resistant transgenic tomato plants in the future.Keywords: tomato spotted wild virus (TSWV), Solanum lycopersicum, plant virus, miRNAs, microRNA target prediction, mRNA
Procedia PDF Downloads 1624246 The Development of Psychosis in Offenders and Its Relationship to Crime
Authors: Belinda Crissman
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Serious mental disorder is greatly overrepresented in prisoners compared to the general community, with consequences for prison management, recidivism and the prisoners themselves. Incarcerated individuals with psychotic disorders experience insufficient detection and treatment and higher rates of suicide in custody. However direct evidence to explain the overrepresentation of individuals with psychosis in prisons is sparse. The current study aimed to use a life course criminology perspective to answer two key questions: 1) What is the temporal relationship between psychosis and offending (does first mental health contact precede first recorded offence, or does the offending precede the mental health diagnosis)? 2) Are there key temporal points or system contacts prior to incarceration that could be identified as opportunities for early intervention? Data from the innovative Queensland Linkage project was used to link individuals with their corrections, health and relevant social service systems to answer these questions.Keywords: mental disorder, crime, life course criminology, prevention
Procedia PDF Downloads 1334245 Effects of Butea superba Roxb. on Skeletal Muscle Functions and Parvalbumin Levels of Orchidectomized Rat
Authors: Surapong Vongvatcharanon, Fardeela Binalee, Wandee Udomuksorn, Ekkasit Kumarnsit, Uraporn Vongvatcharanon
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Hypogonadism is characterized by a decline in sex hormone levels, especially testosterone. It has been shown to be an important contributor to the decrease in muscle mass, muscle strength and performance, a condition known as sarcopenia. Preparations from Butea superba Roxb. (red Kwao Krua) have been reported to have androgenic properties. The active compounds are proposed to be flavonoids and flavonoid glycosides. Treatment with B. superba has been shown to improve erectile dysfunction in males. Parvalbumin (PV) is a relaxing factor and identified in fast twitch fibers. Alterations of the PV levels affects skeletal muscle functions. This study aimed to investigate the effects of orhchidectomy, testosterone replacement and different doses of Butea superba Roxb. on the structure, performance, levels of parvalbumin, parvalbumin and androgen receptor immunoreactivities in the extensor digitorum longus (EDL) and gastrocnemius muscles of orchidectomized rats. Twelve-week old male Wistar rats were randomly divided into 6 groups; sham-operated (SHAM), orchidectomized (BS-0), orchidectomized group that was treated with testosterone replacement of 6 µg/kg (TP) or an orchidectomized group that was treated with various doses of an extract from Butea superba Roxb.; 5 mg/kg (BS-5), 50 mg/kg (BS-50) and 500 mg/kg (BS-500) all for 90 days. The testosterone level, epididymis, seminal vesicle, prostate gland, vas deference weight, muscle fiber size, strength and endurance in both the EDL and gastrocnemius muscle were decreased in the BS-0 group but increased in the testosterone replacement group. Treatment with the B. superba Roxb. extract replacement group improved muscle fiber size, strength and endurance, but not total testosterone levels, or the epididymis, seminal vesicle, prostate gland, vas deference weight. Furthermore, the parvalbumin level, parvalbumin and androgen receptor immunoreactivities were reduced in the BS-0 group but increased in the testosterone replacement group and the B. superba Roxb. extract groups for both the EDL and gastrocnemius muscle. This study indicated that the reduction of testosterone level led to a decrease of the androgen receptor density resulting in a decline in the muscle mass and parvalbumin levels. The decrease of parvalbumin levels affected muscle performance. Testosterone replacement increased the androgen receptor density and led to an increase of muscle mass and parvalbumin levels. The increase in the parvalbumin levels may result in an improvement of muscle performance. This may explain one mechanism of testosterone on muscle mass and strength in the testosterone dependent sarcopenia. The B. superba Roxb. extract groups also had improved muscle mass, strength and endurance, parvalbumin level, parvalbumin and androgen immunoreactivities compared to the BS-O group . Butea superba Roxb. Extracts contains a flavonoid (3, 7, 3'-Trihydroxy-4'-methoxyflavone), flavonoiglycoside (3, 3'-dihydroxy-4'-methoxyflavone-7-O-β-D-glucopyranoside) and isoflavanolignans (butesuperins A and butesuperins B) all known to inhibit the cAMP phosphodiesterase enzyme. Therefore, cAMP signaling may have adaptive effects on skeletal muscle by increasing muscle mass, strength and endurance.Keywords: Butea superba, parvalbumin, skeletal muscle, orchidectomy
Procedia PDF Downloads 4274244 Localized Treatment of Cutaneous Candidiasis through Cubosomes in vitro Evaluation
Authors: Aakanchha Jain, D. V. Kohli
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Cubosomes are nanoparticles but instead of the solid particles, cubosomes are self-assembled liquid crystalline particles of certain surfactant with proper ratio of water with a microstructure that provides unique properties of practical interest. Cubosomes encapsulating Fluconazole were prepared by emulsification method and characterized for particle size, entrapment efficiency. The cubosomes prepared were 257.2±2.94 nm in size with drug entrapment efficiency of 66.2±2.69%. The optimized formulation characterized for shape and surface morphology by TEM and SEM analysis. SEM photograph showed the smooth surface of optimized cubosomes and TEM photograph revealed square somewhat circular intact shapes of cubosomes. MIC was determined by XTT based method and antifungal activity was determined in vitro. The cumulative percentage of Fnz from cubosomes permeated via dialysis membrane (MWCO 12-14 KD) showed a percent cumulative drug release of 76.86% while Fnz solution showed release up to 91.04% in 24 hours in PBS (pH 6.5)(p < 0.005).Keywords: Candids albicans, cubosomes, fluconazole, topical delivery
Procedia PDF Downloads 3074243 Diallyl Trisulfide Protects the Rat Liver from CCl4-Induced Injury and Fibrogenesis by Attenuating Oxidative Stress
Authors: Xiao-Jing Zhu, Liang Zhou, Shi-Zhong Zheng
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Various studies have shown that diallyl trisulfide (DATS) can protect the liver injury, and DATS has a strong antioxidant property. The aim of this study is to evaluate the in vivo role of DATS in protecting the liver against injury and fibrogenesis and further explores the underlying mechanisms. Our results demonstrated that DATS protected the liver from CCl4-caused injury by suppressing the elevation of ALT and AST activities, and by improving the histological architecture of the liver. Treatment with DATS or colchicine improved the liver fibrosis by sirius red staining and immunofluorescence. In addition, immunohistochemistry, western blot, and RT-PCR analyses indicated that DATS inhibited HSC activation. Furthermore, DATS attenuated oxidative stress by increasing glutathione and reducing lipid peroxides and malondialdehyde. These findings suggest that the protective effect of DATS on CCl4-caused liver injury and liver fibrogenesis was, at least partially, attributed to its antioxidant activity.Keywords: liver fibrogenesis, liver injury, oxidative stress, DATS
Procedia PDF Downloads 4354242 The Role of Intraluminal Endoscopy in the Diagnosis and Treatment of Fluid Collections in Patients With Acute Pancreatitis
Authors: A. Askerov, Y. Teterin, P. Yartcev, S. Novikov
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Introduction: Acute pancreatitis (AP) is a socially significant problem for public health and continues to be one of the most common causes of hospitalization of patients with pathology of the gastrointestinal tract. It is characterized by high mortality rates, which reaches 62-65% in infected pancreatic necrosis. Aims & Methods: The study group included 63 patients who underwent transluminal drainage (TLD) fluid collection (FC). All patients were performed transabdominal ultrasound, computer tomography of the abdominal cavity and retroperitoneal organs and endoscopic ultrasound (EUS) of the pancreatobiliary zone. The EUS was used as a final diagnostic method to determine the characteristics of FC. The indications for TLD were: the distance between the wall of the hollow organ and the FC was not more than 1 cm, the absence of large vessels on the puncture trajectory (more than 3 mm), and the size of the formation was more than 5 cm. When a homogeneous cavity with clear, even contours was detected, a plastic stent with rounded ends (“double pig tail”) was installed. The indication for the installation of a fully covered self-expanding stent was the detection of nonhomogeneous anechoic FC with hyperechoic inclusions and cloudy purulent contents. In patients with necrotic forms after drainage of the purulent cavity, a cystonasal drainage with a diameter of 7Fr was installed in its lumen under X-ray control to sanitize the cavity with a 0.05% aqueous solution of chlorhexidine. Endoscopic necrectomy was performed every 24-48 hours. The plastic stent was removed in 6 month, the fully covered self-expanding stent - in 1 month after the patient was discharged from the hospital. Results: Endoscopic TLD was performed in 63 patients. The FC corresponding to interstitial edematous pancreatitis was detected in 39 (62%) patients who underwent TLD with the installation of a plastic stent with rounded ends. In 24 (38%) patients with necrotic forms of FC, a fully covered self-expanding stent was placed. Communication with the ductal system of the pancreas was found in 5 (7.9%) patients. They underwent pancreaticoduodenal stenting. A complicated postoperative period was noted in 4 (6.3%) cases and was manifested by bleeding from the zone of pancreatogenic destruction. In 2 (3.1%) cases, this required angiography and endovascular embolization a. gastroduodenalis, in 1 (1.6%) case, endoscopic hemostasis was performed by filling the cavity with 4 ml of Hemoblock hemostatic solution. The combination of both methods was used in 1 (1.6%) patient. There was no evidence of recurrent bleeding in these patients. Lethal outcome occurred in 4 patients (6.3%). In 3 (4.7%) patients, the cause of death was multiple organ failure, in 1 (1.6%) - severe nosocomial pneumonia that developed on the 32nd day after drainage. Conclusions: 1. EUS is not only the most important method for diagnosing FC in AP, but also allows you to determine further tactics for their intraluminal drainage.2. Endoscopic intraluminal drainage of fluid zones in 45.8% of cases is the final minimally invasive method of surgical treatment of large-focal pancreatic necrosis. Disclosure: Nothing to disclose.Keywords: acute pancreatitis, fluid collection, endoscopy surgery, necrectomy, transluminal drainage
Procedia PDF Downloads 1134241 Molecular Characterization of Polyploid Bamboo (Dendrocalamus hamiltonii) Using Microsatellite Markers
Authors: Rajendra K. Meena, Maneesh S. Bhandari, Santan Barthwal, Harish S. Ginwal
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Microsatellite markers are the most valuable tools for the characterization of plant genetic resources or population genetic analysis. Since it is codominant and allelic markers, utilizing them in polyploid species remained doubtful. In such cases, the microsatellite marker is usually analyzed by treating them as a dominant marker. In the current study, it has been showed that despite losing the advantage of co-dominance, microsatellite markers are still a powerful tool for genotyping of polyploid species because of availability of large number of reproducible alleles per locus. It has been studied by genotyping of 19 subpopulations of Dendrocalamus hamiltonii (hexaploid bamboo species) with 17 polymorphic simple sequence repeat (SSR) primer pairs. Among these, ten primers gave typical banding pattern of microsatellite marker as expected in diploid species, but rest 7 gave an unusual pattern, i.e., more than two bands per locus per genotype. In such case, genotyping data are generally analyzed by considering as dominant markers. In the current study, data were analyzed in both ways as dominant and co-dominant. All the 17 primers were first scored as nonallelic data and analyzed; later, the ten primers giving standard banding patterns were analyzed as allelic data and the results were compared. The UPGMA clustering and genetic structure showed that results obtained with both the data sets are very similar with slight variation, and therefore the SSR marker could be utilized to characterize polyploid species by considering them as a dominant marker. The study is highly useful to widen the scope for SSR markers applications and beneficial to the researchers dealing with polyploid species.Keywords: microsatellite markers, Dendrocalamus hamiltonii, dominant and codominant, polyploids
Procedia PDF Downloads 1484240 Concussion: Clinical and Vocational Outcomes from Sport Related Mild Traumatic Brain Injury
Authors: Jack Nash, Chris Simpson, Holly Hurn, Ronel Terblanche, Alan Mistlin
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There is an increasing incidence of mild traumatic brain injury (mTBI) cases throughout sport and with this, a growing interest from governing bodies to ensure these are managed appropriately and player welfare is prioritised. The Berlin consensus statement on concussion in sport recommends a multidisciplinary approach when managing those patients who do not have full resolution of mTBI symptoms. There are as of yet no standardised guideline to follow in the treatment of complex cases mTBI in athletes. The aim of this project was to analyse the outcomes, both clinical and vocational, of all patients admitted to the mild Traumatic Brain Injury (mTBI) service at the UK’s Defence Military Rehabilitation Centre Headley Court between 1st June 2008 and 1st February 2017, as a result of a sport induced injury, and evaluate potential predictive indicators of outcome. Patients were identified from a database maintained by the mTBI service. Clinical and occupational outcomes were ascertained from medical and occupational employment records, recorded prospectively, at time of discharge from the mTBI service. Outcomes were graded based on the vocational independence scale (VIS) and clinical documentation at discharge. Predictive indicators including referral time, age at time of injury, previous mental health diagnosis and a financial claim in place at time of entry to service were assessed using logistic regression. 45 Patients were treated for sport-related mTBI during this time frame. Clinically 96% of patients had full resolution of their mTBI symptoms after input from the mTBI service. 51% of patients returned to work at their previous vocational level, 4% had ongoing mTBI symptoms, 22% had ongoing physical rehabilitation needs, 11% required mental health input and 11% required further vestibular rehabilitation. Neither age, time to referral, pre-existing mental health condition nor compensation seeking had a significant impact on either vocational or clinical outcome in this population. The vast majority of patients reviewed in the mTBI clinic had persistent symptoms which could not be managed in primary care. A consultant-led, multidisciplinary approach to the diagnosis and management of mTBI has resulted in excellent clinical outcomes in these complex cases. High levels of symptom resolution suggest that this referral and treatment pathway is successful and is a model which could be replicated in other organisations with consultant led input. Further understanding of both predictive and individual factors would allow clinicians to focus treatments on those who are most likely to develop long-term complications following mTBI. A consultant-led, multidisciplinary service ensures a large number of patients will have complete resolution of mTBI symptoms after sport-related mTBI. Further research is now required to ascertain the key predictive indicators of outcome following sport-related mTBI.Keywords: brain injury, concussion, neurology, rehabilitation, sports injury
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