Search results for: single cell
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 7910

Search results for: single cell

590 Study on Reusable, Non Adhesive Silicone Male External Catheter: Clinical Proof of Study and Quality Improvement Project

Authors: Venkata Buddharaju, Irene Mccarron, Hazel Alba

Abstract:

Introduction: Male external catheters (MECs) are commonly used to collect and drain urine. MECs are increasingly used in acute care, long-term acute care hospitals, and nursing facilities, and in other patients as an alternative to invasive urinary catheters to reduce catheter-associated urinary tract infections (CAUTI).MECs are also used to avoid the need for incontinence pads and diapers. Most of the Male External Catheters are held in place by skin adhesive, with the exception of a few, which uses a foam strap clamp around the penile shaft. The adhesive condom catheters typically stay for 24 hours or less. It is also a common practice that extra skin adhesive tape is wrapped around the condom catheter for additional security of the device. The fixed nature of the adhesive will not allow the normal skin expansion of penile size over time. The adhesive can cause skin irritation, redness, erosion, and skin damage. Acanthus condom catheter (ACC) is a patented, specially designed, stretchable silicone catheter without adhesive, adapts to the size and contour of the penis. It is held in place with a single elastic strap that wraps around the lower back and tied to the opposite catheter ring holescriss cross. It can be reused for up to 5 days on the same patient after daily cleaning and washingpotentially reducing cost. Methods: The study was conducted from September 17th to October 8th, 2020. The nursing staff was educated and trained on how to use and reuse the catheter. After identifying five (5) appropriate patients, the catheter was placed and maintained by nursing staff. The data on the ease of use, leak, and skin damage were collected and reported by nurses to the nursing education department of the hospital for analysis. Setting: RML Chicago, long-term acute care hospital, an affiliate of Loyola University Medical Center, Chicago, IL USA. Results: The data showed that the catheter was easy to apply, remove, wash and reuse, without skin problems or urine infections. One patient had used for 16 days after wash, reuse, and replacement without any urine leak or skin issues. A minimal leak was observed on two patients. Conclusion: Acanthus condom catheter was easy to use, functioned well with minimal or no leak during use and reuse. The skin was intact in all patients studied. There were no urinary tract infections in any of the studied patients.

Keywords: CAUTI, male external catheter, reusable, skin adhesive

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589 Social Entrepreneurship Core Dimensions and Influential Perspectives: An Exploratory Study

Authors: Filipa Lancastre, Carmen Lages, Filipe Santos

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The concept of social entrepreneurship (SE) remains ambiguous and deprived of a widely accepted operational definition. We argue that an awareness about the consensual constituent elements of SE from all key players from its ecosystem as well as a deeper understanding of apparently divergent perspectives will allow the different stakeholders (social entrepreneurs, corporations, investors, policymakers, the beneficiaries themselves) to bridge and cooperate for societal value co-creation in trying to solve our most pressing societal issues. To address our research question –what are the dimensions of SE that are consensual and controversial across existing perspectives? – We designed a two-step qualitative study. In a first step, we conducted an extensive literature review, collecting and analyzing 155 different SE definitions. From this initial step, we extracted and characterized three consensual and six controversial dimensions of the SE concept. In a second step, we conducted 20 semi-structured interviews with practitioners that are actively involved in the SE field. The goal of this second step was to verify if the literature did not capture any key dimension, understand how the dimensions related to each other and to understand the rationale behind them. The dimensions of the SE concept were extracted based on the relevance of each theme and on the theoretical relationship among them. To identify the relevance, we used as a proxy the frequency of each theme was referred to in our sample of definitions. To understand relationships, as identified in the previous section, we included concepts from both the management and psychology literature, such as the Entrepreneurial Orientation concept from the entrepreneurship literature, the Subjective Well Being construct from psychology literature, and the Resource-Based Theory from the strategy literature. This study has two main contributions; First, the identification of (consensual and controversial) dimensions of SE that exist across scattered definitions from the academic and practitioner literature. Second, a framework that parsimoniously synthesizes four dominant perspectives of SE and relates them with the SE dimensions. Assuming the contested nature of the SE concept, it is not expected that these views will be reconciled at the academic or practitioner field level. In future research, academics can, however, be aware of the existence of different understandings of SE and avoid bias towards a single view, developing holistic studies on SE phenomena or comparing differences by studying their underlying assumptions. Additionally, it is important that researchers make explicit the perspective they are embracing to ensure consistency among the research question, sampling procedures and implications of results. At the practitioner level, individuals or groups following different logics are predictably mutually suspicious and might benefit from taking stock of other perspectives on SE, building bridges and fostering cross-fertilization to the benefit of the SE ecosystem for which all contribute.

Keywords: social entrepreneurship, conceptualization, dimensions, perspectives

Procedia PDF Downloads 178
588 Evaluation of Prehabilitation Prior to Surgery for an Orthopaedic Pathway

Authors: Stephen McCarthy, Joanne Gray, Esther Carr, Gerard Danjoux, Paul Baker, Rhiannon Hackett

Abstract:

Background: The Go Well Health (GWH) platform is a web-based programme that allows patients to access personalised care plans and resources, aimed at prehabilitation prior to surgery. The online digital platform delivers essential patient education and support for patients prior to undergoing total hip replacements (THR) and total knee replacements (TKR). This study evaluated the impact of an online digital platform (ODP) in terms of functional health outcomes, health related quality of life and hospital length of stay following surgery. Methods: A retrospective cohort study comparing a cohort of patients who used the online digital platform (ODP) to deliver patient education and support (PES) prior to undergoing THR and TKR surgery relative to a cohort of patients who did not access the ODP and received usual care. Routinely collected Patient Reported Outcome Measures (PROMs) data was obtained on 2,406 patients who underwent a knee replacement (n=1,160) or a hip replacement (n=1,246) between 2018 and 2019 in a single surgical centre in the United Kingdom. The Oxford Hip and Knee Score and the European Quality of Life Five-Dimensional tool (EQ5D-5L) was obtained both pre-and post-surgery (at 6 months) along with hospital LOS. Linear regression was used to compare the estimate the impact of GWH on both health outcomes and negative binomial regressions were used to impact on LOS. All analyses adjusted for age, sex, Charlson Comorbidity Score and either pre-operative Oxford Hip/Knee scores or pre-operative EQ-5D scores. Fractional polynomials were used to represent potential non-linear relationships between the factors included in the regression model. Findings: For patients who underwent a knee replacement, GWH had a statistically significant impact on Oxford Knee Scores and EQ5D-5L utility post-surgery (p=0.039 and p=0.002 respectively). GWH did not have a statistically significant impact on the hospital length of stay. For those patients who underwent a hip replacement, GWH had a statistically significant impact on Oxford Hip Scores and EQ5D-5L utility post (p=0.000 and p=0.009 respectively). GWH also had a statistically significant reduction in the hospital length of stay (p=0.000). Conclusion: Health Outcomes were higher for patients who used the GWH platform and underwent THR and TKR relative to those who received usual care prior to surgery. Patients who underwent a hip replacement and used GWH also had a reduced hospital LOS. These findings are important for health policy and or decision makers as they suggest that prehabilitation via an ODP can maximise health outcomes for patients following surgery whilst potentially making efficiency savings with reductions in LOS.

Keywords: digital prehabilitation, online digital platform, orthopaedics, surgery

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587 Investigating Early Markers of Alzheimer’s Disease Using a Combination of Cognitive Tests and MRI to Probe Changes in Hippocampal Anatomy and Functionality

Authors: Netasha Shaikh, Bryony Wood, Demitra Tsivos, Michael Knight, Risto Kauppinen, Elizabeth Coulthard

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Background: Effective treatment of dementia will require early diagnosis, before significant brain damage has accumulated. Memory loss is an early symptom of Alzheimer’s disease (AD). The hippocampus, a brain area critical for memory, degenerates early in the course of AD. The hippocampus comprises several subfields. In contrast to healthy aging where CA3 and dentate gyrus are the hippocampal subfields with most prominent atrophy, in AD the CA1 and subiculum are thought to be affected early. Conventional clinical structural neuroimaging is not sufficiently sensitive to identify preferential atrophy in individual subfields. Here, we will explore the sensitivity of new magnetic resonance imaging (MRI) sequences designed to interrogate medial temporal regions as an early marker of Alzheimer’s. As it is likely a combination of tests may predict early Alzheimer’s disease (AD) better than any single test, we look at the potential efficacy of such imaging alone and in combination with standard and novel cognitive tasks of hippocampal dependent memory. Methods: 20 patients with mild cognitive impairment (MCI), 20 with mild-moderate AD and 20 age-matched healthy elderly controls (HC) are being recruited to undergo 3T MRI (with sequences designed to allow volumetric analysis of hippocampal subfields) and a battery of cognitive tasks (including Paired Associative Learning from CANTAB, Hopkins Verbal Learning Test and a novel hippocampal-dependent abstract word memory task). AD participants and healthy controls are being tested just once whereas patients with MCI will be tested twice a year apart. We will compare subfield size between groups and correlate subfield size with cognitive performance on our tasks. In the MCI group, we will explore the relationship between subfield volume, cognitive test performance and deterioration in clinical condition over a year. Results: Preliminary data (currently on 16 participants: 2 AD; 4 MCI; 9 HC) have revealed subfield size differences between subject groups. Patients with AD perform with less accuracy on tasks of hippocampal-dependent memory, and MCI patient performance and reaction times also differ from healthy controls. With further testing, we hope to delineate how subfield-specific atrophy corresponds with changes in cognitive function, and characterise how this progresses over the time course of the disease. Conclusion: Novel sequences on a MRI scanner such as those in route in clinical use can be used to delineate hippocampal subfields in patients with and without dementia. Preliminary data suggest that such subfield analysis, perhaps in combination with cognitive tasks, may be an early marker of AD.

Keywords: Alzheimer's disease, dementia, memory, cognition, hippocampus

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586 Interdigitated Flexible Li-Ion Battery by Aerosol Jet Printing

Authors: Yohann R. J. Thomas, Sébastien Solan

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Conventional battery technology includes the assembly of electrode/separator/electrode by standard techniques such as stacking or winding, depending on the format size. In that type of batteries, coating or pasting techniques are only used for the electrode process. The processes are suited for large scale production of batteries and perfectly adapted to plenty of application requirements. Nevertheless, as the demand for both easier and cost-efficient production modes, flexible, custom-shaped and efficient small sized batteries is rising. Thin-film, printable batteries are one of the key areas for printed electronics. In the frame of European BASMATI project, we are investigating the feasibility of a new design of lithium-ion battery: interdigitated planar core design. Polymer substrate is used to produce bendable and flexible rechargeable accumulators. Direct fully printed batteries lead to interconnect the accumulator with other electronic functions for example organic solar cells (harvesting function), printed sensors (autonomous sensors) or RFID (communication function) on a common substrate to produce fully integrated, thin and flexible new devices. To fulfill those specifications, a high resolution printing process have been selected: Aerosol jet printing. In order to fit with this process parameters, we worked on nanomaterials formulation for current collectors and electrodes. In addition, an advanced printed polymer-electrolyte is developed to be implemented directly in the printing process in order to avoid the liquid electrolyte filling step and to improve safety and flexibility. Results: Three different current collectors has been studied and printed successfully. An ink of commercial copper nanoparticles has been formulated and printed, then a flash sintering was applied to the interdigitated design. A gold ink was also printed, the resulting material was partially self-sintered and did not require any high temperature post treatment. Finally, carbon nanotubes were also printed with a high resolution and well defined patterns. Different electrode materials were formulated and printed according to the interdigitated design. For cathodes, NMC and LFP were efficaciously printed. For anodes, LTO and graphite have shown to be good candidates for the fully printed battery. The electrochemical performances of those materials have been evaluated in a standard coin cell with lithium-metal counter electrode and the results are similar with those of a traditional ink formulation and process. A jellified plastic crystal solid state electrolyte has been developed and showed comparable performances to classical liquid carbonate electrolytes with two different materials. In our future developments, focus will be put on several tasks. In a first place, we will synthesize and formulate new specific nano-materials based on metal-oxyde. Then a fully printed device will be produced and its electrochemical performance will be evaluated.

Keywords: high resolution digital printing, lithium-ion battery, nanomaterials, solid-state electrolytes

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585 A Comparison of Tsunami Impact to Sydney Harbour, Australia at Different Tidal Stages

Authors: Olivia A. Wilson, Hannah E. Power, Murray Kendall

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Sydney Harbour is an iconic location with a dense population and low-lying development. On the east coast of Australia, facing the Pacific Ocean, it is exposed to several tsunamigenic trenches. This paper presents a component of the most detailed assessment of the potential for earthquake-generated tsunami impact on Sydney Harbour to date. Models in this study use dynamic tides to account for tide-tsunami interaction. Sydney Harbour’s tidal range is 1.5 m, and the spring tides from January 2015 that are used in the modelling for this study are close to the full tidal range. The tsunami wave trains modelled include hypothetical tsunami generated from earthquakes of magnitude 7.5, 8.0, 8.5, and 9.0 MW from the Puysegur and New Hebrides trenches as well as representations of the historical 1960 Chilean and 2011 Tohoku events. All wave trains are modelled for the peak wave to coincide with both a low tide and a high tide. A single wave train, representing a 9.0 MW earthquake at the Puysegur trench, is modelled for peak waves to coincide with every hour across a 12-hour tidal phase. Using the hydrodynamic model ANUGA, results are compared according to the impact parameters of inundation area, depth variation and current speeds. Results show that both maximum inundation area and depth variation are tide dependent. Maximum inundation area increases when coincident with a higher tide, however, hazardous inundation is only observed for the larger waves modelled: NH90high and P90high. The maximum and minimum depths are deeper on higher tides and shallower on lower tides. The difference between maximum and minimum depths varies across different tidal phases although the differences are slight. Maximum current speeds are shown to be a significant hazard for Sydney Harbour; however, they do not show consistent patterns according to tide-tsunami phasing. The maximum current speed hazard is shown to be greater in specific locations such as Spit Bridge, a narrow channel with extensive marine infrastructure. The results presented for Sydney Harbour are novel, and the conclusions are consistent with previous modelling efforts in the greater area. It is shown that tide must be a consideration for both tsunami modelling and emergency management planning. Modelling with peak tsunami waves coinciding with a high tide would be a conservative approach; however, it must be considered that maximum current speeds may be higher on other tides.

Keywords: emergency management, sydney, tide-tsunami interaction, tsunami impact

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584 Assessment of Indoor Air Pollution in Naturally Ventilated Dwellings of Mega-City Kolkata

Authors: Tanya Kaur Bedi, Shankha Pratim Bhattacharya

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The US Environmental Protection Agency defines indoor air pollution as “The air quality within and around buildings, especially as it relates to the health and comfort of building occupants”. According to the 2021 report by the Energy Policy Institute at Chicago, Indian residents, a country which is home to the highest levels of air pollution in the world, lose about 5.9 years from life expectancy due to poor air quality and yet has numerous dwellings dependent on natural ventilation. Currently the urban population spends 90% of the time indoors, this scenario raises a concern for occupant health and well-being. This study attempts to demonstrate the causal relationship between the indoor air pollution and its determining aspects. Detailed indoor air pollution audits were conducted in residential buildings located in Kolkata, India in the months of December and January 2021. According to the air pollution knowledge assessment city program in India, Kolkata is also the second most polluted mega-city after Delhi. Although the air pollution levels are alarming year-long, the winter months are most crucial due to the unfavourable environmental conditions. While emissions remain typically constant throughout the year, cold air is denser and moves slower than warm air, trapping the pollution in place for much longer and consequently is breathed in at a higher rate than the summers. The air pollution monitoring period was selected considering environmental factors and major pollution contributors like traffic and road dust. This study focuses on the relationship between the built environment and the spatial-temporal distribution of air pollutants in and around it. The measured parameters include, temperature, relative humidity, air velocity, particulate matter, volatile organic compounds, formaldehyde, and benzene. A total of 56 rooms were audited, selectively targeting the most dominant middle-income group in the urban area of the metropolitan. The data-collection was conducted using a set of instruments positioned in the human breathing-zone. The study assesses the relationship between indoor air pollution levels and factors determining natural ventilation and air pollution dispersion such as surrounding environment, dominant wind, openable window to floor area ratio, windward or leeward side openings, and natural ventilation type in the room: single side or cross-ventilation, floor height, residents cleaning habits, etc.

Keywords: indoor air quality, occupant health, air pollution, architecture, urban environment

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583 Caregivers Burden: Risk and Related Psychological Factors in Caregivers of Patients with Parkinson’s Disease

Authors: Pellecchia M. T., Savarese G., Carpinelli L., Calabrese M.

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Introduction: Parkinson's disease (PD) is characterized by a progressive loss of autonomy which undoubtedly has a significant impact on the quality of life of caregivers, and parents are the main informal caregivers. Caring for a person with PD is associated with an increased risk of psychiatric morbidity and persistent anxiety-depressive distress. The aim of the study is to investigate the burden on caregivers of patients with PD, through the use of multidimensional scales and to identify their personological and environmental determinants. Methods: The study has been approved by the Ethic Committee of the University of Salerno and informed consent for participation to the study was obtained from patients and their caregivers. The study was conducted at the Neurology Department of the A.O.U. "San Giovanni di Dio and Ruggi D’Aragona" of Salerno between September 2020 and May 2021. Materials: The questionnaires used were: a) Caregiver Burden Inventory - CBI a questionnaire of 24 items that allow identifying five sub-categories of burden (objective, psychological, physical, social, emotional); b) Depression Anxiety Stress Scales Short Version - DASS-21 questionnaire consisting of 21 items and valid in examining three distinct but interrelated areas (depression, anxiety and stress); c) Family Strain Questionnaire Short Form - FSQ-SF is a questionnaire of 30 items grouped in areas of increasing psychological risk (OK, R, SR, U); d) Zarit Caregiver Burden Inventory - ZBI, consisting of 22 items based on the analysis of two main factors: personal stress and pressure related to his role; e) Life Satisfaction, a single item that aims to evaluate the degree of life satisfaction in a global way using a 0-100 Likert scale. Findings: N ° 29 caregivers (M age = 55.14, SD = 9.859; 69% F) participated in the study. 20.6% of the sample had severe and severe burden (CBI score = M = 26.31; SD = 22.43) and 13.8% of participants had moderate to severe burden (ZBI). The FSQ-SF highlighted a minority of caregivers who need psychological support, in some cases urgent (Area SR and Area U). The DASS-21 results show a prevalence of stress-related symptoms (M = 10.90, SD = 10.712) compared to anxiety (M = 7.52, SD = 10.752) and depression (M = 8, SD = 10.876). There are significant correlations between some specific variables and mean test scores: retired caregivers report higher ZBI scores (p = 0.423) and lower Life Satisfaction levels (p = -0.460) than working caregivers; years of schooling show a negative linear correlation with the ZBI score (p = -0.491). The T-Test indicates that caregivers of patients with cognitive impairment are at greater risk than those of patients without cognitive impairment. Conclusions: It knows the factors that affect the burden the most would allow for early recognition of risky situations and caregivers who would need adequate support.

Keywords: anxious-depressive axis, caregivers’ burden, Parkinson’ disease, psychological risks

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582 Integrative Omics-Portrayal Disentangles Molecular Heterogeneity and Progression Mechanisms of Cancer

Authors: Binder Hans

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Cancer is no longer seen as solely a genetic disease where genetic defects such as mutations and copy number variations affect gene regulation and eventually lead to aberrant cell functioning which can be monitored by transcriptome analysis. It has become obvious that epigenetic alterations represent a further important layer of (de-)regulation of gene activity. For example, aberrant DNA methylation is a hallmark of many cancer types, and methylation patterns were successfully used to subtype cancer heterogeneity. Hence, unraveling the interplay between different omics levels such as genome, transcriptome and epigenome is inevitable for a mechanistic understanding of molecular deregulation causing complex diseases such as cancer. This objective requires powerful downstream integrative bioinformatics methods as an essential prerequisite to discover the whole genome mutational, transcriptome and epigenome landscapes of cancer specimen and to discover cancer genesis, progression and heterogeneity. Basic challenges and tasks arise ‘beyond sequencing’ because of the big size of the data, their complexity, the need to search for hidden structures in the data, for knowledge mining to discover biological function and also systems biology conceptual models to deduce developmental interrelations between different cancer states. These tasks are tightly related to cancer biology as an (epi-)genetic disease giving rise to aberrant genomic regulation under micro-environmental control and clonal evolution which leads to heterogeneous cellular states. Machine learning algorithms such as self organizing maps (SOM) represent one interesting option to tackle these bioinformatics tasks. The SOMmethod enables recognizing complex patterns in large-scale data generated by highthroughput omics technologies. It portrays molecular phenotypes by generating individualized, easy to interpret images of the data landscape in combination with comprehensive analysis options. Our image-based, reductionist machine learning methods provide one interesting perspective how to deal with massive data in the discovery of complex diseases, gliomas, melanomas and colon cancer on molecular level. As an important new challenge, we address the combined portrayal of different omics data such as genome-wide genomic, transcriptomic and methylomic ones. The integrative-omics portrayal approach is based on the joint training of the data and it provides separate personalized data portraits for each patient and data type which can be analyzed by visual inspection as one option. The new method enables an integrative genome-wide view on the omics data types and the underlying regulatory modes. It is applied to high and low-grade gliomas and to melanomas where it disentangles transversal and longitudinal molecular heterogeneity in terms of distinct molecular subtypes and progression paths with prognostic impact.

Keywords: integrative bioinformatics, machine learning, molecular mechanisms of cancer, gliomas and melanomas

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581 Monoallelic and Biallelic Deletions of 13q14 in a Group of 36 CLL Patients Investigated by CGH Haematological Cancer and SNP Array (8x60K)

Authors: B. Grygalewicz, R. Woroniecka, J. Rygier, K. Borkowska, A. Labak, B. Nowakowska, B. Pienkowska-Grela

Abstract:

Introduction: Chronic lymphocytic leukemia (CLL) is the most common form of adult leukemia in the Western world. Hemizygous and or homozygous loss at 13q14 occur in more than half of cases and constitute the most frequent chromosomal abnormality in CLL. It is believed that deletions 13q14 play a role in CLL pathogenesis. Two microRNA genes miR-15a and miR- 16-1 are targets of 13q14 deletions and plays a tumor suppressor role by targeting antiapoptotic BCL2 gene. Deletion size, as a single change detected in FISH analysis, has haprognostic significance. Patients with small deletions, without RB1 gene involvement, have the best prognosis and the longest overall survival time (OS 133 months). In patients with bigger deletion region, containing RB1 gene, prognosis drops to intermediate, like in patients with normal karyotype and without changes in FISH with overall survival 111 months. Aim: Precise delineation of 13q14 deletions regions in two groups of CLL patients, with mono- and biallelic deletions and qualifications of their prognostic significance. Methods: Detection of 13q14 deletions was performed by FISH analysis with CLL probe panel (D13S319, LAMP1, TP53, ATM, CEP-12). Accurate deletion size detection was performed by CGH Haematological Cancer and SNP array (8x60K). Results: Our investigated group of CLL patients with the 13q14 deletion, detected by FISH analysis, comprised two groups: 18 patients with monoallelic deletions and 18 patients with biallelic deletions. In FISH analysis, in the monoallelic group the range of cells with deletion, was 43% to 97%, while in biallelic group deletion was detected in 11% to 94% of cells. Microarray analysis revealed precise deletion regions. In the monoallelic group, the range of size was 348,12 Kb to 34,82 Mb, with median deletion size 7,93 Mb. In biallelic group discrepancy of total deletions, size was 135,27 Kb to 33,33 Mb, with median deletion size 2,52 Mb. The median size of smaller deletion regions on one copy chromosome 13 was 1,08 Mb while the average region of bigger deletion on the second chromosome 13 was 4,04 Mb. In the monoallelic group, in 8/18 deletion region covered RB1 gene. In the biallelic group, in 4/18 cases, revealed deletion on one copy of biallelic deletion and in 2/18 showed deletion of RB1 gene on both deleted 13q14 regions. All minimal deleted regions included miR-15a and miR-16-1 genes. Genetic results will be correlated with clinical data. Conclusions: Application of CGH microarrays technique in CLL allows accurately delineate the size of 13q14 deletion regions, what have a prognostic value. All deleted regions included miR15a and miR-16-1, what confirms the essential role of these genes in CLL pathogenesis. In our investigated groups of CLL patients with mono- and biallelic 13q14 deletions, patients with biallelic deletion presented smaller deletion sizes (2,52 Mb vs 7,93 Mb), what is connected with better prognosis.

Keywords: CLL, deletion 13q14, CGH microarrays, SNP array

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580 Conceptual Methods of Mitigating Matured Urban Tree Roots Surviving in Conflicts Growth within Built Environment: A Review

Authors: Mohd Suhaizan Shamsuddin

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Urbanization exacerbates the environment quality and pressures of matured urban trees' growth and development in changing environment. The growth of struggled matured urban tree-roots by spreading within the existences of infrastructures, resulting in large damage to the structured and declined growth. Many physiological growths declined or damages by the present and installations of infrastructures within and nearby root zone. Afford to remain both matured urban tree and infrastructures as a service provider causes damage and death, respectively. Inasmuch, spending more expenditure on fixing both or removing matured urban trees as risky to the future environment as the mitigation methods to reduce the problems are unconcerned. This paper aims to explain mitigation method practices of reducing the encountered problems of matured urban tree-roots settling and infrastructures while modified urban soil to sustain at an optimum level. Three categories capturing encountered conflicts growth of matured urban tree-roots growth within and nearby infrastructures by mitigating the problems of limited soil spaces, poor soil structures and soil space barrier installations and maintenance. The limited soil space encountered many conflicts and identified six methods that mitigate the survival tree-roots, such as soil volume/mounding, soil replacement/amendment for the radial trench, soil spacing-root bridge, root tunneling, walkway/pavement rising/diverted, and suspended pavement. The limited soil spaces are mitigation affords of inadequate soil-roots and spreading root settling and modification of construction soil media since the barrier existed and installed in root trails or zones. This is the reason for enabling tree-roots spreading and finds adequate sources (nutrients, water uptake and oxygen), spaces and functioning to stability stand of root anchorage since the matured tree grows larger. The poor soil structures were identified as three methods to mitigate soil materials' problems, and fewer soil voids comprise skeletal soil, structural soil, and soil cell. Mitigation of poor soil structure is altering the existing and introducing new structures by modifying the quantities and materials ratio allowing more voids beneath for roots spreading by considering the above structure of foot and vehicle traffics functioning or load-bearing. The soil space barrier installations and maintenance recognized to sustain both infrastructures and tree-roots grown in limited spaces and its benefits, the root barrier installations and root pruning are recommended. In conclusion, these recommended methods attempt to mitigate the present problems encountered at a particular place and problems among tree-roots and infrastructures exist. The combined method is the best way to alleviates the conflicts since the recognized conflicts are between tree-roots and man-made while the urban soil is modified. These presenting methods are most considered to sustain the matured urban trees' lifespan growth in the urban environment.

Keywords: urban tree-roots, limited soil spaces, poor soil structures, soil space barrier and maintenance

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579 Development of an Appropriate Method for the Determination of Multiple Mycotoxins in Pork Processing Products by UHPLC-TCFLD

Authors: Jason Gica, Yi-Hsieng Samuel Wu, Deng-Jye Yang, Yi-Chen Chen

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Mycotoxins, harmful secondary metabolites produced by certain fungi species, pose significant risks to animals and humans worldwide. Their stable properties lead to contamination during grain harvesting, transportation, and storage, as well as in processed food products. The prevalence of mycotoxin contamination has attracted significant attention due to its adverse impact on food safety and global trade. The secondary contamination pathway from animal products has been identified as an important route of exposure, posing health risks for livestock and humans consuming contaminated products. Pork, one of the highly consumed meat products in Taiwan according to the National Food Consumption Database, plays a critical role in the nation's diet and economy. Given its substantial consumption, pork processing products are a significant component of the food supply chain and a potential source of mycotoxin contamination. This study is paramount for formulating effective regulations and strategies to mitigate mycotoxin-related risks in the food supply chain. By establishing a reliable analytical method, this research contributes to safeguarding public health and enhancing the quality of pork processing products. The findings will serve as valuable guidance for policymakers, food industries, and consumers to ensure a safer food supply chain in the face of emerging mycotoxin challenges. An innovative and efficient analytical approach is proposed using Ultra-High Performance Liquid Chromatography coupled with Temperature Control Fluorescence Detector Light (UHPLC-TCFLD) to determine multiple mycotoxins in pork meat samples due to its exceptional capacity to detect multiple mycotoxins at the lowest levels of concentration, making it highly sensitive and reliable for comprehensive mycotoxin analysis. Additionally, its ability to simultaneously detect multiple mycotoxins in a single run significantly reduces the time and resources required for analysis, making it a cost-effective solution for monitoring mycotoxin contamination in pork processing products. The research aims to optimize the efficient mycotoxin QuEChERs extraction method and rigorously validate its accuracy and precision. The results will provide crucial insights into mycotoxin levels in pork processing products.

Keywords: multiple-mycotoxin analysis, pork processing products, QuEChERs, UHPLC-TCFLD, validation

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578 Groundwater Quality Assessment in the Vicinity of Tannery Industries in Warangal, India

Authors: Mohammed Fathima Shahanaaz, Shaik Fayazuddin, M. Uday Kiran

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Groundwater quality is deteriorating day by day in different parts of the world due to various reasons, toxic chemicals are being discharged without proper treatment into inland water bodies and land which in turn add pollutants to the groundwater. In this kind of situation, the rural communities which do not have municipal drinking water have to rely on groundwater though it is polluted for various uses. Tannery industry is one of the major industry which provides economy and employment to India. Since most of the developed countries stopped using chemicals which are toxic, the tanning industry which uses chromium as its major element are being shifted towards developing countries. Most of the tanning industries in India can be found in clusters concentrated mainly in states of Tamilnadu, West Bengal, Uttar Pradesh and limited places of Punjab. Limited work is present in the case of tanneries of Warangal. There exists 18 group of tanneries in Desaipet, Enamamula region of Warangal, out of which 4 are involved in dry process and are low responsible for groundwater pollution. These units of tanneries are discharging their effluents after treatment into Sai Cheruvu. Though the treatment effluents are being discharged, the Sai Cheruvu is turned in to Pink colour, with higher levels of BOD, COD, chromium, chlorides, total hardness, TDS and sulphates. An attempt was made to analyse the groundwater samples around this polluted Sai Cheruvu region since literature shows that a single tannery can pollute groundwater to a radius of 7-8 kms from the point of disposal. Sample are collected from 6 different locations around Sai Cheruvu. Analysis was performed for determining various constituents in groundwater such as pH, EC, TDS, TH, Ca+2, Mg+2, HCO3-, Na+, K+, Cl-, SO42-, NO3-, F and Cr+6. The analysis of these constitutes gave values greater than permissible limits. Even chromium is also present in groundwater samples which is exceeding permissible limits People in Paidepally and Sardharpeta villages already stopped the usage of groundwater. They are buying bottle water for drinking purpose. Though they are not using groundwater for drinking purpose complaints are made about using this water for washing also. So treatment process should be adopted for groundwater which should be simple and efficient. In this study rice husk silica (RHS) is used to treat pollutants in groundwater with varying dosages of RHS and contact time. Rice husk is treated, dried and place in a muffle furnace for 6 hours at 650°C. Reduction is observed in total hardness, chlorides and chromium levels are observed after the application RHS. Pollutants reached permissible limits for 27.5mg/l and 50 mg/l of dosage for a contact time of 130 min at constant pH and temperature.

Keywords: chromium, groundwater, rice husk silica, tanning industries

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577 Evaluation of Regional Anaesthesia Practice in Plastic Surgery: A Retrospective Cross-Sectional Study

Authors: Samar Mousa, Ryan Kerstein, Mohanad Adam

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Regional anaesthesia has been associated with favourable outcomes in patients undergoing a wide range of surgeries. Beneficial effects have been demonstrated in terms of postoperative respiratory and cardiovascular endpoints, 7-day survival, time to ambulation and hospital discharge, and postoperative analgesia. Our project aimed at assessing the regional anaesthesia practice in the plastic surgery department of Buckinghamshire trust and finding out ways to improve the service in collaboration with the anaesthesia team. It is a retrospective study associated with a questionnaire filled out by plastic surgeons and anaesthetists to get the full picture behind the numbers. The study period was between 1/3/2022 and 23/5/2022 (12 weeks). The operative notes of all patients who had an operation under plastic surgery, whether emergency or elective, were reviewed. The criteria of suitable candidates for the regional block were put by the consultant anaesthetists as follows: age above 16, single surgical site (arm, forearm, leg, foot), no drug allergy, no pre-existing neuropathy, no bleeding disorders, not on ant-coagulation, no infection to the site of the block. For 12 weeks, 1061 operations were performed by plastic surgeons. Local cases were excluded leaving 319 cases. Of the 319, 102 patients were suitable candidates for regional block after applying the previously mentioned criteria. However, only seven patients had their operations under the regional block, and the rest had general anaesthesia that could have been easily avoided. An online questionnaire was filled out by both plastic surgeons and anaesthetists of different training levels to find out the reasons behind the obvious preference for general over regional anaesthesia, even if this was against the patients’ interest. The questionnaire included the following points: training level, time taken to give GA or RA, factors that influence the decision, percentage of RA candidates that had GA, reasons behind this percentage, recommendations. Forty-four clinicians filled out the questionnaire, among which were 23 plastic surgeons and 21 anaesthetists. As regards the training level, there were 21 consultants, 4 associate specialists, 9 registrars, and 10 senior house officers. The actual percentage of patients who were good candidates for RA but had GA instead is 93%. The replies estimated this percentage as between 10-30%. 29% of the respondents thought that this percentage is because of surgeons’ preference to have GA rather than RA for their operations without medical support for the decision. 37% of the replies thought that anaesthetists prefer giving GA even if the patient is a suitable candidate for RA. 22.6% of the replies thought that patients refused to have RA, and 11.3% had other causes. The recommendations were in 5 main accesses, which are protocols and pathways for regional blocks, more training opportunities for anaesthetists on regional blocks, providing a separate block room in the hospital, better communication between surgeons and anaesthetists, patient education about the benefits of regional blocks.

Keywords: regional anaesthesia, regional block, plastic surgery, general anaesthesia

Procedia PDF Downloads 85
576 Biocompatible Hydrogel Materials Containing Cytostatics for Cancer Treatment

Authors: S. Kudlacik-Kramarczyk, M. Kedzierska, B. Tyliszczak

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Recently, the continuous development of medicine and related sciences has been observed. Particular emphasis is directed on the development of biomaterials, i.e., non-toxic, biocompatible and biodegradable materials that may improve the effectiveness of treatment as well as the comfort of patients. This is particularly important in the case of cancer treatment. Currently, there are many methods of cancer treatment based primarily on chemotherapy and the surgical removal of the tumor, but it is worth noting that these therapies also cause many side effects. Among women, the most common cancer is breast cancer. It may be completely cured, but the consequence of treatment is partial or complete breast mastectomy and radiation therapy, which results in severe skin burns. The skin of the patient after radiation therapy is very burned, and therefore requires intensive care and high frequency of dressing changes. The traditional dressing adheres to the burn wounds and does not absorb adequate amount of exudate from injuries and the patient is forced to change the dressing every 2 hours. Therefore, the main purpose was to develop an innovative combination of dressing material with drug carriers that may be used in anti-cancer therapy. The innovation of this solution is the combination of these two products into one system, i.e., a transdermal system with the possibility of a controlled release of the drug- cytostatic. Besides, the possibility of modifying the hydrogel matrix with aloe vera juice provides this material with new features favorable from the point of view of healing processes of burn wounds resulting from the radiation therapy. In this study, hydrogel materials containing protein spheres with the active substance have been obtained as a result of photopolymerization process. The reaction mixture consisting of the protein (albumin) spheres incorporated with cytostatic, chitosan, adequate crosslinking agent and photoinitiator has been subjected to the UV radiation for 2 minutes. Prepared materials have been subjected to the numerous studies including the analysis of cytotoxicity using murine fibroblasts L929. Analysis was conducted based on the mitochondrial activity test (MTT reduction assay) which involves the determining the number of cells characterized by proper metabolism. Hydrogel materials obtained using different amount of crosslinking agents have been subjected to the cytotoxicity analysis. According to the standards, tested material is defined as cytotoxic when the viability of cells after 24 h incubation with this material is lower than 70%. In the research, hydrogel polymer materials containing protein spheres incorporated with the active substance, i.e. a cytostatic, have been developed. Such a dressing may support the treatment of cancer due to the content of the anti-cancer drug - cytostatic, and may also provide a soothing effect on the healing of the burn wounds resulted from the radiation therapy due to the content of aloe vera juice in the hydrogel matrix. Based on the conducted cytotoxicity studies, it may be concluded that the obtained materials do not adversely affect the tested cell lines, therefore they can be subjected to more advanced analyzes.

Keywords: hydrogel polymers, cytostatics, drug carriers, cytotoxicity

Procedia PDF Downloads 133
575 Finite Element Modeling of Mass Transfer Phenomenon and Optimization of Process Parameters for Drying of Paddy in a Hybrid Solar Dryer

Authors: Aprajeeta Jha, Punyadarshini P. Tripathy

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Drying technologies for various food processing operations shares an inevitable linkage with energy, cost and environmental sustainability. Hence, solar drying of food grains has become imperative choice to combat duo challenges of meeting high energy demand for drying and to address climate change scenario. But performance and reliability of solar dryers depend hugely on sunshine period, climatic conditions, therefore, offer a limited control over drying conditions and have lower efficiencies. Solar drying technology, supported by Photovoltaic (PV) power plant and hybrid type solar air collector can potentially overpower the disadvantages of solar dryers. For development of such robust hybrid dryers; to ensure quality and shelf-life of paddy grains the optimization of process parameter becomes extremely critical. Investigation of the moisture distribution profile within the grains becomes necessary in order to avoid over drying or under drying of food grains in hybrid solar dryer. Computational simulations based on finite element modeling can serve as potential tool in providing a better insight of moisture migration during drying process. Hence, present work aims at optimizing the process parameters and to develop a 3-dimensional (3D) finite element model (FEM) for predicting moisture profile in paddy during solar drying. COMSOL Multiphysics was employed to develop a 3D finite element model for predicting moisture profile. Furthermore, optimization of process parameters (power level, air velocity and moisture content) was done using response surface methodology in design expert software. 3D finite element model (FEM) for predicting moisture migration in single kernel for every time step has been developed and validated with experimental data. The mean absolute error (MAE), mean relative error (MRE) and standard error (SE) were found to be 0.003, 0.0531 and 0.0007, respectively, indicating close agreement of model with experimental results. Furthermore, optimized process parameters for drying paddy were found to be 700 W, 2.75 m/s at 13% (wb) with optimum temperature, milling yield and drying time of 42˚C, 62%, 86 min respectively, having desirability of 0.905. Above optimized conditions can be successfully used to dry paddy in PV integrated solar dryer in order to attain maximum uniformity, quality and yield of product. PV-integrated hybrid solar dryers can be employed as potential and cutting edge drying technology alternative for sustainable energy and food security.

Keywords: finite element modeling, moisture migration, paddy grain, process optimization, PV integrated hybrid solar dryer

Procedia PDF Downloads 151
574 Pregnancy Rate and Outcomes after Uterine Fibroid Embolization Single Centre Experience in the Middle East from the United Arab Emirates at Alain Hospital

Authors: Jamal Alkoteesh, Mohammed Zeki, Mouza Alnaqbi

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Objective: To evaluate pregnancy outcomes, complications and neonatal outcomes in women who had previously undergone uterine arterial embolization. Design: Retrospective study. In this study, most women opted for UFE as a fertility treatment after failure of myomectomy or in vitro fertilization, or because hysterectomy was the only suggested option. Background. Myomectomy is the standard approach in patients with fibroids desiring a future pregnancy. However, myomectomy may be difficult in cases of numerous interstitial and/or submucous fibroids.In these cases, UFE has the advantage of embolizing all fibroids in one procedure. This procedure is an accepted nonsurgical treatment for symptomatic uterine fibroids. Study Methods: A retrospective study of 210 patients treated with UFE for symptomatic uterine fibroids between 2011-2016 was performed. UFE was performed using ((PVA; Embozen, Beadblock) (500-900 µm in diameter). Pregnancies were identified using screening questionnaires and the study database. Of the 210 patients who received UFE treatment, 35 women younger than the age of 40 wanted to conceive and had been unable. All women in our study were advised to wait six months or more after UFE before attempting to become pregnant, of which the reported time range before attempting to conceive was seven to 33 months (average 20 months). RESULTS: In a retrospective chart review of patients younger than the age of 40 (35 patients,18 patients reported 23 pregnancies, of which five were miscarriages. Two more pregnancies were complicated by premature labor. Of the 23 pregnancies, 16 were normal full-term pregnancies, 15 women had conceived once, and four had become pregnant twice. The remaining patients did not conceive. In the study, there was no reported intrauterine growth retardation in the prenatal period, fetal distress during labor, or problems related to uterine integrity. Two patients reported minor problems during pregnancy that were borderline oligohydramnios and low-lying placenta. In the cohort of women who did conceive, overall, 16 out of 18 births proceeded normally without any complications (86%). Eight women delivered by cesarean section, and 10 women had normal vaginal delivery. In this study of 210 women, UFE had a fertility rate of 47%. Our group of 23 pregnancies was small, but did confirm successful pregnancy after UFE. The 45.7% pregnancy rate in women below the age of 40 years old who completed a term pregnancy compares favorably with women who underwent myomectomy via other method. Of the women in the cohort who did conceive, subsequent birth proceeded normally (86%). Conclusion: Pregnancy after UFE is well-documented. The risks of infertility following embolization, premature menopause, and hysterectomy are small, as is the radiation exposure during embolization. Fertility rates appear similar to patients undergoing myomectomy.UFE should not be contraindicated in patients who want to conceive and they should be able to choose between surgical options and UFE.

Keywords: fibroid, pregnancy, therapeutic embolization, uterine artery

Procedia PDF Downloads 228
573 Bi-objective Network Optimization in Disaster Relief Logistics

Authors: Katharina Eberhardt, Florian Klaus Kaiser, Frank Schultmann

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Last-mile distribution is one of the most critical parts of a disaster relief operation. Various uncertainties, such as infrastructure conditions, resource availability, and fluctuating beneficiary demand, render last-mile distribution challenging in disaster relief operations. The need to balance critical performance criteria like response time, meeting demand and cost-effectiveness further complicates the task. The occurrence of disasters cannot be controlled, and the magnitude is often challenging to assess. In summary, these uncertainties create a need for additional flexibility, agility, and preparedness in logistics operations. As a result, strategic planning and efficient network design are critical for an effective and efficient response. Furthermore, the increasing frequency of disasters and the rising cost of logistical operations amplify the need to provide robust and resilient solutions in this area. Therefore, we formulate a scenario-based bi-objective optimization model that integrates pre-positioning, allocation, and distribution of relief supplies extending the general form of a covering location problem. The proposed model aims to minimize underlying logistics costs while maximizing demand coverage. Using a set of disruption scenarios, the model allows decision-makers to identify optimal network solutions to address the risk of disruptions. We provide an empirical case study of the public authorities’ emergency food storage strategy in Germany to illustrate the potential applicability of the model and provide implications for decision-makers in a real-world setting. Also, we conduct a sensitivity analysis focusing on the impact of varying stockpile capacities, single-site outages, and limited transportation capacities on the objective value. The results show that the stockpiling strategy needs to be consistent with the optimal number of depots and inventory based on minimizing costs and maximizing demand satisfaction. The strategy has the potential for optimization, as network coverage is insufficient and relies on very high transportation and personnel capacity levels. As such, the model provides decision support for public authorities to determine an efficient stockpiling strategy and distribution network and provides recommendations for increased resilience. However, certain factors have yet to be considered in this study and should be addressed in future works, such as additional network constraints and heuristic algorithms.

Keywords: humanitarian logistics, bi-objective optimization, pre-positioning, last mile distribution, decision support, disaster relief networks

Procedia PDF Downloads 80
572 Effect of Human Use, Season and Habitat on Ungulate Densities in Kanha Tiger Reserve

Authors: Neha Awasthi, Ujjwal Kumar

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Density of large carnivores is primarily dictated by the density of their prey. Therefore, optimal management of ungulates populations permits harbouring of viable large carnivore populations within protected areas. Ungulate density is likely to respond to regimes of protection and vegetation types. This has generated the need among conservation practitioners to obtain strata specific seasonal species densities for habitat management. Kanha Tiger Reserve (KTR) of 2074 km2 area comprises of two distinct management strata: The core (940 km2), devoid of human settlements and buffer (1134 km2) which is a multiple use area. In general, four habitat strata, grassland, sal forest, bamboo-mixed forest and miscellaneous forest are present in the reserve. Stratified sampling approach was used to access a) impact of human use and b) effect of habitat and season on ungulate densities. Since 2013 to 2016, ungulates were surveyed in winter and summer of each year with an effort of 1200 km walk in 200 spatial transects distributed throughout Kanha Tiger Reserve. We used a single detection function for each species within each habitat stratum for each season for estimating species specific seasonal density, using program DISTANCE. Our key results state that the core area had 4.8 times higher wild ungulate biomass compared with the buffer zone, highlighting the importance of undisturbed area. Chital was found to be most abundant, having a density of 30.1(SE 4.34)/km2 and contributing 33% of the biomass with a habitat preference for grassland. Unlike other ungulates, Gaur being mega herbivore, showed a major seasonal shift in density from bamboo-mixed and sal forest in summer to miscellaneous forest in winter. Maximum diversity and ungulate biomass were supported by grassland followed by bamboo-mixed habitat. Our study stresses the importance of inviolate core areas for achieving high wild ungulate densities and for maintaining populations of endangered and rare species. Grasslands accounts for 9% of the core area of KTR maintained in arrested stage of succession, therefore enhancing this habitat would maintain ungulate diversity, density and cater to the needs of only surviving population of the endangered barasingha and grassland specialist the blackbuck. We show the relevance of different habitat types for differential seasonal use by ungulates and attempt to interpret this in the context of nutrition and cover needs by wild ungulates. Management for an optimal habitat mosaic that maintains ungulate diversity and maximizes ungulate biomass is recommended.

Keywords: distance sampling, habitat management, ungulate biomass, diversity

Procedia PDF Downloads 305
571 Efficacy of Preimplantation Genetic Screening in Women with a Spontaneous Abortion History with Eukaryotic or Aneuploidy Abortus

Authors: Jayeon Kim, Eunjung Yu, Taeki Yoon

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Most spontaneous miscarriage is believed to be a consequence of embryo aneuploidies. Transferring eukaryotic embryos selected by PGS is expected to decrease the miscarriage rate. Current PGS indications include advanced maternal age, recurrent pregnancy loss, repeated implantation failure. Recently, use of PGS for healthy women without above indications for the purpose of improving in vitro fertilization (IVF) outcomes is on the rise. However, it is still controversy about the beneficial effect of PGS in this population, especially, in women with a history of no more than 2 miscarriages or miscarriage of eukaryotic abortus. This study aimed to investigate if karyotyping result of abortus is a good indicator of preimplantation genetic screening (PGS) in subsequent IVF cycle in women with a history of spontaneous abortion. A single-center retrospective cohort study was performed. Women who had spontaneous abortion(s) (less than 3) and dilatation and evacuation, and subsequent IVF from January 2016 to November 2016 were included. Their medical information was extracted from the charts. Clinical pregnancy was defined as presence of a gestational sac with fetal heart beat detected on ultrasound in week 7. Statistical analysis was performed using SPSS software. Total 234 women were included. 121 out of 234 (51.7%) underwent karyotyping of the abortus, and 113 did not have the abortus karyotyped. Embryo biopsy was performed on 3 or 5 days after oocyte retrieval, followed by embryo transfer (ET) on a fresh or frozen cycle. The biopsied materials were subjected to microarray comparative genomic hybridization. Clinical pregnancy rate per ET was compared between PGS and non-PGS group in each study group. Patients were grouped by two criteria: karyotype of the abortus from previous miscarriage (unknown fetal karyotype (n=89, Group 1), eukaryotic abortus (n=36, Group 2) or aneuploidy abortus (n=67, Group 3)), and pursuing PGS in subsequent IVF cycle (pursuing PGS (PGS group, n=105) or not pursuing PGS (non-PGS group, n=87)). The PGS group was significantly older and had higher number of retrieved oocytes and prior miscarriages compared to non-PGS group. There were no differences in BMI and AMH level between those two groups. In PGS group, the mean number of transferable embryos (eukaryotic embryo) was 1.3 ± 0.7, 1.5 ± 0.5 and 1.4 ± 0.5, respectively (p = 0.049). In 42 cases, ET was cancelled because all embryos biopsied turned out to be abnormal. In all three groups (group 1, 2, and 3), clinical pregnancy rates were not statistically different between PGS and non-PGS group (Group 1: 48.8% vs. 52.2% (p=0.858), Group 2: 70% vs. 73.1% (p=0.730), Group 3: 42.3% vs. 46.7% (p=0.640), in PGS and non-PGS group, respectively). In both groups who had miscarriage with eukaryotic and aneuploidy abortus, the clinical pregnancy rate between IVF cycles with and without PGS was not different. When we compare miscarriage and ongoing pregnancy rate, there were no significant differences between PGS and non-PGS group in all three groups. Our results show that the routine application of PGS in women who had less than 3 miscarriages would not be beneficial, even in cases that previous miscarriage had been caused by fetal aneuploidy.

Keywords: preimplantation genetic diagnosis, miscarriage, kpryotyping, in vitro fertilization

Procedia PDF Downloads 182
570 Effect of Toxic Metals Exposure on Rat Behavior and Brain Morphology: Arsenic, Manganese

Authors: Tamar Bikashvili, Tamar Lordkipanidze, Ilia Lazrishvili

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Heavy metals remain one of serious environmental problems due to their toxic effects. The effect of arsenic and manganese compounds on rat behavior and neuromorphology was studied. Wistar rats were assigned to four groups: rats in control group were given regular water, while rats in other groups drank water with final manganese concentration of 10 mg/L (group A), 20 mg/L (group B) and final arsenic concentration 68 mg/L (group C), respectively, for a month. To study exploratory and anxiety behavior and also to evaluate aggressive performance in “home cage” rats were tested in “Open Field” and to estimate learning and memory status multi-branched maze was used. Statistically significant increase of motor and oriental-searching activity in experimental groups was revealed by an open field test, which was expressed in increase of number of lines crossed, rearing and hole reflexes. Obtained results indicated the suppression of fear in rats exposed to manganese. Specifically, this was estimated by the frequency of getting to the central part of the open field. Experiments revealed that 30-day exposure to 10 mg/ml manganese did not stimulate aggressive behavior in rats, while exposure to the higher dose (20 mg/ml), 37% of initially non-aggressive animals manifested aggressive behavior. Furthermore, 25% of rats were extremely aggressive. Obtained data support the hypothesis that excess manganese in the body is one of the immediate causes of enhancement of interspecific predatory aggressive and violent behavior in rats. It was also discovered that manganese intoxication produces non-reversible severe learning disability and insignificant, reversible memory disturbances. Studies of rodents exposed to arsenic also revealed changes in the learning process. As it is known, the distribution of metal ions differs in various brain regions. The principle manganese accumulation was observed in the hippocampus and in the neocortex, while arsenic was predominantly accumulated in nucleus accumbens, striatum, and cortex. These brain regions play an important role in the regulation of emotional state and motor activity. Histopathological analyzes of brain sections illustrated two morphologically distinct altered phenotypes of neurons: (1) shrunk cells with indications of apoptosis - nucleus and cytoplasm were very difficult to be distinguished, the integrity of neuronal cytoplasm was not disturbed; and (2) swollen cells - with indications of necrosis. Pyknotic nucleus, plasma membrane disruption and cytoplasmic vacuoles were observed in swollen neurons and they were surrounded by activated gliocytes. It’s worth to mention that in the cortex the majority of damaged neurons were apoptotic while in subcortical nuclei –neurons were mainly necrotic. Ultrastructural analyses demonstrated that all cell types in the cortex and the nucleus caudatus represent destructed mitochondria, widened neurons’ vacuolar system profiles, increased number of lysosomes and degeneration of axonal endings.

Keywords: arsenic, manganese, behavior, learning, neuron

Procedia PDF Downloads 360
569 A Comparison of the Microbiology Profile for Periprosthetic Joint Infection (PJI) of Knee Arthroplasty and Lower Limb Endoprostheses in Tumour Surgery

Authors: Amirul Adlan, Robert A McCulloch, Neil Jenkins, MIchael Parry, Jonathan Stevenson, Lee Jeys

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Background and Objectives: The current antibiotic prophylaxis for oncological patients is based upon evidence from primary arthroplasty despite significant differences in both patient group and procedure. The aim of this study was to compare the microbiology organisms responsible for PJI in patients who underwent two-stage revision for infected primary knee replacement with those of infected oncological endoprostheses of the lower limb in a single institution. This will subsequently guide decision making regarding antibiotic prophylaxis at primary implantation for oncological procedures and empirical antibiotics for infected revision procedures (where the infecting organism(s) are unknown). Patient and Methods: 118 patients were treated with two-stage revision surgery for infected knee arthroplasty and lower limb endoprostheses between 1999 and 2019. 74 patients had two-stage revision for PJI of knee arthroplasty, and 44 had two-stage revision of lower limb endoprostheses. There were 68 males and 50 females. The mean age for the knee arthroplasty cohort and lower limb endoprostheses cohort were 70.2 years (50-89) and 36.1 years (12-78), respectively (p<0.01). Patient host and extremity criteria were categorised according to the MSIS Host and Extremity Staging System. Patient microbiological culture, the incidence of polymicrobial infection and multi-drug resistance (MDR) were analysed and recorded. Results: Polymicrobial infection was reported in 16% (12 patients) from knee arthroplasty PJI and 14.5% (8 patients) in endoprostheses PJI (p=0.783). There was a significantly higher incidence of MDR in endoprostheses PJI, isolated in 36.4% of cultures, compared to knee arthroplasty PJI (17.2%) (p=0.01). Gram-positive organisms were isolated in more than 80% of cultures from both cohorts. Coagulase-negative Staphylococcus (CoNS) was the commonest gram-positive organism, and Escherichia coli was the commonest Gram-negative organism in both groups. According to the MSIS staging system, the host and extremity grade of knee arthroplasty PJI cohort were significantly better than endoprostheses PJI(p<0.05). Conclusion: Empirical antibiotic management of PJI in orthopaedic oncology is based upon PJI in arthroplasty despite differences in both host and microbiology. Our results show a significant increase in MDR pathogens within the oncological group despite CoNS being the most common infective organism in both groups. Endoprosthetic patients presented with poorer host and extremity criteria. These factors should be considered when managing this complex patient group, emphasising the importance of broad-spectrum antibiotic prophylaxis and preoperative sampling to ensure appropriate perioperative antibiotic cover.

Keywords: microbiology, periprosthetic Joint infection, knee arthroplasty, endoprostheses

Procedia PDF Downloads 118
568 Childhood Adversity and Delinquency in Youth: Self-Esteem and Depression as Mediators

Authors: Yuhui Liu, Lydia Speyer, Jasmin Wertz, Ingrid Obsuth

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Childhood adversities refer to situations where a child's basic needs for safety and support are compromised, leading to substantial disruptions in their emotional, cognitive, social, or neurobiological development. Given the prevalence of adversities (8%-39%), their impact on developmental outcomes is challenging to completely avoid. Delinquency is an important consequence of childhood adversities, given its potential causing violence and other forms of victimisation, influencing victims, delinquents, their families, and the whole of society. Studying mediators helps explain the link between childhood adversity and delinquency, which aids in designing effective intervention programs that target explanatory variables to disrupt the path and mitigate the effects of childhood adversities on delinquency. The Dimensional Model of Adversity and Psychopathology suggests that threat-based adversities influence outcomes through emotion processing, while deprivation-based adversities do so through cognitive mechanisms. Thus, considering a wide range of threat-based and deprivation-based adversities and their co-occurrence and their associations with delinquency through cognitive and emotional mechanisms is essential. This study employs the Millennium Cohort Study, tracking the development of approximately 19,000 individuals born across England, Scotland, Wales and Northern Ireland, representing a nationally representative sample. Parallel mediation models compare the mediating roles of self-esteem (cognitive) and depression (affective) in the associations between childhood adversities and delinquency. Eleven types of childhood adversities were assessed both individually and through latent class analysis, considering adversity experiences from birth to early adolescence. This approach aimed to capture how threat-based, deprived-based, or combined threat and deprived-based adversities are associated with delinquency. Eight latent classes were identified: three classes (low adversity, especially direct and indirect violence; low childhood and moderate adolescent adversities; and persistent poverty with declining bullying victimisation) were negatively associated with delinquency. In contrast, three classes (high parental alcohol misuse, overall high adversities, especially regarding household instability, and high adversity) were positively associated with delinquency. When mediators were included, all classes showed a significant association with delinquency through depression, but not through self-esteem. Among the eleven single adversities, seven were positively associated with delinquency, with five linked through depression and none through self-esteem. The results imply the importance of affective variables, not just for threat-based but also deprivation-based adversities. Academically, this suggests exploring other mechanisms linking adversities and delinquency since some adversities are linked through neither depression nor self-esteem. Clinically, intervention programs should focus on affective variables like depression to mitigate the effects of childhood adversities on delinquency.

Keywords: childhood adversity, delinquency, depression, self-esteem

Procedia PDF Downloads 34
567 Toxicological Analysis of Some Plant Combinations Used for the Treatment of Hypertension by Lay People in Northern Kwazulu-Natal, South Africa

Authors: Mmbulaheni Ramulondi, Sandy Van Vuuren, Helene De Wet

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The use of plant combinations to treat various medical conditions is not a new concept, and it is known that traditional people do not only rely on a single plant extract for efficacy but often combine various plant species for treatment. The knowledge of plant combinations is transferred from one generation to the other in the belief that combination therapy may enhance efficacy, reduce toxicity, decreases adverse effects, increase bioavailability and result in lower dosages. However, combination therapy may also be harmful when the interaction is antagonistic, since it may result in increasing toxicity. Although a fair amount of research has been done on the toxicity of medicinal plants, there is very little done on the toxicity of medicinal plants in combination. The aim of the study was to assess the toxicity potential of 19 plant combinations which have been documented as treatments of hypertension in northern KwaZulu-Natal by lay people. The aqueous extracts were assessed using two assays; the Brine shrimp assay (Artemia franciscana) and the Ames test (Mutagenicity). Only one plant combination (Aloe marlothii with Hypoxis hemerocallidea) in the current study has been previously assessed for toxicity. With the Brine shrimp assay, the plant combinations were tested in two concentrations (2 and 4 mg/ml), while for mutagenicity tests, they were tested at 5 mg/ml. The results showed that in the Brine shrimp assay, six combinations were toxic at 4 mg/ml. The combinations were Albertisia delagoensis with Senecio serratuloides (57%), Aloe marlothii with Catharanthus roseus (98%), Catharanthus roseus with Hypoxis hemerocallidea (66%), Catharanthus roseus with Musa acuminata (89%), Catharanthus roseus with Momordica balsamina (99%) and Aloe marlothii with Trichilia emetica and Hyphaene coriacea (50%). However when the concentration was reduced to 2 mg/ml, only three combinations were toxic which were Aloe marlothii with Catharanthus roseus (76%), Catharanthus roseus with Musa acuminata (66%) and Catharanthus roseus with Momordica balsamina (73%). For the mutagenicity assay, only the combinations between Catharanthus roseus with Hypoxis hemerocallidea and Catharanthus roseus with Momordica balsamina were mutagenic towards the Salmonella typhimurium strains TA98 and TA100. Most of the combinations which were toxic involve C. roseus which was also toxic when tested singularly. It is worth noting that C. roseus was one of the most frequently used plant species both to treat hypertension singularly and in combination and some of the individuals have been using this for the last 20 years. The mortality percentage of the Brine shrimp showed a significant correlation between dosage and toxicity thus toxicity was dosage dependant. A combination which is worth noting is the combination between A. delagoensis and S. serratuloides. Singularly these plants were non-toxic towards Brine shrimp, however their combination resulted in antagonism with the mortality rate of 57% at the total concentration of 4 mg/ml. Low toxicity was mostly observed, giving some validity to combined use, however the few combinations showing increased toxicity demonstrate the importance of analysing plant combinations.

Keywords: dosage, hypertension, plant combinations, toxicity

Procedia PDF Downloads 355
566 An Inquiry of the Impact of Flood Risk on Housing Market with Enhanced Geographically Weighted Regression

Authors: Lin-Han Chiang Hsieh, Hsiao-Yi Lin

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This study aims to determine the impact of the disclosure of flood potential map on housing prices. The disclosure is supposed to mitigate the market failure by reducing information asymmetry. On the other hand, opponents argue that the official disclosure of simulated results will only create unnecessary disturbances on the housing market. This study identifies the impact of the disclosure of the flood potential map by comparing the hedonic price of flood potential before and after the disclosure. The flood potential map used in this study is published by Taipei municipal government in 2015, which is a result of a comprehensive simulation based on geographical, hydrological, and meteorological factors. The residential property sales data of 2013 to 2016 is used in this study, which is collected from the actual sales price registration system by the Department of Land Administration (DLA). The result shows that the impact of flood potential on residential real estate market is statistically significant both before and after the disclosure. But the trend is clearer after the disclosure, suggesting that the disclosure does have an impact on the market. Also, the result shows that the impact of flood potential differs by the severity and frequency of precipitation. The negative impact for a relatively mild, high frequency flood potential is stronger than that for a heavy, low possibility flood potential. The result indicates that home buyers are of more concern to the frequency, than the intensity of flood. Another contribution of this study is in the methodological perspective. The classic hedonic price analysis with OLS regression suffers from two spatial problems: the endogeneity problem caused by omitted spatial-related variables, and the heterogeneity concern to the presumption that regression coefficients are spatially constant. These two problems are seldom considered in a single model. This study tries to deal with the endogeneity and heterogeneity problem together by combining the spatial fixed-effect model and geographically weighted regression (GWR). A series of literature indicates that the hedonic price of certain environmental assets varies spatially by applying GWR. Since the endogeneity problem is usually not considered in typical GWR models, it is arguable that the omitted spatial-related variables might bias the result of GWR models. By combing the spatial fixed-effect model and GWR, this study concludes that the effect of flood potential map is highly sensitive by location, even after controlling for the spatial autocorrelation at the same time. The main policy application of this result is that it is improper to determine the potential benefit of flood prevention policy by simply multiplying the hedonic price of flood risk by the number of houses. The effect of flood prevention might vary dramatically by location.

Keywords: flood potential, hedonic price analysis, endogeneity, heterogeneity, geographically-weighted regression

Procedia PDF Downloads 290
565 An A-Star Approach for the Quickest Path Problem with Time Windows

Authors: Christofas Stergianos, Jason Atkin, Herve Morvan

Abstract:

As air traffic increases, more airports are interested in utilizing optimization methods. Many processes happen in parallel at an airport, and complex models are needed in order to have a reliable solution that can be implemented for ground movement operations. The ground movement for aircraft in an airport, allocating a path to each aircraft to follow in order to reach their destination (e.g. runway or gate), is one process that could be optimized. The Quickest Path Problem with Time Windows (QPPTW) algorithm has been developed to provide a conflict-free routing of vehicles and has been applied to routing aircraft around an airport. It was subsequently modified to increase the accuracy for airport applications. These modifications take into consideration specific characteristics of the problem, such as: the pushback process, which considers the extra time that is needed for pushing back an aircraft and turning its engines on; stand holding where any waiting should be allocated to the stand; and runway sequencing, where the sequence of the aircraft that take off is optimized and has to be respected. QPPTW involves searching for the quickest path by expanding the search in all directions, similarly to Dijkstra’s algorithm. Finding a way to direct the expansion can potentially assist the search and achieve a better performance. We have further modified the QPPTW algorithm to use a heuristic approach in order to guide the search. This new algorithm is based on the A-star search method but estimates the remaining time (instead of distance) in order to assess how far the target is. It is important to consider the remaining time that it is needed to reach the target, so that delays that are caused by other aircraft can be part of the optimization method. All of the other characteristics are still considered and time windows are still used in order to route multiple aircraft rather than a single aircraft. In this way the quickest path is found for each aircraft while taking into account the movements of the previously routed aircraft. After running experiments using a week of real aircraft data from Zurich Airport, the new algorithm (A-star QPPTW) was found to route aircraft much more quickly, being especially fast in routing the departing aircraft where pushback delays are significant. On average A-star QPPTW could route a full day (755 to 837 aircraft movements) 56% faster than the original algorithm. In total the routing of a full week of aircraft took only 12 seconds with the new algorithm, 15 seconds faster than the original algorithm. For real time application, the algorithm needs to be very fast, and this speed increase will allow us to add additional features and complexity, allowing further integration with other processes in airports and leading to more optimized and environmentally friendly airports.

Keywords: a-star search, airport operations, ground movement optimization, routing and scheduling

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564 Safety Validation of Black-Box Autonomous Systems: A Multi-Fidelity Reinforcement Learning Approach

Authors: Jared Beard, Ali Baheri

Abstract:

As autonomous systems become more prominent in society, ensuring their safe application becomes increasingly important. This is clearly demonstrated with autonomous cars traveling through a crowded city or robots traversing a warehouse with heavy equipment. Human environments can be complex, having high dimensional state and action spaces. This gives rise to two problems. One being that analytic solutions may not be possible. The other is that in simulation based approaches, searching the entirety of the problem space could be computationally intractable, ruling out formal methods. To overcome this, approximate solutions may seek to find failures or estimate their likelihood of occurrence. One such approach is adaptive stress testing (AST) which uses reinforcement learning to induce failures in the system. The premise of which is that a learned model can be used to help find new failure scenarios, making better use of simulations. In spite of these failures AST fails to find particularly sparse failures and can be inclined to find similar solutions to those found previously. To help overcome this, multi-fidelity learning can be used to alleviate this overuse of information. That is, information in lower fidelity can simulations can be used to build up samples less expensively, and more effectively cover the solution space to find a broader set of failures. Recent work in multi-fidelity learning has passed information bidirectionally using “knows what it knows” (KWIK) reinforcement learners to minimize the number of samples in high fidelity simulators (thereby reducing computation time and load). The contribution of this work, then, is development of the bidirectional multi-fidelity AST framework. Such an algorithm, uses multi-fidelity KWIK learners in an adversarial context to find failure modes. Thus far, a KWIK learner has been used to train an adversary in a grid world to prevent an agent from reaching its goal; thus demonstrating the utility of KWIK learners in an AST framework. The next step is implementation of the bidirectional multi-fidelity AST framework described. Testing will be conducted in a grid world containing an agent attempting to reach a goal position and adversary tasked with intercepting the agent as demonstrated previously. Fidelities will be modified by adjusting the size of a time-step, with higher-fidelity effectively allowing for more responsive closed loop feedback. Results will compare the single KWIK AST learner with the multi-fidelity algorithm with respect to number of samples, distinct failure modes found, and relative effect of learning after a number of trials.

Keywords: multi-fidelity reinforcement learning, multi-fidelity simulation, safety validation, falsification

Procedia PDF Downloads 158
563 Hybrid Renewable Energy Systems for Electricity and Hydrogen Production in an Urban Environment

Authors: Same Noel Ngando, Yakub Abdulfatai Olatunji

Abstract:

Renewable energy micro-grids, such as those powered by solar or wind energy, are often intermittent in nature. This means that the amount of energy generated by these systems can vary depending on weather conditions or other factors, which can make it difficult to ensure a steady supply of power. To address this issue, energy storage systems have been developed to increase the reliability of renewable energy micro-grids. Battery systems have been the dominant energy storage technology for renewable energy micro-grids. Batteries can store large amounts of energy in a relatively small and compact package, making them easy to install and maintain in a micro-grid setting. Additionally, batteries can be quickly charged and discharged, allowing them to respond quickly to changes in energy demand. However, the process involved in recycling batteries is quite costly and difficult. An alternative energy storage system that is gaining popularity is hydrogen storage. Hydrogen is a versatile energy carrier that can be produced from renewable energy sources such as solar or wind. It can be stored in large quantities at low cost, making it suitable for long-distance mass storage. Unlike batteries, hydrogen does not degrade over time, so it can be stored for extended periods without the need for frequent maintenance or replacement, allowing it to be used as a backup power source when the micro-grid is not generating enough energy to meet demand. When hydrogen is needed, it can be converted back into electricity through a fuel cell. Energy consumption data is got from a particular residential area in Daegu, South Korea, and the data is processed and analyzed. From the analysis, the total energy demand is calculated, and different hybrid energy system configurations are designed using HOMER Pro (Hybrid Optimization for Multiple Energy Resources) and MATLAB software. A techno-economic and environmental comparison and life cycle assessment (LCA) of the different configurations using battery and hydrogen as storage systems are carried out. The various scenarios included PV-hydrogen-grid system, PV-hydrogen-grid-wind, PV-hydrogen-grid-biomass, PV-hydrogen-wind, PV-hydrogen-biomass, biomass-hydrogen, wind-hydrogen, PV-battery-grid-wind, PV- battery -grid-biomass, PV- battery -wind, PV- battery -biomass, and biomass- battery. From the analysis, the least cost system for the location was the PV-hydrogen-grid system, with a net present cost of about USD 9,529,161. Even though all scenarios were environmentally friendly, taking into account the recycling cost and pollution involved in battery systems, all systems with hydrogen as a storage system produced better results. In conclusion, hydrogen is becoming a very prominent energy storage solution for renewable energy micro-grids. It is easier to store compared with electric power, so it is suitable for long-distance mass storage. Hydrogen storage systems have several advantages over battery systems, including flexibility, long-term stability, and low environmental impact. The cost of hydrogen storage is still relatively high, but it is expected to decrease as more hydrogen production, and storage infrastructure is built. With the growing focus on renewable energy and the need to reduce greenhouse gas emissions, hydrogen is expected to play an increasingly important role in the energy storage landscape.

Keywords: renewable energy systems, microgrid, hydrogen production, energy storage systems

Procedia PDF Downloads 94
562 Sequential and Combinatorial Pre-Treatment Strategy of Lignocellulose for the Enhanced Enzymatic Hydrolysis of Spent Coffee Waste

Authors: Rajeev Ravindran, Amit K. Jaiswal

Abstract:

Waste from the food-processing industry is produced in large amount and contains high levels of lignocellulose. Due to continuous accumulation throughout the year in large quantities, it creates a major environmental problem worldwide. The chemical composition of these wastes (up to 75% of its composition is contributed by polysaccharide) makes it inexpensive raw material for the production of value-added products such as biofuel, bio-solvents, nanocrystalline cellulose and enzymes. In order to use lignocellulose as the raw material for the microbial fermentation, the substrate is subjected to enzymatic treatment, which leads to the release of reducing sugars such as glucose and xylose. However, the inherent properties of lignocellulose such as presence of lignin, pectin, acetyl groups and the presence of crystalline cellulose contribute to recalcitrance. This leads to poor sugar yields upon enzymatic hydrolysis of lignocellulose. A pre-treatment method is generally applied before enzymatic treatment of lignocellulose that essentially removes recalcitrant components in biomass through structural breakdown. Present study is carried out to find out the best pre-treatment method for the maximum liberation of reducing sugars from spent coffee waste (SPW). SPW was subjected to a range of physical, chemical and physico-chemical pre-treatment followed by a sequential, combinatorial pre-treatment strategy is also applied on to attain maximum sugar yield by combining two or more pre-treatments. All the pre-treated samples were analysed for total reducing sugar followed by identification and quantification of individual sugar by HPLC coupled with RI detector. Besides, generation of any inhibitory compounds such furfural, hydroxymethyl furfural (HMF) which can hinder microbial growth and enzyme activity is also monitored. Results showed that ultrasound treatment (31.06 mg/L) proved to be the best pre-treatment method based on total reducing content followed by dilute acid hydrolysis (10.03 mg/L) while galactose was found to be the major monosaccharide present in the pre-treated SPW. Finally, the results obtained from the study were used to design a sequential lignocellulose pre-treatment protocol to decrease the formation of enzyme inhibitors and increase sugar yield on enzymatic hydrolysis by employing cellulase-hemicellulase consortium. Sequential, combinatorial treatment was found better in terms of total reducing yield and low content of the inhibitory compounds formation, which could be due to the fact that this mode of pre-treatment combines several mild treatment methods rather than formulating a single one. It eliminates the need for a detoxification step and potential application in the valorisation of lignocellulosic food waste.

Keywords: lignocellulose, enzymatic hydrolysis, pre-treatment, ultrasound

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561 Analysis of Distance Travelled by Plastic Consumables Used in the First 24 Hours of an Intensive Care Admission: Impacts and Methods of Mitigation

Authors: Aidan N. Smallwood, Celestine R. Weegenaar, Jack N. Evans

Abstract:

The intensive care unit (ICU) is a particularly resource heavy environment, in terms of staff, drugs and equipment required. Whilst many areas of the hospital are attempting to cut down on plastic use and minimise their impact on the environment, this has proven challenging within the confines of intensive care. Concurrently, as globalization has progressed over recent decades, there has been a tendency towards centralised manufacturing with international distribution networks for products, often covering large distances. In this study, we have modelled the standard consumption of plastic single-use items over the course of the first 24-hours of an average individual patient’s stay in a 12 bed ICU in the United Kingdom (UK). We have identified the country of manufacture and calculated the minimum possible distance travelled by each item from factory to patient. We have assumed direct transport via the shortest possible straight line from country of origin to the UK and have not accounted for transport within either country. Assuming an intubated patient with invasive haemodynamic monitoring and central venous access, there are a total of 52 distincts, largely plastic, disposable products which would reasonably be required in the first 24-hours after admission. Each product type has only been counted once to account for multiple items being shipped as one package. Travel distances from origin were summed to give the total distance combined for all 52 products. The minimum possible total distance travelled from country of origin to the UK for all types of product was 273,353 km, equivalent to 6.82 circumnavigations of the globe, or 71% of the way to the moon. The mean distance travelled was 5,256 km, approximately the distance from London to Mecca. With individual packaging for each item, the total weight of consumed products was 4.121 kg. The CO2 produced shipping these items by air freight would equate to 30.1 kg, however doing the same by sea would produce 0.2 kg CO2. Extrapolating these results to the 211,932 UK annual ICU admissions (2018-2019), even with the underestimates of distance and weight of our assumptions, air freight would account for 6586 tons CO2 emitted annually, approximately 130 times that of sea freight. Given the drive towards cost saving within the UK health service, and the decline of the local manufacturing industry, buying from intercontinental manufacturers is inevitable However, transporting all consumables by sea where feasible would be environmentally beneficial, as well as being less costly than air freight. At present, the NHS supply chain purchases from medical device companies, and there is no freely available information as to the transport mode used to deliver the product to the UK. This must be made available to purchasers in order to give a fuller picture of life cycle impact and allow for informed decision making in this regard.

Keywords: CO2, intensive care, plastic, transport

Procedia PDF Downloads 182