Search results for: biomechanics and clinical applications
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 9934

Search results for: biomechanics and clinical applications

2584 Using a Phenomenological Approach to Explore the Experiences of Nursing Students in Coping with Their Emotional Responses in Caring for End-Of-Life Patients

Authors: Yun Chan Lee

Abstract:

Background: End-of-life care is a large area of all nursing practice and student nurses are likely to meet dying patients in many placement areas. It is therefore important to understand the emotional responses and coping strategies of student nurses in order for nursing education systems to have some appreciation of how nursing students might be supported in the future. Methodology: This research used a qualitative phenomenological approach. Six student nurses understanding a degree-level adult nursing course were interviewed. Their responses to questions were analyzed using interpretative phenomenological analysis. Finding: The findings identified 3 main themes. First, the common experience of ‘unpreparedness’. A very small number of participants felt that this was unavoidable and that ‘no preparation is possible’, the majority felt that they were unprepared because of ‘insufficient input’ from the university and as a result of wider ‘social taboos’ around death and dying. The second theme showed that emotions were affected by ‘the personal connection to the patient’ and the important sub-themes of ‘the evoking of memories’, ‘involvement in care’ and ‘sense of responsibility’. The third theme, the coping strategies used by students, seemed to fall into two broad areas those ‘internal’ with the student and those ‘external’. In terms of the internal coping strategies, ‘detachment’, ‘faith’, ‘rationalization’ and ‘reflective skills’ are the important components of this part. Regarding the external coping strategies, ‘clinical staff’ and ‘the importance of family and friends’ are the importance of accessing external forms of support. Implication: It is clear that student nurses are affected emotionally by caring for dying patients and many of them have apprehension even before they begin on their placements but very often this is unspoken. Those anxieties before the placement become more pronounced during and continue after the placements. This has implications for when support is offered and possibly its duration. Another significant point of the study is that participants often highlighted their wish to speak to qualified nurses after their experiences of being involved in end-of-life care and especially when they had been present at the time of death. Many of the students spoke that qualified nurses were not available to them. This seemed to be due to a number of reasons. Because the qualified nurses were not available, students had to make use of family members and friends to talk to. Consequently, the implication of this study is not only to educate student nurses but also to educate the qualified mentors on the importance of providing emotional support to students.

Keywords: nursing students, coping strategies, end-of-life care, emotional responses

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2583 Comparison of Two Strategies in Thoracoscopic Ablation of Atrial Fibrillation

Authors: Alexander Zotov, Ilkin Osmanov, Emil Sakharov, Oleg Shelest, Aleksander Troitskiy, Robert Khabazov

Abstract:

Objective: Thoracoscopic surgical ablation of atrial fibrillation (AF) includes two technologies in performing of operation. 1st strategy used is the AtriCure device (bipolar, nonirrigated, non clamping), 2nd strategy is- the Medtronic device (bipolar, irrigated, clamping). The study presents a comparative analysis of clinical outcomes of two strategies in thoracoscopic ablation of AF using AtriCure vs. Medtronic devices. Methods: In 2 center study, 123 patients underwent thoracoscopic ablation of AF for the period from 2016 to 2020. Patients were divided into two groups. The first group is represented by patients who applied the AtriCure device (N=63), and the second group is - the Medtronic device (N=60), respectively. Patients were comparable in age, gender, and initial severity of the condition. Among the patients, in group 1 were 65% males with a median age of 57 years, while in group 2 – 75% and 60 years, respectively. Group 1 included patients with paroxysmal form -14,3%, persistent form - 68,3%, long-standing persistent form – 17,5%, group 2 – 13,3%, 13,3% and 73,3% respectively. Median ejection fraction and indexed left atrial volume amounted in group 1 – 63% and 40,6 ml/m2, in group 2 - 56% and 40,5 ml/m2. In addition, group 1 consisted of 39,7% patients with chronic heart failure (NYHA Class II) and 4,8% with chronic heart failure (NYHA Class III), when in group 2 – 45% and 6,7%, respectively. Follow-up consisted of laboratory tests, chest Х-ray, ECG, 24-hour Holter monitor, and cardiopulmonary exercise test. Duration of freedom from AF, distant mortality rate, and prevalence of cerebrovascular events were compared between the two groups. Results: Exit block was achieved in all patients. According to the Clavien-Dindo classification of surgical complications fraction of adverse events was 14,3% and 16,7% (1st group and 2nd group, respectively). Mean follow-up period in the 1st group was 50,4 (31,8; 64,8) months, in 2nd group - 30,5 (14,1; 37,5) months (P=0,0001). In group 1 - total freedom of AF was in 73,3% of patients, among which 25% had additional antiarrhythmic drugs (AADs) therapy or catheter ablation (CA), in group 2 – 90% and 18,3%, respectively (for total freedom of AF P<0,02). At follow-up, the distant mortality rate in the 1st group was – 4,8%, and in the 2nd – no fatal events. Prevalence of cerebrovascular events was higher in the 1st group than in the 2nd (6,7% vs. 1,7% respectively). Conclusions: Despite the relatively shorter follow-up of the 2nd group in the study, applying the strategy using the Medtronic device showed quite encouraging results. Further research is needed to evaluate the effectiveness of this strategy in the long-term period.

Keywords: atrial fibrillation, clamping, ablation, thoracoscopic surgery

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2582 The Effect of Substrate Temperature on the Structural, Optical, and Electrical of Nano-Crystalline Tin Doped-Cadmium Telluride Thin Films for Photovoltaic Applications

Authors: Eman A. Alghamdi, A. M. Aldhafiri

Abstract:

It was found that the induce an isolated dopant close to the middle of the bandgap by occupying the Cd position in the CdTe lattice structure is an efficient factor in reducing the nonradiative recombination rate and increasing the solar efficiency. According to our laboratory results, this work has been carried out to obtain the effect of substrate temperature on the CdTe0.6Sn0.4 prepared by thermal evaporation technique for photovoltaic application. Various substrate temperature (25°C, 100°C, 150°C, 200°C, 250°C and 300°C) was applied. Sn-doped CdTe thin films on a glass substrate at a different substrate temperature were made using CdTe and SnTe powders by the thermal evaporation technique. The structural properties of the prepared samples were determined using Raman, x-Ray Diffraction. Spectroscopic ellipsometry and spectrophotometric measurements were conducted to extract the optical constants as a function of substrate temperature. The structural properties of the grown films show hexagonal and cubic mixed structures and phase change has been reported. Scanning electron microscopy (SEM) reviled that a homogenous with a bigger grain size was obtained at 250°C substrate temperature. The conductivity measurements were recorded as a function of substrate temperatures. The open-circuit voltage was improved by controlling the substrate temperature due to the improvement of the fundamental material issues such as recombination and low carrier concentration. All the result was explained and discussed on the biases of the influences of the Sn dopant and the substrate temperature on the structural, optical and photovoltaic characteristics.

Keywords: CdTe, conductivity, photovoltaic, ellipsometry

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2581 Design of a Permanent Magnet Based Focusing Lens for a Miniature Klystron

Authors: Kumud Singh, Janvin Itteera, Priti Ukarde, Sanjay Malhotra, P. PMarathe, Ayan Bandyopadhay, Rakesh Meena, Vikram Rawat, L. M. Joshi

Abstract:

Application of Permanent magnet technology to high frequency miniature klystron tubes to be utilized for space applications improves the efficiency and operational reliability of these tubes. But nevertheless the task of generating magnetic focusing forces to eliminate beam divergence once the beam crosses the electrostatic focusing regime and enters the drift region in the RF section of the tube throws several challenges. Building a high quality magnet focusing lens to meet beam optics requirement in cathode gun and RF interaction region is considered to be one of the critical issues for these high frequency miniature tubes. In this paper, electromagnetic design and particle trajectory studies in combined electric and magnetic field for optimizing the magnetic circuit using 3D finite element method (FEM) analysis software is presented. A rectangular configuration of the magnet was constructed to accommodate apertures for input and output waveguide sections and facilitate coupling of electromagnetic fields into the input klystron cavity and out from output klystron cavity through coupling loops. Prototype lenses have been built and have been tested after integration with the klystron tube. We discuss the design requirements and challenges, and the results from beam transmission of the prototype lens.

Keywords: beam transmission, Brillouin, confined flow, miniature klystron

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2580 A Sensitive Approach on Trace Analysis of Methylparaben in Wastewater and Cosmetic Products Using Molecularly Imprinted Polymer

Authors: Soukaina Motia, Nadia El Alami El Hassani, Alassane Diouf, Benachir Bouchikhi, Nezha El Bari

Abstract:

Parabens are the antimicrobial molecules largely used in cosmetic products as a preservative agent. Among them, the methylparaben (MP) is the most frequently used ingredient in cosmetic preparations. Nevertheless, their potential dangers led to the development of sensible and reliable methods for their determination in environmental samples. Firstly, a sensitive and selective molecular imprinted polymer (MIP) based on screen-printed gold electrode (Au-SPE), assembled on a polymeric layer of carboxylated poly(vinyl-chloride) (PVC-COOH), was developed. After the template removal, the obtained material was able to rebind MP and discriminate it among other interfering species such as glucose, sucrose, and citric acid. The behavior of molecular imprinted sensor was characterized by Cyclic Voltammetry (CV), Differential Pulse Voltammetry (DPV) and Electrochemical Impedance Spectroscopy (EIS) techniques. Then, the biosensor was found to have a linear detection range from 0.1 pg.mL-1 to 1 ng.mL-1 and a low limit of detection of 0.12 fg.mL-1 and 5.18 pg.mL-1 by DPV and EIS, respectively. For applications, this biosensor was employed to determine MP content in four wastewaters in Meknes city and two cosmetic products (shower gel and shampoo). The operational reproducibility and stability of this biosensor were also studied. Secondly, another MIP biosensor based on tungsten trioxide (WO3) functionalized by gold nanoparticles (Au-NPs) assembled on a polymeric layer of PVC-COOH was developed. The main goal was to increase the sensitivity of the biosensor. The developed MIP biosensor was successfully applied for the MP determination in wastewater samples and cosmetic products.

Keywords: cosmetic products, methylparaben, molecularly imprinted polymer, wastewater

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2579 Designing and Prototyping Permanent Magnet Generators for Wind Energy

Authors: T. Asefi, J. Faiz, M. A. Khan

Abstract:

This paper introduces dual rotor axial flux machines with surface mounted and spoke type ferrite permanent magnets with concentrated windings; they are introduced as alternatives to a generator with surface mounted Nd-Fe-B magnets. The output power, voltage, speed and air gap clearance for all the generators are identical. The machine designs are optimized for minimum mass using a population-based algorithm, assuming the same efficiency as the Nd-Fe-B machine. A finite element analysis (FEA) is applied to predict the performance, emf, developed torque, cogging torque, no load losses, leakage flux and efficiency of both ferrite generators and that of the Nd-Fe-B generator. To minimize cogging torque, different rotor pole topologies and different pole arc to pole pitch ratios are investigated by means of 3D FEA. It was found that the surface mounted ferrite generator topology is unable to develop the nominal electromagnetic torque, and has higher torque ripple and is heavier than the spoke type machine. Furthermore, it was shown that the spoke type ferrite permanent magnet generator has favorable performance and could be an alternative to rare-earth permanent magnet generators, particularly in wind energy applications. Finally, the analytical and numerical results are verified using experimental results.

Keywords: axial flux, permanent magnet generator, dual rotor, ferrite permanent magnet generator, finite element analysis, wind turbines, cogging torque, population-based algorithms

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2578 Numerical and Simulation Analysis of Composite Friction Materials Using Single Plate Clutch Pad in Agricultural Tractors

Authors: Ravindra Raju, Vidhu Kampurath

Abstract:

For smooth transition of the power from the engine to the transmission system, a clutch is used. In agricultural tractors, friction clutches are widely used in power transmission applications. To transmit the maximum torque in friction clutches, selection of materials is one of the important tasks. The present used material for friction disc is Asbestos, Ceramic etc. In this study, analysis is performed using composites materials. The composite materials are considered due to their high strength to weight ratio. Composite materials like kevlar49, kevlar 29U were used in the study. The paper presents a systematic approach to optimize the structural and thermal characteristics of the clutch friction pad. A single plate clutch is modeled using Creo 2.0 software and analyzed using ANSYS. Thermal analysis considers the reduction of heat generated between the friction surfaces and reducing the temperature rise during the steady state period. Structural analysis is done to minimize the stresses developed as a result of the loading contact between friction surfaces. Also, modal analysis is done to optimize the natural frequency of the friction plate to avoid being in resonance with the engine frequency range. The analysis carried out on ANSYS workbench to get the foremost appropriate friction material for clutch. From the analyzed results stress, strain / total deformation values and natural frequency of the materials were compared for all the composite materials and the best one was taken out. For the study purpose, specifications of the clutch are obtained from the MF1035 (47KW) Tractor model.

Keywords: ANSYS, clutch, composite materials, creo

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2577 Predicting of Hydrate Deposition in Loading and Offloading Flowlines of Marine CNG Systems

Authors: Esam I. Jassim

Abstract:

The main aim of this paper is to demonstrate the prediction of the model capability of predicting the nucleation process, the growth rate, and the deposition potential of second phase particles in gas flowlines. The primary objective of the research is to predict the risk hazards involved in the marine transportation of compressed natural gas. However, the proposed model can be equally used for other applications including production and transportation of natural gas in any high-pressure flow-line. The proposed model employs the following three main components to approach the problem: computational fluid dynamics (CFD) technique is used to configure the flow field; the nucleation model is developed and incorporated in the simulation to predict the incipient hydrate particles size and growth rate; and the deposition of the gas/particle flow is proposed using the concept of the particle deposition velocity. These components are integrated in a comprehended model to locate the hydrate deposition in natural gas flowlines. The present research is prepared to foresee the deposition location of solid particles that could occur in a real application in Compressed Natural Gas loading and offloading. A pipeline with 120 m length and different sizes carried a natural gas is taken in the study. The location of particle deposition formed as a result of restriction is determined based on the procedure mentioned earlier and the effect of water content and downstream pressure is studied. The critical flow speed that prevents such particle to accumulate in the certain pipe length is also addressed.

Keywords: hydrate deposition, compressed natural gas, marine transportation, oceanography

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2576 Treatment of Papillary Thyroid Carcinoma Metastasis to the Sternum: A Case Report

Authors: Geliashvili T. M., Tyulyandina A. S., Valiev A. K., Kononets P. V., Kharatishvili T. K., Salkov A. G., Pronin A. I., Gadzhieva E. H., Parnas A. V., Ilyakov V. S.

Abstract:

Aim/Introduction: Metastasis (Mts) to the sternum, while extremely rare in differentiated thyroid cancer (DTC) (1), requires a personalized, multidisciplinary treatment approach. In aggressively growing Mts to the sternum, which rapidly become unresectable, a comprehensive therapeutic and diagnostic approach is particularly important. Materials and methods: We present a clinical case of solitary Mts to the sternum as first manifestation of a papillary thyroid microcarcinoma in a 55-year-old man. Results: 18F-FDG PET/CT after thyroidectomy confirmed the solitary Mts to the sternum with extremely high FDG uptake (SUVmax=71,1), which predicted its radioiodine-refractory (RIR). Due to close attachment to the mediastinum and rapid growth, Mts was considered unresectable. During the next three months, the patient received targeted therapy with the tyrosine kinase inhibitor (TKI) Lenvatinib 24 mg per day. 1st course of radioiodine therapy (RIT) 6 GBq was also performed, the results of which confirmed the RIR of the tumor process. As a result of systemic therapy (targeted therapy combined with RIT and suppressive hormone therapy with L-thyroxine), there was a significant biochemical response (decrease of serum thyroglobulin level from 50,000 ng/ml to 550 ng/ml) and a partial response with decrease of tumor size (from 80x69x123 mm to 65x50x112 mm) and decrease of FDG accumulation (SUVmax from 71.1 to 63). All of this made possible to perform surgical treatment of Mts - sternal extirpation with its replacement by an individual titanium implant. At the control examination, the stimulated thyroglobulin level was only 134 ng/ml, and PET/CT revealed postoperative areas of 18F-FDG metabolism in the removed sternal Mts. Also, 18F-FDG PET/CT in the early (metabolic) stage revealed two new bone Mts (in the area of L3 SUVmax=17,32 and right iliac bone SUVmax=13,73), which, as well as the removed sternal Mts, appeared to be RIRs at the 2nd course of RIT 6 GBq. Subsequently, on 02.2022, external beam radiation therapy (EBRT) was performed on the newly identified oligometastatic bone foci. At present, the patient is under dynamic monitoring and in the process of suppressive hormone therapy with L-thyroxine. Conclusion: Thus, only due to the early prescription of targeted TKI therapy was it possible to perform surgical resection of Mts to the sternum, thereby improve the patient's quality of life and preserve the possibility of radical treatment in case of oligometastatic disease progression.

Keywords: differentiated thyroid cancer, metastasis to the sternum, radioiodine therapy, radioiodine-refractory cancer, targeted therapy, lenvatinib

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2575 Effect of Sodium Hydroxide on Geotechnical Properties of Soft Soil in Kathmandu Valley

Authors: Bal Deep Sharma, Suresh Ray Yadav

Abstract:

Local soils are often chosen due to their widespread availability and low cost. However, these soils typically have poor durability, which can lead to significant limitations in their use for construction. To address this issue, various soil stabilization techniques have been developed and used over the years. This study investigates the viability of employing the mineral polymerization (MIP) technique to stabilize black soils, intending to enhance their suitability for construction applications. This technique involves the microstructural transformation of certain clay minerals into solid and stable compounds exhibiting characteristics similar to hydroxy sodalite, feldspathoid, or zeolite. This transformation occurs through the action of an alkaline reactant at atmospheric pressure and low temperature. The soil sample was characterized using grain size distribution, Atterberg limit test, organic content test, and pH-value tests. The unconfined compressive strength of the soil specimens, prepared with varying percentages of sodium hydroxide as an additive and sand as a filler by weight, was determined at the optimum moisture content. The unconfined compressive strength of the specimens was tested under three different conditions: dry, wet, and cycling. The maximum unconfined compressive strengths were 77.568 kg/cm², 38.85 kg/cm², and 56.3 kg/cm² for the dry, wet, and cycling specimens, respectively, while the unconfined compressive strength of the untreated soil was 7.38 kg/cm². The minimum unconfined compressive strength of the wet and cycling specimens was greater than that of the untreated soil. Based on these findings, it can be concluded that these soils can be effectively used as construction material after treatment with sodium hydroxide.

Keywords: soil stabilization technique, soft soil treatment, sodium hydroxide, unconfined compressive strength

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2574 Recurrent Fevers with Weight Gain - Possible Rapid onset Obesity with Hypoventilation, Hypothalamic Dysfunction and Autonomic Dysregulation Syndrome

Authors: Lee Rui, Rajeev Ramachandran

Abstract:

The approach to recurrent fevers in the paediatric or adolescent age group is not a straightforward one. Causes range from infectious diseases to rheumatological conditions to endocrinopathies, and are usually accompanied by weight loss rather than weight gain. We present an interesting case of a 16-year-old girl brought by her mother to the General Pediatrics Clinic for concerns of recurrent fever paired with significant weight gain over 1.5 years, with no identifiable cause found despite extensive work-up by specialists ranging from Rheumatologists to Oncologists. This case provides a learning opportunity on the approach to weight gain paired with persistent fevers in a paediatric population, one which is not commonly encountered and prompts further evaluation and consideration of less common diagnoses. In a span of 2 years, the girl’s weight had increased from 55 kg at 13 years old (75th centile) to 73.9 kg at 16 years old (>97th centile). About 1 year into her rapid weight gain, she started developing recurrent fevers of documented temperatures > 37.5 – 38.6 every 2-3 days, resulting in school absenteeism when she was sent home after temperature-taking in school found her to be febrile. The rapid onset of weight gain paired with unexplained fevers prompted the treating physician to consider the diagnosis of ROHHAD syndrome. Rapid onset obesity with hypoventilation, hypothalamic dysfunction and autonomic dysregulation (ROHHAD) syndrome is a rare disorder first described in 2007. It is characterized by dysfunction of the autonomic and endocrine system, characterized by hyperphagia and rapid-onset weight gain. This rapid weight gain is classically followed by hypothalamic manifestations with neuroendocrine deficiencies, hypo-ventilatory breathing abnormalities, and autonomic dysregulation. ROHHAD is challenging to diagnose with and diagnosis is made based mostly on clinical judgement. However if truly diagnosed, the condition is characterized by high morbidity and mortality rates. Early recognition of sleep disorders breathing and targeted therapeutic interventions helps limit morbidity and mortality associated with ROHHAD syndrome. This case poses an interesting diagnostic challenge and a diagnosis of ROHHAD has to be considered, given the serious complications that can come with disease progression while conditions such as Munchausen’s or drug fever remain as diagnoses of exclusion until we have exhausted all other possible conditions.

Keywords: pediatrics, endocrine, weight gain, recurrent fever, adolescent

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2573 The Personal Characteristics of Nurse Managers and the Personal and Professional Factors That Affect Them

Authors: Handan Alan, Ulkü Baykal

Abstract:

Personal characteristics help people understand and recognize both themselves and other people. They are also known to have direct effects on managerial behaviors. Managers’ personalities indicate how they think, perceive reality and relate to others, and affect their decision-making and problem-solving methods. This descriptive study aims to determine the personal characteristics of nurse managers and the personal and professional factors that affect them since sufficient data does not exist on personal characteristics despite the focus on the leadership and managerial characteristics in nursing. The study population consisted of nurses working in administrative positions at hospitals affiliated with the public hospitals union, research and practice hospitals affiliated with universities and private hospitals in cities in the Marmara Region. The study sample consisted of nurse managers working in the hospitals that permitted conducting the study (excluding private branch hospitals). The data were collected after obtaining the approval of the Clinical Research Ethics Committee of Çanakkale Onsekiz Mart University (Approval date: 1.7.2015, Decision No: 2015-01) and written official permissions from the administrations of the hospitals included in the study. The data analysis was carried out using means and standard deviations (SD) as descriptive statistics, one-way analysis of variance for inter-group comparisons and the independent samples t-test for paired group comparisons. A significance threshold of p < 0.05 was used to evaluate the findings. The data were collected using the Five Factor Personality Inventory. The study included 900 nurse managers, who obtained the highest mean score on the conscientiousness dimension (X=4.22 ±0.35). This dimension was followed by their mean scores on the agreeableness (X=4.06±0.40), intelligence (X=4.05±0.37), extroversion (X=3.50±0.43), and emotional instability (X=2.07±0.53) dimensions. Statistically significant differences were found between the independent variables of age, gender, marital status, education level, work institution, professional experience, institutional experience, managerial experience, administrative position, work unit and managerial education when compared using the five factor personality inventory (p < 0.05). In conclusion, the nurse managers described themselves having high conscientiousness. Statistically significant differences were found between the five factor personality inventory mean scores and their personal and professional characteristics.

Keywords: nurse manager, personality, personal characteristics, professional characteristics

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2572 Detection and Identification of Antibiotic Resistant Bacteria Using Infra-Red-Microscopy and Advanced Multivariate Analysis

Authors: Uraib Sharaha, Ahmad Salman, Eladio Rodriguez-Diaz, Elad Shufan, Klaris Riesenberg, Irving J. Bigio, Mahmoud Huleihel

Abstract:

Antimicrobial drugs have an important role in controlling illness associated with infectious diseases in animals and humans. However, the increasing resistance of bacteria to a broad spectrum of commonly used antibiotics has become a global health-care problem. Rapid determination of antimicrobial susceptibility of a clinical isolate is often crucial for the optimal antimicrobial therapy of infected patients and in many cases can save lives. The conventional methods for susceptibility testing like disk diffusion are time-consuming and other method including E-test, genotyping are relatively expensive. Fourier transform infrared (FTIR) microscopy is rapid, safe, and low cost method that was widely and successfully used in different studies for the identification of various biological samples including bacteria. The new modern infrared (IR) spectrometers with high spectral resolution enable measuring unprecedented biochemical information from cells at the molecular level. Moreover, the development of new bioinformatics analyses combined with IR spectroscopy becomes a powerful technique, which enables the detection of structural changes associated with resistivity. The main goal of this study is to evaluate the potential of the FTIR microscopy in tandem with machine learning algorithms for rapid and reliable identification of bacterial susceptibility to antibiotics in time span of few minutes. The bacterial samples, which were identified at the species level by MALDI-TOF and examined for their susceptibility by the routine assay (micro-diffusion discs), are obtained from the bacteriology laboratories in Soroka University Medical Center (SUMC). These samples were examined by FTIR microscopy and analyzed by advanced statistical methods. Our results, based on 550 E.coli samples, were promising and showed that by using infrared spectroscopic technique together with multivariate analysis, it is possible to classify the tested bacteria into sensitive and resistant with success rate higher than 85% for eight different antibiotics. Based on these preliminary results, it is worthwhile to continue developing the FTIR microscopy technique as a rapid and reliable method for identification antibiotic susceptibility.

Keywords: antibiotics, E. coli, FTIR, multivariate analysis, susceptibility

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2571 Suggestions to the Legislation about Medical Ethics and Ethics Review in the Age of Medical Artificial Intelligence

Authors: Xiaoyu Sun

Abstract:

In recent years, the rapid development of Artificial Intelligence (AI) has extensively promoted medicine, pharmaceutical, and other related fields. The medical research and development of artificial intelligence by scientific and commercial organizations are on the fast track. The ethics review is one of the critical procedures of registration to get the products approved and launched. However, the SOPs for ethics review is not enough to guide the healthy and rapid development of artificial intelligence in healthcare in China. Ethical Review Measures for Biomedical Research Involving Human Beings was enacted by the National Health Commission of the People's Republic of China (NHC) on December 1st, 2016. However, from a legislative design perspective, it was neither updated timely nor in line with the trends of AI international development. Therefore, it was great that NHC published a consultation paper on the updated version on March 16th, 2021. Based on the most updated laws and regulations in the States and EU, and in-depth-interviewed 11 subject matter experts in China, including lawmakers, regulators, and key members of ethics review committees, heads of Regulatory Affairs in SaMD industry, and data scientists, several suggestions were proposed on top of the updated version. Although the new version indicated that the Ethics Review Committees need to be created by National, Provincial and individual institute levels, the review authorities of different levels were not clarified. The suggestion is that the precise scope of review authorities for each level should be identified based on Risk Analysis and Management Model, such as the complicated leading technology, gene editing, should be reviewed by National Ethics Review Committees, it will be the job of individual institute Ethics Review Committees to review and approve the clinical study with less risk such as an innovative cream to treat acne. Furthermore, to standardize the research and development of artificial intelligence in healthcare in the age of AI, more clear guidance should be given to data security in the layers of data, algorithm, and application in the process of ethics review. In addition, transparency and responsibility, as two of six principles in the Rome Call for AI Ethics, could be further strengthened in the updated version. It is the shared goal among all countries to manage well and develop AI to benefit human beings. Learned from the other countries who have more learning and experience, China could be one of the most advanced countries in artificial intelligence in healthcare.

Keywords: biomedical research involving human beings, data security, ethics committees, ethical review, medical artificial intelligence

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2570 Diabetes and Medical Plant's Treatment: Ethnobotanical Studies Carried out in Morocco

Authors: Jamila Fakchich, Mostafa Jamila Lazaar Elachouri, Lakhder Fakchich, Fatna Ouali, Abd Errazzak Belkacem

Abstract:

Diabetes is a chronic metabolic disease that has a significant impact on the health, quality of life, and life expectancy of patients as well as the health care system. By its nature diabetes, is a multisystem disease with wide-ranging complication that span nearly all region of the body. This epidemic problem, however, is not unique to the industrialized society, but has also hardly struck the developing countries. In Morocco, as developing country, there is an epidemic rise in diabetes, with ensuing concern about the management and control of this disease; it began a chronic burdensome disease of largely middle-aged and elderly people, with a long course and serious complications often resulting in high death-rate, the treatment of diabetes spent vast amount of resources including medicines, diets, physical training. Treatment of this disease is considered problematic due to the lack of effective and safe drugs capable of inducing sustained clinical, biochemical, and histological cure. In Moroccan society, the phytoremedies are some times the only affordable sources of healthcare, particularly for the people in remote areas. In this paper, we present a synthesis work obtained from the ethnobotanical data reported in different specialized journals. A Synthesis of four published ethnobotanical studies that have been carried out in different region of Morocco by different team seekers during the period from 1997 to 2015. Medicinal plants inventoried by different seekers in four Moroccan’s areas have been regrouped and codified, then, Factorial Analysis (FA) and Principal Components Analysis (PCA) are used to analyse the aggregated data from the four studies and plants are classified according to their frequency of use by population. Our work deals with an attempt to gather information on some traditional uses of medicinal plants from different regions of Morocco, also, it was designed to give a set of medicinal plants commonly used by Moroccan people in the treatment of diabetes; In this paper, we intended to provide a basic knowledge about plant species used by Moroccan society for treatment of diabetes. One of the most interesting aspects of this type of works is to assess the relative cultural importance of medicinal plants for specific illnesses and exploring its usefulness in the context of diabetes.

Keywords: Morocco, medicinal plants, ethnobotanical, diabetes, phytoremedies

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2569 An Orphan Software Engineering Course: Supportive Ways toward a True Software Engineer

Authors: Haya Sammana

Abstract:

A well-defined curricula must be adopted to meet the increasing complexity and diversity in the software applications. In reality, some IT majors such as computer science and computer engineering receive the software engineering education in a single course which is considered as a big challenged for the instructors and universities. Also, it requires students to gain the most of practical experiences that simulate the real work in software companies. Furthermore, we have noticed that there is no consensus on how, when and what to teach in that introductory course to gain the practical experiences that are required by the software companies. Because all of software engineering disciplines will not fit in just one course, so the course needs reasonable choices in selecting its topics. This arises an important question which is an essential one to ask: Is this course has the ability to formulate a true software engineer that meets the needs of industry? This question arises a big challenge in selecting the appropriate topics. So answering this question is very important for the next undergraduate students. During teaching this course in the curricula, the feedbacks from an undergraduate students and the keynotes of the annual meeting for an advisory committee from industrial side provide a probable answer for the proposed question: it is impossible to build a true software engineer who possesses all the essential elements of software engineering education such teamwork, communications skills, project management skills and contemporary industrial practice from one course and it is impossible to have a one course covering all software engineering topics. Besides the used teaching approach, the author proposes an implemented three supportive ways aiming for mitigating the expected risks and increasing the opportunity to build a true software engineer.

Keywords: software engineering course, software engineering education, software experience, supportive approach

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2568 Study on the Post-Traumatic Stress Disorder and Its Psycho-Social-Genetic Risk Factors among Tibetan Alolescents in Heavily-Hit Area Three Years after Yushu Earthquake in Qinghai Province, China

Authors: Xiaolian Jiang, Dongling Liu, Kun Liu

Abstract:

Aims: To examine the prevalence of POST-TRAUMATIC STRESS DISORDER (PTSD) symptoms among Tibetan adolescents in heavily-hit disaster area three years after Yushu earthquake, and to explore the interactions of the psycho-social-genetic risk factors. Methods: This was a three-stage study. Firstly, demographic variables,PTSD Checklist-Civilian Version (PCL-C),the Internality、Powerful other、Chance Scale,(IPC),Coping Style Scale(CSS),and the Social Support Appraisal(SSA)were used to explore the psychosocial factors of PTSD symptoms among adolescent survivors. PCL-C was used to examine the PTSD symptoms among 4072 Tibetan adolescents,and the Structured Clinical Interview for DSM-IV Disorders(SCID)was used by psychiatrists to make the diagnosis precisely. Secondly,a case-control trial was used to explore the relationship between PTSD and gene polymorphisms. 287adolescents diagnosed with PTSD were recruited in study group, and 280 adolescents without PTSD in control group. Polymerase chain reaction-restriction fragment length polymorphism technology(PCR-RFLP)was used to test gene polymorphisms. Thirdly,SPSS 22.0 was used to explore the interactions of the psycho-social-genetic risk factors of PTSD on the basis of the above results. Results and conclusions: 1.The prevalence of PTSD was 9.70%. 2.The predictive psychosocial factors of PTSD included earthquake exposure, support from others, imagine, abreact, tolerant, powerful others and family support. 3.Synergistic interactions between A1 gene of DRD2 TaqIA and the external locus of control, negative coping style, severe earthquake exposure were found. Antagonism interactions between A1 gene of DRD2 TaqIA and poor social support was found. Synergistic interactions between A1/A1 genotype and the external locus of control, negative coping style were found. Synergistic interactions between 12 gene of 5-HTTVNTR and the external locus of control, negative coping style, severe earthquake exposure were found. Synergistic interactions between 12/12 genotype and the external locus of control, negative coping style, severe earthquake exposure were also found.

Keywords: adolescents, earthquake, PTSD, risk factors

Procedia PDF Downloads 152
2567 The Acquisition of /r/ By Setswana-Learning Children

Authors: Keneilwe Matlhaku

Abstract:

Crosslinguistic studies (theoretical and clinical) have shown delays and significant misarticulation in the acquisition of the rhotics. This article provides a detailed analysis of the early development of the rhotic phoneme, an apical trill /r/, by monolingual Setswana (Tswana S30) children of age ranges between 1 and 4 years. The data display the following trends: (1) late acquisition of /r/; (2) a wide range of substitution patterns involving this phoneme (i.e., gliding, coronal stopping, affrication, deletion, lateralization, as well as, substitution to a dental and uvular fricative). The primary focus of the article is on the potential origins of these variations of /r/, even within the same language. Our data comprises naturalistic longitudinal audio recordings of 6 children (2 males and 4 females) whose speech was recorded in their homes over a period of 4 months with no or only minimal disruptions in their daily environments. Phon software (Rose et al. 2013; Rose & MacWhinney 2014) was used to carry out the orthographic and phonetic transcriptions of the children’s data. Phon also enabled the generation of the children’s phonological inventories for comparison with adult target IPA forms. We explain the children’s patterns through current models of phonological emergence (MacWhinney 2015) as well as McAllister Byun, Inkelas & Rose (2016); Rose et al., (2022), which highlight the perceptual and articulatory factors influencing the development of sounds and sound classes. We highlight how the substitution patterns observed in the data can be captured through a consideration of the auditory properties of the target speech sounds, combined with an understanding of the types of articulatory gestures involved in the production of these sounds. These considerations, in turn, highlight some of the most central aspects of the challenges faced by the child toward learning these auditory-articulatory mappings. We provide a cross-linguistic survey of the acquisition of rhotic consonants in a sample of related and unrelated languages in which we show that the variability and volatility in the substitution patterns of /r/ is also brought about by the properties of the children’s ambient languages. Beyond theoretical issues, this article sets an initial foundation for developing speech-language pathology materials and services for Setswana learning children, an emerging area of public service in Botswana.

Keywords: rhotic, apical trill, Phon, phonological emergence, auditory, articulatory, mapping

Procedia PDF Downloads 38
2566 Vermicomposting Amended With Microorganisms and Biochar: Phytopathogen Resistant Seedbeds for Vegetables and Heavy Metal Polluted Waste Treatment

Authors: Fuad Ameen, Ali A. Al-Homaidan

Abstract:

Biochar can be used in numerous biotechnological applications due to its properties to adsorb beneficial nutrients and harmful pollutants. Objectives: We aimed to treat heavy metal polluted organic wastes using vermicomposting process and produce a fertilizer that can be used in agriculture. We improved the process by adding biochar as well as microbial inoculum and biomass into household waste or sewage sludge before vermicomposting. The earthworm Eisenia fetida used in vermicomposting was included to accumulate heavy metals, biochar to adsorb heavy metals, and the microalga Navicula sp. or the mangrove fungus Acrophialophora sp. to promote plant growth in the final product used as a seedbed for Solanaceae vegetables. We carried out vermicomposting treatments to see the effect of different amendments. Final compost quality was analyzed for maturity. The earthworms were studied for their vitality, heavy metal accumulation, and metallothionein protein content to verify their role in the process. The compost was used as a seedbed for vegetables that were inoculated with a phytopathogen Pythium sp. known to cause root rot and destroy seeds. Compost as seedbed promoted plant growth and reduced disease symptoms in leaves. In the treatment where E. fetida, 6% biochar, and Navicula sp. had been added, 90% of the seeds germinated, while less than 20% germinated in the control treatment. The experimental plants had acquired resistance against Pythium sp. The metagenomic profile of microbial communities will be reported.

Keywords: organic wastes, vermicomposting process, biochar, mangrove fungus

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2565 Non-Burn Treatment of Health Care Risk Waste

Authors: Jefrey Pilusa, Tumisang Seodigeng

Abstract:

This research discusses a South African case study for the potential of utilizing refuse-derived fuel (RDF) obtained from non-burn treatment of health care risk waste (HCRW) as potential feedstock for green energy production. This specific waste stream can be destroyed via non-burn treatment technology involving high-speed mechanical shredding followed by steam or chemical injection to disinfect the final product. The RDF obtained from this process is characterised by a low moisture, low ash, and high calorific value which means it can be potentially used as high-value solid fuel. Due to the raw feed of this RDF being classified as hazardous, the final RDF has been reported to be non-infectious and can blend with other combustible wastes such as rubber and plastic for waste to energy applications. This study evaluated non-burn treatment technology as a possible solution for on-site destruction of HCRW in South African private and public health care centres. Waste generation quantities were estimated based on the number of registered patient beds, theoretical bed occupancy. Time and motion study was conducted to evaluate the logistics viability of on-site treatment. Non-burn treatment technology for HCRW is a promising option for South Africa, and successful implementation of this method depends upon the initial capital investment, operational cost and environmental permitting of such technology; there are other influencing factors such as the size of the waste stream, product off-take price as well as product demand.

Keywords: autoclave, disposal, fuel, incineration, medical waste

Procedia PDF Downloads 177
2564 Functionalized Single Walled Carbon Nanotubes: Targeting, Cellular Uptake, and Applications in Photodynamic Therapy

Authors: Prabhavathi Sundaram, Heidi Abrahamse

Abstract:

In recent years, nanotechnology coupled with photodynamic therapy (PDT) has received considerable attention in terms of improving the effectiveness of drug delivery in cancer therapeutics. The development of functionalized single-walled carbon nanotubes (SWCNTs) has become revolutionary in targeted photosensitizers delivery since it improves the therapeutic index of drugs. The objective of this study was to prepare, characterize and evaluate the potential of functionalized SWCNTs using hyaluronic acid and loading it with photosensitizer and to effectively target colon cancer cells. The single-walled carbon nanotubes were covalently functionalized with hyaluronic acid and the loaded photosensitizer by non-covalent interaction. The photodynamic effect of SWCNTs is detected under laser irradiation in vitro. The hyaluronic acid-functionalized nanocomposites had a good affinity with CD44 receptors, and it avidly binds on to the surface of CACO-2 cells. The cellular uptake of nanocomposites was studied using fluorescence microscopy using lyso tracker. The anticancer activity of nanocomposites was analyzed in CACO-2 cells using different studies such as cell morphology, cell apoptosis, and nuclear morphology. The combined effect of nanocomposites and PDT improved the therapeutic effect of cancer treatment. The study suggested that the nanocomposites and PDT have great potential in the treatment of colon cancer.

Keywords: colon cancer, hyaluronic acid, single walled carbon nanotubes, photosensitizers, photodynamic therapy

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2563 Work in the Industry of the Future-Investigations of Human-Machine Interactions

Authors: S. Schröder, P. Ennen, T. Langer, S. Müller, M. Shehadeh, M. Haberstroh, F. Hees

Abstract:

Since a bit over a year ago, Festo AG and Co. KG, Festo Didactic SE, robomotion GmbH, the researchers of the Cybernetics-Lab IMA/ZLW and IfU, as well as the Human-Computer Interaction Center at the RWTH Aachen University, have been working together in the focal point of assembly competences to realize different scenarios in the field of human-machine interaction (HMI). In the framework of project ARIZ, questions concerning the future of production within the fourth industrial revolution are dealt with. There are many perspectives of human-robot collaboration that consist Industry 4.0 on an individual, organization and enterprise level, and these will be addressed in ARIZ. The aim of the ARIZ projects is to link AI-Approaches to assembly problems and to implement them as prototypes in demonstrators. To do so, island and flow based production scenarios will be simulated and realized as prototypes. These prototypes will serve as applications of flexible robotics as well as AI-based planning and control of production process. Using the demonstrators, human interaction strategies will be examined with an information system on one hand, and a robotic system on the other. During the tests, prototypes of workspaces that illustrate prospective production work forms will be represented. The human being will remain a central element in future productions and will increasingly be in charge of managerial tasks. Questions thus arise within the overall perspective, primarily concerning the role of humans within these technological revolutions, as well as their ability to act and design respectively to the acceptance of such systems. Roles, such as the 'Trainer' of intelligent systems may become a possibility in such assembly scenarios.

Keywords: human-machine interaction, information technology, island based production, assembly competences

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2562 Artificial Neural Network in Ultra-High Precision Grinding of Borosilicate-Crown Glass

Authors: Goodness Onwuka, Khaled Abou-El-Hossein

Abstract:

Borosilicate-crown (BK7) glass has found broad application in the optic and automotive industries and the growing demands for nanometric surface finishes is becoming a necessity in such applications. Thus, it has become paramount to optimize the parameters influencing the surface roughness of this precision lens. The research was carried out on a 4-axes Nanoform 250 precision lathe machine with an ultra-high precision grinding spindle. The experiment varied the machining parameters of feed rate, wheel speed and depth of cut at three levels for different combinations using Box Behnken design of experiment and the resulting surface roughness values were measured using a Taylor Hobson Dimension XL optical profiler. Acoustic emission monitoring technique was applied at a high sampling rate to monitor the machining process while further signal processing and feature extraction methods were implemented to generate the input to a neural network algorithm. This paper highlights the training and development of a back propagation neural network prediction algorithm through careful selection of parameters and the result show a better classification accuracy when compared to a previously developed response surface model with very similar machining parameters. Hence artificial neural network algorithms provide better surface roughness prediction accuracy in the ultra-high precision grinding of BK7 glass.

Keywords: acoustic emission technique, artificial neural network, surface roughness, ultra-high precision grinding

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2561 The Incidence of Postoperative Atrial Fibrillation after Coronary Artery Bypass Grafting in Patients with Local and Diffuse Coronary Artery Disease

Authors: Kamil Ganaev, Elina Vlasova, Andrei Shiryaev, Renat Akchurin

Abstract:

De novo atrial fibrillation (AF) after coronary artery bypass grafting (CABG) is a common complication. To date, there are no data on the possible effect of diffuse lesions of coronary arteries on the incidence of postoperative AF complications. Methods. Patients operated on-pump under hypothermic conditions during the calendar year (2020) were studied. Inclusion criteria - isolated CABG and achievement of complete myocardial revascularization. Patients with a history of AF moderate and severe valve dysfunction, hormonal thyroid pathology, initial CHF(Congestive heart failure), as well as patients with developed perioperative complications (IM, acute heart failure, massive blood loss) and deceased were excluded. Thus 227 patients were included; mean age 65±9 years; 69% were men. 89% of patients had a 3-vessel lesion of the coronary artery; the remainder had a 2-vessel lesion. Mean LV size: 3.9±0.3 cm, indexed LV volume: 29.4±5.3 mL/m2. Two groups were considered: D (n=98), patients with diffuse coronary heart disease, and L (n=129), patients with local coronary heart disease. Clinical and demographic characteristics in the groups were comparable. Rhythm assessment: continuous bedside ECG monitoring up to 5 days; ECG CT at 5-7 days after CABG; daily routine ECG registration. Follow-up period - postoperative hospital period. Results. The Median follow-up period was 9 (7;11) days. POFP (Postoperative atrial fibrillation) was detected in 61/227 (27%) patients: 34/98 (35%) in group D versus 27/129 (21%) in group L; p<0.05. Moreover, the values of revascularization index in groups D and L (3.9±0.7 and 3.8±0.5, respectively) were equal, and the mean time Cardiopulmonary bypass (CPB) (107±27 and 80±13min), as well as the mean ischemic time (67±17 and 55±11min) were significantly longer in group D (p<0.05). However, a separate analysis of these parameters in patients with and without developed AF did not reveal any significant differences in group D (CPB time 99±21.2 min, ischemic time 63±12.2 min), or in group L (CPB time 88±13.1 min, ischemic time 58.7±13.2 min). Conclusion. With the diffuse nature of coronary lesions, the incidence of AF in the hospital period after isolated CABG definitely increases. To better understand the role of severe coronary atherosclerosis in the development of POAF, it is necessary to distinguish the influence of organic features of atrial and ventricular myocardium (as a consequence of chronic coronary disease) from the features of surgical correction in diffuse coronary lesions.

Keywords: atrial fibrillation, diffuse coronary artery disease, coronary artery bypass grafting, local coronary artery disease

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2560 Assessment of Tidal Current Energy Potential at LAMU and Mombasa in Kenya

Authors: Lucy Patricia Onundo, Wilfred Njoroge Mwema

Abstract:

The tidal power potential available for electricity generation from Mombasa and Lamu sites in Kenya will be examined. Several African countries in the Western Indian Ocean endure insufficiencies in the power sector, including both generation and distribution. One important step towards increasing energy security and availability is to intensify the use of renewable energy sources. The access to cost-efficient hydropower is low in Mombasa and Lamu hence Ocean energy will play an important role. Global-Level resource assessments and oceanographic literature and data have been compiled in an analysis between technology-specific requirements for ocean energy technologies (salinity, tide, tidal current, wave, Ocean thermal energy conversion, wind and solar) and the physical resources in Lamu and Mombasa. The potential for tide and tidal current power is more restricted but may be of interest at some locations. The theoretical maximum power produced over a tidal cycle is determined by the product of the forcing tide and the undisturbed volumetric flow-rate. The extraction of the maximum power reduces the flow-rate, but a significant portion of the maximum power can be extracted with little change to the tidal dynamics. Two-dimensional finite-element, numerical simulations designed and developed agree with the theory. Temporal variations in resource intensity, as well as the differences between small-scale and large-scale applications, are considered.

Keywords: energy assessment, marine tidal power, renewable energy, tidal dynamics

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2559 Building an Absurdist Approach to the Philosophy of Science: Combining Camus and Feyerabend

Authors: Robert Herold

Abstract:

This project aims to begin building out a new approach within the philosophy of science that is based around a combination of insights from Albert Camus and Paul Feyerabend. This approach is one that will be labeled an absurdist approach as it uses, for its foundation, the philosophy of the absurd as discussed by Camus. While Camus didn’t directly discuss the philosophy of science, nor did he offer his own views on the subject in any substantial way, that doesn’t mean that his work doesn’t have applications within the philosophy of science. In fact, as is argued throughout the piece, much of the work done by Paul Feyerabend stems from a similar metaphysical and epistemological foundation as Camus. This foundation is the notion of the absurd and the inability of us as humans to reach some sort of objective truth. In modern times both Camus and Feyerabend have been largely pushed to the wayside, though Feyerabend has undoubtedly received the most unfair treatment of the two, and this is something that serves to act more as a hindrance than anything else. Much of the claims and arguments made by both Camus and Feyerabend have not been truly refuted and have simply been pushed aside by pointing to supposed contradictions or inconsistencies. However, while it would be a monumental task to attempt to discuss all of this past work, perhaps it might be better to move beyond both Camus and Feyerabend and chart a new path. This is the overall goal of this paper. This research will demonstrate that not only are the philosophies of Camus and Feyerabend surprisingly similar and able to mesh well together, they also are able to form into something that is truly more than the sum of its parts. While the task of actually building out an approach is a monumental undertaking, the plan is to use this project as a jumping-off point. As such, this paper will start by examining some of the main claims made by both Camus and Feyerabend. Once this is done, then begin weaving them together and demonstrating where the links between the philosophies of both are. Then this study will end by building out the very begging foundations of the absurdist approach to the philosophy of science.

Keywords: philosophy, philosophy of science, albert camus, paul feyerabend

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2558 A Multi-Layer Based Architecture for the Development of an Open Source CAD/CAM Integration Virtual Platform

Authors: Alvaro Aguinaga, Carlos Avila, Edgar Cando

Abstract:

This article proposes a n-layer architecture, with a web client as a front-end, for the development of a virtual platform for process simulation on CNC machines. This Open-Source platform includes a CAD-CAM interface drawing primitives, and then used to furnish a CNC program that triggers a touch-screen virtual simulator. The objectives of this project are twofold. First one is an educational component that fosters new alternatives for the CAD-CAM/CNC learning process in undergrad and grade schools and technical and technological institutes emphasizing in the development of critical skills, discussion and collaborative work. The second objective puts together a research and technological component that will take the state of the art in CAD-CAM integration to a new level with the development of optimal algorithms and virtual platforms, on-line availability, that will pave the way for the long-term goal of this project, that is, to have a visible and active graduate school in Ecuador and a world wide Open-Innovation community in the area of CAD-CAM integration and operation of CNC machinery. The virtual platform, developed as a part of this study: (1) delivers improved training process of students, (2) creates a multidisciplinary team and a collaborative work space that will push the new generation of students to face future technological challenges, (3) implements industry standards for CAD/CAM, (4) presents a platform for the development of industrial applications. A protoype of this system was developed and implemented in a network of universities and technological institutes in Ecuador.

Keywords: CAD-CAM integration, virtual platforms, CNC machines, multi-layer based architecture

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2557 Extracorporeal Co2 Removal (Ecco2r): An Option for Treatment for Refractory Hypercapnic Respiratory Failure

Authors: Shweh Fern Loo, Jun Yin Ong, Than Zaw Oo

Abstract:

Acute respiratory distress syndrome (ARDS) is a common serious condition of bilateral lung infiltrates that develops secondary to various underlying conditions such as diseases or injuries. ARDS with severe hypercapnia is associated with higher ICU mortality and morbidity. Venovenous Extracorporeal membrane oxygenation (VV-ECMO) support has been established to avert life-threatening hypoxemia and hypercapnic respiratory failure despite optimal conventional mechanical ventilation. However, VV-ECMO is relatively not advisable in particular groups of patients, especially in multi-organ failure, advanced age, hemorrhagic complications and irreversible central nervous system pathology. We presented a case of a 79-year-old Chinese lady without any pre-existing lung disease admitted to our hospital intensive care unit (ICU) after acute presentation of breathlessness and chest pain. After extensive workup, she was diagnosed with rapidly progressing acute interstitial pneumonia with ARDS and hypercapnia respiratory failure. The patient received lung protective strategies of mechanical ventilation and neuromuscular blockage therapy as per clinical guidelines. However, hypercapnia respiratory failure was refractory, and she was deemed not a good candidate for VV-ECMO support given her advanced age and high vasopressor requirements from shock. Alternative therapy with extracorporeal CO2 removal (ECCO2R) was considered and implemented. The patient received 12 days of ECCO2R paired with muscle paralysis, optimization of lung-protective mechanical ventilation and dialysis. Unfortunately, the patient still had refractory hypercapnic respiratory failure with dual vasopressor support despite prolonged therapy. Given failed and futile medical treatment, the family opted for withdrawal of care, a conservative approach, and comfort care, which led to her demise. The effectivity of extracorporeal CO2 removal may depend on disease burden, involvement and severity of the disease. There is insufficient data to make strong recommendations about its benefit-risk ratio for ECCO2R devices, and further studies and data would be required. Nonetheless, ECCO2R can be considered an alternative treatment for refractory hypercapnic respiratory failure patients who are unsuitable for initiating venovenous ECMO.

Keywords: extracorporeal CO2 removal (ECCO2R), acute respiratory distress syndrome (ARDS), acute interstitial pneumonia (AIP), hypercapnic respiratory failure

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2556 Lived Experiences of Parents in Disciplining Their Children

Authors: Bernardino Vinoya, Cassandra D. Batton, Samantha Gayle M. Bonavente, Johnson O. Canoza, Lhea Flynn B. Capones, Camille S. Dispo, Johanna Neilvin T. Dontogan, Louise Angelica C. Lipana, Charlene Pearl P. Navalta, Rechelle Vhen W. Payo-os, Mary Reyna D. Ridao, Rushnol Jade P. Tupac, Pauline B. Sol

Abstract:

Parenting is preparing children for life as productive adults and discipline strategies are needed to achieve it like non-aggressive, psychologically aggressive and physical discipline. The effects of disciplinary strategies on children are well explored as evidenced by existing studies, local and international laws and active international organizations which are all brimmed towards child protection but status quo shows a profound scarcity of studies engaged in the effects of disciplining the child on the parent. To know the deeper unexplored reasons and untold stories of the parent, mainly the lived experiences of parents in disciplining their children. Design is descriptive phenomelogical. Participants were chosen using snowball purposive sampling. Data were collected through interview with the general question, “Ano ang mga karanasan ninyo sa pagdidisiplina ng inyong anak (What are your experiences when disciplining your child?)”, followed with unstructured questions. Collaizi method was used in analyzing data. Data collected was verified through focused group discussion. Results show three main themes: Reason, Disciplinary Strategy, and Aftermath. The use of disciplinary strategy is influenced by the experiences of the parent, the triggers like the child’s misbehavior and parental desires or wishes for the child. Disciplinary strategy can either be physical punishment or verbal. Parent’s generally used both when children disrespects or disobeys. Parents also experience both positive and negative effects on their physical, social, emotional aspects after disciplining their children. As a result, parents use coping mechanisms to maintain ego stability. Disciplining a child is a cyclical process. Parents, just like the child will also experience both positive and negative outcomes after using different disciplinary strategies. Future researchers can replicate study or use triangulation in multi-site qualitative and quantitative studies, professors can teach findings on parents in the concepts of pediatric nursing and apply the findings in the clinical area particularly when dealing with families.

Keywords: parents, disciplinary strategy, parental effects, pediatric nursing

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2555 Design of an Artificial Oil Body-Cyanogen Bromide Technology Platform for the Expression of Small Bioactive Peptide, Mastoparan B

Authors: Tzyy-Rong Jinn, Sheng-Kuo Hsieh, Yi-Ching Chung, Feng-Chia Hsieh

Abstract:

In this study, we attempted to develop a recombinant oleosin-based fusion expression strategy in Escherichia coli (E. coli) and coupled with the artificial oil bodies (AOB)-cyanogen bromide technology platform to produce bioactive mastoparan B (MP-B). As reported, the oleosin in AOB system plays a carrier (fusion with target protein), since oleosin possess two amphipathic regions (at the N-terminus and C-terminus), which result in the N-terminus and C-terminus of oleosin could be arranged on the surface of AOB. Thus, the target protein fused to the N-terminus or C-terminus of oleosin which also is exposed on the surface of AOB, and this process will greatly facilitate the subsequent separation and purification of target protein from AOB. In addition, oleosin, a unique structural protein of seed oil bodies, has the added advantage of helping the fused MP-B expressed in inclusion bodies, which can protect from proteolytic degradation. In this work, MP-B was fused to the C-terminus of oleosin and then was expressed in E. coli as an insoluble recombinant protein. As a consequence, we successfully developed a reliable recombinant oleosin-based fusion expression strategy in Escherichia coli and coupled with the artificial oil bodies (AOB)-cyanogen bromide technology platform to produce the small peptide, MP-B. Take together, this platform provides an insight into the production of active MP-B, which will facilitate studies and applications of this peptide in the future.

Keywords: artificial oil bodies, Escherichia coli, Oleosin-fusion protein, Mastoparan-B

Procedia PDF Downloads 451