Search results for: untrusted rate
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 8043

Search results for: untrusted rate

693 Seasonal Variability of M₂ Internal Tides Energetics in the Western Bay of Bengal

Authors: A. D. Rao, Sachiko Mohanty

Abstract:

The Internal Waves (IWs) are generated by the flow of barotropic tide over the rapidly varying and steep topographic features like continental shelf slope, subsurface ridges, and the seamounts, etc. The IWs of the tidal frequency are generally known as internal tides. These waves have a significant influence on the vertical density and hence causes mixing in the region. Such waves are also important in submarine acoustics, underwater navigation, offshore structures, ocean mixing and biogeochemical processes, etc. over the shelf-slope region. The seasonal variability of internal tides in the Bay of Bengal with special emphasis on its energetics is examined by using three-dimensional MITgcm model. The numerical simulations are performed for different periods covering August-September, 2013; November-December, 2013 and March-April, 2014 representing monsoon, post-monsoon and pre-monsoon seasons respectively during which high temporal resolution in-situ data sets are available. The model is initially validated through the spectral estimates of density and the baroclinic velocities. From the estimates, it is inferred that the internal tides associated with semi-diurnal frequency are more dominant in both observations and model simulations for November-December and March-April. However, in August, the estimate is found to be maximum near-inertial frequency at all the available depths. The observed vertical structure of the baroclinic velocities and its magnitude are found to be well captured by the model. EOF analysis is performed to decompose the zonal and meridional baroclinic tidal currents into different vertical modes. The analysis suggests that about 70-80% of the total variance comes from Mode-1 semi-diurnal internal tide in both observations as well as in the model simulations. The first three modes are sufficient to describe most of the variability for semidiurnal internal tides, as they represent 90-95% of the total variance for all the seasons. The phase speed, group speed, and wavelength are found to be maximum for post-monsoon season compared to other two seasons. The model simulation suggests that the internal tide is generated all along the shelf-slope regions and propagate away from the generation sites in all the months. The model simulated energy dissipation rate infers that its maximum occurs at the generation sites and hence the local mixing due to internal tide is maximum at these sites. The spatial distribution of available potential energy is found to be maximum in November (20kg/m²) in northern BoB and minimum in August (14kg/m²). The detailed energy budget calculation are made for all the seasons and results are analysed.

Keywords: available potential energy, baroclinic energy flux, internal tides, Bay of Bengal

Procedia PDF Downloads 170
692 A Mixed Method Approach for Modeling Entry Capacity at Rotary Intersections

Authors: Antonio Pratelli, Lorenzo Brocchini, Reginald Roy Souleyrette

Abstract:

A rotary is a traffic circle intersection where vehicles entering from branches give priority to circulating flow. Vehicles entering the intersection from converging roads move around the central island and weave out of the circle into their desired exiting branch. This creates merging and diverging conflicts among any entry and its successive exit, i.e., a section. Therefore, rotary capacity models are usually based on the weaving of the different movements in any section of the circle, and the maximum rate of flow value is then related to each weaving section of the rotary. Nevertheless, the single-section capacity value does not lead to the typical performance characteristics of the intersection, such as the entry average delay which is directly linked to its level of service. From another point of view, modern roundabout capacity models are based on the limitation of the flow entering from the single entrance due to the amount of flow circulating in front of the entrance itself. Modern roundabouts capacity models generally lead also to a performance evaluation. This paper aims to incorporate a modern roundabout capacity model into an old rotary capacity method to obtain from the latter the single input capacity and ultimately achieve the related performance indicators. Put simply; the main objective is to calculate the average delay of each single roundabout entrance to apply the most common Highway Capacity Manual, or HCM, criteria. The paper is organized as follows: firstly, the rotary and roundabout capacity models are sketched, and it has made a brief introduction to the model combination technique with some practical instances. The successive section is deserved to summarize the TRRL old rotary capacity model and the most recent HCM-7th modern roundabout capacity model. Then, the two models are combined through an iteration-based algorithm, especially set-up and linked to the concept of roundabout total capacity, i.e., the value reached due to a traffic flow pattern leading to the simultaneous congestion of all roundabout entrances. The solution is the average delay for each entrance of the rotary, by which is estimated its respective level of service. In view of further experimental applications, at this research stage, a collection of existing rotary intersections operating with the priority-to-circle rule has already started, both in the US and in Italy. The rotaries have been selected by direct inspection of aerial photos through a map viewer, namely Google Earth. Each instance has been recorded by location, general urban or rural, and its main geometrical patterns. Finally, conclusion remarks are drawn, and a discussion on some further research developments has opened.

Keywords: mixed methods, old rotary and modern roundabout capacity models, total capacity algorithm, level of service estimation

Procedia PDF Downloads 86
691 Evaluation of Role of Surgery in Management of Pediatric Germ Cell Tumors According to Risk Adapted Therapy Protocols

Authors: Ahmed Abdallatif

Abstract:

Background: Patients with malignant germ cell tumors have age distribution in two peaks, with the first one during infancy and the second after the onset of puberty. Gonadal germ cell tumors are the most common malignant ovarian tumor in females aged below twenty years. Sacrococcygeal and retroperitoneal abdominal tumors usually presents in a large size before the onset of symptoms. Methods: Patients with pediatric germ cell tumors presenting to Children’s Cancer Hospital Egypt and National Cancer Institute Egypt from January 2008 to June 2011 Patients underwent stratification according to risk into low, intermediate and high risk groups according to children oncology group classification. Objectives: Assessment of the clinicopathologic features of all cases of pediatric germ cell tumors and classification of malignant cases according to their stage, and the primary site to low, intermediate and high risk patients. Evaluation of surgical management in each group of patients focusing on surgical approach, the extent of surgical resection according to each site, ability to achieve complete surgical resection and perioperative complications. Finally, determination of the three years overall and disease-free survival in different groups and the relation to different prognostic factors including the extent of surgical resection. Results: Out of 131 cases surgically explored only 26 cases had re exploration with 8 cases explored for residual disease 9 cases for remote recurrence or metastatic disease and the other 9 cases for other complications. Patients with low risk kept under follow up after surgery, out of those of low risk group (48 patients) only 8 patients (16.5%) shifted to intermediate risk. There were 20 patients (14.6%) diagnosed as intermediate risk received 3 cycles of compressed (Cisplatin, Etoposide and Bleomycin) and all high risk group patients 69patients (50.4%) received chemotherapy. Stage of disease was strongly and significantly related to overall survival with a poorer survival in late stages (stage IV) as compared to earlier stages. Conclusion: Overall survival rate at 3 three years was (76.7% ± 5.4, 3) years EFS was (77.8 % ±4.0), however 3 years DFS was much better (89.8 ± 3.4) in whole study group with ovarian tumors had significantly higher Overall survival (90% ± 5.1). Event Free Survival analysis showed that Male gender was 3 times likely to have bad events than females. Patients who underwent incomplete resection were 4 times more than patients with complete resection to have bad events. Disease free survival analysis showed that Patients who underwent incomplete surgery were 18.8 times liable for recurrence compared to those who underwent complete surgery, and patients who were exposed to re-excision were 21 times more prone to recurrence compared to other patients.

Keywords: extragonadal, germ cell tumors, gonadal, pediatric

Procedia PDF Downloads 218
690 Muscle and Cerebral Regional Oxygenation in Preterm Infants with Shock Using Near-Infrared Spectroscopy

Authors: Virany Diana, Martono Tri Utomo, Risa Etika

Abstract:

Background: Shock is one severe condition that can be a major cause of morbidity and mortality in the Neonatal Intensive Care Unit. Preterm infants are very susceptible to shock caused by many complications such as asphyxia, patent ductus arteriosus, intra ventricle haemorrhage, necrotizing enterocolitis, persistent pulmonal hypertension of the newborn, and septicaemia. Limited hemodynamic monitoring for early detection of shock causes delayed intervention and comprises the outcomes. Clinical parameters still used in neonatal shock detection, such as Capillary Refill Time, heart rate, cold extremity, and urine production. Blood pressure is most frequently used to evaluate preterm's circulation, but hypotension indicates uncompensated shock. Near-infrared spectroscopy (NIRS) is known as a noninvasive tool for monitoring and detecting the state of inadequate tissue perfusion. Muscle oxygen saturation shows decreased cardiac output earlier than systemic parameters of tissue oxygenation when cerebral regional oxygen saturation is still stabilized by autoregulation. However, to our best knowledge, until now, no study has analyzed the decrease of muscle oxygen regional saturation (mRSO₂) and the ratio of muscle and cerebral oxygen regional saturation (mRSO₂/cRSO₂) by NIRS in preterm with shock. Purpose: The purpose of this study is to analyze the decrease of mRSO₂ and ratio of muscle to cerebral oxygen regional saturation (mRSO₂/cRSO₂) by NIRS in preterm with shock. Patients and Methods: This cross-sectional study was conducted on preterm infants with 28-34 weeks gestational age, admitted to the NICU of Dr. Soetomo Hospital from November to January 2022. Patients were classified into two groups: shock and non-shock. The diagnosis of shock is based on clinical criteria (tachycardia, prolonged CRT, cold extremity, decreased urine production, and MAP Blood Pressure less than GA in weeks). Measurement of mRSO₂ and cRSO₂ by NIRS was performed by the doctor in charge when the patient came to NICU. Results: We enrolled 40 preterm infants. The initial conventional hemodynamic parameter as the basic diagnosis of shock showed significant differences in all variables. Preterm with shock had higher mean HR (186.45±1.5), lower MAP (29.8±2.1), and lower SBP (45.1±4.28) than non-shock children, and most had a prolonged CRT. The patients’ outcome was not a significant difference between shock and non-shock patients. The mean mRSO₂ in the shock and non-shock groups were 33,65 ± 11,32 vs. 69,15 ± 3,96 (p=0.001), and the mean ratio mRSO₂/cRSO₂ 0,45 ± 0,12 vs. 0,84 ± 0,43 (p=0,001), were significantly different. The mean cRSO₂ in the shock and non-shock groups were 71,60 ± 4,90 vs. 81,85 ± 7,85 (p 0.082), not significantly different. Conclusion: The decrease of mRSO₂ and ratio of mRSO₂/cRSO₂ can differentiate between shock and non-shock in the preterm infant when cRSO₂ is still normal.

Keywords: preterm infant, regional muscle oxygen saturation, regional cerebral oxygen saturation, NIRS, shock

Procedia PDF Downloads 91
689 Cell Adhesion, Morphology and Cytokine Expression of Synoviocytes Can Be Altered on Different Nano-Topographic Oxidized Silicon Nanosponges

Authors: Hung-Chih Hsu, Pey-Jium Chang, Ching-Hsein Chen, Jer-Liang Andrew Yeh

Abstract:

Osteoarthritis (OA) is a common disorder in rehabilitation clinic. The main characteristics include joint pain, localized tenderness and enlargement, joint effusion, cartilage destruction, loss of adhesion of perichondrium, synovium hyperplasia. Synoviocytes inflammation might be a cause of local tenderness and effusion. Inflammation cytokines might also play an important role in joint pain, cartilage destruction, decrease adhesion of perichondrium to the bone. Treatments of osteoarthritis include non-steroid anti-inflammation drugs (NSAID), glucosamine supplementation, hyaluronic acid, arthroscopic debridement, and total joint replacement. Total joint replacement is commonly used in patients with severe OA who failed respond to pharmacological treatment. However, some patients received surgery had serious adverse events, including instability of the implants due to insufficient adhesion to the adjacent bony tissue or synovial inflammation. We tried to develop ideal nano-topographic oxidized silicon nanosponges by using with various chemicals to produce thickness difference in nanometers in order to study more about the cell-environment interactions in vitro like the alterations of cell adhesion, morphology, extracellular matrix secretions in the pathogenesis of osteoarthritis. Cytokines studies like growth factor, reactive oxygen species, reactive inflammatory materials (Like nitrous oxide and prostaglandin E2), extracellular matrix (ECM) degradation enzymes, and synthesis of collagen will also be observed and discussed. Extracellular and intracellular expression transforming growth factor beta (TGF-β) will be studied by reverse transcription-polymerase chain reaction (RT-PCR). The degradation of ECM will be observed by the bioactivity ratio of matrix metalloproteinase (MMP) and tissue inhibitors of metalloproteinase by ELISA (Enzyme-linked immunosorbent assay). When rabbit synoviocytes were cultured on these nano-topographic structures, they demonstrate better cell adhesion rate, decreased expression of MMP-2,9 and PGE2, and increased expression of TGF-β when cultured in nano-topographic oxidized silicon nanosponges than in the planar oxidized silicon ones. These results show cell behavior, cytokine production can be influenced by physical characteristics from different nano-topographic structures. Our study demonstrates the possibility of manipulating cell behavior in these nano-topographic biomaterials.

Keywords: osteoarthritis, synoviocyte, oxidized silicon surfaces, reactive oxygen species

Procedia PDF Downloads 386
688 Comparative Analysis of Biodegradation on Polythene and Plastics Buried in Fadama Soil Amended With Organic and Inorganic Fertilizer

Authors: Baba John, Abdullahi Mohammed

Abstract:

The aim of this research is to compare the analysis of biodegradation on polythene and plastics buried in fadama soil amended with Organic and Inorganic fertilizer. Physico- chemical properties of the samples were determined. Bacteria and Fungi implicated in the biodegradation were identified and enumerated. Physico- chemical properties before the analysis indicated pH range of the samples from 4.28 – 5.80 , While the percentage Organic carbon and Organic matter was highest in cow dung samples with 3.89% and 6.69% respectively. The total Nitrogen percentage was recorded to be highest in Chicken dropping (0.68), while the availability of Phosphorus (P), Sodium (Na), Pottasium (K), and Magnessium (mg) was recorded to be highest in F – soil (Control), with values to be 37ppm, 1.63 Cmolkg-1, 0.35 Cmolkg-1 and 1.18 Cmolkg-1 respectively, except for calcium which was recorded to be highest in Cow dung (5.80 Cmolkg-1). However, physico – chemical properties of the samples after analysis indicated pH range of 4.6 – 5.80, Percentage Organic carbon and Organic matter was highest in Fadama soil mixed with fertilizer, having 0.7% and 1.2% respectively. Total Percentage Nitrogen content was found to be highest (0.56) in Fadama soil mixed with poultry dropping. Availability of Sodium (Na), Pottasium (K), and Calcium (Ca) was recorded to be highest in Fadama Soil mixed with Cow dung with values to be 0.64 Cmolkg-1, 2.07 Cmolkg-1 and 3.36 Cmolkg-1 respectively. The percentage weight loss of polythene and plastic bags after nine months in fadama soil mixed with poultry dropping was 11.9% for polythene and 6.0% for plastics. Weight loss in fadama soil mixed with cow dung was 18.1% for polythene and 4.7% for plastics. Weight loss of polythene and plastic in fadama soil mixed with fertilizer (NPK) was 7.4% for polythene and 3.3% for plastics. While, the percentage weight loss of polythene and plastics after nine months of burial in fadama soil (control) was 3.5% and 0.0% respectively. The bacteria species isolated from Fadama soil, organic and inorganic fertilizers before amendments include: S. aureus, Micrococcus sp, Streptococcus. pyogenes, Psuedomonas aeruginosa Bacillus subtilis and Bacillus cereus. The fungi species include: Aspergillus niger, Aspergillus fumigatus, Aspergillus flavus, Fusarium sp, Mucor sp Penicillium sp and Candida sp. The bacteria species isolated and characterized after nine months of seeding include: S. aureus, Micrococcus sp, S. pyogenes, P. aeruginosa and B. subtilis. The fungi species are: A. niger A. flavus, A. fumigatus, Mucor sp, Penicillium sp and Fusarium sp. The result of this study indicated that plastic materials can be degraded in the fadama soil irrespective of whether the soil is amended or not. The Period of composting also has a significant impact on the rate at which polythene and plastics are degraded.

Keywords: Fadama, fertilizer, plastic and polythene, biodegradation

Procedia PDF Downloads 543
687 Arbuscular Mycorrhizal Symbiosis Modulates Antioxidant Capacity of in vitro Propagated Hyssop, Hyssopus officinalis L.

Authors: Maria P. Geneva, Ira V. Stancheva, Marieta G. Hristozkova, Roumiana D. Vasilevska-Ivanova, Mariana T. Sichanova, Janet R. Mincheva

Abstract:

Hyssopus officinalis L., Lamiaceae, commonly called hyssop, is an aromatic, semi-evergreen, woody-based, shrubby perennial plant. Hyssop is a good expectorant and antiviral herb commonly used to treat respiratory conditions such as influenza, sinus infections, colds, and bronchitis. Most of its medicinal properties are attributed to the essential oil of hyssop. The study was conducted to evaluate the influence of inoculation with arbuscular mycorrhizal fungi of in vitro propagated hyssop plants on the: activities of antioxidant enzymes superoxide dismutase, catalase, guaiacol peroxidase and ascorbate peroxidase; accumulation of non-enzymatic antioxidants total phenols and flavonoid, water-soluble soluble antioxidant metabolites expressed as ascorbic acid; the antioxidant potential of hyssop methanol extracts assessed by two common methods: free radical scavenging activity using free stable radical (2,2-diphenyl-1-picrylhydrazyl, DPPH• and ferric reducing antioxidant power FRAP in flowers and leaves. The successfully adapted to field conditions in vitro plants (survival rate 95%) were inoculated with arbuscular mycorrhizal fungi (Claroideoglomus claroideum, ref. EEZ 54). It was established that the activities of enzymes with antioxidant capacity (superoxide dismutase, catalase, guaiacol peroxidase and ascorbate peroxidase) were significantly higher in leaves than in flowers in both control and mycorrhized plants. In flowers and leaves of inoculated plants, the antioxidant enzymes activity were lower than in non-inoculated plants, only in SOD activity, there was no difference. The content of low molecular metabolites with antioxidant capacity as total phenols, total flavonoids, and water soluble antioxidants was higher in inoculated plants. There were no significant differences between control and inoculated plants both for FRAP and DPPH antioxidant activity. According to plant essential oil content, there was no difference between non-inoculated and inoculated plants. Based on our results we could suggest that antioxidant capacity of in vitro propagated hyssop plant under conditions of cultivation is determined by the phenolic compounds-total phenols and flavonoids as well as by the levels of water-soluble metabolites with antioxidant potential. Acknowledgments: This study was conducted with financial support from National Science Fund at the Bulgarian Ministry of Education and Science, Project DN06/7 17.12.16.

Keywords: antioxidant enzymes, antioxidant metabolites, arbuscular mycorrhizal fungi, Hyssopus officinalis L.

Procedia PDF Downloads 326
686 Assessment of Rainfall Erosivity, Comparison among Methods: Case of Kakheti, Georgia

Authors: Mariam Tsitsagi, Ana Berdzenishvili

Abstract:

Rainfall intensity change is one of the main indicators of climate change. It has a great influence on agriculture as one of the main factors causing soil erosion. Splash and sheet erosion are one of the most prevalence and harmful for agriculture. It is invisible for an eye at first stage, but the process will gradually move to stream cutting erosion. Our study provides the assessment of rainfall erosivity potential with the use of modern research methods in Kakheti region. The region is the major provider of wheat and wine in the country. Kakheti is located in the eastern part of Georgia and characterized quite a variety of natural conditions. The climate is dry subtropical. For assessment of the exact rate of rainfall erosion potential several year data of rainfall with short intervals are needed. Unfortunately, from 250 active metro stations running during the Soviet period only 55 of them are active now and 5 stations in Kakheti region respectively. Since 1936 we had data on rainfall intensity in this region, and rainfall erosive potential is assessed, in some old papers, but since 1990 we have no data about this factor, which in turn is a necessary parameter for determining the rainfall erosivity potential. On the other hand, researchers and local communities suppose that rainfall intensity has been changing and the number of haily days has also been increasing. However, finding a method that will allow us to determine rainfall erosivity potential as accurate as possible in Kakheti region is very important. The study period was divided into three sections: 1936-1963; 1963-1990 and 1990-2015. Rainfall erosivity potential was determined by the scientific literature and old meteorological stations’ data for the first two periods. And it is known that in eastern Georgia, at the boundary between steppe and forest zones, rainfall erosivity in 1963-1990 was 20-75% higher than that in 1936-1963. As for the third period (1990-2015), for which we do not have data of rainfall intensity. There are a variety of studies, where alternative ways of calculating the rainfall erosivity potential based on lack of data are discussed e.g.based on daily rainfall data, average annual rainfall data and the elevation of the area, etc. It should be noted that these methods give us a totally different results in case of different climatic conditions and sometimes huge errors in some cases. Three of the most common methods were selected for our research. Each of them was tested for the first two sections of the study period. According to the outcomes more suitable method for regional climatic conditions was selected, and after that, we determined rainfall erosivity potential for the third section of our study period with use of the most successful method. Outcome data like attribute tables and graphs was specially linked to the database of Kakheti, and appropriate thematic maps were created. The results allowed us to analyze the rainfall erosivity potential changes from 1936 to the present and make the future prospect. We have successfully implemented a method which can also be use for some another region of Georgia.

Keywords: erosivity potential, Georgia, GIS, Kakheti, rainfall

Procedia PDF Downloads 224
685 Social Problems and Gender Wage Gap Faced by Working Women in Readymade Garment Sector of Pakistan

Authors: Narjis Kahtoon

Abstract:

The issue of the wage discrimination on the basis of gender and social problem has been a significant research problem for several decades. Whereas lots of have explored reasons for the persistence of an inequality in the wages of male and female, none has successfully explained away the entire differentiation. The wage discrimination on the basis of gender and social problem of working women is a global issue. Although inequality in political and economic and social make-up of countries all over the world, the gender wage discrimination, and social constraint is present. The aim of the research is to examine the gender wage discrimination and social constraint from an international perspective and to determine whether any pattern exists among cultural dimensions of a country and the man and women remuneration gap in Readymade Garment Sector of Pakistan. Population growth rate is significant indicator used to explain the change in population and play a crucial point in the economic development of a country. In Pakistan, readymade garment sector consists of small, medium and large sized firms. With an estimated 30 percent of the workforce in textile- Garment is females’. Readymade garment industry is a labor intensive industry and relies on the skills of individual workers and provides highest value addition in the textile sector. In the Garment sector, female workers are concentrated in poorly paid, labor-intensive down-stream production (readymade garments, linen, towels, etc.), while male workers dominate capital- intensive (ginning, spinning and weaving) processes. Gender wage discrimination and social constraint are reality in Pakistan Labor Market. This research allows us not only to properly detect the size of gender wage discrimination and social constraint but to also fully understand its consequences in readymade garment sector of Pakistan. Furthermore, research will evaluated this measure for the three main clusters like Lahore, Karachi, and Faisalabad. These data contain complete details of male and female workers and supervisors in the readymade garment sector of Pakistan. These sources of information provide a unique opportunity to reanalyze the previous finding in the literature. The regression analysis focused on the standard 'Mincerian' earning equation and estimates it separately by gender, the research will also imply the cultural dimensions developed by Hofstede (2001) to profile a country’s cultural status and compare those cultural dimensions to the wage inequalities. Readymade garment of Pakistan is one of the important sectors since its products have huge demand at home and abroad. These researches will a major influence on the measures undertaken to design a public policy regarding wage discrimination and social constraint in readymade garment sector of Pakistan.

Keywords: gender wage differentials, decomposition, garment, cultural

Procedia PDF Downloads 209
684 The Surgical Trainee Perception of the Operating Room Educational Environment

Authors: Neal Rupani

Abstract:

Background: A surgical trainee has limited learning opportunities in the operating room in order to gain an ever-increasing standard of surgical skill, competency, and proficiency. These opportunities continue to decline due to numerous factors such as the European Working Time Directive and increasing requirement for service provision. It is therefore imperative to obtain the highest educational value from each educational opportunity. A measure that has yet to be validated in England on surgical trainees called the Operating Room Educational Environment Measure (OREEM) has been developed to identify and evaluate each component of the educational environment with a view to steer future change in optimising educational events in theatre. Aims: The aims of the study are to assess the reliability of the OREEM within England and to evaluate the surgical trainee’s objective perspective of the current operating room educational environment within one region within England. Methods: Using a quantitative study approach, data was collected over one month from surgical trainees within Health Education Thames Valley (Oxford) using an online questionnaire consisting of demographic data, the OREEM, a global satisfaction score. Results: 140 surgical trainees were invited to the study, with an online response of 54 participants (response rate = 38.6%). The OREEM was shown to have good internal consistency (α = 0.906, variables = 40) and unidimensionality, along with all four of its subgroups. The mean OREEM score was 79.16%. The areas highlighted for improvement predominantly focused on improving learning opportunities (average subscale score = 72.9%) and conducting pre- and post-operative teaching (average score = 70.4%). The trainee perception is most satisfactory for the level of supervision and workload (average subscale score = 82.87%). There was no differences found between gender (U = 191.5, p = 0.535) or type of hospital (U = 258.0, p = 0.099), but the learning environment was favoured towards senior trainees (U = 223.5, p = 0.017). There was strong correlation between OREEM and the global satisfaction score (r = 0.755, p<0.001). Conclusions: The OREEM was shown to be reliable in measuring the educational environment in the operating room. This can be used to identify potentially modifiable components for improvement and as an audit tool to ensure high standards are being met. The current perception of the education environment in Health Education Thames Valley is satisfactory, and modifiable internal and external factors such as reducing service provision requirements, empowering trainees to plan lists, creating a team-working ethic between all personnel, and using tools that maximise learning from each operation have been identified to improve learning in the future. There is a favourable attitude to use of such improvement tools, especially for those currently dissatisfied.

Keywords: education environment, surgery, post-graduate education, OREEM

Procedia PDF Downloads 184
683 Liquid Food Sterilization Using Pulsed Electric Field

Authors: Tanmaya Pradhan, K. Midhun, M. Joy Thomas

Abstract:

Increasing the shelf life and improving the quality are important objectives for the success of packaged liquid food industry. One of the methods by which this can be achieved is by deactivating the micro-organisms present in the liquid food through pasteurization. Pasteurization is done by heating, but some serious disadvantages such as the reduction in food quality, flavour, taste, colour, etc. were observed because of heat treatment, which leads to the development of newer methods instead of pasteurization such as treatment using UV radiation, high pressure, nuclear irradiation, pulsed electric field, etc. In recent years the use of the pulsed electric field (PEF) for inactivation of the microbial content in the food is gaining popularity. PEF uses a very high electric field for a short time for the inactivation of microorganisms, for which we require a high voltage pulsed power source. Pulsed power sources used for PEF treatments are usually in the range of 5kV to 50kV. Different pulse shapes are used, such as exponentially decaying and square wave pulses. Exponentially decaying pulses are generated by high power switches with only turn-on capacity and, therefore, discharge the total energy stored in the capacitor bank. These pulses have a sudden onset and, therefore, a high rate of rising but have a very slow decay, which yields extra heat, which is ineffective in microbial inactivation. Square pulses can be produced by an incomplete discharge of a capacitor with the help of a switch having both on/off control or by using a pulse forming network. In this work, a pulsed power-based system is designed with the help of high voltage capacitors and solid-state switches (IGBT) for the inactivation of pathogenic micro-organism in liquid food such as fruit juices. The high voltage generator is based on the Marx generator topology, which can produce variable amplitude, frequency, and pulse width according to the requirements. Liquid food is treated in a chamber where pulsed electric field is produced between stainless steel electrodes using the pulsed output voltage of the supply. Preliminary bacterial inactivation tests were performed by subjecting orange juice inoculated with Escherichia Coli bacteria. With the help of the developed pulsed power source and the chamber, the inoculated orange has been PEF treated. The voltage was varied to get a peak electric field up to 15kV/cm. For a total treatment time of 200µs, a 30% reduction in the bacterial count has been observed. The detailed results and analysis will be presented in the final paper.

Keywords: Escherichia coli bacteria, high voltage generator, microbial inactivation, pulsed electric field, pulsed forming line, solid-state switch

Procedia PDF Downloads 184
682 Eggshell Waste Bioprocessing for Sustainable Acid Phosphatase Production and Minimizing Environmental Hazards

Authors: Soad Abubakr Abdelgalil, Gaber Attia Abo-Zaid, Mohamed Mohamed Yousri Kaddah

Abstract:

Background: The Environmental Protection Agency has listed eggshell waste as the 15th most significant food industry pollution hazard. The utilization of eggshell waste as a source of renewable energy has been a hot topic in recent years. Therefore, finding a sustainable solution for the recycling and valorization of eggshell waste by investigating its potential to produce acid phosphatase (ACP) and organic acids by the newly-discovered B. sonorensis was the target of the current investigation. Results: The most potent ACP-producing B. sonorensis strain ACP2 was identified as a local bacterial strain obtained from the effluent of paper and pulp industries on basis of molecular and morphological characterization. The use of consecutive statistical experimental approaches of Plackett-Burman Design (PBD), and Orthogonal Central Composite Design (OCCD), followed by pH-uncontrolled cultivation conditions in a 7 L bench-top bioreactor, revealed an innovative medium formulation that substantially improved ACP production, reaching 216 U L⁻¹ with ACP yield coefficient Yp/x of 18.2 and a specific growth rate (µ) of 0.1 h⁻¹. The metals Ag+, Sn+, and Cr+ were the most efficiently released from eggshells during the solubilization process by B. sonorensis. The uncontrolled pH culture condition is the most suited and favored setting for improving the ACP and organic acids production simultaneously. Quantitative and qualitative analyses of produced organic acids were carried out using liquid chromatography-tandem mass spectrometry (LC-MS/MS). Lactic acid, citric acid, and hydroxybenzoic acid isomer were the most common organic acids produced throughout the cultivation process. The findings of thermogravimetric analysis (TGA), differential scan calorimeter (DSC), scanning electron microscope (SEM), energy-dispersive spectroscopy (EDS), Fourier-Transform Infrared Spectroscopy (FTIR), and X-Ray Diffraction (XRD) analysis emphasize the significant influence of organic acids and ACP activity on the solubilization of eggshells particles. Conclusions: This study emphasized robust microbial engineering approaches for the large-scale production of a newly discovered acid phosphatase accompanied by organic acids production from B. sonorensis. The biovalorization of the eggshell waste and the production of cost-effective ACP and organic acids were integrated into the current study, and this was done through the implementation of a unique and innovative medium formulation design for eggshell waste management, as well as scaling up ACP production on a bench-top scale.

Keywords: chicken eggshells waste, bioremediation, statistical experimental design, batch fermentation

Procedia PDF Downloads 376
681 A 20 Year Comparison of Australian Childhood Bicycle Injuries – Have We Made a Difference?

Authors: Bronwyn Griffin, Caroline Acton, Tona Gillen, Roy Kimble

Abstract:

Background: Bicycle riding is a common recreational activity enjoyed by many children throughout Australia that has been associated with the usual caveat of benefits related to exercise and recreation. Given Australia was the first country in the world to introduce cyclist helmet laws in 1991, very few publications have reviewed paediatric cycling injuries (fatal or non-fatal) since. Objectives: To identify trends in children (0-16 years) who required admission for greater than 24 hours following a bicycle-related injury (fatal and non-fatal) in Queensland. Further, to discuss changes that have occurred in paediatric cycling injury trends in Queensland since a prominent local study/publication in 1995. This paper aims to establish evidence to inform interventions promoting safer riding to parents, children and communities. Methods: Data on paediatric (0-16 years) cycling injuries in Queensland resulting in hospital admission more than 24 hours across three tertiary paediatric hospitals in Brisbane between November 2008-June 2015 was compiled by the Paediatric Trauma Data Registry for non-fatal injuries. The Child Death Review Team at the Queensland Families and Childhood Commission provided data on fatalities in children <17years from (June 2004 –June 2015). Comparing trends to a local study published in 1995 Results: Between 2008-2015 there were 197 patients admitted for greater than 24 hours following a cycling injury. The median age was 11 years, with males more frequently involved (n=139, 87%) compared to females. Mean length of stay was three days, with 47 (28%) children admitted to PICU, location of injury was most often the street (n=63, 37%). Between 2004 –2015 there were 15 fatalities (Incidence rate 0.25/100,000); all were male, 14/15 occurred on the street, with eight stated to have not been wearing a helmet, 11/15 children came from the least advantaged socio-economic group (SEIFA) compared to a local publication in 1995, finding of 94 fatalities between (1981-1992). Conclusions: There has been a notable decrease in incidence of fatalities between the two time periods with incidence rates dropping from 1.75-0.25/100,000. More statistics need to be run to ascertain if this is a true reduction or perhaps a decrease in children riding bicycles. Injuries that occur on the street that come in contact with a car remain of serious concern. The purpose of this paper is not to discourage bicycle riding among child and adolescent populations, rather, inform parents and the wider community about the risks associated with cycling in order to reduce injuries associated with this sport, whilst promoting safe cycling.

Keywords: paediatric, cycling, trauma, prevention, emergency

Procedia PDF Downloads 249
680 Numerical and Experimental Investigation of Air Distribution System of Larder Type Refrigerator

Authors: Funda Erdem Şahnali, Ş. Özgür Atayılmaz, Tolga N. Aynur

Abstract:

Almost all of the domestic refrigerators operate on the principle of the vapor compression refrigeration cycle and removal of heat from the refrigerator cabinets is done via one of the two methods: natural convection or forced convection. In this study, airflow and temperature distributions inside a 375L no-frost type larder cabinet, in which cooling is provided by forced convection, are evaluated both experimentally and numerically. Airflow rate, compressor capacity and temperature distribution in the cooling chamber are known to be some of the most important factors that affect the cooling performance and energy consumption of a refrigerator. The objective of this study is to evaluate the original temperature distribution in the larder cabinet, and investigate for better temperature distribution solutions throughout the refrigerator domain via system optimizations that could provide uniform temperature distribution. The flow visualization and airflow velocity measurements inside the original refrigerator are performed via Stereoscopic Particle Image Velocimetry (SPIV). In addition, airflow and temperature distributions are investigated numerically with Ansys Fluent. In order to study the heat transfer inside the aforementioned refrigerator, forced convection theories covering the following cases are applied: closed rectangular cavity representing heat transfer inside the refrigerating compartment. The cavity volume has been represented with finite volume elements and is solved computationally with appropriate momentum and energy equations (Navier-Stokes equations). The 3D model is analyzed as transient, with k-ε turbulence model and SIMPLE pressure-velocity coupling for turbulent flow situation. The results obtained with the 3D numerical simulations are in quite good agreement with the experimental airflow measurements using the SPIV technique. After Computational Fluid Dynamics (CFD) analysis of the baseline case, the effects of three parameters: compressor capacity, fan rotational speed and type of shelf (glass or wire) are studied on the energy consumption; pull down time, temperature distributions in the cabinet. For each case, energy consumption based on experimental results is calculated. After the analysis, the main effective parameters for temperature distribution inside a cabin and energy consumption based on CFD simulation are determined and simulation results are supplied for Design of Experiments (DOE) as input data for optimization. The best configuration with minimum energy consumption that provides minimum temperature difference between the shelves inside the cabinet is determined.

Keywords: air distribution, CFD, DOE, energy consumption, experimental, larder cabinet, refrigeration, uniform temperature

Procedia PDF Downloads 109
679 A Markov Model for the Elderly Disability Transition and Related Factors in China

Authors: Huimin Liu, Li Xiang, Yue Liu, Jing Wang

Abstract:

Background: As one of typical case for the developing countries who are stepping into the aging times globally, more and more older people in China might face the problem of which they could not maintain normal life due to the functional disability. While the government take efforts to build long-term care system and further carry out related policies for the core concept, there is still lack of strong evidence to evaluating the profile of disability states in the elderly population and its transition rate. It has been proved that disability is a dynamic condition of the person rather than irreversible so it means possible to intervene timely on them who might be in a risk of severe disability. Objective: The aim of this study was to depict the picture of the disability transferring status of the older people in China, and then find out individual characteristics that change the state of disability to provide theory basis for disability prevention and early intervention among elderly people. Methods: Data for this study came from the 2011 baseline survey and the 2013 follow-up survey of the China Health and Retirement Longitudinal Study (CHARLS). Normal ADL function, 1~2 ADLs disability,3 or above ADLs disability and death were defined from state 1 to state 4. Multi-state Markov model was applied and the four-state homogeneous model with discrete states and discrete times from two visits follow-up data was constructed to explore factors for various progressive stages. We modeled the effect of explanatory variables on the rates of transition by using a proportional intensities model with covariate, such as gender. Result: In the total sample, state 2 constituent ratio is nearly about 17.0%, while state 3 proportion is blow the former, accounting for 8.5%. Moreover, ADL disability statistics difference is not obvious between two years. About half of the state 2 in 2011 improved to become normal in 2013 even though they get elder. However, state 3 transferred into the proportion of death increased obviously, closed to the proportion back to state 2 or normal functions. From the estimated intensities, we see the older people are eleven times as likely to develop at 1~2 ADLs disability than dying. After disability onset (state 2), progression to state 3 is 30% more likely than recovery. Once in state 3, a mean of 0.76 years is spent before death or recovery. In this model, a typical person in state 2 has a probability of 0.5 of disability-free one year from now while the moderate disabled or above has a probability of 0.14 being dead. Conclusion: On the long-term care cost considerations, preventive programs for delay the disability progression of the elderly could be adopted based on the current disabled state and main factors of each stage. And in general terms, those focusing elderly individuals who are moderate or above disabled should go first.

Keywords: Markov model, elderly people, disability, transition intensity

Procedia PDF Downloads 290
678 Challenges Faced by the Parents of Mentally Challenged Children in India

Authors: Chamaraja Parulli

Abstract:

Family is an important social institution devoted to the growth of a child, and parents are the important agents of socialization. Mentally challenged children are those who are affected by intellectual disability, which is manifested by limitation in intellectual functioning and adoptive behavior. Intellectual disability affects about 3-4 percentage of the general population. Intellectual disability is caused by genetic condition, problems during pregnancy, problems during childbirth, or illness. Mental retardation is the world’s most complex and challenging issue. The stigmatization of disability results in social and economic marginalization. Parents of the mentally challenged children will have a very high level of parenting stress, which is significantly more than the stress perceived by the parents of the children without disability. The prevalence of severe mental disorder called Schizophrenia is among 1.1 percent of the total population in India. On the other hand, 11 to 12 percent is the overall lifetime occurrence rate of mental disorders. While the government has a separate program for mental health, the segment is marred by lack of adequate doctors and infrastructure. Mentally retarded children have certain limitations in mental functioning and skills, which makes them slow learners in speaking, walking, and taking care of their personal needs such as dressing and eating. Accepting a child with mental handicap becomes difficult for parents and to the whole family, as they have to face many problems, including those of management, finance, deprivation of rest, and leisure. Also, the problems faced by the parents can be seen in different areas like – educational, psychological, social, emotional, financial and family related issues. The study brought out various difficulties and problems faced by the parents as well as family members. The findings revealed that the mental retardation is not only a medico-psychological problem but also a socio-cultural problem. The study results, however, indicate that the quality of life of the family having children with mental retardation can be improved to a greater extent by building up a child-friendly ambience at home. The main aim of the present study is to assess the problems faced by the parents of mentally challenged children, with the help of personal interview data collected from the parents of mentally challenged children, residing in Shimoga District of Karnataka State, India. These individuals were selected using stratified random sampling method. Organizing effective intervention programs for parents, family, society, and educational institutions towards reduction of family stress, augmenting the family’s strengths, increasing child’s competence and enhancing the positive attitudes and values of the society will go a long way for the peaceful existence of the mentally challenged children.

Keywords: mentally challenged children, intellectual disability, special children, social infrastructure, differently abled, psychological stress, marginalization

Procedia PDF Downloads 109
677 Prevalence of Bovine Mastitis and Associated Risk Factors in Selected Dairy Farms in Zoba Anseba, Eritrea

Authors: Redie Kidane Ghebrehawariat, Betiel Habte Hadgu, Filmon Berhane Kahsay, Rim Berhane Fisehaye, Samuel Haile Kahsay, Saron Yemane Yosief, Selemawit Mosazghi Gilazghi

Abstract:

A cross-sectional study was conducted from 22 February to 9 April 2022 on small, medium, and large holder dairy farms to determine the bovine mastitis prevalence and associated risk factors in the Anseba region, Eritrea. A total of 34 dairy farms and 193 dairy cows were randomly selected. Dairy cows were physically examined for any change on the udder and milk; a California mastitis test was performed to check sub-clinical mastitis; a closed-ended semi-structured questionnaire composed of 28 variables/risk factors (21 management risk factors and 7 animal-level risk factors) was used to determine the risk factors responsible for clinical and sub-clinical mastitis in the dairy cows. The overall cow-level prevalence of mastitis was 147 (76.2%). The animal level prevalence rate of clinical and sub-clinical mastitis was found to be 22 (11.4%) and 125 (64.8%), respectively, while herd level prevalence both for clinical and subclinical mastitis was found to be 14 (41.2%) and 26 (76.5%) respectively. Based on the already set P-value, which is <0.05, a number of risk factors were found to have a significant relationship with the occurrence of clinical and sub-clinical mastitis. Generally, animal risk factors such as animal age, parity, injury on the udder or teat, and previous history of mastitis presence of injury on the udder and lactation stage were risk factors with a significant relationship with the occurrence of clinical and sub-clinical mastitis. On the other hand, management risk factors with a significant relationship to the occurrence of clinical and sub-clinical mastitis were herd size, failure to milk mastitic cow, at last, educational level, floor type, failure to use a towel, using one towel for more than one cow and failure to practice mastitis test. From a total of 772 quarters, 280 (36.3%) were found positive for sub-clinical mastitis using the California mastitis test; of these, 70 (9%) were weakly positive, 90 (11.7%) were distinct positive, and 120 (15.5%) were strongly positive. Furthermore, 13 (1.7%) quarters were blocked. Quarter level prevalence was right front 80 (41.5%), left front 64 (33.3%), right hind 69 (35.8%) and left hind 67 (34.7%). The study has shown that mastitis is a major problem for dairy farms and the findings suggested that mastitis is one of the limiting factors in increasing milk production. Subclinical mastitis was found to be a devastating problem, and it occurred in all three breeds of lactating dairy cattle. Therefore, farmers should work hard to avoid the above-mentioned risk factors to minimize the infection of their dairy cattle by mastitis and thereby increase their profit. On the other hand, the Ministry of Agriculture, through the extension unit, should work in close contact with the farmers to increase awareness of the economic importance of the disease and associated risk factors.

Keywords: mastitis, prevalence, dairy cattle, Anseba, Eritrea

Procedia PDF Downloads 128
676 Cross Carpeting in Nigerian Politics: Some Legal and Moral Issues Generated

Authors: Agbana Olaseinde Julius, Opadere Olaolu Stephen

Abstract:

The concept of cross carpeting is as old as politics itself. Basically, it entails an individual leaving a political party/group, to join another. The reasons for which cross carpeting is embarked upon are diverse: ideological differences; ethnic and/or religious differences; access to actual or perceived better political opportunities; liberty of association; rancor; etc. The current democratic dispensation in Nigeria has experienced renewed and rather alarming rate of cross carpeting, for reasons including those enumerated above and others. Right to cross carpet is inherent in a democratic setting as well as the political stakeholder; so does it also comprise of the constitutional right of ‘freedom of association’. However, the current species of cross carpeting in Nigeria requires scrutiny, in view of some potential legal and moral challenges it poses for both the present and the future. Cross carpeting is considered both legal and constitutional, but the current spate raises the question of expediency, particularly in a nascent democracy. It is considered to have a propensity of negatively impacting political stability in a polity with fragile nerves. Importantly too, cross carpeting is considered a potential damage to the psyche of posterity with regards to a warped disposition to promises, honour and integrity. The perceived peculiar dimension of cross carpeting in Nigeria raises questions on the quality of leadership presently obtainable in the country, vis-à-vis greed, self-centeredness, disregard for the concern and interest of avowed followers/fans, entrenchment of distrust, etc. Thus, the study made use of primary and secondary sources of information. The primary sources included the Constitutions of the Federal Republic of Nigeria 1999 (as amended); judicial decisions; and the Electoral Act, 2010 (as Amended). The secondary sources comprised of information from books, journals, newspapers, magazines and Internet documents. Data obtained from these sources were subjected to content analysis. Findings of this study show that though the act of cross carpeting may not be in breach of any Statute or Law, it however, in most cases, breaches the morals of expediency. The morality thereof is far from justifiable, and should be condemned in the interest of the present and posterity. There is a great and urgent need to embark on a re-entrenchment of the culture of political ideology in the Nigerian polity, as obtainable in developed democracies. In conclusion, the need to exercise the right of cross carpeting with caution cannot be overemphasized. Membership of a political group/party should be backed by commitment to well defined ideologies and values. Commitment to them should be regarded akin to that found in the family, which is not easily or flippantly jettisoned.

Keywords: cross-carpeting, Nigeria, legal, moral issues, politics

Procedia PDF Downloads 447
675 The Impact of HKUST-1 Metal-Organic Framework Pretreatment on Dynamic Acetaldehyde Adsorption

Authors: M. François, L. Sigot, C. Vallières

Abstract:

Volatile Organic Compounds (VOCs) are a real health issue, particularly in domestic indoor environments. Among these VOCs, acetaldehyde is frequently monitored in dwellings ‘air, especially due to smoking and spontaneous emissions from the new wall and soil coverings. It is responsible for respiratory complaints and is classified as possibly carcinogenic to humans. Adsorption processes are commonly used to remove VOCs from the air. Metal-Organic Frameworks (MOFs) are a promising type of material for high adsorption performance. These hybrid porous materials composed of metal inorganic clusters and organic ligands are interesting thanks to their high porosity and surface area. The HKUST-1 (also referred to as MOF-199) is a copper-based MOF with the formula [Cu₃(BTC)₂(H₂O)₃]n (BTC = benzene-1,3,5-tricarboxylate) and exhibits unsaturated metal sites that can be attractive sites for adsorption. The objective of this study is to investigate the impact of HKUST-1 pretreatment on acetaldehyde adsorption. Thus, dynamic adsorption experiments were conducted in 1 cm diameter glass column packed with 2 cm MOF bed height. MOF were sieved to 630 µm - 1 mm. The feed gas (Co = 460 ppmv ± 5 ppmv) was obtained by diluting a 1000 ppmv acetaldehyde gas cylinder in air. The gas flow rate was set to 0.7 L/min (to guarantee a suitable linear velocity). Acetaldehyde concentration was monitored online by gas chromatography coupled with a flame ionization detector (GC-FID). Breakthrough curves must allow to understand the interactions between the MOF and the pollutant as well as the impact of the HKUST-1 humidity in the adsorption process. Consequently, different MOF water content conditions were tested, from a dry material with 7 % water content (dark blue color) to water saturated state with approximately 35 % water content (turquoise color). The rough material – without any pretreatment – containing 30 % water serves as a reference. First, conclusions can be drawn from the comparison of the evolution of the ratio of the column outlet concentration (C) on the inlet concentration (Co) as a function of time for different HKUST-1 pretreatments. The shape of the breakthrough curves is significantly different. The saturation of the rough material is slower (20 h to reach saturation) than that of the dried material (2 h). However, the breakthrough time defined for C/Co = 10 % appears earlier in the case of the rough material (0.75 h) compared to the dried HKUST-1 (1.4 h). Another notable difference is the shape of the curve before the breakthrough at 10 %. An abrupt increase of the outlet concentration is observed for the material with the lower humidity in comparison to a smooth increase for the rough material. Thus, the water content plays a significant role on the breakthrough kinetics. This study aims to understand what can explain the shape of the breakthrough curves associated to the pretreatments of HKUST-1 and which mechanisms take place in the adsorption process between the MOF, the pollutant, and the water.

Keywords: acetaldehyde, dynamic adsorption, HKUST-1, pretreatment influence

Procedia PDF Downloads 237
674 The Effects of Grape Waste Bioactive Compounds on the Immune Response and Oxidative Stress in Pig Kidney

Authors: Mihai Palade, Gina Cecilia Pistol, Mariana Stancu, Veronica Chedea, Ionelia Taranu

Abstract:

Nutrition is an important determinant of general health status, with especially focus on prevention and/or attenuation of the inflammatory-associated pathologies. People with chronic kidney disease can experience chronic inflammation that can lead to cardiovascular disease and even an increased rate of death. There are important links between chronic kidney diseases, inflammation and nutritional strategies that may prevent or protect against undesirable inflammation and oxidative stress. The grape by-products either seeds or pomace are rich in polyphenols which may be beneficial in prevention of inflammatory, antioxidant and antimicrobial processes. As a model for studying the impact of grape seeds on renal inflammation and oxidative stress, we used in this study weaned piglets. After a feeding trial of 30 days with a control diet and an experimental diet containing 5% grape seed (GS), kidney samples were collected. In renal tissues were determined the expression and activity of important markers of immune respose and oxidative stress: pro-inflammatory cytokines (TNF-alpha, IL-1 beta, IL-6, IL-8, IFN-gamma), anti-inflammatory cytokines (IL-4, IL-10), anti-oxidant enzymes (catalase CAT, superoxide dismutase SOD, glutathione peroxidise GPx) and important mediators belonging to nuclear receptors (NF-kB1, Nrf-2 and PPAR-gamma). Gene expression was evaluated by qPCR, whereas protein concentration was determined using proteomic techniques (ELISA). The activity of anti-oxidant enzymes was determined using specific kits. Our results showed that GS enriched in polyphenols does not have effect on TNF-alpha, IL-6 and IL-1 beta gene expression and protein concentration in kidney. By contrast, the gene expression and protein level of IL-8 and IFN-gamma were decreased in GS kidney. Anti-inflammatory cytokines IL-4 and IL-10 gene levels were increased in kidneys collected from GS piglets in comparison with controls, with no modification of protein levels between the two groups. The activities of anti-oxidant enzymes CAT and GPx were increased in kidney by GS, whereas SOD activity was unmodified in comparison with control samples. Also, the GS diet was associated with no modulation of mRNAs for nuclear receptors NF-kB1, Nrf-2 and PPAR-gamma gene expressions in kidneys. In conclusion, our results demonstrated that GS enriched in bioactive compounds such polyphenols could modulate inflammation and oxidative stress markers in kidney tissues. Further studies are necessary to elucidate the mechanism of action of GS compounds in case kidney inflammation associated with oxidative stress, and signalling molecules involved in these mechanisms.

Keywords: animal model, kidney inflammation, oxidative stress, grape seed

Procedia PDF Downloads 298
673 The GRIT Study: Getting Global Rare Disease Insights Through Technology Study

Authors: Aneal Khan, Elleine Allapitan, Desmond Koo, Katherine-Ann Piedalue, Shaneel Pathak, Utkarsh Subnis

Abstract:

Background: Disease management of metabolic, genetic disorders is long-term and can be cumbersome to patients and caregivers. Patient-Reported Outcome Measures (PROMs) have been a useful tool in capturing patient perspectives to help enhance treatment compliance and engagement with health care providers, reduce utilization of emergency services, and increase satisfaction with their treatment choices. Currently, however, PROMs are collected during infrequent and decontextualized clinic visits, which makes translation of patient experiences challenging over time. The GRIT study aims to evaluate a digital health journal application called Zamplo that provides a personalized health diary to record self-reported health outcomes accurately and efficiently in patients with metabolic, genetic disorders. Methods: This is a randomized controlled trial (RCT) (1:1) that assesses the efficacy of Zamplo to increase patient activation (primary outcome), improve healthcare satisfaction and confidence to manage medications (secondary outcomes), and reduce costs to the healthcare system (exploratory). Using standardized online surveys, assessments will be collected at baseline, 1 month, 3 months, 6 months, and 12 months. Outcomes will be compared between patients who were given access to the application versus those with no access. Results: Seventy-seven patients were recruited as of November 30, 2021. Recruitment for the study commenced in November 2020 with a target of n=150 patients. The accrual rate was 50% from those eligible and invited for the study, with the majority of patients having Fabry disease (n=48) and the remaining having Pompe disease and mitochondrial disease. Real-time clinical responses, such as pain, are being measured and correlated to disease-modifying therapies, supportive treatments like pain medications, and lifestyle interventions. Engagement with the application, along with compliance metrics of surveys and journal entries, are being analyzed. An interim analysis of the engagement data along with preliminary findings from this pilot RCT, and qualitative patient feedback will be presented. Conclusions: The digital self-care journal provides a unique approach to disease management, allowing patients direct access to their progress and actively participating in their care. Findings from the study can help serve the virtual care needs of patients with metabolic, genetic disorders in North America and the world over.

Keywords: eHealth, mobile health, rare disease, patient outcomes, quality of life (QoL), pain, Fabry disease, Pompe disease

Procedia PDF Downloads 151
672 Influence of Biochar Application on Growth, Dry Matter Yield and Nutrition of Corn (Zea mays L.) Grown on Sandy Loam Soils of Gujarat, India

Authors: Pravinchandra Patel

Abstract:

Sustainable agriculture in sandy loam soil generally faces large constraints due to low water holding and nutrient retention capacity, and accelerated mineralization of soil organic matter. There is need to increase soil organic carbon in the soil for higher crop productivity and soil sustainability. Recently biochar is considered as sixth element and work as a catalyst for increasing crop yield, soil fertility, soil sustainability and mitigation of climate change. Biochar was generated at the Sansoli Farm of Anand Agricultural University, Gujarat, India by pyrolysis at temperatures (250-400°C) in absence of oxygen using slow chemical process (using two kilns) from corn stover (Zea mays, L), cluster bean stover (Cyamopsis tetragonoloba) and Prosopis julifera wood. There were 16 treatments; 4 organic sources (3 biochar; corn stover biochar (MS), cluster bean stover (CB) & Prosopis julifera wood (PJ) and one farmyard manure-FYM) with two rate of application (5 & 10 metric tons/ha), so there were eight treatments of organic sources. Eight organic sources was applied with the recommended dose of fertilizers (RDF) (80-40-0 kg/ha N-P-K) while remaining eight organic sources were kept without RDF. Application of corn stover biochar @ 10 metric tons/ha along with RDF (RDF+MS) increased dry matter (DM) yield, crude protein (CP) yield, chlorophyll content and plant height (at 30 and 60 days after sowing) than CB and PJ biochar and FYM. Nutrient uptake of P, K, Ca, Mg, S and Cu were significantly increased with the application of RDF + corn stover @ 10 metric tons/ha while uptake of N and Mn were significantly increased in RDF + corn stover @ 5 metric tons/ha. It was found that soil application of corn stover biochar @ 10 metric tons/ha along with the recommended dose of chemical fertilizers (RDF+MS ) exhibited the highest impact in obtaining significantly higher dry matter and crude protein yields and larger removal of nutrients from the soil and it also beneficial for built up nutrients in soil. It also showed significantly higher organic carbon content and cation exchange capacity in sandy loam soil. The lower dose of corn stover biochar @ 5 metric tons/ha (RDF+ MS) was also remained the second highest for increasing dry matter and crude protein yields of forage corn crop which ultimately resulted in larger removals of nutrients from the soil. This study highlights the importance of mixing of biochar along with recommended dose of fertilizers on its synergistic effect on sandy loam soil nutrient retention, organic carbon content and water holding capacity hence, the amendment value of biochar in sandy loam soil.

Keywords: biochar, corn yield, plant nutrient, fertility status

Procedia PDF Downloads 149
671 Effect of Minimalist Footwear on Running Economy Following Exercise-Induced Fatigue

Authors: Jason Blair, Adeboye Adebayo, Mohamed Saad, Jeannette M. Byrne, Fabien A. Basset

Abstract:

Running economy is a key physiological parameter of an individual’s running efficacy and a valid tool for predicting performance outcomes. Of the many factors known to influence running economy (RE), footwear certainly plays a role owing to its characteristics that vary substantially from model to model. Although minimalist footwear is believed to enhance RE and thereby endurance performance, conclusive research reports are scarce. Indeed, debates remain as to which footwear characteristics most alter RE. The purposes of this study were, therefore, two-fold: (a) to determine whether wearing minimalist shoes results in better RE compared to shod and to identify relationships with kinematic and muscle activation patterns; (b) to determine whether changes in RE with minimalist shoes are still evident following a fatiguing bout of exercise. Well-trained male distance runners (n=10; 29.0 ± 7.5 yrs; 71.0 ± 4.8 kg; 176.3 ± 6.5 cm) partook first in a maximal O₂ uptake determination test (VO₂ₘₐₓ = 61.6 ± 7.3 ml min⁻¹ kg⁻¹) 7 days prior to the experimental sessions. Second, in a fully randomized fashion, an RE test consisting of three 8-min treadmill runs in shod and minimalist footwear were performed prior to and following exercise induced fatigue (EIF). The minimalist and shod conditions were tested with a minimum of 7-day wash-out period between conditions. The RE bouts, interspaced by 2-min rest periods, were run at 2.79, 3.33, and 3.89 m s⁻¹ with a 1% grade. EIF consisted of 7 times 1000 m at 94-97% VO₂ₘₐₓ interspaced with 3-min recovery. Cardiorespiratory, electromyography (EMG), kinematics, rate of perceived exertion (RPE) and blood lactate were measured throughout the experimental sessions. A significant main speed effect on RE (p=0.001) and stride frequency (SF) (p=0.001) was observed. The pairwise comparisons showed that running at 2.79 m s⁻¹ was less economic compared to 3.33, and 3.89 m s⁻¹ (3.56 ± 0.38, 3.41 ± 0.45, 3.40 ± 0.45 ml O₂ kg⁻¹ km⁻¹; respectively) and that SF increased as a function of speed (79 ± 5, 82 ± 5, 84 ± 5 strides min⁻¹). Further, EMG analyses revealed that root mean square EMG significantly increased as a function of speed for all muscles (Biceps femoris, Gluteus maximus, Gastrocnemius, Tibialis anterior, Vastus lateralis). During EIF, the statistical analysis revealed a significant main effect of time on lactate production (from 2.7 ± 5.7 to 11.2 ± 6.2 mmol L⁻¹), RPE scores (from 7.6 ± 4.0 to 18.4 ± 2.7) and peak HR (from 171 ± 30 to 181 ± 20 bpm), expect for the recovery period. Surprisingly, a significant main footwear effect was observed on running speed during intervals (p=0.041). Participants ran faster with minimalist shoes compared to shod (3:24 ± 0:44 min [95%CI: 3:14-3:34] vs. 3:30 ± 0:47 min [95%CI: 3:19-3:41]). Although EIF altered lactate production and RPE scores, no other effect was noticeable on RE, EMG, and SF pre- and post-EIF, except for the expected speed effect. The significant footwear effect on running speed during EIF was unforeseen but could be due to shoe mass and/or heel-toe-drop differences. We also cannot discard the effect of speed on foot-strike pattern and therefore, running performance.

Keywords: exercise-induced fatigue, interval training, minimalist footwear, running economy

Procedia PDF Downloads 247
670 Creative Radio Advertising in Turkey

Authors: Mehmet Sinan Erguven

Abstract:

A number of authorities argue that radio is an outdated medium for advertising and does not have the same impact on consumers as it did in the past. This grim outlook on the future of radio has its basis in the audio-visual world that consumers now live in and the popularity of Internet-based marketing tools among advertising professionals. Nonetheless, consumers still appear to overwhelmingly prefer radio as an entertainment tool. Today, in Canada, 90% of all adults (18+) tune into the radio on a weekly basis, and they listen for 17 hours. Teens are the most challenging group for radio to capture as an audience, but still, almost 75% tune in weekly. One online radio station reaches more than 250 million registered listeners worldwide, and revenues from radio advertising in Australia are expected to grow at an annual rate of 3% for the foreseeable future. Radio is also starting to become popular again in Turkey, with a 5% increase in the listening rates compared to 2014. A major matter of concern always affecting radio advertising is creativity. As radio generally serves as a background medium for listeners, the creativity of the radio commercials is important in terms of attracting the attention of the listener and directing their focus on the advertising message. This cannot simply be done by using audio tools like sound effects and jingles. This study aims to identify the creative elements (execution formats appeals and approaches) and creativity factors of radio commercials in Turkey. As part of the study, all of the award winning radio commercials produced throughout the history of the Kristal Elma Advertising Festival were analyzed using the content analysis technique. Two judges (an advertising agency copywriter and an academic) coded the commercials. The reliability was measured according to the proportional agreement. The results showed that sound effects, jingles, testimonials, slices of life and announcements were the most common execution formats in creative Turkish radio ads. Humor and excitement were the most commonly used creative appeals while award-winning ads featured various approaches, such as surprise musical performances, audio wallpaper, product voice, and theater of the mind. Some ads, however, were found to not contain any creativity factors. In order to be accepted as creative, an ad must have at least one divergence factor, such as originality, flexibility, unusual/empathic perspective, and provocative questions. These findings, as well as others from the study, hold great value for the history of creative radio advertising in Turkey. Today, the nature of radio and its listeners is changing. As more and more people are tuning into online radio channels, brands will need to focus more on this relatively cheap advertising medium in the very near future. This new development will require that advertising agencies focus their attention on creativity in order to produce radio commercials for their customers that will differentiate them from their competitors.

Keywords: advertising, creativity, radio, Turkey

Procedia PDF Downloads 395
669 Control of Asthma in Children with Asthma during the Containment Period following the Covid-19 Pandemic

Authors: Meryam Labyad, Karima Fakiri, Widad Lahmini, Ghizlane Draiss, Mohamed Bouskraoui, Nadia Ouzennou

Abstract:

Background: Asthma is the most common chronic disease in children, affecting nearly 235 million people worldwide (OMS). In Morocco, asthma is much more common in children than in adults; the prevalence rate in children between 13 and 14 years of age is 20%.1 This pathology is marked by high morbidity, a significant impact on the quality of life and development of children 2 This requires a rigorous management strategy in order to achieve clinical control and reduce any risk to the patient 3 A search for aggravating factors is mandatory if a child has difficulty maintaining good asthma control. The objective of the present study is to describe asthma control during this confinement period in children aged 4 to 11 years followed by a pneumo-paediatric consultation. For children whose asthma is not controlled, a search for associations with promoting factors and adherence to treatment is also among the objectives of the study. Knowing the level of asthma control and influencing factors is a therapeutic priority in order to reduce hospitalizations and emergency care use. Objective: To assess asthma control and determine the factors influencing asthma levels in children with asthma during confinement following the COVID 19 pandemic. Method: Prospective cross-sectional study by questionnaire and structured interview among 66 asthmatic children followed in pediatric pneumology consultation at the CHU MED VI of Marrakech from 13/06/2020 to 13/07/2020, asthma control was assessed by the Childhood Asthma Control Test (C-ACT). Results: 66 children and their parents were included (mean age is 7.5 years), asthma was associated with allergic rhinitis (13.5% of cases), conjunctivitis (9% of cases), eczema (12% of cases), occurrence of infection (10.5% of cases). The period of confinement was marked by a decrease in the number of asthma attacks translated by a decrease in the number of emergency room visits (7.5%) of these asthmatic children, control was well controlled in 71% of the children, this control was significantly associated with good adherence to treatment (p<0.001), no infection (p<0.001) and no conjunctivitis (p=002) or rhinitis (p<0.001). This improvement in asthma control during confinement can be explained by the measures taken in the Kingdom to prevent the spread of COVID 19 (school closures, reduction in industrial activity, fewer means of transport, etc.), leading to a decrease in children's exposure to triggers, which justifies the decrease in the number of children having had an infection, allergic rhinitis or conjunctivitis during this period. In addition, the close monitoring of parents resulted in better therapeutic adherence (42.4% were fully observant). Confinement was positively perceived by 68% of the parents; this perception is significantly associated with the level of asthma control (p<0.001). Conclusion: Maintaining good control can be achieved through improved therapeutic adherence and avoidance of triggers, both of which were achieved during the containment period following the VIDOC pandemic 19.

Keywords: Asthma, control , COVID-19 , children

Procedia PDF Downloads 185
668 Homeless Population Modeling and Trend Prediction Through Identifying Key Factors and Machine Learning

Authors: Shayla He

Abstract:

Background and Purpose: According to Chamie (2017), it’s estimated that no less than 150 million people, or about 2 percent of the world’s population, are homeless. The homeless population in the United States has grown rapidly in the past four decades. In New York City, the sheltered homeless population has increased from 12,830 in 1983 to 62,679 in 2020. Knowing the trend on the homeless population is crucial at helping the states and the cities make affordable housing plans, and other community service plans ahead of time to better prepare for the situation. This study utilized the data from New York City, examined the key factors associated with the homelessness, and developed systematic modeling to predict homeless populations of the future. Using the best model developed, named HP-RNN, an analysis on the homeless population change during the months of 2020 and 2021, which were impacted by the COVID-19 pandemic, was conducted. Moreover, HP-RNN was tested on the data from Seattle. Methods: The methodology involves four phases in developing robust prediction methods. Phase 1 gathered and analyzed raw data of homeless population and demographic conditions from five urban centers. Phase 2 identified the key factors that contribute to the rate of homelessness. In Phase 3, three models were built using Linear Regression, Random Forest, and Recurrent Neural Network (RNN), respectively, to predict the future trend of society's homeless population. Each model was trained and tuned based on the dataset from New York City for its accuracy measured by Mean Squared Error (MSE). In Phase 4, the final phase, the best model from Phase 3 was evaluated using the data from Seattle that was not part of the model training and tuning process in Phase 3. Results: Compared to the Linear Regression based model used by HUD et al (2019), HP-RNN significantly improved the prediction metrics of Coefficient of Determination (R2) from -11.73 to 0.88 and MSE by 99%. HP-RNN was then validated on the data from Seattle, WA, which showed a peak %error of 14.5% between the actual and the predicted count. Finally, the modeling results were collected to predict the trend during the COVID-19 pandemic. It shows a good correlation between the actual and the predicted homeless population, with the peak %error less than 8.6%. Conclusions and Implications: This work is the first work to apply RNN to model the time series of the homeless related data. The Model shows a close correlation between the actual and the predicted homeless population. There are two major implications of this result. First, the model can be used to predict the homeless population for the next several years, and the prediction can help the states and the cities plan ahead on affordable housing allocation and other community service to better prepare for the future. Moreover, this prediction can serve as a reference to policy makers and legislators as they seek to make changes that may impact the factors closely associated with the future homeless population trend.

Keywords: homeless, prediction, model, RNN

Procedia PDF Downloads 121
667 Entrepreneurial Resilience and Unemployment Curbing among Graduates. The Case of the Catholic University of Cameroon (CATUC) Bamenda, North West Region of Cameroon

Authors: Elizabeth Ankiambom Chiatii

Abstract:

The effective participation of graduates as leaders in entrepreneurial resilience is a key driver to achieving sustainable job creation and curbing unemployment issues in the urban and rural communities of Cameroon. The unemployment problem is a global challenge in the Labour market, especially for youths graduating from universities. Statistics from the Cameroon National Institute of statistics indicate that the unemployment rate in the country increased to 3.9% in 2021 from 3.8% in 2020. One of the main causes of unemployment challenges and job hooping among university graduates is the high expectation for “white-collar jobs syndrome” as opposed to involvement in ‘blue-collar jobs’. In the recent years, the Catholic University of Cameroon has engaged its resources in problem and project based learning (PBL) approaches in order to enable the students at the end of their course work to be competent and resourceful in impacting their communities and the world at large. It is so encouraging to notice that most of our current and female ex-students have engaged as leaders in fostering entrepreneurial resilience through small and medium size ‘blue-collar’ enterprises like seamstresses or tailors, designers, catering services, poultry owners, traditional regalia designers, phone booth operators, farming (gardening) activities, saloon owners, wedding designers, restaurant operators and many other creative jobs where they also act as petty employers. A good number of them sponsor their university studies through these self-income generating activities. Part one of this paper centres on the introduction and background of study. Part two embodies some literature review in which we concentrate on some related conceptual issues. For example, we have some analogy of employment difficulties faced by the university graduates. Secondly, we will examine the details on entrepreneurial resilience within the context of Bamenda- Cameroon. Thirdly, we expound on the leadership role played by these graduates in building resilience as entrepreneurs stemming from their university training. The primary method of data collection is implemented, where questionnaires are distributed to at least 100 of these graduates engaged in building entrepreneurial resilience. The IVProbit regression analysis is used to determine the effect of these graduate participation as leader on entrepreneurial resilience. The results can contribute to the development of entrepreneurial resilience, and recommendations will be made to CATUC Bamenda, some communities and government leaders to enhance their policies to empower these young graduates in fostering these resourceful activities.

Keywords: graduates entrepreneurial resilience, unemployment challenges, white-collar job syndrome, small and medium size blue-collar enterprises

Procedia PDF Downloads 64
666 Effect of Antimony on Microorganisms in Aerobic and Anaerobic Environments

Authors: Barrera C. Monserrat, Sierra-Alvarez Reyes, Pat-Espadas Aurora, Moreno Andrade Ivan

Abstract:

Antimony is a toxic and carcinogenic metalloid considered a pollutant of priority interest by the United States Environmental Protection Agency. It is present in the environment in two oxidation states: antimonite (Sb (III)) and antimony (Sb (V)). Sb (III) is toxic to several aquatic organisms, but the potential inhibitory effect of Sb species for microorganisms has not been extensively evaluated. The fate and possible toxic impact of antimony on aerobic and anaerobic wastewater treatment systems are unknown. For this reason, the objective of this study was to evaluate the microbial toxicity of Sb (V) and Sb (III) in aerobic and anaerobic environments. Sb(V) and Sb(III) were used as potassium hexahydroxoantimonate (V) and potassium antimony tartrate, respectively (Sigma-Aldrich). The toxic effect of both Sb species in anaerobic environments was evaluated on methanogenic activity and the inhibition of hydrogen production of microorganisms from a wastewater treatment bioreactor. For the methanogenic activity, batch experiments were carried out in 160 mL serological bottles; each bottle contained basal mineral medium (100 mL), inoculum (1.5 g of VSS/L), acetate (2.56 g/L) as substrate, and variable concentrations of Sb (V) or Sb (III). Duplicate bioassays were incubated at 30 ± 2°C on an orbital shaker (105 rpm) in the dark. Methane production was monitored by gas chromatography. The hydrogen production inhibition tests were carried out in glass bottles with a working volume of 0.36 L. Glucose (50 g/L) was used as a substrate, pretreated inoculum (5 g VSS/L), mineral medium and varying concentrations of the two species of antimony. The bottles were kept under stirring and at a temperature of 35°C in an AMPTSII device that recorded hydrogen production. The toxicity of Sb on aerobic microorganisms (from a wastewater activated sludge treatment plant) was tested with a Microtox standardized toxicity test and respirometry. Results showed that Sb (III) is more toxic than Sb (V) for methanogenic microorganisms. Sb (V) caused a 50% decrease in methanogenic activity at 250 mg/L. In contrast, exposure to Sb (III) resulted in a 50% inhibition at a concentration of only 11 mg/L, and an almost complete inhibition (95%) at 25 mg/L. For hydrogen-producing microorganisms, Sb (III) and Sb (V) inhibited 50% of this production with 12.6 mg/L and 87.7 mg/L, respectively. The results for aerobic environments showed that 500 mg/L of Sb (V) do not inhibit the Allivibrio fischeri (Microtox) activity or specific oxygen uptake rate of activated sludge. In the case of Sb (III), this caused a loss of 50% of the respiration of the microorganisms at concentrations below 40 mg/L. The results obtained indicate that the toxicity of the antimony will depend on the speciation of this metalloid and that Sb (III) has a significantly higher inhibitory potential compared to Sb (V). It was shown that anaerobic microorganisms can reduce Sb (V) to Sb (III). Acknowledgments: This work was funded in part by grants from the UA-CONACYT Binational Consortium for the Regional Scientific Development and Innovation (CAZMEX), the National Institute of Health (NIH ES- 04940), and PAPIIT-DGAPA-UNAM (IN105220).

Keywords: aerobic inhibition, antimony reduction, hydrogen inhibition, methanogenic toxicity

Procedia PDF Downloads 167
665 Geosynthetic Containment Systems for Coastal Protection: An Indian Perspective

Authors: Tom Elias, Kiran G. Shirlal

Abstract:

Coastal erosion is one of the major issue faced by maritime countries, globally. More than 1200 km stretch of Indian coastline is marked eroding. There have been numerous attempts to impede the erosion rate and to attain equilibrium beach profiles. High cost and unavailability of natural rocks forced coastal engineers to find alternatives for conventional hard options like seawalls and groynes. Geosynthetic containment systems, emerged in the mid 20th century proved promising in catering coastal protection in countries like Australia, Germany and United States. The present study aims at reviewing Indian timeline of protection works that uses geosynthetic containment systems. Indian exploration regarding geosynthetic containment system dates back to early 2000s. Generally, protection structures use geosynthetics in the form of Geotubes, Geocontainers, and Geobags with Geotubes being most widely used in the form of submerged reefs, seawalls, groynes and breakwaters. Sand and dredged waste are used to fill these containment systems with calculated sand fill ratio. Reviewing the prominent protection works constructed in the east and west coast of India provides an insight into benefits and the difficulties faced by the practical installation. Initially, geosynthetic structures were considered as a temporary protection method prior to the construction of some other hard structure. Later Dahanu, Hamala and Pentha experiences helped in establishing geotubes as an alternative to conventional structures. Nearshore geotubes reefs aimed to attain equilibrium beach served its purpose in Hamala and Dahanu, Maharashtra, while reef constructed at Candolim, Goa underwent serious damage due to Toe Scour. In situ filling by pumping of sand slurry as in case of Shankarpur Seawall, West Bengal remains as a major concern. Geosynthetic systems supplemented by gabions and rock armours improves the wave dissipation, stability and reflection characteristics as implied in Pentha Coast, Odisha, Hazira, Gujarat and Uppada, Andhra Pradesh. Keeping improper design and deliberate destruction by vandals apart, geosynthetic containment systems offer a cost-effective alternative to conventional coastal protection methods in India. Additionally, geosynthetics supports marine growth in its surface which enhances its demand as an eco-friendly material and encourages usage.

Keywords: coastal protection, geotubes, geobags, geocontainers

Procedia PDF Downloads 151
664 Comparative Evaluation of Ultrasound Guided Internal Jugular Vein Cannulation Using Measured Guided Needle and Conventional Size Needle for Success and Complication of Cannulation

Authors: Devendra Gupta, Vikash Arya, Prabhat K. Singh

Abstract:

Background: Ultrasound guidance could be beneficial in placing central venous catheters by improving the success rate, reducing the number of needle passes, and decreasing complications. Central venous cannulation set has a single puncture needle of a fixed length of 6.4 cm. However, the average distance of midpoint of IJV to the skin is around 1 cm to 2 cm. The long length needle has tendency to go in depth more than required and this is very common during learning period of any individual. Therefore, we devised a long needle with a guard which can be adjusted according to the required length. Methods: After approval from the institute ethics committee and patient’s written informed consent, a prospective, randomized, single-blinded controlled study was conducted. Adult patient aged of both sexes with ASA grade 1-2 undergoing surgery requiring internal jugular venous (IJV) access was included. After intubation, the head was rotated to the contralateral side at 30 degree head rotation on the position of the right IJV. The transducer probe a 6.5 to 13-MHz linear transducer (Sonosite, USA) had been placed at the apex of triangle with minimal pressure to avoid IJV compression. The distance from skin to midpoint of the right IJV and skin to anterior wall of Common Carotid Artery (CCA) had been done using B-mode duplex sonography with a 6.5 to 13-MHz linear transducer. Depending upon the results of randomization 420 patients had been divided into two groups of equal numbers (n=210). Group 1. USG guided right sided IJV cannulation was done with conventional (6.4 cm) needle; and Group 2. USG guided right sided IJV cannulation was done with conventional (6.4 cm) needle with guard fixed to a required length (length between skin and midpoint of IJV) by an experienced anesthesiologist. Independent observer has noted the number of attempts and occurrence of complications (CCA puncture, pneumothorax or adjacent tissue damage). Results: Demographic data were similar in both the group. The groups were comparable when considered for relationship of IJV to CCA. There was no significant difference between groups as regard to distance of midpoint of IJV to the skin (p<0.05). IJV cannulation was successfully done in single attempts in 180 (85.7%), in two attempts in 27 (12.9%) and three attempts in 3 (1.4%) in group I, whereas in single attempt in 207 (98.6%) and second attempts in 3 (1.4%) in group II (p <0.000). Incidence of carotid artery puncture was significantly more in group I (7.1%) compared to group II (0%) (p<0.000). Incidence of adjacent tissue puncture was significantly more in group I (8.6%) compared to group II (0%) (p<0.000). Conclusion: Therefore IJV catheterization using guard over the needle at predefined length with the help of real-time ultrasound results in better success rates and lower immediate complications.

Keywords: ultrasound guided, internal jugular vein cannulation, measured guided needle, common carotid artery puncture

Procedia PDF Downloads 222