Search results for: congenital heart defects (CHD)
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1859

Search results for: congenital heart defects (CHD)

1079 Ergonomic Assessment of Workplace Environment of Flour Mill Workers

Authors: Jayshree P. Zend, Ashatai B. Pawar

Abstract:

The study was carried out in Parbhani district of Maharashtra state, India with the objectives to study environmental problems faced by flour mill workers, prevalence of work-related health hazards and the physiological cost of workers while performing work in flour mill in traditional method as well as improved method. The use of flour presser, dust controlling bag and noise and dust controlling mask developed by AICRP College of Home Science, VNMKV, Parbhani was considered as an improved method. This investigation consisted survey and experiment which was conducted in the respective locations of flour mills. Healthy, non-smoking 30 flour mill workers ranged between the age group of 20-50 yrs comprising 16 female and 14 male working at flour mill for 4-8 hrs/ day and 6 days/ week and had minimum five years experience of work in flour mill were selected for the study. Pulmonary function test of flour mill workers was carried out by trained technician at Dr. ShankarraoChavan Government Medical College, Nanded by using Electronic Spirometer. The data regarding heart rate (resting, working and recovery), energy expenditure, musculoskeletal problems and occupational health hazards and accidents were recorded by using pretested questionnaire. Scientific equipment used in the experiment were polar sport test heart rate monitor, Hygrometer, Goniometer, Dialed Thermometer, Sound Level Meter, Lux Meter, Ambient Air Sampler and Air Quality Monitor. The collected data were subjected to appropriate statistical analysis such as 't' test and correlation coefficient test. Results indicated that improved method i.e. use of noise and dust controlling mask, flour presser and dust controlling bag were effective in reducing physiological cost of work of flour mill workers. Lung function test of flour mill workers showed decreased values of all parameters, hence the results of present study support paying attention to use of personal protective noise and dust controlling mask by flour mill workers and also to the working conditions in flour mill especially ventilation and illumination level needs to be enhanced in flour mill. The study also emphasizes the need to develop some mechanism for lifting load of grains and unloading in the hopper. It is also suggested that the flour mill workers should use flour presser suitable to their height to avoid frequent bending and should use dust controlling bag to flour outlet of machine to reduce inhalable flour dust level in the flour mill.

Keywords: physiological cost, energy expenditure, musculoskeletal problems

Procedia PDF Downloads 401
1078 A Comparison of TLD Measurements to MIRD Estimates of the Dose to the Ovaries and Uterus from Tc-99m in Liver

Authors: Karim Adinehvand, Bakhtiar Azadbakht, Amin Sahebnasagh

Abstract:

Relation to high absorption fraction of Tc SESTAMIBI by internal organs in heart scan, and these organs are near to generation organs (Ovaries and uterus). In this study, Liver is specified as source organ. Method: we have set amount of absorbed fraction radiopharmaceutical in position of Liver in RANDO-phantom in form of elliptical surfaces, then absorbed dose to ovaries and uterus measured by TLD-100 that had set at position of these organs in RANDO-phantom. Calculation had done by MIRD method. Results from direct measurement and MIRD method are too similar. The absorbed dose to uterus and ovaries for Rest are 26.05µGyMBq-1, 17.23µGyMBq-1 and for Stress are 2.04µGyMBq-1, 1.35µGyMBq-1 respectively.

Keywords: absorbed dose, TLD, MIRD, RANDO-phantom, Tc-99m

Procedia PDF Downloads 565
1077 Ilizarov's External Fixator. A Bone Regeneration Method Little Used in Africa. Our Experience of 20 Years in Cameroon.

Authors: Ibrahima Farikou, Kolontchang Gatchou Alberic Lionel, Tsiagadgui Jean Gustave, Ngo Yamben Marie-Ange, Handy Eone Daniel

Abstract:

Introduction: It was in 1956 that Ilizarov pioneered the concept of osteogenesis in distraction by the device that bears his name to help produce bone and soft tissue regeneration and bone consolidation. This technique is not widely used in Africa where, however, its applications are numerous (loss of bone substances, congenital or acquired malformations). Our goal is to bring the indications of Ilizarov's device back to our practice conditions. Methods: Our study was conducted in 2 hospitals over a period of 20 years. For the retrospective phase, this study included all complete usable records of patients operated on in the Ilizarov external fixator department, and for the prospective phase, all patients operated on in the departments with complete usable records. Our sample was consecutive and not exhaustive. Data were analyzed by SPSS software version 23.0. Results: A total of 52 patients were reviewed. The average age of our patients was 14.7 years. The sex ratio was 1.6 in favor of men. The lower limb was the most affected (49), with a predominance of the tibia (62.4%). The average elongation was 6.4 cm. Traumatic acquired pathologies (delayed union, malunion) represented 60.6%. The mean time to union was seven months. Correction of the limb length discrepancy or filling of loss of bone substance was obtained in 75% of cases. Functionally, 80.8% of the patients treated had regained autonomy at the end of treatment, but in 17.3% of the patients, pain and limping persisted. Conclusion: This technique should be popularized in Africa because the benefit that would accrue to patients is invaluable and would be an attractive alternative to many amputations sometimes carried out in Africa by despair.

Keywords: ilizarov, external fixator, limb lengthening, bone regeneration, africa

Procedia PDF Downloads 101
1076 Spectral Analysis of Heart Rate Variability for Normal and Preeclamptic Pregnants

Authors: Abdulnasir Hossen, Alaa Barhoum, Deepali Jaju, V. Gowri, L. Al-Kharusi, M. Hassan, K. Al-Hashmi

Abstract:

Preeclampsia is a pregnancy disorder associated with increase in blood pressure and excess amount of protein in the urine. HRV analysis has been used by many researchers to identify preeclamptic pregnancy from normal pregnancy. A study in this regard to identify preeclamptic pregnancy in Oman from normal pregnant was conducted on 40 subjects (20 patients and 20 normal). The subjects were collected from two hospitals in Oman. A Fast Fourier transform (FFT) spectral analysis has shown that patients with preeclamptic pregnancy have a reduction in the power of the HF band and an increase in the power of the LF band of HRV compared with subjects with normal pregnancy. The accuracy of identification obtained was 80%.

Keywords: preelampsia, pregnancy hypertension, normal pregnant, FFT, spectral analysis, HRV

Procedia PDF Downloads 556
1075 Rrelationship Between Intrauterine Growth Retardation and TORCH Infections in Neonates

Authors: Seyed Saeid Nabavi

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Background: Many infants with intrauterine growth disorder are screened for TORCH infections. This action has no economic justification in terms of the imposed costs. In this regard, due to the research gap in this field, this study aimed to investigate the relationship between intrauterine growth disorder and TORCH infection in neonates referred to Milad hospital in 2019 and 2020. Materials and Methods: In this cross-sectional study, 41IUGR newborns were selected and evaluated based on diagnostic and clinical studies in Milad Hospital in 2019 and 2020. TORCH results found in IgG and IgM antibody titer assay were tested in mother and infant. Antibody titers of toxoplasmosis, rubella, cytomegalovirus, herpes, and syphilis were determined in cases, and other variables were compared. The collected data were entered in SPSS software 25 and analyzed at a significant level of 0.05 using the statistical tests of Kolmogorov–Smirnov, Shapiro–Wilk, chi-square, and Mann–Whitney. Results: Most of the IUGR infants studied were girls (68.3%), Gravida and Parity were reported to be 68.3% and 80%, respectively, in the study. Mean weight, APGAR score, and neonatal gestational age are reported as 1710.62±334.43 g, 7.71±1.47, and 35.7+ 1.98 weeks, respectively. Most of the newborns were born by cesarean section (92.7%). TORCH infection was reported in three patients, 7.3%. The mean gestational age of IUGR infants with TORCH infection was reported to be less than other babies with IUGR. Therefore, the mean gestational age of subjects with TORCH infection was 33±1.4 weeks and in others 35.94±1.91 weeks (p-value = 0.038). No significant relationship between TORCH infection and gender, gravidity, and parity of newborns was found (p-value > 0.05). Conclusion: TORCH infection was reported in 3 patients( 7.3%). No significant relationship between TORCH infection and gender, gravidity, and parity of newborns was found. p-value > 0.05

Keywords: congenital infection, intrauterine growth restriction, TORCH infections, neonates

Procedia PDF Downloads 133
1074 Trends in All-Cause Mortality and Inpatient and Outpatient Visits for Ambulatory Care Sensitive Conditions during the First Year of the COVID-19 Pandemic: A Population-Based Study

Authors: Tetyana Kendzerska, David T. Zhu, Michael Pugliese, Douglas Manuel, Mohsen Sadatsafavi, Marcus Povitz, Therese A. Stukel, Teresa To, Shawn D. Aaron, Sunita Mulpuru, Melanie Chin, Claire E. Kendall, Kednapa Thavorn, Rebecca Robillard, Andrea S. Gershon

Abstract:

The impact of the COVID-19 pandemic on the management of ambulatory care sensitive conditions (ACSCs) remains unknown. To compare observed and expected (projected based on previous years) trends in all-cause mortality and healthcare use for ACSCs in the first year of the pandemic (March 2020 - March 2021). A population-based study using provincial health administrative data.General adult population (Ontario, Canada). Monthly all-cause mortality, and hospitalizations, emergency department (ED) and outpatient visit rates (per 100,000 people at-risk) for seven combined ACSCs (asthma, COPD, angina, congestive heart failure, hypertension, diabetes, and epilepsy) during the first year were compared with similar periods in previous years (2016-2019) by fitting monthly time series auto-regressive integrated moving-average models. Compared to previous years, all-cause mortality rates increased at the beginning of the pandemic (observed rate in March-May 2020 of 79.98 vs. projected of 71.24 [66.35-76.50]) and then returned to expected in June 2020—except among immigrants and people with mental health conditions where they remained elevated. Hospitalization and ED visit rates for ACSCs remained lower than projected throughout the first year: observed hospitalization rate of 37.29 vs. projected of 52.07 (47.84-56.68); observed ED visit rate of 92.55 vs. projected of 134.72 (124.89-145.33). ACSC outpatient visit rates decreased initially (observed rate of 4,299.57 vs. projected of 5,060.23 [4,712.64-5,433.46]) and then returned to expected in June 2020. Reductions in outpatient visits for ACSCs at the beginning of the pandemic combined with reduced hospital admissions may have been associated with temporally increased mortality—disproportionately experienced by immigrants and those with mental health conditions. The Ottawa Hospital Academic Medical Organization

Keywords: COVID-19, chronic disease, all-cause mortality, hospitalizations, emergency department visits, outpatient visits, modelling, population-based study, asthma, COPD, angina, heart failure, hypertension, diabetes, epilepsy

Procedia PDF Downloads 92
1073 Performance Evaluation of an Inventive Co2 Gas Separation Inorganic Ceramic Membrane System

Authors: Ngozi Claribelle Nwogu, Mohammed Nasir Kajama, Oyoh Kechinyere, Edward Gobina

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Atmospheric carbon dioxide emissions are considered as the greatest environmental challenge the world is facing today. The challenges to control the emissions include the recovery of CO2 from flue gas. This concern has been improved due to recent advances in materials process engineering resulting in the development of inorganic gas separation membranes with excellent thermal and mechanical stability required for most gas separations. This paper therefore evaluates the performance of a highly selective inorganic membrane for CO2 recovery applications. Analysis of results obtained is in agreement with experimental literature data. Further results show the prediction performance of the membranes for gas separation and the future direction of research. The materials selection and the membrane preparation techniques are discussed. Method of improving the interface defects in the membrane and its effect on the separation performance has also been reviewed and in addition advances to totally exploit the potential usage of this innovative membrane.

Keywords: carbon dioxide, gas separation, inorganic ceramic membrane, permselectivity

Procedia PDF Downloads 344
1072 Cardiac Hypertrophy in Diabetes; The Role of Factor Forkhead Box Class O-Regulation by O-GlcNAcylation

Authors: Mohammadjavad Sotoudeheian, Navid Farahmandian

Abstract:

Cardiac hypertrophy arises in response to persistent increases in hemodynamic loads. In comparison, diabetic cardiomyopathy is defined by an abnormal myocardial changes without other cardiac-related risk factors. Pathological cardiac hypertrophy and myocardial remodeling are hallmarks of cardiovascular diseases and are risk factors for heart failure. The transcription factor forkhead box class O (FOXOs) can protect heart tissue by hostile oxidative stress and stimulating apoptosis and autophagy. FOXO proteins, as sensitive elements and mediators in response to environmental changes, have been revealed to prevent and inverse cardiac hypertrophy. FOXOs are inhibited by insulin and are critical mediators of insulin action. Insulin deficiency and uncontrolled diabetes lead to a catabolic state. FOXO1 acts downstream of the insulin-dependent pathways, which are dysregulated in diabetes. It regulates cardiomyocyte hypertrophy downstream of IGF1R/PI3K/Akt activation, which are critical regulators of cardiac hypertrophy. The complex network of signaling pathways comprising insulin/IGF-1 signaling, AMPK, JNK, and Sirtuins regulate the development of cardiovascular dysfunction by modulating the activity of FOXOs. Insulin receptors and IGF1R act via the PI3k/Akt and the MAPK/ERK pathways. Activation of Akt in response to insulin or IGF-1 induces phosphorylation of FOXOs. Increased protein synthesis induced by activation of the IGF-I/Akt/mTOR signaling pathway leads to hypertrophy. This pathway and the myostatin/Smad pathway are potent negative muscle development regulators. In cardiac muscle, insulin receptor substrates (IRS)-1 or IRS-2 activates the Akt signaling pathway and inactivate FOXO1. Under metabolic stress, p38 MAPK promotes degradation of IRS-1 and IRS-2 in cardiac myocytes and activates FOXO1, leading to cardiomyopathy. Sirt1 and FOXO1 interaction play an essential role in starvation-induced autophagy in cardiac metabolism. Inhibition of Angiotensin-II induced cardiomyocyte hypertrophy is associated with reduced FOXO1 acetylation and activation of Sirt1. The NF-κB, ERK, and FOXOs are de-acetylated by SIRT1. De-acetylation of FOXO1 induces the expression of genes involved in autophagy and stimulates autophagy flux. Therefore, under metabolic stress, FOXO1 can cause diabetic cardiomyopathy. The overexpression of FOXO1 leads to decreased cardiomyocyte size and suppresses cardiac hypertrophy through inhibition of the calcineurin–NFAT pathway. Diabetes mellitus is associated with elevation of O-GlcNAcylation. Some of its binding partners regulate the substrate selectivity of O-GlcNAc transferase (OGT). O-GlcNAcylation of essential contractile proteins may inhibit protein-protein interactions, reduce calcium sensitivity, and modulate contractile function. Uridine diphosphate (UDP)-GlcNAc is the obligatory substrate of OGT, which catalyzes a reversible post-translational protein modification. The increase of O-GlcNAcylation is accompanied by impaired cardiac hypertrophy in diabetic hearts. Inhibition of O-GlcNAcylation blocks activation of ERK1/2 and hypertrophic growth. O-GlcNAc modification on NFAT is required for its translocation from the cytosol to the nucleus, where NFAT stimulates the transcription of various hypertrophic genes. Inhibition of O-GlcNAcylation dampens NFAT-induced cardiac hypertrophic growth. Transcriptional activity of FOXO1 is enriched by improved O-GlcNAcylation upon high glucose stimulation or OGT overexpression. In diabetic conditions, the modification of FOXO1 by O-GlcNAc is promoted in cardiac troponin I and myosin light chain 2. Therefore targeting O-GlcNAcylation represents a potential therapeutic option to prevent hypertrophy in the diabetic heart.

Keywords: diabetes, cardiac hypertrophy, O-GlcNAcylation, FOXO1, Akt, PI3K, AMPK, insulin

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1071 Investigation of Failures in Wadi-Crossing Pipe Culverts, Sennar State, Sudan

Authors: Magdi M. E. Zumrawi

Abstract:

Crossing culverts are essential element of rural roads. The paper aims to investigate failures of recently constructed wadi-crossing pipe culverts in Sennar state and provide necessary remedial measures. The investigation is conducted to provide an extensive diagnosis study in order to find out the main structural and hydrological weaknesses of the culverts. Literature of steel pipe culverts related to construction practices and common types of culvert failures and their appropriate mitigation measures were reviewed. A detailed field survey was conducted to detect failures and defects appeared on the existing culverts. The results revealed that seepage of water through the embankment and foundation of the culverts leads to excessive erosion and scouring causing sever failures and damages. The design mistakes and poor construction were detected as the main causes of culverts failures. For sustainability of the culverts, various remedial measures are recommended to be considered in urgent rehabilitation of the existing crossings.

Keywords: culvert, erosion, failure, sustainability

Procedia PDF Downloads 309
1070 Development of Ceramic Spheres Buoyancy Modules for Deep-Sea Oil Exploration

Authors: G. Blugan, B. Jiang, J. Thornberry, P. Sturzenegger, U. Gonzenbach, M. Misson, D. Cartlidge, R. Stenerud, J. Kuebler

Abstract:

Low-cost ceramic spheres were developed and manufactured from the engineering ceramic aluminium oxide. Hollow spheres of 50 mm diameter with a wall thickness of 0.5-1.0 mm were produced via an adapted slip casting technique. It was possible to produce the spheres with good repeatability and with no defects or failures in the spheres due to the manufacturing process. The spheres were developed specifically for use in buoyancy devices for deep-sea exploration conditions at depths of 3000 m below sea level. The spheres with a 1.0 mm wall thickness exhibit a buoyancy of over 54% while the spheres with a 0.5 mm wall thickness exhibit a buoyancy of over 73%. The mechanical performance of the spheres was confirmed by performing a hydraulic burst pressure test on individual spheres. With a safety factor of 3, all spheres with 1.0 mm wall thickness survived a hydraulic pressure of greater than 150 MPa which is equivalent to a depth of more than 5000 m below sea level. The spheres were then incorporated into a buoyancy module. These hollow aluminium oxide ceramic spheres offer an excellent possibility of deep-sea exploration to depths greater than the currently used technology.

Keywords: buoyancy, ceramic spheres, deep-sea, oil exploration

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1069 Generic Hybrid Models for Two-Dimensional Ultrasonic Guided Wave Problems

Authors: Manoj Reghu, Prabhu Rajagopal, C. V. Krishnamurthy, Krishnan Balasubramaniam

Abstract:

A thorough understanding of guided ultrasonic wave behavior in structures is essential for the application of existing Non Destructive Evaluation (NDE) technologies, as well as for the development of new methods. However, the analysis of guided wave phenomena is challenging because of their complex dispersive and multimodal nature. Although numerical solution procedures have proven to be very useful in this regard, the increasing complexity of features and defects to be considered, as well as the desire to improve the accuracy of inspection often imposes a large computational cost. Hybrid models that combine numerical solutions for wave scattering with faster alternative methods for wave propagation have long been considered as a solution to this problem. However usually such models require modification of the base code of the solution procedure. Here we aim to develop Generic Hybrid models that can be directly applied to any two different solution procedures. With this goal in mind, a Numerical Hybrid model and an Analytical-Numerical Hybrid model has been developed. The concept and implementation of these Hybrid models are discussed in this paper.

Keywords: guided ultrasonic waves, Finite Element Method (FEM), Hybrid model

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1068 An Investigation of the Strength Deterioration of Forged Aluminum 6082 (T6) Alloy

Authors: Rajveer, Abhinav Saxena, Sanjeev Das

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The study is focused on the strength of forged aluminum alloy (AA) 6082 (T6). Aluminum alloy 6082 belongs to Al-Mg-Si family which has a wide range of automotive applications. A decrease in the strength of AA 6082 alloy was observed after T6 treatment. The as-received (extruded), forged, and forged + heat treated samples were examined to understand the reason. These examinations were accomplished by optical (OM) and scanning electron microscope (SEM) and X-ray diffraction (XRD) studies. It was observed that the defects had an insignificant effect on the alloy strength. The alloy samples were subjected to age hardening treatment and the time to achieve peak hardening was acquired. Standard tensile specimens were prepared from as-received (extruded), forged, forged + solutionized and forged + solutionized + age hardened. Tensile tests were conducted by Instron universal testing machine. It was observed that there was a significant drop in tensile strength in the case of solutionized sample. The detailed study of the fracture samples showed that the solutionizing after forging was not the best way to increase the strength of Al 6082 alloy.

Keywords: aluminum alloy 6082, strength, forging, age hardening

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1067 Analysis of Different Resins in Web-to-Flange Joints

Authors: W. F. Ribeiro, J. L. N. Góes

Abstract:

The industrial process adds to engineering wood products features absent in solid wood, with homogeneous structure and reduced defects, improved physical and mechanical properties, bio-deterioration, resistance and better dimensional stability, improving quality and increasing the reliability of structures wood. These features combined with using fast-growing trees, make them environmentally ecological products, ensuring a strong consumer market. The wood I-joists are manufactured by the industrial profiles bonding flange and web, an important aspect of the production of wooden I-beams is the adhesive joint that bonds the web to the flange. Adhesives can effectively transfer and distribute stresses, thereby increasing the strength and stiffness of the composite. The objective of this study is to evaluate different resins in a shear strain specimens with the aim of analyzing the most efficient resin and possibility of using national products, reducing the manufacturing cost. First was conducted a literature review, where established the geometry and materials generally used, then established and analyzed 8 national resins and produced six specimens for each.

Keywords: engineered wood products, structural resin, wood i-joist, Pinus taeda

Procedia PDF Downloads 278
1066 Deformulation and Comparative Analysis of Apparently Similar Polymers Using Multiple Modes of Pyrolysis-Gc/Ms

Authors: Athena Nguyen, Rojin Belganeh

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Detecting and identifying differences in like polymer materials are key factors in deformulation, comparative analysis as well as reverse engineering. Pyrolysis-GC/MS is an easy solid sample introduction technique which expands the application areas of gas chromatography and mass spectrometry. The Micro-furnace pyrolyzer is directly interfaced with the GC injector preventing any potential of cold spot, carryover, and cross contamination. This presentation demonstrates the study of two similar polymers by performing different mode of operations in the same system: Evolve gas analysis (EGA), Flash pyrolysis, Thermal desorption analysis, and Heart-cutting analysis. Unknown polymer materials and their chemical compositions are identified.

Keywords: gas chromatography/mass spectrometry, pyrolysis, pyrolyzer, thermal desorption-GC/MS

Procedia PDF Downloads 264
1065 Estimating the Effect of Fluid in Pressing Process

Authors: A. Movaghar, R. A. Mahdavinejad

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To analyze the effect of various parameters of fluid on the material properties such as surface and depth defects and/or cracks, it is possible to determine the affection of pressure field on these specifications. Stress tensor analysis is also able to determine the points in which the probability of defection creation is more. Besides, from pressure field, it is possible to analyze the affection of various fluid specifications such as viscosity and density on defect created in the material. In this research, the concerned boundary conditions are analyzed first. Then the solution network and stencil used are mentioned. With the determination of relevant equation on the fluid flow between notch and matrix and their discretion according to the governed boundary conditions, these equations can be solved. Finally, with the variation creations on fluid parameters such as density and viscosity, the affection of these variations can be determined on pressure field. In this direction, the flowchart and solution algorithm with their results as vortex and current function contours for two conditions with most applications in pressing process are introduced and discussed.

Keywords: pressing, notch, matrix, flow function, vortex

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1064 Technology Changing Senior Care

Authors: John Kosmeh

Abstract:

Introduction – For years, senior health care and skilled nursing facilities have been plagued with the dilemma of not having the necessary tools and equipment to adequately care for senior residents in their communities. This has led to high transport rates to emergency departments and high 30-day readmission rates, costing billions of unnecessary dollars each year, as well as quality assurance issues. Our Senior care telemedicine program is designed to solve this issue. Methods – We conducted a 1-year pilot program using our technology coupled with our 24/7 telemedicine program with skilled nursing facilities in different parts of the United States. We then compared transports rates and 30-day readmission rates to previous years before the use of our program, as well as transport rates of other communities of similar size not using our program. This data was able to give us a clear and concise look at the success rate of reducing unnecessary transport and readmissions as well as cost savings. Results – A 94% reduction nationally of unnecessary out-of-facility transports, and to date, complete elimination of 30-day readmissions. Our virtual platform allowed us to instruct facility staff on the utilization of our tools and system as well as deliver treatment by our ER-trained providers. Delay waiting for PCP callbacks was eliminated. We were able to obtain lung, heart, and abdominal ultrasound imaging, 12 lead EKG, blood labs, auscultate lung and heart sounds, and collect other diagnostic tests at the bedside within minutes, providing immediate care and allowing us to treat residents within the SNF. Are virtual capabilities allowed for loved ones, family members, and others who had medical power of attorney to virtually connect with us at the time of visit, to speak directly with the medical provider, providing increased confidence in the decision to treat the resident in-house. The decline in transports and readmissions will greatly reduce governmental cost burdens, as well as fines imposed on SNF for high 30-day readmissions, reduce the cost of Medicare A readmissions, and significantly impact the number of patients visiting overcrowded ERs. Discussion – By utilizing our program, SNF can effectively reduce the number of unnecessary transports of residents, as well as create significant savings from loss of day rates, transportation costs, and high CMS fines. The cost saving is in the thousands monthly, but more importantly, these facilities can create a higher quality of life and medical care for residents by providing definitive care instantly with ER-trained personnel.

Keywords: senior care, long term care, telemedicine, technology, senior care communities

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1063 Anthropometric Measurements of Facial Proportions in Azerbaijan Population

Authors: Nigar Sultanova

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Facial morphology is a constant topic of concern for clinicians. When anthropometric methods were introduced into clinical practice to quantify changes in the craniofacial framework, features distinguishing various ethnic group were discovered. Normative data of facial measurements are indispensable to precise determination of the degree of deviations from normal. Establish the reference range of facial proportions in Azerbaijan population by anthropometric measurements of craniofacial complex. The study group consisted of 350 healthy young subjects, 175 males and 175 females, 18 to 25 years of age, from 7 different regions of Azerbaijan. The anthropometric examination was performed according to L.Farkas's method with our modification. In order to determine the morphologic characteristics of seven regions of the craniofacial complex 42 anthropometric measurements were selected. The anthropometric examination. Included the usage of 33 anthropometric landmarks. The 80 indices of the facial proportions, suggested by Farkas and Munro, were calculated: head -10, face - 23, nose - 23, lips - 9, orbits - 11, ears - 4. The date base of the North American white population was used as a reference group. Anthropometric measurements of facial proportions in Azerbaijan population revealed a significant difference between mеn and womеn, according to sexual dimorphism. In comparison with North American whites, considerable differences of facial proportions were observed in the head, face, orbits, labio-oral, nose and ear region. However, in women of the Azerbaijani population, 29 out of 80 proportion indices were similar to the proportions of NAW women. In the men of the Azerbaijani population, 27 out of 80 proportion indices did not reveal a statistically significant difference from the proportions of NAW men. Estimation of the reference range of facial proportions in Azerbaijan population migth be helpful to formulate surgical plan in treatment of congenital or post-traumatic facial deformities successfully.

Keywords: facial morphology, anthropometry, indices of proportion, measurement

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1062 Wave Interaction with Defects in Pressurized Composite Structures

Authors: R. K. Apalowo, D. Chronopoulos, V. Thierry

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A wave finite element (WFE) and finite element (FE) based computational method is presented by which the dispersion properties as well as the wave interaction coefficients for one-dimensional structural system can be predicted. The structural system is discretized as a system comprising a number of waveguides connected by a coupling joint. Uniform nodes are ensured at the interfaces of the coupling element with each waveguide. Then, equilibrium and continuity conditions are enforced at the interfaces. Wave propagation properties of each waveguide are calculated using the WFE method and the coupling element is modelled using the FE method. The scattering of waves through the coupling element, on which damage is modelled, is determined by coupling the FE and WFE models. Furthermore, the central aim is to evaluate the effect of pressurization on the wave dispersion and scattering characteristics of the prestressed structural system compared to that which is not prestressed. Numerical case studies are exhibited for two waveguides coupled through a coupling joint.

Keywords: Finite Element, Prestressed Structures, Wave Finite Element, Wave Propagation Properties, Wave Scattering Coefficients.

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1061 Phenomenon of Raveling Distress on the Flexible Pavements: An Overview

Authors: Syed Ali Shahbaz Shah

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In the last few years, Bituminous Asphaltic roads are becoming popular day by day in the world. Plenty of research has been carried out to identify many advantages like safety, environmental effects, and comfort. Some other benefits are minimal noise and skid resistance enhancement. Besides the benefits of asphaltic roads, the permeable structure of the road also causes some distress, and raveling is one of the crucial defects. The main reason behind this distress is the failure of adhesion between bitumen mortar, specifically due to excessive load from heavy traffic. The main focus of this study is to identify the root cause and propose both the long-term and the short-term solutions of raveling on a specific road section depicting the overall road situation from the bridge of Kahuta road towards the intersection of the Islamabad express highway. The methodology adopted for this purpose is visual inspections in-situ. It was noted that there were chunks of debris on the road surface, which indicates that the asphalt binder is aged the most probably. Further laboratory testing would confirm that either asphalt binder is aged or inadequate compaction was adept during cold weather paving.

Keywords: asphaltic roads, asphalt binder, distress, raveling

Procedia PDF Downloads 116
1060 Defective Autophagy Disturbs Neural Migration and Network Activity in hiPSC-Derived Cockayne Syndrome B Disease Models

Authors: Julia Kapr, Andrea Rossi, Haribaskar Ramachandran, Marius Pollet, Ilka Egger, Selina Dangeleit, Katharina Koch, Jean Krutmann, Ellen Fritsche

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It is widely acknowledged that animal models do not always represent human disease. Especially human brain development is difficult to model in animals due to a variety of structural and functional species-specificities. This causes significant discrepancies between predicted and apparent drug efficacies in clinical trials and their subsequent failure. Emerging alternatives based on 3D in vitro approaches, such as human brain spheres or organoids, may in the future reduce and ultimately replace animal models. Here, we present a human induced pluripotent stem cell (hiPSC)-based 3D neural in a vitro disease model for the Cockayne Syndrome B (CSB). CSB is a rare hereditary disease and is accompanied by severe neurologic defects, such as microcephaly, ataxia and intellectual disability, with currently no treatment options. Therefore, the aim of this study is to investigate the molecular and cellular defects found in neural hiPSC-derived CSB models. Understanding the underlying pathology of CSB enables the development of treatment options. The two CSB models used in this study comprise a patient-derived hiPSC line and its isogenic control as well as a CSB-deficient cell line based on a healthy hiPSC line (IMR90-4) background thereby excluding genetic background-related effects. Neurally induced and differentiated brain sphere cultures were characterized via RNA Sequencing, western blot (WB), immunocytochemistry (ICC) and multielectrode arrays (MEAs). CSB-deficiency leads to an altered gene expression of markers for autophagy, focal adhesion and neural network formation. Cell migration was significantly reduced and electrical activity was significantly increased in the disease cell lines. These data hint that the cellular pathologies is possibly underlying CSB. By induction of autophagy, the migration phenotype could be partially rescued, suggesting a crucial role of disturbed autophagy in defective neural migration of the disease lines. Altered autophagy may also lead to inefficient mitophagy. Accordingly, disease cell lines were shown to have a lower mitochondrial base activity and a higher susceptibility to mitochondrial stress induced by rotenone. Since mitochondria play an important role in neurotransmitter cycling, we suggest that defective mitochondria may lead to altered electrical activity in the disease cell lines. Failure to clear the defective mitochondria by mitophagy and thus missing initiation cues for new mitochondrial production could potentiate this problem. With our data, we aim at establishing a disease adverse outcome pathway (AOP), thereby adding to the in-depth understanding of this multi-faced disorder and subsequently contributing to alternative drug development.

Keywords: autophagy, disease modeling, in vitro, pluripotent stem cells

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1059 Considerations in Pregnancy Followed by Obesity Surgery

Authors: Maryam Nazari, Atefeh Ghanbari, Saghar Noorinia

Abstract:

Obesity, as an abnormal or excessive accumulation of fat, is caused by genetic, behavioral and environmental factors. Recently, obesity surgeries, such as bariatric surgery, as the last measure to control obesity, have attracted experts and society, especially women, attention, so knowing the possible complications of this major surgery and their control in reproductive age is of particular importance due to its effects on pregnancy outcomes. Bariatric surgery reduces the risk of diabetes and high blood pressure associated with pregnancy, premature birth, macrosomia, stillbirth and dumping syndrome. Although in the first months after surgery, nausea and vomiting caused by changes in intra-abdominal pressure are associated with an increased risk of malabsorption of micronutrients such as folic acid, iron, vitamin B1, D, calcium, selenium and phosphorus and finally, fetal growth disorder. Moreover, serum levels of micronutrients such as vitamin D, calcium, and iron in mothers who used to have bariatric surgery and their babies have been shown to be lower than in mothers without a history of bariatric surgery. Moreover, vitamin A deficiency is shown to be more widespread in pregnancies after bariatric surgery, which leads to visual problems in newborns and premature delivery. However, complications such as the duration of hospitalization of newborns in the NICU, disease rate in the first 28 days of life and congenital anomalies are not significantly different in babies born to mothers undergoing bariatric surgery compared to the control group. In spite of the vast advantages following obesity surgeries, due to the catabolic conditions and severe weight loss followed by such major intervention and the probability of nutrients malnutrition in a pregnant woman and her baby, after having surgery, at least 12 to 18 months should be considered to get pregnant as a recovery period. In addition, taking essential supplements before and at least 6 months after this approach is recommended.

Keywords: bariatric surgery, pregnancy, malnutrition, vitamin and mineral deficiency

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1058 Comparison of the Effects of Alprazolam and Zaleplon on Anxiety Levels in Patients Undergoing Abdominal Gynecological Surgery

Authors: Shekoufeh Behdad, Amirhossein Yadegari, Leila Ghodrati, Saman Yadegari

Abstract:

Context: Preoperative anxiety is a common psychological reaction experienced by all patients undergoing surgery. It can have negative effects on the patient's well-being and even impact surgical outcomes. Therefore, finding effective interventions to reduce preoperative anxiety is important in improving patient care. Research Aim: The aim of this study is to compare the effects of oral administration of zaleplon (5 mg) and alprazolam (0.5 mg) on preoperative anxiety levels in women undergoing gynecological abdominal surgery. Methodology: This study is a double-blind, randomized clinical trial conducted after receiving approval from the university's ethics committee and obtaining written informed consent from the patients. The night before the surgery, patients were randomly assigned to receive either 0.5 mg of alprazolam or 5 mg of zaleplon orally. Anxiety levels, measured using a 10-cm visual analog scale, and hemodynamic variables (blood pressure and heart rate) were assessed before drug administration and on the morning of the operation after the patient entered the pre-operation room. Findings: The study found that there were no significant differences in mean anxiety levels or hemodynamic variables before and after administration of either drug in both groups (P value > 0.05). This suggests that both 0.5 mg of alprazolam and 5 mg of zaleplon effectively reduce preoperative anxiety in women undergoing abdominal surgery without serious side effects. Theoretical Importance: This study contributes to the understanding of the effectiveness of alprazolam and zaleplon in reducing preoperative anxiety. It adds to the existing literature on pharmacological interventions for anxiety management, specifically in the context of gynecological abdominal surgery. Data Collection: Data for this study were collected through the assessment of anxiety levels using a visual analog scale and measuring hemodynamic variables, including systolic, diastolic, and mean arterial blood pressures, as well as heart rate. These measurements were taken before drug administration and on the morning of the surgery. Analysis Procedures: Statistical analysis was performed to compare the mean anxiety levels and hemodynamic variables before and after drug administration in the two groups. The significance of the differences was determined using appropriate statistical tests. Questions Addressed: This study aimed to answer the question of whether there are differences in the effects of alprazolam and zaleplon on preoperative anxiety levels in women undergoing gynecological abdominal surgery. Conclusion: The oral administration of both 0.5 mg of alprazolam and 5 mg of zaleplon the night before surgery effectively reduces preoperative anxiety in women undergoing abdominal surgery. These findings have important implications for the management of preoperative anxiety and can contribute to improving the overall surgical experience for patients.

Keywords: zaleplon, alprazolam, premedication, abdominal surgery

Procedia PDF Downloads 80
1057 Sterilization Effects of Low Concentration of Hydrogen Peroxide Solution on 3D Printed Biodegradable Polyurethane Nanocomposite Scaffold for Heart Valve Regeneration

Authors: S. E. Mohmad-Saberi, W. Song, N. Oliver, M. Adrian, T.C. Hsu, A. Darbyshire

Abstract:

Biodegradable polyurethane (PU) has emerged as a potential material to promote repair and regeneration of damaged/diseased tissues in heart valve regeneration due to its excellent biomechanical profile. Understanding the effects of sterilization on their properties is vital since they are more sensitive and more critical of porous structures compared to bulk ones. In this study, the effects of low concentration of hydrogen peroxide (H₂O₂) solution sterilization has been investigated to determine whether the procedure would be efficient and non-destructive to porous three-dimensional (3D) elastomeric nanocomposite, polyhedral oligomeric silsesquioxane-terminated poly (ethylene-diethylene glycol succinate-sebacate) urea-urethane (POSS-EDSS-PU) scaffold. All the samples were tested for sterility following sterilization using phosphate buffer saline (PBS) as control and 5 % v/v H₂O₂ solution. The samples were incubated in tryptic soy broth for the cultivation of microorganisms under agitation at 37˚C for 72 hours. The effects of the 5 % v/v H₂O₂ solution sterilization were evaluated in terms of morphology, chemical and mechanical properties using scanning electron microscopy (SEM), Fourier transform infrared (FTIR) and tensile tester apparatus. Toxicity effects of the 5 % v/v H₂O₂ solution decontamination were studied by in vitro cytotoxicity test, where the cellular responses of human dermal fibroblast (HDF) were examined. A clear, uncontaminated broth using 5 % v/v H₂O₂ solution method indicated efficient sterilization after 3 days, while the non-sterilized control shows clouding broth indicated contamination. The morphology of 3D POSS-EDSS-PU scaffold appeared to have similar morphology after sterilization with 5 % v/v H₂O₂ solution regarding of pore size and surface. FTIR results show that the sterilized samples and non-sterilized control share the same spectra pattern, confirming no significant alterations over the surface chemistry. For the mechanical properties of the H₂O₂ solution-treated scaffolds, the tensile strain was not significantly decreased, however, become significantly stiffer after the sterilization. No cytotoxic effects were observed after the 5 % v/v H₂O₂ solution sterilization as confirmed by cell viability assessed by Alamar Blue assay. The results suggest that low concentration of 5 % v/v hydrogen peroxide solution can be used as an alternative method for sterilizing biodegradable 3D porous scaffold with micro/nano-architecture without structural deformation. This study provides the understanding of the sterilization effects on biomechanical profile and cell proliferation of 3D POSS-EDSS-PU scaffolds.

Keywords: biodegradable, hydrogen peroxide solution, POSS-EDSS-PU, sterilization

Procedia PDF Downloads 159
1056 Preparation vADL.net: A Software Architecture Tool with Support to All of Architectural Concepts Title

Authors: Adel Smeda, Badr Najep

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Software architecture is a method of describing the architecture of a software system at a high level of abstraction. It represents a common abstraction of a system that stakeholders can use as a basis for mutual understanding, negotiation, consensus, and communication. It also manifests the earliest design decisions about a system, and these early bindings carry weight far out of proportion to their individual gravity with respect to the system's remaining development, its deployment, and its maintenance life, therefore it is the earliest point at which design decisions governing the system to be built can be analyzed. In this paper, we present a tool to model the architecture of software systems. It represents the first method by which system defects can be detected, and provide a clear representation of a system’s components and interactions at a high level of abstraction. It can be distinguished from other tools by its support to all software architecture elements. The tool is built using VB.net 2010. We used this tool to describe two well know systems, i.e. Capitalize and Client/Server, and the descriptions we obtained support all architectural elements of the two systems.

Keywords: software architecture, architecture description languages, modeling

Procedia PDF Downloads 467
1055 Prioritization of the Failure Factors of Rural Cooperatives in Iran: The Case of Isfahan Province

Authors: Maryam Najafi, Mahdi Rajabi

Abstract:

Although the rural cooperatives are an effective way for rural development in Iran, their potential is not applied effectively. The investigation of the failures of rural cooperatives helps the authorities to improve the routine procedures and eliminate the current barriers to the success of these cooperatives, and to remove the defects in order to have a more efficient policy. Therefore, this research aims to prioritize the failure factors of rural cooperatives in Isfahan province via the survey research method. For this purpose, the effective factors of these failures were investigated by the available research documents and then by the new information which was obtained from 20 questionnaires from the experts of Central Organization Rural Cooperatives in Isfahan province. The questionnaire results were analyzed by Analytical Hierarchy Process (AHP), Excel, and Expert Choice software. The results of this research showed that the most important failure factor of these cooperatives is the lack of the participation culture of cooperative members and then the performance of Central Organization Rural Cooperatives, and also loss of confidence of the members in the cooperation.

Keywords: cooperative, rural cooperatives, failure factors, analytical hierarchy process

Procedia PDF Downloads 130
1054 Changes in the Median Sacral Crest Associated with Sacrocaudal Fusion in the Greyhound

Authors: S. M. Ismail, H-H Yen, C. M. Murray, H. M. S. Davies

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A recent study reported a 33% incidence of complete sacrocaudal fusion in greyhounds compared to a 3% incidence in other dogs. In the dog, the median sacral crest is formed by the fusion of sacral spinous processes. Separation of the 1st spinous process from the median crest of the sacrum in the dog has been reported as a diagnostic tool of type one lumbosacral transitional vertebra (LTV). LTV is a congenital spinal anomaly, which includes either sacralization of the caudal lumbar part or lumbarization of the most cranial sacral segment of the spine. In this study, the absence or reduction of fusion (presence of separation) between the 1st and 2ndspinous processes of the median sacral crest has been identified in association with sacrocaudal fusion in the greyhound, without any feature of LTV. In order to provide quantitative data on the absence or reduction of fusion in the median sacral crest between the 1st and 2nd sacral spinous processes, in association with sacrocaudal fusion. 204 dog sacrums free of any pathological changes (192 greyhound, 9 beagles and 3 labradors) were grouped based on the occurrence and types of fusion and the presence, absence, or reduction in the median sacral crest between the 1st and 2nd sacral spinous processes., Sacrums were described and classified as follows: F: Complete fusion (crest is present), N: Absence (fusion is absent), and R: Short crest (fusion reduced but not absent (reduction). The incidence of sacrocaudal fusion in the 204 sacrums: 57% of the sacrums were standard (3 vertebrae) and 43% were fused (4 vertebrae). Type of sacrum had a significant (p < .05) association with the absence and reduction of fusion between the 1st and 2nd sacral spinous processes of the median sacral crest. In the 108 greyhounds with standard sacrums (3 vertebrae) the percentages of F, N and R were 45% 23% and 23% respectively, while in the 84 fused (4 vertebrae) sacrums, the percentages of F, N and R were 3%, 87% and 10% respectively and these percentages were significantly different between standard (3 vertebrae) and fused (4 vertebrae) sacrums (p < .05). This indicates that absence of spinous process fusion in the median sacral crest was found in a large percentage of the greyhounds in this study and was found to be particularly prevalent in those with sacrocaudal fusion – therefore in this breed, at least, absence of sacral spinous process fusion may be unlikely to be associated with LTV.

Keywords: greyhound, median sacral crest, sacrocaudal fusion, sacral spinous process

Procedia PDF Downloads 446
1053 3D Dentofacial Surgery Full Planning Procedures

Authors: Oliveira M., Gonçalves L., Francisco I., Caramelo F., Vale F., Sanz D., Domingues M., Lopes M., Moreia D., Lopes T., Santos T., Cardoso H.

Abstract:

The ARTHUR project consists of a platform that allows the virtual performance of maxillofacial surgeries, offering, in a photorealistic concept, the possibility for the patient to have an idea of the surgical changes before they are performed on their face. For this, the system brings together several image formats, dicoms and objs that, after loading, will generate the bone volume, soft tissues and hard tissues. The system also incorporates the patient's stereophotogrammetry, in addition to their data and clinical history. After loading and inserting data, the clinician can virtually perform the surgical operation and present the final result to the patient, generating a new facial surface that contemplates the changes made in the bone and tissues of the maxillary area. This tool acts in different situations that require facial reconstruction, however this project focuses specifically on two types of use cases: bone congenital disfigurement and acquired disfiguration such as oral cancer with bone attainment. Being developed a cloud based solution, with mobile support, the tool aims to reduce the decision time window of patient. Because the current simulations are not realistic or, if realistic, need time due to the need of building plaster models, patient rates on decision, rely on a long time window (1,2 months), because they don’t identify themselves with the presented surgical outcome. On the other hand, this planning was performed time based on average estimated values of the position of the maxilla and mandible. The team was based on averages of the facial measurements of the population, without specifying racial variability, so the proposed solution was not adjusted to the real individual physiognomic needs.

Keywords: 3D computing, image processing, image registry, image reconstruction

Procedia PDF Downloads 206
1052 Access the Knowledge, Awareness, and Factors Associated With Hypertension Among the Residents of Modeca District of Tiko, South West Region of Cameroon, in the Middle of a Separatist Violence Since 2017

Authors: Franck Kem Acho

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The trends of diseases have been changed from the last few years, now the burden of non-communicable diseases is increasing day by day. In all the non-communicable diseases, Hypertension is one of the leading causes of premature death and morbidity worldwide. This disease is a silent killer, it mostly affects the people with no obvious symptoms. Not only the heart it also increases the risk of brain, kidney and other diseases, now a days it is a serious medical problem. Over a billion people near about 1 in 4 men and 1 in 5 women having hypertension. In this case study men and women of ages between 30-80 years with Hypertension were identified in community remote area with their Health status being checked and monitored for one week and Health Education was provided for the importance of regular Health checkup alongside the continuous taking of medications.

Keywords: hypertension, health status, health check up, health education

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1051 Degradation Kinetics of Cardiovascular Implants Employing Full Blood and Extra-Corporeal Circulation Principles: Mimicking the Human Circulation In vitro

Authors: Sara R. Knigge, Sugat R. Tuladhar, Hans-Klaus HöFfler, Tobias Schilling, Tim Kaufeld, Axel Haverich

Abstract:

Tissue engineered (TE) heart valves based on degradable electrospun fiber scaffold represent a promising approach to overcome the known limitations of mechanical or biological prostheses. But the mechanical stress in the high-pressure system of the human circulation is a severe challenge for the delicate materials. Hence, the prediction of the scaffolds` in vivo degradation kinetics must be as accurate as possible to prevent fatal events in future animal or even clinical trials. Therefore, this study investigates whether long-term testing in full blood provides more meaningful results regarding the degradation behavior than conventional tests in simulated body fluids (SBF) or Phosphate Buffered Saline (PBS). Fiber mats were produced from a polycaprolactone (PCL)/tetrafluoroethylene solution by electrospinning. The morphology of the fiber mats was characterized via scanning electron microscopy (SEM). A maximum physiological degradation environment utilizing a test set-up with porcine full blood was established. The set-up consists of a reaction vessel, an oxygenator unit, and a roller pump. The blood parameters (pO2, pCO2, temperature, and pH) were monitored with an online test system. All tests were also carried out in the test circuit with SBF and PBS to compare conventional degradation media with the novel full blood setting. The polymer's degradation is quantified by SEM picture analysis, differential scanning calorimetry (DSC), and Raman spectroscopy. Tensile and cyclic loading tests were performed to evaluate the mechanical integrity of the scaffold. Preliminary results indicate that PCL degraded slower in full blood than in SBF and PBS. The uptake of water is more pronounced in the full blood group. Also, PCL preserved its mechanical integrity longer when degraded in full blood. Protein absorption increased during the degradation process. Red blood cells, platelets, and their aggregates adhered on the PCL. Presumably, the degradation led to a more hydrophilic polymeric surface which promoted the protein adsorption and the blood cell adhesion. Testing degradable implants in full blood allows for developing more reliable scaffold materials in the future. Material tests in small and large animal trials thereby can be focused on testing candidates that have proven to function well in an in-vivo-like setting.

Keywords: Electrospun scaffold, full blood degradation test, long-term polymer degradation, tissue engineered aortic heart valve

Procedia PDF Downloads 150
1050 Study of Laser Induced Damage Threshold in HfO₂/SiO₂ Multilayer Films after β-Ray Irradiation

Authors: Meihua Fang, Tao Fei

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Post-processing can effectively improve the resistance to laser damage in multilayer films used in a high power laser system. In this work, HfO₂/SiO₂ multilayer films are prepared by e-beam evaporation and then β-ray irradiation is employed as the post-processing method. The particle irradiation affects the laser induced damage threshold (LIDT), which includes defects, surface roughness, packing density, and residual stress. The residual stress that is relaxed during irradiation changes from compressive stress into tensile stress. Our results indicate that appropriate tensile stress can improve LIDT remarkably. In view of the fact that LIDT rises from 8 J/cm² to 12 J/cm², i.e., 50% increase, after the film has been irradiated by 2.2×10¹³/cm² β-ray, the particle irradiation can be used as a controllable and desirable post-processing method to improve the resistance to laser induced damage.

Keywords: β-ray irradiation, multilayer film, residual stress, laser-induced damage threshold

Procedia PDF Downloads 153