Search results for: symptom screening
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1510

Search results for: symptom screening

670 Tracheal Stenting to Relieve Respiratory Distress in Patient with Advanced Esophageal Malignancy and Its Anaesthetic Management

Authors: Aarti Agarwal, Ajmal Khan

Abstract:

Background and Objective: Breathing difficulty is most distressing symptom for the patient and their caregivers providing palliative care to individuals with advanced malignancy. It needs to be tackled effectively and sometimes preemptively to provide relief from respiratory obstruction. Interventional procedures like tracheal stenting are becoming increasingly popular as a part of palliation for respiratory symptoms. We present a case of esophageal tumor earlier stented by Gastroenterologist to maintain esophageal patency, but the tumor outgrew to produce tracheal infiltration and thereby causing airway obstruction. Method and Result: 62-year-old man presented with unresectable Carcinoma oesophagus with inability to swallow. A metallic stent was placed by the gastroenterologist, to maintain esophageal patency and enable patient to swallow. Two months later, the patient returned to hospital in emergency with respiratory distress. CT neck and thorax revealed tumor infiltration through posterior tracheal wall. Lower extent of the tumor was till 1 cm above the carina. Airway stenting with Tracheo bronchial stent with Y configuration was planned under general anaesthesia with airway blocks. Superior Laryngeal Nerve Block, Glossopharyngeal block and Trans tracheal infiltration of local anaesthetics were performed. The patient was sedated with Fentanyl, Midazolam and propofol infusion but was breathing spontaneously. Once the rigid bronchoscope was placed inside trachea, breathing was supported with oxygen and sevoflurane. Initially, the trachea was cleared of tumor by coring. After creating space, tracheal stent was positioned and deployed. After stent placement patient was awakened, suctioned and nebulized. His respiratory stridor relieved instantaneously and was shifted to recovery. Conclusion: Airway blocks help in decreasing the incidence and severity of coughing during airway instrumentation thereby help in proper stent placement. They also reduce the requirement of general anaesthetics and hasten the post stenting recovery. Airway stent provided immediate relief to patient from symptoms of respiratory difficulty. Decision for early tracheal stenting may be taken for a select group of patients with high propensity for local spread, thereby avoiding respiratory complications and providing better quality of life in patients with inoperable malignancy.

Keywords: tracheal stent, respiratory difficulty, esophageal tumor, anaesthetic management

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669 Biosensor Design through Molecular Dynamics Simulation

Authors: Wenjun Zhang, Yunqing Du, Steven W. Cranford, Ming L. Wang

Abstract:

The beginning of 21st century has witnessed new advancements in the design and use of new materials for biosensing applications, from nano to macro, protein to tissue. Traditional analytical methods lack a complete toolset to describe the complexities introduced by living systems, pathological relations, discrete hierarchical materials, cross-phase interactions, and structure-property dependencies. Materiomics – via systematic molecular dynamics (MD) simulation – can provide structure-process-property relations by using a materials science approach linking mechanisms across scales and enables oriented biosensor design. With this approach, DNA biosensors can be utilized to detect disease biomarkers present in individuals’ breath such as acetone for diabetes. Our wireless sensor array based on single-stranded DNA (ssDNA)-decorated single-walled carbon nanotubes (SWNT) has successfully detected trace amount of various chemicals in vapor differentiated by pattern recognition. Here, we present how MD simulation can revolutionize the way of design and screening of DNA aptamers for targeting biomarkers related to oral diseases and oral health monitoring. It demonstrates great potential to be utilized to build a library of DNDA sequences for reliable detection of several biomarkers of one specific disease, and as well provides a new methodology of creating, designing, and applying of biosensors.

Keywords: biosensor, DNA, biomarker, molecular dynamics simulation

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668 Poultry as a Carrier of Chlamydia gallinacea

Authors: Monika Szymańska-Czerwińsk, Kinga Zaręba-Marchewka, Krzysztof Niemczuk

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Chlamydiaceae are Gram-negative bacteria distributed worldwide in animals and humans. One of them is Chlamydia gallinacea recently discovered. Available data show that C. gallinacea is dominant chlamydial agent found in poultry in European and Asian countries. The aim of the studies was screening of poultry flocks in order to evaluate frequency of C. gallinacea shedding and genetic diversity. Sampling was conducted in different regions of Poland in 2019-2020. Overall, 1466 cloacal/oral swabs were collected in duplicate from 146 apparently healthy poultry flocks including chickens, turkeys, ducks, geese and quails. Dry swabs were used for DNA extraction. DNA extracts were screened using a Chlamydiaceae 23S rRNA real-time PCR assay. To identify Chlamydia species, specific real-time PCR assays were performed. Furthermore, selected samples were used for sequencing based on ompA gene fragments and variable domains (VD1-2, VD3-4). In total, 10.3% of the tested flocks were Chlamydiaceae-positive (15/146 farms). The presence of Chlamydiaceae was confirmed mainly in chickens (13/92 farms) but also in turkey (1/19 farms) and goose (1/26 farms) flocks. Eleven flocks were identified as C. gallinacea-positive while four flocks remained unclassified. Phylogenetic analysis revealed at least 16 genetic variants of C. gallinacea. Research showed that Chlamydiaceae occur in a poultry flock in Poland. The strains of C. gallinacea as dominant species show genetic variability.

Keywords: C. gallinacea, emerging agent, poultry, real-time PCR

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667 Development and Characterization of Polymorphic Genomic-SSR Markers in Asian Long-Horned Beetle (Anoplophora glabripennis)

Authors: Zhao Yang Liu, Jing Tao

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The Asian long-horned beetle, Anoplophora glabripennis (Motschulsky) (Coleoptera: Cerambycidae: Lamiinae), is a wood-borer and polyphagous xylophages native to Asia and killing healthy trees. As it causes serious danger to trees, the beetle has been paid close attention in the world. However, the genetic markers limited, especially microsatellite. In this study, 24 novel simple sequence repeat (SSR) molecular markers, a powerful tool for genetic diversity studies and linkage map construction, were developed and characterized from whole genome shotgun sequences. We developed SSR loci of 2 to 6 repeated and perfect units including 9895 points, the density of SSRs was found one SSR per 56.57 kb and the abundance of SSR was 0.02/kb, besides 140 types of repeats motifs were found. Half of the 48 pairs SSR primers (containing 4 di-, 7 tri-, 2 tetra- and 11 hexamers SSRs) we selected randomly from 1222 pairs of primers were polymorphism. The number of alleles for these markers in 48 individuals varied from 3 to 21 with an average of 7.71, the number of effective alleles ranged from 1.22 to 9.97 with an average of 3.54. Besides this, the polymorphic information content (PIC) ranged from 0.18 to 0.89 with a mean of 0.65, And Shannon's Information index (I) ranged from 0.46 to 2.62 with an average of 1.44. The results suggest that the method for screening of SSR in the whole genome is feasible and efficient. SSR markers developed in this study can be used for population genetic studies of A. glabripennis. Moreover, they may also be helpful for the development of microsatellites for other Coleoptera.

Keywords: SSR markers, Anoplophora glabripennis, genetic diversity, whole genome

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666 Screening and Optimization of Pretreatments for Rice Straw and Their Utilization for Bioethanol Production Using Developed Yeast Strain

Authors: Ganesh Dattatraya Saratale, Min Kyu Oh

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Rice straw is one of the most abundant lignocellulosic waste materials and its annual production is about 731 Mt in the world. This study treats the subject of effective utilization of this waste biomass for biofuels production. We have showed a comparative assessment of numerous pretreatment strategies for rice straw, comprising of major physical, chemical and physicochemical methods. Among the different methods employed for pretreatment alkaline pretreatment in combination with sodium chlorite/acetic acid delignification found efficient pretreatment with significant improvement in the enzymatic digestibility of rice straw. A cellulase dose of 20 filter paper units (FPU) released a maximum 63.21 g/L of reducing sugar with 94.45% hydrolysis yield and 64.64% glucose yield from rice straw, respectively. The effects of different pretreatment methods on biomass structure and complexity were investigated by FTIR, XRD and SEM analytical techniques. Finally the enzymatic hydrolysate of rice straw was used for ethanol production using developed Saccharomyces cerevisiae SR8. The developed yeast strain enabled efficient fermentation of xylose and glucose and produced higher ethanol production. Thus development of bioethanol production from lignocellulosic waste biomass is generic, applicable methodology and have great implication for using ‘green raw materials’ and producing ‘green products’ much needed today.

Keywords: rice straw, pretreatment, enzymatic hydrolysis, FPU, Saccharomyces cerevisiae SR8, ethanol fermentation

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665 Executive Function in Youth With ADHD and ASD: A Systematic Review and Meta-analysis

Authors: Parker Townes, Prabdeep Panesar, Chunlin Liu, Soo Youn Lee, Dan Devoe, Paul D. Arnold, Jennifer Crosbie, Russell Schachar

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Attention-deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) are impairing childhood neurodevelopmental disorders with problems in executive functions. Executive functions are higher-level mental processes essential for daily functioning and goal attainment. There is genetic and neural overlap between ADHD and ASD. The aim of this meta-analysis was to evaluate if pediatric ASD and ADHD have distinct executive function profiles. This review was completed following Cochrane guidelines. Fifty-eight articles were identified through database searching, followed by a blinded screening in duplicate. A meta-analysis was performed for all task performance metrics evaluated by at least two articles. Forty-five metrics from 24 individual tasks underwent analysis. No differences were found between youth with ASD and ADHD in any domain under direct comparison. However, individuals with ASD and ADHD exhibited deficient attention, flexibility, visuospatial abilities, working memory, processing speed, and response inhibition compared to controls. No deficits in planning were noted in either disorder. Only 11 studies included a group with comorbid ASD+ADHD, making it difficult to determine whether common executive function deficits are a function of comorbidity. Further research is needed to determine if comorbidity accounts for the apparent commonality in executive function between ASD and ADHD.

Keywords: autism spectrum disorder, ADHD, neurocognition, executive function, youth

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664 The Study of Effective Microorganism's Biopreperation for Wastewater Treatment

Authors: Batsukh Chultem, Oyunbileg Natsagdorj, Namsrai Steyrmunkh

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Many industries, tourist camps and houses, discharge aqueous effluents containing relatively high levels of heavy metals, harmful organic compounds water. Untreated effluent from these manufacturing processes has an adverse impact on the environment. A specific problem associated with waste water in the environment is accumulation in the food chain and persistence in the environment. The screening of microorganisms resistant to pollution and able to detoxification them is essential for the development of clean-up technologies. The purpose of this study is to use advanced microbiological technology products for oxidizing organic and heavy metals pollutants as a biological treatment, to reduce water pollution, which arise as a result of waste water due to day-to-day operations of industries and houses of Ulaanbaatar city and tourist camps located around the lake Hovsgol, in Hovsgol province of Mongolia. By comparing the results from tests of effective microorganism’s bio-preparation treated sewage samples and not treated sewage samples shows that the treated sewage samples pollution decreased defending on treatment period and ratio. Treated water analyses show that: the suspended solids 352 mg/l, pH 5.85-7.95, ammonium nitrate 81.25-221.2 mg NH₄/l, nitrite 0.088-0.227 mg NO₂/l, nitrate 8.5-11.5 mg NO₃/l, and orthophosphate 1.06-15.46 mg PO₄/l. Also, heavy metals were decreased and microbiological test results defined parameters, respectively show the waste water pollution was reduced.

Keywords: effective microorganims, environment, pollution, treatment

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663 Simulation Study of Enhanced Terahertz Radiation Generation by Two-Color Laser Plasma Interaction

Authors: Nirmal Kumar Verma, Pallavi Jha

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Terahertz (THz) radiation generation by propagation of two-color laser pulses in plasma is an active area of research due to its potential applications in various areas, including security screening, material characterization and spectroscopic techniques. Due to non ionizing nature and the ability to penetrate several millimeters, THz radiation is suitable for diagnosis of cancerous cells. Traditional THz emitters like optically active crystals when irradiated with high power laser radiation, are subject to material breakdown and hence low conversion efficiencies. This problem is not encountered in laser - plasma based THz radiation sources. The present paper is devoted to the simulation study of the enhanced THz radiation generation by propagation of two-color, linearly polarized laser pulses through magnetized plasma. The two laser pulses orthogonally polarized are co-propagating along the same direction. The direction of the external magnetic field is such that one of the two laser pulses propagates in the ordinary mode, while the other pulse propagates in the extraordinary mode through homogeneous plasma. A transverse electromagnetic wave with frequency in the THz range is generated due to the presence of the static magnetic field. It is observed that larger amplitude terahertz can be generated by mixing of ordinary and extraordinary modes of two-color laser pulses as compared with a single laser pulse propagating in the extraordinary mode.

Keywords: two-color laser pulses, terahertz radiation, magnetized plasma, ordinary and extraordinary mode

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662 Screening Deformed Red Blood Cells Irradiated by Ionizing Radiations Using Windowed Fourier Transform

Authors: Dahi Ghareab Abdelsalam Ibrahim, R. H. Bakr

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Ionizing radiation, such as gamma radiation and X-rays, has many applications in medical diagnoses and cancer treatment. In this paper, we used the windowed Fourier transform to extract the complex image of the deformed red blood cells. The real values of the complex image are used to extract the best fitting of the deformed cell boundary. Male albino rats are irradiated by γ-rays from ⁶⁰Co. The male albino rats are anesthetized with ether, and then blood samples are collected from the eye vein by heparinized capillary tubes for studying the radiation-damaging effect in-vivo by the proposed windowed Fourier transform. The peripheral blood films are prepared according to the Brown method. The peripheral blood film is photographed by using an Automatic Image Contour Analysis system (SAMICA) from ELBEK-Bildanalyse GmbH, Siegen, Germany. The SAMICA system is provided with an electronic camera connected to a computer through a built-in interface card, and the image can be magnified up to 1200 times and displayed by the computer. The images of the peripheral blood films are then analyzed by the windowed Fourier transform method to extract the precise deformation from the best fitting. Based on accurate deformation evaluation of the red blood cells, diseases can be diagnosed in their primary stages.

Keywords: windowed Fourier transform, red blood cells, phase wrapping, Image processing

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661 Branding Tourism Destinations; The Trending Initiatives for Edifice Image Choices of Foreign Policy

Authors: Mehtab Alam, Mudiarasan Kuppusamy, Puvaneswaran Kunaserkaran

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The purpose of this paper is to bridge the gap and complete the relationship between tourism destinations and image branding as a choice of edifice foreign policy. Such options became a crucial component for individuals interested in leisure and travel activities. The destination management factors have been evaluated and analyzed using the primary and secondary data in a mixed-methods approach (quantitative sample of 384 and qualitative 8 semi-structured interviews at saturated point). The study chose the Environmental Management Accounting (EMA) and Image Restoration (IR) theories, along with a schematic diagram and an analytical framework supported by NVivo software 12, for two locations in Abbottabad, KPK, Pakistan: Shimla Hill and Thandiani. This incorporates the use of PLS-SEM model for assessing validity of data while SPSS for data screening of descriptive statistics. The results show that destination management's promotion of tourism has significantly improved Pakistan's state image. The use of institutional setup, environmental drivers, immigration, security, and hospitality as well as recreational initiatives on destination management is encouraged. The practical ramifications direct the heads of tourism projects, diplomats, directors, and policymakers to complete destination projects before inviting people to Pakistan. The paper provides the extent of knowledge for academic tourism circles to use tourism destinations as brand ambassadors.

Keywords: tourism, management, state image, foreign policy, image branding

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660 Quality Evaluation of Treated Ballast Seawater for Potential Reuse

Authors: Siti Nur Muhamad, Mohamad Abu Ubaidah Amir, Adenen Shuhada Abdul Aziz, Siti Sarah Mohd Isnan, Ainul Husna Abdul Rahman, Nur Afiqah Rosly, Roshamida Abd Jamil

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The International Convention for the Control and Management of Ships’ Ballast Water and Sediments (BWM Convention) will commencing on 8 September 2017 after ratified by 51 States in September 2016. However, there is no value recovered for the treated ballast water as it simply discharged during de-ballasting. In order to evaluate value creation of treated ballast water, three seawater applications which are seawater toilet flushing, cooling tower and desalination was studied and compared with treated ballast seawater. An exploratory study was conducted in Singapore as a case study as this country is facing water scarcity issues and a busy port in the world which received more than 28 billion m3 of ballast water in 2015. Surprisingly the treatment technology between seawater toilet flushing and ballast water management has similarity as both applications use screening and disinfection process and quality standard and analysis between treated ballast water with seawater applications found that seawater toilet flushing have the same quality parameter with treated ballast water. Thus, the treated ballast water can replace the raw seawater for seawater desalination. As such, with reduction of cost for screen unit, desalination water can exceed water production by NEWater in Singapore as the cost can recover the energy needed for desalination. It can conclude that treated ballast water has high recovery value and can be reused in seawater application.

Keywords: ballast water treatment, desalination, BWM convention, ballast water management

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659 Transformation of Periodic Fuzzy Membership Function to Discrete Polygon on Circular Polar Coordinates

Authors: Takashi Mitsuishi

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Fuzzy logic has gained acceptance in the recent years in the fields of social sciences and humanities such as psychology and linguistics because it can manage the fuzziness of words and human subjectivity in a logical manner. However, the major field of application of the fuzzy logic is control engineering as it is a part of the set theory and mathematical logic. Mamdani method, which is the most popular technique for approximate reasoning in the field of fuzzy control, is one of the ways to numerically represent the control afforded by human language and sensitivity and has been applied in various practical control plants. Fuzzy logic has been gradually developing as an artificial intelligence in different applications such as neural networks, expert systems, and operations research. The objects of inference vary for different application fields. Some of these include time, angle, color, symptom and medical condition whose fuzzy membership function is a periodic function. In the defuzzification stage, the domain of the membership function should be unique to obtain uniqueness its defuzzified value. However, if the domain of the periodic membership function is determined as unique, an unintuitive defuzzified value may be obtained as the inference result using the center of gravity method. Therefore, the authors propose a method of circular-polar-coordinates transformation and defuzzification of the periodic membership functions in this study. The transformation to circular polar coordinates simplifies the domain of the periodic membership function. Defuzzified value in circular polar coordinates is an argument. Furthermore, it is required that the argument is calculated from a closed plane figure which is a periodic membership function on the circular polar coordinates. If the closed plane figure is continuous with the continuity of the membership function, a significant amount of computation is required. Therefore, to simplify the practice example and significantly reduce the computational complexity, we have discretized the continuous interval and the membership function in this study. In this study, the following three methods are proposed to decide the argument from the discrete polygon which the continuous plane figure is transformed into. The first method provides an argument of a straight line passing through the origin and through the coordinate of the arithmetic mean of each coordinate of the polygon (physical center of gravity). The second one provides an argument of a straight line passing through the origin and the coordinate of the geometric center of gravity of the polygon. The third one provides an argument of a straight line passing through the origin bisecting the perimeter of the polygon (or the closed continuous plane figure).

Keywords: defuzzification, fuzzy membership function, periodic function, polar coordinates transformation

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658 Enhancement of Rice Straw Composting Using UV Induced Mutants of Penicillium Strain

Authors: T. N. M. El Sebai, A. A. Khattab, Wafaa M. Abd-El Rahim, H. Moawad

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Fungal mutant strains have produced cellulase and xylanase enzymes, and have induced high hydrolysis with enhanced of rice straw. The mutants were obtained by exposing Penicillium strain to UV-light treatments. Screening and selection after treatment with UV-light were carried out using cellulolytic and xylanolytic clear zones method to select the hypercellulolytic and hyperxylanolytic mutants. These mutants were evaluated for their cellulase and xylanase enzyme production as well as their abilities for biodegradation of rice straw. The mutant 12 UV/1 produced 306.21% and 209.91% cellulase and xylanase, respectively, as compared with the original wild type strain. This mutant showed high capacity of rice straw degradation. The effectiveness of tested mutant strain and that of wild strain was compared in relation to enhancing the composting process of rice straw and animal manures mixture. The results obtained showed that the compost product of inoculated mixture with mutant strain (12 UV/1) was the best compared to the wild strain and un-inoculated mixture. Analysis of the composted materials showed that the characteristics of the produced compost were close to those of the high quality standard compost. The results obtained in the present work suggest that the combination between rice straw and animal manure could be used for enhancing the composting process of rice straw and particularly when applied with fungal decomposer accelerating the composting process.

Keywords: rice straw, composting, UV mutants, Penicillium

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657 Prevalence of High Risk Human Papillomavirus in Cervical Dysplasia and Cancer Samples from Twin Cities in Pakistan

Authors: Sana Gul, Sheeba Murad, Aneela Javed

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Introduction: Human Papilloma Virus (HPV) is small DNA virus mostly infecting mucosa and cutaneous keratinocytes. So far, more than 200 Human papillomaviruses are known. HPV have been divided into high- and low-risk on the basis of their oncogenic potential. High risk HPV is considered to be the main etiological cause for cervical cancer. Objective: Current study was designed to screen the local cervical cancer patients from the twin cities of Pakistan for the occurance of high risk HPV. Methodology: A total of 67 formalin fixed paraffin-embedded samples of cervical cancer biopsies were obtained from the government hospitals in Islamabad and Rawalpindi. Cervical cancer biopsies were examined for the presence of HPV DNA. Polymerase chain reaction (PCR) was used for the amplification of a region in the HPV-L1 gene for the general detection of the Papilloma virus and for the genotype specific detection of high risk HPV 16 and 18 using the GP5/GP6 primers and genotype specific primers respectively. Results: HPV DNA was detected in 59 out of 67 samples analyzed. 30 samples showed the presence of HPV16 while 22 samples were positive for HPV 18 . HPV subtype could not be determined in 7 samples. Conclusion: Our results show a strong association between HPV infection and cervical cancer among women in twin cities of Pakistan. One way to minimize the disease burden in relation to HPV infection in Pakistani population is the use of prophylactic vaccines and routine screening. An early diagnosis of HPV infection will allow better health management to reduce the risk of developing cervical cancer.

Keywords: cervical cancer, Pakistan, human papillomavirus, HPV 16

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656 Production of Camel Nanobodies against of Anti-Morphine-3-Glucuronide for the Development of a Biosensor for Detecting Illicit Drug

Authors: Shirin Jalili, Sadegh Hasannia, Hadi Shirzad, Afshin Khara

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Morphine is one of the most medicinally important analgesics and narcotics. Structurally, it is classified as an alkaloid because of the presence of nitrogen. Its structure is similar to that of codeine, thebaine, and heroin. An immunoassay to accurately discriminate between these analogous alkaloids would be highly beneficial. A key factor for such an assay is specificity with high sensitivity, which is totally dependent on the antibody employed. However, most antibodies against haptens are polyclonal serum antibodies that exhibit significant cross-reactivities with closely related compounds. The camel-derived single-chain antibody fragments (VHH) are the smallest molecules with antigen-binding capacity, possessing unique properties compared to other conventional antibodies. In this study, a library containing the VHH genes of a camel immunized with with morphine conjugated BSA following phage display technology was generated. By screening the camel-derived variable region of the heavy chain cDNA phage display library with the ability to bind the desired hapten, we obtained some nanobodies that recognize this hapten. Phage display expression of the Nbs from this library and pannings against this hapten resulted in a clear enrichment of four distinct Nb-displaying phages with specificity for morphine that could be a potential target site for the development of new strategies for the development of a biosensor for detecting illicit drug.

Keywords: phage display, nanobody, Morphine-3, glucuronide, ELISA, biosensor

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655 Pilot Scale Sub-Surface Constructed Wetland: Evaluation of Performance of Bed Vegetated with Water Hyacinth in the Treatment of Domestic Sewage

Authors: Abdul-Hakeem Olatunji Abiola, A. E. Adeniran, A. O. Ajimo, A. B. Lamilisa

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Introduction: Conventional wastewater treatment technology has been found to fail in developing countries because they are expensive to construct, operate and maintain. Constructed wetlands are nowadays considered as a low-cost alternative for effective wastewater treatment, especially where suitable land can be available. This study aims to evaluate the performance of the constructed wetland vegetated with water hyacinth (Eichhornia crassipes) plant for the treatment of wastewater. Methodology: The sub-surface flow wetland used for this study was an experimental scale constructed wetland consisting of four beds A, B, C, and D. Beds A, B, and D were vegetated while bed C which was used as a control was non-vegetated. This present study presents the results from bed B vegetated with water hyacinth (Eichhornia crassipes) and control bed C which was non-vegetated. The influent of the experimental scale wetland has been pre-treated with sedimentation, screening and anaerobic chamber before feeding into the experimental scale wetland. Results: pH and conductivity level were more reduced, colour of effluent was more improved, nitrate, iron, phosphate, and chromium were more removed, and dissolved oxygen was more improved in the water hyacinth bed than the control bed. While manganese, nickel, cyanuric acid, and copper were more removed from the control bed than the water hyacinth bed. Conclusion: The performance of the experimental scale constructed wetland bed planted with water hyacinth (Eichhornia crassipes) is better than that of the control bed. It is therefore recommended that plain bed without any plant should not be encouraged.

Keywords: constructed experimental scale wetland, domestic sewage, treatment, water hyacinth

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654 Binding Studies of Complexes of Anticancer Drugs with DNA and Enzymes Involved in DNA Replication Using Molecular Docking and Cell Culture Techniques

Authors: Fouzia Perveen, Rumana Qureshi

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The presently studied twelve anticancer drugs are the cytotoxic agents which inhibit the replication of DNA and activity of enzymes involved in DNA replication namely topoisomerase-II, polymerase and helicase and have shown remarkable anticancer activity in clinical trials. In this study, we performed molecular docking studies of twelve antitumor drugs against DNA and DNA enzymes in the presence and absence of ascorbic acid (AA) and developed the quantitative structure-activity relationship (QSAR) model for anticancer activity screening. A number of electronic and steric descriptors were calculated using MOE software package. QSAR was established showing a correlation of binding strength with various physicochemical descriptors. Out of these twelve, eight cytotoxic drugs were tested on Non-Small Cell Lung Cancer cell lines (H-157 and H-1299) in the absence and presence of ascorbic acid and experimental IC50 values were calculated. From the docking studies, binding constants were calculated indicating the strength of drug-DNA and drug-enzyme complex formation and it was correlated to the IC50 values (both experimental and theoretical). These results can offer useful references for directing the molecular design of DNA enzyme inhibitor with improved anticancer activity.

Keywords: ascorbic acid, binding constant, cytotoxic agents, cell culture, DNA, DNA enzymes, molecular docking

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653 Hyaluronic Acid Binding to Link Domain of Stabilin-2 Receptor

Authors: Aleksandra Twarda, Dobrosława Krzemień, Grzegorz Dubin, Tad A. Holak

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Stabilin-2 belongs to the group of scavenger receptors and plays a crucial role in clearance of more than 10 ligands from the bloodstream, including hyaluronic acid, products of degradation of extracellular matrix and metabolic products. The Link domain, a defining feature of stabilin-2, has a sequence similar to Link domains in other hyaluronic acid receptors, such as CD44 or TSG-6, and is responsible for most of ligands binding. Present knowledge of signal transduction by stabilin-2, as well as ligands’ recognition and binding mechanism, is limited. Until now, no experimental structures have been solved for any segments of stabilin-2. It has recently been demonstrated that the stabilin-2 knock-out or blocking of the receptor by an antibody effectively opposes cancer metastasis by elevating the level of circulating hyaluronic acid. Moreover, loss of expression of stabilin-2 in a peri-tumourous liver correlates with increased survival. Solving of the crystal structure of stabilin-2 and elucidation of the binding mechanism of hyaluronic acid could enable the precise characterization of the interactions in the binding site. These results may allow for designing specific small-molecule inhibitors of stabilin-2 that could be used in cancer therapy. To carry out screening for crystallization of stabilin-2, we cloned constructs of the Link domain of various lengths with or without surrounding domains. The folding properties of the constructs were checked by nuclear magnetic resonance (NMR). It is planned to show the binding of hyaluronic acid to the Link domain using several biochemical methods, i.a. NMR, isothermal titration calorimetry and fluorescence polarization assay.

Keywords: stabilin-2, Link domain, X-ray crystallography, NMR, hyaluronic acid, cancer

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652 Nutritional Status and Body Image Perception among Thai Adolescents

Authors: Nareemarn Neelapaichit, Sookfong Wongsathapat, Noppawan Piaseu

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Body image plays an important role in adolescents. Thai adolescents put high concern on their body image result in unsatisfied their body shapes. Therefore, inappropriate weight management methods have been used. This study examined the body image perception and the nutritional status of Thai adolescents. Body mass index screening was done on 181 nursing students of Ramathibodi School of Nursing to categorized obesity, overweight, normal weight and underweight respondents by using recommended body-mass index (BMI) cut-off points for Asian populations. Self report questionnaire on demographics and body image perception were completed. Results showed that the respondents were mainly female (93.4%) and their mean age were 19.2 years. The prevalence of obesity, overweight, normal weight and underweight of the nursing students were 5.5%, 7.2%, 55.2% and 32.0%, respectively. Of all the respondents, 57.5% correctly perceived themselves, with 37.0% overestimating and 5.5% underestimating their weight status. Of those in the obesity category, 20.0% correctly perceived themselves and 80.0% perceived themselves as overweight. For overweight category, total respondents correctly perceived themselves. Fifty two percent of the normal weight respondents perceived themselves as overweight and 2.0% perceived themselves as obesity. Of the underweight respondents, 77.6% correctly perceived themselves and 20.7% perceived themselves as normal weight. These findings show high occurrence of body image misperception among Thai adolescents. Being concerned with this situation can promote adolescents for healthy weight and practice appropriate weight management methods.

Keywords: nutritional status, body image perception, Thai adolescents, body-mass index (BMI)

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651 Determination of Acid Volatile Sulfides–Simultaneously Extracted Metal Relationship and Toxicity in Contaminated Sediment Layer in Mid-Black Sea Coasts

Authors: Arife Simsek, Gulfem Bakan

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Sediment refers to the accumulation of varying amounts of sediment material in natural waters and the formation of bottom sludge. Sediments are the most important sources of pollutants as well as important future sources and carriers of pollutants. The accumulation of pollutants in sediments can cause serious environmental problems for the surrounding areas. Heavy metals (such as Cr, Cd, Al, Pb, Cu, Al, Zn) disrupt the water quality, affect the useful use of sediment, affect the ecosystem and have a toxic effect on the life of the sediment layer. This effect, which accumulates in the aquatic organisms, can enter the human body with the food chain and affect health seriously. Potential metal toxicity can be determined by comparing acid volatile sulfides (AVS) – simultaneously extracted metal (SEM) ratio in anoxic sediments to determine the effect of metals. Determination of the concentration of SEM and AVS is useful in screening sediments for potential toxicity due to the high metal concentration. In the case of SEM/AVS < 0 (anoxic sediment); in terms of AVS biomass production, its toxicity can be controlled. No toxic effects may be observed when SEM / AVS < 0. SEM / AVS > 0 (in the case of oxic sediment); metals with sensitive fraction such as Cu, As, Ag, Zn are stored. In this study, AVS and SEM measurements of sediment samples collected from five different points in the district of Tekkeköy in Samsun province were performed. The SEM - AVS ratio was greater than 0 in all samples. Therefore, it is necessary to test the toxicity against the risks that may occur in the ecosystem.

Keywords: AVS-SEM, Black Sea, heavy metal, sediment, toxicity

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650 The out of Proportion - Pulmonary Hypertension in Indians with Chronic Lung Disease

Authors: S. P. Chintan, A. M. Khoja, M. Modi, R. K. Chopra, S. Garde, D. Jain, O. Kajale

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Pulmonary Hypertension is a rare but debilitating disease that affects individuals of all ages and walks of life. As recent as 15 years ago, a patient diagnosed with PH was given an average survival rate of 2.8 years. Recent advances in treatment options have allowed patients to improve quality o and quantity of life. Initial screening for PH is through echocardiography with final diagnosis confirmed through right heart catheterization. PH is now considered to have five major classifications with subgroups among each. The mild to moderate PH is common in chronic lung diseases like Chronic obstructive pulmonary diseases and Interstitial lung disease. But very severe PH is noted in few cases. In COPD patients, PH is associated with an increased risk of severe exacerbations and a reduced life expectancy. Similarly, in patients with ILD, the presence of PH correlates with a poor prognosis. Early diagnosis is essential to slow disease progression. We report here five cases of severe PH (Out of Proportion) of which four cases were of COPD and another one of IPF (UIP pattern). There echocardiography showed gross RA/RV dilatation, interventricular septum bulging to the left and mPAP of more than 100 mmHg in all the five cases. These patients were put on LTOT, pulmonary rehabilitation, combination pharmacotherapy of vasodilators and diuretics in continuation to the treatment of underlying disease. As these patients have grave prognosis close monitoring and follow up is required. Physicians associated with respiratory care and treating chronic lung disease should have knowledge in the diagnosis and management of patients with PH.

Keywords: COPD, pulmonary hypertension, chronic lung disease, India

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649 Avidity and IgE versus IgG and IgM in Diagnosis of Maternal Toxoplasmosis

Authors: Ghada A. Gamea, Nabila A. Yaseen, Ahmed A. Othman, Ahmed S. Tawfik

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Infection with Toxoplasma gondii can cause serious complications in pregnant women, leading to abortion, stillbirth, and congenital anomalies in the fetus. Definitive diagnosis of T. gondii acute infection is therefore critical for the clinical management of a mother and her fetus. This study was conducted on 250 pregnant females in the first trimester who were inpatients or outpatients at Obstetrics and Gynaecology Department at Tanta University Hospital. Screening of the selected females was done for the detection of immunoglobulin (IgG and IgM), and all subjects were submitted to history taking through a questionnaire including personal data, risk factors for Toxoplasma, complaint and history of the present illness. Thirty-eight samples, including 18 IgM +ve and 20 IgM-ve cases were further investigated by the avidity and IgE ELISA tests. The seroprevalence of toxoplasmosis in pregnant women was (42.8%) based on the presence of IgG antibodies in their sera. Contact with cats and consumption of raw or undercooked meat are important risk factors that were associated with toxoplasmosis in pregnant women. By serology, it could be observed that in the IgM +ve group, only one case (5.6%) showed an acute pattern by using the avidity test, though 10 (55.6%) cases were found to be acute by the IgE assay. On the other hand, in the IgM –ve group, 3 (15%) showed low avidity, but none of them was positive by using the IgE assay. In conclusion, there is no single serological test that can be used to confirm whether T. gondii infection is recent or was acquired in the distant past. A panel of tests for detection of toxoplasmosis will certainly have higher discriminatory power than any test alone.

Keywords: diagnosis, serology, seroprevalence, toxoplasmosis

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648 Botulinum Toxin a in the Treatment of Late Facial Nerve Palsy Complications

Authors: Akulov M. A., Orlova O. R., Zaharov V. O., Tomskij A. A.

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Introduction: One of the common postoperative complications of posterior cranial fossa (PCF) and cerebello-pontine angle tumor treatment is a facial nerve palsy, which leads to multiple and resistant to treatment impairments of mimic muscles structure and functions. After 4-6 months after facial nerve palsy with insufficient therapeutic intervention patients develop a postparalythic syndrome, which includes such symptoms as mimic muscle insufficiency, mimic muscle contractures, synkinesis and spontaneous muscular twitching. A novel method of treatment is the use of a recent local neuromuscular blocking agent– botulinum toxin A (BTA). Experience of BTA treatment enables an assumption that it can be successfully used in late facial nerve palsy complications to significantly increase quality of life of patients. Study aim. To evaluate the efficacy of botulinum toxin A (BTA) (Xeomin) treatment in patients with late facial nerve palsy complications. Patients and Methods: 31 patients aged 27-59 years 6 months after facial nerve palsy development were evaluated. All patients received conventional treatment, including massage, movement therapy etc. Facial nerve palsy developed after acoustic nerve tumor resection in 23 (74,2%) patients, petroclival meningioma resection – in 8 (25,8%) patients. The first group included 17 (54,8%) patients, receiving BT-therapy; the second group – 14 (45,2%) patients continuing conventional treatment. BT-injections were performed in synkinesis or contracture points 1-2 U on injured site and 2-4 U on healthy side (for symmetry). Facial nerve function was evaluated on 2 and 4 months of therapy according to House-Brackman scale. Pain syndrome alleviation was assessed on VAS. Results: At baseline all patients in the first and second groups demonstrated аpostparalytic syndrome. We observed a significant improvement in patients receiving BTA after only one month of treatment. Mean VAS score at baseline was 80,4±18,7 and 77,9±18,2 in the first and second group, respectively. In the first group after one month of treatment we observed a significant decrease of pain syndrome – mean VAS score was 44,7±10,2 (р<0,01), whereas in the second group VAS score was as high as 61,8±9,4 points (p>0,05). By the 3d month of treatment pain syndrome intensity continued to decrease in both groups, but, the first group demonstrated significantly better results; mean score was 8,2±3,1 and 31,8±4,6 in the first and second group, respectively (р<0,01). Total House-Brackman score at baseline was 3,67±0,16 in the first group and 3,74±0,19 in the second group. Treatment resulted in a significant symptom improvement in the first group, with no improvement in the second group. After 4 months of treatment House-Brockman score in the first group was 3,1-fold lower, than in the second group (р<0,05). Conclusion: Botulinum toxin injections decrease postparalytic syndrome symptoms in patients with facial nerve palsy.

Keywords: botulinum toxin, facial nerve palsy, postparalytic syndrome, synkinesis

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647 Internet-Delivered Cognitive Behaviour Therapy for Depression Comorbid with Diabetes: Preliminary Findings

Authors: Lisa Robins, Jill Newby, Kay Wilhelm, Therese Fletcher, Jessica Smith, Trevor Ma, Adam Finch, Lesley Campbell, Jerry Greenfield, Gavin Andrews

Abstract:

Background:Depression treatment for people living with depression comorbid with diabetes is of critical importance for improving quality of life and diabetes self-management, however depression remains under-recognised and under-treated in this population. Cost—effective and accessible forms of depression treatment that can enhance the delivery of mental health services in routine diabetes care are needed. Provision of internet-delivered Cognitive Behaviour Therapy (iCBT) provides a promising way to deliver effective depression treatment to people with diabetes. Aims:To explore the outcomes of the clinician assisted iCBT program for people with comorbid Major Depressive Disorder (MDD) and diabetes compared to those who remain under usual care. The main hypotheses are that: (1) Participants in the treatment group would show a significant improvement on disorder specific measures (Patient Health Questionnaire; PHQ-9) relative to those in the control group; (2) Participants in the treatment group will show a decrease in diabetes-related distress relative to those in the control group. This study will also examine: (1) the effect of iCBT for MDD on disability (as measured by the SF-12 and SDS), general distress (as measured by the K10), (2) the feasibility of these treatments in terms of acceptability to diabetes patients and practicality for clinicians (as measured by the Credibility/Expectancy Questionnaire; CEQ). We hypothesise that associated disability, and general distress will reduce, and that patients with comorbid MDD and diabetes will rate the program as acceptable. Method:Recruit 100 people with MDD comorbid with diabetes (either Type 1 or Type 2), and randomly allocate to: iCBT (over 10 weeks) or treatment as usual (TAU) for 10 weeks, then iCBT. Measure pre- and post-intervention MDD severity, anxiety, diabetes-related distress, distress, disability, HbA1c, lifestyle, adherence, satisfaction with clinicians input and the treatment. Results:Preliminary results comparing MDD symptom levels, anxiety, diabetes-specific distress, distress, disability, HbA1c levels, and lifestyle factors from baseline to conclusion of treatment will be presented, as well as data on adherence to the lessons, homework downloads, satisfaction with the clinician's input and satisfaction with the mode of treatment generally.

Keywords: cognitive behaviour therapy, depression, diabetes, internet

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646 Evaluation of Prevalence of the Types of Thyroid Disorders Using Ultrasound and Pathology of One-Humped Camel in Iran: Camelus dromedarius

Authors: M. Yadegari

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The thyroid gland is the largest classic endocrine organ that effects many organs of the body and plays a significant role in the process of Metabolism in animals. The aim of this study was to investigate the prevalence of thyroid disorders diagnosed by ultrasound and microscopic Lesions of the thyroid during the slaughter of apparently healthy One Humped Camels (Camelus dromedarius) in Iran. Randomly, 520 male camels (With an age range of 4 to 8 years), were studied in 2012 to 2013. The Camels’ thyroid glands were evaluated by sonographic examination. In both longitudinal and transverse view and then tissue sections were provide and stained with H & E and finally examined by light microscopy. The results obtained indicated the following: hyperplastic goiter (21%), degenerative changes (12%), follicular cysts (8%), follicular atrophy (4%), nodular hyperplasia (3%), adenoma (1%), carcinoma (1%) and simple goiter colloid (1%). Ultrasound evaluation of thyroid gland in adenoma and carcinoma showed enlargement and irregular of the gland, decreased echogenicity, and the heterogeneous thyroid parenchyma. Also, in follicular cysts were observed in the enlarged gland with no echo structures of different sizes and decreased echogenicity as a local or general. In nodular hyperplasia, increase echogenicity and heterogeneous parenchymal were seen. These findings suggest the use of Ultrasound as a screening test in the diagnosis of complications of thyroid disorders. Pathology also to be used for the diagnosis of thyroid problems and other side effects.

Keywords: thyroid gland, one humped camel, sonography, pathology

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645 Tunable Optoelectronic Properties of WS₂ by Local Strain Engineering and Folding

Authors: Ahmed Raza Khan

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Local-strain engineering is an exciting approach to tune the optoelectronic properties of materials and enhance the performance of devices. Two dimensional (2D) materials such as 2D transition metal dichalcogenides (TMDCs) are particularly well-suited for this purpose because they have high flexibility and can withstand high deformations before rupture. Wrinkles on thick TMDC layers have been reported to show the interesting photoluminescence enhancement due to bandgap modulation and funneling effect. However, the wrinkles in ultrathin TMDCs have not been investigated, because the wrinkles can easily fall down to form folds in these ultrathin layers of TMDCs. Here, we have achieved both wrinkle and fold nano-structures simultaneously on 1-3L WS₂ using a new fabrication technique. The comparable layer dependent reduction in surface potential is observed for both folded layers and corresponding perfect pack layers due to the dominant interlayer screening effect. The strains produced from the wrinkle nanostructures considerably vary semi conductive junction properties. Thermo-ionic modelling suggests that the strained (1.6%) wrinkles can lower the Schottky barrier height (SBH) by 20%. The photo-generated carriers would further significantly lower the SBH. These results present an important advance towards controlling the optoelectronic properties of atomically thin WS₂ using strain engineering, with important implications for practical device applications.

Keywords: strain engineering, folding, WS₂, Kelvin probe force microscopy, KPFM, surface potential, photo current, layer dependence

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644 Smart Energy Consumers: An Empirical Investigation on the Intention to Adopt Innovative Consumption Behaviour

Authors: Cecilia Perri, Vincenzo Corvello

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The aim of the present study is to investigate consumers' determinants of intention toward the adoption of Smart Grid solutions and technologies. Ajzen's Theory of Planned Behaviour (TPB) model is applied and tested to explain the formation of such adoption intention. An exogenous variable, taking into account the resistance to change of individuals, was added to the basic model. The elicitation study allowed obtaining salient modal beliefs, which were used, with the support of literature, to design the questionnaire. After the screening phase, data collected from the main survey were analysed for evaluating measurement model's reliability and validity. Consistent with the theory, the results of structural equation analysis revealed that attitude, subjective norm, and perceived behavioural control positively, which affected the adoption intention. Specifically, the variable with the highest estimate loading factor was found to be the perceived behavioural control, and, the most important belief related to each construct was determined (e.g., energy saving was observed to be the most significant belief linked with attitude). Further investigation indicated that the added exogenous variable has a negative influence on intention; this finding confirmed partially the hypothesis, since this influence was indirect: such relationship was mediated by attitude. Implications and suggestions for future research are discussed.

Keywords: adoption of innovation, consumers behaviour, energy management, smart grid, theory of planned behaviour

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643 Clinical Impact of Delirium and Antipsychotic Therapy: 10-Year Experience from a Referral Coronary Care Unit

Authors: Niyada Naksuk, Thoetchai Peeraphatdit, Vitaly Herasevich, Peter A. Brady, Suraj Kapa, Samuel J. Asirvatham

Abstract:

Introduction: Little is known about the safety of antipsychotic therapy for delirium in the coronary care unit (CCU). Our aim was to examine the effect of delirium and antipsychotic therapy among CCU patients. Methods: Pre-study Confusion Assessment Method-Intensive Care Unit (CAM–ICU) criteria were implemented in screening consecutive patients admitted to Mayo Clinic, Rochester, the USA from 2004 through 2013. Death status was prospectively ascertained. Results: Of 11,079 study patients, the incidence of delirium was 8.3% (n=925). Delirium was associated with an increased risk of in-hospital mortality (adjusted OR 1.49; 95% CI, 1.08-2.08; P=.02) and one-year mortality among patients who survived from CCU admission (adjusted HR 1.46; 95% CI, 1.12-1.87; P=.005). A total of 792 doses of haloperidol (5 IQR [3-10] mg/day) or quetiapine (25 IQR [13-50] mg/day) were given to 244 patients with delirium. The clinical characteristics of patients with delirium who did and did not receive antipsychotic therapy were not different (baseline corrected QT [QTc] interval 460±61 ms vs. 457±58 ms, respectively; P = 0.57). In comparison to baseline, mean QTc intervals after the first and third doses of the antipsychotics were not significantly prolonged in haloperidol (448±56, 458±57, and 450±50 ms, respectively) or quetiapine groups (459±54, 467±68, and 462±46 ms, respectively) (P > 0.05 for all). Additionally, in-hospital mortality (adjusted OR 0.67; 95% CI, 0.42-1.04; P=.07), ventricular arrhythmia (adjusted OR 0.87; 95% CI, 0.17-3.62; P=.85) and one-year mortality among the hospital survivors (adjusted HR 0.86; 95% CI 0.62-1.17; P = 0.34) were not different in patients with delirium irrespective of whether or not they received antipsychotics. Conclusions: In patients admitted to the CCU, delirium was associated with an increase in both in-hospital and one-year mortality. Low doses of haloperidol and quetiapine appeared to be safe, without an increase in risk of sudden cardiac death, in-hospital mortality, or one-year mortality in carefully monitored patients.

Keywords: arrhythmias, haloperidol, mortality, qtc interval, quetiapine

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642 Physiological Regulation of Lignin-Modifying Enzymes Synthesis by Selected Basidiomycetes

Authors: Ana Tsokilauri

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The uppermost factor in the regulation of lignin-cellulose activity of decaying white rot or free rot are the substances serving as carbon and nitrogen nutrition of microorganisms and are considered as the most important factor of generative activity of white rot. The research object was Basidiomycete Fungi, peculiar and common in Georgia, and the separation of 10 of them as pure crops. The unidentified pure crops have tasted in order to be determined the potential of synthesis of lignin-degrading enzymes and the substrate of optimal lignocellulose growth. One of the most important aspects of the research conducted on Basidiomycetes was the use of specific lignocellulosic residues for selecting Fungi as a substrate of their growth. In order to increase lignocellulose with the help of substrate, crops were selected from the screening stage that showed good laccase activity. (Dusheti 1; Dusheti 10; Fshavi 5; Fshavi1; Fshavi 8; Fshavi 32; Manglisi 26; Sabaduri20; Dusheti 7; Sabaduri 1 ), Among the selected cultures, the crops with good laccase activity against the following substances, in particular: Dusheti 1- in this case, the rate of enzymatic activity on bran substrate was -105,6 u/ml, mandarin-96,4 u/ml. In case of corn - 102,9 u/ml. In case of Dusheti 7- the indicators were as follows: bananas-121,7 u/ml, mandarin-125,4 u/ml, corn - 117,1 u/ml. In the case of Sanaduri 32, the laccase activity was as follows: pomegranate- 101,2 u/ml. As a result of conducted experiments, the synthesis and activity rates of enzymes depending on plant substrates varied within a fairly wide range, which is still being under research.

Keywords: Lignocellulosic substrate, Basidiomycetes, white-rot basidiomycetes, Laccase

Procedia PDF Downloads 180
641 Electromagnetic Radiation Generation by Two-Color Sinusoidal Laser Pulses Propagating in Plasma

Authors: Nirmal Kumar Verma, Pallavi Jha

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Generation of the electromagnetic radiation oscillating at the frequencies in the terahertz range by propagation of two-color laser pulses in plasma is an active area of research due to its potential applications in various areas, including security screening, material characterization, and spectroscopic techniques. Due to nonionizing nature and the ability to penetrate several millimeters, THz radiation is suitable for diagnosis of cancerous cells. Traditional THz emitters like optically active crystals, when irradiated with high power laser radiation, are subject to material breakdown and hence low conversion efficiencies. This problem is not encountered in laser-plasma based THz radiation sources. The present paper is devoted to the study of the enhanced electromagnetic radiation generation by propagation of two-color, linearly polarized laser pulses through the magnetized plasma. The two lasers pulse orthogonally polarized are co-propagating along the same direction. The direction of the external magnetic field is such that one of the two laser pulses propagates in the ordinary mode, while the other pulse propagates in the extraordinary mode through the homogeneous plasma. A transverse electromagnetic wave with frequency in the THz range is generated due to the presence of the static magnetic field. It is observed that larger amplitude terahertz can be generated by mixing of ordinary and extraordinary modes of two-color laser pulses as compared with a single laser pulse propagating in the extraordinary mode.

Keywords: two-color laser pulses, electromagnetic radiation, magnetized plasma, ordinary and extraordinary modes

Procedia PDF Downloads 269