Search results for: treatment plant
2237 Impact of the Achyranthes aspera (Amaranthaceae) Extracts on the Survival and Histological Architecture of the Midgut Epithelial Tissue of Early Fourth Instars of Aedes aegypti (Diptera: Culicidae)
Authors: Aarti Sharma, Sarita Kumar, Pushplata Tripathi
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Aedes aegypti L. is one of the most important insect vectors in the world transmitting several diseases of concern; dengue fever, dengue haemorrhagic fever and yellow fever. Though since ages the control of dengue vector is primarily relied upon the use of synthetic chemical insecticides, the continued and indiscriminate use of insecticides for their control has received wide public apprehension because of multifarious problems including insecticide resistance, resurgence of pest species, environmental pollution, toxic hazards to humans and non-target organisms. These problems have necessitated the need to explore and develop alternative strategies using eco-friendly and bio-degradable plant products. Bio-insecticides, despite being the focus of research nowadays, have not been investigated much regarding their physiological effects on the mosquitoes. Thus, the present studies were carried out to investigate the anti-mosquito potential of the leaf and stem hexane extracts of Achyranthes aspera against early fourth instars of Aedes aegypti L and their effects on the histological architecture of their midgut. The larvicidal bioassays conducted with the A. aspera leaf hexane extracts revealed the respective LC30, LC50 and LC90 values of 66.545 ppm, 82.555 ppm, 139.817 ppm while the assays with stem hexane extracts resulted in respective values of 54.982 ppm, 68.133 ppm, 115.075 ppm. The studies clearly indicate the efficacy of extracts as larvicidal agents against Ae. aegypti, the stem extracts being found more effective than the leaf extracts. When the larvae assayed with extracts were investigated for the modifications in the histo-architecture of the midgut, the studies showed significant damage, shrinkage, distortion and vacuolization of gut tissues and peritrophic membrane causing disintegration of epithelial cells and cytoplasmic organelles; extent of toxicity and damage varied depending upon the concentration and exposure time period. These changes revealed appreciable stomach poison potential of A. aspera extracts against Ae. aegypti larvae, which may have also caused adverse impact on the growth and development of larvae. These effects were also found to be more pronounced with the stem extract than the leaf extract. Our findings may prove significant suggesting the use of A. aspera extract as a bio-insecticide against early fourth instar larvae of Ae. aegypti. Further studies are needed to identify the bioactive component in the extracts and to ascertain the use of component in the fields as anti-mosquito control agent.Keywords: Achyranthes aspera, Aedes aegypti, histological architecture, larvicidal, midgut, stomach poison
Procedia PDF Downloads 2982236 Endoscopic Ultrasound-Guided Choledochoduodenostomy in an Advanced Extrahepatic Cholangiocarcinoma
Authors: Diego Carrasco, Catarina Freitas, Hugo Rio Tinto, Ricardo Rio Tinto, Nuno Couto, Joaquim Gago, Carlos Carvalho
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Introduction: Endoscopic ultrasound-guided choledochoduodenostomy (EUS-CD) to drain the gallbladder can be a palliative care procedure for non-surgical oncologic patients with cholelithiasis and cholangitis process. Case description: A 59-years old Caucasian male diagnosed with extrahepatic cholangiocarcinoma with multiple liver, lung and peritoneum metastasis, unresponsive to treatment with gemcitabine/cisplatin, presented in the institution with fever, hypotension, and severe upper right abdominal pain secondary to cholelithiasis and cholangitis process. The patient was admitted and started on large spectrum antibiotics plus fluid-challenge. Afterward, a percutaneous transhepatic biliary drainage (PTBD) was performed to drain the gallbladder. This procedure temporarily stabilized the patient. However, the definitive solution required gallbladder removal. Since the patient exhibited an advanced oncologic disease and poor response to the chemotherapy, he was not a candidate for surgical intervention. Diagnostic Pathways: A self-expanding metal stent was placed from the duodenum into the bile duct by endoscopic ultrasound-guided. The stent allowed efficient drainage of the contrast from the gallbladder at the end of the endoscopic procedure. Conclusion and Discussion: The stent allowed efficient drainage of the contrast from the gallbladder at the end of the endoscopic procedure and successfully reversed the cholangitis process. EUS-CD is an effective and safe technique and can be used as a palliative care procedure for non-surgical oncologic patients.Keywords: palliative care, cholangiocarcinoma, choledochoduodenostomy, endoscopic ultrasound-guided
Procedia PDF Downloads 1852235 Survey of the Effect of the Probiotic Bacterium Lactobacillus plantarum and Streptococcus mutans on Casp3, AKT/PTEN, and MAPK Signaling Pathways at Co-Culture with KB Oral Cancer Cell Line and HUVEC Cells
Authors: Negar Zaheddoust, Negin Zaheddoust, Abbas Asoudeh-Fard
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Probiotic bacteria have been employed as a novel and less side-effect strategy for anticancer therapy. Since the oral cavity is a host for probiotic and pathogen bacteria to colonize, more investigation is needed to evaluate the effectiveness of this novel adjunctive treatment for oral cancer. We considered Lactobacillus plantarum as a probiotic and Streptococcus mutans as a pathogen bacterium in our study. The aim of this study is to examine the effect of Lactobacillus plantarum and Streptococcus mutans on Casp3, AKT / PTEN, and MAPK signaling pathway, which is involved in apoptosis or survival of oral cancer KB cells. On the other hand, to study the effects of these bacteria on normal cells, we used HUVEC cells. The KB and HUVEC cell lines were co-cultured with Lactobacillus plantarum and Streptococcus mutans isolated from traditional Iranian dairy and dental plaque, respectively. The growth-inhibitory effects of these two bacteria on KB and HUVEC cells were determined by (3-(4, 5-dimethylthiazolyl-2)-2,5diphenyltetrazolium bromide) MTT assay. MTT results demonstrated that the proliferation of KB cells was affected in a time, dose, and strain-dependent manner. In the following, the examination of induced apoptosis or necrosis in co-cultured KB cells with the best IC50 concentration of the Lactobacillus plantarum and Streptococcus mutans will be analyzed by FACS flow cytometry, and the changes in gene expression of Casp3, AKT / PTEN, MAPK genes will be evaluated using real-time polymerase chain reaction.Keywords: cancer therapy, induced apoptosis, oral cancer, probiotics
Procedia PDF Downloads 2482234 Investigating the Feasibility of Berry Production in Central Oregon under Protected and Unprotected Culture
Authors: Clare S. Sullivan
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The high desert of central Oregon, USA is a challenging growing environment: short growing season (70-100 days); average annual precipitation of 280 mm; drastic swings in diurnal temperatures; possibility of frost any time of year; and sandy soils low in organic matter. Despite strong demand, there is almost no fruit grown in central Oregon due to potential yield loss caused by early and late frosts. Elsewhere in the USA, protected culture (i.e., high tunnels) has been used to extend fruit production seasons and improve yields. In central Oregon, high tunnels are used to grow multiple high-value vegetable crops, and farmers are unlikely to plant a perennial crop in a high tunnel unless proven profitable. In May 2019, two berry trials were established on a farm in Alfalfa, OR, to evaluate raspberry and strawberry yield, season length, and fruit quality in protected (high tunnels) vs. unprotected culture (open field). The main objective was to determine whether high tunnel berry production is a viable enterprise for the region. Each trial was arranged using a split-plot design. The main factor was the production system (high tunnel vs. open field), and the replicated, subplot factor was berry variety. Four day-neutral strawberry varieties and four primocane-bearing raspberry varieties were planted for the study and were managed using organic practices. Berries were harvested once a week early in the season, and twice a week as production increased. Harvested berries were separated into ‘marketable’ and ‘unmarketable’ in order to calculate percent cull. First-year results revealed berry yield and quality differences between varieties and production systems. Strawberry marketable yield and berry fruit size increased significantly in the high tunnel compared to the field; percent yield increase ranged from 7-46% by variety. Evie 2 was the highest yielding strawberry, although berry quality was lower than other berries. Raspberry marketable yield and berry fruit size tended to increase in the high tunnel compared to the field, although variety had a more significant effect. Joan J was the highest yielding raspberry and out-yielded the other varieties by 250% outdoor and 350% indoor. Overall, strawberry and raspberry yields tended to improve in high tunnels as compared to the field, but data from a second year will help determine whether high tunnel investment is worthwhile. It is expected that the production system will have more of an effect on berry yield and season length for second-year plants in 2020.Keywords: berries, high tunnel, local food, organic
Procedia PDF Downloads 1182233 Hybrid Recovery of Copper and Silver from Photovoltaic Ribbon and Ag finger of End-Of-Life Solar Panels
Authors: T. Patcharawit, C. Kansomket, N. Wongnaree, W. Kritsrikan, T. Yingnakorn, S. Khumkoa
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Recovery of pure copper and silver from end-of-life photovoltaic panels was investigated in this paper using an effective hybrid pyro-hydrometallurgical process. In the first step of waste treatment, solar panel waste was first dismantled to obtain a PV sheet to be cut and calcined at 500°C, to separate out PV ribbon from glass cullet, ash, and volatile while the silicon wafer containing silver finger was collected for recovery. In the second step of metal recovery, copper recovery from photovoltaic ribbon was via 1-3 M HCl leaching with SnCl₂ and H₂O₂ additions in order to remove the tin-lead coating on the ribbon. The leached copper band was cleaned and subsequently melted as an anode for the next step of electrorefining. Stainless steel was set as the cathode with CuSO₄ as an electrolyte, and at a potential of 0.2 V, high purity copper of 99.93% was obtained at 96.11% recovery after 24 hours. For silver recovery, the silicon wafer containing silver finger was leached using HNO₃ at 1-4 M in an ultrasonic bath. In the next step of precipitation, silver chloride was then obtained and subsequently reduced by sucrose and NaOH to give silver powder prior to oxy-acetylene melting to finally obtain pure silver metal. The integrated recycling process is considered to be economical, providing effective recovery of high purity metals such as copper and silver while other materials such as aluminum, copper wire, glass cullet can also be recovered to be reused commercially. Compounds such as PbCl₂ and SnO₂ obtained can also be recovered to enter the market.Keywords: electrorefining, leaching, calcination, PV ribbon, silver finger, solar panel
Procedia PDF Downloads 1352232 Impact of Lobular Carcinoma in situ on Local Recurrence in Breast Cancer Treated with Breast Conservation Therapy: A Systematic Review and Meta-Analysis
Authors: Christopher G. Harris, Guy D. Eslick
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Purpose: Lobular carcinoma in situ (LCIS) is a known risk factor for breast cancer of unclear significance when detected in association with invasive carcinoma. This meta-analysis aims to determine the impact of LCIS on local recurrence risk for individuals with breast cancer treated with breast conservation therapy to help guide appropriate treatment strategies. Methods: We identified relevant studies from five electronic databases. Studies were deemed suitable for inclusion where they compared patients with invasive breast cancer and concurrent LCIS to those with breast cancer alone, all patients underwent breast conservation therapy (lumpectomy with adjuvant radiation therapy), and local recurrence was evaluated. Recurrence data were pooled by use of a random effects model. Results: From 1488 citations screened by our search, 8 studies were deemed suitable for inclusion. These studies comprised of 908 cases and 10638 controls. Median follow-up time was 90 months. There was a significantly increased overall risk of local breast cancer recurrence for individuals with LCIS in association with breast cancer following breast conservation therapy [pOR 1.87; 95% CI 1.14-3.04; p = 0.012]. The risk of local recurrence was non-significantly increased at 5 [pOR 1.09; 95% CI 0.48-2.48; p = 0.828] and 10 years [pOR 1.90; 95% CI 0.89-4.06; p = 0.096]. Conclusions: Individuals with LCIS in association with invasive breast cancer have an increased risk of local recurrence following breast conservation therapy. This supports consideration of aggressive local control of LCIS by way of completion mastectomy or re-excision for certain high-risk patients.Keywords: breast cancer, breast conservation therapy, lobular carcinoma in situ, lobular neoplasia, local recurrence, meta-analysis
Procedia PDF Downloads 1602231 Chemical Composition and Antioxidant Activity of Fresh Chokeberries
Authors: Vesna Tumbas Šaponjac, Sonja Djilas, Jasna Čanadanović-Brunet, Gordana Ćetković, Jelena Vulić, Slađana Stajčić, Milica Vinčić
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Substantial interest has been expressed in fruits and berries due to their potential favourable health effects and high content of polyphenols, especially flavonoids and anthocyanins. Chokeberries (Aronia melanocarpa) are dark berries, similar to blackcurrants, that have been used by native Americans both as a food resource and in traditional medicine for treatment of cold. Epidemiological studies revealed positive effects of chokeberries on colorectal cancer, cardiovascular diseases, and various inflammatory conditions. Chokeberries are well known as good natural antioxidants, which contain phenolic compounds, flavonoids, anthocyanidins and antioxidant vitamins. The aim of this study was to provide information on polyphenolic compounds present in fresh chokeberries as well as to determine its antioxidant activity. Individual polyphenolic compounds have been identified and quantified using HPLC/UV-Vis. Results showed that the most dominant phenolic acid was protocatechuic acid (274.23 mg/100 g FW), flavonoid rutin (319.66 mg/100 g FW) and anthocyanin cyanidin-3-galactoside (1532.68 mg/100 g FW). Generally, anthocyanins were predominant compounds in fresh chokeberry (2342.82 mg/100 g FW). Four anthocyanins have been identified in fresh chokeberry and all of them were cyanidin glicosides. Antioxidant activity was determined using spectrophotometric DPPH assay and compared to standard antioxidant compound vitamin C. The resulting EC50 value (amount of fresh chokeberries that scavenge 50% of DPPH radicals) is 0.33 mg vitamin C equivalent/100 g FW. The results of this investigation provide evidence on high contents of phenolic compounds, especially anthocyanins, in chokeberries as well as high antioxidant activity of this fruit.Keywords: chokeberry, polyphenols, antioxidant, DPPH radicals
Procedia PDF Downloads 5732230 Research on Strategies of Building a Child Friendly City in Wuhan
Authors: Tianyue Wan
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Building a child-friendly city (CFC) contributes to improving the quality of urbanization. It also forms a local system committed to fulfilling children's rights and development. Yet, the work related to CFC is still at the initial stage in China. Therefore, taking Wuhan, the most populous city in central China, as the pilot city would offer some reference for other cities. Based on the analysis of theories and practice examples, this study puts forward the challenges of building a child-friendly city under the particularity of China's national conditions. To handle these challenges, this study uses four methods to collect status data: literature research, site observation, research inquiry, and semantic differential (SD). And it adopts three data analysis methods: case analysis, geographic information system (GIS) analysis, and analytic hierarchy process (AHP) method. Through data analysis, this study identifies the evaluation system and appraises the current situation of Wuhan. According to the status of Wuhan's child-friendly city, this study proposes three strategies: 1) construct the evaluation system; 2) establish a child-friendly space system integrating 'point-line-surface'; 3) build a digitalized service platform. At the same time, this study suggests building a long-term mechanism for children's participation and multi-subject supervision from laws, medical treatment, education, safety protection, social welfare, and other aspects. Finally, some conclusions of strategies about CFC are tried to be drawn to promote the highest quality of life for all citizens in Wuhan.Keywords: action plan, child friendly city, construction strategy, urban space
Procedia PDF Downloads 922229 Hybrid-Nanoengineering™: A New Platform for Nanomedicine
Authors: Mewa Singh
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Nanomedicine, a fusion of nanotechnology and medicine, is an emerging technology ideally suited to the targeted therapies. Nanoparticles overcome the low selectivity of anti-cancer drugs toward the tumor as compared to normal tissue and hence result-in less severe side-effects. Our new technology, HYBRID-NANOENGINEERING™, uses a new molecule (MR007) in the creation of nanoparticles that not only helps in nanonizing the medicine but also provides synergy to the medicine. The simplified manufacturing process will result in reduced manufacturing costs. Treatment is made more convenient because hybrid nanomedicines can be produced in oral, injectable or transdermal formulations. The manufacturing process uses no protein, oil or detergents. The particle size is below 180 nm with a narrow distribution of size. Importantly, these properties confer great stability of the structure. The formulation does not aggregate in plasma and is stable over a wide range of pH. The final hybrid formulation is stable for at least 18 months as a powder. More than 97 drugs, including paclitaxel, docetaxel, tamoxifen, doxorubicinm prednisone, and artemisinin have been nanonized in water soluble formulations. Preclinical studies on cell cultures of tumors show promising results. Our HYBRID-NANOENGINEERING™ platform enables the design and development of hybrid nano-pharmaceuticals that combine efficacy with tolerability, giving patients hope for both extended overall survival and improved quality of life. This study would discuss or present this new discovery of HYBRID-NANOENGINEERING™ which targets drug delivery, synergistic, and potentiating effects, and barriers of drug delivery and advanced drug delivery systems.Keywords: nano-medicine, nano-particles, drug delivery system, pharmaceuticals
Procedia PDF Downloads 4862228 hsa-miR-1204 and hsa-miR-639 Prominent Role in Tamoxifen's Molecular Mechanisms on the EMT Phenomenon in Breast Cancer Patients
Authors: Mahsa Taghavi
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In the treatment of breast cancer, tamoxifen is a regularly prescribed medication. The effect of tamoxifen on breast cancer patients' EMT pathways was studied. In this study to see if it had any effect on the cancer cells' resistance to tamoxifen and to look for specific miRNAs associated with EMT. In this work, we used continuous and integrated bioinformatics analysis to choose the optimal GEO datasets. Once we had sorted the gene expression profile, we looked at the mechanism of signaling, the ontology of genes, and the protein interaction of each gene. In the end, we used the GEPIA database to confirm the candidate genes. after that, I investigated critical miRNAs related to candidate genes. There were two gene expression profiles that were categorized into two distinct groups. Using the expression profile of genes that were lowered in the EMT pathway, the first group was examined. The second group represented the polar opposite of the first. A total of 253 genes from the first group and 302 genes from the second group were found to be common. Several genes in the first category were linked to cell death, focal adhesion, and cellular aging. Two genes in the second group were linked to cell death, focal adhesion, and cellular aging. distinct cell cycle stages were observed. Finally, proteins such as MYLK, SOCS3, and STAT5B from the first group and BIRC5, PLK1, and RAPGAP1 from the second group were selected as potential candidates linked to tamoxifen's influence on the EMT pathway. hsa-miR-1204 and hsa-miR-639 have a very close relationship with the candidates genes according to the node degrees and betweenness index. With this, the action of tamoxifen on the EMT pathway was better understood. It's important to learn more about how tamoxifen's target genes and proteins work so that we can better understand the drug.Keywords: tamoxifen, breast cancer, bioinformatics analysis, EMT, miRNAs
Procedia PDF Downloads 1292227 Audit on Compliance with Ottawa Ankle Rules in Ankle Radiograph Requests
Authors: Daud Muhammad
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Introduction: Ankle radiographs are frequently requested in Emergency Departments (ED) for patients presenting with traumatic ankle pain. The Ottawa Ankle Rules (OAR) serve as a clinical guideline to determine the necessity of these radiographs, aiming to reduce unnecessary imaging. This audit was conducted to evaluate the adequacy of clinical information provided in radiograph requests in relation to the OAR. Methods: A retrospective analysis was performed on 50 consecutive ankle radiograph requests under ED clinicians' names for patients aged above 5 years, specifically excluding follow-up radiographs for known fractures. The study assessed whether the provided clinical information met the criteria outlined by the OAR. Results: The audit revealed that none of the 50 radiograph requests contained sufficient information to satisfy the Ottawa Ankle Rules. Furthermore, 10 out of the 50 radiographs (20%) identified fractures. Discussion: The findings indicate a significant lack of adherence to the OAR, suggesting potential overuse of radiography and unnecessary patient exposure to radiation. This non-compliance may also contribute to increased healthcare costs and resource utilization, as well as possible delays in diagnosis and treatment. Recommendations: To address these issues, the following recommendations are proposed: (1) Education and Training: Enhance awareness and training among ED clinicians regarding the OAR. (2) Standardised Request Forms: Implement changes to imaging request forms to mandate relevant information according to the OAR. (3) Scan Vetting: Promote awareness among radiographers to discuss the appropriateness of scan requests with clinicians. (4) Regular re-audits should be conducted to monitor improvements in compliance.Keywords: Ottawa ankle rules, ankle radiographs, emergency department, traumatic pain
Procedia PDF Downloads 452226 Nutritional Status of Surgical and Orthopedic Patients: 3B Ward
Authors: Jitaree Tantiyasawatdikul, Bantita Jadnok, Sarunya Tijana
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Background: Nutritional status is an important factor before, during, and after an operation. It can help wound healing. If the patients have good nutritional status before and after an operation, wound healing can occur more easily. It can strengthen the immune system leading to decreased infection, reduced length of stay, and reducing the cost to patients and caregivers. Therefore, screening to evaluate the nutritional status of patients in 3B becomes the database for further developing the treatment and also will lead to excellent service from the interdisciplinary team. Objective: To study the nutritional status of patients in surgical ward 3B at Surgical and Orthopedics Nursing Division, Srinagarind Hospital. Method: A descriptive study, to evaluate the nutritional status of 86 patients admitted in 3B between October 2014 and March 2015.The instruments used in this study consisted of two parts: 1) personal data, 2) Screening nutritional status. The data were analyzed by percentage and mean. Results: A sample population of 86 patients aged 22-81 years old, mean age 52.59years, 90.69% are married, female were 55.81%, regular diet 70.93%, patients with no problem oral cavity was 87.21%.The sample population had high incidence of CA 47.67% and secondly cardiovascular disease 36.05 %. Patients with high-risk nutrition was 12.79 % including 45.45% cardiovascular disease and 36.36% CA. Screening of nutritional status of high-risk nutrition was 39.36% severe triceps skinfold (TSF), severe mid-arm muscle circumference(MAMC) 9.09% and severe total lymphocyte 39.36%. Conclusion: The result of nutritional status screening of surgical ward 3B found 12.79% patients with high-risk nutrition including 45.45% with cardiovascular disease .There was no problem with oral cavity and eating.Keywords: nutritional status, screening, surgical patients, 3B ward, Srinagarind Hospital
Procedia PDF Downloads 3262225 Effect of Zingerone on High-Fructose Diet-Indeuced Metabolic Derangements in Growing Sprague-Dawley Rats
Authors: Nondumiso Lushozi, Busisani Lembede, Eliton Chivandi
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Consumption of fructose increases the risk of obesity, nonalcoholic fatty liver disease (NAFLD) and metabolic syndrome in children. Zingerone which is found in ginger has antidiabetic and antiobesogenic properties. Therefore, the aim of the study was to investigate the potential of orally administered zingerone to protect growing Sprague-Dawley rats (mimicking growing children) against high-fructose diet-induced metabolic derangements. Forty, 21-day old female Sprague-Dawley rats were randomly allocated and administered the following four treatments for 12 weeks: group I: standard rat chow (SR) + plain water (PW) + plain gelatine cube (PC). group II: SR + 20% (w/v) fructose solution (FS) + PC. group III: SR + FS + 100 mg/kg/day of fenofibrate in gelatine cube. group IV: SR+ FS + 20 mg/kg/day of zingerone in gelatine cube. The rats’ triglyceride, cholesterol, insulin & adiponectin concentration, visceral fat liver lipid content, homoeostasis model assessment of insulin resistance (HOMA-IR) and ability to handle glucose were determined. Oral administration of zingerone significantly increased (P<0.001) visceral fat and liver lipid content (P<0.001), respectively. Results from the study revealed that administration of 20% fructose solution did not induce metabolic dysfunction, however the zingerone treatment increased visceral fat and liver lipid content, all these lipid abnormalities are typical features of the metabolic syndrome, therefore the current study suggests that zingerone has no effect on metabolic dysfunction in adolescent females.Keywords: antidiabetic, metabolic syndrome, zingerone, antiobesogenic
Procedia PDF Downloads 1292224 Herapeutic Modalities for Anorexia Nervosa in Adolescents: A Narrative Review
Authors: Adam Al-Harbi, Chanel Powell, Katelyn Ward
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In the age of social media and online body forums, the perception of body image among teenagers is constantly evolving. Growing up in an era of instant comparison facilitated by the internet, adolescents often struggle with self-identity, comparing their lives and bodies to countless others online. This environment has made it easier for them to access information on restrictive diets and fasting, contributing to the unfortunate glamorization of eating disorders. Although beauty standards have existed for centuries, social media amplifies these pressures. Platforms such as Instagram and TikTok have created spaces where teens are constantly exposed to idealized body types and beauty standards. This exposure often leads to harmful comparisons, fostering feelings of inadequacy and negative self-worth. Research indicates that adolescents, especially young girls, are at heightened risk for developing eating disorders like anorexia nervosa as they internalize these unrealistic standards. Anorexia nervosa, which has the highest mortality rate of any psychiatric disorder, is particularly alarming, with one in five anorexia deaths resulting from suicide. Young individuals with anorexia are twelve times more likely to die than their peers without the disorder. This paper aims to summarize the current state of literature comparing cognitive-behavioral therapy (CBT) and family-based therapy (FBT) in reducing morbidity, and mortality, and preventing symptom recurrence among adolescents with anorexia. CBT is a widely used treatment for eating disorders, particularly anorexia nervosa, while FBT is notable for its involvement of family members, which is crucial for developing teens and adolescents.Keywords: psychology, CBT, FBT, eating disorders, anorexia, therapeutic modalities
Procedia PDF Downloads 192223 Structure Conduct and Performance of Rice Milling Industry in Sri Lanka
Authors: W. A. Nalaka Wijesooriya
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The increasing paddy production, stabilization of domestic rice consumption and the increasing dynamism of rice processing and domestic markets call for a rethinking of the general direction of the rice milling industry in Sri Lanka. The main purpose of the study was to explore levels of concentration in rice milling industry in Polonnaruwa and Hambanthota which are the major hubs of the country for rice milling. Concentration indices reveal that the rice milling industry in Polonnaruwa operates weak oligopsony and is highly competitive in Hambanthota. According to the actual quantity of paddy milling per day, 47 % is less than 8Mt/Day, while 34 % is 8-20 Mt/day, and the rest (19%) is greater than 20 Mt/day. In Hambanthota, nearly 50% of the mills belong to the range of 8-20 Mt/day. Lack of experience of the milling industry, poor knowledge on milling technology, lack of capital and finding an output market are the major entry barriers to the industry. Major problems faced by all the rice millers are the lack of a uniform electricity supply and low quality paddy. Many of the millers emphasized that the rice ceiling price is a constraint to produce quality rice. More than 80% of the millers in Polonnaruwa which is the major parboiling rice producing area have mechanical dryers. Nearly 22% millers have modern machineries like color sorters, water jet polishers. Major paddy purchasing method of large scale millers in Polonnaruwa is through brokers. In Hambanthota major channel is miller purchasing from paddy farmers. Millers in both districts have major rice selling markets in Colombo and suburbs. Huge variation can be observed in the amount of pledge (for paddy storage) loans. There is a strong relationship among the storage ability, credit affordability and the scale of operation of rice millers. The inter annual price fluctuation ranged 30%-35%. Analysis of market margins by using series of secondary data shows that farmers’ share on rice consumer price is stable or slightly increases in both districts. In Hambanthota a greater share goes to the farmer. Only four mills which have obtained the Good Manufacturing Practices (GMP) certification from Sri Lanka Standards Institution can be found. All those millers are small quantity rice exporters. Priority should be given for the Small and medium scale millers in distribution of storage paddy of PMB during the off season. The industry needs a proper rice grading system, and it is recommended to introduce a ceiling price based on graded rice according to the standards. Both husk and rice bran were underutilized. Encouraging investment for establishing rice oil manufacturing plant in Polonnaruwa area is highly recommended. The current taxation procedure needs to be restructured in order to ensure the sustainability of the industry.Keywords: conduct, performance, structure (SCP), rice millers
Procedia PDF Downloads 3282222 Culture of Primary Cortical Neurons on Hydrophobic Nanofibers Induces the Formation of Organoid-Like Structures
Authors: Nick Weir, Robert Stevens, Alan Hargreaves, Martin McGinnity, Chris Tinsley
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Hydrophobic materials have previously demonstrated the ability to elevate cell-cell interactions and promote the formation of neural networks whilst aligned nanofibers demonstrate the ability to induce extensive neurite outgrowth in an aligned manner. Hydrophobic materials typically elicit an immune response upon implantation and thus materials used for implantation are typically hydrophilic. Poly-L-lactic acid (PLLA) is a hydrophobic, non-immunogenic, FDA approved material that can be electrospun to form aligned nanofibers. Primary rat cortical neurons cultured for 10 days on aligned PLLA nanofibers formed 3D cell clusters, approximately 800 microns in diameter. Neurites that extended from these clusters were highly aligned due to the alignment of the nanofibers they were cultured upon and fasciculation was also evident. Plasma treatment of the PLLA nanofibers prior to seeding of cells significantly reduced the hydrophobicity and abolished the cluster formation and neurite fasciculation, whilst reducing the extent and directionality of neurite outgrowth; it is proposed that hydrophobicity induces the changes to cellular behaviors. Aligned PLLA nanofibers induced the formation of a structure that mimics the grey-white matter compartmentalization that is observed in vivo and thus represents a step forward in generating organoids or biomaterial-based implants. Upon implantation into the brain, the biomaterial architectures described here may provide a useful platform for both brain repair and brain remodeling initiatives.Keywords: hydrophobicity, nanofibers, neurite fasciculation, neurite outgrowth, PLLA
Procedia PDF Downloads 1602221 Personalized Climate Change Advertising: The Role of Augmented Reality (A.R.) Technology in Encouraging Users for Climate Change Action
Authors: Mokhlisur Rahman
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The growing consensus among scientists and world leaders indicates that immediate action should be considered regarding the climate change phenomenon. However, climate change is no more a global issue but a personal one. Thus, individual participation is necessary to address such a significant issue. Studies show that individuals who perceive climate change as a personal issue are more likely to act toward it. This abstract presents augmented reality (A.R.) technology in the social media platform Facebook video advertising. The idea involves creating a video advertisement that enables users to interact with the video by navigating its features and experiencing the result uniquely and engagingly. This advertisement uses A.R. to bring changes, such as people making changes in real-life scenarios by simple clicks on the video and hearing an instant rewarding fact about their choices. The video shows three options: room, lawn, and driveway. Users select one option and engage in interaction based on while holding the camera in their personal spaces: Suppose users select the first option, room, and hold their camera toward spots such as by the windows, balcony, corners, and even walls. In that case, the A.R. offers users different plants appropriate for those unoccupied spaces in the room. Users can change the options of the plants and see which space at their house deserves a plant that makes it more natural. When a user adds a natural element to the video, the video content explains a piece of beneficiary information about how the user contributes to the world more to be livable and why it is necessary. With the help of A.R., if users select the second option, lawn, and hold their camera toward their lawn, the options are various small trees for their lawn to make it more environmentally friendly and decorative. The video plays a beneficiary explanation here too. Suppose users select the third option, driveway, and hold their camera toward their driveway. In that case, the A.R. video option offers unique recycle bin designs using A.I. measurement of spaces. The video plays audio information on anthropogenic contribution to greenhouse gas emission. IoT embeds tracking code in the video ad on Facebook, which stores the exact number of views in the cloud for data analysis. An online survey at the end collects short qualitative answers. This study helps understand the number of users involved and willing to change their behavior; It makes personalized advertising in social media. Considering the current state of climate change, the urgency for action is increasing. This ad increases the chance to make direct connections with individuals and gives a sense of personal responsibility for climate change to actKeywords: motivations, climate, iot, personalized-advertising, action
Procedia PDF Downloads 732220 Quantitative Analysis of Orphan Nuclear Receptors in Insulin Resistant C2C12 Skeletal Muscle Cells
Authors: Masocorro Gawned, Stephen Myers, Guat Siew Chew
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Nuclear Receptors (NR) are a super family of transcription factors that play a major role in lipid and glucose metabolism in skeletal muscle. Recently, pharmacological evidence supports the view that stimulation of nuclear receptors alleviates Type 2 Diabetes (T2D). The orphan nuclear receptors (ONR) are members of the nuclear receptor (NR) superfamily whose ligands and physiological functions remain unknown. To date, no systematic studies have been carried out to screen for ONRs expressed in insulin resistant (IR) skeletal muscle cells. Therefore, in this study, we have established a model for IR by treating C2C12 skeletal muscle cells with insulin (10nM) for 48 hours. Western Blot analysis of phosphorylated AKT confirmed IR. Real-time quantitative polymerase chain reaction (qPCR) results highlighted key ONRs including NUR77 (NR4A1), NURR1 (NR4A2) and NOR1 (NR4A3) which have been associated with fatty acid oxidation regulation and glucose homeostasis. Increased mRNA expression levels of estrogen-related receptors (ERRs), REV-ERBα, NUR77, NURR1, NOR1, in insulin resistant C2C12 skeletal muscle cells, indicated that these ONRs could potentially play a pivotal regulatory role of insulin secretion in lipid metabolism. Taken together, this study has successfully contributed to the complete analysis of ONR in IR, and has filled in an important void in the study and treatment of T2D.Keywords: type 2 diabetes, orphan nuclear receptors, transcription receptors, quantitative mRNA expression
Procedia PDF Downloads 4272219 Botulism Clinical Experience and Update
Authors: Kevin Yeo, Christine Hall, Babinchak Tim
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BAT® [Botulism Antitoxin Heptavalent (A,B,C,D,E,F,G)-(Equine)] anti-toxin is a mixture of equine immune globulin fragments indicated for the treatment of symptomatic botulism in adult and pediatric patients. The effectiveness of BAT anti-toxin is based on efficacy studies conducted in animal models. A general explanation of the pivotal animal studies, post market surveillance and outcomes of an observational patient registry for patients treated with BAT product distributed in the USA is briefly discussed. Overall it took 20 animal studies for two well-designed and appropriately powered pivotal efficacy studies – one in which the effectiveness of BAT was assessed against all 7 serotypes in the guinea pig, and the other where efficacy is confirmed in the Rhesus macaque using Serotype A. Clinical Experience for BAT to date involves approximately 600 adult and pediatric patients with suspected botulism. In pre-licensure, patient data was recorded under the US CDC expanded access program (259 adult and pediatric patients between 10 days to 88 years of age). In post licensure, greater than 350 patients to date have received BAT and been followed up by enhanced expanded access program. The analysis of the post market surveillance data provided a unique opportunity to demonstrate clinical benefit in the field study required by the animal rule. While the animal rule is applied because human efficacy studies are not ethical or feasible, a post-marketing requirement is to conduct a study to evaluate safety and clinical benefit when circumstances arise and demonstrate the favourable benefit-risk profile that supported licensure.Keywords: botulism, threat, clinical benefit, observational patient registry
Procedia PDF Downloads 1792218 Moving beyond Medical Tourism: An Analysis of Intra-Regional Medical Mobility in the Global South
Authors: Tyler D. Cesarone, Tatiana M. Wugalter
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The movement of patients from the Global North to the Global South in pursuit of inexpensive healthcare and touristic experiences dominates the academic discourse on international medical travel (IMT). However, medical travel exists in higher numbers between Global South countries as patients who lack trust in, and feel disenfranchised by, their national healthcare systems seek treatment in nearby countries. Through a review of the existing literature, this paper examines patterns of IMT in the Middle East, Southeast Asia, and Southern Africa, distinguishing North-South medical tourism from South-South intra-regional medical mobility (IRMM). Evidence from these case studies demonstrates that notions of medical distrust and disenfranchisement, rooted in low-resourced and poor quality healthcare systems, are key drivers of IRMM in the Global South. The movement of patients from lower income to proximate higher income countries not only reveals tensions between patients and their healthcare systems but widens gaps in the quality of healthcare between departing and destination countries. In analyzing these cross-regional similarities, the paper moves beyond the current literature’s focus on singular case studies to expose global patterns of South-South IRMM. This presents a shift from the traditional focus on North-South medical tourism, demonstrating how disparities in healthcare systems both influence and are influenced by IRMM.Keywords: global South, healthcare quality, international medical travel (IMT), intra-regional medical mobility (IRMM), medical disenfranchisement, medical distrust, medical tourism
Procedia PDF Downloads 3992217 Mesenteric Vasculitis Causing Perforated Diverticulitis Mimicking Abdominal Sepsis
Authors: Christopher Leung, Assad Zahid
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Mesenteric vasculitis can often mimic abdominal sepsis in a postoperative setting leading to a predicament where steroids could improve mesenteric vasculitis whilst worsening abdominal sepsis. Here this study presents a unique and rare case of perforated sigmoid diverticulitis secondary to systemic vasculitis. A 68-year-old gentleman presented with perforated sigmoid diverticulitis requiring an emergency Hartmann’s procedure. Early in his postoperative course, he had painful and asymmetrical neuropathy that, after a careful history and examination, revealed a patient with mono neuritis multiplex on a background history of longstanding rheumatoid arthritis. On day seven of his postoperative course, he had rising inflammatory markers and a CT abdomen and pelvis showing fluid around the mesentery. Whilst contamination from sigmoid perforation was somewhat congruent with these signs, a diagnosis of polyarteritis nodosa, a common cause of mononeuritis multiplex, is also possible, although involvement of the large bowel in polyarteritis nodosa is extremely rare. The histopathology from the initial Hartmann’s procedure was re-examined, showing medium vessel disease vasculitis. Given his lack of fevers, absence of abdominal pain, and worsening neurology, he was given a provisional diagnosis of polyarteritis nodosa and was treated successfully, not on IV antibiotics but on steroids. Large bowel involvement of polyarteritis nodosa is extremely rare and this is the first case of polyarteritis nodosa causing perforated diverticulitis. The learning point here is to obtain a good clinical picture of a patient to identify mesenteric vasculitis as compared to abdominal sepsis as the treatment of one worsens the other.Keywords: abdominal sepsis, diverticulitis, mesenteric vasculitis, polyarteritis nodosa
Procedia PDF Downloads 2522216 The Generation of Insulin Producing Cells from Human Mesenchymal Stem Cells by miR-375 and Anti-miR-9
Authors: Arefeh Jafarian, Mohammad Taghikani, Saied Abroun, Amir Allahverdi, Masoud Soleimani
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Introduction: The miRNAs have key roles in control of pancreatic islet development and insulin secretion. In this regards, current study investigated the pancreatic differentiation of human bone marrow mesenchymal stem cells (hBM-MSCs) by up-regulation of miR-375 and down-regulation of miR-9 by lentiviruses containing miR-375 and anti-miR-9. Findings: After 21 days of induction, islet-like clusters containing insulin producing cells (IPCs) were confirmed by dithizone (DTZ) staining. The IPCs and β cell specific related genes and proteins were detected using qRT-PCR and immunofluorescence on days 7, 14 and 21 of differentiation. Glucose challenge test was performed at different concentrations of glucose as well as extracellular and intracellular insulin and C-peptide were assayed using ELISA kit. In derived IPCs by miR-375 alone are capable to express insulin and other endocrine specific transcription factors, the cells lack the machinery to respond to glucose. The differentiated hMSCs by miR-375 and anti-miR-9 lentiviruses could secrete insulin and c-peptide in a glucose-regulated manner. Conclusion: It was found that over-expression of miR-375 led to a reduction in levels of Mtpn protein in derived IPCs, while treatment with anti-miR-9 following miR-375 over-expression had synergistic effects on MSCs differentiation and insulin secretion in a glucose-regulated manner. The researchers reported that silencing of miR-9 increased OC-2 protein in IPCs that may contribute to the observed glucose-regulated insulin secretion. These findings highlight miRNAs functions in stem cells differentiation and suggest that they could be used as therapeutic tools for gene-based therapy in diabetes mellitus.Keywords: diabetes, differentiation, MSCs, insulin producing cells, miR-375, miR-9
Procedia PDF Downloads 3172215 Combined Aerobic-Resistance Exercise Training and Broccoli Supplementation on Plasma Decitin-1 and Insulin Resistance in Men with Type 2 Diabetes
Authors: Mohammad Soltani, Ayoub Saeidi, Nikoo Khosravi, Hanieh Nohbaradar, Seyedeh Parya Barzanjeh, Hassane Zouhal
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Exercise training and herbs supplement represent have role in the treatment for patients with type 2 diabetes (T2D). However, it is unclear combined effects of exercise training and herbs supplements on diabetic risk markers. This study aimed to determine the effect of 12 weeks of combined exercise and broccoli supplementation on decitin-1 and insulin resistance in men with type 2 diabetes. Forty-four type 2 diabetes men (age, 48.52 ± 4.36) were randomly allocated to training -supplement (TS, n = 11), training- placebo (TP, n = 11), supplement (S, n = 11) and control- placebo (CP, n = 11) groups. The combined exercise program included 12 weeks, three sessions per week, that each session contained 45 minutes of resistance training with intensity 60-70% of one maximal repetition and 30 minutes aerobic training (running) with intensity 60-70% of maximum heart rate. In addition supplement groups consumed 10 grams of Broccoli per day for 12 weeks. Plasma Decitin-1, HOMA-IR, Insulin, glucose and body composition were assessed before and after training. Plasma Dectin-1, HOMA-IR, glucose and BMI significantly decreased in TS, TP and S groups compared with CP group (P < .05). In addition Insulin and skeletal muscles mass showed significant increase in TS and TP groups compared with S and CP groups (P < .05). It is concluded that both combined exercise training (aerobic-resistance) or broccoli supplement can improve plasma Decitin-1 and insulin resistance in two diabetic patients however combine of exercise training and broccoli supplement have more effective on these markers.Keywords: broccoli supplements, combined training, decitin-1, insulin resistance, type 2 diabetes
Procedia PDF Downloads 1342214 Co-Culture of Neonate Mouse Spermatogonial Stem Cells with Sertoli Cells: Inductive Role of Melatonin following Transplantation: Adult Azoospermia Mouse Model
Authors: Mehdi Abbasi, Shadan Navid, Mohammad Pourahmadi, M. Majidi Zolbin
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We have recently reported that melatonin as antioxidant enhances the efficacy of colonization of spermatogonial stem cells (SSCs). Melatonin as an antioxidant plays a vital role in the development of SSCs in vitro. This study aimed to investigate evaluation of sertoli cells and melatonin simultaneously on SSC proliferation following transplantation to testis of adult mouse busulfan-treated azoospermia model. SSCs and sertoli cells were isolated from the testes of three to six-day old male mice.To determine the purity, Flow cytometry technique using PLZF antibody were evaluated. Isolated testicular cells were cultured in αMEM medium in the absence (control group) or presence (experimental group) of sertoli cells and melatonin extract for 2 weeks. We then transplanted SSCs by injection into the azoospermia mice model. Higher viability, proliferation, and Id4, Plzf, expression were observed in the presence of simultaneous sertoli cells and melatonin in vitro. Moreover, immunocytochemistry results showed higher Oct4 expression in this group. Eight weeks after transplantation, injected cells were localized at the base of seminiferous tubules in the recipient testes. The number of spermatogonia and the weight of testis were higher in the experimental group relative to control group. The results of our study suggest that this new protocol can increase the transplantation of these cells can be useful in the treatment of male infertility.Keywords: colonization, melatonin, spermatogonial stem cell, transplantation
Procedia PDF Downloads 1702213 Secondary Traumatic Stress and Related Factors in Australian Social Workers and Psychologists
Authors: Cindy Davis, Samantha Rayner
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Secondary traumatic stress (STS) is an indirect form of trauma affecting the psychological well-being of mental health workers; STS is found to be a prevalent risk in mental health occupations. Various factors impact the development of STS within the literature; including the level of trauma individuals are exposed to and their level of empathy. Research is limited on STS in mental health workers in Australia; therefore, this study examined STS and related factors of empathetic behavior and trauma caseload among mental health workers. The research utilized an online survey quantitative research design with a purposive sample of 190 mental health workers (176 females) recruited via professional websites and unofficial social media groups. Participants completed an online questionnaire comprising of demographics, the secondary traumatic stress scale and the empathy scale for social workers. A standard hierarchical regression analysis was conducted to examine the significance of covariates, traumatized clients, traumatic stress within workload and empathy in predicting STS. The current research found 29.5% of participants to meet the criteria for a diagnosis of STS. Age and past trauma within the covariates were significantly associated with STS. Amount of traumatized clients significantly predicted 4.7% of the variance in STS, traumatic stress within workload significantly predicted 4.8% of the variance in STS and empathy significantly predicted 4.9% of the variance in STS. These three independent variables and the covariates accounted for 18.5% of the variance in STS. Practical implications include a focus on developing risk strategies and treatment methods that can diminish the impact of STS.Keywords: mental health, PTSD, social work, trauma
Procedia PDF Downloads 3322212 Analytical Study and Conservation Processes of a Wooden Coffin of Middel Kingdom, Ancient Egypt
Authors: Mohamed Ahmed Abd El Kader
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This paper describes the conservation processes of an Ancient Egyptian wooden coffin dating back to the Middle Kingdom, ancient Egypt, using several scientific and analytical methods in order to provide a deeper understanding of the deterioration status and a greater awareness of how well preserved the object is. Visual observation and 2D Programs, as well as Optical Microscopy (OM), Environmental scanning Electron Microscopy (ESEM), X-ray Diffraction (XRD) and Fourier Transform Infrared Spectroscopy (FTIR) were used in our study. The identification of wood species and the composition of the pigments and previous restoration materials were made. The coffin was previously conserved and stored in improper conditions, which led to its further deterioration; the surface of the lid dust, which obscured the decorations as well as all necessary restoration work was promptly carried out as soon as the coffin was transferred from the display hall from the Egyptian Museum to the Wood Conservation Laboratory of the Grand Egyptian Museum-Conservation Center (GEM-CC). The analyses provided detailed information concerning the original materials and the materials added during the previous treatment interventions, which was considered when applying the conservation plan. Conservation procedures have been applied with high accuracy to conserve the coffin including cleaning, consolidation of fragile painted layers, and the wooden boards forming the sides of the coffin were reassembled in their original positions. The materials and methods that were applied were extremely effective in stability and reinforcement of the coffin without harmfulness to the original materials and the coffin was successfully conserved and ready to display in the Grand Egyptian Museum (GEM).Keywords: coffin, middle kingdom, deterioration, 2d program
Procedia PDF Downloads 532211 Electrochemical Detection of the Chemotherapy Agent Methotrexate in vitro from Physiological Fluids Using Functionalized Carbon Nanotube past Electrodes
Authors: Shekher Kummari, V. Sunil Kumar, K. Vengatajalabathy Gobi
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A simple, cost-effective, reusable and reagent-free electrochemical biosensor is developed with functionalized multiwall carbon nanotube paste electrode (f-CNTPE) for the sensitive and selective determination of the important chemotherapeutic drug methotrexate (MTX), which is widely used for the treatment of various cancer and autoimmune diseases. The electrochemical response of the fabricated electrode towards the detection of MTX is examined by cyclic voltammetry (CV), differential pulse voltammetry (DPV) and square wave voltammetry (SWV). CV studies have shown that f-CNTPE electrode system exhibited an excellent electrocatalytic activity towards the oxidation of MTX in phosphate buffer (0.2 M) compared with a conventional carbon paste electrode (CPE). The oxidation peak current is enhanced by nearly two times in magnitude. Applying the DPV method under optimized conditions, a linear calibration plot is achieved over a wide range of concentration from 4.0×10⁻⁷ M to 5.5×10⁻⁶ M with the detection limit 1.6×10⁻⁷ M. further, by applying the SWV method a parabolic calibration plot was achieved starting from a very low concentration of 1.0×10⁻⁸ M, and the sensor could detect as low as 2.9×10⁻⁹ M MTX in 10 s and 10 nM were detected in steady state current-time analysis. The f-CNTPE shows very good selectivity towards the specific recognition of MTX in the presence of important biological interference. The electrochemical biosensor detects MTX in-vitro directly from pharmaceutical sample, undiluted urine and human blood serum samples at a concentration range 5.0×10⁻⁷ M with good recovery limits.Keywords: amperometry, electrochemical detection, human blood serum, methotrexate, MWCNT, SWV
Procedia PDF Downloads 3092210 Genome-Wide Expression Profiling of Cicer arietinum Heavy Metal Toxicity
Authors: B. S. Yadav, A. Mani, S. Srivastava
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Chickpea (Cicer arietinum L.) is an annual, self-pollinating, diploid (2n = 2x = 16) pulse crop that ranks second in world legume production after common bean (Phaseolus vulgaris). ICC 4958 flowers approximately 39 days after sowing under peninsular Indian conditions and the crop matures in less than 90 days in rained environments. The estimated collective yield losses due to abiotic stresses (6.4 million t) have been significantly higher than for biotic stresses (4.8 million t). Most legumes are known to be salt sensitive, and therefore, it is becoming increasingly important to produce cultivars tolerant to high-salinity in addition to other abiotic and biotic stresses for sustainable chickpea production. Our aim was to identify the genes that are involved in the defence mechanism against heavy metal toxicity in chickpea and establish the biological network of heavy metal toxicity in chickpea. ICC4958 variety of chick pea was taken and grown in normal condition and 150µM concentration of different heavy metal salt like CdCl₂, K₂Cr2O₇, NaAsO₂. At 15th day leave samples were collected and stored in RNA Later solution microarray was performed for checking out differential gene expression pattern. Our studies revealed that 111 common genes that involved in defense mechanism were up regulated and 41 genes were commonly down regulated during treatment of 150µM concentration of CdCl₂, K₂Cr₂O₇, and NaAsO₂. Biological network study shows that the genes which are differentially expressed are highly connected and having high betweenness and centrality.Keywords: abiotic stress, biological network, chickpea, microarray
Procedia PDF Downloads 1972209 An Estimating Equation for Survival Data with a Possibly Time-Varying Covariates under a Semiparametric Transformation Models
Authors: Yemane Hailu Fissuh, Zhongzhan Zhang
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An estimating equation technique is an alternative method of the widely used maximum likelihood methods, which enables us to ease some complexity due to the complex characteristics of time-varying covariates. In the situations, when both the time-varying covariates and left-truncation are considered in the model, the maximum likelihood estimation procedures become much more burdensome and complex. To ease the complexity, in this study, the modified estimating equations those have been given high attention and considerations in many researchers under semiparametric transformation model was proposed. The purpose of this article was to develop the modified estimating equation under flexible and general class of semiparametric transformation models for left-truncated and right censored survival data with time-varying covariates. Besides the commonly applied Cox proportional hazards model, such kind of problems can be also analyzed with a general class of semiparametric transformation models to estimate the effect of treatment given possibly time-varying covariates on the survival time. The consistency and asymptotic properties of the estimators were intuitively derived via the expectation-maximization (EM) algorithm. The characteristics of the estimators in the finite sample performance for the proposed model were illustrated via simulation studies and Stanford heart transplant real data examples. To sum up the study, the bias for covariates has been adjusted by estimating density function for the truncation time variable. Then the effect of possibly time-varying covariates was evaluated in some special semiparametric transformation models.Keywords: EM algorithm, estimating equation, semiparametric transformation models, time-to-event outcomes, time varying covariate
Procedia PDF Downloads 1522208 Health Care using Queuing Theory
Authors: S. Vadivukkarasi, K. Karthi, M. Karthick, C. Dinesh, S. Santhosh, A. Yogaraj
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The appointment system was designed to minimize patient’s idle time overlooking patients waiting time in hospitals. This is no longer valid in today’s consumer oriented society. Long waiting times for treatment in the outpatient department followed by short consultations has long been a complaint. Nowadays, customers use waiting time as a decisive factor in choosing a service provider. Queuing theory constitutes a very powerful tool because queuing models require relatively little data and are simple and fast to use. Because of this simplicity and speed, modelers can be used to quickly evaluate and compare various alternatives for providing service. The application of queuing models in the analysis of health care systems is increasingly accepted by health care decision makers. Timely access to care is a key component of high-quality health care. However, patient delays are prevalent throughout health care systems, resulting in dissatisfaction and adverse clinical consequences for patients as well as potentially higher costs and wasted capacity for providers. Arguably, the most critical delays for health care are the ones associated with health care emergencies. The allocation of resources can be divided into three general areas: bed management, staff management, and room facility management. Effective and efficient patient flow is indicated by high patient throughput, low patient waiting times, a short length of stay at the hospital and overtime, while simultaneously maintaining adequate staff utilization rates and low patient’s idle times.Keywords: appointment system, patient scheduling, bed management, queueing calculation, system analysis
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