Search results for: good modelling practice
3251 Magneto-Hydrodynamic Mixed Convection of Water-Al2O3 Nanofluid in a Wavy Lid-Driven Cavity
Authors: Farshid Fathinia
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This paper examines numerically the laminar steady magneto-hydrodynamic mixed convection flow and heat transfer in a wavy lid-driven cavity filled with water-Al2O3 nanofluid using FDM method. The left and right sidewalls of the cavity have a wavy geometry and are maintained at a cold and hot temperature, respectively. The top and bottom walls are considered flat and insulated while, the bottom wall moves from left to right direction with a uniform lid-driven velocity. A magnetic field is applied vertically downward on the bottom wall of the cavity. Based on the numerical results, the effects of the dominant parameters such as Rayleigh number, Hartmann number, solid volume fraction, and wavy wall geometry parameters are examined. The numerical results are obtained for Hartmann number varying as 0 ≤ Ha ≤ 0.6, Rayleigh numbers varying as 103≤ Ra ≤105, and the solid volume fractions varying as 0 ≤ φ ≤ 0.0003. Comparisons with previously published numerical works on mixed convection in a nanofluid filled cavity are performed and good agreements between the results are observed. It is found that the flow circulation and mean Nusselt number decrease as the solid volume fraction and Hartmann number increase. Moreover, the convection enhances when the amplitude ratio of the wavy surface increases. The results also show that both the flow and thermal fields are significantly affected by the amplitude ratio (i.e., wave form) of the wavy wall.Keywords: nanofluid, mixed convection, magnetic field, wavy cavity, lid-driven, SPH method
Procedia PDF Downloads 3113250 The Effect of Silanization on Alumina for Improving the Compatibility with Poly(Methacrylic Acid) Matrix for Dental Restorative Materials
Authors: Andrei Tiberiu Cucuruz, Ecaterina Andronescu, Cristina Daniela Ghitulica, Andreia Cucuruz
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In modern dentistry, the application of resin-based composites continues to increase and in the majority of countries has completely replaced mercury amalgams. Alumina (Al2O3) is a representative bioinert ceramic with a variety of applications in industry as well as in medicine. Alumina has the potential to improve electrical resistivity and thermal conductivity of polymers. The application of poly(methacrylic acid) (PMAA) in medicine was poorly investigated in the past but can lead to good results by the incorporation of alumina particles that can bring bioinertness to the composite. However, because of the differences related to chemical bonding of these materials, the interaction is very weak at the interface leading to no significant values in practical situations. The aim of this work was to modify the structure of alumina with silane coupling agents and to study the influence of silanization on the physicomechanical properties of the resulting composite materials. Two silanes were used in this study: 3-aminopropyl-trimethoxysilane (APTMS) and dichlorodimethylsilane (DCDMS). Both silanes proved to have a significant effect on the overall performance of composites by establishing bonds with the polymer matrix and the filler. All these improvements in dental adhesive systems made for bonding resin composites to tooth structure have enhanced the clinical application of polymeric restorative materials to the position that they are now considered the material of choice for esthetic restoration.Keywords: alumina, compressive strength, dental materials, silane coupling agents, poly(methacrylic acid)
Procedia PDF Downloads 3523249 The Production of Collagen and Collagen Peptides from Nile Tilapia Skin Using Membrane Technology
Authors: M. Thuanthong, W. Youravong, N. Sirinupong
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Nile tilapia (Oreochromis niloticus) is one of fish species cultured in Thailand with a high production volume. A lot of skin is generated during fish processing. In addition, there are many research reported that fish skin contains abundant of collagen. Thus, the use of Nile tilapia skin as collagen source can increase the benefit of industrial waste. In this study, Acid soluble collagen (ASC) was extracted at 5, 15 or 25 ˚C with 0.5 M acetic acid then the acid was removed out and collagen was concentrated by ultrafiltration-diafiltration (UFDF). The triple helix collagen from UFDF process was used as substrate to produce collagen peptides by alcalase hydrolysis in an enzymatic membrane reactor (EMR) coupling with 1 kDa molecular weight cut off (MWCO) polysulfone hollow fiber membrane. The results showed that ASC extracted at high temperature (25 ˚C) with 0.5 M acetic acid for 5 h still preserved triple helix structure. In the UFDF process, the acid removal was higher than 90 % without any effect on ASC properties, particularly triple helix structure as indicated by circular dichroism spectrum. Moreover, Collagen from UFDF was used to produce collagen peptides by EMR. In EMR, collagen was pre-hydrolyzed by alcalase for 60 min before introduced to membrane separation. The EMR operation was operated for 10 h and provided a good of protein conversion stability. The results suggested that there is a successfulness of UF in application for acid removal to produce ASC with desirable preservation of its quality. In addition, the EMR was proven to be an effective process to produce low molecular weight peptides with ACE-inhibitory activity properties.Keywords: acid soluble collagen, ultrafiltration-diafiltration, enzymatic membrane reactor, ace-inhibitory activity
Procedia PDF Downloads 4773248 Exploratory Analysis and Development of Sustainable Lean Six Sigma Methodologies Integration for Effective Operation and Risk Mitigation in Manufacturing Sectors
Authors: Chukwumeka Daniel Ezeliora
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The Nigerian manufacturing sector plays a pivotal role in the country's economic growth and development. However, it faces numerous challenges, including operational inefficiencies and inherent risks that hinder its sustainable growth. This research aims to address these challenges by exploring the integration of Lean and Six Sigma methodologies into the manufacturing processes, ultimately enhancing operational effectiveness and risk mitigation. The core of this research involves the development of a sustainable Lean Six Sigma framework tailored to the specific needs and challenges of Nigeria's manufacturing environment. This framework aims to streamline processes, reduce waste, improve product quality, and enhance overall operational efficiency. It incorporates principles of sustainability to ensure that the proposed methodologies align with environmental and social responsibility goals. To validate the effectiveness of the integrated Lean Six Sigma approach, case studies and real-world applications within select manufacturing companies in Nigeria will be conducted. Data were collected to measure the impact of the integration on key performance indicators, such as production efficiency, defect reduction, and risk mitigation. The findings from this research provide valuable insights and practical recommendations for selected manufacturing companies in South East Nigeria. By adopting sustainable Lean Six Sigma methodologies, these organizations can optimize their operations, reduce operational risks, improve product quality, and enhance their competitiveness in the global market. In conclusion, this research aims to bridge the gap between theory and practice by developing a comprehensive framework for the integration of Lean and Six Sigma methodologies in Nigeria's manufacturing sector. This integration is envisioned to contribute significantly to the sector's sustainable growth, improved operational efficiency, and effective risk mitigation strategies, ultimately benefiting the Nigerian economy as a whole.Keywords: lean six sigma, manufacturing, risk mitigation, sustainability, operational efficiency
Procedia PDF Downloads 2093247 Performance of the Aptima® HIV-1 Quant Dx Assay on the Panther System
Authors: Siobhan O’Shea, Sangeetha Vijaysri Nair, Hee Cheol Kim, Charles Thomas Nugent, Cheuk Yan William Tong, Sam Douthwaite, Andrew Worlock
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The Aptima® HIV-1 Quant Dx Assay is a fully automated assay on the Panther system. It is based on Transcription-Mediated Amplification and real time detection technologies. This assay is intended for monitoring HIV-1 viral load in plasma specimens and for the detection of HIV-1 in plasma and serum specimens. Nine-hundred and seventy nine specimens selected at random from routine testing at St Thomas’ Hospital, London were anonymised and used to compare the performance of the Aptima HIV-1 Quant Dx assay and Roche COBAS® AmpliPrep/COBAS® TaqMan® HIV-1 Test, v2.0. Two-hundred and thirty four specimens gave quantitative HIV-1 viral load results in both assays. The quantitative results reported by the Aptima Assay were comparable those reported by the Roche COBAS AmpliPrep/COBAS TaqMan HIV-1 Test, v2.0 with a linear regression slope of 1.04 and an intercept on -0.097. The Aptima assay detected HIV-1 in more samples than the Roche assay. This was not due to lack of specificity of the Aptima assay because this assay gave 99.83% specificity on testing plasma specimens from 600 HIV-1 negative individuals. To understand the reason for this higher detection rate a side-by-side comparison of low level panels made from the HIV-1 3rd international standard (NIBSC10/152) and clinical samples of various subtypes were tested in both assays. The Aptima assay was more sensitive than the Roche assay. The good sensitivity, specificity and agreement with other commercial assays make the HIV-1 Quant Dx Assay appropriate for both viral load monitoring and detection of HIV-1 infections.Keywords: HIV viral load, Aptima, Roche, Panther system
Procedia PDF Downloads 3773246 Hourly Solar Radiations Predictions for Anticipatory Control of Electrically Heated Floor: Use of Online Weather Conditions Forecast
Authors: Helene Thieblemont, Fariborz Haghighat
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Energy storage systems play a crucial role in decreasing building energy consumption during peak periods and expand the use of renewable energies in buildings. To provide a high building thermal performance, the energy storage system has to be properly controlled to insure a good energy performance while maintaining a satisfactory thermal comfort for building’s occupant. In the case of passive discharge storages, defining in advance the required amount of energy is required to avoid overheating in the building. Consequently, anticipatory supervisory control strategies have been developed forecasting future energy demand and production to coordinate systems. Anticipatory supervisory control strategies are based on some predictions, mainly of the weather forecast. However, if the forecasted hourly outdoor temperature may be found online with a high accuracy, solar radiations predictions are most of the time not available online. To estimate them, this paper proposes an advanced approach based on the forecast of weather conditions. Several methods to correlate hourly weather conditions forecast to real hourly solar radiations are compared. Results show that using weather conditions forecast allows estimating with an acceptable accuracy solar radiations of the next day. Moreover, this technique allows obtaining hourly data that may be used for building models. As a result, this solar radiation prediction model may help to implement model-based controller as Model Predictive Control.Keywords: anticipatory control, model predictive control, solar radiation forecast, thermal storage
Procedia PDF Downloads 2733245 Electron-Ion Recombination for Photoionized and Collisionally Ionized Plasmas
Authors: Shahin A. Abdel-Naby, Asad T. Hassan
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Astrophysical plasma environments can be classified into collisionally ionized (CP) and photoionizedplasmas (PP). In the PP, ionization is caused by an external radiation field, while it is caused by electron collision in the CP. Accurate and reliable laboratory astrophysical data for electron-ion recombination is needed for plasma modeling for low and high-temperatures. Dielectronic recombination (DR) is the dominant recombination process for the CP for most of the ions. When a free electron is captured by an ion with simultaneous excitation of its core, a doubly-exited intermediate state may be formed. The doubly excited state relaxes either by electron emission (autoionization) or by radiative decay (photon emission). DR process takes place when the relaxation occurs to a bound state by a photon emission. DR calculations at low-temperatures are problematic and challenging since small uncertaintiesin the low-energy DR resonance positions can produce huge uncertainties in DR rate coefficients.DR rate coefficients for N²⁺ and O³⁺ ions are calculated using state-of-the-art multi-configurationBreit-Pauli atomic structure AUTOSTRUCTURE collisional package within the generalized collisional-radiative framework. Level-resolved calculations for RR and DR rate coefficients from the ground and metastable initial states are produced in an intermediate coupling scheme associated withn = 0 and n = 1 core-excitations. DR cross sections for these ions are convoluted with the experimental electron-cooler temperatures to produce DR rate coefficients. Good agreements are foundbetween these rate coefficients and theexperimental measurements performed at CRYRING heavy-ionstorage ring for both ions.Keywords: atomic data, atomic process, electron-ion collision, plasmas
Procedia PDF Downloads 993244 A Genre-Based Approach to the Teaching of Pronunciation
Authors: Marden Silva, Danielle Guerra
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Some studies have indicated that pronunciation teaching hasn’t been paid enough attention by teachers regarding EFL contexts. In particular, segmental and suprasegmental features through genre-based approach may be an opportunity on how to integrate pronunciation into a more meaningful learning practice. Therefore, the aim of this project was to carry out a survey on some aspects related to English pronunciation that Brazilian students consider more difficult to learn, thus enabling the discussion of strategies that can facilitate the development of oral skills in English classes by integrating the teaching of phonetic-phonological aspects into the genre-based approach. Notions of intelligibility, fluency and accuracy were proposed by some authors as an ideal didactic sequence. According to their proposals, basic learners should be exposed to activities focused on the notion of intelligibility as well as intermediate students to the notion of fluency, and finally more advanced ones to accuracy practices. In order to test this hypothesis, data collection was conducted during three high school English classes at Federal Center for Technological Education of Minas Gerais (CEFET-MG), in Brazil, through questionnaires and didactic activities, which were recorded and transcribed for further analysis. The genre debate was chosen to facilitate the oral expression of the participants in a freer way, making them answering questions and giving their opinion about a previously selected topic. The findings indicated that basic students demonstrated more difficulty with aspects of English pronunciation than the others. Many of the intelligibility aspects analyzed had to be listened more than once for a better understanding. For intermediate students, the speeches recorded were considerably easier to understand, but nevertheless they found it more difficult to pronounce the words fluently, often interrupting their speech to think about what they were going to say and how they would talk. Lastly, more advanced learners seemed to express their ideas more fluently, but still subtle errors related to accuracy were perceptible in speech, thereby confirming the proposed hypothesis. It was also seen that using genre-based approach to promote oral communication in English classes might be a relevant method, considering the socio-communicative function inherent in the suggested approach.Keywords: EFL, genre-based approach, oral skills, pronunciation
Procedia PDF Downloads 1323243 Vertical Urbanization Over Public Structures: The Example of Mostar Junction in Belgrade, Serbia
Authors: Sladjana Popovic
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The concept of vertical space urbanization, defined in English as "air rights development," can be considered a mechanism for the development of public spaces in urban areas of high density. A chronological overview of the transformation of space within the vertical projection of the existing traffic infrastructure that penetrates through the central areas of a city is given in this paper through the analysis of two illustrative case studies: more advanced and recent - "Plot 13" in Boston, and less well-known European example of structures erected above highways throughout Italy - the "Pavesi auto grill" chain. The backbone of this analysis is the examination of the possibility of yielding air rights within the vertical projection of public structures in the two examples by considering the factors that would enable its potential application in capitals in Southeastern Europe. The cession of air rights in the Southeastern Europe region, as a phenomenon, has not been a recognized practice in urban planning. In a formal sense, legal and physical feasibility can be seen to some extent in local models of structures built above protected historical heritage (i.e., archaeological sites); however, the mechanisms of the legal process of assigning the right to use and develop air rights above public structures is not a recognized concept. The goal of the analysis is to shed light on the influence of institutional participants in the implementation of innovative solutions for vertical urbanization, as well as strategic planning mechanisms in public-private partnership models that would enable the implementation of the concept in the region. The main question is whether the manipulation of the vertical projection of space could provide for innovative urban solutions that overcome the deficit and excessive use of the available construction land, particularly above the dominant public spaces and traffic infrastructure that penetrate central parts of a city. Conclusions reflect upon vertical urbanization that can bridge the spatial separation of the city, reduce noise pollution and contribute to more efficient urban planning along main transportation corridors.Keywords: air rights development, innovative urbanism, public-private partnership, transport infrastructure, vertical urbanization
Procedia PDF Downloads 783242 Nonparametric Truncated Spline Regression Model on the Data of Human Development Index in Indonesia
Authors: Kornelius Ronald Demu, Dewi Retno Sari Saputro, Purnami Widyaningsih
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Human Development Index (HDI) is a standard measurement for a country's human development. Several factors may have influenced it, such as life expectancy, gross domestic product (GDP) based on the province's annual expenditure, the number of poor people, and the percentage of an illiterate people. The scatter plot between HDI and the influenced factors show that the plot does not follow a specific pattern or form. Therefore, the HDI's data in Indonesia can be applied with a nonparametric regression model. The estimation of the regression curve in the nonparametric regression model is flexible because it follows the shape of the data pattern. One of the nonparametric regression's method is a truncated spline. Truncated spline regression is one of the nonparametric approach, which is a modification of the segmented polynomial functions. The estimator of a truncated spline regression model was affected by the selection of the optimal knots point. Knot points is a focus point of spline truncated functions. The optimal knots point was determined by the minimum value of generalized cross validation (GCV). In this article were applied the data of Human Development Index with a truncated spline nonparametric regression model. The results of this research were obtained the best-truncated spline regression model to the HDI's data in Indonesia with the combination of optimal knots point 5-5-5-4. Life expectancy and the percentage of an illiterate people were the significant factors depend to the HDI in Indonesia. The coefficient of determination is 94.54%. This means the regression model is good enough to applied on the data of HDI in Indonesia.Keywords: generalized cross validation (GCV), Human Development Index (HDI), knots point, nonparametric regression, truncated spline
Procedia PDF Downloads 3433241 Sense-Based Approach in the Design of Anti-Violence Shelters: A Comparative Analysis
Authors: Annunziata Albano
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Intimate Partner Violence (IPV) and Non-Partner Sexual Violence (NPSV) are still the most common forms of interpersonal violence against women today, and numerous studies have shown how they can affect women's physical and psychological well-being, frequently leading to depression, posttraumatic stress disorder (PTSD), and substance abuse. The primary goal of Italian Anti-Violence Centres (AVCs) is to provide an appropriate context for women to embark on a personalised path out of violence by providing various services such as listening groups, psychological and legal support, housing support in collaboration with shelters, work orientation, and specific support in the case of minor children. However, their physical environment is frequently overlooked, partly because these centres are typically established in pre-existing buildings and have a limited budget. Several studies on healthcare design and mental health, on the other hand, emphasise the potential of the built environment to facilitate healing by providing a restorative setting that aids in coping with stress and traumatic experiences, investigating the positive role of natural features and sensorial qualities such as light, colours, sound, and smell. This research aims to collect and summarise the key evidence-based principles derived from a multidisciplinary literature review about interior design elements that can help women recover after their traumatic experience. Furthermore, the study examines multiple case studies of Italian AVCs through the lens of previously determined principles, to understand how and whether these guidelines have been applied and which outcomes can provide relevant insights for design practice, with an emphasis on sensory qualities, usually overlooked in favour of other requirements. The outlined guidelines may serve as a framework for various typologies of services provided to women who are the victims of interpersonal violence, such as women's crisis centres and shelters.Keywords: anti-violence centres, environmental psychology, interior design, interpersonal violence, restorative environments
Procedia PDF Downloads 1133240 A Sharp Interface Model for Simulating Seawater Intrusion in the Coastal Aquifer of Wadi Nador (Algeria)
Authors: Abdelkader Hachemi, Boualem Remini
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Seawater intrusion is a significant challenge faced by coastal aquifers in the Mediterranean basin. This study aims to determine the position of the sharp interface between seawater and freshwater in the aquifer of Wadi Nador, located in the Wilaya of Tipaza, Algeria. A numerical areal sharp interface model using the finite element method is developed to investigate the spatial and temporal behavior of seawater intrusion. The aquifer is assumed to be homogeneous and isotropic. The simulation results are compared with geophysical prospection data obtained through electrical methods in 2011 to validate the model. The simulation results demonstrate a good agreement with the geophysical prospection data, confirming the accuracy of the sharp interface model. The position of the sharp interface in the aquifer is found to be approximately 1617 meters from the sea. Two scenarios are proposed to predict the interface position for the year 2024: one without pumping and the other with pumping. The results indicate a noticeable retreat of the sharp interface position in the first scenario, while a slight decline is observed in the second scenario. The findings of this study provide valuable insights into the dynamics of seawater intrusion in the Wadi Nador aquifer. The predicted changes in the sharp interface position highlight the potential impact of pumping activities on the aquifer's vulnerability to seawater intrusion. This study emphasizes the importance of implementing measures to manage and mitigate seawater intrusion in coastal aquifers. The sharp interface model developed in this research can serve as a valuable tool for assessing and monitoring the vulnerability of aquifers to seawater intrusion.Keywords: seawater intrusion, sharp interface, coastal aquifer, algeria
Procedia PDF Downloads 1223239 Developing a Health Promotion Program to Prevent and Solve Problem of the Frailty Elderly in the Community
Authors: Kunthida Kulprateepunya, Napat Boontiam, Bunthita Phuasa, Chatsuda Kankayant, Bantoeng Polsawat, Sumran Poontong
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Frailty is the thin line between good health and illness. The syndrome is more common in the elderly who transition from strong to weak. (Vulnerability). Fragility can prevent and promote healthy recovery before it goes into disability. This research and development aim to analyze the situation analysis of frailty of the elderly, develop a program, and evaluate the effect of a health promotion program to prevent and solve the problem of frailty among the elderly. The research consisted of 3 phases: 1) analysis of the frailty situation, 2) development of a model, 3) evaluation of the effectiveness of the model. Samples were 328, 122 elderlies using the multi-stage random sampling method. The research instrument was a frailty questionnaire use of the five symptoms, the main characteristics were muscle weakness, slow walking, low physical activity. Fatigue and unintentional weight loss, criteria frailty use more than or equal to three or more symptoms are frailty. Data were analyzed by descriptive and t-test dependent test statistics. The findings showed three parts. First, frailty in the elderly was 23.05 percentage and 56.70% pre-frailty. Second, it was development of a health promotion program to prevent and solve the problem of frailty the elderly with a combination of Nine-Square Exercise, Elastic Band Exercise, Elastic Coconut Shell. Third, evaluation of the effectiveness of the model by comparison of the elderly's get up and go test, the average time before using the program was 14.42 and after using the program was 8.57. It was statistically significant at the .05 level. In conclusion, the findings can used to develop guidelines to promote the health of the frailty elderly.Keywords: elderly, fragile, nine-square exercise, elastic coconut shell
Procedia PDF Downloads 1063238 Temperature Distribution for Asphalt Concrete-Concrete Composite Pavement
Authors: Tetsya Sok, Seong Jae Hong, Young Kyu Kim, Seung Woo Lee
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The temperature distribution for asphalt concrete (AC)-Concrete composite pavement is one of main influencing factor that affects to performance life of pavement. The temperature gradient in concrete slab underneath the AC layer results the critical curling stress and lead to causes de-bonding of AC-Concrete interface. These stresses, when enhanced by repetitive axial loadings, also contribute to the fatigue damage and eventual crack development within the slab. Moreover, the temperature change within concrete slab extremely causes the slab contracts and expands that significantly induces reflective cracking in AC layer. In this paper, the numerical prediction of pavement temperature was investigated using one-dimensional finite different method (FDM) in fully explicit scheme. The numerical predicted model provides a fundamental and clear understanding of heat energy balance including incoming and outgoing thermal energies in addition to dissipated heat in the system. By using the reliable meteorological data for daily air temperature, solar radiation, wind speech and variable pavement surface properties, the predicted pavement temperature profile was validated with the field measured data. Additionally, the effects of AC thickness and daily air temperature on the temperature profile in underlying concrete were also investigated. Based on obtained results, the numerical predicted temperature of AC-Concrete composite pavement using FDM provided a good accuracy compared to field measured data and thicker AC layer significantly insulates the temperature distribution in underlying concrete slab.Keywords: asphalt concrete, finite different method (FDM), curling effect, heat transfer, solar radiation
Procedia PDF Downloads 2713237 Technical Efficiency of Small-Scale Honey Producer in Ethiopia: A Stochastic Frontier Analysis
Authors: Kaleb Shiferaw, Berhanu Geberemedhin
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Ethiopian farmers have a long tradition of beekeeping and the country has huge potential for honey production. However traditional mode of production still dominates the sub sector which negatively affect the total production and productivity. A number of studies have been conducted to better understand the working honey production, however, none of them systematically investigate the extent of technical efficiency of the sub-sector. This paper uses Stochastic Frontier production model to quantifying the extent of technical efficiency and identify exogenous determinant of inefficiency. The result showed that consistent with other studies traditional practice dominate small scale honey production in Ethiopia. The finding also revealed that use of purchased inputs such as bee forage and other supplement is very limited among honey producers indicating that natural bee forage is the primary source of bee forage. The immediate consequence of all these is low production and productivity. The number of hives the household owns, whether the household used improved apiculture technologies, availability of natural forest which is the primary sources of nectar for bees and amount of land owned by the households were found to have a significant influence on the amount of honey produced by beekeeper. Our result further showed that the mean technical efficiency of honey producers is 0.79 implying that, on average honey producer produce 80 percent of the maximum output. The implication is that 20 percent of the potential output is lost due to technical inefficiency. Number of hives owned by a honey produces, distance to district town-a proxy to market access, household wealth, and whether the household head has a leadership role in the PA affect the technical efficiency of honey producers. The finding suggest that policies that aim to expand the use of improved hives is expected to increase the honey production at household level. The result also suggest that investment on rural infrastructure would be instrumental in improving technical efficiency of honey producer.Keywords: small-scale honey producer, Ethiopia, technical efficiency in apiculture, stochastic frontier analysis
Procedia PDF Downloads 2383236 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 5743235 Patriarchy in Caste Society and Control over Women’s Sexuality in India
Authors: Renu Singh
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The caste system in Indian society plays an important role in subjugation of women. It creates divides and controls over women’s sexuality in various ways. This paper attempts to look into various modes in which the institution of caste makes some forms of sexuality as socially “acceptable” norms, while deems others as obscene, immoral and against social ethos. Based on a review of existing literature in this area this paper attempts to understand the notion of sexuality in Indian context. It tries to understand how the emergence of norms and values of sexual behaviour has been entwined with the evolution of caste system and the subjugation of many sections of Indian society. It also attempts to trace the internalisation of patriarchal values in Indian society, and the role played by the colonial rulers in creating and maintaining stringent division of space into public and private ones. It is argued here that brahmanical patriarchy, which is a unique phenomenon of the Indian Subcontinent, plays a crucial role in subjugating and controlling women in general and their sexuality in particular. It also creates a divide among women of different castes. Furthermore, the process of colonisation played an important role in shaping the discourse of sexuality in its present form. There were contradictions as well as consensus between the colonial rulers over the questions of regulation of the private domain, as in introducing reform legislation in the nineteenth century informed the debate on sexuality in postcolonial India. The process of emergence of the dichotomous notions of ‘good’ and ‘bad’ sexuality, and the resistance to any ‘deviation’ from the ‘normal’ sexuality is located, not merely in the ‘passive’ evolution of society, but in the actual politics of it.Keywords: caste, control, sexuality, regulation, brahmanical patriarchy, India
Procedia PDF Downloads 3333234 Role of Basic Health Units in Provision of Primary Health Services in District Swabi
Authors: Naila Awan, Shahrukh Inam
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This study was conducted to highlight the role of basic health units in district Swabi, which provides primary health services to the people of district Swabi having four tehsils. Tehsil Swabi was selected purposively for the study. Three villages were purposively selected from district Swabi. A sum of 110 respondents was randomly selected for interview i.e., 27 from Botakaa, 39 from Gulatee, and 44 from Darra Cham, using proportion allocation sampling technique. A pretested and well-designed interview schedule was used to collect as per the objective and Chi square test was applied to find an association between the quality of medicines and health improvement. The output of the test shows that the government was doing its best and providing enough facilities to the individuals at the healthcare units, and they were utilizing them. These resources were easily accessible to the people of the community. Medicines provided by the government were of good quality and quantity. There were also school health sessions and community health sessions (SHS/CHS) to deliver useful information and awareness regarding health problems and diseases were conducted. The staff of the BHU was present at work time and was performing their duties. The respondents seemed satisfied with their behavior and the duty of the staff. However, there were no emergency resources existing at the BHU after the working hours of the medical staff. It is recommended that government should provide appropriate quantity and quality of medicines to the basic health units so that these healthcare units don’t have to face any shortages regarding medicines at the end of the month. In addition, laboratory and blood testing facilities need to be provided in the basic health units, and also the infrastructure should be made suitable, satisfactory, and more functional.Keywords: community health session, basic health units, outpatient department, tuberculosis
Procedia PDF Downloads 843233 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 3283232 Modeling and Simulation of Vibratory Behavior of Hybrid Smart Composite Plate
Authors: Salah Aguib, Noureddine Chikh, Abdelmalek Khabli, Abdelkader Nour, Toufik Djedid, Lallia Kobzili
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This study presents the behavior of a hybrid smart sandwich plate with a magnetorheological elastomer core. In order to improve the vibrational behavior of the plate, the pseudo‐fibers formed by the effect of the magnetic field on the elastomer charged by the ferromagnetic particles are oriented at 45° with respect to the direction of the magnetic field at 0°. Ritz's approach is taken to solve the physical problem. In order to verify and compare the results obtained by the Ritz approach, an analysis using the finite element method was carried out. The rheological property of the MRE material at 0° and at 45° are determined experimentally, The studied elastomer is prepared by a mixture of silicone oil, RTV141A polymer, and 30% of iron particles of total mixture, the mixture obtained is mixed for about 15 minutes to obtain an elastomer paste with good homogenization. In order to develop a magnetorheological elastomer (MRE), this paste is injected into an aluminum mold and subjected to a magnetic field. In our work, we have chosen an ideal percentage of filling of 30%, to obtain the best characteristics of the MRE. The mechanical characteristics obtained by dynamic mechanical viscoanalyzer (DMA) are used in the two numerical approaches. The natural frequencies and the modal damping of the sandwich plate are calculated and discussed for various magnetic field intensities. The results obtained by the two methods are compared. These off‐axis anisotropic MRE structures could open up new opportunities in various fields of aeronautics, aerospace, mechanical engineering and civil engineering.Keywords: hybrid smart sandwich plate, vibratory behavior, FEM, Ritz approach, MRE
Procedia PDF Downloads 693231 Climate Change Impact on Mortality from Cardiovascular Diseases: Case Study of Bucharest, Romania
Authors: Zenaida Chitu, Roxana Bojariu, Liliana Velea, Roxana Burcea
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A number of studies show that extreme air temperature affects mortality related to cardiovascular diseases, particularly among elderly people. In Romania, the summer thermal discomfort expressed by Universal Thermal Climate Index (UTCI) is highest in the Southern part of the country, where Bucharest, the largest Romanian urban agglomeration, is also located. The urban characteristics such as high building density and reduced green areas enhance the increase of the air temperature during summer. In Bucharest, as in many other large cities, the effect of heat urban island is present and determines an increase of air temperature compared to surrounding areas. This increase is particularly important during heat wave periods in summer. In this context, the researchers performed a temperature-mortality analysis based on daily deaths related to cardiovascular diseases, recorded between 2010 and 2019 in Bucharest. The temperature-mortality relationship was modeled by applying distributed lag non-linear model (DLNM) that includes a bi-dimensional cross-basis function and flexible natural cubic spline functions with three internal knots in the 10th, 75th and 90th percentiles of the temperature distribution, for modelling both exposure-response and lagged-response dimensions. Firstly, this study applied this analysis for the present climate. Extrapolation of the exposure-response associations beyond the observed data allowed us to estimate future effects on mortality due to temperature changes under climate change scenarios and specific assumptions. We used future projections of air temperature from five numerical experiments with regional climate models included in the EURO-CORDEX initiative under the relatively moderate (RCP 4.5) and pessimistic (RCP 8.5) concentration scenarios. The results of this analysis show for RCP 8.5 an ensemble-averaged increase with 6.1% of heat-attributable mortality fraction in future in comparison with present climate (2090-2100 vs. 2010-219), corresponding to an increase of 640 deaths/year, while mortality fraction due to the cold conditions will be reduced by 2.76%, corresponding to a decrease by 288 deaths/year. When mortality data is stratified according to the age, the ensemble-averaged increase of heat-attributable mortality fraction for elderly people (> 75 years) in the future is even higher (6.5 %). These findings reveal the necessity to carefully plan urban development in Bucharest to face the public health challenges raised by the climate change. Paper Details: This work is financed by the project URCLIM which is part of ERA4CS, an ERA-NET initiated by JPI Climate, and funded by Ministry of Environment, Romania with co-funding by the European Union (Grant 690462). A part of this work performed by one of the authors has received funding from the European Union’s Horizon 2020 research and innovation programme from the project EXHAUSTION under grant agreement No 820655.Keywords: cardiovascular diseases, climate change, extreme air temperature, mortality
Procedia PDF Downloads 1293230 Determination of Community Based Reference Interval of Aspartate Aminotransferase to Platelet Ratio Index (APRI) among Healthy Populations in Mekelle City Tigray, Northern Ethiopia
Authors: Getachew Belay Kassahun
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Background: Aspartate aminotransferase to Platelet Ratio Index (APRI) currently becomes a biomarker for screening liver fibrosis since liver biopsy procedure is invasive and variation in pathological interpretation. Clinical Laboratory Standard Institute recommends establishing age, sex and environment specific reference interval for biomarkers in a homogenous population. The current study was aimed to derive community based reference interval of APRI aged between 12 and 60 years old in Mekelle city Tigrai, Northern Ethiopia. Method: Six hundred eighty eight study participants were collected from three districts in Mekelle city. The 3 districts were selected through random sampling technique and sample size to kebelles (small administration) were distributed proportional to household number in each district. Lottery method was used at household level if more than 2 study participants to each age partition were found. A community based cross sectional in a total of 534 study participants, 264 male and 270 females, were included in the final laboratory and data analysis but around 154 study participants were excluded through exclusion criteria. Aspartate aminotransferase was analyzed through Biosystem chemistry analyzer and Sysmix machine was used to analyze platelet. Man Whitney U test non parametric stastical tool was used to appreciate stastical difference among gender after excluding the outliers through Box and Whisker. Result: The study appreciated stastical difference among gender for APRI reference interval. The combined, male and female reference interval in the current study was 0.098-0.390, 0.133-0.428 and 0.090-0.319 respectively. The upper and lower reference interval of males was higher than females in all age partition and there was no stastical difference (p-value (<0.05)) between age partition. Conclusion: The current study showed using sex specific reference interval is significant to APRI biomarker in clinical practice for result interpretation.Keywords: reference interval, aspartate aminotransferase to platelet ratio Index, Ethiopia, tigray
Procedia PDF Downloads 1183229 Effects of Folic Acid, Alone or in Combination with Other Nutrients on Homocysteine Level and Cognitive Function in Older People: A Systematic Review
Authors: Jiayan Gou, Kexin He, Xin Zhang, Fei Wang, Liuni Zou
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Background: Homocysteine is a high-risk factor for cognitive decline, and folic acid supplementation can lower homocysteine levels. However, current clinical research results are inconsistent, and the effects of folic acid on homocysteine levels and cognitive function in older people are inconsistent. Objective: The objective of this study is to systematically evaluate the effects of folic acid alone or in combination with other nutrients on homocysteine levels and cognitive function in older adults. Methods: Systematic searches were conducted in five databases, including PubMed, Embase, the Cochrane Library, Web of Science, and CINAHL, from inception to June 1, 2023. Randomized controlled trials were included investigating the effects of folic acid alone or in combination with other nutrients on cognitive function in older people. Results: 17 articles were included, with six focusing on the effects of folic acid alone and 11 examining folic acid in combination with other nutrients. The study included 3,100 individuals aged 60 to 83.2 years, with a relatively equal gender distribution (approximately 51.82% male). Conclusion: Folic acid alone or combined with other nutrients can effectively lower homocysteine level and improve cognitive function in patients with mild cognitive impairment. But for patients with Alzheimer's disease and dementia, the intervention only can reduce the homocysteine level, but the improvement in cognitive function is not significant. In healthy older people, high baseline homocysteine levels (>11.3 μmol/L) and good ω-3 fatty acid status (>590 μmol/L) can enhance the improvement effect of folic acid on cognitive function. This trial has been registered on PROSPERO as CRD42023433096.Keywords: B-complex vitamins, cognitive function, folic acid, homocysteine
Procedia PDF Downloads 743228 The application of Gel Dosimeters and Comparison with other Dosimeters in Radiotherapy: A Literature Review
Authors: Sujan Mahamud
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Purpose: A major challenge in radiotherapy treatment is to deliver precise dose of radiation to the tumor with minimum dose to the healthy normal tissues. Recently, gel dosimetry has emerged as a powerful tool to measure three-dimensional (3D) dose distribution for complex delivery verification and quality assurance. These dosimeters act both as a phantom and detector, thus confirming the versatility of dosimetry technique. The aim of the study is to know the application of Gel Dosimeters in Radiotherapy and find out the comparison with 1D and 2D dimensional dosimeters. Methods and Materials: The study is carried out from Gel Dosimeter literatures. Secondary data and images have been collected from different sources such as different guidelines, books, and internet, etc. Result: Analyzing, verifying, and comparing data from treatment planning system (TPS) is determined that gel dosimeter is a very excellent powerful tool to measure three-dimensional (3D) dose distribution. The TPS calculated data were in very good agreement with the dose distribution measured by the ferrous gel. The overall uncertainty in the ferrous-gel dose determination was considerably reduced using an optimized MRI acquisition protocol and a new MRI scanner. The method developed for comparing measuring gel data with calculated treatment plans, the gel dosimetry method, was proven to be a useful for radiation treatment planning verification. In 1D and 2D Film, the depth dose and lateral for RMSD are 1.8% and 2%, and max (Di-Dj) are 2.5% and 8%. Other side 2D+ ( 3D) Film Gel and Plan Gel for RMSDstruct and RMSDstoch are 2.3% & 3.6% and 1% & 1% and system deviation are -0.6% and 2.5%. The study is investigated that the result fined 2D+ (3D) Film Dosimeter is better than the 1D and 2D Dosimeter. Discussion: Gel Dosimeters is quality control and quality assurance tool which will used the future clinical application.Keywords: gel dosimeters, phantom, rmsd, QC, detector
Procedia PDF Downloads 1533227 Modeling of Sediment Yield and Streamflow of Watershed Basin in the Philippines Using the Soil Water Assessment Tool Model for Watershed Sustainability
Authors: Warda L. Panondi, Norihiro Izumi
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Sedimentation is a significant threat to the sustainability of reservoirs and their watershed. In the Philippines, the Pulangi watershed experienced a high sediment loss mainly due to land conversions and plantations that showed critical erosion rates beyond the tolerable limit of -10 ton/ha/yr in all of its sub-basin. From this event, the prediction of runoff volume and sediment yield is essential to examine using the country's soil conservation techniques realistically. In this research, the Pulangi watershed was modeled using the soil water assessment tool (SWAT) to predict its watershed basin's annual runoff and sediment yield. For the calibration and validation of the model, the SWAT-CUP was utilized. The model was calibrated with monthly discharge data for 1990-1993 and validated for 1994-1997. Simultaneously, the sediment yield was calibrated in 2014 and validated in 2015 because of limited observed datasets. Uncertainty analysis and calculation of efficiency indexes were accomplished through the SUFI-2 algorithm. According to the coefficient of determination (R2), Nash Sutcliffe efficiency (NSE), King-Gupta efficiency (KGE), and PBIAS, the calculation of streamflow indicates a good performance for both calibration and validation periods while the sediment yield resulted in a satisfactory performance for both calibration and validation. Therefore, this study was able to identify the most critical sub-basin and severe needs of soil conservation. Furthermore, this study will provide baseline information to prevent floods and landslides and serve as a useful reference for land-use policies and watershed management and sustainability in the Pulangi watershed.Keywords: Pulangi watershed, sediment yield, streamflow, SWAT model
Procedia PDF Downloads 2113226 The Importance of including All Data in a Linear Model for the Analysis of RNAseq Data
Authors: Roxane A. Legaie, Kjiana E. Schwab, Caroline E. Gargett
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Studies looking at the changes in gene expression from RNAseq data often make use of linear models. It is also common practice to focus on a subset of data for a comparison of interest, leaving aside the samples not involved in this particular comparison. This work shows the importance of including all observations in the modeling process to better estimate variance parameters, even when the samples included are not directly used in the comparison under test. The human endometrium is a dynamic tissue, which undergoes cycles of growth and regression with each menstrual cycle. The mesenchymal stem cells (MSCs) present in the endometrium are likely responsible for this remarkable regenerative capacity. However recent studies suggest that MSCs also plays a role in the pathogenesis of endometriosis, one of the most common medical conditions affecting the lower abdomen in women in which the endometrial tissue grows outside the womb. In this study we compared gene expression profiles between MSCs and non-stem cell counterparts (‘non-MSC’) obtained from women with (‘E’) or without (‘noE’) endometriosis from RNAseq. Raw read counts were used for differential expression analysis using a linear model with the limma-voom R package, including either all samples in the study or only the samples belonging to the subset of interest (e.g. for the comparison ‘E vs noE in MSC cells’, including only MSC samples from E and noE patients but not the non-MSC ones). Using the full dataset we identified about 100 differentially expressed (DE) genes between E and noE samples in MSC samples (adj.p-val < 0.05 and |logFC|>1) while only 9 DE genes were identified when using only the subset of data (MSC samples only). Important genes known to be involved in endometriosis such as KLF9 and RND3 were missed in the latter case. When looking at the MSC vs non-MSC cells comparison, the linear model including all samples identified 260 genes for noE samples (including the stem cell marker SUSD2) while the subset analysis did not identify any DE genes. When looking at E samples, 12 genes were identified with the first approach and only 1 with the subset approach. Although the stem cell marker RGS5 was found in both cases, the subset test missed important genes involved in stem cell differentiation such as NOTCH3 and other potentially related genes to be used for further investigation and pathway analysis.Keywords: differential expression, endometriosis, linear model, RNAseq
Procedia PDF Downloads 4333225 Multiscale Cohesive Zone Modeling of Composite Microstructure
Authors: Vincent Iacobellis, Kamran Behdinan
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A finite element cohesive zone model is used to predict the temperature dependent material properties of a polyimide matrix composite with unidirectional carbon fiber arrangement. The cohesive zone parameters have been obtained from previous research involving an atomistic-to-continuum multiscale simulation of the fiber-matrix interface using the bridging cell multiscale method. The goal of the research was to both investigate the effect of temperature change on the composite behavior with respect to transverse loading as well as the validate the use of cohesive parameters obtained from atomistic-to-continuum multiscale modeling to predict fiber-matrix interfacial cracking. From the multiscale model cohesive zone parameters (i.e. maximum traction and energy of separation) were obtained by modeling the interface between the coarse-grained polyimide matrix and graphite based carbon fiber. The cohesive parameters from this simulation were used in a cohesive zone model of the composite microstructure in order to predict the properties of the macroscale composite with respect to changes in temperature ranging from 21 ˚C to 316 ˚C. Good agreement was found between the microscale RUC model and experimental results for stress-strain response, stiffness, and material strength at low and high temperatures. Examination of the deformation of the composite through localized crack initiation at the fiber-matrix interface also agreed with experimental observations of similar phenomena. Overall, the cohesive zone model was shown to be both effective at modeling the composite properties with respect to transverse loading as well as validated the use of cohesive zone parameters obtained from the multiscale simulation.Keywords: cohesive zone model, fiber-matrix interface, microscale damage, multiscale modeling
Procedia PDF Downloads 4893224 Evaluation of the Efficiency of Nanomaterials in Consolidation of Limestone
Authors: Mohamed Saad Gad Eloghby
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Nanomaterials are widely used nowadays for the consolidation of degraded archaeological limestone. It’s one of the most predominant stones in monumental buildings and statuary works. Exposure to different weathering processes caused degradation and the presence of deterioration pattern as cracks, fissures, and granular disintegration. Nanomaterials have been applied to limestone consolidation. Among these nanomaterials are nanolimes, i.e., dispersions of lime nanoparticles in alcohols and nanosilica, i.e., dispersions of silica nanoparticles in water promising consolidating products for limestone. It was investigated and applied to overcome the disadvantages of traditional consolidation materials such as lime water, water glass and paraliod. So, researchers investigated and tested the effectiveness of nanomaterials as consolidation materials for limestone. The present study includes the evaluation of some nano materials in consolidation limestone stone in comparison with traditional consolidantes. These consolidation materials are nano calcium hydroxide nanolime and nanosilica. The latter is known commercially as Nano Estel and the former is known as Nanorestore compared to traditional consolidantes Wacker OH (ethyl silicate) and Paraloid B72 (a copolymer of ethyl methacrylate and methyl acrylate). The study evaluated the consolidation effectiveness of nanomaterials and traditional consolidantes by using followed methods, Characterization of physical properties of stone, Scanning electron microscopy (SEM), X-ray diffractometry, Fourier transform infrared spectroscopy and Mechanical properties. The study confirmed that nanomaterials were better in the distribution and encapsulation of calcite grains in limestone, and traditional materials were better in improving the physical properties of limestone. It demonstrated that good results can be achieved through mixtures of nanomaterials and traditional consolidants.Keywords: nanomaterials, limestone, consolidation, evaluation, weathering, nanolime, nanosilica, scanning electron microscope
Procedia PDF Downloads 783223 Web-Based Learning in Nursing: The Sample of Delivery Lesson Program
Authors: Merve Kadioğlu, Nevin H. Şahin
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Purpose: This research is organized to determine the influence of the web-based learning program. The program has been developed to gain information about normal delivery skill that is one of the topics of nursing students who take the woman health and illness. Material and Methods: The methodology of this study was applied as pre-test post-test single-group quasi-experimental. The pilot study consisted of 28 nursing student study groups who agreed to participate in the study. The findings were gathered via web-based technologies: student information form, information evaluation tests, Web Based Training Material Evaluation Scale and web-based learning environment feedback form. In the analysis of the data, the percentage, frequency and Wilcoxon Signed Ranks Test were used. The Web Based Instruction Program was developed in the light of full learning model, Mayer's research-based multimedia development principles and Gagne's Instructional Activities Model. Findings: The average scores of it was determined in accordance with the web-based educational material evaluation scale: ‘Instructional Suitability’ 4.45, ‘Suitability to Educational Program’ 4.48, ‘Visual Adequacy’ 4.53, ‘Programming Eligibility / Technical Adequacy’ 4.00. Also, the participants mentioned that the program is successful and useful. A significant difference was found between the pre-test and post-test results of the seven modules (p < 0.05). Results: According to pilot study data, the program was rated ‘very good’ by the study group. It was also found to be effective in increasing knowledge about normal labor.Keywords: normal delivery, web-based learning, nursing students, e-learning
Procedia PDF Downloads 1793222 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 253