Search results for: complicated intra-abdominal infections
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1630

Search results for: complicated intra-abdominal infections

730 Prevalence of Extended Spectrum of Beta Lactamase Producers among Gram Negative Uropathogens

Authors: Y. V. S. Annapurna, V. V. Lakshmi

Abstract:

Urinary tract infection (UTI) is one of the most common infectious diseases at the community level with a high rate of morbidity . This is further augmented by increase in the number of resistant and multi resistant strains of bacteria particularly by those producing Extended spectrum of beta lactamases. The present study was aimed at analysis of antibiograms of E.coli and Klebsiella sp causing urinary tract infections. Between November 2011 and April 2013, a total of 1120 urine samples were analyzed,. Antibiotic sensitivity testing was done with 542(48%) isolates of E.coli and 446(39%) of Klebsiella sp using the standard disc diffusion method against eleven commonly used antibiotics .Organisms showed high susceptibility to Amikacin and Netilimicin and low susceptibility to Cephalosporins. MAR index was calculated for the multidrug resistant strains. Maximum MAR index detected among the isolates was 0.9. Phenotypic identification for ESBL production was confirmed by double disk synergy test (DDST) according to CLSI guidelines. Plasmid profile of the isolates was carried out using alkaline hydrolysis method. Agarose-gel electrophoresis showed presence of high-molecular weight plasmid DNA among the ESBL strains. This study emphasizes the importance of indiscriminate use of antibiotics which if discontinued, in turn would prevent further development of bacterial drug resistance. For this, a proper knowledge of susceptibility pattern of uropathogens is necessary before prescribing empirical antibiotic therapy and it should be made mandatory.

Keywords: escherichia coli, extended spectrum of beta lactamase, Klebsiella spp, Uropathogens

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729 Asymptotic Analysis of the Viscous Flow through a Pipe and the Derivation of the Darcy-Weisbach Law

Authors: Eduard Marusic-Paloka

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The Darcy-Weisbach formula is used to compute the pressure drop of the fluid in the pipe, due to the friction against the wall. Because of its simplicity, the Darcy-Weisbach formula became widely accepted by engineers and is used for laminar as well as the turbulent flows through pipes, once the method to compute the mysterious friction coefficient was derived. Particularly in the second half of the 20th century. Formula is empiric, and our goal is to derive it from the basic conservation law, via rigorous asymptotic analysis. We consider the case of the laminar flow but with significant Reynolds number. In case of the perfectly smooth pipe, the situation is trivial, as the Navier-Stokes system can be solved explicitly via the Poiseuille formula leading to the friction coefficient in the form 64/Re. For the rough pipe, the situation is more complicated and some effects of the roughness appear in the friction coefficient. We start from the Navier-Stokes system in the pipe with periodically corrugated wall and derive an asymptotic expansion for the pressure and for the velocity. We use the homogenization techniques and the boundary layer analysis. The approximation derived by formal analysis is then justified by rigorous error estimate in the norm of the appropriate Sobolev space, using the energy formulation and classical a priori estimates for the Navier-Stokes system. Our method leads to the formula for the friction coefficient. The formula involves resolution of the appropriate boundary layer problems, namely the boundary value problems for the Stokes system in an infinite band, that needs to be done numerically. However, theoretical analysis characterising their nature can be done without solving them.

Keywords: Darcy-Weisbach law, pipe flow, rough boundary, Navier law

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728 Synergistic Effect of Eugenol Acetate with Betalactam Antibiotic on Betalactamase and Its Bioinformatics Analysis

Authors: Vinod Nair, C. Sadasivan

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Beta-lactam antibiotics are the most frequently prescribed medications in modern medicine. The antibiotic resistance by the production of enzyme beta-lactamase is an important mechanism seen in microorganisms. Resistance to beta-lactams mediated by beta-lactamases can be overcome successfully with the use of beta-lactamase inhibitors. New generations of the antibiotics contain mostly synthetic compounds, and many side effects have been reported for them. Combinations of beta-lactam and beta-lactamase inhibitors have become one of the most successful antimicrobial strategies in the current scenario of bacterial infections. Plant-based drugs are very cheap and having lesser adverse effect than synthetic compounds. The synergistic effect of eugenol acetate with beta-lactams restores the activity of beta-lactams, allowing their continued clinical use. It is reported here the enhanced inhibitory effect of phytochemical, eugenol acetate, isolated from the plant Syzygium aromaticum with beta-lactams on beta-lactamase. The compound was found to have synergistic effect with the antibiotic amoxicillin against antibiotic-resistant strain of S.aureus. The enzyme was purified from the organism and incubated with the compound. The assay showed that the compound could inhibit the enzymatic activity of beta-lactamase. Modeling and molecular docking studies indicated that the compound can fit into the active site of beta-lactamase and can mask the important residue for hydrolysis of beta-lactams. The synergistic effects of eugenol acetate with beta-lactam antibiotics may justify, the use of these plant compounds for the preparation of β-lactamase inhibitors against β-lactam resistant S.aureus.

Keywords: betalactamase, eugenol acetate, synergistic effect, molecular modeling

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727 Revolutionizing Financial Forecasts: Enhancing Predictions with Graph Convolutional Networks (GCN) - Long Short-Term Memory (LSTM) Fusion

Authors: Ali Kazemi

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Those within the volatile and interconnected international economic markets, appropriately predicting market trends, hold substantial fees for traders and financial establishments. Traditional device mastering strategies have made full-size strides in forecasting marketplace movements; however, monetary data's complicated and networked nature calls for extra sophisticated processes. This observation offers a groundbreaking method for monetary marketplace prediction that leverages the synergistic capability of Graph Convolutional Networks (GCNs) and Long Short-Term Memory (LSTM) networks. Our suggested algorithm is meticulously designed to forecast the traits of inventory market indices and cryptocurrency costs, utilizing a comprehensive dataset spanning from January 1, 2015, to December 31, 2023. This era, marked by sizable volatility and transformation in financial markets, affords a solid basis for schooling and checking out our predictive version. Our algorithm integrates diverse facts to construct a dynamic economic graph that correctly reflects market intricacies. We meticulously collect opening, closing, and high and low costs daily for key inventory marketplace indices (e.g., S&P 500, NASDAQ) and widespread cryptocurrencies (e.g., Bitcoin, Ethereum), ensuring a holistic view of marketplace traits. Daily trading volumes are also incorporated to seize marketplace pastime and liquidity, providing critical insights into the market's shopping for and selling dynamics. Furthermore, recognizing the profound influence of the monetary surroundings on financial markets, we integrate critical macroeconomic signs with hobby fees, inflation rates, GDP increase, and unemployment costs into our model. Our GCN algorithm is adept at learning the relational patterns amongst specific financial devices represented as nodes in a comprehensive market graph. Edges in this graph encapsulate the relationships based totally on co-movement styles and sentiment correlations, enabling our version to grasp the complicated community of influences governing marketplace moves. Complementing this, our LSTM algorithm is trained on sequences of the spatial-temporal illustration discovered through the GCN, enriched with historic fee and extent records. This lets the LSTM seize and expect temporal marketplace developments accurately. Inside the complete assessment of our GCN-LSTM algorithm across the inventory marketplace and cryptocurrency datasets, the version confirmed advanced predictive accuracy and profitability compared to conventional and opportunity machine learning to know benchmarks. Specifically, the model performed a Mean Absolute Error (MAE) of 0.85%, indicating high precision in predicting day-by-day charge movements. The RMSE was recorded at 1.2%, underscoring the model's effectiveness in minimizing tremendous prediction mistakes, which is vital in volatile markets. Furthermore, when assessing the model's predictive performance on directional market movements, it achieved an accuracy rate of 78%, significantly outperforming the benchmark models, averaging an accuracy of 65%. This high degree of accuracy is instrumental for techniques that predict the course of price moves. This study showcases the efficacy of mixing graph-based totally and sequential deep learning knowledge in economic marketplace prediction and highlights the fee of a comprehensive, records-pushed evaluation framework. Our findings promise to revolutionize investment techniques and hazard management practices, offering investors and economic analysts a powerful device to navigate the complexities of cutting-edge economic markets.

Keywords: financial market prediction, graph convolutional networks (GCNs), long short-term memory (LSTM), cryptocurrency forecasting

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726 Child Feeding Practices Among Mothers in Urban Areas of Akure, Ondo State, Nigeria

Authors: Olufemi Samuel Shola, Oladapo Adenike Adesola

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Inadequate dietary intake has increased the susceptibility of under five children to malnutrition and infections. This study, therefore, assessed the feeding practices of children of 0-23 months of age among mothers in urban areas of Akure, Ondo State, Nigeria. Simple random sampling technique was used to select four hundred (400) mothers out of 710 mothers from 7 primary health care centres in Akure metropolis for the study. Data were collected using modified WHO 2003 Questionnaire on child feeding practices. Data were analyzed using descriptive statistics, while chi-square was used to determine the association between variables. Results showed that 52.0% of the children were males, with 47.5% in the 6-8 months age group. More than half (57.0%) of the mothers were between the ages of 20-29 years, and 45.0% had secondary education. Majority (94.3%) of the mothers breastfed their children in the last 24 hours preceding the survey. The feeding practices history of mothers showed that 28.0% and 53.7% of the mothers initiated breastfeeding less than 30 minutes and between 30 minutes to 1 hour after delivery, respectively. Also, 52.0% of mothers practiced exclusive breastfeeding for six months, while 26.2% breastfed from 6 months up to 2 years of age. Dietary diversity of the children age 6-23 months revealed that 68.7% of the children attained the minimum dietary diversity by consuming 4 or more food groups in the last 24 hours. There was a significant association (P < 0.05) between mothers’ education (n=180), occupation(n=41) and dietary diversity (n= 150) and meal frequency (n=209). Therefore, the study concluded that the duration of breastfeeding and time of introduction of complementary food did not meet WHO recommended guidelines. There is urgent need to launching more programmes.

Keywords: breastfeeding, mothers, child feeding, urban areas, ondo state, nigeria

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725 Design of SAE J2716 Single Edge Nibble Transmission Digital Sensor Interface for Automotive Applications

Authors: Jongbae Lee, Seongsoo Lee

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Modern sensors often embed small-size digital controller for sensor control, value calibration, and signal processing. These sensors require digital data communication with host microprocessors, but conventional digital communication protocols are too heavy for price reduction. SAE J2716 SENT (single edge nibble transmission) protocol transmits direct digital waveforms instead of complicated analog modulated signals. In this paper, a SENT interface is designed in Verilog HDL (hardware description language) and implemented in FPGA (field-programmable gate array) evaluation board. The designed SENT interface consists of frame encoder/decoder, configuration register, tick period generator, CRC (cyclic redundancy code) generator/checker, and TX/RX (transmission/reception) buffer. Frame encoder/decoder is implemented as a finite state machine, and it controls whole SENT interface. Configuration register contains various parameters such as operation mode, tick length, CRC option, pause pulse option, and number of nibble data. Tick period generator generates tick signals from input clock. CRC generator/checker generates or checks CRC in the SENT data frame. TX/RX buffer stores transmission/received data. The designed SENT interface can send or receives digital data in 25~65 kbps at 3 us tick. Synthesized in 0.18 um fabrication technologies, it is implemented about 2,500 gates.

Keywords: digital sensor interface, SAE J2716, SENT, verilog HDL

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724 Using Wearable Device with Neuron Network to Classify Severity of Sleep Disorder

Authors: Ru-Yin Yang, Chi Wu, Cheng-Yu Tsai, Yin-Tzu Lin, Wen-Te Liu

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Background: Sleep breathing disorder (SDB) is a condition demonstrated by recurrent episodes of the airway obstruction leading to intermittent hypoxia and quality fragmentation during sleep time. However, the procedures for SDB severity examination remain complicated and costly. Objective: The objective of this study is to establish a simplified examination method for SDB by the respiratory impendence pattern sensor combining the signal processing and machine learning model. Methodologies: We records heart rate variability by the electrocardiogram and respiratory pattern by impendence. After the polysomnography (PSG) been done with the diagnosis of SDB by the apnea and hypopnea index (AHI), we calculate the episodes with the absence of flow and arousal index (AI) from device record. Subjects were divided into training and testing groups. Neuron network was used to establish a prediction model to classify the severity of the SDB by the AI, episodes, and body profiles. The performance was evaluated by classification in the testing group compared with PSG. Results: In this study, we enrolled 66 subjects (Male/Female: 37/29; Age:49.9±13.2) with the diagnosis of SDB in a sleep center in Taipei city, Taiwan, from 2015 to 2016. The accuracy from the confusion matrix on the test group by NN is 71.94 %. Conclusion: Based on the models, we established a prediction model for SDB by means of the wearable sensor. With more cases incoming and training, this system may be used to rapidly and automatically screen the risk of SDB in the future.

Keywords: sleep breathing disorder, apnea and hypopnea index, body parameters, neuron network

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723 Medical Nutritional Therapy in Human Immunodeficiency Virus Infection with Tuberculosis and Severe Malnutrition: A Case Report

Authors: Lista Andriyati, Nurpudji A Taslim

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The human immunodeficiency virus (HIV) patients have potential nutritional and metabolic problems. HIV is a virus that attacks cells T helper and impairs the function of immune cells. Infected individuals gradually become immunodeficient, results in increased susceptibility to a wide range of infections such as tuberculosis (TB). Malnutrition has destructive effects on the immune system and host defense mechanisms. Effective and proper nutritional therapies are important to improve medical outcomes and quality of life, which is associated with functional improvement. A case of 38-years old man admitted to hospital with loss of consciousness and was diagnosed HIV infection and relapse lung TB with severe malnutrition, fever, oral candidiasis, anemia (6.3 g/dL), severe hypoalbuminemia (1.9 g/dL), severe hypokalemia (2.2 mmol/L), immune depletion (1085 /µL) and elevated liver enzyme (ALT 1198/AST 375 U/L). Nutritional intervention by giving 2300 kcal of energy, protein 2 g/IBW/day, carbohydrate 350 g, fat 104 g through enteral and parenteral nutrition. Supplementations administered are zinc, vitamin A, vitamin B1, vitamin B6, vitamin B12, vitamin C, vitamin D, and snakehead fish extract high content of protein albumin (Pujimin®). After 46 days, there are clinical and metabolic improvement in Hb (6.3 to 11.2 g/dL), potassium (2.2 to 3.4 mmol/L), albumin (1.9 to 2.3 g/dL), ALT 1198 to 47/AST 375 to 68 U/L) and improved awareness. In conclusion, nutritional therapy in HIV infection with adequate macronutrients and micronutrients fulfillment and immunonutrition is very important to avoid cachexia and to improve nutritional status and immune disfunction.

Keywords: HIV, hypoalbuminemia, malnutrition, tuberculosis

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722 An Application of Path Planning Algorithms for Autonomous Inspection of Buried Pipes with Swarm Robots

Authors: Richard Molyneux, Christopher Parrott, Kirill Horoshenkov

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This paper aims to demonstrate how various algorithms can be implemented within swarms of autonomous robots to provide continuous inspection within underground pipeline networks. Current methods of fault detection within pipes are costly, time consuming and inefficient. As such, solutions tend toward a more reactive approach, repairing faults, as opposed to proactively seeking leaks and blockages. The paper presents an efficient inspection method, showing that autonomous swarm robotics is a viable way of monitoring underground infrastructure. Tailored adaptations of various Vehicle Routing Problems (VRP) and path-planning algorithms provide a customised inspection procedure for complicated networks of underground pipes. The performance of multiple algorithms is compared to determine their effectiveness and feasibility. Notable inspirations come from ant colonies and stigmergy, graph theory, the k-Chinese Postman Problem ( -CPP) and traffic theory. Unlike most swarm behaviours which rely on fast communication between agents, underground pipe networks are a highly challenging communication environment with extremely limited communication ranges. This is due to the extreme variability in the pipe conditions and relatively high attenuation of acoustic and radio waves with which robots would usually communicate. This paper illustrates how to optimise the inspection process and how to increase the frequency with which the robots pass each other, without compromising the routes they are able to take to cover the whole network.

Keywords: autonomous inspection, buried pipes, stigmergy, swarm intelligence, vehicle routing problem

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721 Iterative Method for Lung Tumor Localization in 4D CT

Authors: Sarah K. Hagi, Majdi Alnowaimi

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In the last decade, there were immense advancements in the medical imaging modalities. These advancements can scan a whole volume of the lung organ in high resolution images within a short time. According to this performance, the physicians can clearly identify the complicated anatomical and pathological structures of lung. Therefore, these advancements give large opportunities for more advance of all types of lung cancer treatment available and will increase the survival rate. However, lung cancer is still one of the major causes of death with around 19% of all the cancer patients. Several factors may affect survival rate. One of the serious effects is the breathing process, which can affect the accuracy of diagnosis and lung tumor treatment plan. We have therefore developed a semi automated algorithm to localize the 3D lung tumor positions across all respiratory data during respiratory motion. The algorithm can be divided into two stages. First, a lung tumor segmentation for the first phase of the 4D computed tomography (CT). Lung tumor segmentation is performed using an active contours method. Then, localize the tumor 3D position across all next phases using a 12 degrees of freedom of an affine transformation. Two data set where used in this study, a compute simulate for 4D CT using extended cardiac-torso (XCAT) phantom and 4D CT clinical data sets. The result and error calculation is presented as root mean square error (RMSE). The average error in data sets is 0.94 mm ± 0.36. Finally, evaluation and quantitative comparison of the results with a state-of-the-art registration algorithm was introduced. The results obtained from the proposed localization algorithm show a promising result to localize alung tumor in 4D CT data.

Keywords: automated algorithm , computed tomography, lung tumor, tumor localization

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720 In-silico Antimicrobial Activity of Bioactive Compounds of Ricinus communis against DNA Gyrase of Staphylococcus aureus as Molecular Target

Authors: S. Rajeswari

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Medicinal Plant extracts and their bioactive compounds have been used for antimicrobial activities and have significant remedial properties. In the recent years, a wide range of investigations have been carried out throughout the world to confirm antimicrobial properties of different medicinally important plants. A number of plants showed efficient antimicrobial activities, which were comparable to that of synthetic standard drugs or antimicrobial agents. The large family Euphorbiaceae contains nearly about 300 genera and 7,500 speciesand one among is Ricinus communis or castor plant which has high traditional and medicinal value for disease free healthy life. Traditionally the plant is used as laxative, purgative, fertilizer and fungicide etc. whereas the plant possess beneficial effects such as anti-oxidant, antihistamine, antinociceptive, antiasthmatic, antiulcer, immunomodulatory anti diabetic, hepatoprotective, anti inflammatory, antimicrobial, and many other medicinal properties. This activity of the plant possess due to the important phytochemical constituents like flavonoids, saponins, glycosides, alkaloids and steroids. The presents study includes the phytochemical properties of Ricinus communis and to prediction of the anti-microbial activity of Ricinus communis using DNA gyrase of Staphylococcus aureus as molecular target. Docking results of varies chemicals compounds of Ricinus communis against DNA gyrase of Staphylococcus aureus by maestro 9.8 of Schrodinger show that the phytochemicals are effective against the target protein DNA gyrase. our studies suggest that the phytochemical from Ricinus communis such has INDICAN (G.Score 4.98) and SUPLOPIN-2(G.Score 5.74) can be used as lead molecule against Staphylococcus infections.

Keywords: euphorbiaceae, antimicrobial activity, Ricinus communis, Staphylococcus aureus

Procedia PDF Downloads 478
719 Internal Combustion Engine Fuel Composition Detection by Analysing Vibration Signals Using ANFIS Network

Authors: M. N. Khajavi, S. Nasiri, E. Farokhi, M. R. Bavir

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Alcohol fuels are renewable, have low pollution and have high octane number; therefore, they are important as fuel in internal combustion engines. Percentage detection of these alcoholic fuels with gasoline is a complicated, time consuming, and expensive process. Nowadays, these processes are done in equipped laboratories, based on international standards. The aim of this research is to determine percentage detection of different fuels based on vibration analysis of engine block signals. By doing, so considerable saving in time and cost can be achieved. Five different fuels consisted of pure gasoline (G) as base fuel and combination of this fuel with different percent of ethanol and methanol are prepared. For example, volumetric combination of pure gasoline with 10 percent ethanol is called E10. By this convention, we made M10 (10% methanol plus 90% pure gasoline), E30 (30% ethanol plus 70% pure gasoline), and M30 (30% Methanol plus 70% pure gasoline) were prepared. To simulate real working condition for this experiment, the vehicle was mounted on a chassis dynamometer and run under 1900 rpm and 30 KW load. To measure the engine block vibration, a three axis accelerometer was mounted between cylinder 2 and 3. After acquisition of vibration signal, eight time feature of these signals were used as inputs to an Adaptive Neuro Fuzzy Inference System (ANFIS). The designed ANFIS was trained for classifying these five different fuels. The results show suitable classification ability of the designed ANFIS network with 96.3 percent of correct classification.

Keywords: internal combustion engine, vibration signal, fuel composition, classification, ANFIS

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718 Augmentation of Conventional Medicine for Post-concussion Syndrome with Cognitive Behavioral Therapy Accelerates Symptomatic Relief in Affected Individuals

Authors: Waqas Mehdi, Muhammad Umar Hassan, Khadeeja Mustafa

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Objective: Post-concussion syndrome (PCS) is a medical term used to point out the complicated combination of physical, emotional, cognitive and behavioral signs and symptoms associated with Mild Traumatic Brain Injury(mTBI). This study was conducted to assess the improvement or debilitating effect of behavioral therapy in addition to the conventional treatment and to document these results for increasing the efficiency of treatment provided to such cases. Method: This was primarily an interventional prospective cohort study which was conducted in the Department of Neurosurgery, Mayo Hospital Lahore. The sample size was 200 patients who were randomly distributed into two groups. The interventional group with Cognitive behavioral therapy was added in addition to the conventional treatment regimen and the Control group receiving only conventional treatment. Results were noted initially as well as after two weeks of the follow-up period. Data were subsequently analyzed by Statistical Package for Social Sciences (SPSS) software and associations worked out. Result and conclusion: Among the patients that were given therapy sessions along with conventional medicine, there was a significant improvement in the symptoms and their overall quality of life. It is also important to notice that the time period taken for these effects to wane is cut down by psychiatric solutions too. So we can conclude that CBT sessions not only speed up recovery in patients with post-concussion syndrome they also aid in the efficiency improvement in functional capability and quality of life.

Keywords: neurosurgery, CBT, PCS, mTBI

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717 Optimization of Personnel Selection Problems via Unconstrained Geometric Programming

Authors: Vildan Kistik, Tuncay Can

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From a business perspective, cost and profit are two key factors for businesses. The intent of most businesses is to minimize the cost to maximize or equalize the profit, so as to provide the greatest benefit to itself. However, the physical system is very complicated because of technological constructions, rapid increase of competitive environments and similar factors. In such a system it is not easy to maximize profits or to minimize costs. Businesses must decide on the competence and competence of the personnel to be recruited, taking into consideration many criteria in selecting personnel. There are many criteria to determine the competence and competence of a staff member. Factors such as the level of education, experience, psychological and sociological position, and human relationships that exist in the field are just some of the important factors in selecting a staff for a firm. Personnel selection is a very important and costly process in terms of businesses in today's competitive market. Although there are many mathematical methods developed for the selection of personnel, unfortunately the use of these mathematical methods is rarely encountered in real life. In this study, unlike other methods, an exponential programming model was established based on the possibilities of failing in case the selected personnel was started to work. With the necessary transformations, the problem has been transformed into unconstrained Geometrical Programming problem and personnel selection problem is approached with geometric programming technique. Personnel selection scenarios for a classroom were established with the help of normal distribution and optimum solutions were obtained. In the most appropriate solutions, the personnel selection process for the classroom has been achieved with minimum cost.

Keywords: geometric programming, personnel selection, non-linear programming, operations research

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716 Fixed Point Iteration of a Damped and Unforced Duffing's Equation

Authors: Paschal A. Ochang, Emmanuel C. Oji

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The Duffing’s Equation is a second order system that is very important because they are fundamental to the behaviour of higher order systems and they have applications in almost all fields of science and engineering. In the biological area, it is useful in plant stem dependence and natural frequency and model of the Brain Crash Analysis (BCA). In Engineering, it is useful in the study of Damping indoor construction and Traffic lights and to the meteorologist it is used in the prediction of weather conditions. However, most Problems in real life that occur are non-linear in nature and may not have analytical solutions except approximations or simulations, so trying to find an exact explicit solution may in general be complicated and sometimes impossible. Therefore we aim to find out if it is possible to obtain one analytical fixed point to the non-linear ordinary equation using fixed point analytical method. We started by exposing the scope of the Duffing’s equation and other related works on it. With a major focus on the fixed point and fixed point iterative scheme, we tried different iterative schemes on the Duffing’s Equation. We were able to identify that one can only see the fixed points to a Damped Duffing’s Equation and not to the Undamped Duffing’s Equation. This is because the cubic nonlinearity term is the determining factor to the Duffing’s Equation. We finally came to the results where we identified the stability of an equation that is damped, forced and second order in nature. Generally, in this research, we approximate the solution of Duffing’s Equation by converting it to a system of First and Second Order Ordinary Differential Equation and using Fixed Point Iterative approach. This approach shows that for different versions of Duffing’s Equations (damped), we find fixed points, therefore the order of computations and running time of applied software in all fields using the Duffing’s equation will be reduced.

Keywords: damping, Duffing's equation, fixed point analysis, second order differential, stability analysis

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715 Determining the Efficacy of Phenol, Sodium Hypochlorite and Ethanol for Inactivation of Carbapenem-Resistant Strain of Acinetobacter baumannii

Authors: Deepika Biswas

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Acinetobacter baumannii, a hospital-acquired pathogen, causes nosocomial infections including pneumonia, urinary tract infection, and secondary meningitis. Carbapenem is most effective antibiotics against it. Its increased resistance to carbapenems has been a rising global concern. Antibiotics such as carbapenem are unable to use on hospital setups to eradicate A. baumannii, hence different concentrations of disinfectants including phenol; sodium hypochlorite and ethanol are increasingly being used. The objective of the present study is to find an effective concentration of above disinfectants against carbapenem-resistant strain RS307 of A. baumannii. Growth kinetics of RS307 has been determined using UV-Vis spectrophotometer in the presence and absence of disinfectants in triplicate and its standard deviation has also been calculated which make the results more reliable. Differential growth curves were plotted, which showed the effective concentration among all the concentrations of phenol, sodium hypochlorite and ethanol. On disc diffusion assay, antimicrobial effect was observed by comparing all the concentrations of disinfectants to check its synergy with imipenem, most effective carbapenem. All the results collectively revealed that 0.5% phenol, 0.5% sodium hypochlorite, and 70% ethanol could preferably be used as disinfectant for hospital setup against the carbapenem-resistant strain of A. baumannii. SDS PAGE analysis showed differential expression in the protein profile of A. baumannii after treatment. The present study highlighted that few disinfectants even in low concentration had shown better antimicrobial activity hence may be recommended for regular use in the hospitals, which will be cost effective and less harmful.

Keywords: Acenatobacter bomunii, phenol, sodium hypoclirite, ethanol, carbapenem resistance, disinfectant

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714 Genetic Diversity and Molecular Basis of Carbapenem Resistance in Acinetobacter Baumannii Isolates from Cattle

Authors: Minhas Alam, Muhammad Hidayat Rasool, Mohsin Khurshid, Bilal Aslam

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Acinetobacter baumannii is a notorious bacterial pathogen that is an emerging nightmare in clinical settings and is mainly involved in severe nosocomial infections. However, the data related to carbapenem-resistant A. baumannii (CRAB) from veterinary settings is limited, especially in developing countries like Pakistan. To investigate the genetic diversity and molecular basis of carbapenem resistance in Acinetobacter baumannii isolates from Cattle, a total of 1960 samples were collected from cattle from Punjab, Pakistan. The isolates were analyzed by routine microbiological procedures and confirmed by polymerase chain reaction (PCR). The isolates were further screened for antimicrobial susceptibility and the presence of multiple antimicrobial-resistant determinants by PCR. Multilocus sequence typing (MLST) was performed. The results of the current study revealed that the overall prevalence of A. baumannii in cattle was 3.28% (65/1980). Among cattle 27.7% (18/65) were found CRAB strains. The CRAB isolates harbor class D β- lactamases genes, e-g, blaOXA-23 and blaOXA-51, 94.4% (17/18). CRAB isolates carry class B β- lactamases gene blaIMP, and only one isolate carries the blaNDM-1 gene. The MLST results of CRAB isolates from cattle demonstrated 5 STs and one new ST. The commonly found sequence types in CRAB isolates were ST2 (n=10, 55.5%), followed by ST642 (n=5, 27.8%) and ST600 & ST889 (n=1, 5.55%). The presence of CRAB isolates in cattle indicates an alarming situation in Punjab, Pakistan. Immediate control measures should be taken to stop the transmission of CRAB isolates within cattle, to the environment, and to clinical settings.

Keywords: acinetobacter baumannii, carbapenemases, veterinary, drug resistance

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713 Object Oriented Fault Tree Analysis Methodology

Authors: Yi Xiong, Tao Kong

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Traditional safety, risk and reliability analysis approaches are problem-oriented, which make it great workload when analyzing complicated and huge system, besides, too much repetitive work would to do if the analyzed system composed by many similar components. It is pressing need an object and function oriented approach to maintain high consistency with problem domain. A new approach is proposed to overcome these shortcomings of traditional approaches, the concepts: class, abstract, inheritance, polymorphism and encapsulation are introduced into FTA and establish the professional class library that the abstractions of physical objects in real word, four areas relevant information also be proposed as the establish help guide. The interaction between classes is completed by the inside or external methods that mapping the attributes to base events through fully search the knowledge base, which forms good encapsulation. The object oriented fault tree analysis system that analyze and evaluate the system safety and reliability according to the original appearance of the problem is set up, where could mapped directly from the class and object to the problem domain of the fault tree analysis. All the system failure situations can be analyzed through this bottom-up fault tree construction approach. Under this approach architecture, FTA approach is developed, which avoids the human influence of the analyst on analysis results. It reveals the inherent safety problems of analyzed system itself and provides a new way of thinking and development for safety analysis. So that object oriented technology in the field of safety applications and development, safety theory is conducive to innovation.

Keywords: FTA, knowledge base, object-oriented technology, reliability analysis

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712 Method of Estimating Absolute Entropy of Municipal Solid Waste

Authors: Francis Chinweuba Eboh, Peter Ahlström, Tobias Richards

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Entropy, as an outcome of the second law of thermodynamics, measures the level of irreversibility associated with any process. The identification and reduction of irreversibility in the energy conversion process helps to improve the efficiency of the system. The entropy of pure substances known as absolute entropy is determined at an absolute reference point and is useful in the thermodynamic analysis of chemical reactions; however, municipal solid waste (MSW) is a structurally complicated material with unknown absolute entropy. In this work, an empirical model to calculate the absolute entropy of MSW based on the content of carbon, hydrogen, oxygen, nitrogen, sulphur, and chlorine on a dry ash free basis (daf) is presented. The proposed model was derived from 117 relevant organic substances which represent the main constituents in MSW with known standard entropies using statistical analysis. The substances were divided into different waste fractions; namely, food, wood/paper, textiles/rubber and plastics waste and the standard entropies of each waste fraction and for the complete mixture were calculated. The correlation of the standard entropy of the complete waste mixture derived was found to be somsw= 0.0101C + 0.0630H + 0.0106O + 0.0108N + 0.0155S + 0.0084Cl (kJ.K-1.kg) and the present correlation can be used for estimating the absolute entropy of MSW by using the elemental compositions of the fuel within the range of 10.3%  C 95.1%, 0.0%  H  14.3%, 0.0%  O  71.1%, 0.0  N  66.7%, 0.0%  S  42.1%, 0.0%  Cl  89.7%. The model is also applicable for the efficient modelling of a combustion system in a waste-to-energy plant.

Keywords: absolute entropy, irreversibility, municipal solid waste, waste-to-energy

Procedia PDF Downloads 307
711 Patterns and Extent of Self-Medication Practice among Adolescents in Selected Public Secondary Schools in IFE Central Local Government Area of Osun State, Nigeria

Authors: Olajumoke A. Ojeleye

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The study assessed the patterns and extent of self-medication practice among adolescents in selected public senior secondary schools in Ife Central Local Government Area of Osun State. The objectives of the study were to find out the patterns of self-medication among adolescents, to elucidate whether age or gender has any effect on the self-medication patterns of adolescent, to ascertain to what extent adolescents indulge in self-medication, to examine the sources of drug information of these adolescents and also to examine the sources of these drugs. A cross-sectional design was employed for the study. A self-administered questionnaire tested for validity was used to collect data. Multistage sampling technique was used and 238 adolescents participated in the study. Data collection took two weeks and was analysed using Statistical Package for Social Sciences version 17. Results were presented using descriptive (e.g. frequency counts) and inferential statistics (e.g. chi-square). Results showed that more females (55.9%) than males (44.1%) practiced self-medication. Although the results showed that there is a low prevalence rate (33.6%) of self-medication among adolescents, chemists served as both the source of information on how to use the drug as well as the source of the drugs. Also, adolescents under study will only self-medicate in medical conditions such as malaria or wound/injuries but will prefer to see a doctor for conditions such as abdominal pain, infections or allergic reactions. It was recommended that government officials responsible for regulating and controlling of drugs should be more active in ensuring that safe drugs are made available over the counter and the consumer be given adequate information about the use of drugs and when to consult the doctor.

Keywords: adolescents, drugs, patterns, self-medication

Procedia PDF Downloads 204
710 Human Immune Response to Surgery: The Surrogate Prediction of Postoperative Outcomes

Authors: Husham Bayazed

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Immune responses following surgical trauma play a pivotal role in predicting postoperative outcomes from healing and recovery to postoperative complications. Postoperative complications, including infections and protracted recovery, occur in a significant number of about 300 million surgeries performed annually worldwide. Complications cause personal suffering along with a significant economic burden on the healthcare system in any community. The accurate prediction of postoperative complications and patient-targeted interventions for their prevention remain major clinical provocations. Recent Findings: Recent studies are focusing on immune dysregulation mechanisms that occur in response to surgical trauma as a key determinant of postoperative complications. Antecedent studies mainly were plunging into the detection of inflammatory plasma markers, which facilitate in providing important clues regarding their pathogenesis. However, recent Single-cell technologies, such as mass cytometry or single-cell RNA sequencing, have markedly enhanced our ability to understand the immunological basis of postoperative immunological trauma complications and to identify their prognostic biological signatures. Summary: The advent of proteomic technologies has significantly advanced our ability to predict the risk of postoperative complications. Multiomic modeling of patients' immune states holds promise for the discovery of preoperative predictive biomarkers and providing patients and surgeons with information to improve surgical outcomes. However, more studies are required to accurately predict the risk of postoperative complications in individual patients.

Keywords: immune dysregulation, postoperative complications, surgical trauma, flow cytometry

Procedia PDF Downloads 84
709 Study and Solving High Complex Non-Linear Differential Equations Applied in the Engineering Field by Analytical New Approach AGM

Authors: Mohammadreza Akbari, Sara Akbari, Davood Domiri Ganji, Pooya Solimani, Reza Khalili

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In this paper, three complicated nonlinear differential equations(PDE,ODE) in the field of engineering and non-vibration have been analyzed and solved completely by new method that we have named it Akbari-Ganji's Method (AGM) . As regards the previous published papers, investigating this kind of equations is a very hard task to do and the obtained solution is not accurate and reliable. This issue will be emerged after comparing the achieved solutions by Numerical Method. Based on the comparisons which have been made between the gained solutions by AGM and Numerical Method (Runge-Kutta 4th), it is possible to indicate that AGM can be successfully applied for various differential equations particularly for difficult ones. Furthermore, It is necessary to mention that a summary of the excellence of this method in comparison with the other approaches can be considered as follows: It is noteworthy that these results have been indicated that this approach is very effective and easy therefore it can be applied for other kinds of nonlinear equations, And also the reasons of selecting the mentioned method for solving differential equations in a wide variety of fields not only in vibrations but also in different fields of sciences such as fluid mechanics, solid mechanics, chemical engineering, etc. Therefore, a solution with high precision will be acquired. With regard to the afore-mentioned explanations, the process of solving nonlinear equation(s) will be very easy and convenient in comparison with the other methods. And also one of the important position that is explored in this paper is: Trigonometric and exponential terms in the differential equation (the method AGM) , is no need to use Taylor series Expansion to enhance the precision of the result.

Keywords: new method (AGM), complex non-linear partial differential equations, damping ratio, energy lost per cycle

Procedia PDF Downloads 468
708 Histopathological Effects of Trichodiniasis in Farmed Freshwater Rainbow Trout, Oncorhynchus mykiss, in West of Iran

Authors: Zahra Khoshnood, Reza Khoshnood

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The aim of present study was to monitor the presence of Trichodina sp. in Rainbow trout, Oncorhynchus mykiss collected from various fish farms in the western provinces of Iran during January, 2013- January, 2014. Out of 675 sampled fish 335, (49.16%) were infested with Trichodina. The highest prevalence was observed in the spring and winter followed by autumn and summer. In general, the intensity of infection was low except in cases where outbreaks of Trichodiniasis endangered the survival of fish in some ponds. In light infestation Trichodina is usually present on gills, fins and skin of apparently healthy fish. Clinical signs of Trichodiniasis only appear on fish with heavy infections and cases of moderate ones that are usually exposed to one or more stress factors including, rough handling during transportation from ponds, overcrowdness, malnutrition, high of free ammonia and low of oxygen concentration. Clinical signs of Trichodiniasis in sampled fish were sluggish movement, loss of appetite, black coloration, necrosis and ulcer on different parts of the body, detached scales and excessive accumulation of mucous in gill pouches. The most obvious histopathological changes in diseased fish were sloughing of the epidermal layer, aggregation of leucocytes and melanine-carrying cells (between the dermis and hypodermis) and proliferative changes including hyperplasia and hypertrophy of the epithelial lining cells of gill filaments which resulted in fusion of secondary lamellae. Control of Trichodiniasis, has been achieved by formalin bath treatment at a concentration of 250 ppm for one hour.

Keywords: gill, histopathology, rainbow trout, Trichodina

Procedia PDF Downloads 426
707 A Photoemission Study of Dye Molecules Deposited by Electrospray on rutile TiO2 (110)

Authors: Nouf Alharbi, James O'shea

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For decades, renewable energy sources have received considerable global interest due to the increase in fossil fuel consumption. The abundant energy produced by sunlight makes dye-sensitised solar cells (DSSCs) a promising alternative compared to conventional silicon and thin film solar cells due to their transparency and tunable colours, which make them suitable for applications such as windows and glass facades. The transfer of an excited electron onto the surface is an important procedure in the DSSC system, so different groups of dye molecules were studied on the rutile TiO2 (110) surface. Currently, the study of organic dyes has become an interest of researchers due to ruthenium being a rare and expensive metal, and metal-free organic dyes have many features, such as high molar extinction coefficients, low manufacturing costs, and ease of structural modification and synthesis. There are, of course, some groups that have developed organic dyes and exhibited lower light-harvesting efficiency ranging between 4% and 8%. Since most dye molecules are complicated or fragile to be deposited by thermal evaporation or sublimation in the ultra-high vacuum (UHV), all dyes (i.e, D5, SC4, and R6) in this study were deposited in situ using the electrospray deposition technique combined with X-ray photoelectron spectroscopy (XPS) as an alternative method to obtain high-quality monolayers of titanium dioxide. These organic molecules adsorbed onto rutile TiO2 (110) are explored by XPS, which can be used to obtain element-specific information on the chemical structure and study bonding and interaction sites on the surface.

Keywords: dyes, deposition, electrospray, molecules, organic, rutile, sensitised, XPS

Procedia PDF Downloads 72
706 High Prevalence of Multi-drug Resistant Diarrheagenic Escherichia coli among Hospitalised Diarrheal Patients in Kolkata, India

Authors: Debjani Ghosh, Goutam Chowdhury, Prosenjit Samanta, Asish Kumar Mukhopadhyay

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Acute diarrhoea caused by diarrheagenic Escherichia coli (DEC) is one of the major public health problem in developing countries, mainly in Asia and Africa. DEC consists of six pathogroups, but the majority of the cases were associated with the three pathogropus, enterotoxigenic E. coli (ETEC), enteroaggregative E. coli (EAEC), and enteropathogenic E. coli (EPEC). Hence, we studied the prevalence and antimicrobial resistance of these three major DEC pathogroups in hospitalized diarrheal patients in Kolkata, India, during 2012-2019 with a large sample size. 8,891 stool samples were processed, and 7.8% of them was identified as DEC infection screened by multiplex PCR, in which ETEC was most common (47.7%) followed by EAEC (38.4%) and EPEC (13.9%). Clinical patient history suggested that children <5 years of age were mostly affected with ETEC and EAEC, whereas people within >5-14 years of age were significantly associated with EPEC and ETEC infections. Antibiogram profile showed a high prevalence of multidrug resistant (MDR) isolates among DEC (56.9%), in which 9% were resistant to antibiotics of six different antimicrobial classes. Screening of the antibiotic resistance conferring genes in DEC showed the presence of blaCTX-M (30.2%) in highest number followed by blaTEM (27.5%), tetB (18%), sul2 (12.6%), strA (11.8%), aadA1 (9.8%), blaOXA-1 (9%), dfrA1 (1.6%) and blaSHV (1.2%) which indicates the existence of mobile genetic elements in those isolates. Therefore, the presence of MDR DEC strains in higher number alarms the public health authorities to take preventive measures before the upsurge of the DEC caused diarrhea cases in near future.

Keywords: diarrheagenic escherichia coli, ETEC, EAEC, EPEC

Procedia PDF Downloads 160
705 A Transient Coupled Numerical Analysis of the Flow of Magnetorheological Fluids in Closed Domains

Authors: Wael Elsaady, S. Olutunde Oyadiji, Adel Nasser

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The non-linear flow characteristics of magnetorheological (MR) fluids in MR dampers are studied via a coupled numerical approach that incorporates a two-phase flow model. The approach couples the Finite Element (FE) modelling of the damper magnetic circuit, with the Computational Fluid Dynamics (CFD) analysis of the flow field in the damper. The two-phase flow CFD model accounts for the effect of fluid compressibility due to the presence of liquid and gas in the closed domain of the damper. The dynamic mesh model included in ANSYS/Fluent CFD solver is used to simulate the movement of the MR damper piston in order to perform the fluid excitation. The two-phase flow analysis is studied by both Volume-Of-Fluid (VOF) model and mixture model that are included in ANSYS/Fluent. The CFD models show that the hysteretic behaviour of MR dampers is due to the effect of fluid compressibility. The flow field shows the distributions of pressure, velocity, and viscosity contours. In particular, it shows the high non-Newtonian viscosity in the affected fluid regions by the magnetic field and the low Newtonian viscosity elsewhere. Moreover, the dependence of gas volume fraction on the liquid pressure inside the damper is predicted by the mixture model. The presented approach targets a better understanding of the complicated flow characteristics of viscoplastic fluids that could be applied in different applications.

Keywords: viscoplastic fluid, magnetic FE analysis, computational fluid dynamics, two-phase flow, dynamic mesh, user-defined functions

Procedia PDF Downloads 173
704 Society and Cinema in Iran

Authors: Seyedeh Rozhano Azimi Hashemi

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There is no doubt that ‘Art’ is a social phenomena and cinema is the most social kind of art. Hence, it’s clear that we can analyze the relation’s of cinema and art from different aspects. In this paper sociological cinema will be investigated which, is a subdivision of sociological art. This term will be discussed by two main approaches. One of these approaches is focused on the effects of cinema on the society, which is known as “Effects Theory” and the second one, which is dealing with the reflection of social issues in cinema is called ” Reflection Theory”. "Reflect theory" approach, unlike "Effects theory" is considering movies as documents, in which social life is reflected, and by analyzing them, the changes and tendencies of a society are understood. Criticizing these approaches to cinema and society doesn’t mean that they are not real. Conversely, it proves the fact that for better understanding of cinema and society’s relation, more complicated models are required, which should consider two aspects. First, they should be bilinear and they should provide a dynamic and active relation between cinema and society, as for the current concept social life and cinema have bi-linear effects on each other, and that’s how they fit in a dialectic and dynamic process. Second, it should pay attention to the role of inductor elements such as small social institutions, marketing, advertisements, cultural pattern, art’s genres and popular cinema in society. In the current study, image of middle class in cinema of Iran and changing the role of women in cinema and society which were two bold issue that cinema and society faced since 1979 revolution till 80s are analyzed. Films as an artwork on one hand, are reflections of social changes and with their effects on the society on the other hand, are trying to speed up the trends of these changes. Cinema by the illustration of changes in ideologies and approaches in exaggerated ways and through it’s normalizing functions, is preparing the audiences and public opinions for the acceptance of these changes. Consequently, audience takes effect from this process, which is a bi-linear and interactive process.

Keywords: Iranian Cinema, Cinema and Society, Middle Class, Woman’s Role

Procedia PDF Downloads 340
703 A Three-Dimensional (3D) Numerical Study of Roofs Shape Impact on Air Quality in Urban Street Canyons with Tree Planting

Authors: Bouabdellah Abed, Mohamed Bouzit, Lakhdar Bouarbi

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The objective of this study is to investigate numerically the effect of roof shaped on wind flow and pollutant dispersion in a street canyon with one row of trees of pore volume, Pvol = 96%. A three-dimensional computational fluid dynamics (CFD) model for evaluating air flow and pollutant dispersion within an urban street canyon using Reynolds-averaged Navier–Stokes (RANS) equations and the k-Epsilon EARSM turbulence model as close of the equation system. The numerical model is performed with ANSYS-CFX code. Vehicle emissions were simulated as double line sources along the street. The numerical model was validated against the wind tunnel experiment. Having established this, the wind flow and pollutant dispersion in urban street canyons of six roof shapes are simulated. The numerical simulation agrees reasonably with the wind tunnel data. The results obtained in this work, indicate that the flow in 3D domain is more complicated, this complexity is increased with presence of tree and variability of the roof shapes. The results also indicated that the largest pollutant concentration level for two walls (leeward and windward wall) is observed with the upwind wedge-shaped roof. But the smallest pollutant concentration level is observed with the dome roof-shaped. The results also indicated that the corners eddies provide additional ventilation and lead to lower traffic pollutant concentrations at the street canyon ends.

Keywords: street canyon, pollutant dispersion, trees, building configuration, numerical simulation, k-Epsilon EARSM

Procedia PDF Downloads 363
702 Thresholding Approach for Automatic Detection of Pseudomonas aeruginosa Biofilms from Fluorescence in situ Hybridization Images

Authors: Zonglin Yang, Tatsuya Akiyama, Kerry S. Williamson, Michael J. Franklin, Thiruvarangan Ramaraj

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Pseudomonas aeruginosa is an opportunistic pathogen that forms surface-associated microbial communities (biofilms) on artificial implant devices and on human tissue. Biofilm infections are difficult to treat with antibiotics, in part, because the bacteria in biofilms are physiologically heterogeneous. One measure of biological heterogeneity in a population of cells is to quantify the cellular concentrations of ribosomes, which can be probed with fluorescently labeled nucleic acids. The fluorescent signal intensity following fluorescence in situ hybridization (FISH) analysis correlates to the cellular level of ribosomes. The goals here are to provide computationally and statistically robust approaches to automatically quantify cellular heterogeneity in biofilms from a large library of epifluorescent microscopy FISH images. In this work, the initial steps were developed toward these goals by developing an automated biofilm detection approach for use with FISH images. The approach allows rapid identification of biofilm regions from FISH images that are counterstained with fluorescent dyes. This methodology provides advances over other computational methods, allowing subtraction of spurious signals and non-biological fluorescent substrata. This method will be a robust and user-friendly approach which will enable users to semi-automatically detect biofilm boundaries and extract intensity values from fluorescent images for quantitative analysis of biofilm heterogeneity.

Keywords: image informatics, Pseudomonas aeruginosa, biofilm, FISH, computer vision, data visualization

Procedia PDF Downloads 132
701 A Review on the Importance of Nursing Approaches in Nutrition of Children with Cancer

Authors: Ş. Çiftcioğlu, E. Efe

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In recent years, cancer has been at the top of diseases that cause death in children. Adequate and balanced nutrition plays an important role in the treatment of cancer. Cancer and cancer treatment is affecting food intake, absorption and metabolism, causing nutritional disorders. Appropriate nutrition is very important for the cancerous child to feel well before, during and after the treatment. There are various difficulties in feeding children with cancer. These are the cancer-related factors. Other factors are environmental and behavioral. As health professionals who spend more time with children in the hospital, nurses should be able to support the children on nutrition and help them to have balanced nutrition. This study aimed to evaluate the importance of nursing approaches in the nutrition of children with cancer. This article is planned as a review article by searching the literature on this field. Anorexia may develop due to psychogenic causes or chemotherapeutic agents or accompanying infections and nutrient uptake may be reduced.  In addition, stomatitis, mucositis, taste and odor changes in the mouth, the feeling of nausea, vomiting and diarrhea can also reduce oral intake and result in significant losses in the energy deficit. In assessing the nutritional status of children with cancer, determining weight loss and good nutrition is essential anamnesis of a child.  Some anthropometric measurements and biochemical tests should be used to evaluate the nutrition of the child. The nutritional status of pediatric cancer patients has been studied for a long time and malnutrition, in particular under nutrition, in this population has long been recognized. Yet, its management remains variable with many malnourished children going unrecognized and consequently untreated. Nutritional support is important to pediatric cancer patients and should be integrated into the overall treatment of these children.

Keywords: cancer treatment, children, complication, nutrition, nursing approaches

Procedia PDF Downloads 218