Search results for: active body weight
704 A Failure to Strike a Balance: The Use of Parental Mediation Strategies by Foster Carers and Social Workers
Authors: Jennifer E Simpson
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Background and purpose: The ubiquitous use of the Internet and social media by children and young people has had a dual effect. The first is to open a world of possibilities and promise that is characterized by the ability to consume and create content, connect with friends, explore and experiment. The second relates to risks such as unsolicited requests, sexual exploitation, cyberbullying and commercial exploitation. This duality poses significant difficulties for a generation of foster carers and social workers who have no childhood experience to draw on in terms of growing up using the Internet, social media and digital devices. This presentation is concerned with the findings of a small qualitative study about the use of digital devices and the Internet by care-experienced young people to stay in touch with their families and the way this was managed by foster carers and social workers using specific parental mediation strategies. The findings highlight that restrictive strategies were used by foster carers and endorsed by social workers. An argument is made for an approach that develops a series of balanced solutions that move foster carers from such restrictive approaches to those that are grounded in co-use and are interpretive in nature. Methods: Using a purposive sampling strategy, 12 triads consisting of care-experienced young people (aged 13-18 years), their foster carers and allocated social workers were recruited. All respondents undertook a semi-structured interview, with the young people detailing what social media apps and other devices they used to contact their families via an Ecomap. The foster carers and social workers shared details of the methods and approaches they used to manage digital devices and the Internet in general. Data analysis was performed using a Framework analytic method to explore the various attitudes, as well as complementary and contradictory perspectives of the young people, their foster carers and allocated social workers. Findings: The majority of foster carers made use of parental mediation strategies that erred on the side of typologies that included setting rules and regulations (restrictive), ad-hoc checking of a young person’s behavior and device (monitoring), and software used to limit or block access to inappropriate websites (technical). It was noted that minimal use was made by foster carers of parental mediation strategies that included talking about content (active/interpretive) or sharing Internet activities (co-use). Amongst the majority of the social workers, they also had a strong preference for restrictive approaches. Conclusions and implications: Trepidations on the part of both foster carers and social workers about the use of digital devices and the Internet meant that the parental strategies used were weighted more towards restriction, with little use made of approaches such as co-use and interpretative. This lack of balance calls for solutions that are grounded in co-use and an interpretive approach, both of which can be achieved through training and support, as well as wider policy change.Keywords: parental mediation strategies, risk, children in state care, online safety
Procedia PDF Downloads 74703 Gradient Length Anomaly Analysis for Landslide Vulnerability Analysis of Upper Alaknanda River Basin, Uttarakhand Himalayas, India
Authors: Hasmithaa Neha, Atul Kumar Patidar, Girish Ch Kothyari
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The northward convergence of the Indian plate has a dominating influence over the structural and geomorphic development of the Himalayan region. The highly deformed and complex stratigraphy in the area arises from a confluence of exogenic and endogenetic geological processes. This region frequently experiences natural hazards such as debris flows, flash floods, avalanches, landslides, and earthquakes due to its harsh and steep topography and fragile rock formations. Therefore, remote sensing technique-based examination and real-time monitoring of tectonically sensitive regions may provide crucial early warnings and invaluable data for effective hazard mitigation strategies. In order to identify unusual changes in the river gradients, the current study demonstrates a spatial quantitative geomorphic analysis of the upper Alaknanda River basin, Uttarakhand Himalaya, India, using gradient length anomaly analysis (GLAA). This basin is highly vulnerable to ground creeping and landslides due to the presence of active faults/thrusts, toe-cutting of slopes for road widening, development of heavy engineering projects on the highly sheared bedrock, and periodic earthquakes. The intersecting joint sets developed in the bedrocks have formed wedges that have facilitated the recurrence of several landslides. The main objective of current research is to identify abnormal gradient lengths, indicating potential landslide-prone zones. High-resolution digital elevation data and geospatial techniques are used to perform this analysis. The results of GLAA are corroborated with the historical landslide events and ultimately used for the generation of landslide susceptibility maps of the current study area. The preliminary results indicate that approximately 3.97% of the basin is stable, while about 8.54% is classified as moderately stable and suitable for human habitation. However, roughly 19.89% fall within the zone of moderate vulnerability, 38.06% are classified as vulnerable, and 29% fall within the highly vulnerable zones, posing risks for geohazards, including landslides, glacial avalanches, and earthquakes. This research provides valuable insights into the spatial distribution of landslide-prone areas. It offers a basis for implementing proactive measures for landslide risk reduction, including land-use planning, early warning systems, and infrastructure development techniques.Keywords: landslide vulnerability, geohazard, GLA, upper Alaknanda Basin, Uttarakhand Himalaya
Procedia PDF Downloads 73702 Influence of Spirituality on Health Outcomes and General Well-Being in Patients with End-Stage Renal Disease
Authors: Ali A Alshraifeen, Josie Evans, Kathleen Stoddart
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End-stage renal disease (ESRD) introduces physical, psychological, social, emotional and spiritual challenges into patients’ lives. Spirituality has been found to contribute to improved health outcomes, mainly in the areas of quality of life (QOL) and well-being. No studies exist to explore the influence of spirituality on the health outcomes and general well-being in patients with end-stage renal disease receiving hemodialysis (HD) treatment in Scotland. This study was conducted to explore spirituality in the daily lives of among these patients and how it may influence their QOL and general well-being. The study employed a qualitative method. Data were collected using semi-structured interviews with a sample of 21 patients. A thematic approach using Framework Analysis informed the qualitative data analysis. Participants were recruited from 11 dialysis units across four Health Boards in Scotland. The participants were regular patients attending the dialysis units three times per week. Four main themes emerged from the qualitative interviews: ‘Emotional and Psychological Turmoil’, ‘Life is Restricted’, ‘Spirituality’ and ‘Other Coping Strategies’. The findings suggest that patients’ QOL might be affected because of the physical challenges such as unremitting fatigue, disease unpredictability and being tied down to a dialysis machine, or the emotional and psychological challenges imposed by the disease into their lives such as wholesale changes, dialysis as a forced choice and having a sense of indebtedness. The findings also revealed that spirituality was an important coping strategy for the majority of participants who took part in the qualitative component (n=16). Different meanings of spirituality were identified including connection with God or Supernatural Being, connection with the self, others and nature/environment. Spirituality encouraged participants to accept their disease and offered them a sense of protection, instilled hope in them and helped them to maintain a positive attitude to carry on with their daily lives, which may have had a positive influence on their health outcomes and general well-being. The findings also revealed that humor was another coping strategy that helped to diffuse stress and anxiety for some participants and encouraged them to carry on with their lives. The findings from this study provide a significant contribution to a very limited body of work. The study contributes to our understanding of spirituality and how people receiving dialysis treatment use it to manage their daily lives. Spirituality is of particular interest due to its connection with health outcomes in patients with chronic illnesses. The link between spirituality and many chronic illnesses has gained some recognition, yet the identification of its influence on the health outcomes and well-being in patients with ESRD is still evolving. There is a need to understand patients’ experiences and examine the factors that influence their QOL and well-being to ensure that the services available are adequately tailored to them. Hence, further research is required to obtain a better understanding of the influence of spirituality on the health outcomes and general well-being of patients with ESRD.Keywords: end-stage renal disease, general well-being, quality of life, spirituality
Procedia PDF Downloads 226701 Optimization of Ultrasound-Assisted Extraction of Oil from Spent Coffee Grounds Using a Central Composite Rotatable Design
Authors: Malek Miladi, Miguel Vegara, Maria Perez-Infantes, Khaled Mohamed Ramadan, Antonio Ruiz-Canales, Damaris Nunez-Gomez
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Coffee is the second consumed commodity worldwide, yet it also generates colossal waste. Proper management of coffee waste is proposed by converting them into products with higher added value to achieve sustainability of the economic and ecological footprint and protect the environment. Based on this, a study looking at the recovery of coffee waste is becoming more relevant in recent decades. Spent coffee grounds (SCG's) resulted from brewing coffee represents the major waste produced among all coffee industry. The fact that SCGs has no economic value be abundant in nature and industry, do not compete with agriculture and especially its high oil content (between 7-15% from its total dry matter weight depending on the coffee varieties, Arabica or Robusta), encourages its use as a sustainable feedstock for bio-oil production. The bio-oil extraction is a crucial step towards biodiesel production by the transesterification process. However, conventional methods used for oil extraction are not recommended due to their high consumption of energy, time, and generation of toxic volatile organic solvents. Thus, finding a sustainable, economical, and efficient extraction technique is crucial to scale up the process and to ensure more environment-friendly production. Under this perspective, the aim of this work was the statistical study to know an efficient strategy for oil extraction by n-hexane using indirect sonication. The coffee waste mixed Arabica and Robusta, which was used in this work. The temperature effect, sonication time, and solvent-to-solid ratio on the oil yield were statistically investigated as dependent variables by Central Composite Rotatable Design (CCRD) 23. The results were analyzed using STATISTICA 7 StatSoft software. The CCRD showed the significance of all the variables tested (P < 0.05) on the process output. The validation of the model by analysis of variance (ANOVA) showed good adjustment for the results obtained for a 95% confidence interval, and also, the predicted values graph vs. experimental values confirmed the satisfactory correlation between the model results. Besides, the identification of the optimum experimental conditions was based on the study of the surface response graphs (2-D and 3-D) and the critical statistical values. Based on the CCDR results, 29 ºC, 56.6 min, and solvent-to-solid ratio 16 were the better experimental conditions defined statistically for coffee waste oil extraction using n-hexane as solvent. In these conditions, the oil yield was >9% in all cases. The results confirmed the efficiency of using an ultrasound bath in extracting oil as a more economical, green, and efficient way when compared to the Soxhlet method.Keywords: coffee waste, optimization, oil yield, statistical planning
Procedia PDF Downloads 119700 Partisan Agenda Setting in Digital Media World
Authors: Hai L. Tran
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Previous research on agenda setting effects has often focused on the top-down influence of the media at the aggregate level, while overlooking the capacity of audience members to select media and content to fit their individual dispositions. The decentralized characteristics of online communication and digital news create more choices and greater user control, thereby enabling each audience member to seek out a unique blend of media sources, issues, and elements of messages and to mix them into a coherent individual picture of the world. This study examines how audiences use media differently depending on their prior dispositions, thereby making sense of the world in ways that are congruent with their preferences and cognitions. The current undertaking is informed by theoretical frameworks from two distinct lines of scholarship. According to the ideological migration hypothesis, individuals choose to live in communities with ideologies like their own to satisfy their need to belong. One tends to move away from Zip codes that are incongruent and toward those that are more aligned with one’s ideological orientation. This geographical division along ideological lines has been documented in social psychology research. As an extension of agenda setting, the agendamelding hypothesis argues that audiences seek out information in attractive media and blend them into a coherent narrative that fits with a common agenda shared by others, who think as they do and communicate with them about issues of public. In other words, individuals, through their media use, identify themselves with a group/community that they want to join. Accordingly, the present study hypothesizes that because ideology plays a role in pushing people toward a physical community that fits their need to belong, it also leads individuals to receive an idiosyncratic blend of media and be influenced by such selective exposure in deciding what issues are more relevant. Consequently, the individualized focus of media choices impacts how audiences perceive political news coverage and what they know about political issues. The research project utilizes recent data from The American Trends Panel survey conducted by Pew Research Center to explore the nuanced nature of agenda setting at the individual level and amid heightened polarization. Hypothesis testing is performed with both nonparametric and parametric procedures, including regression and path analysis. This research attempts to explore the media-public relationship from a bottom-up approach, considering the ability of active audience members to select among media in a larger process that entails agenda setting. It helps encourage agenda-setting scholars to further examine effects at the individual, rather than aggregate, level. In addition to theoretical contributions, the study’s findings are useful for media professionals in building and maintaining relationships with the audience considering changes in market share due to the spread of digital and social media.Keywords: agenda setting, agendamelding, audience fragmentation, ideological migration, partisanship, polarization
Procedia PDF Downloads 60699 An Analysis of Teacher Knowledge of Recognizing and Addressing the Needs of Traumatized Students
Authors: Tiffany Hollis
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Childhood trauma is well documented in mental health research, yet has received little attention in urban schools. Child trauma affects brain development and impacts cognitive, emotional, and behavioral functioning. When educators understand that some of the behaviors that appear to be aggressive in nature might be the result of a hidden diagnosis of trauma, learning can take place, and the child can thrive in the classroom setting. Traumatized children, however, do not fit neatly into any single ‘box.’ Although many children enter school each day carrying with them the experience of exposure to violence in the home, the symptoms of their trauma can be multifaceted and complex, requiring individualized therapeutic attention. The purpose of this study was to examine how prepared educators are to address the unique challenges facing children who experience trauma. Given the vast number of traumatized children in our society, it is evident that our education system must investigate ways to create an optimal learning environment that accounts for trauma, addresses its impact on cognitive and behavioral development, and facilitates mental and emotional health and well-being. The researcher describes the knowledge, attitudes, dispositions, and skills relating to trauma-informed knowledge of induction level teachers in a diverse middle school. The data for this study were collected through interviews with teachers, who are in the induction phase (the first three years of their teaching career). The study findings paint a clear picture of how ill-prepared educators are to address the needs of students who have experienced trauma and the implications for the development of a professional development workshop or series of workshops that train teachers how to recognize and address and respond to the needs of students. The study shows how teachers often lack skills to meet the needs of students who have experienced trauma. Traumatized children regularly carry a heavy weight on their shoulders. Children who have experienced trauma may feel that the world is filled with unresponsive, threatening adults, and peers. Despite this, supportive interventions can provide traumatized children with places to go that are safe, stimulating, and even fun. Schools offer an environment that potentially meets these requirements by creating safe spaces where students can feel at ease and have fun while also learning via stimulating educational activities. This study highlights the lack of preparedness of educators to address the academic, behavioral, and cognitive needs of students who have experienced trauma. These findings provide implications for the creation of a professional development workshop that addresses how to recognize and address the needs of students who have experienced some type of trauma. They also provide implications for future research with a focus on specific interventions that enable the creation of optimal learning environments where students who have experienced trauma and all students can succeed, regardless of their life experiences.Keywords: educator preparation, induction educators, professional development, trauma-informed
Procedia PDF Downloads 126698 Identifying the Effects of the Rural Demographic Changes in the Northern Netherlands: A Holistic Approach to Create Healthier Environment
Authors: A. R. Shokoohi, E. A. M. Bulder, C. Th. van Alphen, D. F. den Hertog, E. J. Hin
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The Northern region of the Netherlands has beautiful landscapes, a nice diversity of green and blue areas, and dispersed settlements. However, some recent population changes can become threats to health and wellbeing in these areas. The rural areas in the three northern provinces -Groningen, Friesland, and Drenthe, see youngsters leave the region for which reason they are aging faster than other regions in the Netherlands. As a result, some villages have faced major population decline that is leading to loss of facilities/amenities and a decrease in accessibility and social cohesion. Those who still live in these villages are relatively old, low educated and have low-income. To develop a deeper understanding of the health status of the people living in these areas, and help them to improve their living environment, the GO!-Method is being applied in this study. This method has been developed by the National Institute for Public Health and the Environment (RIVM) of the Netherlands and is inspired by the broad definition of health by Machteld Huber: the ability to adapt and direct control, in terms of the physical, emotional and social challenges of life, while paying extra attention to vulnerable groups. A healthy living environment is defined as an environment that residents find it pleasant and encourages and supports healthy behavior. The GO!-method integrates six domains that constitute a healthy living environment: health and lifestyle, facilities and development, safety and hygiene, social cohesion and active citizens, green areas, and air and noise pollution. First of all, this method will identify opportunities for a healthier living environment using existing information and perceptions of residents and other local stakeholders in order to strengthen social participation and quality of life in these rural areas. Second, this approach will connect identified opportunities with available and effective evidence-based interventions in order to develop an action plan from the residents and local authorities perspective which will help them to design their municipalities healthier and more resilient. This method is being used for the first time in rural areas to our best knowledge, in close collaboration with the residents and local authorities of the three provinces to create a sustainable process and stimulate social participation. Our paper will present the outcomes of the first phase of this project in collaboration with the municipality of Westerkwartier, located in the northwest of the province of Groningen. And will describe the current situation, and identify local assets, opportunities, and policies relating to healthier environment; as well as needs and challenges to achieve goals. The preliminary results show that rural demographic changes in the northern Netherlands have negative impacts on service provisions and social cohesion, and there is a need to understand this complicated situation and improve the quality of life in those areas.Keywords: population decline, rural areas, healthy environment, Netherlands
Procedia PDF Downloads 98697 The Effects of Exercise Training on LDL Mediated Blood Flow in Coronary Artery Disease: A Systematic Review
Authors: Aziza Barnawi
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Background: Regular exercise reduces risk factors associated with cardiovascular diseases. Over the past decade, exercise interventions have been introduced to reduce the risk of and prevent coronary artery disease (CAD). Elevated low-density lipoproteins (LDL) contribute to the formation of atherosclerosis, its manifestations on the endothelial narrow the coronary artery and affect the endothelial function. Therefore, flow-mediated dilation (FMD) technique is used to assess the function. The results of previous studies have been inconsistent and difficult to interpret across different types of exercise programs. The relationship between exercise therapy and lipid levels has been extensively studied, and it is known to improve the lipid profile and endothelial function. However, the effectiveness of exercise in altering LDL levels and improving blood flow is controversial. Objective: This review aims to explore the evidence and quantify the impact of exercise training on LDL levels and vascular function by FMD. Methods: Electronic databases were searched PubMed, Google Scholar, Web of Science, the Cochrane Library, and EBSCO using the keywords: “low and/or moderate aerobic training”, “blood flow”, “atherosclerosis”, “LDL mediated blood flow”, “Cardiac Rehabilitation”, “low-density lipoproteins”, “flow-mediated dilation”, “endothelial function”, “brachial artery flow-mediated dilation”, “oxidized low-density lipoproteins” and “coronary artery disease”. The studies were conducted for 6 weeks or more and influenced LDL levels and/or FMD. Studies with different intensity training and endurance training in healthy or CAD individuals were included. Results: Twenty-one randomized controlled trials (RCTs) (14 FMD and 7 LDL studies) with 776 participants (605 exercise participants and 171 control participants) met eligibility criteria and were included in the systematic review. Endurance training resulted in a greater reduction in LDL levels and their subfractions and a better FMD response. Overall, the training groups showed improved physical fitness status compared with the control groups. Participants whose exercise duration was ≥150 minutes /week had significant improvement in FMD and LDL levels compared with those with <150 minutes/week.Conclusion: In conclusion, although the relationship between physical training, LDL levels, and blood flow in CAD is complex and multifaceted, there are promising results for controlling primary and secondary prevention of CAD by exercise. Exercise training, including resistance, aerobic, and interval training, is positively correlated with improved FMD. However, the small body of evidence for LDL studies (resistance and interval training) did not prove to be significantly associated with improved blood flow. Increasing evidence suggests that exercise training is a promising adjunctive therapy to improve cardiovascular health, potentially improving blood flow and contributing to the overall management of CAD.Keywords: exercise training, low density lipoprotein, flow mediated dilation, coronary artery disease
Procedia PDF Downloads 74696 Leuco Dye-Based Thermochromic Systems for Application in Temperature Sensing
Authors: Magdalena Wilk-Kozubek, Magdalena Rowińska, Krzysztof Rola, Joanna Cybińska
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Leuco dye-based thermochromic systems are classified as intelligent materials because they exhibit thermally induced color changes. Thanks to this feature, they are mainly used as temperature sensors in many industrial sectors. For example, placing a thermochromic material on a chemical reactor may warn about exceeding the maximum permitted temperature for a chemical process. Usually two components, a color former and a developer are needed to produce a system with irreversible color change. The color former is an electron donating (proton accepting) compound such as fluoran leuco dye. The developer is an electron accepting (proton donating) compound such as organic carboxylic acid. When the developer melts, the color former - developer complex is created and the termochromic system becomes colored. Typically, the melting point of the applied developer determines the temperature at which the color change occurs. When the lactone ring of the color former is closed, then the dye is in its colorless state. The ring opening, induced by the addition of a proton, causes the dye to turn into its colored state. Since the color former and the developer are often solid, they can be incorporated into polymer films to facilitate their practical use in industry. The objective of this research was to fabricate a leuco dye-based termochromic system that will irreversibly change color after reaching the temperature of 100°C. For this purpose, benzofluoran leuco dye (as color former) and phenoxyacetic acid (as developer with a melting point of 100°C) were introduced into the polymer films during the drop casting process. The film preparation process was optimized in order to obtain thin films with appropriate properties such as transparency, flexibility and homogeneity. Among the optimized factors were the concentration of benzofluoran leuco dye and phenoxyacetic acid, the type, average molecular weight and concentration of the polymer, and the type and concentration of the surfactant. The selected films, containing benzofluoran leuco dye and phenoxyacetic acid, were combined by mild heat treatment. Structural characterization of single and combined films was carried out by FTIR spectroscopy, morphological analysis was performed by optical microscopy and SEM, phase transitions were examined by DSC, color changes were investigated by digital photography and UV-Vis spectroscopy, while emission changes were studied by photoluminescence spectroscopy. The resulting thermochromic system is colorless at room temperature, but after reaching 100°C the developer melts and it turns irreversibly pink. Therefore, it could be used as an additional sensor to warn against boiling of water in power plants using water cooling. Currently used electronic temperature indicators are prone to faults and unwanted third-party actions. The sensor constructed in this work is transparent, thanks to which it can be unnoticed by an outsider and constitute a reliable reference for the person responsible for the apparatus.Keywords: color developer, leuco dye, thin film, thermochromism
Procedia PDF Downloads 101695 Cognitive Mechanisms of Mindfulness-Based Cognitive Therapy on Depressed Older Adults: The Mediating Role of Rumination and Autobiographical Memory Specificity
Authors: Wai Yan Shih, Sau Man Wong, Wing Chung Chang, Wai Chi Chan
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Background: Late-life depression is associated with significant consequences. Although symptomatic reduction is achievable through pharmacological interventions, older adults are more vulnerable to the side effects than their younger counterparts. In addition, drugs do not address underlying cognitive dysfunctions such as rumination and reduced autobiographical memory specificity (AMS), both shown to be maladaptive coping styles that are associated with a poorer prognosis in depression. Considering how aging is accompanied by cognitive, psychological and physical changes, the interplay of these age-related factors may potentially aggravate and interfere with these depressive cognitive dysfunctions in late-life depression. Special care should, therefore, be drawn to ensure these cognitive dysfunctions are adequately addressed. Aim: This randomized controlled trial aims to examine the effect of mindfulness-based cognitive therapy (MBCT) on depressed older adults, and whether the potential benefits of MBCT are mediated by improvements in rumination and AMS. Method: Fifty-seven participants with an average age of 70 years old were recruited from multiple elderly centers and online mailing lists. Participants were assessed with: (1) Hamilton depression scale, (2) ruminative response scale, (3) autobiographical memory test, (4) mindful attention awareness scale, and (5) Montreal cognitive assessment. Eligible participants with mild to moderate depressive symptoms and normal cognitive functioning were randomly allocated to an 8-week MBCT group or active control group consisting of a low-intensity exercise program and health education. Post-intervention assessments were conducted after the 8-week program. Ethics approval was given by the Institutional Review Board of the University of Hong Kong/Hospital Authority. Results: Mixed-factorials ANOVAs demonstrated significant time x group interaction effects for depressive symptoms, AMS, and dispositional mindfulness. A marginally significant interaction effect was found for rumination. Simple effect analyses revealed a significant reduction in depressive symptoms for the both the MBCT group (mean difference = 7.1, p = .000), and control group (mean difference = 2.7, p = .023). However, only participants in the MBCT group demonstrated improvements in rumination, AMS, and dispositional mindfulness. Bootstrapping-based mediation analyses showed that the effect of MBCT in alleviating depressive symptoms was only mediated by the reduction in rumination. Conclusions: The findings support the use of MBCT as an effective intervention for depressed older adults, considering the improvements in depressive symptoms, rumination, AMS and dispositional mindfulness despite their age. Reduction in ruminative tendencies plays a major role in the cognitive mechanism of MBCT.Keywords: mindfulness-based cognitive therapy, depression, older adults, rumination, autobiographical memory specificity
Procedia PDF Downloads 211694 The Effect of Mindfulness Meditation on Pain, Sleep Quality, and Self-Esteem in Patients Receiving Hemodialysis in Jordan
Authors: Hossam N. Alhawatmeh, Areen I. Albustanji
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Hemodialysis negatively affects physical and psychological health. Pain, poor sleep quality, and low self-esteem are highly prevalent among patients with end-stage renal disease (ESRD) who receive hemodialysis, significantly increasing mortality and morbidity of those patients. Mind-body interventions (MBI), such as mindfulness meditation, have been recently gaining popularity that improved pain, sleep quality, and self-esteem in different populations. However, to our best knowledge, its effects on these health problems in patients receiving hemodialysis have not been studied in Jordan. Thus, the purpose of the study was to examine the effect of mindfulness meditation on pain, sleep quality, and self-esteem in patients with ESR receiving hemodialysis in Jordan. An experimental repeated-measures, randomized, parallel control design was conducted on (n =60) end-stage renal disease patients undergoing hemodialysis between March and June 2023 in the dialysis center at a public hospital in Jordan. Participants were randomly assigned to the experimental (n =30) and control groups (n =30) using a simple random assignment method. The experimental group practiced mindfulness meditation for 30 minutes three times per week for five weeks during their hemodialysis treatments. The control group's patients continued to receive hemodialysis treatment as usual for five weeks during hemodialysis sessions. The study variables for both groups were measured at baseline (Time 0), two weeks after intervention (Time 1), and at the end of intervention (Time 3). The numerical rating scale (NRS), the Rosenberg Self-Esteem Scale (RSES-M), and the Pittsburgh Sleep Quality Index (PSQI) were used to measure pain, self-esteem, and sleep quality, respectively. SPSS version 25 was used to analyze the study data. The sample was described by frequency, mean, and standard deviation as an appropriate. The repeated measures analysis of variance (ANOVA) tests were run to test the study hypotheses. The results of repeated measures ANOVA (within-subject) revealed that mindfulness meditation significantly decrease pain by the end of the intervention in the experimental group. Additionally, mindfulness meditation improved sleep quality and self-esteem in the experimental group, and these improvements occurred significantly after two weeks of the intervention and at the end of the intervention. The results of repeated measures ANOVA (within and between-subject) revealed that the experimental group, compared to the control group, experienced lower levels of pain and higher levels of sleep quality and self-esteem over time. In conclusion, the results provided substantial evidence supporting the positive impacts of mindfulness meditation on pain, sleep quality, and self-esteem in patients with ESRD undergoing hemodialysis. These results highlight the potential of mindfulness meditation as an adjunctive therapy in the comprehensive care of this patient population. Incorporating mindfulness meditation into the treatment plan for patients receiving hemodialysis may contribute to improved well-being and overall quality of life.Keywords: hemodialysis, pain, sleep quality, self-esteem, mindfulness
Procedia PDF Downloads 89693 Augusto De Campos Translator: The Role of Translation in Brazilian Concrete Poetry Project
Authors: Juliana C. Salvadori, Jose Carlos Felix
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This paper aims at discussing the role literary translation has played in Brazilian Concrete Poetry Movement – an aesthetic, critical and pedagogical project which conceived translation as poiesis, i.e., as both creative and critic work in which the potency (dynamic) of literary work is unfolded in the interpretive and critic act (energeia) the translating practice demands. We argue that translation, for concrete poets, is conceived within the framework provided by the reinterpretation –or deglutition– of Oswald de Andrade’s anthropophagy – a carefully selected feast from which the poets pick and model their Paideuma. As a case study, we propose to approach and analyze two of Augusto de Campos’s long-term translation projects: the translation of Emily Dickinson’s and E. E. Cummings’s works to Brazilian readers. Augusto de Campos is a renowned poet, translator, critic and one of the founding members of Brazilian Concrete Poetry movement. Since the 1950s he has produced a consistent body of translated poetry from English-speaking poets in which the translator has explored creative translation processes – transcreation, as concrete poets have named it. Campos’s translation project regarding E. E. Cummings’s poetry comprehends a span of forty years: it begins in 1956 with 10 poems and unfolds in 4 works – 20 poem(a)s, 40 poem(a)s, Poem(a)s, re-edited in 2011. His translations of Dickinson’s poetry are published in two works: O Anticrítico (1986), in which he translated 10 poems, and Emily Dickinson Não sou Ninguém (2008), in which the poet-translator added 35 more translated poems. Both projects feature bilingual editions: contrary to common sense, Campos translations aim at being read as such: the target readers, to fully enjoy the experience, must be proficient readers of English and, also, acquainted with the poets in translation – Campos expects us to perform translation criticism, as Antoine Berman has proposed, by assessing the choices he, as both translator and poet, has presented in order to privilege aesthetic information (verse lines, word games, etc.). To readers not proficient in English, his translations play a pedagogycal role of educating and preparing them to read both the target poet works as well as concrete poetry works – the detailed essays and prefaces in which the translator emphasizes the selection of works translated and strategies adopted enlighten his project as translator: for Cummings, it has led to the oblieraton of the more traditional and lyrical/romantic examples of his poetry while highlighting the more experimental aspects and poems; for Dickinson, his project has highligthed the more hermetic traits of her poems. To the domestic canons of both poets in Brazilian literary system, we analyze Campos’ contribution in this work.Keywords: translation criticism, Augusto de Campos, E. E. Cummings, Emily Dickinson
Procedia PDF Downloads 295692 Predictors of Sexually Transmitted Infection of Korean Adolescent Females: Analysis of Pooled Data from Korean Nationwide Survey
Authors: Jaeyoung Lee, Minji Je
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Objectives: In adolescence, adolescents are curious about sex, but sexual experience before becoming an adult can cause the risk of high probability of sexually transmitted infection. Therefore, it is very important to prevent sexually transmitted infections so that adolescents can grow in healthy and upright way. Adolescent females, especially, have sexual behavior distinguished from that of male adolescents. Protecting female adolescents’ reproductive health is even more important since it is directly related to the childbirth of the next generation. This study, thus, investigated the predictors of sexually transmitted infection in adolescent females with sexual experiences based on the National Health Statistics in Korea. Methods: This study was conducted based on the National Health Statistics in Korea. The 11th Korea Youth Behavior Web-based Survey in 2016 was conducted in the type of anonymous self-reported survey in order to find out the health behavior of adolescents. The target recruitment group was middle and high school students nationwide as of April 2016, and 65,528 students from a total of 800 middle and high schools participated. The study was conducted in 537 female high school students (Grades 10–12) among them. The collected data were analyzed as complex sampling design using SPSS statistics 22. The strata, cluster, weight, and finite population correction provided by Korea Center for Disease Control & Prevention (KCDC) were reflected to constitute complex sample design files, which were used in the statistical analysis. The analysis methods included Rao-Scott chi-square test, complex samples general linear model, and complex samples multiple logistic regression analysis. Results: Out of 537 female adolescents, 11.9% (53 adolescents) had experiences of venereal infection. The predictors for venereal infection of the subjects were ‘age at first intercourse’ and ‘sexual intercourse after drinking’. The sexually transmitted infection of the subjects was decreased by 0.31 times (p=.006, 95%CI=0.13-0.71) for middle school students and 0.13 times (p<.001, 95%CI=0.05-0.32) for high school students whereas the age of the first sexual experience was under elementary school age. In addition, the sexually transmitted infection of the subjects was 3.54 times (p < .001, 95%CI=1.76-7.14) increased when they have experience of sexual relation after drinking alcohol, compared to those without the experience of sexual relation after drinking alcohol. Conclusions: The female adolescents had high probability of sexually transmitted infection if their age for the first sexual experience was low. Therefore, the female adolescents who start sexual experience earlier shall have practical sex education appropriate for their developmental stage. In addition, since the sexually transmitted infection increases, if they have sexual relations after drinking alcohol, the consideration for prevention of alcohol use or intervention of sex education shall be required. When health education intervention is conducted for health promotion for female adolescents in the future, it is necessary to reflect the result of this study.Keywords: adolescent, coitus, female, sexually transmitted diseases
Procedia PDF Downloads 192691 Recovery of Food Waste: Production of Dog Food
Authors: K. Nazan Turhan, Tuğçe Ersan
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The population of the world is approximately 8 billion, and it increases uncontrollably and irrepressibly, leading to an increase in consumption. This situation causes crucial problems, and food waste is one of these. The Food and Agriculture Organization of the United Nations (FAO) defines food waste as the discarding or alternative utilization of food that is safe and nutritious for the consumption of humans along the entire food supply chain, from primary production to end household consumer level. In addition, according to the estimation of FAO, one-third of all food produced for human consumption is lost or wasted worldwide every year. Wasting food endangers natural resources and causes hunger. For instance, excessive amounts of food waste cause greenhouse gas emissions, contributing to global warming. Therefore, waste management has been gaining significance in the last few decades at both local and global levels due to the expected scarcity of resources for the increasing population of the world. There are several ways to recover food waste. According to the United States Environmental Protection Agency’s Food Recovery Hierarchy, food waste recovery ways are source reduction, feeding hungry people, feeding animals, industrial uses, composting, and landfill/incineration from the most preferred to the least preferred, respectively. Bioethanol, biodiesel, biogas, agricultural fertilizer and animal feed can be obtained from food waste that is generated by different food industries. In this project, feeding animals was selected as a food waste recovery method and food waste of a plant was used to provide ingredient uniformity. Grasshoppers were used as a protein source. In other words, the project was performed to develop a dog food product by recovery of the plant’s food waste after following some steps. The collected food waste and purchased grasshoppers were sterilized, dried and pulverized. Then, they were all mixed with 60 g agar-agar solution (4%w/v). 3 different aromas were added, separately to the samples to enhance flavour quality. Since there are differences in the required amounts of different species of dogs, fulfilling all nutritional needs is one of the problems. In other words, there is a wide range of nutritional needs in terms of carbohydrates, protein, fat, sodium, calcium, and so on. Furthermore, the requirements differ depending on age, gender, weight, height, and species. Therefore, the product that was developed contains average amounts of each substance so as not to cause any deficiency or surplus. On the other hand, it contains more protein than similar products in the market. The product was evaluated in terms of contamination and nutritional content. For contamination risk, detection of E. coli and Salmonella experiments were performed, and the results were negative. For the nutritional value test, protein content analysis was done. The protein contents of different samples vary between 33.68% and 26.07%. In addition, water activity analysis was performed, and the water activity (aw) values of different samples ranged between 0.2456 and 0.4145.Keywords: food waste, dog food, animal nutrition, food waste recovery
Procedia PDF Downloads 66690 Controlled Synthesis of Pt₃Sn-SnOx/C Electrocatalysts for Polymer Electrolyte Membrane Fuel Cells
Authors: Dorottya Guban, Irina Borbath, Istvan Bakos, Peter Nemeth, Andras Tompos
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One of the greatest challenges of the implementation of polymer electrolyte membrane fuel cells (PEMFCs) is to find active and durable electrocatalysts. The cell performance is always limited by the oxygen reduction reaction (ORR) on the cathode since it is at least 6 orders of magnitude slower than the hydrogen oxidation on the anode. Therefore high loading of Pt is required. Catalyst corrosion is also more significant on the cathode, especially in case of mobile applications, where rapid changes of loading have to be tolerated. Pt-Sn bulk alloys and SnO2-decorated Pt3Sn nanostructures are among the most studied bimetallic systems for fuel cell applications. Exclusive formation of supported Sn-Pt alloy phases with different Pt/Sn ratios can be achieved by using controlled surface reactions (CSRs) between hydrogen adsorbed on Pt sites and tetraethyl tin. In this contribution our results for commercial and a home-made 20 wt.% Pt/C catalysts modified by tin anchoring via CSRs are presented. The parent Pt/C catalysts were synthesized by modified NaBH4-assisted ethylene-glycol reduction method using ethanol as a solvent, which resulted either in dispersed and highly stable Pt nanoparticles or evenly distributed raspberry-like agglomerates according to the chosen synthesis parameters. The 20 wt.% Pt/C catalysts prepared that way showed improved electrocatalytic performance in the ORR and stability in comparison to the commercial 20 wt.% Pt/C catalysts. Then, in order to obtain Sn-Pt/C catalysts with Pt/Sn= 3 ratio, the Pt/C catalysts were modified with tetraethyl tin (SnEt4) using three and five consecutive tin anchoring periods. According to in situ XPS studies in case of catalysts with highly dispersed Pt nanoparticles, pre-treatment in hydrogen even at 170°C resulted in complete reduction of the ionic tin to Sn0. No evidence of the presence of SnO2 phase was found by means of the XRD and EDS analysis. These results demonstrate that the method of CSRs is a powerful tool to create Pt-Sn bimetallic nanoparticles exclusively, without tin deposition onto the carbon support. On the contrary, the XPS results revealed that the tin-modified catalysts with raspberry-like Pt agglomerates always contained a fraction of non-reducible tin oxide. At the same time, they showed increased activity and long-term stability in the ORR than Pt/C, which was assigned to the presence of SnO2 in close proximity/contact with Pt-Sn alloy phase. It has been demonstrated that the content and dispersion of the fcc Pt3Sn phase within the electrocatalysts can be controlled by tuning the reaction conditions of CSRs. The bimetallic catalysts displayed an outstanding performance in the ORR. The preparation of a highly dispersed 20Pt/C catalyst permits to decrease the Pt content without relevant decline in the electrocatalytic performance of the catalysts.Keywords: anode catalyst, cathode catalyst, controlled surface reactions, oxygen reduction reaction, PtSn/C electrocatalyst
Procedia PDF Downloads 235689 Testing Nitrogen and Iron Based Compounds as an Environmentally Safer Alternative to Control Broadleaf Weeds in Turf
Authors: Simran Gill, Samuel Bartels
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Turfgrass is an important component of urban and rural lawns and landscapes. However, broadleaf weeds such as dandelions (Taraxacum officinale) and white clovers (Trifolium repens) pose major challenges to the health and aesthetics of turfgrass fields. Chemical weed control methods, such as 2,4-D weedicides, have been widely deployed; however, their safety and environmental impacts are often debated. Alternative, environmentally friendly control methods have been considered, but experimental tests for their effectiveness have been limited. This study investigates the use and effectiveness of nitrogen and iron compounds as nutrient management methods of weed control. In a two-phase experiment, the first conducted on a blend of cool season turfgrasses in plastic containers, the blend included Perennial ryegrass (Lolium perenne), Kentucky bluegrass (Poa pratensis) and Creeping red fescue (Festuca rubra) grown under controlled conditions in the greenhouse, involved the application of different combinations of nitrogen (urea and ammonium sulphate) and iron (chelated iron and iron sulphate) compounds and their combinations (urea × chelated iron, urea × iron sulphate, ammonium sulphate × chelated iron, ammonium sulphate × iron sulphate) contrasted with chemical 2, 4-D weedicide and a control (no application) treatment. There were three replicates of each of the treatments, resulting in a total of 30 treatment combinations. The parameters assessed during weekly data collection included a visual quality rating of weeds (nominal scale of 0-9), number of leaves, longest leaf span, number of weeds, chlorophyll fluorescence of grass, the visual quality rating of grass (0-9), and the weight of dried grass clippings. The results drawn from the experiment conducted over the period of 12 weeks, with three applications each at an interval of every 4 weeks, stated that the combination of ammonium sulphate and iron sulphate appeared to be most effective in halting the growth and establishment of dandelions and clovers while it also improved turf health. The second phase of the experiment, which involved the ammonium sulphate × iron sulphate, weedicide, and control treatments, was conducted outdoors on already established perennial turf with weeds under natural field conditions. After 12 weeks of observation, the results were comparable among the treatments in terms of weed control, but the ammonium sulphate × iron sulphate treatment fared much better in terms of the improved visual quality of the turf and other quality ratings. Preliminary results from these experiments thus suggest that nutrient management based on nitrogen and iron compounds could be a useful environmentally friendly alternative for controlling broadleaf weeds and improving the health and quality of turfgrass.Keywords: broadleaf weeds, nitrogen, iron, turfgrass
Procedia PDF Downloads 75688 Structure Modification of Leonurine to Improve Its Potency as Aphrodisiac
Authors: Ruslin, R. E. Kartasasmita, M. S. Wibowo, S. Ibrahim
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An aphrodisiac is a substance contained in food or drug that can arouse sexual instinct and increase pleasure while working, these substances derived from plants, animals, and minerals. When consuming substances that have aphrodisiac activity and duration can improve the sexual instinct. The natural aphrodisiac effect can be obtained through plants, animals, and minerals. Leonurine compound has aphrodisiac activity, these compounds can be isolated from plants of Leonurus Sp, Sundanese people is known as deundereman, this plant is empirical has aphrodisiac activity and based on the isolation of active compounds from plants known to contain compounds leonurine, so that the compound is expected to have activity aphrodisiac. Leonurine compound can be isolated from plants or synthesized chemically with material dasa siringat acid. Leonurine compound can be obtained commercial and derivatives of these compounds can be synthesized in an effort to increase its activity. This study aims to obtain derivatives leonurine better aphrodisiac activity compared with the parent compound, modified the structure of the compounds in the form leonurin guanidino butyl ester group with butyl amin and bromoetanol. ArgusLab program version 4.0.1 is used to determine the binding energy, hydrogen bonds and amino acids involved in the interaction of the compound PDE5 receptor. The in vivo test leonurine compounds and derivatives as an aphrodisiac ingredients and hormone testosterone levels using 27 male rats Wistar strain and 9 female mice of the same species, ages ranged from 12 weeks rats weighing + 200 g / tail. The test animal is divided into 9 groups according to the type of compounds and the dose given. Each treatment group was orally administered 2 ml per day for 5 days. On the sixth day was observed male rat sexual behavior and taking blood from the heart to measure testosterone levels using ELISA technique. Statistical analysis was performed in this study is the ANOVA test Least Square Differences (LSD) using the program Statistical Product and Service Solutions (SPSS). Aphrodisiac efficacy of the leonurine compound and its derivatives have proven in silico and in vivo test, the in silico testing leonurine derivatives have smaller binding energy derivatives leonurine so that activity better than leonurine compounds. Testing in vivo using rats of wistar strain that better leonurine derivative of this compound shows leonurine that in silico studies in parallel with in vivo tests. Modification of the structure in the form of guanidine butyl ester group with butyl amin and bromoethanol increase compared leonurine compound for aphrodisiac activity, testosterone derivatives of compounds leonurine experienced a significant improvement especial is 1RD compounds especially at doses of 100 and 150 mg/bb. The results showed that the compound leonurine and its compounds contain aphrodisiac activity and increase the amount of testosterone in the blood. The compound test used in this study acts as a steroid precursor resulting in increased testosterone.Keywords: aphrodisiac dysfunction erectile leonurine 1-RD 2-RD, dysfunction, erectile leonurine, 1-RD 2-RD
Procedia PDF Downloads 279687 Re-Evaluation of Field X Located in Northern Lake Albert Basin to Refine the Structural Interpretation
Authors: Calorine Twebaze, Jesca Balinga
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Field X is located on the Eastern shores of L. Albert, Uganda, on the rift flank where the gross sedimentary fill is typically less than 2,000m. The field was discovered in 2006 and encountered about 20.4m of net pay across three (3) stratigraphic intervals within the discovery well. The field covers an area of 3 km2, with the structural configuration comprising a 3-way dip-closed hanging wall anticline that seals against the basement to the southeast along the bounding fault. Field X had been mapped on reprocessed 3D seismic data, which was originally acquired in 2007 and reprocessed in 2013. The seismic data quality is good across the field, and reprocessing work reduced the uncertainty in the location of the bounding fault and enhanced the lateral continuity of reservoir reflectors. The current study was a re-evaluation of Field X to refine fault interpretation and understand the structural uncertainties associated with the field. The seismic data, and three (3) wells datasets were used during the study. The evaluation followed standard workflows using Petrel software and structural attribute analysis. The process spanned from seismic- -well tie, structural interpretation, and structural uncertainty analysis. Analysis of three (3) well ties generated for the 3 wells provided a geophysical interpretation that was consistent with geological picks. The generated time-depth curves showed a general increase in velocity with burial depth. However, separation in curve trends observed below 1100m was mainly attributed to minimal lateral variation in velocity between the wells. In addition to Attribute analysis, three velocity modeling approaches were evaluated, including the Time-Depth Curve, Vo+ kZ, and Average Velocity Method. The generated models were calibrated at well locations using well tops to obtain the best velocity model for Field X. The Time-depth method resulted in more reliable depth surfaces with good structural coherence between the TWT and depth maps with minimal error at well locations of 2 to 5m. Both the NNE-SSW rift border fault and minor faults in the existing interpretation were reevaluated. However, the new interpretation delineated an E-W trending fault in the northern part of the field that had not been interpreted before. The fault was interpreted at all stratigraphic levels and thus propagates from the basement to the surface and is an active fault today. It was also noted that the entire field is less faulted with more faults in the deeper part of the field. The major structural uncertainties defined included 1) The time horizons due to reduced data quality, especially in the deeper parts of the structure, an error equal to one-third of the reflection time thickness was assumed, 2) Check shot analysis showed varying velocities within the wells thus varying depth values for each well, and 3) Very few average velocity points due to limited wells produced a pessimistic average Velocity model.Keywords: 3D seismic data interpretation, structural uncertainties, attribute analysis, velocity modelling approaches
Procedia PDF Downloads 59686 Combination of Unmanned Aerial Vehicle and Terrestrial Laser Scanner Data for Citrus Yield Estimation
Authors: Mohammed Hmimou, Khalid Amediaz, Imane Sebari, Nabil Bounajma
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Annual crop production is one of the most important macroeconomic indicators for the majority of countries around the world. This information is valuable, especially for exporting countries which need a yield estimation before harvest in order to correctly plan the supply chain. When it comes to estimating agricultural yield, especially for arboriculture, conventional methods are mostly applied. In the case of the citrus industry, the sale before harvest is largely practiced, which requires an estimation of the production when the fruit is on the tree. However, conventional method based on the sampling surveys of some trees within the field is always used to perform yield estimation, and the success of this process mainly depends on the expertise of the ‘estimator agent’. The present study aims to propose a methodology based on the combination of unmanned aerial vehicle (UAV) images and terrestrial laser scanner (TLS) point cloud to estimate citrus production. During data acquisition, a fixed wing and rotatory drones, as well as a terrestrial laser scanner, were tested. After that, a pre-processing step was performed in order to generate point cloud and digital surface model. At the processing stage, a machine vision workflow was implemented to extract points corresponding to fruits from the whole tree point cloud, cluster them into fruits, and model them geometrically in a 3D space. By linking the resulting geometric properties to the fruit weight, the yield can be estimated, and the statistical distribution of fruits size can be generated. This later property, which is information required by importing countries of citrus, cannot be estimated before harvest using the conventional method. Since terrestrial laser scanner is static, data gathering using this technology can be performed over only some trees. So, integration of drone data was thought in order to estimate the yield over a whole orchard. To achieve that, features derived from drone digital surface model were linked to yield estimation by laser scanner of some trees to build a regression model that predicts the yield of a tree given its features. Several missions were carried out to collect drone and laser scanner data within citrus orchards of different varieties by testing several data acquisition parameters (fly height, images overlap, fly mission plan). The accuracy of the obtained results by the proposed methodology in comparison to the yield estimation results by the conventional method varies from 65% to 94% depending mainly on the phenological stage of the studied citrus variety during the data acquisition mission. The proposed approach demonstrates its strong potential for early estimation of citrus production and the possibility of its extension to other fruit trees.Keywords: citrus, digital surface model, point cloud, terrestrial laser scanner, UAV, yield estimation, 3D modeling
Procedia PDF Downloads 143685 Comparison between the Quadratic and the Cubic Linked Interpolation on the Mindlin Plate Four-Node Quadrilateral Finite Elements
Authors: Dragan Ribarić
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We employ the so-called problem-dependent linked interpolation concept to develop two cubic 4-node quadrilateral Mindlin plate finite elements with 12 external degrees of freedom. In the problem-independent linked interpolation, the interpolation functions are independent of any problem material parameters and the rotation fields are not expressed in terms of the nodal displacement parameters. On the contrary, in the problem-dependent linked interpolation, the interpolation functions depend on the material parameters and the rotation fields are expressed in terms of the nodal displacement parameters. Two cubic 4-node quadrilateral plate elements are presented, named Q4-U3 and Q4-U3R5. The first one is modelled with one displacement and two rotation degrees of freedom in every of the four element nodes and the second element has five additional internal degrees of freedom to get polynomial completeness of the cubic form and which can be statically condensed within the element. Both elements are able to pass the constant-bending patch test exactly as well as the non-zero constant-shear patch test on the oriented regular mesh geometry in the case of cylindrical bending. In any mesh shape, the elements have the correct rank and only the three eigenvalues, corresponding to the solid body motions are zero. There are no additional spurious zero modes responsible for instability of the finite element models. In comparison with the problem-independent cubic linked interpolation implemented in Q9-U3, the nine-node plate element, significantly less degrees of freedom are employed in the model while retaining the interpolation conformity between adjacent elements. The presented elements are also compared to the existing problem-independent quadratic linked-interpolation element Q4-U2 and to the other known elements that also use the quadratic or the cubic linked interpolation, by testing them on several benchmark examples. Simple functional upgrading from the quadratic to the cubic linked interpolation, implemented in Q4-U3 element, showed no significant improvement compared to the quadratic linked form of the Q4-U2 element. Only when the additional bubble terms are incorporated in the displacement and rotation function fields, which complete the full cubic linked interpolation form, qualitative improvement is fulfilled in the Q4-U3R5 element. Nevertheless, the locking problem exists even for the both presented elements, like in all pure displacement elements when applied to very thin plates modelled by coarse meshes. But good and even slightly better performance can be noticed for the Q4-U3R5 element when compared with elements from the literature, if the model meshes are moderately dense and the plate thickness not extremely thin. In some cases, it is comparable to or even better than Q9-U3 element which has as many as 12 more external degrees of freedom. A significant improvement can be noticed in particular when modeling very skew plates and models with singularities in the stress fields as well as circular plates with distorted meshes.Keywords: Mindlin plate theory, problem-independent linked interpolation, problem-dependent interpolation, quadrilateral displacement-based plate finite elements
Procedia PDF Downloads 313684 Enhancing Industrial Wastewater Treatment: Efficacy and Optimization of Ultrasound-Assisted Laccase Immobilized on Magnetic Fe₃O₄ Nanoparticles
Authors: K. Verma, v. S. Moholkar
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In developed countries, water pollution caused by industrial discharge has emerged as a significant environmental concern over the past decades. However, despite ongoing efforts, a fully effective and sustainable remediation strategy has yet to be identified. This paper describes how enzymatic and sonochemical treatments have demonstrated great promise in degrading bio-refractory pollutants. Mainly, a compelling area of interest lies in the combined technique of sono-enzymatic treatment, which has exhibited a synergistic enhancement effect surpassing that of the individual techniques. This study employed the covalent attachment method to immobilize Laccase from Trametes versicolor onto amino-functionalized magnetic Fe₃O₄ nanoparticles. To comprehensively characterize the synthesized free nanoparticles and the laccase-immobilized nanoparticles, various techniques such as X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FT-IR), scanning electron microscope (SEM), vibrating sample magnetometer (VSM), and surface area through Brunauer-Emmett-Teller (BET) were employed. The size of immobilized Fe₃O₄@Laccase was found to be 60 nm, and the maximum loading of laccase was found to be 24 mg/g of nanoparticle. An investigation was conducted to study the effect of various process parameters, such as immobilized Fe₃O₄ Laccase dose, temperature, and pH, on the % Chemical oxygen demand (COD) removal as a response. The statistical design pinpointed the optimum conditions (immobilized Fe₃O₄ Laccase dose = 1.46 g/L, pH = 4.5, and temperature = 66 oC), resulting in a remarkable 65.58% COD removal within 60 minutes. An even more significant improvement (90.31% COD removal) was achieved with ultrasound-assisted enzymatic reaction utilizing a 10% duty cycle. The investigation of various kinetic models for free and immobilized laccase, such as the Haldane, Yano, and Koga, and Michaelis-Menten, showed that ultrasound application impacted the kinetic parameters Vmax and Km. Specifically, Vmax values for free and immobilized laccase were found to be 0.021 mg/L min and 0.045 mg/L min, respectively, while Km values were 147.2 mg/L for free laccase and 136.46 mg/L for immobilized laccase. The lower Km and higher Vmax for immobilized laccase indicate its enhanced affinity towards the substrate, likely due to ultrasound-induced alterations in the enzyme's confirmation and increased exposure of active sites, leading to more efficient degradation. Furthermore, the toxicity and Liquid chromatography-mass spectrometry (LC-MS) analysis revealed that after the treatment process, the wastewater exhibited 70% less toxicity than before treatment, with over 25 compounds degrading by more than 75%. At last, the prepared immobilized laccase had excellent recyclability retaining 70% activity up to 6 consecutive cycles. A straightforward manufacturing strategy and outstanding performance make the recyclable magnetic immobilized Laccase (Fe₃O₄ Laccase) an up-and-coming option for various environmental applications, particularly in water pollution control and treatment.Keywords: kinetic, laccase enzyme, sonoenzymatic, ultrasound irradiation
Procedia PDF Downloads 68683 Survey of the Literacy by Radio Project as an Innovation in Literacy Promotion in Nigeria
Authors: Stella Chioma Nwizu
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The National Commission for Adult and Non Formal Education (NMEC) in Nigeria is charged with the reduction of illiteracy rate through the development, monitoring, and supervision of literacy programmes in Nigeria. In spite of various efforts by NMEC to reduce illiteracy, literature still shows that the illiteracy rate is still high. According to NMEC/UNICEF, about 60 million Nigerians are non-literate, and nearly two thirds of them are women. This situation forced the government to search for innovative and better approaches to literacy promotion and delivery. The literacy by radio project was adopted as an innovative intervention to literacy delivery in Nigeria because the radio is the cheapest and most easily affordable medium for non-literates. The project aimed at widening access to literacy programmes for the non-literate marginalized and disadvantaged groups in Nigeria by taking literacy programmes to their door steps. The literacy by radio has worked perfectly well in non-literacy reduction in Cuba. This innovative intervention of literacy by radio is anchored on the diffusion of innovation theory by Rogers. The literacy by radio has been going on for fifteen years and the efficacy and contributions of this innovation need to be investigated. Thus, the purpose of this research is to review the contributions of the literacy by radio in Nigeria. The researcher adopted the survey research design for the study. The population for the study consisted of 2,706 participants and 47 facilitators of the literacy by radio programme in the 10 pilot states in Nigeria. A sample of four states made up of 302 participants and eight facilitators were used for the study. Information was collected through Focus Group Discussion (FGD), interviews and content analysis of official documents. The data were analysed qualitatively to review the contributions of literacy by radio project and determine the efficacy of this innovative approach in facilitating literacy in Nigeria. Results from the field experience showed, among others, that more non-literates have better access to literacy programmes through this innovative approach. The pilot project was 88% successful; not less than 2,110 adults were made literate through the literacy by radio project in 2017. However, lack of enthusiasm and commitment on the part of the technical committee and facilitators due to non-payment of honorarium, poor signals from radio stations, interruption of lectures with adverts, low community involvement in decision making in the project are challenges to the success rate of the project. The researcher acknowledges the need to customize all materials and broadcasts in all the dialects of the participants and the inclusion of more civil rights, environmental protection and agricultural skills into the project. The study recommends among others, improved and timely funding of the project by the Federal Government to enable NMEC to fulfill her obligations towards the greater success of the programme, setting up of independent radio stations for airing the programmes and proper monitoring and evaluation of the project by NMEC and State Agencies for greater effectiveness. In an era of the knowledge-driven economy, no one should be allowed to get saddled with the weight of illiteracy.Keywords: innovative approach, literacy, project, radio, survey
Procedia PDF Downloads 67682 Fast Detection of Local Fiber Shifts by X-Ray Scattering
Authors: Peter Modregger, Özgül Öztürk
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Glass fabric reinforced thermoplastic (GFRT) are composite materials, which combine low weight and resilient mechanical properties rendering them especially suitable for automobile construction. However, defects in the glass fabric as well as in the polymer matrix can occur during manufacturing, which may compromise component lifetime or even safety. One type of these defects is local fiber shifts, which can be difficult to detect. Recently, we have experimentally demonstrated the reliable detection of local fiber shifts by X-ray scattering based on the edge-illumination (EI) principle. EI constitutes a novel X-ray imaging technique that utilizes two slit masks, one in front of the sample and one in front of the detector, in order to simultaneously provide absorption, phase, and scattering contrast. The principle of contrast formation is as follows. The incident X-ray beam is split into smaller beamlets by the sample mask, resulting in small beamlets. These are distorted by the interaction with the sample, and the distortions are scaled up by the detector masks, rendering them visible to a pixelated detector. In the experiment, the sample mask is laterally scanned, resulting in Gaussian-like intensity distributions in each pixel. The area under the curves represents absorption, the peak offset refraction, and the width of the curve represents the scattering occurring in the sample. Here, scattering is caused by the numerous glass fiber/polymer matrix interfaces. In our recent publication, we have shown that the standard deviation of the absorption and scattering values over a selected field of view can be used to distinguish between intact samples and samples with local fiber shift defects. The quantification of defect detection performance was done by using p-values (p=0.002 for absorption and p=0.009 for scattering) and contrast-to-noise ratios (CNR=3.0 for absorption and CNR=2.1 for scattering) between the two groups of samples. This was further improved for the scattering contrast to p=0.0004 and CNR=4.2 by utilizing a harmonic decomposition analysis of the images. Thus, we concluded that local fiber shifts can be reliably detected by the X-ray scattering contrasts provided by EI. However, a potential application in, for example, production monitoring requires fast data acquisition times. For the results above, the scanning of the sample masks was performed over 50 individual steps, which resulted in long total scan times. In this paper, we will demonstrate that reliable detection of local fiber shift defects is also possible by using single images, which implies a speed up of total scan time by a factor of 50. Additional performance improvements will also be discussed, which opens the possibility for real-time acquisition. This contributes a vital step for the translation of EI to industrial applications for a wide variety of materials consisting of numerous interfaces on the micrometer scale.Keywords: defects in composites, X-ray scattering, local fiber shifts, X-ray edge Illumination
Procedia PDF Downloads 63681 Applicability of Polyisobutylene-Based Polyurethane Structures in Biomedical Disciplines: Some Calcification and Protein Adsorption Studies
Authors: Nihan Nugay, Nur Cicek Kekec, Kalman Toth, Turgut Nugay, Joseph P. Kennedy
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In recent years, polyurethane structures are paving the way for elastomer usage in biology, human medicine, and biomedical application areas. Polyurethanes having a combination of high oxidative and hydrolytic stability and excellent mechanical properties are focused due to enhancing the usage of PUs especially for implantable medical device application such as cardiac-assist. Currently, unique polyurethanes consisting of polyisobutylenes as soft segments and conventional hard segments, named as PIB-based PUs, are developed with precise NCO/OH stoichiometry (∽1.05) for obtaining PIB-based PUs with enhanced properties (i.e., tensile stress increased from ∽11 to ∽26 MPa and elongation from ∽350 to ∽500%). Static and dynamic mechanical properties were optimized by examining stress-strain graphs, self-organization and crystallinity (XRD) traces, rheological (DMA, creep) profiles and thermal (TGA, DSC) responses. Annealing procedure was applied for PIB-based PUs. Annealed PIB-based PU shows ∽26 MPa tensile strength, ∽500% elongation, and ∽77 Microshore hardness with excellent hydrolytic and oxidative stability. The surface characters of them were examined with AFM and contact angle measurements. Annealed PIB-based PU exhibits the higher segregation of individual segments and surface hydrophobicity thus annealing significantly enhances hydrolytic and oxidative stability by shielding carbamate bonds by inert PIB chains. According to improved surface and microstructure characters, greater efforts are focused on analyzing protein adsorption and calcification profiles. In biomedical applications especially for cardiological implantations, protein adsorption inclination on polymeric heart valves is undesirable hence protein adsorption from blood serum is followed by platelet adhesion and subsequent thrombus formation. The protein adsorption character of PIB-based PU examines by applying Bradford assay in fibrinogen and bovine serum albumin solutions. Like protein adsorption, calcium deposition on heart valves is very harmful because vascular calcification has been proposed activation of osteogenic mechanism in the vascular wall, loss of inhibitory factors, enhance bone turnover and irregularities in mineral metabolism. The calcium deposition on films are characterized by incubating samples in simulated body fluid solution and examining SEM images and XPS profiles. PIB-based PUs are significantly more resistant to hydrolytic-oxidative degradation, protein adsorption and calcium deposition than ElastEonTM E2A, a commercially available PDMS-based PU, widely used for biomedical applications.Keywords: biomedical application, calcification, polyisobutylene, polyurethane, protein adsorption
Procedia PDF Downloads 258680 Development of International Entry-Level Nursing Competencies to Address the Continuum of Substance Use
Authors: Cheyenne Johnson, Samantha Robinson, Christina Chant, Ann M. Mitchell, Carol Price, Carmel Clancy, Adam Searby, Deborah S. Finnell
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Introduction: Substance use along the continuum from at-risk use to a substance use disorder (SUD) contributes substantially to the burden of disease and related harms worldwide. There is a growing body of literature that highlights the lack of substance use related content in nursing curricula. Furthermore, there is also a lack of consensus on key competencies necessary for entry-level nurses. Globally, there is a lack of established nursing competencies related to prevention, health promotion, harm reduction and treatment of at-risk substance use and SUDs. At a critical time in public health, this gap in nursing curricula contributes to a lack of preparation for entry-level nurses to support people along the continuum of substance use. Thus, in practice, early opportunities for screening, support, and interventions may be missed. To address this gap, an international committee was convened to develop international entry-level nursing competencies specifying the knowledge, skills, and abilities that all nurses should possess in order to address the continuum of substance use. Methodology: An international steering committee, including representation from Canada, United States, United Kingdom, and Australia was established to lead this work over a one-year time period. The steering committee conducted a scoping review, undertaken to examine nursing competency frameworks, and to inform a competency structure that would guide this work. The next steps were to outline key competency areas and establish leaders for working groups to develop the competencies. In addition, a larger international committee was gathered to contribute to competency working groups, review the collective work and concur on the final document. Findings: A comprehensive framework was developed with competencies covering a wide spectrum of substance use across the lifespan and in the context of prevention, health promotion, harm reduction and treatment, including special populations. The development of this competency-based framework meets an identified need to provide guidance for universities, health authorities, policy makers, nursing regulators and other organizations that provide and support nursing education which focuses on care for patients and families with at-risk substance use and SUDs. Conclusion: Utilizing these global competencies as expected outcomes of an educational and skill building curricula for entry-level nurses holds great promise for incorporating evidence-informed training in the care and management of people across the continuum of substance use.Keywords: addiction nursing, addiction nursing curriculum, competencies, substance use
Procedia PDF Downloads 178679 Influence of Kneading Conditions on the Textural Properties of Alumina Catalysts Supports for Hydrotreating
Authors: Lucie Speyer, Vincent Lecocq, Séverine Humbert, Antoine Hugon
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Mesoporous alumina is commonly used as a catalyst support for the hydrotreating of heavy petroleum cuts. The process of fabrication usually involves: the synthesis of the boehmite AlOOH precursor, a kneading-extrusion step, and a calcination in order to obtain the final alumina extrudates. Alumina is described as a complex porous medium, generally agglomerates constituted of aggregated nanocrystallites. Its porous texture directly influences the active phase deposition and mass transfer, and the catalytic properties. Then, it is easy to figure out that each step of the fabrication of the supports has a role on the building of their porous network, and has to be well understood to optimize the process. The synthesis of boehmite by precipitation of aluminum salts was extensively studied in the literature and the effect of various parameters, such as temperature or pH, are known to influence the size and shape of the crystallites and the specific surface area of the support. The calcination step, through the topotactic transition from boehmite to alumina, determines the final properties of the support and can tune the surface area, pore volume and pore diameters from those of boehmite. However, the kneading extrusion step has been subject to a very few studies. It generally consists in two steps: an acid, then a basic kneading, where the boehmite powder is introduced in a mixer and successively added with an acid and a base solution to form an extrudable paste. During the acid kneading, the induced positive charges on the hydroxyl surface groups of boehmite create an electrostatic repulsion which tends to separate the aggregates and even, following the conditions, the crystallites. The basic kneading, by reducing the surface charges, leads to a flocculation phenomenon and can control the reforming of the overall structure. The separation and reassembling of the particles constituting the boehmite paste have a quite obvious influence on the textural properties of the material. In this work, we are focused on the influence of the kneading step on the alumina catalysts supports. Starting from an industrial boehmite, extrudates are prepared using various kneading conditions. The samples are studied by nitrogen physisorption in order to analyze the evolution of the textural properties, and by synchrotron small-angle X-ray scattering (SAXS), a more original method which brings information about agglomeration and aggregation of the samples. The coupling of physisorption and SAXS enables a precise description of the samples, as same as an accurate monitoring of their evolution as a function of the kneading conditions. These ones are found to have a strong influence of the pore volume and pore size distribution of the supports. A mechanism of evolution of the texture during the kneading step is proposed and could be attractive in order to optimize the texture of the supports and then, their catalytic performances.Keywords: alumina catalyst support, kneading, nitrogen physisorption, small-angle X-ray scattering
Procedia PDF Downloads 254678 Structural Analysis of a Composite Wind Turbine Blade
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The design of an optimised horizontal axis 5-meter-long wind turbine rotor blade in according with IEC 61400-2 standard is a research and development project in order to fulfil the requirements of high efficiency of torque from wind production and to optimise the structural components to the lightest and strongest way possible. For this purpose, a research study is presented here by focusing on the structural characteristics of a composite wind turbine blade via finite element modelling and analysis tools. In this work, first, the required data regarding the general geometrical parts are gathered. Then, the airfoil geometries are created at various sections along the span of the blade by using CATIA software to obtain the two surfaces, namely; the suction and the pressure side of the blade in which there is a hat shaped fibre reinforced plastic spar beam, so-called chassis starting at 0.5m from the root of the blade and extends up to 4 m and filled with a foam core. The root part connecting the blade to the main rotor differential metallic hub having twelve hollow threaded studs is then modelled. The materials are assigned as two different types of glass fabrics, polymeric foam core material and the steel-balsa wood combination for the root connection parts. The glass fabrics are applied using hand wet lay-up lamination with epoxy resin as METYX L600E10C-0, is the unidirectional continuous fibres and METYX XL800E10F having a tri-axial architecture with fibres in the 0,+45,-45 degree orientations in a ratio of 2:1:1. Divinycell H45 is used as the polymeric foam. The finite element modelling of the blade is performed via MSC PATRAN software with various meshes created on each structural part considering shell type for all surface geometries, and lumped mass were added to simulate extra adhesive locations. For the static analysis, the boundary conditions are assigned as fixed at the root through aforementioned bolts, where for dynamic analysis both fixed-free and free-free boundary conditions are made. By also taking the mesh independency into account, MSC NASTRAN is used as a solver for both analyses. The static analysis aims the tip deflection of the blade under its own weight and the dynamic analysis comprises normal mode dynamic analysis performed in order to obtain the natural frequencies and corresponding mode shapes focusing the first five in and out-of-plane bending and the torsional modes of the blade. The analyses results of this study are then used as a benchmark prior to modal testing, where the experiments over the produced wind turbine rotor blade has approved the analytical calculations.Keywords: dynamic analysis, fiber reinforced composites, horizontal axis wind turbine blade, hand-wet layup, modal testing
Procedia PDF Downloads 426677 Evaluation of the Risk Factors on the Incidence of Adjacent Segment Degeneration After Anterior Neck Discectomy and Fusion
Authors: Sayyed Mostafa Ahmadi, Neda Raeesi
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Background and Objectives: Cervical spondylosis is a common problem that affects the adult spine and is the most common cause of radiculopathy and myelopathy in older patients. Anterior discectomy and fusion is a well-known technique in degenerative cervical disc disease. However, one of the late undesirable complications is adjacent disc degeneration, which affects about 91% of patients in ten years. Many factors can be effective in causing this complication, but some are still debatable. Discovering these risk factors and eliminating them can improve the quality of life. Methods: This is a retrospective cohort study. All patients who underwent anterior discectomy and fusion surgery in the neurosurgery ward of Imam Khomeini Hospital between 2013 and 2016 were evaluated. Their demographic information was collected. All patients were visited and examined for radiculopathy, myelopathy, and muscular force. At the same visit, all patients were asked to have a facelift, and neck profile, as well as a neck MRI(General Tesla 3). Preoperative graphs were used to measure the diameter of the cervical canal(Pavlov ratio) and to evaluate sagittal alignment(Cobb Angle). Preoperative MRI of patients was reviewed for anterior and posterior longitudinal ligament calcification. Result: In this study, 57 patients were studied. The mean age of patients was 50.63 years, and 49.1% were male. Only 3.5% of patients had anterior and posterior longitudinal ligament calcification. Symptomatic ASD was observed in 26.6%. The X-rays and MRIs showed evidence of 80.7% radiological ASD. Among patients who underwent one-level surgery, 20% had symptomatic ASD, but among patients who underwent two-level surgery, the rate of ASD was 50%.In other words, the higher the number of surfaces that are operated and fused, the higher the probability of symptomatic ASD(P-value <0.05). The X-rays and MRIs showed 80.7% of radiological ASD. Among patients who underwent surgery at one level, 78% had radiological ASD, and this number was 92% among patients who underwent two-level surgery(P-value> 0.05). Demographic variables such as age, sex, height, weight, and BMI did not have a significant effect on the incidence of radiological ASD(P-value> 0.05), but sex and height were two influential factors on symptomatic ASD(P-value <0.05). Other related variables such as family history, smoking and exercise also have no significant effect(P-value> 0.05). Radiographic variables such as Pavlov ratio and sagittal alignment were also unaffected by the incidence of radiological and symptomatic ASD(P-value> 0.05). The number of surgical surfaces and the incidence of anterior and posterior longitudinal ligament calcification before surgery also had no statistically significant effect(P-value> 0.05). In the study of the ability of the neck to move in different directions, none of these variables are statistically significant in the two groups with radiological and symptomatic ASD and the non-affected group(P-value> 0.05). Conclusion: According to the findings of this study, this disease is considered to be a multifactorial disease. The incidence of radiological ASD is much higher than symptomatic ASD (80.7% vs. 26.3%) and sex, height and number of fused surfaces are the only factors influencing the incidence of symptomatic ASD and no variable influences radiological ASD.Keywords: risk factors, anterior neck disectomy and fusion, adjucent segment degeneration, complication
Procedia PDF Downloads 63676 Preliminary Studies on Poloxamer-Based Hydrogels with Oregano Essential Oil as Potential Topical Treatment of Cutaneous Papillomas
Authors: Ana Maria Muț, Georgeta Coneac, Ioana Olariu, Ștefana Avram, Ioana Zinuca Pavel, Ionela Daliana Minda, Lavinia Vlaia, Cristina Adriana Dehelean, Corina Danciu
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Oregano essential oil is obtained from different parts of the plant Origanum vulgare (fam. Lamiaceae) and carvacrol and thymol are primary components, widely recognized for their antimicrobial activity, as well as their antiviral and antifungal properties. Poloxamers are triblock copolymers (Pluronic®), formed of three non-ionic blocks with a hydrophobic polyoxypropylene central chain flanked by two polyoxyethylene hydrophilic chains. They are known for their biocompatibility, sensitivity to temperature changes (sol-to-gel transition of aqueous solution with temperature increase), but also for their amphiphilic and surface active nature determining the formation of micelles, useful for solubilization of different hydrophobic compounds such as the terpenes and terpenoids contained in essential oils. Thus, these polymers, listed in European and US Pharmacopoeia and approved by FDA, are widely used as solubilizers and gelling agents for various pharmaceutical preparations, including topical hydrogels. The aim of this study was to investigate the posibility of solubilizing oregano essential oil (OEO) in polymeric micelles using polyoxypropylene (PPO)-polyoxyethylene (PEO)-polyoxypropylene (PPO) triblock polymers to obtain semisolid systems suitable for topical application. A formulation screening was performed, using Pluronic® F-127 in concentration of 20%, Pluronic® L-31, Pluronic® L-61 and Pluronic® L-62 in concentration of 0.5%, 0.8% respectively 1% to obtain the polymeric micelles-based systems. Then, to each selected system, with or without 10% absolute ethanol, 5% or 8% OEO was added. The obtained transparent poloxamer-based hydrogels containing solubilized OEO were further evaluated for pH, rheological characteristics (flow behaviour, viscosity, consistency and spreadability), using consacrated techniques like potentiometric titration, stationary shear flow test, penetrometric method and parallel plate method. Also, in vitro release and permeation of carvacrol from the hydrogels was carried out, using vertical diffusion cells and synthetic hydrophilic membrane and porcine skin respectively. The pH values and rheological features of all tested formulations were in accordance with official requirements for semisolid cutaneous preparations. But, the formulation containing 0.8% Pluronic® L-31, 10% absolute ethanol, 8% OEO and water and the formulation with 1% Pluronic® L-31, 5% OEO and water, produced the highest cumulative amounts of carvacrol released/permeated through the membrane. The present study demonstrated that oregano essential oil can be successfully solubilized in the investigated poloxamer-based hydrogels. These systems can be further investigated as potential topical therapy for cutaneous papillomas. Funding: This research was funded by Project PN-III-P1-1.1-TE2019-0130, Contract number TE47, Romania.Keywords: oregano essential oil, carvacrol, poloxamer, topical hydrogels
Procedia PDF Downloads 113675 Experience of Two Major Research Centers in the Diagnosis of Cardiac Amyloidosis from Transthyretin
Authors: Ioannis Panagiotopoulos, Aristidis Anastasakis, Konstantinos Toutouzas, Ioannis Iakovou, Charalampos Vlachopoulos, Vasilis Voudris, Georgios Tziomalos, Konstantinos Tsioufis, Efstathios Kastritis, Alexandros Briassoulis, Kimon Stamatelopoulos, Alexios Antonopoulos, Paraskevi Exadaktylou, Evanthia Giannoula, Anastasia Katinioti, Maria Kalantzi, Evangelos Leontiadis, Eftychia Smparouni, Ioannis Malakos, Nikolaos Aravanis, Argyrios Doumas, Maria Koutelou
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Introduction: Cardiac amyloidosis from Transthyretin (ATTR-CA) is an infiltrative disease characterized by the deposition of pathological transthyretin complexes in the myocardium. This study describes the characteristics of patients diagnosed with ATTR-CA from 2019 until present at the Nuclear Medicine Department of Onassis Cardiac Surgery Center and AHEPA Hospital. These centers have extensive experience in amyloidosis and modern technological equipment for its diagnosis. Materials and Methods: Records of consecutive patients (N=73) diagnosed with any type of amyloidosis were collected, analyzed, and prospectively followed. The diagnosis of amyloidosis was made using specific myocardial scintigraphy with Tc-99m DPD. Demographic characteristics, including age, gender, marital status, height, and weight, were collected in a database. Clinical characteristics, such as amyloidosis type (ATTR and AL), serum biomarkers (BNP, troponin), electrocardiographic findings, ultrasound findings, NYHA class, aortic valve replacement, device implants, and medication history, were also collected. Some of the most significant results are presented. Results: A total of 73 cases (86% male) were diagnosed with amyloidosis over four years. The mean age at diagnosis was 82 years, and the main symptom was dyspnea. Most patients suffered from ATTR-CA (65 vs. 8 with AL). Out of all the ATTR-CA patients, 61 were diagnosed with wild-type and 2 with two rare mutations. Twenty-eight patients had systemic amyloidosis with extracardiac involvement, and 32 patients had a history of bilateral carpal tunnel syndrome. Four patients had already developed polyneuropathy, and the diagnosis was confirmed by DPD scintigraphy, which is known for its high sensitivity. Among patients with isolated cardiac involvement, only 6 had left ventricular ejection fraction below 40%. The majority of ATTR patients underwent tafamidis treatment immediately after diagnosis. Conclusion: In conclusion, the experiences shared by the two centers and the continuous exchange of information provide valuable insights into the diagnosis and management of cardiac amyloidosis. Clinical suspicion of amyloidosis and early diagnostic approach are crucial, given the availability of non-invasive techniques. Cardiac scintigraphy with DPD can confirm the presence of the disease without the need for a biopsy. The ultimate goal still remains continuous education and awareness of clinical cardiologists so that this systemic and treatable disease can be diagnosed and certified promptly and treatment can begin as soon as possible.Keywords: amyloidosis, diagnosis, myocardial scintigraphy, Tc-99m DPD, transthyretin
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