Search results for: minor wound healing
Commenced in January 2007
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Edition: International
Paper Count: 1196

Search results for: minor wound healing

206 Bacteriophage Is a Novel Solution of Therapy Against S. aureus Having Multiple Drug Resistance

Authors: Sanjay Shukla, A. Nayak, R. K. Sharma, A. P. Singh, S. P. Tiwari

Abstract:

Excessive use of antibiotics is a major problem in the treatment of wounds and other chronic infections, and antibiotic treatment is frequently non-curative, thus alternative treatment is necessary. Phage therapy is considered one of the most promising approaches to treat multi-drug resistant bacterial pathogens. Infections caused by Staphylococcus aureus are very efficiently controlled with phage cocktails, containing a different individual phages lysate infecting a majority of known pathogenic S. aureus strains. The aim of the present study was to evaluate the efficacy of a purified phage cocktail for prophylactic as well as therapeutic application in mouse model and in large animals with chronic septic infection of wounds. A total of 150 sewage samples were collected from various livestock farms. These samples were subjected for the isolation of bacteriophage by the double agar layer method. A total of 27 sewage samples showed plaque formation by producing lytic activity against S. aureus in the double agar overlay method out of 150 sewage samples. In TEM, recovered isolates of bacteriophages showed hexagonal structure with tail fiber. In the bacteriophage (ØVS) had an icosahedral symmetry with the head size 52.20 nm in diameter and long tail of 109 nm. Head and tail were held together by connector and can be classified as a member of the Myoviridae family under the order of Caudovirale. Recovered bacteriophage had shown the antibacterial activity against the S. aureus in vitro. Cocktail (ØVS1, ØVS5, ØVS9, and ØVS 27) of phage lysate were tested to know in vivo antibacterial activity as well as the safety profile. Result of mice experiment indicated that the bacteriophage lysate were very safe, did not show any appearance of abscess formation, which indicates its safety in living system. The mice were also prophylactically protected against S. aureus when administered with cocktail of bacteriophage lysate just before the administration of S. aureuswhich indicates that they are good prophylactic agent. The S. aureusinoculated mice were completely recovered by bacteriophage administration with 100% recovery, which was very good as compere to conventional therapy. In the present study, ten chronic cases of the wound were treated with phage lysate, and follow up of these cases was done regularly up to ten days (at 0, 5, and 10 d). The result indicated that the six cases out of ten showed complete recovery of wounds within 10 d. The efficacy of bacteriophage therapy was found to be 60% which was very good as compared to the conventional antibiotic therapy in chronic septic wounds infections. Thus, the application of lytic phage in single dose proved to be innovative and effective therapy for the treatment of septic chronic wounds.

Keywords: phage therapy, S aureus, antimicrobial resistance, lytic phage, and bacteriophage

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205 Functional Finishing of Organic Cotton Fabric Using Vetiver Root Extract

Authors: Sakeena Naikwadi, K. Jagaluraiah Sannapapamma

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Vetiveria zizanioides is an aromatic grass and traditionally been used in aromatherapy and ayurvedic medicine. Vetiver root is multi-functional biopolymer and has highly aromatic, antimicrobial, UV blocking, antioxidant properties suitable for textile finishing. The vetiver root (Gulabi) powder of different concentration (2, 4, 6,8 percent) were extracted by aqueous and solvent methods subjected to bioassay for antimicrobial efficiency and GCMS spectral analysis. The organic cotton fabric was finished with vetiver root extract (8 percent) by exhaust and pad dry cure methods. The finished fabric was assessed for functional properties viz., UV protective factor, antimicrobial efficiency and aroma intensity. The results revealed that Ethanol extraction showed a greater zone of inhibition compared to aqueous extract in root powder. Among the concentrations, 8 percent root extract in ethanol showed a greater zone of inhibition against gram-positive organism S. aureus and gram-negative organism E. coli. The major compounds present in vetiver root extracts were diethyl pathalate with greater percentage (87.73 %) followed by 7- Isopropyl dimethyl carboxylic acid (4.05 %), 2-butanone 4-trimethyle cyclohexen (1.21 %), phenanthrene carboxylic acid (1.03 %), naphthalene pentanoic acid (0.99 %), 1-phenanthrene carboxylic acid and 1 cyclohexenone 2-methyl oxobuty (0.89 %). The sample finished by pad dry cure method exhibited better UV protection even after 10th wash as compared to exhaust method. Vetiver extract treated samples exhibited maximum zone of inhibition against S. aureus than the E. coli organism. The vetiver root extract treated organic cotton fabric through pad dry cure method possessed good antimicrobial activity against S. aureus and E. coli even after 20th washes compared to vetiver root extract treated by exhaust method. The olfactory analysis was carried out by 30 panels of members and opined that vetiver root extract treated fabric has very good and pleasant aroma with better tactile properties that provide cooling, soothing effect and enhances the mood of the wearer. Vetiver root extract finished organic cotton fabric possessed aroma, antimicrobial and UV properties which are aptly suitable for medical and healthcare textiles viz., wound dressing, bandage gauze, surgical cloths, baby diapers and sanitary napkins. It can be used as after finishing agent for variegated garments and made-ups and can be replaced with commercial after finishing agents.

Keywords: antimicrobial, olfactory analysis, UV protection factor, vetiver root extract

Procedia PDF Downloads 209
204 Statistical Design of Central Point for Evaluate the Combination of PH and Cinnamon Essential Oil on the Antioxidant Activity Using the ABTS Technique

Authors: H. Minor-Pérez, A. M. Mota-Silva, S. Ortiz-Barrios

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Substances of vegetable origin with antioxidant capacity have a high potential for application on the conservation of some foods, can prevent or reduce for example oxidation of lipids. However a food is a complex system whose wide variety of components wich can reduce or eliminate this antioxidant capacity. The antioxidant activity can be determined with the ABTS technique. The radical ABTS+ is generated from the acid 2, 2´ - Azino-bis (3-ethylbenzothiazoline-6-sulfonic acid) (ABTS). This radical is a composite color bluish-green, stable and with a spectrum of absorption into the UV-visible. The addition of antioxidants causes discoloration, value that can be reported as a percentage of inhibition of the cation radical ABTS+. The objective of this study was evaluated the effect of the combination of the pH and the essential oil of cinnamon (EOC) on inhibition of the radical ABTS+, using statistical design of central point (Design Expert) to obtain mathematical models that describe this phenomenon. Were evaluated 17 treatments with combinations of pH 5, 6 and 7 (citrate-phosphate buffer) and the concentration of essential oil of cinnamon (C): 0 µg/mL, 100 µg/mL and 200 µg/mL. The samples were analyzed using the ABTS technique. The reagent was dissolved in methanol 80% to standardized the absorbance to 0.7 +/- 0.1 at 754 nm. Then samples were mixed with reagent standardized ABTS and after 1 min and 7 min absorbance was read for each treatment at 754 nm. Was used a curve pattern with vitamin C and reported the values as inhibition (%) of radical ABTS+. The statistical analysis shows the experimental results were adjusted to a quadratic model, to the times of 1 min and 7 min. This model describes the influence of the factors investigated independently: pH and cinnamon essential oil (µg/mL) and the effect of the interaction between pH*C, as well as the square of the pH2 and C2. The model obtained was Y = 10.33684 - 3.98118*pH + 1.17031*C + 0.62745*pH2 - 3.26675*10-3*C2 - 0.013112*pH*C, where Y is the response variable. The coefficient of determination was 0.9949 for 1 min. The equation was obtained at 7 min and = - 10.89710 + 1.52341*pH + 1.32892*C + 0.47953*pH2 - 3.56605*10- *C2 - 0.034687*pH*C. The coefficient of determination was 0.9970. This means that only 1% of the total variation is not explained by the developed models. At 100 µg/mL of EOC was obtained an inhibition percentage of 80%, 84% and 97% for the pH values of 5,6 and 7 respectively, while a value of 200 µg/mL the inhibition (%) was very similar for the treatments. In these values of pH was obtained an inhibition close 97%. In conclusion the pH does not have a significant effect on the antioxidant capacity, while the concentration of EOC was decisive for the antioxidant capacity. The authors acknowledge the funding provided by the CONACYT for the project 131998.

Keywords: antioxidant activity, ABTS technique, essential oil of cinnamon, mathematical models

Procedia PDF Downloads 387
203 Effect of Locally Injected Mesenchymal Stem Cells on Bone Regeneration of Rat Calvaria Defects

Authors: Gileade P. Freitas, Helena B. Lopes, Alann T. P. Souza, Paula G. F. P. Oliveira, Adriana L. G. Almeida, Paulo G. Coelho, Marcio M. Beloti, Adalberto L. Rosa

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Bone tissue presents great capacity to regenerate when injured by trauma, infectious processes, or neoplasia. However, the extent of injury may exceed the inherent tissue regeneration capability demanding some kind of additional intervention. In this scenario, cell therapy has emerged as a promising alternative to treat challenging bone defects. This study aimed at evaluating the effect of local injection of bone marrow-derived mesenchymal stem cells (BM-MSCs) and adipose tissue-derived mesenchymal stem cells (AT-MSCs) on bone regeneration of rat calvaria defects. BM-MSCs and AT-MSCs were isolated and characterized by expression of surface markers; cell viability was evaluated after injection through a 21G needle. Defects of 5 mm in diameter were created in calvaria and after two weeks a single injection of BM-MSCs, AT-MSCs or vehicle-PBS without cells (Control) was carried out. Cells were tracked by bioluminescence and at 4 weeks post-injection bone formation was evaluated by micro-computed tomography (μCT) and histology, nanoindentation, and through gene expression of bone remodeling markers. The data were evaluated by one-way analysis of variance (p≤0.05). BM-MSCs and AT-MSCs presented characteristics of mesenchymal stem cells, kept viability after passing through a 21G needle and remained in the defects until day 14. In general, injection of both BM-MSCs and AT-MSCs resulted in higher bone formation compared to Control. Additionally, this bone tissue displayed elastic modulus and hardness similar to the pristine calvaria bone. The expression of all evaluated genes involved in bone formation was upregulated in bone tissue formed by BM-MSCs compared to AT-MSCs while genes involved in bone resorption were upregulated in AT-MSCs-formed bone. We show that cell therapy based on the local injection of BM-MSCs or AT-MSCs is effective in delivering viable cells that displayed local engraftment and induced a significant improvement in bone healing. Despite differences in the molecular cues observed between BM-MSCs and AT-MSCs, both cells were capable of forming bone tissue at comparable amounts and properties. These findings may drive cell therapy approaches toward the complete bone regeneration of challenging sites.

Keywords: cell therapy, mesenchymal stem cells, bone repair, cell culture

Procedia PDF Downloads 159
202 Understanding the Influence of Social Media on Individual’s Quality of Life Perceptions

Authors: Biljana Marković

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Social networks are an integral part of our everyday lives, becoming an indispensable medium for communication in personal and business environments. New forms and ways of communication change the general mindset and significantly affect the quality of life of individuals. Quality of life is perceived as an abstract term, but often people are not aware that they directly affect the quality of their own lives, making minor but significant everyday choices and decisions. Quality of life can be defined broadly, but in the widest sense, it involves a subjective sense of satisfaction with one's life. Scientific knowledge about the impact of social networks on self-assessment of the quality of life of individuals is only just beginning to be researched. Available research indicates potential benefits as well as a number of disadvantages. In the context of the previous claims, the focus of the study conducted by the authors of this paper focuses on analyzing the impact of social networks on individual’s self-assessment of quality of life and the correlation between time spent on social networks, and the choice of content that individuals choose to share to present themselves. Moreover, it is aimed to explain how much and in what ways they critically judge the lives of others online. The research aspires to show the positive as well as negative aspects that social networks, primarily Facebook and Instagram, have on creating a picture of individuals and how they compare themselves with others. The topic of this paper is based on quantitative research conducted on a representative sample. An analysis of the results of the survey conducted online has elaborated a hypothesis which claims that content shared by individuals on social networks influences the image they create about themselves. A comparative analysis of the results obtained with the results of similar research has led to the conclusion about the synergistic influence of social networks on the feeling of the quality of life of respondents. The originality of this work is reflected in the approach of conducting research by examining attitudes about an individual's life satisfaction, the way he or she creates a picture of himself/herself through social networks, the extent to which he/she compares herself/himself with others, and what social media applications he/she uses. At the cognitive level, scientific contributions were made through the development of information concepts on quality of life, and at the methodological level through the development of an original methodology for qualitative alignment of respondents' attitudes using statistical analysis. Furthermore, at the practical level through the application of concepts in assessing the creation of self-image and the image of others through social networks.

Keywords: quality of life, social media, self image, influence of social media

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201 Effects of Hawthorn (Crataegus monogyna) Polyphenols on Oxymyoglobin and Myofibrillar Proteins Stability in Meat

Authors: Valentin Nicorescu, Nicoleta C. Predescu, Camelia Papuc, Iuliana Gajaila, Carmen D. Petcu

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The oxidation of the fresh muscle oxymyoglobin (bright red colour) to metmyoglobin (brown colour) leads to discoloration of red meats. After slaughter, enzymatic systems involved in metmyoglobin reduction are continually depleted as time post-mortem progresses, thus the meat colour is affected. Phenolic compounds are able to scavenge reactive species involved in oxymyoglobin oxidation and to reduce metmyoglobin to oxymyoglobin. The aim of this study was to investigate the effect of polyphenols extracted from hawthorn fruits on the stability of oxymyoglobin and myofibrillar proteins in ground pork subject to refrigeration for 6 days. Hawthorn polyphenols (HP) were added in ground pork in 100, 200 and 300 ppm concentrations. Oxymyoglobin and metmyoglobin were evaluated spectrophotometrically at every 2 days and electrophoretic pattern of myofibrillar proteins was investigated at days 0 and 6 by Sodium Dodecyl Sulfate Polyacrylamide Gel Electrophoresis (SDS-PAGE). For all meat samples, oxymyoglobin concentration significantly decreased during the first 4 days of refrigeration. After 6 days, the significant decrease of oxymyoglobin concentration continued only in the negative control samples. In samples treated with HP and butylated hydroxylanisole (BHA - positive control), oxymyoglobin concentration increased after 6 days of refrigeration, the highest levels complying with the following order: 100 ppm HP > 200 ppm HP > 300 ppm HP > 100 ppm BHA. The increase in metmyoglobin was coincidental with the decrease in oxymyoglobin; metmyoglobin concentration progressively increased during the first 4 days of refrigeration in all meat samples. After 6 days, in meat samples treated with HP and BHA, lower metmyoglobin concentrations were found (compared to day 4), respecting the following order: 100 ppm HP < 200 ppm HP < 300 ppm HP < 100 ppm BHA. These results showed that hawthorn polyphenols and BHA reduced metmyoglobin (MbFe3+) to oxymyoglobin (MbFe2+), and the strongest reducing character was recorded for 100 ppm HP. After 6 days of refrigeration, electrophoretic pattern of myofibrillar proteins showed minor changes compared to day 0, indicating that HP prevent protein degradation as well as synthetic antioxidant BHA. Also, HP did not induce cross-links in the myofibrillar proteins, to form protein aggregates, and no risk of reducing their ability to retain water was identified. The pattern of oxymyoglobin and metmyoglobin concentrations determined in this study showed that hawthorn polyphenols are able to reduce metmyoglobin to oxymyoglobin and to delay oxymyoglobin oxidation, especially when they are added to ground meat in concentration of 100 ppm. This work was carried out through Partnerships in priority areas Program – PN II, implemented with the support of MEN – UEFISCDI (Romania), project nr. 149/2014.

Keywords: Hawthorn polyphenols, metmyoglobin, oxymyoglobin, proteins stability

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200 Preventing the Septic Shock in an Oncological Patient with Febrile Neutropenia Submitted to Chemotherapy: The Nurse's Responsibility

Authors: Hugo Reis, Isabel Rabiais

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The main purpose of the present study is to understand the nurse’s responsibility in preventing the septic shock in an oncological patient with febrile neutropenia submitted to chemotherapy. In order to do it, an integrative review of literature has been conducted. In the research done in many databases, it was concluded that only 7 out of 5202 articles compiled the entire inclusion standard present in the strict protocol of research, being this made up by all different methodologies. On the research done in the 7 articles it has resulted 8 text macro-units associated to different nursing interventions: ‘Health Education’; ‘Prophylactic Therapy Administration’; ‘Scales Utilization’; ‘Patient Evaluation’; ‘Environment Control’; ‘Performance of Diagnostic Auxiliary Exams’; ‘Protocol Enforcement/Procedure Guidelines’; ‘Antibiotic Therapy Administration’. Concerning the prevalence/result’s division there can be identified many conclusions: the macro-units ‘Patient Evaluation’, ‘Performance of Diagnostic Auxiliary Exams’, and ‘Antibiotic Therapy Administration’ present themselves to be the most prevalent in the research – 6 in 7 occurrences (approximately 85.7%). Next, the macro-unit ‘Protocol Enforcement/Procedure Guidelines’ presents itself as an important expression unit – being part of 5 out of the 7 analyzed studies (approximately 71.4%). The macro-unit ‘Health Education’, seems to be in the same way, an important expression unit – 4 out of the 7 (or approximately 57%). The macro-unit ‘Scales Utilization’, represents a minor part in the research done – it’s in only 2 out of the 7 cases (approximately 28.6%). On the other hand, the macro-units ‘Prophylactic Therapy Administration’ and ‘Environment Control’ are the two categories with fewer results in the research - 1 out of the 7 cases, the same as approximately 14.3% of the research results. Every research done to the macro-unit ‘Antibiotic Therapy Administration’ agreed to refer that the intervention should be strictly done, in a period of time less than one hour after diagnosing the fever, with the purpose of controlling the quick spread of infection – minimizing its seriousness. Identifying these interventions contributes, concluding that, to adopt strategies in order to prevent the phenomenon that represents a daily scenario responsible for the cost´s increase in health institutions, being at the same time responsible for the high morbidity rates and mortality increase associated with this specific group of patients.

Keywords: febrile neutropenia, oncology nursing, patient, septic shock

Procedia PDF Downloads 191
199 An Infinite Mixture Model for Modelling Stutter Ratio in Forensic Data Analysis

Authors: M. A. C. S. Sampath Fernando, James M. Curran, Renate Meyer

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Forensic DNA analysis has received much attention over the last three decades, due to its incredible usefulness in human identification. The statistical interpretation of DNA evidence is recognised as one of the most mature fields in forensic science. Peak heights in an Electropherogram (EPG) are approximately proportional to the amount of template DNA in the original sample being tested. A stutter is a minor peak in an EPG, which is not masking as an allele of a potential contributor, and considered as an artefact that is presumed to be arisen due to miscopying or slippage during the PCR. Stutter peaks are mostly analysed in terms of stutter ratio that is calculated relative to the corresponding parent allele height. Analysis of mixture profiles has always been problematic in evidence interpretation, especially with the presence of PCR artefacts like stutters. Unlike binary and semi-continuous models; continuous models assign a probability (as a continuous weight) for each possible genotype combination, and significantly enhances the use of continuous peak height information resulting in more efficient reliable interpretations. Therefore, the presence of a sound methodology to distinguish between stutters and real alleles is essential for the accuracy of the interpretation. Sensibly, any such method has to be able to focus on modelling stutter peaks. Bayesian nonparametric methods provide increased flexibility in applied statistical modelling. Mixture models are frequently employed as fundamental data analysis tools in clustering and classification of data and assume unidentified heterogeneous sources for data. In model-based clustering, each unknown source is reflected by a cluster, and the clusters are modelled using parametric models. Specifying the number of components in finite mixture models, however, is practically difficult even though the calculations are relatively simple. Infinite mixture models, in contrast, do not require the user to specify the number of components. Instead, a Dirichlet process, which is an infinite-dimensional generalization of the Dirichlet distribution, is used to deal with the problem of a number of components. Chinese restaurant process (CRP), Stick-breaking process and Pólya urn scheme are frequently used as Dirichlet priors in Bayesian mixture models. In this study, we illustrate an infinite mixture of simple linear regression models for modelling stutter ratio and introduce some modifications to overcome weaknesses associated with CRP.

Keywords: Chinese restaurant process, Dirichlet prior, infinite mixture model, PCR stutter

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198 Direct Phoenix Identification and Antimicrobial Susceptibility Testing from Positive Blood Culture Broths

Authors: Waad Al Saleemi, Badriya Al Adawi, Zaaima Al Jabri, Sahim Al Ghafri, Jalila Al Hadhramia

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Objectives: Using standard lab methods, a positive blood culture requires a minimum of two days (two occasions of overnight incubation) to obtain a final identification (ID) and antimicrobial susceptibility results (AST) report. In this study, we aimed to evaluate the accuracy and precision of identification and antimicrobial susceptibility testing of an alternative method (direct method) that will reduce the turnaround time by 24 hours. This method involves the direct inoculation of positive blood culture broths into the Phoenix system using serum separation tubes (SST). Method: This prospective study included monomicrobial-positive blood cultures obtained from January 2022 to May 2023 in SQUH. Blood cultures containing a mixture of organisms, fungi, or anaerobic organisms were excluded from this study. The result of the new “direct method” under study was compared with the current “standard method” used in the lab. The accuracy and precision were evaluated for the ID and AST using Clinical and Laboratory Standards Institute (CLSI) recommendations. The categorical agreement, essential agreement, and the rates of very major errors (VME), major errors (ME), and minor errors (MIE) for both gram-negative and gram-positive bacteria were calculated. Passing criteria were set according to CLSI. Result: The results of ID and AST were available for a total of 158 isolates. Of 77 isolates of gram-negative bacteria, 71 (92%) were correctly identified at the species level. Of 70 isolates of gram-positive bacteria, 47(67%) isolates were correctly identified. For gram-negative bacteria, the essential agreement of the direct method was ≥92% when compared to the standard method, while the categorical agreement was ≥91% for all tested antibiotics. The precision of ID and AST were noted to be 100% for all tested isolates. For gram-positive bacteria, the essential agreement was >93%, while the categorical agreement was >92% for all tested antibiotics except moxifloxacin. Many antibiotics were noted to have an unacceptable higher rate of very major errors including penicillin, cotrimoxazole, clindamycin, ciprofloxacin, and moxifloxacin. However, no error was observed in the results of vancomycin, linezolid, and daptomycin. Conclusion: The direct method of ID and AST for positive blood cultures using SST is reliable for gram negative bacteria. It will significantly decrease the turnaround time and will facilitate antimicrobial stewardship.

Keywords: bloodstream infection, oman, direct ast, blood culture, rapid identification, antimicrobial susceptibility, phoenix, direct inoculation

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197 Influence of Single and Multiple Skin-Core Debonding on Free Vibration Characteristics of Innovative GFRP Sandwich Panels

Authors: Indunil Jayatilake, Warna Karunasena, Weena Lokuge

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An Australian manufacturer has fabricated an innovative GFRP sandwich panel made from E-glass fiber skin and a modified phenolic core for structural applications. Debonding, which refers to separation of skin from the core material in composite sandwiches, is one of the most common types of damage in composites. The presence of debonding is of great concern because it not only severely affects the stiffness but also modifies the dynamic behaviour of the structure. Generally, it is seen that the majority of research carried out has been concerned about the delamination of laminated structures whereas skin-core debonding has received relatively minor attention. Furthermore, it is observed that research done on composite slabs having multiple skin-core debonding is very limited. To address this gap, a comprehensive research investigating dynamic behaviour of composite panels with single and multiple debonding is presented. The study uses finite-element modelling and analyses for investigating the influence of debonding on free vibration behaviour of single and multilayer composite sandwich panels. A broad parametric investigation has been carried out by varying debonding locations, debonding sizes and support conditions of the panels in view of both single and multiple debonding. Numerical models were developed with Strand7 finite element package by innovatively selecting the suitable elements to diligently represent their actual behavior. Three-dimensional finite element models were employed to simulate the physically real situation as close as possible, with the use of an experimentally and numerically validated finite element model. Comparative results and conclusions based on the analyses are presented. For similar extents and locations of debonding, the effect of debonding on natural frequencies appears greatly dependent on the end conditions of the panel, giving greater decrease in natural frequency when the panels are more restrained. Some modes are more sensitive to debonding and this sensitivity seems to be related to their vibration mode shapes. The fundamental mode seems generally the least sensitive mode to debonding with respect to the variation in free vibration characteristics. The results indicate the effectiveness of the developed three-dimensional finite element models in assessing debonding damage in composite sandwich panels

Keywords: debonding, free vibration behaviour, GFRP sandwich panels, three dimensional finite element modelling

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196 Control of an Outbreak of Vancomycin-Resistant Enterococci in a Tunisian Teaching Hospital

Authors: Hela Ghali, Sihem Ben Fredj, Mohamed Ben Rejeb, Sawssen Layouni, Salwa Khefacha, Lamine Dhidah, Houyem Said Laatiri

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Background: Antimicrobial resistance is a growing threat to public health and motivates to improve prevention and control programs both at international (WHO) and national levels. Despite their low pathogenicity, vancomycin-resistant enterococci (VRE) are common nosocomial pathogens in several countries. The high potential for transmission of VRE between patients and the threat to send its resistance genes to other bacteria such as staphylococcus aureus already resistant to meticilin, justify strict control measures. Indeed, in Europe, the proportion of Enterococcus faecium responsible for invasive infections, varies from 1% to 35% in 2011 and less than 5% were resistant to vancomycin. In addition, it represents the second cause of urinary tract and wound infections and the third cause of nosocomial bacteremia in the United States. The nosocomial outbreaks of VRE have been mainly described in intensive care services, hematology-oncology and haemodialysis. An epidemic of VRE has affected our hospital and the objective of this work is to describe the measures put in place. Materials/Methods: Following the alert given by the service of plastic surgery concerning a patient carrier of VRE, a team of the prevention and healthcare security service (doctor + technician) made an investigation. A review of files was conducted to draw the synoptic table and the table of cases. Results: By contacting the microbiology laboratory, we have identified four other cases of VRE and who were hospitalized in Medical resuscitation department (2 cases, one of them was transferred to the Physical rehabilitation department), and Nephrology department (2 cases). The visit has allowed to detect several malfunctions in professional practice. A crisis cell has allowed to validate, coordinate and implement control measures following the recommendations of the Technical Center of nosocomial infections. In fact, the process was to technically isolate cases in their sector of hospitalization, to restrict the use of antibiotics, to strength measures of basic hygiene, and to make a screening by rectal swab for both cases and contacts (other patients and health staff). These measures have helped to control the situation and no other case has been reported for a month. 2 new cases have been detected in the intensive care unit after a month. However, these are short-term strategies, and other measures in the medium and long term should be taken into account in order to face similar outbreaks. Conclusion: The efforts to control the outbreak were not efficient since 2 new cases have been reported after a month. Therefore, a continuous monitoring in order to detect new cases earlier is crucial to minimize the dissemination of VRE.

Keywords: hospitals, nosocomial infection, outbreak, vancomycin-resistant enterococci

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195 Evaluating the Characteristics of Paediatric Accidental Poisonings

Authors: Grace Fangmin Tan, Elaine Yiling Tay, Elizabeth Huiwen Tham, Andrea Wei Ching Yeo

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Background: While accidental poisonings in children may seem unavoidable, knowledge of circumstances surrounding such incidents and identification of risk factors is important in the development of secondary prevention strategies. Some risk factors include age of the child, lack of adequate supervision and improper storage of substances. The aim of this study is to assess risk factors and circumstances influencing outcomes in these children. Methodology: A retrospective medical record review of all accidental poisoning cases presenting to the Children’s Emergency at National University Hospital (NUH), Singapore between January 2014 and December 2015 was conducted. Information on demographics, poisoning circumstances and clinical outcomes were collected. Results: Ninety-nine of a total of 186 poisoning cases were accidental ingestions, with a mean age of 4.7 (range 0.4 to 18.3 years). The gender distribution is rather equal with 52(52.5%) females and 47(47.5%) males. Seventy-nine (79.8%) were self-administered by the child and in 20 cases (20.2%), the substance was administered erroneously by caregivers 12/20 (60.0%) of whom were given the wrong drug dose while 8/20 (40.0%) were given the wrong substance. Self-administration was associated with presentation to the ED within 12 hours (p=0.027, OR 6.65, 95% CI 1.24-35.72). Notably, 94.9% of the cases involved substances kept within reach of the child. Sixty-nine (82.1%) had the substance kept in the original container, 3(3.6%) in food containers, 8(9.5%) in other containers and 4(4.8%) without a container. Of the 50 cases with information on labelling, 40/50(80.0%) were accurately labelled, 2/50 (4.0%) wrongly labelled, and 8/50 (16.0%) were unlabelled. Implicated substances included personal care products (11.1%), household cleaning products (3.0%), and different classes of drugs such as paracetamol (22.2%), antihistamines (17.2%) and sympathomimetics (8.1%). Children < 3 years of age were 4.8 times more likely to be poisoned by household substances than children >3 years of age (p=0.009, 95% CI 1.48-15.77). Prehospital interventions were more likely to have been done in poisoning with household substances (p=0.005, OR 6.12 95% CI 1.73-21.68). Fifty-nine (59.6%) were asymptomatic, 34 (34.3%) had a Poisoning Severity Score (PSS) grade of 1 (minor) and 6 (6.1%) grade 2 (moderate). Older children were 9.3 times more likely to be symptomatic (p<0.001, 95% CI 3.15-27.25). Thirty (32%) required admission. Conclusion: A significant proportion of accidental poisoning cases were due to medication administration errors by caregivers, which should be preventable. Risk factors for accidental poisoning included lack of adequate caregiver supervision, improper labelling and young age of the child. There is an urgent need to improve caregiver counselling during medication dispensing as well as to educate caregivers on basic child safety measures in the home to prevent future accidental poisonings.

Keywords: accidental, caregiver, paediatrics, poisoning

Procedia PDF Downloads 191
194 The People's Tribunal: Empowerment by Survivors for Survivors of Child Abuse

Authors: Alan Collins

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This study explains how The People’s Tribunal empowered survivors of child abuse. It examines how People’s tribunals can be effective mean of empowerment; the challenges of empowerment – expectation v. reality; the findings and how they reflect other inquiry findings; and the importance of listening and learning from survivors. UKCSAPT “The People’s Tribunal” was established by survivors of child sex abuse and members of civil society to investigate historic cases of institutional sex abuse. The independent inquiry, led by a panel of four judges, listened to evidence spanning four decades from survivors and experts. A common theme throughout these accounts showed that a series of institutional failures prevented abuse from being reported; and that there are clear links between children being rendered vulnerable by these failures and predatory abuse on an organised scale. It made a series of recommendations including the establishment of a permanent and open forum for victims to share experiences and give evidence, better links between mental health services and police investigations, and training for police and judiciary professionals on the effects of undisclosed sexual abuse. The main findings of the UKCSAPT report were:-There are clear links between children rendered vulnerable by institutional failures and predatory abuse on an organised scale, even if these links often remain obscure. -UK governmental institutions have failed to provide survivors with meaningful opportunities for either healing or justice. -The vital mental health needs of survivors are not being met and this undermines both their psychological recovery and access to justice. -Police and other authorities often lack the training to understand the complex reasons for the inability of survivors to immediately disclose a history of abuse. -Without far-reaching changes in institutional culture and practices, the sexual abuse of children will continue to be a significant scourge in the UK. The report also outlined a series of recommendations for improving reporting and mental health provision, and access to justice for victims were made, including: -A permanent, government-funded popular tribunal should be established to enable survivors to come forward and tell their stories. -Survivors giving evidence should be assigned an advocate to assist their access to justice. -Mental health services should be linked to police investigations to help victims disclose abuse. -Victims who fear reprisals should be provided with a channel though which to give evidence anonymously.

Keywords: empowerment, survivors, sexual, abuse

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193 The History Of Mental Health In The Middle East: Analytical Literature Review

Authors: Mohamad Musa

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The history of mental health practices and services in the Middle East region has been deeply intertwined with its rich cultural, religious, and societal context. Tracing back to ancient times, mental health approaches were heavily influenced by the traditions of major monotheistic religions, with a strong emphasis on spiritual and traditional healing methods. As psychiatric institutions and Western medicine gradually gained a foothold in the region during the 20th century, a notable shift occurred. However, the integration of Western psychiatric practices faced significant challenges due to cultural barriers and deeply rooted beliefs. Families and communities often turned to traditional healers and religious practices as their initial recourse for mental health concerns, viewing Western interventions with skepticism and hesitation. Historically, mental health services in the Middle East have been overshadowed by a focus on physical health and the biomedical model. Mental illness carried substantial stigma, with individuals and families often reluctant to disclose mental health struggles due to fears of societal ostracization and discrimination. This stigma posed a significant barrier to accessing and accepting formal mental health support. Later in the 20th century, governments in the Middle East began recognizing the need for modernizing mental health services and integrating them into the broader healthcare system. However, this process was hindered by several factors, including limited resources, inadequate training for healthcare professionals, and ongoing conflicts and instability in certain regions, which disrupted the delivery of mental health services. As the 21st century progressed, several Middle Eastern nations, particularly those in the Arabian Gulf region, began implementing national mental health strategies and legislative reforms to address the growing need for comprehensive mental health care. These efforts aimed to destigmatize mental illness, protect the rights of individuals with mental health conditions, and promote public awareness and education. Despite these positive developments, the historical legacy of stigma, cultural barriers, and limited resources continues to pose challenges in the provision of accessible and culturally responsive mental health services across the diverse populations of the Middle East.

Keywords: mental health, history, middle east, literature review

Procedia PDF Downloads 19
192 A Construction Management Tool: Determining a Project Schedule Typical Behaviors Using Cluster Analysis

Authors: Natalia Rudeli, Elisabeth Viles, Adrian Santilli

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Delays in the construction industry are a global phenomenon. Many construction projects experience extensive delays exceeding the initially estimated completion time. The main purpose of this study is to identify construction projects typical behaviors in order to develop a prognosis and management tool. Being able to know a construction projects schedule tendency will enable evidence-based decision-making to allow resolutions to be made before delays occur. This study presents an innovative approach that uses Cluster Analysis Method to support predictions during Earned Value Analyses. A clustering analysis was used to predict future scheduling, Earned Value Management (EVM), and Earned Schedule (ES) principal Indexes behaviors in construction projects. The analysis was made using a database with 90 different construction projects. It was validated with additional data extracted from literature and with another 15 contrasting projects. For all projects, planned and executed schedules were collected and the EVM and ES principal indexes were calculated. A complete linkage classification method was used. In this way, the cluster analysis made considers that the distance (or similarity) between two clusters must be measured by its most disparate elements, i.e. that the distance is given by the maximum span among its components. Finally, through the use of EVM and ES Indexes and Tukey and Fisher Pairwise Comparisons, the statistical dissimilarity was verified and four clusters were obtained. It can be said that construction projects show an average delay of 35% of its planned completion time. Furthermore, four typical behaviors were found and for each of the obtained clusters, the interim milestones and the necessary rhythms of construction were identified. In general, detected typical behaviors are: (1) Projects that perform a 5% of work advance in the first two tenths and maintain a constant rhythm until completion (greater than 10% for each remaining tenth), being able to finish on the initially estimated time. (2) Projects that start with an adequate construction rate but suffer minor delays culminating with a total delay of almost 27% of the planned time. (3) Projects which start with a performance below the planned rate and end up with an average delay of 64%, and (4) projects that begin with a poor performance, suffer great delays and end up with an average delay of a 120% of the planned completion time. The obtained clusters compose a tool to identify the behavior of new construction projects by comparing their current work performance to the validated database, thus allowing the correction of initial estimations towards more accurate completion schedules.

Keywords: cluster analysis, construction management, earned value, schedule

Procedia PDF Downloads 240
191 Recognising and Managing Haematoma Following Thyroid Surgery: Simulation Teaching is Effective

Authors: Emily Moore, Dora Amos, Tracy Ellimah, Natasha Parrott

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Postoperative haematoma is a well-recognised complication of thyroid surgery with an incidence of 1-5%. Haematoma formation causes progressive airway obstruction, necessitating emergency bedside haematoma evacuation in up to ¼ of patients. ENT UK, BAETS and DAS have developed consensus guidelines to improve perioperative care, recommending that all healthcare staff interacting with patients undergoing thyroid surgery should be trained in managing post-thyroidectomy haematoma. The aim was to assess the effectiveness of a hybrid simulation model in improving clinician’s confidence in dealing with this surgical emergency. A hybrid simulation was designed, consisting of a standardised patient wearing a part-task trainer to mimic a post-thyroidectomy haematoma in a real patient. The part-task trainer was an adapted C-spine collar with layers of silicone representing the skin and strap muscles and thickened jelly representing the haematoma. Both the skin and strap muscle layers had to be opened in order to evacuate the haematoma. Boxes have been implemented into the appropriate post operative areas (recovery and surgical wards), which contain a printed algorithm designed to assist in remembering a sequence of steps for haematoma evacuation using the ‘SCOOP’ method (skin exposure, cut sutures, open skin, open muscles, pack wound) along with all the necessary equipment to open the front of the neck. Small-group teaching sessions were delivered by ENT and anaesthetic trainees to members of the multidisciplinary team normally involved in perioperative patient care, which included ENT surgeons, anaesthetists, recovery nurses, HCAs and ODPs. The DESATS acronym of signs and symptoms to recognise (difficulty swallowing, EWS score, swelling, anxiety, tachycardia, stridor) was highlighted. Then participants took part in the hybrid simulation in order to practice this ‘SCOOP’ method of haematoma evacuation. Participants were surveyed using a Likert scale to assess their level of confidence pre- and post teaching session. 30 clinicians took part. Confidence (agreed/strongly agreed) in recognition of post thyroidectomy haematoma improved from 58.6% to 96.5%. Confidence in management improved from 27.5% to 89.7%. All participants successfully decompressed the haematoma. All participants agreed/strongly agreed, that the sessions were useful for their learning. Multidisciplinary team simulation teaching is effective at significantly improving confidence in both the recognition and management of postoperative haematoma. Hybrid simulation sessions are useful and should be incorporated into training for clinicians.

Keywords: thyroid surgery, haematoma, teaching, hybrid simulation

Procedia PDF Downloads 78
190 Study of the Prevalence, Associated Factors and Impact of Maternal Perinatal Depression in Women Alexandria 2022

Authors: Nermeen Saad Elbeltagy, Hoda Ghareeb, Hesham Adel Elsheshtawy, Nadim Hamed, Amany Ibrahim Mostafa, Sara Hazem Hassan

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Introduction: Depression is one of the most common mental health problems occurring in women during their child bearing years. Perinatal depression refers to major and minor depressive episodes that occur either during pregnancy or aer delivery. Although perinatal depression is common in developing countries, it is under-recognized in low and middle income countries making a substantial contribution to maternal and infant morbidity and mortality. About 12.5 - 42% of pregnant women and, 12 - 50% of post natal mothers in low and middle income countries such as Ethiopia had depression AIM OF THE WORK: To study prevalence, associated factors and impact of maternal perinatal depression in Alexandria. Patients and method: This study was conducted on 300 mothers at the postnatal ward in ElShatby Maternity Hospital from April 2022 unl October 2022. Females with past history of depression before pregnancy or females who receive medications inducing depression were excluded. The participants were asked to complete the questionnaire that includes the Edinburgh Postnatal Depression Scale (EPDS) as a screening test to obtain information concerning the current frame of mind at antepartum, partum and postpartum periods Results: The prevalence of perinatal depression was 22.3%. It was found that there is a significant negave moderate correlation between socioeconomic status and perinatal depression(r=-0.42). The present study revealed that about two thirds (60.7%) of postpartum women had low socioeconomic level. Also, less than one fourth (20%) of parents had high education and only one fourth (25.3%) of postpartum women were working. There was a statically significance difference between the number of previous abortions and perinatal depression (p=0.04). There was a significant moderate correlation between the amount of blood lost during delivery and an increased risk of developing postpartum depression. The prevalence of perinatal depression was high in cases of female neonates more than male ones. Conclusion: the prevalence of perinatal depression among the studied women was 22.3% of studied group. The significant factors identified in this study can be targeted to reduce the occurrence of perinatal depression among pregnant women in Alexandria through appropriate health interventions which includes perinatal depression screening, counseling, and the provision of support for pregnant women during antenatal care as well as lifestyle modification.

Keywords: mental health, depression in pregnancy, mental disorders, psychology in pregnancy

Procedia PDF Downloads 52
189 Winkler Springs for Embedded Beams Subjected to S-Waves

Authors: Franco Primo Soffietti, Diego Fernando Turello, Federico Pinto

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Shear waves that propagate through the ground impose deformations that must be taken into account in the design and assessment of buried longitudinal structures such as tunnels, pipelines, and piles. Conventional engineering approaches for seismic evaluation often rely on a Euler-Bernoulli beam models supported by a Winkler foundation. This approach, however, falls short in capturing the distortions induced when the structure is subjected to shear waves. To overcome these limitations, in the present work an analytical solution is proposed considering a Timoshenko beam and including transverse and rotational springs. The present research proposes ground springs derived as closed-form analytical solutions of the equations of elasticity including the seismic wavelength. These proposed springs extend the applicability of previous plane-strain models. By considering variations in displacements along the longitudinal direction, the presented approach ensures the springs do not approach zero at low frequencies. This characteristic makes them suitable for assessing pseudo-static cases, which typically govern structural forces in kinematic interaction analyses. The results obtained, validated against existing literature and a 3D Finite Element model, reveal several key insights: i) the cutoff frequency significantly influences transverse and rotational springs; ii) neglecting displacement variations along the structure axis (i.e., assuming plane-strain deformation) results in unrealistically low transverse springs, particularly for wavelengths shorter than the structure length; iii) disregarding lateral displacement components in rotational springs and neglecting variations along the structure axis leads to inaccurately low spring values, misrepresenting interaction phenomena; iv) transverse springs exhibit a notable drop in resonance frequency, followed by increasing damping as frequency rises; v) rotational springs show minor frequency-dependent variations, with radiation damping occurring beyond resonance frequencies, starting from negative values. This comprehensive analysis sheds light on the complex behavior of embedded longitudinal structures when subjected to shear waves and provides valuable insights for the seismic assessment.

Keywords: shear waves, Timoshenko beams, Winkler springs, sol-structure interaction

Procedia PDF Downloads 46
188 Predicting Mortality among Acute Burn Patients Using BOBI Score vs. FLAMES Score

Authors: S. Moustafa El Shanawany, I. Labib Salem, F. Mohamed Magdy Badr El Dine, H. Tag El Deen Abd Allah

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Thermal injuries remain a global health problem and a common issue encountered in forensic pathology. They are a devastating cause of morbidity and mortality in children and adults especially in developing countries, causing permanent disfigurement, scarring and grievous hurt. Burns have always been a matter of legal concern in cases of suicidal burns, self-inflicted burns for false accusation and homicidal attempts. Assessment of burn injuries as well as rating permanent disabilities and disfigurement following thermal injuries for the benefit of compensation claims represents a challenging problem. This necessitates the development of reliable scoring systems to yield an expected likelihood of permanent disability or fatal outcome following burn injuries. The study was designed to identify the risk factors of mortality in acute burn patients and to evaluate the applicability of FLAMES (Fatality by Longevity, APACHE II score, Measured Extent of burn, and Sex) and BOBI (Belgian Outcome in Burn Injury) model scores in predicting the outcome. The study was conducted on 100 adult patients with acute burn injuries admitted to the Burn Unit of Alexandria Main University Hospital, Egypt from October 2014 to October 2015. Victims were examined after obtaining informed consent and the data were collected in specially designed sheets including demographic data, burn details and any associated inhalation injury. Each burn patient was assessed using both BOBI and FLAMES scoring systems. The results of the study show the mean age of patients was 35.54±12.32 years. Males outnumbered females (55% and 45%, respectively). Most patients were accidently burnt (95%), whereas suicidal burns accounted for the remaining 5%. Flame burn was recorded in 82% of cases. As well, 8% of patients sustained more than 60% of total burn surface area (TBSA) burns, 19% of patients needed mechanical ventilation, and 19% of burnt patients died either from wound sepsis, multi-organ failure or pulmonary embolism. The mean length of hospital stay was 24.91±25.08 days. The mean BOBI score was 1.07±1.27 and that of the FLAMES score was -4.76±2.92. The FLAMES score demonstrated an area under the receiver operating characteristic (ROC) curve of 0.95 which was significantly higher than that of the BOBI score (0.883). A statistically significant association was revealed between both predictive models and the outcome. The study concluded that both scoring systems were beneficial in predicting mortality in acutely burnt patients. However, the FLAMES score could be applied with a higher level of accuracy.

Keywords: BOBI, burns, FLAMES, scoring systems, outcome

Procedia PDF Downloads 309
187 Komedya: St. Denis' Philippine Theater in the US

Authors: Nenita Pambid Domingo

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The komedya otherwise known as moro-moro or pretending to be Moors, is a traditional Filipino play in the vernacular adapted from the Spanish comedia de capa y espada. It was used by Spanish colonizers in the Philippines, circa 1766 to evangelize and strengthen the faith of Indios or Filipino natives to Christianity. Unlike the Moros y Cristianos festival held all over Spain celebrating the Reconquista from the 8th to the 15th century, the Philippine Moro-Moro or Komedya is a romance between a Muslim and a Christian and the battles between Christians and Moros, where the Moros are always defeated and the Muslim prince is converted to the Christian faith and marries the Christian princess at the end of the play. For over 200 years, the komedya has been part of the Filipinos’ life and has been dubbed by some Philippine scholars as the Philippine’s national theater. Until now postings of performances in different parts of the Philippines in different Philippine languages are uploaded at youtube. In the US, “San Dionisio sa America (SDA),” an organization of natives from Barrio San Dionisio, Parañaque, Philippines has been performing the komedya for the past 16 years during their town’s fiesta, in honor of the barrio's patron saints St Denis of Paris, France and Saint Joseph whom the devotees fondly call "Tata Dune" and "Tata Hosep". The komedya performed in the US is infused with modern elements in the production and content, but retain the basic form in verse and the stylized war dance, marches, and singsong delivery of lines. Most of the Celebras or town fiestas and komedya performances are held at The Barnsdall Art Park and Gallery Theatre in Hollywood, Los Angeles. The presentation will focus on the linguistic and content analysis of the Tagalog verses in the 2010 komedya entitled Mga Prinsesa ng Cordova (The Princesses of Cordova) publicized as a modern komedya. The presentation will also touch on the healing function of the language and performance that is part of the town’s religious festivities. It will also look into the aesthetics of the production, audience reception, participation of the sponsors, producers called Hermana/Hermano Mayor, the performers who are a mix of Filipinos from the Philippines and Filipino-Americans who are starting to lose the Tagalog language and the non-Filipino participants, as well as the general audience who are from Parañaque and those not from Parañaque, who come to witness the event and enjoy the festivities.

Keywords: devotion, diaspora nationalism, komedya, st. denis of Paris, France, traditional Philippine theater

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186 Two-Stage Estimation of Tropical Cyclone Intensity Based on Fusion of Coarse and Fine-Grained Features from Satellite Microwave Data

Authors: Huinan Zhang, Wenjie Jiang

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Accurate estimation of tropical cyclone intensity is of great importance for disaster prevention and mitigation. Existing techniques are largely based on satellite imagery data, and research and utilization of the inner thermal core structure characteristics of tropical cyclones still pose challenges. This paper presents a two-stage tropical cyclone intensity estimation network based on the fusion of coarse and fine-grained features from microwave brightness temperature data. The data used in this network are obtained from the thermal core structure of tropical cyclones through the Advanced Technology Microwave Sounder (ATMS) inversion. Firstly, the thermal core information in the pressure direction is comprehensively expressed through the maximal intensity projection (MIP) method, constructing coarse-grained thermal core images that represent the tropical cyclone. These images provide a coarse-grained feature range wind speed estimation result in the first stage. Then, based on this result, fine-grained features are extracted by combining thermal core information from multiple view profiles with a distributed network and fused with coarse-grained features from the first stage to obtain the final two-stage network wind speed estimation. Furthermore, to better capture the long-tail distribution characteristics of tropical cyclones, focal loss is used in the coarse-grained loss function of the first stage, and ordinal regression loss is adopted in the second stage to replace traditional single-value regression. The selection of tropical cyclones spans from 2012 to 2021, distributed in the North Atlantic (NA) regions. The training set includes 2012 to 2017, the validation set includes 2018 to 2019, and the test set includes 2020 to 2021. Based on the Saffir-Simpson Hurricane Wind Scale (SSHS), this paper categorizes tropical cyclone levels into three major categories: pre-hurricane, minor hurricane, and major hurricane, with a classification accuracy rate of 86.18% and an intensity estimation error of 4.01m/s for NA based on this accuracy. The results indicate that thermal core data can effectively represent the level and intensity of tropical cyclones, warranting further exploration of tropical cyclone attributes under this data.

Keywords: Artificial intelligence, deep learning, data mining, remote sensing

Procedia PDF Downloads 36
185 Personalized Infectious Disease Risk Prediction System: A Knowledge Model

Authors: Retno A. Vinarti, Lucy M. Hederman

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This research describes a knowledge model for a system which give personalized alert to users about infectious disease risks in the context of weather, location and time. The knowledge model is based on established epidemiological concepts augmented by information gleaned from infection-related data repositories. The existing disease risk prediction research has more focuses on utilizing raw historical data and yield seasonal patterns of infectious disease risk emergence. This research incorporates both data and epidemiological concepts gathered from Atlas of Human Infectious Disease (AHID) and Centre of Disease Control (CDC) as basic reasoning of infectious disease risk prediction. Using CommonKADS methodology, the disease risk prediction task is an assignment synthetic task, starting from knowledge identification through specification, refinement to implementation. First, knowledge is gathered from AHID primarily from the epidemiology and risk group chapters for each infectious disease. The result of this stage is five major elements (Person, Infectious Disease, Weather, Location and Time) and their properties. At the knowledge specification stage, the initial tree model of each element and detailed relationships are produced. This research also includes a validation step as part of knowledge refinement: on the basis that the best model is formed using the most common features, Frequency-based Selection (FBS) is applied. The portion of the Infectious Disease risk model relating to Person comes out strongest, with Location next, and Weather weaker. For Person attribute, Age is the strongest, Activity and Habits are moderate, and Blood type is weakest. At the Location attribute, General category (e.g. continents, region, country, and island) results much stronger than Specific category (i.e. terrain feature). For Weather attribute, Less Precise category (i.e. season) comes out stronger than Precise category (i.e. exact temperature or humidity interval). However, given that some infectious diseases are significantly more serious than others, a frequency based metric may not be appropriate. Future work will incorporate epidemiological measurements of disease seriousness (e.g. odds ratio, hazard ratio and fatality rate) into the validation metrics. This research is limited to modelling existing knowledge about epidemiology and chain of infection concepts. Further step, verification in knowledge refinement stage, might cause some minor changes on the shape of tree.

Keywords: epidemiology, knowledge modelling, infectious disease, prediction, risk

Procedia PDF Downloads 215
184 High Strength, High Toughness Polyhydroxybutyrate-Co-Valerate Based Biocomposites

Authors: S. Z. A. Zaidi, A. Crosky

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Biocomposites is a field that has gained much scientific attention due to the current substantial consumption of non-renewable resources and the environmentally harmful disposal methods required for traditional polymer composites. Research on natural fiber reinforced polyhydroxyalkanoates (PHAs) has gained considerable momentum over the past decade. There is little work on PHAs reinforced with unidirectional (UD) natural fibers and little work on using epoxidized natural rubber (ENR) as a toughening agent for PHA-based biocomposites. In this work, we prepared polyhydroxybutyrate-co-valerate (PHBV) biocomposites reinforced with UD 30 wt.% flax fibers and evaluated the use of ENR with 50% epoxidation (ENR50) as a toughening agent for PHBV biocomposites. Quasi-unidirectional flax/PHBV composites were prepared by hand layup, powder impregnation followed by compression molding.  Toughening agents – polybutylene adiphate-co-terephthalate (PBAT) and ENR50 – were cryogenically ground into powder and mechanically mixed with main matrix PHBV to maintain the powder impregnation process. The tensile, flexural and impact properties of the biocomposites were measured and morphology of the composites examined using optical microscopy (OM) and scanning electron microscopy (SEM). The UD biocomposites showed exceptionally high mechanical properties as compared to the results obtained previously where only short fibers have been used. The improved tensile and flexural properties were attributed to the continuous nature of the fiber reinforcement and the increased proportion of fibers in the loading direction. The improved impact properties were attributed to a larger surface area for fiber-matrix debonding and for subsequent sliding and fiber pull-out mechanisms to act on, allowing more energy to be absorbed. Coating cryogenically ground ENR50 particles with PHBV powder successfully inhibits the self-healing nature of ENR-50, preventing particles from coalescing and overcoming problems in mechanical mixing, compounding and molding. Cryogenic grinding, followed by powder impregnation and subsequent compression molding is an effective route to the production of high-mechanical-property biocomposites based on renewable resources for high-obsolescence applications such as plastic casings for consumer electronics.

Keywords: natural fibers, natural rubber, polyhydroxyalkanoates, unidirectional

Procedia PDF Downloads 269
183 Control for Fluid Flow Behaviours of Viscous Fluids and Heat Transfer in Mini-Channel: A Case Study Using Numerical Simulation Method

Authors: Emmanuel Ophel Gilbert, Williams Speret

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The control for fluid flow behaviours of viscous fluids and heat transfer occurrences within heated mini-channel is considered. Heat transfer and flow characteristics of different viscous liquids, such as engine oil, automatic transmission fluid, one-half ethylene glycol, and deionized water were numerically analyzed. Some mathematical applications such as Fourier series and Laplace Z-Transforms were employed to ascertain the behaviour-wave like structure of these each viscous fluids. The steady, laminar flow and heat transfer equations are reckoned by the aid of numerical simulation technique. Further, this numerical simulation technique is endorsed by using the accessible practical values in comparison with the anticipated local thermal resistances. However, the roughness of this mini-channel that is one of the physical limitations was also predicted in this study. This affects the frictional factor. When an additive such as tetracycline was introduced in the fluid, the heat input was lowered, and this caused pro rata effect on the minor and major frictional losses, mostly at a very minute Reynolds number circa 60-80. At this ascertained lower value of Reynolds numbers, there exists decrease in the viscosity and minute frictional losses as a result of the temperature of these viscous liquids been increased. It is inferred that the three equations and models are identified which supported the numerical simulation via interpolation and integration of the variables extended to the walls of the mini-channel, yields the utmost reliance for engineering and technology calculations for turbulence impacting jets in the near imminent age. Out of reasoning with a true equation that could support this control for the fluid flow, Navier-stokes equations were found to tangential to this finding. Though, other physical factors with respect to these Navier-stokes equations are required to be checkmated to avoid uncertain turbulence of the fluid flow. This paradox is resolved within the framework of continuum mechanics using the classical slip condition and an iteration scheme via numerical simulation method that takes into account certain terms in the full Navier-Stokes equations. However, this resulted in dropping out in the approximation of certain assumptions. Concrete questions raised in the main body of the work are sightseen further in the appendices.

Keywords: frictional losses, heat transfer, laminar flow, mini-channel, number simulation, Reynolds number, turbulence, viscous fluids

Procedia PDF Downloads 156
182 Analysis of Delays during Initial Phase of Construction Projects and Mitigation Measures

Authors: Sunaitan Al Mutairi

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A perfect start is a key factor for project completion on time. The study examined the effects of delayed mobilization of resources during the initial phases of the project. This paper mainly highlights the identification and categorization of all delays during the initial construction phase and their root cause analysis with corrective/control measures for the Kuwait Oil Company oil and gas projects. A relatively good percentage of the delays identified during the project execution (Contract award to end of defects liability period) attributed to mobilization/preliminary activity delays. Data analysis demonstrated significant increase in average project delay during the last five years compared to the previous period. Contractors had delays/issues during the initial phase, which resulted in slippages and progressively increased, resulting in time and cost overrun. Delays/issues not mitigated on time during the initial phase had very high impact on project completion. Data analysis of the delays for the past five years was carried out using trend chart, scatter plot, process map, box plot, relative importance index and Pareto chart. Construction of any project inside the Gathering Centers involves complex management skills related to work force, materials, plant, machineries, new technologies etc. Delay affects completion of projects and compromises quality, schedule and budget of project deliverables. Works executed as per plan during the initial phase and start-up duration of the project construction activities resulted in minor slippages/delays in project completion. In addition, there was a good working environment between client and contractor resulting in better project execution and management. Mainly, the contractor was on the front foot in the execution of projects, which had minimum/no delays during the initial and construction period. Hence, having a perfect start during the initial construction phase shall have a positive influence on the project success. Our research paper studies each type of delay with some real example supported by statistic results and suggests mitigation measures. Detailed analysis carried out with all stakeholders based on impact and occurrence of delays to have a practical and effective outcome to mitigate the delays. The key to improvement is to have proper control measures and periodic evaluation/audit to ensure implementation of the mitigation measures. The focus of this research is to reduce the delays encountered during the initial construction phase of the project life cycle.

Keywords: construction activities delays, delay analysis for construction projects, mobilization delays, oil & gas projects delays

Procedia PDF Downloads 296
181 Intensive Neurophysiological Rehabilitation System: New Approach for Treatment of Children with Autism

Authors: V. I. Kozyavkin, L. F. Shestopalova, T. B. Voloshyn

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Introduction: Rehabilitation of children with Autism is the issue of the day in psychiatry and neurology. It is attributed to constantly increasing quantity of autistic children - Autistic Spectrum Disorders (ASD) Existing rehabilitation approaches in treatment of children with Autism improve their medico- social and social- psychological adjustment. Experience of treatment for different kinds of Autistic disorders in International Clinic of Rehabilitation (ICR) reveals the necessity of complex intensive approach for healing this malady and wider implementation of a Kozyavkin method for treatment of children with ASD. Methods: 19 children aged from 3 to 14 years were examined. They were diagnosed ‘Autism’ (F84.0) with comorbid neurological pathology (from pyramidal insufficiency to para- and tetraplegia). All patients underwent rehabilitation in ICR during two weeks, where INRS approach was used. INRS included methods like biomechanical correction of the spine, massage, physical therapy, joint mobilization, wax-paraffin applications. They were supplemented by art- therapy, ergotherapy, rhythmical group exercises, computer game therapy, team Olympic games and other methods for improvement of motivation and social integration of the child. Estimation of efficacy was conducted using parent’s questioning and done twice- on the onset of INRS rehabilitation course and two weeks afterward. For efficacy assessment of rehabilitation of autistic children in ICR standardized tool was used, namely Autism Treatment Evaluation Checklist (ATEC). This scale was selected because any rehabilitation approaches for the child with Autism can be assessed using it. Results: Before the onset of INRS treatment mean score according to ATEC scale was 64,75±9,23, it reveals occurrence in examined children severe communication, speech, socialization and behavioral impairments. After the end of the rehabilitation course, the mean score was 56,5±6,7, what indicates positive dynamics in comparison to the onset of rehabilitation. Generally, improvement of psychoemotional state occurred in 90% of cases. Most significant changes occurred in the scope of speech (16,5 before and 14,5 after the treatment), socialization (15.1 before and 12,5 after) and behavior (20,1 before and 17.4 after). Conclusion: As a result of INRS rehabilitation course reduction of autistic symptoms was noted. Particularly improvements in speech were observed (children began to spell out new syllables, words), there was some decrease in signs of destructiveness, quality of contact with the surrounding people improved, new skills of self-service appeared. The prospect of the study is further, according to evidence- based medicine standards, deeper examination of INRS and assessment of its usefulness in treatment for Autism and ASD.

Keywords: intensive neurophysiological rehabilitation system (INRS), international clinic od rehabilitation, ASD, rehabilitation

Procedia PDF Downloads 150
180 Understanding the Benefits of Multiple-Use Water Systems (MUS) for Smallholder Farmers in the Rural Hills of Nepal

Authors: RAJ KUMAR G.C.

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There are tremendous opportunities to maximize smallholder farmers’ income from small-scale water resource development through micro irrigation and multiple-use water systems (MUS). MUS are an improved water management approach, developed and tested successfully by iDE that pipes water to a community both for domestic use and for agriculture using efficient micro irrigation. Different MUS models address different landscape constraints, water demand, and users’ preferences. MUS are complemented by micro irrigation kits, which were developed by iDE to enable farmers to grow high-value crops year-round and to use limited water resources efficiently. Over the last 15 years, iDE’s promotion of the MUS approach has encouraged government and other key stakeholders to invest in MUS for better planning of scarce water resources. Currently, about 60% of the cost of MUS construction is covered by the government and community. Based on iDE’s experience, a gravity-fed MUS costs approximately $125 USD per household to construct, and it can increase household income by $300 USD per year. A key element of the MUS approach is keeping farmers well linked to input supply systems and local produce collection centers, which helps to ensure that the farmers can produce a sufficient quantity of high-quality produce that earns a fair price. This process in turn creates an enabling environment for smallholders to invest in MUS and micro irrigation. Therefore, MUS should be seen as an integrated package of interventions –the end users, water sources, technologies, and the marketplace– that together enhance technical, financial, and institutional sustainability. Communities are trained to participate in sustainable water resource management as a part of the MUS planning and construction process. The MUS approach is cost-effective, improves community governance of scarce water resources, helps smallholder farmers to improve rural health and livelihoods, and promotes gender equity. MUS systems are simple to maintain and communities are trained to ensure that they can undertake minor maintenance procedures themselves. All in all, the iDE Nepal MUS offers multiple benefits and represents a practical and sustainable model of the MUS approach. Moreover, there is a growing national consensus that rural water supply systems should be designed for multiple uses, acknowledging that substantial work remains in developing national-level and local capacity and policies for scale-up.

Keywords: multiple-use water systems , small scale water resources, rural livelihoods, practical and sustainable model

Procedia PDF Downloads 273
179 Optimization Based Design of Decelerating Duct for Pumpjets

Authors: Mustafa Sengul, Enes Sahin, Sertac Arslan

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Pumpjets are one of the marine propulsion systems frequently used in underwater vehicles nowadays. The reasons for frequent use of pumpjet as a propulsion system are that it has higher relative efficiency at high speeds, better cavitation, and acoustic performance than its rivals. Pumpjets are composed of rotor, stator, and duct, and there are two different types of pumpjet configurations depending on the desired hydrodynamic characteristic, which are with accelerating and decelerating duct. Pumpjet with an accelerating channel is used at cargo ships where it works at low speeds and high loading conditions. The working principle of this type of pumpjet is to maximize the thrust by reducing the pressure of the fluid through the channel and throwing the fluid out from the channel with high momentum. On the other hand, for decelerating ducted pumpjets, the main consideration is to prevent the occurrence of the cavitation phenomenon by increasing the pressure of the fluid about the rotor region. By postponing the cavitation, acoustic noise naturally falls down, so decelerating ducted systems are used at noise-sensitive vehicle systems where acoustic performance is vital. Therefore, duct design becomes a crucial step during pumpjet design. This study, it is aimed to optimize the duct geometry of a decelerating ducted pumpjet for a highly speed underwater vehicle by using proper optimization tools. The target output of this optimization process is to obtain a duct design that maximizes fluid pressure around the rotor region to prevent from cavitation and minimizes drag force. There are two main optimization techniques that could be utilized for this process which are parameter-based optimization and gradient-based optimization. While parameter-based algorithm offers more major changes in interested geometry, which makes user to get close desired geometry, gradient-based algorithm deals with minor local changes in geometry. In parameter-based optimization, the geometry should be parameterized first. Then, by defining upper and lower limits for these parameters, design space is created. Finally, by proper optimization code and analysis, optimum geometry is obtained from this design space. For this duct optimization study, a commercial codedparameter-based optimization algorithm is used. To parameterize the geometry, duct is represented with b-spline curves and control points. These control points have x and y coordinates limits. By regarding these limits, design space is generated.

Keywords: pumpjet, decelerating duct design, optimization, underwater vehicles, cavitation, drag minimization

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178 Linkage Disequilibrium and Haplotype Blocks Study from Two High-Density Panels and a Combined Panel in Nelore Beef Cattle

Authors: Priscila A. Bernardes, Marcos E. Buzanskas, Luciana C. A. Regitano, Ricardo V. Ventura, Danisio P. Munari

Abstract:

Genotype imputation has been used to reduce genomic selections costs. In order to increase haplotype detection accuracy in methods that considers the linkage disequilibrium, another approach could be used, such as combined genotype data from different panels. Therefore, this study aimed to evaluate the linkage disequilibrium and haplotype blocks in two high-density panels before and after the imputation to a combined panel in Nelore beef cattle. A total of 814 animals were genotyped with the Illumina BovineHD BeadChip (IHD), wherein 93 animals (23 bulls and 70 progenies) were also genotyped with the Affymetrix Axion Genome-Wide BOS 1 Array Plate (AHD). After the quality control, 809 IHD animals (509,107 SNPs) and 93 AHD (427,875 SNPs) remained for analyses. The combined genotype panel (CP) was constructed by merging both panels after quality control, resulting in 880,336 SNPs. Imputation analysis was conducted using software FImpute v.2.2b. The reference (CP) and target (IHD) populations consisted of 23 bulls and 786 animals, respectively. The linkage disequilibrium and haplotype blocks studies were carried out for IHD, AHD, and imputed CP. Two linkage disequilibrium measures were considered; the correlation coefficient between alleles from two loci (r²) and the |D’|. Both measures were calculated using the software PLINK. The haplotypes' blocks were estimated using the software Haploview. The r² measurement presented different decay when compared to |D’|, wherein AHD and IHD had almost the same decay. For r², even with possible overestimation by the sample size for AHD (93 animals), the IHD presented higher values when compared to AHD for shorter distances, but with the increase of distance, both panels presented similar values. The r² measurement is influenced by the minor allele frequency of the pair of SNPs, which can cause the observed difference comparing the r² decay and |D’| decay. As a sum of the combinations between Illumina and Affymetrix panels, the CP presented a decay equivalent to a mean of these combinations. The estimated haplotype blocks detected for IHD, AHD, and CP were 84,529, 63,967, and 140,336, respectively. The IHD were composed by haplotype blocks with mean of 137.70 ± 219.05kb, the AHD with mean of 102.10kb ± 155.47, and the CP with mean of 107.10kb ± 169.14. The majority of the haplotype blocks of these three panels were composed by less than 10 SNPs, with only 3,882 (IHD), 193 (AHD) and 8,462 (CP) haplotype blocks composed by 10 SNPs or more. There was an increase in the number of chromosomes covered with long haplotypes when CP was used as well as an increase in haplotype coverage for short chromosomes (23-29), which can contribute for studies that explore haplotype blocks. In general, using CP could be an alternative to increase density and number of haplotype blocks, increasing the probability to obtain a marker close to a quantitative trait loci of interest.

Keywords: Bos taurus indicus, decay, genotype imputation, single nucleotide polymorphism

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177 Case Study on the Effects of Early Mobilization in the Post-Surgical Recovery of Athletes with Open Triangular Fibrocartilage Complex Repair

Authors: Blair Arthur Agero Jr., Lucia Garcia Heras

Abstract:

The triangular fibrocartilage complex (TFCC) is one of the crucial stabilizing ligaments of the wrist. The TFCC is also subject to excessive stress amongst performance athletes and enthusiasts. The excessive loading of the TFCC may lead to a partial or complete rupture that requires surgery. The recovery from an open TFCC surgical repair may take several months. Immobilization of the repaired wrist for a given period is part of all the current protocols in the post-surgical treatment. The immobilization to prevent the rotation of the forearm can last from six weeks to eight weeks with the wrist held in a neutral position. In all protocols reviewed, the pronosupination is only initiated between the 6th week and 8th week or even later after the cast is removed. The prolonged immobilization can cause stiffness of the wrist and hand. Furthermore, the entire period of post-surgical hand therapy has its economic impact, especially for performing athletes. However, delayed mobilization, specifically rotation of the wrist, is necessary to allow ligament healing. This study aims to report the effects of early mobilization of the wrist in athletes who had an open surgical repair of the TFCC. The surgery was done by the co-author, and the hand therapy was implemented by the main author. The cases documented spans from 2014 to 2019 and were all performed in Dubai, United Arab Emirates. All selected participants in this case study were provided with a follow-up questionnaire to ascertain their current condition since their surgery. The respondents reported high satisfaction in the results of their treatment and have verified zero re-rupture of their TFCC despite mobilizing and rotating the wrist at the third-week post-surgery during their hand therapy. There is also a negligible number of respondents who reported a limitation in their ranges of pronosupination. This case study suggests that early mobilization of the wrist after an open TFCC surgical repair can be more beneficial to the patient as opposed to the traditional treatment of prolonged immobilization. However, it should be considered that the patients selected in this case study are professional performance athletes and advanced fitness enthusiasts. Athletes are known to withstand vigorous physical stress in their training that may correlate to their ability to better cope with the progressive stress that was implemented during their hand therapy. Nevertheless, this approach has its merits, and application of it may be adjusted for patients with a similar injury and surgical procedure.

Keywords: hand therapy, performance athlete, TFCC repair, wrist ligament

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