Search results for: AIDS mortality rates
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4442

Search results for: AIDS mortality rates

3392 Curcumin Nanomedicine: A Breakthrough Approach for Enhanced Lung Cancer Therapy

Authors: Shiva Shakori Poshteh

Abstract:

Lung cancer is a highly prevalent and devastating disease, representing a significant global health concern with profound implications for healthcare systems and society. Its high incidence, mortality rates, and late-stage diagnosis contribute to its formidable nature. To address these challenges, nanoparticle-based drug delivery has emerged as a promising therapeutic strategy. Curcumin (CUR), a natural compound derived from turmeric, has garnered attention as a potential nanomedicine for lung cancer treatment. Nanoparticle formulations of CUR offer several advantages, including improved drug delivery efficiency, enhanced stability, controlled release kinetics, and targeted delivery to lung cancer cells. CUR exhibits a diverse array of effects on cancer cells. It induces apoptosis by upregulating pro-apoptotic proteins, such as Bax and Bak, and downregulating anti-apoptotic proteins, such as Bcl-2. Additionally, CUR inhibits cell proliferation by modulating key signaling pathways involved in cancer progression. It suppresses the PI3K/Akt pathway, crucial for cell survival and growth, and attenuates the mTOR pathway, which regulates protein synthesis and cell proliferation. CUR also interferes with the MAPK pathway, which controls cell proliferation and survival, and modulates the Wnt/β-catenin pathway, which plays a role in cell proliferation and tumor development. Moreover, CUR exhibits potent antioxidant activity, reducing oxidative stress and protecting cells from DNA damage. Utilizing CUR as a standalone treatment is limited by poor bioavailability, lack of targeting, and degradation susceptibility. Nanoparticle-based delivery systems can overcome these challenges. They enhance CUR’s bioavailability, protect it from degradation, and improve absorption. Further, Nanoparticles enable targeted delivery to lung cancer cells through surface modifications or ligand-based targeting, ensuring sustained release of CUR to prolong therapeutic effects, reduce administration frequency, and facilitate penetration through the tumor microenvironment, thereby enhancing CUR’s access to cancer cells. Thus, nanoparticle-based CUR delivery systems promise to improve lung cancer treatment outcomes. This article provides an overview of lung cancer, explores CUR nanoparticles as a treatment approach, discusses the benefits and challenges of nanoparticle-based drug delivery, and highlights prospects for CUR nanoparticles in lung cancer treatment. Future research aims to optimize these delivery systems for improved efficacy and patient prognosis in lung cancer.

Keywords: lung cancer, curcumin, nanomedicine, nanoparticle-based drug delivery

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3391 Response of Newzealand Rabbits to Drinking Water Treated with PolyDADMAC

Authors: Amna Beshir Medani Ahmed, Samia Mohammed Ali El Badwi, Ahmed El Amin Mohammed

Abstract:

This work has been managed to yield toxicity information on water treatment agents in the Sudan namely polyDADMAC, using New Zealand rabbits at multiple daily oral doses for a period of 10 weeks. Thirty-three heads of New Zealand rabbits were divided into 11 groups, each of three. Group 1 animals were the undosed controls. Test groups of either species were given polyDADMAC at similar dose rates of 0.5, 2.5, 4.5, 10, 15, 20, 25, 50, 100 and 150 mg/kg body weight respectively for groups 2,3,4,5,6,7,8,9,10 and 11. Clinical signs were closely observed with postmortem and histopathological examinations. Chemical investigations included enzymatic concentrations of ALP, GOT, CK, GPT and LDH together with hematological changes in Hb, PCV, RBCs and WBCs. Mortalities occurred to variable degrees irrespective of the dose level. On polyDADMAC challenge, the test species showed clinical signs of dullness, loss of weight, anorexia, diarrhea, difficulty in respiration, hind limb paralysis and recumbency. Notably oral dosing with polyDADMAC caused lung emphysema, hepatic and renal dysfunctions, irregularity in enzymatic activities and serum metabolites, sloughing of intestinal epithelium, decreased electrolytes in serum, and splenic haemosiderosis. On evaluation of the above results, polyDADMAC was considered toxic to New Zealand rabbits at all dose rates tried. Practical implications of the results were highlighted and suggestions for future work were put forward.

Keywords: polydiallyldiethylaluminiumchloride (polyDADMAC), nubian goats, toxicity of drinking water, treatment of drinking water using chemicals

Procedia PDF Downloads 370
3390 Improving Student Retention: Enhancing the First Year Experience through Group Work, Research and Presentation Workshops

Authors: Eric Bates

Abstract:

Higher education is recognised as being of critical importance in Ireland and has been linked as a vital factor to national well-being. Statistics show that Ireland has one of the highest rates of higher education participation in Europe. However, student retention and progression, especially in Institutes of Technology, is becoming an issue as rates on non-completion rise. Both within Ireland and across Europe student retention is seen as a key performance indicator for higher education and with these increasing rates the Irish higher education system needs to be flexible and adapt to the situation it now faces. The author is a Programme Chair on a Level 6 full time undergraduate programme and experience to date has shown that the first year undergraduate students take some time to identify themselves as a group within the setting of a higher education institute. Despite being part of a distinct class on a specific programme some individuals can feel isolated as he or she take the first step into higher education. Such feelings can contribute to students eventually dropping out. This paper reports on an ongoing initiative that aims to accelerate the bonding experience of a distinct group of first year undergraduates on a programme which has a high rate of non-completion. This research sought to engage the students in dynamic interactions with their peers to quickly evolve a group sense of coherence. Two separate modules – a Research Module and a Communications module - delivered by the researcher were linked across two semesters. Students were allocated into random groups and each group was given a topic to be researched. There were six topics – essentially the six sub-headings on the DIT Graduate Attribute Statement. The research took place in a computer lab and students also used the library. The output from this was a document that formed part of the submission for the Research Module. In the second semester the groups then had to make a presentation of their findings where each student spoke for a minimum amount of time. Presentation workshops formed part of that module and students were given the opportunity to practice their presentation skills. These presentations were video recorded to enable feedback to be given. Although this was a small scale study preliminary results found a strong sense of coherence among this particular cohort and feedback from the students was very positive. Other findings indicate that spreading the initiative across two semesters may have been an inhibitor. Future challenges include spreading such Initiatives College wide and indeed sector wide.

Keywords: first year experience, student retention, group work, presentation workshops

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3389 Effect of the Endotracheal Care Nursing Guideline Utilization on the Incidence of Endotracheal Tube Displacement, Oxygen Deficiency after Extubation, Re-intubation, and Nurses Satisfaction

Authors: Rabeab Khunpukdee, Aranya Sukchoui, Nonluk Somgit, Chitima Bunnaul

Abstract:

Endotracheal displacement is a major risk of life threatening among critically ill patients. Standard nursing protocol is needed to minimize this risk and to improve clinical outcomes. To evaluate the effectiveness of the endothacheal care nursing guideline. The incidence rates of endochacheal displacement, oxygen deficiency after extubation, re-intubation, and nurse’s satisfaction on the utilization of the endotracheal care nursing guideline. An evidence-based nursing practice framework was used to develop the endotracheal care nursing guideline. The guideline valid content was review by a 3 panel of experts. The index of item objective (IOC) of the guideline was 0.93. The guideline was implemented in 130 patients (guideline group) and 19 registered nurses at a medicine ward, Had Yai hospital, Thailand. Patient’s outcomes were evaluated by comparison with those 155 patients who received the routine nursing care (routine care group). Descriptive statistics, frequency, percentage, mean, standard deviation and Mann Whitney U-test was analyzed using the computer program. All significantly and better outcomes were found in the guideline group compared to the routine care group. The guideline group has less incidence rates of endotracheal displacement (1.54 % vs 9.03 %, p < 0.05), and none of the guideline group had oxygen deficiency after extubation (0 % vs 83.33%) compared to the routine care group. All of the 2 patients in the guideline group, compared to 6 of 14 patients in the routine care group were re-intubation. The overall rate of re-intubation in the total group (n = 130 vs 155) was seen less in the guideline group than the routine care group (1.54 % vs 3.87). Overall, nurses satisfaction was at high-level (89.50%) on the utilization of the guideline.

Keywords: endotracheal care, nursing guideline, re-intubation, satisfaction

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3388 Serological Evidence of Enzootic Bovine Leukosis in Dairy Cattle Herds in the United Arab Emirates

Authors: Nabeeha Hassan Abdel Jalil, Lulwa Saeed Al Badi, Mouza Ghafan Alkhyeli, Khaja Mohteshamuddin, Ahmad Al Aiyan, Mohamed Elfatih Hamad, Robert Barigye

Abstract:

The present study was done to elucidate the prevalence of enzootic bovine leucosis (EBL) in the UAE, the seroprevalence rates of EBL in dairy herds from the Al Ain area, Abu Dhabi (AD) and indigenous cattle at the Al Ain livestock market (AALM) were assessed. Of the 949 sera tested by ELISA, 657 were from adult Holstein-Friesians from three farms and 292 from indigenous cattle at the AALM. The level of significance between the proportions of seropositive cattle were analyzed by the Marascuilo procedure and questionnaire data on husbandry and biosecurity practices evaluated. Overall, the aggregated farm and AALM data demonstrated a seroprevalence of 25.9%, compared to 37.0% for the study farms, and 1.0% for the indigenous cattle. Additionally, the seroprevalence rates at farms #1, #2 and #3 were 54.7%, 0.0%, and 26.3% respectively. Except for farm #2 and the AALM, statistically significant differences were noted between the proportions of seropositive cattle for farms #1 and #2 (Critical Range or CR=0.0803), farms #1 and #3 (p=0.1069), and farms #2 and #3 (CR=0.0707), farm #1 and the AALM (CR=0.0819), and farm #3 and the AALM (CR=0.0726). Also, the proportions of seropositive animals on farm #1 were 9.8%, 59.8%, 29.3%, and 1.2% in the 12-36, 37-72, 73-108, and 109-144-mo-old age groups respectively compared to 21.5%, 60.8%, 15.2%, and 2.5% in the respective age groups for farm #2. On both farms and the AALM, the 37-72-mo-old age group showed the highest EBL seroprevalence rate while all the 57 cattle on farm #2 were seronegative. Additionally, farms #1 and #3 had 3,130 and 2,828 intensively managed Holstein-Friesian cattle respectively, and all animals were routinely immunized against several diseases except EBL. On both farms #1 and #3, artificial breeding was practiced using semen sourced from the USA, and USA and Canada respectively, all farms routinely quarantined new stock, and farm #1 previously imported dairy cattle from an unspecified country, and farm #3 from the Netherlands, Australia and South Africa. While farm #1 provided no information on animal nutrition, farm #3 cited using hay, concentrates, and ad lib water. To the authors’ best knowledge, this is the first serological evidence of EBL in the UAE and as previously reported, the seroprevalence rates are comparatively higher in the intensively managed dairy herds than in indigenous cattle. As two of the study farms previously sourced cattle and semen from overseas, biosecurity protocols need to be revisited to avoid inadvertent EBL incursion and the possibility of regional transboundary disease spread also needs to be assessed. After the proposed molecular studies have adduced additional data, the relevant UAE animal health authorities may need to develop evidence-based EBL control policies and programs.

Keywords: cattle, enzootic bovine leukosis, seroprevalence, UAE

Procedia PDF Downloads 143
3387 Ameliorative Effect of Curcuma Longa against Arsenic Induced Reproductive Toxicity in Charles Foster Rats

Authors: Shazia Naheed Akhter, Rekha Kumari

Abstract:

An estimated 70 million population are exposed to arsenic poisoning in India in recent times. Arsenic contamination in the groundwater has caused serious health hazards among the exposed population. In Bihar, the first district was Bhojpur, where arsenic causing health issues were reported in 2002. Presently, there are 18 districts that are reported arsenic poisoning in the groundwater. The exposed population is firstly diseased with various symptoms such as skin manifestations, loss of appetite, constipation, hormonal disorders, etc. The long duration exposure has led to cause infertility in the male subjects. The present study thus aims to develop the antidote against arsenic-induced male reproductive toxicity in animal models. The study was carried out on Charles Foster Rats after the approval from Institutional Animal Ethics Committee. A total of n=18 rats (12 weeks old) of an average weight of 160 ± 20 g were used for the study. The study group included n=6 control and n= 12 treated with sodium arsenite orally at the dose of 8mg/Kg b.w daily for 40 days. The n= 6 animals were dissected and the rest n=6 was administered orally with Curcuma longa rhizome ethanolic extract at the dose of 600mg/Kg b.w per day for 40 days. At the end of the entire experiment, all the animals were dissected out and their reproductive organs were taken out, especially epididymis for sperm counts, sperm motility, sperm mortality, sperm morphology. The blood samples were collected for the hormonal assay (testosterone and luteinizing hormone), as well as for hematological and biochemical analysis. The study showed a high magnitude of degeneration in the reproductive organs of the rats in the arsenic-treated group. There were degenerative fluctuations in the sperm counts, sperm motility, sperm mortality, sperm morphology and in the hormonal parameters, as well as in the hematological and biochemical parameters in the arsenic-treated rats. But, after the administration of Curcuma longa, there was significant amelioration in all these parameters. Therefore, the present study shows that Curcuma longa plays a vital role to combat arsenic-induced male reproductive toxicity.

Keywords: sodium arsenite, Charles foster rats, ethanolic rhizome extract of curcuma longa, male reproductive toxicity, amelioration

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3386 Agile Implementation of 'PULL' Principles in a Manufacturing Process Chain for Aerospace Composite Parts

Authors: Torsten Mielitz, Dietmar Schulz, York C. Roth

Abstract:

Market forecasts show a significant increase in the demand for aircraft within the next two decades and production rates will be adapted accordingly. Improvements and optimizations in the industrial system are becoming more important to cope with future challenges in manufacturing and assembly. Highest quality standards have to be met for aerospace parts, whereas cost effective production in industrial systems and methodologies are also a key driver. A look at other industries like e.g., automotive shows well established processes to streamline existing manufacturing systems. In this paper, the implementation of 'PULL' principles in an existing manufacturing process chain for a large scale composite part is presented. A nonlinear extrapolation based on 'Little's Law' showed a risk of a significant increase of parts needed in the process chain to meet future demand. A project has been set up to mitigate the risk whereas the methodology has been changed from a traditional milestone approach in the beginning towards an agile way of working in the end in order to facilitate immediate benefits in the shop-floor. Finally, delivery rates could be increased avoiding more semi-finished parts in the process chain (work in progress & inventory) by the successful implementation of the 'PULL' philosophy in the shop-floor between the work stations. Lessons learned during the running project as well as implementation and operations phases are discussed in order to share best practices.

Keywords: aerospace composite part manufacturing, PULL principles, shop-floor implementation, lessons learned

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3385 Person-Centered Approaches in Face-to-Face Interventions to Support Enrolment in Cardiac Rehabilitation: A Scoping Review Study

Authors: Birgit Rasmussen, Thomas Maribo, Bente S. Toft

Abstract:

BACKGROUND: Cardiac rehabilitation is the standard treatment for ischemic heart disease. Cardiac rehabilitation improves quality of life, reduces mortality and the risk of readmission, and provides patients with valuable knowledge and encouragement from peers and staff. Still, less than half of eligible patients enroll. Face-to-face interventions have the potential to support patients' decision-making and increase enrolment in cardiac rehabilitation. However, we lack knowledge of the content and characteristics of interventions. AIM: The aim was to outline and evaluate the content and characteristics of studies that have reported on face-to-face interventions to encourage enrolment in cardiac rehabilitation in patients with ischemic heart disease. METHOD: This scoping review followed the Joanne Briggs Institute methodology. Based on an a-priori protocol that defined the systematic search criteria, six databases were searched for studies published between 2001 and 2023. Two reviewers independently screened and selected studies. All authors discussed the summarized data prior to the narrative presentation. RESULTS: After screening and full text review of 5583 records, 20 studies of heterogeneous design and content were included. Four studies described the key contents in face-to-face interventions to be education, support of autonomy, addressing reasons for change, and emotional and cognitive support while showing understanding. Two studies used motivational interviewing to target patients' experiences and address worries and anticipated difficulties. Four quantitative studies found associations between enrolment and intention to attend, cardiac rehabilitation barriers, exercise self-efficacy, and perceived control. When patients asked questions, enrolment rates were higher, while providing reassurance and optimism could lead to non-attendance if patients had a high degree of worry. In qualitative studies, support to overcome barriers and knowledge about health benefits from participation in cardiac rehabilitation facilitated enrolment. Feeling reassured that the cardiac condition was good could lead to non-attendance. DISCUSSION AND CONCLUSION: To support patients' enrolment in cardiac rehabilitation, it is recommended that interventions integrate a person-centered dialogue. Individual worries and barriers to cardiac rehabilitation should be jointly explored. When talking with patients for whom worries predominate, the recommendation is to focus on the patients' perspectives and avoid too much focus on reassurance and problem-solving. The patients' perspectives, the mechanisms of change, and the process evaluation of the intervention including person-centeredness are relevant to include in future studies.

Keywords: ischemic heart disease, cardiac rehabilitation, enrolment, person-centered, in-hospital interventions

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3384 Utilization of Synthetic and Natural Ascorbic Acid (African Locust Bean, Baobab, and Prosopis Africana) Pulp for Sustainable Broiler Production in the Era of Global Warming

Authors: Lawan Adamu, Aminu Maidala

Abstract:

Heat stress exerts a high deteriorating impact on the poultry industry which could be ameliorated by dietary incorporation of synthetic vitamin C. Certain herbs either alone or in combination thereof are also a rich source of ascorbic acid in natural form. Gashua is located in the semi arid zones with temperature ranges of 38-43oC especially in the months of March up to June/July which make survival and production much difficult to poultry especially broilers chickens as it was found that high ambient temperatures above 380C feed consumption, growth rate, feed efficiency, survivability, egg production and egg quality tends to decline. In order to address the problem of heat stress, an experiment was conducted in the month of March/April to determine the effect of synthetic ascorbic-acid (vitamin C), natural ascorbic from baobab, African locust bean and prosopis africana pulp was administer in drinking water and basal diets adlibitum. 300 day old marshal breed chicks were used for this experiment which was divided into five treatment group with 20 birds per replicate which designated as zero, synthetic ascorbic acid 40g/L, baobab pulp 40g/L, African locust pulp 40g/L and iron wood pulp 40g/L for T1, T2 T3 T4 and T5 respectively. The experiment was lasted for eight weeks (four weeks each for the starter and finisher). Data collected were subjected to analysis of variance (ANOVA) using SAS 2002 soft wire and significant difference observed means were separated using Duncan multiple range test. The result revealed that bird on control diet were significantly (p<0.05) lowered in terms total and daily weight gain and feed efficiency but significantly (p<0.05) higher in terms feed intake, water intake, rectal temperature and mortality. This study concluded that ascorbic acid increased broiler performance and reduced mortality under high temperature thereby maintain the sustainability of broiler production to bridge the gap of animal protein deficit in the hot arid zone.

Keywords: ascorbic acid, heat stress, broiler, performance

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3383 Triose Phosphate Utilisation at the (Sub)Foliar Scale Is Modulated by Whole-plant Source-sink Ratios and Nitrogen Budgets in Rice

Authors: Zhenxiang Zhou

Abstract:

The triose phosphate utilisation (TPU) limitation to leaf photosynthesis is a biochemical process concerning the sub-foliar carbon sink-source (im)balance, in which photorespiration-associated amino acids exports provide an additional outlet for carbon and increases leaf photosynthetic rate. However, whether this process is regulated by whole-plant sink-source relations and nitrogen budgets remains unclear. We address this question by model analyses of gas-exchange data measured on leaves at three growth stages of rice plants grown at two-nitrogen levels, where three means (leaf-colour modification, adaxial vs abaxial measurements, and panicle pruning) were explored to alter source-sink ratios. Higher specific leaf nitrogen (SLN) resulted in higher rates of TPU and also led to the TPU limitation occurring at a lower intercellular CO2 concentration. Photorespiratory nitrogen assimilation was greater in higher-nitrogen leaves but became smaller in cases associated with yellower-leaf modification, abaxial measurement, or panicle pruning. The feedback inhibition of panicle pruning on rates of TPU was not always observed because panicle pruning blocked nitrogen remobilisation from leaves to grains, and the increased SLN masked the feedback inhibition. The (sub)foliar TPU limitation can be modulated by whole-plant source-sink ratios and nitrogen budgets during rice grain filling, suggesting a close link between sub-foliar and whole-plant sink limitations.

Keywords: triose phosphate utilization, sink limitation, panicle pruning, oryza sativa

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3382 Effect of Swirling Mixer on the Exhaust Flow in a Diesel SCR Aftertreatment System

Authors: Doo Ki Lee, Kumaresh Selvakumar, Man Young Kim, In Jae Song

Abstract:

The widespread utilization of mixer in selective catalytic reduction (SCR) system marks a remarkable advantage in diesel engines. In the automotive selective catalytic reduction (SCR) system, the de-NOX efficiency can be improved by highly uniform flow with effective turbulent mixing. In this paper, the exhaust pipe is complemented with the swirling mixers of three different vane angles installed at the upstream of the SCR reactor. The attributes of the mixer are established by the variation in flow behavior followed by the drawback owing to the absence of mixer. In particular, the information pertaining to the selection of proper static mixer is provided based on the correlation between the uniformity index (UI) and the pressure drop. The uniform distribution of the flow at the entrance of the SCR reactor aids to determine the configuration which gives high mixing performance and comprehend the function of the mixer.

Keywords: pressure drop, selective catalytic reduction, static mixer, turbulent mixing, uniformity index

Procedia PDF Downloads 934
3381 Assessment of Fluid Flow Hydrodynamics for Cylindrical and Conical Fluidized Bed Reactor

Authors: N. G. Thangan, A. B. Deoghare, P. M. Padole

Abstract:

Computational Fluid Dynamics (CFD) aids in modeling the prototype of a real world processes. CFD approach is useful in predicting the fluid flow, heat transfer mass transfer and other flow related phenomenon. In present study, hydrodynamic characteristics of gas-solid cylindrical fluidized bed is compared with conical fluidized beds. A 2D fluidized bed consists of different configurations of particle size of iron oxide, bed height and superficial velocities of nitrogen. Simulations are performed to capture the complex physics associated with it. The Eulerian multiphase model is prepared in ANSYS FLUENT v.14 which is used to simulate fluidization process. It is analyzed with nitrogen as primary phase and iron oxide as secondary phase. The bed hydrodynamics is assessed prominently to examine effect on fluidization time, pressure drop, minimum fluidization velocity, and gas holdup in the system.

Keywords: fluidized bed, bed hydrodynamics, Eulerian multiphase approach, computational fluid dynamics

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3380 Impinging Acoustics Induced Combustion: An Alternative Technique to Prevent Thermoacoustic Instabilities

Authors: Sayantan Saha, Sambit Supriya Dash, Vinayak Malhotra

Abstract:

Efficient propulsive systems development is an area of major interest and concern in aerospace industry. Combustion forms the most reliable and basic form of propulsion for ground and space applications. The generation of large amount of energy from a small volume relates mostly to the flaming combustion. This study deals with instabilities associated with flaming combustion. Combustion is always accompanied by acoustics be it external or internal. Chemical propulsion oriented rockets and space systems are well known to encounter acoustic instabilities. Acoustic brings in changes in inter-energy conversion and alter the reaction rates. The modified heat fluxes, owing to wall temperature, reaction rates, and non-linear heat transfer are observed. The thermoacoustic instabilities significantly result in reduced combustion efficiency leading to uncontrolled liquid rocket engine performance, serious hazards to systems, assisted testing facilities, enormous loss of resources and every year a substantial amount of money is spent to prevent them. Present work attempts to fundamentally understand the mechanisms governing the thermoacoustic combustion in liquid rocket engine using a simplified experimental setup comprising a butane cylinder and an impinging acoustic source. Rocket engine produces sound pressure level in excess of 153 Db. The RL-10 engine generates noise of 180 Db at its base. Systematic studies are carried out for varying fuel flow rates, acoustic levels and observations are made on the flames. The work is expected to yield a good physical insight into the development of acoustic devices that when coupled with the present propulsive devices could effectively enhance combustion efficiency leading to better and safer missions. The results would be utilized to develop impinging acoustic devices that impinge sound on the combustion chambers leading to stable combustion thus, improving specific fuel consumption, specific impulse, reducing emissions, enhanced performance and fire safety. The results can be effectively applied to terrestrial and space application.

Keywords: combustion instability, fire safety, improved performance, liquid rocket engines, thermoacoustics

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3379 Using Groundwater Modeling System to Create a 3-D Groundwater Flow and Solute Transport Model for a Semiarid Region: A Case Study of the Nadhour Saouaf Sisseb El Alem Aquifer, Central Tunisia

Authors: Emna Bahri Hammami, Zammouri Mounira, Tarhouni Jamila

Abstract:

The Nadhour Saouaf Sisseb El Alem (NSSA) system comprises some of the most intensively exploited aquifers in central Tunisia. Since the 1970s, the growth in economic productivity linked to intensive agriculture in this semiarid region has been sustained by increasing pumping rates of the system’s groundwater. Exploitation of these aquifers has increased rapidly, ultimately causing their depletion. With the aim to better understand the behavior of the aquifer system and to predict its evolution, the paper presents a finite difference model of the groundwater flow and solute transport. The model is based on the Groundwater Modeling System (GMS) and was calibrated using data from 1970 to 2010. Groundwater levels observed in 1970 were used for the steady-state calibration. Groundwater levels observed from 1971 to 2010 served to calibrate the transient state. The impact of pumping discharge on the evolution of groundwater levels was studied through three hypothetical pumping scenarios. The first two scenarios replicated the approximate drawdown in the aquifer heads (about 17 m in scenario 1 and 23 m in scenario 2 in the center of NSSA) following an increase in pumping rates by 30% and 50% from their current values, respectively. In addition, pumping was stopped in the third scenario, which could increase groundwater reserves by about 7 Mm3/year. NSSA groundwater reserves could be improved considerably if the pumping rules were taken seriously.

Keywords: pumping, depletion, groundwater modeling system GMS, Nadhour Saouaf

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3378 Sports for the Children with Autism

Authors: Mohamed A. Abdelnaby

Abstract:

Relevance of the research: A few people known about Autism and also about Sports for Autism. Children with Autism have difficult experience with sport that makes many problems during the sports activities. There are several areas of motor skills development essential for participating daily life and several sports activities. The object of the research is describe the program for the sports activities for children with Autism, and the aim is to improving their movement skills, motor skills and social skills. Research methods and organization: Twenty-five children with Autism perceived barriers to sports activities participation, and functioning. All the program inside the Pegasus Dreamland Sports Club and all the facilities available for the research. Results and discussion: Standard, children were reported to meet or exceeded general PA occurrence guidelines, belonged to active participated in a variety of sports activities. We identified several barriers to optimal sports activities for their children. Conclusions: Children with Autism can achieve optimal sports activities. Exposure to a variety of sports activities opportunities and experiences aids in identifying the model activity for each individual child.

Keywords: autism, sports activates, movement skills, motor skills

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3377 Molecular-Dynamics Study of H₂-C₃H₈-Hydrate Dissociation: Non-Equilibrium Analysis

Authors: Mohammad Reza Ghaani, Niall English

Abstract:

Hydrogen is looked upon as the next-generation clean-energy carrier; the search for an efficient material and method for storing hydrogen has been, and is, pursued relentlessly. Clathrate hydrates are inclusion compounds wherein guest gas molecules like hydrogen are trapped in a host water-lattice framework. These types of materials can be categorised as potentially attractive hosting environments for physical hydrogen storage (i.e., no chemical reaction upon storage). Non-equilibrium molecular dynamics (NEMD) simulations have been performed to investigate thermal-driven break-up of propane-hydrate interfaces with liquid water at 270-300 K, with the propane hydrate containing either one or no hydrogen molecule in each of its small cavities. In addition, two types of hydrate-surface water-lattice molecular termination were adopted, at the hydrate edge with water: a 001-direct surface cleavage and one with completed cages. The geometric hydrate-ice-liquid distinction criteria of Báez and Clancy were employed to distinguish between the hydrate, ice lattices, and liquid-phase. Consequently, the melting temperatures of interface were estimated, and dissociation rates were observed to be strongly dependent on temperature, with higher dissociation rates at larger over-temperatures vis-à-vis melting. The different hydrate-edge terminations for the hydrate-water interface led to statistically-significant differences in the observed melting point and dissociation profile: it was found that the clathrate with the planar interface melts at around 280 K, whilst the melting temperature of the cage-completed interface was determined to be circa 270 K.

Keywords: hydrogen storage, clathrate hydrate, molecular dynamics, thermal dissociation

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3376 Characterization and Evaluation of the Dissolution Increase of Molecular Solid Dispersions of Efavirenz

Authors: Leslie Raphael de M. Ferraz, Salvana Priscylla M. Costa, Tarcyla de A. Gomes, Giovanna Christinne R. M. Schver, Cristóvão R. da Silva, Magaly Andreza M. de Lyra, Danilo Augusto F. Fontes, Larissa A. Rolim, Amanda Carla Q. M. Vieira, Miracy M. de Albuquerque, Pedro J. Rolim-Neto

Abstract:

Efavirenz (EFV) is a drug used as first-line treatment of AIDS. However, it has poor aqueous solubility and wettability, presenting problems in the gastrointestinal tract absorption and bioavailability. One of the most promising strategies to improve the solubility is the use of solid dispersions (SD). Therefore, this study aimed to characterize SD EFZ with the polymers: PVP-K30, PVPVA 64 and SOLUPLUS in order to find an optimal formulation to compose a future pharmaceutical product for AIDS therapy. Initially, Physical Mixtures (PM) and SD with the polymers were obtained containing 10, 20, 50 and 80% of drug (w/w) by the solvent method. The best formulation obtained between the SD was selected by in vitro dissolution test. Finally, the drug-carrier system chosen, in all ratios obtained, were analyzed by the following techniques: Differential Scanning Calorimetry (DSC), polarization microscopy, Scanning Electron Microscopy (SEM) and spectrophotometry of absorption in the region of infrared (IR). From the dissolution profiles of EFV, PM and SD, the values of area Under The Curve (AUC) were calculated. The data showed that the AUC of all PM is greater than the isolated EFV, this result is derived from the hydrophilic properties of the polymers thus favoring a decrease in surface tension between the drug and the dissolution medium. In adittion, this ensures an increasing of wettability of the drug. In parallel, it was found that SD whom had higher AUC values, were those who have the greatest amount of polymer (with only 10% drug). As the amount of drug increases, it was noticed that these results either decrease or are statistically similar. The AUC values of the SD using the three different polymers, followed this decreasing order: SD PVPVA 64-EFV 10% > SD PVP-K30-EFV 10% > SD Soluplus®-EFV 10%. The DSC curves of SD’s did not show the characteristic endothermic event of drug melt process, suggesting that the EFV was converted to its amorphous state. The analysis of polarized light microscopy showed significant birefringence of the PM’s, but this was not observed in films of SD’s, thus suggesting the conversion of the drug from the crystalline to the amorphous state. In electron micrographs of all PM, independently of the percentage of the drug, the crystal structure of EFV was clearly detectable. Moreover, electron micrographs of the SD with the two polymers in different ratios investigated, we observed the presence of particles with irregular size and morphology, also occurring an extensive change in the appearance of the polymer, not being possible to differentiate the two components. IR spectra of PM corresponds to the overlapping of polymer and EFV bands indicating thereby that there is no interaction between them, unlike the spectra of all SD that showed complete disappearance of the band related to the axial deformation of the NH group of EFV. Therefore, this study was able to obtain a suitable formulation to overcome the solubility limitations of the EFV, since SD PVPVA 64-EFZ 10% was chosen as the best system in delay crystallization of the prototype, reaching higher levels of super saturation.

Keywords: characterization, dissolution, Efavirenz, solid dispersions

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3375 Study on the Changes in Material Strength According to Changes in Forming Methods in Hot-Stamping Process

Authors: Yong-Jun Jeon, Hyung-Pil Park, Min-Jae Song, Baeg-Soon Cha

Abstract:

Following the recent trend of having increased demand in producing lighter-weight car bodies for improvement of automobile safety and gas mileage, there is a forming method that makes use of hot-stamping technique, which satisfies all conditions mentioned above. Hot-stamping is a forming technique with advantages of excellent formability, good dimensional precision and others since it is a process in which steel plates are heated up to temperatures of at least approximately 900°C after which forming is conducted in die at room temperature followed by rapid cooling. In addition, it has characteristics of allowing for improvement in material strength through achievement of quenching effect by having simultaneous forming and rapid cooling of material of high temperatures. However, there is insufficient information on the changes in material strength according to changes in material temperature with regards to material heating method and forming process in hot-stamping. Accordingly, this study aims to design and press die for T-type product of the scale models of the center pillar and to understand the changes in material strength in relation to changes in forming methods of hot-stamping process. Thus in order to understand the changes in material strength due to quenching effect among the hot-stamping process, material strength and material forming precision were to be studied while varying the forming and forming method when forming. For test methods, material strength was observed by using boron steel that has boron additives, which was heated up to 950°C, after which it was transferred to a die and was cooled down to material temperature of 400°C followed by air cooling process. During the forming and cooling process here, experiment was conducted with forming parameters of 2 holding rates and 3 flange heating rates wherein changing appearance in material strength according to changes forming method were observed by verifying forming strength and forming precision for each of the conditions.

Keywords: hot-stamping, formability, quenching, forming, press die, forming methods

Procedia PDF Downloads 459
3374 Basal Cell Carcinoma: Epidemiological Analysis of a 5-Year Period in a Brazilian City with a High Level of Solar Radiation

Authors: Maria E. V. Amarante, Carolina L. Cerdeira, Julia V. Cortes, Fiorita G. L. Mundim

Abstract:

Basal cell carcinoma (BCC) is the most prevalent type of skin cancer in humans. It arises from the basal cells of the epidermis and cutaneous appendages. The role of sunlight exposure as a risk factor for BCC is very well defined due to its power to influence genetic mutations, in addition to having a suppressor effect on the skin immune system. Despite showing low metastasis and mortality rates, the tumor is locally infiltrative, aggressive, and destructive. Considering the high prevalence rate of this carcinoma and the importance of early detection, a retrospective study was carried out in order to correlate the clinical data available on BBC, characterize it epidemiologically, and thus enable effective prevention measures for the population. Data on the period from January 2015 to December 2019 were collected from the medical records of patients registered at one pathology service located in the southeast region of Brazil, known as SVO, which delivers skin biopsy results. The study was aimed at correlating the variables, sex, age, and subtypes found. Data analysis was performed using the chi-square test at a nominal significance level of 5% in order to verify the independence between the variables of interest. Fisher's exact test was applied in cases where the absolute frequency in the cells of the contingency table was less than or equal to five. The statistical analysis was performed using the R® software. Ninety-three basal cell carcinoma were analyzed, and its frequency in the 31-to 45-year-old age group was 5.8 times higher in men than in women, whereas, from 46 to 59 years, the frequency was found 2.4 times higher in women than in men. Between the ages of 46 to 59 years, it should be noted that the sclerodermiform subtype appears more than the solid one, with a difference of 7.26 percentage points. Reversely, the solid form appears more frequently in individuals aged 60 years or more, with a difference of 8.57 percentage points. Among women, the frequency of the solid subtype was 9.93 percentage points higher than the sclerodermiform frequency. In males, the same percentage difference is observed, but sclerodermiform is the most prevalent subtype. It is concluded in this study that, in general, there is a predominance of basal cell carcinoma in females and in individuals aged 60 years and over, which demonstrates the tendency of this tumor. However, when rarely found in younger individuals, the male gender prevailed. The most prevalent subtype was the solid one. It is worth mentioning that the sclerodermiform subtype, which is more aggressive, was seen more frequently in males and in the 46-to 59-year-old range.

Keywords: basal cell carcinoma, epidemiology, sclerodermiform basal cell carcinoma, skin cancer, solar radiation, solid basal cell carcinoma

Procedia PDF Downloads 138
3373 Effect of Plant Growth Regulator on Vegetative Growth and Yield Components of Winter Wheat under Different Levels of Irrigation

Authors: Mohammed Ahmed Alghamdi

Abstract:

Field experiment were carried out to investigate the effect of the plant growth regulator on vegetative growth and yield components of reduced height isogenic lines of the wheat (Triticum aestivum L.) cultivar Mercia. The Field experiment compared the growth regulator response of seven isogenic lines of Mercia. Growth regulators reduced plant height significantly in all lines. Growth regulator decreased total dry matter and grain yield with greatest reduction generally for the control and Rht8 lines. Rht1 was the least affected. There were few significant effects of growth regulator on gas exchange and chlorophyll fluorescence but the trend was for greater values with growth regulator. In this field experiment, a rate of 2.0 l ha-1 applied just before the third node detectable stage under non water stressed and water stressed conditions gave slight increases in yield of up to 14% except for line Rht10 which increased significantly in non-stressed conditions. In the second glasshouse experiment, a rate of 2.5 l ha-1 applied at the start of stem elongation under 30% FC and 100% FC gave reductions in yield up to 16% for the growth regulator and 55% under water stress. In the field experiment, rates of 2.5 and 3.0 l ha-1 applied at the start of stem elongation gave reductions in yield up to 20% mainly through individual seed weight. In the final glasshouse experiment, rates of 2.5 and 3.0 l ha-1 applied at 6 leaves unfolded and 1st node detectable both reduced grain yield.

Keywords: growth regulator, irrigation, isogenic lines, yield, winter wheat

Procedia PDF Downloads 457
3372 Locus of Control and Self-Esteem as Predictors of Maternal and Child Healthcare Services Utilization in Nigeria

Authors: Josephine Aikpitanyi, Friday Okonofua, Lorrettantoimo, Sandy Tubeuf

Abstract:

Every day, 800 women die from conditions related to pregnancy and childbirth, resulting in an estimated 300,000 maternal deaths worldwide per year. Over 99 percent of all maternal deaths occur in developing countries, with more than half of them occurring in sub-Saharan Africa. Nigeria being the most populous nation in sub-Saharan Africa bears a significant burden of worsening maternal and child health outcomes with a maternal mortality rate of 917 per 100,000 live births and child mortality rate of 117 per 1,000 live births. While several studies have documented that financial barriers disproportionately discourage poor women from seeking needed maternal and child healthcare, other studies have indicated otherwise. Evidence shows that there are instances where health facilities with skilled healthcare providers exist, and yet maternal, and child health outcomes remain abysmally low, indicating the presence of non-cognitive and behavioural factors that may affect the utilization of healthcare services. This study investigated the influence of locus of control and self-esteem on utilization of maternal and child healthcare services in Nigeria. Specifically, it explored the differences in utilization of antenatal care, skilled birth care, postnatal care, and child vaccination by women having an internal and external locus of control and women having high and low self-esteem. We collected information on non-cognitive traits of 1411 randomly selected women, along with information on utilization of the various indicators of maternal and child healthcare. Estimating logistic regression models for various components of healthcare services utilization, we found that women’s internal locus of control was a significant predictor of utilization of antenatal care, skilled birth care, and completion of child vaccination. We also found that having high self-esteem was a significant predictor of utilization of antenatal care, postnatal care, and completion of child vaccination after adjusting for other control variables. By improving our understanding of non-cognitive traits as possible barriers to maternal and child healthcare utilization, our findings offer important insights for enhancing participant engagement in intervention programs that are initiated to improve maternal and child health outcomes in low-and-middle-income countries.

Keywords: behavioural economics, health-seeking behaviour, locus of control and self-esteem, maternal and child healthcare, non-cognitive traits, and healthcare utilization

Procedia PDF Downloads 163
3371 Premarital Sex, HIV and Use of Condom among Youths in Nigeria

Authors: Okechukwu Odinaka Ajaegbu

Abstract:

In the recent past, discussing about sex among children and youths was frowned at by traditional norms and as such sexual discussions and behavior were approached with great respect. Things are actually falling apart with the increasing number of young people that engage in premarital sex. Due to lack of experience and sex education, many young people are becoming increasingly exposed to the risk of HIV infection. In the light of the above, this study discussed premarital sex, HIV and use of condom among youths in Nigeria. Data for this study came from 2013 Nigeria Demographic and Health Survey and other secondary data. The survey revealed that only 18.5 percent of young women that had sex in the 12 months preceding the survey used condom. Out of 3306 never-married sexually active men and women, 1728 representing 52 percent live in urban areas and 43 percent of them did not use condom during sexual intercourse in the 12 months preceding the survey. This study concludes that for there to be reduction in prevalence of HIV/AIDS among Nigerian youths, there is need for concerted effort to be made towards educating youths on the expedient of the use of condom during sexual intercourse.

Keywords: condom, HIV, Nigeria, premarital sex, youths

Procedia PDF Downloads 244
3370 Response of Caldeira De Tróia Saltmarsh to Sea Level Rise, Sado Estuary, Portugal

Authors: A. G. Cunha, M. Inácio, M. C. Freitas, C. Antunes, T. Silva, C. Andrade, V. Lopes

Abstract:

Saltmarshes are essential ecosystems both from an ecological and biological point of view. Furthermore, they constitute an important social niche, providing valuable economic and protection functions. Thus, understanding their rates and patterns of sedimentation is critical for functional management and rehabilitation, especially in an SLR scenario. The Sado estuary is located 40 km south of Lisbon. It is a bar built estuary, separated from the sea by a large sand spit: the Tróia barrier. Caldeira de Tróia is located on the free edge of this barrier, and encompasses a salt marsh with ca. 21,000 m². Sediment cores were collected in the high and low marshes and in the mudflat area of the North bank of Caldeira de Tróia. From the low marsh core, fifteen samples were chosen for ²¹⁰Pb and ¹³⁷Cs determination at University of Geneva. The cores from the high marsh and the mudflat are still being analyzed. A sedimentation rate of 2.96 mm/year was derived from ²¹⁰Pb using the Constant Flux Constant Sedimentation model. The ¹³⁷Cs profile shows a peak in activity (1963) between 15.50 and 18.50 cm, giving a 3.1 mm/year sedimentation rate for the past 53 years. The adopted sea level rise scenario was based on a model built with the initial rate of SLR of 2.1 mm/year in 2000 and an acceleration of 0.08 mm/year². Based on the harmonic analysis of Setubal-Tróia tide gauge of 2005 data, the tide model was estimated and used to build the tidal tables to the period 2000-2016. With these tables, the average mean water levels were determined for the same time span. A digital terrain model was created from LIDAR scanning with 2m horizontal resolution (APA-DGT, 2011) and validated with altimetric data obtained with a DGPS-RTK. The response model calculates a new elevation for each pixel of the DTM for 2050 and 2100 based on the sedimentation rates specific of each environment. At this stage, theoretical values were chosen for the high marsh and the mudflat (respectively, equal and double the low marsh rate – 2.92 mm/year). These values will be rectified once sedimentation rates are determined for the other environments. For both projections, the total surface of the marsh decreases: 2% in 2050 and 61% in 2100. Additionally, the high marsh coverage diminishes significantly, indicating a regression in terms of maturity.

Keywords: ¹³⁷Cs, ²¹⁰Pb, saltmarsh, sea level rise, response model

Procedia PDF Downloads 248
3369 Computational Simulations and Assessment of the Application of Non-Circular TAVI Devices

Authors: Jonathon Bailey, Neil Bressloff, Nick Curzen

Abstract:

Transcatheter Aortic Valve Implantation (TAVI) devices are stent-like frames with prosthetic leaflets on the inside, which are percutaneously implanted. The device in a crimped state is fed through the arteries to the aortic root, where the device frame is opened through either self-expansion or balloon expansion, which reveals the prosthetic valve within. The frequency at which TAVI is being used to treat aortic stenosis is rapidly increasing. In time, TAVI is likely to become the favoured treatment over Surgical Valve Replacement (SVR). Mortality after TAVI has been associated with severe Paravalvular Aortic Regurgitation (PAR). PAR occurs when the frame of the TAVI device does not make an effective seal against the internal surface of the aortic root, allowing blood to flow backwards about the valve. PAR is common in patients and has been reported to some degree in as much as 76% of cases. Severe PAR (grade 3 or 4) has been reported in approximately 17% of TAVI patients resulting in post-procedural mortality increases from 6.7% to 16.5%. TAVI devices, like SVR devices, are circular in cross-section as the aortic root is often considered to be approximately circular in shape. In reality, however, the aortic root is often non-circular. The ascending aorta, aortic sino tubular junction, aortic annulus and left ventricular outflow tract have an average ellipticity ratio of 1.07, 1.09, 1.29, and 1.49 respectively. An elliptical aortic root does not severely affect SVR, as the leaflets are completely removed during the surgical procedure. However, an elliptical aortic root can inhibit the ability of the circular Balloon-Expandable (BE) TAVI devices to conform to the interior of the aortic root wall, which increases the risk of PAR. Self-Expanding (SE) TAVI devices are considered better at conforming to elliptical aortic roots, however the valve leaflets were not designed for elliptical function, furthermore the incidence of PAR is greater in SE devices than BE devices (19.8% vs. 12.2% respectively). If a patient’s aortic root is too severely elliptical, they will not be suitable for TAVI, narrowing the treatment options to SVR. It therefore follows that in order to increase the population who can undergo TAVI, and reduce the risk associated with TAVI, non-circular devices should be developed. Computational simulations were employed to further advance our understanding of non-circular TAVI devices. Radial stiffness of the TAVI devices in multiple directions, frame bending stiffness and resistance to balloon induced expansion are all computationally simulated. Finally, a simulation has been developed that demonstrates the expansion of TAVI devices into a non-circular patient specific aortic root model in order to assess the alterations in deployment dynamics, PAR and the stresses induced in the aortic root.

Keywords: tavi, tavr, fea, par, fem

Procedia PDF Downloads 437
3368 Comparison of Two Strategies in Thoracoscopic Ablation of Atrial Fibrillation

Authors: Alexander Zotov, Ilkin Osmanov, Emil Sakharov, Oleg Shelest, Aleksander Troitskiy, Robert Khabazov

Abstract:

Objective: Thoracoscopic surgical ablation of atrial fibrillation (AF) includes two technologies in performing of operation. 1st strategy used is the AtriCure device (bipolar, nonirrigated, non clamping), 2nd strategy is- the Medtronic device (bipolar, irrigated, clamping). The study presents a comparative analysis of clinical outcomes of two strategies in thoracoscopic ablation of AF using AtriCure vs. Medtronic devices. Methods: In 2 center study, 123 patients underwent thoracoscopic ablation of AF for the period from 2016 to 2020. Patients were divided into two groups. The first group is represented by patients who applied the AtriCure device (N=63), and the second group is - the Medtronic device (N=60), respectively. Patients were comparable in age, gender, and initial severity of the condition. Among the patients, in group 1 were 65% males with a median age of 57 years, while in group 2 – 75% and 60 years, respectively. Group 1 included patients with paroxysmal form -14,3%, persistent form - 68,3%, long-standing persistent form – 17,5%, group 2 – 13,3%, 13,3% and 73,3% respectively. Median ejection fraction and indexed left atrial volume amounted in group 1 – 63% and 40,6 ml/m2, in group 2 - 56% and 40,5 ml/m2. In addition, group 1 consisted of 39,7% patients with chronic heart failure (NYHA Class II) and 4,8% with chronic heart failure (NYHA Class III), when in group 2 – 45% and 6,7%, respectively. Follow-up consisted of laboratory tests, chest Х-ray, ECG, 24-hour Holter monitor, and cardiopulmonary exercise test. Duration of freedom from AF, distant mortality rate, and prevalence of cerebrovascular events were compared between the two groups. Results: Exit block was achieved in all patients. According to the Clavien-Dindo classification of surgical complications fraction of adverse events was 14,3% and 16,7% (1st group and 2nd group, respectively). Mean follow-up period in the 1st group was 50,4 (31,8; 64,8) months, in 2nd group - 30,5 (14,1; 37,5) months (P=0,0001). In group 1 - total freedom of AF was in 73,3% of patients, among which 25% had additional antiarrhythmic drugs (AADs) therapy or catheter ablation (CA), in group 2 – 90% and 18,3%, respectively (for total freedom of AF P<0,02). At follow-up, the distant mortality rate in the 1st group was – 4,8%, and in the 2nd – no fatal events. Prevalence of cerebrovascular events was higher in the 1st group than in the 2nd (6,7% vs. 1,7% respectively). Conclusions: Despite the relatively shorter follow-up of the 2nd group in the study, applying the strategy using the Medtronic device showed quite encouraging results. Further research is needed to evaluate the effectiveness of this strategy in the long-term period.

Keywords: atrial fibrillation, clamping, ablation, thoracoscopic surgery

Procedia PDF Downloads 109
3367 Happiness, Media and Sustainability of Communities in Donkeaw, Mearim District, Chiang Mai, Thailand

Authors: Panida Jongsuksomsakul

Abstract:

This study of the ‘happiness’ and ‘sustainability’ in the community of Donkeaw, Amphoe Mae Rim, Chiang Mai Province during the non-election period in Thailand, noted that their happiness levels are in the middle-average range. This was found using a mixed approach of qualitative and quantitative methods (N = 386, α = 0.05). The study explores indicators for six aspects of well-being and happiness, including, good local governance, administrative support for the health system that maintains people’s mental and physical health, environment and weather, job security and a regular income aids them in managing a sustainable lifestyle. The impact of economic security and community relationships on social and cultural capital, and the way these aspects impact on the life style of the community, affects the sustainable well-being of people. Moreover, living with transparency and participatory communication led to diverse rewards in many areas.

Keywords: communication, happiness, well-being, Donkeaw community, social and cultural capital

Procedia PDF Downloads 234
3366 User-Centered Design in the Development of Patient Decision Aids

Authors: Ariane Plaisance, Holly O. Witteman, Patrick Michel Archambault

Abstract:

Upon admission to an intensive care unit (ICU), all patients should discuss their wishes concerning life-sustaining interventions (e.g., cardiopulmonary resuscitation (CPR)). Without such discussions, interventions that prolong life at the cost of decreasing its quality may be used without appropriate guidance from patients. We employed user-centered design to adapt an existing decision aid (DA) about CPR to create a novel wiki-based DA adapted to the context of a single ICU and tailored to individual patient’s risk factors. During Phase 1, we conducted three weeks of ethnography of the decision-making context in our ICU to identify clinician and patient needs for a decision aid. During this time, we observed five dyads of intensivists and patients discussing their wishes concerning life-sustaining interventions. We also conducted semi-structured interviews with the attending intensivists in this ICU. During Phase 2, we conducted three rounds of rapid prototyping involving 15 patients and 11 other allied health professionals. We recorded discussions between intensivists and patients and used a standardized observation grid to collect patients’ comments and sociodemographic data. We applied content analysis to field notes, verbatim transcripts and the completed observation grids. Each round of observations and rapid prototyping iteratively informed the design of the next prototype. We also used the programming architecture of a wiki platform to embed the GO-FAR prediction rule programming code that we linked to a risk graphics software to better illustrate outcome risks calculated. During Phase I, we identified the need to add a section in our DA concerning invasive mechanical ventilation in addition to CPR because both life-sustaining interventions were often discussed together by physicians. During Phase II, we produced a context-adapted decision aid about CPR and mechanical ventilation that includes a values clarification section, questions about the patient’s functional autonomy prior to admission to the ICU and the functional decline that they would judge acceptable upon hospital discharge, risks and benefits of CPR and invasive mechanical ventilation, population-level statistics about CPR, a synthesis section to help patients come to a final decision and an online calculator based on the GO-FAR prediction rule. Even though the three rounds of rapid prototyping led to simplifying the information in our DA, 60% (n= 3/5) of the patients involved in the last cycle still did not understand the purpose of the DA. We also identified gaps in the discussion and documentation of patients’ preferences concerning life-sustaining interventions (e.g.,. CPR, invasive mechanical ventilation). The final version of our DA and our online wiki-based GO-FAR risk calculator using the IconArray.com risk graphics software are available online at www.wikidecision.org and are ready to be adapted to other contexts. Our results inform producers of decision aids on the use of wikis and user-centered design to develop DAs that are better adapted to users’ needs. Further work is needed on the creation of a video version of our DA. Physicians will also need the training to use our DA and to develop shared decision-making skills about goals of care.

Keywords: ethnography, intensive care units, life-sustaining therapies, user-centered design

Procedia PDF Downloads 352
3365 Anthropometric Indices of Obesity and Coronary Artery Atherosclerosis: An Autopsy Study in South Indian population

Authors: Francis Nanda Prakash Monteiro, Shyna Quadras, Tanush Shetty

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The association between human physique and morbidity and mortality resulting from coronary artery disease has been studied extensively over several decades. Multiple studies have also been done on the correlation between grade of atherosclerosis, coronary artery diseases and anthropometrical measurements. However, the number of autopsy-based studies drastically reduces this number. It has been suggested that while in living subjects, it would be expensive, difficult, and even harmful to subject them to imaging modalities like CT scans and procedures involving contrast media to study mild atherosclerosis, no such harm is encountered in study of autopsy cases. This autopsy-based study was aimed to correlate the anthropometric measurements and indices of obesity, such as waist circumference (WC), hip circumference (HC), body mass index (BMI) and waist hip ratio (WHR) with the degree of atherosclerosis in the right coronary artery (RCA), main branch of the left coronary artery (LCA) and the left anterior descending artery (LADA) in 95 South Indian origin victims of both the genders between the age of 18 years and 75 years. The grading of atherosclerosis was done according to criteria suggested by the American Heart Association. The study also analysed the correlation of the anthropometric measurements and indices of obesity with the number of coronaries affected with atherosclerosis in an individual. All the anthropometric measurements and the derived indices were found to be significantly correlated to each other in both the genders except for the age, which is found to have a significant correlation only with the WHR. In both the genders severe degree of atherosclerosis was commonly observed in LADA, followed by LCA and RCA. Grade of atherosclerosis in RCA is significantly related to the WHR in males. Grade of atherosclerosis in LCA and LADA is significantly related to the WHR in females. Significant relation was observed between grade of atherosclerosis in RCA and WC, and WHR, and between grade of atherosclerosis in LADA and HC in males. Significant relation was observed between grade of atherosclerosis in RCA and WC, and WHR, and between grade of atherosclerosis in LADA and HC in females. Anthropometric measurements/indices of obesity can be an effective means to identify high risk cases of atherosclerosis at an early stage that can be effective in reducing the associated cardiac morbidity and mortality. A person with anthropometric measurements suggestive of mild atherosclerosis can be advised to modify his lifestyle, along with decreasing his exposure to the other risk factors. Those with measurements suggestive of higher degree of atherosclerosis can be subjected to confirmatory procedures to start effective treatment.

Keywords: atherosclerosis, coronary artery disease, indices, obesity

Procedia PDF Downloads 65
3364 The Effect of Nepodin-Enrich Plant on Dyslipidemia and Hyperglycemia in High-Fat Diet-Induced Obese C57BL/6J Mice

Authors: Mi Kyeong Yu, Seon Jeong Lee, So Young Kim, Bora Choi, Young Mi Lee, Su-Jung Cho, Je Tae Woo, Myung-Sook Choi

Abstract:

A high-fat diet (HFD) induces excessive fat accumulation in white adipose tissue (WAT), which increases metabolic disorders such as obesity, dyslipidemia and type 2 diabetes. Many plants are known to have effects that improve metabolic disorders. Therefore, the aim of this present study is to investigate the effect of nepodin-enrich plant extract on dyslipidemia, hyperglycemia in high fat diet-induced C57BL/6J mice. Male C57BL/6J mice were randomly divided into two groups, and fed HFD (20% fat, w/w) or HFD supplemented with nepodin-enrich plant extract (NPE 0.005%, w/w) for 16 weeks. Body weight and food intake were measured every week. And we also analysed metabolic rates (respiratory quotient), blood glucose level, and plasma high-density lipoprotein (HDL)-cholesterol, free fatty acid, apolipoprotein (apo) A-1 and apo B levels. Food intakes and body weights were not different between NPE group and HFD group, while plasma apo B, free fatty acid levels, and blood glucose concentration were significantly decreased in NPE group than in HFD group. Furthermore, plasma apo A and HDL-cholesterol levels in NPE group were remarkably increased than in HFD group. Metabolic rates (respiratory quotient) were significantly increased in NPE group than in HFD group. These results indicate that NPE can alleviate dyslipidemia, hyperglycemia. Further studies are required to identify the effects of NPE on metabolic disorders.

Keywords: dyslipidemia, hyperglycemia, metabolic disorders, nepodin enrich plant extract

Procedia PDF Downloads 372
3363 GynApp: A Mobile Application for the Organization and Control of Gynecological Studies

Authors: Betzabet García-Mendoza, Rocío Abascal-Mena

Abstract:

Breast and cervical cancer are among the leading causes of death of women in Mexico. The mortality rate for these diseases is alarming, even though there have been many campaigns for making people self-aware of the importance of conducting gynecological studies for a timely prevention and detection, these have not been enough. This paper presents a mobile application for organizing and controlling gynecological studies in order to help and boost women to take care of their bodies and health. The process of analyzing and designing the mobile application is presented, along with all the steps carried out by following a user-centered design methodology.

Keywords: breast cancer, cervical cancer, gynecological mobile application, paper prototyping, storyboard, women health

Procedia PDF Downloads 307