Search results for: maintenance free operating period (MFOP)

Authors: Salwa Mohamed Salah Eldin, Howida Kamal Ibrahim

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Introduction: Major depressive disorder affects high proportion of the world’s population presenting cost load in health care. Extended release venlafaxine is more convenient and could reduce discontinuation syndrome. The once daily dosing also reduces the potential for adverse events such as nausea due to reduced Cmax. Venlafaxine is an effective first-line agent in the treatment of depression. A once daily formulation was designed to enhance patient compliance. Complexing with a resin was suggested to improve loading of the water soluble drug. The formulated systems were thoroughly evaluated in vitro to prove superiority to previous trials and were compared to the commercial extended release product in experimental animals. Materials and Methods: Venlafaxine-resinates were prepared using Dowex®50WX4-400 and Dowex®50WX8-100 at drug to resin weight ratio of 1: 1. The prepared resinates were evaluated for their drug content, particle shape and surface properties and in vitro release profile in gradient pH. The release kinetics and mechanism were evaluated. Venlafaxine-Dowex® resinates were encapsulated using O/W solvent evaporation technique. Poly-ε-caprolactone, Poly(D, L-lactide-co-glycolide) ester, Poly(D, L-lactide) ester and Eudragit®RS100 were used as coating polymers alone and in combination. Drug-resinate microcapsules were evaluated for morphology, entrapment efficiency and in-vitro release profile. The selected formula was tested in rabbits using a randomized, single-dose, 2-way crossover study against Effexor-XR tablets under fasting condition. Results and Discussion: The equilibrium time was 30 min for Dowex®50WX4-400 and 90 min for Dowex®50WX8-100. The percentage drug loaded was 93.96 and 83.56% for both resins, respectively. Both drug-Dowex® resintes were efficient in sustaining venlafaxine release in comparison to the free drug (up to 8h.). Dowex®50WX4-400 based venlafaxine-resinate was selected for further encapsulation to optimize the release profile for once daily dosing and to lower the burst effect. The selected formula (coated with a mixture of Eudragit RS and PLGA in a ratio of 50/50) was chosen by applying a group of mathematical equations according to targeted values. It recorded the minimum burst effect, the maximum MDT (Mean dissolution time) and a Q24h (percentage drug released after 24 hours) between 95 and 100%. The 90% confidence intervals for the test/reference mean ratio of the log-transformed data of AUC0–24 and AUC0−∞ are within (0.8–1.25), which satisfies the bioequivalence criteria. Conclusion: The optimized formula could be a promising extended release form of the water soluble, short half lived venlafaxine. Being a multiple unit formulation, it lowers the probability of dose dumping and reduces the inter-subject variability in absorption.

Keywords: biodegradable polymers, cation-exchange resin, microencapsulation, venlafaxine hcl

Procedia PDF Downloads 394

Authors: D. M. Rey, V. Delgado, J. Zambrano Nájera

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Increases in urbanization during XX century, has produced changes in natural dynamics of the basins, which has resulted in increases in runoff volumes, peak flows and flow velocities, that in turn increases flood risk. Higher runoff volumes decrease sewerage networks hydraulic capacity and can cause its failure. This in turn generates increasingly recurrent floods causing mobility problems and general economic detriment in the cities. In Latin America, especially Colombia, this is a major problem because urban population at late XX century was more than 70% is in urban areas increasing approximately in 790% in 1940-1990 period. Besides, high slopes product of Andean topography and high precipitation typical of tropical climates increases velocities and volumes even more, causing stopping of cities during storms. Thus, it becomes very important to know hydrological behavior of Andean Urban Watersheds. This research aims to determine the impact of urbanization in high sloped urban watersheds in its hydrology. To this end, it will be used as study area experimental urban watershed named Palogrande-San Luis watershed, located in the city of Manizales, Colombia. Manizales is a city in central western Colombia, located in Colombian Central Mountain Range (part of Los Andes Mountains) with an abrupt topography (average altitude is 2.153 m). The climate in Manizales is quite uniform, but due to its high altitude it presents high precipitations (1.545 mm/year average) with high humidity (83% average). It was applied HEC-HMS Hydrologic model on the watershed. The inputs to the model were derived from Geographic Information Systems (GIS) theme layers of the Instituto de Estudios Ambientales –IDEA of Universidad Nacional de Colombia, Manizales (Institute of Environmental Studies) and aerial photography taken for the research in conjunction with available literature and look up tables. Rainfall data from a network of 4 rain gages and historical stream flow data were used to calibrate and validate runoff depth using the hydrologic model. Manual calibration was made, and the simulation results show that the model selected is able to characterize the runoff response of the watershed due to land use for urbanization in high mountain watersheds.

Keywords: Andean watersheds modelling, high mountain urban hydrology, urban planning, hydrologic modelling

Procedia PDF Downloads 233

Authors: M. Saleem, M. Shahnawaz, A. W. Gandahi, S. M. Bhatti

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The micronutrients boron and zinc deficiencies are extensive in the areas of rice-wheat cropping system. Optimum levels of these nutrients in soil are necessary for healthy crop growth. Since rice and wheat are major staple food of worlds’ populace, the higher yields and nutrition status of these crops has direct effect on the health of human being and economy of the country. A field study was conducted to observe the direct and residual effect of two selected micronutrients boron (B) and zinc (Zn)) on rice and wheat crop growth and its grain nutrient status. Each plot received either B or Zn at the rates of 0, 1, 2, 3 and 4 kg B ha⁻¹, and 5, 10, 15 and 20 kg Zn ha⁻¹, combined B and Zn application at 1 kg B and 5 kg Zn ha⁻¹, 2 kg B and 10 kg Zn ha⁻¹. Colemanite ore were used as source of B and zinc sulfate for Zn. The second season wheat crop was planted in the same plots after the interval period of 30 days and during this time gap soil was fallow. Boron and Zn application significantly enhanced the plant height, number of tillers, Grains panicle⁻¹ seed index fewer empty grains panicle⁻¹ and yield of rice crop at all defined levels as compared to control. The highest yield (10.00 tons/ha) was recorded at 2 Kg B, 10 Kg Zn ha⁻¹ rates. Boron and Zn concentration in grain and straw significantly increased. The application of B also improved the nutrition status of rice as B, protein and total carbohydrates content of grain augmented. The analysis of soil samples collected after harvest of rice crop showed that the B and Zn content in post-harvest soil samples was high in colemanite and zinc sulfate applied plots. The residual B and Zn were also effectual for the second season wheat crop, as the growth parameters plant height, number of tillers, earhead length, weight 1000 grains, B and Zn content of grain significantly improved. The highest wheat grain yield (4.23 tons/ha) was recorded at the residual rates of 2 kg B and 10 kg Zn ha⁻¹ than the other treatments. This study showed that one application of B and Zn can increase crop yields for at least two consecutive seasons and the mineral colemanite can confidently be used as source of B for rice crop because very small quantities of these nutrients are consumed by first season crop and remaining amount was present in soil which were used by second season wheat crop for healthy growth. Consequently, there is no need to apply these micronutrients to the following crop when it is applied on the previous one.

Keywords: residual boron, zinc, rice, wheat

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Authors: Henrique Rangel, Alexandre Fadel, Igor De Lazari, Bianca Neri, Carlos Bolonha

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This paper promotes a comparative analysis of American and Brazilian models of federalism assuming their levels of political centralization as main criterion. The central problem faced herein is the Brazilian approach of Unitarian regime. Although the hegemony of federative form after 1989, Brazil had a historical frame of political centralization that remains under the 1988 constitutional regime. Meanwhile, United States framed a federalism in which States absorb significant authorities. The hypothesis holds that the amount of alternative criteria of federalization – which can generate political centralization –, and the way they are upheld on judicial review, are crucial to understand the levels of political centralization achieved in each model. To test this hypothesis, the research is conducted by a methodology temporally delimited to 1994-2014 period. Three paradigmatic precedents of U.S. Supreme Court were selected: United States vs. Morrison (2000), on gender-motivated violence, Gonzales vs. Raich (2005), on medical use of marijuana, and United States vs. Lopez (1995), on firearm possession on scholar zones. These most relevant cases over federalism in the recent activity of Supreme Court indicates a determinant parameter of deliberation: the commerce clause. After observe the criterion used to permit or prohibit the political centralization in America, the Brazilian normative context is presented. In this sense, it is possible to identify the eventual legal treatment these controversies could receive in this Country. The decision-making reveals some deliberative parameters, which characterizes each federative model. At the end of research, the precedents of Rehnquist Court promote a broad revival of federalism debate, establishing the commerce clause as a secure criterion to uphold or not the necessity of centralization – even with decisions considered conservative. Otherwise, the Brazilian federalism solves them controversies upon in a formalist fashion, within numerous and comprehensive – sometimes casuistic too – normative devices, oriented to make an intense centralization. The aim of this work is indicate how jurisdictional federalism found in United States can preserve a consistent model with States robustly autonomous, while Brazil gives preference to normative mechanisms designed to starts from centralization.

Keywords: constitutional design, federalism, U.S. Supreme Court, legislative authority

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Authors: Robin Anderson, David Nisbet

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Nitrate, 3-nitro-1-propionic acid (NPA) and 3-nitro-1-propanol (NPOH) are biologically active chemicals that can accumulate naturally in rangeland grasses forages consumed by grazing cattle, sheep and goats. While toxic to livestock if accumulations and amounts consumed are high enough, particularly in animals having no recent exposure to the forages, these chemicals are known to be potent inhibitors of methane-producing bacteria inhabiting the rumen. Consequently, there is interest in examining their potential use as anti-methanogenic compounds to decrease methane emissions by grazing ruminants. Presently, rumen microbes, collected freshly from a cannulated Holstein cow maintained on 50:50 corn based concentrate:alfalfa diet were mixed (10 mL fluid) in 18 x 150 mm crimp top tubes with 0.5 of high nitrate-containing barley (Hordeum vulgare; containing 272 µmol nitrate per g forage dry matter), and NPA- or NPOH- containing milkvetch forages (Astragalus canadensis and Astragalus miser containing 80 and 174 soluble µmol NPA or NPOH/g forage dry matter respectively). Incubations containing 0.5 g alfalfa (Medicago sativa) were used as controls. Tubes (3 per each respective forage) were capped and incubated anaerobically (using oxygen free carbon dioxide) for 24 h at 39oC after which time amounts of total gas produced were measured via volume displacement and headspace samples were analyzed by gas chromatography to determine concentrations of hydrogen and methane. Fluid samples were analyzed by gas chromatography to measure accumulations of fermentation acids. A completely randomized analysis of variance revealed that the nitrate-containing barley and both the NPA- and the NPOH-containing milkvetches significantly decreased methane production, by > 50%, when compared to methane produced by populations incubated similarly with alfalfa (70.4 ± 3.6 µmol/ml incubation fluid). Accumulations of hydrogen, which are typically increased when methane production is inhibited, by incubations with the nitrate-containing barley and the NPA- and NPOH-containing milkvetches did not differ from accumulations observed in the alfalfa controls (0.09 ± 0.04 µmol/mL incubation fluid). Accumulations of fermentation acids produced in the incubations containing the high-nitrate barley and the NPA- and NPOH-containing milkvetches likewise did not differ from accumulations observed in incubations containing alfalfa (123.5 ± 10.8, 36.0 ± 3.0, 17.1 ± 1.5, 3.5 ± 0.3, 2.3 ± 0.2, 2.2 ± 0.2 µmol/mL incubation fluid for acetate, propionate, butyrate, valerate, isobutyrate, and isovalerate, respectively). This finding indicates the microbial populations did not compensate for the decreased methane production via compensatory changes in production of fermentative acids. Stoichiometric estimation of fermentation balance revealed that > 77% of reducing equivalents generated during fermentation of the forages were recovered in fermentation products and the recoveries did not differ between the alfalfa incubations and those with the high-nitrate barley or the NPA- or NPOH-containing milkvetches. Stoichiometric estimates of amounts of hexose fermented similarly did not differ between the nitrate-, NPA and NPOH-containing incubations and those with the alfalfa, averaging 99.6 ± 37.2 µmol hexose consumed/mL of incubation fluid. These results suggest that forages containing nitrate, NPA or NPOH may be useful to reduce methane emissions of grazing ruminants provided risks of toxicity can be effectively managed.

Keywords: nitrate, nitropropanol, nitropropionic acid, rumen methane emissions

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Authors: Muhammad Arshad, M. Sufian, Muhammad D. Gogi, A. Aslam

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The transgenic cotton expressing Bacillus thuringiensis (Bt) provides an effective control of Helicoverpa armigera, a most damaging pest of the cotton crop. However, Bt cotton may not be the optimal solution owing to the selection pressure of Cry toxins. As Bt cotton express the insecticidal proteins throughout the growing seasons, there are the chances of resistance development in the target pests. A regular monitoring and surveillance of target pest’s baseline susceptibility to Bt Cry toxins is crucial for early detection of any resistance development. The present study was conducted to monitor the changes in the baseline susceptibility of the field population of H. armigera to Bt Cry1Ac toxin. The field-collected larval populations were maintained in the laboratory on artificial diet and F1 generation larvae were used for diet incorporated diagnostic studies. The LC₅₀ and MIC₅₀ were calculated to measure the level of resistance of population as a ratio over susceptible population. The monitoring results indicated a significant difference in the susceptibility (LC₅₀) of H. armigera for first, second, third and fourth instar larval populations sampled from different cotton growing areas over the study period 2016-17. The variations in susceptibility among the tested insects depended on the age of the insect and susceptibility decreased with the age of larvae. The overall results show that the average resistant ratio (RR) of all field-collected populations (FSD, SWL, MLT, BWP and DGK) exposed to Bt toxin Cry1Ac ranged from 3.381-fold to 7.381-fold for 1st instar, 2.370-fold to 3.739-fold for 2nd instar, 1.115-fold to 1.762-fold for 3rd instar and 1.141-fold to 2.504-fold for 4th instar, depicting maximum RR from MLT population, whereas minimum RR for FSD and SWL population. The results regarding moult inhibitory concentration of H. armigera larvae (1-4th instars) exposed to different concentrations of Bt Cry1Ac toxin indicated that among all field populations, overall Multan (MLT) and Bahawalpur (BWP) populations showed higher MIC₅₀ values as compared to Faisalabad (FSD) and Sahiwal (SWL), whereas DG Khan (DGK) population showed an intermediate moult inhibitory concentrations. This information is important for the development of more effective resistance monitoring programs. The development of Bt Cry toxins baseline susceptibility data before the widespread commercial release of transgenic Bt cotton cultivars in Pakistan is important for the development of more effective resistance monitoring programs to identify the resistant H. armigera populations.

Keywords: Bt cotton, baseline, Cry1Ac toxins, H. armigera

Procedia PDF Downloads 141

Authors: P. W. G. D. P. Samarasekara, S. M. K. S. Seneviratne, D. Munidasa, S. S. Williams

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Sustaining a spinal cord injury (SCI) causes severe disruption of all aspects of a person’s life, resulting in the difficult process of coping with the distressing effects of paralysis affecting their ability to lead a meaningful life. These persons are hospitalized in the acute stage of injury and subsequently for rehabilitation and the treatment of complications. The purpose of this study was to explore coping strategies used by persons with SCI during their rehabilitation period. A qualitative study was conducted among persons with SCI, undergoing rehabilitation at the Rheumatology and Rehabilitation Hospitals, Ragama and Digana Sri Lanka. Twelve participants were selected purposively to represent both males and females, with cervical, thoracic or lumbar levels of injuries due to traumatic and non-traumatic causes as well as from different socioeconomic backgrounds. Informed consent was taken from the participants. In-depth interviews were conducted using an interview guide to collect data. Probes were used to get more information and to encourage participants. Interviews were audio taped and transcribed verbatim. Qualitative content analysis was conducted. Ethical approval for this study was obtained from the Ethics Review Committee, Faculty of Medicine, University of Kelaniya. Five themes were identified in the content analysis: social support, religious beliefs, determination, acceptance and making comparisons. Participants indicated that the support from their family members had been an essential factor in coping, after sustaining an SCI and they expressed the importance of emotional support from family members during their rehabilitation. Many participants had a strong belief towards the God, who had a personal interest in their lives, played an important role in their ability to cope with the injury. They believed that what happens to them in this life results from their actions in previous lives. They expressed that determination was essential as a factor that helps them cope with their injury. They indicated their focus on the positive aspects of the life and accepted the disability. They made comparisons to other persons who were worse off than them to help lift them out of unpleasant experience. Even some of the most severely injured and disabled participants presented evidence of using this coping strategy. Identification of coping strategies used by persons with SCI will help nurses and other health-care professionals in reinforcing the most effective coping strategies among persons with SCI. The findings recommend that engagement coping positively influences psychosocial adaptation.

Keywords: content analysis, coping strategies, rehabilitation, spinal cord injury

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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

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Authors: Elvis Enowbeyang Tarkang

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Background: Since students in high schools in Cameroon fall within the age group hardest hit by HIV/AIDS, it is assumed that these students might be exposed to sexual risk behaviours. Sexual risk behaviours include engaging in unprotected sexual intercourse, early sexual debut, multiple sexual partners and coerced or forced sex, and these behaviours might predispose youth to HIV transmission. However, little has been explored on the sexual risk behaviours of high school learners in Cameroon. This study aimed at examining the sexual risk behaviours of high school students in an urban town of Cameroon. Method: A quantitative cross sectional design was adopted, using a self-administered questionnaire to collect data from a disproportional stratified simple random sample of 480 (240 male and 240 female) grade 10 to grade 12 students from two participating secondary school in Limbe in the Southwest region of Cameroon August 2014. Descriptive and Chi square statistics were calculated using statistical Package for Social Sciences (SPSS) version 20 software program at the level 0.05. Results: Majority of the respondents, 63.4% reported being sexually active, of whom only 33.2% used condoms consistently. Up to 37% of the sexually active respondents had multiple sexual partners in the past one year before the study, while 23% had multiple sexual partners during the study period. The mean age of first sex was 15.4 years. Among Christians, Pentecostals, 17 (58.6%) were more likely to have experienced sexual coercion than non-Pentecostals, 111 (42.2%) (p= 0.000). Christians, 41 (10.3%) were more likely to have been forced into first sex than Muslims, 0 (0.0%); while among the Christians, Pentecostals, 6 (15.0%) were more likely to have been forced into first sex than non-Pentecostals, 35 (10.9%) (p=0.004). Among the Christians, Pentecostals, 16 (66.7%) were more likely to have experienced sex by age 16 years than non-Pentecostals, 125 (64.1%) (p= 0.000). Students who lived in rented places, 32 (22.7%) were more likely to have had multiple sexual partners than those who lived in their parents’ houses, 35 (18.1%) (p= 0.000). Males, 36 (16.0%) were likely to have had multiple concurrent sexual partners than females, 14 (6.0%) (p=0.002). Students who used condoms consistently, 25 (33.3%) were more likely to have a higher perception of risk of contracting HIV than those who did not use condoms consistently, 38 (29.9%) (p=0.002). Students who lived in their parents’ houses, 35 (35.4%) were more likely to use condoms consistently during sex, than those who lived in rented places, 31 (29.8%) (p=0.021). Students who passed their examinations, 57 (30.9%) were more likely to have used condoms consistently than those with low academic profiles, 24 (27.9%) (p= 0.034). Conclusions and Recommendations: Gender, lack of parental control, religion, academic profile, poverty, place of residence and perception of risk of HIV infection were the main factors associated with sexual risk behaviours among students in urban Cameroon. The findings indicate that sexual risk behaviours exist among high school students in Limbe urban town of Cameroon. There is need for campaigns and interventions to bring about sexual behaviour change.

Keywords: Cameroon, high school students, HIV/AIDS, Limbe urban town, sexual risk behaviours

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Authors: Pillay J. D., D. De Wit, J. F. Ducray

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Field hockey is a popular international sport which is played in more than 100 countries across the world. Due to the nature of hockey, players repeatedly perform a combination of forward flexion and rotational movements of the spine in order to strike the ball. These movements have been shown to increase the risk of pain and injury to the lumbar spine. The aim of this study was to determine the prevalence and incidence of low back pain (LBP) in male adolescent field hockey players and the characteristics of LBP in terms of location, chronicity, disability, and treatment sought, as well as its association with selected risk factors. A survey was conducted on 112 male adolescent field hockey players in the eThekwini Municipality of KwaZulu-Natal, South Africa. The questionnaire contained sections on the demographics of participants, general characteristics of participants, health and lifestyle characteristics, low back pain patterns, treatment of low back pain, and the level of disability associated with LBP. The data were statistically analysed using IBM SPSS version 25 with statistical significance set at p-value <0.05. Descriptive statistics such as mean and standard deviation were used to summarise responses to continuous variables as appropriate. Categorical variables were described using frequency tables. Associations between risk factors and low back pain were tested using Pearson’s chi-square test and t-tests as appropriate. A total of 68 questionnaires were completed for analysis (67% participation rate); the period prevalence of LBP was 63.2% (35.0%:beginning of the season, 32.4%:mid-season, 22.1%: end of season). Incidence was 38.2%. The most common location for LBP was the middle low back region (39.5%), and the most common duration of pain was a few hours (32.6%). Most participants (79.1%) did not classify their pain as a disability, and only 44.2% of participants received medical treatment for their LBP. An interesting finding was the association between hydration and LBP (p = 0.050), i.e., those individuals who did not hydrate frequently during matches and training were significantly more likely to experience LBP. The results of this study, although limited to a select group of adolescents, showed a higher prevalence of LBP than that of previous studies. More importantly, even though most participants did not experience LBP classified as a disability, LBP still had a large impact on participants, as nearly half of the participants consulted with a medical professional for treatment. Need for the application of further strategies in the prevention and management of LBP in field hockey, such as adequate warm-up and cool-down, stretching exercises, rest between sessions, etc., are recommended as simple strategies to reduce LBP prevalence.

Keywords: adolescents, field hockey players, incidence, low back pain, prevalence, risk factors

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Authors: Shagufta Jabeen, Faez Jesse Firdaus Abdullah, Zunita Zakaria, Nurulfiza Mat Isa, Yung Chie Tan, Wai Yan Yee, Abdul Rahman Omar

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Pasteurella multocida is associated with acute, as well as, chronic infections in avian and bovine such as pasteurellosis and hemorrhagic septicemia (HS) in cattle and buffaloes. Iron is one of the most important nutrients for pathogenic bacteria including Pasteurella and acts as a cofactor or prosthetic group in several essential enzymes and is needed for amino acid, pyrimidine, and DNA biosynthesis. In our recent study, we showed that 2% of Pasteurella multocida serotype A strain PMTB2.1 encode for iron regulating genes (Accession number CP007205.1). Genome sequencing of other Pasteurella multocida serotypes namely PM70 and HB01 also indicated up to 2.5% of the respective genome encode for iron regulating genes, suggesting that Pasteurella multocida genome comprises of multiple systems for iron uptake. Since P. multocida PMTB2.1 has more than 40 CDs out of 2097 CDs (approximately 2%), encode for iron-regulated. The gene expression profiling of four iron-regulating genes namely fbpb, yfea, fece and fur were characterized under iron-restricted environment. The P. multocida strain PMTB2.1 was grown in broth with and without iron chelating agent and samples were collected at different time points. Relative mRNA expression profile of these genes was determined using Taqman probe based real-time PCR assay. The data analysis, normalization with two house-keeping genes and the quantification of fold changes were carried out using Bio-Rad CFX manager software version 3.1. Results of this study reflect that iron reduced environment has significant effect on expression profile of iron regulating genes (p < 0.05) when compared to control (normal broth) and all evaluated genes act differently with response to iron reduction in media. The highest relative fold change of fece gene was observed at early stage of treatment indicating that PMTB2.1 may utilize its periplasmic protein at early stage to acquire iron. Furthermore, down-regulation expression of fece with the elevated expression of other genes at later time points suggests that PMTB2.1 control their iron requirements in response to iron availability by down-regulating the expression of iron proteins. Moreover, significantly high relative fold change (p ≤ 0.05) of fbpb gene is probably associated with the ability of P. multocida to directly use host iron complex such as hem, hemoglobin. In addition, the significant increase (p ≤ 0.05) in fbpb and yfea expressions also reflects the utilization of multiple iron systems in P. multocida strain PMTB2.1. The findings of this study are very much important as relative scarcity of free iron within hosts creates a major barrier to microbial growth inside host and utilization of outer-membrane proteins system in iron acquisition probably occurred at early stage of infection with P. multocida. In conclusion, the presence and utilization of multiple iron system in P. multocida strain PMTB2.1 revealed the importance of iron in the survival of P. multocida.

Keywords: iron-related genes, real-time PCR, gene expression profiling, fold changes

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Authors: Reinaldo Biscaro, Luciano R. Ferreira, Leonardo C. Biscaro, Raphael C. Biscaro, Isabela S. Vasconcelos, Laura C. R. Ferreira, Cristiano M. Galhardi, Erica P. Baciuk

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Introduction: The present study had the objective to present the profile of workers with shoulder disorders related to labor lawsuits in Brazil. The study analyzed the association between the worker’s health and the actions performed by the companies related to injured professional. The research method performed a retrospective, cross-sectional and quantitative database analysis. The documents of labor lawsuits with shoulder injury registered at the Regional Labor Court in the 15^th region (Campinas - São Paulo) were submitted to the medical examination and evaluated during the period from 2012 until 2015. The data collected were age, gender, onset of symptoms, length of service, current occupation, type of shoulder injury, referred complaints, type of acromion, associated or related diseases, company actions as CAT (workplace accident communication), compliance of NR7 by the organization (Environmental Risk Prevention Program - PPRA and Medical Coordination Program in Occupational Health - PCMSO). Results: From the 93 workers evaluated, there was a prevalence of men (58.1%), with a mean age of 42.6 y-o, and 54.8% were included in the age group 35-49 years. Regarding the length of work time in the company, 66.7% have worked for more than 5 years. There was an association between gender and current occupational status (p < 0.005), with predominance of women in household occupation (13 vs. 2) and predominance of unemployed men in job search situation (24 vs. 10) and reintegrated to work by judicial decision (8 vs. 2). There was also a correlation between pain and functional limitation (p < 0.01). There was a positive association of PPRA with the complaint of functional limitation and negative association with pain (p < 0.04). There was also a correlation between the sedentary lifestyle and the presence of PCMSO and PPRA (p < 0.04), and the absence of CAT in the companies (p < 0.001). It was concluded that the appearance or aggravation of osseous and articular shoulder pathologies in workers who have undertaken labor law suits seem to be associated with individual habits or inadequate labor practices. These data can help preventing the occurrence of these lesions by implementing local health promotion policies at work.

Keywords: work-related accidents, cross-sectional study, shoulder lesions, labor lawsuits

Procedia PDF Downloads 218

Authors: N. Šarlija, S. Pfeifer, M. Jeger, A. Bilandžić

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Enterprise growth is generally considered as a key driver of competitiveness, employment, economic development and social inclusion. As such, it is perceived to be a highly desirable outcome of entrepreneurship for scholars and decision makers. The huge academic debate resulted in the multitude of theoretical frameworks focused on explaining growth stages, determinants and future prospects. It has been widely accepted that enterprise growth is most likely nonlinear, temporal and related to the variety of factors which reflect the individual, firm, organizational, industry or environmental determinants of growth. However, factors that affect growth are not easily captured, instruments to measure those factors are often arbitrary, causality between variables and growth is elusive, indicating that growth is not easily modeled. Furthermore, in line with heterogeneous nature of the growth phenomenon, there is a vast number of measurement constructs assessing growth which are used interchangeably. Differences among various growth measures, at conceptual as well as at operationalization level, can hinder theory development which emphasizes the need for more empirically robust studies. In line with these highlights, the main purpose of this paper is twofold. Firstly, to compare structure and performance of three growth prediction models based on the main growth measures: Revenues, employment and assets growth. Secondly, to explore the prospects of financial indicators, set as exact, visible, standardized and accessible variables, to serve as determinants of enterprise growth. Finally, to contribute to the understanding of the implications on research results and recommendations for growth caused by different growth measures. The models include a range of financial indicators as lag determinants of the enterprises’ performances during the 2008-2013, extracted from the national register of the financial statements of SMEs in Croatia. The design and testing stage of the modeling used the logistic regression procedures. Findings confirm that growth prediction models based on different measures of growth have different set of predictors. Moreover, the relationship between particular predictors and growth measure is inconsistent, namely the same predictor positively related to one growth measure may exert negative effect on a different growth measure. Overall, financial indicators alone can serve as good proxy of growth and yield adequate predictive power of the models. The paper sheds light on both methodology and conceptual framework of enterprise growth by using a range of variables which serve as a proxy for the multitude of internal and external determinants, but are unlike them, accessible, available, exact and free of perceptual nuances in building up the model. Selection of the growth measure seems to have significant impact on the implications and recommendations related to growth. Furthermore, the paper points out to potential pitfalls of measuring and predicting growth. Overall, the results and the implications of the study are relevant for advancing academic debates on growth-related methodology, and can contribute to evidence-based decisions of policy makers.

Keywords: growth measurement constructs, logistic regression, prediction of growth potential, small and medium-sized enterprises

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Authors: Neerja Bharti, Drishya P.

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Introduction: Thyroidectomies are extensive surgeries involving a significant degree of tissue handling and dissection and are associated with considerable postoperative pain. Regional anaesthesia techniques have immerged as possible inexpensive and safe alternatives to opioids in the management of pain after thyroidectomy. The front of the neck is innervated by branches from the cervical plexus, and hence, several approaches for superficial and deep cervical plexus block (CPB) have been described to provide postoperative analgesia after neck surgery. However, very few studies have explored the analgesic efficacy of intermediate CPB for thyroid surgery. In this study, we have evaluated the effects of ultrasound-guided bilateral intermediate CPB on perioperative opioid consumption in patients undergoing thyroidectomy under general anesthesia. Methods: In this prospective randomized controlled study, fifty ASA grade I-II adult patients undergoing thyroidectomy were randomly divided into two groups: the study group received ultrasound-guided bilateral intermediate CPB with 10 ml 0.5% ropivacaine on each side, while the control group received the same block with 10 ml normal saline on each side just after induction of anesthesia. Anesthesia was induced with propofol, fentanyl, and vecuronium and maintained with propofol infusion titrated to maintain the BIS between 40 and 60. During the postoperative period, rescue analgesia was provided with PCA fentanyl, and the pain scores, total fentanyl consumption, and incidence of nausea and vomiting during 24 hours were recorded, and overall patient satisfaction was assessed. Results: The groups were well-matched with respect to age, gender, BMI, and duration of surgery. The difference in intraoperative propofol and fentanyl consumption was not statistically significant between groups. However, the intraoperative haemodynamic parameters were better maintained in the study group than in the control group. The postoperative pain scores, as measured by VAS at rest and during movement, were lower, and the total fentanyl consumption during 24 hours was significantly less in the study group as compared to the control group. Patients in the study group reported better satisfaction scores than those in the control group. No adverse effects of ultrasound-guided intermediate CPB block were reported. Conclusion: We concluded that ultrasound-guided intermediate cervical plexus block is a safe and effective method for providing perioperative analgesia during thyroid surgery.

Keywords: thyroidectomy, cervical plexus block, pain relief, opioid consumption

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Authors: Syed Asif Hassan, Tabrej Khan

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Multiple sclerosis (MS) is a chronic demyelinating autoimmune disorder, of the central nervous system (CNS). In the present scenario, the current therapies either do not halt the progression of the disease or have side effects which limit the usage of current Disease Modifying Therapies (DMTs) for a longer period of time. Therefore, keeping the current treatment failure schema, we are focusing on screening novel analogues of the available DMTs that specifically bind and inhibit the Sphingosine1-phosphate receptor1 (S1PR1) thereby hindering the lymphocyte propagation toward CNS. The novel drug-like analogs molecule will decrease the frequency of relapses (recurrence of the symptoms associated with MS) with higher efficacy and lower toxicity to human system. In this study, an integrated approach involving ligand-based virtual screening protocol (Ultrafast Shape Recognition with CREDO Atom Types (USRCAT)) to identify the non-toxic drug like analogs of the approved DMTs were employed. The potency of the drug-like analog molecules to cross the Blood Brain Barrier (BBB) was estimated. Besides, molecular docking and simulation using Auto Dock Vina 1.1.2 and GOLD 3.01 were performed using the X-ray crystal structure of Mtb LprG protein to calculate the affinity and specificity of the analogs with the given LprG protein. The docking results were further confirmed by DSX (DrugScore eXtented), a robust program to evaluate the binding energy of ligands bound to the ligand binding domain of the Mtb LprG lipoprotein. The ligand, which has a higher hypothetical affinity, also has greater negative value. Further, the non-specific ligands were screened out using the structural filter proposed by Baell and Holloway. Based on the USRCAT, Lipinski’s values, toxicity and BBB analysis, the drug-like analogs of fingolimod and BG-12 showed that RTL and CHEMBL1771640, respectively are non-toxic and permeable to BBB. The successful docking and DSX analysis showed that RTL and CHEMBL1771640 could bind to the binding pocket of S1PR1 receptor protein of human with greater affinity than as compared to their parent compound (Fingolimod). In this study, we also found that all the drug-like analogs of the standard MS drugs passed the Bell and Holloway filter.

Keywords: antagonist, binding affinity, chemotherapeutics, drug-like, multiple sclerosis, S1PR1 receptor protein

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Authors: D. Desai, J.Dixon, N. Jain, M. Datta

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Microbial infections of scalp consist of symptomatic appearances associated with seborrhoeic dermatitis, folliculitis, furuncles, carbuncles and ringworm. The main causative organisms in these scalp-based infections are bacteria like S. aureus, P. aeruginosa and a fungus M. Furfur. Allopathic treatment of these infections is available and efficient, but occasionally, topical applications have been found to cause side effects. India is known as the botanical garden of the world and considered as the epicentre for utilization of traditional drugs. Many treatments based on herb extracts are commonly used in India. It has been observed treatment with ethnomedicines requires a higher dosage and greater time period. Additionally, repeated applications are required to obtain the full efficacy of the treatment. An attempt has been made to imbibe the traditional knowledge with nanotechnology to generate a proficient therapeutic against scalp infections. We have imbibed metallic nanoparticles with extracts from traditional medicines and propose to formulate an antimicrobial hair massager. Four commonly used herbs for treatment against scalp disorders like Zingiber officinale (ginger), Allium sativum (garlic), Azadirachta indica (neem) leaves and Citrus limon (lemon) peel was taken. 30 gms of dried homogenized powder was obtained and processed for obtaining the aqueous and ethanolic extract by soxhlet apparatus. The extract was dried and reconstituted to obtain working solution of 1mg/ml. Phytochemical analysis for the obtained extract was done. Synthesis of nanoparticles was mediated by incubating 1mM silver nitrate with extracts of various herbs to obtain silver nanoparticles. The formation of the silver nanoparticles (AgNPs) was monitored using UV-Vis spectroscopy. The AgNPs thus obtained were centrifuged and dried. The AgNPs thus formed were characterized by X Ray Diffraction, scanning electron microscopy and transmission electron microscopy. The size of the AgNPs varied from 10-20 nm and was spherical in shape. P. aeruginosa was plated on nutrient agar and comparative antibacterial activity was tested. Comparative antimicrobial potential was calculated for the extracts and the corresponding nanoconstructs. It was found AgNPs were more efficient than their aqueous and ethanolic counterparts except in the ase of C. limon. Statistical analysis was performed to validate the results obtained.

Keywords: ethnomedicine, nanoconstructs, scalp infections, Zingiber officinale

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Authors: Abdulmajeed Abdullah Alqarni

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This paper is devoted a study of the current frameworks applicable to foreign investments at the levels of domestic and international law, with a particular focus on the legitimate balance to be achieved between the rights of the host state and the legal protections owed to foreign investors. At the wider level of analysis, the paper attempts to map and critically examine the relationship between foreign investment and economic development. In doing so, the paper offers a study in how current discourses and practices on investment law can reconcile the competing interests of developing and developed countries. The study draws on the growing economic imperative for developing nations to create a favorable investment climate capable of attracting private foreign investment. It notes that that over the past decades, an abundance of legal standards that establish substantive and procedural protections for legal forms of foreign investments in the host countries have evolved and crystalized. The study then goes on to offer a substantive analysis of legal reforms at the domestic level in countries such as Saudi Arabia before going on to provide an in- depth and substantive examination of the most important instruments developed at the levels of international law: bilateral investment agreements and double taxation agreements. As to its methods, the study draws on case studies and from data assessing the link between double taxation and economic development. Drawing from the extant literature and doctrinal research, and international and comparative jurisprudence, the paper excavates and critically examines contemporary definitions and norms of international investment law, many of which have been given concrete form and specificity in an ever-expanding number of bilateral and multilateral investment treaties. By reconsidering the wider challenges of conflicts of law and jurisdiction, and the competing aims of the modern investment law regime, the study reflects on how bilateral investment treaties might succeed in achieving the dual aims of rights protection and economic sovereignty. Through its examination of the double taxation phenomena, the study goes on to identify key practical challenges raised by the implementation of bilateral treaties whilst also assessing the sufficiency of the domestic and international legal solutions that are proposed in response. In its final analysis, the study aims to contribute to existing scholarship by assessing contemporary legal and economic barriers to the free flow of investment with due regard for the legitimate concerns and diversity of developing nations. It does by situating its analysis of the domestic enforcement of international investment instrument in its wider historical and normative context. By focusing on the economic and legal dimensions of foreign investment, the paper also aims to offer an interdisciplinary and holistic perspective on contemporary issues and developments in investment law while offering practical reform proposals that can be used to be achieve a more equitable balance between the rights and interests of states and private entities in an increasingly trans nationalized sphere of investment regulation and treaty arbitration.

Keywords: foreign investment, bilateral investment treaties, international tax law, double taxation treaties

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Authors: Sawyer Spurry

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Problem: Palliative care providers at an academic medical center in Maryland stated medical intensive care unit (MICU) patients are often referred late in their hospital stay. The MICU has performed well below the hospital quality performance metric of 80% of patients who expire with expected outcomes should have received a palliative care consult within 48 hours of admission. Purpose: The purpose of this quality improvement (QI) project is to increase palliative care utilization in the MICU through the implementation of a Nurse-Driven PalliativeTriggerTool to prompt the need for specialty palliative care consult. Methods: MICU nursing staff and providers received education concerning the implications of underused palliative care services and the literature data supporting the use of nurse-driven palliative care tools as a means of increasing utilization of palliative care. A MICU population specific criteria of palliative triggers (Palliative Care Trigger Tool) was formulated by the QI implementation team, palliative care team, and patient care services department. Nursing staff were asked to assess patients daily for the presence of palliative triggers using the Palliative Care Trigger Tool and present findings during bedside rounds. MICU providers were asked to consult palliative medicinegiven the presence of palliative triggers; following interdisciplinary rounds. Rates of palliative consult, given the presence of triggers, were collected via electronic medical record e-data pull, de-identified, and recorded in the data collection tool. Preliminary Results: Over 140 MICU registered nurses were educated on the palliative trigger initiative along with 8 nurse practitioners, 4 intensivists, 2 pulmonary critical care fellows, and 2 palliative medicine physicians. Over 200 patients were admitted to the MICU and screened for palliative triggers during the 15-week implementation period. Primary outcomes showed an increase in palliative care consult rates to those patients presenting with triggers, a decreased mean time from admission to palliative consult, and increased recognition of unmet palliative care needs by MICU nurses and providers. Conclusions: Anticipatory findings of this QI project would suggest a positive correlation between utilizing palliative care trigger criteria and decreased time to palliative care consult. The direct outcomes of effective palliative care results in decreased length of stay, healthcare costs, and moral distress, as well as improved symptom management and quality of life (QOL).

Keywords: palliative care, nursing, quality improvement, trigger tool

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Authors: Nonita Sarin, K.J.Singh, Anuj Kumar, Davinder Singh

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Polymeric 3D hydrogels have pivotal role in bone tissue regeneration applications. Hydrogels behave similar to the living tissues because they have large water imbibing capacity in swollen state and adjust their shape according to the tissues during tissue formation after implantation. On the other hand, hydrogels are very soft, fragile and lack mechanical strength. Incorporation of bioceramics can improve mechanical strength. Furthermore, bioceramics synthesized by sol gel technique may enhance the apatite formation and degradation rates which can lead to the increase in faster rates for new bone and tissue regeneration. Simulated body fluid (SBF) induces the poly-condensation of silanol groups which leads to formation of silica matrix and provide active sites for the precipitation of Ca2+ and PO43- ions to form apatite layer which is similar to mineral form of bone. Therefore, authors have synthesized bioceramic incorporated Polyacrylamide-carboxymethylcellulose hydrogels by free radical polymerization and bioceramic compositions of xSrO-(36-x)CaO-45SiO2-ySeO3-(12-y)P2O5-7MgO (where x=0,4 and y=0,2 mol%) were synthesized by sol gel technique. Bioceramics incorporated in polymer matrix induces quicker apatite formation during immersion in SBF by raising the pH with the release of alkaline ions during ion exchange process and the apatite formation takes place in alkaline medium. The behavior of samples PABC-0 (without bioceramics) and PABC-20 (with 20 wt% bioceramics) were evaluated by X-Ray Diffraction and FTIR. In term of bioactivity, it was observed that PABC-20 has shown hydroxyapatite (HA) formation on 1st day of immersion whereas, PABC-0 was shown apatite formation on 7th day of immersion in SBF. The rapid rate of HA growth on 1st day of immersion in SBF signifies easy regeneration of damaged bone tissues. Degradation studies have been undertaken in Phosphate Buffer Saline and PABC-20 exhibited slower degradation rate up to 9%as compared to PABC-0 up to 18%. Slower degradation rate is suitable for new tissue regeneration and cell attachment. Also, Zeta potential studies have been employed to check the surface charge and it has been observed that samples carry negative charge when immersed in SBF. In addition, the swelling test of the samples have been performed and relative swelling ratio % observed for PABC-0 is 607% and PABC-20 is 305%. This indicates that the incorporation of bioceramics leads to the filling up of the voids in between the polymer matrix which in result reduces porosity and increase the mechanical strength by filling the voids. The porosity of PABC-0 is 84% and PABC-20 is 72%. PABC-20 sample demonstrates that bioceramics incorporation reduce the porosity and improves mechanical strength. Also, maximum in vitro cell viability up to 98% with MG63 cell line has been observed which indicate that the bioceramic incorporated hydrogel(PABC-20) provide the alkaline medium which is suitable environment for cell growth.

Keywords: hydrogels, hydroxyapatite, MG63 cell line, zeta potential

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Authors: Sylwia Laba, Robert Laba, Krystian Szczepanski, Mikolaj Niedek, Anna Kaminska-Dworznicka

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Meat and its products are considered food products, having the most unfavorable effect on the environment that requires rational management of these products and waste, originating throughout the whole chain of manufacture, processing, transport, and trade of meat. From the economic and environmental viewpoints, it is important to limit the losses and food wastage and the food waste in the whole meat sector. The link to basic production includes obtaining raw meat, i.e., animal breeding, management, and transport of animals to the slaughterhouse. Food is any substance or product, intended to be consumed by humans. It was determined (for the needs of the present studies) when the raw material is considered as a food. It is the moment when the animals are prepared to loading with the aim to be transported to a slaughterhouse and utilized for food purposes. The aim of the studies was to determine the reasons for loss generation in the basic production of the meat sector in Poland during the years 2017 – 2018. The studies on food losses and waste in the meat sector in basic production were carried out in two areas: red meat i.e., pork and beef and poultry meat. The studies of basic production were conducted in the period of March-May 2019 at the territory of the whole country on a representative trial of 278 farms, including 102 pork production, 55–beef production, and 121 poultry meat production. The surveys were carried out with the utilization of questionnaires by the PAPI (Paper & Pen Personal Interview) method; the pollsters conducted direct questionnaire interviews. Research results indicate that it is followed that any losses were not recorded during the preparation, loading, and transport of the animals to the slaughterhouse in 33% of the visited farms. In the farms where the losses were indicated, the crushing and suffocations, occurring during the production of pigs, beef cattle and poultry, were the main reasons for these losses. They constituted ca. 40% of the reported reasons. The stress generated by loading and transport caused 16 – 17% (depending on the season of the year) of the loss reasons. In the case of poultry production, in 2017, additionally, 10.7% of losses were caused by inappropriate conditions of loading and transportation, while in 2018 – 11.8%. The diseases were one of the reasons for the losses in pork and beef production (7% of the losses). The losses and waste, generated during livestock production and in meat processing and trade cannot be managed or recovered. They have to be disposed of. It is, therefore, important to prevent and minimize the losses throughout the whole production chain. It is possible to introduce the appropriate measures, connected mainly with the appropriate conditions and methods of animal loading and transport.

Keywords: food losses, food waste, livestock production, meat sector

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Authors: Hollie Ashworth, Sarah Heath, Nick Bryan, Liam Abrahamsen, Simon Kellet

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Sellafield has a number of fuel storage ponds, some of which have been open to the air for a number of decades. This has caused corrosion of the fuel resulting in a release of some activity into solution, reduced water clarity, and accumulation of sludge at the bottom of the pond consisting of brucite (Mg(OH)2) and other uranium corrosion products. Both of these phases are also present as colloidal material. 90Sr and 137Cs are known to constitute a small volume of the radionuclides present in the pond, but a large fraction of the activity, thus they are most at risk of challenging effluent discharge limits. Organic molecules are known to be present also, due to the ponds being open to the air, with occasional algal blooms restricting visibility further. The contents of the pond need to be retrieved and safely stored, but dealing with such a complex, undefined inventory poses a unique challenge. This work aims to determine and understand the sorption-desorption interactions of 90Sr and 137Cs to brucite and uranium phases, with and without the presence of organic molecules from chemical degradation and bio-organisms. The influence of organics on these interactions has not been widely studied. Partitioning of these radionuclides and organic molecules has been determined through LSC, ICP-AES/MS, and UV-vis spectrophotometry coupled with ultrafiltration in both binary and ternary systems. Further detailed analysis into the surface and bonding environment of these components is being investigated through XAS techniques and PHREEQC modelling. Experiments were conducted in CO2-free or N2 atmosphere across a high pH range in order to best simulate conditions in the pond. Humic acid used in brucite systems demonstrated strong competition against 90Sr for the brucite surface regardless of the order of addition of components. Variance of pH did have a small effect, however this range (10.5-11.5) is close to the pHpzc of brucite, causing the surface to buffer the solution pH towards that value over the course of the experiment. Sorption of 90Sr to UO2 obeyed Ho’s rate equation and demonstrated a slow second-order reaction with respect to the sharing of valence electrons from the strontium atom, with the initial rate clearly dependent on pH, with the equilibrium concentration calculated at close to 100% sorption. There was no influence of humic acid seen when introduced to these systems. Sorption of 137Cs to UO3 was significant, with more than 95% sorbed in just over 24 hours. Again, humic acid showed no influence when introduced into this system. Both brucite and uranium based systems will be studied with the incorporation of cyanobacterial cultures harvested at different stages of growth. Investigation of these systems provides insight into, and understanding of, the effect of organics on radionuclide partitioning to brucite and uranium phases at high pH. The majority of sorption-desorption work for radionuclides has been conducted at neutral to acidic pH values, and mostly without organics. These studies are particularly important for the characterisation of legacy wastes at Sellafield, with a view to their safe retrieval and storage.

Keywords: caesium, legacy wastes, organics, sorption-desorption, strontium, uranium

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Authors: Marin Kanarev, Delyan Stoyanov, Ivanna Popova, Nadezhda Petrova

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Thanks to increased survival rates in patients bearing oncological malignancies due to recent developments in anti-cancer therapies and diagnostic techniques, observation of clinical cases of metachronous cancers is more common and can provide more in-depth knowledge of their development and, as a result, help clinicians apply suitable therapy. This unusual case of three metachronous tumors presented the opportunity to follow their occurrence, progression, and treatment thoroughly. A 77-year-old male presented with carcinoma ventriculi of the pylorus region, which was surgically removed via upper subtotal stomach resection, a lateral antecolical gastro-enteroanastomosis, and a subsequent Braun anastomosis. An EOX chemotherapy regimen followed. A CT scan four months later showed no indication of recurrence or dissemination. The same scan, performed as a part of the follow-up plan two years later, showed an indication of neoplastic growth in the urinary bladder. After the patient had been directed to a urologist, the suspicion was confirmed, and the growth was histologically diagnosed as a carcinoma of the urinary bladder. An immunohistochemistry test showed an expression of PDL1 of less than 5%, which resulted in treatment with GemCis chemotherapy regimen that led to full remission. Two years and seven months after the first surgery, a CT scan showed again that the two carcinomas were gone. However, four months later, elevated tumor markers prompted a PET/CT scan, which showed data indicative of recurring neoplastic growth in the region of the stomach cardia. It was diagnosed as an adenocarcinoma infiltrating the esophagus. Preoperative chemotherapy with the ECF regimen was completed in four courses, and a CT scan showed no progression of the disease. In less than a month after therapy, the patient underwent laparotomy, debridement, gastrectomy, and a subsequent mechanical terminal-lateral esophago-jejunoanasthomosis. It was verified that the tumor originated from metastasis from the carcinoma ventriculi, which was located in the pylorus. In conclusion, this case report highlights the importance of patient follow-up and studying recurring neoplastic growth. Despite the absence of symptoms, clinicians should maintain a high level of suspicion when evaluating the patient data and choosing the most suitable therapy.

Keywords: carcinoma, follow-up, metachronous, neoplastic growth, recurrence

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Authors: Karolina Wieczorek, Sophie Wiliams

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Introduction: Patient data is often collected in Electronic Health Record Systems (EHR) for purposes such as providing care as well as reporting data. This information can be re-used to validate data models in clinical trials or in epidemiological studies. Manual validation of automated tools is vital to pick up errors in processing and to provide confidence in the output. Mentioning a disease in a discharge letter does not necessarily mean that a patient suffers from this disease. Many of them discuss a diagnostic process, different tests, or discuss whether a patient has a certain disease. The COVID-19 dataset in this study used natural language processing (NLP), an automated algorithm which extracts information related to COVID-19 symptoms, complications, and medications prescribed within the hospital. Free-text patient clinical patient notes are rich sources of information which contain patient data not captured in a structured form, hence the use of named entity recognition (NER) to capture additional information. Methods: Patient data (discharge summary letters) were exported and screened by an algorithm to pick up relevant terms related to COVID-19. Manual validation of automated tools is vital to pick up errors in processing and to provide confidence in the output. A list of 124 Systematized Nomenclature of Medicine (SNOMED) Clinical Terms has been provided in Excel with corresponding IDs. Two independent medical student researchers were provided with a dictionary of SNOMED list of terms to refer to when screening the notes. They worked on two separate datasets called "A” and "B”, respectively. Notes were screened to check if the correct term had been picked-up by the algorithm to ensure that negated terms were not picked up. Results: Its implementation in the hospital began on March 31, 2020, and the first EHR-derived extract was generated for use in an audit study on June 04, 2020. The dataset has contributed to large, priority clinical trials (including International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC) by bulk upload to REDcap research databases) and local research and audit studies. Successful sharing of EHR-extracted datasets requires communicating the provenance and quality, including completeness and accuracy of this data. The results of the validation of the algorithm were the following: precision (0.907), recall (0.416), and F-score test (0.570). Percentage enhancement with NLP extracted terms compared to regular data extraction alone was low (0.3%) for relatively well-documented data such as previous medical history but higher (16.6%, 29.53%, 30.3%, 45.1%) for complications, presenting illness, chronic procedures, acute procedures respectively. Conclusions: This automated NLP algorithm is shown to be useful in facilitating patient data analysis and has the potential to be used in more large-scale clinical trials to assess potential study exclusion criteria for participants in the development of vaccines.

Keywords: automated, algorithm, NLP, COVID-19

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Authors: Diego Caballero Vélez

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In 1997 the Schengen Convention was incorporated in the mainstream of EU law by the Amsterdam Treaty. It came into effect in 1999 with the abolition of internal border controls in the EU, a milestone in the European integration project. In the meantime, due to the Yugoslav wars, nearly 700,000 asylum applications were filed in the European countries provoking a major refugee crisis. During this period, the opening of Eastern Europe fostered more cooperation and policy-making at the EU level in migration issues. Currently, a similar migratory crisis is taking place in Europe. The Syrian war has caused the most massive influx of immigrants in Europe since World War II. Nevertheless, the EU is adopting different migration policies from those implemented during the Yugoslav migration crisis. The current crisis has not led to a common European position but national responses have been offered on migration policies and responsibility for border security and asylum-seekers. A lot of factors can explain this change from a cooperation scenario to a no cooperation one, such as the economic crisis, but this research is focused on the premise that 'threat perception' lies at the core of some states grand strategies towards migration and it also influences in multilateral or unilateral responses. Migration rests at the nexus of three dimensions of security, including geopolitical interests, material production, and internal security. According to some scholars, migration policy is an 'integral instrument' of state grand strategy in that context. Political integration at the EU might be altered with the emergence of existential threats. In other words, some areas of the European cooperation can be transformed when a 'critical juncture' occurs, for instance a migration crisis. In that instance, Member states could see migration as a matter of threat that modifies their national interests and willingness to embrace international cooperation. This research will focus on EU Member states´ perceptions of the 90´s migration crisis and the current one. The goal is to evaluate to what extent the perceptions of threat are one of the main factors for explaining the transition from a cooperation scenario to a no-cooperation one in European asylum and security policies. To analyze threat perception in both migration crisis, some relevant Member states are treated as cases of study and a comparative analysis is carried out based on public opinion polls, public and policy discourse in migration, voting practices and deconstruction of the migration policies themselves both at EU level and a national one.

Keywords: cooperation, migration crisis, national responses, threat perception

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Authors: M. A. Spielmann, L. Schebek

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In order to reach the long-term national climate goals of the German government for the building sector, substantial energetic measures have to be executed. Historically, those measures were primarily energetic efficiency measures at the buildings’ shells. Advanced technologies for the on-site generation of heat (or other types of energy) often are not feasible at this small spatial scale of a single building. Therefore, the present approach uses the spatially larger dimension of a quarter. The main focus of the present paper is the long-term economic-ecological assessment of available decentralized heat-generating (CHP power plants and electrical heat pumps) technologies at the quarter level for the German unrefurbished residential buildings. Three distinct terms have to be described methodologically: i) Quarter approach, ii) Economic assessment, iii) Ecological assessment. The quarter approach is used to enable synergies and scaling effects over a single-building. For the present study, generic quarters that are differentiated according to significant parameters concerning their heat demand are used. The core differentiation of those quarters is made by the construction time period of the buildings. The economic assessment as the second crucial parameter is executed with the following structure: Full costs are quantized for each technology combination and quarter. The investment costs are analyzed on an annual basis and are modeled with the acquisition of debt. Annuity loans are assumed. Consequently, for each generic quarter, an optimal technology combination for decentralized heat generation is provided in each year of the temporal boundaries (2016-2050). The ecological assessment elaborates for each technology combination and each quarter a Life Cycle assessment. The measured impact category hereby is GWP 100. The technology combinations for heat production can be therefore compared against each other concerning their long-term climatic impacts. Core results of the approach can be differentiated to an economic and ecological dimension. With an annual resolution, the investment and running costs of different energetic technology combinations are quantified. For each quarter an optimal technology combination for local heat supply and/or energetic refurbishment of the buildings within the quarter is provided. Coherently to the economic assessment, the climatic impacts of the technology combinations are quantized and compared against each other.

Keywords: building sector, economic-ecological assessment, heat, LCA, quarter level

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Authors: Benjamin Thomas Greer, Grace Cotulla, Mandy Johnson

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Human trafficking is one of the fastest growing international crimes and human rights violations in the world. The United States Department of State (State Department) approximates some 800,000 to 900,000 people are annually trafficked across sovereign borders, with approximately 14,000 to 17,500 of these people coming into the United States. Today’s slavery is conducted by unscrupulous individuals who are often connected to organized criminal enterprises and transnational gangs, extracting huge monetary sums. According to the International Labour Organization (ILO), human traffickers collect approximately $32 billion worldwide annually. Surpassed only by narcotics dealing, trafficking of humans is tied with illegal arms sales as the second largest criminal industry in the world and is the fastest growing field in the 21st century. Perpetrators of this heinous crime abound. They are not limited to single or “sole practitioners” of human trafficking, but rather, often include Transnational Criminal Organizations (TCO), domestic street gangs, labor contractors, and otherwise seemingly ordinary citizens. Monetary gain is being elevated over territorial disputes and street gangs are increasingly operating in a collaborative effort with TCOs to further disguise their criminal activity; to utilizing their vast networks, in an attempt to avoid detection. Traffickers rely on a network of clandestine routes to sell their commodities with impunity. As law enforcement agencies seek to retard the expansion of transnational criminal organization’s entry into human trafficking, it is imperative that they develop reliable trafficking mapping of known exploitative routes. In a recent report given to the Mexican Congress, The Procuraduría General de la República (PGR) disclosed, from 2008 to 2010 they had identified at least 47 unique criminal networking routes used to traffic victims and that Mexico’s estimated domestic victims number between 800,000 adults and 20,000 children annually. Designing a reliable mapping system is a crucial step to effective law enforcement response and deploying a successful victim support system. Creating this mapping analytic is exceedingly difficult. Traffickers are constantly changing the way they traffic and exploit their victims. They swiftly adapt to local environmental factors and react remarkably well to market demands, exploiting limitations in the prevailing laws. This article will highlight how human trafficking has become one of the fastest growing and most high profile human rights violations in the world today; compile current efforts to map and illustrate trafficking routes; and will demonstrate how the proprietary analytical mapping analysis of point-source and destination-source mapping can help local law enforcement, governmental agencies and victim services providers effectively respond to the type and nature of trafficking to their specific geographical locale. Trafficking transcends state and international borders. It demands an effective and consistent cooperation between local, state, and federal authorities. Each region of the world has different impact factors which create distinct challenges for law enforcement and victim services. Our mapping system lays the groundwork for a targeted anti-trafficking response.

Keywords: human trafficking, mapping, routes, law enforcement intelligence

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Authors: S. M. A. Ismail, M. I. Ibrahim, H. Masdar, F. M. Effendi, M. F. Suhaimi, A. Suun

Abstract:

Introduction: It is generally known that the rehabilitation process is as important as the reconstruction surgery. Several literature has focused on how early the rehabilitation modalities can be initiated after the surgery to ensure a safe return of patients to sports or at least regaining the pre-injury level of function following an ACL reconstruction. Objectives: The main objective is to study and evaluate the outcome of early balance exercises and agility training in sports rehabilitation for patients post ACL reconstruction. To compare between early balance exercises and agility training as intervention and control. (material or non-material). All of them were recruited for material exercise (balance exercises and agility training with strengthening) and strengthening only rehabilitation protocol (non-material). Followed the prospective intervention trial. Materials and Methods: Post-operative ACL reconstruction patients performed in Selayang and Sg Buloh Hospitals from 2012 to 2014 were selected for this study. They were taken from Malaysian Knee Ligament Registry (MKLR) and all patients had single bundle reconstruction with autograft hamstring tendon (semitendinosus and gracilis). ACL injury from any type of sports were included. Subjects performed various type of physical activity for rehabilitation in every 18 week for a different type of rehab activity. All subject attended all 18 sessions of rehabilitation exercises and evaluation was done during the first, 9th and 18th session. Evaluation format were based on clinical assessment (anterior drawer, Lachmann, pivot shift, laxity with rolimeter, the end point and thigh circumference) and scoring (Lysholm Knee scoring and Tegner Activity Level scale). Rehabilitation protocol initiated from 24 week after the surgery. Evaluation format were based on clinical assessment (anterior drawer, Lachmann, pivot shift, laxity with rolimeter, the end point and thigh circumference) and scoring (Lysholm Knee scoring and Tegner Activity Level scale). Results and Discussion: 100 patients were selected of which 94 patients are male and 6 female. Age range is 18 to 54 year with the average of 28 years old for included 100 patients. All patients are evaluated after 24 week after the surgery. 50 of them were recruited for material exercise (balance exercises and agility training with strengthening) and 50 for strengthening only rehabilitation protocol (non-material). Demographically showed 85% suffering sports injury mainly from futsal and football. 39 % of them have abnormal BMI (26 – 38) and involving of the left knee. 100% of patient had the basic radiographic x-ray of knee and 98% had MRI. All patients had negative anterior drawer’s, Lachman test and Pivot shift test during the post ACL reconstruction after the complete rehabilitation. There was 95 subject sustained grade I injury, 5 of grade II and 0 of grade III with 90% of them had soft end-point. Overall they scored badly on presentation with 53% of Lysholm score (poor) and Tegner activity score level 3/10. After completing 9 weeks of exercises, of material group 90% had grade I laxity, 75% with firm end-point, Lysholm score 71% (fair) and Tegner activity level 5/10 comparing non-material group who had 62% of grade I laxity , 54% of firm end-point, Lyhslom score 62 % (poor) and Tegner activity level 4/10. After completed 18 weeks of exercises, of material group maintained 90% grade I laxity with 100 % with firm end-point, Lysholm score increase 91% (excellent) and Tegner activity level 7/10 comparing non-material group who had 69% of grade I laxity but maintained 54% of firm end-point, Lysholm score 76% (fair) and Tegner activity level 5/10. These showed the improvement were achieved fast on material group who have achieved satisfactory level after 9th cycle of exercises 75% (15/20) comparing non-material group who only achieved 54% (7/13) after completed 18th session. Most of them were grade I. These concepts are consolidated into our approach to prepare patients for return to play including field testing and maintenance training. Conclusions: The basic approach in ACL rehabilitation is to ensure return to sports at post-operative 6 month. Grade I and II laxity has favourable and early satisfactory outcome base on clinical assessment and Lysholm and Tegner scoring point. Reduction of laxity grading indicates satisfactory outcome. Firm end-point showed the adequacy of rehabilitation before starting previous sports game. Material exercise (balance exercises and agility training with strengthening) were beneficial and reliable in order to achieve favourable and early satisfactory outcome comparing strengthening only (non-material).We have identified that rehabilitation protocol varies between different patients. Therefore future post ACL reconstruction rehabilitation guidelines should look into focusing on rehabilitation techniques instead of time.

Keywords: post anterior cruciate ligament (ACL) reconstruction, single bundle, hamstring tendon, sports rehabilitation, balance exercises, agility balance

Procedia PDF Downloads 255

Authors: Mustarakh Gelfi, Tiedo Vellinga, Poonam Taneja, Delon Hamonangan

Abstract:

The development of New Priok/Kalibaru as an expansion terminal of the old port has been being done by IPC (Indonesia Port Cooperation) together with the subsidiary company, Port Developer (PT Pengembangan Pelabuhan Indonesia). As stated in the master plan, from 2 phases that had been proposed, phase I has shown its form and even Container Terminal I has been operated in 2016. It was planned principally, the development will be divided into Phase I (2013-2018) consist of 3 container terminals and 2 product terminals and Phase II (2018-2023) consist of 4 container terminals. In fact, the master plan has to be changed due to some major uncertainties which were escaped in prediction. This study is focused on the design scenario of phase II (2035- onwards) to deal with future uncertainty. The outcome is the robust design of phase II of the Kalibaru Terminal taking into account the future changes. Flexibility has to be a major goal in such a large infrastructure project like New Priok in order to deal and manage future uncertainty. The phasing of project needs to be adapted and re-look frequently before being irrelevant to future challenges. One of the frameworks that have been developed by an expert in port planning is Adaptive Port Planning (APP) with scenario-based planning. The idea behind APP framework is the adaptation that might be needed at any moment as an answer to a challenge. It is a continuous procedure that basically aims to increase the lifespan of waterborne transport infrastructure by increasing flexibility in the planning, contracting and design phases. Other methods used in this study are brainstorming with the port authority, desk study, interview and site visit to the real project. The result of the study is expected to be the insight for the port authority of Tanjung Priok over the future look and how it will impact the design of the port. There will be guidelines to do the design in an uncertain environment as well. Solutions of flexibility can be divided into: 1 - Physical solutions, all the items related hard infrastructure in the projects. The common things in this type of solution are using modularity, standardization, multi-functional, shorter and longer design lifetime, reusability, etc. 2 - Non-physical solutions, usually related to the planning processes, decision making and management of the projects. To conclude, APP framework seems quite robust to deal with the problem of designing phase II of New Priok Project for such a long period.

Keywords: Indonesia port, port's design, port planning, scenario-based planning

Procedia PDF Downloads 240

Authors: Arlan S. Freitas, Leila M. Carvalho, Adriana L. Soares, Arnoud Neto, Marta S. Madruga, Elza I. Ida, Massami Shimokomaki

Abstract:

The objective of this work was to evaluate the influence of microclimatic profile of broiler transport trucks under commercial conditions over the breast meat quality and DOA (Death On Arrival) in a tropical Brazilian regions as the North East where routinely the season is divided into dry and wet seasons. The temperature remains fairly constant and obviously the relative humidity changes accordingly. Three loads of 4,100 forty seven days old broiler were monitored from farm to slaughterhouse in a distance of 4.3 km, morning period of October 2015 rainy days. The profile of the environmental variables inside the container truck throughout the journey was obtained by the installation of thermo anemometers in 6 different locations by monitoring the heat index (HI), air velocity (AV), temperature (T), and relative humidity (RH). Meat qualities were evaluated by determining the occurrence of PSE (pale, soft, exudative) meat and DFD (dark, firm dry) meat. The percentage of birds DOA per loaded truck was determined by counting the dead broiler during the hanging step at the slaughtering plant. The analysis of variance was performed using statistical software (Statistica 8 for windows, Statsoft 2007, Tulsa, OK, USA). The Tukey significance test (P<0.05) was applied to compare means from microenvironmental data, PSE, DFD and DOA. Fillet samples were collected at 24h post mortem for pH e color (L*, a* e b*) determination through the CIELAB system. Results showed the occurrence of 2.98% of PSE and 0.66% de DFD and only 0.016% of DOA and overall the most uncomfortable container location was at the truck frontal inferior presenting 6.25% of PSE. DFD of 2.0% were obtained from birds located at central and inferior rear locations. These values were unexpected in comparison to other results obtained in our laboratories in previous experiments carried out within the country south state. The results reported herein were lower in every aspect. Reasonable explanation would be the shorter distance, wet conditions throughout around 15-20 min journeys and lower T and RH values as observed in samples taken from the rear location as higher DFD values were obtained. These facts mean the animals were not under heat stressful condition but in fact under cold stress conditions as the result of DFD suggested in association to the lower number of DOA.

Keywords: cold stress, DFD, microclimatic profile, PSE

Procedia PDF Downloads 234

Authors: Mustaffa Kamal Bashar Mohd Fauzi, Puteri Shireen Jahn Kassim, Nurul Syala Abdul Latip

Abstract:

It is increasingly realized that sustainability includes both a response to the climatic and cultural context of a place. To assess the cultural context, a morphological analysis of urban patterns from heritage legacies is necessary. While the climatic form is derived from an analysis of meteorological data, cultural patterns and forms must be abstracted from a typological and morphological study. This current study aims to analyzes morphological and formal elements of water-based architectural and urban design of past Islamic vernacular complexes in the hot arid regions and how a vast utilization of water was shaped and sited to act as cooling devices for an entire complex. Apart from its pleasant coolness, water can be used in an aesthetically way such as emphasizing visual axes, vividly enhancing the visual of the surrounding environment and symbolically portraying the act of purity in the design. By comparing 2 case studies based on the analysis of interactions of water features into the form, planning and morphology of 2 Islamic heritage complexes, Fatehpur Sikri (India) and Lahore Fort (Pakistan) with a focus on Shish Mahal of Lahore Fort in terms of their mass, architecture and urban planning, it is agreeable that water plays an integral role in their climatic amelioration via different methods of water conveyance system. Both sites are known for their substantial historical values and prominent for their sustainable vernacular buildings for example; the courtyard of Shish Mahal in Lahore fort are designed to provide continuous coolness by constructing various miniatures water channels that run underneath the paved courtyard. One of the most remarkable features of this system that all water is made dregs-free before it was inducted into these underneath channels. In Fatehpur Sikri, the method of conveyance seems differed from Lahore Fort as the need to supply water to the ridge where Fatehpur Sikri situated is become the major challenges. Thus, the achievement of supplying water to the palatial complexes is solved by placing inhabitable water buildings within the two supply system for raising water. The process of raising the water can be either mechanical or laborious inside the enclosed well and water rising houses. The studies analyzes and abstract the water supply forms, patterns and flows in 3-dimensional shapes through the actions of evaporative cooling and wind-induced ventilation under arid climates. Through the abstraction analytical and descriptive relational morphology of the spatial configurations, the studies can suggest the idealized spatial system that can be used in urban design and complexes which later became a methodological and abstraction tool of sustainability to suit the modern contemporary world.

Keywords: heritage site, Islamic vernacular architecture, water features, morphology, urban design

Procedia PDF Downloads 375