Search results for: risk factor prevention paradigm

Authors: K. Genise, S. Murthy

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Introductory Statement: The results of this retrospective chart review suggest the effects of bacterial colonization in critically ill children with viral bronchiolitis, currently unproven, are clinically insignificant. Background: Viral bronchiolitis is one of the most prevalent causes of illness requiring hospitalization among children worldwide and one of the most common reasons for admission to pediatric intensive care. It has been hypothesized that co-infection with bacteria results in more severe clinical outcomes. Conversely, the effects of bacterial colonization in critically ill patients with bronchiolitis are poorly defined. Current clinical management of colonized patients consists primarily of supportive therapies with the role of antibiotics remaining controversial. Methods: A retrospective review of all critically ill children admitted to the BC Children’s Hospital Pediatric Intensive Care Unit (PICU) from 2014-2017 with a diagnosis of bronchiolitis was performed. Routine testing in this time frame consisted of complete pathogen testing, including PCR for Streptococcus pneumoniae. Analyses were performed to determine the impact of bacterial colonization and antibiotic use on a primary outcome of PICU length-of-stay, with secondary outcomes of hospital length-of-stay and duration of ventilation. Results: There were 92 patients with complete pathogen testing performed during the assessed timeframe. A comparison between children with detected Streptococcus pneumoniae (n=22) and those without (n=70) revealed no significant (p=0.20) differences in severity of illness on presentation as per Pediatric Risk of Mortality III scores (mean=3.0). Patients colonized with S. pneumoniae had significantly shorter PICU stays (p=0.002), hospital stays (p=0.0001) and duration of non-invasive ventilation (p=0.002). Multivariate analyses revealed that these effects on length of PICU stay and duration of ventilation do not persist after controlling for antibiotic use, presence of radiographic consolidation, age, and severity of illness (p=0.15, p=0.32). The relationship between colonization and duration of hospital stay persists after controlling for these variables (p=0.008). Conclusions: Children with viral bronchiolitis colonized with S. pneumoniae do not appear to have significantly different PICU length-of-stays or duration of ventilation compared to children who are not colonized. Colonized children appear to have shorter hospital stays. The results of this study suggest bacterial colonization is not associated with increased severity of presenting illness or negative clinical outcomes.

Keywords: bronchiolitis, colonization, critical care, pediatrics, pneumococcal, infection

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Authors: E. Njuguna, S. Ilovi, P. Muiruri, K. Mutai, J. Kinuthia, P. Njoroge

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Introduction: Cervical cancer is the commonest cause of cancer-related morbidity and mortality among women in developing countries in Sub Saharan Africa. Screening for cervical cancer in all women regardless of HIV status is crucial for the early detection of cancer of the cervix when treatment is most effective in curing the disease. It is particularly more important to screen HIV infected women as they are more at risk of developing the disease and progressing faster once infected with HPV (Human Papilloma Virus). We aimed to determine the factors affecting the utilization of cervical cancer screenings among HIV infected women above 18 years of age at Kenyatta National Hospital (KNH) Comprehensive Care Center (CCC). Materials and Methods: A cross-sectional mixed quantitative and qualitative study involving randomly and purposefully selected HIV positive female respectively was conducted. Qualitative data collection involved 4 focus group discussions of eligible female participants while quantitative data were acquired by one to one interviewer administered structured questionnaires. The outcome variable was the utilization of cervical cancer screening. Data were entered into Access data base and analyzed using Stata version 11.1. Qualitative data were analyzed after coding for significant clauses and transcribing to determine themes arising. Results: We enrolled a total of 387 patients, mean age (IQ range) 40 years (36-44). Cervical cancer screening utilization was 46% despite a health care provider recommendation of 85%. The screening results were reported as normal in 72 of 81 (88.9%) and abnormal 7 of 81(8.6%) of the cases. Those who did not know their result were 2 of 81(2.5%). Patients were less likely to utilize the service with increasing number of years attending the clinic (OR 0.9, 95% CI 0.86-0.99, p-value 0.02), but more likely to utilize the service if recommendation by a staff was made (OR 10, 95% CI 4.2-23.9, p<0.001), and if cervical screening had been done before joining KNH CCC (OR 2.9, 95% CI 1.7-4.9, p < 0.001). Similarly, they were more likely to rate the services on cervical cancer screening as good (OR 5.0, 95% CI 1.7-3.4, p <0.001) and very good (OR 8.1, 95% CI 2.5-6.1, p<0.001) if they had utilized the service. The main barrier themes emerging from qualitative data included fear of screening due to excessive pain or bleeding, lack of proper communication on screening procedures and increased waiting time. Conclusions: Utilization of cervical cancer screening services was low despite health care recommendation. Patient socio-demographic characteristics did not influence whether or not they utilized the services, indicating the important role of the health care provider in the referral and provision of the service.

Keywords: cervical, cancer, HIV, women, comprehensive care center

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Authors: Monika Szpringer, Aneta Pawlinska

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Adverse childhood experiences are linked to various types of health and adapt problems at different stages of life. They include various types of abuse, neglect, and dysfunctional environment. They have an unfavorable impact on the development of a child and his future functioning in society. Adolescents who were exposed to bad treatment may suffer from health problems during adulthood, like chronic diseases, psychological disorders, drug addiction, and suicide attempts. Objective: The aim of the project is to assess the relationship between adverse childhood experiences and the sense of efficacy and coping with emotions among teenagers aged 16-18 taking drugs. Material And Methods: The research was carried out in the period from March to December 2018 in Mazowieckie, Świętokrzyskie, Łódzkie, and Lubelskie Voivodship. The group consisted of 600 people aged 16-18 (M=16,58; SD=0, 78), men (63,2%) aged 16-18 (M=16,60;SD= 0,78) and women (35,5%) aged 16-18 (M16,55;SD=0,79). Participants included residents from Youth Educational Centers and Youth Sociotherapy Centers. Each participant filled in Author's Questionnaire, Adverse Childhood Questionnaire, then Courtland Emotional Control Scale-CECS and Generalized Self Efficacy Scale-GSES. Results and conclusions: The most common adverse experiences, according to teenagers, were family abuse, divorce/separation/parent's death, overuse of alcohol or drugs by an inmate, and emotional neglect. Adolescents who suffered from five to twelve adverse experiences had a higher level of depression's control. Adverse childhood experiences have an importance for the level of anger and depression's control among teenagers taking drugs. The greatest importance of the level of anger's control has emotional neglect. A higher level of emotional neglect is linked to a lower ability to control anger. The greatest importance of the level of depression's control has physical abuse and emotional neglect. The higher physical abuse during childhood, and the higher frequency of emotional neglect, the bigger the depression's control. The sense of efficacy in the group of people who suffered from one to four adverse experiences is close to the sense of efficacy that suffered people from five to twelve adverse experiences. The most important factor lowering the sense of one's efficacy was the intensification of sexual abuse. It was confirmed that the intensification and frequency of adverse childhood experiences were higher among women than men. Women also characterized lower anger control and greater depression's control. The authors’ own analyses confirmed the relationship between adverse childhood experiences and the sense of efficacy and coping with emotions among teenagers aged 16-18 taking drugs.

Keywords: adolescences, adverse childhood experiences, coping with emotions, drugs

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Authors: S. Surapa Raju

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In Andhra Pradesh, the symptoms of climate variations in coastal villages can be observed from various studies. The Andhra Pradesh coast is known its frequent tropical cyclones and associated floods and tidal surges causing loss of life and property in the region. In the last decade alone, the state experienced 18 devastating storms causing huge loss to coastal people. The year 2007 was the fourth warmest year on record since 1901 and 2009 witnessed the heat wave conditions prevailing over the coastal Andhra Pradesh. With regarding to sea level rise (SLR), 43 percent of the coastal areas considered to be at high risk. The main objectives of the study are: to know the perceptions of fisher people on climate variations and to find out the awareness of the fisher people on climate variations and its effects at village and on fishing households. Altogether 150 households were chosen purposively for this study and collected information from the households based on semi-structured schedule. The present field-based study observed that most of the fisher people are experienced about the changes in climate variations in their villages. The first generation fisher people expressed that the at least 1/2km of sea erosion taken place from the last 20 years and most of them displaced. With regard to fishing activities, first generation fisher people revealed that 20 years back they were fishing in near-shore areas, but now availability of near shore is decreased at a large extent. The present study observed the lot of variations in growth of species in marine districts of Andhra Pradesh from the year 2005-2010. Some species like Silver pomfret, Sole (flat fish), Chriocentrus, Thrisocies, Stakes, Rays etc. are in decaling. The results of the study indicate that huge variation observed in growth rates of fish species. Small and traditional fishers have drastically effected in El NiNo years than the normal years as they have not own suitable equipment such as crafts and nets. The study discovered that many changes taken place in the fishing activities and they are: go for long distance for fishing which increases the cost of fishing operations; decrease in fish catches. Need to take up in-depth studies in the marine villages and tackle the situation by creating more awareness about the negative effects of climate variations among fishing households. Suitable fish craft technology is to be supplied and create more employment opportunities for the fishers in other than fishery.

Keywords: climate, Andhra Pradesh, El nino years, India

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Authors: Güllü Yakar, Adnan Tepecik

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A university campus resembles an independent city that is spread over a wide area. Campuses that incorporate thousands of new domestic and international users at the beginning of every academic period also host scientific, cultural and sportive events, in addition to embodying regular users such as students and staff. Wayfinding and signage systems are necessary for the regulation of vehicular traffic, and they enable users’ to navigate without losing time or feeling anxiety. While designing the system or testing the functionality of it, opinions of existing users or likely behaviors of typical user profiles (personas) provide designers with insight. The purpose of this study is to identify the wayfinding attitudes and expectations of Kastamonu University Kuzeykent Campus users. This study applies a mixed method in which a questionnaire, developed by the researcher, constitute the quantitative phase of the study. The survey was carried out with 850 participants who filled a questionnaire form which was tested in terms of construct validity by using Exploratory Factor Analysis. While interpreting the data obtained, Chi-Square, T- Test and ANOVA analyses were applied as well as descriptive analyses such as frequency (f) and percentage (%) values. The results of this survey, which was conducted during the absence of systematic wayfinding signs in the campus, reveals the participants expectations for insertion of floor plans and wayfinding signs to indoors, maps to outdoors, symbols and color codes to the existing signs and for the adequate arrangement of those for the use of visually impaired people. The fact that there is a direct proportional relation between the length of institution membership and wayfinding competency within campus, leads to the conclusion that especially the new comers are in need of wayfinding signs. In order to determine the effectiveness of campus-wide wayfinding system implemented after the survey and in order to identify the further expectations of users in this respect, a semi-structured interview form developed by the researcher and assessments of 20 participants are compiled. Subjected to content analysis, this data constitute the qualitative dimension of the study. Research results indicate that despite the presence of the signs, the participants experienced either inability or stress while finding their way, showed tendency to receive help from others and needed outdoor maps and signs, in addition to bigger-sized texts.

Keywords: environmental graphic design, environmental perception, wayfinding and signage design, wayfinding system

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Authors: Jos Olijve

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Introduction and Purpose: Endotoxins are found in the outer membrane of gram-negative bacteria and have profound in vitro and in vivo responses. They can trigger strong immune responses and negatively affect various cellar activities particular cells expressing toll-like receptors. They are therefore unwanted contaminants of biomaterials sourced from natural raw materials, and their activity must be as low as possible. Collagen and gelatin are natural extracellular matrix components and have, due to their low allergenic potential, suitable biological properties, and tunable physical characteristics, high potential in biomedical applications. The purpose of this study was to determine the influence of autoclave sterilization of gelatin on physical properties and endotoxin level compared to surfactant purified gelatin. Methods: Type A gelatin from Sigma-Aldrich (G1890) with endotoxin level of 35000 endotoxin units (EU) per gram gelatin and type A gelatins from Rousselot Gent with endotoxin activity of 30000 EU per gram were used. A 10 w/w% G1890 gelatin solution was autoclave sterilized during 30 minutes at 121°C and 1 bar over pressure. The physical properties and the endotoxin level of the sterilized G1890 gelatin were compared to a type A gelatin from Rousselot purified with Triton X100 surfactant. The Triton X100 was added to a concentration of 0.5 w/w% which is above the critical micellar concentration. The gelatin surfactant mixtures were kept for 30-45 minutes under constant stirring at 55-60°C. The Triton X100 was removed by active carbon filtration. The endotoxin levels of the gelatins were measured using the Endozyme recombinant factor C method from Hyglos GmbH (Germany). Results and Discussion: Autoclave sterilization significantly affect the physical properties of gelatin. Molecular weight of G1890 decreased from 140 to 50kDa, and gel strength decreased from 300 to 40g. The endotoxin level of the gelatin reduced after sterilization from 35000 EU/g to levels of 400-500 EU/g. These endotoxin levels are however still far above the upper endotoxin level of 0.05 EU/ml, which resembles 5 EU/g gelatin based on a 1% gelatin solution, to avoid cell proliferation alteration. Molecular weight and gel strength of Rousselot gelatin was not altered after Triton X100 purification and remained 150kDa and 300g respectively. The endotoxin levels of Triton X100 purified Rousselot gelatin was < 5EU/g gelatin. Conclusion: Autoclave sterilization of gelatin is, in comparison to Triton X100 purification, not efficient to inactivate endotoxin levels in gelatin to levels below the upper limit to avoid cell proliferation alteration. Autoclave sterilization gave a significant decrease in molecular weight and gel strength which makes autoclave sterilized gelatin, in comparison to Triton X100 purified gelatin, not suitable for 3D printing.

Keywords: endotoxin, gelatin, molecular weight, sterilization, Triton X100

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Authors: Zeinab Yazdanfar, Dilan Robert, Daniel Lester, S. Setunge

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Scour has been identified as the most common threat to bridge stability worldwide. Traditionally, scour around bridge piers is calculated using the empirical approaches that have considerable limitations and are difficult to generalize. The multi-physic nature of scouring which involves turbulent flow, soil mechanics and solid-fluid interactions cannot be captured by simple empirical equations developed based on limited laboratory data. These limitations can be overcome by direct numerical modeling of coupled hydro-mechanical scour process that provides a robust prediction of bridge scour and valuable insights into the scour process. Several numerical models have been proposed in the literature for bridge scour estimation including Eulerian flow models and coupled Euler-Lagrange models incorporating an empirical sediment transport description. However, the contact forces between particles and the flow-particle interaction haven’t been taken into consideration. Incorporating collisional and frictional forces between soil particles as well as the effect of flow-driven forces on particles will facilitate accurate modeling of the complex nature of scour. In this study, a coupled Computational Fluid Dynamics and Discrete Element Model (CFD-DEM) has been developed to simulate the scour process that directly models the hydro-mechanical interactions between the sediment particles and the flowing water. This approach obviates the need for an empirical description as the fundamental fluid-particle, and particle-particle interactions are fully resolved. The sediment bed is simulated as a dense pack of particles and the frictional and collisional forces between particles are calculated, whilst the turbulent fluid flow is modeled using a Reynolds Averaged Navier Stocks (RANS) approach. The CFD-DEM model is validated against experimental data in order to assess the reliability of the CFD-DEM model. The modeling results reveal the criticality of particle impact on the assessment of scour depth which, to the authors’ best knowledge, hasn’t been considered in previous studies. The results of this study open new perspectives to the scour depth and time assessment which is the key to manage the failure risk of bridge infrastructures.

Keywords: bridge scour, discrete element method, CFD-DEM model, multi-phase model

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Authors: Arnab Hazra

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Breath analysis is a quick, noninvasive and inexpensive technique for disease diagnosis can be used on people of all ages without any risk. Only a limited number of volatile organic compounds (VOCs) can be associated with the occurrence of specific diseases. These VOCs can be considered as disease markers or breath markers. Selective detection with specific concentration of breath marker in exhaled human breath is required to detect a particular disease. For example, acetone (C₃H₆O), ethanol (C₂H₅OH), ethane (C₂H₆) etc. are the breath markers and abnormal concentrations of these VOCs in exhaled human breath indicates the diseases like diabetes mellitus, renal failure, breast cancer respectively. Nanomaterial-based vapor sensors are inexpensive, small and potential candidate for the detection of breath markers. In practical measurement, selectivity is the most crucial issue where trace detection of breath marker is needed to identify accurately in the presence of several interfering vapors and gases. Current article concerns a novel technique for selective and lower ppb level detection of breath markers at very low temperature based on TiO₂ nanotube array based vapor sensor devices. Highly ordered and oriented TiO₂ nanotube array was synthesized by electrochemical anodization of high purity tatinium (Ti) foil. 0.5 wt% NH₄F, ethylene glycol and 10 vol% H₂O was used as the electrolyte and anodization was carried out for 90 min with 40 V DC potential. Au/TiO₂ Nanotube/Ti, sandwich type sensor device was fabricated for the selective detection of VOCs in low concentration range. Initially, sensor was characterized where resistive and capacitive change of the sensor was recorded within the valid concentration range for individual breath markers (or organic vapors). Sensor resistance was decreased and sensor capacitance was increased with the increase of vapor concentration. Now, the ratio of resistive slope (mR) and capacitive slope (mC) provided a concentration independent constant term (M) for a particular vapor. For the detection of unknown vapor, ratio of resistive change and capacitive change at any concentration was same to the previously calculated constant term (M). After successful identification of the target vapor, concentration was calculated from the straight line behavior of resistance as a function of concentration. Current technique is suitable for the detection of particular vapor from a mixture of other interfering vapors.

Keywords: breath marker, vapor sensors, selective detection, TiO₂ nanotube array

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Authors: Shengnan Chen, Shuhua Wang

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Successful production of hydrocarbon from unconventional tight oil reserves has changed the energy landscape in North America. The oil contained within these reservoirs typically will not flow to the wellbore at economic rates without assistance from advanced horizontal well and multi-stage hydraulic fracturing. Efficient and economic development of these reserves is a priority of society, government, and industry, especially under the current low oil prices. Meanwhile, society needs technological and process innovations to enhance oil recovery while concurrently reducing environmental impacts. Recently, big data analysis and artificial intelligence become very popular, developing data-driven insights for better designs and decisions in various engineering disciplines. However, the application of data mining in petroleum engineering is still in its infancy. The objective of this research aims to apply intelligent data analysis and data-driven models to exploit unconventional oil reserves both efficiently and economically. More specifically, a comprehensive database including the reservoir geological data, reservoir geophysical data, well completion data and production data for thousands of wells is firstly established to discover the valuable insights and knowledge related to tight oil reserves development. Several data analysis methods are introduced to analysis such a huge dataset. For example, K-means clustering is used to partition all observations into clusters; principle component analysis is applied to emphasize the variation and bring out strong patterns in the dataset, making the big data easy to explore and visualize; exploratory factor analysis (EFA) is used to identify the complex interrelationships between well completion data and well production data. Different data mining techniques, such as artificial neural network, fuzzy logic, and machine learning technique are then summarized, and appropriate ones are selected to analyze the database based on the prediction accuracy, model robustness, and reproducibility. Advanced knowledge and patterned are finally recognized and integrated into a modified self-adaptive differential evolution optimization workflow to enhance the oil recovery and maximize the net present value (NPV) of the unconventional oil resources. This research will advance the knowledge in the development of unconventional oil reserves and bridge the gap between the big data and performance optimizations in these formations. The newly developed data-driven optimization workflow is a powerful approach to guide field operation, which leads to better designs, higher oil recovery and economic return of future wells in the unconventional oil reserves.

Keywords: big data, artificial intelligence, enhance oil recovery, unconventional oil reserves

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Authors: Umair Shoukat Ali, Kamil Zafar, Rashna Hoshang Sukhia, Mubassar Fida, Aqeel Ahmed

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Objective: This systematic review and meta-analysis aimed to summarize the effectiveness of bonded and removable retainers (Hawley and Essix retainer) in terms of improvement in occlusal settling (occlusal contact points/areas) after orthodontic treatment. Search Method: We searched the Cochrane Library, CINAHL Plus, PubMed, Web of Science, Orthodontic journals, and Google scholar for eligible studies. We included randomized control trials (RCT) along with Cohort studies. Studies that reported occlusal contacts/areas during retention with fixed bonded and removable retainers were included. To assess the quality of the RCTs Cochrane risk of bias tool was utilized, whereas Newcastle-Ottawa Scale was used for assessing the quality of cohort studies. Data analysis: The data analysis was limited to reporting mean values of occlusal contact points/areas with different retention methods. By utilizing the RevMan software V.5.3, a meta-analysis was performed for all the studies with the quantitative data. For the computation of the summary effect, a random effect model was utilized in case of high heterogeneity. I2 statistics were utilized to assess the heterogeneity among the selected studies. Results: We included 6 articles in our systematic review after scrutinizing 219 articles and eliminating them based on duplication, titles, and objectives. We found significant differences between fixed and removable retainers in terms of occlusal settling within the included studies. Bonded retainer (BR) allowed faster and better posterior tooth settling as compared to Hawley retainer (HR). However, HR showed good occlusal settling in the anterior dental arch. Essix retainer showed a decrease in occlusal contact during the retention phase. Meta-analysis showed no statistically significant difference between BR and removable retainers. Conclusions: HR allowed better overall occlusal settling as compared to other retainers in comparison. However, BR allowed faster settling in the posterior teeth region. Overall, there are insufficient high-quality RCTs to provide additional evidence, and further high-quality RCTs research is needed.

Keywords: orthodontic retainers, occlusal contact, Hawley, fixed, vacuum-formed

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Authors: Madhvi Bhayani

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Introduction: Due to the rapid pace of urbanization, the urban health issues have become one of the significant threats to future development in India. It also poses serious repercussions on the citizen’s health. As urbanization in India is increasing at an unprecedented rate and it has generated the urban health crisis among the city dwellers especially the urban poor. The increasing proportion of the urban poor and vulnerable to the health indicators worse than the rural counterparts, they face social and financial barriers in accessing healthcare services and these conditions make human health at risk. The Local as well as the State and National governments are alike tackling with the challenges of urbanization as it has become very essential for the government to provide the basic necessities and better infrastructure that make life in cities safe and healthy. Thus, the paper argues that if no major realistic steps are taken with immediate effect, the citizens will face a huge burden of health hazards. Aim: This paper attempts to analyze the current infrastructure, government planning, and its future policy, it also discusses the challenges and outcomes of urbanization on health and its impact on it and it will also predict the future trend with regard to disease burden in the urban areas. Methods: The paper analyzes on the basis of the secondary data by taking into consideration the connection between the Rapid Urbanization and Public Health Challenges, health and health care system and its services delivery to the citizens especially to the urban poor. Extensive analyses of government census reports, health information and policy, the government health-related schemes, urban development and based on the past trends, the future status of urban infrastructure and health outcomes are predicted. The social-economic and political dimensions are also taken into consideration from regional, national and global perspectives, which are incorporated in the paper to make realistic predictions for the future. Findings and Conclusion: The findings of the paper show that India suffers a lot due to the double burden of rapidly increasing in diseases and also growing health inequalities and disparities in health outcomes. Existing tools of governance of urban health are falling short to provide the better health care services. They need to strengthen the collaboration and communication among the state, national and local governments and also with the non-governmental partners. Based on the findings the policy implications are then described and areas for future research are defined.

Keywords: health care, urbanization, urban health, service delivery

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Authors: Y. Landkocz, P. Gosset, A. Héliot, C. Corbière, C. Vendeville, V. Keravec, S. Billet, A. Verdin, C. Monteil, D. Préterre, J-P. Morin, F. Sichel, T. Douki, P. J. Martin

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Air Pollution produced by automobile traffic is one of the main sources of pollutants in urban atmosphere and is largely due to exhausts of the diesel engine powered vehicles. The International Agency for Research on Cancer, which is part of the World Health Organization, classified in 2012 diesel engine exhaust as carcinogenic to humans (Group 1), based on sufficient evidence that exposure is associated with an increased risk for lung cancer. Amongst the strategies aimed at limiting exhausts in order to take into consideration the health impact of automobile pollution, filtration of the emissions and use of biofuels are developed, but their toxicological impact is largely unknown. Diesel exhausts are indeed complex mixtures of toxic substances difficult to study from a toxicological point of view, due to both the necessary characterization of the pollutants, sampling difficulties, potential synergy between the compounds and the wide variety of biological effects. Here, we studied the potential indirect genotoxicity of emission of Diesel engines through on-line exposure of rats in inhalation chambers to a subchronic high but realistic dose. Following exposure to standard gasoil +/- rapeseed methyl ester either upstream or downstream of a particle filter or control treatment, rats have been sacrificed and their lungs collected. The following indirect genotoxic parameters have been measured: (i) telomerase activity and telomeres length associated with rTERT and rTERC gene expression by RT-qPCR on frozen lungs, (ii) γH2AX quantification, representing double-strand DNA breaks, by immunohistochemistry on formalin fixed-paraffin embedded (FFPE) lung samples. These preliminary results will be then associated with global cellular response analyzed by pan-genomic microarrays, monitoring of oxidative stress and the quantification of primary DNA lesions in order to identify biological markers associated with a potential pro-carcinogenic response of diesel or biodiesel, with or without filters, in a relevant system of in vivo exposition.

Keywords: diesel exhaust exposed rats, γH2AX, indirect genotoxicity, lung carcinogenicity, telomerase activity, telomeres length

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Authors: Karin M. Granstrom

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Paper mills produce wastewater with a high content of organic substances. Treatment usually consists of sedimentation, biological treatment of activated sludge basins, and chemical precipitation. The resulting sludges are currently a waste problem, deposited in landfills or used as low-grade fuels for incineration. There is a growing awareness of the need for energy efficiency and environmentally sound management of sludge. A resource-efficient method would be to digest the wastewater sludges anaerobically to produce biogas, refine the biogas to biomethane for use in the transportation sector, and utilize the resulting digestate for soil improvement. The biomethane yield of pulp and paper wastewater sludge is comparable to that of straw or manure. As a bonus, the digestate has an improved dewaterability compared to the feedstock biosludge. Limitations of this process are predominantly a weak economic viability - necessitating both sufficiently large-scale paper production for the necessary large amounts of produced wastewater sludge, and the resolving of remaining questions on the certifiability of the digestate and thus its sales price. A way to improve the practical and economical feasibility of using paper mill wastewater for biomethane production and soil improvement is to co-digest it with other feedstocks. In this study, pulp and paper sludge were co-digested with (1) silage and manure, (2) municipal sewage sludge, (3) food waste, or (4) microalgae. Biomethane yield analysis was performed in 500 ml batch reactors, using an Automatic Methane Potential Test System at thermophilic temperature, with a 20 days test duration. The results show that (1) the harvesting season of grass silage and manure collection was an important factor for methane production, with spring feedstocks producing much more than autumn feedstock, and pulp mill sludge benefitting the most from co-digestion; (2) pulp and paper mill sludge is a suitable co-substrate to add when a high nitrogen content cause impaired biogas production due to ammonia inhibition; (3) the combination of food waste and paper sludge gave higher methane yield than either of the substrates digested separately; (4) pure microalgae gave the highest methane yield. In conclusion, although pulp and paper mills are an almost untapped resource for biomethane production, their wastewater is a suitable feedstock for such a process. Furthermore, through co-digestion, the pulp and paper mill wastewater and mill sludges can aid biogas production from more nutrient-rich waste streams from other industries. Such co-digestion also enhances the soil improvement properties of the residue digestate.

Keywords: anaerobic, biogas, biomethane, paper, sludge, soil

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Authors: Marco Camilli

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This article examines the impact of the pandemic outbreak of COVID-19 in the tourism sector in Italy, analyzing the current scenario, the government decisions and the private company reaction for the summer season 2020. The framework of the data analyzed shows how massive it’s the impact of the pandemic outbreak in the tourism revenue, and the weaknesses of the measures proposed. Keywords Travel &Tourism, Transportation, Sustainability, COVID-19, Businesses Introduction The current COVID-19 scenario shows a shocking situation for the tourism and transportation sectors: it could be the most affected by the Coronavirus in Italy. According to forecasts, depending on the duration of the epidemic outbreak and the lockdown strategy applied by the Government, businesses in the supply chain could lose between 24 and 66 billion in turnover in the period of 2020-21, with huge diversified impacts at the national and regional level. Many tourist companies are on the verge of survival and if there are no massive measures by the government they risk closure. Data analysis The tourism and transport sector could be among the sectors most damaged by Covid-19 in Italy. Considering the two-year period 2020-21, companies operating in the travel & tourism sector (Tour operator, Travel Agencies, Hotel, Guides, Bus Company, etc..) could in suffer losses in revenues of 24 to 64 billion euros, especially in the sectors such as the travel agencies, hotel and rental. According to Statista Research Department, from April 2020 estimated that the coronavirus (COVID-19) pandemic will have a significant impact on revenues of the tourism industry in Italy. Revenues are expected to decrease by over 40 billion euros in the first semester of 2020, compared to the same period of the previous year. According to the study, hotel and non-hotel accommodations will experience the highest loss. Revenues of this sector are expected to decrease by 13 billion euros compared to the first semester of 2019 when accommodations registered revenues for about 17 billion euros. According to Statista.com, in 2020, Italy is expected to register a decrease of roughly 28.5 million tourist arrivals due to the impact of coronavirus (COVID-19) on the country's tourist sector. According to the estimate, the region of Veneto will record the highest drop with a decrease of roughly 4.61 million arrivals. Similarly, Lombardy is expected to register a decrease of about 3.87 million arrivals in 2020.

Keywords: travel and tourism, sustainability, COVID-19, businesses, transportation

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Authors: P. L. Madhushi Kavindya

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Sri Lanka is a developing country where hydrology plays an important role in its economic and social growth, followed by irrigation and power generation. Therefore, reservoirs are a principal element of the culture and social status of Sri Lankans. The emergence of a newly built reservoir goes along with a community relocation process which eventually causes alterations in the cultural landscape around it. From the 18th century, the emergence of reservoirs has caused major impacts on the landscape of Sri Lanka. Foremost aspects can be identified as the increased and decreased value of the cultural landscape around a reservoir. Community relocation in regard to reservoir projects is discussed as a key factor in the research. The study further carries out observations and findings of the relocation process of reservoirs in global and local contexts. Consequently, the study discusses the vast study area of ‘cultural landscape’ in brief and its behavior overall. Besides, specific data about reservoir-related cultural landscapes in a worldwide context, along with facts about the evolution, has been discussed. The significance and diversity of the Sri Lankan reservoir-related cultural landscape are explored in the succeeding study. This study will mainly identify the existing constraints and tendencies regarding the relocation process in an overall status. The base for the research has been laid thereafter by broadening the study on alterations which occur in the cultural landscape in relevance to reservoir-related relocation. Uma Oya multipurpose development project is selected as the exemplary study area considering its visible impacts. This analysis will indicate strategies, theories, and methods that can be applied to apprehend the impact of the relocation process on the cultural landscape of reservoirs. The research was carried out by conducting the Uma Oya multipurpose development project case study and by defining its cultural landscape and process of relocation. A suitable theoretical framework is developed in order to assess the set of vulnerable areas of a cultural landscape which are likely to change due to relocation. A questionnaire survey is done in order to assess socio-economic aspects, and a GIS data analysis is conducted to analyze the impact on physical aspects. Findings show that the impacts of the cultural landscape fall under both positive and negative categories. It also shows that the previous condition before resettlement and post stages have significant changes, where the previous condition had more socio-economic benefits for the community. And it also shows a clear alteration pattern of physical environment changes. These specifically developed theories, areas of assessment, and strategies, along with the outcomes, can be used for any location with geographical similarities worldwide.

Keywords: cultural diffusion theory, cultural landscape, physical aspects, relocation, reservoirs, socio-economic aspects

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Authors: Hsiang-Ru Lin

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Cholesterol plays an essential role in the regulation of the progression of numerous important diseases including atherosclerosis and Alzheimer disease so the generation of suitable cholesterol-lowering reagents is urgent to develop. Liver X receptor (LXR) is a ligand-activated transcription factor whose natural ligands are cholesterols, oxysterols and glucose. Once being activated, LXR can transactivate the transcription action of various genes including CYP7A1, ABCA1, and SREBP1c, involved in the lipid metabolism, glucose metabolism and inflammatory pathway. Essentially, the upregulation of ABCA1 facilitates cholesterol efflux from the cells and attenuates the production of beta-amyloid (ABeta) 42 in brain so LXR is a promising target to develop the cholesterol-lowering reagents and preventative treatment of Alzheimer disease. Engelhardia roxburghiana is a deciduous tree growing in India, China, and Taiwan. However, its chemical composition is only reported to exhibit antitubercular and anti-inflammatory effects. In this study, four compounds, engelheptanoxides A, C, engelhardiol A, and B isolated from the root of Engelhardia roxburghiana were evaluated for their agonistic activity against LXR by the transient transfection reporter assays in the HepG2 cells. Furthermore, their interactive modes with LXR ligand binding pocket were generated by molecular modeling programs. By using the cell-based biological assays, engelheptanoxides A, C, engelhardiol A, and B showing no cytotoxic effect against the proliferation of HepG2 cells, exerted obvious LXR agonistic effects with similar activity as T0901317, a novel synthetic LXR agonist. Further modeling studies including docking and SAR (structure-activity relationship) showed that these compounds can locate in LXR ligand binding pocket in the similar manner as T0901317. Thus, LXR is one of nuclear receptors targeted by pharmaceutical industry for developing treatments of Alzheimer and atherosclerosis diseases. Importantly, the cell-based assays, together with molecular modeling studies suggesting a plausible binding mode, demonstrate that engelheptanoxides A, C, engelhardiol A, and B function as LXR agonists. This is the first report to demonstrate that the extract of Engelhardia roxburghiana contains LXR agonists. As such, these active components of Engelhardia roxburghiana or subsequent analogs may show important therapeutic effects through selective modulation of the LXR pathway.

Keywords: Liver X receptor (LXR), Engelhardia roxburghiana, CYP7A1, ABCA1, SREBP1c, HepG2 cells

Procedia PDF Downloads 420

Authors: Taleb Lotfi, Benarbia Maheidine, Allam Hamza, Boutira Fatima, Boukerche Abdelbaki

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Introduction and purpose of the study: This is a retrospective single-center study with an analytical aim to determine the prognostic factors for relapse in patients treated with radiotherapy after total laryngectomy with lymph node dissection for laryngeal cancer at the Emir Abdelkader cancer center in Oran (Algeria). Material and methods: During the study period from January 2014 to December 2018, eighty-nine patients (n=89) with squamous cell carcinoma of the larynx were treated with postoperative radiotherapy. Relapse-free survival was studied in the univariate analysis according to pre-treatment criteria using Kaplan-Meier survival curves. We performed a univariate analysis to identify relapse factors. Statistically significant factors have been studied in the multifactorial analysis according to the Cox model. Results and statistical analysis: The average age was 62.7 years (40-86 years). It was a squamous cell carcinoma in all cases. Postoperatively, the tumor was classified as pT3 and pT4 in 93.3% of patients. Histological lymph node involvement was found in 36 cases (40.4%), with capsule rupture in 39% of cases, while the limits of surgical excision were microscopically infiltrated in 11 patients (12.3%). Chemotherapy concomitant with radiotherapy was used in 67.4% of patients. With a median follow-up of 57 months (23 to 104 months), the probabilities of relapse-free survival and five-year overall survival are 71.2% and 72.4%, respectively. The factors correlated with a high risk of relapse were locally advanced tumor stage pT4 (p=0.001), tumor site in case of subglottic extension (p=0.0003), infiltrated surgical limits R1 (p=0.001), l lymph node involvement (p=0.002), particularly in the event of lymph node capsular rupture (p=0.0003) as well as the time between surgery and adjuvant radiotherapy (p=0.001). However, in the subgroup analysis, the major prognostic factors for disease-free survival were subglottic tumor extension (p=0.001) and time from surgery to adjuvant radiotherapy (p=0.005). Conclusion: Combined surgery and postoperative radiation therapy are effective treatment modalities in the management of laryngeal cancer. Close cooperation of the entire cervicofacial oncology team is essential, expressed during a multidisciplinary consultation meeting, with the need to respect the time between surgery and radiotherapy.

Keywords: laryngeal cancer, laryngectomy, postoperative radiotherapy, survival

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Authors: Bharti Verma, Chandrajit Balomajumder

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Water pollution is escalated owing to industrialization and random ejection of one or more toxic heavy metal ions from the semiconductor industry, electroplating, metallurgical, mining, chemical manufacturing, tannery industries, etc., In semiconductor industry various kinds of chemicals in wafers preparation are used . Fluoride, toxic solvent, heavy metals, dyes and salts, suspended solids and chelating agents may be found in wastewater effluent of semiconductor manufacturing industry. Also in the chrome plating, in the electroplating industry, the effluent contains heavy amounts of Chromium. Since Cr(VI) is highly toxic, its exposure poses an acute risk of health. Also, its chronic exposure can even lead to mutagenesis and carcinogenesis. On the contrary, Cr (III) which is naturally occurring, is much less toxic than Cr(VI). Discharge limit of hexavalent chromium and trivalent chromium are 0.05 mg/L and 5 mg/L, respectively. There are numerous methods such as adsorption, chemical precipitation, membrane filtration, ion exchange, and electrochemical methods for the heavy metal removal. The present study focuses on the removal of Chromium ions by using flat sheet UF5kDa membrane. The Ultra filtration membrane process is operated above micro filtration membrane process. Thus separation achieved may be influenced due to the effect of Sieving and Donnan effect. Ultrafiltration is a promising method for the rejection of heavy metals like chromium, fluoride, cadmium, nickel, arsenic, etc. from effluent water. Benefits behind ultrafiltration process are that the operation is quite simple, the removal efficiency is high as compared to some other methods of removal and it is reliable. Polyamide membranes have been selected for the present study on rejection of Cr(VI) from feed solution. The objective of the current work is to examine the rejection of Cr(VI) from aqueous feed solutions by flat sheet UF5kDa membranes with different parameters such as pressure, feed concentration and pH of the feed. The experiments revealed that with increasing pressure, the removal efficiency of Cr(VI) is increased. Also, the effect of pH of feed solution, the initial dosage of chromium in the feed solution has been studied. The membrane has been characterized by FTIR, SEM and AFM before and after the run. The mass transfer coefficients have been estimated. Membrane transport parameters have been calculated and have been found to be in a good correlation with the applied model.

Keywords: heavy metal removal, membrane process, waste water treatment, ultrafiltration

Procedia PDF Downloads 139

Authors: Namrata Jain, Vishaka Karnad

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Fashion has always fascinated people through ages. Indian women’s wear in particular women's western formal wear has gone through transformational phases during the past decade. Increasing number of working women, independence in deciding financial matters, media exposure and awareness of current trends has provided a different dimension to the apparel segment. With globalization and sharing of cultures, in India formal women’s wear is no longer restricted to ethnic outfits like a sari or salwarkameez. Strong western influence has been observed in the process of designing, production and use of western formal wear by working women as consumers. The present study focuses on the psychographics parameters, consumer buying preferences and their relation to the present market scenario. Qualitative and quantitative data was gathered through a observation, consumer survey and study of brands. A questionnaire was prepared and uploaded as a google form to gather primary data from hundred consumer respondents. The respondent samples were drawn through snowball and purposive sampling technique. Consumers’ buying behavior is influenced by various aspects like age group, occupation, income and their personal preferences. Frequency of use, criteria for brand selection, styles of formal wear and motivating factors for purchase of western formals by working women were the other influential factors under consideration. It was observed that higher consumption and more popularity was indicated by women in the age group of 21-30 years. Amongst western formal wear shirts and trousers were noted to be the most preferred in Mumbai. It may be noted that consumers purchased and used branded western formal wear for reasons of comfort and value for money. Past experience in using the product and price were some of the important criteria for brand loyalty but the need for variety lured consumers to look for other brands. Fit of the garment was rated as the most important motivational factor while selecting products for purchase. With the advancement of women’s economic status, self-reliance, women role and image in the society, impulsive buying has increased with increase in consumerism. There is an ever growing demand for innovations in cuts, styles, designs, colors and fabrics. The growing fashion consciousness at the work place has turned women’s formal wear segment into a lucrative and highly evolving market thus providing space for new entrepreneurs to become a part of this developing sector.

Keywords: buying behavior, consumerism, fashion, western formal wear

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Authors: Oseyemi Omowunmi Olubomehin, Olufemi Michael Denton

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Diabetes mellitus is a disease that is related to the digestion of carbohydrates, proteins and fats and how this affects the blood glucose levels. Various synthetic drugs employed in the management of the disease work through different mechanisms. Keeping postprandial blood glucose levels within acceptable range is a major factor in the management of type 2 diabetes and its complications. Thus, the inhibition of carbohydrate-hydrolyzing enzymes such as α-amylase is an important strategy in lowering postprandial blood glucose levels, but synthetic inhibitors have undesirable side effects like flatulence, diarrhea, gastrointestinal disorders to mention a few. Therefore, it is necessary to identify and explore the α-amylase inhibitors from plants due to their availability, safety, and low costs. In the present study, extracts from the leaves of Rauvolfia vomitoria and seeds of Picralima nitida which are used in the Nigeria traditional system of medicine to treat diabetes were tested for their α-amylase inhibitory effect. The powdered plant samples were subjected to phytochemical screening using standard procedures. The leaves and seeds macerated successively using n-hexane, ethyl acetate and methanol resulted in the crude extracts which at different concentrations (0.1, 0.5 and 1 mg/mL) alongside the standard drug acarbose, were subjected to α-amylase inhibitory assay using the Benfield and Miller methods, with slight modification. Statistical analysis was done using ANOVA, SPSS version 2.0. The phytochemical screening results of the leaves of Rauvolfia vomitoria and the seeds of Picralima nitida showed the presence of alkaloids, tannins, saponins and cardiac glycosides while in addition Rauvolfia vomitoria had phenols and Picralima nitida had terpenoids. The α-amylase assay results revealed that at 1 mg/mL the methanol, hexane, and ethyl acetate extracts of the leaves of Rauvolfia vomitoria gave (15.74, 23.13 and 26.36 %) α-amylase inhibitions respectively, the seeds of Picralima nitida gave (15.50, 30.68, 36.72 %) inhibitions which were not significantly different from the control at p < 0.05, while acarbose gave a significant 56 % inhibition at p < 0.05. The presence of alkaloids, phenols, tannins, steroids, saponins, cardiac glycosides and terpenoids in these plants are responsible for the observed anti-diabetic activity. However, the low percentages of α-amylase inhibition by these plant samples shows that α-amylase inhibition is not the major way by which both plants exhibit their anti-diabetic effect.

Keywords: alpha-amylase, Picralima nitida, postprandial hyperglycemia, Rauvolfia vomitoria

Procedia PDF Downloads 191

Authors: Rezaul K. Sk., Mohammad Ashiq, Avinash K. Srivastava

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The use of radiation shielding technology ranging from EMI to high energy gamma rays in various areas such as devices, medical science, defense, nuclear power plants, medical diagnostics etc. is increasing all over the world. However, exposure to different radiations such as X-ray, gamma ray, neutrons and EMI above the permissible limits is harmful to living beings, the environment and sensitive laboratory equipment. In order to solve this problem, there is a need to develop effective radiation shielding materials. Conventionally, lead and lead-based materials are used in making shielding materials, as lead is cheap, dense and provides very effective shielding to radiation. However, the problem associated with the use of lead is its toxic nature and carcinogenic. So, to overcome these drawbacks, there is a great need for lead-free radiation shielding materials and that should also be economically sustainable. Therefore, it is necessary to look for the synthesis of radiation-shielding glass by using other heavy metal oxides (HMO) instead of lead. The lead-free BaO-doped TeZnCaB glass systems have been synthesized by the traditional melt-quenching method. X-ray diffraction analysis confirmed the glassy nature of the synthesized samples. The densities of the developed glass samples were increased by doping the BaO concentration, ranging from 4.292 to 4.725 g/cm3. The vibrational and bending modes of the BaO-doped glass samples were analyzed by Raman spectroscopy, and FTIR (Fourier-transform infrared spectroscopy) was performed to study the functional group present in the samples. UV-visible characterization revealed the significance of optical parameters such as Urbach’s energy, refractive index and optical energy band gap. The indirect and direct energy band gaps were decreased with the BaO concentration whereas the refractive index was increased. X-ray attenuation measurements were performed to determine the radiation shielding parameters such as linear attenuation coefficient (LAC), mass attenuation coefficient (MAC), half value layer (HVL), tenth value layer (TVL), mean free path (MFP), attenuation factor (Att%) and lead equivalent thickness of the lead-free BaO-doped TeZnCaB glass system. It was observed that the radiation shielding characteristics were enhanced with the addition of BaO content in the TeZnCaB glass samples. The glass samples with higher contents of BaO have the best attenuation performance. So, it could be concluded that the addition of BaO into TeZnCaB glass samples is a significant technique to improve the radiation shielding performance of the glass samples. The best lead equivalent thickness was 2.626 mm, and these glasses could be good materials for medical diagnostics applications.

Keywords: heavy metal oxides, lead-free, melt-quenching method, x-ray attenuation

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Authors: A. Caicedo Padilla, J. Zambrano Nájera

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Cali, the capital of Valle del Cauca and the second city of Colombia, is located in the Cauca River Valley between the Western and Central Cordillera that is South West of the country. The topography of the city is mainly flat, but it is possibly to find mountains in the west. The city has increased urbanization during XX century, especially since 1958 when started a rapid growth due to migration of people from other parts of the region. Much of that population has settled in eastern of Cali, an area originally intended for cane cultivation and a zone of flood from Cauca River and its tributaries. Due to the unplanned migration, settling was inadequate and 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. Sewerage networks capacity were not enough for this higher runoff volume, because in first term they were not adequately designed and built, causing its failure. This in turn generates increasingly recurrent floods generating considerable effects on the economy and development of normal activities in Cali. Thus, it becomes very important to know hydrological behavior of Urban Watersheds. This research aims to determine the impact of urbanization on hydrology of watersheds with very low slopes. The project aims to identify changes in natural drainage patterns caused by the changes made on landscape. From the identification of such modifications it will be defined the most critical areas due to recurring flood events in the city of Cali. Critical areas are defined as areas where the sewerage system does not work properly as surface runoff increases considerable with storm events, and floods are recurrent. The assessment will be done from the analysis of Geographic Information Systems (GIS) theme layers from CVC Environmental Institution of Regional Control in Valle del Cauca, hydrological data and disaster database developed by OSSO Corporation. Rainfall data from a network and historical stream flow data will be used for analysis of historical behavior and change of precipitation and hydrological response according to homogeneous zones characterized by EMCALI S.A. public utility enterprise of Cali in 1999.

Keywords: drainage systems, land cover changes, urban hydrology, urban planning

Procedia PDF Downloads 263

Authors: Amir Gharavi, Mohamed Hassan, Amjad Shah

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The main characteristics of unconventional reservoirs include low-to ultra low permeability and low-to-moderate porosity. As a result, hydrocarbon production from these reservoirs requires different extraction technologies than from conventional resources. An unconventional reservoir must be stimulated to produce hydrocarbons at an acceptable flow rate to recover commercial quantities of hydrocarbons. Permeability for unconventional reservoirs is mostly below 0.1 mD, and reservoirs with permeability above 0.1 mD are generally considered to be conventional. The hydrocarbon held in these formations naturally will not move towards producing wells at economic rates without aid from hydraulic fracturing which is the only technique to assess these tight reservoir productions. Horizontal well with multi-stage fracking is the key technique to maximize stimulated reservoir volume and achieve commercial production. The main objective of this research paper is to investigate development options for a tight mature oilfield. This includes multistage hydraulic fracturing and spacing by building of reservoir models in the Reveal simulator to model potential development options based on sidetracking the existing vertical well. To simulate potential options, reservoir models have been built in the Reveal. An existing Petrel geological model was used to build the static parts of these models. A FBHP limit of 40bars was assumed to take into account pump operating limits and to maintain the reservoir pressure above the bubble point. 300m, 600m and 900m lateral length wells were modelled, in conjunction with 4, 6 and 8 stages of fracs. Simulation results indicate that higher initial recoveries and peak oil rates are obtained with longer well lengths and also with more fracs and spacing. For a 25year forecast, the ultimate recovery ranging from 0.4% to 2.56% for 300m and 1000m laterals respectively. The 900m lateral with 8 fracs 100m spacing gave the highest peak rate of 120m3/day, with the 600m and 300m cases giving initial peak rates of 110m3/day. Similarly, recovery factor for the 900m lateral with 8 fracs and 100m spacing was the highest at 2.65% after 25 years. The corresponding values for the 300m and 600m laterals were 2.37% and 2.42%. Therefore, the study suggests that longer laterals with 8 fracs and 100m spacing provided the optimal recovery, and this design is recommended as the basis for further study.

Keywords: unconventional, resource, hydraulic, fracturing

Procedia PDF Downloads 298

Authors: Morgan Dombroski, Alexis Hartman

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Purpose: The present study aimed to explore factors related to overtraining within a female collegiate sample by analyzing the aftereffects of overtraining on athletes' physical and emotional well-being. Methods: 51 female collegiate athletes participated in a de-identified survey to assess factors related to overtraining. All survey questions were derived from the Recovery-Stress Questionnaire. Descriptive and bivariate correlations were conducted to test for significant factors related to the athletes' physical and emotional well-being relating to sports engagement. Results: Descriptive statistics indicated: 80.4% of athletes reported feeling tired from sport-related work, 72.5% reported parts of their body were aching, 47.1% reported feeling emotionally drained, and 37.3% reported feeling burnt out by sport. These findings were consistent with bivariate correlations, which yielded statistically significant findings between physical fatigue and emotional distress. Discussion: In a general sense, athletes increase their training to maximize their performance. The current study aimed to analyze how this training process can result in overtraining of female collegiate athletes, which in turn may negatively impact their physical and emotional functioning. Overtraining syndrome can occur as a maladaptive response to excessive exercise and inappropriate rest caused by systemic inflammation, which negatively affects the central nervous system. The physical manifestations of overtraining can then lead to depressed mood, fatigue, and neurohormonal changes in athletes. To remain competitive and high performing in sports, athletes partaking in excessive training can result in overtraining syndrome, athlete burnout, and compulsive exercise. Additionally, overtrained athletes were defined by displaying high levels of perfectionism, maladaptive coping, and training distress. The current study supported these findings, which yielded a strong correlation between physical and emotional functioning in the context of overtraining in sports. All in all, the environment revolving around sports and the intensity of training can be extremely stressful for athletes. There is a need to monitor athletes’ subjective responses to training, which will allow for early identification of at-risk athletes giving clinicians various opportunities to reduce the negative consequences of overtraining. By better understanding symptoms of emotional and physical fatigue, collegiate sports can become more aware of overtraining symptoms to prevent further detriment to female athletes' overall well-being.

Keywords: burnout, emotionally drained, overtraining, performance, well-being

Procedia PDF Downloads 61

Authors: Veronique Jubera, Ka-Young Kim, U-Chan Chung, Amelie Veillere, Jean-Marc Heintz

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Emitting materials and all solid state lasers are widely used in the field of optical applications and materials science as a source of excitement, instrumental measurements, medical applications, metal shaping etc. Recently promising optical efficiencies were recorded on ceramics which result from a cheaper and faster ways to obtain crystallized materials. The choice and optimization of the sintering process is the key point to fabricate transparent ceramics. It includes a high control on the preparation of the powder with the choice of an adequate synthesis, a pre-heat-treatment, the reproducibility of the sintering cycle, the polishing and post-annealing of the ceramic. The densification is the main factor needed to reach a satisfying transparency, and many technologies are now available. The symmetry of the unit cell plays a crucial role in the diffusion rate of the material. Therefore, the cubic symmetry compounds having an isotropic refractive index is preferred. The cubic Y3NbO7 matrix is an interesting host which can accept a high concentration of rare earth doping element and it has been demonstrated that SPS is an efficient way to sinter this material. The optimization of diffusion losses requires a microstructure of fine ceramics, generally less than one hundred nanometers. In this case, grain growth is not an obstacle to transparency. The ceramics properties are then isotropic thereby to free-shaping step by orienting the ceramics as this is the case for the compounds of lower symmetry. After optimization of the synthesis route, several SPS parameters as heating rate, holding, dwell time and pressure were adjusted in order to increase the densification of the Eu3+ doped Y3NbO7 pellets. The luminescence data coupled with X-Ray diffraction analysis and electronic diffraction microscopy highlight the existence of several distorted environments of the doping element in the studied defective fluorite-type host lattice. Indeed, the fast and high crystallization rate obtained to put in evidence a lack of miscibility in the phase diagram, being the final composition of the pellet driven by the ratio between niobium and yttrium elements. By following the luminescence properties, we demonstrate a direct impact on the SPS process on this material.

Keywords: emission, niobate of rare earth, Spark plasma sintering, lack of miscibility

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Authors: Hakan Duger, Alparslan Ersoy, Canan Ersoy

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Diabetes mellitus is the most common etiology of end-stage renal disease (ESRD). Also, diabetic nephropathy is the etiology of ESRD in approximately 23% of kidney transplant recipients. A successful kidney transplant improves the quality of life and reduces the mortality risk for most patients. However, patients require close follow-up after transplantation due to medical complications. Diabetes mellitus can affect patient morbidity and mortality due to possible effects of immunosuppressive therapy on glucose metabolism. We compared the frequency of medical complications and the outcomes in diabetic and non-diabetic kidney transplant recipients. Materials and Methods: This retrospective study conducted in 498 patients who underwent kidney transplant surgery at our center in 10-year periods. The patients were divided into two groups: diabetics (46 ± 10 year, 26 males, 16 females) and non-diabetics (39 ± 12 year, 259 males, 197 females). The medical complications, graft functions, causes of graft loss and death were obtained from medical records. Results: There was no significant difference between recipient age, duration of dialysis, body mass index, gender, donor type, donor age, dialysis type, histories of HBV, HCV and coronary artery disease between two groups. The history of hypertension in diabetics was higher (69% vs. 36%, p < 0.001). The ratios of hypertension (50.1% vs. 57.1%), pneumonia (21.9% vs. 20%), urinary infection (16.9% vs. 20%), transaminase elevation (11.5% vs. 20%), hyperpotasemia (14.7% vs. 17.1%), hyponatremia (9.7% vs. 20%), hypotension (7.1% vs. 7.9%), hypocalcemia (1.4% vs. 0%), thrombocytopenia (8.6% vs. 8.6%), hypoglycemia (0.7% vs. 0%) and neutropenia (1.8% vs. 0%) were comparable in non-diabetic and diabetic groups, respectively. The frequency of hyperglycaemia in diabetics was higher (8.6% vs. 54.3%, p < 0.001). After transplantation, primary non-function (3.4% vs. 2.6%), delayed graft function (25.1% vs. 34.2%) and acute rejection (7.3% vs. 10.5%) ratios of in non-diabetic and diabetic groups were similar, respectively. Hospitalization durations in non-diabetics and diabetics were 22.5 ± 17.5 and 18.7 ± 13 day (p=0.094). Mean serum creatinine levels in non-diabetics and diabetics were 1.54 ± 0.74 and 1.52 ± 0.62 mg/dL at 6th month. Forty patients had graft loss. The ratios of graft loss and death in non-diabetic and diabetic groups were 8.2% vs. 7.1% and 7.1% vs. 2.6% (p > 0.05). There was no significant relationship between graft and patient survivals with the development of medical complication. Conclusion: As a result, medical complications are common in the early period. Hyperglycaemia was frequently seen following transplantation due to the effects of immunosuppressant regimens. However, the frequency of other medical complications in diabetic patients did not differ from non-diabetic one. The most important cause of death is still infections. The development of medical complications during the first 6 months did not significantly affect transplant outcomes.

Keywords: kidney transplantation, diabetes mellitus, complication, graft function

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Authors: Alexander Buhr, Klaus Ehrenfried

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Trackside induced airflow velocities, also known as slipstream velocities, are an important criterion for the design of high-speed trains. The maximum permitted values are given by the Technical Specifications for Interoperability (TSI) and have to be checked in the approval process. For train manufactures it is of great interest to know in advance, how new train geometries would perform in TSI tests. The Reynolds number in moving model experiments is lower compared to full-scale. Especially the limited model length leads to a thinner boundary layer at the rear end. The hypothesis is that the boundary layer rolls up to characteristic flow structures in the train wake, in which the maximum flow velocities can be observed. The idea is to enlarge the boundary layer using roughness elements at the train model head so that the ratio between the boundary layer thickness and the car width at the rear end is comparable to a full-scale train. This may lead to similar flow structures in the wake and better prediction accuracy for TSI tests. In this case, the design of the roughness elements is limited by the moving model rig. Small rectangular roughness shapes are used to get a sufficient effect on the boundary layer, while the elements are robust enough to withstand the high accelerating and decelerating forces during the test runs. For this investigation, High-Speed Particle Image Velocimetry (HS-PIV) measurements on an ICE3 train model have been realized in the moving model rig of the DLR in Göttingen, the so called tunnel simulation facility Göttingen (TSG). The flow velocities within the boundary layer are analysed in a plain parallel to the ground. The height of the plane corresponds to a test position in the EN standard (TSI). Three different shapes of roughness elements are tested. The boundary layer thickness and displacement thickness as well as the momentum thickness and the form factor are calculated along the train model. Conditional sampling is used to analyse the size and dynamics of the flow structures at the time of maximum velocity in the train wake behind the train. As expected, larger roughness elements increase the boundary layer thickness and lead to larger flow velocities in the boundary layer and in the wake flow structures. The boundary layer thickness, displacement thickness and momentum thickness are increased by using larger roughness especially when applied in the height close to the measuring plane. The roughness elements also cause high fluctuations in the form factors of the boundary layer. Behind the roughness elements, the form factors rapidly are approaching toward constant values. This indicates that the boundary layer, while growing slowly along the second half of the train model, has reached a state of equilibrium.

Keywords: boundary layer, high-speed PIV, ICE3, moving train model, roughness elements

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Authors: Yun-Hsiang Lee

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Cancer is the main cause of death worldwide. With advances in medical technology, immunotherapy, which is a newly developed advanced treatment, is currently a crucial cancer treatment option. For better quality cancer care, the ability to communicate and critical thinking plays a central role in clinical oncology settings. However, few studies have explored the impact of communication skills on immunotherapy-related issues and their related factors. This study was to (i) explore the current status of communication skill ability for immunotherapy-related issues, self-efficacy for immunotherapy-related care, and critical thinking ability; and (ii) identify factors related to communication skill ability. This is a cross-sectional study. Oncology nurses were recruited from the Taiwan Oncology Nursing Society, in which nurses came from different hospitals distributed across four major geographic regions (North, Center, South, East) of Taiwan. A total of 123 oncology nurses participated in this study. A set of questionnaires were used for collecting data. Communication skill ability for immunotherapy issues, self-efficacy for immunotherapy-related care, critical thinking ability, and background information were assessed in this survey. Independent T-test and one-way ANOVA were used to examine different levels of communication skill ability based on nurses having done oncology courses (yes vs. no) and education years (< 1 year, 1-3 years, and > 3 years), respectively. Spearman correlation was conducted to understand the relationships between communication skill ability and other variables. Among the 123 oncology nurses in the current study, the majority of them were female (98.4%), and most of them were employed at a hospital in the North (46.8%) of Taiwan. Most of them possessed a university degree (78.9%) and had at least 3 years of prior work experience (71.7%). Forty-three of the oncology nurses indicated in the survey that they had not received oncology nurses-related training. Those oncology nurses reported moderate to high levels of communication skill ability for immunotherapy issues (mean=4.24, SD=0.7, range 1-5). Nurses reported moderate levels of self-efficacy for immunotherapy-related care (mean=5.20, SD=1.98, range 0-10) and also had high levels of critical thinking ability (mean=4.76, SD=0.60, range 1-6). Oncology nurses who had received oncology training courses had significantly better communication skill ability than those who had not received oncology training. Oncology nurses who had higher work experience (1-3 years, or > 3 years) had significantly higher levels of communication skill ability for immunotherapy-related issues than those with lower work experience (<1 year). When those nurses reported better communication skill ability, they also had significantly better self-efficacy (r=.42, p<.01) and better critical thinking ability (r=.47, p<.01). Taken altogether, courses designed to improve communication skill ability for immunotherapy-related issues can make a significant impact in clinical settings. Communication skill ability for oncology nurses is the major factor associated with self-efficacy and critical thinking, especially for those with lower work experience (< 1 year).

Keywords: communication skills, critical thinking, immunotherapy, oncology nurses, self-efficacy

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Authors: Christakis Chatzichristou, Elias Kranos

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Architectural awards, especially if they are given by the state, recognize excellence in the field and, at the same time, strongly contribute to the making of the architectural culture of a place. The present research looks at the houses that have been awarded through such a system in Cyprus in order to discuss the values promoted, directly or not, by such a setup which is quite similar to other prestigious award systems such as the Mies van de Rohe Prize in Europe. In fact, many of the projects signed out through the state award system end up being selected to represent the country for the European awards. The residential architecture encouraged by such systems is quite interesting in that the most public of institutions influence how the most private unit of society is architecturally accommodated. The methodology uses both qualitative as well as quantitative research tools in order to analyze: the official state call for entries to the competition; the final report of the evaluation committee; the spatial characteristics of the houses through the Space Syntax methodology; the statements of the architects regarding their intentions and the final outcome; the feelings of the owners and users of the houses regarding the design process as well as the degree of satisfaction regarding the final product. The above-mentioned analyses allow for a more thorough discussion regarding not only the values promoted explicitly by the system through the brief that describes what the evaluation committee is looking for but also the values that are actually being promoted indirectly through the results of the actual evaluation itself. The findings suggest that: the strong emphasis in brief on bioclimatic design and issues of sustainability weakens significantly, if at all present, in the actual selection process; continuous improvement seems to be fuzzily used as a concept; most of the houses tend to have a similar spatial genotype; most of the houses have similar aesthetic qualities; discrepancies between the proposed lifestyle through the design and the actual use of the spaces do not seem to be acknowledged in the evaluation as an issue; the temporal factor seems to be ignored as the projects are required to be ‘finished projects’ as though the users and their needs do not change through time. The research suggests that, rather than preserving a critical attitude regarding the role of the architect in society, the state award system tends, like any other non-reflective social organism, to simply promote its own unexamined values as well as prejudices. This is perhaps more evident in the shared aesthetic character of the awarded houses and less so in the hidden spatial genotype to which they belong. If the design of houses is indeed a great opportunity for architecture to contribute in a more deliberate manner to the evolution of society, then what the present study shows is that this opportunity seems to be largely missed. The findings may serve better less as a verdict and more as a chance for introspection and discussion.

Keywords: award systems, houses, spatial genotype, aesthetic qualities

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Authors: Karthik Chamari, Vasudha Rudraraju, Gaurav Chaudhari

Abstract:

Background: Mantle cell lymphoma (MCL) is one of the mature B cell non-Hodgkin lymphomas (NHL). The course of MCL is moderately aggressive and variable, and it has median overall survival of 8 to 10 years. Ibrutinib, a Bruton’s tyrosine kinase inhibitor, was approved by the United States (US) Food and Drug Administration in November of 2013 for the treatment of MCL patients who have received at least one prior therapy. In this study, we aimed to evaluate whether there has been a change in survival and patterns of second primary malignancies (SPMs) among the MCL population in the US after ibrutinib approval. Methods: Using the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER)-18, we conducted a retrospective study with patients diagnosed with MCL (ICD-0-3 code 9673/3) between 2007 and 2018. We divided patients into two six-year cohorts, pre-ibrutinib approval (2007-2012) and post-ibrutinib approval (2013-2018), and compared relative survival rates (RSRs) and standardized incidence ratios (SIRs) of SPMs between cohorts. Results: We included 9,257 patients diagnosed with MCL between 2007 and 2018 in the SEER-18 survival and SIR registries. Of these, 4,205 (45%) patients were included in the pre-ibrutinib cohort, and 5052 (55%) patients were included in the post-ibrutinib cohort. The median follow-up duration for the pre-ibrutinib cohort was 54 months (range 0 to 143 months), and the post-ibrutinib cohort was 20 months (range 0 to 71 months). There was a significant difference in the five-year RSRs between pre-ibrutinib and post-ibrutinib cohorts (57.5% vs. 62.6%, p < 0.005). Out of the 9,257 patients diagnosed with MCL, 920 developed SPMs. A higher proportion of SPMs occurred in the post-ibrutinib cohort (63%) when compared with the pre-ibrutinib cohort (37%). Non-hematological malignancies comprised most of all SPMs. A higher incidence of non-hematological malignancies occurred in the post-ibrutinib cohort (SIR 1.42, 95% CI 1.29 to 1.56) when compared with the pre-ibrutinib cohort (SIR 1.14, 95% CI 1 to 1.3). There was a statistically significant increase in the incidence of cancers of the respiratory tract (SIR 1.77, 95% CI 1.43 to 2.18), urinary tract (SIR 1.61, 95% CI 1.23 to 2.06) when compared with other non-hematological malignancies in post-ibrutinib cohort. Conclusions: Our study results suggest the relative survival rates have increased since the approval of ibrutinib for mantle cell lymphoma patients. Additionally, for some unclear reasons, the incidence of SPM’s (non-hematological malignancies), mainly cancers of the respiratory tract, urinary tract, have increased in the six years following the approval of ibrutinib. Further studies should be conducted to determine the cause of these findings.

Keywords: mantle cell lymphoma, Ibrutinib, relative survival analysis, secondary primary cancers

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