Search results for: alternative therapy
4488 Treatment of Non-Small Cell Lung Cancer (NSCLC) With Activating Mutations Considering ctDNA Fluctuations
Authors: Moiseenko F. V., Volkov N. M., Zhabina A. S., Stepanova E. O., Kirillov A. V., Myslik A. V., Artemieva E. V., Agranov I. R., Oganesyan A. P., Egorenkov V. V., Abduloeva N. H., Aleksakhina S. Yu., Ivantsov A. O., Kuligina E. S., Imyanitov E. N., Moiseyenko V. M.
Abstract:
Analysis of ctDNA in patients with NSCLC is an emerging biomarker. Multiple research efforts of quantitative or at least qualitative analysis before and during the first periods of treatment with TKI showed the prognostic value of ctDNA clearance. Still, these important results are not incorporated in clinical standards. We evaluated the role of ctDNA in EGFR-mutated NSCLC receiving first-line TKI. Firstly, we analyzed sequential plasma samples from 30 patients that were collected before intake of the first tablet (at baseline) and at 6, 12, 24, 36, and 48 hours after the “starting point.” EGFR-M+ allele was measured by ddPCR. Afterward, we included sequential qualitative analysis of ctDNA with cobas® EGFR Mutation Test v2 from 99 NSCLC patients before the first dose, after 2 and 4 months of treatment, and on progression. Early response analysis showed the decline of EGFR-M+ level in plasma within the first 48 hours of treatment in 11 subjects. All these patients showed objective tumor response. 10 patients showed either elevation of EGFR-M+ plasma concentration (n = 5) or stable content of circulating EGFR-M+ after the start of the therapy (n = 5); only 3 of these patients achieved an objective response (p = 0.026) when compared to the former group). The rapid decline of plasma EGFR-M+ DNA concentration also predicted for longer PFS (13.7 vs. 11.4 months, p = 0.030). Long-term ctDNA monitoring showed clinically significant heterogeneity of EGFR-mutated NSCLC treated with 1st line TKIs in terms of progression-free and overall survival. Patients without detectable ctDNA at baseline (N = 32) possess the best prognosis on the duration of treatment (PFS: 24.07 [16.8-31.3] and OS: 56.2 [21.8-90.7] months). Those who achieve clearance after two months of TKI (N = 42) have indistinguishably good PFS (19.0 [13.7 – 24.2]). Individuals who retain ctDNA after 2 months (N = 25) have the worst prognosis (PFS: 10.3 [7.0 – 13.5], p = 0.000). 9/25 patients did not develop ctDNA clearance at 4 months with no statistical difference in PFS from those without clearance at 2 months. Prognostic heterogeneity of EGFR-mutated NSCLC should be taken into consideration in planning further clinical trials and optimizing the outcomes of patients.Keywords: NSCLC, EGFR, targeted therapy, ctDNA, prognosis
Procedia PDF Downloads 554487 Community Based Heritage Tourism in the Old City of Nazareth
Authors: Alon Gelbman, Daniel Laven
Abstract:
The paper focuses on a case study of a small-scale heritage tourism venture that seeks to influence tourism development in Nazareth’s old city. This is an exploratory case study that uses qualitative research methods including extensive participant observation and in-depth interviews with the venture’s senior management group and selected employees. Study findings indicate a model of the relationship between community-based tourism development, heritage, and peace-building in a city that has experienced a wide range of cross-cultural conflicts. This model represents an alternative view to the notion that heritage serves to enhance differences and dissonance between different cultural groups. In contrast, findings from this study suggest that heritage in the form of tourism; can help create shared interests between different communities in settings characterized by cross-cultural conflict. This model represents an alternative view to the notion that heritage serves to enhance differences and dissonance between different cultural groups. In contrast, findings from this study suggest that heritage in the form of tourism; can help create shared interests between different communities in settings characterized by cross-cultural conflict.Keywords: cultural heritage tourism, tourism and peace, community-based tourism, sustainable tourism, cross-cultural conflict, Nazareth historic city
Procedia PDF Downloads 4324486 Increasing the Efficiency of the Biomass Gasification Technology with Using the Organic Rankin Cycle
Authors: Jaroslav Frantík, Jan Najser
Abstract:
This article deals with increasing the energy efficiency of a plant in terms of optimizing the process. The European Union is striving to achieve the climate-energy package in the area increasing of energy efficiency. The goal of energy efficiency is to reduce primary energy consumption by 20% within the EU until 2020. The objective of saving energy consumption in the Czech Republic was set at 47.84 PJ (13.29 TWh). For reducing electricity consumption, it is possible to choose: a) mandatory increasing of energy efficiency, b) alternative scheme, c) combination of both actions. The Czech Republic has chosen for reducing electricity consumption using-alternative scheme. The presentation is focused on the proposal of a technological unit dealing with the gasification process of processing of biomass with an increase of power in the output. The synthesis gas after gasification of biomass is used as fuel in a cogeneration process of reciprocating internal combustion engine with the classic production of heat and electricity. Subsequently, there is an explanation of the ORC system dealing with the conversion of waste heat to electricity with the using closed cycle of the steam process with organic medium. The arising electricity is distributed to the power grid as a further energy source, or it is used for needs of the partial coverage of the technological unit. Furthermore, there is a presented schematic description of the technology with the identification of energy flows starting from the biomass treatment by drying, through its conversion to gaseous fuel, producing of electricity and utilize of thermal energy with minimizing losses. It has been found that using of ORC system increased the efficiency of the produced electricity by 7.5%.Keywords: biomass, efficiency, gasification, ORC system
Procedia PDF Downloads 2204485 Total Plaque Area in Chronic Renal Failure
Authors: Hernán A. Perez, Luis J. Armando, Néstor H. García
Abstract:
Background and aims Cardiovascular disease rates are very high in patients with renal failure (CRF), but the underlying mechanisms are incompletely understood. Traditional cardiovascular risk factors do not explain the increased risk, and observational studies have observed paradoxical or absent associations between classical risk factors and mortality in dialysis patients. A large randomized controlled trial, the 4D Study, the AURORA and the ALERT study found that statin therapy in CRF do not reduce cardiovascular events. These results may be the results of ‘accelerated atherosclerosis’ observed on these patients. The objective of this study was to investigate if carotid total plaque area (TPA), a measure of carotid plaque burden growth is increased at progressively lower creatinine clearance in patients with CRF. We studied a cohort of patients with CRF not on dialysis, reasoning that risk factor associations might be more easily discerned before end stage renal disease. Methods: The Blossom DMO Argentina ethics committee approved the study and informed consent from each participant was obtained. We performed a cohort study in 412 patients with Stage 1, 2 and 3 CRF. Clinical and laboratory data were obtained. TPA was determined using bilateral carotid ultrasonography. Modification of Diet in Renal Disease estimation formula was used to determine renal function. ANOVA was used when appropriate. Results: Stage 1 CRF group (n= 16, 43±2yo) had a blood pressure of 123±2/78±2 mmHg, BMI 30±1, LDL col 145±10 mg/dl, HbA1c 5.8±0.4% and had the lowest TPA 25.8±6.9 mm2. Stage 2 CRF (n=231, 50±1 yo) had a blood pressure of 132±1/81±1 mmHg, LDL col 125±2 mg/dl, HbA1c 6±0.1% and TPA 48±10mm2 ( p< 0.05 vs CRF stage 1) while Stage 3 CRF (n=165, 59±1 yo) had a blood pressure of 134±1/81±1, LDL col 125±3 mg/dl, HbA1c 6±0.1% and TPA 71±6mm2 (p < 0.05 vs CRF stage 1 and 2). Conclusion: Our data indicate that TPA increases along the renal function deterioration, and it is not related with the LDL cholesterol and triglycerides levels. We suggest that mechanisms other than the classics are responsible for the observed excess of cardiovascular disease in CKD patients and finally, determination of total plaque area should be used to measure effects of antiatherosclerotic therapy.Keywords: hypertension, chronic renal failure, atherosclerosis, cholesterol
Procedia PDF Downloads 2724484 An Analysis of the Movie “Sunset Boulevard” through the Transactional Analysis Paradigm
Authors: Borislava Dimitrova, Didem Kepir Savoly
Abstract:
The movie analysis offers a dynamic and multifaceted lens in order to explore and understand various aspects of human behavior and relationship, emotion, and cognition. Cinema therapy can be an important tool for counselor education and counselors in therapy. Therefore, this paper aims to delve deeper into human relationships and individual behavior patterns and analyze some of their most vivid aspects in light of the transactional analysis and its main components. While describing certain human behaviors and emotional states in real life, sometimes it can be difficult even for mental health practitioners to become aware of the subtle social cues and hints that are being transmitted, often in a rushed and swift manner. To address this challenge, the current paper focuses on the relationship dynamics as conveyed through the plot of the movie “Sunset Boulevard”, and examines slightly exaggerated yet true-to-life examples. The movie was directed by Billy Wilder and written by Charles Brackett, Billy Wilder, and D.M. Marshman Jr. The scenes of interest were examined through Transactional Analysis concepts: the different ego states, strokes, the various kinds of transactions, the paradigm of games in transactional analysis, and lastly, with the help of the drama triangle. The addressed themes comprised mainly the way the main characters engaged in game playing, which eventually had a negative outcome on the sequences of interactions between the individuals and the desired payoffs that they craved as a result. Furthermore, counselor educators can use the result of this paper for educational purposes, such as for teaching theoretical knowledge about Transactional Analysis, and for utilizing characters’ interactions and behaviors as real-life situations that can serve as case studies and role-playing activities. Finally, the paper aims to foster the use of movies as materials for psychological analysis which can assist the teaching of new mental health professionals in the field.Keywords: transactional analysis, movie analysis, drama triangle, games, ego-state
Procedia PDF Downloads 1054483 Outcome of Unilateral Retinoblastoma: A Ten Years Experience of Children's Cancer, Hospital Egypt
Authors: Ahmed Elhussein, Hossam El-Zomor, Adel Alieldin, Mahmoud A. Afifi, Abdullah Elhusseiny, Hala Taha, Amal Refaat, Soha Ahmed, Mohamed S. Zagloul
Abstract:
Background: A majority of children with retinoblastoma (60%) have a disease in one eye only (unilateral disease). This is a retrospective study to evaluate two different treatment modalities in those patients for saving their lives and vision. Methods: Four hundred and four patients were diagnosed with unilateral intraocular retinoblastoma at Children’s Cancer, Hospital Egypt (CCHE) through the period of July/2007 until December/2017. Management strategies included primary enucleation versus ocular salvage treatment. Results: Patients presented with mean age 24.5 months with range (1.2-154.3 months). According to the international retinoblastoma classification, Group D (n=172, 42%) was the most common, followed by group E (n=142, 35%), group C (n=63, 16%), and group B (n=27, 7%). All patients were alive at the end of the study except four patients who died, with 5-years overall survival 98.3% [CI, (96.5-100%)]. Patients presented with advanced disease and poor visual prognosis (n=241, 59.6%) underwent primary enucleation with 6 cycles adjuvant chemotherapy if they had high-risk features in the enucleated eye; only four patients out of 241 ended-up either with extraocular metastasis (n=3) or death (n=1). While systemic chemotherapy and focal therapy were the primary treatment for those who presented with favorable disease status and good visual prognosis (n=163, 40.4%); seventy-seven patients of them (47%) ended up with a pre-defined event (enucleation, EBRT, off protocol chemotherapy or 2ry malignancy). Ocular survival for patients received primary chemotherapy + focal therapy was [50.9% (CI, 43.5-59.6%)] at 3 years and [46.9% (CI,39.3-56%)] at 5 years. Comparison between upfront enucleation and primary chemotherapy for occurrence of extraocular metastasis revealed that there was no statistical difference between them except in group D (p value). While for occurrence of death, no statistical difference in all classification groups. Conclusion: In retinoblastoma, primary chemotherapy is a reasonable option and has a good probability for ocular salvage without increasing the risk of metastasis in comparison to upfront enucleation except in group D.Keywords: CCHE, chemotherapy, enucleation, retinoblastoma
Procedia PDF Downloads 1554482 A Review of the Agroecological Farming System as a Viable Alternative Food Production Approach in South Africa
Authors: Michael Rudolph, Evans Muchesa, Katiya Yassim, Venkatesha Prasad
Abstract:
Input-intensive production systems characterise industrial agriculture as an unsustainable means to address food and nutrition security and sustainable livelihoods. There is extensive empirical evidence that supports the diversification and reorientation of industrial agriculture and that incorporates ecological practices viewed as essential for achieving balanced and productive farming systems. An agroecological farming system is a viable alternative approach that can improve food production, especially for the most vulnerable communities and households. Furthermore, substantial proof and supporting evidence show that such a system holds the key to increasing dietary diversity at the local level and reducing the multiple health and environmental risks stemming from industrial agriculture. This paper, therefore, aims to demonstrate the benefits of the agroecology food system through an evidenced-based approach that shows how the broader agricultural network structures can play a meaningful role, particularly for impoverished households in today’s reality. The methodology is centered on a structured literature review that analyses urban agriculture, agroecology, and food insecurity. Notably, ground-truthing, practical experiences, and field observation of agroecological farming were deployed. This paper places particular emphasis on the practical application of the agroecological approach in urban and peri-urban settings. Several evaluation reports on local and provincial initiatives clearly show that very few households engage in food gardens and urban agriculture. These households do not make use of their backyards or nearby open spaces for a number of reasons, such as stringent city by-laws, restricted access to land, little or no knowledge of innovative or alternative farming practices, and a general lack of interest. Furthermore, limited resources such as water and energy and lack of capacity building and training implementation are additional constraints that are hampering small scale food gardens and farms in other settings. The Agroecology systems approach is viewed as one of the key solutions to tackling these problems.Keywords: agroecology, water-energy-food nexus, sutainable development goals, social, environmental and economc impact
Procedia PDF Downloads 1144481 Production of Biotechnological Chondroitin from Recombinant E, Coli K4 Strains on Renewable Substrates
Authors: Donatella Cimini, Sergio D’ambrosio, Saba Sadiq, Chiara Schiraldi
Abstract:
Chondroitin sulfate (CS), as well as modified CS, and unsulfated chondroitin, are largely applied in research today. CS is a linear glycosaminoglycan normally present in cartilage-rich tissues and bones in the form of proteoglycans decorated with sulfate groups in different positions. CS is used as an effective non-pharmacological alternative for the treatment of osteoarthritis, and other potential applications in the biomedical field are being investigated. Some bacteria, such as E. coli K4, produce a polysaccharide that is a precursor of CS (unsulfated chondroitin). This work focused on the construction of integrative E. coli K4 recombinant strains overexpressing genes (kfoA, kfoF, pgm and galU in different combinations) involved in the biosynthesis of the nucleotide sugars necessary for polysaccharide synthesis. Strain growth and polymer production were evaluated using renewable waste materials as substrates in shake flasks and small-scale batch fermentation processes. Results demonstrated the potential to replace pure sugars with cheaper medium components to establish environmentally sustainable and cost-effective production routes for potential industrial development. In fact, although excellent fermentation results have been described so far by employing strains that naturally produce chondroitin-like polysaccharides on semi-defined media, there is still the need to reduce manufacturing costs by providing a cost-effective biotechnological alternative to currently used animal-based extraction procedures.Keywords: E. coli K4, chondroitin, microbial cell factories, glycosaminoglycans, renewable resources
Procedia PDF Downloads 814480 Mental Wellbeing Using Music Intervention: A Case Study of Therapeutic Role of Music, From Both Psychological and Neurocognitive Perspectives
Authors: Medha Basu, Kumardeb Banerjee, Dipak Ghosh
Abstract:
After the massive blow of the COVID-19 pandemic, several health hazards have been reported all over the world. Serious cases of Major Depressive Disorder (MDD) are seen to be common in about 15% of the global population, making depression one of the leading mental health diseases, as reported by the World Health Organization. Various psychological and pharmacological treatment techniques are regularly being reported. Music, a globally accepted mode of entertainment, is often used as a therapeutic measure to treat various health conditions. We have tried to understand how Indian Classical Music can affect the overall well-being of the human brain. A case study has been reported here, where a Flute-rendition has been chosen from a detailed audience response survey, and the effects of that clip on human brain conditions have been studied from both psychological and neural perspectives. Taking help from internationally-accepted depression-rating scales, two questionnaires have been designed to understand both the prolonged and immediate effect of music on various emotional states of human lives. Thereafter, from EEG experiments on 5 participants using the same clip, the parameter ‘ALAY’, alpha frontal asymmetry (alpha power difference of right and left frontal hemispheres), has been calculated. Works of Richard Davidson show that an increase in the ‘ALAY’ value indicates a decrease in depressive symptoms. Using the non-linear technique of MFDFA on EEG analysis, we have also calculated frontal asymmetry using the complexity values of alpha-waves in both hemispheres. The results show a positive correlation between both the psychological survey and the EEG findings, revealing the prominent role of music on the human brain, leading to a decrease in mental unrest and an increase in overall well-being. In this study, we plan to propose the scientific foundation of music therapy, especially from a neurocognition perspective, with appropriate neural bio-markers to understand the positive and remedial effects of music on the human brain.Keywords: music therapy, EEG, psychological survey, frontal alpha asymmetry, wellbeing
Procedia PDF Downloads 434479 An Analysis of the Regression Hypothesis from a Shona Broca’s Aphasci Perspective
Authors: Esther Mafunda, Simbarashe Muparangi
Abstract:
The present paper tests the applicability of the Regression Hypothesis on the pathological language dissolution of a Shona male adult with Broca’s aphasia. It particularly assesses the prediction of the Regression Hypothesis, which states that the process according to which language is forgotten will be the reversal of the process according to which it will be acquired. The main aim of the paper is to find out whether mirror symmetries between L1 acquisition and L1 dissolution of tense in Shona and, if so, what might cause these regression patterns. The paper also sought to highlight the practical contributions that Linguistic theory can make to solving language-related problems. Data was collected from a 46-year-old male adult with Broca’s aphasia who was receiving speech therapy at St Giles Rehabilitation Centre in Harare, Zimbabwe. The primary data elicitation method was experimental, using the probe technique. The TART (Test for Assessing Reference Time) Shona version in the form of sequencing pictures was used to access tense by Broca’s aphasic and 3.5-year-old child. Using the SPSS (Statistical Package for Social Studies) and Excel analysis, it was established that the use of the future tense was impaired in Shona Broca’s aphasic whilst the present and past tense was intact. However, though the past tense was intact in the male adult with Broca’s aphasic, a reference to the remote past was made. The use of the future tense was also found to be difficult for the 3,5-year-old speaking child. No difficulties were encountered in using the present and past tenses. This means that mirror symmetries were found between L1 acquisition and L1 dissolution of tense in Shona. On the basis of the results of this research, it can be concluded that the use of tense in a Shona adult with Broca’s aphasia supports the Regression Hypothesis. The findings of this study are important in terms of speech therapy in the context of Zimbabwe. The study also contributes to Bantu linguistics in general and to Shona linguistics in particular. Further studies could also be done focusing on the rest of the Bantu language varieties in terms of aphasia.Keywords: Broca’s Aphasia, regression hypothesis, Shona, language dissolution
Procedia PDF Downloads 974478 Approaches to Inducing Obsessional Stress in Obsessive-Compulsive Disorder (OCD): An Empirical Study with Patients Undergoing Transcranial Magnetic Stimulation (TMS) Therapy
Authors: Lucia Liu, Matthew Koziol
Abstract:
Obsessive-compulsive disorder (OCD), a long-lasting anxiety disorder involving recurrent, intrusive thoughts, affects over 2 million adults in the United States. Transcranial magnetic stimulation (TMS) stands out as a noninvasive, cutting-edge therapy that has been shown to reduce symptoms in patients with treatment-resistant OCD. The Food and Drug Administration (FDA) approved protocol pairs TMS sessions with individualized symptom provocation, aiming to improve the susceptibility of brain circuits to stimulation. However, limited standardization or guidance exists on how to conduct symptom provocation and which methods are most effective. This study aims to compare the effect of internal versus external techniques to induce obsessional stress in a clinical setting during TMS therapy. Two symptom provocation methods, (i) Asking patients thought-provoking questions about their obsessions (internal) and (ii) Requesting patients to perform obsession-related tasks (external), were employed in a crossover design with repeated measurement. Thirty-six treatments of NeuroStar TMS were administered to each of two patients over 8 weeks in an outpatient clinic. Patient One received 18 sessions of internal provocation followed by 18 sessions of external provocation, while Patient Two received 18 sessions of external provocation followed by 18 sessions of internal provocation. The primary outcome was the level of self-reported obsessional stress on a visual analog scale from 1 to 10. The secondary outcome was self-reported OCD severity, collected biweekly in a four-level Likert-scale (1 to 4) of bad, fair, good and excellent. Outcomes were compared and tested between provocation arms through repeated measures ANOVA, accounting for intra-patient correlations. Ages were 42 for Patient One (male, White) and 57 for Patient Two (male, White). Both patients had similar moderate symptoms at baseline, as determined through the Yale-Brown Obsessive Compulsive Scale (YBOCS). When comparing obsessional stress induced across the two arms of internal and external provocation methods, the mean (SD) was 6.03 (1.18) for internal and 4.01 (1.28) for external strategies (P=0.0019); ranges were 3 to 8 for internal and 2 to 8 for external strategies. Internal provocation yielded 5 (31.25%) bad, 6 (33.33%) fair, 3 (18.75%) good, and 2 (12.5%) excellent responses for OCD status, while external provocation yielded 5 (31.25%) bad, 9 (56.25%) fair, 1 (6.25%) good, and 1 (6.25%) excellent responses (P=0.58). Internal symptom provocation tactics had a significantly stronger impact on inducing obsessional stress and led to better OCD status (non-significant). This could be attributed to the fact that answering questions may prompt patients to reflect more on their lived experiences and struggles with OCD. In the future, clinical trials with larger sample sizes are warranted to validate this finding. Results support the increased integration of internal methods into structured provocation protocols, potentially reducing the time required for provocation and achieving greater treatment response to TMS.Keywords: obsessive-compulsive disorder, transcranial magnetic stimulation, mental health, symptom provocation
Procedia PDF Downloads 574477 Hydrodynamic and Sediment Transport Analysis of Computational Fluid Dynamics Designed Flow Regulating Liner (Smart Ditch)
Authors: Saman Mostafazadeh-Fard, Zohrab Samani, Kenneth Suazo
Abstract:
Agricultural ditch liners are used to prevent soil erosion and reduce seepage losses. This paper introduced an approach to validate a computational fluid dynamics (CFD) platform FLOW-3D code and its use to design a flow-regulating corrugated agricultural ditch liner system (Smart Ditch (SM)). Hydrodynamic and sediment transport analyses were performed on the proposed liner flow using the CFD platform FLOW-3D code. The code's hydrodynamic and scour and sediment transport models were calibrated and validated using lab data with an accuracy of 94 % and 95%, respectively. The code was then used to measure hydrodynamic parameters of sublayer turbulent intensity, kinetic energy, dissipation, and packed sediment mass normalized with respect to sublayer flow velocity. Sublayer turbulent intensity, kinetic energy, and dissipation in the SM flow were significantly higher than CR flow. An alternative corrugated liner was also designed, and sediment transport was measured and compared to SM and CR flows. Normalized packed sediment mass with respect to average sublayer flow velocity was 27.8 % lower in alternative flow compared to SM flow. CFD platform FLOW-3D code could effectively be used to design corrugated ditch liner systems and perform hydrodynamic and sediment transport analysis under various corrugation designs.Keywords: CFD, hydrodynamic, sediment transport, ditch, liner design
Procedia PDF Downloads 1234476 Real World Cancer Pain Incidence and Treatment in Daily Hospital
Authors: Alexandru Grigorescu, Alexandra Protesanu
Abstract:
Background: Approximately 34-67 percent of cancer patients experience an episode of uncontrolled pain during the course of their disease, depending on the stage. The aim is to provide evidence-based data for pain prevalence, diagnosis and treatment recommendations on an integrative model of medical oncology and palliative care for patients with cancer diagnostic in a day hospital. Patients and method: Consultation registers and electronic records of 166 Patients (Pts) were studied from April 2022 to March 2023. Pts with pain syndrome were selected. The pain was objectified by the visual pain scale. To elucidate the causes of the pain, investigations were carried out: bone scintigraphy, CT scan, and PET-CT. The analgesic treatments were represented by weak and strong morphine, radiotherapy, and bisphosphonates. Result: During the mentioned period, 166 oncological patients (74 women and 92 men) were treated in the oncology day hospitalization service. There were 1,500 consultations, 40 of which were only for pain. The neoplastic locations were: gynecological, malignant melanoma, breast, gastric, bronchopulmonary, colorectal, liver, pancreatic, bladder, and kidney. 70 Pts presented pain syndrome. The causes of the pain were represented by bone metastases, compressive tumors, and post-surgical status. Drug treatment: Tramadol 47 Pts, of which 10 switched to a major opioid (Oxycodonum, Morphine sulfate), 20 Pts were treated with Oxycodonum as the first intention. In 5 patients ry to rotated morphine, 20 Pts received palliative radiotherapy, 10 Pts were treated with bisphosphonates. 2 Pts required neurosurgery consultation for an antalgic intervention. 5 Pts had important adverse reactions to morphine. All patients and their families were advised by a medical oncologist and psychologist for a lifestyle change. Conclusions: The prevalence of pain was similar to that described in the literature. In most cases, the pain could be managed in the day hospital. Weak and strong morphine represented the main pain therapy. Palliative radiotherapy was the second most effective therapy. Treatment with bisphosphonates was useful. Surgical interventions were rarely indicated. Discussions with patients and their families regarding the lifestyle change were important.Keywords: cancer pain, opioids, medical oncology, palliative care
Procedia PDF Downloads 664475 Epidemiological Correlates of Adherence to Anti-Hypertensive Treatment in Primary Health Care Setting of Ludhiana, Punjab
Authors: Sangeeta Girdhar, Amanat Grewal, Nahush Bansal
Abstract:
Introduction: There is an increasing burden of hypertension in India. The morbidity and mortality arising from complications are mainly due to non-adherence to medication, unhealthy dietary habits, and lack of physical activity. Non-adherence is a well-recognised factor contributing to inadequate control of high blood pressure. Adherence to pharmacotherapy for hypertension varies from 43% to 88%. Non-adherence is influenced by various socio-demographic factors. Understanding these factors is useful in managing non-adherence. Therefore, the study was planned to determine adherence among hypertensives and factors associated with non-adherence to treatment. Methodology: A cross-sectional study was conducted at Urban Health Training Centre of Dayanand Medical College and Hospital Ludhiana. Patients attending the OPD over a period of 3 months were included in the study. Prior ethical approval was obtained, and informed consent was taken from subjects. A predesigned semi-structured questionnaire was applied, which included socio-demographic profile, treatment-seeking behaviour, adherence to the antihypertensive medication, lifestyle factors (intake of alcohol, smoking, consumption of junk food, high salt intake) contributing to the development of the disease. Reasons for non-adherence to the therapy were also explored. Data was entered into excel, and SPSS 26 version was used for analysis. Results: A total of 186 individuals were interviewed. Out of these, 113 females (60.8%) and 73 males (39.2%) participated in the study. Mean age of participants was 60.9 ± 10.7 years. Adherence to anti-hypertensive treatment was found in 68.3% of the participants. It was observed that adherence was more in literate individuals as compared to illiterate (p value- 0.78). Adherence was lower among smokers (33.3%) and alcohol consumers (53.8%) as compared to non-users (69.4% and 70.6%, respectively). The predominant reasons for skipping medications were discontinuing medication when feeling well, forgetfulness and unawareness. Conclusion: There is a need to generate awareness regarding the importance of adherence to therapy among patients. Intensive health education and counselling of the patients is the need of the hour.Keywords: hypertension, anti-hypertensive, adherence, counselling
Procedia PDF Downloads 914474 Feasibility on Introducing an Alternative Solar Powered Propelling Mechanism for Multiday Fishing Boats in Sri Lanka
Authors: Oshada Gamage, Chamal Wimalasooriya, Chrismal Boteju, W. K. Wimalsiri
Abstract:
This paper presents a study on the feasibility of introducing a solar powered propelling mechanism to multi-day fishing boats as an alternative energy source. Since solar energy is readily available on the sea throughout the year, this free energy could be utilized to power multi-day fishing vessels. Multi-day boats have a large deck area where solar panels can be mounted above without much effort. This project involves studying the amount of power that can be generated using onboard solar panels and implementing an independent propelling system to run the boat. A chain drive system was designed to propel the boat, when the batteries are fully charged, from an electric motor using the same propeller. A 60 feet multi-day fishing boat built by a local boat manufacturer was chosen for the study. The service speed of the boat was around 6 knots with the electric motor, and the duration of cruising is 1 hour per day with around 11 hours of charging. 350-watt Mono-crystalline PV module, 75 kW HVH type motor, and 10 kWh lithium-ion battery packs were chosen for the study. From the calculations, it was obtained that the boat has 30 PV modules (10.5 kW), 5 batteries (47 kWh), The boat dimensions are 20 meter length of water line, 5.51 meter of beam, 1.8 meter of draught, and 77 ton of total displacement with the PV system net present value of USD 12445 for 20 years of operation and a payback period of around 8.2 years.Keywords: multiday fishing boats, photovoltaic cells, solar energy, solar powered boat
Procedia PDF Downloads 1494473 Comparing the Behaviour of the FRP and Steel Reinforced Shear Walls under Cyclic Seismic Loading in Aspect of the Energy Dissipation
Authors: H. Rahman, T. Donchev, D. Petkova
Abstract:
Earthquakes claim thousands of lives around the world annually due to inadequate design of lateral load resisting systems particularly shear walls. Additionally, corrosion of the steel reinforcement in concrete structures is one of the main challenges in construction industry. Fibre Reinforced Polymer (FRP) reinforcement can be used as an alternative to traditional steel reinforcement. FRP has several excellent mechanical properties than steel such as high resistance to corrosion, high tensile strength and light self-weight; additionally, it has electromagnetic neutrality advantageous to the structures where it is important such as hospitals, some laboratories and telecommunications. This paper is about results of experimental research and it is incorporating experimental testing of two medium-scale concrete shear wall samples; one reinforced with Basalt FRP (BFRP) bar and one reinforced with steel bars as a control sample. The samples are tested under quasi-static-cyclic loading following modified ATC-24 protocol standard seismic loading. The results of both samples are compared to allow a judgement about performance of BFRP reinforced against steel reinforced concrete shear walls. The results of the conducted researches show a promising momentum toward utilisation of the BFRP as an alternative to traditional steel reinforcement with the aim of improving durability with suitable energy dissipation in the reinforced concrete shear walls.Keywords: shear walls, internal fibre reinforced polymer reinforcement, cyclic loading, energy dissipation, seismic behaviour
Procedia PDF Downloads 1314472 In Vitro Antimycoplasmal Activity of Peganum harmala on Mycoplasma hominis Tunisian Strains
Authors: Nadine khadraoui, Rym Essid, Olfa Tabbene, Imen Chniba, Safa Boujemaa, Selim Jallouli, Nadia Fares, Behija Mlik, Boutheina Ben Abdelmoumen Mardassi
Abstract:
Background and aim: Mycoplasma hominis is an opportunistic pathogen that can cause various gynecological infections such cervicitis, infertility, and, less frequently, extra-genital infections. Previous studies on the antimicrobial susceptibility of Mycoplasma hominis Tunisian strains have highlighted a significant resistance, even multi-resistance, to the most used antibiotic in the therapy of consequential infections. To address this concern, the present study aimed for the alternative of phytotherapy. Peganum harmala seed extract was tested as an antibacterial agent against multidrug-resistant M.hominis clinical strains. Material and Methods: Peganum harmala plant was collected from Ain Sebaa, Tabarka, North West region of Tunisia in April 2018, air-dried, grounded and extracted by different solvents.The crude methanolic extract was further partitioned with n-HEX, DCM, EtOAC and n-BuOl. Antibacterial activity was evaluated against M. hominis ATCC 23114 and 20 M. hominis clinical strains.The antimycoplasmal activity was tested by the microdilution method, and MIC values were determined. Phytochemical analysis and hemolytic activity on human erythrocytes were also performed. The active fraction was then subjected to purification, and the chemical identification of the active compound was investigated. Results: Among the tested fractions, the n-BuOH extract was the most active fraction since it exhibited an inhibitory effect against M. hominis ATCC 23114 and 80% of the tested clinical strains with MIC between 125 and 1000 µg/ml. The phytochemical analysis of the n-BuOH revealed its metabolic abundance in polyphenols, flavonoids and condensed tannin with levels of 257.37 mg AGE/g, 172.27 mg EC/g and 58.27 mg EC/g, respectively. In addition, P. harmala n-BuOH extract exhibited potent bactericidal activity against all M. hominis isolates with CMB values ranging between 125 and 4000 µg/ml. Further, the active fraction exhibited weak cytotoxicity effect at active concentrations when tested on human erythrocytes. The active compound was identified by gas chromatography–mass spectrometry as an indole alkaloid harmaline. Conclusion: In summary, Peganum harmala extract demonstrated an interesting anti-mycoplasmal activity against M. hominis Tunisian strains. Therefore, it could be considered as a potential candidate for the treatment of consequential infections. However, further studies are necessary to evaluate its mechanism of action in mycoplasmas.Keywords: mycoplasma hominis, peganum harmala, antibioresistance, phytotherapy, phytochemical analysis
Procedia PDF Downloads 1174471 Investigation of Physical Performance of Denim Fabrics Washed with Sustainable Foam Washing Process
Authors: Hazal Yılmaz, Hale Karakaş
Abstract:
In the scope of the study, it is aimed to investigate and review the performance of denim fabrics that are foam washed. Foam washing was compared as an alternative to stone washing in terms of sustainability and performance parameters. For this purpose, seven different denim fabrics, which are both stone washed and foam washed separately in 3 different washing durations (30-60-90 mins), were compared. In the study, the same fabrics were processed with both foam and stone separately. The washing process steps were reviewed, and their water consumption values were compared. After washing, a total of 42 fabric samples were obtained, and tensile strength, tear strength, abrasion, weight loss after abrasion, rubbing fastness, color fastness tests were carried out on the fabric samples. The obtained test results were reviewed and evaluated. As a result of tests, it has been observed that the performance of foam washed fabrics in terms of tensile, tear strength and rubbing fastness test results are better than stone washed fabrics, and it has been seen that foam washed fabrics' color fastness test results are as stone washed. As a result of all these tests, it can be seen that foam washing is an alternative to stone washing due to its performance parameters and its sustainability performance with less water usage.Keywords: denim fabrics, denim washing, foam washing, performance properties, stone washing, sustainability
Procedia PDF Downloads 714470 Mycophenolate-Induced Disseminated TB in a PPD-Negative Patient
Authors: Megan L. Srinivas
Abstract:
Individuals with underlying rheumatologic diseases such as dermatomyositis may not adequately respond to tuberculin (PPD) skin tests, creating false negative results. These illnesses are frequently treated with immunosuppressive therapy making proper identification of TB infection imperative. A 59-year-old Filipino man was diagnosed with dermatomyositis on the basis of rash, electromyography, and muscle biopsy. He was initially treated with IVIG infusions and transitioned to oral prednisone and mycophenolate. The patient’s symptoms improved on this regimen. Six months after starting mycophenolate, the patient began having fevers, night sweats, and productive cough without hemoptysis. He moved from the Philippines 5 years prior to dermatomyositis diagnosis, denied sick contacts, and was PPD negative both at immigration and immediately prior to starting mycophenolate treatment. A third PPD was negative following the onset of these new symptoms. He was treated for community-acquired pneumonia, but symptoms worsened over 10 days and he developed watery diarrhea and a growing non-tender, non-mobile mass on the left side of his neck. A chest x-ray demonstrated a cavitary lesion in right upper lobe suspicious for TB that had not been present one month earlier. Chest CT corroborated this finding also exhibiting necrotic hilar and paratracheal lymphadenopathy. Neck CT demonstrated the left-sided mass as cervical chain lymphadenopathy. Expectorated sputum and stool samples contained acid-fast bacilli (AFB), cultures showing TB bacteria. Fine-needle biopsy of the neck mass (scrofula) also exhibited AFB. An MRI brain showed nodular enhancement suspected to be a tuberculoma. Mycophenolate was discontinued and dermatomyositis treatment was switched to oral prednisone with a 3-day course of IVIG. The patient’s infection showed sensitivity to standard RIPE (rifampin, isoniazid, pyrazinamide, and ethambutol) treatment. Within a week of starting RIPE, the patient’s diarrhea subsided, scrofula diminished, and symptoms significantly improved. By the end of treatment week 3, the patient’s sputum no longer contained AFB; he was removed from isolation, and was discharged to continue RIPE at home. He was discharged on oral prednisone, which effectively addressed his dermatomyositis. This case illustrates the unreliability of PPD tests in patients with long-term inflammatory diseases such as dermatomyositis. Other immunosuppressive therapies (adalimumab, etanercept, and infliximab) have been affiliated with conversion of latent TB to disseminated TB. Mycophenolate is another immunosuppressive agent with similar mechanistic properties. Thus, it is imperative that patients with long-term inflammatory diseases and high-risk TB factors initiating immunosuppressive therapy receive a TB blood test (such as a quantiferon gold assay) prior to the initiation of therapy to ensure that latent TB is unmasked before it can evolve into a disseminated form of the disease.Keywords: dermatomyositis, immunosuppressant medications, mycophenolate, disseminated tuberculosis
Procedia PDF Downloads 2084469 MR Imaging Spectrum of Intracranial Infections: An Experience of 100 Cases in a Tertiary Hospital in Northern India
Authors: Avik Banerjee, Kavita Saggar
Abstract:
Infections of the nervous system and adjacent structures are often life-threatening conditions. Despite the recent advances in neuroimaging evaluation, the diagnosis of unclear infectious CNS disease remains a challenge. Our aim is to evaluate the typical and atypical neuro-imaging features of the various routinely encountered CNS infected patients so as to form guidelines for their imaging recognition and differentiation from tumoral, vascular and other entities that warrant a different line of therapy.Keywords: central nervous system (CNS), Cerebro Spinal Fluid (Csf), Creutzfeldt Jakob Disease (CJD), progressive multifocal leukoencephalopathy (PML)
Procedia PDF Downloads 3014468 Embodied Spirituality in Gestalt Therapy
Authors: Silvia Alaimo
Abstract:
This lecture brings to our attention the theme of spirituality within Gestalt therapy’s theoretical and clinical perspectives and which is closely connected to the fertile emptiness and creative indifference’ experiences. First of all, the premise that must be done is the overcoming traditional western culture’s philosophical and religious misunderstandings, such as the dicotomy between spirituality and pratical/material daily life, as well as the widespread secular perspective of classic psychology. Even fullness and emptiness have traditionally been associated with the concepts of being and not being. "There is only one way through which we can contact the deepest layers of our existence, rejuvenate our thinking and reach intuition (the harmony of thought and being): inner silence" (Perls) *. Therefore, "fertile void" doesn't mean empty in itself, but rather an useful condition of every creative and responsible act, making room for a deeper dimension close to spirituality. Spirituality concerns questions about the meaning of existence, which lays beyond the concrete and literal dimension, looking for the essence of things, and looking at the value of personal experience. Looking at fundamentals of Gestalt epistemology, phenomenology, aesthetics, and the relationship, we can reach the heart of a therapeutic work that takes spiritual contours and which are based on an embodied (incarnate size), through the relational aesthetic knowledge (Spagnuolo Lobb ), the deep contact with each other, the role of compassion and responsibility, as the patient's recognition criteria (Orange, 2013) rooted in the body. The aesthetic dimension, like the spiritual dimension to which it is often associated, is a subtle dimension: it is the dimension of the essence of things, of their "soul." In clinical practice, it implies that the relationship between therapist and patient is "in the absence of judgment," also called "zero point of creative indifference," expressed by ‘therapeutic mentality’. It consists in following with interest and authentic curiosity where the patient wants to go and support him in his intentionality of contact. It’s a condition of pure and simple awareness, of the full acceptance of "what is," a moment of detachment from one's own life in which one does not take oneself too seriously, a starting point for finding a center of balance and integration that brings to the creative act, to growth, and, as Perls would say, to the excitement and adventure of living.Keywords: spirituality, bodily, embodied aesthetics, phenomenology, relationship
Procedia PDF Downloads 1384467 Binge Eating among Women Who Suffer from Psychological Abuse in Their Relationship: The Moderating Role of Defense Mechanisms
Authors: Orly Yona Drori, Shirley Ben Shlomo
Abstract:
Objectives: The participants will be able to recognize the predictors of binge eating addiction among women who suffer from psychological abuse in their relationships and will recognize the role of woman's defense mechanisms in moderating the association between psychological abuse and binge eating addiction. Methods: A convenience sample of 380 Israeli women in relationships were located via the Internet, and after consenting to participate in the study, they completed a series of structured questionnaires (The Yale Food Addiction Scale; The Defense Style Questionnaire; psychological maltreatment of women by their male partners; level of differentiation of self; sociodemographic questionnaire). Results: The higher the level of differentiation and mature defense mechanisms, the less addictive a woman is. However, the level of addiction among women who experience psychological abuse within their intimate relations is higher than women who do not experience psychological abuse in their relationship. Among women who experienced psychological abuse in their relations, the defense mechanisms moderate the association between psychological abuse within intimate relations and the extent of the addiction to binge eating. Conclusions: The study contributes to the therapy of women with binge eating addictions, as it raises awareness of therapeutic-related content that could strengthen women and help them to cope with situations in their lives without the need to binge. One of the significant variables for therapeutic work is the level of differentiation of the self. In addition, identifying the types of defense mechanisms might help to match treatment to the woman's emotional needs. The current study found also that it is important to identify the environmental systems by which the addict is surrounded, such as whether woman is in an abusive relationship. Finally the study leads to the recognition that binge eating, which is usually treated with an emphasis on nutritional behavior change, is an addiction, and as such, it requires a combination of mental, nutritional and behavioral therapy. In view of this approach, it is recommended that treating a woman who is addicted to binge eating should involve a multi-disciplinary team comprised of physicians, clinical dietitians, and clinical psychotherapists.Keywords: binge eating, defence mechanism, food addiction, psychological abuse
Procedia PDF Downloads 1694466 LCA of Waste Disposal from Olive Oil Production: Anaerobic Digestion and Conventional Disposal on Soil
Authors: T. Tommasi, E. Batuecas, G. Mancini, G. Saracco, D. Fino
Abstract:
Extra virgin olive-oil (EVO) production is an important economic activity for several countries, especially in the Mediterranean area such as Spain, Italy, Greece and Tunisia. The two major by-products from olive oil production, solid-liquid Olive Pomace (OP) and the Olive Mill Waste Waters (OMWW), are still mainly disposed on soil, in spite of the existence of legislation which already limits this practice. The present study compares the environmental impacts associated with two different scenarios for the management of waste from olive oil production through a comparative Life Cycle Assessment (LCA). The two alternative scenarios are: (I) Anaerobic Digestion and (II) current Disposal on soil. The analysis was performed through SimaPro software and the assessment of the impact categories was based on International Life Cycle Data and Cumulative Energy Demand methods. Both the scenarios are mostly related to the cultivation and harvesting phase and are highly dependent on the irrigation practice and related energy demand. Results from the present study clearly show that as the waste disposal on soil causes the worst environmental performance of all the impact categories here considered. Important environmental benefits have been identified when anaerobic digestion is instead chosen as the final treatment. It was consequently demonstrated that anaerobic digestion should be considered a feasible alternative for olive mills, to produce biogas from common olive oil residues, reducing the environmental burden and adding value to the olive oil production chain.Keywords: anaerobic digestion, waste management, agro-food waste, biogas
Procedia PDF Downloads 1484465 Malaysian Knowledge, Belief and Attitude towards Hypnosis as a Health Intervention: An Interpretative Phenomenological Analysis
Authors: Ying Chern Yeoh, Mark J. Forshaw
Abstract:
Although hypnosis has been widely endorsed in Europe since 1950s, it was still viewed as a typically new therapy in Asia. There are very little findings regarding hypnosis in Asian countries, especially in culturally diverse countries such as Malaysia. The knowledge of the beneficial effects of hypnosis was not widespread to the public, however knowledge of the negative effects was frequently being highlighted. Therefore, the acceptance of hypnosis as a new effective health treatment can be a challenge in Malaysia. Recognising Malaysian’s perception, belief and attitude towards hypnosis could increase the public awareness of hypnosis, which in turn will alter their misconception and increase acceptance of hypnosis as an effective therapy. Eight individuals (N = 8) from the general public with different background, ethnicity (Malays, Chinese and Indians) and religion (Islamic, Buddhism, Hinduism, Taoism, Christianity, free-thinker) and two local experienced practitioners with minimum of five years experiences (N = 2) were being interviewed to determine their views, beliefs and level of acceptance towards hypnosis. Semi-structured interviews were conducted, transcribed with pseudonyms and analyzed by using Interpretative Phenomenological Analysis. The three emergent themes were illustrated under the captions of ‘traditional vs mainstream’, ‘myths vs truth’, and ‘dissemination and public awareness’. The finding suggested that individual knowledge and personal experience primarily influenced people’s level of acceptance towards hypnosis as a beneficial health treatment, rather than the diversity of cultural and religious background. Subsequent findings regarding hypnosis and the effort of promoting it will provide the society an opportunity to increase public education and health awareness. Several associations had started to advance its development by organizing conferences and setting up therapeutic centers. However, health promotion on hypnosis is yet to be conducted to raise public awareness of its beneficial effects. By requesting for hypnosis to be included as a subject in medical education and psychology curriculum and formatting it under Ministry of Health’s legislation body might enhance the knowledge of hypnosis for Malaysian as one of the health intervention in the future.Keywords: awareness, hypnosis, intervention, Malaysian, promotion
Procedia PDF Downloads 1594464 Poverty Versus Interest-Based Loans in East Africa: Can Interest-Free Loans Rescue the Situation?
Authors: Maulana Ayoub Ali
Abstract:
“Both Socialist as well as the capitalist in the economic systems have proven their failure to ensure economic justice that serves to benefit all in the society, both the rich and the poor. In particular, capitalism is currently causing a terrifying scenario by making the rich richer and the poor poorer” . In this paper, the author looks at the level of exploitation which is taking place to small and middle entrepreneurs (SME’s), government and private employees as well as large investors in East African countries who depends on interest-based loans which undermines their lives every day due to heavy monthly returns. Numbers of families have been evicted from their family premises and SME’s properties have been attached in the courts due to failure to return their loans timely. In fact, there are a lot of issues which have taken place on the ground which badly affected number of families socially and most importantly economically due to engagement in interest-based loans offered by commercial banks in East Africa. This paper looks on the alternative ways of eliminating interest-based loans to better lives of devastated Africans who are almost “dying” of heavy debts generated through higher interest loans. Reaching to that particular root the author has visited various literatures in a bid to deeply investigate and find out the best alternative mode of enabling African SME’s, businessmen and employees to benefit from the interest-free loans. The question is whether interest-free loans can be a long term solution towards poverty alleviation in East Africa generally and Tanzania in particular.Keywords: interest-free loans, SME’s, financial institutions, poverty, east Africa
Procedia PDF Downloads 3304463 Advancement of Oscillating Water Column Wave Energy Technologies through Integrated Applications and Alternative Systems
Authors: S. Doyle, G. A. Aggidis
Abstract:
Wave energy converter technologies continue to show good progress in worldwide research. One of the most researched technologies, the Oscillating Water Column (OWC), is arguably one of the most popular categories within the converter technologies due to its robustness, simplicity and versatility. However, the versatility of the OWC is still largely untapped with most deployments following similar trends with respect to applications and operating systems. As the competitiveness of the energy market continues to increase, the demand for wave energy technologies to be innovative also increases. For existing wave energy technologies, this requires identifying areas to diversify for lower costs of energy with respect to applications and synergies or integrated systems. This paper provides a review of all OWCs systems integrated into alternative applications in the past and present. The aspects and variation in their design, deployment and system operation are discussed. Particular focus is given to the Multi-OWCs (M-OWCs) and their great potential to increase capture on a larger scale, especially in synergy applications. It is made clear that these steps need to be taken in order to make wave energy a competitive and viable option in the renewable energy mix as progression to date shows that stand alone single function devices are not economical. Findings reveal that the trend of development is moving toward these integrated applications in order to reduce the Levelised Cost of Energy (LCOE) and will ultimately continue in this direction in efforts to make wave energy a competitive option in the renewable energy mix.Keywords: wave energy converter, oscillating water column, ocean energy, renewable energy
Procedia PDF Downloads 1344462 Management of Hypoglycemia in Von Gierke’s Disease
Authors: Makda Aamir, Sood Aayushi, Syed Omar, Nihan Khuld, Iskander Peter, Ijaz Naeem, Sharma Nishant
Abstract:
Introduction:Glycogen Storage Disease Type-1 (GSD-1) is a rare phenomenon primarily affecting the liver and kidney. Excessive accumulation of glycogen and fat in liver, kidney, and intestinal mucosa is noted in patients with deficiency of Glucose-6-phosphatase deficiency. Patients with GSD-1 have a wide spectrum of symptoms, including hepatomegaly, hypoglycemia, lactic acidemia, hyperlipidemia, hyperuricemia, and growth retardation. Age of onset, rate of disease progression and its severity is variable in this disease.Case:An 18-year-old male with GSD-1a, Von Gierke’s disease, hyperuricemia, and hypertension presented to the hospital with nausea and vomiting. The patient followed an hourly cornstarch regimen during the day and overnight through infusion via a PEG tube. The complaints started at work, where he was unable to tolerate oral cornstarch. He washemodynamically stable on arrival. ABG showed pH 7.372, PaCO2 30.3, and PaO2 92.2. WBC 16.80, K+ 5.8, HCO3 13, BUN 28, Cr 2.2, Glucose 60, AST 115, ALT 128, Cholesterol 352, Triglycerides >1000, Uric Acid 10.6, Lactic Acid 11.8 which trended down to 8.0. CT abdomen showed hepatomegaly and fatty infiltration with the PEG tube in place.He was admitted to the ICU and started on D5NS for hypoglycemia and lactic acidosis. Per request by the patient’s pediatrician, he was transitioned to IV D10/0.45NS at 110mL/Hr to maintain blood glucose above 75 mg/L. Frequent accuchecks were done till he could tolerate his dietary regimen with cornstarch. Lactic acid downtrend to 2.9, and accuchecks ranged between 100-110. Cr improved to 1.3, and his home medications (Allopurinol and Lisinopril) were resumed. He was discharged in stable condition with plans for further genetic therapy work up.Discussion:Mainstay therapy for Von Gierke’s Disease is the prevention of metabolic derangements for which dietary and lifestyle changes are recommended. A low fructose and sucrose diet is recommended by limiting the intake of galactose and lactose to one serving per day. Hypoglycemia treatment in such patients is two-fold, utilizing both quick and stable release sources. Cornstarch has been one such therapy since the 1980s; its slow digestion provides a steady release of glucose over a longer period of time as compared with other sources of carbohydrates. Dosing guidelines vary from age to age and person to person, but it is highly recommended to check BG levels frequently to maintain a BG > 70 mg/dL. Associated high levels of triglycerides and cholesterol can be treated with statins, fibrates, etc. Conclusion:The management of hypoglycemia in GSD 1 disease presents various obstacles which could prove to be fatal. Due to the deficiency of G6P, treatment with a specialized hypoglycemic regimen is warranted. A D10 ½ NS infusion can be used to maintain blood sugar levels as well as correct metabolic or lactate imbalances. Infusion should be gradually weaned off after the patient can tolerate oral feeds as this can help prevent the risk of hypoglycemia and other derangements. Further research is needed in regards to these patients for more sustainable regimens.Keywords: von gierke, glycogen storage disease, hypoglycemia, genetic disease
Procedia PDF Downloads 1074461 Investigation of Bending Behavior of Ultra High Performance Concrete with Steel and Glass Fiber Polymer Reinforcement
Authors: Can Otuzbir
Abstract:
It is one of the most difficult areas of civil engineering to provide long-lasting structures with the rapid development of concrete and reinforced concrete structures. Concrete is a living material, and the structure where the concrete is located is constantly exposed to external influences. One of these effects is reinforcement corrosion. Reinforcement corrosion of reinforced concrete structures leads to a significant decrease in the carrying capacity of the structural elements, as well as reduced service life. It is undesirable that the service life should be completed sooner than expected. In recent years, advances in glass fiber technology and its use with concrete have developed rapidly. As a result of inability to protect steel reinforcements against corrosion, fiberglass reinforcements have started to be investigated as an alternative material to steel reinforcements, and researches and experimental studies are still continuing. Glass fiber reinforcements have become an alternative material to steel reinforcement because they are resistant to corrosion, lightweight and simple to install compared to steel reinforcement. Glass fiber reinforcements are not corroded and have higher tensile strength, longer life, lighter and insulating properties compared to steel reinforcement. In experimental studies, glass fiber reinforcements have been shown to show superior mechanical properties similar to beams produced with steel reinforcement. The performance of long-term use of glass fiber fibers continues with accelerated experimental studies.Keywords: glass fiber polymer reinforcement, steel fiber concrete, ultra high performance concrete, bending, GFRP
Procedia PDF Downloads 1294460 Binder-Free Porous Photocathode Based on Cuprous Oxide for High-Performing P-Type Dye-Sensitized Solar Cells
Authors: Marinela Miclau, Melinda Vajda, Nicolae Miclau, Daniel Ursu
Abstract:
Characterized by a simple structure, easy and low cost fabrication, the dye-sensitized solar cell (DSSC) attracted the interest of the scientific community as an attractive alternative of conventional Si-based solar cells and thin-film solar cells. Over the past 20 years, the main efforts have attempted to enhance the efficiency of n-type DSSCs, the highest efficiency record of 14.30% was achieved using the co-sensitization of two metal-free organic dyes and Co (II/III) tris(phenanthroline)-based redox electrolyte. In the last years, the development of the efficient p-type DSSC has become a research focus owing to the fact that the concept of tandem solar cell was proposed as the solution to increase the power conversion efficiency. A promising alternative for the photocathodes of p-type DSSC, cuprous (Cu2O) and cupric (CuO) oxides have been investigated because of its nontoxic nature, low cost, high natural abundance, a good absorption coefficient for visible light and a higher dielectric constant than NiO. In case of p-type DSSC based on copper oxides with I3-/I- as redox mediator, the highest conversion efficiency of 0.42% (Cu2O) and 0.03% (CuO) has achieved. Towards the increase in the performance, we have fabricated and analyzed the performance of p-type DSSC prepared with the binder-free porous Cu2O photocathodes. Porous thin film could be an attractive alternative for DSSC because of their large surface areas which enable the efficient absorption of the dyes and light. We propose a simple and one-step hydrothermal method for the preparation of porous Cu2O thin film using copper substrate, cupric acetate and ethyl cellulose. The cubic structure of Cu2O has been determined by X-ray diffraction (XRD) and porous morphology of thin film was emphasized by Scanning Electron Microscope Inspect S (SEM). Optical and Mott-Schottky measurements attest of the high quality of the Cu2O thin film. The binder-free porous Cu2O photocathode has confirmed the excellent photovoltaic properties, the best value reported for p-type DSSC (1%) in similar conditions being reached.Keywords: cuprous oxide, dye-sensitized solar cell, hydrothermal method, porous photocathode
Procedia PDF Downloads 1684459 Evaluation of the Performance of Solar Stills as an Alternative for Brine Treatment Applying the Monte Carlo Ray Tracing Method
Authors: B. E. Tarazona-Romero, J. G. Ascanio-Villabona, O. Lengerke-Perez, A. D. Rincon-Quintero, C. L. Sandoval-Rodriguez
Abstract:
Desalination offers solutions for the shortage of water in the world, however, the process of eliminating salts generates a by-product known as brine, generally eliminated in the environment through techniques that mitigate its impact. Brine treatment techniques are vital to developing an environmentally sustainable desalination process. Consequently, this document evaluates three different geometric configurations of solar stills as an alternative for brine treatment to be integrated into a low-scale desalination process. The geometric scenarios to be studied were selected because they have characteristics that adapt to the concept of appropriate technology; low cost, intensive labor and material resources for local manufacturing, modularity, and simplicity in construction. Additionally, the conceptual design of the collectors was carried out, and the ray tracing methodology was applied through the open access software SolTrace and Tonatiuh. The simulation process used 600.00 rays and modified two input parameters; direct normal radiation (DNI) and reflectance. In summary, for the scenarios evaluated, the ladder-type distiller presented higher efficiency values compared to the pyramid-type and single-slope collectors. Finally, the efficiency of the collectors studied was directly related to their geometry, that is, large geometries allow them to receive a greater number of solar rays in various paths, affecting the efficiency of the device.Keywords: appropriate technology, brine treatment techniques, desalination, monte carlo ray tracing
Procedia PDF Downloads 72