Search results for: graft rejection
321 Multivariate Control Chart to Determine Efficiency Measurements in Industrial Processes
Authors: J. J. Vargas, N. Prieto, L. A. Toro
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Control charts are commonly used to monitor processes involving either variable or attribute of quality characteristics and determining the control limits as a critical task for quality engineers to improve the processes. Nonetheless, in some applications it is necessary to include an estimation of efficiency. In this paper, the ability to define the efficiency of an industrial process was added to a control chart by means of incorporating a data envelopment analysis (DEA) approach. In depth, a Bayesian estimation was performed to calculate the posterior probability distribution of parameters as means and variance and covariance matrix. This technique allows to analyse the data set without the need of using the hypothetical large sample implied in the problem and to be treated as an approximation to the finite sample distribution. A rejection simulation method was carried out to generate random variables from the parameter functions. Each resulting vector was used by stochastic DEA model during several cycles for establishing the distribution of each efficiency measures for each DMU (decision making units). A control limit was calculated with model obtained and if a condition of a low level efficiency of DMU is presented, system efficiency is out of control. In the efficiency calculated a global optimum was reached, which ensures model reliability.Keywords: data envelopment analysis, DEA, Multivariate control chart, rejection simulation method
Procedia PDF Downloads 370320 Pattern of Admission and Recruitment for PhD Positions in European Universities: Globalization of Education or Evading the Hidden Agenda of Racism through Systematic Rejection
Authors: Bashar Dahiru Bashar
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Growing research reveals an unprecedented increase in African applicants for PhD positions across European universities. Meanwhile, a very small percentage is accepted as qualified candidates to marginalize, perpetuate stereotypes, and institute racial discrimination. Candidates of color very often encounter barriers and prejudices that not only diminish their sense of belonging but also hinder their academic progress. Although this issue has existed for quite some time, it attracts little attention, even from the academic community in higher education. Moreover, the focus is mostly on the applicants. In this contribution, concern has been raised that the African applicants for PhD positions in European Universities are the victims rather than the perpetrators. The Universities designed a recruitment process that is in all respects exclusive, biased, and European. The recruitment exercise is a hocus-post in order to cover language and racial and ethnic rejection. Just in the same way legacy admission is practiced in the US. The paper further expressed that the logic is to systematically maintain racial hierarchy and social dominance within the education sector. And because those at an advantage are also the ones that have the media and are predominant in academia, issues like this are not receiving deserved attention. Many people were victims of this recruitment process, while others survived severely wounded as a result of mental, social, and economic trauma. It is not the aim of this paper to provide an armchair solution to this issue but only to showcase the process with the hope of providing something that is needed to improve the present day's literacy and situation. The findings contribute to the broader discourse on diversity, equity, and inclusiveness within European Universities, emphasizing, amongst others, the need for cultivating an atmosphere where individuals are valued for their contributions rather than assessed based on race and ethnicity is essential for creating a vibrant and equitable global academic community, forging a path towards a just and harmonious educational landscape where everyone irrespective of race or ethnicity can thrive and contribute to the collective pursuit of knowledge.Keywords: admission and recruitment for PhD position, globalization of education, systemic rejection, European university
Procedia PDF Downloads 44319 Impact of CYP3A5 Polymorphism on Tacrolimus to Predict the Optimal Initial Dose Requirements in South Indian Renal Transplant Recipients
Authors: S. Sreeja, Radhakrishnan R. Nair, Noble Gracious, Sreeja S. Nair, M. Radhakrishna Pillai
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Background: Tacrolimus is a potent immunosuppressant clinically used for the long term treatment of antirejection of transplanted organs in liver and kidney transplant recipients though dose optimization is poorly managed. However, So far no study has been carried out on the South Indian kidney transplant patients. The objective of this study is to evaluate the potential influence of a functional polymorphism in CYP3A5*3 gene on tacrolimus physiological availability/dose ratio in South Indian renal transplant patients. Materials and Methods: Twenty five renal transplant recipients receiving tacrolimus were enrolled in this study. Their body weight, drug dosage, and therapeutic concentration of Tacrolimus were observed. All patients were on standard immunosuppressive regime of Tacrolimus-Mycophenolate mofetil along with steroids on a starting dose of Tac 0.1 mg/kg/day. CYP3A5 genotyping was performed by PCR followed with RFLP. Conformation of RFLP analysis and variation in the nucleotide sequence of CYP3A5*3 gene were determined by direct sequencing using a validated automated generic analyzer. Results: A significant association was found between tacrolimus per dose/kg/d and CYP3A5 gene (A6986G) polymorphism in the study population. The CYP3A5 *1/*1, *1/*3 and *3/*3 genotypes were detected in 5 (20 %), 5 (20 %) and 15 (60 %) of the 25 graft recipients, respectively. CYP3A5*3 genotypes were found to be a good predictor of tacrolimus Concentration/Dose ratio in kidney transplant recipients. Significantly higher L/D was observed among non-expressors 9.483 ng/mL(4.5- 14.1) as compared with the expressors 5.154 ng/mL (4.42-6.5 ) of CYP3A5. Acute rejection episodes were significantly higher for CYP3A5*1 homozygotes compared to patients with CYP3A5*1/*3 and CYP3A5*3/*3 genotypes (40 % versus 20 % and 13 %, respectively ). The dose normalized TAC concentration (ng/ml/mg/kg) was significantly lower in patients having CYP3A5*1/*3 polymorphism. Conclusion: This is the first study to extensively determine the effect of CYP3A5*3 genetic polymorphism on tacrolimus pharmacokinetics in South Indian renal transplant recipients and also shows that majority of our patients carry mutant allele A6986G in CYP3A5*3 gene. Identification of CYP3A5 polymorphism prior to transplantation could contribute to evaluate the appropriate initial dosage of tacrolimus for each patient.Keywords: kidney transplant patients, CYP3A5 genotype, tacrolimus, RFLP
Procedia PDF Downloads 294318 The Modulation of Self-interest Instruction on the Fair-Proposing Behavior in Ultimatum Game
Authors: N. S. Yen, T. H. Yang, W. H. Huang, Y. F. Fang, H. W. Cho
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Ultimatum game is an experimental paradigm to study human decision making. There are two players, a proposer and a responder, to split a fixed amount of money. According to the traditional economic theory on ultimatum game, proposer should propose the selfish offers to responder as much as possible to maximize proposer’s own outcomes. However, most evidences had showed that people chose more fair offers, hence two hypotheses – fairness favoring and strategic concern were proposed. In current study, we induced the motivation in participants to be either selfish or altruistic, and manipulated the task variables, the stake sizes (NT$100, 1000, 10000) and the share sizes (the 40%, 30%, 20%, 10% of the sum as selfish offers, and the 60%, 70%, 80%, 90% of the sum as altruistic offers), to examine the two hypotheses. The results showed that most proposers chose more fair offers with longer reaction times (RTs) no matter in choosing between the fair and selfish offers, or between the fair and altruistic offers. However, the proposers received explicit self-interest instruction chose more selfish offers accompanied with longer RTs in choosing between the fair and selfish offers. Therefore, the results supported the strategic concern hypothesis that previous proposers choosing the fair offers might be resulted from the fear of rejection by responders. Proposers would become more self-interest if the fear of being rejected is eliminated.Keywords: ultimatum game, proposer, self-interest, fear of rejection
Procedia PDF Downloads 372317 Removal of Heavy Metal Ions from Aqueous Solution by Polymer Enhanced Ultrafiltration Using Unmodified Starch as Biopolymer
Authors: Nurul Huda Baharuddin, Nik Meriam Nik Sulaiman, Mohammed Kheireddine Aroua
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The effects of pH, polymer concentration, and metal ions feed concentration for four selected heavy metals Zn (II), Pb (II), Cr (III) and Cr (VI) were tested by using Polymer Enhanced Ultrafiltration (PEUF). An alternative biopolymer namely unmodified starch is proposed as a binding reagent in consequences, as compared to commonly used water-soluble polymers namely polyethylene glycol (PEG) and polyethyleneimine (PEI) in the removal of selected four heavy metal ions. The speciation species profiles of four selected complexes ions namely Zn (II), Pb (II), Cr (III) and Cr (VI) and the present of hydroxides ions (OH-) in variously charged ions were investigated by available software at certain pH range. In corresponds to identify the potential of complexation behavior between metal ion-polymers, potentiometric titration studies were obtained at first before carried out experimental works. Experimental works were done using ultrafiltration systems obtained by laboratory ultrafiltration bench scale equipped with 10 kDa polysulfone hollow fiber membrane. Throughout the laboratory works, the rejection coefficient and permeate flux were found to be significantly affected by the main operating parameter, namely the effects of pH, polymer composition and metal ions concentrations. The interaction of complexation between two binding polymers namely unmodified starch and PEG were occurred due to physical attraction of metal ions to the polymer on the molecular surface with high possibility of chemical occurrence. However, these selected metal ions are mainly complexes by polymer functional groups whenever there is interaction with PEI polymer. For study of single metal ions solutions, Zn (II) ions' rejections approaching over 90% were obtained at pH 7 for each tested polymer. This behavior was similar to Pb (II), Cr (III) and Cr (VI); where the rejections were obtained at lower acidic pH and increased at neutral pH of 7. Different behavior was found by Cr (VI) ions where a high rejection was only achieved at acidic pH region with PEI. Polymer concentration and metal ions concentration are found to have a significant effect on rejections. For mixed metal ion solutions, the behavior of metal ion rejections was similar to single metal ion solutions for investigation on the effects of pH. Rejection values were high at pH 7 for Zn (II) pH 7 for Zn (II) and Cr (III) ions, corresponding to higher rejections with unmodified starch. Pb (II) ions obtained high rejections when tested with PEG whenever carried out in mixed metal ion solutions. High Cr (VI) ions' rejection was found with PEI in single and mixed metal ions solutions at neutral pH range. The influence of starch’s granule structure towards the rejections of these four selected metal ions is found to be attracted in a non-ionic manner. No significant effects on permeate flux were obtained when tested at different pH ranges, polymer concentrations and metal ions feed either by single or mixtures metal ions solutions. Canizares Model was employed as the theoretical model to predict permeate flux and metal ions retention on the study of heavy metal ions removal.Keywords: polyethyleneimine, polyethylene glycol, polymer-enhanced ultrafiltration, unmodified starch
Procedia PDF Downloads 164316 Low Power CMOS Amplifier Design for Wearable Electrocardiogram Sensor
Authors: Ow Tze Weng, Suhaila Isaak, Yusmeeraz Yusof
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The trend of health care screening devices in the world is increasingly towards the favor of portability and wearability, especially in the most common electrocardiogram (ECG) monitoring system. This is because these wearable screening devices are not restricting the patient’s freedom and daily activities. While the demand of low power and low cost biomedical system on chip (SoC) is increasing in exponential way, the front end ECG sensors are still suffering from flicker noise for low frequency cardiac signal acquisition, 50 Hz power line electromagnetic interference, and the large unstable input offsets due to the electrode-skin interface is not attached properly. In this paper, a high performance CMOS amplifier for ECG sensors that suitable for low power wearable cardiac screening is proposed. The amplifier adopts the highly stable folded cascode topology and later being implemented into RC feedback circuit for low frequency DC offset cancellation. By using 0.13 µm CMOS technology from Silterra, the simulation results show that this front end circuit can achieve a very low input referred noise of 1 pV/√Hz and high common mode rejection ratio (CMRR) of 174.05 dB. It also gives voltage gain of 75.45 dB with good power supply rejection ratio (PSSR) of 92.12 dB. The total power consumption is only 3 µW and thus suitable to be implemented with further signal processing and classification back end for low power biomedical SoC.Keywords: CMOS, ECG, amplifier, low power
Procedia PDF Downloads 243315 Variation In Gastrocnemius and Hamstring Muscle Activity During Peak Knee Flexor Torque After Anterior Cruciate Ligament Reconstruction with Hamstring Graft
Authors: Luna Sequier, Florian Forelli, Maude Traulle, Amaury Vandebrouck, Pascal Duffiet, Louis Ratte, Jean Mazeas
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The study's objective is to compare the muscular activity of the flexor knee muscle in patients who underwent an anterior cruciate ligament reconstruction with hamstring autograft and the individuals who have not undergone surgery. Methods: The participants were divided into two groups: a healthy group and an experimental group who had undergone an anterior cruciate ligament reconstruction with a hamstring graft. All participants had to perform a knee flexion strength test on an isokinetic dynamometer. The medial Gastrocnemius, lateral Gastrocnemius, Biceps femoris, and medial Hamstring muscle activity were measured during this test. Each group’s mean muscle activity was tested with statistical analysis, and a muscle activity ratio of gastrocnemius and hamstring muscles was calculated Results: The results showed a significant difference in activity of the medial gastrocnemius (p = 0,004901), the biceps femoris (p = 5,394.10-6), and the semitendinosus muscles (p = 1,822.10-6), with a higher Biceps femoris and Semitendinosus activity for the experimental group. It is however noticeable that inter-subject differences were important. Conclusion: This study has shown a difference in the gastrocnemius and hamstring muscle activity between patients who underwent an anterior cruciate ligament reconstruction surgery and healthy participants. With further results, this could show a modification of muscle activity patterns after surgery which could lead to compensatory behaviors at a return to sport and eventually explain a higher injury risk for our patients.Keywords: anterior cruciate ligament, electromyography, muscle activity, physiotherapy
Procedia PDF Downloads 233314 Food and Parasitic on Balls of Grand Corbeau Corvus corax tingitanus Irby, 1874 (Aves - Corvidae) in the Garbage Dump of Oum El Bouaghi (Guelif Road)
Authors: Faiza Marniche, Amel Milla, Salah Eddine Doumandji, Samiha Belmania, Ahlem Fadheli
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Within the public discharge of Oum El Bouaghi region through the analysis of balls of rejection that have been picked up during the year 2008 and 2009. The diet of Grand Corbeau Corvus corax tingitanus is studied in relation to food availability represented by prey-insects with a parasitic study, on the balls of the latter. Food stokes are taken to the public discharge of Oum El Bouaghi during all three seasons, autumn (2008), winter (2009) and spring (2009). We note that insects are dominant in the course of three seasons, fall (91.62%), winter (58.95%) and spring (77.78%). The analysis of 42 balls of rejection collected at the level of this station have revealed that insects dominate the diet of Raven over the three seasons whose family the best represented is those of the Formicidae in autumn (43.5%) and spring (24.2%) however in winter is that of family Carabidae with a percentage of 9.1%. Parasitic analysis on the 30 balls of this species has revealed the existence of three endoparasites, Isospora Sp. (Protozoa-Coccidae), Eimeria Sp. (Protozoa-Coccidae) and Nematoda Sp. IND. (Metazoa - Nemathelmintes).Keywords: big raven Corvus corax tingitanus, diet, garbage dump, Oum El Bouaghi, parasites
Procedia PDF Downloads 437313 Anal Repair and Diamond Flap in Moderate Anal Stenosis Patient After an Open Hemorrhoidectomy Surgery: A Case Report
Authors: Andriana Purnama, Reno Rudiman, Kezia Christy
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Anal stenosis which develops due to anoderm scarring usually caused by secondary to surgical trauma, has become common, causing significant decrease patient’s quality of life. Even though mild anal stenosis was treated with non-surgical treatment, but surgical reconstruction in unavoidable for moderate to severe anal stenosis that cause distressing, severe anal pain and inability to defecate. In our study, we intend to share our result with the use of diamond flap in treatment of anal stenosis. This case report illustrates a 57-year-old male patient who presented with difficulty and discomfort in defecation caused by anal stenosis after 2 years of open hemorrhoidectomy surgery. At physical examination, there was requirement of forceful dilatation when the index finger was inserted or precisely 6mm as measured by hegar dilator (moderate anal stenosis). Blood test result was within normal limits. The patient underwent anal repair and diamond flap where the scar tissue at 6 and 9 o’clock directions was excised and diamond graft was incised carefully while paying attention to the vascular supply. Finally, the graft was fixated without any tension to the anal canal, resulting in diameter of 2 cm after operation. After 2 days post operation, the patient was in stable condition, without any complication, and discharged. There was no abnormality concerning the stool. Ten days after the operation, diamond flap was in normal condition and without any complication. He was scheduled for futher follow up at the Digestive Surgery Department. Anal stenosis due to overzealous hemorrhoidectomy is a complication that is preventable when performed in experienced hands. Diamond flap was one of the options for the anal stenosis treatment with less complication.Keywords: anal stenosis, diamond flap, post hemorrhoidectomy, anal repair
Procedia PDF Downloads 88312 Augmented ADRC for Trajectory Tracking of a Novel Hydraulic Spherical Motion Mechanism
Authors: Bin Bian, Liang Wang
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A hydraulic spherical motion mechanism (HSMM) is proposed. Unlike traditional systems using serial or parallel mechanisms for multi-DOF rotations, the HSMM is capable of implementing continuous 2-DOF rotational motions in a single joint without the intermediate transmission mechanisms. It has some advantages of compact structure, low inertia and high stiffness. However, as HSMM is a nonlinear and multivariable system, it is very complicate to realize accuracy control. Therefore, an augmented active disturbance rejection controller (ADRC) is proposed in this paper. Compared with the traditional PD control method, three compensation items, i.e., dynamics compensation term, disturbance compensation term and nonlinear error elimination term, are added into the proposed algorithm to improve the control performance. The ADRC algorithm aims at offsetting the effects of external disturbance and realizing accurate control. Euler angles are applied to describe the orientation of rotor. Lagrange equations are utilized to establish the dynamic model of the HSMM. The stability of this algorithm is validated with detailed derivation. Simulation model is formulated in Matlab/Simulink. The results show that the proposed control algorithm has better competence of trajectory tracking in the presence of uncertainties.Keywords: hydraulic spherical motion mechanism, dynamic model, active disturbance rejection control, trajectory tracking
Procedia PDF Downloads 99311 The Mediator Role of Social Competence in the Relation between Effortful Control and Maths Achievement
Authors: M. A. Fernández-Vilar, M. D. Galián, E. Ato
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The aim of this work was to analyze the relation between children´s effortful control and Maths achievement in a sample of 447 Spanish children aged between 6 and 8 years. Traditionally, the literature confirms that higher level of effortful control has been associated with higher academic achievement, but there are few studies that include the effect that children´s social competence exert to this relation. To measure children’s effortful control parents were given the TMCQ (Temperament in Middle Childhood Questionnaire), and Maths achievement was taken from teacher´s rates. To measure social competence, we used the nominations method in the classroom context. Results confirmed that higher effortful control predicted a better maths achievement, whereas lower effortful control scores predicted lower Maths scores. Using a statistical modeling approach, we tested a mediation model that revealed the mediating role of social competence (popularity and rejection) in the relation between effortful control and Maths achievement. Concretely, higher social competence (higher popularity and lower rejection) seems to mediate the better Maths achievement showed by better self´regulated children. Therefore, an adequate social competence mediates the positive effect that self-regulatory capacity exerts to academic achievement. The clinical implications of the present findings should be considered. Specifically, rejected children must be detected and evaluated in community settings, such as school or community programs, due the relevant role of social competence in the relation between temperament and academic achievement.Keywords: effortful control, maths achievement, social competence, mediation
Procedia PDF Downloads 383310 Suppression of Immunostimulatory Function of Dendritic Cells and Prolongation of Skin Allograft Survival by Dryocrassin
Authors: Hsin-Lien Lin, Ju-Hui Fu
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Dendritic cells (DCs) are the major professional antigen-presenting cells for the development of optimal T-cell immunity. DCs can be used as pharmacological targets to screen novel biological modifiers for the treatment of harmful immune responses, such as transplantation rejection. Dryopteris crassirhizoma Nakai (Aspiadaceae) is used for traditional herbal medicine in the region of East Asia. The root of this fern plant has been listed for treating inflammatory diseases. Dryocrassin is the tetrameric phlorophenone component derived from Dryopteris. Here, we tested the immunomodulatory potential of dryocrassin on lipopolysaccharide (LPS)-stimulated activation of mouse bone marrow-derived DCs in vitro and in skin allograft transplantation in vivo. Results demonstrated that dryocrassin reduced the secretion of tumor necrosis factor-α, interleukin-6, and interleukin-12p70 by LPS-stimulated DCs. The expression of LPS-induced major histocompatibility complex class II, CD40, and CD86 on DCs was also blocked by dryocrassin. Moreover, LPS-stimulated DC-elicited allogeneic T-cell proliferation was lessened by dryocrassin. In addition, dryocrassin inhibited LPS-induced activation of IϰB kinase, JNK/p38 mitogen-activated protein kinase, as well as the translocation of NF-ϰB. Treatment with dryocrassin obviously diminished 2,4-dinitro-1-fluorobenzene- induced delayed-type hypersensitivity and prolonged skin allograft survival. Dryocrassin may be one of the potent immunosuppressive agents for transplant rejection through the destruction of DC maturation and function.Keywords: dryocrassin, dendritic cells, immunosuppression, skin allograft
Procedia PDF Downloads 383309 Prognostic Impact of Pre-transplant Ferritinemia: A Survival Analysis Among Allograft Patients
Authors: Mekni Sabrine, Nouira Mariem
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Background and aim: Allogeneic hematopoietic stem cell transplantation is a curative treatment for several hematological diseases; however, it has a non-negligible morbidity and mortality depending on several prognostic factors, including pre-transplant hyperferritinemia. The aim of our study was to estimate the impact of hyperferritinemia on survivals and on the occurrence of post-transplant complications. Methods: It was a longitudinal study conducted over 8 years and including all patients who had a first allograft. The impact of pretransplant hyperferritinemia (ferritinemia ≥1500) on survivals was studied using the Kaplan Meier method and the COX model for uni- and multivariate analysis. The Khi-deux test and binary logistic regression were used to study the association between pretransplant ferritinemia and post-transplant complications. Results: One hundred forty patients were included with an average age of 26.6 years and a sex ratio (M/F)=1.4. Hyperferritinemia was found in 33% of patients. It had no significant impact on either overall survival (p=0.9) or event -free survival (p=0.6). In multivariate analysis, only the type of disease was independently associated with overall survival (p=0.04) and event-free survival (p=0.002). For post-allograft complications: The occurrence of early documented infections was independently associated with pretransplant hyperferritinemia (p=0.02) and the presence of acute graft versus host disease( GVHD) (p<10-3). The occurrence of acute GVHD was associated with early documented infection (p=0.002) and Cytomegalovirus reactivation (p<10-3). The occurrence of chronic GVHD was associated with the presence of Cytomegalovirus reactivation (p=0.006) and graft source (p=0.009). Conclusion: Our study showed the significant impact of pre-transplant hyperferritinemia on the occurrence of early infections but not on survivals. Early and more accurate assessment iron overload by other tests such as liver magnetic resonance imaging with initiation of chelating treatment could prevent the occurrence of such complications after transplantation.Keywords: allogeneic, transplants, ferritin, survival
Procedia PDF Downloads 61308 Left Posterior Pericardiotomy in the Prevention of Post-Operative Atrial Fibrillation and Cardiac Tamponade: A Retrospective Study of 2118 Isolated Coronary Artery Bypass Graft Patients
Authors: Ayeshmanthe Rathnayake, Siew Goh, Carmel Fenton, Ashutosh Hardikar
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Post-Operative Atrial Fibrillation (POAF) is the most frequent complication of cardiac surgery and is associated with reduced survival, increased rates of cognitive changes and cerebrovascular accident, heart failure, renal dysfunction, infection and length of stay, and hospital costs. Cardiac tamponade, although less common, carries high morbidity and mortality. Shed mediastinal blood in the pericardial space is a major source of intrapericardial oxidative stress and inflammation that triggers POAF. The utilisation of a left posterior pericardiotomy aims to shunt blood from the pericardium into the pleural space and have a role in the prevention of POAF as well as cardiac tamponade. 2118 patients had undergone isolated Coronary Artery Bypass Graft (CABG) at Royal Hobart Hospital from 2008-2021. They were divided into pericardiotomy vs control group. Patient baseline demographics, intraoperative data, and post-operative outcomes were reviewed retrospectively. Total incidence of new POAF and cardiac tamponade was 26.1% and 0.75%, respectively. Primary outcome of both the incidence of POAF(22.9% vs27.8%OR 0.77 p<0.05) and Cardiac Tamponade (0% vs 1.1% OR 0.85 p<0.05) were less in the pericardiotomy group.Increasing age, BMI, poor left ventricular function (EF <30%), and return to theatre were independent predictors of developing POAF. There were similar rates of return to theatre for bleeding however, no cases of tamponade in the pericardiotomy group. There were no complications attributable to left posterior pericardiotomy and the time added to the duration of surgery was minimal. Left posterior pericardiotomy is associated with a significant reduction in the incidence of POAFand cardiac tamponade and issafe and efficient.Keywords: cardiac surgery, pericardiotomy, post-operative atrial fibrillation, cardiac tamponade
Procedia PDF Downloads 86307 Arthroscopic Assisted Fibertape Technique For Recurrent MPFL Reconstruction - Case Series Done In The UK Population
Authors: Naufal Ahmed, Michael Lwin
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Background: MPFL reconstructions are ideally performed with au-tografts like gracilis semitendinosus tendon, which may be associated with donor site morbidity and complications. In this case series, we have tried to use fiber tape, which avoids the above complications and also keeps the graft virgin. This kind of synthetic graft has been used successfully in rotator cuffs and ACJ reconstructions with good results. Materials and methods: It was a retrospective data analysis of 45 patients who underwent this procedure from 2014-2020 under a single consultant in a DGH . These patiens have been followed up at 6 weeks, 6 months, 1 year, and 1 ½ years with clinical assessment and KOOS scores. We compared the results with the NJR and also with the Belgium report and was found to be satisfactory and comparable with them. Surgical technique : We used Arthrex fiber tape for the reconstruction of MPFL . Initially, two parallel holes drilled over sup aspect of the patella with help of an image intensifier, and then fiber wire passed through them from the medial to the lateral side and back to the medial side. The fiber wire was attached to the schottle point on the femoral side, giving a good extra articular internal brac-ing to the MPFL. All patients were scoped before the procedure, and the final tightening over the femoral side was done directly under vision to see the position of the patella. Results: We had 45 MPFL reconstructions along with 4 additional procedures 1 ACLR, 2 ACL REPAIR, 1 TTT advancement ( revision MPFL ). There were 14 males and 31 females, and their average age was 25 (13-55 ). We did not have any donor site morbidity, no infection, no fractures, no recurrent dislocations, no reoperations yet. Conclusion: Fiber tape is a feasible and appropriate option for MPFL reconstruction. We haven’t seen any re -operation in our 5 year follow up. This technique avoids the use of autograft, which can be used in the future if needed for revision surgeries. We don’t lose anything by following this simple novel technique.Keywords: arthroscopy, fibertape, MPFL reconstruction, recurrent patella dislocation
Procedia PDF Downloads 135306 Synthesis and Properties of Chitosan-Graft-Polyacrylamide/Gelatin Superabsorbent Composites for Wastewater Purification
Authors: Hafida Ferfera-Harrar, Nacera Aiouaz, Nassima Dairi
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Super absorbents polymers received much attention and are used in many fields because of their superior characters to traditional absorbents, e.g., sponge and cotton. So, it is very important but challenging to prepare highly and fast-swelling super absorbents. A reliable, efficient and low-cost technique for removing heavy metal ions from waste water is the adsorption using bio-adsorbents obtained from biological materials, such as polysaccharides-based hydrogels super absorbents. In this study, novel multi-functional super absorbent composites type semi-interpenetrating polymer networks (Semi-IPNs) were prepared via graft polymerization of acrylamide onto chitosan backbone in presence of gelatin, CTS-g-PAAm/Ge, using potassium persulfate and N,N’ -methylenebisacrylamide as initiator and cross linker, respectively. These hydrogels were also partially hydrolyzed to achieve superabsorbents with ampholytic properties and uppermost swelling capacity. The formation of the grafted network was evidenced by Fourier Transform Infrared Spectroscopy (ATR-FTIR) and thermo gravimetric Analysis (TGA). The porous structures were observed by Scanning Electron Microscope (SEM). From TGA analysis, it was concluded that the incorporation of the Ge in the CTS-g-PAAm network has marginally affected its thermal stability. The effect of gelatin content on the swelling capacities of these super absorbent composites was examined in various media (distilled water, saline and pH-solutions).The water absorbency was enhanced by adding Ge in the network, where the optimum value was reached at 2 wt. % of Ge. Their hydrolysis has not only greatly optimized their absorption capacity but also improved the swelling kinetic. These materials have also showed reswelling ability. We believe that these super-absorbing materials would be very effective for the adsorption of harmful metal ions from waste water.Keywords: chitosan, gelatin, superabsorbent, water absorbency
Procedia PDF Downloads 455305 Anti-Graft Instruments and Their Role in Curbing Corruption: Integrity Pact and Its Impact on Indian Procurement
Authors: Jot Prakash Kaur
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The paper aims to showcase that with the introduction of anti-graft instruments and willingness of the governments towards their implementation, a significant change can be witnessed in the anti-corruption landscape of any country. Since the past decade anti-graft instruments have been introduced by several international non-governmental organizations with the vision of curbing corruption. Transparency International’s ‘Integrity Pact’ has been one such initiative. Integrity Pact has been described as a tool for preventing corruption in public contracting. Integrity Pact has found its relevance in a developing country like India where public procurement constitutes 25-30 percent of Gross Domestic Product. Corruption in public procurement has been a cause of concern even though India has in place a whole architecture of rules and regulations governing public procurement. Integrity Pact was first adopted by a leading Oil and Gas government company in 2006. Till May 2015, over ninety organizations had adopted Integrity Pact, of which majority of them are central government units. The methodology undertaken to understand impact of Integrity Pact on Public procurement is through analyzing information received from important stakeholders of the instrument. Government, information was sought through Right to Information Act 2005 about the details of adoption of this instrument by various government organizations and departments. Contractor, Company websites and annual reports were used to find out the steps taken towards implementation of Integrity Pact. Civil Society, Transparency International India’s resource materials which include publications and reports on Integrity Pact were also used to understand the impact of Integrity Pact. Some of the findings of the study include organizations adopting Integrity pacts in all kinds of contracts such that 90% of their procurements fall under Integrity Pact. Indian State governments have found merit in Integrity Pact and have adopted it in their procurement contracts. Integrity Pact has been instrumental in creating a brand image of companies. External Monitors, an essential feature of Integrity Pact have emerged as arbitrators for the bidders and are the first line of procurement auditors for the organizations. India has cancelled two defense contracts finding it conflicting with the provisions of Integrity Pact. Some of the clauses of Integrity Pact have been included in the proposed Public Procurement legislation. Integrity Pact has slowly but steadily grown to become an integral part of big ticket procurement in India. Government’s commitment to implement Integrity Pact has changed the way in which public procurement is conducted in India. Public Procurement was a segment infested with corruption but with the adoption of Integrity Pact a number of clean up acts have been performed to make procurement transparent. The paper is divided in five sections. First section elaborates on Integrity Pact. Second section talks about stakeholders of the instrument and the role it plays in its implementation. Third section talks about the efforts taken by the government to implement Integrity Pact in India. Fourth section talks about the role of External Monitor as Arbitrator. The final section puts forth suggestions to strengthen the existing form of Integrity Pact and increase its reach.Keywords: corruption, integrity pact, procurement, vigilance
Procedia PDF Downloads 330304 Identification of Potential Large Scale Floating Solar Sites in Peninsular Malaysia
Authors: Nur Iffika Ruslan, Ahmad Rosly Abbas, Munirah Stapah@Salleh, Nurfaziera Rahim
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Increased concerns and awareness of environmental hazards by fossil fuels burning for energy have become the major factor driving the transition toward green energy. It is expected that an additional of 2,000 MW of renewable energy is to be recorded from the renewable sources by 2025 following the implementation of Large Scale Solar projects in Peninsular Malaysia, including Large Scale Floating Solar projects. Floating Solar has better advantages over its landed counterparts such as the requirement for land acquisition is relatively insignificant. As part of the site selection process established by TNB Research Sdn. Bhd., a set of mandatory and rejection criteria has been developed in order to identify only sites that are feasible for the future development of Large Scale Floating Solar power plant. There are a total of 85 lakes and reservoirs identified within Peninsular Malaysia. Only lakes and reservoirs with a minimum surface area of 120 acres will be considered as potential sites for the development of Large Scale Floating Solar power plant. The result indicates a total of 10 potential Large Scale Floating Solar sites identified which are located in Selangor, Johor, Perak, Pulau Pinang, Perlis and Pahang. This paper will elaborate on the various mandatory and rejection criteria, as well as on the various site selection process required to identify potential (suitable) Large Scale Floating Solar sites in Peninsular Malaysia.Keywords: Large Scale Floating Solar, Peninsular Malaysia, Potential Sites, Renewable Energy
Procedia PDF Downloads 173303 Piled Critical Size Bone-Biomimetic and Biominerizable Nanocomposites: Formation of Bioreactor-Induced Stem Cell Gradients under Perfusion and Compression
Authors: W. Baumgartner, M. Welti, N. Hild, S. C. Hess, W. J. Stark, G. Meier Bürgisser, P. Giovanoli, J. Buschmann
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Perfusion bioreactors are used to solve problems in tissue engineering in terms of sufficient nutrient and oxygen supply. Such problems especially occur in critical size grafts because vascularization is often too slow after implantation ending up in necrotic cores. Biominerizable and biocompatible nanocomposite materials are attractive and suitable scaffold materials for bone tissue engineering because they offer mineral components in organic carriers – mimicking natural bone tissue. In addition, human adipose derived stem cells (ASCs) can potentially be used to increase bone healing as they are capable of differentiating towards osteoblasts or endothelial cells among others. In the present study, electrospun nanocomposite disks of poly-lactic-co-glycolic acid and amorphous calcium phosphate nanoparticles (PLGA/a-CaP) were seeded with human ASCs and eight disks were stacked in a bioreactor running with normal culture medium (no differentiation supplements). Under continuous perfusion and uniaxial cyclic compression, load-displacement curves as a function of time were assessed. Stiffness and energy dissipation were recorded. Moreover, stem cell densities in the layers of the piled scaffold were determined as well as their morphologies and differentiation status (endothelial cell differentiation, chondrogenesis and osteogenesis). While the stiffness of the cell free constructs increased over time caused by the transformation of the a-CaP nanoparticles into flake-like apatite, ASC-seeded constructs showed a constant stiffness. Stem cell density gradients were histologically determined with a linear increase in the flow direction from the bottom to the top of the 3.5 mm high pile (r2 > 0.95). Cell morphology was influenced by the flow rate, with stem cells getting more roundish at higher flow rates. Less than 1 % osteogenesis was found upon osteopontin immunostaining at the end of the experiment (9 days), while no endothelial cell differentiation and no chondrogenesis was triggered under these conditions. All ASCs had mainly remained in their original pluripotent status within this time frame. In summary, we have fabricated a critical size bone graft based on a biominerizable bone-biomimetic nanocomposite with preserved stiffness when seeded with human ASCs. The special feature of this bone graft was that ASC densities inside the piled construct varied with a linear gradient, which is a good starting point for tissue engineering interfaces such as bone-cartilage where the bone tissue is cell rich while the cartilage exhibits low cell densities. As such, this tissue-engineered graft may act as a bone-cartilage interface after the corresponding differentiation of the ASCs.Keywords: bioreactor, bone, cartilage, nanocomposite, stem cell gradient
Procedia PDF Downloads 301302 Removal of Chromium by UF5kDa Membrane: Its Characterization, Optimization of Parameters, and Evaluation of Coefficients
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 135301 Identification of Membrane Foulants in Direct Contact Membrane Distillation for the Treatment of Reject Brine
Authors: Shefaa Mansour, Hassan Arafat, Shadi Hasan
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Management of reverse osmosis (RO) brine has become a major area of research due to the environmental concerns associated with it. This study worked on studying the feasibility of the direct contact membrane distillation (DCMD) system in the treatment of this RO brine. The system displayed great potential in terms of its flux and salt rejection, where different operating conditions such as the feed temperature, feed salinity, feed and permeate flow rates were varied. The highest flux of 16.7 LMH was reported with a salt rejection of 99.5%. Although the DCMD has displayed potential of enhanced water recovery from highly saline solutions, one of the major drawbacks associated with the operation is the fouling of the membranes which impairs the system performance. An operational run of 77 hours for the treatment of RO brine of 56,500 ppm salinity was performed in order to investigate the impact of fouling of the membrane on the overall operation of the system over long time operations. Over this time period, the flux was observed to have reduced by four times its initial flux. The fouled membrane was characterized through different techniques for the identification of the organic and inorganic foulants that have deposited on the membrane surface. The Infrared Spectroscopy method (IR) was used to identify the organic foulants where SEM images displayed the surface characteristics of the membrane. As for the inorganic foulants, they were identified using X-ray Diffraction (XRD), Ion Chromatography (IC) and Energy Dispersive Spectroscopy (EDS). The major foulants found on the surface of the membrane were inorganic salts such as sodium chloride and calcium sulfate.Keywords: brine treatment, membrane distillation, fouling, characterization
Procedia PDF Downloads 430300 Flying Women in Chinese Folklore – Male Narrator’s Rejection of Gender Role Division in Patriarchal Societies
Authors: Emma H. Zhang
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In Women Who Fly (2018), Serinity Young connects tales and legends of flying women in Greco-Roman, Indo-European, Mesopotamian, and Asian cultures with ancient matriarchal bird goddesses and argues that tales of flying women are reminiscent of the rituals and rites related to the worship of goddesses in pre-patriarchal times and that flying women, including swan maidens, harpies, fairies, and witches are “abnormal women” because they reject patriarchal order, defy, and desert their domestic roles. Tales of flying women in Chinese folklore, exemplified by the story of The Cowherd and the Weaver Girl, replicated in countless tales that depicts the courtship between a mortal man and a divine or magical woman suggest otherwise. In these tales, the divine woman exhibits idealized Confucian femininity and fulfills the needs of the male protagonist by providing him with marriage, children, social status, and financial affluence. This paper argues that the flying women in Chinese folklores are not a symbol of defiance but are exemplars that embodyideal Confucian femininity. These tales are instead a reflection of male rejection of gender division in patriarchal societies. The male protagonists, like the male storytellers, reject the necessity to pursue and provide for women in courtship and marriage. Though these tales show their authors’ and readers’ discontent with gender role division, they do not subvert the patriarchal social order but rather offers an escape through fantasy.Keywords: bird goddess, folklore, gender role division, patriarchy
Procedia PDF Downloads 161299 Equipment Donation: A Perspective from a Teaching Tertiary Care Hospital in North India
Authors: Jitender Sodhi, Shweta Talati, A. K. Gupta, Pankaj Arora
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Background:Equipment donation to hospitals in resource-limited settings can significantly benefit services in these settings albeit requires important ethical, practical and financial issues to be considered before accepting donations. Objective: To understand the decision making process leading to acceptance/ rejection/ deferment of equipment donation from the perspective of a public sector teaching tertiary care hospital. Design: Retrospective, record based study. Setting: 2000-bedded public sector teaching tertiary care hospital in North India. Methods: A total of 30 cases of equipment donation from March 2010-October 2013, were analysed for their decision process leading to acceptance/rejection/deferment.Each case was studied retrospectively and data pertaining to the agenda and decision taken was collected. Results: A total of 30 cases of equipment donation received from March 2010- October 2013 were screened, out of which 17 (56.6%) were for diagnostic purpose and 13 (43.3%) for therapeutic purpose. Out of 30 cases, 16 (53.3%) were accepted and 8 (26.6%) were rejected. The remaining 6 cases included 3 (10%) which required further clarification and other 3 (10%) which were out of the domain of committee. Conclusion: This study highlights the importance of equipment donation in resource limited settings and considerations involved while making decisions for acceptance/rejections/defermentof such donations.Keywords: equipment donation, teaching hospital, decision-making, North India
Procedia PDF Downloads 288298 Developing Scaffolds for Tissue Regeneration using Low Temperature Plasma (LTP)
Authors: Komal Vig
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Cardiovascular disease (CVD)-related deaths occur in 17.3 million people globally each year, accounting for 30% of all deaths worldwide, with a predicted annual incidence of deaths to reach 23.3 million globally by 2030. Autologous bypass grafts remain an important therapeutic option for the treatment of CVD, but the poor quality of the donor patient’s blood vessels, the invasiveness of the resection surgery, and postoperative movement restrictions create issues. The present study is aimed to improve the endothelialization of intimal surface of graft by using low temperature plasma (LTP) to increase the cell attachment and proliferation. Polytetrafluoroethylene (PTFE) was treated with LTP. Air was used as the feed-gas, and the pressure in the plasma chamber was kept at 800 mTorr. Scaffolds were also modified with gelatin and collagen by dipping method. Human umbilical vein endothelial cells (HUVEC) were plated on the developed scaffolds, and cell proliferation was determined by the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay and by microscopy. mRNA expressions levels of different cell markers were investigated using quantitative real-time PCR (qPCR). XPS confirmed the introduction of oxygenated functionalities from LTP. HUVEC cells showed 80% seeding efficiency on the scaffold. Microscopic and MTT assays indicated increase in cell viability in LTP treated scaffolds, especially when treated with gelatin or collagen, compared to untreated scaffolds. Gene expression studies shows enhanced expression of cell adhesion marker Integrin- α 5 gene after LTP treatment. LTP treated scaffolds exhibited better cell proliferation and viability compared to untreated scaffolds. Protein treatment of scaffold increased cell proliferation. Based on our initial results, more scaffolds alternatives will be developed and investigated for cell growth and vascularization studies. Acknowledgments: This work is supported by the NSF EPSCoR RII-Track-1 Cooperative Agreement OIA-2148653.Keywords: LTP, HUVEC cells, vascular graft, endothelialization
Procedia PDF Downloads 64297 Differential Impact of Parenting on Mental Health Functioning of Pakistani Adolescents: A Cultural Perspective
Authors: Zahid Mahmood
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Mental health problems in adolescents are said to be increasing tremendously, and a large proportion of adolescents are suffering from serious mental health problems that result in short and long term socio-emotional negative consequences. Contemporary clinical and school psychology is now focused on prevention rather than intervene in the mental health concerns of adolescents. Therefore, a wealth of literature is devoted to identify the risk and protective factors so that adolescents may be prevented and identified earlier. This quest has led to identify many risk factors including the early parent-child relationship. Parenting has a long last impact on the growth and development of an individual. If the parent-child relationship is secure and warm, the child tends to have a positive psychological outcome. On the other hand, if parenting is rejecting and distant, it may lead to more mental health problems. Keeping in view the cross-cultural influence of parenting, the current study was aimed to explore the relationship between parental rearing practices and mental health problems on a group of Pakistani adolescents. A sample of 805 participants (49% boys and 51% girls) were selected through a stratified sample with the age range of 13-18 years. All the participants were given protocol of EMBU-C and School Children Problem Scale (SCPS). Results indicate that age, the gender of the participant and parental rejection were found to be a significant positive predictor of mental health problems in adolescents. It can be concluded that parenting may be a universal phenomenon comprising rejection and acceptance yet the differential impact on mental health varies from culture to culture.Keywords: parenting, mental health, adolescents, cross cultural
Procedia PDF Downloads 116296 Dual-Actuated Vibration Isolation Technology for a Rotary System’s Position Control on a Vibrating Frame: Disturbance Rejection and Active Damping
Authors: Kamand Bagherian, Nariman Niknejad
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A vibration isolation technology for precise position control of a rotary system powered by two permanent magnet DC (PMDC) motors is proposed, where this system is mounted on an oscillatory frame. To achieve vibration isolation for this system, active damping and disturbance rejection (ADDR) technology is presented which introduces a cooperation of a main and an auxiliary PMDC, controlled by discrete-time sliding mode control (DTSMC) based schemes. The controller of the main actuator tracks a desired position and the auxiliary actuator simultaneously isolates the induced vibration, as its controller follows a torque trend. To determine this torque trend, a combination of two algorithms is introduced by the ADDR technology. The first torque-trend producing algorithm rejects the disturbance by counteracting the perturbation, estimated using a model-based observer. The second torque trend applies active variable damping to minimize the oscillation of the output shaft. In this practice, the presented technology is implemented on a rotary system with a pendulum attached, mounted on a linear actuator simulating an oscillation-transmitting structure. In addition, the obtained results illustrate the functionality of the proposed technology.Keywords: active damping, discrete-time nonlinear controller, disturbance tracking algorithm, oscillation transmitting support, position control, stability robustness, vibration isolation
Procedia PDF Downloads 96295 Discrete PID and Discrete State Feedback Control of a Brushed DC Motor
Authors: I. Valdez, J. Perdomo, M. Colindres, N. Castro
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Today, digital servo systems are extensively used in industrial manufacturing processes, robotic applications, vehicles and other areas. In such control systems, control action is provided by digital controllers with different compensation algorithms, which are designed to meet specific requirements for a given application. Due to the constant search for optimization in industrial processes, it is of interest to design digital controllers that offer ease of realization, improved computational efficiency, affordable return rates, and ease of tuning that ultimately improve the performance of the controlled actuators. There is a vast range of options of compensation algorithms that could be used, although in the industry, most controllers used are based on a PID structure. This research article compares different types of digital compensators implemented in a servo system for DC motor position control. PID compensation is evaluated on its two most common architectures: PID position form (1 DOF), and PID speed form (2 DOF). State feedback algorithms are also evaluated, testing two modern control theory techniques: discrete state observer for non-measurable variables tracking, and a linear quadratic method which allows a compromise between the theoretical optimal control and the realization that most closely matches it. The compared control systems’ performance is evaluated through simulations in the Simulink platform, in which it is attempted to model accurately each of the system’s hardware components. The criteria by which the control systems are compared are reference tracking and disturbance rejection. In this investigation, it is considered that the accurate tracking of the reference signal for a position control system is particularly important because of the frequency and the suddenness in which the control signal could change in position control applications, while disturbance rejection is considered essential because the torque applied to the motor shaft due to sudden load changes can be modeled as a disturbance that must be rejected, ensuring reference tracking. Results show that 2 DOF PID controllers exhibit high performance in terms of the benchmarks mentioned, as long as they are properly tuned. As for controllers based on state feedback, due to the nature and the advantage which state space provides for modelling MIMO, it is expected that such controllers evince ease of tuning for disturbance rejection, assuming that the designer of such controllers is experienced. An in-depth multi-dimensional analysis of preliminary research results indicate that state feedback control method is more satisfactory, but PID control method exhibits easier implementation in most control applications.Keywords: control, DC motor, discrete PID, discrete state feedback
Procedia PDF Downloads 262294 Stress Hyperglycaemia and Glycaemic Control Post Cardiac Surgery: Relaxed Targets May Be Acceptable
Authors: Nicholas Bayfield, Liam Bibo, Charley Budgeon, Robert Larbalestier, Tom Briffa
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Introduction: Stress hyperglycaemia is common following cardiac surgery. Its optimal management is uncertain and may differ by diabetic status. This study assesses the in-hospital glycaemic management of cardiac surgery patients and associated postoperative outcomes. Methods: A retrospective cohort analysis of all patients undergoing cardiac surgery at Fiona Stanley Hospital from February 2015 to May 2019 was undertaken. Management and outcomes of hyperglycaemia following cardiac surgery were assessed. Follow-up was assessed to 1 year postoperatively. Multivariate regression modelling was utilised. Results: 1050 non-diabetic patients and 689 diabetic patients were included. In the non-diabetic cohort, patients with mild (peak blood sugar level [BSL] < 14.3), transient stress hyperglycaemia managed without insulin were not at an increased risk of wound-related morbidity (P=0.899) or mortality at 1 year (P=0.483). Insulin management was associated with wound-related readmission to hospital (P=0.004) and superficial sternal wound infection (P=0.047). Prolonged or severe stress hyperglycaemia was predictive of hospital re-admission (P=0.050) but not morbidity or mortality (P=0.546). Diabetes mellitus was an independent risk factor 1-year mortality (OR; 1.972 [1.041–3.736], P=0.037), graft harvest site wound infection (OR; 1.810 [1.134–2.889], P=0.013) and wound-related readmission (OR; 1.866 [1.076–3.236], P=0.026). In diabetics, postoperative peak BSL > 13.9mmol/L was predictive of graft harvest site infections (OR; 3.528 [1.724-7.217], P=0.001) and wound-related readmission OR; 3.462 [1.540-7.783], P=0.003) regardless of modality of management. A peak BSL of 10.0-13.9 did not increase the risk of morbidity/mortality compared to a peak BSL of < 10.0 (P=0.557). Diabetics with a peak BSL of 13.9 or less did not have significantly increased morbidity/mortality outcomes compared to non-diabetics (P=0.418). Conclusion: In non-diabetic patients, transient mild stress hyperglycaemia following cardiac surgery does not uniformly require treatment. In diabetic patients, postoperative hyperglycaemia with peak BSL exceeding 13.9mmol/L was associated with wound-related morbidity and hospital readmission following cardiac surgery.Keywords: cardiac surgery, pulmonary embolism, pulmonary embolectomy, cardiopulmonary bypass
Procedia PDF Downloads 157293 Thin-Film Nanocomposite Membrane with Single-Walled Carbon Nanotubes Axial Positioning in Support Layer for Desalination of Water
Authors: Ahmed A. Alghamdi
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Single-walled carbon nanotubes (SWCNTs) are an outstanding material for applications in thermoelectric power generation, nanoelectronics, electrochemical energy storage, photovoltaics, and light emission. They are ultra-lightweight and possess electrical as well as thermal conductivity, flexibility, and mechanical strength. SWCNT is applicable in water treatment, brine desalination, removal of heavy metal ions associated with pollutants, and oil-water separation. Carbon nanotube (CNT) is believed to tackle the trade-off issue between permeability, selectivity, and fouling issues in membrane filtration applications. Studying these CNT structures, as well as their interconnection in nanotechnology, assists in finding the precise position to be placed for water desalination. Reverse osmosis (RO) has been used globally for desalination, resulting in purified water. Thin film composite (TFC) membranes were utilized in the RO process for desalination. The sheet thickness increases the salt rejection and decreases the water flux when CNT is utilized as a support layer to this membrane. Thus, through a temperature-induced phase separation technique (TIPS), axially aligned SWCNT (AASWCNT) is fabricated, and its use enhances the salt rejection and water flux at short reaction times with a modified procedure. An evaluation was conducted and analogized with prior works in the literature, which exhibited that the prepared TFC membrane showed a better outcome.Keywords: single-walled carbon nanotubes, thin film composite, axially aligned swcnt, temperature induced phase separation technique, reverse osmosis
Procedia PDF Downloads 46292 The Mediating Role of Early Maladaptive Schemas in the Relationship between Attachment and Trait Anger and Anger Expression
Authors: Ayperi̇ Haspolat Özcan, Meltem Anafarta Şendağ
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This study aimed to establish a model in the light of current approaches for understanding the mediating role of early maladaptive schemas in the relationship between attachment and anger. Accordingly, the proposed mediation model was tested by mediation with bootstrapping technique, considering gender and attachment figure differences. The university students (N= 444) with ages ranging from 17 to 28 participated in the study. Participants filled out Parental and Peer Attachment Scale Short Form, Young Schema Questionnaire - Short Form 3, Trait Anger and Anger Expression Scales. The mediating role of early maladaptive schemas (impaired autonomy, disconnection and rejection, unrelenting standards, other-directedness, and impaired limits) in the relationship between attachment (mother and father) and anger aspects (trait anger, anger in, anger out and anger control) were found to be significant for both male and female participants. Separate mediation analyses for both genders and different attachment figures have also drawn attention to noticeable differences in the results. Specifically, for females, various paths were discovered in predicting various aspects of anger (anger in, anger out, anger control, and trait anger). On the other hand, for males only anger directed inwards was found to be predicted by any source of attachment through disconnection and rejection schema only. These obvious gender differences in understanding the mechanism of anger are discussed in the light of cultural gender roles and the social acceptance of anger in males. In the area of application, the study of various aspects of anger with particular attention to attachment and early maladaptive schemas as well as the importance of distinguishing the gender differences are emphasized as important points.Keywords: anger expression, attachment, early maladaptive schemas, trait anger
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