Search results for: minimal invasive

Authors: D. M. Lewis, L. Frisby, U. Stead

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Objective: Many patients are receiving invasive treatments in acute care or are dying in hospital without having had comprehensive goals of care conversations. Some of these treatments may not align with the patient’s wishes, may be futile, and may cause unnecessary suffering. While many staff may recognize the benefits of engaging patients and families in Serious Illness Conversations (a goal of care framework developed by Ariadne Labs in Boston), few staff feel confident and/or competent in having these conversations in acute care. Another barrier to having these conversations may be due to a lack of incorporation in the current workflow. An educational exercise, titled the Two Question Challenge, was initiated on four medical units across two Vancouver Coastal Health (VCH) hospitals in attempt to engage the entire interdisciplinary team in asking patients and families questions around goals of care and to improve the documentation of these expressed wishes and preferences. Methods: Four acute care units across two separate hospitals participated in the Two Question Challenge. On each unit, over the course of two eight-hour shifts, all members of the interdisciplinary team were asked to select at least two questions from a selection of nine goals of care questions. They were asked to pose these questions of a patient or family member throughout their shift and then asked to document their conversations in a centralized Advance Care Planning/Goals of Care discussion record in the patient’s chart. A visual representation of conversation outcomes was created to demonstrate to staff and patients the breadth of conversations that took place throughout the challenge. Staff and patients were interviewed about their experiences throughout the challenge. Two palliative approach leads remained present on the units throughout the challenge to support, guide, or role model these conversations. Results: Across four acute care medical units, 47 interdisciplinary staff participated in the Two Question Challenge, including nursing, allied health, and a physician. A total of 88 questions were asked of patients, or their families around goals of care and 50 newly documented goals of care conversations were charted. Two code statuses were changed as a result of the conversations. Patients voiced an appreciation for these conversations and staff were able to successfully incorporate these questions into their daily care. Conclusion: The Two Question Challenge proved to be an effective way of having teams explore the goals of care of patients and families in an acute care setting. Staff felt that they gained confidence and competence. Both staff and patients found these conversations to be meaningful and impactful and felt they were notably different from their usual interactions. Documentation of these conversations in a centralized location that is easily accessible to all care providers increased significantly. Application of the Two Question Challenge in non-medical units or other care settings, such as long-term care facilities or community health units, should be explored in the future.

Keywords: advance care planning, goals of care, interdisciplinary, palliative approach, serious illness conversations

Procedia PDF Downloads 86

Authors: Davendra S. Malik

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Bhimtal lake is located between 290 21’ N latitude and 790 24’ E longitude, at an elevation of 1332m above mean sea level in the Kumaun region of Uttarakhand of Indian subcontinent. The lake surface area is decreasing in water area, depth level in relation to ecological and biological characteristics due to climatic variations, invasive land use pattern, degraded forest zones and changed agriculture pattern in lake catchment basin. The present study is focused on long and short term effects of climate change on aquatic biodiversity and productivity of Bhimtal lake. The meteorological data of last fifteen years of Bhimtal lake catchment basin revealed that air temperature has been increased 1.5 to 2.1oC in summer, 0.2 to 0.8 C in winter, relative humidity increased 4 to 6% in summer and rainfall pattern changed erratically in rainy seasons. The surface water temperature of Bhimtal lake showed an increasing pattern as 0.8 to 2.6 C, pH value decreased 0.5 to 0.2 in winter and increased 0.4 to 0.6 in summer. Dissolved oxygen level in lake showed a decreasing trend as 0.7 to 0.4mg/l in winter months. The mesotrophic nature of Bhimtal lake is changing towards eutrophic conditions and contributed for decreasing biodiversity. The aquatic biodiversity of Bhimtal lake consisted mainly phytoplankton, zooplankton, benthos and fish species. In the present study, a total of 5 groups of phytoplankton, 3 groups of zooplankton, 11 groups of benthos and 15 fish species were recorded from Bhimtal lake. The comparative data of biodiversity of Bhimtal lake since January, 2000 indicated the changing pattern of phytoplankton biomass were decreasing as 1.99 and 1.08% of Chlorophyceae and Bacilleriophyceae families respectively. The biomass of Cynophyceae was increasing as 0.45% and contributing the algal blooms during summer season in lake. The biomass of zooplankton and benthos were found decreasing in winter season and increasing during summer season. The endemic fish species (18 no.) were found in year 2000-05, as while the fish species (15 no.) were recorded in present study. The relative fecundity of major fish species were observed decreasing trends during their breeding periods in lake. The natural and anthropogenic factors were identified as ecological threats for existing aquatic biodiversity of Bhimtal lake. The present research paper emphasized on the effect of changing pattern of different climatic variables on species composition, biomass of phytoplankton, zooplankton, benthos, and fishes in Bhimtal lake of Kumaun region. The present research data will be contributed significantly to assess the changing pattern of aquatic biodiversity and productivity of Bhimtal lake with different time scale.

Keywords: aquatic biodiversity, Bhimtal lake, climate change, lake ecology

Procedia PDF Downloads 191

Authors: Aidan N. Smallwood, Celestine R. Weegenaar, Jack N. Evans

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The intensive care unit (ICU) is a particularly resource heavy environment, in terms of staff, drugs and equipment required. Whilst many areas of the hospital are attempting to cut down on plastic use and minimise their impact on the environment, this has proven challenging within the confines of intensive care. Concurrently, as globalization has progressed over recent decades, there has been a tendency towards centralised manufacturing with international distribution networks for products, often covering large distances. In this study, we have modelled the standard consumption of plastic single-use items over the course of the first 24-hours of an average individual patient’s stay in a 12 bed ICU in the United Kingdom (UK). We have identified the country of manufacture and calculated the minimum possible distance travelled by each item from factory to patient. We have assumed direct transport via the shortest possible straight line from country of origin to the UK and have not accounted for transport within either country. Assuming an intubated patient with invasive haemodynamic monitoring and central venous access, there are a total of 52 distincts, largely plastic, disposable products which would reasonably be required in the first 24-hours after admission. Each product type has only been counted once to account for multiple items being shipped as one package. Travel distances from origin were summed to give the total distance combined for all 52 products. The minimum possible total distance travelled from country of origin to the UK for all types of product was 273,353 km, equivalent to 6.82 circumnavigations of the globe, or 71% of the way to the moon. The mean distance travelled was 5,256 km, approximately the distance from London to Mecca. With individual packaging for each item, the total weight of consumed products was 4.121 kg. The CO2 produced shipping these items by air freight would equate to 30.1 kg, however doing the same by sea would produce 0.2 kg CO2. Extrapolating these results to the 211,932 UK annual ICU admissions (2018-2019), even with the underestimates of distance and weight of our assumptions, air freight would account for 6586 tons CO2 emitted annually, approximately 130 times that of sea freight. Given the drive towards cost saving within the UK health service, and the decline of the local manufacturing industry, buying from intercontinental manufacturers is inevitable However, transporting all consumables by sea where feasible would be environmentally beneficial, as well as being less costly than air freight. At present, the NHS supply chain purchases from medical device companies, and there is no freely available information as to the transport mode used to deliver the product to the UK. This must be made available to purchasers in order to give a fuller picture of life cycle impact and allow for informed decision making in this regard.

Keywords: CO2, intensive care, plastic, transport

Procedia PDF Downloads 143

Authors: Boris Barbolyas, Kristina Buckova, Tomas Volensky, Cyril Belavy, Ladislav Dedik

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Background: Based on statokinezigram, the human balance control is often studied. Approach to human postural reaction analysis is based on a combination of stabilometry output signal with retroreflective marker data signal processing, analysis, and understanding, in this study. The study shows another original application of Method of Developed Statokinesigram Trajectory (MDST), too. Methods: In this study, the participants maintained quiet bipedal standing for 10 s on stabilometry platform. Consequently, bilateral vibration stimuli to Achilles tendons in 20 s interval was applied. Vibration stimuli caused that human postural system took the new pseudo-steady state. Vibration frequencies were 20, 60 and 80 Hz. Participant's body segments - head, shoulders, hips, knees, ankles and little fingers were marked by 12 retroreflective markers. Markers positions were scanned by six cameras system BTS SMART DX. Registration of their postural reaction lasted 60 s. Sampling frequency was 100 Hz. For measured data processing were used Method of Developed Statokinesigram Trajectory. Regression analysis of developed statokinesigram trajectory (DST) data and retroreflective marker developed trajectory (DMT) data were used to find out which marker trajectories most correlate with stabilometry platform output signals. Scaling coefficients (λ) between DST and DMT by linear regression analysis were evaluated, too. Results: Scaling coefficients for marker trajectories were identified for all body segments. Head markers trajectories reached maximal value and ankle markers trajectories had a minimal value of scaling coefficient. Hips, knees and ankles markers were approximately symmetrical in the meaning of scaling coefficient. Notable differences of scaling coefficient were detected in head and shoulders markers trajectories which were not symmetrical. The model of postural system behavior was identified by MDST. Conclusion: Value of scaling factor identifies which body segment is predisposed to postural instability. Hypothetically, if statokinesigram represents overall human postural system response to vibration stimuli, then markers data represented particular postural responses. It can be assumed that cumulative sum of particular marker postural responses is equal to statokinesigram.

Keywords: center of pressure (CoP), method of developed statokinesigram trajectory (MDST), model of postural system behavior, retroreflective marker data

Procedia PDF Downloads 317

Authors: Kamal Kaushik, Dandpani Epili, Ajay G. V., Ashutosh, S. Pradhaan

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Introduction: Radiation therapy has come a long way over a period of decades, from 2-dimensional radiotherapy to intensity-modulated radiation therapy (IMRT) or VMAT. For advanced radiation therapy, we need better patient position reproducibility to deliver precise and quality treatment, which raises the need for better image guidance technologies for precise patient positioning. This study presents a two tattoo simulation with roll correction technique which is comparable to other advanced patient positioning techniques. Objective: This is a site-specific study is aimed to perform a comparison between various treatment positioning techniques used for the treatment of patients of Ca- Breast undergoing radiotherapy. In this study, we are comparing 5 different positioning methods used for the treatment of ca-breast, namely i) Vacloc with 3 tattoos, ii) Breast board with three tattoos, iii) Thermoplastic cast with three fiducials, iv) Breast board with a thermoplastic mask with 3 tattoo, v) Breast board with 2 tattoos – A roll correction method. Methods and material: All in one (AIO) solution immobilization was used in all patient positioning techniques for immobilization. The process of two tattoo simulations includes positioning of the patient with the help of a thoracic-abdomen wedge, armrest & knee rest. After proper patient positioning, we mark two tattoos on the treatment side of the patient. After positioning, place fiducials as per the clinical borders markers (1) sternum notch (lower border of clavicle head) (2) 2 cm below from contralateral breast (3) midline between 1 & 2 markers (4) mid axillary on the same axis of 3 markers (Marker 3 & 4 should be on the same axis). During plan implementation, a roll depth correction is applied as per the anterior and lateral positioning tattoos, followed by the shifts required for the Isocentre position. The shifts are then verified by SSD on the patient surface followed by radiographic verification using Cone Beam Computed Tomography (CBCT). Results: When all the five positioning techniques were compared all together, the produced shifts in Vertical, Longitudinal and lateral directions are as follows. The observations clearly suggest that the Longitudinal average shifts in two tattoo roll correction techniques are less than every other patient positioning technique. Vertical and lateral Shifts are also comparable to other modern positioning techniques. Concluded: The two tattoo simulation with roll correction technique provides us better patient setup with a technique that can be implemented easily in most of the radiotherapy centers across the developing nations where 3D verification techniques are not available along with delivery units as the shifts observed are quite minimal and are comparable to those with Vacloc and modern amenities.

Keywords: Ca. breast, breast board, roll correction technique, CBCT

Procedia PDF Downloads 102

Authors: Jung-En Kuan, Whei-Fen Wu

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In this study, a symbiotic bacteria from yellow mealworm's (Tenebrio molitor) mid-gut was isolated with characteristics of growth on minimal-tributyrin medium. After a PCR-amplification of its 16s rDNA, the resultant nucleotide sequences were then analyzed by schemes of the phylogeny trees. Accordingly, it was designated as Pseudomonas nitroreducens D-01. Next, by searching the lipolytic enzymes in its protein data bank, one of those potential lipolytic α/β hydrolases was identified, again using PCR-amplification and nucleotide-sequencing methods. To construct an expression of this lipolytic gene in plasmids, the target-gene primers were then designed, carrying the C-terminal his-tag sequences. Using the vector pET21a, a recombinant lipolytic hydrolase D gene with his-tag nucleotides was successfully cloned into it, of which the lipolytic D gene is under a control of the T7 promoter. After transformation of the resultant plasmids into Eescherichia coli BL21 (DE3), an IPTG inducer was used for the induction of the recombinant proteins. The protein products were then purified by metal-ion affinity column, and the purified proteins were found capable of forming a clear zone on tributyrin agar plate. Shortly, its enzyme activities were determined by degradation of p-nitrophenyl ester(s), and the substantial yellow end-product, p-nitrophenol, was measured at O.D.405 nm. Specifically, this lipolytic enzyme efficiently targets p-nitrophenyl butyrate. As well, it shows the most reactive activities at 40°C, pH 8 in potassium phosphate buffer. In thermal stability assays, the activities of this enzyme dramatically drop when the temperature is above 50°C. In metal ion assays, MgCl₂ and NH₄Cl induce the enzyme activities while MnSO₄, NiSO₄, CaCl₂, ZnSO₄, CoCl₂, CuSO₄, FeSO₄, and FeCl₃ reduce its activities. Besides, NaCl has no effects on its enzyme activities. Most organic solvents decrease the activities of this enzyme, such as hexane, methanol, ethanol, acetone, isopropanol, chloroform, and ethyl acetate. However, its enzyme activities increase when DMSO exists. All the surfactants like Triton X-100, Tween 80, Tween 20, and Brij35 decrease its lipolytic activities. Using Lineweaver-Burk double reciprocal methods, the function of the enzyme kinetics were determined such as Km = 0.488 (mM), Vmax = 0.0644 (mM/min), and kcat = 3.01x10³ (s⁻¹), as well the total efficiency of kcat/Km is 6.17 x10³ (mM⁻¹/s⁻¹). Afterwards, based on the phylogenetic analyses, this lipolytic protein is classified to type IV lipase by its homologous conserved region in this lipase family.

Keywords: enzyme, esterase, lipotic hydrolase, type IV

Procedia PDF Downloads 111

Authors: Yi-Hung Ho, Chih-Wei Wang, Chih-Hsien Chen, Chih-Han Chang

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Unilateral laminotomy and bilateral laminotomies were successful decompressions methods for managing spinal stenosis that numerous studies have reported. Thus, unilateral laminotomy was rated technically much more demanding than bilateral laminotomies, whereas the bilateral laminotomies were associated with a positive benefit to reduce more complications. There were including incidental durotomy, increased radicular deficit, and epidural hematoma. However, no relative biomechanical analysis for evaluating spinal instability treated with unilateral and bilateral laminotomies. Therefore, the purpose of this study was to compare the outcomes of different decompressions methods by experimental and finite element analysis. Three porcine lumbar spines were biomechanically evaluated for their range of motion, and the results were compared following unilateral or bilateral laminotomies. The experimental protocol included flexion and extension in the following procedures: intact, unilateral, and bilateral laminotomies (L2–L5). The specimens in this study were tested in flexion (8 Nm) and extension (6 Nm) of pure moment. Spinal segment kinematic data was captured by using the motion tracking system. A 3D finite element lumbar spine model (L1-S1) containing vertebral body, discs, and ligaments were constructed. This model was used to simulate the situation of treating unilateral and bilateral laminotomies at L3-L4 and L4-L5. The bottom surface of S1 vertebral body was fully geometrically constrained in this study. A 10 Nm pure moment also applied on the top surface of L1 vertebral body to drive lumbar doing different motion, such as flexion and extension. The experimental results showed that in the flexion, the ROMs (±standard deviation) of L3–L4 were 1.35±0.23, 1.34±0.67, and 1.66±0.07 degrees of the intact, unilateral, and bilateral laminotomies, respectively. The ROMs of L4–L5 were 4.35±0.29, 4.06±0.87, and 4.2±0.32 degrees, respectively. No statistical significance was observed in these three groups (P>0.05). In the extension, the ROMs of L3–L4 were 0.89±0.16, 1.69±0.08, and 1.73±0.13 degrees, respectively. In the L4-L5, the ROMs were 1.4±0.12, 2.44±0.26, and 2.5±0.29 degrees, respectively. Significant differences were observed among all trials, except between the unilateral and bilateral laminotomy groups. At the simulation results portion, the similar results were discovered with the experiment. No significant differences were found at L4-L5 both flexion and extension in each group. Only 0.02 and 0.04 degrees variation were observed during flexion and extension between the unilateral and bilateral laminotomy groups. In conclusions, the present results by finite element analysis and experimental reveal that no significant differences were observed during flexion and extension between unilateral and bilateral laminotomies in short-term follow-up. From a biomechanical point of view, bilateral laminotomies seem to exhibit a similar stability as unilateral laminotomy. In clinical practice, the bilateral laminotomies are likely to reduce technical difficulties and prevent perioperative complications; this study proved this benefit through biomechanical analysis. The results may provide some recommendations for surgeons to make the final decision.

Keywords: unilateral laminotomy, bilateral laminotomies, spinal stenosis, finite element analysis

Procedia PDF Downloads 377

Authors: Rekha S., S. J. Nalini, S. Bhuvana, S. Kanmani, Vidhya Venugopal

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Introduction: Pregnant women's occupational heat exposure has been linked to foetal abnormalities and pregnancy complications. The presence of heat in the workplace is expected to lead to Adverse Pregnancy Outcomes (APO), especially in tropical countries where temperatures are rising and workplace cooling interventions are minimal. For effective interventions, in-depth understanding and evidence about occupational heat stress and APO are required. Methodology: Approximately 800 pregnant women in and around Chennai who were employed in jobs requiring moderate to hard labour participated in the cohort research. During the study period (2014-2019), environmental heat exposures were measured using a Questemp WBGT monitor, and heat strain markers, such as Core Body Temperature (CBT) and Urine Specific Gravity (USG), were evaluated using an Infrared Thermometer and a refractometer, respectively. Using a valid HOTHAPS questionnaire, self-reported health symptoms were collected. In addition, a postpartum follow-up with the mothers was done to collect APO-related data. Major findings of the study: Approximately 47.3% of pregnant workers have workplace WBGTs over the safe manual work threshold value for moderate/heavy employment (Average WBGT of 26.6°C±1.0°C). About 12.5% of the workers had CBT levels above the usual range, and 24.8% had USG levels above 1.020, both of which suggested mild dehydration. Miscarriages (3%), stillbirths/preterm births (3.5%), and low birth weights (8.8%) were the most common unfavorable outcomes among pregnant employees. In addition, WBGT exposures above TLVs during all trimesters were associated with a 2.3-fold increased risk of adverse fetal/maternal outcomes (95% CI: 1.4-3.8), after adjusting for potential confounding variables including age, education, socioeconomic status, abortion history, stillbirth, preterm, LBW, and BMI. The study determined that WBGTs in the workplace had direct short- and long-term effects on the health of both the mother and the foetus. Despite the study's limited scope, the findings provided valuable insights and highlighted the need for future comprehensive cohort studies and extensive data in order to establish effective policies to protect vulnerable pregnant women from the dangers of heat stress and to promote reproductive health.

Keywords: adverse outcome, heat stress, interventions, physiological strain, pregnant women

Procedia PDF Downloads 47

Authors: Axel Thallemer, Aleksandar Kostadinov, Abel Fam, Alex Teo

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For centuries, the forming processes in nature served as a source of inspiration for both architects and designers. It seems as most human artifacts are based on ideas which stem from the observation of the biological world and its principles of growth. As a fact, in the cultural history of Homo faber, materials have been mostly used in their solid state: From hand axe to computer mouse, the principle of employing matter has not changed ever since the first creation. In the scope of history only recently and by the help of additive-generative fabrication processes through Computer Aided Design (CAD), designers were enabled to deconstruct solid artifacts into an outer skin and an internal lattice structure. The intention behind this approach is to create a new topology which reduces resources and integrates functions into an additively manufactured component. However, looking at the currently employed lattice structures, it is very clear that those lattice structure geometries have not been thoroughly designed, but rather taken out of basic-geometry libraries which are usually provided by the CAD. In the here presented study, a group of 20 industrial design students created new and unique lattice structures using natural paragons as their models. The selected natural models comprise both the animate and inanimate world, with examples ranging from the spiraling of narwhal tusks, off-shooting of mangrove roots, minimal surfaces of soap bubbles, up to the rhythmical arrangement of molecular geometry, like in the case of SiOC (Carbon-Rich Silicon Oxicarbide). This ideation process leads to a design of a geometric cell, which served as a basic module for the lattice structure, whereby the cell was created in visual analogy to its respective natural model. The spatial lattices were fabricated additively in mostly [X]3 by [Y]3 by [Z]3 units’ volumes using selective powder bed melting in polyamide with (z-axis) 50 mm and 100 µm resolution and subdued to mechanical testing of their elastic zone in a biomedical laboratory. The results demonstrate that additively manufactured lattice structures can acquire different properties when they are designed in analogy to natural models. Several of the lattices displayed the ability to store and return kinetic energy, while others revealed a structural failure which can be exploited for purposes where a controlled collapse of a structure is required. This discovery allows for various new applications of functional lattice structures within industrially created objects.

Keywords: bio-inspired, biomimetic, lattice structures, additive manufacturing

Procedia PDF Downloads 126

Authors: Jared R. Chapman

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This study introduces a type of motivational information system called an educational engagement information system (EEIS). An EEIS draws on principles of behavioral economics, motivation theory, and learning cognition theory to design information systems that help students want to improve their performance. This study compares academic outcomes for course sections taught by part- and full-time instructors both with and without an EEIS. Without an EEIS, students in the part-time instructor's course sections demonstrated significantly higher failure rates (a 143.8% increase) and dropout rates (a 110.4% increase) with significantly fewer students scoring a B- or higher (39.8% decrease) when compared to students in the course sections taught by a full-time instructor. It is concerning that students in the part-time instructor’s course without an EEIS had significantly lower academic outcomes, suggesting less understanding of the course content. This could impact retention and continuation in a major. With an EEIS, when comparing part- and full-time instructors, there was no significant difference in failure and dropout rates or in the number of students scoring a B- or higher in the course. In fact, with an EEIS, the failure and dropout rates were statistically identical for part- and full-time instructor courses. When using an EEIS (compared with not using an EEIS), the part-time instructor showed a 62.1% decrease in failures, a 61.4% decrease in dropouts, and a 41.7% increase in the number of students scoring a B- or higher in the course. We are unaware of other interventions that yield such large improvements in academic performance. This suggests that using an EEIS such as Delphinium may compensate for part-time instructors’ limitations of expertise, time, or rewards that can have a negative impact on students’ academic outcomes. The EEIS had only a minimal impact on failure rates (7.7% decrease) and dropout rates (18.8% decrease) for the full-time instructor. This suggests there is a ceiling effect for the improvements that an EEIS can make in student performance. This may be because experienced instructors are already doing the kinds of things that an EEIS does, such as motivating students, tracking grades, and providing feedback about progress. Additionally, full-time instructors have more time to dedicate to students outside of class than part-time instructors and more rewards for doing so. Using adjunct and other types of part-time instructors will likely remain a prevalent practice in higher education management courses. Given that using part-time instructors can have a negative impact on student graduation and persistence in a field of study, it is important to identify ways we can augment part-time instructors’ performance. We demonstrated that when part-time instructors use an EEIS, it can result in significantly lower students’ failure and dropout rates and an increase in the rate of students earning a B- or above; and bring their students’ performance to parity with the performance of students taught by a full-time instructor.

Keywords: gamification, engagement, motivation, academic outcomes

Procedia PDF Downloads 45

Authors: Vivek Bhat, Rohini Kelkar, Sanjay Biswas

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Introduction: Cancer patients are at increased risk of bacterial infections. This may due to the disease process itself, the effect of chemotherapeutic drugs or invasive procedures such as catheterization. A wide variety of bacteria including some emerging pathogens are increasingly being reported from these patients. The incidence of multidrug-resistant organisms particularly in the Gram negative group is also increasing, with higher resistance rates seen to cephalosporins, β-lactam/β-lactam inhibitor combinations, and the carbapenems. This study documents the bacteriological spectrum of infections and their resistance patterns in cancer patients. Methods: This study includes all bacterial isolates recovered from infections cancer patients over a period of 18 months. Samples included Blood cultures, Pus/wound swabs, urine, tissue biopsies, body fluids, catheter tips and respiratory specimens such as sputum and bronchoalveolar lavage (BAL). All samples were processed in the microbiology laboratory as per standard laboratory protocols. Organisms were identified to species level and antimicrobial susceptibility testing was performed manually by the disc diffusion technique or in the Vitek-2 (Biomereux, France) instrument. Interpretations were as per Clinical laboratory Standards Institute (CLSI) guidelines. Results: A total of 1150 bacterial isolates were cultured from 884 test samples during the study period. Of these 227 were Gram-positive and 923 were Gram-negative organisms. Staphylococcus aureus (99 isolates) was the commonest Gram-positive isolate followed by Enterococcus (79) and Gr A Streptococcus (30). Among the Gram negatives, E. coli (304), Pseudomonas aeruginosa (201) and Klebsiella pneumoniae (190) were the most common. Of the Staphylococcus aureus isolates 27.2% were methicillin resistant. Only 5.06% enterococci were vancomycin resistant. High rates of resistance to cefotaxime and ciprofloxacin were seen amongst E. coli (84.8% & 83.55%) and Klebsiella pneumoniae (71 & 62.1%) respectively. Resistance to carbapenems (meropenem) was high at 70% in Acinetobacter spp.; however all isolates were sensitive to colistin. Among the aminoglycosides, amikacin retained good efficacy against Escherichia coli (82.9%) and Pseudomonas aeruginosa (78.1%). Occasional isolates of emerging pathogens such as Chryseobacterium indologens, Roseomonas, and Achromobacter xyloxidans were also recovered. Conclusion: The common infections in cancer patients include respiratory, wound, tract infections and sepsis. The commonest isolates include Staphylococcus aureus, Enterococci, Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa. There is a high level of resistance to the commonly used antibiotics among Gram-negative organisms.

Keywords: bacteria, resistance, infection, cancer

Procedia PDF Downloads 276

Authors: Shreyas S. Hegde, Anindya Deb, Suresh Nagesh

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Computational bio-mechanics is developing rapidly as a non-invasive tool to assist the medical fraternity to help in both diagnosis and prognosis of human body related issues such as injuries, cardio-vascular dysfunction, atherosclerotic plaque etc. Any system that would help either properly diagnose such problems or assist prognosis would be a boon to the doctors and medical society in general. Recently a lot of work is being focused in this direction which includes but not limited to various finite element analysis related to dental implants, skull injuries, orthopedic problems involving bones and joints etc. Such numerical solutions are helping medical practitioners to come up with alternate solutions for such problems and in most cases have also reduced the trauma on the patients. Some work also has been done in the area related to the use of computational fluid mechanics to understand the flow of blood through the human body, an area of hemodynamics. Since cardio-vascular diseases are one of the main causes of loss of human life, understanding of the blood flow with and without constraints (such as blockages), providing alternate methods of prognosis and further solutions to take care of issues related to blood flow would help save valuable life of such patients. This project is an attempt to use computational fluid dynamics (CFD) to solve specific problems related to hemodynamics. The hemodynamics simulation is used to gain a better understanding of functional, diagnostic and theoretical aspects of the blood flow. Due to the fact that many fundamental issues of the blood flow, like phenomena associated with pressure and viscous forces fields, are still not fully understood or entirely described through mathematical formulations the characterization of blood flow is still a challenging task. The computational modeling of the blood flow and mechanical interactions that strongly affect the blood flow patterns, based on medical data and imaging represent the most accurate analysis of the blood flow complex behavior. In this project the mathematical modeling of the blood flow in the arteries in the presence of successive blockages has been analyzed using CFD technique. Different cases of blockages in terms of percentages have been modeled using commercial software CATIA V5R20 and simulated using commercial software ANSYS 15.0 to study the effect of varying wall shear stress (WSS) values and also other parameters like the effect of increase in Reynolds number. The concept of fluid structure interaction (FSI) has been used to solve such problems. The model simulation results were validated using in vivo measurement data from existing literature

Keywords: computational fluid dynamics, hemodynamics, blood flow, results validation, arteries

Procedia PDF Downloads 379

Authors: Ana Carolina Kogawa, Selma Gutierrez Antonio, Hérida Regina Nunes Salgado

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Rifaximin is an oral antimicrobial, gut - selective and not systemic with adverse effects compared to placebo. It is used for the treatment of hepatic encephalopathy, travelers diarrhea, irritable bowel syndrome, Clostridium difficile, ulcerative colitis and acute diarrhea. The crystalline form present in the rifaximin with minimal systemic absorption is α, being the amorphous form significantly different. Regulators are increasingly attention to polymorphisms. Polymorphs can change the form by altering the drug characteristics compromising the effectiveness and safety of the finished product. International Conference on Harmonization issued the ICH Guidance Q6A, which aim to improve the control of polymorphism in new and existing pharmaceuticals. The objective of this study was to obtain polymorphic forms of rifaximin employing recrystallization processes and characterize them by thermal analysis (thermogravimetry - TG and differential scanning calorimetry - DSC), X-ray diffraction, scanning electron microscopy and solubility test. Six polymorphic forms of rifaximin, designated I to VI were obtained by the crystallization process by evaporation of the solvent. The profiles of the TG curves obtained from polymorphic forms of rifaximin are similar to rifaximin and each other, however, the DTG are different, indicating different thermal behaviors. Melting temperature values of all the polymorphic forms were greater to that shown by the rifaximin, indicating the higher thermal stability of the obtained forms. The comparison of the diffractograms of the polymorphic forms of rifaximin with rifaximin α, β and γ constant in patent indicate that forms III, V and VI are formed by mixing polymorph β and α and form III is formed by polymorph β. The polymorphic form I is formed by polymorph β, but with a significant amount of amorphous material. Already, the polymorphic form II consists of polymorph γ, amorphous. In scanning electron microscope is possible to observe the heterogeneity of morphological characteristics of crystals of polymorphic forms among themselves and with rifaximin. The solubility of forms I and II was greater than the solubility of rifaximin, already, forms III, IV and V presented lower solubility than of rifaximin. Similarly, the bioavailability of the amorphous form of rifaximin is considered significantly higher than the form α, the polymorphic forms obtained in this work can not guarantee the excellent tolerability of the reference medicine. Therefore, studies like these are extremely important and they point to the need for greater requirements by the regulatory agencies competent about polymorphs analysis of the raw materials used in the manufacture of medicines marketed globally. These analyzes are not required in the majority of official compendia. Partnerships between industries, research centers and universities would be a viable way to consolidate researches in this area and contribute to improving the quality of solid drugs.

Keywords: electronic microscopy, polymorphism, rifaximin, solubility, X-ray diffraction

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Authors: Seolah Lee, Yoohyk Jang, Soyoung Lee, Kon Chu, Sang Kun Lee

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Objective: The International League Against Epilepsy (ILAE) currently suggests a topiramate serum level range of 5-20 mg/L. However, numerous institutions have observed substantial drug response at lower levels. This study aims to investigate the correlation between topiramate serum levels, drug responsiveness, and adverse events to establish a more accurate and tailored therapeutic range. Methods: We retrospectively analyzed topiramate serum samples collected between January 2017 and January 2022 at Seoul National University Hospital. Clinical data, including serum levels, antiseizure regimens, seizure frequency, and adverse events, were collected. Patient responses were categorized as "insufficient" (reduction in seizure frequency <50%) or "sufficient" (reduction ≥ 50%). Within the "sufficient" group, further subdivisions included seizure-free and tolerable seizure subgroups. A population pharmacokinetic model estimated serum levels from spot measurements. ROC curve analysis determined the optimal serum level cut-off. Results: A total of 389 epilepsy patients, with 555 samples, were reviewed, having a mean dose of 178.4±117.9 mg/day and a serum level of 3.9±2.8 mg/L. Out of the samples, only 5.6% (n=31) exhibited insufficient response, with a mean serum level of 3.6±2.5 mg/L. In contrast, 94.4% (n=524) of samples demonstrated sufficient response, with a mean serum level of 4.0±2.8 mg/L. This difference was not statistically significant (p = 0.45). Among the 78 reported adverse events, logistic regression analysis identified a significant association between ataxia and serum concentration (p = 0.04), with an optimal cut-off value of 6.5 mg/L. In the subgroup of patients receiving monotherapy, those in the tolerable seizure group exhibited a significantly higher serum level compared to the seizure-free group (4.8±2.0 mg/L vs 3.4±2.3 mg/L, p < 0.01). Notably, patients in the tolerable seizure group displayed a higher likelihood of progressing into drug-resistant epilepsy during follow-up visits compared to the seizure-free group. Significance: This study proposed an optimal therapeutic concentration for topiramate based on the patient's responsiveness to the drug and the incidence of adverse effects. We employed a population pharmacokinetic model and analyzed topiramate serum levels to recommend a serum level below 6.5 mg/L to mitigate the risk of ataxia-related side effects. Our findings also indicated that topiramate dose elevation is unnecessary for suboptimal responders, as the drug's effectiveness plateaus at minimal doses.

Keywords: topiramate, therapeutic range, low dos, antiseizure effect

Procedia PDF Downloads 34

Authors: Reza Karimpour

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Ports play a decisive role in the EU's external and internal trade, as about 74% of imports and exports and 37% of exchanges go through ports. Although ports, especially Deep Sea Shipping (DSS) ports, are integral nodes within multimodal logistic flows, Short Sea Shipping (SSS) and inland waterways are not so well integrated. The automated vessels and supply chain optimisations for sustainable shortsea shipping (MOSES) project aims to enhance the short sea shipping component of the European supply chain by addressing the vulnerabilities and strains related to the operation of large containerships. The MOSES concept can be shortly described as a large containership (mother-vessel) approaching a DSS port (or a large container terminal). Upon her arrival, a combined intelligent mega-system consisting of the MOSES Autonomous tugboat swarm for manoeuvring and the MOSES adapted AutoMoor system. Then, container handling processes are ready to start moving containers to their destination via hinterland connections (trucks and/or rail) or to be shipped to destinations near small ports (on the mainland or island). For the first case, containers are stored in a dedicated port area (Storage area), waiting to be moved via trucks and/or rail. For the second case, containers are stacked by existing port equipment near-dedicated berths of the DSS port. They then are loaded on the MOSES Innovative Feeder Vessel, equipped with the MOSES Robotic Container-Handling System that provides (semi-) autonomous (un) feeding of the feeder. The Robotic Container-Handling System is remotely monitored through a Shore Control Centre. When the MOSES innovative Feeder vessel approaches the small port, where her docking is achieved without tugboats, she automatically unloads the containers using the Robotic Container-Handling System on the quay or directly on trucks. As a result, ports with minimal or no available infrastructure may be effectively integrated with the container supply chain. Then, the MOSES innovative feeder vessel continues her voyage to the next small port, or she returns to the DSS port. MOSES exploitation activity mainly aims to exploit research outcomes beyond the project, facilitate utilisation of the pilot results by others, and continue the pilot service after the project ends. By the mid-lifetime of the project, the exploitation plan introduces the reader to the MOSES project and its key exploitable results. It provides a plan for delivering the MOSES innovations to the market as part of the overall exploitation plan.

Keywords: automated vessels, exploitation, shortsea shipping, supply chain

Procedia PDF Downloads 82

Authors: Hela Ghali, Sihem Ben Fredj, Mohamed Ben Rejeb, Sawssen Layouni, Salwa Khefacha, Lamine Dhidah, Houyem Said Laatiri

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Background: Antimicrobial resistance is a growing threat to public health and motivates to improve prevention and control programs both at international (WHO) and national levels. Despite their low pathogenicity, vancomycin-resistant enterococci (VRE) are common nosocomial pathogens in several countries. The high potential for transmission of VRE between patients and the threat to send its resistance genes to other bacteria such as staphylococcus aureus already resistant to meticilin, justify strict control measures. Indeed, in Europe, the proportion of Enterococcus faecium responsible for invasive infections, varies from 1% to 35% in 2011 and less than 5% were resistant to vancomycin. In addition, it represents the second cause of urinary tract and wound infections and the third cause of nosocomial bacteremia in the United States. The nosocomial outbreaks of VRE have been mainly described in intensive care services, hematology-oncology and haemodialysis. An epidemic of VRE has affected our hospital and the objective of this work is to describe the measures put in place. Materials/Methods: Following the alert given by the service of plastic surgery concerning a patient carrier of VRE, a team of the prevention and healthcare security service (doctor + technician) made an investigation. A review of files was conducted to draw the synoptic table and the table of cases. Results: By contacting the microbiology laboratory, we have identified four other cases of VRE and who were hospitalized in Medical resuscitation department (2 cases, one of them was transferred to the Physical rehabilitation department), and Nephrology department (2 cases). The visit has allowed to detect several malfunctions in professional practice. A crisis cell has allowed to validate, coordinate and implement control measures following the recommendations of the Technical Center of nosocomial infections. In fact, the process was to technically isolate cases in their sector of hospitalization, to restrict the use of antibiotics, to strength measures of basic hygiene, and to make a screening by rectal swab for both cases and contacts (other patients and health staff). These measures have helped to control the situation and no other case has been reported for a month. 2 new cases have been detected in the intensive care unit after a month. However, these are short-term strategies, and other measures in the medium and long term should be taken into account in order to face similar outbreaks. Conclusion: The efforts to control the outbreak were not efficient since 2 new cases have been reported after a month. Therefore, a continuous monitoring in order to detect new cases earlier is crucial to minimize the dissemination of VRE.

Keywords: hospitals, nosocomial infection, outbreak, vancomycin-resistant enterococci

Procedia PDF Downloads 277

Authors: David Ofosu-Hamilton, John K. E. Edumadze

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Universities have come to recognize the role Information and Communication Technology (ICT) skills plays in the daily activities of tertiary students. The ability to use ICT – essentially, computers and their diverse applications – are important resources that influence an individual’s economic and social participation and human capital development. Our society now increasingly relies on the Internet, and the Cloud as a means to communicate and disseminate information. The educated individual should, therefore, be able to use ICT to create and share knowledge that will improve society. It is, therefore, important that universities require incoming students to demonstrate a level of computer proficiency or trained to do so at a minimal cost by deploying advanced educational technologies. The training and standardized assessment of all in-coming first-year students of the University of Cape Coast in Information Technology Skills (ITS) have become a necessity as students’ most often than not highly overestimate their digital skill and digital ignorance is costly to any economy. The one-semester course is targeted at fresh students and aimed at enhancing the productivity and software skills of students. In this respect, emphasis is placed on skills that will enable students to be proficient in using Microsoft Office and Google Apps for Education for their academic work and future professional work whiles using emerging digital multimedia technologies in a safe, ethical, responsible, and legal manner. The course is delivered in blended mode - online and self-paced (student centered) using Alison’s free cloud-based tutorial (Moodle) of Microsoft Office videos. Online support is provided via discussion forums on the University’s Moodle platform and tutor-directed and assisted at the ICT Centre and Google E-learning laboratory. All students are required to register for the ITS course during either the first or second semester of the first year and must participate and complete it within a semester. Assessment focuses on Alison online assessment on Microsoft Office, Alison online assessment on ALISON ABC IT, Peer assessment on e-portfolio created using Google Apps/Office 365 and an End of Semester’s online assessment at the ICT Centre whenever the student was ready in the cause of the semester. This paper, therefore, focuses on the digital culture approach of hybrid teaching, learning and paperless examinations and the possible adoption by other courses or programs at the University of Cape Coast.

Keywords: assessment, blended, cloud, paperless

Procedia PDF Downloads 222

Authors: Yung-Chih Kuo, I-Hsin Wang

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Catanionic solid lipid nanoparticles (CASLNs) with surface wheat germ agglutinin (WGA) and lactoferrin (Lf) were formulated for entrapping and releasing etoposide (ETP), crossing the blood–brain barrier (BBB), and inhibiting the growth of glioblastoma multiforme (GBM). Microemulsified ETP-CASLNs were modified with WGA and Lf for permeating a cultured monolayer of human brain-microvascular endothelial cells (HBMECs) regulated by human astrocytes and for treating malignant U87MG cells. Experimental evidence revealed that an increase in the concentration of catanionic surfactant from 5 μM to 7.5 μM reduced the particle size. When the concentration of catanionic surfactant increased from 7.5 μM to 12.5 μM, the particle size increased, yielding a minimal diameter of WGA-Lf-ETP-CASLNs at 7.5 μM of catanionic surfactant. An increase in the weight percentage of BW from 25% to 75% enlarged WGA-Lf-ETP-CASLNs. In addition, an increase in the concentration of catanionic surfactant from 5 to 15 μM increased the absolute value of zeta potential of WGA-Lf-ETP-CASLNs. It was intriguing that the increment of the charge as a function of the concentration of catanionic surfactant was approximately linear. WGA-Lf-ETP-CASLNs revealed an integral structure with smooth particle contour, displayed a lighter exterior layer of catanionic surfactant, WGA, and Lf and showed a rigid interior region of solid lipids. A variation in the concentration of catanionic surfactant between 5 μM and 15 μM yielded a maximal encapsulation efficiency of ETP ata 7.5 μM of catanionic surfactant. An increase in the concentration of Lf/WGA decreased the grafting efficiency of Lf/WGA. Also, an increase in the weight percentage of ETP decreased its encapsulation efficiency. Moreover, the release rate of ETP from WGA-Lf-ETP-CASLNs reduced with increasing concentration of catanionic surfactant, and WGA-Lf-ETP-CASLNs at 12.5 μM of catanionic surfactant exhibited a feature of sustained release. The order in the viability of HBMECs was ETP-CASLNs ≅ Lf-ETP-CASLNs ≅ WGA-Lf-ETP-CASLNs > ETP. The variation in the transendothelial electrical resistance (TEER) and permeability of propidium iodide (PI) was negligible when the concentration of Lf increased. Furthermore, an increase in the concentration of WGA from 0.2 to 0.6 mg/mL insignificantly altered the TEER and permeability of PI. When the concentration of Lf increased from 2.5 to 7.5 μg/mL and the concentration of WGA increased from 2.5 to 5 μg/mL, the enhancement in the permeability of ETP was minor. However, 10 μg/mL of Lf promoted the permeability of ETP using Lf-ETP-CASLNs, and 5 and 10 μg/mL of WGA could considerably improve the permeability of ETP using WGA-Lf-ETP-CASLNs. The order in the efficacy of inhibiting U87MG cells was WGA-Lf-ETP-CASLNs > Lf-ETP-CASLNs > ETP-CASLNs > ETP. As a result, WGA-Lf-ETP-CASLNs reduced the TEER, enhanced the permeability of PI, induced a minor cytotoxicity to HBMECs, increased the permeability of ETP across the BBB, and improved the antiproliferative efficacy of U87MG cells. The grafting of WGA and Lf is crucial to control the medicinal property of ETP-CASLNs and WGA-Lf-ETP-CASLNs can be promising colloidal carriers in GBM management.

Keywords: catanionic solid lipid nanoparticle, etoposide, glioblastoma multiforme, lactoferrin, wheat germ agglutinin

Procedia PDF Downloads 218

Authors: Kayode A. Olaniyi, Olabanji F. Omotoye, Adeola A. Ogunleye

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The skew detection and correction form an important part of digital document analysis. This is because uncompensated skew can deteriorate document features and can complicate further document image processing steps. Efficient text document analysis and digitization can rarely be achieved when a document is skewed even at a small angle. Once the documents have been digitized through the scanning system and binarization also achieved, document skew correction is required before further image analysis. Research efforts have been put in this area with algorithms developed to eliminate document skew. Skew angle correction algorithms can be compared based on performance criteria. Most important performance criteria are accuracy of skew angle detection, range of skew angle for detection, speed of processing the image, computational complexity and consequently memory space used. The standard Hough Transform has successfully been implemented for text documentation skew angle estimation application. However, the standard Hough Transform algorithm level of accuracy depends largely on how much fine the step size for the angle used. This consequently consumes more time and memory space for increase accuracy and, especially where number of pixels is considerable large. Whenever the Hough transform is used, there is always a tradeoff between accuracy and speed. So a more efficient solution is needed that optimizes space as well as time. In this paper, an improved Hough transform (HT) technique that optimizes space as well as time to robustly detect document skew is presented. The modified algorithm of Hough Transform presents solution to the contradiction between the memory space, running time and accuracy. Our algorithm starts with the first step of angle estimation accurate up to zero decimal place using the standard Hough Transform algorithm achieving minimal running time and space but lacks relative accuracy. Then to increase accuracy, suppose estimated angle found using the basic Hough algorithm is x degree, we then run again basic algorithm from range between ±x degrees with accuracy of one decimal place. Same process is iterated till level of desired accuracy is achieved. The procedure of our skew estimation and correction algorithm of text images is implemented using MATLAB. The memory space estimation and process time are also tabulated with skew angle assumption of within 00 and 450. The simulation results which is demonstrated in Matlab show the high performance of our algorithms with less computational time and memory space used in detecting document skew for a variety of documents with different levels of complexity.

Keywords: hough-transform, skew-detection, skew-angle, skew-correction, text-document

Procedia PDF Downloads 130

Authors: Sahar Heidary

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Radiography and radiotherapy have emerged as crucial pillars of modern medical practice, revolutionizing diagnostics and treatment for a myriad of health conditions. This abstract highlights the pivotal role of radiography and radiotherapy in favor of healthcare and society. Radiography, a non-invasive imaging technique, has significantly advanced medical diagnostics by enabling the visualization of internal structures and abnormalities within the human body. With the advent of digital radiography, clinicians can obtain high-resolution images promptly, leading to faster diagnoses and informed treatment decisions. Radiography plays a pivotal role in detecting fractures, tumors, infections, and various other conditions, allowing for timely interventions and improved patient outcomes. Moreover, its widespread accessibility and cost-effectiveness make it an indispensable tool in healthcare settings worldwide. On the other hand, radiotherapy, a branch of medical science that utilizes high-energy radiation, has become an integral component of cancer treatment and management. By precisely targeting and damaging cancerous cells, radiotherapy offers a potent strategy to control tumor growth and, in many cases, leads to cancer eradication. Additionally, radiotherapy is often used in combination with surgery and chemotherapy, providing a multifaceted approach to combat cancer comprehensively. The continuous advancements in radiotherapy techniques, such as intensity-modulated radiotherapy and stereotactic radiosurgery, have further improved treatment precision while minimizing damage to surrounding healthy tissues. Furthermore, radiography and radiotherapy have demonstrated their worth beyond oncology. Radiography is instrumental in guiding various medical procedures, including catheter placement, joint injections, and dental evaluations, reducing complications and enhancing procedural accuracy. On the other hand, radiotherapy finds applications in non-cancerous conditions like benign tumors, vascular malformations, and certain neurological disorders, offering therapeutic options for patients who may not benefit from traditional surgical interventions. In conclusion, radiography and radiotherapy stand as indispensable tools in modern medicine, driving transformative improvements in patient care and treatment outcomes. Their ability to diagnose, treat, and manage a wide array of medical conditions underscores their favor in medical practice. As technology continues to advance, radiography and radiotherapy will undoubtedly play an ever more significant role in shaping the future of healthcare, ultimately saving lives and enhancing the quality of life for countless individuals worldwide.

Keywords: radiology, radiotherapy, medical imaging, cancer treatment

Procedia PDF Downloads 39

Authors: Stefano Iannello, Massimiliano Materazzi

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Fluidized bed reactor technologies are one of the most valuable pathways for thermochemical conversions of biogenic fuels due to their good operating flexibility. Nevertheless, there are still issues related to the mixing and separation of heterogeneous phases during operation with highly volatile feedstocks, including biomass and waste. At high temperatures, the volatile content of the feedstock is released in the form of the so-called endogenous bubbles, which generally exert a “lift” effect on the particle itself by dragging it up to the bed surface. Such phenomenon leads to high release of volatile matter into the freeboard and limited mass and heat transfer with particles of the bed inventory. The aim of this work is to get a better understanding of the behaviour of a single reacting particle in a hot fluidized bed reactor during the devolatilization stage. The analysis has been undertaken at different fluidization regimes and temperatures to closely mirror the operating conditions of waste-to-energy processes. Beechwood and polypropylene particles were used to resemble the biomass and plastic fractions present in waste materials, respectively. The non-invasive X-ray technique was coupled to particle tracking algorithms to characterize the motion of a single feedstock particle during the devolatilization with high resolution. A high-energy X-ray beam passes through the vessel where absorption occurs, depending on the distribution and amount of solids and fluids along the beam path. A high-speed video camera is synchronised to the beam and provides frame-by-frame imaging of the flow patterns of fluids and solids within the fluidized bed up to 72 fps (frames per second). A comprehensive mathematical model has been developed in order to validate the experimental results. Beech wood and polypropylene particles have shown a very different dynamic behaviour during the pyrolysis stage. When the feedstock is fed from the bottom, the plastic material tends to spend more time within the bed than the biomass. This behaviour can be attributed to the presence of the endogenous bubbles, which drag effect is more pronounced during the devolatilization of biomass, resulting in a lower residence time of the particle within the bed. At the typical operating temperatures of thermochemical conversions, the synthetic polymer softens and melts, and the bed particles attach on its outer surface, generating a wet plastic-sand agglomerate. Consequently, this additional layer of sand may hinder the rapid evolution of volatiles in the form of endogenous bubbles, and therefore the establishment of a poor drag effect acting on the feedstock itself. Information about the mixing and segregation of solid feedstock is of prime importance for the design and development of more efficient industrial-scale operations.

Keywords: fluidized bed, pyrolysis, waste feedstock, X-ray

Procedia PDF Downloads 148

Authors: Tomás Sobrino, Lara García-Varela, Marta Aramburu-Núñez, Mónica Castro, Noemí Gómez-Lado, Mariña Rodríguez-Arrizabalaga, Antía Custodia, Juan Manuel Pías-Peleteiro, José Manuel Aldrey, Daniel Romaus-Sanjurjo, Ángeles Almeida, Pablo Aguiar, Alberto Ouro

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Introduction: Alzheimer’s disease (AD) and other tauopathies are primary causes of dementia, causing progressive cognitive deterioration that entails serious repercussions for the patients' performance of daily tasks. Currently, there is no effective approach for the early diagnosis and treatment of AD and tauopathies. This study suggests a theragnostic approach based on the importance of phosphorylated tau protein (p-Tau) in the early pathophysiological processes of AD. We have developed a novel theragnostic monoclonal antibody (mAb) to provide both diagnostic and therapeutic effects. Methods/Results: We have developed a p-Tau mAb, which was doped with deferoxamine for radiolabeling with Zirconium-89 (89Zr) for PET imaging, as well as fluorescence dies for immunofluorescence assays. The p-Tau mAb was evaluated in vitro for toxicity by MTT assay, LDH activity, propidium iodide/Annexin V assay, caspase-3, and mitochondrial membrane potential (MMP) assay in both mouse endothelial cell line (bEnd.3) and cortical primary neurons cell cultures. Importantly, non-toxic effects (up to concentrations of p-Tau mAb greater than 100 ug/mL) were detected. In vivo experiments in the tauopathy model mice (PS19) show that the 89Zr-pTau-mAb and 89Zr-Fragments-pTau-mAb are stable in circulation for up to 10 days without toxic effects. However, only less than 0.2% reached the brain, so further strategies have to be designed for crossing the Brain-Blood-Barrier (BBB). Moreover, an intraparenchymal treatment strategy was carried out. The PS19 mice were operated to implement osmotic pumps (Alzet 1004) at two different times, at 4 and 7 months, to stimulate the controlled release for one month each of the B6 antibody or the IgG1 control antibody. We demonstrated that B6-treated mice maintained their motor and memory abilities significantly compared with IgG1 treatment. In addition, we observed a significant reduction in p-Tau deposits in the brain. Conclusions /Discussion: A theragnostic pTau-mAb was developed. Moreover, we demonstrated that our p-Tau mAb recognizes very-early pathology forms of p-Tau by non-invasive techniques, such as PET. In addition, p-Tau mAb has non-toxic effects, both in vitro and in vivo. Although the p-Tau mAb is stable in circulation, only 0.2% achieve the brain. However, direct intraventricular treatment significantly reduces cognitive impairment in Alzheimer's animal models, as well as the accumulation of toxic p-Tau species.

Keywords: alzheimer's disease, theragnosis, tau, PET, immunotherapy, tauopathies

Procedia PDF Downloads 44

Authors: Rubisha Adhikari, Rajani Shah

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Introduction: Aging is a natural, global and inevitable phenomenon every single person has to go through, and nobody can escape the process. One of the emerging challenges to public health is to improve the quality of later years of life as life expectancy continues to increase. Quality of life (QoL) has grown to be a key goal for many public health initiatives. Population aging has become a global phenomenon as they are growing more quickly in emerging nations than they are in industrialized nations, leaving minimal opportunities to regulate the consequences of the demographic shift. Methods: A community-based descriptive analytical approach was used to examine the quality of life and associated factors among elderly people. A mixed method was chosen for the study. For the quantitative data collection, a household survey was conducted using the WHOQOL-OLD tool. In-depth interviews were conducted among twenty participants for qualitative data collection. Data generated through in-depth interviews were transcribed verbatim. In-depth interviews lasted about an hour and were audio recorded. The in-depth interview guide had been developed by the research team and pilot-tested before actual interviews. Results: This study result showed the association between quality of life and socio-demographic variables. Among all the variables under socio-demographic variable of this study, age (ꭓ2=14.445, p=0.001), gender (ꭓ2=14.323, p=<0.001), marital status (ꭓ2=10.816, p=0.001), education status (ꭓ2=23.948, p=<0.001), household income (ꭓ2=13.493, p=0.001), personal income (ꭓ2=14.129, p=0.001), source of personal income (ꭓ2=28.332,p=<0.001), social security allowance (ꭓ2=18.005,p=<0.001), alcohol consumption (ꭓ2=9.397,p=0.002) are significantly associated with quality of life of elderly. In addition, affordability (ꭓ2=12.088, p=0.001), physical activity (ꭓ2=9.314, p=0.002), emotional support (ꭓ2=9.122, p=0.003), and economic support (ꭓ2=8.104, p=0.004) are associated with quality of life of elderly people. Conclusion: In conclusion, this mixed method study provides insight into the attributes of the quality of life of elderly people in Nepal and similar settings. As the geriatric population is growing in full swing, maintaining a high quality of life has become a major challenge. This study showed that determinants such as age, gender, marital status, education status, household income, personal income, source of personal income, social security allowance and alcohol consumption, economic support, emotional support, affordability and physical activity have an association with quality of life of the elderly.

Keywords: ageing, chitwan, elderly, health status, quality of life

Procedia PDF Downloads 31

Authors: Rupam Saikia, Ashim Kanti Dey

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Sonapur is an intense hilly region on the border of Assam and Meghalaya lying in North-East India and is very near to a seismic fault named as Dauki besides which makes the region seismically active. Besides, these recently two earthquakes of magnitude 6.7 and 6.9 have struck North-East India in January and April 2016. Also, the slope concerned for this study is adjacent to NH 44 which for a long time has been a sole important connecting link to the states of Manipur and Mizoram along with some parts of Assam and so has been a cause of considerable loss to life and property since past decades as there has been several recorded incidents of landslide, road-blocks, etc. mostly during the rainy season which comes into news. Based on this issue this paper reports a static and dynamic slope stability analysis of Sonapur which has been carried out in MIDAS GTS NX. The slope being highly unreachable due to terrain and thick vegetation in-situ test was not feasible considering the current scope available so disturbed soil sample was collected from the site for the determination of strength parameters. The strength parameters were so determined for varying relative density with further variation in water content. The slopes were analyzed considering plane strain condition for three slope heights of 5 m, 10 m and 20 m which were then further categorized based on slope angles 30, 40, 50, 60, and 70 considering the possible extent of steepness. Initially static analysis under dry state was performed then considering the worst case that can develop during rainy season the slopes were analyzed for fully saturated condition along with partial degree of saturation with an increase in the waterfront. Furthermore, dynamic analysis was performed considering the El-Centro Earthquake which had a magnitude of 6.7 and peak ground acceleration of 0.3569g at 2.14 sec for the slope which were found to be safe during static analysis under both dry and fully saturated condition. Some of the conclusions were slopes with inclination above 40 onwards were found to be highly vulnerable for slopes of height 10 m and above even under dry static condition. Maximum horizontal displacement showed an exponential increase with an increase in inclination from 30 to 70. The vulnerability of the slopes was seen to be further increased during rainy season as even slopes of minimal steepness of 30 for height 20 m was seen to be on the verge of failure. Also, during dynamic analysis slopes safe during static analysis were found to be highly vulnerable. Lastly, as a part of the study a comparative study on Strength Reduction Method (SRM) versus Limit Equilibrium Method (LEM) was also carried out and some of the advantages and disadvantages were figured out.

Keywords: dynamic analysis, factor of safety, slope stability, strength reduction method

Procedia PDF Downloads 237

Authors: Rohit Kamal, Devaki Perumal Rajaram, Rajam Krishna, Sai Kumar Pindagiri, Silas Danielraj

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Introduction: According to WHO, Global health observatory at least 2.8 million people die each year because of obesity and overweight. This is mainly because of the adverse metabolic effects of obesity and overweight on blood pressure, lipid profile especially cholesterol and insulin resistance. To achieve optimum health WHO has set the BMI in the range of 18.5 to 24.9 kg/m2. Due to modernization of life style, physical exercise in the form of work is no longer a possibility and hence an effective way to burn out calories to achieve the optimum BMI is the need of the hour. Studies have shown that exercising for more than 60 minutes /day helps to maintain the weight and to reduce the weight exercise should be done for 90 minutes a day. Moderate exercise for about 30 min is essential for burning up of calories. People with low endurance fail to perform even the low intensity exercise for minimal time. Hence, it is necessary to find out some effective method to increase the endurance time. Methodology: This study was approved by the Institutional Ethical committee of our college. After getting written informed consent, 25 apparently healthy males between the age group 18-20 years were selected. Subjects are with muscular disorder, subjects who are Hypertensive, Diabetes, Smokers, Alcoholics, taking drugs affecting the muscle strength. To determine the endurance time: Maximum voluntary contraction (MVC) was measured by asking the participants to squeeze the hand grip dynamometer as hard as possible and hold it for 3 seconds. This procedure was repeated thrice and the average of the three reading was taken as the maximum voluntary contraction. The participant was then asked to squeeze the dynamometer and hold it at 70% of the maximum voluntary contraction while hearing fast tempo music which was played for about ten minutes then the participant was asked to relax for ten minutes and was made to hold the hand grip dynamometer at 70% of the maximum voluntary contraction while hearing slow tempo music. To avoid the bias of getting habituated to the procedure the order of hearing for the fast and slow tempo music was changed. The time for which they can hold it at 70% of MVC was determined by using a stop watch and that was taken as the endurance time. Results: The mean value of the endurance time during fast and slow tempo music was compared in all the subjects. The mean MVC was 34.92 N. The mean endurance time was 21.8 (16.3) seconds with slow tempo music which was more then with fast tempo music with which the mean endurance time was 20.6 (11.7) seconds. The preference was more for slow tempo music then for fast tempo music. Conclusion: Music when played during exercise by some unknown mechanism helps to increase the endurance time by alleviating the symptoms of lactic acid accumulation.

Keywords: endurance time, fast tempo music, maximum voluntary contraction, slow tempo music

Procedia PDF Downloads 279

Authors: A. O. Adenaiya, S. F. Curling, O. Y. Ogunsanwo, G . A. Ormondroyd

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Treatment of wood with chemicals in order to prolong its service life may prove difficult in some refractory wood species. This impermeability in wood is usually due to biochemical changes which occur during heartwood formation. Bioincision, which is a short-term, controlled microbial decomposition of wood, is one of the promising approaches capable of improving the amenability of refractory wood to chemical treatments. Gmelina Arborea, a mainstay timber species in Nigeria, has impermeable heartwood due to the excessive tyloses which occlude its vessels. Therefore, the chemical uptake and penetration in Gmelina arborea heartwood bioincised with Inonotus dryophilus fungus was investigated. Five mature Gmelina Arborea trees were harvested at the Departmental plantation in Ajibode, Ibadan, Nigeria and a bolt of 300 cm was obtained from the basal portion of each tree. The heartwood portion of the bolts was extracted and converted into dimensions 20 mm x 20 mm x 60 mm and subsequently conditioned (200C at 65% Relative Humidity). Twenty wood samples each were bioincised with the white-rot fungus Inonotus dryophilus (ID, 999) for 3, 5, 7 and 9 weeks using standard procedure, while a set of sterile control samples were prepared. Ten of each bioincised and control sample were pressure-treated with 5% tanalith preservative, while the other ten of each bioincised and control samples were pressure-treated with a liquid dye for easy traceability of the chemical in the wood, both using a full cell treatment process. The bioincised and control samples were evaluated for their Weight Loss before chemical treatment (WL, %), Preservative Absorption (PA, Kg/m3), Preservative Retention (PR, Kg/m3), Axial Absorption (AA, Kg/m3), Lateral Absorption (LA, Kg/m3), Axial Penetration Depth (APD, mm), Radial Penetration Depth (RPD, mm), and Tangential Penetration Depth (TPD, mm). The data obtained were analyzed using ANOVA at α0.05. Results show that the weight loss was least in the samples bioincised for three weeks (0.09%) and highest after 7 weeks of bioincision (0.48%). The samples bioincised for 3 weeks had the least PA (106.72 Kg/m3) and PR (5.87 Kg/m3), while the highest PA (134.9 Kg/m3) and PR were observed after 7 weeks of bioincision (7.42 Kg/m3). The AA ranged from 27.28 Kg/m3 (3 weeks) to 67.05 Kg/m3 (5 weeks), while the LA was least after 5 weeks of incubation (28.1 Kg/m3) and highest after 9 weeks (71.74 Kg/m3). Significantly lower APD was observed in control samples (6.97 mm) than in the samples bioincised after 9weeks (19.22 mm). The RPD increased from 0.08 mm (control samples) to 3.48 mm (5 weeks), while TPD ranged from 0.38 mm (control samples) to 0.63 mm (9 weeks), implying that liquid flow in the wood was predominantly through the axial pathway. Bioincising G. arborea heartwood with I. dryophilus fungus for 9 weeks is capable of enhancing chemical uptake and deeper penetration of chemicals in the wood through the degradation of the occluding vessel tyloses, which is accompanied by a minimal degradation of the polymeric wood constituents.

Keywords: Bioincision, chemical uptake, penetration depth, refractory wood, tyloses

Procedia PDF Downloads 79

Authors: B. M. M. D. Mendis, L. I. Rajapaksa, P. S. K. Gunathunga, R. C. Fernando, M. Jayalath

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Background / introduction: During the year 2011, 8511 males received services from the sexual health clinics island wide. At present there is only limited information on the risk behaviours of male attendees. Information on risk behaviours related to STI /HIV transmission is helpful in planning suitable prevention interventions. Aim(s)/objectives: The objectives were to determines the sexual partners (other than the marital partner and regular partners) responsible for transmitting STI( Sexually transmitted infections)/ HIV and to understand the practice of safer sex. Methods: Study was a clinic based prospective study conducted for a one year period using an interviewer administered questionnaire. Results: 983 attendees were interviewed. . Mean age was 34.02 years. 75% of the sample had completed GCE O/L (ordinary level examination). Skilled labourers, drivers and forces/police comprised 40% of the sample. 50% admitted sex with a casual female, 12% with a casual male, and 13% with CSW (commercial sex workers) while MSW (male sex workers) exposures were minimal. It was identified that younger males had more contacts with males, and regular female partners while more older males with CSW. Anal sex among males was reported by 11.5%. 20.5% used alcohol frequently and 5.9% used drugs and 1.4% injected. Common STI were genital herpes (7.9%), Non gonococcal urethritis (6.2%) and gonorrhoea (6.2%). Among those who had contacts with FSW 6.7% gonorrhoea (GC), 8.2% non gonococcal urethritis (NGU), 7.5% genital herpes and 0.7% HIV. Non regular partner exposures 3.7% had gonorrhoea, 8.3% NGU, 6.6% genital herpes and 0.8% HIV. Among MSM contacts 10.6% had GC, 4.5% NGU, 5.3% genital herpes, 5.3% secondary syphilis and 0.8% HIV. Only 9.0% used condoms correctly. Friends, doctors, newspapers, internet, and forces were important sources of information on condoms. Non use of condoms were due to worry about satisfaction (24.6%) and faith in the partner (25.6%). Discussion/conclusion: Casual partners for unsafe sex is a concern. MSM and CSW are remained as an important source of infection. Early Syphilis and gonorrhoea infections were mostly seen among MSM exposures. The findings indicate that the male population in the sample had satisfactory education. However, still the unsafe sexual contacts are common. . Newspapers, internet were more important sources of information on condoms. Low condom use remains another concern.. More males contracted STI through casual partners. Therefore strategies used for prevention need to be revisited also emphasizing on general population where casual partners represent. . Increasing awareness of men and women through mass media and primary health care teams may be important strategies that can be used to keep the HIV epidemic in a low level.

Keywords: STI, HIV, Males, safe sex practices

Procedia PDF Downloads 301

Authors: Elizabeth M. Seabrook, Nikki S. Rickard

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Examining time-dependent measures of emotion such as variability, instability, and inertia, provide critical and complementary insights into mental health status. Observing changes in the pattern of emotional expression over time could act as a tool to identify meaningful shifts between psychological well- and ill-being. From a practical standpoint, however, examining emotion dynamics day-to-day is likely to be burdensome and invasive. Utilizing social media data as a facet of lived experience can provide real-world, temporally specific access to emotional expression. Emotional language on social media may provide accurate and sensitive insights into individual and community mental health and well-being, particularly with focus placed on the within-person dynamics of online emotion expression. The objective of the current study was to examine the dynamics of emotional expression on the social network platform Facebook for active users and their relationship with psychological well- and ill-being. It was expected that greater positive and negative emotion variability, instability, and inertia would be associated with poorer psychological well-being and greater depression symptoms. Data were collected using a smartphone app, MoodPrism, which delivered demographic questionnaires, psychological inventories assessing depression symptoms and psychological well-being, and collected the Status Updates of consenting participants. MoodPrism also delivered an experience sampling methodology where participants completed items assessing positive affect, negative affect, and arousal, daily for a 30-day period. The number of positive and negative words in posts was extracted and automatically collated by MoodPrism. The relative proportion of positive and negative words from the total words written in posts was then calculated. Preliminary analyses have been conducted with the data of 9 participants. While these analyses are underpowered due to sample size, they have revealed trends that greater variability in the emotion valence expressed in posts is positively associated with greater depression symptoms (r(9) = .56, p = .12), as is greater instability in emotion valence (r(9) = .58, p = .099). Full data analysis utilizing time-series techniques to explore the Facebook data set will be presented at the conference. Identifying the features of emotion dynamics (variability, instability, inertia) that are relevant to mental health in social media emotional expression is a fundamental step in creating automated screening tools for mental health that are temporally sensitive, unobtrusive, and accurate. The current findings show how monitoring basic social network characteristics over time can provide greater depth in predicting risk and changes in depression and positive well-being.

Keywords: emotion, experience sampling methods, mental health, social media

Procedia PDF Downloads 220

Authors: Mujahid Muhammad, Paul Kearney, Adel Aneiba

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The ability for vehicles to communicate with other vehicles (V2V), the physical (V2I) and network (V2N) infrastructures, pedestrians (V2P), etc. – collectively known as V2X (Vehicle to Everything) – will enable a broad and growing set of applications and services within the intelligent transport domain for improving road safety, alleviate traffic congestion and support autonomous driving. The telecommunication research and industry communities and standardization bodies (notably 3GPP) has finally approved in Release 14, cellular communications connectivity to support V2X communication (known as LTE – V2X). LTE – V2X system will combine simultaneous connectivity across existing LTE network infrastructures via LTE-Uu interface and direct device-to-device (D2D) communications. In order for V2X services to function effectively, a robust security mechanism is needed to ensure legal and safe interaction among authenticated V2X entities in the LTE-based V2X architecture. The characteristics of vehicular networks, and the nature of most V2X applications, which involve human safety makes it significant to protect V2X messages from attacks that can result in catastrophically wrong decisions/actions include ones affecting road safety. Attack vectors include impersonation attacks, modification, masquerading, replay, MiM attacks, and Sybil attacks. In this paper, we focus our attention on LTE-based V2X security and access control mechanisms. The current LTE-A security framework provides its own access authentication scheme, the AKA protocol for mutual authentication and other essential cryptographic operations between UEs and the network. V2N systems can leverage this protocol to achieve mutual authentication between vehicles and the mobile core network. However, this protocol experiences technical challenges, such as high signaling overhead, lack of synchronization, handover delay and potential control plane signaling overloads, as well as privacy preservation issues, which cannot satisfy the adequate security requirements for majority of LTE-based V2X services. This paper examines these challenges and points to possible ways by which they can be addressed. One possible solution, is the implementation of the distributed peer-to-peer LTE security mechanism based on the Bitcoin/Namecoin framework, to allow for security operations with minimal overhead cost, which is desirable for V2X services. The proposed architecture can ensure fast, secure and robust V2X services under LTE network while meeting V2X security requirements.

Keywords: authentication, long term evolution, security, vehicle-to-everything

Procedia PDF Downloads 146

Authors: Joseph Mwiti Marangu, Joseph Karanja Thiong'o, Jackson Muthengia Wachira

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The mechanical performance of hydrated cements mortars mainly depends on its compressive strength and setting time. These properties are crucial in the construction industry. Pozzolana based cements are mostly characterized by low 28 day compressive strength and long setting times. These are some of the major impediments to their production and diverse uses despite numerous technological and environmental benefits associated with them. The study investigated the effects of potential chemical activators on calcined clay- Portland cement blends with an aim to achieve high early compressive strength and shorter setting times in cement mortar. In addition, standard consistency, soundness and insoluble residue of all cement categories was determined. The test cement was made by blending calcined clays with Ordinary Portland Cement (OPC) at replacement levels from 35 to 50 percent by mass of the OPC to make test cement labeled PCC for the purposes of this study. Mortar prisms measuring 40mmx40mmx160mm were prepared and cured in accordance with KS EAS 148-3:2000 standard. Solutions of Na2SO4, NaOH, Na2SiO3 and Na2CO3 containing 0.5- 2.5M were separately added during casting. Compressive strength was determined at 2rd, 7th, 28th and 90th day of curing. For comparison purposes, commercial Portland Pozzolana cement (PPC) and Ordinary Portland Cement (OPC) were also investigated without activators under similar conditions. X-Ray Florescence (XRF) was used for chemical analysis while X-Ray Diffraction (XRD) and Fourier Transform Infrared Spectroscopy (FTIR) were used for mineralogical analysis of the test samples. The results indicated that addition of activators significantly increased the 2nd and 7th day compressive strength but minimal increase on the 28th and 90th day compressive strength. A relatively linear relationship was observed between compressive strength and concentration of activator solutions up to 28th of curing. Addition of the said activators significantly reduced both initial and final setting time. Standard consistency and soundness varied with increased amount of clay in the test cement and concentration of activators. Amount of insoluble residues increased with increased replacement of OPC with calcined clays. Mineralogical studies showed that N-A-S-H is formed in addition to C-S-H. In conclusion, the concentration of 2 molar for all activator solutions produced the optimum compressive strength and greatly reduced the setting times for all cement mortars.

Keywords: activators, admixture, cement, clay, pozzolana

Procedia PDF Downloads 232