Search results for: combined surgery
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3678

Search results for: combined surgery

2478 Mental Health and Well-Being: Capacity Building of Community to Respond to Mental Health Needs of Transgender Populations

Authors: Harjyot Khosa

Abstract:

In India and south Asia, stigma and discrimination against transgender community remain disproportionately high. Lack of mental health care restricts effective treatment and care for both physical and mental health. Knowledge assessment of 80 counsellors across India reflected that only 28% counsellors knew about the transgender community. Whereas, only 6% of them felt, that transgender community require a specific mental health support, considering the stigma they face in day to day life. Lastly, 62% did agree that they require specific training to address unmet needs of transgender community. A robust counselling module was developed with focus on technical counselling skills and strategies, specific counselling issues, identity and sexuality, disclosure, hormone therapy and sex reassignment surgery. Mental health related support should be an integral part of government and non-government programs for the overall well-being of transgender community who face stigma and discrimination at every level. Needs based capacity building and technical assistance is required towards providing mental health support for transgender populations and their partners.

Keywords: identity and sexuality, mental health, stigma, transgender

Procedia PDF Downloads 550
2477 Modeling of Reverse Osmosis Water Desalination Powered by Photovoltaic Solar Energy

Authors: Salma El Aimani

Abstract:

Freshwater is an essential material in our daily life; its availability is on the decline due to population growth and climate change. To meet the demand for fresh water in regions where reserves are insufficient, several countries have adopted seawater desalination. Several physical methods allow the production of fresh water from seawater; among these methods are distillation and reverse osmosis, and there is great potential to use renewable energy sources such as solar Photovoltaics. The work presented in this paper consists of three parts. First, the generalities of desalination technologies will be presented. The second part is devoted to the presentation of different water desalination systems combined with renewable energy and their benefits and drawbacks on different sides. In the third part, we will perform a modeling of a PV water desalination system under Matlab Simulink software. Then, according to the obtained simulation results, we conclude this paper with the prospects of the presented work.

Keywords: reverse-osmosis, desalination, modelling, ‎irradiation, Matlab

Procedia PDF Downloads 86
2476 Experience in Caring for a Patient with Terminal Aortic Dissection of Lung Cancer and Paralysis of the Lower Limbs after Surgery

Authors: Pei-Shan Liang

Abstract:

Objective: This article explores the care experience of a terminal lung cancer patient who developed lower limb paralysis after surgery for aortic dissection. The patient, diagnosed with aortic dissection during chemotherapy for lung cancer, faced post-surgical lower limb paralysis, leading to feelings of helplessness and hopelessness as they approached death with reduced mobility. Methods: The nursing period was from July 19 to July 27, during which the author, alongside the intensive care team and palliative care specialists, conducted a comprehensive assessment through observation, direct care, conversations, physical assessments, and medical record review. Gordon's eleven functional health patterns were used for a holistic evaluation, identifying four nursing health issues: "pain related to terminal lung cancer and invasive procedures," "decreased cardiac tissue perfusion due to hemodynamic instability," "impaired physical mobility related to lower limb paralysis," and "hopelessness due to the unpredictable prognosis of terminal lung cancer." Results: The medical team initially focused on symptom relief, administering Morphine 5mg in 0.9% N/S 50ml IVD q6h for pain management and continuing chemotherapy as prescribed. Open communication was employed to address the patient's physical, psychological, and spiritual concerns. Non-pharmacological interventions, including listening, caring, companionship, opioid medication, and distraction techniques like comfortable positioning and warm foot baths, were used to alleviate pain, reducing the pain score to 3 on the numeric rating scale and easing respiratory discomfort. The palliative care team was also involved, guiding the patient and family through the "Four Paths of Life," helping the patient achieve a good end-of-life experience and the family to experience a peaceful life. This process also served to promote the concept of palliative care, enabling more patients and families to receive high-quality and dignified care. The patient was encouraged to express inner anxiety through drawing or writing, which helped reduce the hopelessness caused by psychological distress and uncertainty about the disease's prognosis, as assessed by the Hospital Anxiety and Depression Scale, reaching a level of mild anxiety but acceptable without affecting sleep. Conclusion: What left a deep impression during the care process was the need for intensive care providers to consider the patient's psychological state, not just their physical condition, when the patient's situation changes. Family support and involvement often provide the greatest solace for the patient, emphasizing the importance of comfort and dignity. This includes oral care to maintain cleanliness and comfort, frequent repositioning to alleviate pressure and discomfort, and timely removal of invasive devices and unnecessary medications to avoid unnecessary suffering. The nursing process should also address the patient's psychological needs, offering comfort and support to ensure that they can face the end of life with peace and dignity.

Keywords: intensive care, lung cancer, aortic dissection, lower limb paralysis

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2475 Multivariate Analysis of Spectroscopic Data for Agriculture Applications

Authors: Asmaa M. Hussein, Amr Wassal, Ahmed Farouk Al-Sadek, A. F. Abd El-Rahman

Abstract:

In this study, a multivariate analysis of potato spectroscopic data was presented to detect the presence of brown rot disease or not. Near-Infrared (NIR) spectroscopy (1,350-2,500 nm) combined with multivariate analysis was used as a rapid, non-destructive technique for the detection of brown rot disease in potatoes. Spectral measurements were performed in 565 samples, which were chosen randomly at the infection place in the potato slice. In this study, 254 infected and 311 uninfected (brown rot-free) samples were analyzed using different advanced statistical analysis techniques. The discrimination performance of different multivariate analysis techniques, including classification, pre-processing, and dimension reduction, were compared. Applying a random forest algorithm classifier with different pre-processing techniques to raw spectra had the best performance as the total classification accuracy of 98.7% was achieved in discriminating infected potatoes from control.

Keywords: Brown rot disease, NIR spectroscopy, potato, random forest

Procedia PDF Downloads 189
2474 Protein Remote Homology Detection and Fold Recognition by Combining Profiles with Kernel Methods

Authors: Bin Liu

Abstract:

Protein remote homology detection and fold recognition are two most important tasks in protein sequence analysis, which is critical for protein structure and function studies. In this study, we combined the profile-based features with various string kernels, and constructed several computational predictors for protein remote homology detection and fold recognition. Experimental results on two widely used benchmark datasets showed that these methods outperformed the competing methods, indicating that these predictors are useful computational tools for protein sequence analysis. By analyzing the discriminative features of the training models, some interesting patterns were discovered, reflecting the characteristics of protein superfamilies and folds, which are important for the researchers who are interested in finding the patterns of protein folds.

Keywords: protein remote homology detection, protein fold recognition, profile-based features, Support Vector Machines (SVMs)

Procedia PDF Downloads 160
2473 Modelling Residential Space Heating Energy for Romania

Authors: Ion Smeureanu, Adriana Reveiu, Marian Dardala, Titus Felix Furtuna, Roman Kanala

Abstract:

This paper proposes a linear model for optimizing domestic energy consumption, in Romania. Both techno-economic and consumer behavior approaches have been considered, in order to develop the model. The proposed model aims to reduce the energy consumption, in households, by assembling in a unitary model, aspects concerning: residential lighting, space heating, hot water, and combined space heating – hot water, space cooling, and passenger transport. This paper focuses on space heating domestic energy consumption model, and quantify not only technical-economic issues, but also consumer behavior impact, related to people decision to envelope and insulate buildings, in order to minimize energy consumption.

Keywords: consumer behavior, open source energy modeling system (OSeMOSYS), MARKAL/TIMES Romanian energy model, virtual technologies

Procedia PDF Downloads 540
2472 Clinical Pathway for Postoperative Organ Transplants

Authors: Tahsien Okasha

Abstract:

Transplantation medicine is one of the most challenging and complex areas of modern medicine. Some of the key areas for medical management are the problems of transplant rejection, during which the body has an immune response to the transplanted organ, possibly leading to transplant failure and the need to immediately remove the organ from the recipient. When possible, transplant rejection can be reduced through serotyping to determine the most appropriate donor-recipient match and through the use of immunosuppressant drugs. Postoperative care actually begins before the surgery in terms of education, discharge planning, nutrition, pulmonary rehabilitation, and patient/family education. This also allows for expectations to be managed. A multidisciplinary approach is the key, and collaborative team meetings are essential to ensuring that all team members are "on the same page.". The following clinical pathway map and guidelines with the aim to decrease alteration in clinical practice and are intended for those healthcare professionals who look after organ transplant patients. They are also intended to be useful to both medical and surgical trainees as well as nurse specialists and other associated healthcare professionals involved in the care of organ transplant patients. This pathway is general pathway include the general guidelines that can be applicable for all types of organ transplant with special considerations to each organ.

Keywords: organ transplant, clinical pathway, postoperative care, same page

Procedia PDF Downloads 435
2471 Comparative Effects of Resveratrol and Energy Restriction on Liver Fat Accumulation and Hepatic Fatty Acid Oxidation

Authors: Iñaki Milton-Laskibar, Leixuri Aguirre, Maria P. Portillo

Abstract:

Introduction: Energy restriction is an effective approach in preventing liver steatosis. However, due to social and economic reasons among others, compliance with this treatment protocol is often very poor, especially in the long term. Resveratrol, a natural polyphenolic compound that belongs to stilbene group, has been widely reported to imitate the effects of energy restriction. Objective: To analyze the effects of resveratrol under normoenergetic feeding conditions and under a mild energy restriction on liver fat accumulation and hepatic fatty acid oxidation. Methods: 36 male six-week-old rats were fed a high-fat high-sucrose diet for 6 weeks in order to induce steatosis. Then, rats were divided into four groups and fed a standard diet for 6 additional weeks: control group (C), resveratrol group (RSV, resveratrol 30 mg/kg/d), restricted group (R, 15 % energy restriction) and combined group (RR, 15 % energy restriction and resveratrol 30 mg/kg/d). Liver triacylglycerols (TG) and total cholesterol contents were measured by using commercial kits. Carnitine palmitoyl transferase 1a (CPT 1a) and citrate synthase (CS) activities were measured spectrophotometrically. TFAM (mitochondrial transcription factor A) and peroxisome proliferator-activator receptor alpha (PPARα) protein contents, as well as the ratio acetylated peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC1α)/Total PGC1α were analyzed by Western blot. Statistical analysis was performed by using one way ANOVA and Newman-Keuls as post-hoc test. Results: No differences were observed among the four groups regarding liver weight and cholesterol content, but the three treated groups showed reduced TG when compared to the control group, being the restricted groups the ones showing the lowest values (with no differences between them). Higher CPT 1a and CS activities were observed in the groups supplemented with resveratrol (RSV and RR), with no difference between them. The acetylated PGC1α /total PGC1α ratio was lower in the treated groups (RSV, R and RR) than in the control group, with no differences among them. As far as TFAM protein expression is concerned, only the RR group reached a higher value. Finally, no changes were observed in PPARα protein expression. Conclusions: Resveratrol administration is an effective intervention for liver triacylglycerol content reduction, but a mild energy restriction is even more effective. The mechanisms of action of these two strategies are different. Thus resveratrol, but not energy restriction, seems to act by increasing fatty acid oxidation, although mitochondriogenesis seems not to be induced. When both treatments (resveratrol administration and a mild energy restriction) were combined, no additive or synergic effects were appreciated. Acknowledgements: MINECO-FEDER (AGL2015-65719-R), Basque Government (IT-572-13), University of the Basque Country (ELDUNANOTEK UFI11/32), Institut of Health Carlos III (CIBERobn). Iñaki Milton is a fellowship from the Basque Government.

Keywords: energy restriction, fat, liver, oxidation, resveratrol

Procedia PDF Downloads 210
2470 Comparative Analysis of Technologies for Production of Granular NPKS-Fertilizers

Authors: Andrey Norov

Abstract:

Based on a comparison of technologies for the production of granular nitrate-containing and nitrate-free NPKS-fertilizers, this paper considers the effect of process parameters on the economic feasibility of production, on physical & chemical, and structural & mechanical properties and quality of final products (caking, static strength of granules, hygroscopicity, etc.), as well as on thermal stability of fertilizers, eco-friendly production, and other aspects. This comparative analysis allows to select the optimal technology for specific conditions and requirements. Additionally, the report considers flexible, a unique technology for the production of granular NPKS-fertilizers containing sulfur and calcium, suggested by Samoilov Research Institute for Mineral Fertilizers JSC “NIUIF” - the oldest industry-oriented institute in Russia. This technology is implemented at one of the Russian plants where combined drum is used for granulation and drying.

Keywords: caking, granule static strength, granulating-drying drum, NPKS-fertilizers

Procedia PDF Downloads 111
2469 The Combined Use of L-Arginine and Progesterone During the Post-breeding Period in Female Rabbits Increases the Weight of Their Fetuses

Authors: Diego F. Carrillo-González, Milena Osorio, Natalia M. Cerro, Yasser Y. Lenis

Abstract:

Introduction: mortality during the implantation and early embryonic development periods reach around 30% in different mammalian species. It has been described that progesterone (P4) and Arginine (Arg) play a beneficial role in establishing and maintaining early pregnancy in mammals. The combined effect between Arg and P4 on reproductive parameters in the rabbit species is not yet elucidated, to our best knowledge. Objective: to assess the effect of L-arginine and progesterone during the post-breeding period in female rabbits on the composition of the amniotic fluid, the placental structure, and the bone growth in their fetuses. Methods: crossbred female rabbits (n=16) were randomly distributed into four experimental groups (Ctrl, Arg, P4, and Arg+P4). In the control group, 0.9% saline solution was administered as a placebo, the Arg group was administered arginine (50 mg/kg BW) from day 4.5 to day 19 post-breeding, the P4 group was administered progesterone (Gestavec®, 1.5 mg/kg BW) from 24 hours to day 4 post-breeding and for the Arg+P4 group, an administration was performed under the same time and dose guidelines as the Arg and P4 treatments. Four females were sacrificed, and the amniotic fluid was collected and analyzed with rapid urine test strips, while the placenta and fetuses were processed in the laboratory to obtain histological plates. The percentage of deciduous, labyrinthine, and junctional zones was determined, and the length of the femur for each fetus was measured as an indicator of growth. Descriptive statistics were applied to identify the success rates for each of the tests. Afterwards, A one-way analysis of variance (ANOVA) was performed, and a comparison of means was conducted by Tukey's test. Results: a higher density (p<0.05) was observed in the amniotic fluid for fetuses in the control group (1022±2.5g/mL) compared to the P4 (1015±5.3g/mL) and Arg+P4 (1016±4,9g/mL) groups. Additionally, the density of amniotic fluid in the Arg group (1021±2.5g/mL) was higher (p<0.05) than in the P4 group. The concentration of protein, glucose, and ascorbic acid had no statistical difference between treatments (p>0.05). The histological analysis of the uteroplacental regions, a statistical difference (p<0,05) in the proportion of deciduous zone was found between the P4 group (9.6±2.6%) when compared with the Ctrl (28.15±12.3%), and Arg+P4 (26.3±4.9) groups. In the analysis of the fetuses, the weight was higher for the Arg group (2.69±0.18), compared to the other groups (p<0.05), while a shorter length was observed (p<0.05) in the fetuses for the Arg+P4 group (25.97±1.17). However, no difference (p>0.05) was found when comparing the length of the developing femurs between the experimental groups. Conclusion: the combination of L-arginine and progesterone allows a reduction in the density of amniotic fluid, without affecting the protein, energy, and antioxidant components. However, the use of L-arginine stimulates weight gain in fetuses, without affecting size, which could be used to improve production parameters in rabbit production systems. In addition, the modification in the deciduous zone could show a placental adaptation based on the fetal growth process, however more specific studies on the placentation process are required.

Keywords: arginine, progesterone, rabbits, reproduction

Procedia PDF Downloads 87
2468 Multiple-Channel Coulter Counter for Cell Sizing and Enumeration

Authors: Yu Chen, Seong-Jin Kim, Jaehoon Chung

Abstract:

High throughput cells counting and sizing are often required for biomedical applications. Here we report design, fabrication and validating of a micro-machined Coulter counter device with multiple-channel to realize such application for low cost. Multiple vertical through-holes were fabricated on a silicon chip, combined with the PDMS micro-fluidics channel that serves as the sensing channel. In order to avoid the crosstalk introduced by the electrical connection, instead of measuring the current passing through, the potential of each channel is monitored, thus the high throughput is possible. A peak of the output potential can be captured when the cell/particle is passing through the microhole. The device was validated by counting and sizing the polystyrene beads with diameter of 6 μm, 10 μm and 15 μm. With the sampling frequency to be set at 100 kHz, up to 5000 counts/sec for each channel can be realized. The counting and enumeration of MCF7 cancer cells are also demonstrated.

Keywords: Coulter counter, cell enumeration, high through-put, cell sizing

Procedia PDF Downloads 609
2467 Comparison of Different Intraocular Lens Power Calculation Formulas in People With Very High Myopia

Authors: Xia Chen, Yulan Wang

Abstract:

purpose: To compare the accuracy of Haigis, SRK/T, T2, Holladay 1, Hoffer Q, Barrett Universal II, Emmetropia Verifying Optical (EVO) and Kane for intraocular lens power calculation in patients with axial length (AL) ≥ 28 mm. Methods: In this retrospective single-center study, 50 eyes of 41 patients with AL ≥ 28 mm that underwent uneventful cataract surgery were enrolled. The actual postoperative refractive results were compared to the predicted refraction calculated with different formulas (Haigis, SRK/T, T2, Holladay 1, Hoffer Q, Barrett Universal II, EVO and Kane). The mean absolute prediction errors (MAE) 1 month postoperatively were compared. Results: The MAE of different formulas were as follows: Haigis (0.509), SRK/T (0.705), T2 (0.999), Holladay 1 (0.714), Hoffer Q (0.583), Barrett Universal II (0.552), EVO (0.463) and Kane (0.441). No significant difference was found among the different formulas (P = .122). The Kane and EVO formulas achieved the lowest level of mean prediction error (PE) and median absolute error (MedAE) (p < 0.05). Conclusion: The Kane and EVO formulas had a better success rate than others in predicting IOL power in high myopic eyes with AL longer than 28 mm in this study.

Keywords: cataract, power calculation formulas, intraocular lens, long axial length

Procedia PDF Downloads 82
2466 Investigation of Regional Differences in Strong Ground Motions for the Iranian Plateau

Authors: Farhad Sedaghati, Shahram Pezeshk

Abstract:

Regional variations in strong ground motions for the Iranian Plateau have been investigated by using a simple statistical method called Analysis of Variance (ANOVA). In this respect, a large database consisting of 1157 records occurring within the Iranian Plateau with moment magnitudes of greater than or equal to 5 and Joyner-Boore distances up to 200 km has been considered. Geometric averages of horizontal peak ground accelerations (PGA) as well as 5% damped linear elastic response spectral accelerations (SA) at periods of 0.2, 0.5, 1.0, and 2.0 sec are used as strong motion parameters. The initial database is divided into two different datasets, for Northern Iran (NI) and Central and Southern Iran (CSI). The comparison between strong ground motions of these two regions reveals that there is no evidence for significant differences; therefore, data from these two regions may be combined to estimate the unknown coefficients of attenuation relationships.

Keywords: ANOVA, attenuation relationships, Iranian Plateau, PGA, regional variation, SA, strong ground motion

Procedia PDF Downloads 313
2465 Melaleuca alternifolia Fibre Composites: Effect of Different Type of Fibre on Mechanical and Physical Properties

Authors: Sahari Japar, Rodney Jammy, M. A. Maleque

Abstract:

The fabrication of melaleuca alternifolia fibre reinforced thermoplastic starch composites was successfully done. This paper aims to show the effect of melaleuca alternifolia fibres on mechanical and physical properties of composites by using starch as a matrix. The fibres were extracted from three different part i.e. tea tree trunk (TTT), tea tree bunch (TTB) and tea tree leaf (TTL) and combined with tapioca starch by casting method. All composites showed superior mechanical properties in comparison to TS. The addition of 5% (v/v) fibres as a filler to TS led to the improvement in young’s modulus by 350% for TTB/TS, 282% for TTT/TS and 220% for TTL/TS. The tensile strength also increased to 34.39% for TTL/TS, 82.80% for TTB/TS and 203.18% for TTT/TS respectively. The trend can be correlated to the amount of cellulose in the fibres. For physical properties, it can be seen that, with the addition of fibres, the water absorption and swelling of composites decreased. The addition of melaleuca alternifolia fibre improved mechanical and physical properties of thermoplastic starch composites.

Keywords: melaleuca alternifolia, fibre, starch, mechanical, physical

Procedia PDF Downloads 396
2464 Effectiveness of Dry Needling on Pain and Pressure Point Threshold in Cervicogenic Headache

Authors: Ramesh Chandra Patra, Ajay P. Gautam, Patitapaban Mohanty

Abstract:

Headache disorders are one of the 10 most disabling conditions for men and women. Headache that originated from upper cervical spine and refereed to the one side of the head and/or face is known as cervicogenic headache (CH) which constitute15% to 20% among all the headaches. In our best knowledge manual therapy is often advocated for managing CH, but very little focus given on muscle system although it is a musculoskeletal disorder. In this study, 75 patients with CH were selected and divided into two groups Group A: Manual therapy and Group B: dry needling along with manual therapy group. Assessment was done using NPRS (0-10) for pain, wide spread pressure pain threshold using an algometer at the beginning and end of the study. There is a consistent reduction in pain and tenderness in both the group but significant improvement was shown in combined group. Outcome of the study has explored that the effectiveness of dry needling along with Mulligan is more beneficial in patients with cervicogenic headaches.

Keywords: cervicogenic headaches, dry needling, NPRS, pressure point threshold

Procedia PDF Downloads 227
2463 The Effect of Flue Gas Condensation on the Exergy Efficiency and Economic Performance of a Waste-To-Energy Plant

Authors: Francis Chinweuba Eboh, Tobias Richards

Abstract:

In this study, a waste-to-energy combined heat and power plant under construction was modelled and simulated with the Aspen Plus software. The base case process plant was evaluated and compared when integrated with flue gas condensation (FGC) in order to find out the impact of the exergy efficiency and economic feasibility as well as the effect of overall system exergy losses and revenue generated in the investigated plant. The economic evaluations were carried out using the vendor cost data from Aspen process economic analyser. The results indicate that 4 % increase in the exergy efficiency and 29 % reduction in the exergy loss in the flue gas were obtained when the flue gas condensation was incorporated. Furthermore, with the integrated FGC, the net present values (NPV) and income generated in the base process plant were increased by 29 % and 10 % respectively after 20 years of operation.

Keywords: economic feasibility, exergy efficiency, exergy losses, flue gas condensation, waste-to-energy

Procedia PDF Downloads 189
2462 The Potential Use of Crude Palm Oil Liquid Wastes to Improve Nutrient Levels in Vegetable Plants

Authors: Hasan Basri Jumin

Abstract:

Application of crude palm oil waste combined to suitable concentration of benzyl-adenine give the significant effect to mean relative growth rate of vegetable plants and the same pattern in net assimilation rate crude palm oil waste has also significantly increased during 28 days old plants. Combination of treatment of suitable concentration of crude palm oil and benzyl adenine increased the growth and production of vegetable plants. The relative growth rate of vegetable plants was rapid 3 weeks after planting and gradually decreased at the end of the harvest time period. Combination of 400 mg.l-1 CPO with 1.0 mgl-1 till 10mgl-1 BA increased the Mean Relative Growth Rate (MRGR), Net assimilation rate (NAR), Leaf area and dry weight of Brassica juncea, Brassica oleraceae and Lactuca sativa.

Keywords: benzyladenine, crude-palm-oil, nutrient, vegetable, waste

Procedia PDF Downloads 192
2461 Power Integrity Analysis of Power Delivery System in High Speed Digital FPGA Board

Authors: Anil Kumar Pandey

Abstract:

Power plane noise is the most significant source of signal integrity (SI) issues in a high-speed digital design. In this paper, power integrity (PI) analysis of multiple power planes in a power delivery system of a 12-layer high-speed FPGA board is presented. All 10 power planes of HSD board are analyzed separately by using 3D Electromagnetic based PI solver, then the transient simulation is performed on combined PI data of all planes along with voltage regulator modules (VRMs) and 70 current drawing chips to get the board level power noise coupling on different high-speed signals. De-coupling capacitors are placed between power planes and ground to reduce power noise coupling with signals.

Keywords: power integrity, power-aware signal integrity analysis, electromagnetic simulation, channel simulation

Procedia PDF Downloads 434
2460 Using Group Concept Mapping to Identify a Pharmacy-Based Trigger Tool to Detect Adverse Drug Events

Authors: Rodchares Hanrinth, Theerapong Srisil, Peeraya Sriphong, Pawich Paktipat

Abstract:

The trigger tool is the low-cost, low-tech method to detect adverse events through clues called triggers. The Institute for Healthcare Improvement (IHI) has developed the Global Trigger Tool for measuring and preventing adverse events. However, this tool is not specific for detecting adverse drug events. The pharmacy-based trigger tool is needed to detect adverse drug events (ADEs). Group concept mapping is an effective method for conceptualizing various ideas from diverse stakeholders. This technique was used to identify a pharmacy-based trigger to detect adverse drug events (ADEs). The aim of this study was to involve the pharmacists in conceptualizing, developing, and prioritizing a feasible trigger tool to detect adverse drug events in a provincial hospital, the northeastern part of Thailand. The study was conducted during the 6-month period between April 1 and September 30, 2017. Study participants involved 20 pharmacists (17 hospital pharmacists and 3 pharmacy lecturers) engaging in three concept mapping workshops. In this meeting, the concept mapping technique created by Trochim, a highly constructed qualitative group technic for idea generating and sharing, was used to produce and construct participants' views on what triggers were potential to detect ADEs. During the workshops, participants (n = 20) were asked to individually rate the feasibility and potentiality of each trigger and to group them into relevant categories to enable multidimensional scaling and hierarchical cluster analysis. The outputs of analysis included the trigger list, cluster list, point map, point rating map, cluster map, and cluster rating map. The three workshops together resulted in 21 different triggers that were structured in a framework forming 5 clusters: drug allergy, drugs induced diseases, dosage adjustment in renal diseases, potassium concerning, and drug overdose. The first cluster is drug allergy such as the doctor’s orders for dexamethasone injection combined with chlorpheniramine injection. Later, the diagnosis of drug-induced hepatitis in a patient taking anti-tuberculosis drugs is one trigger in the ‘drugs induced diseases’ cluster. Then, for the third cluster, the doctor’s orders for enalapril combined with ibuprofen in a patient with chronic kidney disease is the example of a trigger. The doctor’s orders for digoxin in a patient with hypokalemia is a trigger in a cluster. Finally, the doctor’s orders for naloxone with narcotic overdose was classified as a trigger in a cluster. This study generated triggers that are similar to some of IHI Global trigger tool, especially in the medication module such as drug allergy and drug overdose. However, there are some specific aspects of this tool, including drug-induced diseases, dosage adjustment in renal diseases, and potassium concerning which do not contain in any trigger tools. The pharmacy-based trigger tool is suitable for pharmacists in hospitals to detect potential adverse drug events using clues of triggers.

Keywords: adverse drug events, concept mapping, hospital, pharmacy-based trigger tool

Procedia PDF Downloads 162
2459 Mechanical Properties of Sugar Palm Fibre Reinforced Thermoplastic Polyurethane Composites

Authors: Dandi Bachtiar, Mohammed Ausama Abbas, Januar Parlaungan Siregar, Mohd Ruzaimi Bin Mat Rejab

Abstract:

Short sugar palm fibre and thermoplastic polyurethane were combined to produce new composites by using the extrude method. Two techniques used to prepare a new composite material, firstly, extrusion of the base material with short fibre, secondly hot pressing them. The size of sugar palm fibre was fixed at 250µm. Different weight percent (10 wt%, 20 wt% and 30 wt%) were used in order to optimise preparation process. The optimization of process depended on the characterization mechanical properties such as impact, tensile, and flexural of the new (TPU/SPF) composite material. The results proved that best tensile and impact properties of weight additive fibre applied 10 wt%. There was an increasing trend recorded of flexural properties during increased the fibre loading. Meanwhile, the maximum tensile strength was 14.0 MPa at 10 wt% of the fibre. Moreover, there was no significant effect for additions more than 30 wt% of the fibre.

Keywords: composites, natural fibre, polyurethane, sugar palm

Procedia PDF Downloads 381
2458 The Effect of Exercise Therapy and Electroacupuncture on Some Clinical Outcomes in People with Post Total Hip Arthroplasty

Authors: Marzieh Yassin, Masoud Rashed, Soheil Mansour Sohani, Reza Salehi

Abstract:

Background: Hip arthroplasty is one of the surgical methods to improve symptoms in patients with hip osteoarthritis. The use of electroacupuncture and TENS reduces pain, increases range of motion and improves performance. Methods: In this clinical trial study, 30 patients after hip arthroplasty were randomly divided into two groups: electroacupuncture (n=16) with exercise therapy and TENS with exercise therapy (n=14). Severity of pain, quality of life, range of motion, edema and function were evaluated in two groups before and after the interventions. Interventions of 10 sessions (three sessions per week) were conducted for two groups. The significance level in all tests was below 0.05. Results: The results showed that both groups improved all of the symptoms after the intervention (p≤0.05), although there was no statistically significant difference between the two groups in terms of effectiveness (p≥0.05). Conclusion: The results showed that both methods improve symptoms in patients after surgery. According to this study, electroacupuncture is suggested as a new method effective for the treatment of people with post-Total Hip Arthroplasty.

Keywords: electroacupuncture, physical performance, total hip arthroplasty, TENS

Procedia PDF Downloads 82
2457 Clinical Pathway for Postoperative Organ Transplantation

Authors: Tahsien Okasha

Abstract:

Transplantation medicine is one of the most challenging and complex areas of modern medicine. Some of the key areas for medical management are the problems of transplant rejection, during which the body has an immune response to the transplanted organ, possibly leading to transplant failure and the need to immediately remove the organ from the recipient. When possible, transplant rejection can be reduced through serotyping to determine the most appropriate donor-recipient match and through the use of immunosuppressant drugs. Postoperative care actually begins before the surgery in terms of education, discharge planning, nutrition, pulmonary rehabilitation, and patient/family education. This also allows for expectations to be managed. A multidisciplinary approach is the key, and collaborative team meetings are essential to ensuring that all team members are "on the same page." .The following clinical pathway map and guidelines with the aim to decrease alteration in clinical practice and are intended for those healthcare professionals who look after organ transplant patients. They are also intended to be useful to both medical and surgical trainees as well as nurse specialists and other associated healthcare professionals involved in the care of organ transplant patients. This pathway is general pathway include the general guidelines that can be applicable for all types of organ transplant with special considerations to each organ.

Keywords: postoperative care, organ transplant, clinical pathway, patient

Procedia PDF Downloads 457
2456 Finite Element Analysis of Low-Velocity Impact Damage on Stiffened Composite Panels

Authors: Xuan Sun, Mingbo Tong

Abstract:

To understand the factors which affect impact damage on composite structures, particularly the effects of impact position and ribs. In this paper, a finite element model (FEM) of low-velocity impact damage on the composite structure was established via the nonlinear finite element method, combined with the user-defined materials subroutine (VUMAT) of the ABAQUS software. The structural elements chosen for the investigation comprised a series of stiffened composite panels, representative of real aircraft structure. By impacting the panels at different positions relative to the ribs, the effect of relative position of ribs was found out. Then the simulation results and the experiments data were compared. Finally, the factors which affect impact damage on the structures were discussed. The paper was helpful for the design of stiffened composite structures.

Keywords: stiffened, low-velocity impact, Abaqus, impact energy

Procedia PDF Downloads 619
2455 Temperature Dependent Interaction Energies among X (=Ru, Rh) Impurities in Pd-Rich PdX Alloys

Authors: M. Asato, C. Liu, N. Fujima, T. Hoshino, Y. Chen, T. Mohri

Abstract:

We study the temperature dependence of the interaction energies (IEs) of X (=Ru, Rh) impurities in Pd, due to the Fermi-Dirac (FD) distribution and the thermal vibration effect by the Debye-Grüneisen model. The n-body (n=2~4) IEs among X impurities in Pd, being used to calculate the internal energies in the free energies of the Pd-rich PdX alloys, are determined uniquely and successively from the lower-order to higher-order, by the full-potential Korringa-Kohn-Rostoker Green’s function method (FPKKR), combined with the generalized gradient approximation in the density functional theory. We found that the temperature dependence of IEs due to the FD distribution, being usually neglected, is very important to reproduce the X-concentration dependence of the observed solvus temperatures of the Pd-rich PdX (X=Ru, Rh) alloys.

Keywords: full-potential KKR-green’s function method, Fermi-Dirac distribution, GGA, phase diagram of Pd-rich PdX (X=Ru, Rh) alloys, thermal vibration effect

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2454 The Acquisition of Case in Biological Domain Based on Text Mining

Authors: Shen Jian, Hu Jie, Qi Jin, Liu Wei Jie, Chen Ji Yi, Peng Ying Hong

Abstract:

In order to settle the problem of acquiring case in biological related to design problems, a biometrics instance acquisition method based on text mining is presented. Through the construction of corpus text vector space and knowledge mining, the feature selection, similarity measure and case retrieval method of text in the field of biology are studied. First, we establish a vector space model of the corpus in the biological field and complete the preprocessing steps. Then, the corpus is retrieved by using the vector space model combined with the functional keywords to obtain the biological domain examples related to the design problems. Finally, we verify the validity of this method by taking the example of text.

Keywords: text mining, vector space model, feature selection, biologically inspired design

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2453 O-(2-18F-Fluoroethyl)-L-Tyrosine Positron Emission Tomography/Computed Tomography in Patients with Suspicious Recurrent Low and High-Grade Glioma

Authors: Mahkameh Asadi, Habibollah Dadgar

Abstract:

The precise definition margin of high and low-grade glioma is crucial for choosing best treatment approach after surgery and radio-chemotherapy. The aim of the current study was to assess the O-(2-18F-fluoroethyl)-L-tyrosine (18F-FET) positron emission tomography (PET)/computed tomography (CT) in patients with low (LGG) and high grade glioma (HGG). We retrospectively analyzed 18F-FET PET/CT of 10 patients (age: 33 ± 12 years) with suspicious for recurrent LGG and HGG. The final decision of recurrence was made by magnetic resonance imaging (MRI) and registered clinical data. While response to radio-chemotherapy by MRI is often complex and sophisticated due to the edema, necrosis, and inflammation, emerging amino acid PET leading to better interpretations with more specifically differentiate true tumor boundaries from equivocal lesions. Therefore, integrating amino acid PET in the management of glioma to complement MRI will significantly improve early therapy response assessment, treatment planning, and clinical trial design.

Keywords: positron emission tomography, amino acid positron emission tomography, magnetic resonance imaging, low and high grade glioma

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2452 The Experimental Investigation of Temperature Influence on the Oscillations of Particles on Liquid Surfaces

Authors: Sathish K. Gurupatham, Farhad Sayedzada, Naji Dauk, Valmiki Sooklal, Laura Ruhala

Abstract:

It was shown recently that small particles and powders spontaneously disperse on liquid surfaces when they come into contact with the interface for the first time. This happens due to the combined effect of the capillary force, buoyant weight of the particle and the viscous drag that the particle experiences in the liquid. The particle undergoes oscillations normal to the interface before it comes to rest on the interface. These oscillations, in turn, induce a flow on the interface which disperses the particles radially outward. This phenomenon has a significant role in the pollination of sea plants such as Ruppia in which the formation of ‘pollen rafts’ is the first step. This paper investigates, experimentally, the influence of the temperature of the liquid on which this dispersion occurs. It was observed that the frequency of oscillations of the particles decreased with the increase in the temperature of the liquid. It is because the magnitude of capillary force also decreased when the temperature of the liquid increased.

Keywords: particle dispersion, capillary force, viscous drag, oscillations

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2451 The Combined Methodology To Detect Onboard Driver Fatigue

Authors: K. Senthil Nathan, P. Rajasekaran

Abstract:

Fatigue is a feeling of extreme physical or mental tiredness. Almost everyone becomes fatigued at some time, but driver’s fatigue is a serious problem that leads to thousands of automobile crashes each year. Fatigue process is often a change from the alertness and vigor state to the tiredness and weakness state. It is not only accompanied by drowsiness but also has a negative impact on mood. There have been studies to detect and quantify fatigue from the measurement of physiology variables such as electroencephalogram (EEG), electrooculogram (EOG), and electromyogram (EMG). This project involves a multimodal sensing of driver’s drowsiness. The first method is to count the eye blinking rate. In the second level, we authenticate the results of eye blink module with a grip sensor. The Flexiforce sensor is placed over the steering wheel. In the third level, the activities are sensed, the time elapsed from the driver’s last activity is counted here. The activities in the sense: Changing gear, applying brake, pressing sound horns, and turning the steering wheel. Absence of these activities is also an indicator of fatigue.

Keywords: eye blink sensor, Flexiforce sensor, EEG, EOG, EMG

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2450 Lung Cancer Patients in Eastern Region of Nepal

Authors: Ram Sharan Mehta

Abstract:

The number of new cancer cases annually is estimated to rise from 10.9 million in 2002 to more than 16 million by 2020, if current trends continue. Much of this increase in absolute numbers derives from the ageing of populations worldwide. The objectives of this study were to find out the demographic characteristics of the admitted cancer patients in BPKIHS. It was hospital based descriptive cross-sectional study conducted reviewing all the records of admitted diagnosed cancer patients in BPKIHS from 15th October 2004 to 14th October 2012. Using total enumerative sampling technique all 1379 diagnosed cancer patients record were reviewed after obtaining the permission from concerned authorities. Using SPSS-15 software package data was analyzed. It was found that majority (71%) of cancer patients were of age more than 40 years and equal of both sexes. Most of the clients were form Sunsari (31.1%), Morang (16.6%) and Jhapa (17%) districts. The mean hospitalization day is 8.32 and very few patients (5.2%) were only cured. The numbers of cancer patients are markedly increases in BPKIHS, especially in advanced stage. It is mandatory to start the cancer information and education programme in eastern region of Nepal and proper management of cancer patients using chemotherapy, radiotherapy and surgery at BPKIHS for quality patient care.

Keywords: lung, cancer, patients, Nepal

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2449 Evaluating Therapeutic Efficacy of Intravesical Xenogeneic Urothelial Cell Treatment Alone and in Combination with Chemotherapy or Immune Checkpoint Inhibitors in a Mouse Non-Muscle-Invasive Bladder Cancer Model

Authors: Chih-Rong Shyr, Chi-Ping Huang

Abstract:

Intravesical BCG is the gold-standard therapy for high risk non-muscle invasive bladder cancer (NMIBC) after TURBT, but if not responsive to BCG, these BCG unresponsive patients face cystectomy that causes morbidity and comes with a morality risk. To provide the bladder sparing options for patients with BCG-unresponsive NMIBC, several new treatments have been developed to salvage the bladders and prevent progression to muscle invasive or metastatic, but however, most approved or developed treatments still fail in a significant proportion of patients without long term success. Thus more treatment options and the combination of different therapeutic modalities are urgently needed to change the outcomes. Xenogeneic rejection has been proposed to a mechanism of action to induce anti-tumor immunity for the treatment of cancers due to the similarities between rejection mechanism to xenoantigens (proteins, glycans and lipids) and anti-tumor immunities to tumor specific antigens (neoantigens, tumor associated carbohydrates and lipids). Xenogeneic urothelial cells (XUC) of porcine origin have been shown to induce anti-tumor immune responses to inhibit bladder tumor progression in mouse bladder cancer models. To further demonstrate the efficacy of the distinct intravesical XUC treatment in NMIBC, and the combined effects with chemotherapy and immune checkpoint inhibitors (ICIs) as a alternate therapeutic option, this study investigated the therapeutic effects and mechanisms of intravesical XUC immunotherapy in an orthotopic mouse immune competent model of NMIBC, generated from a mouse bladder cancer cell line. We found that the tumor progression was inhibited by intravescial XUC treatment and there was a synergy between intravesical XUC with intravesical chemotherapeutic agent, gemcitabine or systemic ICI, anti-PD1 antibody treatment. The cancer cell proliferation was decreased but the cell death was increased by the intravecisal XUC treatment. Most importantly, the mechanisms of action of intravesical XUC immunotherapy were found to be linked to enhanced infiltration of CD4+ and CD8+ T-cell as well as NK cells, but decreased presence of myeloid immunosuppressive cells in XUC treated tumors. The increased stimulation of immune cells of XUC treated mice to xenogeneic urothelial cells and mouse bladder cancer cells in immune cell proliferation and cytokine secretion were observed both as a monotherapy and in combination with intravesical gemcitabine or systemic anti PD-L1 treatment. In sum, we identified the effects of intravesical XUC treatment in monotherapy and combined therapy on tumor progression and its cellular and molecular events related to immune activation to understand the anti-tumoral mechanisms behind intravesical XUC immunotherapy for NMIBC. These results contribute to the understanding of the mechanisms behind successful xenogeneic cell immunotherapy against NMIBC and characterize a novel therapeutic approach with a new xenogeneic cell modality for BCG-unresponsive NMIBC.

Keywords: xenoantigen, neoantigen, rejection, immunity

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