Search results for: maximum loss
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 7264

Search results for: maximum loss

6034 The OverStitch and OverStitch SX Endoscopic Suturing System in Bariatric Surgery, Closing Perforations and Fistulas and Revision Procedures

Authors: Mohammad Tayefeh Norooz, Amirhossein Kargarzadeh

Abstract:

Overweight and obesity as an abnormality are health threatening factors. Body mass index (BMI) above 25 is referred to as overweight and above 30 as obese. Apollo Endosurgery, Inc., a pioneering company in endoscopy surgeries, is poised to revolutionize patient care with its minimally invasive treatment options. Some product solutions are designed to improve patient outcomes and redefine the future of healthcare. Weight gain post-weight-loss surgery may stem from an enlarged stomach opening, reducing fullness and increasing food intake. Apollo Endosurgery's OverStitch system, a minimally invasive approach, addresses this by using sutures to reduce stomach opening size. This reflects Apollo's commitment to transformative improvements in healing endoscopy, emphasizing a shift towards minimally invasive options. The system's versatility and precision in full-thickness suturing offer treatment alternatives, exemplified in applications like Endoscopic Sleeve Gastroplasty for reshaping obesity management. Apollo’s dedication to pioneering advancements suggests ongoing breakthroughs in minimally invasive surgery, positioning the OverStitch systems as a testament to innovation in patient care.

Keywords: apollo endosurgery, endoscopic sleeve gastroplasty, weight loss system, overstitch endoscopic suturing system, therapeutic, perforations, fistula

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6033 Educational Deprivation and Their Determinants in India: Evidence from National Sample Survey

Authors: Mukesh Ranjan

Abstract:

Applying probit model on the micro data of NSS 71st round on education for understanding the access to education post the passage of Right to Education act,2009 in India. The empirical analysis shows that at all India level the mean age of enrollment in school is 5.5 years and drop-out age is around 14 years (or studied up to class 7) and around 60 percent females never get enrolled in any school in their lifetime. Nearly 20 percent children in Bihar never seen school and surprisingly, the relatively developed states like Gujarat, Maharashtra, Karnataka, Kerala and Tamil Nadu have more than one-third of the children and half of the children in Andhra Pradesh, West Bengal and Orissa as educationally wasted. The relative contribution in educational wastage is maximum by Bengal (10 %) while UP contributed a maximum of 30 % in educational non-enrollment in the country. Educational wastage is more likely to increase with age. Marriage is a resistive factor in getting education. Muslims are educationally more deprived than Hindus. Larger family and rich household are less likely to be educationally deprived. Major reasons for drop-out until 9 years were lack of interest in education and financial constraint; between 10-12 years, lack of interest and unable to cope up with studies and post 12 years financial constraint, marriage and other household reasons.

Keywords: probit model, educational wastage, educational non-enrollment, educational deprivation

Procedia PDF Downloads 300
6032 Open Circuit MPPT Control Implemented for PV Water Pumping System

Authors: Rabiaa Gammoudi, Najet Rebei, Othman Hasnaoui

Abstract:

Photovoltaic systems use different techniques for tracking the Maximum Power Point (MPPT) to provide the highest possible power to the load regardless of the climatic conditions variation. In this paper, the proposed method is the Open Circuit (OC) method with sudden and random variations of insolation. The simulation results of the water pumping system controlled by OC method are validated by an experimental experience in real-time using a test bench composed by a centrifugal pump powered by a PVG via a boost chopper for the adaptation between the source and the load. The output of the DC/DC converter supplies the motor pump LOWARA type, assembly by means of a DC/AC inverter. The control part is provided by a computer incorporating a card DS1104 running environment Matlab/Simulink for visualization and data acquisition. These results show clearly the effectiveness of our control with a very good performance. The results obtained show the usefulness of the developed algorithm in solving the problem of degradation of PVG performance depending on the variation of climatic factors with a very good yield.

Keywords: PVWPS (PV Water Pumping System), maximum power point tracking (MPPT), open circuit method (OC), boost converter, DC/AC inverter

Procedia PDF Downloads 449
6031 Infrared Thermography as an Informative Tool in Energy Audit and Software Modelling of Historic Buildings: A Case Study of the Sheffield Cathedral

Authors: Ademuyiwa Agbonyin, Stamatis Zoras, Mohammad Zandi

Abstract:

This paper investigates the extent to which building energy modelling can be informed based on preliminary information provided by infrared thermography using a thermal imaging camera in a walkthrough audit. The case-study building is the Sheffield Cathedral, built in the early 1400s. Based on an informative qualitative report generated from the thermal images taken at the site, the regions showing significant heat loss are input into a computer model of the cathedral within the integrated environmental solution (IES) virtual environment software which performs an energy simulation to determine quantitative heat losses through the building envelope. Building data such as material thermal properties and building plans are provided by the architects, Thomas Ford and Partners Ltd. The results of the modelling revealed the portions of the building with the highest heat loss and these aligned with those suggested by the thermal camera. Retrofit options for the building are also considered, however, may not see implementation due to a desire to conserve the architectural heritage of the building. Results show that thermal imaging in a walk-through audit serves as a useful guide for the energy modelling process. Hand calculations were also performed to serve as a 'control' to estimate losses, providing a second set of data points of comparison.

Keywords: historic buildings, energy retrofit, thermal comfort, software modelling, energy modelling

Procedia PDF Downloads 168
6030 The Influence of Different Flux Patterns on Magnetic Losses in Electric Machine Cores

Authors: Natheer Alatawneh

Abstract:

The finite element analysis of magnetic fields in electromagnetic devices shows that the machine cores experience different flux patterns including alternating and rotating fields. The rotating fields are generated in different configurations range between circular and elliptical with different ratios between the major and minor axis of the flux locus. Experimental measurements on electrical steel exposed to different flux patterns disclose different magnetic losses in the samples under test. Consequently, electric machines require special attention during the cores loss calculation process to consider the flux patterns. In this study, a circular rotational single sheet tester is employed to measure the core losses in electric steel sample of M36G29. The sample was exposed to alternating field, circular field, and elliptical fields with axis ratios of 0.2, 0.4, 0.6 and 0.8. The measured data was implemented on 6-4 switched reluctance motor at three different frequencies of interest to the industry as 60 Hz, 400 Hz, and 1 kHz. The results disclose a high margin of error that may occur during the loss calculations if the flux patterns issue is neglected. The error in different parts of the machine associated with considering the flux patterns can be around 50%, 10%, and 2% at 60Hz, 400Hz, and 1 kHz, respectively. The future work will focus on the optimization of machine geometrical shape which has a primary effect on the flux pattern in order to minimize the magnetic losses in machine cores.

Keywords: alternating core losses, electric machines, finite element analysis, rotational core losses

Procedia PDF Downloads 248
6029 Experimental on Free and Forced Heat Transfer and Pressure Drop of Copper Oxide-Heat Transfer Oil Nanofluid in Horizontal and Inclined Microfin Tube

Authors: F. Hekmatipour, M. A. Akhavan-Behabadi, B. Sajadi

Abstract:

In this paper, the combined free and forced convection heat transfer of the Copper Oxide-Heat Transfer Oil (CuO-HTO) nanofluid flow in horizontal and inclined microfin tubes is studied experimentally. The flow regime is laminar, and pipe surface temperature is constant. The effect of nanoparticle and microfin tube on the heat transfer rate is investigated with the Richardson number which is between 0.1 and 0.7. The results show an increasing nanoparticle concentration between 0% and 1.5% leads to enhance the combined free and forced convection heat transfer rate. According to the results, five correlations are proposed to provide estimating the free and forced heat transfer rate as the increasing Richardson number from 0.1 to 0.7. The maximum deviation of both correlations is less than 16%. Moreover, four correlations are suggested to assess the Nusselt number based on the Rayleigh number in inclined tubes from 1800000 to 7000000. The maximum deviation of the correlation is almost 16%. The Darcy friction factor of the nanofluid flow has been investigated. Furthermore, CuO-HTO nanofluid flows in inclined microfin tubes.

Keywords: nanofluid, heat transfer oil, mixed convection, inclined tube, laminar flow

Procedia PDF Downloads 253
6028 Effect of Cigarette Smoke on Micro-Architecture of Respiratory Organs with and without Dietary Probiotics

Authors: Komal Khan, Hafsa Zaneb, Saima Masood, Muhammad Younus, Sanan Raza

Abstract:

Cigarette smoke induces many physiological and pathological changes in respiratory tract like goblet cell hyperplasia and regional distention of airspaces. It is also associated with elevation of inflammatory profiles in different airway compartments. As probiotics are generally known to promote mucosal tolerance, it was postulated that prophylactic use of probiotics can be helpful in reduction of respiratory damage induced by cigarette smoke exposure. Twenty-four adult mice were randomly divided into three groups (cigarette-smoke (CS) group, cigarette-smoke+ Lactobacillus (CS+ P) group, control (Cn) group), each having 8 mice. They were exposed to cigarette smoke for 28 days (6 cigarettes/ day for 6 days/week). Wright-Giemsa staining of bronchoalveolar lavage fluid (BALF) was performed in three mice per group. Tissue samples of trachea and lungs of 7 mice from each group were processed by paraffin embedding technique for haematoxylin & eosin (H & E) and alcian blue- periodic acid-Schiff (AB-PAS) staining. Then trachea (goblet cell number, ratio and loss of cilia) and lungs (airspace distention) were studied. The results showed that the number of goblet cells was increased in CS group as a result of defensive mechanism of the respiratory system against irritating substances. This study also revealed that the cells of CS group having acidic glycoprotein were found to be higher in quantity as compared to those containing neutral glycoprotein. However, CS + P group showed a decrease in goblet cell index due to enhanced immunity by prophylactically used probiotics. Moreover, H & E stained tracheas showed significant loss of cilia in CS group due to propelling of mucous but little loss in CS + P group because of having good protective tracheal epithelium. In lungs, protection of airspaces was also much more evident in CS+ P group as compared to CS group having distended airspaces, especially at 150um distance from terminal bronchiole. In addition, a comprehensive analysis of inflammatory cells population of BALF showed neutrophilia and eosinophilia was significantly reduced in CS+ P group. This study proved that probiotics are found to be useful for reduction of changes in micro-architecture of the respiratory system. Thus, dietary supplementation of probiotic as prophylactic measure can be useful in achieving immunomodulatory effects.

Keywords: cigarette smoke, probiotics, goblet cells, airspace enlargement, BALF

Procedia PDF Downloads 362
6027 Fatigue Analysis and Life Estimation of the Helicopter Horizontal Tail under Cyclic Loading by Using Finite Element Method

Authors: Defne Uz

Abstract:

Horizontal Tail of helicopter is exposed to repeated oscillatory loading generated by aerodynamic and inertial loads, and bending moments depending on operating conditions and maneuvers of the helicopter. In order to ensure that maximum stress levels do not exceed certain fatigue limit of the material and to prevent damage, a numerical analysis approach can be utilized through the Finite Element Method. Therefore, in this paper, fatigue analysis of the Horizontal Tail model is studied numerically to predict high-cycle and low-cycle fatigue life related to defined loading. The analysis estimates the stress field at stress concentration regions such as around fastener holes where the maximum principal stresses are considered for each load case. Critical element identification of the main load carrying structural components of the model with rivet holes is performed as a post-process since critical regions with high-stress values are used as an input for fatigue life calculation. Once the maximum stress is obtained at the critical element and the related mean and alternating components, it is compared with the endurance limit by applying Soderberg approach. The constant life straight line provides the limit for several combinations of mean and alternating stresses. The life calculation based on S-N (Stress-Number of Cycles) curve is also applied with fully reversed loading to determine the number of cycles corresponds to the oscillatory stress with zero means. The results determine the appropriateness of the design of the model for its fatigue strength and the number of cycles that the model can withstand for the calculated stress. The effect of correctly determining the critical rivet holes is investigated by analyzing stresses at different structural parts in the model. In the case of low life prediction, alternative design solutions are developed, and flight hours can be estimated for the fatigue safe operation of the model.

Keywords: fatigue analysis, finite element method, helicopter horizontal tail, life prediction, stress concentration

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6026 Age Estimation and Sex Determination by CT-Scan Analysis of the Hyoid Bone: Application on a Tunisian Population

Authors: N. Haj Salem, M. Belhadj, S. Ben Jomâa, R. Dhouieb, S. Saadi, M. A. Mesrati, A. Chadly

Abstract:

Introduction: The hyoid bone is considered as one of many bones used to identify a missed person. There is a specificity of each population group in human identifications. Objective: To analyze the relationship between age, sex and metric parameters of hyoid bone in Tunisian population sample, using CT-scan. Materials and Methods: A prospective study was conducted in the Department of Forensic Medicine of FattoumaBourguiba Hospital of Monastir-Tunisia during 4 years. A total of 240 samples of hyoid bone were studied. The age of cases ranged from 18 days to 81 years. The specimens were collected only from the deceased of known age. Once dried, each hyoid bone was scanned using CT scan. For each specimen, 10 measurements were taken using a computer program. The measurements consisted of 6 lengths and 4 widths. A regression analysis was used to estimate the relationship between age, sex, and different measurements. For age estimation, a multiple logistic regression was carried out for samples ≤ 35 years. For sex determination, ROC curve was performed. Discriminant value finally retained was based on the best specificity with the best sensitivity. Results: The correlation between real age and estimated age was good (r²=0.72) for samples aged 35 years or less. The unstandardised canonical function equation was estimated using three variables: maximum length of the right greater cornua, length from the middle of the left joint space to the middle of the right joint space and perpendicular length from the centre point of a line between the distal ends of the right and left greater cornua to the centre point of the anterior view of the body of the hyoid bone. For sex determination, the ROC curve analysis reveals that the area under curve was at 81.8%. Discriminant value was 0.451 with a specificity of 73% and sensibility of 79%. The equation function was estimated based on two variables: maximum length of the greater cornua and maximum length of the hyoid bone. Conclusion: The findings of the current study suggest that metric analysis of the hyoid bone may predict the age ≤ 35 years. Sex estimation seems to be more reliable. Further studies dealing with the fusion of the hyoid bone and the current study could help to achieve more accurate age estimation rates.

Keywords: anthropology, age estimation, CT scan, sex determination, Tunisia

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6025 Assess Changes in Groundwater Dynamics Caused by Mini Dam Construction in Arid Zone of District Killa Abdullah, Pakistan

Authors: Akhtar Malik Muhammad, Agha Mirwais

Abstract:

Dams are considered to recharge aquifers by raising the water table, especially the ones near wells. The present study investigates the impact of dams on groundwater recharge in Jilga, Pakistan. The comparative analysis of changes in the groundwater table of the year 2012 and 2019 was carried out using ArcGIS 10.5 through the kriging method and remote sensing techniques to evaluate the mini dam's impact on the upstream area. Arc Info Spatial Analyze extension was used to find static water level maps of the years. The water table was observed minimum 67.08 feet and maximum 130.09 feet in 2012 whereas in 2019 the minimum water table level 49.89 feet and maximum 115.85 feet. Groundwater recharge with different ratio was noted, but the most significant was at Rabbani dam with 26ft due to supported lithology conditions and the lowest recharge was found at Garang dam14ft. The overall positive trend indicates the rehabilitation of dead karez and agriculture activities by increasing 36% the vegetation area in 2019. An over 6% increase in human settlement indicates socioeconomic development. Thus, it highlights the need for preferential focus on the construction of the dam so that the water level could be sustained to cater to the agricultural and domestic needs of the local population around the year

Keywords: water table, GIS, land cover, mini dams, agriculture

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6024 Biosynthesis of Tumor Inhibitory Podophyllotoxin, Quercetin and Kaempferol from Callogenesis of Dysosma Pleiantha (Hance) Woodson

Authors: Palaniyandi Karuppaiya, Hsin Sheng Tsay, Fang Chen

Abstract:

Medicinal herbs do represent a huge and noteworthy reservoir for novel anticancer drugs discovery. Dysosma pleiantha (Hance) Woodson (Berberidaceae), one of the oldest traditional Chinese medicinal herb, highly prized by the mountain tribes of Taiwan and China for its medicinal properties contained pharmaceutically important antitumor compounds podophyllotoxin, quercetin and kaempferol. Among lignans, podophyllotoxin is an active antitumor compound and has now been modified to produce clinically useful drugs etoposide and teniposide. In recent years, natural populations of D. peliantha have declined considerably due to anthropogenic activities such as habitat destruction and commercial exploitation for medicinal applications. As to its overall conservation status, D. pleiantha has been ranked as threatened on the China Species Red List. In the present study, an efficient in vitro callus culture system of D. pleiantha was established on Gamborg’s medium with various combinations and concentrations of different auxins and cytokinins under dark condition. Best callus induction was recorded in 2 mg/L 2, 4 - Dichlorophenoxyacetic acid (2,4-D) along with 0.2 mg/L kinetin and the maximum callus proliferation was achieved at 1 mg/L 2,4-D. Among the explants tested, maximum callus induction (86 %) was achieved from tender leaves. Hence, in subsequent experiments, leaf callus was further investigated for suitable callus biomass and production level of anticancer compounds under the influence of different additives. A maximum fresh callus biomass (8.765 g) was recorded in callus proliferation medium contained 500 mg/L casein hydrolysate. High performance liquid chromatography results revealed that the addition of different concentrations of peptone (1, 2 and 4 g/L) in callus proliferation medium enhanced podophyllotoxin (16 fold), quercetin (12 fold) and kaempferol (5 fold) accumulation than control. Thus, the established in vitro callus culture under the influence of different additives may offer an alternative source of enhanced production of podophyllotoxin, kaempferol and quecertin without harming natural plant population.

Keywords: dysosma pleiantha, kaempferol, podophyllotoxin, quercetin

Procedia PDF Downloads 276
6023 Estimation of the Effect of Initial Damping Model and Hysteretic Model on Dynamic Characteristics of Structure

Authors: Shinji Ukita, Naohiro Nakamura, Yuji Miyazu

Abstract:

In considering the dynamic characteristics of structure, natural frequency and damping ratio are useful indicator. When performing dynamic design, it's necessary to select an appropriate initial damping model and hysteretic model. In the linear region, the setting of initial damping model influences the response, and in the nonlinear region, the combination of initial damping model and hysteretic model influences the response. However, the dynamic characteristics of structure in the nonlinear region remain unclear. In this paper, we studied the effect of setting of initial damping model and hysteretic model on the dynamic characteristics of structure. On initial damping model setting, Initial stiffness proportional, Tangent stiffness proportional, and Rayleigh-type were used. On hysteretic model setting, TAKEDA model and Normal-trilinear model were used. As a study method, dynamic analysis was performed using a lumped mass model of base-fixed. During analysis, the maximum acceleration of input earthquake motion was gradually increased from 1 to 600 gal. The dynamic characteristics were calculated using the ARX model. Then, the characteristics of 1st and 2nd natural frequency and 1st damping ratio were evaluated. Input earthquake motion was simulated wave that the Building Center of Japan has published. On the building model, an RC building with 30×30m planes on each floor was assumed. The story height was 3m and the maximum height was 18m. Unit weight for each floor was 1.0t/m2. The building natural period was set to 0.36sec, and the initial stiffness of each floor was calculated by assuming the 1st mode to be an inverted triangle. First, we investigated the difference of the dynamic characteristics depending on the difference of initial damping model setting. With the increase in the maximum acceleration of the input earthquake motions, the 1st and 2nd natural frequency decreased, and the 1st damping ratio increased. Then, in the natural frequency, the difference due to initial damping model setting was small, but in the damping ratio, a significant difference was observed (Initial stiffness proportional≒Rayleigh type>Tangent stiffness proportional). The acceleration and the displacement of the earthquake response were largest in the tangent stiffness proportional. In the range where the acceleration response increased, the damping ratio was constant. In the range where the acceleration response was constant, the damping ratio increased. Next, we investigated the difference of the dynamic characteristics depending on the difference of hysteretic model setting. With the increase in the maximum acceleration of the input earthquake motions, the natural frequency decreased in TAKEDA model, but in Normal-trilinear model, the natural frequency didn’t change. The damping ratio in TAKEDA model was higher than that in Normal-trilinear model, although, both in TAKEDA model and Normal-trilinear model, the damping ratio increased. In conclusion, in initial damping model setting, the tangent stiffness proportional was evaluated the most. In the hysteretic model setting, TAKEDA model was more appreciated than the Normal-trilinear model in the nonlinear region. Our results would provide useful indicator on dynamic design.

Keywords: initial damping model, damping ratio, dynamic analysis, hysteretic model, natural frequency

Procedia PDF Downloads 173
6022 Maximum Initial Input Allowed to Iterative Learning Control Set-up Using Singular Values

Authors: Naser Alajmi, Ali Alobaidly, Mubarak Alhajri, Salem Salamah, Muhammad Alsubaie

Abstract:

Iterative Learning Control (ILC) known to be a controlling tool to overcome periodic disturbances for repetitive systems. This technique is required to let the error signal tends to zero as the number of operation increases. The learning process that lies within this context is strongly dependent on the initial input which if selected properly tends to let the learning process be more effective compared to the case where a system starts from blind. ILC uses previous recorded execution data to update the following execution/trial input such that a reference trajectory is followed to a high accuracy. Error convergence in ILC is generally highly dependent on the input applied to a plant for trial $1$, thus a good choice of initial starting input signal would make learning faster and as a consequence the error tends to zero faster as well. In the work presented within, an upper limit based on the Singular Values Principle (SV) is derived for the initial input signal applied at trial $1$ such that the system follow the reference in less number of trials without responding aggressively or exceeding the working envelope where a system is required to move within in a robot arm, for example. Simulation results presented illustrate the theory introduced within this paper.

Keywords: initial input, iterative learning control, maximum input, singular values

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6021 Study of Morphological Changes of the River Ganga in Patna District, Bihar Using Remote Sensing and GIS Techniques

Authors: Bhawesh Kumar, A. P. Krishna

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There are continuous changes upon earth’s surface by a variety of natural and anthropogenic agents cut, carry away and depositing of minerals from land. Running water has higher capacity of erosion than other geomorphologic agents. This research work has been carried out on Ganga River, whose channel is continuously changing under the influence of geomorphic agents and human activities in the surrounding regions. The main focus is to study morphological characteristics and sand dynamics of Ganga River with particular emphasis on bank lines and width changes using remote sensing and GIS techniques. The advance remote sensing data and topographical data were interpreted for obtaining 52 years of changes. For this, remote sensing data of different years (LANDSAT TM 1975, 1988, 1993, ETM 2005 and ETM 2012) and toposheet of SOI for the year 1960 were used as base maps for this study. Sinuosity ratio, braiding index and migratory activity index were also established. It was found to be 1.16 in 1975 and in 1988, 1993, 2005 and 2005 it was 1.09, 1.11, 1.1, 1.09 respectively. The analysis also shows that the minimum value found in 1960 was in reach 1 and maximum value is 4.8806 in 2012 found in reach 4 which suggests creation of number of islands in reach 4 for the year 2012. Migratory activity index (MAI), which is a standardized function of both length and time, was computed for the 8 representative reaches. MAI shows that maximum migration was in 1975-1988 in reach 6 and 7 and minimum migration was in 1993-2005. From the channel change analysis, it was found that the shifting of bank line was cyclic and the river Ganges showed a trend of southward maximum values. The advanced remote sensing data and topographical data helped in obtaining 52 years changes in the river due to various natural and manmade activities like flood, water velocity and excavation, removal of vegetation cover and fertile soil excavation for the various purposes of surrounding regions.

Keywords: braided index, migratory activity index (MAI), Ganga river, river morphology

Procedia PDF Downloads 342
6020 Prevalence of Cyp2d6 and Its Implications for Personalized Medicine in Saudi Arabs

Authors: Hamsa T. Tayeb, Mohammad A. Arafah, Dana M. Bakheet, Duaa M. Khalaf, Agnieszka Tarnoska, Nduna Dzimiri

Abstract:

Background: CYP2D6 is a member of the cytochrome P450 mixed-function oxidase system. The enzyme is responsible for the metabolism and elimination of approximately 25% of clinically used drugs, especially in breast cancer and psychiatric therapy. Different phenotypes have been described displaying alleles that lead to a complete loss of enzyme activity, reduced function (poor metabolizers – PM), hyperfunctionality (ultrarapid metabolizers–UM) and therefore drug intoxication or loss of drug effect. The prevalence of these variants may vary among different ethnic groups. Furthermore, the xTAG system has been developed to categorized all patients into different groups based on their CYP2D6 substrate metabolization. Aim of the study: To determine the prevalence of the different CYP2D6 variants in our population, and to evaluate their clinical relevance in personalized medicine. Methodology: We used the Luminex xMAP genotyping system to sequence 305 Saudi individuals visiting the Blood Bank of our Institution and determine which polymorphisms of CYP2D6 gene are prevalent in our region. Results: xTAG genotyping showed that 36.72% (112 out of 305 individuals) carried the CYP2D6_*2. Out of the 112 individuals with the *2 SNP, 6.23% had multiple copies of *2 SNP (19 individuals out of 305 individuals), resulting in an UM phenotype. About 33.44% carried the CYP2D6_*41, which leads to decreased activity of the CYP2D6 enzyme. 19.67% had the wild-type alleles and thus had normal enzyme function. Furthermore, 15.74% carried the CYP2D6_*4, which is the most common nonfunctional form of the CYP2D6 enzyme worldwide. 6.56% carried the CYP2D6_*17, resulting in decreased enzyme activity. Approximately 5.73% carried the CYP2D6_*10, consequently decreasing the enzyme activity, resulting in a PM phenotype. 2.30% carried the CYP2D6_*29, leading to decreased metabolic activity of the enzyme, and 2.30% carried the CYP2D6_*35, resulting in an UM phenotype, 1.64% had a whole-gene deletion CYP2D6_*5, thus resulting in the loss of CYP2D6 enzyme production, 0.66% carried the CYP2D6_*6 variant. One individual carried the CYP2D6_*3(B), producing an inactive form of the enzyme, which leads to decrease of enzyme activity, resulting in a PM phenotype. Finally, one individual carried the CYP2D6_*9, which decreases the enzyme activity. Conclusions: Our study demonstrates that different CYP2D6 variants are highly prevalent in ethnic Saudi Arabs. This finding sets a basis for informed genotyping for these variants in personalized medicine. The study also suggests that xTAG is an appropriate procedure for genotyping the CYP2D6 variants in personalized medicine.

Keywords: CYP2D6, hormonal breast cancer, pharmacogenetics, polymorphism, psychiatric treatment, Saudi population

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6019 Optimizing the Performance of Thermoelectric for Cooling Computer Chips Using Different Types of Electrical Pulses

Authors: Saleh Alshehri

Abstract:

Thermoelectric technology is currently being used in many industrial applications for cooling, heating and generating electricity. This research mainly focuses on using thermoelectric to cool down high-speed computer chips at different operating conditions. A previously developed and validated three-dimensional model for optimizing and assessing the performance of cascaded thermoelectric and non-cascaded thermoelectric is used in this study to investigate the possibility of decreasing the hotspot temperature of computer chip. Additionally, a test assembly is built and tested at steady-state and transient conditions. The obtained optimum thermoelectric current at steady-state condition is used to conduct a number of pulsed tests (i.e. transient tests) with different shapes to cool the computer chips hotspots. The results of the steady-state tests showed that at hotspot heat rate of 15.58 W (5.97 W/cm2), using thermoelectric current of 4.5 A has resulted in decreasing the hotspot temperature at open circuit condition (89.3 °C) by 50.1 °C. Maximum and minimum hotspot temperatures have been affected by ON and OFF duration of the electrical current pulse. Maximum hotspot temperature was resulted by longer OFF pulse period. In addition, longer ON pulse period has generated the minimum hotspot temperature.

Keywords: thermoelectric generator, TEG, thermoelectric cooler, TEC, chip hotspots, electronic cooling

Procedia PDF Downloads 138
6018 Ear Protectors and Their Action in Protecting Hearing System of Workers against Occupational Noise

Authors: F. Forouharmajd, S. Pourabdian, N. Ziayi Ghahnavieh

Abstract:

For many years, the ear protectors have been used to preventing the audio and non-audio effects of received noise from occupation environments. Despite performing hearing protection programs, there are many people which still suffer from noise-induced hearing loss. This study was conducted with the aim of determination of human hearing system response to received noise and the effectiveness of ear protectors on preventing of noise-induced hearing loss. Sound pressure microphones were placed in a simulated ear canal. The severity of noise measured inside and outside of ear canal. The noise reduction values due to installing ear protectors were calculated in the octave band frequencies and LabVIEW programmer. The results of noise measurement inside and outside of ear canal showed a different in received sound levels by ear canal. The effectiveness of ear protectors has been considerably reduced for the low frequency limits. A change in resonance frequency also was observed after using ear protectors. The study indicated the ear canal structure may affect the received noise and it may lead a difference between the received sound from the measured sound by a sound level meter, and hearing system. It means the human hearing system may probably respond different from a sound level meter. Hearing protectors’ efficiency declines by increasing the noise levels, and thus, they are not suitable to protect workers against industrial noise particularly low frequency noise. Hearing protectors may be solely a reason to damaging of hearing system in a special frequency via changing of human hearing system acoustical structure. We need developing the subjective method of hearing protectors testing, because their evaluation is not designed based on industrial noise or in the field.

Keywords: ear protector, hearing system, occupational noise, workers

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6017 Seismic Hazard Analysis for a Multi Layer Fault System: Antalya (SW Turkey) Example

Authors: Nihat Dipova, Bulent Cangir

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This article presents the results of probabilistic seismic hazard analysis (PSHA) for Antalya (SW Turkey). South west of Turkey is characterized by large earthquakes resulting from the continental collision between the African, Arabian and Eurasian plates and crustal faults. Earthquakes around the study area are grouped into two; crustal earthquakes (D=0-50 km) and subduction zone earthquakes (50-140 km). Maximum observed magnitude of subduction earthquakes is Mw=6.0. Maximum magnitude of crustal earthquakes is Mw=6.6. Sources for crustal earthquakes are faults which are related with Isparta Angle and Cyprus Arc tectonic structures. A new earthquake catalogue for Antalya, with unified moment magnitude scale has been prepared and seismicity of the area around Antalya city has been evaluated by defining ‘a’ and ‘b’ parameters of the Gutenberg-Richter recurrence relationship. The Standard Cornell-McGuire method has been used for hazard computation utilizing CRISIS2007 software. Attenuation relationships proposed by Chiou and Youngs (2008) has been used for 0-50 km earthquakes and Youngs et. al (1997) for deep subduction earthquakes. Finally, Seismic hazard map for peak horizontal acceleration on a uniform site condition of firm rock (average shear wave velocity of about 1130 m/s) at a hazard level of 10% probability of exceedance in 50 years has been prepared.

Keywords: Antalya, peak ground acceleration, seismic hazard assessment, subduction

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6016 Performance Improvement of Long-Reach Optical Access Systems Using Hybrid Optical Amplifiers

Authors: Shreyas Srinivas Rangan, Jurgis Porins

Abstract:

The internet traffic has increased exponentially due to the high demand for data rates by the users, and the constantly increasing metro networks and access networks are focused on improving the maximum transmit distance of the long-reach optical networks. One of the common methods to improve the maximum transmit distance of the long-reach optical networks at the component level is to use broadband optical amplifiers. The Erbium Doped Fiber Amplifier (EDFA) provides high amplification with low noise figure but due to the characteristics of EDFA, its operation is limited to C-band and L-band. In contrast, the Raman amplifier exhibits a wide amplification spectrum, and negative noise figure values can be achieved. To obtain such results, high powered pumping sources are required. Operating Raman amplifiers with such high-powered optical sources may cause fire hazards and it may damage the optical system. In this paper, we implement a hybrid optical amplifier configuration. EDFA and Raman amplifiers are used in this hybrid setup to combine the advantages of both EDFA and Raman amplifiers to improve the reach of the system. Using this setup, we analyze the maximum transmit distance of the network by obtaining a correlation diagram between the length of the single-mode fiber (SMF) and the Bit Error Rate (BER). This hybrid amplifier configuration is implemented in a Wavelength Division Multiplexing (WDM) system with a BER of 10⁻⁹ by using NRZ modulation format, and the gain uniformity noise ratio (signal-to-noise ratio (SNR)), the efficiency of the pumping source, and the optical signal gain efficiency of the amplifier are studied experimentally in a mathematical modelling environment. Numerical simulations were implemented in RSoft OptSim simulation software based on the nonlinear Schrödinger equation using the Split-Step method, the Fourier transform, and the Monte Carlo method for estimating BER.

Keywords: Raman amplifier, erbium doped fibre amplifier, bit error rate, hybrid optical amplifiers

Procedia PDF Downloads 64
6015 Reconstruction of Complex Post Oncologic Maxillectomy Defects

Authors: Vinay Kant Shankhdhar

Abstract:

Purpose: Maxillary defects are three dimensional and require complex bone and soft tissue reconstruction. Maxillary reconstruction using fibula osteocutaneous flaps in situation requiring orbital floor, orbital wall, palatal defects, and external skin, all at the same time require special planning and multiple osteotomies. We tried to improvise our reconstruction using multiple osteotomies and skin paddle designs for fibula and Flexor Hallucis Longus Muscle. This study aims at discussing the planning and outcome in complex maxillary reconstructions using fibula flaps and soft tissue flaps with or without bone grafts. Material and Methods: From 2011 to 2017 a total of 129 Free fibula flaps were done, 67 required two or more struts, 164 Anterolateral Thigh Flaps, 11 Deep Inferior Epigastric Artery perforator flaps and 3 vertical rectus abdominis muscle flaps with iliac crest bone graft. The age range was 2 to 70 years. The reconstruction was evaluated based on the post-operative rehabilitation including orbital support (prevention of diplopia), oral diet, speech and cosmetic appearance. Results: The follow- up is from 5 years to 1 year. In this series, we observed that the common complications were the de-vascularisation of most distal segment of osteotomised fibula and native skin necrosis. Commonest area of breakdown is the medial canthal region. Plate exposure occurs most commonly at the pyriform sinus. There was extrusion of one non-vascularized bone graft. All these complications were noticed post-radiotherapy. Conclusions: The use of free fibula osteocutaneous flap gives very good results when only alveolar reconstruction is required. The reconstruction of orbital floor with extensive skin loss with post operative radiotherapy has maximum complication rate in long term follow up. A soft tissue flap with non vascularized bone graft may be the best option in such cases.

Keywords: maxilla reconstruction, fibula maxilla, post cancer maxillary reconstruction

Procedia PDF Downloads 131
6014 Adsorption of Peppermint Essential Oil by Polypropylene Nanofiber

Authors: Duduku Krishnaiah, S. M. Anisuzzaman, Kumaran Govindaraj, Chiam Chel Ken, Zykamilia Kamin

Abstract:

Pure essential oil is highly demanded in the market since most of the so-called pure essential oils in the market contains alcohol. This is because of the usage of alcohol in separating oil and water mixture. Removal of pure essential oil from water without using any chemical solvent has become a challenging issue. Adsorbents generally have the properties of separating hydrophobic oil from hydrophilic mixture. Polypropylen nanofiber is a thermoplastic polymer which is produced from propylene. It was used as an adsorbent in this study. Based on the research, it was found that the polypropylene nanofiber was able to adsorb peppermint oil from the aqueous solution over a wide range of concentration. Based on scanning electron microscope (SEM), nanofiber has very small nano diameter fiber size in average before the adsorption and larger scaled average diameter of fibers after adsorption which indicates that smaller diameter of nanofiber enhances the adsorption process. The adsorption capacity of peppermint oil increases as the initial concentration of peppermint oil and amount of polypropylene nanofiber used increases. The maximum adsorption capacity of polypropylene nanofiber was found to be 689.5 mg/g at (T= 30°C). Moreover, the adsorption capacity of peppermint oil decreases as the temperature of solution increases. The equilibrium data of polypropylene nanofiber is best represented by Freundlich isotherm with the maximum adsorption capacity of 689.5 mg/g. The adsorption kinetics of polypropylene nanofiber was best represented by pseudo-second order model.

Keywords: nanofiber, adsorption, peppermint essential oil, isotherms, adsorption kinetics

Procedia PDF Downloads 154
6013 An Empirical Study of the Best Fitting Probability Distributions for Stock Returns Modeling

Authors: Jayanta Pokharel, Gokarna Aryal, Netra Kanaal, Chris Tsokos

Abstract:

Investment in stocks and shares aims to seek potential gains while weighing the risk of future needs, such as retirement, children's education etc. Analysis of the behavior of the stock market returns and making prediction is important for investors to mitigate risk on investment. Historically, the normal variance models have been used to describe the behavior of stock market returns. However, the returns of the financial assets are actually skewed with higher kurtosis, heavier tails, and a higher center than the normal distribution. The Laplace distribution and its family are natural candidates for modeling stock returns. The Variance-Gamma (VG) distribution is the most sought-after distributions for modeling asset returns and has been extensively discussed in financial literatures. In this paper, it explore the other Laplace family, such as Asymmetric Laplace, Skewed Laplace, Kumaraswamy Laplace (KS) together with Variance-Gamma to model the weekly returns of the S&P 500 Index and it's eleven business sector indices. The method of maximum likelihood is employed to estimate the parameters of the distributions and our empirical inquiry shows that the Kumaraswamy Laplace distribution performs much better for stock returns modeling among the choice of distributions used in this study and in practice, KS can be used as a strong alternative to VG distribution.

Keywords: stock returns, variance-gamma, kumaraswamy laplace, maximum likelihood

Procedia PDF Downloads 69
6012 Humans’ Physical Strength Capacities on Different Handwheel Diameters and Angles

Authors: Saif K. Al-Qaisi, Jad R. Mansour, Aseel W. Sakka, Yousef Al-Abdallat

Abstract:

Handwheels are common to numerous industries, such as power generation plants, oil refineries, and chemical processing plants. The forces required to manually turn handwheels have been shown to exceed operators’ physical strengths, posing risks for injuries. Therefore, the objectives of this research were twofold: (1) to determine humans’ physical strengths on handwheels of different sizes and angles and (2) to subsequently propose recommended torque limits (RTLs) that accommodate the strengths of even the weaker segment of the population. Thirty male and thirty female participants were recruited from a university student population. Participants were asked to exert their maximum possible forces in a counter-clockwise direction on handwheels of different sizes (35 cm, 45 cm, 60 cm, and 70 cm) and angles (0°-horizontal, 45°-slanted, and 90°-vertical). The participant’s posture was controlled by adjusting the handwheel to be at the elbow level of each participant, requiring the participant to stand erect, and restricting the hand placements to be in the 10-11 o’clock position for the left hand and the 4-5 o’clock position for the right hand. A torque transducer (Futek TDF600) was used to measure the maximum torques generated by the human. Three repetitions were performed for each handwheel condition, and the average was computed. Results showed that, at all handwheel angles, as the handwheel diameter increased, the maximum torques generated also increased, while the underlying forces decreased. In controlling the handwheel diameter, the 0° handwheel was associated with the largest torques and forces, and the 45° handwheel was associated with the lowest torques and forces. Hence, a larger handwheel diameter –as large as 70 cm– in a 0° angle is favored for increasing the torque production capacities of users. Also, it was recognized that, regardless of the handwheel diameter size and angle, the torque demands in the field are much greater than humans’ torque production capabilities. As such, this research proposed RTLs for the different handwheel conditions by using the 25th percentile values of the females’ torque strengths. The proposed recommendations may serve future standard developers in defining torque limits that accommodate humans’ strengths.

Keywords: handwheel angle, handwheel diameter, humans’ torque production strengths, recommended torque limits

Procedia PDF Downloads 109
6011 Development of Total Maximum Daily Load Using Water Quality Modelling as an Approach for Watershed Management in Malaysia

Authors: S. A. Che Osmi, W. M. F. Wan Ishak, H. Kim, M. A. Azman, M. A. Ramli

Abstract:

River is one of important water sources for many activities including industrial and domestic usage such as daily usage, transportation, power supply and recreational activities. However, increasing activities in a river has grown the sources of pollutant enters the water bodies, and degraded the water quality of the river. It becomes a challenge to develop an effective river management to ensure the water sources of the river are well managed and regulated. In Malaysia, several approaches for river management have been implemented such as Integrated River Basin Management (IRBM) program for coordinating the management of resources in a natural environment based on river basin to ensure their sustainability lead by Department of Drainage and Irrigation (DID), Malaysia. Nowadays, Total Maximum Daily Load (TMDL) is one of the best approaches for river management in Malaysia. TMDL implementation is regulated and implemented in the United States. A study on the development of TMDL in Malacca River has been carried out by doing water quality monitoring, the development of water quality model by using Environmental Fluid Dynamic Codes (EFDC), and TMDL implementation plan. The implementation of TMDL will help the stakeholders and regulators to control and improve the water quality of the river. It is one of the good approaches for river management in Malaysia.

Keywords: EFDC, river management, TMDL, water quality modelling

Procedia PDF Downloads 324
6010 The Underestimate of the Annual Maximum Rainfall Depths Due to Coarse Time Resolution Data

Authors: Renato Morbidelli, Carla Saltalippi, Alessia Flammini, Tommaso Picciafuoco, Corrado Corradini

Abstract:

A considerable part of rainfall data to be used in the hydrological practice is available in aggregated form within constant time intervals. This can produce undesirable effects, like the underestimate of the annual maximum rainfall depth, Hd, associated with a given duration, d, that is the basic quantity in the development of rainfall depth-duration-frequency relationships and in determining if climate change is producing effects on extreme event intensities and frequencies. The errors in the evaluation of Hd from data characterized by a coarse temporal aggregation, ta, and a procedure to reduce the non-homogeneity of the Hd series are here investigated. Our results indicate that: 1) in the worst conditions, for d=ta, the estimation of a single Hd value can be affected by an underestimation error up to 50%, while the average underestimation error for a series with at least 15-20 Hd values, is less than or equal to 16.7%; 2) the underestimation error values follow an exponential probability density function; 3) each very long time series of Hd contains many underestimated values; 4) relationships between the non-dimensional ratio ta/d and the average underestimate of Hd, derived from continuous rainfall data observed in many stations of Central Italy, may overcome this issue; 5) these equations should allow to improve the Hd estimates and the associated depth-duration-frequency curves at least in areas with similar climatic conditions.

Keywords: central Italy, extreme events, rainfall data, underestimation errors

Procedia PDF Downloads 188
6009 Influence of Hearing Aids on Non-medically Treatable Deafness

Authors: Donatien Niragira

Abstract:

The progress of technology creates new expectations for patients. The world of deafness is no exception. In recent years, there have been considerable advances in the field of technologies aimed at assisting failing hearing. According to the usual medical vocabulary, hearing aids are actually orthotics. They do not replace an organ but compensate for a functional impairment. The Amplifier Hearing amplification is useful for a large number of people with hearing loss. Hearing aids restore speech audibility. However, their benefits vary depending on the quality of residual hearing. The hearing aid is not a "cure" for deafness. It cannot correct all affected hearing abilities. It should be considered as an aid to communication. The urge to judge from the audiogram alone should be resisted here, as audiometry only indicates the ability to detect non-verbal sounds. To prevent hearing aids from ending up in the drawer, it is important to ensure that the patient's disability situations justify the use of this type of orthosis. If the problems of receptive Pre-fitting counseling are crucial: the person with hearing loss must be informed of the advantages and disadvantages of amplification in his or her case. Their expectations must be realistic. They also need to be aware that the adaptation process requires a good deal of patience and perseverance. They should be informed about the various models and types of hearing aids, including all the aesthetic, functional and financial considerations. If the person's motivation "survives" pre-fitting counseling, we are in the presence of a good candidate for amplification. In addition to its relevance, it shows that the results found in this study significantly improve the quality of audibility in the patient, from where this technology must be made accessible everywhere in the world.

Keywords: auditives protheses, hearing, aids, no medicaly treatable deafnes

Procedia PDF Downloads 52
6008 Effect of Thistle Ecotype in the Physical-Chemical and Sensorial Properties of Serra da Estrela Cheese

Authors: Raquel P. F. Guiné, Marlene I. C. Tenreiro, Ana C. Correia, Paulo Barracosa, Paula M. R. Correia

Abstract:

The objective of this study was to evaluate the physical and chemical characteristics of Serra da Estrela cheese and compare these results with those of the sensory analysis. For the study were taken six samples of Serra da Estrela cheese produced with 6 different ecotypes of thistle in a dairy situated in Penalva do Castelo. The chemical properties evaluated were moisture content, protein, fat, ash, chloride and pH; the physical properties studied were color and texture; and finally a sensory evaluation was undertaken. The results showed moisture varying in the range 40-48%, protein in the range 15-20%, fat between 41-45%, ash between 3.9-5.0% and chlorides varying from 1.2 to 3.0%. The pH varied from 4.8 to 5.4. The textural properties revealed that the crust hardness is relatively low (maximum 7.3 N), although greater than flesh firmness (maximum 1.7 N), and also that these cheeses are in fact soft paste type, with measurable stickiness and intense adhesiveness. The color analysis showed that the crust is relatively light (L* over 50), and with a predominant yellow coloration (b* around 20 or over) although with a slight greenish tone (a* negative). The results of the sensory analysis did not show great variability for most of the attributes measured, although some differences were found in attributes such as crust thickness, crust uniformity, and creamy flesh.

Keywords: chemical composition, color, sensorial analysis, Serra da Estrela cheese, texture

Procedia PDF Downloads 299
6007 A Service Evaluation Exploring the Effectiveness of a Tier 3 Weight Management Programme Offering Face-To-Face and Remote Dietetic Support

Authors: Rosemary E. Huntriss, Lucy Jones

Abstract:

Obesity and excess weight continue to be significant health problems in England. Traditional weight management programmes offer face-to-face support or group education. Remote care is recognised as a viable means of support; however, its effectiveness has not previously been evaluated in a tier 3 weight management setting. This service evaluation explored the effectiveness of online coaching, telephone support, and face-to-face support as optional management strategies within a tier 3 weight management programme. Outcome data were collected for adults with a BMI ≥ 45 or ≥ 40 with complex comorbidity who were referred to a Tier 3 weight management programme from January 2018 and had been discharged before October 2018. Following an initial 45-minute consultation with a specialist weight management dietitian, patients were offered a choice of follow-up support in the form of online coaching supported by an app (8 x 15 minutes coaching), face-to-face or telephone appointments (4 x 30 minutes). All patients were invited to a final 30-minute face-to-face assessment. The planned intervention time was between 12 and 24 weeks. Patients were offered access to adjunct face-to-face or telephone psychological support. One hundred and thirty-nine patients were referred into the programme from January 2018 and discharged before October 2018. One hundred and twenty-four patients (89%) attended their initial assessment. Out of those who attended their initial assessment, 110 patients (88.0%) completed more than half of the programme and 77 patients (61.6%) completed all sessions. The average length of the completed programme (all sessions) was 17.2 (SD 4.2) weeks. Eighty-five (68.5%) patients were coached online, 28 (22.6%) patients were supported face-to-face support, and 11 (8.9%) chose telephone support. Two patients changed from online coaching to face-to-face support due to personal preference and were included in the face-to-face group for analysis. For those with data available (n=106), average weight loss across the programme was 4.85 (SD 3.49)%; average weight loss was 4.70 (SD 3.19)% for online coaching, 4.83 (SD 4.13)% for face-to-face support, and 6.28 (SD 4.15)% for telephone support. There was no significant difference between weight loss achieved with face-to-face vs. online coaching (4.83 (SD 4.13)% vs 4.70 (SD 3.19) (p=0.87) or face-to-face vs. remote support (online coaching and telephone support combined) (4.83 (SD 4.13)% vs 4.85 (SD 3.30)%) (p=0.98). Remote support has been shown to be as effective as face-to-face support provided by a dietitian in the short-term within a tier 3 weight management setting. The completion rates were high compared with another tier 3 weight management services suggesting that offering remote support as an option may improve completion rates within a weight management service.

Keywords: dietitian, digital health, obesity, weight management

Procedia PDF Downloads 138
6006 The Different Essence of Death in the Elegies of Shelley's Adonais and Lord Tennyson's In Memoriam

Authors: Sulistyaningtyas

Abstract:

The topic about death and dying is interesting to discuss since it is strongly related to every individual life. As represented in its title, Adonais: An Elegy on the Death of John Keats is a mournful poem written in 1821 by Percy Bysshe Shelley to mourn the loss of young poet John Keats. To compare, In Memoriam A.H.H. is an elegy written in 1850 about the death of Lord Tennyson’s dearest friend, Arthur Henry Hallam. Although both elegies were written to grieve the authors’ loved ones, their grief affects differently to the psychological being of the narrators. Thus, this research aims to examine the essence of death in affecting the narrators psychologically. By using psychoanalytic criticism, this research reveals the different essence of death in the two elegies as the result of the analysis. Moreover, these two elegies also portray the concept of the afterlife, immortality, and the figure of God. In Adonais, the grief of the narrator to Keats leads him to question the very purpose of life. The loss of his favorite poet which makes him feel sorrowful and mad along his 55 stanzas brings him to a higher psychological level to understand himself. He even sees himself as a Christ-like figure, which shows the idea that God is imaginable. Different from Adonais, the narrator of In Memoriam finds something more spiritual by doing his passionate mourning to Hallam. Through some contemplation in his 133 cantos, in the end, he is convinced that the dear one now dwells with a great Spirit who controls the world. He believes that all of the creation in the universe has to follow one law which is set by God. Hence, it can be concluded that death might bring different consequence to the psyche of every living creature.

Keywords: elegy, comparative study, psychoanalytic criticism, the essence of death

Procedia PDF Downloads 418
6005 Medical Complications in Diabetic Recipients after Kidney Transplantation

Authors: Hakan Duger, Alparslan Ersoy, Canan Ersoy

Abstract:

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

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

Procedia PDF Downloads 329