Search results for: early stage
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 6328

Search results for: early stage

5068 Interdialytic Acupuncture Is an Add-on Option for Preserving Residual Renal Function: A Case Series Report

Authors: Lai Tzu-Hsuan, Lai Jung-Nien, Lin Jaung-Geng, Kao Shung-Te, Hsuan-Kuang Jung

Abstract:

Background: Whether acupuncture therapy contributes to preserving residual renal function (RRF) remains largely unknown. This case series evidenced the potential beneficial effects of acupuncture for preserving RRF in five patients with the end-stage renal disease under hemodialysis (HD) treatment. Participants: Five patients on HD receiving eight sessions of weekly 30-min interdialytic acupuncture (Inter-A) with residual urine volume (rUV) and residual glomerular filtration rate (rGFR) recorded once every two weeks were included for analysis. Outcomes: Changes in rUV and rGFR calculated using 24-hour urine collection data were analyzed to assess RRF. Variations in hemoglobin, urea Kt/V and serum albumin levels measured monthly were analyzed to evaluate HD adequacy. Results: After eight Inter-A sessions, mean (standard deviation (SD)) rUV and rGFR increased from 612 (184) ml/day and 1.48 (.94) ml/min/1.73 m2 at baseline to 803(289) ml/day and 2.04(1.17) ml/min/1.73m2 at 2- and 4-week follow-up, respectively. The mean percentage difference increased by 31% in rUV and 38% in rGFR. Routine measurements on HD adequacy also showed improvement. Conclusions: Acupuncture might be an optional add-on treatment for HD population with poor control of water; however, further well-designed controlled trials are warranted.

Keywords: end-stage renal disease, hemodialysis, acupuncture, residual renal function, residual urine volume

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5067 Optimisation of a Dragonfly-Inspired Flapping Wing-Actuation System

Authors: Jia-Ming Kok, Javaan Chahl

Abstract:

An optimisation method using both global and local optimisation is implemented to determine the flapping profile which will produce the most lift for an experimental wing-actuation system. The optimisation method is tested using a numerical quasi-steady analysis. Results of an optimised flapping profile show a 20% increase in lift generated as compared to flapping profiles obtained by high speed cinematography of a Sympetrum frequens dragonfly. Initial optimisation procedures showed 3166 objective function evaluations. The global optimisation parameters - initial sample size and stage one sample size, were altered to reduce the number of function evaluations. Altering the stage one sample size had no significant effect. It was found that reducing the initial sample size to 400 would allow a reduction in computational effort to approximately 1500 function evaluations without compromising the global solvers ability to locate potential minima. To further reduce the optimisation effort required, we increase the local solver’s convergence tolerance criterion. An increase in the tolerance from 0.02N to 0.05N decreased the number of function evaluations by another 20%. However, this potentially reduces the maximum obtainable lift by up to 0.025N.

Keywords: flapping wing, optimisation, quasi-steady model, dragonfly

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5066 Conscious Intention-based Processes Impact the Neural Activities Prior to Voluntary Action on Reinforcement Learning Schedules

Authors: Xiaosheng Chen, Jingjing Chen, Phil Reed, Dan Zhang

Abstract:

Conscious intention can be a promising point cut to grasp consciousness and orient voluntary action. The current study adopted a random ratio (RR), yoked random interval (RI) reinforcement learning schedule instead of the previous highly repeatable and single decision point paradigms, aimed to induce voluntary action with the conscious intention that evolves from the interaction between short-range-intention and long-range-intention. Readiness potential (RP) -like-EEG amplitude and inter-trial-EEG variability decreased significantly prior to voluntary action compared to cued action for inter-trial-EEG variability, mainly featured during the earlier stage of neural activities. Notably, (RP) -like-EEG amplitudes decreased significantly prior to higher RI-reward rates responses in which participants formed a higher plane of conscious intention. The present study suggests the possible contribution of conscious intention-based processes to the neural activities from the earlier stage prior to voluntary action on reinforcement leanring schedule.

Keywords: Reinforcement leaning schedule, voluntary action, EEG, conscious intention, readiness potential

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5065 Geodynamics Behaviour of Greater Cairo as Deduced from 4D Gravity and Seismic Activities

Authors: Elsayed A. Issawy, Anwar H. Radwan

Abstract:

Recent crustal deformations studies in Egypt are applied on the most active areas with relation to seismic activity. Temporal gravity variations in parallel with the geodetic technique (GPS) were used to monitor recent crustal movements in Egypt since 1997. The non-tidal gravity changes were constrained by the vertical component of surface movements derived from the GPS observations. The gravity changes were used to understand the surface tectonics and geodynamic modelling of the Greater Cairo region after the occurrence of an earthquake of 1992. It was found that there is a certain relation showed by increasing of gravity values before the main seismic activity. As example, relative considerable increase of gravity values was noticed for the network between the epochs of 2000 and 2004. Otherwise, the temporal gravity variations were reported a considerable decrease in gravity values between the two campaigns of 2004 and 2007 for the same stations. This behaviour could explain by compressive deformation and strain build-up stage before the South western Cairo earthquake (July 31, 2005 with magnitude of 4.3) and the stress release stage occurred after the main event. The geodetic measurements showed that, the estimated horizontal velocities for almost of points are 5.5 mm/year in approximately NW direction.

Keywords: temporal gravity variations, geodynamics, greater Cairo, recent crustal movements, earthquakes

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5064 Structural Element Vibration Analysis with finite element method: Use of Rayleigh Quotient

Authors: Houari Boumediene University of Science, Technology.

Abstract:

"Various methods are typically used in the dynamic analysis of transversely vibrating beams. To achieve this, numerical methods are used to solve the general eigenvalue problem. The equations of equilibrium, which describe the motion, are derived from a fourth-order differential equation. Our study is based on the finite element method, and the results of the investigation are the vibration frequencies obtained using the Jacobi method. Two types of elementary mass matrices are considered: one representing a uniform distribution of mass along the element and the other consisting of concentrated masses located at fixed points whose number increases progressively with equal distances at each evaluation stage. The beams studied have different boundary constraints, representing several classical situations. Comparisons are made for beams where the distributed mass is replaced by n concentrated masses. As expected, the first calculation stage involves determining the lowest number of beam parts that gives a frequency comparable to that obtained from the Rayleigh formula. The obtained values are then compared to theoretical results based on the assumptions of the Bernoulli-Euler theory. These steps are repeated for the second type of mass representation in the same manner."

Keywords: finite element method, bernouilli eulertheory, structural analysis, vibration analysis, rayleigh quotient

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5063 Efficacy of Defender 2% WS (Tebuconazole) and Imidal 70 WS (Imidacloprid) to Control Damping-Off Diseases and Early Insect Pests in Sesame in Rain Fed Areas, Sudan

Authors: Anas Fadlelmula, Elsafi M. M. Ahmed

Abstract:

The efficacy of Defender 2% WS (tebuconazole) and Imidal 70 WS (imidacloprid) to control damping-off diseases and early insect pests in sesame crop under rain fed conditions at Damazine and Gedarif areas was evaluated. Defender 2% WS with dosage rates 0.5, 0.75, 1.0 and 1.25 g/kg of seeds and Imidal 70 WS at 2.25, 3.0, and 3.75 g/ kg of seeds were tested singly and as a mixture during 2010/2011 and 2012/013. Sesame seeds treated with Defender at the rates of 0.5 g and 0.75 g/ kg of seeds gave a high significant increase in percent seedlings emergence (84% and 85%) respectively. Imidal 70 WS at rate of 3g/kg seed showed the least percent damaged leaves by sesame webworm (1.7%). However, the mixed Defender at rate 0.75g with Imidal at 3 g/kg seed, significantly gave a highest percentage of sesame seedling emergence (85.1%) and reduced the incidence of post-emergence damping off and percent damaged leaves to the least per cent (2.1% and 0.4% ) respectively, compared to other treatments. Consequently, the mixed treatment of 0.75 g of Defender + 3 g of Imidal improved the crop stand and significantly gave the highest yield (405.2 kg and 418.8 kg/fed) respectively in both sites compared to the other treatments.

Keywords: seed dressers, damage, daming off, insects

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5062 Female Subjectivity in William Faulkner's Light in August

Authors: Azza Zagouani

Abstract:

Introduction: In the work of William Faulkner, characters often evade the boundaries and categories of patriarchal standards of order. Female characters like Lena Grove and Joanna Burden cross thresholds in attempts to gain liberation, while others fail to do so. They stand as non-conformists and refuse established patterns of feminine behavior, such as marriage and motherhood after. They refute submissiveness, domesticity and abstinence to reshape their own identities. The presence of independent and creative women represents new, unconventional images of female subjectivity. This paper will examine the structures of submission and oppression faced by Lena and Joanna, and will show how, in the end, they reshape themselves and their identities, and disrupt or even destroy patriarchal structures. Objectives: Participants will understand through the examples of Lena Grove and Joanna Burden that female subjectivities are constructions, and are constantly subject to change. Approaches: Two approaches will be used in the analysis of the subjectivity formation of Lena Grove and Joanna Burden. Following the arguments propounded by Judith Butler, We explore the ways in which Lena Grove maneuvers around the restrictions and the limitations imposed on her without any physical or psychological violence. She does this by properly performing the roles prescribed to her gendered body. Her repetitious performances of these roles are both the ones that are constructed to confine women and the vehicle for her travel. Her performance parodies the prescriptive roles and thereby reveals that they are cultural constructions. Second, We will explore the argument propounded by Kristeva that subjectivity is always in a state of development because we are always changing in context with changing circumstances. For example, in Light in August, Lena Grove changes the way she defines herself in light of the events of the novel. Also, Kristeva talks about stages of development: the semiotic stage and the symbolic stage. In Light in August, Joanna shows different levels of subjectivity as time passes. Early in the novel, Joanna is very connected to her upbringing. This suggests Kristeva’s concept of the semiotic, in which the daughter identifies closely to her parents. Kristeva relates the semiotic to a strong daughter/mother connection, but in the novel it is strong daughter/father/grandfather identification instead. Then as Joanna becomes sexually involved with Joe, she breaks off, and seems to go into an identity crisis. To me, this represents Kristeva’s move from the semiotic to the symbolic. When Joanna returns to a religious fanaticism, she is returning to a semiotic state. Detailed outline: At the outset of this paper, We will investigate the subjugation of women: social constraints, and the formation of the feminine identity in Light in August. Then, through the examples of Lena Grove’s attempt to cross the boundaries of community moralities and Joanna Burden’s refusal to submit to the standards of submissiveness, domesticity, and obstinance, We will reveal the tension between progressive conceptions of individual freedom and social constraints that limit this freedom. In the second part of the paper, We will underscore the rhetoric of femininity in Light in August: subjugation through naming. The implications of both female’s names offer a powerful contrast between the two different forms of subjectivity. Conclusion: Through Faulkner’s novel, We demonstrate that female subjectivity is an open-ended issue. The spiral shaping of its form maintains its characteristics as a process changing according to different circumstances.

Keywords: female subjectivity, Faulkner’s light August, gender, sexuality, diversity

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5061 A Study on the Construction Process and Sustainable Renewal Development of High-Rise Residential Areas in Chongqing (1978-2023)

Authors: Xiaoting Jing, Ling Huang

Abstract:

After the reform and opening up, Chongqing has formed far more high-rise residential areas than other cities in its more than 40 years of urban construction. High-rise residential areas have become one of the main modern living models in Chongqing and an important carrier reflecting the city's high quality of life. Reviewing the construction process and renewal work helps understand the characteristics of high-rise residential areas in Chongqing at different stages, clarify current development demands, and look forward to the focus of future renewal work. Based on socio-economic development and policy background, the article sorts the construction process of high-rise residential areas in Chongqing into four stages: the early experimental construction period of high-rise residential areas (1978-1996), the rapid start-up period of high-rise commodity housing construction (1997-2006), the large-scale construction period of high-rise commodity housing and public rental housing (2007-2014), and the period of renewal and renovation of high-rise residential areas and step-by-step construction of quality commodity housing (2015-present). Based on the construction demands and main construction types of each stage, the article summarizes that the construction of high-rise residential areas in Chongqing features large scale, high speed, and high density. It points out that a large number of high-rise residential areas built after 2000 will become important objects of renewal and renovation in the future. Based on existing renewal work experience, it is urgent to explore a path for sustainable renewal and development in terms of policy mechanisms, digital supervision, and renewal and renovation models, leading the high-rise living in Chongqing toward high-quality development.

Keywords: high-rise residential areas, construction process, renewal and renovation, Chongqing

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5060 A Selection Approach: Discriminative Model for Nominal Attributes-Based Distance Measures

Authors: Fang Gong

Abstract:

Distance measures are an indispensable part of many instance-based learning (IBL) and machine learning (ML) algorithms. The value difference metrics (VDM) and inverted specific-class distance measure (ISCDM) are among the top-performing distance measures that address nominal attributes. VDM performs well in some domains owing to its simplicity and poorly in others that exist missing value and non-class attribute noise. ISCDM, however, typically works better than VDM on such domains. To maximize their advantages and avoid disadvantages, in this paper, a selection approach: a discriminative model for nominal attributes-based distance measures is proposed. More concretely, VDM and ISCDM are built independently on a training dataset at the training stage, and the most credible one is recorded for each training instance. At the test stage, its nearest neighbor for each test instance is primarily found by any of VDM and ISCDM and then chooses the most reliable model of its nearest neighbor to predict its class label. It is simply denoted as a discriminative distance measure (DDM). Experiments are conducted on the 34 University of California at Irvine (UCI) machine learning repository datasets, and it shows DDM retains the interpretability and simplicity of VDM and ISCDM but significantly outperforms the original VDM and ISCDM and other state-of-the-art competitors in terms of accuracy.

Keywords: distance measure, discriminative model, nominal attributes, nearest neighbor

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5059 Sustainability Modelling and Sustainability Evaluation of a Mechanical System in a Concurrent Engineering Environment: A Digraph and Matrix Approach

Authors: Anand Ankush, Wani Mohammed Farooq

Abstract:

A procedure based on digraph and matrix method is developed for modelling and evaluation of sustainability of Mechanical System in a concurrent engineering environment.The sustainability parameters of a Mechanical System are identified and are called sustainability attributes. Consideration of attributes and their interrelations is rudiment in modeling and evaluation of sustainability index. Sustainability attributes of a Mechanical System are modelled in termsof sustainability digraph. The graph is represented by a one-to-one matrix for sustainability expression which is based on sustainability attributes. A variable sustainability relationship permanent matrix is defined to develop sustainability expression(VPF-t) which is also useful in comparing two systems in a concurrent environment. The sustainability index of Mechanical System is obtained from permanent of matrix by substituting the numerical values of attributes and their interrelations. A higher value of index implies better sustainability of system.The ideal value of index is obtained from matrix expression which is useful in assessing relative sustainability of a Mechanical System in a concurrent engineering environment. The procedure is not only useful for evaluation of sustainability of a Mechanical System at conceptual design stage but can also be used for design and development of systems at system design stage. A step-by-step procedure for evaluation of sustainability index is also suggested and is illustrated by means of an example.

Keywords: digraph, matrix method, mechanical system, sustainability

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5058 Comparative Demography of Lady Beetle, Coccinella septempunctata Linnaeus (Coleoptera: Coccinellidae) with Respect to Different Aphid Species

Authors: Muhammad Farooq, Muhammad R. Shahid, M. Shakeel, A. Iftikhar, M. Sagheer, Riaz A. Kainth

Abstract:

Comparative demography of Coccinella septempunctata Linnaeus (Coleoptera: Coccinellidae) was studied with respect to four host aphid species viz; Rhopalosiphum padi, Rhopalosiphum maidis, Sitobion avenae, and Shizaphis graminum under laboratory conditions using Two-sex Age-stage life table instead of traditional age specific life table which considers only female. Results revealed that developmental period from egg to adult of C. septempunctata were shorter on R. padi (16.49 days) whereas longer on R. maidis (22.83 days). Net reproductive rate varied from 110.01 offspring on R. maidis to 288.78 offspring on R. padi. Mean generation time (T) ranged from 29.02 d on R. padi to 39.788 d on R. maidis. Highest to lowest values of intrinsic rate of increase (rm) were recorded on R. padi, S. graminum, S. avenae, and R. maidis (0.194, 0.143, 0.140 and 0.117 d⁻¹, respectively). Highest finite rate of increase was observed on R. padi (1.214 d⁻¹) followed by S. graminum (1.154 d⁻¹) whereas lowest values were obtained on R. maidis and S. avenae (1.124 and 1.150 d⁻¹, respectively). In this study, the data on the life table of both predator and prey provide useful information in the mass rearing and practical application of a natural agent to biological control systems.

Keywords: C. septempunctata, two-sex age-stage life table, population parameters, aphid species

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5057 Creating a Dementia-Friendly Community

Authors: Annika Kjallman Alm, Ove Hellzen, Malin Rising-Homlstrom

Abstract:

The concept of dementia‐friendly communities focuses on the lived experience of people who have dementia and is most relevant to addressing their needs and the needs of those people who live with and provide support for them. The goal of communities becoming dementia‐friendly is for dementia to be normalized and recognized as a disabling condition. People with dementia find being connected to self, to others, and to the environment by meaningful activities as important. According to the concept underlying dementia-friendly communities, people with dementia or cognitive decline can continue to live in the community if their residential community has sufficiently strong social capital. The aim of this study is to explore staff and leaders’ experiences in implementing interventions to enhance a more inclusive dementia-friendly community. A municipality in northern Sweden with a population of approx. 100 000 inhabitants decided to create a dementia friendly municipality. As part of the initiative, a Centre for support was established. The Centre offered support for both individuals and groups, did home visits, and provided information about Dementia. Interviews were conducted with staff who had undergone training in a structured form of multidimensional support, the PER-model®, and worked at the Centre for support. The staff consisted of registered nurses, occupational therapists, and specialized nurses who had worked there for more than five years, and all had training in dementia. All interviews were audio-recorded and transcribed verbatim. The transcribed data were analyzed using qualitative content analysis. Results suggest that implementing the PER-model® of support for persons in the early stages of dementia and their next of kin added a much-needed form of support and perceived possibilities to enhance daily life in the early stages of dementia. The staff appreciated that the structure of PER-model® was evidenced based. They also realized that they never even considered that the person with dementia also needed support in the early stages but that they now had tools for that as well. Creating a dementia friendly municipality offering different kinds of support for all stages of dementia is a challenge. However, evidence-based tools and a broad spectrum of different types of support, whether individual or group, are needed to tailor to everyone’s needs. A conviction that all citizens are equal and should all be involved in the community is a strong motivator.

Keywords: dementia, dementia-friendly, municipality, support

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5056 Robustness Conditions for the Establishment of Stationary Patterns of Drosophila Segmentation Gene Expression

Authors: Ekaterina M. Myasnikova, Andrey A. Makashov, Alexander V. Spirov

Abstract:

First manifestation of a segmentation pattern in the early Drosophila development is the formation of expression domains (along with the main embryo axis) of genes belonging to the trunk gene class. Highly variable expression of genes from gap family in early Drosophila embryo is strongly reduced by the start of gastrulation due to the gene cross-regulation. The dynamics of gene expression is described by a gene circuit model for a system of four gap genes. It is shown that for the formation of a steep and stationary border by the model it is necessary that there existed a nucleus (modeling point) in which the gene expression level is constant in time and hence is described by a stationary equation. All the rest genes expressed in this nucleus are in a dynamic equilibrium. The mechanism of border formation associated with the existence of a stationary nucleus is also confirmed by the experiment. An important advantage of this approach is that properties of the system in a stationary nucleus are described by algebraic equations and can be easily handled analytically. Thus we explicitly characterize the cross-regulation properties necessary for the robustness and formulate the conditions providing this effect through the properties of the initial input data. It is shown that our formally derived conditions are satisfied for the previously published model solutions.

Keywords: drosophila, gap genes, reaction-diffusion model, robustness

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5055 Data Science-Based Key Factor Analysis and Risk Prediction of Diabetic

Authors: Fei Gao, Rodolfo C. Raga Jr.

Abstract:

This research proposal will ascertain the major risk factors for diabetes and to design a predictive model for risk assessment. The project aims to improve diabetes early detection and management by utilizing data science techniques, which may improve patient outcomes and healthcare efficiency. The phase relation values of each attribute were used to analyze and choose the attributes that might influence the examiner's survival probability using Diabetes Health Indicators Dataset from Kaggle’s data as the research data. We compare and evaluate eight machine learning algorithms. Our investigation begins with comprehensive data preprocessing, including feature engineering and dimensionality reduction, aimed at enhancing data quality. The dataset, comprising health indicators and medical data, serves as a foundation for training and testing these algorithms. A rigorous cross-validation process is applied, and we assess their performance using five key metrics like accuracy, precision, recall, F1-score, and area under the receiver operating characteristic curve (AUC-ROC). After analyzing the data characteristics, investigate their impact on the likelihood of diabetes and develop corresponding risk indicators.

Keywords: diabetes, risk factors, predictive model, risk assessment, data science techniques, early detection, data analysis, Kaggle

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5054 Development of Filling Material in 3D Printer with the Aid of Computer Software for Supported with Natural Zeolite for the Removal of Nitrogen and Phosphorus

Authors: Luís Fernando Cusioli, Leticia Nishi, Lucas Bairros, Gabriel Xavier Jorge, Sandro Rogério Lautenschalager, Celso Varutu Nakamura, Rosângela Bergamasco

Abstract:

Focusing on the elimination of nitrogen and phosphorus from sewage, the study proposes to face the challenges of eutrophication and to optimize the effectiveness of sewage treatment through biofilms and filling produced by a 3D printer, seeking to identify the most effective Polylactic Acid (PLA), Acrylonitrile Butadiene Styrene (ABS). The study also proposes to evaluate the nitrification process in a Submerged Aerated Biological Filter (FBAS) on a pilot plant scale, quantifying the removal of nitrogen and phosphorus. The experiment will consist of two distinct phases, namely, a bench stage and the implementation of a pilot plant. During the bench stage, samples will be collected at five points to characterize the microbiota. Samples will be collected, and the microbiota will be investigated using Fluorescence In Situ Hybridization (FISH), deepening the understanding of the performance of biofilms in the face of multiple variables. In this context, the study contributes to the search for effective solutions to mitigate eutrophication and, thus, strengthen initiatives to improve effluent treatment.

Keywords: eutrophication, sewage treatment, biofilms, nitrogen and phosphorus removal, 3d printer, environmental efficiency

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5053 Comparison of the Effect of Two Rootstocks Citrus Macrophylla and Citrus Volkameriana on Water Productivity of Citrus “Orogrande” Under Three Irrigation Doses

Authors: Hicham Elomari, Absa Fall, Taoufiq Elkrochni

Abstract:

This present work mainly concerns the improvement of citrus water productivity in the Souss Massa region. The objective is to evaluate the effect of deficit irrigation applied during the fruit growth stage on fruit size, quality and yield of the Orogrande variety grafted on Citrus macrophylla and Citrus volkameriana. Three irrigation regimes were adopted, a control D0 of 3.6 l/h and two doses D1 (58% D0 =2.1 l/h) and D2 (236% D0 =8.5 l/h). The experimental design was a randomized complete block while keeping the same spacing between drippers, the same duration of irrigation and the beginning of trials (fruit growth stage). Results showed that at the end of the cycle from October 1, 2020, to September 30, 2021, a total water supply of 732 mm and 785 mm using the D1 dose was provided to trees of Orogrande variety, respectively grafted on Citrus macrophylla and Citrus volkameriana rootstocks. Citrus macrophylla presented largest fruit size of 38 mm compared to Citrus volkameriana (33mm) with a significant difference. Total soluble sugar (8°Brix) and juice content level (40%) were higher with the application of the D1 dose on both rootstocks. Yield of 36 Tons was not affected by the deficit irrigation. Reduction of water supply by 18% increases agronomic productivity (6 MAD/m³) and economic productivity (3 MAD/m³).

Keywords: citrus, irrigation, fruit size, fruit quality, yield

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5052 Climate Change Scenario Phenomenon in Malaysia: A Case Study in MADA Area

Authors: Shaidatul Azdawiyah Abdul Talib, Wan Mohd Razi Idris, Liew Ju Neng, Tukimat Lihan, Muhammad Zamir Abdul Rasid

Abstract:

Climate change has received great attention worldwide due to the impact of weather causing extreme events. Rainfall and temperature are crucial weather components associated with climate change. In Malaysia, increasing temperatures and changes in rainfall distribution patterns lead to drought and flood events involving agricultural areas, especially rice fields. Muda Agricultural Development Authority (MADA) is the largest rice growing area among the 10 granary areas in Malaysia and has faced floods and droughts in the past due to changing climate. Changes in rainfall and temperature patter affect rice yield. Therefore, trend analysis is important to identify changes in temperature and rainfall patterns as it gives an initial overview for further analysis. Six locations across the MADA area were selected based on the availability of meteorological station (MetMalaysia) data. Historical data (1991 to 2020) collected from MetMalaysia and future climate projection by multi-model ensemble of climate model from CMIP5 (CNRM-CM5, GFDL-CM3, MRI-CGCM3, NorESM1-M and IPSL-CM5A-LR) have been analyzed using Mann-Kendall test to detect the time series trend, together with standardized precipitation anomaly, rainfall anomaly index, precipitation concentration index and temperature anomaly. Future projection data were analyzed based on 3 different periods; early century (2020 – 2046), middle century (2047 – 2073) and late-century (2074 – 2099). Results indicate that the MADA area does encounter extremely wet and dry conditions, leading to drought and flood events in the past. The Mann-Kendall (MK) trend analysis test discovered a significant increasing trend (p < 0.05) in annual rainfall (z = 0.40; s = 15.12) and temperature (z = 0.61; s = 0.04) during the historical period. Similarly, for both RCP 4.5 and RCP 8.5 scenarios, a significant increasing trend (p < 0.05) was found for rainfall (RCP 4.5: z = 0.15; s = 2.55; RCP 8.5: z = 0.41; s = 8.05;) and temperature (RCP 4.5: z = 0.84; s = 0.02; RCP 8.5: z = 0.94; s = 0.05). Under the RCP 4.5 scenario, the average temperature is projected to increase up to 1.6 °C in early century, 2.0 °C in the middle century and 2.4 °C in the late century. In contrast, under RCP 8.5 scenario, the average temperature is projected to increase up to 1.8 °C in the early century, 3.1 °C in the middle century and 4.3 °C in late century. Drought is projected to occur in 2038 and 2043 (early century); 2052 and 2069 (middle century); and 2095, 2097 to 2099 (late century) under RCP 4.5 scenario. As for RCP 8.5 scenario, drought is projected to occur in 2021, 2031 and 2034 (early century); and 2069 (middle century). No drought is projected to occur in the late century under the RCP 8.5 scenario. Thus, this information can be used for the analysis of the impact of climate change scenarios on rice growth and yield besides other crops found in MADA area. Additionally, this study, it would be helpful for researchers and decision-makers in developing applicable adaptation and mitigation strategies to reduce the impact of climate change.

Keywords: climate projection, drought, flood, rainfall, RCP 4.5, RCP 8.5, temperature

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5051 TopClosure® of Large Abdominal Wall Defect Instead of Staged Hernia Repair as Part of Damage Control Laparotomy

Authors: Andriy Fedorenko

Abstract:

Background Early closure of the open abdomen is a priority after damage control laparotomy to prevent retraction of fascial layers and prevent hernia formation that requires definitive repair at a later stage. This substantially reduces the complications associated with ventral hernia formation for up to a year after initial surgery. TopClosure® is an innovative method that employs stress-relaxation and mechanical creep for skin stretching. Its use enables the primary closure of large abdominal wall defects and mitigates large ventral hernia formation. Materials and Methods A 7-year-old girl presented with severe blast injury. She underwent initial laparotomy in a facility within the conflict zone and was transferred in a state of septic shock to our facility for further care. Her abdominal injuries included liver lacerations, multiple perforations of the transverse colon and ileum, and a 8x16cm oblique abdominal wall defect. Further damage control laparotomy was performed with primary suture of the colon and ileum and temporary closure of the abdomen using a Bagota bag. Twelve hours later, negative pressure wound therapy (NPWT) was applied to the abdominal wound after relook laparotomy. Five days later, TopClosure® was applied to the lower part of the wound incorporating NPWT to the upper wound. Results The patient suffered leak from the colonic suture line and required relaparotomy. TopClosure® abdominal closure was achieved after every laparotomy. Conclusion TopClosure® utilizes the viscoelastic properties of the skin achieving full closure of the abdominal wall (including the fascia and skin),eliminating the need for prolonged NPWT, skin graft, and delayed ventral hernia repair surgery.

Keywords: topclosure, abdominal wall defect, hernia, damage control

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5050 Influence of Spirituality on Health Outcomes and General Well-Being in Patients with End-Stage Renal Disease

Authors: Ali A Alshraifeen, Josie Evans, Kathleen Stoddart

Abstract:

End-stage renal disease (ESRD) introduces physical, psychological, social, emotional and spiritual challenges into patients’ lives. Spirituality has been found to contribute to improved health outcomes, mainly in the areas of quality of life (QOL) and well-being. No studies exist to explore the influence of spirituality on the health outcomes and general well-being in patients with end-stage renal disease receiving hemodialysis (HD) treatment in Scotland. This study was conducted to explore spirituality in the daily lives of among these patients and how it may influence their QOL and general well-being. The study employed a qualitative method. Data were collected using semi-structured interviews with a sample of 21 patients. A thematic approach using Framework Analysis informed the qualitative data analysis. Participants were recruited from 11 dialysis units across four Health Boards in Scotland. The participants were regular patients attending the dialysis units three times per week. Four main themes emerged from the qualitative interviews: ‘Emotional and Psychological Turmoil’, ‘Life is Restricted’, ‘Spirituality’ and ‘Other Coping Strategies’. The findings suggest that patients’ QOL might be affected because of the physical challenges such as unremitting fatigue, disease unpredictability and being tied down to a dialysis machine, or the emotional and psychological challenges imposed by the disease into their lives such as wholesale changes, dialysis as a forced choice and having a sense of indebtedness. The findings also revealed that spirituality was an important coping strategy for the majority of participants who took part in the qualitative component (n=16). Different meanings of spirituality were identified including connection with God or Supernatural Being, connection with the self, others and nature/environment. Spirituality encouraged participants to accept their disease and offered them a sense of protection, instilled hope in them and helped them to maintain a positive attitude to carry on with their daily lives, which may have had a positive influence on their health outcomes and general well-being. The findings also revealed that humor was another coping strategy that helped to diffuse stress and anxiety for some participants and encouraged them to carry on with their lives. The findings from this study provide a significant contribution to a very limited body of work. The study contributes to our understanding of spirituality and how people receiving dialysis treatment use it to manage their daily lives. Spirituality is of particular interest due to its connection with health outcomes in patients with chronic illnesses. The link between spirituality and many chronic illnesses has gained some recognition, yet the identification of its influence on the health outcomes and well-being in patients with ESRD is still evolving. There is a need to understand patients’ experiences and examine the factors that influence their QOL and well-being to ensure that the services available are adequately tailored to them. Hence, further research is required to obtain a better understanding of the influence of spirituality on the health outcomes and general well-being of patients with ESRD.

Keywords: end-stage renal disease, general well-being, quality of life, spirituality

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5049 Technology Futures in Global Militaries: A Forecasting Method Using Abstraction Hierarchies

Authors: Mark Andrew

Abstract:

Geopolitical tensions are at a thirty-year high, and the pace of technological innovation is driving asymmetry in force capabilities between nation states and between non-state actors. Technology futures are a vital component of defence capability growth, and investments in technology futures need to be informed by accurate and reliable forecasts of the options for ‘systems of systems’ innovation, development, and deployment. This paper describes a method for forecasting technology futures developed through an analysis of four key systems’ development stages, namely: technology domain categorisation, scanning results examining novel systems’ signals and signs, potential system-of systems’ implications in warfare theatres, and political ramifications in terms of funding and development priorities. The method has been applied to several technology domains, including physical systems (e.g., nano weapons, loitering munitions, inflight charging, and hypersonic missiles), biological systems (e.g., molecular virus weaponry, genetic engineering, brain-computer interfaces, and trans-human augmentation), and information systems (e.g., sensor technologies supporting situation awareness, cyber-driven social attacks, and goal-specification challenges to proliferation and alliance testing). Although the current application of the method has been team-centred using paper-based rapid prototyping and iteration, the application of autonomous language models (such as GPT-3) is anticipated as a next-stage operating platform. The importance of forecasting accuracy and reliability is considered a vital element in guiding technology development to afford stronger contingencies as ideological changes are forecast to expand threats to ecology and earth systems, possibly eclipsing the traditional vulnerabilities of nation states. The early results from the method will be subjected to ground truthing using longitudinal investigation.

Keywords: forecasting, technology futures, uncertainty, complexity

Procedia PDF Downloads 98
5048 Effect of a new Released Bio Organic-Fertilizer in Improving Tomato Growth in Hydroponic System and Under Greenhouse

Authors: Zayneb Kthiri, Walid Hamada

Abstract:

The application of organic fertilizers is generally known to be useful to sustain soil fertility and plant growth, especially in poor soils, with less than 1% of organic matter, as it is very common in our Tunisian fields. Therefore, we focused on evaluating the effect of a new released liquid organic fertilizer named Solorga (with 5% of organic matter) compared to a reference product (Espartan: Kimitec, Spain) on tomato plant growth and physiology. Both fertilizers, derived from plant decomposition, were applied at an early stage in hydroponic system and under greenhouse. In hydroponic system, after 14 days of their application by root feeding, a significant difference was observed between treatments. Indeed, Solorga improved shoots and roots length, as well as the biomass respectively, by 45%, 27%, and 27.8% increase rate, while compared to control plants. However, Espartan induced less the measured parameters while compared to untreated control. Moreover, Solorga significantly increased the chlorophyll content by 42% compared to control and by 32% compared to Espartan. In the greenhouse, after 20 days of treatments, the results showed a significant effect of both fertilizers on SPAD index and the number of flowers blossom. Solorga increased the amount of chlorophyll present in the leaf by 7% compared to Espartan as well as the plant height under greenhouse. Moreover, the number of flowers blossom increased by 15% in plants treated with Solorga while compared to Espartan. Whereas, there is no notable difference between both organic fertilizers on the fruits blossom and the number of fruits per blossom. In conclusion, even though there is a difference in the organic matter between both fertilizers, Solorga improved better the plant growth in controlled conditions in hydroponic system while compared to Espartan. Altogether the obtained results are encouraging for the use of Solorga as a soil enriching source of organic matter to help plants to boost their growth and help them to overcome abiotic stresses linked to soil fertility.

Keywords: tomato, plant growth, organic fertilizer, hydroponic system, greenhouse

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5047 Acclimation of in vitro-Propagated Apple Plantlets as Affected by Light Intensity

Authors: Guem-Jae Chung, Jin-Hui Lee, Myung-Min Oh

Abstract:

Environmental control of in vitro-propagated apple plantlets is required for successful acclimation to ex vitro due to its low survival rate. This study aimed to determine the proper lighting condition for ex vitro acclimation of the apple plantlets in plant factories. In vitro-propagated M9 apple plantlets treated with pre-acclimatization for 1 week were exposed to following light treatments for additional 6 weeks; 60 μmol·m⁻²·s⁻¹ (A), 100 μmol·m⁻²·s⁻¹ (B), 140 μmol·m⁻²·s⁻¹ (C), 180 μmol·m⁻²·s⁻¹ (D), 60 μmol·m⁻²·s⁻¹ → 100 μmol·m⁻²·s⁻¹ at 2 weeks (E) or 4 weeks (F), 60 μmol·m⁻²·s⁻¹ → 100 μmol·m⁻²·s⁻¹ at 2 weeks → 140 μmol·m⁻²·s⁻¹ at 4 weeks (G) and 60 μmol·m⁻²·s⁻¹ → 140 μmol·m⁻²·s⁻¹ at 4 weeks (H). Shoot height, total leaf area, soil-plant analysis development (SPAD) value, root length, fresh and dry weights of shoots and roots were measured every 2 weeks after transplanting. In addition, the photosynthetic rate was measured at 5 weeks after transplanting. At 6 weeks after transplanting, shoot height of B was significantly higher than the other treatments. SPAD value, total leaf area and root length of B and F were relatively higher than the other treatments. Root fresh weights of B, D, F, and G were relatively higher than those in the other treatments. D induced the highest value in shoot fresh weight probably due to stem hardening, but it also resulted in shoot damage in the early stage of acclimation. Photosynthetic rate at 5 weeks after the transplanting was significantly increased as the light intensity increased. These results suggest that 100 μmol·m⁻²·s⁻¹ for 6 weeks (B) or gradually increased treatment from 60 μmol·m⁻²·s⁻¹ to 140 μmol·m⁻²·s⁻¹ at 2 weeks interval (F) were the proper lighting conditions for successful acclimation of in vitro-propagated apple plantlets. Acknowledgment: This work was supported by Korea Institute of Planning and Evaluation for Technology in Food, Agriculture, Forestry and Fisheries (IPET) through Agri-Bio industry Technology Development Program, funded by Ministry of Agriculture, Food and Rural Affairs (MAFRA) (315003051SB020).

Keywords: acclimation, in vitro-propagated apple plantlets, light intensity, plant factory

Procedia PDF Downloads 115
5046 Design and Construction of a Solar Mobile Anaerobic Digestor for Rural Communities

Authors: César M. Moreira, Marco A. Pazmiño-Hernández, Marco A. Pazmiño-Barreno, Kyle Griffin, Pratap Pullammanappallil

Abstract:

An anaerobic digestion system that was completely operated on solar power (both photovoltaic and solar thermal energy), and mounted on a trailer to make it mobile, was designed and constructed. A 55-gallon batch digester was placed within a chamber that was heated by hot water pumped through a radiator. Hot water was produced by a solar thermal collector and photovoltaic panels charged a battery which operated pumps for recirculating water. It was found that the temperature in the heating chamber was maintained above ambient temperature but it follows the same trend as ambient temperature. The temperature difference between the chamber and ambient values was not constant but varied with time of day. Advantageously, the temperature difference was highest during night and early morning and lowest near noon. In winter, when ambient temperature dipped to 2 °C during early morning hours, the chamber temperature did not drop below 10 °C. Model simulations showed that even if the digester is subjected to diurnal variations of temperature (as observed in winter of a subtropical region), about 63 % of the waste that would have been processed under constant digester temperature of 38 °C, can still be processed. The cost of the digester system without the trailer was $1,800.

Keywords: anaerobic digestion, solar-mobile, rural communities, solar, hybrid

Procedia PDF Downloads 247
5045 Diagnostics of Subclinical Mastitis in Dairy Cows

Authors: G. Tanbayeva, Z. Myrzabekov, O. Tagayev, B. Barakhov, M. Tokayeva

Abstract:

Mastitis is widely spread among dairy cows bringing large economic damage resulting in decreased milk yield, deterioration of the milk quality, gastrointestinal tract disorders among young animals, culling of breeding stock, and expenses for sick animal treatment. Up-to-date and accurate diagnostics of subclinical (latent) mastitis in dairy cows has huge practical and economical significance. The aim of the research was to develop a new optimal alternative rapid method for the diagnosis of subclinical mastitis in cows. The study was performed in the laboratory of the Hygiene and Sanitation of Kazakh National Agrarian University. The first stage was to evaluate the different percentages of “Promastit” preparation. It showed that the best diagnostics capacity had 10% dilution. The second stage was to compare “Promastit” with some of the domestic and foreign analogues “Somatic-Test” (Denmark), “MastTest” (Russia), “Mastidin” (Ukraine), “Diagmast” (Kazakhstan). The observation was carried out on 520 dairy cows with subclinical mastitis on farms of Almaty region of Kazakhstan. The effectiveness was checked by milk sedimentation test. Our research tends to show that the diagnostic test "Promastitis" revealed subclinical mastitis in 193 out of 520 lactating cows (37.1% of those examined). At the same time, in the case of using other diagnostic tests, the given index was as follows: 35.5% (mastidin), 34.4% (masttest-AF), 33.8% (somatic-test Ecotest), 30.7% (diagmast).

Keywords: dairy cows, diagnostics, subclinical mastitis, test Promastit

Procedia PDF Downloads 338
5044 Re-Framing Resilience Turn in Risk and Management with Anti-Positivistic Perspective of Holling's Early Work

Authors: Jose CanIzares

Abstract:

In the last decades, resilience has received much attention in relation to understanding and managing new forms of risk, especially in the context of urban adaptation to climate change. There are abundant concerns, however, on how to best interpret resilience and related ideas, and on whether they can guide ethically appropriate risk-related or adaptation efforts. Narrative creation and framing are critical steps in shaping public discussion and policy in large-scale interventions, since they favor or inhibit early decision and interpretation habits, which can be morally sensitive and then become persistent on time. This article adds to such framing process by contesting a conventional narrative on resilience and offering an alternative one. Conventionally, present ideas on resilience are traced to the work of ecologist C. S. Holling, especially to his article Resilience and Stability in Ecosystems. This article is usually portrayed as a contribution of complex systems thinking to theoretical ecology, where Holling appeals to resilience in order to challenge received views on ecosystem stability and the diversity-stability hypothesis. In this regard, resilience is construed as a “purely scientific”, precise and descriptive concept, denoting a complex property that allows ecosystems to persist, or to maintain functions, after disturbance. Yet, these formal features of resilience supposedly changed with Holling’s later work in the 90s, where, it is argued, Holling begun to use resilience as a more pragmatic “boundary term”, aimed at unifying transdisciplinary research about risks, ecological or otherwise, and at articulating public debate and governance strategies on the issue. In the conventional story, increased vagueness and degrees of normativity are the price to pay for this conceptual shift, which has made the term more widely usable, but also incompatible with scientific purposes and morally problematic (if not completely objectionable). This paper builds on a detailed analysis of Holling’s early work to propose an alternative narrative. The study will show that the “complexity turn” has often entangled theoretical and pragmatic aims. Accordingly, Holling’s primary aim was to fight what he termed “pathologies of natural resource management” or “pathologies of command and control management”, and so, the terms of his reform of ecosystem science are partly subordinate to the details of his proposal for reforming the management sciences. As regards resilience, Holling used it as a polysemous, ambiguous and normative term: sometimes, as an instrumental value that is closely related to various stability concepts; other times, and more crucially, as an intrinsic value and a tool for attacking efficiency and instrumentalism in management. This narrative reveals the limitations of its conventional alternative and has several practical advantages. It captures well the structure and purposes of Holling’s project, and the various roles of resilience in it. It helps to link Holling’s early work with other philosophical and ideological shifts at work in the 70s. It highlights the currency of Holling’s early work for present research and action in fields such as risk and climate adaptation. And it draws attention to morally relevant aspects of resilience that the conventional narrative neglects.

Keywords: resilience, complexity turn, risk management, positivistic, framing

Procedia PDF Downloads 150
5043 Estimations of Spectral Dependence of Tropospheric Aerosol Single Scattering Albedo in Sukhothai, Thailand

Authors: Siriluk Ruangrungrote

Abstract:

Analyses of available data from MFR-7 measurement were performed and discussed on the study of tropospheric aerosol and its consequence in Thailand. Since, ASSA (w) is one of the most important parameters for a determination of aerosol effect on radioactive forcing. Here the estimation of w was directly determined in terms of the ratio of aerosol scattering optical depth to aerosol extinction optical depth (ωscat/ωext) without any utilization of aerosol computer code models. This is of benefit for providing the elimination of uncertainty causing by the modeling assumptions and the estimation of actual aerosol input data. Diurnal w of 5 cloudless-days in winter and early summer at 5 distinct wavelengths of 415, 500, 615, 673 and 870 nm with the consideration of Rayleigh scattering and atmospheric column NO2 and Ozone contents were investigated, respectively. Besides, the tendency of spectral dependence of ω representing two seasons was observed. The characteristic of spectral results reveals that during wintertime the atmosphere of the inland rural vicinity for the period of measurement possibly dominated with a lesser amount of soil dust aerosols loading than one in early summer. Hence, the major aerosol loading particularly in summer was subject to a mixture of both soil dust and biomass burning aerosols.

Keywords: aerosol scattering optical depth, aerosol extinction optical depth, biomass burning aerosol, soil dust aerosol

Procedia PDF Downloads 388
5042 A Textual Analysis of Prospective Teachers’ Social Justice Identity Development and LGBTQ Advocacy

Authors: Mi Ok Kang

Abstract:

This study examined the influences of including LGBTQ-related content in a multicultural teacher education course on the development of prospective teachers’ social justice identities. Appling a content analysis to 53 reflection texts written by participating prospective teachers in response to the relevant course content, this study deduced the stages of social justice identity development (naïve, acceptance, resistance, redefinition, and internalization) that participants reached during the course. The analysis demonstrated that the participants reached various stages in the social identity development model and none of the participants remained at the naïve stage during/after class. The majority (53%) of the participants reached the internalization stage during the coursework and became conscious about the heterosexual privileges they have had and aware of possible impacts of such privilege on their future LGBTQ students. Also the participants had begun to develop pedagogic action plans and devised applicable teaching strategies for their future students based on the new understanding of heteronormativity. We expect this study will benefit teacher educators and educational administrators who want to address LGBTQ-related issues in their multicultural education programs and/or revisit the goals, directions, and implications of their approach.

Keywords: LGBTQ, heteronormativity, social justice identity, teacher education, multicultural education, content analysis

Procedia PDF Downloads 243
5041 Mangrove Plantation in a Reclaimed Land From the Sea

Authors: Anusree Ghosh, Nahid Morshed, Tapas Ranjan Chakraborty, Moniruzzaman Khan, Liakath Ali

Abstract:

To establish the Bangabandhu Sheikh Mujib Shilpa Nagar in Mirsarai, Chattogram land was reclaimed from the river mouth of the Feni River in the Bay of Bangle. The sandy land has a salinity of 9.5 EC ds/m, and the water of the adjacent Bay was 13.2 EC ds/m during winter, i.e., it has moderate salinity. The selection of plant species for the plantation was following the local practices. Mangrove plantation in a such landscape is not common in the country, and some actions towards the plantation seem ineffective and could be accomplished differently. The aim of this paper is to analyze the trial and develop a strategy for mangrove afforestation in reclaimed land where the tidal effect does not occur year-round. Though the Keora (Sonneratia apetala) is the priority species in a typical mangrove plantation, the success rate is comparatively high for the Baen (Avcennia officinalis) and Sada Baen (Avicennia alba). The natural growth was recorded for Keora, Goran (Ceriops decandra), Lal Jhau (Tamarix dioica) and Baen. Though there was the natural growth of Durba grass (Cynodon dactylon) and Motha Gash (Cyperus rotundus), no growth of climber was reported at the early stage of the natural growth. The transplanted growth of Keora, Gewa (Excoecaria agallocha), and Baen was found not suitable for plantation. The saplings growing from the viviparous germinated bean show no germination failure. Since the plantation site remains dry for 5 months, there was irrigation from the river; though it resulted in an increase in land salinity. To increase fertility, cow dung was used, and green manuring by planting Doincha (Sesbania bispinosa) shows a very insignificant contribution. The plantation of, only one and a half years old, is now a habitat of more than 100 species. The learning from the mangrove plantation from August 2021 to February 2023 assumes that in reclaimed land where there is inundation during monsoon only and salinity is moderate, the plantation from viviparous germinated Baen is better.

Keywords: mangrove plantation, reclaimed land, climate change, habitat restoration

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5040 Preliminary Study on Milk Composition and Milk Protein Polymorphism in the Algerian Local Sheep's Breeds

Authors: A. Ameur Ameur, F. Chougrani, M. Halbouche

Abstract:

In order to characterize the sheep's milk, we analyzed and compared, in a first stage of our work, the physical and chemical characteristics in two Algerian sheep breeds: Hamra race and race Ouled Djellal breeding at the station the experimental ITELV Ain Hadjar (Saïda Province). Analyses are performed by Ekomilk Ultra-analyzer (EON TRADING LLC, USA), they focused on the pH, density, freezing, fat, total protein, solids-the total dry extract. The results obtained for these parameters showed no significant differences between the two breeds studied. The second stage of this work was the isolation and characterization of milk proteins. For this, we used the precipitation of caseins phi [pH 4.6]. For this, we used the precipitation of caseins Phi (pH 4.6). After extraction, purification and assay, both casein and serum protein fractions were then assayed by the Bradford method and controlled by polyacrylamide gel electrophoresis (PAGE) in the different conditions (native, in the presence of urea and in the presence of SDS). The electrophoretic pattern of milk samples showed the presence similarities of four major caseins variants (αs1-, αs2-β-and k-casein) and two whey proteins (β-lactoglobulin, α-lactalbumin) of two races Hamra and Ouled Djellal. But compared to bovine milk, they have helped to highlight some peculiarities as related to serum proteins (α La β Lg) as caseins, including αs1-Cn.

Keywords: Hamra, Ouled Djellal, protein polymorphism, sheep breeds

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5039 Extending ACOSOG Z0011 to Encompass Mastectomy Patients: A Retrospective Review

Authors: Ruqayya Naheed Khan, Awais Amjad Malik, Awais Naeem, Amina Khan, Asad Parvaiz

Abstract:

Introduction: Axillary nodal status in breast cancer patients is a paramount prognosticator, next to primary tumor size and grade. It has been well established that patients with negative sentinel lymph node biopsy can safely avoid axillary lymph node dissection. A positive sentinel lymph node has traditionally required subsequent axillary dissection. According to ACOSOG Z11 trial, patients who underwent axillary dissection with 3 or more positive sentinel nodes or opted for observation in case of negative sentinel lymph node, did not find any difference in Overall Survival (OS) and Disease Free Survival (DFS). The Z11 trial included patients who underwent breast conserving surgery and excluded patients with mastectomies. The purpose of this study is to determine whether Z0011 can be applied to mastectomy patients as well in 1-3 positive sentinel lymph nodes and avoid unnecessary ALND. Methods: A retrospective review was conducted at Shaukat Khanam Memorial Cancer Hospital Pakistan from Jan 2015 to Dec 2017 including patients who were treated for invasive breast cancer and required upfront mastectomy. They were clinically node negative, so sentinel lymph node biopsy was performed. Patients underwent ALND with positive sentinel lymph node. A total of 156 breast cancer patients with mastectomies were reviewed. Results: 95% of the patients were female while 3% were male. Average age was 44 years. There was no difference in race, comorbidities, histology, T stage, N stage, and overall stage, use of adjuvant chemotherapy and radiation therapy. 64 patients underwent ALND for positive lymph node while 92 patients were spared of axillary dissection due to negative sentinel lymph node biopsy. Out of 64 patients, 38 patients (59%) had only 1 lymph node positive which was the sentinel node. 18 patients (28%) had 2 lymph nodes positive including the sentinel node while only 8 patients (13%) had 3 or more positive nodes. Conclusion: Keeping in mind the complications related to ALND, above results clearly show that ALND could have been avoided in 87% of patients in the setting of adjuvant radiation, possibly avoiding the morbidity associated with axillary lymphadenectomy although a prospective randomized trial needs to confirm these results.

Keywords: mastectomy, sentinel lymph node biopsy, axillary lymph node dissection, breast cancer

Procedia PDF Downloads 172