Search results for: medical oxygen
3462 Making Haste Slowly: South Africa's Transition from a Medical to a Social Model regarding Persons with Disabilities
Authors: Leoni Van Der Merwe
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Historically, in South Africa, disability has been viewed as a dilemma of the individual. The discourse surrounding the definition of disability and applicable theories are as fluid as the differing needs of persons with disabilities within society. In 1997, the Office of the Deputy President published the White Paper on the Integrated National Disability Strategy (WPINDS) which sought to integrate disability issues in all governmental development strategies, planning and programs as well as to solidify the South African government’s stance that disability was to be considered according to the social model and not the, previously utilized, medical model of disability. The models of disability are conceptual frameworks for understanding disability and can provide some insight into why certain attitudes exist and how they are reinforced in society. Although the WPINDS was regarded as a critical milestone in the history of the disability rights struggle in South Africa; it has taken approximately twenty years for the publication of a similar document taking into account South Africa’s changing social, economic, political and technological dispensation. December 2015 marked the approval of the White Paper on the Rights of Persons with Disabilities (WPRPD) which seeks to update the WPINDS, integrate principles contained in international law instruments and endorse a mainstreaming trajectory for realizing the rights of persons with disabilities. While the WPINDS and the WPRPD were published two decades apart, both documents contain an emphasis on a transition from the medical model to the social model. Whereas, the medical model presupposes that disability is mainly a health and welfare matter and is focused on an individualistic and dependency-based approach; the social model requires a paradigm shift in the manner in which disability is constructed so as to highlight the shortcomings of society in respect of disability and to bring to the fore the capabilities of persons with disabilities. The social model has led to unmatched success in changing the perceptions surrounding disability. This article seeks to investigate the progress made in the implementation of the social model in South Africa by taking into account the effect of the diverse political and cultural landscape in promoting the historically entrenched medical model and the rise of disability activism prior to the new democratic dispensation as well as legislation, case law, policy documents and barriers in respect of persons with disabilities that are pervasive in South African society. The research paper will conclude that although numerous interventions have been identified and implemented to promote the consideration of disability within a social construct in South Africa, such interventions require increased national and international collaboration, resources and pace to ensure that the efforts made lead to sustainable results. For persons with disabilities, what remains to be seen is whether the proliferation of activism by interest groups, social awareness as well as the development of policy documents, legislation and case law will serve as the impetus to dissipate the view that disability is burden to be carried solely on the shoulders of the person with the disability.Keywords: disability, medical model, social model, societal barriers, South Africa
Procedia PDF Downloads 3783461 Long-Term Efficacy of Integrated Constructed Wetlands for Pollutant Removal Using Biowaste Materials
Authors: Khadija Kraiem, Salma Bessadok, Dorra Tabassi, Atef Jaouani
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This study investigated the long-term impact of incorporating biowaste (i.e., cork and date stones) as a natural and cost-effective alternative to traditional substrates (e.g., gravel) in constructed wetlands (CWs). Results showed that pollutant removal efficiency was significantly improved after the addition of biowaste under different hydraulic retention time (HRT) conditions. The addition of cork in vertical flow constructed wetlands (VFCWs) improved chemical oxygen demand (COD) removal from 64% to 86%.. Similarly, in horizontal flow constructed wetlands (HFCWs), COD removal increased from 67% to 81% with cork and 85% with date seeds. In terms of ammonium removal, cork in VFCWs increased efficiency from 34% to 56%, while in HFCWs; it improved from 24% to 47% with cork and reached 44% with date stones. Furthermore, our data showed that the addition of biowastes improved the removal of micropollutants, such as bisphenol A (BPA) and diclofenac (DFC), with the highest removal of BPA of 86% and DFC of 89% observed in the date seeds wetland. However, no significant changes were observed in pathogens removal.The evaluation of the impact of biowaste addition on the contribution of plant species and its interaction with hydraulic retention time (HRT) was also conducted to pollutant removal. The addition of biowaste resulted in a decrease in the required HRT for effective contaminant elimination, but it had no notable impact on the contribution of plant species.Keywords: biowaste, constructed wetlands, micropollutants, wastewater tratment
Procedia PDF Downloads 83460 Investigation of Poly P-Dioxanone as Promising Biodegradable Polymer for Short-Term Medical Application
Authors: Stefanie Ficht, Lukas Schübel, Magdalena Kleybolte, Markus Eblenkamp, Jana Steger, Dirk Wilhelm, Petra Mela
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Although 3D printing as transformative technology has become of increasing interest in the medical field and the demand for biodegradable polymers has developed to a considerable extent, there are only a few additively manufactured, biodegradable implants on the market. Additionally, the sterilization of such implants and its side effects on degradation have still not been sufficiently studied. Within this work, thermosensitive poly p-dioxanone (PPDO) samples were printed with fused filament fabrication (FFF) and investigated. Subsequently, H₂O₂ plasma and gamma radiation were used as low-temperature sterilization techniques and compared among each other and the control group (no sterilization). In order to assess the effect of different sterilization on the degradation behavior of PPDO, the samples were immersed in phosphate-buffered solution (PBS) over 28 days, and surface morphology, thermal properties, molecular weight, inherent viscosity, and mechanical properties were examined at regular time intervals. The study demonstrates that PPDO was printed with great success and that thermal properties, molecular weight (Mw), and inherent viscosity (IV) were not significantly affected by the printing process itself. H₂O₂ plasma sterilization did not significantly harm the thermosensitive polymer, while gamma radiation lowered IV and Mw statistically significantly compared to the control group (p < 0.001). During immersion in PBS, a decrease in Mw and mechanical strength occurred for all samples. However, gamma sterilized samples were affected to a much higher extent compared to the two other sample groups both in final values and timeline. This was confirmed by scanning electron microscopy showing no changes of surface morphology of (non-sterilized) control samples, first microcracks appearing on plasma sterilized samples after two weeks while being present on gamma sterilized samples already immediately after radiation to then further deteriorate over immersion duration. To conclude, we demonstrated that FFF and H₂O₂ plasma sterilization are well suited for processing thermosensitive, biodegradable polymers used for the development of innovative short-term medical applications.Keywords: additive manufacturing, sterilization, biodegradable, thermosensitive, medical application
Procedia PDF Downloads 1263459 Challenges to Tuberculosis Control in Angola: The Narrative of Medical Professionals
Authors: Domingos Vita, Patrick Brady
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Background: There is a tuberculosis (TB) epidemic in Angola that has been getting worse for more than a decade despite the active implementation of the DOTS strategy. The aim of this study was to directly interrogate healthcare workers involved in TB control on what they consider to be the drivers of the TB epidemic in Angola. Methods: Twenty four in-depth qualitative interviews were conducted with medical staff working in this field in the provinces of Luanda and Benguela. Results: The healthcare professionals see the migrant working poor as a particular problem for the control of TB. These migrants are constructed as ‘Rural People’ and are seen as non-compliant and late-presenting. This is a stigmatized and marginal group contending with the additional stigma associated with TB infection. The healthcare professionals interviewed also see the interruption of treatment and self medication generally as a better explanation for the TB epidemic than urbanization or lack of medication. Conclusions: The local narrative is in contrast to previous explanations used elsewhere in the developing world. To be effective policy must recognize the local issues of the migrant workforce, interruption of treatment and the stigma associated with TB in Angola.Keywords: Africa, Angola, migrants, qualitative, research, tuberculosis
Procedia PDF Downloads 1643458 Quality Parameters of Offset Printing Wastewater
Authors: Kiurski S. Jelena, Kecić S. Vesna, Aksentijević M. Snežana
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Samples of tap and wastewater were collected in three offset printing facilities in Novi Sad, Serbia. Ten physicochemical parameters were analyzed within all collected samples: pH, conductivity, m - alkalinity, p - alkalinity, acidity, carbonate concentration, hydrogen carbonate concentration, active oxygen content, chloride concentration and total alkali content. All measurements were conducted using the standard analytical and instrumental methods. Comparing the obtained results for tap water and wastewater, a clear quality difference was noticeable, since all physicochemical parameters were significantly higher within wastewater samples. The study also involves the application of simple linear regression analysis on the obtained dataset. By using software package ORIGIN 5 the pH value was mutually correlated with other physicochemical parameters. Based on the obtained values of Pearson coefficient of determination a strong positive correlation between chloride concentration and pH (r = -0.943), as well as between acidity and pH (r = -0.855) was determined. In addition, statistically significant difference was obtained only between acidity and chloride concentration with pH values, since the values of parameter F (247.634 and 182.536) were higher than Fcritical (5.59). In this way, results of statistical analysis highlighted the most influential parameter of water contamination in offset printing, in the form of acidity and chloride concentration. The results showed that variable dependence could be represented by the general regression model: y = a0 + a1x+ k, which further resulted with matching graphic regressions.Keywords: pollution, printing industry, simple linear regression analysis, wastewater
Procedia PDF Downloads 2373457 Ontology-Driven Generation of Radiation Protection Procedures
Authors: Chamseddine Barki, Salam Labidi, Hanen Boussi Rahmouni
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In this article, we present the principle and suitable methodology for the design of a medical ontology that highlights the radiological and dosimetric knowledge, applied in diagnostic radiology and radiation-therapy. Our ontology, which we named «Onto.Rap», is the subject of radiation protection in medical and radiology centers by providing a standardized regulatory oversight. Thanks to its added values of knowledge-sharing, reuse and the ease of maintenance, this ontology tends to solve many problems. Of which we name the confusion between radiological procedures a practitioner might face while performing a patient radiological exam. Adding to it, the difficulties they might have in interpreting applicable patient radioprotection standards. Here, the ontology, thanks to its concepts simplification and expressiveness capabilities, can ensure an efficient classification of radiological procedures. It also provides an explicit representation of the relations between the different components of the studied concept. In fact, an ontology based-radioprotection expert system, when used in radiological center, could implement systematic radioprotection best practices during patient exam and a regulatory compliance service auditing afterwards.Keywords: knowledge, ontology, radiation protection, radiology
Procedia PDF Downloads 3183456 Flame Spray Pyrolysis as a High-Throughput Method to Generate Gadolinium Doped Titania Nanoparticles for Augmented Radiotherapy
Authors: Malgorzata J. Rybak-Smith, Benedicte Thiebaut, Simon Johnson, Peter Bishop, Helen E. Townley
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Gadolinium doped titania (TiO2:Gd) nanoparticles (NPs) can be activated by X-ray radiation to generate Reactive Oxygen Species (ROS), which can be effective in killing cancer cells. As such, treatment with these NPs can be used to enhance the efficacy of conventional radiotherapy. Incorporation of the NPs in to tumour tissue will permit the extension of radiotherapy to currently untreatable tumours deep within the body, and also reduce damage to neighbouring healthy cells. In an attempt to find a fast and scalable method for the synthesis of the TiO2:Gd NPs, the use of Flame Spray Pyrolysis (FSP) was investigated. A series of TiO2 NPs were generated with 1, 2, 5 and 7 mol% gadolinium dopant. Post-synthesis, the TiO2:Gd NPs were silica-coated to improve their biocompatibility. Physico-chemical characterisation was used to determine the size and stability in aqueous suspensions of the NPs. All analysed TiO2:Gd NPs were shown to have relatively high photocatalytic activity. Furthermore, the FSP synthesized silica-coated TiO2:Gd NPs generated enhanced ROS in chemico. Studies on rhabdomyosarcoma (RMS) cell lines (RD & RH30) demonstrated that in the absence of irradiation all TiO2:Gd NPs were inert. However, application of TiO2:Gd NPs to RMS cells, followed by irradiation, showed a significant decrease in cell proliferation. Consequently, our studies showed that the X-ray-activatable TiO2:Gd NPs can be prepared by a high-throughput scalable technique to provide a novel and affordable anticancer therapy.Keywords: cancer, gadolinium, ROS, titania nanoparticles, X-ray
Procedia PDF Downloads 4343455 Paraoxonase 1 (PON 1) Arylesterase and Lactonase Activities, Polymorphism and Conjugated Dienes in Gastroenteritis in Paediatric Population
Authors: M. R. Mogarekar, Shraddha V. More, Pankaj Kumar
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Gastroenteritis, the third leading killer of children in India today is responsible for 13% of all deaths in children <5 years of age and kills an estimated 300,000 children in India each year. We decided to investigate parameters which can help in early disease detection and prompt treatment. Serum paraoxonase is calcium dependent esterase which is widely distributed among tissues such as liver, kidney, and intestine and is located in the chromosomal region 7q21.3 22.1. Studies show the presence of excessive reactive oxygen metabolites and antioxidant imbalance in the gastrointestinal tract leading to oxidative stress in gastroenteritis. To our knowledge, this is the first ever study done. The objective of present study is to investigate the role of paraoxonase 1 (PON 1) status i.e arylesterase and lactonase activities and Q192R polymorphism and conjugated dienes, in gastroenteritis of paediatric population. The study and control group consists of 40 paediatric patients with and without gastroenteritis. Paraoxonase arylesterase and lactonase activities were assessed and phenotyping was determined. Conjugated dienes were also assessed. PON 1 arylesterase activities in cases (61.494±13.220) and controls (70.942±15.385) and lactonase activities in cases (15.702±1.036) and controls (17.434±1.176) were significantly decreased (p<0.05). There is no significant difference of phenotypic distribution in cases and controls. Conjugated dienes were found significantly increased in patients (0.086±0.024) than the control group (0.064±0.019) (p<0.05). Paraoxonase 1 activities (arylesterase and lactonase) and conjugated dienes may be useful in risk assessment and management in gastroenteritis in paediatric population.Keywords: paraoxonase 1 polymorphism, arylesterase, lactonase, conjugated dienes, p-nitrophenylacetate, DHC
Procedia PDF Downloads 3093454 Conversion of Glycerol to 3-Hydroxypropanoic Acid by Genetically Engineered Bacillus subtilis
Authors: Aida Kalantari, Boyang Ji, Tao Chen, Ivan Mijakovic
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3-hydroxypropanoic acid (3-HP) is one of the most important biomass-derivable platform chemicals that can be converted into a number of industrially important compounds. There have been several attempts at production of 3-HP from renewable sources in cell factories, focusing mainly on Escherichia coli, Klebsiella pneumoniae, and Saccharomyces cerevisiae. Despite the significant progress made in this field, commercially exploitable large-scale production of 3-HP in microbial strains has still not been achieved. In this study, we investigated the potential of Bacillus subtilis to be used as a microbial platform for bioconversion of glycerol into 3-HP. Our recombinant B. subtilis strains overexpress the two-step heterologous pathway containing glycerol dehydratase and aldehyde dehydrogenase from various backgrounds. The recombinant strains harboring the codon-optimized synthetic pathway from K. pneumoniae produced low levels of 3-HP. Since the enzymes in the heterologous pathway are sensitive to oxygen, we had to perform our experiments in micro-aerobic conditions. Under these conditions, the cell produces lactate in order to regenerate NAD+, and we found the lactate production to be in competition with the production of 3-HP. Therefore, based on the in silico predictions, we knocked out the glycerol kinase (glpk), which in combination with growth on glucose, resulted in improving the 3-HP titer to 1 g/L and the removal of lactate. Cultivation of the same strain in an enriched medium improved the 3-HP titer up to 7.6 g/L. Our findings provide the first report of successful introduction of the biosynthetic pathway for conversion of glycerol into 3-HP in B. subtilis.Keywords: bacillus subtilis, glycerol, 3-hydroxypropanoic acid, metabolic engineering
Procedia PDF Downloads 2503453 Treatment of Leather Industry Wastewater with Advance Treatment Methods
Authors: Seval Yilmaz, Filiz Bayrakci Karel, Ali Savas Koparal
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Textile products produced by leather have been indispensable for human consumption. Various chemicals are used to enhance the durability of end-products in the processing of leather products. The wastewaters from the leather industry which contain these chemicals exhibit toxic effects on the receiving environment and threaten the natural ecosystem. In this study, leather industry wastewater (LIW), which has high loads of contaminants, was treated using advanced treatment techniques instead of conventional methods. During the experiments, the performance of electrochemical methods was investigated. During the electrochemical experiments, the performance of batch electrooxidation (EO) using boron-doped diamond (BDD) electrodes with monopolar configuration for removal of chemical oxygen demand (COD) from LIW were investigated. The influences of electrolysis time, current density (which varies as 5 mA/cm², 10 mA/cm², 20 mA/cm², 30 mA/cm², 50 mA/cm²) and initial pH (which varies as 3,80 (natural pH of LIW), 7, 9) on removal efficiency were investigated in a batch stirred cell to determine the best treatment conditions. The current density applied to the electrochemical reactors is directly proportional to the consumption of electric energy, so electrical energy consumption was monitored during the experiment. The best experimental conditions obtained in electrochemical studies were as follows: electrolysis time = 60 min, current density = 30.0 mA/cm², pH 7. Using these parameters, 53.59% COD removal rates for LIW was achieved and total energy consumption was obtained as 13.03 kWh/m³. It is concluded that electrooxidation process constitutes a plausible and developable method for the treatment of LIW.Keywords: BDD electrodes, COD removal, electrochemical treatment, leather industry wastewater
Procedia PDF Downloads 1643452 Institutional Capacity of Health Care Institutes for Diagnosis and Management of Common Genetic Diseases-a Study from a North Coastal District of Andhra Pradesh, India
Authors: Koteswara Rao Pagolu, Raghava Rao Tamanam
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In India, genetic disease is a disregarded service element in the community health- protection system. This study aims to gauge the accessibility of services for treating genetic disorders and also to evaluate the practices on deterrence and management services in the district health system. A cross-sectional survey of selected health amenities in the government health sector was conducted from 15 primary health centers (PHC’s), 4 community health centers (CHC’s), 1 district government hospital (DGH) and 3 referral hospitals (RH’s). From these, the existing manpower like 130 medical officers (MO’s), 254 supporting staff, 409 nursing staff (NS) and 45 lab technicians (LT’s) was examined. From the side of private health institutions, 25 corporate hospitals (CH’s), 3 medical colleges (MC’s) and 25 diagnostic laboratories (DL’s) were selected for the survey and from these, 316 MO’s, 995 NS and 254 LT’s were also reviewed. The findings show that adequate staff was in place at more than 70% of health centers, but none of the staff have obtained any operative training on genetic disease management. The largest part of the DH’s had rudimentary infrastructural and diagnostic facilities. However, the greater part of the CHC’s and PHC’s had inadequate diagnostic facilities related to genetic disease management. Biochemical, molecular, and cytogenetic services were not available at PHC’s and CHC’s. DH’s, RH’s, and all selected medical colleges were found to have offered the basic Biochemical genetics units during the survey. The district health care infrastructure in India has a shortage of basic services to be provided for the genetic disorder. With some policy resolutions and facility strengthening, it is possible to provide advanced services for a genetic disorder in the district health system.Keywords: district health system, genetic disorder, infrastructural amenities, management practices
Procedia PDF Downloads 1853451 Self-Care and Risk Behaviors in Primary Caregiver of Cancer Patients
Authors: Ivonne N. Pérez-Sánchez. María L. Rascón- Gasca, Angélica Riveros-Rosas, Rebeca Robles García
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Introduction: Primary caregivers of cancer patients have health problems related to their lack of time, stress, and fiscal strain. Their health problems could affect their patients’ health and also increase the expenses in public health. Aim: To describe self-care and risk behaviors in a sample of Mexican primary caregiver and the relation of these behaviors with emotional distress (caregiver burden, anxiety and depression symptoms), coping and sociodemographic variables. Method: Participated in this study 173 caregivers of a third level reference medical facility (age: M=49.4, SD=13.5) females 78%, males 22%, 57.5% were caregivers of patients with terminal cancer (CPTC), and 40.5% were caregivers of patients on oncology treatment (CPOT). Results: The 75.7% of caregivers reported to have had health problem in last six months as well as several symptoms which were related to emotional distress, these symptoms were more frequently between CPTC and female caregivers. A half (47.3%) of sample reported have had difficulties in caring their health; these difficulties were related to emotional distress and lower coping, more affected caregivers were who attend male patients and CPTC. The 76.8% of caregivers had health problems in last six months, but 26.5% of them waited to search medical care until they were very sick, and 11% didn't do it. Also, more than a half of sample (56.1%) admitted to have risk behaviors as drink alcohol, smoke or overeating for feeling well, these caregivers showed high emotional distress and lower coping. About caregivers healthy behaviors, 80% of them had a hobby; 27.2% do exercise usually and between 12% to 60% did medical checkups (glucose tests, blood pressure and cholesterol tests, eye exams and watched their weight), these caregivers had lower emotional distress and high coping, some variables related health behaviors were: care only one patient or a female patient and be a CPOT, social support, high educational level and experience as a caregiver in past. The half of caregivers were worrying to develop cancer in the future; this idea was 2.5 times more frequent in caregiver with problems to care their health. Conclusions: The results showed a big proportion of caregivers with medical problems. High emotional distress and low coping were related to physical symptoms, risk behaviors, and low self-care; poor self-care was frequently even in caregiver who have chronic illness.Keywords: cancer, primary caregiver, risk behaviors, self-care
Procedia PDF Downloads 4093450 Protective Role of Phycobiliproteins in ROS-Associated Physiological Anomalies
Authors: Ravi Raghav Sonani, Niraj Kumar Singh, Jitendra Kumar, Datta Madamwar
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Phycobiliproteins (PBPs) are light harvesting proteins showing very strong absorbance and fluorescence in the visible range of the solar spectrum. Phycoerythrin (PE) and phycocyanin (PC) are majorly found PBPs in the cyanobacteria and red algae. In the present study, we have investigated the reactive oxygen species (ROS)-averting capacity of purified PE and PC of cyanobacterial origin. Furthermore, the possibility - whether the ROS-averting potential of PBPs can be explored in the therapeutics of oxidative stress associated physiological anomalies including aging and neurodegenerative diseases. The nematode Caenorhabditis elegans has been used as model organism in this study. PE and PC treatment moderated normal aging and associated physiological functionalities like pharyngeal pumping and locomotion of C. elegans. Moreover, PE-treatment enhanced the stress (oxidative and heat) tolerance upon PE and PC treatment. Specifically, PE treatment was also noted to moderate the progression of Alzheimer’s disease in transgenic C. elegans CL4176. However, PC-treatment curtailed the polyQ aggregation mediated proteotoxicity in C. elegans AM141 (Huntington disease model) under stressed (paraquat stress) as well as normal conditions. The effectiveness of PE and PC in expanding the lifespan of mutant C. elegans knockout for some up- (daf 16) and down- (daf-2 and age-1) stream regulators of insulin/IGF-1 signalling (IIS) shows the independency of their effects from DAF-2–AGE-1–DAF-16 signalling pathway. In conclusion, the present report demonstrates the anti-aging and neuro-protective potential of cyanobacterial PE and PC.Keywords: phycobiliproteins, aging, alzheimer, huntington, C. elegans
Procedia PDF Downloads 3973449 Role of Tele-health in Expansion of Medical Care
Authors: Garima Singh, Kunal Malhotra
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Objective: The expansion of telehealth has been instrumental in increasing access to medical services, especially for underserved and rural communities. In 2020, 14 million patients received virtual care through telemedicine and the global telemedicine market is expected to reach up to $185 million by 2023. It provides a platform and allows a patient to receive primary care as well as specialized care using technology and the comfort of their homes. Telemedicine was particularly useful during COVID-pandemic and the number of telehealth visits increased by 5000% during that time. It continues to serve as a significant resource for patients seeking care and to bridge the gap between the disease and the treatment. Method: As per APA (American Psychiatric Association), Telemedicine is the process of providing health care from a distance through technology. It is a subset of telemedicine, and can involve providing a range of services, including evaluations, therapy, patient education and medication management. It can involve direct interaction between a physician and the patient. It also encompasses supporting primary care providers with specialist consultation and expertise. It can also involve recording medical information (images, videos, etc.) and sending this to a distant site for later review. Results: In our organization, we are using telepsychiatry and serving 25 counties and approximately 1.4 million people. We provide multiple services, including inpatient, outpatient, crisis intervention, Rehab facility, autism services, case management, community treatment and multiple other modalities. With project ECHO (Extension for Community Healthcare Outcomes) it has been used to advise and assist primary care providers in treating mental health. It empowers primary care providers to treat patients in their own community by sharing knowledge. Conclusion: Telemedicine has shown to be a great medium in meeting patients’ needs and accessible mental health. It has been shown to improve access to care in both urban and rural settings by bringing care to a patient and reducing barriers like transportation, financial stress and resources. Telemedicine is also helping with reducing ER visits, integrating primary care and improving the continuity of care and follow-up. There has been substantial evidence and research about its effectiveness and its usage.Keywords: telehealth, telemedicine, access to care, medical technology
Procedia PDF Downloads 1073448 Simulation-based Decision Making on Intra-hospital Patient Referral in a Collaborative Medical Alliance
Authors: Yuguang Gao, Mingtao Deng
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The integration of independently operating hospitals into a unified healthcare service system has become a strategic imperative in the pursuit of hospitals’ high-quality development. Central to the concept of group governance over such transformation, exemplified by a collaborative medical alliance, is the delineation of shared value, vision, and goals. Given the inherent disparity in capabilities among hospitals within the alliance, particularly in the treatment of different diseases characterized by Disease Related Groups (DRG) in terms of effectiveness, efficiency and resource utilization, this study aims to address the centralized decision-making of intra-hospital patient referral within the medical alliance to enhance the overall production and quality of service provided. We first introduce the notion of production utility, where a higher production utility for a hospital implies better performance in treating patients diagnosed with that specific DRG group of diseases. Then, a Discrete-Event Simulation (DES) framework is established for patient referral among hospitals, where patient flow modeling incorporates a queueing system with fixed capacities for each hospital. The simulation study begins with a two-member alliance. The pivotal strategy examined is a "whether-to-refer" decision triggered when the bed usage rate surpasses a predefined threshold for either hospital. Then, the decision encompasses referring patients to the other hospital based on DRG groups’ production utility differentials as well as bed availability. The objective is to maximize the total production utility of the alliance while minimizing patients’ average length of stay and turnover rate. Thus the parameter under scrutiny is the bed usage rate threshold, influencing the efficacy of the referral strategy. Extending the study to a three-member alliance, which could readily be generalized to multi-member alliances, we maintain the core setup while introducing an additional “which-to-refer" decision that involves referring patients with specific DRG groups to the member hospital according to their respective production utility rankings. The overarching goal remains consistent, for which the bed usage rate threshold is once again a focal point for analysis. For the two-member alliance scenario, our simulation results indicate that the optimal bed usage rate threshold hinges on the discrepancy in the number of beds between member hospitals, the distribution of DRG groups among incoming patients, and variations in production utilities across hospitals. Transitioning to the three-member alliance, we observe similar dependencies on these parameters. Additionally, it becomes evident that an imbalanced distribution of DRG diagnoses and further disparity in production utilities among member hospitals may lead to an increase in the turnover rate. In general, it was found that the intra-hospital referral mechanism enhances the overall production utility of the medical alliance compared to individual hospitals without partnership. Patients’ average length of stay is also reduced, showcasing the positive impact of the collaborative approach. However, the turnover rate exhibits variability based on parameter setups, particularly when patients are redirected within the alliance. In conclusion, the re-structuring of diagnostic disease groups within the medical alliance proves instrumental in improving overall healthcare service outcomes, providing a compelling rationale for the government's promotion of patient referrals within collaborative medical alliances.Keywords: collaborative medical alliance, disease related group, patient referral, simulation
Procedia PDF Downloads 613447 Pilot Scale Sub-Surface Constructed Wetland: Evaluation of Performance of Bed Vegetated with Water Hyacinth in the Treatment of Domestic Sewage
Authors: Abdul-Hakeem Olatunji Abiola, A. E. Adeniran, A. O. Ajimo, A. B. Lamilisa
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Introduction: Conventional wastewater treatment technology has been found to fail in developing countries because they are expensive to construct, operate and maintain. Constructed wetlands are nowadays considered as a low-cost alternative for effective wastewater treatment, especially where suitable land can be available. This study aims to evaluate the performance of the constructed wetland vegetated with water hyacinth (Eichhornia crassipes) plant for the treatment of wastewater. Methodology: The sub-surface flow wetland used for this study was an experimental scale constructed wetland consisting of four beds A, B, C, and D. Beds A, B, and D were vegetated while bed C which was used as a control was non-vegetated. This present study presents the results from bed B vegetated with water hyacinth (Eichhornia crassipes) and control bed C which was non-vegetated. The influent of the experimental scale wetland has been pre-treated with sedimentation, screening and anaerobic chamber before feeding into the experimental scale wetland. Results: pH and conductivity level were more reduced, colour of effluent was more improved, nitrate, iron, phosphate, and chromium were more removed, and dissolved oxygen was more improved in the water hyacinth bed than the control bed. While manganese, nickel, cyanuric acid, and copper were more removed from the control bed than the water hyacinth bed. Conclusion: The performance of the experimental scale constructed wetland bed planted with water hyacinth (Eichhornia crassipes) is better than that of the control bed. It is therefore recommended that plain bed without any plant should not be encouraged.Keywords: constructed experimental scale wetland, domestic sewage, treatment, water hyacinth
Procedia PDF Downloads 1383446 Linguistic Insights Improve Semantic Technology in Medical Research and Patient Self-Management Contexts
Authors: William Michael Short
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Semantic Web’ technologies such as the Unified Medical Language System Metathesaurus, SNOMED-CT, and MeSH have been touted as transformational for the way users access online medical and health information, enabling both the automated analysis of natural-language data and the integration of heterogeneous healthrelated resources distributed across the Internet through the use of standardized terminologies that capture concepts and relationships between concepts that are expressed differently across datasets. However, the approaches that have so far characterized ‘semantic bioinformatics’ have not yet fulfilled the promise of the Semantic Web for medical and health information retrieval applications. This paper argues within the perspective of cognitive linguistics and cognitive anthropology that four features of human meaning-making must be taken into account before the potential of semantic technologies can be realized for this domain. First, many semantic technologies operate exclusively at the level of the word. However, texts convey meanings in ways beyond lexical semantics. For example, transitivity patterns (distributions of active or passive voice) and modality patterns (configurations of modal constituents like may, might, could, would, should) convey experiential and epistemic meanings that are not captured by single words. Language users also naturally associate stretches of text with discrete meanings, so that whole sentences can be ascribed senses similar to the senses of words (so-called ‘discourse topics’). Second, natural language processing systems tend to operate according to the principle of ‘one token, one tag’. For instance, occurrences of the word sound must be disambiguated for part of speech: in context, is sound a noun or a verb or an adjective? In syntactic analysis, deterministic annotation methods may be acceptable. But because natural language utterances are typically characterized by polyvalency and ambiguities of all kinds (including intentional ambiguities), such methods leave the meanings of texts highly impoverished. Third, ontologies tend to be disconnected from everyday language use and so struggle in cases where single concepts are captured through complex lexicalizations that involve profile shifts or other embodied representations. More problematically, concept graphs tend to capture ‘expert’ technical models rather than ‘folk’ models of knowledge and so may not match users’ common-sense intuitions about the organization of concepts in prototypical structures rather than Aristotelian categories. Fourth, and finally, most ontologies do not recognize the pervasively figurative character of human language. However, since the time of Galen the widespread use of metaphor in the linguistic usage of both medical professionals and lay persons has been recognized. In particular, metaphor is a well-documented linguistic tool for communicating experiences of pain. Because semantic medical knowledge-bases are designed to help capture variations within technical vocabularies – rather than the kinds of conventionalized figurative semantics that practitioners as well as patients actually utilize in clinical description and diagnosis – they fail to capture this dimension of linguistic usage. The failure of semantic technologies in these respects degrades the efficiency and efficacy not only of medical research, where information retrieval inefficiencies can lead to direct financial costs to organizations, but also of care provision, especially in contexts of patients’ self-management of complex medical conditions.Keywords: ambiguity, bioinformatics, language, meaning, metaphor, ontology, semantic web, semantics
Procedia PDF Downloads 1363445 Laboratory Scale Experimental Studies on CO₂ Based Underground Coal Gasification in Context of Clean Coal Technology
Authors: Geeta Kumari, Prabu Vairakannu
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Coal is the largest fossil fuel. In India, around 37 % of coal resources found at a depth of more than 300 meters. In India, more than 70% of electricity production depends on coal. Coal on combustion produces greenhouse and pollutant gases such as CO₂, SOₓ, NOₓ, and H₂S etc. Underground coal gasification (UCG) technology is an efficient and an economic in-situ clean coal technology, which converts these unmineable coals into valuable calorific gases. The UCG syngas (mainly H₂, CO, CH₄ and some lighter hydrocarbons) which can utilized for the production of electricity and manufacturing of various useful chemical feedstock. It is an inherent clean coal technology as it avoids ash disposal, mining, transportation and storage problems. Gasification of underground coal using steam as a gasifying medium is not an easy process because sending superheated steam to deep underground coal leads to major transportation difficulties and cost effective. Therefore, for reducing this problem, we have used CO₂ as a gasifying medium, which is a major greenhouse gas. This paper focus laboratory scale underground coal gasification experiment on a coal block by using CO₂ as a gasifying medium. In the present experiment, first, we inject oxygen for combustion for 1 hour and when the temperature of the zones reached to more than 1000 ºC, and then we started supplying of CO₂ as a gasifying medium. The gasification experiment was performed at an atmospheric pressure of CO₂, and it was found that the amount of CO produced due to Boudouard reaction (C+CO₂ 2CO) is around 35%. The experiment conducted to almost 5 hours. The maximum gas composition observed, 35% CO, 22 % H₂, and 11% CH4 with LHV 248.1 kJ/mol at CO₂/O₂ ratio 0.4 by volume.Keywords: underground coal gasification, clean coal technology, calorific value, syngas
Procedia PDF Downloads 2333444 Silver Nanoparticles Loaded Cellulose Nanofibers (Cnf)/mesoporous Bioactive Glass Hydrogels For Periodontitis Treatment
Authors: Anika Pallapothu
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Periodontitis, a severe gum disease, poses a significant threat to the integrity of bone and soft tissues supporting teeth, primarily initiated by bacterial accumulation around the gum line. Conventional treatments like scaling/root planning and plaque removal are widely employed, but integrating modern technologies such as nanotechnology holds promise for innovative therapeutic approaches. This study explores the utilization of silver nanoparticles encapsulated within cellulose nanofiber (CNF) and mesoporous bioactive glass hydrogel matrices for periodontitis management. Silver nanoparticles exhibit potent antimicrobial properties by disrupting microbial cell membranes, inducing reactive oxygen species (ROS) generation, and interfering with vital cellular processes like ATP production and nucleic acid synthesis. Mesoporous bioactive glass, renowned for its high surface area, osteoconductive, and bioactivity, presents a favorable platform for pharmaceutical applications. Incorporating CNF enhances the properties of the hydrogel due to its biocompatibility, biodegradability, and water absorption capacity. The proposed composite material is anticipated to exert beneficial effects in periodontitis treatment by demonstrating antibacterial and anti-inflammatory activities, offering a promising avenue for future therapeutic interventions.Keywords: periodontitis, cellulose nanofibers, silver nanoparticles, mesoporous bioactive glass, antibacterial activity, anti-inflammatory activity
Procedia PDF Downloads 583443 Assessment of Escherichia coli along Nakibiso Stream in Mbale Municipality, Uganda
Authors: Abdul Walusansa
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The aim of this study was to assess the level of microbial pollution along Nakibiso stream. The study was carried out in polluted waters of Nakibiso stream, originating from Mbale municipality and running through ADRA Estates to Namatala Wetlands in Eastern Uganda. Four sites along the stream were selected basing on the activities of their vicinity. A total of 120 samples were collected in sterile bottles from the four sampling locations of the stream during the wet and dry seasons of the year 2011. The samples were taken to the National water and Sewerage Cooperation Laboratory for Analysis. Membrane filter technique was used to test for Erischerichia coli. Nitrogen, Phosphorus, pH, dissolved oxygen, electrical conductivity, total suspended solids, turbidity and temperature were also measured. Results for Nitrogen and Phosphorus for sites; 1, 2, 3 and 4 were 1.8, 8.8, 7.7 and 13.8 NH4-N mg/L; and 1.8, 2.1, 1.8 and 2.3 PO4-P mg/L respectively. Basing on these results, it was estimated that farmers use 115 and 24 Kg/acre of Nitrogen and Phosphorus respectively per month. Taking results for Nitrogen, the same amount of Nutrients in artificial fertilizers would cost $ 88. This shows that reuse of wastewater has a potential in terms of nutrients. The results for E. coli for sites 1, 2, 3 and 4 were 1.1 X 107, 9.1 X 105, 7.4 X 105, and 3.4 X 105 respectively. E. coli hence decreased downstream with statistically significant variations between sites 1 and 4. Site 1 had the highest mean E.coli counts. The bacterial contamination was significantly higher during the dry season when more water was needed for irrigation. Although the water had the potential for reuse in farming, bacterial contamination during both seasons was higher than 103 FC/100ml recommended by WHO for unrestricted Agriculture.Keywords: E. coli, nitrogen, phosphorus, water reuse, waste water
Procedia PDF Downloads 2513442 Co-Immobilization of Palladium Nanoparticles and Polyoxometalate into the Cavities of the Mesocellular Foams: A Biomimetic Cooperative Catalytic System for Aerobic Oxidation of Alcohols under Green Conditions
Authors: Saeed Chehri, Sirvan Moradi, Amin Rostami
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Cooperative catalyst systems have been developed as highly promising sustainable alternatives to traditional catalysts. In these catalysts, two or more catalytic centers cooperate to reduce the energy of chemical transformations. In nature, such systems are abundantly seen in metalloenzymes that use metal and an organic cofactor. We have designed a reusable cooperative catalyst oxidation system consisting of palladium nanoparticles and polyoxometalate. This biomimetic cooperative catalytic system was synthesized by the stepwise immobilization of palladium nanoparticlesandpolyoxometalateinto the same cavity of siliceous mesocellularfoams (Pd-POM@MCF)and wascharacterizedby SEM, EDX, FT-IR, TGAand ICP techniques. POM-Pd@MCF/HQexhibits high activity toward aerobic oxidation of alcohols to the corresponding carbonyl compoundsin water solvent at room temperature. The major novelties and advantages of this oxidation method are as follows: (i) this is the first report of the co-immobilization of polyoxometalateand palladium for use as a robust and highlyefficient heterogeneouscooperative oxidative nanocatalyst system for aerobic oxidation of alcohols, (ii) oxidation of alcoholswere performed using an ideal oxidant with good to high yields in a green solvent at ambient temperature and (iii) the immobilization of the oxygen-activating catalyst(polyoxometalate) and oxidizing catalyst (Pd) onto MCF provide practical cooperative catalyst the system that can be reused several times without a significant loss of activity (vi) the methodsconform to several of the guiding principles of green chemistry.Keywords: palladium nanoparticles, polyoxometalate, reusable cooperative catalytic system, biomimetic oxidation reaction
Procedia PDF Downloads 1223441 Thermochemical Study of the Degradation of the Panels of Wings in a Space Shuttle by Utilization of HSC Chemistry Software and Its Database
Authors: Ahmed Ait Hou
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The wing leading edge and nose cone of the space shuttle are fabricated from a reinforced carbon/carbon material. This material attains its durability from a diffusion coating of silicon carbide (SiC) and a glass sealant. During re-entry into the atmosphere, this material is subject to an oxidizing high-temperature environment. The use of thermochemical calculations resulting at the HSC CHEMISTRY software and its database allows us to interpret the phenomena of oxidation and chloridation observed on the wing leading edge and nose cone of the space shuttle during its mission in space. First study is the monitoring of the oxidation reaction of SiC. It has been demonstrated that thermal oxidation of the SiC gives the two compounds SiO₂(s) and CO(g). In the extreme conditions of very low oxygen partial pressures and high temperatures, there is a reaction between SiC and SiO₂, leading to SiO(g) and CO(g). We had represented the phase stability diagram of Si-C-O system calculated by the use of the HSC Chemistry at 1300°C. The principal characteristic of this diagram of predominance is the line of SiC + SiO₂ coexistence. Second study is the monitoring of the chloridation reaction of SiC. The other problem encountered in addition to oxidation is the phenomenon of chloridation due to the presence of NaCl. Indeed, after many missions, the leading edge wing surfaces have exhibited small pinholes. We have used the HSC Chemistry database to analyze these various reactions. Our calculations concorde with the phenomena we announced in research work resulting in NASA LEWIS Research center.Keywords: thermochchemicals calculations, HSC software, oxidation and chloridation, wings in space
Procedia PDF Downloads 1283440 Using Medicinal Herbs in Designing Green Roofs
Authors: Mohamad Javad Shakouri, Behshad Riahipour
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Today, the use of medicinal herbs in architecture and green space has a significant effect on the process of calming human and increases the reliability coefficient of design and design flexibility. The current research was conducted with the aim to design green roof and investigate the effect of medicinal herbs such as cress, leek, fenugreek, beet, sweet fennel, green basil, purple basil, and purslane on reducing the number of environmental pollutants (copper, zinc, and cadmium). Finally, the weight of the dry plant and the concentration of elements zinc, lead, and cadmium in the herbs was measured. According to the results, the maximum dry weight (88.10 and 73.79 g) was obtained in beet and purslane respectively and the minimum dry weight (24.12 and 25.21) was obtained in purple basil, and green basil respectively. The maximum amount of element zinc (235 and 213 mg/kg) and the maximum amount of lead (143 mg/kg) were seen in sweet fennel and purple basil. In addition, the maximum amount of cadmium (13 mg/kg) was seen in sweet fennel and purple basil and the minimum amount of lead and cadmium (78 and 7 mg/kg) was seen in green basil, and the minimum amount of zinc (110 mg/kg) was seen in leek. On the other hand, the absorption amount of element lead in the herbs beet and purslane was the same and both absorbed 123 mg/kg lead. Environmentally, if green roofs are implemented extensively and in wide dimensions in urban spaces, they will purify and reduce pollution significantly by absorbing carbon dioxide and producing oxygen.Keywords: medicinal herbs, green space, green roof, heavy metals, lead, green basil
Procedia PDF Downloads 1673439 Hyperthyroidism in a Private Medical Services Center, Addis Ababa: A 5-Year Experience
Authors: Ersumo Tessema, Bogale Girmaye Tamrat, Mohammed Burka
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Background: Hyperthyroidism is a common thyroid disorder especially in women and characterized by increased thyroid hormone synthesis and secretion. The disorder manifests predominantly as Graves’ disease in iodine-sufficient areas and has increasing prevalence in iodine-deficient countries in patients with nodular thyroid disease and following iodine fortification. In Ethiopia, the magnitude of the disorder is unknown and, in Africa, due to scarcity of resources, its management remains suboptimal. Objective: The aim of this study was to analyze the pattern and management of patients with hyperthyroidism at the United Vision Medical Services Center, Addis Ababa between August 30, 2013, and February 1, 2018. Patients and methods: The study was a retrospective analysis of medical records of all patients with hyperthyroidism at the United Vision Private Medical Services Center, Addis Ababa. A questionnaire was filled out; the collected data entered into a computer and statistically analyzed using the SPSS package. The results were tabulated and discussed with literature review. Results: A total of 589 patients were included in this study. The median age was 40 years, and the male to female ratio was 1.0:7.9. Most patients (93%) presented with goiter and the associated features of toxic goiter except weight loss, sweating and tachycardia were uncommon. Majority of patients presented more than two years after the onset of their presenting symptoms. The most common physical finding (91%), as well as diagnosis, was toxic nodular goiter. The most frequent (83%) derangement in the thyroid function tests was a low thyroid-stimulating hormone, and the most commonly (94%) used antithyroid drug was a propylthiouracil. The most common (96%) surgical procedure in 213 patients was a near-total thyroidectomy with a postoperative course without incident in 92% of all the patients. Conclusion: The incidence and prevalence of hyperthyroidism are apparently on the increase in Addis Ababa, which may be related to the existing severe iodine-deficiency and or the salt iodation program (iodine-induced hyperthyroidism). Hyperthyroidism predominantly affects women and, in surgical services, toxic nodular goiter is more common than diffuse goiter, and the treatment of choice in experienced hands is a near-total thyroidectomy.Keywords: Ethiopia, grave’s disease, hyperthyroidism, toxic nodular goiter
Procedia PDF Downloads 1813438 Physical and Chemical Parameters of Lower Ogun River, Ogun State, Nigeria
Authors: F.I. Adeosun, A.A. Idowu, D.O. Odulate,
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The aims of carrying out this experiment were to determine the water quality and to investigate if the various human and ecological activities around the river have any effect on the physico-chemical parameters of the river’s resources with a view to effectively utilizing these resources. Water samples were collected from two stations on the surface water of Lower Ogun River Akomoje biweekly for a period of 5 months (January to May, 2011). Results showed that temperature ranged between 24.0-30.7oC, transparency (0.53-1.00 m), depth (1.0-3.88 m), alkalinity (4.5-14.5 mg/l), nitrates (0.235-5.445 mg/l), electrical conductivity (140-190µS/cm), dissolved oxygen (4.12-5.32 mg/l), phosphates (0.02 mg/l-0.7 5 mg/l) and total dissolved solids (70-95).The parameters at the deep end (station A) accounted for the bulk of the highest values; there was however no significant differences between the stations at P˂0.05 with the exception of transparency, depth, total dissolved solids and electrical conductivity. The phosphate value was relatively low which accounted for the low productivity and high transparency. The results obtained from the physico-chemical parameters agreed with the limits set by both national and international bodies for drinking and fish growth. It was however observed that during the period of data collection, catch was low and this could be attributed to low level of primary productivity due to the quality of physico-chemical parameters of the water. It is recommended that the agencies involved in the management of the river should put the right policies in place that will effectively enhance proper exploitation of the water resources. More research should also be carried out on the physico-chemical parameters since this work only studied the water for five months.Keywords: physical, chemical, parameters, water quality, Ogunriver
Procedia PDF Downloads 6843437 Surface Water Pollution by Open Refuse Dumpsite in North Central of Nigeria
Authors: Abimbola Motunrayo Folami, Ibironke Titilayo Enitan, Feroz Mohomed Swalaha
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Water is a vital resource that is important in ensuring the growth and development of any country. To sustain the basic human needs and the demands for agriculture, industry, conservational and ecosystem, enough quality and quantity water is needed. Contamination of water resources is now a global and public health concern. Hence, this study assessed the water quality of Ndawuse River by measuring the physicochemical parameters and heavy metals concentrations of the river using standard methods. In total, 16 surface water samples were obtained from five locations along the river, from upstream to downstream as well as samples from the dumpsite. The results obtained were compared with the standard limits set by both the World Health Organization and the Federal Environmental Protection Agency for domestic purposes. The results of the measured parameters indicated that biological oxygen demand (85.88 mg/L), turbidity (44.51 NTU), Iron (0.014 - 3.511 mg /L) and chromium (0.078 - 0.14 mg /L) were all above the standard limits. The results further showed that the quality of surface water is being significantly affected by human activities around the Ndawuse River which could pose an adverse health risk to several communities that rely on this river as their primary source of water. Therefore, there is a need for strict enforcement of environmental laws to protect the aquatic ecosystem and to avoid long term cumulative exposure risk that heavy metals may pose on human health.Keywords: Abuja, contaminants, heavy metals, Ndawuse River, Nigeria, surface water
Procedia PDF Downloads 1623436 Smartphone Based Wound Assessment System for Diabetes Patients
Authors: Vaibhav V. Dixit, Shubham Ajay Karwa
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Diabetic foot ulcers speak to a critical medical problem. Right now, clinicians and medical caretakers primarily construct their injury evaluation in light of visual examination of wound size and mending status, while the patients themselves rarely have a chance to play a dynamic part. Henceforth, love quantitative and practical examination technique that empowers the patients and their parental figures to take a more dynamic part in every day wound care possibly can quicken wound recuperating, spare travel cost and diminish human services costs. Considering the commonness of cell phones with a high-determination computerized camera, evaluating wounds by breaking down pictures of ceaseless foot ulcers is an alluring choice. In this paper, we propose a novel injury picture examination framework actualized using feature extraction and color segmentation. Here we are using the Normalized minimum distance classifier for classifying the output.Keywords: diabetic, Gabor wavelet, normalized minimum distance classifier, quantiable parameters
Procedia PDF Downloads 2723435 Illness-Related PTSD Among Type 1 Diabetes Patients
Authors: Omer Zvi Shaked, Amir Tirosh
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Type 1 Diabetes (T1DM) is an incurable chronic illness with no known preventive measures. Excess to insulin therapy can lead to hypoglycemia with neuro-glycogenic symptoms such as shakiness, nausea, sweating, irritability, fatigue, excessive thirst or hunger, weakness, seizure, and coma. Severe Hypoglycemia (SH) is also considered a most aversive event since it may put patients at risk for injury and death, which matches the criteria of a traumatic event. SH has a ranging prevalence of 20%, which makes it a primary medical Issue. One of the results of SH is an intense emotional fear reaction resembling the form of post-traumatic stress symptoms (PTS), causing many patients to avoid insulin therapy and social activities in order to avoid the possibility of hypoglycemia. As a result, they are at risk for irreversible health deterioration and medical complications. Fear of Hypoglycemia (FOH) is, therefore, a major disturbance for T1DM patients. FOH differs from prevalent post-traumatic stress reactions to other forms of traumatic events since the threat to life continuously exists in the patient's body. That is, it is highly probable that orthodox interventions may not be sufficient for helping patients after SH to regain healthy social function and proper medical treatment. Accordingly, the current presentation will demonstrate the results of a study conducted among T1DM patients after SH. The study was designed in two stages. First, a preliminary qualitative phenomenological study among ten patients after SH was conducted. Analysis revealed that after SH, patients confuse between stress symptoms and Hypoglycemia symptoms, divide life before and after the event, report a constant sense of fear, a loss of freedom, a significant decrease in social functioning, a catastrophic thinking pattern, a dichotomous split between the self and the body, and internalization of illness identity, a loss of internal locus of control, a damaged self-representation, and severe loneliness for never being understood by others. The second stage was a two steps study of intervention among five patients after SH. The first part of the intervention included three months of therapeutic 3rd wave CBT therapy. The contents of the therapeutic process were: acceptance of fear and tolerance to stress; cognitive de-fusion combined with emotional self-regulation; the adoption of an active position relying on personal values; and self-compassion. Then, the intervention included a one-week practical real-time 24/7 support by trained medical personnel, alongside a gradual exposure to increased insulin therapy in a protected environment. The results of the intervention are a decrease in stress symptoms, increased social functioning, increased well-being, and decreased avoidance of medical treatment. The presentation will discuss the unique emotional state of T1DM patients after SH. Then, the presentation will discuss the effectiveness of the intervention for patients with chronic conditions after a traumatic event. The presentation will make evident the unique situation of illness-related PTSD. The presentation will also demonstrate the requirement for multi-professional collaboration between social work and medical care for populations with chronic medical conditions. Limitations of the study and recommendations for further research will be discussed.Keywords: type 1 diabetes, chronic illness, post-traumatic stress, illness-related PTSD
Procedia PDF Downloads 1803434 Data Analytics of Electronic Medical Records Shows an Age-Related Differences in Diagnosis of Coronary Artery Disease
Authors: Maryam Panahiazar, Andrew M. Bishara, Yorick Chern, Roohallah Alizadehsani, Dexter Hadleye, Ramin E. Beygui
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Early detection plays a crucial role in enhancing the outcome for a patient with coronary artery disease (CAD). We utilized a big data analytics platform on ~23,000 patients with CAD from a total of 960,129 UCSF patients in 8 years. We traced the patients from their first encounter with a physician to diagnose and treat CAD. Characteristics such as demographic information, comorbidities, vital, lab tests, medications, and procedures are included. There are statistically significant gender-based differences in patients younger than 60 years old from the time of the first physician encounter to coronary artery bypass grafting (CABG) with a p-value=0.03. There are no significant differences between the patients between 60 and 80 years old (p-value=0.8) and older than 80 (p-value=0.4) with a 95% confidence interval. This recognition would affect significant changes in the guideline for referral of the patients for diagnostic tests expeditiously to improve the outcome by avoiding the delay in treatment.Keywords: electronic medical records, coronary artery disease, data analytics, young women
Procedia PDF Downloads 1523433 The Effect of Particulate Matter on Cardiomyocyte Apoptosis Through Mitochondrial Fission
Authors: Tsai-chun Lai, Szu-ju Fu, Tzu-lin Lee, Yuh-Lien Chen
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There is much evidence that exposure to fine particulate matter (PM) from air pollution increases the risk of cardiovascular morbidity and mortality. According to previous reports, PM in the air enters the respiratory tract, contacts the alveoli, and enters the blood circulation, leading to the progression of cardiovascular disease. PM pollution may also lead to cardiometabolic disturbances, increasing the risk of cardiovascular disease. The effects of PM on cardiac function and mitochondrial damage are currently unknown. We used mice and rat cardiomyocytes (H9c2) as animal and in vitro cell models, respectively, to simulate an air pollution environment using PM. These results indicate that the apoptosis-related factor PUMA, a regulator of apoptosis upregulated by p53, is increased in mice treated with PM. Apoptosis was aggravated in cardiomyocytes treated with PM, as measured by TUNEL assay and Annexin V/PI. Western blot results showed that CASPASE3 was significantly increased and BCL2 (B-cell lymphoid 2) was significantly decreased under PM treatment. Concurrent exposure to PM increases mitochondrial reactive oxygen species (ROS) production by MitoSOX Red staining. Furthermore, using Mitotracker staining, PM treatment significantly shortened mitochondrial length, indicating mitochondrial fission. The expression of mitochondrial fission-related proteins p-DRP1 (phosphodynamics-related protein 1) and FIS1 (mitochondrial fission 1 protein) was significantly increased. Based on these results, the exposure to PM worsens mitochondrial function and leads to cardiomyocyte apoptosis.Keywords: particulate matter, cardiomyocyte, apoptosis, mitochondria
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