Search results for: procedure established by law
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 5534

Search results for: procedure established by law

5414 Enzyme Linked Immuno Sorbent Assay Based Detection of Aflatoxin M1 and Ochratoxin A in Raw Milk in Punjab, India

Authors: Pallavi Moudgil, J. S. Bedi, R. S. Aulakh, J. P. S. Gill

Abstract:

Mycotoxins in milk are of major public health concern. The present study was envisaged with an aim to monitor the occurrence of aflatoxin M1 and ochratoxin A in raw milk samples collected from individual animals from dairy farms located in Punjab (India). A total of 168 raw milk samples were collected and analysed using competitive ELISA kits. Out of these, 9 (5.4%) samples were found positive for aflatoxin M1 with the mean concentration of 0.006-0.13 ng/ml and 2 (1.2%) samples exceeded the established maximum residue limit of 0.05 ng/ml established by the European Union. For ochratoxin A, 2 (0.1%) samples were found positive with the mean concentration of 0.61-0.83 ng/ml with both the samples below the established maximum residue limit of 2 ng/ml. The results showed that the milk of dairy cattle is safe with respect to ochratoxin A contamination but occurrence of aflatoxin M1 above maximum residue limit suggested that feed contaminated with mycotoxins might have been offered to dairy cattle that can pose serious health risks to consumers.

Keywords: Aflatoxin M1, health risks, maximum residue limit, milk, Ochratoxin A

Procedia PDF Downloads 482
5413 Inverse Heat Transfer Analysis of a Melting Furnace Using Levenberg-Marquardt Method

Authors: Mohamed Hafid, Marcel Lacroix

Abstract:

This study presents a simple inverse heat transfer procedure for predicting the wall erosion and the time-varying thickness of the protective bank that covers the inside surface of the refractory brick wall of a melting furnace. The direct problem is solved by using the Finite-Volume model. The melting/solidification process is modeled using the enthalpy method. The inverse procedure rests on the Levenberg-Marquardt method combined with the Broyden method. The effect of the location of the temperature sensors and of the measurement noise on the inverse predictions is investigated. Recommendations are made concerning the location of the temperature sensor.

Keywords: melting furnace, inverse heat transfer, enthalpy method, levenberg–marquardt method

Procedia PDF Downloads 324
5412 Shifting to Electronic Operative Notes in Plastic surgery

Authors: Samar Mousa, Galini Mavromatidou, Rebecca Shirley

Abstract:

Surgeons carry out numerous operations in the busy burns and plastic surgery department daily. Writing an accurate operation note with all the essential information is crucial for communication not only within the plastics team but also to the multi-disciplinary team looking after the patient, including other specialties, nurses and GPs. The Royal college of surgeons of England, in its guidelines of good surgical practice, mentioned that the surgeon should ensure that there are clear (preferably typed) operative notes for every procedure. The notes should accompany the patient into recovery and to the ward and should give sufficient detail to enable continuity of care by another doctor. The notes should include the Date and time, Elective/emergency procedure, Names of the operating surgeon and assistant, Name of the theatre anesthetist, Operative procedure carried out, Incision, Operative diagnosis, Operative findings, Any problems/complications, Any extra procedure performed and the reason why it was performed, Details of tissue removed, added or altered, Identification of any prosthesis used, including the serial numbers of prostheses and other implanted materials, Details of closure technique, Anticipated blood loss, Antibiotic prophylaxis (where applicable), DVT prophylaxis (where applicable), Detailed postoperative care instructions and Signature. Fourteen random days were chosen in December 2021 to assess the accuracy of operative notes and post-operative care. A total of 163 operative notes were examined. The average completion rates in all domains were 85.4%. An electronic operative note template was designed to cover all domains mentioned in the Royal College of surgeons' good surgical practice. It is kept in the hospital drive for all surgeons to use.

Keywords: operative notes, plastic surgery, documentation, electronic

Procedia PDF Downloads 79
5411 Transverse Testicular Ectopia: A Case Report with Review of Literature

Authors: Rida Ahmad, Areej S. Habib, Sohail A. Dogar, Saqib H. Qazi

Abstract:

Transverse testicular ectopia is a rare congenital disorder involving mal descent and mal-positioning of the testes, reported in the medical literature about 300 times. Many theories attempt to explain the failure of the testes to migrate to their correct location. While the age at presentation can vary; most cases present in early adolescents or late adulthood. It is often an incidental discovery made during an operative intervention, most commonly during hernia exploration. It can be isolated or present with a plethora of anomalies. We present the case of a 2-year-old male with transverse testicular ectopia who presented with vague abdominal pain. He was managed successfully with the Modified Ombredanne procedure and good outcome 6 months after the procedure.

Keywords: cryptorchidism, persistent Mullerian duct syndrome, transverse testicular ectopia, testicular mal-descent

Procedia PDF Downloads 341
5410 Mechanical Behavior of Laminated Glass Cylindrical Shell with Hinged Free Boundary Conditions

Authors: Ebru Dural, M. Zulfu Asık

Abstract:

Laminated glass is a kind of safety glass, which is made by 'sandwiching' two glass sheets and a polyvinyl butyral (PVB) interlayer in between them. When the glass is broken, the interlayer in between the glass sheets can stick them together. Because of this property, the hazards of sharp projectiles during natural and man-made disasters reduces. They can be widely applied in building, architecture, automotive, transport industries. Laminated glass can easily undergo large displacements even under their own weight. In order to explain their true behavior, they should be analyzed by using large deflection theory to represent nonlinear behavior. In this study, a nonlinear mathematical model is developed for the analysis of laminated glass cylindrical shell which is free in radial directions and restrained in axial directions. The results will be verified by using the results of the experiment, carried out on laminated glass cylindrical shells. The behavior of laminated composite cylindrical shell can be represented by five partial differential equations. Four of the five equations are used to represent axial displacements and radial displacements and the fifth one for the transverse deflection of the unit. Governing partial differential equations are derived by employing variational principles and minimum potential energy concept. Finite difference method is employed to solve the coupled differential equations. First, they are converted into a system of matrix equations and then iterative procedure is employed. Iterative procedure is necessary since equations are coupled. Problems occurred in getting convergent sequence generated by the employed procedure are overcome by employing variable underrelaxation factor. The procedure developed to solve the differential equations provides not only less storage but also less calculation time, which is a substantial advantage in computational mechanics problems.

Keywords: laminated glass, mathematical model, nonlinear behavior, PVB

Procedia PDF Downloads 319
5409 How to Modernise the ECN

Authors: Dorota Galeza

Abstract:

This paper argues that networks, such as the ECN and the American network, are affected by certain small events which are inherent to path dependence and preclude the full evolution towards efficiency. It is advocated that the American network is superior to the ECN in many respects due to its greater flexibility and longer history. This stems in particular from the creation of the American network, which was based on a small number of cases. Such structure encourages further changes and modifications which are not necessarily radical. The ECN, by contrast, was established by legislative action, which explains its rigid structure and resistance to change. It might be the case that the ECN is subject not so much to path dependence but to past dependence. It might have to be replaced, as happened to its predecessor. This paper is an attempt to transpose the superiority of the American network on to the ECN. It looks at concepts such as judicial cooperation, harmonization of procedure, peer review and regulatory impact assessments (RIAs), and dispute resolution procedures. The aim is to adopt these concepts into the EU setting without recourse to legal transplantation. The major difficulty is that many of these concepts have been tested only in the US and it is difficult to tell whether they could be modified to meet EU standards. Concepts such as judicial cooperation might be difficult due to different language traditions in EU member states. It is hoped that greater flexibility, as in the American network, would boost legitimacy and transparency.

Keywords: ECN, networks, regulation, competition

Procedia PDF Downloads 428
5408 Comparing Russian and American Students’ Metaphorical Competence

Authors: Svetlana L. Mishlanova, Evgeniia V. Ermakova, Mariia E. Timirkina

Abstract:

The paper is concerned with the study of metaphor production in essays written by Russian and English native speakers in the framework of cognitive metaphor theory. It considers metaphorical competence as individual’s ability to recognize, understand and use metaphors in speech. The work analyzes the influence of visual metaphor on production and density of conventional and novel verbal metaphors. The main methods of research include experiment connected with image interpretation, metaphor identification procedure (MIPVU) and visual conventional metaphors identification procedure proposed by VisMet group. The research findings will be used in the project aimed at comparing metaphorical competence of native and non-native English speakers.

Keywords: metaphor, metaphorical competence, conventional, novel

Procedia PDF Downloads 286
5407 Robotic Mini Gastric Bypass Surgery

Authors: Arun Prasad, Abhishek Tiwari, Rekha Jaiswal, Vivek Chaudhary

Abstract:

Background: Robotic Roux en Y gastric bypass is being done for some time but is technically difficult, requiring operating in both the sub diaphragmatic and infracolic compartments of the abdomen. This can mean a dual docking of the robot or a hybrid partial laparoscopic and partial robotic surgery. The Mini /One anastomosis /omega loop gastric bypass (MGB) has the advantage of having all dissection and anastomosis in the supracolic compartment and is therefore suitable technically for robotic surgery. Methods: We have done 208 robotic mini gastric bypass surgeries. The robot is docked above the head of the patient in the midline. Camera port is placed supra umbilically. Two ports are placed on the left side of the patient and one port on the right side of the patient. An assistant port is placed between the camera port and right sided robotic port for use of stapler. Distal stomach is stapled from the lesser curve followed by a vertical sleeve upwards leading to a long sleeve pouch. Jejunum is taken at 200 cm from the duodenojejunal junction and brought up to do a side to side gastrojejunostomy. Results: All patients had a successful robotic procedure. Mean time taken was 85 minutes. There were major intraoperative or post operative complications. No patient needed conversion or re-explorative surgery. Mean excess weight loss over a period of 2 year was about 75%. There was no mortality. Patient satisfaction score was high and was attributed to the good weight loss and minimal dietary modifications that were needed after the procedure. Long term side effects were anemia and bile reflux in a small number of patients. Conclusions: MGB / OAGB is gaining worldwide interest as a short simple procedure that has been shown to very effective and safe bariatric surgery. The purpose of this study was to report on the safety and efficacy of robotic surgery for this procedure. This is the first report of totally robotic mini gastric bypass.

Keywords: MGB, mini gastric bypass, OAGB, robotic bariatric surgery

Procedia PDF Downloads 297
5406 An Automated Procedure for Estimating the Glomerular Filtration Rate and Determining the Normality or Abnormality of the Kidney Stages Using an Artificial Neural Network

Authors: Hossain A., Chowdhury S. I.

Abstract:

Introduction: The use of a gamma camera is a standard procedure in nuclear medicine facilities or hospitals to diagnose chronic kidney disease (CKD), but the gamma camera does not precisely stage the disease. The authors sought to determine whether they could use an artificial neural network to determine whether CKD was in normal or abnormal stages based on GFR values (ANN). Method: The 250 kidney patients (Training 188, Testing 62) who underwent an ultrasonography test to diagnose a renal test in our nuclear medical center were scanned using a gamma camera. Before the scanning procedure, the patients received an injection of ⁹⁹ᵐTc-DTPA. The gamma camera computes the pre- and post-syringe radioactive counts after the injection has been pushed into the patient's vein. The artificial neural network uses the softmax function with cross-entropy loss to determine whether CKD is normal or abnormal based on the GFR value in the output layer. Results: The proposed ANN model had a 99.20 % accuracy according to K-fold cross-validation. The sensitivity and specificity were 99.10 and 99.20 %, respectively. AUC was 0.994. Conclusion: The proposed model can distinguish between normal and abnormal stages of CKD by using an artificial neural network. The gamma camera could be upgraded to diagnose normal or abnormal stages of CKD with an appropriate GFR value following the clinical application of the proposed model.

Keywords: artificial neural network, glomerular filtration rate, stages of the kidney, gamma camera

Procedia PDF Downloads 103
5405 Topology Optimization of Composite Structures with Material Nonlinearity

Authors: Mengxiao Li, Johnson Zhang

Abstract:

Currently, topology optimization technique is widely used to define the layout design of structures that are presented as truss-like topologies. However, due to the difficulty in combining optimization technique with more realistic material models where their nonlinear properties should be considered, the achieved optimized topologies are commonly unable to apply straight towards the practical design problems. This study presented an optimization procedure of composite structures where different elastic stiffness, yield criteria, and hardening models are assumed for the candidate materials. From the results, it can be concluded that a more explicit modeling has the significant influence on the resulting topologies. Also, the isotropic or kinematic hardening is important for elastoplastic structural optimization design. The capability of the proposed optimization procedure is shown through several cases.

Keywords: topology optimization, material composition, nonlinear modeling, hardening rules

Procedia PDF Downloads 482
5404 Development of In Situ Permeability Test Using Constant Discharge Method for Sandy Soils

Authors: A. Rifa’i, Y. Takeshita, M. Komatsu

Abstract:

The post-rain puddles problem that occurs in the first yard of Prambanan Temple are often disturbing visitor activity. A poodle layer and a drainage system has ever built to avoid such a problem, but puddles still didn’t stop appearing after rain. Permeability parameter needs to be determined by using more simple procedure to find exact method of solution. The instrument modelling were proposed according to the development of field permeability testing instrument. This experiment used proposed Constant Discharge method. Constant Discharge method used a tube poured with constant water flow. The procedure were carried out from unsaturated until saturated soil condition. Volumetric water content (θ) were being monitored by soil moisture measurement device. The results were relationship between k and θ which drawn by numerical approach Van Genutchen model. Parameters θr optimum value obtained from the test was at very dry soil. Coefficient of permeability with a density of 19.8 kN/m3 for unsaturated conditions was in range of 3 x 10-6 cm/sec (Sr= 68 %) until 9.98 x 10-4 cm/sec (Sr= 82 %). The equipment and testing procedure developed in this research was quite effective, simple and easy to be implemented on determining field soil permeability coefficient value of sandy soil. Using constant discharge method in proposed permeability test, value of permeability coefficient under unsaturated condition can be obtained without establish soil water characteristic curve.

Keywords: constant discharge method, in situ permeability test, sandy soil, unsaturated conditions

Procedia PDF Downloads 384
5403 Service Evaluation of Consent for Hand and Wrist Surgery and Formulation of Evidence-Based Guidelines

Authors: Parsa Keyvani, Alistair Phillips, David Warwick

Abstract:

Background: The current process for gaining patient consent for hand and wrist surgery at University Hospital Southampton (UHS) is paper-based and makes use of generic forms provided by the NHS and no patient information leaflet is available relating to hand and wrist surgery. Aims: To evaluate the process of obtaining clinical consent and suggest ways in which the service can be improved. Methods: A log-book review of four orthopaedic surgeons at UHS was carried out over a three-month period in order to identify the 10 most common types of elective hand and wrist surgeries performed. A literature review was carried out to identify the complications of these surgeries. The surgeries were then divided into 6 types: nerve, bone, ligament, joint, tendon and dupuytren’s surgery. A digitised consent form was created covering the complications of all 6 surgery types. Finally, the surgeons at the orthopaedic department of UHS were asked whether they prefer the old paper-based or the digitised consent form. Results: All of the surgeons felt that the procedure type-based form was easier to read, use and understand. Conclusion: This research highlights a number of problems related to the use of current NHS consent forms. The proposed solution is to use a set of digitised, procedure type-based consent forms. Digital consent forms can be filled in in advance and sent to the patient electronically along with any relevant information leaflets, thus giving them time to absorb the information and come up with any questions before they have their pre-procedure discussion with their doctor. This would allow the doctor to focus the consultation on the patient rather than writing out the consent form and would ultimately be a step forward in making the NHS a global digital leader and fully embrace the opportunity offered by technology.

Keywords: digitised consent form, elective surgery, hand surgery complications, informed consent, procedure type-based consent form

Procedia PDF Downloads 86
5402 Design and Implementation of a Wearable Artificial Kidney Prototype for Home Dialysis

Authors: R. A. Qawasma, F. M. Haddad, H. O. Salhab

Abstract:

Hemodialysis is a life-preserving treatment for a number of patients with kidney failure. The standard procedure of hemodialysis is three times a week during the hemodialysis procedure, the patient usually suffering from many inconvenient, exhausting feeling and effect on the heart and cardiovascular system are the most common signs. This paper provides a solution to reduce the previous problems by designing a wearable artificial kidney (WAK) taking in consideration a minimization the size of the dialysis machine. The WAK system consists of two circuits: blood circuit and dialysate circuit. The blood from the patient is filtered in the dialyzer before returning back to the patient. Several parameters using an advanced microcontroller and array of sensors. WAK equipped with visible and audible alarm system to aware the patients if there is any problem.

Keywords: artificial kidney, home dialysis, renal failure, wearable kidney

Procedia PDF Downloads 235
5401 Controlled Deconstruction and Rehabilitation of Fire Damaged Structure

Authors: Javed Y. Uppal

Abstract:

In this paper, a case study of a 13 storied multi storied main headquarters building of the Lahore Development Authority Lahore Pakistan has been presented, the 9th floor of which caught fire due to short circuiting and the flare spread through air-conditioning ducts to top three floors, and the building remained under fire for 15 hours before it was quenched. Some columns at the upper 3 floors started crumbling down, which were immediately propped. A visual inspection of site was first carried out, followed by onsite material tests and lab tests for residual strengths, which led to the decision of removal of the top 3 floors in a planned sequence of diamond cutting of middle strips, column strips, and shear walls, in panels and their lifting up by overhead cranes. The waffle slabs were stitched and jacketed with low viscosity polymer layer. The damaged bars were supplemented. The cracked columns were jacketed as well. The validity of rehabilitation procedure was established by load deflection behavior tests and long term performance observation over a period of 5 years. The paper concludes that the procedures adopted could be recommended for such events.

Keywords: fire damage, shotcrete, waffle slabs, delamination, drying cracking, jacketing

Procedia PDF Downloads 112
5400 Minimization Entropic Applied to Rotary Dryers to Reduce the Energy Consumption

Authors: I. O. Nascimento, J. T. Manzi

Abstract:

The drying process is an important operation in the chemical industry and it is widely used in the food, grain industry and fertilizer industry. However, for demanding a considerable consumption of energy, such a process requires a deep energetic analysis in order to reduce operating costs. This paper deals with thermodynamic optimization applied to rotary dryers based on the entropy production minimization, aiming at to reduce the energy consumption. To do this, the mass, energy and entropy balance was used for developing a relationship that represents the rate of entropy production. The use of the Second Law of Thermodynamics is essential because it takes into account constraints of nature. Since the entropy production rate is minimized, optimals conditions of operations can be established and the process can obtain a substantial gain in energy saving. The minimization strategy had been led using classical methods such as Lagrange multipliers and implemented in the MATLAB platform. As expected, the preliminary results reveal a significant energy saving by the application of the optimal parameters found by the procedure of the entropy minimization It is important to say that this method has shown easy implementation and low cost.

Keywords: thermodynamic optimization, drying, entropy minimization, modeling dryers

Procedia PDF Downloads 258
5399 Tunable Crystallinity of Zinc Gallogermanate Nanoparticles via Organic Ligand-Assisted Biphasic Hydrothermal Synthesis

Authors: Sarai Guerrero, Lijia Liu

Abstract:

Zinc gallogermanate (ZGGO) is a persistent phosphor that can emit in the near infrared (NIR) range once dopped with Cr³⁺ enabling its use for in-vivo deep-tissue bio-imaging. Such a property also allows for its application in cancer diagnosis and therapy. Given this, work into developing a synthetic procedure that can be done using common laboratory instruments and equipment as well as understanding ZGGO overall, is in demand. However, the ZGGO nanoparticles must have a size compatible for cell intake to occur while still maintaining sufficient photoluminescence. The nanoparticle must also be made biocompatible by functionalizing the surface for hydrophilic solubility and for high particle uniformity in the final product. Additionally, most research is completed on doped ZGGO, leaving a gap in understanding the base form of ZGGO. It also leaves a gap in understanding how doping affects the synthesis of ZGGO. In this work, the first step of optimizing the particle size via the crystalline size of ZGGO was done with undoped ZGGO using the organic acid, oleic acid (OA) for organic ligand-assisted biphasic hydrothermal synthesis. The effects of this synthesis procedure on ZGGO’s crystallinity were evaluated using Powder X-Ray Diffraction (PXRD). OA was selected as the capping ligand as experiments have shown it beneficial in synthesizing sub-10 nm zinc gallate (ZGO) nanoparticles as well as palladium nanocrystals and magnetite (Fe₃O₄) nanoparticles. Later it is possible to substitute OA with a different ligand allowing for hydrophilic solubility. Attenuated Total Reflection Fourier-Transform Infrared (ATR-FTIR) was used to investigate the surface of the nanoparticle to investigate and verify that OA had capped the nanoparticle. PXRD results showed that using this procedure led to improved crystallinity, comparable to the high-purity reagents used on the ZGGO nanoparticles. There was also a change in the crystalline size of the ZGGO nanoparticles. ATR-FTIR showed that once capped ZGGO cannot be annealed as doing so will affect the OA. These results point to this new procedure positively affecting the crystallinity of ZGGO nanoparticles. There are also repeatable implying the procedure is a reliable source of highly crystalline ZGGO nanoparticles. With this completed, the next step will be working on substituting the OA with a hydrophilic ligand. As these ligands effect the solubility of the nanoparticle as well as the pH that the nanoparticles can dissolve in, further research is needed to verify which ligand is best suited for preparing ZGGO for bio-imaging.

Keywords: biphasic hydrothermal synthesis, crystallinity, oleic acid, zinc gallogermanate

Procedia PDF Downloads 133
5398 Addressing Head Transplantation and Its Legal, Social and Neuroethical Implications

Authors: Joseph P. Mandala

Abstract:

This paper examines the legal and medical ethics concerns, which proponents of human head transplantation continue to defy since the procedure was first attempted on dogs in 1908. Despite recent bioethical objections, proponents have proceeded with radical experimentation, claiming transplantation would treat incurable diseases and improve patients’ quality of life. In 2018, Italian neurosurgeon, Sergio Canavero, and Dr. Xiaoping Ren claimed to have performed a head transplant on a corpse in China. Content analysis of literature shows that the procedure failed to satisfy scientific, legal, and bioethical elements because, unlike humans, corpses cannot coordinate function. Putting a severed head onto a body that has been dead for several days is not equivalent to a transplant which would require successfully reconnecting and restoring function to a spinal cord. While reconnection without restoration of bodily function is not transplantation, the publicized procedure on animals and corpses could leapfrog to humans, sparking excitement in society likely to affect organ donors and recipients from territorial jurisdictions with varying legal and ethical regimes. As neurodiscoveries generate further excitement, the need to preemptively address the legal and medical ethics impact of head transplantation in our society cannot be overstated. A preemptive development of methods to address the impact of head transplantation will help harmonizing national and international laws on organ donations, advance directives, and laws affecting end of life.

Keywords:

Procedia PDF Downloads 144
5397 Establishing Reference Intervals for Routine Coagulation Tests

Authors: Santina Sahibon, Sivasooriar Sivaneson, Martin Giddy, Nelson Nheu, Siti Sazeelah, Choo Kok Ming, Thuhairah Abdul Rahman, Fatmawati Binti Kamal

Abstract:

Introduction: Establishing population-based reference intervals (RI) are essential when evaluating laboratory test results and for method verification. Our laboratory initiated an exercise to establish RI for routine coagulation profile as part of the method verification procedure and to determine any differences in RI between three analyzers planned to be used in the laboratory. Methodology: 145 blood samples were collected and analysed for activated partial thromboplastin time (aPTT), prothrombin time (PT), international normalized ratio (INR), and fibrinogen] using three coagulation analysers which were CA104, CA660, and CS-2500 (Sysmex, USA). RI was established at 2.5th and 97.5th percentiles. Results: The RI for aPTT between C104, C660 and CS-2500 are (RI: 20.5-30.2 sec), (RI: 21.5-29.2 sec) and (RI: 22.7-30.3 sec) respectively. The RI for PT were (RI: 7.5-10.3 sec), (RI: 9.2- 11.1 sec) and (RI: 9.8-11.9 sec) for C104, CA660 and CS-2500 respectively. INR had an RI of (RI: 0.87- 1.16), (RI: 0.89-1.10) and (0.90-1.11) respectively on CA104, C660 and CS-2500. Fibrinogen RI was (RI: 2.04-4.62 g/L) and (2.05-4.76 g/L) on the CA660 and CS-2500, respectively. Conclusion: The RI was similar across the analytical platforms for aPTT, INR, and fibrinogen. However, CA104 showed lower RI compared to the other two analysers for PT. This highlights the potential variability in results between instruments that need to be addressed when verifying RI.

Keywords: coagulation, reference interval, APTT, PT, INR, fibrinogen

Procedia PDF Downloads 187
5396 2-Dimensional Transition Metal Dichalcogenides for Photodetection and Biosensing Endoscopies After a 5-Year Follow-Up on Central Venous Access Receiving Home (HPN) Patients with Prophylaxis at Tertiary Healthcare Facility

Authors: Michelle Themalil, Celia Bueno, Rulla Al- Araji

Abstract:

Objective and Study: There are no established guidelines for antibiotic prophylaxis in children with central venous catheters (CVCs) on home parenteral nutrition (HPN), leading to varying practices across UK Centres. We hypothesize that children with intestinal failure are at increased risk for bacteraemia due to altered anatomy, dysmotility, inflammation, biofilm formation in long-term CVCs, and the use of central lines during procedures. Given the bacteraemia rates of up to 8% in upper and 25% in lower endoscopy for adults without central lines, we argue that prophylactic antibiotics are reasonable, given the increased risks faced by this high-risk group of children. Methods: We conducted a five-year review of patients with central venous access receiving home parenteral nutrition (HPN) who underwent endoscopies with antibiotic prophylaxis at our center (tertiary). We documented and analyzed post-procedure infections and their associated risk factors. Results: A total of 15 patients on HPN underwent 29 endoscopic procedures, including 4 upper, 9 combined upper and lower, and 16 combined upper, lower, and ileoscopy. Confirmed infection rates remained at 0% up to 28 days post-procedure. The agreed-upon prophylaxis regimen was implemented, with ciprofloxacin and metronidazole administered as the primary antibiotics. Notably, only 51.7% of patients received a peripheral cannula despite recommendations to avoid central line use during anesthesia, and 20.6% had small intestinal bacterial overgrowth. Conclusions: This study is the first to investigate post-endoscopy infection rates in pediatric patients on HPN. Despite a small sample size, we observed a 0% infection rate, significantly lower than reported rates in adults. These findings suggest that further research is warranted to explore the implications of antibiotic prophylaxis in this unique patient cohort and to establish guidelines that may enhance patient safety during endoscopic procedures.

Keywords: post endosopy infections, central venous access, home parenteral nutrition, intestinal failure

Procedia PDF Downloads 6
5395 A Fishery Regulation Model: Bargaining over Fishing Pressure

Authors: Duplan Yves Jamont Junior

Abstract:

The Diamond-Mortensen-Pissarides model widely used in labor economics is tailored to fishery. By this way, a fishing function is defined to depict the fishing technology, and Bellman equations are established to describe the behaviors of fishermen and conservationists. On this basis, a negotiation takes place as a Nash-bargaining over the upper limit of the fishing pressure between both political representative groups of fishermen and conservationists. The existence and uniqueness conditions of the Nash-bargained fishing pressure are established. Given the biomass evolution equation, the dynamics of the model variables (fishing pressure, biomass, fish need) is studied.

Keywords: conservation, fishery, fishing, Nash bargaining

Procedia PDF Downloads 260
5394 Application and Assessment of Artificial Neural Networks for Biodiesel Iodine Value Prediction

Authors: Raquel M. De sousa, Sofiane Labidi, Allan Kardec D. Barros, Alex O. Barradas Filho, Aldalea L. B. Marques

Abstract:

Several parameters are established in order to measure biodiesel quality. One of them is the iodine value, which is an important parameter that measures the total unsaturation within a mixture of fatty acids. Limitation of unsaturated fatty acids is necessary since warming of a higher quantity of these ones ends in either formation of deposits inside the motor or damage of lubricant. Determination of iodine value by official procedure tends to be very laborious, with high costs and toxicity of the reagents, this study uses an artificial neural network (ANN) in order to predict the iodine value property as an alternative to these problems. The methodology of development of networks used 13 esters of fatty acids in the input with convergence algorithms of backpropagation type were optimized in order to get an architecture of prediction of iodine value. This study allowed us to demonstrate the neural networks’ ability to learn the correlation between biodiesel quality properties, in this case iodine value, and the molecular structures that make it up. The model developed in the study reached a correlation coefficient (R) of 0.99 for both network validation and network simulation, with Levenberg-Maquardt algorithm.

Keywords: artificial neural networks, biodiesel, iodine value, prediction

Procedia PDF Downloads 606
5393 Procedure for Recommendation of Archival Documents

Authors: Marlon J. Remedios, Maria T. Morell, Jesse D. Cano

Abstract:

Diffusion and accessibility of historical collections is one of the main objectives of the institutions that aim to safeguard archival documents (General Archives). Several countries have Web applications that try to make accessible and public the large number of documents that they guard. Each of these sites has a set of features in order to facilitate access, navigability, and search for information. Different sources of information include Recommender Systems as a way of customizing content. This paper aims at describing a process for the production of archival documents relevant to the user. To comply with this, the characteristics ruling archival description, elements and main techniques that establishes the design of Recommender Systems, a set of rules to follow, and how these rules operate and the way in which take advantage of the domain knowledge are discussed. Finally, relevant issues are discussed in the design of the proposed tests and the results obtained are shown.

Keywords: archival document, recommender system, procedure, information management

Procedia PDF Downloads 514
5392 Social Support in Adherence to Therapy in Bioenterics Intragastric Balloon

Authors: Mariela González, Zoraide Lugli

Abstract:

Objective: to determine the relationship between perceived social support and adherence to therapy in patients who have been placed BioEnteric intragastric balloon (BIB). Material and method: 75 obese (56 women and 19 men) between 18 and 65 years (M = 39.29, SD = 11.82), who attended five centers in the city of Caracas, where he carried out this procedure. We used Social Support Scale and treatment adherence behavior respectively. The procedure was contacted the centers and the sample was selected. Subsequently, the inventories were applied before and the month after the before and three months after the balloon set. Results: Show that participants were characterized by moderate levels in the variables. On the other hand, those who perceive that they perceived support from friends are those who report adherence to therapy. Conclusions: From the results, it is suggested promote social support networks, which could be essential to achieve and maintain adherence to therapy in patients with BioEnterics intragastric balloon.

Keywords: BioEnteric intragastric balloon, perceived social support, adherence to therapy, patients

Procedia PDF Downloads 344
5391 Boundedness and Asymptotic Behavior of Solutions for Gierer-Meinhardt Systems

Authors: S. Henine, A. Youkana

Abstract:

This work is devoted to study the global existence and asymptotic behavior of solutions for Gierer-Meinhardt systems arising in biological phenomena. We prove that the solutions are global and uniformly bounded by a positive constant independent of the time. Our technique is based on Lyapunov functional argument. Under suitable conditions, we established a result on the asymptotic behavior of solutions. These results are valid for any positive continuous initial data, and improve some recently results established.

Keywords: asymptotic behavior, Gierer-Meinhardt systems, global existence, Lyapunov functional

Procedia PDF Downloads 388
5390 Operative Technique of Glenoid Anteversion Osteotomy and Soft Tissue Rebalancing for Brachial Plexus Birth Palsy

Authors: Michael Zaidman, Naum Simanovsky

Abstract:

The most of brachial birth palsies are transient. Children with incomplete recovery almost always develop an internal rotation and adduction contracture. The muscle imbalance around the shoulder results in glenohumeral joint deformity and functional limitations. Natural history of glenohumeral deformity is it’s progression with worsening of function. Anteversion glenoid osteotomy with latissimus dorsi and teres major tendon transfers could be an alternative procedure of proximal humeral external rotation osteotomy for patients with severe glenohumeral dysplasia secondary to brachial plexus birth palsy. We will discuss pre-operative planning and stepped operative technique of the procedure on clinical example.

Keywords: obstetric brachial plexus palsy, glenoid anteversion osteotomy, tendon transfer, operative technique

Procedia PDF Downloads 74
5389 Effect of Cr2O3 on Mechanical Properties of Aluminum Produced Powder Metallurgy

Authors: Yasin Akgul, Fazil Husem, Memis Isik

Abstract:

In this study, effect of content of chromium (III) oxide on production of Al/Cr203 alloys were investigated. Experimental procedure was started with mixturing of powders in the presence of absolute ethanol, vacuum distillation technique was used for evaporation, by ultrasonic bath and mechanic stirrer. Pressing procedure was achieved by hydrolic press that has 100 tons forcing for production of 25 mm diameter compact green billets. Green bodies were sintered at 600 °C in argon atmosphere. Scanning electron microscope (SEM) analysis for characterization of microstructure, compression test for determination of strength and Vickers test for measuring of hardness of sintered billets were done. End of the study is concluded that, enhancement of physical and mechanical properties is observed by increasing content of chromium (III) oxide.

Keywords: aluminium, chromium (III) oxide, powder metallurgy, sintering

Procedia PDF Downloads 230
5388 Early Predictive Signs for Kasai Procedure Success

Authors: Medan Isaeva, Anna Degtyareva

Abstract:

Context: Biliary atresia is a common reason for liver transplants in children, and the Kasai procedure can potentially be successful in avoiding the need for transplantation. However, it is important to identify factors that influence surgical outcomes in order to optimize treatment and improve patient outcomes. Research aim: The aim of this study was to develop prognostic models to assess the outcomes of the Kasai procedure in children with biliary atresia. Methodology: This retrospective study analyzed data from 166 children with biliary atresia who underwent the Kasai procedure between 2002 and 2021. The effectiveness of the operation was assessed based on specific criteria, including post-operative stool color, jaundice reduction, and bilirubin levels. The study involved a comparative analysis of various parameters, such as gestational age, birth weight, age at operation, physical development, liver and spleen sizes, and laboratory values including bilirubin, ALT, AST, and others, measured pre- and post-operation. Ultrasonographic evaluations were also conducted pre-operation, assessing the hepatobiliary system and related quantitative parameters. The study was carried out by two experienced specialists in pediatric hepatology. Comparative analysis and multifactorial logistic regression were used as the primary statistical methods. Findings: The study identified several statistically significant predictors of a successful Kasai procedure, including the presence of the gallbladder and levels of cholesterol and direct bilirubin post-operation. A detectable gallbladder was associated with a higher probability of surgical success, while elevated post-operative cholesterol and direct bilirubin levels were indicative of a reduced chance of positive outcomes. Theoretical importance: The findings of this study contribute to the optimization of treatment strategies for children with biliary atresia undergoing the Kasai procedure. By identifying early predictive signs of success, clinicians can modify treatment plans and manage patient care more effectively and proactively. Data collection and analysis procedures: Data for this analysis were obtained from the health records of patients who received the Kasai procedure. Comparative analysis and multifactorial logistic regression were employed to analyze the data and identify significant predictors. Question addressed: The study addressed the question of identifying predictive factors for the success of the Kasai procedure in children with biliary atresia. Conclusion: The developed prognostic models serve as valuable tools for early detection of patients who are less likely to benefit from the Kasai procedure. This enables clinicians to modify treatment plans and manage patient care more effectively and proactively. Potential limitations of the study: The study has several limitations. Its retrospective nature may introduce biases and inconsistencies in data collection. Being single centered, the results might not be generalizable to wider populations due to variations in surgical and postoperative practices. Also, other potential influencing factors beyond the clinical, laboratory, and ultrasonographic parameters considered in this study were not explored, which could affect the outcomes of the Kasai operation. Future studies could benefit from including a broader range of factors.

Keywords: biliary atresia, kasai operation, prognostic model, native liver survival

Procedia PDF Downloads 55
5387 Rationality and Evidence of Pre-Prepared Treatment Plan in Oesophageal HDR Brachytherapy

Authors: Jim S. Meng, Mammo H. Yewondwossen

Abstract:

As a part of routine oesophageal HDR brachytherapy procedure, treatment planning takes about 45 minutes while patients are under light sedation. Some patients may suffer gagging and/or spasms, and the treatment may need to be aborted. A pre-prepared plan generated before the patient’s sedation may reduce the brachytherapy procedure time by forty minutes. This paper reports the rationality and evidence of pre-prepared treatment plans. A retrospective study of 28 patients confirm that all of the pre-prepared plans would be acceptable. The rationality of pre-prepared HDR brachytherapy plans is further confirmed by a systemic study with a wide range of applicator curvature and treatment volume. Detailed comparison between CT based treatment plans and pre-prepared plans are discussed. This argument holds also for endobronchial HDR brachytherapy. With the above evidence, pre-prepared plans have been used for all oesophagus and bronchus HDR brachytherapy cases in our clinic.

Keywords: HDR brachytherapy, treatment planning, oesophageal carcinoma, pre-planning

Procedia PDF Downloads 395
5386 Cranioplasty With Custom Implant Realized Using 3D Printing Technology

Authors: R. Trad Khodja, A. Guessmi, R. Ghoul, A. Mahtout, S. A. Benbouali, M. A. Boulahlib

Abstract:

Cranioplasty is a surgical act that aims to restore cranial bone losses in order to protect the brain from external aggressions and to improve the patient's aesthetic appearance. This objective can be achieved by taking advantage of the current technological development in computer science and biomechanics. The objective of this paper is to present an approach for the realization of high-precision biocompatible cranial implants using new 3D printing technologies at the lowest cost. The proposed method is to reproduce the missing part of the skull by referring to its healthy contralateral part. Once the model is validated by the neurosurgeons, a mold is 3D printed for the production of a biocompatible implant in Poly-Methyl-Methacrylate (PMMA) acrylic cement. Using this procedure, ten patients underwent this procedure with excellent aesthetic results.

Keywords: cranioplasty, cranial defect, PMMA, 3d printing, custom made implants

Procedia PDF Downloads 56
5385 Evaluation of Iranian Standard for Assessment of Liquefaction Potential of Cohesionless Soils Based on SPT

Authors: Reza Ziaie Moayad, Azam Kouhpeyma

Abstract:

In-situ testing is preferred to evaluate the liquefaction potential in cohesionless soils due to high disturbance during sampling. Although new in-situ methods with high accuracy have been developed, standard penetration test, the simplest and the oldest in-situ test, is still used due to the profusion of the recorded data. This paper reviews the Iranian standard of evaluating liquefaction potential in soils (codes 525) and compares the liquefaction assessment methods based on SPT results on cohesionless soil in this standard with the international standards. To this, methods for assessing liquefaction potential which are presented by Cetin et al. (2004), Boulanger and Idriss (2014) are compared with what is presented in standard 525. It is found that although the procedure used in Iranian standard of evaluating the potential of liquefaction has not been updated according to the new findings, it is a conservative procedure.

Keywords: cohesionless soil, liquefaction, SPT, standard 525

Procedia PDF Downloads 170