Search results for: magnetic saturation

Authors: Thomas Larm, Anna Wahlsten

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An international literature study has been carried out for comparison of commonly used methods for the dimensioning of transport systems and stormwater facilities for flow detention. The focus of the literature study regarding the calculation of design flow and detention has been the widely used Rational method and its underlying parameters. The impact of chosen design parameters such as return time, rain intensity, runoff coefficient, and climate factor have been studied. The parameters used in the calculations have been analyzed regarding how they can be calculated and within what limits they can be used. Data used within different countries have been specified, e.g., recommended rainfall return times, estimated runoff times, and climate factors used for different cases and time periods. The literature study concluded that the determination of runoff coefficients is the most uncertain parameter that also affects the calculated flow and required detention volume the most. Proposals have been developed for new runoff coefficients, including a new proposed method with equations for calculating runoff coefficients as a function of return time (years) and rain intensity (l/s/ha), respectively. Suggestions have been made that it is recommended not to limit the use of the Rational Method to a specific catchment size, contrary to what many design manuals recommend, with references to this. The proposed relationships between return time or rain intensity and runoff coefficients need further investigation and to include the quantification of uncertainties. Examples of parameters that have not been considered are the influence on the runoff coefficients of different dimensioning rain durations and the degree of water saturation of green areas, which will be investigated further. The influence of climate effects and design rain on the dimensioning of the stormwater facilities grassed ditches and biofilters (bio retention systems) has been studied, focusing on flow detention capacity. We have investigated how the calculated runoff coefficients regarding climate effect and the influence of changed (increased) return time affect the inflow to and dimensioning of the stormwater facilities. We have developed a smart design of ditches and biofilters that results in both high treatment and flow detention effects and compared these with the effect from dry and wet ponds. Studies of biofilters have generally before focused on treatment of pollutants, but their effect on flow volume and how its flow detention capability can improve is only rarely studied. For both the new type of stormwater ditches and biofilters, it is required to be able to simulate their performance in a model under larger design rains and future climate, as these conditions cannot be tested in the field. The stormwater model StormTac Web has been used on case studies. The results showed that the new smart design of ditches and biofilters had similar flow detention capacity as dry and wet ponds for the same facility area.

Keywords: runoff coefficients, flow detention, smart design, biofilter, ditch

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Authors: Awais Ahmed, Atif Rana, Haseeb Zia, Maham Jahangir, Rashed Nazir, Faisal Dar

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Purpose: Biliary complications represent the most common cause of morbidity in living related liver donor transplantation and detailed preoperative evaluation of biliary anatomic variants is crucial for safe patient selection and improved surgical outcomes. Purpose of this study is to determine the accuracy of preoperative MRCP in predicting biliary variations when compared to intraoperative cholangiography in living related liver donors. Materials and Methods: From 44 potential donors, 40 consecutive living related liver donors (13 females and 28 males) underwent donor hepatectomy at our centre from April 2012 to August 2013. MRCP and IOC of all patients were retrospectively reviewed separately by two radiologists and a transplant surgeon.MRCP was performed on 1.5 Tesla MR magnets using breath-hold heavily T2 weighted radial slab technique. One patient was excluded due to suboptimal MRCP. The accuracy of MRCP for variant biliary anatomy was calculated. Results: MRCP accurately predicted the biliary anatomy in 38 of 39 cases (97 %). Standard biliary anatomy was predicted by MRCP in 25 (64 %) donors (100% sensitivity). Variant biliary anatomy was noted in 14 (36 %) IOCs of which MRCP predicted precise anatomy of 13 variants (93 % sensitivity). The two most common variations were drainage of the RPSD into the LHD (50%) and the triple confluence of the RASD, RPSD and LHD (21%). Conclusion: MRCP is a sensitive imaging tool for precise pre-operative mapping of biliary variations which is critical to surgical decision making in living related liver transplantation.

Keywords: intraoperative cholangiogram, liver transplantation, living related donors, magnetic resonance cholangio-pancreaticogram (MRCP)

Procedia PDF Downloads 375

Authors: Sharvare Palwai, Padmaja Guggilla

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Smart materials, also called as responsive materials, undergo reversible physical or chemical changes in their properties as a consequence of small environmental variations. They can respond to a single or multiple stimuli such as stress, temperature, moist, electric or magnetic fields, light, or chemical compounds. Hence smart materials are the basis of many applications, including biosensors and transducers, particularly electroactive polymers. As the polymers exhibit good flexibility, high transparency, easy processing, and low cost, they would be promising for the sensor material. Polyvinylidene Fluoride (PVDF), being a ferroelectric polymer, exhibits piezoelectric and pyro electric properties. Pyroelectric materials convert heat directly into electricity, while piezoelectric materials convert mechanical energy into electricity. These characteristics of PVDF make it useful in biosensor devices and batteries. However, the influence of nanoparticle fillers such as Lithium Tantalate (LiTaO₃/LT), Potassium Niobate (KNbO₃/PN), and Zinc Titanate (ZnTiO₃/ZT) in polymer films will be studied comprehensively. Developing advanced and cost-effective biosensors is pivotal to foresee the fullest potential of polymer based wireless sensor networks, which will further enable new types of self-powered applications. Finally, nanocomposites films with best set of properties; the sensory elements will be designed and tested for their performance as electric generators under laboratory conditions. By characterizing the materials for their optical properties and investigate the effects of doping on the bandgap energies, the science in the next-generation biosensor technologies can be advanced.

Keywords: polyvinylidene fluoride, PVDF, lithium tantalate, potassium niobate, zinc titanate

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Authors: Nora A. Guerrero, Adan Leon, María I. Sandoval, Romel Perez, Samuel Munoz

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The addition of solvents in cyclic steam stimulation is a technique that has shown an impact on the improved recovery of heavy oils. In this technique, it is possible to reduce the steam/oil ratio in the last stages of the process, at which time this ratio increases significantly. The mobility of improved crude oil increases due to the structural changes of its components, which at the same time reflected in the decrease in density and viscosity. In the present work, the effect of the variables such as temperature, time, and weight percentage of naphtha was evaluated, using a factorial design of experiments 23. From the results of analysis of variance (ANOVA) and Pareto diagram, it was possible to identify the effect on viscosity reduction. The experimental representation of the crude-vapor-naphtha interaction was carried out in a batch reactor on a Colombian heavy oil of 12.8° API and 3500 cP. The conditions of temperature, reaction time, and percentage of naphtha were 270-300 °C, 48-66 hours, and 3-9% by weight, respectively. The results showed a decrease in density with values in the range of 0.9542 to 0.9414 g/cm³, while the viscosity decrease was in the order of 55 to 70%. On the other hand, simulated distillation results, according to ASTM 7169, revealed significant conversions of the 315°C+ fraction. From the spectroscopic techniques of nuclear magnetic resonance NMR, infrared FTIR and UV-VIS visible ultraviolet, it was determined that the increase in the performance of the light fractions in the improved crude is due to the breakdown of alkyl chains. The methodology for cyclic steam injection with naphtha and laboratory-scale characterization can be considered as a practical tool in improved recovery processes.

Keywords: viscosity reduction, cyclic steam stimulation, factorial design, naphtha

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Authors: P. F. Msomi, P. T. Nonjola, P. G. Ndungu, J. Ramontja

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In view of the projected global energy demand and increasing levels of greenhouse gases and pollutants issues have inspired an intense search for alternative new energy technologies, which will provide clean, low cost and environmentally friendly solutions to meet the end user requirements. Alkaline anion exchange membrane fuel cells (AAEMFC) have been recognized as ideal candidates for the generation of such clean energy for future stationary and mobile applications due to their many advantages. The key component of the AAEMFC is the anion exchange membrane (AEM). In this report, a series of quaternized poly (2.6 dimethyl – 1.4 phenylene oxide)/ polysulfone (QPPO/PSF) blend anionic exchange membranes (AEM) were successfully fabricated and characterized for alkaline fuel cell application. Zinc Oxide (ZnO) nanoparticles were introduced in the polymer matrix to enhance the intrinsic properties of the AEM. The characteristic properties of the QPPO/PSF and QPPO/PSF-ZnO blend membrane were investigated with X-ray diffraction (XRD), thermogravimetric analysis (TGA) scanning electron microscope (SEM) and contact angle (CA). To confirm successful quaternisation, FT-IR spectroscopy and proton nuclear magnetic resonance (1H NMR) were used. Other properties such as ion exchange capacity (IEC), water uptake, contact angle and ion conductivity (IC) were also undertaken to check if the prepared nanocomposite materials are suitable for fuel cell application. The membrane intrinsic properties were found to be enhanced by the addition of ZnO nanoparticles. The addition of ZnO nanoparticles resulted to a highest IEC of 3.72 mmol/g and a 30-fold IC increase of the nanocomposite due to its lower methanol permeability. The above results indicate that QPPO/PSF-ZnO is a good candidate for AAEMFC application.

Keywords: anion exchange membrane, fuel cell, zinc oxide nanoparticle, nanocomposite

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Authors: Rahele Mesbah, Nic Van Der Wee, Manja Koenders, Erik Giltay, Albert Van Hemert, Max De Leeuw

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Introduction: Patients with bipolar disorder (BD), characterized by depressive and manic episodes, often suffer from cognitive dysfunction. An up-to-date meta-analysis of functional Magnetic Resonance Imaging (fMRI) studies examining cognitive function in BD is lacking. Objective: The aim of the current fMRI meta-analysis is to investigate brain functioning of bipolar patients compared with healthy subjects within three domains of emotion processing, reward processing, and working memory. Method: Differences in brain regions activation were tested within whole-brain analysis using the activation likelihood estimation (ALE) method. Separate analyses were performed for each cognitive domain. Results: A total of 50 fMRI studies were included: 20 studies used an emotion processing (316 BD and 369 HC) task, 9 studies a reward processing task (215 BD and 213 HC), and 21 studies used a working memory task (503 BD and 445 HC). During emotion processing, BD patients hyperactivated parts of the left amygdala and hippocampus as compared to HC’s, but showed hypoactivation in the inferior frontal gyrus (IFG). Regarding reward processing, BD patients showed hyperactivation in part of the orbitofrontal cortex (OFC). During working memory, BD patients showed increased activity in the prefrontal cortex (PFC) and anterior cingulate cortex (ACC). Conclusions: This meta-analysis revealed evidence for activity disturbances in several brain areas involved in the cognitive functioning of BD patients. Furthermore, most of the found regions are part of the so-called fronto-limbic network which is hypothesized to be affected as a result of BD candidate genes' expression.

Keywords: cognitive functioning, fMRI analysis, bipolar disorder, fronto-limbic network

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Authors: C. Busuioc, S. I. Jinga, E. Pavel

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The continuous need of more non-volatile memories with a higher storage capacity, smaller dimensions and weight, as well as lower costs, has led to the exploration of optical lithography on active media, as well as patterned magnetic composites. In this context, optical lithography is a technique that can provide a significant decrease of the information bit size to the nanometric scale. However, there are some restrictions that arise from the need of breaking the optical diffraction limit. Major achievements have been obtained by employing a vitoceramic material as active medium and a laser beam operated at low power for the direct writing procedure. Thus, optical discs with ultra-high density were fabricated by a conventional melt-quenching method starting from analytical purity reagents. They were subsequently used for 3D recording based on their photosensitive features. Naturally, the next step consists in the elucidation of the composition and structure of the active centers, in correlation with the use of silver and rare-earth compounds for the synthesis of the optical supports. This has been accomplished by modern characterization methods, namely transmission electron microscopy coupled with selected area electron diffraction, scanning transmission electron microscopy and electron energy loss spectroscopy. The influence of laser diode parameters, silver concentration and fluorescent compounds formation on the writing process and final material properties was investigated. The results indicate performances in terms of capacity with two order of magnitude higher than other reported information storage systems. Moreover, the fluorescent photosensitive vitroceramics may be integrated in other applications which appeal to nanofabrication as the driving force in electronics and photonics fields.

Keywords: data storage, fluorescent compounds, laser writing, vitroceramics

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Authors: Atitallah Sofien, Bouyahia Olfa, Romdhani Meriam, Missaoui Nada, Ben Rabeh Rania, Yahyaoui Salem, Mazigh Sonia, Boukthir Samir

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Introduction: Traditional medicine refers to a diverse range of therapeutic practices and knowledge systems that have been employed by different cultures over an extended period to uphold and rejuvenate health. These practices can involve herbal remedies, acupuncture, massage, and alternative healing methods that deviate from conventional medical approaches. In Tunisia, we often use unidentified utensils to scratch the oral cavity internally in infants in order to widen the oral cavity for better breathing and swallowing. However, these practices can be risky and may jeopardize the patients' prognosis or even their lives. Aim: This is the case of a nine-month-old infant, admitted to the pediatric department and subsequently to the intensive care unit due to a peritonsillar abscess following the utilization of an unidentifiable tool to scrape the interior of the oral cavity. Case Report: This is a 9-month-old infant with no particular medical history, admitted for high respiratory distress and a fever persisting for 4 days. On clinical examination, he had a respiratory rate of 70 cycles per minute with an oxygen saturation of 97% and subcostal retractions, along with a heart rate of 175 beats per minute. His white blood cell count was 40,960/mm³, and his C-reactive protein was 250 mg/L. Given the severity of the clinical presentation, the infant was transferred to the intensive care unit, intubated, and mechanically ventilated. A cervical-thoracic CT scan was performed, revealing a ruptured 18 mm left peritonsillar abscess in the oropharynx associated with cellulitis of the retropharyngeal space. The oto-rhino-laryngoscopic examination revealed an asymmetry involving the left lateral wall of the oropharynx with the presence of a fistula behind the posterior pillar. Dissection of the collection cavity was performed, allowing the drainage of 2 ml of pus. The culture was negative. The patient received cefotaxime in combination with metronidazole and gentamicin for a duration of 10 days, followed by a switch to amoxicillin-clavulanic acid for 7 days. The patient was extubated after 4 days of treatment, and the clinical and radiological progress was favorable. Conclusions: Traditional medicine remains risky due to the lack of scientific evidence and the potential for injuries and transmission of infectious diseases, especially in children, who constitute a vulnerable population. Therefore, parents should consult healthcare professionals and rely on evidence-based care.

Keywords: children, peritonsillar abscess, traditional medicine, respiratory distress

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Authors: Mansa Radhakrishnan, Anwar Ali, Muhammad Rizwan Mughal

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Many universities around the world are working on modular and low budget architecture of small spacecraft to reduce the development cost of the overall system. This paper focuses on the design of a modular solar power harvesting system for a hexagonal-shaped small satellite. The designed solar power harvesting systems are composed of solar panels and power converter subsystems. The solar panel is composed of solar cells mounted on the external face of the printed circuit board (PCB), while the electronic components of power conversion are mounted on the interior side of the same PCB. The solar panel with dimensions 16.5cm × 99cm is composed of 36 solar cells (each solar cell is 4cm × 7cm) divided into four parallel banks where each bank consists of 9 solar cells. The output voltage of a single solar cell is 2.14V, and the combined output voltage of 9 series connected solar cells is around 19.3V. The output voltage of the solar panel is boosted to the satellite power distribution bus voltage level (28V) by a boost converter working on a constant voltage maximum power point tracking (MPPT) technique. The solar panel module is an eight-layer PCB having embedded coil in 4 internal layers. This coil is used to control the attitude of the spacecraft, which consumes power to generate a magnetic field and rotate the spacecraft. As power converter and distribution subsystem components are mounted on the PCB internal layer, therefore it is mandatory to do thermal analysis in order to ensure that the overall module temperature is within thermal safety limits. The main focus of the overall design is on compactness, miniaturization, and efficiency enhancement.

Keywords: small satellites, power subsystem, efficiency, MPPT

Procedia PDF Downloads 49

Authors: Ekki Kurniawan, Yusuf Nur Jayanto, Erna Sugesti, Efri Suhartono, Agus Ganda Permana, Jaspar Hasudungan, Jangkung Raharjo, Rintis Manfaati

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The purpose of this research is to study the current characteristic of the electrolysis of mineral water to produce hydrogen, alkaline water, and acid water. Alkaline and hydrogen water are believed to have health benefits. Alkaline water containing hydrogen can be an anti-oxidant that captures free radicals, which will increase the immune system. In Indonesia, there are two existing types of alkaline water producing equipment, but the installation is complicated, and the price is relatively expensive. The electrolysis process is slow (6-8 hours) since they are locally made using 311 VDC full bridge rectifier power supply. This paper intends to discuss how to make hydrogen and alkaline water by a simple portable mineral water ionizer. This is an electrolysis device that is easy to carry and able to separate ions of mineral water into acidic and alkaline water. With an electric field, positive ions will be attracted to the cathode, while negative ions will be attracted to the anode. The circuit equivalent can be depicted as RLC transient ciruit. The diode component ensures that the electrolytic current is direct current. Switch S divides the switching times t1, t2, and t3. In the first stage up to t1, the electrolytic current increases exponentially, as does the inductor charging current (L). The molecules in drinking water experience magnetic properties. The direction of the dipole ions, which are random in origin, will regularly flare with the direction of the electric field. In the second stage up to t2, the electrolytic current decreases exponentially, just like the charging current of a capacitor (C). In the 3rd stage, start t3 until it tends to be constant, as is the case with the current flowing through the resistor (R).

Keywords: current electrolysis, mineral water, ions, alkaline and acid waters, inductor, capacitor, resistor

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Authors: Pradeepa Teegala, Ramreddy Chitteti

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This article analyzes the mixed convection flow of chemically reacting micropolar fluid over a truncated cone embedded in non-Darcy porous medium with convective boundary condition. In addition, heat generation/absorption and Joule heating effects are taken into consideration. The similarity solution does not exist for this complex fluid flow problem, and hence non-similarity transformations are used to convert the governing fluid flow equations along with related boundary conditions into a set of nondimensional partial differential equations. Many authors have been applied the spectral quasi-linearization method to solve the ordinary differential equations, but here the resulting nonlinear partial differential equations are solved for non-similarity solution by using a recently developed method called the spectral quasi-linearization method (SQLM). Comparison with previously published work on special cases of the problem is performed and found to be in excellent agreement. The effect of pertinent parameters namely, Biot number, mixed convection parameter, heat generation/absorption, Joule heating, Forchheimer number, chemical reaction, micropolar and magnetic field on physical quantities of the flow are displayed through graphs and the salient features are explored in detail. Further, the results are analyzed by comparing with two special cases, namely, vertical plate and full cone wherever possible.

Keywords: chemical reaction, convective boundary condition, joule heating, micropolar fluid, mixed convection, spectral quasi-linearization method

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Authors: Peter G. Hollis, Kim G. Clarke

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Accurate quantification of the overall volumetric oxygen transfer coefficient (KLa) is ubiquitously measured in bioprocesses by analysing the response of dissolved oxygen (DO) to a step change in the oxygen partial pressure in the sparge gas using a DO probe. Typically, the response lag (τ) of the probe has been ignored in the calculation of KLa when τ is less than the reciprocal KLa, failing which a constant τ has invariably been assumed. These conventions have now been reassessed in the context of multiphase bioprocesses, such as a hydrocarbon-based system. Here, significant variation of τ in response to changes in process conditions has been documented. Experiments were conducted in a 5 L baffled stirred tank bioreactor (New Brunswick) in a simulated hydrocarbon-based bioprocess comprising a C14-20 alkane-aqueous dispersion with suspended non-viable Saccharomyces cerevisiae solids. DO was measured with a polarographic DO probe fitted with a Teflon membrane (Mettler Toledo). The DO concentration response to a step change in the sparge gas oxygen partial pressure was recorded, from which KLa was calculated using a first order model (without incorporation of τ) and a second order model (incorporating τ). τ was determined as the time taken to reach 63.2% of the saturation DO after the probe was transferred from a nitrogen saturated vessel to an oxygen saturated bioreactor and is represented as the inverse of the probe constant (KP). The relative effects of the process parameters on KP were quantified using a central composite design with factor levels typical of hydrocarbon bioprocesses, namely 1-10 g/L yeast, 2-20 vol% alkane and 450-1000 rpm. A response surface was fitted to the empirical data, while ANOVA was used to determine the significance of the effects with a 95% confidence interval. KP varied with changes in the system parameters with the impact of solid loading statistically significant at the 95% confidence level. Increased solid loading reduced KP consistently, an effect which was magnified at high alkane concentrations, with a minimum KP of 0.024 s-1 observed at the highest solids loading of 10 g/L. This KP was 2.8 fold lower that the maximum of 0.0661 s-1 recorded at 1 g/L solids, demonstrating a substantial increase in τ from 15.1 s to 41.6 s as a result of differing process conditions. Importantly, exclusion of KP in the calculation of KLa was shown to under-predict KLa for all process conditions, with an error up to 50% at the highest KLa values. Accurate quantification of KLa, and therefore KP, has far-reaching impact on industrial bioprocesses to ensure these systems are not transport limited during scale-up and operation. This study has shown the incorporation of τ to be essential to ensure KLa measurement accuracy in multiphase bioprocesses. Moreover, since τ has been conclusively shown to vary significantly with process conditions, it has also been shown that it is essential for τ to be determined individually for each set of process conditions.

Keywords: effect of process conditions, measuring oxygen transfer coefficients, multiphase bioprocesses, oxygen probe response lag

Procedia PDF Downloads 254

Authors: Mohamed Farhat O. Hameed, Yasamin K. A. Alrayk, A. A Shaalan, S. S. A. Obayya

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The surface plasmon resonance (SPR) sensors are widely used due to its high sensitivity with molecular labels free. The commercial SPR sensors depend on the conventional prism-coupled configuration. However, this type of configuration suffers from miniaturization and integration. Therefore, the search for compact, portable and highly sensitive SPR sensors becomes mandatory.In this paper, sensitivity enhancement of a novel photonic crystal fiber biosensoris introduced and studied. The suggested design has microstructure of air holes in the core region surrounded by two large semicircular metallized channels filled with the analyte. The inner surfaces of the two channels are coated by a silver layer followed by a gold layer.The simulation results are obtained using full vectorial finite element methodwith perfect matched layer (PML) boundary conditions. The proposed design depends on bimetallic configuration to enhance the biosensor sensitivity. Additionally, the suggested biosensor can be used for multi-channel/multi-analyte sensing. In this study, the sensor geometrical parameters are studied to maximize the sensitivity for the two polarized modes. The numerical results show that high refractive index sensitivity of 4750 nm/RIU (refractive index unit) and 4300 nm/RIU can be achieved for the quasi (transverse magnetic) TM and quasi (transverse electric) TE modes of the proposed biosensor, respectively. The reportedbiosensor has advantages of integration of microfluidics setup, waveguide and metallic layers into a single structure. As a result, compact biosensor with better integration compared to conventional optical fiber SPR biosensors can be obtained.

Keywords: photonic crystal fibers, gold, silver, surface plasmon, biosensor

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Authors: D. Tedesco, G. Feletti, P. Trucco

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The present study aims to develop a Decision Support System (DSS) to support the operational decision of the Emergency Medical Service (EMS) regarding the assignment of medical emergency requests to Emergency Departments (ED). In the literature, this problem is also known as “hospital selection” and concerns the definition of policies for the selection of the ED to which patients who require further treatment are transported by ambulance. The employed research methodology consists of the first phase of revision of the technical-scientific literature concerning DSSs to support the EMS management and, in particular, the hospital selection decision. From the literature analysis, it emerged that current studies are mainly focused on the EMS phases related to the ambulance service and consider a process that ends when the ambulance is available after completing a request. Therefore, all the ED-related issues are excluded and considered as part of a separate process. Indeed, the most studied hospital selection policy turned out to be proximity, thus allowing to minimize the transport time and release the ambulance in the shortest possible time. The purpose of the present study consists in developing an optimization model for assigning medical emergency requests to the EDs, considering information relating to the subsequent phases of the process, such as the case-mix, the expected service throughput times, and the operational capacity of different EDs in hospitals. To this end, a Discrete Event Simulation (DES) model was created to evaluate different hospital selection policies. Therefore, the next steps of the research consisted of the development of a general simulation architecture, its implementation in the AnyLogic software and its validation on a realistic dataset. The hospital selection policy that produced the best results was the minimization of the Time To Provider (TTP), considered as the time from the beginning of the ambulance journey to the ED at the beginning of the clinical evaluation by the doctor. Finally, two approaches were further compared: a static approach, which is based on a retrospective estimate of the TTP, and a dynamic approach, which is based on a predictive estimate of the TTP determined with a constantly updated Winters model. Findings reveal that considering the minimization of TTP as a hospital selection policy raises several benefits. It allows to significantly reduce service throughput times in the ED with a minimum increase in travel time. Furthermore, an immediate view of the saturation state of the ED is produced and the case-mix present in the ED structures (i.e., the different triage codes) is considered, as different severity codes correspond to different service throughput times. Besides, the use of a predictive approach is certainly more reliable in terms of TTP estimation than a retrospective approach but entails a more difficult application. These considerations can support decision-makers in introducing different hospital selection policies to enhance EMSs performance.

Keywords: discrete event simulation, emergency medical services, forecast model, hospital selection

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Authors: Melissa Langevin, Natalie Ward, Colleen Fitzgibbons, Christa Ramsey, Melanie Hogue, Anna Theresa Lobos

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Description: Root Cause Analysis (RCA) is used by health care teams to examine adverse events (AEs) to identify causes which then leads to recommendations for prevention Despite widespread use, RCA has limitations. Best practices have not been established for implementing recommendations or tracking the impact of interventions after AEs. During phase 1 of this study, we used simulation to analyze two fictionalized AEs that occurred in hospitalized paediatric patients to identify and understand how the errors occurred and generated recommendations to mitigate and prevent recurrences. Scenario A involved an error of commission (inpatient drug error), and Scenario B involved detecting an error that already occurred (critical care drug infusion error). Recommendations generated were: improved drug labeling, specialized drug kids, alert signs and clinical checklists. Aim: Use simulation to optimize interventions recommended post critical event analysis prior to implementation in the clinical environment. Methods: Suggested interventions from Phase 1 were designed and tested through scenario simulation in the clinical environment (medicine ward or pediatric intensive care unit). Each scenario was simulated 8 times. Recommendations were tested using different, voluntary teams and each scenario was debriefed to understand why the error was repeated despite interventions and how interventions could be improved. Interventions were modified with subsequent simulations until recommendations were felt to have an optimal effect and data saturation was achieved. Along with concrete suggestions for design and process change, qualitative data pertaining to employee communication and hospital standard work was collected and analyzed. Results: Each scenario had a total of three interventions to test. In, scenario 1, the error was reproduced in the initial two iterations and mitigated following key intervention changes. In scenario 2, the error was identified immediately in all cases where the intervention checklist was utilized properly. Independently of intervention changes and improvements, the simulation was beneficial to identify which of these should be prioritized for implementation and highlighted that even the potential solutions most frequently suggested by participants did not always translate into error prevention in the clinical environment. Conclusion: We conclude that interventions that help to change process (epinephrine kit or mandatory checklist) were more successful at preventing errors than passive interventions (signage, change in memory aids). Given that even the most successful interventions needed modifications and subsequent re-testing, simulation is key to optimizing suggested changes. Simulation is a safe, practice changing modality for institutions to use prior to implementing recommendations from RCA following AE reviews.

Keywords: adverse events, patient safety, pediatrics, root cause analysis, simulation

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Authors: Raquel Amanda Villamizar Gallardo, Oscar Orlando Ortíz Rodríguez

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Enteric viruses are cosmopolitan agents present in several environments including water. These viruses can cause different diseases including gastroenteritis, hepatitis, conjunctivitis, respiratory problems among others. Although in Colombia there are not regulations concerning to routine viral analysis of drinking water, an enhanced understanding of viral pollution and resistance to treatments is desired in order to assure pure water to the population. Viral detection is often complex due to the need of specialized and time-consuming procedures. In addition, viruses are highly diluted in water which is a drawback from the analytical point of view. To this end, a fast and selective detection method for detection enteric viruses (i.e. Hepatitis A and Rotavirus) were applied. Micro- magnetic particles were functionalized with monoclonal antibodies anti-Hepatitis and anti-Rotavirus and they were used to capture, concentrate and separate whole viral particles in raw water and drinking water samples from four treatment plants identified as CAR-01, MON-02, POR-03, TON-04 and located in the Northeastern Colombia. Viruses were molecularly by using RT-PCR One Step Superscript III. Each plant was analyzed at the entry and exit points, in order to determine the initial presence and eventual reduction of Hepatitis A and Rotavirus after disinfection. The results revealed the presence of both enteric viruses in a 100 % of raw water analyzed in all plants. This represents a potential health hazard, especially for those people whose use this water for agricultural purposes. However, in drinking water analysis, enteric viruses was only positive in CAR-01, where was found the presence of Rotavirus. As a conclusion, the results confirm Rotavirus as the best indicator to evaluate the efficacy of potable treatment plant in eliminating viruses. CAR potable water plant should improve their disinfection process in order to remove efficiently enteric viruses.

Keywords: drinking water, hepatitis A, rotavirus, virus removal

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Authors: Sergey N. Ermoliev, Margarita A. Belousova, Aida D. Goncharenko

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Application of the diagnostic complex of highly informative functional methods (electromyography, reodentography, laser Doppler flowmetry, reoperiodontography, vital computer capillaroscopy, optical tissue oximetry, laser fluorescence diagnosis) allows to perform a multifactorial analysis of the dental status and to prescribe complex etiopathogenetic treatment. Introduction. It is necessary to create a complex of innovative highly informative and safe functional diagnostic methods for improvement of the quality of patient treatment by the early detection of stomatologic diseases. The purpose of the present study was to investigate the etiology and pathogenesis of functional disorders identified in the pathology of hard tissue, dental pulp, periodontal, oral mucosa and chewing function, and the creation of new approaches to the diagnosis of dental diseases. Material and methods. 172 patients were examined. Density of hard tissues of the teeth and jaw bone was studied by intraoral ultrasonic densitometry (USD). Electromyographic activity of masticatory muscles was assessed by electromyography (EMG). Functional state of dental pulp vessels assessed by reodentography (RDG) and laser Doppler flowmetry (LDF). Reoperiodontography method (RPG) studied regional blood flow in the periodontal tissues. Microcirculatory vascular periodontal studied by vital computer capillaroscopy (VCC) and laser Doppler flowmetry (LDF). The metabolic level of the mucous membrane was determined by optical tissue oximetry (OTO) and laser fluorescence diagnosis (LFD). Results and discussion. The results obtained revealed changes in mineral density of hard tissues of the teeth and jaw bone, the bioelectric activity of masticatory muscles, regional blood flow and microcirculation in the dental pulp and periodontal tissues. LDF and OTO methods estimated fluctuations of saturation level and oxygen transport in microvasculature of periodontal tissues. With LFD identified changes in the concentration of enzymes (nicotinamide, flavins, lipofuscin, porphyrins) involved in metabolic processes Conclusion. Our preliminary results confirmed feasibility and safety the of intraoral ultrasound densitometry technique in the density of bone tissue of periodontium. Conclusion. Application of the diagnostic complex of above mentioned highly informative functional methods allows to perform a multifactorial analysis of the dental status and to prescribe complex etiopathogenetic treatment.

Keywords: electromyography (EMG), reodentography (RDG), laser Doppler flowmetry (LDF), reoperiodontography method (RPG), vital computer capillaroscopy (VCC), optical tissue oximetry (OTO), laser fluorescence diagnosis (LFD)

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Authors: Belaynesh Tefera, Ahmed Mohammed, Zelalem Bayisa

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This study focuses on the issue of underage internal migration from rural to urban areas in Ethiopia, specifically in the context of child labor. It addresses the significant disparities in living standards between rural and urban areas, which motivate individuals from rural areas to migrate to urban areas in search of better economic opportunities. The study was conducted in Addis Ababa, where there is a high prevalence of underage internal migrants engaged in child labor due to extreme poverty in rural parts of the country. The aim of this study is to explore the life experiences of shoe-makers who have migrated from rural areas of Ethiopia to Addis Ababa. The focus is on understanding the factors that push these underage individuals to migrate, the challenges they face, and the implications for child labor. This study adopts a qualitative approach, using semistructured face-to-face interviews with underage migrants. A total of 27 interviews were conducted in Addis Ababa, Ethiopia, until the point of data saturation. The criteria for selecting interviewees include working as shoemakers and migrating to Addis Ababa underage, below 16 years old. The interviews were audio-taped, transcribed into Amharic, and then translated into English for analysis. The study reveals that the major push factors for underage internal migration are socioeconomic and environmental factors. Despite improvements in living standards for underage migrants and their families, there is a high prevalence of child labor and lack of access to education among them. Most interviewees migrated without the accompaniment of their family members and faced various challenges, including sleeping on the streets. This study highlights the role of social marketing in addressing the issues of underage internal migration and child labor. It suggests that social marketing can be an effective strategy to protect children from abuse, loneliness, and harassment during their migration process. The data collection involved conducting in-depth interviews with the underage migrants. The interviews were transcribed and translated for analysis. The analysis focused on identifying common themes and patterns within the interview data. The study addresses the factors contributing to underage internal migration, the challenges faced by underage migrants, the prevalence of child labor, and the potential role of social marketing in addressing these issues. The study concludes that although Ethiopia has policies against child internal migration, it is difficult to protect underage laborers who migrate from rural to urban areas due to the voluntary nature of their migration. The study suggests that social marketing can serve as a solution to protect children from abuse and other challenges faced during migration.

Keywords: underage, internal migration, social marketing, child labor, Ethiopia

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Authors: Mohsen Hababalahi, Morteza Bastami

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Buried pipeline damage correlations are critical part of loss estimation procedures applied to lifelines for future earthquakes. The vulnerability of buried pipelines against earthquake and liquefaction has been observed during some of previous earthquakes and there are a lot of comprehensive reports about this event. One of the main reasons for impairment of buried pipelines during earthquake is liquefaction. Necessary conditions for this phenomenon are loose sandy soil, saturation of soil layer and earthquake intensity. Because of this fact that pipelines structure are very different from other structures (being long and having light mass) by paying attention to the results of previous earthquakes and compare them with other structures, it is obvious that the danger of liquefaction for buried pipelines is not high risked, unless effective parameters like earthquake intensity and non-dense soil and other factors be high. Recent liquefaction researches for buried pipeline include experimental and theoretical ones as well as damage investigations during actual earthquakes. The damage investigations have revealed that a damage ratio of pipelines (Number/km ) has much larger values in liquefied grounds compared with one in shaking grounds without liquefaction according to damage statistics during past severe earthquakes, and that damages of joints and pipelines connected with manholes were remarkable. The purpose of this research is numerical study of buried pipelines under the effect of liquefaction by case study of the 2013 Dashti (Iran) earthquake. Water supply and electrical distribution systems of this township interrupted during earthquake and water transmission pipelines were damaged severely due to occurrence of liquefaction. The model consists of a polyethylene pipeline with 100 meters length and 0.8 meter diameter which is covered by light sandy soil and the depth of burial is 2.5 meters from surface. Since finite element method is used relatively successfully in order to solve geotechnical problems, we used this method for numerical analysis. For evaluating this case, some information like geotechnical information, classification of earthquakes levels, determining the effective parameters in probability of liquefaction, three dimensional numerical finite element modeling of interaction between soil and pipelines are necessary. The results of this study on buried pipelines indicate that the effect of liquefaction is function of pipe diameter, type of soil, and peak ground acceleration. There is a clear increase in percentage of damage with increasing the liquefaction severity. The results indicate that although in this form of the analysis, the damage is always associated to a certain pipe material, but the nominally defined “failures” include by failures of particular components (joints, connections, fire hydrant details, crossovers, laterals) rather than material failures. At the end, there are some retrofit suggestions in order to decrease the risk of liquefaction on buried pipelines.

Keywords: liquefaction, buried pipelines, lifelines, earthquake, finite element method

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Authors: Pamita Awasthi, Kirna, Shilpa Dogra, Manu Vatsal, Ritu Barthwal

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Doxorubicin, also known as adriamycin, is an anthracycline class of drug used in cancer chemotherapy. It is used in the treatment of non-Hodgkin’s lymphoma, multiple myeloma, acute leukemias, breast cancer, lung cancer, endometrium cancer and ovary cancers. It functions via intercalating DNA and ultimately killing cancer cells. The major side effects of doxorubicin are hair loss, myelosuppression, nausea & vomiting, oesophagitis, diarrhoea, heart damage and liver dysfunction. The minor modifications in the structure of compound exhibit large variation in the biological activity, has prompted us to carry out the synthesis of sulfonamide derivatives. Sulfonamide is an important feature with broad spectrum of biological activity such as antiviral, antifungal, diuretics, anti-inflammatory, antibacterial and anticancer activities. Structure of the synthesized compound N-(1-methyl-2-oxo-2-N-methyl anilino-ethyl)benzene sulfonamide confirmed by proton nuclear magnetic resonance (1H NMR),13C NMR, Mass and FTIR spectroscopic tools to assure the position of all protons and hence stereochemistry of the molecule. Further we have reported the binding potential of synthesized sulfonamide analogues in comparison to doxorubicin drug using Auto Dock 4.2 software. Computational binding energy (B.E.) and inhibitory constant (Ki) has been evaluated for the synthesized compound in comparison of doxorubicin against Poly (dA-dT).Poly (dA-dT) and Poly (dG-dC).Poly (dG-dC) sequences. The in vitro cytotoxic study against human breast cancer cell lines confirms the better anticancer activity of the synthesized compound over currently in use anticancer drug doxorubicin. The IC50 value of the synthesized compound is 7.12 µM where as for doxorubicin is 7.2 µ.

Keywords: Doxorubicin, auto dock, in silco, in vitro

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Authors: Yasmeen Jamal Alabdallat, Almutazballlah Bassam Qablan, Hamza Al-Salhi, Salameh Alarood, Ibraheem Alkhawaldeh, Obada Abunar, Adam Abdallah

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Obstructive sleep apnea (OSA) is a disorder caused by the repeated collapse of the upper airway during sleep. It is the most common cause of sleep-related breathing disorder, as OSA can cause loud snoring, daytime fatigue, or more severe problems such as high blood pressure, cardiovascular disease, coronary artery disease, insulin-resistant diabetes, and depression. The hypoglossal nerve stimulator (HNS) is an implantable medical device that reduces the occurrence of obstructive sleep apnea by electrically stimulating the hypoglossal nerve in rhythm with the patient's breathing, causing the tongue to move. This stimulation helps keep the patient's airways clear while they sleep. This systematic review and meta-analysis aimed to assess the clinical outcome of hypoglossal nerve stimulation as a treatment of obstructive sleep apnea. A computer literature search of PubMed, Scopus, Web of Science, and Cochrane Central Register of Controlled Trials was conducted from inception until August 2022. Studies assessing the following clinical outcomes (Apnea-Hypopnea Index (AHI), Epworth Sleepiness Scale (ESS), Functional Outcomes of Sleep Questionnaire (FOSQ), Oxygen Desaturation Indices (ODI), (Oxygen Saturation (SaO2)) were pooled in the meta-analysis using Review Manager Software. We assessed the quality of studies according to the Cochrane risk-of-bias tool for randomized trials (RoB2), Risk of Bias In Non-randomized Studies - of Interventions (ROBINS-I), and a modified version of NOS for the non-comparative cohort studies.13 Studies (Six Clinical Trials and Seven prospective cohort studies) with a total of 817 patients were included in the meta-analysis. The results of AHI were reported in 11 studies examining OSA 696 patients. We found that there was a significant improvement in the AHI after 12 months of HNS (MD = 18.2 with 95% CI, (16.7 to 19.7; I2 = 0%); P < 0.00001). Further, 12 studies reported the results of ESS after 12 months of intervention with a significant improvement in the range of sleepiness among the examined 757 OSA patients (MD = 5.3 with 95% CI, (4.75 to 5.86; I2 = 65%); P < 0.0001). Moreover, nine studies involving 699 participants reported the results of FOSQ after 12 months of HNS with a significant reported improvement (MD = -3.09 with 95% CI, (-3.41 to 2.77; I2 = 0%); P < 0.00001). In addition, ten studies reported the results of ODI with a significant improvement after 12 months of HNS among the 817 examined patients (MD = 14.8 with 95% CI, (13.25 to 16.32; I2 = 0%); P < 000001). The Hypoglossal Nerve Stimulation showed a significant positive impact on obstructive sleep apnea patients after 12 months of therapy in terms of apnea-hypopnea index, oxygen desaturation indices, manifestations of the behavioral morbidity associated with obstructive sleep apnea, and functional status resulting from sleepiness.

Keywords: apnea, meta-analysis, hypoglossal, stimulation

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Authors: Andrey V. Khromov, Antonida V. Makhotenko, Ekaterina A. Snigir, Svetlana S. Makarova, Natalia O. Kalinina, Valentin V. Makarov, Mikhail E. Taliansky

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Due to its simplicity, CRISPR/Cas9 has become widely used and capable of inducing mutations in the genes of organisms of various kingdoms. The aim of this work was to develop applications for the efficient modification of DNA coding sequences of phytoene desaturase (PDS), coilin and vacuolar invertase (Solanum tuberosum) genes, and to develop a new nanoparticles carrier efficient technology to deliver the CRISPR/Cas9 system for editing the plant genome. For each of the genes - coilin, PDS and vacuolar invertase, five single RNA guide (sgRNAs) were synthesized. To determine the most suitable nanoplatform, two types of NP platforms were used: magnetic NPs (MNPS) and gold NPs (AuNPs). To test the penetration efficiency, they were functionalized with fluorescent agents - BSA * FITS and GFP, as well as labeled Cy3 small-sized RNA. To measure the efficiency, a fluorescence and confocal microscopy were used. It was shown that the best of these options were AuNP - both in the case of proteins and in the case of RNA. The next step was to check the possibility of delivering components of the CRISPR/Cas9 system to plant cells for editing target genes. AuNPs were functionalized with a ribonucleoprotein complex consisting of Cas9 and corresponding to target genes sgRNAs, and they were biolistically bombarded to axillary buds and apical meristems of potato plants. After the treatment by the best NP carrier, potato meristems were grown to adult plants. DNA isolated from this plants was sent to a preliminary fragment of the analysis to screen out the non-transformed samples, and then to the NGS. The present work was carried out with the financial support from the Russian Science Foundation (grant No. 16-16-04019).

Keywords: biobombardment, coilin, CRISPR/Cas9, nanoparticles, NPs, PDS, sgRNA, vacuolar invertase

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Authors: Alessandro Poma, Kal Karim, Sergey Piletsky, Giuseppe Battaglia

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The recent increasing emergency threat to public health of infectious influenza diseases has prompted interest in the detection of avian influenza virus (AIV) H5N1 in humans as well as animals. A variety of technologies for diagnosing AIV infection have been developed. However, various disadvantages (costs, lengthy analyses, and need for high-containment facilities) make these methods less than ideal in their practical application. Molecularly Imprinted Polymeric Nanoparticles (MIP NPs) are suitable to overcome these limitations by having high affinity, selectivity, versatility, scalability and cost-effectiveness with the versatility of post-modification (labeling – fluorescent, magnetic, optical) opening the way to the potential introduction of improved diagnostic tests capable of providing rapid differential diagnosis. Here we present our first results in the production and testing of MIP NPs for the detection of AIV H5N1. Recent developments in the solid-phase synthesis of MIP NPs mean that for the first time a reliable supply of ‘soluble’ synthetic antibodies can be made available for testing as potential biological or diagnostic active molecules. The MIP NPs have the potential to detect viruses that are widely circulating in farm animals and indeed humans. Early and accurate identification of the infectious agent will expedite appropriate control measures. Thus, diagnosis at an early stage of infection of a herd or flock or individual maximizes the efficiency with which containment, prevention and possibly treatment strategies can be implemented. More importantly, substantiating the practicability’s of these novel reagents should lead to an initial reduction and eventually to a potential total replacement of animals, both large and small, to raise such specific serological materials.

Keywords: influenza virus, molecular imprinting, nanoparticles, polymers

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Authors: Magu Raam Prasaad R., Venkatramani Jagadish

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Recent studies in the literature have shown that randomly fluctuating wind flows can give rise to a distinct regime of pre-flutter oscillations called intermittency. Intermittency is characterized by the presence of sporadic bursts of high amplitude oscillations interspersed amidst low-amplitude aperiodic fluctuations. The focus of this study is on investigating the energy harvesting potential of these intermittent oscillations. Available literature has by and large devoted its attention on extracting energy from flutter oscillations. The possibility of harvesting energy from pre-flutter regimes have remained largely unexplored. However, extracting energy from violent flutter oscillations can be severely detrimental to the structural integrity of airfoil structures. Consequently, investigating the relatively stable pre-flutter responses for energy extraction applications is of practical importance. The present study is devoted towards addressing these concerns. A pitch-plunge airfoil with cubic hardening nonlinearity in the plunge and pitch degree of freedom is considered. The input flow fluctuations are modelled using a sinusoidal term with randomly perturbed frequencies. An electromagnetic coupling is provided to the pitch-plunge equations, such that, energy from the wind induced vibrations of the structural response are extracted. With the mean flow speed as the bifurcation parameter, a fourth order Runge-Kutta based time marching algorithm is used to solve the governing aeroelastic equations with electro-magnetic coupling. The harnessed energy from the intermittency regime is presented and the results are discussed in comparison to that obtained from the flutter regime. The insights from this study could be useful in health monitoring of aeroelastic structures.

Keywords: aeroelasticity, energy harvesting, intermittency, randomly fluctuating flows

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Authors: Natsuki Tsuda, Kiyotaka Obunai, Kazuya Okubo, Hideyuki Tashiro, Yoshinori Yamaji, Hideyuki Kato

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The objective of this study is to investigate the effect of belt stiffness on the performance of the CVT unit, such as the required pulley thrust force and the ratio coverage. The CVT unit consists of the V-grooved pulleys and the rubber CVT belt. The width of the driving pulley groove was controlled by the stepper motor, while that of the driven pulley was controlled by the hydraulic pressure. The generated mechanical power on the motor was transmitted from the driving axis to the driven axis through the CVT unit. The rotational speed and the transmitting torque of both axes were measured by the tachometers and the torque meters attached with these axes, respectively. The transmitted, mechanical power was absorbed by the magnetic powder brake. The thrust force acting on both pulleys and the force between both shafts were measured by the load cell. The back face profile of the rubber CVT belt along with width direction was measured by the 2-dimensional laser displacement meter. This paper found that when the stiffness of the rubber CVT belt in the belt width direction was reduced, the thrust force required for shifting was reduced. Moreover, when the stiffness of the rubber CVT belt in the belt width direction was reduced, the ratio coverage of the CVT unit was reduced. Due to the decrement of stiffness in belt width direction, the excessive concave deformation of belt in pulley groove was confirmed. Because of this excessive concave deformation, apparent wrapping radius of belt would have been reduced. Proposed model could be effectively estimated the difference of ratio coverage due to concave deformation. The proposed model could also be utilized for designing the rubber CVT belt with optimal bending stiffness in width direction.

Keywords: CVT, countinuously variable transmission, rubber, belt stiffness, transmission

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Authors: Alejandro Cittadino, David Allende

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Landfilling of municipal solid waste is a common waste management practice in Argentina as in many parts of the world. There is extensive scientific literature on the potential negative effects of landfill leachates on the environment, so it’s necessary to be rigorous with the control and monitoring systems. Due to the specific municipal solid waste composition in Argentina, local landfill leachates contain large amounts of organic matter (biodegradable, but also refractory to biodegradation), as well as ammonia-nitrogen, small trace of some heavy metals, and inorganic salts. In order to investigate the surface water quality in the Reconquista river adjacent to the Norte III landfill, water samples both upstream and downstream the dumpsite are quarterly collected and analyzed for 43 parameters including organic matter, heavy metals, and inorganic salts, as required by the local standards. The objective of this study is to apply a water quality index that considers the leachate characteristics in order to determine the quality status of the watercourse through the landfill. The water pollution index method has been widely used in water quality assessments, particularly rivers, and it has played an increasingly important role in water resource management, since it provides a number simple enough for the public to understand, that states the overall water quality at a certain location and time. The chosen water quality index (ICA) is based on the values of six parameters: dissolved oxygen (in mg/l and percent saturation), temperature, biochemical oxygen demand (BOD5), ammonia-nitrogen and chloride (Cl-) concentration. The index 'ICA' was determined both upstream and downstream the Reconquista river, being the rating scale between 0 (very poor water quality) and 10 (excellent water quality). The monitoring results indicated that the water quality was unaffected by possible leachate runoff since the index scores upstream and downstream were ranked in the same category, although in general, most of the samples were classified as having poor water quality according to the index’s scale. The annual averaged ICA index scores (computed quarterly) were 4.9, 3.9, 4.4 and 5.0 upstream and 3.9, 5.0, 5.1 and 5.0 downstream the river during the study period between 2014 and 2017. Additionally, the water quality seemed to exhibit distinct seasonal variations, probably due to annual precipitation patterns in the study area. The ICA water quality index appears to be appropriate to evaluate landfill impacts since it accounts mainly for organic pollution and inorganic salts and the absence of heavy metals in the local leachate composition, however, the inclusion of other parameters could be more decisive in discerning the affected stream reaches from the landfill activities. A future work may consider adding to the index other parameters like total organic carbon (TOC) and total suspended solids (TSS) since they are present in the leachate in high concentrations.

Keywords: landfill, leachate, surface water, water quality index

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Authors: Mekni Sabrine, Nouira Mariem

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Background and aim: Allogeneic hematopoietic stem cell transplantation is a curative treatment for several hematological diseases; however, it has a non-negligible morbidity and mortality depending on several prognostic factors, including pre-transplant hyperferritinemia. The aim of our study was to estimate the impact of hyperferritinemia on survivals and on the occurrence of post-transplant complications. Methods: It was a longitudinal study conducted over 8 years and including all patients who had a first allograft. The impact of pretransplant hyperferritinemia (ferritinemia ≥1500) on survivals was studied using the Kaplan Meier method and the COX model for uni- and multivariate analysis. The Khi-deux test and binary logistic regression were used to study the association between pretransplant ferritinemia and post-transplant complications. Results: One hundred forty patients were included with an average age of 26.6 years and a sex ratio (M/F)=1.4. Hyperferritinemia was found in 33% of patients. It had no significant impact on either overall survival (p=0.9) or event -free survival (p=0.6). In multivariate analysis, only the type of disease was independently associated with overall survival (p=0.04) and event-free survival (p=0.002). For post-allograft complications: The occurrence of early documented infections was independently associated with pretransplant hyperferritinemia (p=0.02) and the presence of acute graft versus host disease( GVHD) (p<10-3). The occurrence of acute GVHD was associated with early documented infection (p=0.002) and Cytomegalovirus reactivation (p<10-3). The occurrence of chronic GVHD was associated with the presence of Cytomegalovirus reactivation (p=0.006) and graft source (p=0.009). Conclusion: Our study showed the significant impact of pre-transplant hyperferritinemia on the occurrence of early infections but not on survivals. Early and more accurate assessment iron overload by other tests such as liver magnetic resonance imaging with initiation of chelating treatment could prevent the occurrence of such complications after transplantation.

Keywords: allogeneic, transplants, ferritin, survival

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Authors: Sahar Rakhshan, Simonetta Geninatti Crich, Diego Alberti, Rachele Stefania

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The combination of imaging and therapeutic agents in the same smart nanoparticle is a promising option to perform a minimally invasive imaging guided therapy. In this study, Low density lipoproteins (LDL), one of the most attractive biodegradable and biocompatible nanoparticles, were used for the simultaneous delivery of Paclitaxel (PTX), a hydrophobic antitumour drug and an amphiphilic contrast agent, Gd-AAZTA-C17, in B16-F10 melanoma cell line. These cells overexpress LDL receptors, as assessed by Flow cytometry analysis. PTX and Gd-AAZTA-C17 loaded LDLs (LDL-PTX-Gd) have been prepared, characterized and their stability was assessed under 72 h incubation at 37 ◦C and compared to LDL loaded with Gd-AAZTA-C17 (LDL-Gd) and LDL-PTX. The cytotoxic effect of LDL-PTX-Gd was evaluated by MTT assay. The anti-tumour drug loaded into LDLs showed a significantly higher toxicity on B16-F10 cells with respect to the commercially available formulation Paclitaxel Kabi (PTX Kabi) used in clinical applications. It was possible to demonstrate a high uptake of LDL-Gd in B16-F10 cells. As a consequence of the high cell uptake, melanoma cells showed significantly high cytotoxic effect when incubated in the presence of PTX (LDL-PTX-Gd). Furthermore, B16-F10 have been used to perform Magnetic Resonance Imaging. By the analysis of the image signal intensity, it was possible to extrapolate the amount of internalized PTX indirectly by the decrease of relaxation times caused by Gd, proportional to its concentration. Finally, the treatment with PTX loaded LDL on B16-F10 tumour bearing mice resulted in a marked reduction of tumour growth compared to the administration of PTX Kabi alone. In conclusion, LDLs are selectively taken-up by tumour cells and can be successfully exploited for the selective delivery of Paclitaxel and imaging agents.

Keywords: low density lipoprotein, melanoma cell lines, MRI, paclitaxel, personalized medicine application, theragnostic System

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Authors: T. Yılmaz, Ş. Tavman

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In this study, optimization of ultrasound assisted extraction (UAE) of hemicellulose based polysaccharides from plant waste material has been studied. Selected material is hazelnut skin. Extraction variables for the operation are extraction time, amplitude and application temperature. Optimum conditions have been evaluated depending on responses such as amount of wet crude polysaccharide, total carbohydrate content and dried sample. Pretreated hazelnut skin powders were used for the experiments. 10 grams of samples were suspended in 100 ml water in a jacketed vessel with additional magnetic stirring. Mixture was sonicated by immersing ultrasonic probe processor. After the extraction procedures, ethanol soluble and insoluble sides were separated for further examinations. The obtained experimental data were analyzed by analysis of variance (ANOVA). Second order polynomial models were developed using multiple regression analysis. The individual and interactive effects of applied variables were evaluated by Box Behnken Design. The models developed from the experimental design were predictive and good fit with the experimental data with high correlation coefficient value (R2 more than 0.95). Extracted polysaccharides from hazelnut skin are assumed to be pectic polysaccharides according to the literature survey of Fourier Transform Spectrometry (FTIR) analysis results. No more change can be observed between spectrums of different sonication times. Application of UAE at optimized condition has an important effect on extraction of hemicellulose from plant material by satisfying partial hydrolysis to break the bounds with other components in plant cell wall material. This effect can be summarized by varied intensity of microjets and microstreaming at varied sonication conditions.

Keywords: hazelnut skin, optimization, polysaccharide, ultrasound assisted extraction

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Authors: Heru Al Amin

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Sarcoidosis is a granulomatous inflammatory disorder of unclear etiology that can affect multiple different organ systems. Isolated cardiac sarcoidosis is a very rare condition that causes lethal arrhythmia and heart failure. A definite diagnosis of cardiac sarcoidosis remains challenging. The use of multimodality imaging plays a pivotal role in the diagnosis of this entity. Case summary: In this report, we discuss a case of a 50-year-old woman who presented with recurrent palpitation, dizziness, vertigo and presyncope. Electrocardiogram revealed variable heart blocks, including first-degree AV block, second-degree AV block, high-degree AV block, complete AV block, trifascicular block and sometimes supraventricular arrhythmia. Twenty-four hours of Holter monitoring show atrial bigeminy, first-degree AV block and trifascicular block. Transthoracic echocardiography showed Thinning of basal anteroseptal and inferred septum with LV dilatation with reduction of Global Longitudinal Strain. A dual-chamber pacemaker was implanted. CT Coronary angiogram showed no coronary artery disease. Cardiac magnetic resonance revealed basal anteroseptal and inferior septum thinning with focal edema with LGE suggestive of sarcoidosis. Computed tomography of the chest showed no lymphadenopathy or pulmonary infiltration. 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) of the whole body showed. We started steroids and followed up with the patient. Conclusion: This case serves to highlight the challenges in identifying and managing isolated CS in a young patient with recurrent syncope with variable heart block. Early, even late initiation of steroids can improve arrhythmia as well as left ventricular function.

Keywords: cardiac sarcoidosis, conduction abnormality, syncope, cardiac MRI

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