Search results for: variable magnetization
622 Extending Theory of Planned Behavior to Modelling Chronic Patients’ Acceptance of Health Information: An Information Overload Perspective
Authors: Shu-Lien Chou, Chung-Feng Liu
Abstract:
Self-health management of chronic illnesses plays an important part in chronic illness treatments. However, various kinds of health information (health education materials) which government or healthcare institutions provide for patients may not achieve the expected outcome. One of the critical reasons affecting patients’ use intention could be patients’ perceived Information overload regarding the health information. This study proposed an extended model of Theory of Planned Behavior, which integrating perceived information overload as another construct to explore patients’ use intention of the health information for self-health management. The independent variables are attitude, subject norm, perceived behavior control and perceived information overload while the dependent variable is behavior intention to use the health information. The cross-sectional study used a structured questionnaire for data collection, focusing on the chronic patients with coronary artery disease (CAD), who are the potential users of the health information, in a medical center in Taiwan. Data were analyzed using descriptive statistics of the basic information distribution of the questionnaire respondents, and the Partial Least Squares (PLS) structural equation model to study the reliability and construct validity for testing our hypotheses. A total of 110 patients were enrolled in this study and 106 valid questionnaires were collected. The PLS analysis result indicates that the patients’ perceived information overload of health information contributes the most critical factor influencing the behavioral intention. Subjective norm and perceived behavioral control of TPB constructs had significant effects on patients’ intentions to use health information also, whereas the attitude construct did not. This study demonstrated a comprehensive framework, which extending perceived information overload into TPB model to predict patients’ behavioral intention of using heath information. We expect that the results of this study will provide useful insights for studying health information from the perspectives of academia, governments, and healthcare providers.Keywords: chronic patients, health information, information overload, theory of planned behavior
Procedia PDF Downloads 436621 Vibration Analysis of FGM Sandwich Panel with Cut-Outs Using Refined Higher-Order Shear Deformation Theory (HSDT) Based on Isogeometric Analysis
Authors: Lokanath Barik, Abinash Kumar Swain
Abstract:
This paper presents vibration analysis of FGM sandwich structure with a complex profile governed by refined higher-order shear deformation theory (RHSDT) using isogeometric analysis (IGA). Functionally graded sandwich plates provide a wide range of applications in aerospace, defence, and aircraft industries due to their ability to distribute material functions to influence the thermo-mechanical properties as desired. In practical applications, these structures generally have intrinsic profiles, and their response to loads is significantly affected due to cut-outs. IGA is primarily a NURBS-based technique that is effective in solving higher-order differential equations due to its inherent C1 continuity imposition in solution space for a single patch. Complex structures generally require multiple patches to accurately represent the geometry, and hence, there is a loss of continuity at adjoining patch junctions. Therefore, patch coupling is desired to maintain continuity requirements throughout the domain. In this work, a novel strong coupling approach is provided that generates a well-defined NURBS-based model while achieving continuity. The methodology is validated by free vibration analysis of sandwich plates with present literature. The results are in good agreement with the analytical solution for different plate configurations and power law indexes. Numerical examples of rectangular and annular plates are discussed with variable boundary conditions. Additionally, parametric studies are provided by varying the aspect ratio, porosity ratio and their influence on the natural frequency of the plate.Keywords: vibration analysis, FGM sandwich structure, multipatch geometry, patch coupling, IGA
Procedia PDF Downloads 82620 An Evaluation of the Feasibility of Several Industrial Wastes and Natural Materials as Precursors for the Production of Alkali Activated Materials
Authors: O. Alelweet, S. Pavia
Abstract:
In order to face current compelling environmental problems affecting the planet, the construction industry needs to adapt. It is widely acknowledged that there is a need for durable, high-performance, low-greenhouse gas emission binders that can be used as an alternative to Portland cement (PC) to lower the environmental impact of construction. Alkali activated materials (AAMs) are considered a more sustainable alternative to PC materials. The binders of AAMs result from the reaction of an alkali metal source and a silicate powder or precursor which can be a calcium silicate or an aluminosilicate-rich material. This paper evaluates the particle size, specific surface area, chemical and mineral composition and amorphousness of silicate materials (most industrial waste locally produced in Ireland and Saudi Arabia) to develop alkali-activated binders that can replace PC resources in specific applications. These include recycled ceramic brick, bauxite, illitic clay, fly ash and metallurgical slag. According to the results, the wastes are reactive and comply with building standards requirements. The study also evidenced that the reactivity of the Saudi bauxite (with significant kaolinite) can be enhanced on thermal activation; and high calcium in the slag will promote reaction; which should be possible with low alkalinity activators. The wastes evidenced variable water demands that will be taken into account for mixing with the activators. Finally, further research is proposed to further determine the reactive fraction of the clay-based precursors.Keywords: alkali activated materials, alkali-activated binders, sustainable building materials, recycled ceramic brick, bauxite, red mud, clay, fly ash, metallurgical slags, particle size, chemical and mineral composition and amorphousness, water demand, particle density
Procedia PDF Downloads 126619 Parameter Estimation of Additive Genetic and Unique Environment (AE) Model on Diabetes Mellitus Type 2 Using Bayesian Method
Authors: Andi Darmawan, Dewi Retno Sari Saputro, Purnami Widyaningsih
Abstract:
Diabetes mellitus (DM) is a chronic disease in human that occurred if pancreas cannot produce enough of insulin hormone or the body uses ineffectively insulin hormone which causes increasing level of glucose in the blood, or it was called hyperglycemia. In Indonesia, DM is a serious disease on health because it can cause blindness, kidney disease, diabetic feet (gangrene), and stroke. The type of DM criteria can also be divided based on the main causes; they are DM type 1, type 2, and gestational. Diabetes type 1 or previously known as insulin-independent diabetes is due to a lack of production of insulin hormone. Diabetes type 2 or previously known as non-insulin dependent diabetes is due to ineffective use of insulin while gestational diabetes is a hyperglycemia that found during pregnancy. The most one type commonly found in patient is DM type 2. The main factors of this disease are genetic (A) and life style (E). Those disease with 2 factors can be constructed with additive genetic and unique environment (AE) model. In this article was discussed parameter estimation of AE model using Bayesian method and the inheritance character simulation on parent-offspring. On the AE model, there are response variable, predictor variables, and parameters were capable of representing the number of population on research. The population can be measured through a taken random sample. The response and predictor variables can be determined by sample while the parameters are unknown, so it was required to estimate the parameters based on the sample. Estimation of AE model parameters was obtained based on a joint posterior distribution. The simulation was conducted to get the value of genetic variance and life style variance. The results of simulation are 0.3600 for genetic variance and 0.0899 for life style variance. Therefore, the variance of genetic factor in DM type 2 is greater than life style.Keywords: AE model, Bayesian method, diabetes mellitus type 2, genetic, life style
Procedia PDF Downloads 284618 Creation of Computerized Benchmarks to Facilitate Preparedness for Biological Events
Abstract:
Introduction: Communicable diseases and pandemics pose a growing threat to the well-being of the global population. A vital component of protecting the public health is the creation and sustenance of a continuous preparedness for such hazards. A joint Israeli-German task force was deployed in order to develop an advanced tool for self-evaluation of emergency preparedness for variable types of biological threats. Methods: Based on a comprehensive literature review and interviews with leading content experts, an evaluation tool was developed based on quantitative and qualitative parameters and indicators. A modified Delphi process was used to achieve consensus among over 225 experts from both Germany and Israel concerning items to be included in the evaluation tool. Validity and applicability of the tool for medical institutions was examined in a series of simulation and field exercises. Results: Over 115 German and Israeli experts reviewed and examined the proposed parameters as part of the modified Delphi cycles. A consensus of over 75% of experts was attained for 183 out of 188 items. The relative importance of each parameter was rated as part of the Delphi process, in order to define its impact on the overall emergency preparedness. The parameters were integrated in computerized web-based software that enables to calculate scores of emergency preparedness for biological events. Conclusions: The parameters developed in the joint German-Israeli project serve as benchmarks that delineate actions to be implemented in order to create and maintain an ongoing preparedness for biological events. The computerized evaluation tool enables to continuously monitor the level of readiness and thus strengths and gaps can be identified and corrected appropriately. Adoption of such a tool is recommended as an integral component of quality assurance of public health and safety.Keywords: biological events, emergency preparedness, bioterrorism, natural biological events
Procedia PDF Downloads 423617 Consequences of Youth Bulge in Pakistan
Authors: Muhammad Farooq, Muhammad Idrees
Abstract:
The present study has been designed to explore the causes and effects of Youth Bulge in Pakistan. However, youth bulge is a part of population segment which create problem for the whole society. The youth bulge is a common phenomenon in many developing countries, and in particular, in the least developed countries. It is often due to a stage of development where a country achieves success in reducing infant mortality but mothers still have a high fertility rate. The result is that a large share of the population is comprised of children and young adults, and today’s children are tomorrow’s young adults. Youth often play a prominent role in political violence and the existence of a “youth bulge” has been associated with times of political crisis. The population pyramid of Pakistan represents a large youth proportion and our government did not use that youth in positive way and did not provide them opportunity for development, this situation creates frustration in youth that leads them towards conflict, unrest and violence. This study will be focus on the opportunity and motives of the youth bulge situation in Pakistan in the lens of youth bulge theory. Moreover, it will give some suggestions to utilize youth in the development activities and avoid youth bulge situation in Pakistan. The present research was conducted in the metropolitan entities of Punjab, Pakistan. A sample of 300 respondents was taken from three randomly selected metropolitan entities (Faisalabad, Lahore and Rawalpindi) of Punjab Province of Pakistan. Information regarding demography, household, locality and other socio-cultural variables related to causes and effects of youth bulge in the state was collected through a well structured interview schedule. Mean, Standard Deviation and frequency distribution were used to check the measure of central tendency. Multiple linear regression was also applied to measure the influence of various independent variables on the response variable.Keywords: youth bulge, violence, conflict, social unrest, crime, metropolitan entities, mean, standard deviation, multiple linear regression
Procedia PDF Downloads 458616 Oxide Based Memristor and Its Potential Application in Analog-Digital Electronics
Authors: P. Michael Preetam Raj, Souri Banerjee, Souvik Kundu
Abstract:
Oxide based memristors were fabricated in order to establish its potential applications in analog/digital electronics. BaTiO₃-BiFeO₃ (BT-BFO) was employed as an active material, whereas platinum (Pt) and Nb-doped SrTiO₃ (Nb:STO) were served as a top and bottom electrodes, respectively. Piezoelectric force microscopy (PFM) was utilized to present the ferroelectricity and repeatable polarization inversion in the BT-BFO, demonstrating its effectiveness for resistive switching. The fabricated memristors exhibited excellent electrical characteristics, such as hysteresis current-voltage (I-V), high on/off ratio, high retention time, cyclic endurance, and low operating voltages. The band-alignment between the active material BT-BFO and the substrate Nb:STO was experimentally investigated using X-Ray photoelectron spectroscopy, and it attributed to staggered heterojunction alignment. An energy band diagram was proposed in order to understand the electrical transport in BT-BFO/Nb:STO heterojunction. It was identified that the I-V curves of these memristors have several discontinuities. Curve fitting technique was utilized to analyse the I-V characteristic, and the obtained I-V equations were found to be parabolic. Utilizing this analysis, a non-linear BT-BFO memristors equivalent circuit model was developed. Interestingly, the obtained equivalent circuit of the BT-BFO memristors mimics the identical electrical performance, those obtained in the fabricated devices. Based on the developed equivalent circuit, a finite state machine (FSM) design was proposed. Efforts were devoted to fabricate the same FSM, and the results were well matched with those in the simulated FSM devices. Its multilevel noise filtering and immunity to external noise characteristics were also studied. Further, the feature of variable negative resistance was established by controlling the current through the memristor.Keywords: band alignment, finite state machine, polarization inversion, resistive switching
Procedia PDF Downloads 133615 The Impact of Access to Finances on Survival of Small and Medium Enterprises: The South African Perspective in an Covid-19 Era
Authors: Thabiso Sthembiso Msomi
Abstract:
SMEs are the main engine of growth in most developing economies. One of the main factors that hinder the development of SME is access to finance. In this study, we explored the factors that hinder the growth and survival of SMEs in South Africa. The capital structure theory formed the theoretical underpinning for the study. The quantitative research design was adopted and data was collected from retail, construction, manufacturing and agriculture sectors of SMEs within the KwaZulu-Natal province of South Africa. The modified version of the Cochran formula was used to determine the sample size as 321 SMEs and analysed using the five-point Likert scale. The purposive sampling technique was used to select owners of SME. Statistical Package for the Social Sciences (SPSS) was used for the data analysis through Exploratory Factor Analysis (EFA) to determine the factor structures of items employed to measure each of the constructs in this study. Then, the Cronbach’s alpha test was conducted to determine the reliability of each construct. Kaiser-Meyer-Olkin (KMO) was used to determine the adequacy of the sample size. Linear regression was done to determine the effect of the independent variables on the dependent variable. The findings suggest that the main constraints facing South African SMEs were the lack of experienced management. Furthermore, the SMEs would fail to raise customer awareness of their products and services, which in turn affects their market access and monthly turnover. The study recommends that SMEs keep up-to-date records of business transactions to enable the business to keep track of its operations. The study recommends that South African banks adopt an SME accounting and bookkeeping program. The finding of this study benefits policymakers in both the private and public sectors.Keywords: small businesses, access to finances, COVID-19, SMEs survival
Procedia PDF Downloads 176614 The Antecedents of Green Purchase Intention in Nigeria: Mediating Effect of Perceived Behavioral Control
Authors: Victoria Masi Haruna Karatu, Nik Kamariah Nikmat
Abstract:
In recent times awareness about the environment and green purchase has been on the increase across nations due to global warming. Previous researchers have attempted to determine what actually influences the purchase intention of consumers in this environmentally conscious epoch. The consumers too have become conscious of what to buy and who to buy from in their purchasing decisions as this action will reflect their concern about the environment and their personal well-being. This trend is a widespread phenomenon in most developed countries of the world. On the contrary evidence revealed that only 5% of the populations of Nigeria involve in green purchase activities thus making the country lag behind its counterparts in green practices. This is not a surprise as Nigeria is facing problems of inadequate green knowledge, non-enforcement of environmental regulations, sensitivity to the price of green products when compared with the conventional ones and distrust towards green products which has been deduced from prior studies of other regions. The main objectives of this study is to examine the direct antecedents of green purchase intention (green availability, government regulations, perceived green knowledge, perceived value and green price sensitivity) in Nigeria and secondly to establish the mediating role of perceived behavioral control on the relationship between these antecedents and green purchase intention. The study adopts quantitative method whereby 700 questionnaires were administered to lecturers in three Nigerian universities. 502 datasets were collected which represents 72 percent response rate. After screening the data only 440 were usable and analyzed using structural equation modeling (SEM) and bootstrapping. From the findings, three antecedents have significant direct relationships with green purchase intention (perceived green knowledge, perceived behavioral control, and green availability) while two antecedents have positive and significant direct relationship with perceived behavioral control (perceived value and green price sensitivity). On the other hand, PBC does not mediate any of the paths from the predictors to criterion variable. This result is discussed in the Nigerian context.Keywords: Green Availability, Green Price Sensitivity, Green Purchase Intention, Perceived Green Knowledge, Perceived Value
Procedia PDF Downloads 426613 Sexual Behaviours among Iranian Men and Women Aged 15 to 49 Years in Metropolitan Tehran, Iran: A Cross-Sectional Study
Authors: Mahnaz Motamedi, Mohammad Shahbazi, Shahrzad Rahimi-Naghani, Mehrdad Salehi
Abstract:
Introduction and Aim: This study assessed sexual behaviours among men and women aged 15 to 49 years in Tehran. Material and Methods: This was a cross-sectional study conducted on 755 men and women aged 15 to 49 years who were residents of Tehran. To select the participants, a multistage, cluster, random sampling method was used and included different regions of Tehran. The data were collected using the WHO-endorsed Questionnaire of Sexual and Reproductive Health. Descriptive, bivariate, and multivariate analyses were conducted using SPSS version 20. Sexual and reproductive health (SRH) behaviours was a scale variable that was constructed from items of six sections: sexual experiences, characteristics of the first sexual partner, characteristics of the first intercourse, next sexual contact and the consequences of the first sexual contact, homosexual experiences and the causes of sexual abstinence. Results: The mean age at the time of sexual intercourse with penetration (vaginal, anal) was 19.88 in men and 21.82 in women. Multivariate analysis using linear regression showed that by controlling for other variables, gender had a significant relationship with having sexual experience, mean age of first sexual intercourse, and being multi-partner. Thus, women with sexual experience were 0.158 units less than men. The mean age of first intercourse in women was 1.57 units higher than men and being a multi-partner in women was 0.247 less than men (P < 0.001). Sexual experience in very religious and relatively religious individuals was 0.332 and 0.218 units less than those for whom religion did not matter (P < 0.001). 25.6% of men and 40.7% of women who did not have sexual experience at the time of the study stated that their reason for abstinence was their unwillingness to have sex (P < 0.05). 35.9% of men and 16.5% of women stated that the reason for abstinence was not providing a suitable opportunity (P < 0.001). 4.7% of men and 1.7% of women had sexual attraction to the same sex. The difference between men and women was significant (P < 0.001). Conclusion: Sexual relation is also present in singles and younger groups and is not limited to married or final marriage candidates. Therefore, more evaluation should be done in national research and interventions for sexual and reproductive health services should be done at the macro level of policy making.Keywords: sexual behaviours, Iranian men and women, Iran, cross-sectional study
Procedia PDF Downloads 157612 Variability of Energy Efficiency with the Application of Technologies Embedded in Locomotives of a Heavy Haul Railway: Case Study of Vitoria Minas Railway, Brazil
Authors: Eric Wilson Santos Cabral, Marta Monteiro Da Costa Cruz, Rodrigo Pirola Pestana, Vivian Andréa Parreira
Abstract:
In the transportation sector in Brazil, there is a great challenge that is the maintenance of profit in the face of the great variation in the price of diesel. This directly affects the variable cost of transport companies. Within the railways, part of the great challenges is to overcome the annual budget, cargo and ore transported, thus reducing costs compared to previous years, becoming more efficient each year. Within this scenario, the railway companies are looking for effective measures, aiming at reducing the ratio of liter of diesel consumed by KTKB (Kilometer Gross Ton multiplied by thousand). This ratio represents the indicator of energy efficiency of some railroads in Brazil and in other countries. In this study, we sought to analyze the behavior of the energy efficiency indicator on two parts: The first, with the application of technologies used in locomotives, such as the start-stop system of the diesel engine and the system of tracking and monitoring of fuel. The second, evaluation of the behavior of the variation of the type of cargo transported (loading mix). The study focused on locomotive technology will be carried out using statistical analysis, behavioral evaluation in different operating conditions, such as maneuvers for trains, service trains and freight trains. The analysis will also cover the evaluation of the loading mix made using statistical analysis of the existing railroad database, comparing the energy efficiency per loading mine and type of product. With the completion of this study, the railway undertakings should be able to better target decision-making in order to achieve substantial reductions in transport costs.Keywords: railway transport, energy efficiency, railway technology, fuel consumption
Procedia PDF Downloads 304611 Assessment the Infiltration of the Wastewater Ponds and Its Impact on the Water Quality of Pleistocene Aquifer at El Sadat City Using 2-D Electrical Resistivity Tomography and Water Chemistry
Authors: Abeer A. Kenawy, Usama Massoud, El-Said A. Ragab, Heba M. El-Kosery
Abstract:
2-D Electrical Resistivity Tomography (ERT) and hydrochemical study have been conducted at El Sadat industrial city. The study aims to investigate the area around the wastewater ponds to determine the possibility of water percolation from the wastewater ponds to the Pleistocene aquifer and to inspect the effect of this seepage on the groundwater chemistry. Pleistocene aquifer is the main groundwater reservoir in this area, where El Sadat city and its vicinities depend totally on this aquifer for water supplies needed for drinking, agricultural, and industrial activities. In this concern, seven ERT profiles were measured around the wastewater ponds. Besides, 10 water samples were collected from the ponds and the nearby groundwater wells. The water samples have been chemically analyzed for major cations, anions, nutrients, and heavy elements. Also, the physical parameters (pH, Alkalinity, EC, TDS) of the water samples were measured. Inspection of the ERT sections shows that they exhibit lower resistivity values towards the water ponds and higher values in opposite sides. In addition, the water table was detected at shallower depths at the same sides of lower resistivity. This could indicate a wastewater infiltration to the groundwater aquifer near the oxidation ponds. Correlation of the physical parameters and ionic concentrations of the wastewater samples with those of the groundwater samples indicates that; the ionic levels are randomly varying and no specific trend could be obtained. In addition, the wastewater samples shows some ionic levels lower than those detected in other groundwater samples. Besides, the nitrate level is higher in samples taken from the cultivated land than the wastewater samples due to the over using of nitrogen fertilizers. Then, we can say that the infiltrated water from wastewater ponds are not the main controller of the groundwater chemistry in this area, but rather the variable ionic concentrations could be attributed to local, natural, and anthropogenic processes.Keywords: El Sadat city, ERT, hydrochemistry, percolation, wastewater ponds
Procedia PDF Downloads 355610 Improvement in Drying Characteristics of Raisin by Carbonic Maceration– Process Optimization
Authors: Nursac Akyol, Merve S. Turan, Mustafa Ozcelik, Erdogan Kucukoner, Erkan Karacabey
Abstract:
Traditional raisin production is a long time drying process under sunlight. During this procedure, grapes are open to some environmental effects besides the adverse effects of the long drying period. Thus, there is a need to develop an alternative method being applicable instead of traditional one. To this extent, a combination of a potential pretreatment (carbonic maceration, CM) with convectional oven drying was examined. CM application was used in raisin production (grape drying) as a pretreatment process before oven drying. Pressure, temperature and time were examined as application parameters of CM. In conventional oven drying, the temperature is a process variable. The aim is to find out how CM and convectional drying processes affect the drying characteristics of grapes as well as their physical and chemical properties. For this purpose, the response surface method was used to determine both the effects of the variables and the optimum pretreatment and drying conditions. The optimum conditions of CM for raisin production were 0.3 MPa of pressure value, 4°C of application temperature and 8 hours of application time. The optimized drying temperature was 77°C. The results showed that the application of CM before the drying process improved the drying characteristics. Drying took only 389 minutes for grapes pretreated by CM under optimum conditions and 495 minutes for the control group dried only by the conventional drying process. According to these results, a decrease of 21% was achieved in the time requirement for raisin production. Also, it was observed that the samples dried under optimum conditions had similar physical properties as those the control group had. It was seen that raisin, which was dried under optimum conditions were in better condition in terms of some of the bioactive contents compared to control groups. In light of all results, it is seen that CM has an important potential in the industrial drying of grape samples. The current study was financially supported by TUBITAK, Turkey (Project no: 116R038).Keywords: drying time, pretreatment, response surface methodlogy, total phenolic
Procedia PDF Downloads 138609 A Mixed Methods Study: Evaluation of Experiential Learning Techniques throughout a Nursing Curriculum to Promote Empathy
Authors: Joan Esper Kuhnly, Jess Holden, Lynn Shelley, Nicole Kuhnly
Abstract:
Empathy serves as a foundational nursing principle inherent in the nurse’s ability to form those relationships from which to care for patients. Evidence supports, including empathy in nursing and healthcare education, but there is limited data on what methods are effective to do so. Building evidence supports experiential and interactive learning methods to be effective for students to gain insight and perspective from a personalized experience. The purpose of this project is to evaluate learning activities designed to promote the attainment of empathic behaviors across 5 levels of the nursing curriculum. Quantitative analysis will be conducted on data from pre and post-learning activities using the Toronto Empathy Questionnaire. The main hypothesis, that simulation learning activities will increase empathy, will be examined using a repeated measures Analysis of Variance (ANOVA) on Pre and Post Toronto Empathy Questionnaire scores for three simulation activities (Stroke, Poverty, Dementia). Pearson product-moment correlations will be conducted to examine the relationships between continuous demographic variables, such as age, credits earned, and years practicing, with the dependent variable of interest, Post Test Toronto Empathy Scores. Krippendorff’s method of content analysis will be conducted to identify the quantitative incidence of empathic responses. The researchers will use Colaizzi’s descriptive phenomenological method to describe the students’ simulation experience and understand its impact on caring and empathy behaviors employing bracketing to maintain objectivity. The results will be presented, answering multiple research questions. The discussion will be relevant to results and educational pedagogy in the nursing curriculum as they relate to the attainment of empathic behaviors.Keywords: curriculum, empathy, nursing, simulation
Procedia PDF Downloads 111608 Mediation Analysis of the Efficacy of the Nimotuzumab-Cisplatin-Radiation (NCR) Improve Overall Survival (OS): A HPV Negative Oropharyngeal Cancer Patient (HPVNOCP) Cohort
Authors: Akshay Patil
Abstract:
Objective: Mediation analysis identifies causal pathways by testing the relationships between the NCR, the OS, and an intermediate variable that mediates the relationship between the Nimotuzumab-cisplatin-radiation (NCR) and OS. Introduction: In randomized controlled trials, the primary interest is in the mechanisms by which an intervention exerts its effects on the outcomes. Clinicians are often interested in how the intervention works (or why it does not work) through hypothesized causal mechanisms. In this work, we highlight the value of understanding causal mechanisms in randomized trial by applying causal mediation analysis in a randomized trial in oncology. Methods: Data was obtained from a phase III randomized trial (Subgroup of HPVNOCP). NCR is reported to significantly improve the OS of patients locally advanced head and neck cancer patients undergoing definitive chemoradiation. Here, based on trial data, the mediating effect of NCR on patient overall survival was systematically quantified through progression-free survival(PFS), disease free survival (DFS), Loco-regional failure (LRF), and the disease control rate (DCR), Overall response rate (ORR). Effects of potential mediators on the HR for OS with NCR versus cisplatin-radiation (CR) were analyzed by Cox regression models. Statistical analyses were performed using R software Version 3.6.3 (The R Foundation for Statistical Computing) Results: Effects of potential mediator PFS was an association between NCR treatment and OS, with an indirect-effect (IE) 0.76(0.62 – 0.95), which mediated 60.69% of the treatment effect. Taking into account baseline confounders, the overall adjusted hazard ratio of death was 0.64 (95% CI: 0.43 – 0.96; P=0.03). The DFS was also a significant mediator and had an IE 0.77 (95% CI; 0.62-0.93), 58% mediated). Smaller mediation effects (maximum 27%) were observed for LRF with IE 0.88(0.74 – 1.06). Both DCR and ORR mediated 10% and 15%, respectively, of the effect of NCR vs. CR on the OS with IE 0.65 (95% CI; 0.81 – 1.08) and 0.94(95% CI; 0.79 – 1.04). Conclusion: Our findings suggest that PFS and DFS were the most important mediators of the OS with nimotuzumab to weekly cisplatin-radiation in HPVNOCP.Keywords: mediation analysis, cancer data, survival, NCR, HPV negative oropharyngeal
Procedia PDF Downloads 145607 Diagnostic Properties of Exercise or Pharmacological Stress Myocardial Perfusion Scintigraphy in Per-Vessel Basis: A Clinical Validation Study
Authors: Ahmadreza Bagheri, Seyyed S. Eftekhari, Shervin Rashidinia
Abstract:
Background: Various stress tests have been proposed yet to assess patients with suspected coronary artery disease. However, their diagnostic properties in terms of sensitivity, specificity, and accuracy are variable and their applicability remained somewhat vague. The aim of this study is to validate per-vessel diagnostic properties of 3 types of stress myocardial perfusion scintigraphy in gated SPECT (Single-Photon Emission Computed Tomography) using either exercise or pharmacological stress testing with dipyridamole or dobutamine. Materials and Methods: Hospital records of 314 patients who referred to Imam Khomeini hospital of Tehran between September 2015 and January 2017 were completely reviewed in this study. All patients underwent coronary angiography within 3 months after stress myocardial perfusion scan. Eventually, the results were analyzed in per-vessel basis to find the proper modality for each involved vessel or scanned site. Results: The mean age of patients was 62.15 ± 4.94 years (30-85) and 35.03% were women. The overall sensitivity, specificity, and accuracy were calculated as 56.59%, 54.24%, and 55.09%, respectively. These values were 56.43% and 53.25%, 54.46% and 47.36%, 56.75% and 54.83% for dipyridamole and exercise, respectively. Ischemia of the anterior wall through exercise stress testing has the highest diagnostic accuracy in detecting LAD (Left Anterior Descending artery) involvement. Inferior wall hypokinesia and anterolateral wall ischemia during exercise stress testing have the highest diagnostic accuracy in detecting RCA (Right Coronary Artery) and LCX artery (Left Circumflex Artery) stenosis, respectively. Conclusion: Stress myocardial perfusion scan should be carried out on the basis of the findings of the preliminary investigations on suspicion of a specific coronary artery or involved myocardial wall.Keywords: dipyridamole, dobutamine, single-photon emission computed tomography, stress myocardial perfusion scintigraphy
Procedia PDF Downloads 155606 Modeling of Timing in a Cyber Conflict to Inform Critical Infrastructure Defense
Authors: Brian Connett, Bryan O'Halloran
Abstract:
Systems assets within critical infrastructures were seemingly safe from the exploitation or attack by nefarious cyberspace actors. Now, critical infrastructure is a target and the resources to exploit the cyber physical systems exist. These resources are characterized in terms of patience, stealth, replication-ability and extraordinary robustness. System owners are obligated to maintain a high level of protection measures. The difficulty lies in knowing when to fortify a critical infrastructure against an impending attack. Models currently exist that demonstrate the value of knowing the attacker’s capabilities in the cyber realm and the strength of the target. The shortcomings of these models are that they are not designed to respond to the inherent fast timing of an attack, an impetus that can be derived based on open-source reporting, common knowledge of exploits of and the physical architecture of the infrastructure. A useful model will inform systems owners how to align infrastructure architecture in a manner that is responsive to the capability, willingness and timing of the attacker. This research group has used an existing theoretical model for estimating parameters, and through analysis, to develop a decision tool for would-be target owners. The continuation of the research develops further this model by estimating the variable parameters. Understanding these parameter estimations will uniquely position the decision maker to posture having revealed the vulnerabilities of an attacker’s, persistence and stealth. This research explores different approaches to improve on current attacker-defender models that focus on cyber threats. An existing foundational model takes the point of view of an attacker who must decide what cyber resource to use and when to use it to exploit a system vulnerability. It is valuable for estimating parameters for the model, and through analysis, develop a decision tool for would-be target owners.Keywords: critical infrastructure, cyber physical systems, modeling, exploitation
Procedia PDF Downloads 192605 3D Numerical Simulation of Undoweled and Uncracked Joints in Short Paneled Concrete Pavements
Authors: K. Sridhar Reddy, M. Amaranatha Reddy, Nilanjan Mitra
Abstract:
Short paneled concrete pavement (SPCP) with shorter panel size can be an alternative to the conventional jointed plain concrete pavements (JPCP) at the same cost as the asphalt pavements with all the advantages of concrete pavement with reduced thickness, less chance of mid-slab cracking and or dowel bar locking so common in JPCP. Cast-in-situ short concrete panels (short slabs) laid on a strong foundation consisting of a dry lean concrete base (DLC), and cement treated subbase (CTSB) will reduce the thickness of the concrete slab to the order of 180 mm to 220 mm, whereas JPCP was with 280 mm for the same traffic. During the construction of SPCP test sections on two Indian National Highways (NH), it was observed that the joints remain uncracked after a year of traffic. The undoweled and uncracked joints load transfer variability and joint behavior are of interest with anticipation on its long-term performance of the SPCP. To investigate the effects of undoweled and uncracked joints on short slabs, the present study was conducted. A multilayer linear elastic analysis using 3D finite element package for different panel sizes with different thicknesses resting on different types of solid elastic foundation with and without temperature gradient was developed. Surface deflections were obtained from 3D FE model and validated with measured field deflections from falling weight deflectometer (FWD) test. Stress analysis indicates that flexural stresses in short slabs are decreased with a decrease in panel size and increase in thickness. Detailed evaluation of stress analysis with the effects of curling behavior, the stiffness of the base layer and a variable degree of load transfer, is underway.Keywords: joint behavior, short slabs, uncracked joints, undoweled joints, 3D numerical simulation
Procedia PDF Downloads 181604 Traumatic Chiasmal Syndrome Following Traumatic Brain Injury
Authors: Jiping Cai, Ningzhi Wangyang, Jun Shao
Abstract:
Traumatic brain injury (TBI) is one of the major causes of morbidity and mortality that leads to structural and functional damage in several parts of the brain, such as cranial nerves, optic nerve tract or other circuitry involved in vision and occipital lobe, depending on its location and severity. As a result, the function associated with vision processing and perception are significantly affected and cause blurred vision, double vision, decreased peripheral vision and blindness. Here two cases complaining of monocular vision loss (actually temporal hemianopia) due to traumatic chiasmal syndrome after frontal head injury were reported, and were compared the findings with individual case reports published in the literature. Reported cases of traumatic chiasmal syndrome appear to share some common features, such as injury to the frontal bone and fracture of the anterior skull base. The degree of bitemporal hemianopia and visual loss acuity have a variable presentation and was not necessarily related to the severity of the craniocerebral trauma. Chiasmal injury may occur even in the absence bony chip impingement. Isolated bitemporal hemianopia is rare and clinical improvement usually may not occur. Mechanisms of damage to the optic chiasm after trauma include direct tearing, contusion haemorrhage and contusion necrosis, and secondary mechanisms such as cell death, inflammation, edema, neurogenesis impairment and axonal damage associated with TBI. Beside visual field test, MRI evaluation of optic pathways seems to the strong objective evidence to demonstrate the impairment of the integrity of visual systems following TBI. Therefore, traumatic chiasmal syndrome should be considered as a differential diagnosis by both neurosurgeons and ophthalmologists in patients presenting with visual impairment, especially bitemporal hemianopia after head injury causing frontal and anterior skull base fracture.Keywords: bitemporal hemianopia, brain injury, optic chiasma, traumatic chiasmal syndrome.
Procedia PDF Downloads 79603 Remote Sensing and Geographic Information Systems for Identifying Water Catchments Areas in the Northwest Coast of Egypt for Sustainable Agricultural Development
Authors: Mohamed Aboelghar, Ayman Abou Hadid, Usama Albehairy, Asmaa Khater
Abstract:
Sustainable agricultural development of the desert areas of Egypt under the pressure of irrigation water scarcity is a significant national challenge. Existing water harvesting techniques on the northwest coast of Egypt do not ensure the optimal use of rainfall for agricultural purposes. Basin-scale hydrology potentialities were studied to investigate how available annual rainfall could be used to increase agricultural production. All data related to agricultural production included in the form of geospatial layers. Thematic classification of Sentinal-2 imagery was carried out to produce the land cover and crop maps following the (FAO) system of land cover classification. Contour lines and spot height points were used to create a digital elevation model (DEM). Then, DEM was used to delineate basins, sub-basins, and water outlet points using the Soil and Water Assessment Tool (Arc SWAT). Main soil units of the study area identified from Land Master Plan maps. Climatic data collected from existing official sources. The amount of precipitation, surface water runoff, potential, and actual evapotranspiration for the years (2004 to 2017) shown as results of (Arc SWAT). The land cover map showed that the two tree crops (olive and fig) cover 195.8 km2 when herbaceous crops (barley and wheat) cover 154 km2. The maximum elevation was 250 meters above sea level when the lowest one was 3 meters below sea level. The study area receives a massive variable amount of precipitation; however, water harvesting methods are inappropriate to store water for purposes.Keywords: water catchements, remote sensing, GIS, sustainable agricultural development
Procedia PDF Downloads 114602 Nanoprecipitation with Ultrasonication for Enhancement of Oral Bioavailability of Fursemide: Pharmacokinetics and Pharmacodynamics Study in Rat Model
Authors: Malay K. Das, Bhanu P. Sahu
Abstract:
Furosemide is a weakly acidic diuretic indicated for treatment of edema and hypertension. It has very poor solubility but high permeability through stomach and upper gastrointestinal tract (GIT). Due to its limited solubility it has poor and variable oral bioavailability of 10-90%. The aim of this study was to enhance the oral bioavailability of furosemide by preparation of nanosuspensions. The nanosuspensions were prepared by nanoprecipitation with sonication using DMSO (dimethyl sulfoxide) as a solvent and water as an antisolvent (NA). The prepared nanosuspensions were sterically stabilized with polyvinyl acetate (PVA).These were characterized for particle size, ζ potential, polydispersity index, scanning electron microscopy (SEM), differential scanning calorimetry (DSC), X-ray diffraction (XRD) pattern and release behavior. The effect of nanoprecipitation on oral bioavailability of furosemide nanosuspension was studied by in vitro dissolution and in vivo absorption study in rats and compared to pure drug. The stable nanosuspension was obtained with average size range of the precipitated nanoparticles between 150-300 nm and was found to be homogenous showing a narrow polydispersity index of 0.3±0.1. DSC and XRD studies indicated that the crystalline furosemide drug was converted to amorphous form upon precipitation into nanoparticles. The release profiles of nanosuspension formulation showed up to 81.2% release in 4 h. The in vivo studies on rats revealed a significant increase in the oral absorption of furosemide in the nanosuspension compared to pure drug. The AUC0→24 and Cmax values of nanosuspension were approximately 1.38 and 1.68-fold greater than that of pure drug, respectively. Furosemide nanosuspension showed 20.06±0.02 % decrease in systolic blood pressure compared to 13.37±0.02 % in plain furosemide suspension, respectively. The improved oral bioavailability and pharmacodynamics effect of furosemide may be due to the improved dissolution of furosemide in simulated gastric fluid which results in enhanced oral systemic absorption of furosemide from stomach region where it has better permeability.Keywords: furosemide, nanosuspension, bioavailability enhancement, nanoprecipitation, oral drug delivery
Procedia PDF Downloads 573601 Shaping and Improving the Human Resource Management in Small and Medium Enterprises in Poland
Authors: Małgorzata Smolarek
Abstract:
One of the barriers to the development of small and medium-sized enterprises (SME) are difficulties connected with management of human resources. The first part of article defines the specifics of staff management in small and medium enterprises. The practical part presents results of own studies in the area of diagnosis of the state of the human resources management in small and medium-sized enterprises in Poland. It takes into account its impact on the functioning of SME in a variable environment. This part presents findings of empirical studies, which enabled verification of the hypotheses and formulation of conclusions. The findings presented in this paper were obtained during the implementation of the project entitled 'Tendencies and challenges in strategic managing SME in Silesian Voivodeship.' The aim of the studies was to diagnose the state of strategic management and human resources management taking into account its impact on the functioning of small and medium enterprises operating in Silesian Voivodeship in Poland and to indicate improvement areas of the model under diagnosis. One of the specific objectives of the studies was to diagnose the state of the process of strategic management of human resources and to identify fundamental problems. In this area, the main hypothesis was formulated: The enterprises analysed do not have comprehensive strategies for management of human resources. The survey was conducted by questionnaire. Main Research Results: Human resource management in SMEs is characterized by simplicity of procedures, and the lack of sophisticated tools and its specificity depends on the size of the company. The process of human resources management in SME has to be adjusted to the structure of an organisation, result from its objectives, so that an organisation can fully implement its strategic plans and achieve success and competitive advantage on the market. A guarantee of success is an accurately developed policy of human resources management based on earlier analyses of the existing procedures and possessed human resources.Keywords: human resources management, human resources policy, personnel strategy, small and medium enterprises
Procedia PDF Downloads 241600 The Influence of Travel Experience within Perceived Public Transport Quality
Authors: Armando Cartenì, Ilaria Henke
Abstract:
The perceived public transport quality is an important driver that influences both customer satisfaction and mobility choices. The competition among transport operators needs to improve the quality of the services and identify which attributes are perceived as relevant by passengers. Among the “traditional” public transport quality attributes there are, for example: travel and waiting time, regularity of the services, and ticket price. By contrast, there are some “non-conventional” attributes that could significantly influence customer satisfaction jointly with the “traditional” ones. Among these, the beauty/aesthetics of the transport terminals (e.g. rail station and bus terminal) is probably one of the most impacting on user perception. Starting from these considerations, the point stressed in this paper was if (and how munch) the travel experience of the overall travel (e.g. how long is the travel, how many transport modes must be used) influences the perception of the public transport quality. The aim of this paper was to investigate the weight of the terminal quality (e.g. aesthetic, comfort and service offered) within the overall travel experience. The case study was the extra-urban Italian bus network. The passengers of the major Italian terminal bus were interviewed and the analysis of the results shows that about the 75% of the travelers, are available to pay up to 30% more for the ticket price for having a high quality terminal. A travel experience effect was observed: the average perceived transport quality varies with the characteristic of the overall trip. The passengers that have a “long trip” (travel time greater than 2 hours) perceived as “low” the overall quality of the trip even if they pass through a high quality terminal. The opposite occurs for the “short trip” passengers. This means that if a traveler passes through a high quality station, the overall perception of that terminal could be significantly reduced if he is tired from a long trip. This result is important and if confirmed through other case studies, will allow to conclude that the “travel experience impact" must be considered as an explicit design variable for public transport services and planning.Keywords: transportation planning, sustainable mobility, decision support system, discrete choice model, design problem
Procedia PDF Downloads 298599 Obtaining Triploid Plants of Sprekelia formosissima by Artificial Hybridization
Authors: Jose Manuel Rodriguez-Dominguez, Rodrigo Barba-Gonzalez, Ernesto Tapia-Campos
Abstract:
Sprekelia formosissima (L.) Herbert is a bulbous ornamental species of the monocotyledonous Amaryllidaceae family, and it is a perennial, herbaceous monotypic plant commonly known as ‘Aztec Lily’ or ‘Jacobean Lily’; it is distributed through Mexico and Guatemala. Its scarlet flowers with curved petals have made it an exceptional ornamental pot plant. Cytogenetic studies in this species have shown differences in chromosome number (2n=60, 120, 150, 180) with a basic number x=30. Different reports have shown a variable ploidy level (diploid, tetraploid, pentaploid and hexaploid); however, triploid plants have not been reported. In this work, triploid plants of S. formosissima were obtained by crossing tetraploid (2n=4x=120) with diploid (2n=2x=60) genotypes of this species; the seeds obtained from the crosses were placed in pots with a moist substrate made of Peat Moss: Vermiculite (7:3) for germination. Root tips were collected, and metaphasic chromosome preparations were performed. For chromosome counting, the best five metaphases obtained were photographed with a Leica DMRA2 microscope (Leica Microsystems, Germany) microscopy coupled to an Evolution QEI camera under phase contrast (Media-Cybernetics). Chromosomes counting in root-tip cells showed that 100% of the plants were triploid (2n=3x=90). Although tetraploid or pentaploid plants of S. formosissima are highly appreciated, they usually have lower growth rates than related diploid ones. For this reason, it is important to obtain triploid plants, which have advantages such as higher growth rates than tetraploid and pentaploid, larger flowers than those of the diploid plants and they are expected to not be able to produce seeds because their gametes are aneuploids. Furthermore, triploids may become very important for genomic research in the future, creating opportunities for discovering and monitoring genomic and transcriptomic changes in unbalanced genomes, hence the importance of this work.Keywords: Amaryllidaceae, cytogenetics, ornamental, ploidy level
Procedia PDF Downloads 194598 Exercise Intensity Increasing Appetite, Energy, Intake Energy Expenditure, and Fat Oxidation in Sedentary Overweight Individuals
Authors: Ghalia Shamlan, M. Denise Robertson, Adam Collins
Abstract:
Appetite control (i.e. control of energy intake) is important for weight maintenance. Exercise contributes to the most variable component of energy expenditure (EE) but its impact is beyond the energy cost of exercise including physiological, behavioural, and appetite effects. Exercise is known to acutely influence effect appetite but evidence as to the independent effect of intensity is lacking. This study investigated the role of exercise intensity on appetite, energy intake (EI), appetite related hormone, fat utilisation and subjective measures of appetite. One hour after a standardised breakfast, 10 sedentary overweight volunteers. Subjects undertook either 8 repeated 60 second bouts of cycling at 95% VO2max (high intensity) or 30 minutes of continuous cycling, at a fixed cadence, equivalent to 50% of the participant’s VO2max (low intensity) in a randomised crossover design. Glucose, NEFA, glucagon-like peptide-1 (GLP-1) were measured fasted, postprandial, and pre and post-exercise. Satiety was assessed subjectively throughout the study using visual analogue scales (VAS). Ad libitum intake of a pasta meal was measured at the end (3-h post-breakfast). Interestingly, there was not significant difference in EE fat oxidation between HI and LI post-exercise. Also, no significant effect of high intensity (HI) was observed on the ad libitum meal, 24h and 48h EI post-exercise. However the mean 24h EI was 3000 KJ lower following HI than low intensity (LI). Despite, no significant differences in hunger score, glucose, NEFA and GLP-1 between both intensities were observed. However, NEFA and GLP-1 plasma level were higher until 30 min post LI. In conclusion, the similarity of EE and oxidation outcomes could give overweight individuals an option to choose between intensities. However, HI could help to reduce EI. There are mechanisms and consequences of exercise in short and long-term appetite control; however, these mechanisms warrant further explanation. These results support the need for future research in to the role of in regulation energy balance, especially for obese people.Keywords: appetite, exercise, food intake, energy expenditure
Procedia PDF Downloads 505597 Osteoarticular Manifestations and Abnormalities of Bone Metabolism in Celiac Disease
Authors: Soumaya Mrabet, Imen Akkari, Amira Atig, Elhem Ben Jazia
Abstract:
Introduction: Celiac disease (CD) is a chronic autoimmune inflammatory enteropathy caused by gluten. The clinical presentation is very variable. Malabsorption in the MC is responsible for an alteration of the bone metabolism. Our purpose is to study the osteoarticular manifestations related to this condition. Material and methods: It is a retrospective study of 41 cases of CD diagnosed on clinical, immunological, endoscopic and histological arguments, in the Internal Medicine and Gastroenterology Department of Farhat Hached Hospital between September 2005 and January 2016. Results: Osteoarticular manifestations were found in 9 patients (22%) among 41 patients presenting CD. These were 7 women and 2 men with an average age of 35.7 years (25 to 67 years). These manifestations were revelatory of CD in 3 cases. Abdominal pain and diarrhea were present in 6 cases. Inflammatory polyarthralgia of wrists and knees has been reported in 7 patients. Mechanical mono arthralgia was noted in 2 patients. Biological tests revealed microcytic anemia by iron deficiency in 7 cases, hypocalcemia in 5 cases, Hypophosphatemia in 3 cases and elevated alkaline phosphatases in 3 cases. Upper gastrointestinal endoscopy with duodenal biopsy found villous atrophy in all cases. In immunology, Anti-transglutaminase antibodies were positive in all patients, Anti-endomysium in 7 cases. Measurement of bone mineral density (BMD) by biphotonic X-ray absorptiometer with evaluation of the T-score and the Z-score was performed in Twenty patients (48.8%). It was normal in 7 cases (33%) and showed osteopenia in 5 patients (25%) and osteoporosis in 2 patients (10%). All patients were treated with a Gluten-free diet associated with vitamin D and calcium substitution in 5 cases. The evolution was favorable in all cases with reduction of bone pain and normalization of the phosphocalcic balance. Conclusion: The bone impact of CD is frequent but often asymptomatic. Patients with CD should be evaluated by the measurement of bone mineral density and monitored for calcium and vitamin D deficiencies.Keywords: bone mineral density, celiac disease, osteoarticular manifestations, vitamin D and calcium
Procedia PDF Downloads 328596 English Learning Motivation in Communicative Competence
Authors: Sebastianus Menggo
Abstract:
The aim of communicative language teaching is to enable learners to communicate in the target language. Each learner is required to perform the micro and macro components in each utterance produced. Utterances produced must be in line with the understanding of competence and performance of each speaker. These are inter-depended. Competence and performance are obliged to be appeared proportionally in creating the utterances. The representative of competence and performance reflects the linguistics identity of a speaker in providing sentences in each certain language community. Each lexicon spoken may lead that interlocutor in comprehending the intentions utterances given. However proportional performance of both components in an utterance needed to be further elaborated. Finding appropriate gap between competence and performance components in a communicative competence must be supported positive response given by the learners.The learners’ inability to keep communicative competence proportionally is caused by inside and outside factors. The inside factors are certain lacks such as lack of self-confidence and lack of motivation which could make students feel ashamed to produce utterances, scared to make mistakes, and have no enough confidence. Knowing learner’s English learning motivation is an urgent variable to be considered in creating conducive atmosphere classroom which will raise the learners to do more toward the achievement of communicative competence. Meanwhile, the outside factor is related with the teacher. The teacher should be able to recognize the students’ problem in creating conducive atmosphere in the classroom that will raise the students’ ability to be an English speaker qualified. Moreover, the aim of this research is to know and describe the English learning motivation affecting students’ communicative competence of 48 students of XI grade of science program at catholic senior of Saint Ignasius Loyola Labuan Bajo, West Flores, Indonesia. Correlation design with purposive procedure applied in this research. Data were collected through questionnaire, interview, and students’ speaking achievement document. Result shows the description of motivation significantly affecting students’ communicative competence.Keywords: communicative, competence, English, learning, motivation
Procedia PDF Downloads 200595 Hyper-Immunoglobulin E (Hyper-Ige) Syndrome In Skin Of Color: A Retrospective Single-Centre Observational Study
Authors: Rohit Kothari, Muneer Mohamed, Vivekanandh K., Sunmeet Sandhu, Preema Sinha, Anuj Bhatnagar
Abstract:
Introduction: Hyper-IgE syndrome is a rare primary immunodeficiency syndrome characterised by triad of severe atopic dermatitis, recurrent pulmonary infections, and recurrent staphylococcal skin infections. The diagnosis requires a high degree of suspicion, typical clinical features, and not mere rise in serum-IgE levels, which may be seen in multiple conditions. Genetic studies are not always possible in a resource poor setting. This study highlights various presentations of Hyper-IgE syndrome in skin of color children. Case-series: Our study had six children of Hyper-IgE syndrome aged twomonths to tenyears. All had onset in first ten months of life except one with a late-onset at two years. All had recurrent eczematoid rash, which responded poorly to conventional treatment, secondary infection, multiple episodes of hospitalisation for pulmonary infection, and raised serum IgE levels. One case had occasional vesicles, bullae, and crusted plaques over both the extremities. Genetic study was possible in only one of them who was found to have pathogenic homozygous deletions of exon-15 to 18 in DOCK8 gene following which he underwent bone marrow transplant (BMT), however, succumbed to lower respiratory tract infection two months after BMT and rest of them received multiple courses of antibiotics, oral/ topical steroids, and cyclosporine intermittently with variable response. Discussion: Our study highlights various characteristics, presentation, and management of this rare syndrome in children. Knowledge of these manifestations in skin of color will facilitate early identification and contribute to optimal care of the patients as representative data on the same is limited in literature.Keywords: absolute eosinophil count, atopic dermatitis, eczematous rash, hyper-immunoglobulin E syndrome, pulmonary infection, serum IgE, skin of color
Procedia PDF Downloads 138594 Angiogenic Potential of Collagen Based Biomaterials Implanted on Chick Embryo Chorioallantoic Membrane as Alternative Microenvironment for in Vitro and in Vivo Angiogenesis Assays
Authors: Anca Maria Cimpean, Serban Comsa
Abstract:
Chick embryo chorioallantoic membrane (CAM) is a well vascularised in vivo experimental model used as a platform for testing the behavior of different implants inserted on it from tumor fragments to therapeutic agents or various biomaterials. Five types of collagen-based biomaterials with 2D and 3D structure (MotifMesh, Optimaix2D, Optimaix3D, Dual Layer Collagen and Xenoderm) were implanted on CAM and continuously evaluated by stereomicroscope for up to 5 days post-implant with an emphasis of their ability to requisite and develop new blood vessels (BVs) followed by microscopic analysis. MotifMEsh did not induce any angiogenic response lacking to be invaded by BVs from the CAM, but it induced intense inflammatory response necrosis and fibroblastic reaction around the implant. Optimaix2D has good adherence. CAM with minimal or no inflammatory reaction, a good integration of the CAM between the collagen mesh’s fibers, consistent adhesion of the cells to the collagen fibers,and a good ability to form pseudo-vascular channels filled with cells. Optimaix3D induced the highest angiogenic effects on CAM. The material shows good integration on CAM. The collagen fibers of the material show the ability to organize themselves into linear and tubular structures. It is possible to see blood elements, especially at the periphery of the implant. Dual-layer collagen behaves similar to Optimaix 3D, while Xenoderm induced a moderate angiogenic effect on CAM. Based on these data, we may conclude that collagen-based materials have variable ability to requisite and develop new blood vessels. A proper selection of collagen-based biomaterial scaffolds may crucially influence the acquisition and development of blood vessels during angiogenesis assays.Keywords: chick embryo chorioallantoic membrane, collagen scaffolds, blood vessels, vascular microenvironment
Procedia PDF Downloads 193593 The Four-Way Interactions among Host Plant-Whitefly-Virus-Endosymbionts in Insect and Disease Development
Authors: N. R. Prasannakumar, M. N. Maruthi
Abstract:
The whitefly, Bemisia tabaci (Gennadius) (Hemiptera; Aleyrodidae) is a highly polyphagous pest reported to infest over 600 plant hosts globally. About 42 genetic groups/cryptic species of B. tabaci exist in the world on different hosts. The species have variable behaviour with respect to feeding, development and transmission of viral diseases. Feeding on diverse host plants affect both whitefly development and the population of the endosymbionts harboured by the insects. Due to changes in the level of endosymbionts, the virus transmission efficiency by the vector also gets affected. We investigated these interactions on five host plants – egg plant, tomato, beans, okra and cotton - using a single whitefly species Asia 1 infected with three different bacteria Portiera, Wolbachia and Arsenophonus. The Asia 1 transmits the Tomato leaf curl Bangalore virus (ToLCBV) effectively and thus was used in the interaction studies. We found a significant impact of hosts on whitefly growth and development; eggplant was most favourable host, while okra and tomato were least favourable. Among the endosymbiotic bacteria, the titre of Wolbachia was significantly affected by feeding of B. tabaci on different host plants whereas Arsenophonus and Portiera were unaffected. When whitefly fed on ToLCBV-infected tomato plants, the Arsenophonus population was significantly increased, indicating its previously confirmed role in ToLCBV transmission. Further, screening of total proteins of B. tabaci Asia 1 genetic group interacting with ToLCBV coat protein was carried out using Y2H system. Some of the proteins found to be interacting with ToLCBV CP were HSPs 70kDa, GroEL, nucleoproteins, vitellogenins, apolipophorins, lachesins, enolase. The reported protein thus would be the potential targets for novel whitefly control strategies such as RNAi or novel insecticide target sites for sustainable whitefly management after confirmation of genuine proteins.Keywords: cDNA, whitefly, ToLCBV, endosymbionts, Y2H
Procedia PDF Downloads 115