Search results for: therapeutic assessment
5328 Risk Reassessment Using GIS Technologies for the Development of Emergency Response Management Plans for Water Treatment Systems
Authors: Han Gul Lee
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When water treatments utilities are designed, an initial construction site risk assessment is conducted. This helps us to understand general safety risks that each utility needs to be complemented in the designing stage. Once it’s built, an additional risk reassessment process secures and supplements its disaster management and response plan. Because of its constantly changing surroundings with city renovation and developments, the degree of various risks that each facility has to face changes. Therefore, to improve the preparedness for spill incidents or disasters, emergency managers should run spill simulations with the available scientific technologies. This research used a two-dimensional flow routing model to simulate its spill disaster scenario based on its digital elevation model (DEM) collected with drone technologies. The results of the simulations can help emergency managers to supplement their response plan with concrete situational awareness in advance. Planning based on this simulation model minimizes its potential loss and damage when an incident like earthquakes man-made disaster happens, which could eventually be a threat in a public health context. This pilot research provides an additional paradigm to increase the preparedness to spill disasters. Acknowledgment: This work was supported by Korea Environmental Industry & Technology Institute (KEITI) through Environmental R&D Project on the Disaster Prevention of Environmental Facilities Program funded by Korea Ministry of Environment (MOE) (No.202002860001).Keywords: risk assessment, disaster management, water treatment utilities, situational awareness, drone technologies
Procedia PDF Downloads 1445327 Pharmaceutical Evaluation of Five Different Generic Brands of Prednisolone
Authors: Asma A. Ben Ahmed, Hajer M. Alborawy, Alaa A. Mashina, Pradeep K. Velautham, Abdulmonem Gobassa, Emhemmed Elgallal, Mohamed N. El Attug
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Generic medicines are those where patent protection has expired, and which may be produced by manufacturers other than the innovator company. Use of generic medicines has been increasing in recent years, primarily as a cost saving measure in healthcare provision. Generic medicines are typically 20 – 90 % cheaper than originator equivalents. Physicians often continue to prescribe brand-name drugs to their patients even when less expensive pharmacologically equivalent generic drugs are available. Because generics are less expensive than their brand-name counterparts, the cost-savings to the patient is not the only factor that physicians consider when choosing between generic and brand-name drugs. Unfortunately Physicians in general and Libyan Physicians in particular tend to prescribe brand-name drugs, even without evidence of their therapeutic superiority, because neither they nor their insured patients bear these drugs’ increased cost with respect to generic substitutes. This study is to compare the quality of five different prednisolone tablets of the same strength from different companies under different trade names: Julphar, October pharma, Akums, Actavis, Pfizer compared them with pure prednisolone reference (BPCRS).Keywords: quality control, pharmaceutical analysis, generic medicines, prednisolone
Procedia PDF Downloads 5145326 Cultural Self-Efficacy of Child Protection Social Workers in Norway: Barriers and Opportunities in Working with Migrant Families
Authors: Justyna Mroczkowska
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Social worker's ability to provide culturally sensitive assistance in child protection is taken for granted; given limited training opportunities and lack of clear guidance, practitioners report working with migrant families more demanding in comparison to working with native families. In this study, the author developed and factor analyzed the Norwegian Cultural Self-Efficacy Scale to describe the level of cultural capability among Norwegian child protection professionals. The study aimed to determine the main influencing factors to cultural efficacy and examine the relationship between self-efficacy and perceived difficulty in working with migrant families. The scale was administered to child protection workers in Norway (N=251), and the reliability of the scale measured by Cronbach's alpha coefficient was .904. The confirmatory factor analysis of social work cultural self-efficacy found support for four separate but correlated subscales: Assessment, Communication, Support Request, and Teamwork. Regression analyses found the experience in working with migrant families, training and support from external agencies, and colleague support to be significant predictors of cultural self-efficacy. Self-efficacy in assessment skills and self-efficacy in communication skills were moderately related to the perceived difficulty to work with migrant families. The findings conclude with previous research and highlight the need for both professional development programs and institutional resources to be provided to support the practitioner's preparation for multicultural practice in child protection.Keywords: child protection, cultural self-efficacy, cultural competency, migration, resources
Procedia PDF Downloads 1425325 Patient Care Needs Assessment: An Evidence-Based Process to Inform Quality Care and Decision Making
Authors: Wynne De Jong, Robert Miller, Ross Riggs
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Beyond the number of nurses providing care for patients, having nurses with the right skills, experience and education is essential to ensure the best possible outcomes for patients. Research studies continue to link nurse staffing and skill mix with nurse-sensitive patient outcomes; numerous studies clearly show that superior patient outcomes are associated with higher levels of regulated staff. Due to the limited number of tools and processes available to assist nurse leaders with staffing models of care, nurse leaders are constantly faced with the ongoing challenge to ensure their staffing models of care best suit their patient population. In 2009, several hospitals in Ontario, Canada participated in a research study to develop and evaluate an RN/RPN utilization toolkit. The purpose of this study was to develop and evaluate a toolkit for Registered Nurses/Registered Practical Nurses Staff mix decision-making based on the College of Nurses of Ontario, Canada practice standards for the utilization of RNs and RPNs. This paper will highlight how an organization has further developed the Patient Care Needs Assessment (PCNA) questionnaire, a major component of the toolkit. Moreover, it will demonstrate how it has utilized the information from PCNA to clearly identify patient and family care needs, thus providing evidence-based results to assist leaders with matching the best staffing skill mix to their patients.Keywords: nurse staffing models of care, skill mix, nursing health human resources, patient safety
Procedia PDF Downloads 3145324 Comparison of Antimicrobial Activity of Momordica cochinchinesis and Pinus kesiya Extracts
Authors: Pattaramon Pongjetpong
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In recent years, infectious diseases have increased considerably, and they are amongst the most common leading causes of death all over the world. Several medicinal plants are well known to contain active constituents such as flavonoids, carotenoids, and phenolic compounds, which are plausible candidates for therapeutic purposes. This study aimed to examine the antimicrobial activities of M. cochinchinensis and P. kesiya extracts using the agar disk diffusion method and broth microdilution to determine the minimum inhibitory concentration (MIC) value. In this study, Momordica cochinchinensis and Pinus kesiya extracts are investigated for antibacterial activity against Staphylococcus aureus. The results showed that S. aureus was susceptible to P. kesiya extracts with an MIC value of 62.5 µg/ml, while M. cochinchinensis showed MIC against S. aureus was greater than 2000 µg/ml. In summary, P. kesiya extract showed potent antibacterial activity against S. aureus, which could greatly value developing as adjuvant therapy for infectious diseases. However, further investigation regarding purification of the active constituents as well as a determination of the mechanism of antimicrobial action of P. kesiya active compound should be performed to identify the molecular target of the active compounds.Keywords: antimicrobial activity, Momordica cochinchinensis, Pinus kesiya, Staphylococcus aureus
Procedia PDF Downloads 2055323 Potential Probiotic Bacteria Isolated from Dairy Products of Saudi Arabia
Authors: Rashad Al-Hindi
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The aims of the study were to isolate and identify potential probiotic lactic acid bacteria due to their therapeutic and food preservation importance. Sixty-three suspected lactic acid bacteria (LAB) strains were isolated from thirteen different raw milk and fermented milk product samples of various animal origins manufactured indigenously in the Kingdom of Saudi Arabia using de Man, Rogosa and Sharpe (MRS) agar medium and various incubation conditions. The identification of forty-six selected LAB strains was performed using molecular methods (16S rDNA gene sequencing). The LAB counts in certain samples were higher under microaerobic incubation conditions than under anaerobic conditions. The identified LAB belonged to the following genera: Enterococcus (16 strains), Lactobacillus (9 strains), Weissella (10 strains), Streptococcus (8 strains) and Lactococcus (3 strains), constituting 34.78%, 19.57%, 21.74%, 17.39% and 6.52% of the suspected isolates, respectively. This study noted that the raw milk and traditional fermented milk products of Saudi Arabia, especially stirred yogurt (Laban) made from camel milk, could be rich in LAB. The obtained LAB strains in this study will be tested for their probiotic potentials in another ongoing study.Keywords: dairy, LAB, probiotic, Saudi Arabia
Procedia PDF Downloads 2875322 The Evaluation of Child Maltreatment Severity and the Decision-Making Processes in the Child Protection System
Authors: Maria M. Calheiros, Carla Silva, Eunice Magalhães
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Professionals working in child protection services (CPS) need to have common and clear criteria to identify cases of maltreatment and to differentiate levels of severity in order to determine when CPS intervention is required, its nature and urgency, and, in most countries, the service that will be in charge of the case (community or specialized CPS). Actually, decision-making process is complex in CPS, and, for that reason, such criteria are particularly important for who significantly contribute to that decision-making in child maltreatment cases. The main objective of this presentation is to describe the Maltreatment Severity Assessment Questionnaire (MSQ), specifically designed to be used by professionals in the CPS, which adopts a multidimensional approach and uses a scale of severity within subtypes. Specifically, we aim to provide evidence of validity and reliability of this tool, in order to improve the quality and validity of assessment processes and, consequently, the decision making in CPS. The total sample was composed of 1000 children and/or adolescents (51.1% boys), aged between 0 and 18 years old (M = 9.47; DP = 4.51). All the participants were referred to official institutions of the children and youth protective system. Children and adolescents maltreatment (abuse, neglect experiences and sexual abuse) were assessed with 21 items of the Maltreatment Severity Questionnaire (MSQ), by professionals of CPS. Each item (sub-type) was composed of four descriptors of increasing severity. Professionals rated the level of severity, using a 4-point scale (1= minimally severe; 2= moderately severe; 3= highly severe; 4= extremely severe). The construct validity of the Maltreatment Severity Questionnaire was assessed with a holdout method, performing an Exploratory Factor Analysis (EFA) followed by a Confirmatory Factor Analysis (CFA). The final solution comprised 18 items organized in three factors 47.3% of variance explained. ‘Physical neglect’ (eight items) was defined by parental omissions concerning the insurance and monitoring of the child’s physical well-being and health, namely in terms of clothing, hygiene, housing conditions and contextual environmental security. ‘Physical and Psychological Abuse’ (four items) described abusive physical and psychological actions, namely, coercive/punitive disciplinary methods, physically violent methods or verbal interactions that offend and denigrate the child, with the potential to disrupt psychological attributes (e.g., self-esteem). ‘Psychological neglect’ (six items) involved omissions related to children emotional development, mental health monitoring, school attendance, development needs, as well as inappropriate relationship patterns with attachment figures. Results indicated a good reliability of all the factors. The assessment of child maltreatment cases with MSQ could have a set of practical and research implications: a) It is a valid and reliable multidimensional instrument to measure child maltreatment, b) It is an instrument integrating the co-occurrence of various types of maltreatment and a within-subtypes scale of severity; c) Specifically designed for professionals, it may assist them in decision-making processes; d) More than using case file reports to evaluate maltreatment experiences, researchers could guide more appropriately their research about determinants and consequences of maltreatment.Keywords: assessment, maltreatment, children and youth, decision-making
Procedia PDF Downloads 2905321 The Assessment of Particulate Matter Pollution in Kaunas Districts
Authors: Audrius Dedele, Aukse Miskinyte
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Air pollution is a major problem, especially in large cities, causing a variety of environmental issues and a risk to human health effects. In order to observe air quality, to reduce and control air pollution in the city, municipalities are responsible for the creation of air quality management plans, air quality monitoring and emission inventories. Atmospheric dispersion modelling systems, along with monitoring, are powerful tools, which can be used not only for air quality management, but for the assessment of human exposure to air pollution. These models are widely used in epidemiological studies, which try to determine the associations between exposure to air pollution and the adverse health effects. The purpose of this study was to determine the concentration of particulate matter smaller than 10 μm (PM10) in different districts of Kaunas city during winter season. ADMS-Urban dispersion model was used for the simulation of PM10 pollution. The inputs of the model were the characteristics of stationary, traffic and domestic sources, emission data, meteorology and background concentrations were entered in the model. To assess the modelled concentrations of PM10 in Kaunas districts, geographic information system (GIS) was used. More detailed analysis was made using Spatial Analyst tools. The modelling results showed that the average concentration of PM10 during winter season in Kaunas city was 24.8 µg/m3. The highest PM10 levels were determined in Zaliakalnis and Aleksotas districts with are the highest number of individual residential properties, 32.0±5.2 and 28.7±8.2 µg/m3, respectively. The lowest pollution of PM10 was modelled in Petrasiunai district (18.4 µg/m3), which is characterized as commercial and industrial neighbourhood.Keywords: air pollution, dispersion model, GIS, Particulate matter
Procedia PDF Downloads 2695320 Mentha crispa Essential Oil and Rotundifolone Analogues: Cytotoxic Effect on Glioblastoma
Authors: Damião Sousa, Hasan Turkez, Ozlem Tozlu, Tamires Lima
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Glioblastoma (GBM) is an aggressive cancer from the brain and with high prevalence and significant morbimortality. Therefore, it is necessary to investigate new therapeutic options against this pathology. Thus, the purpose of this study was to evaluate the antitumor activity from Mentha crispa essential oil (MCEO), its major constituent rotundifolone (ROT) and a series of six analogues on human U87MG glioblastoma cell line. The antitumor effects of the compounds on human U87MG-GBM cell line were assessed using in vitro cell viability assays. In addition, biosafety tests were performed on cultured human blood cells. The data show that MCEO, 1,2-perillaldehyde epoxide (EPER1) and perillaldehyde (PALD) were the most cytotoxic compounds against the U87MG cells, with IC50 values of 16.263, 15.087 and 14.888 μg/mL, respectively. The treatment with MCEO, EPER1 and PALD did not lead to damage in blood cells. These chemical analogues may be useful as prototypes for development of novel antitumor drugs due to their promising activities and toxicological safety.Keywords: antitumor activity, cancer, natural products, terpenes
Procedia PDF Downloads 1475319 Structural Health Assessment of a Masonry Bridge Using Wireless
Authors: Nalluri Lakshmi Ramu, C. Venkat Nihit, Narayana Kumar, Dillep
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Masonry bridges are the iconic heritage transportation infrastructure throughout the world. Continuous increase in traffic loads and speed have kept engineers in dilemma about their structural performance and capacity. Henceforth, research community has an urgent need to propose an effective methodology and validate on real-time bridges. The presented research aims to assess the structural health of an Eighty-year-old masonry railway bridge in India using wireless accelerometer sensors. The bridge consists of 44 spans with length of 24.2 m each and individual pier is 13 m tall laid on well foundation. To calculate the dynamic characteristic properties of the bridge, ambient vibrations were recorded from the moving traffic at various speeds and the same are compared with the developed three-dimensional numerical model using finite element-based software. The conclusions about the weaker or deteriorated piers are drawn from the comparison of frequencies obtained from the experimental tests conducted on alternative spans. Masonry is a heterogeneous anisotropic material made up of incoherent materials (such as bricks, stones, and blocks). It is most likely the earliest largely used construction material. Masonry bridges, which were typically constructed of brick and stone, are still a key feature of the world's highway and railway networks. There are 1,47,523 railway bridges across India and about 15% of these bridges are built by masonry, which are around 80 to 100 year old. The cultural significance of masonry bridges cannot be overstated. These bridges are considered to be complicated due to the presence of arches, spandrel walls, piers, foundations, and soils. Due to traffic loads and vibrations, wind, rain, frost attack, high/low temperature cycles, moisture, earthquakes, river overflows, floods, scour, and soil under their foundations may cause material deterioration, opening of joints and ring separation in arch barrels, cracks in piers, loss of brick-stones and mortar joints, distortion of the arch profile. Few NDT tests like Flat jack Tests are being employed to access the homogeneity, durability of masonry structure, however there are many drawbacks because of the test. A modern approach of structural health assessment of masonry structures by vibration analysis, frequencies and stiffness properties is being explored in this paper.Keywords: masonry bridges, condition assessment, wireless sensors, numerical analysis modal frequencies
Procedia PDF Downloads 1695318 From Responses of Macroinvertebrate Metrics to the Definition of Reference Thresholds
Authors: Hounyèmè Romuald, Mama Daouda, Argillier Christine
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The present study focused on the use of benthic macrofauna to define the reference state of an anthropized lagoon (Nokoué-Benin) from the responses of relevant metrics to proxies. The approach used is a combination of a joint species distribution model and Bayesian networks. The joint species distribution model was used to select the relevant metrics and generate posterior probabilities that were then converted into posterior response probabilities for each of the quality classes (pressure levels), which will constitute the conditional probability tables allowing the establishment of the probabilistic graph representing the different causal relationships between metrics and pressure proxies. For the definition of the reference thresholds, the predicted responses for low-pressure levels were read via probability density diagrams. Observations collected during high and low water periods spanning 03 consecutive years (2004-2006), sampling 33 macroinvertebrate taxa present at all seasons and sampling points, and measurements of 14 environmental parameters were used as application data. The study demonstrated reliable inferences, selection of 07 relevant metrics and definition of quality thresholds for each environmental parameter. The relevance of the metrics as well as the reference thresholds for ecological assessment despite the small sample size, suggests the potential for wider applicability of the approach for aquatic ecosystem monitoring and assessment programs in developing countries generally characterized by a lack of monitoring data.Keywords: pressure proxies, bayesian inference, bioindicators, acadjas, functional traits
Procedia PDF Downloads 835317 Seismic Vulnerability Assessment of Masonry Buildings in Seismic Prone Regions: The Case of Annaba City, Algeria
Authors: Allaeddine Athmani, Abdelhacine Gouasmia, Tiago Ferreira, Romeu Vicente
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Seismic vulnerability assessment of masonry buildings is a fundamental issue even for moderate to low seismic hazard regions. This fact is even more important when dealing with old structures such as those located in Annaba city (Algeria), which the majority of dates back to the French colonial era from 1830. This category of buildings is in high risk due to their highly degradation state, heterogeneous materials and intrusive modifications to structural and non-structural elements. Furthermore, they are usually shelter a dense population, which is exposed to such risk. In order to undertake a suitable seismic risk mitigation strategies and reinforcement process for such structures, it is essential to estimate their seismic resistance capacity at a large scale. In this sense, two seismic vulnerability index methods and damage estimation have been adapted and applied to a pilot-scale building area located in the moderate seismic hazard region of Annaba city: The first one based on the EMS-98 building typologies, and the second one derived from the Italian GNDT approach. To perform this task, the authors took the advantage of an existing data survey previously performed for other purposes. The results obtained from the application of the two methods were integrated and compared using a geographic information system tool (GIS), with the ultimate goal of supporting the city council of Annaba for the implementation of risk mitigation and emergency planning strategies.Keywords: Annaba city, EMS98 concept, GNDT method, old city center, seismic vulnerability index, unreinforced masonry buildings
Procedia PDF Downloads 6185316 Characterization of Molecular Targets to Mediate Skin Itch and Inflammation
Authors: Anita Jäger, Andrew Salazar, Jörg von Hagen, Harald Kolmar
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In the treatment of individuals with sensitive and psoriatic skin, several inflammation and itch-related molecular and cellular targets have been identified, but many of these have yet to be characterized. In this study, we present two potential targets in the skin that can be linked to the inflammation and itch cycle. 11ßHSD1 is the enzyme responsible for converting inactive cortisone to active cortisol used to transmit signals downstream. The activation of the receptor NK1R correlates with promoting inflammation and the perception of itch and pain in the skin. In this study, both targets have been investigated based on their involvement in inflammation. The role of both identified targets was characterized based on the secretion of inflammation cytokine- IL6, IL-8, and CCL2, as well as phosphorylation and signaling pathways. It was found that treating skin cells with molecules able to inhibit inflammatory pathways results in the reduction of inflammatory signaling molecules secreted by skin cells and increases their proliferative capacity. Therefore, these molecular targets and their associated pathways show therapeutic potential and can be mitigated via small molecules. This research can be used for further studies in inflammation and itch pathways and can help to treat pathological symptoms.Keywords: inflammation, itch, signaling pathway, skin
Procedia PDF Downloads 1235315 A Review of Critical Factors in Budgetary Financing of Public Infrastructure in Nigeria
Authors: Akintayo Opawole, Godwin O. Jagboro
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Research efforts on infrastructure development in Nigeria had not provided adequate assessment of issues essential for policy response by the government to address infrastructure deficiency. One major gap existing in previous studies is the assessment of challenges facing the budgetary financing model. Based on a case study of Osun State in Southwestern Nigeria, factors affecting budgetary financing of public infrastructure were identified from literature and brainstorming. Respondents were: 6 architects, 4 quantity surveyors, 6 town planners, 5 estate surveyors, 4 builders, 21 engineers and 26 economists/accountants ranging from principal to director who have been involved in policy making process with respect to infrastructure development in the public service of Osun state. The identified variables were subjected to factor analysis. The Kaiser-Meyer-Olkin measure of sampling adequacy tests carried out (KMO, 0.785) showed that the data collected were adequate for the analysis and the Bartlett’s test of sphericity (0.000) showed the data upon which the analysis was carried out was reliable. Results showed that factors such as poor collaboration between the state and local government establishments, absence of credible database system and inadequate funding of maintenance were the most significant to infrastructure development in the State. Policy responses to address challenges of infrastructure development in the state were identified to focus on creation of legal framework for liberation policy, enforcement of ‘due process’ in the procurement and establishment of monitoring system for project delivery.Keywords: development, infrastructure, financing, procurement
Procedia PDF Downloads 4115314 Radiographic Predictors of Mandibular Third Molar Extraction Difficulties under General Anaesthetic
Authors: Carolyn Whyte, Tina Halai, Sonita Koshal
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Aim: There are many methods available to assess the potential difficulty of third molar surgery. This study investigated various factors to assess whether they had a bearing on the difficulties encountered. Study design: A retrospective study was completed of 62 single mandibular third molar teeth removed under day case general anaesthesia between May 2016 and August 2016 by 3 consultant oral surgeons. Method: Data collection was by examining the OPG radiographs of each tooth and recording the necessary data. This was depth of impaction, angulation, bony impaction, point of application in relation to second molar, root morphology, Pell and Gregory classification and Winters Lines. This was completed by one assessor and verified by another. Information on medical history, anxiety, ethnicity and age were recorded. Case notes and surgical entries were examined for any difficulties encountered. Results: There were 5 cases which encountered surgical difficulties which included fracture of root apices (3) which were left in situ, prolonged bleeding (1) and post-operative numbness >6 months(1). Four of the 5 cases had Pell and Gregory classification as (B) where the occlusal plane of the impacted tooth is between the occlusal plane and the cervical line of the adjacent tooth. 80% of cases had the point of application as either coronal or apical one third (1/3) in relation to the second molar. However, there was variability in all other aspects of assessment in predicting difficulty of removal. Conclusions: Of the cases which encountered difficulties they all had at least one predictor of potential complexity but these varied case by case.Keywords: impaction, mandibular third molar, radiographic assessment, surgical removal
Procedia PDF Downloads 1815313 Analyzing Changes in Runoff Patterns Due to Urbanization Using SWAT Models
Authors: Asawari Ajay Avhad
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The Soil and Water Assessment Tool (SWAT) is a hydrological model designed to predict the complex interactions within natural and human-altered watersheds. This research applies the SWAT model to the Ulhas River basin, a small watershed undergoing urbanization and characterized by bowl-like topography. Three simulation scenarios (LC17, LC22, and LC27) are investigated, each representing different land use and land cover (LULC) configurations, to assess the impact of urbanization on runoff. The LULC for the year 2027 is generated using the MOLUSCE Plugin of QGIS, incorporating various spatial factors such as DEM, Distance from Road, Distance from River, Slope, and distance from settlements. Future climate data is simulated within the SWAT model using historical data spanning 30 years. A susceptibility map for runoff across the basin is created, classifying runoff into five susceptibility levels ranging from very low to very high. Sub-basins corresponding to major urban settlements are identified as highly susceptible to runoff. With consideration of future climate projections, a slight increase in runoff is forecasted. The reliability of the methodology was validated through the identification of sub-basins known for experiencing severe flood events, which were determined to be highly susceptible to runoff. The susceptibility map successfully pinpointed these sub-basins with a track record of extreme flood occurrences, thus reinforcing the credibility of the assessment methodology. This study suggests that the methodology employed could serve as a valuable tool in flood management planning.Keywords: future land use impact, flood management, run off prediction, ArcSWAT
Procedia PDF Downloads 465312 The Overlooked Problem Among Surgical Patients: Preoperative Anxiety at Ethiopian University Hospital
Authors: Yohtahe Woldegerima Berhe, Tadesse Belayneh Melkie, Girmay Fitiwi Lema, Marye Getnet, Wubie Birlie Chekol
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Introduction: Anxiety was repeatedly reported as the worst aspect of the perioperative time. The objective of this study was to assess the prevalence of preoperative anxiety among adult surgical patients at the University of Gondar Comprehensive Specialized Hospital (UoGCSH), Northwest Ethiopia. Methodology: Hospital-based cross-sectional study was conducted among surgical patients at the university hospital. After obtaining ethical approval, 407 surgical patients were approached during the preoperative period. Preoperative anxiety was assessed by the State-Trait Anxiety Inventory. The association between variables was determined by using binary logistic regression analysis. The strength of association was described in adjusted odds ratio (AOR) and a p-value < 0.05 at a 95% confidence interval which was considered statistically significant. Results: A total of 400 patients were included in this study, with a 98.3% response rate. Preoperative anxiety was observed among 237 (59.3%) patients, and the median (IQR) STAI score was 50 (40 – 56.7). age ≥ 60 years (AOR: 5.7, CI: 1.6 – 20.4, P: 0.007), emergency surgery (AOR: 2.5, CI: 1.3 – 4.7, P: 0.005), preoperative pain (AOR: 2.6, CI: 1.2 – 5.4, P: 0.005), and rural residency (AOR: 1.8, CI: 1.1 – 2.9, P: 0.031) were found significantly associated with preoperative anxiety. Conclusions: The prevalence of preoperative anxiety among surgical patients was high. Older age (≥ 60 years), emergency surgery, preoperative pain, and rural residency were found to be significantly associated with preoperative anxiety. Assessment for preoperative anxiety should be a routine component of preoperative assessment of both elective and emergency surgical patients. Preoperative pain should be appropriately managed as it can help to reduce preoperative anxiety. Optimal anxiety reduction methods should be investigated and implemented in the hospital.Keywords: preoperative anxiety, anxiety, anxiety of anesthesia and surgery, state-trait anxiety inventory, preoperative care
Procedia PDF Downloads 155311 Assessment of Environmental Risk Factors of Railway Using Integrated ANP-DEMATEL Approach in Fuzzy Conditions
Authors: Mehrdad Abkenari, Mehmet Kunt, Mahdi Nourollahi
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Evaluating the environmental risk factors is a combination of analysis of transportation effects. Various definitions for risk can be found in different scientific sources. Each definition depends on a specific and particular perspective or dimension. The effects of potential risks present along the new proposed routes and existing infrastructures of large transportation projects like railways should be studied under comprehensive engineering frameworks. Despite various definitions provided for ‘risk’, all include a uniform concept. Two obvious aspects, loss and unreliability, have always been pointed in all definitions of this term. But, selection as the third aspect is usually implied and means how one notices it. Currently, conducting engineering studies on the environmental effects of railway projects have become obligatory according to the Environmental Assessment Act in developing countries. Considering the longitudinal nature of these projects and probable passage of railways through various ecosystems, scientific research on the environmental risk of these projects have become of great interest. Although many areas of expertise such as road construction in developing countries have not seriously committed to these studies yet, attention to these subjects in establishment or implementation of different systems have become an inseparable part of this wave of research. The present study used environmental risks identified and existing in previous studies and stations to use in next step. The second step proposes a new hybrid approach of analytical network process (ANP) and DEMATEL in fuzzy conditions for assessment of determined risks. Since evaluation of identified risks was not an easy touch, mesh structure was an appropriate approach for analyzing complex systems which were accordingly employed for problem description and modeling. Researchers faced the shortage of real space data and also due to the ambiguity of experts’ opinions and judgments, they were declared in language variables instead of numerical ones. Since fuzzy logic is appropriate for ambiguity and uncertainty, formulation of experts’ opinions in the form of fuzzy numbers seemed an appropriate approach. Fuzzy DEMATEL method was used to extract the relations between major and minor risk factors. Considering the internal relations of risk major factors and its sub-factors in the analysis of fuzzy network, the weight of risk’s main factors and sub-factors were determined. In general, findings of the present study, in which effective railway environmental risk indicators were theoretically identified and rated through the first usage of combined model of DEMATEL and fuzzy network analysis, indicate that environmental risks can be evaluated more accurately and also employed in railway projects.Keywords: DEMATEL, ANP, fuzzy, risk
Procedia PDF Downloads 4135310 Risk Assessment of Lead Element in Red Peppers Collected from Marketplaces in Antalya, Southern Turkey
Authors: Serpil Kilic, Ihsan Burak Cam, Murat Kilic, Timur Tongur
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Interest in the lead (Pb) has considerably increased due to knowledge about the potential toxic effects of this element, recently. Exposure to heavy metals above the acceptable limit affects human health. Indeed, Pb is accumulated through food chains up to toxic concentrations; therefore, it can pose an adverse potential threat to human health. A sensitive and reliable method for determination of Pb element in red pepper were improved in the present study. Samples (33 red pepper products having different brands) were purchased from different markets in Turkey. The selected method validation criteria (linearity, Limit of Detection, Limit of Quantification, recovery, and trueness) demonstrated. Recovery values close to 100% showed adequate precision and accuracy for analysis. According to the results of red pepper analysis, all of the tested lead element in the samples was determined at various concentrations. A Perkin- Elmer ELAN DRC-e model ICP-MS system was used for detection of Pb. Organic red pepper was used to obtain a matrix for all method validation studies. The certified reference material, Fapas chili powder, was digested and analyzed, together with the different sample batches. Three replicates from each sample were digested and analyzed. The results of the exposure levels of the elements were discussed considering the scientific opinions of the European Food Safety Authority (EFSA), which is the European Union’s (EU) risk assessment source associated with food safety. The Target Hazard Quotient (THQ) was described by the United States Environmental Protection Agency (USEPA) for the calculation of potential health risks associated with long-term exposure to chemical pollutants. THQ value contains intake of elements, exposure frequency and duration, body weight and the oral reference dose (RfD). If the THQ value is lower than one, it means that the exposed population is assumed to be safe and 1 < THQ < 5 means that the exposed population is in a level of concern interval. In this study, the THQ of Pb was obtained as < 1. The results of THQ calculations showed that the values were below one for all the tested, meaning the samples did not pose a health risk to the local population. This work was supported by The Scientific Research Projects Coordination Unit of Akdeniz University. Project Number: FBA-2017-2494.Keywords: lead analyses, red pepper, risk assessment, daily exposure
Procedia PDF Downloads 1675309 Case Study of Mechanised Shea Butter Production in South-Western Nigeria Using the LCA Approach from Gate-to-Gate
Authors: Temitayo Abayomi Ewemoje, Oluwamayowa Oluwafemi Oluwaniyi
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Agriculture and food processing, industry are among the largest industrial sectors that uses large amount of energy. Thus, a larger amount of gases from their fuel combustion technologies is being released into the environment. The choice of input energy supply not only directly having affects the environment, but also poses a threat to human health. The study was therefore designed to assess each unit production processes in order to identify hotspots using life cycle assessments (LCA) approach in South-western Nigeria. Data such as machine power rating, operation duration, inputs and outputs of shea butter materials for unit processes obtained at site were used to modelled Life Cycle Impact Analysis on GaBi6 (Holistic Balancing) software. Four scenarios were drawn for the impact assessments. Material sourcing from Kaiama, Scenarios 1, 3 and Minna Scenarios 2, 4 but different heat supply sources (Liquefied Petroleum Gas ‘LPG’ Scenarios 1, 2 and 10.8 kW Diesel Heater, scenarios 3, 4). Modelling of shea butter production on GaBi6 was for 1kg functional unit of shea butter produced and the Tool for the Reduction and Assessment of Chemical and other Environmental Impacts (TRACI) midpoint assessment was tool used to was analyse the life cycle inventories of the four scenarios. Eight categories in all four Scenarios were observed out of which three impact categories; Global Warming Potential (GWP) (0.613, 0.751, 0.661, 0.799) kg CO2¬-Equiv., Acidification Potential (AP) (0.112, 0.132, 0.129, 0.149) kg H+ moles-Equiv., and Smog (0.044, 0.059, 0.049, 0.063) kg O3-Equiv., categories had the greater impacts on the environment in Scenarios 1-4 respectively. Impacts from transportation activities was also seen to contribute more to these environmental impact categories due to large volume of petrol combusted leading to releases of gases such as CO2, CH4, N2O, SO2, and NOx into the environment during the transportation of raw shea kernel purchased. The ratio of transportation distance from Minna and Kaiama to production site was approximately 3.5. Shea butter unit processes with greater impacts in all categories was the packaging, milling and with the churning processes in ascending order of magnitude was identified as hotspots that may require attention. From the 1kg shea butter functional unit, it was inferred that locating production site at the shortest travelling distance to raw material sourcing and combustion of LPG for heating would reduce all the impact categories assessed on the environment.Keywords: GaBi6, Life cycle assessment, shea butter production, TRACI
Procedia PDF Downloads 3235308 Antimicrobial Activity of Olive Mill Wastewater Fractions
Authors: Chahinez Ait Si Said, Ouassila Touafek, Mohamed Reda Zahi, Smain Sabour, Mohamed El Hattab
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Oil mill wastewater (OMW) is a major effluent of the olive industry resulting from olive oil extraction which is a great source for the development of new drugs. The present study aimed to evaluate the antimicrobial activity of seven different fractions separated from OMW extract. The sample was recovered from an oil mill in the Blida region (Algeria). A crude ethyl acetate extract was prepared from OMW according to a well-established protocol; the yield of the extract obtained was 4%. From the extract, different fractions were prepared by fractionating the total extract with an open column chromatography. The obtained fractions were submitted to antimicrobial activity screening in a comparative purpose. All the fractions obtained show great antimicrobial potential. Phytochemical study of the different fractions was assessed by evaluating the total phenolic compounds for all fractions studied as the main compounds found in OMW were phenols like hydroxytyrosol, tyrosol, phenolic acids like caffeic, quinic and ferulic acids which show great therapeutic activities. Keywords: olive mill wastewater, fractionation, total phenolic compound, antimicrobial activity
Procedia PDF Downloads 1045307 Geometry of the Bandaging Procedure and Its Application while Wrapping Bandages for Treatment of Leg Ulcers
Authors: Monica Puri Sikka, Subrato Ghosh Arunangshu Mukhopadhyay
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Appropriate compression bandaging is important for compression therapeutic medical diseases. The high compression approach employed for treating venous leg ulcers should be used correctly so that sufficient (but not excessive) pressure is applied. Bandages used to treat venous disease by compression should achieve and sustain effective levels and gradients of pressure and minimise the risk of pressure trauma. To maintain graduated compression on the limb the bandage needs to be applied at same tension for each layer from ankle to the knee. In this paper the geometry for various bandaging procedures is used to wrap each layer of bandage by marking the relaxed length of the bandage. The relaxed length is calculated depending on the stretch, average circumference of the limb on which it is to be applied and the bandaging technique to be used. This paper aims at developing a scientific approach while applying the bandage to reduce the inter operator variability in applying same tension on each successive layer of bandage.Keywords: bandaging, compression, inter operator variability, graduated, relaxed length, stretch
Procedia PDF Downloads 4965306 A Worldwide Assessment of Geothermal Energy Policy: Systematic, Qualitative and Critical Literature Review
Authors: Diego Moya, Juan Paredes, Clay Aldas, Ramiro Tite, Prasad Kaparaju
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Globally, energy policy for geothermal development is addressed in different forms, depending on the economy, resources, country-development, environment aspects and technology access. Although some countries have established strong regulations and standards for geothermal exploration, exploitation and sustainable use at the policy level (government departments and institutions), others have discussed geothermal laws at legal levels (congress – a national legislative body of a country). Appropriate regulations are needed not only to meet local and international funding requirements but also to avoid speculation in the use of the geothermal resource. In this regards, this paper presents the results of a systematic, qualitative and critical literature review of geothermal energy policy worldwide addressing two scenarios: policy and legal levels. At first, literature is collected and classified from scientific and government sources regarding geothermal energy policy of the most advanced geothermal producing countries, including Iceland, New Zealand, Mexico, the USA, Central America, Italy, Japan, Philippines, Indonesia, Kenia, and Australia. This is followed by a systematic review of the literature aiming to know the best geothermal practices and what remains uncertain regarding geothermal policy implementation. This analysis is made considering the stages of geothermal production. Furthermore, a qualitative analysis is conducted comparing the findings across geothermal policies in the countries mentioned above. Then, a critical review aims to identify significant items in the field to be applied in countries with geothermal potential but with no or weak geothermal policies. Finally, patterns and relationships are detected, and conclusions are drawn.Keywords: assessment, geothermal, energy policy, worldwide
Procedia PDF Downloads 3855305 Kuwait Environmental Remediation Program: Fresh Groudwater Risk Assessement from Tarcrete Material across the Raudhatain and Sabriyah Oil Fields, North Kuwait
Authors: Nada Al-Qallaf, Aisha Al-Barood, Djamel Lekmine, Srinivasan Vedhapuri
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Kuwait Oil Company (KOC) under the supervision of Kuwait National Focal Point (KNFP) is planning to remediate 26 million (M) m3 of oil-contaminated soil in oil fields of Kuwait as a direct and indirect fallout of the Gulf War during 1990-1991. This project is funded by the United Nations Compensation Commission (UNCC) under the Kuwait Environmental Remediation Program (KERP). Oil-contamination of the soil occurred due to the destruction of the oil wells and spilled crude oil across the land surface and created ‘oil lakes’ in low lying land. Aerial fall-out from oil spray and combustion products from oil fires combined with the sand and gravel on the ground surface to form a layer of hardened ‘Tarcrete’. The unique fresh groundwater lenses present in the Raudhatain and Sabriya subsurface areas had been impacted by the discharge and/or spills of dissolved petroleum constituents. These fresh groundwater aquifers were used for drinking water purposes until 1990, prior to invasion. This has significantly damages altered the landscape, ecology and habitat of the flora and fauna and in Kuwait Desert. Under KERP, KOC is fully responsible for the planning and execution of the remediation and restoration projects in KOC oil fields. After the initial recommendation of UNCC to construct engineered landfills for containment and disposal of heavily contaminated soils, two landfills were constructed, one in North Kuwait and another in South East Kuwait of capacity 1.7 million m3 and 0.5 million m3 respectively. KOC further developed the Total Remediation Strategy in conjunction with KNFP and has obtained UNCC approval. The TRS comprises of elements such as Risk Based Approach (RBA), Bioremediation of low Contaminated Soil levels, Remediation Treatment Technologies, Sludge Disposal via Beneficial Recycling or Re-use and Engineered landfills for Containment of untreatable materials. Risk Based Assessment as a key component to avoid any unnecessary remedial works, where it can be demonstrated that human health and the environment are sufficiently protected in the absence of active remediation. This study demonstrates on the risks of tarcrete materials spread over areas 20 Km2 on the fresh Ground water lenses/catchment located beneath the Sabriyah and Raudhatain oil fields in North Kuwait. KOC’s primary objective is to provide justification of using RBA, to support a case with the Kuwait regulators to leave the tarcrete material in place, rather than seek to undertake large-scale removal and remediation. The large-scale coverage of the tarcrete in the oil fields and perception that the residual contamination associated with this source is present in an environmentally sensitive area essentially in ground water resource. As part of this assessment, conceptual site model (CSM) and complete risk-based and fate and transport modelling was carried out which includes derivation of site-specific assessment criteria (SSAC) and quantification of risk to identified waters resource receptors posed by tarcrete impacted areas. The outcome of this assessment was determined that the residual tarcrete deposits across the site area shall not create risks to fresh groundwater resources and the remedial action to remove and remediate the surficial tarcrete deposits is not warranted.Keywords: conceptual site model, fresh groundwater, oil-contaminated soil, tarcrete, risk based assessment
Procedia PDF Downloads 1745304 Circular Tool and Dynamic Approach to Grow the Entrepreneurship of Macroeconomic Metabolism
Authors: Maria Areias, Diogo Simões, Ana Figueiredo, Anishur Rahman, Filipa Figueiredo, João Nunes
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It is expected that close to 7 billion people will live in urban areas by 2050. In order to improve the sustainability of the territories and its transition towards circular economy, it’s necessary to understand its metabolism and promote and guide the entrepreneurship answer. The study of a macroeconomic metabolism involves the quantification of the inputs, outputs and storage of energy, water, materials and wastes for an urban region. This quantification and analysis representing one opportunity for the promotion of green entrepreneurship. There are several methods to assess the environmental impacts of an urban territory, such as human and environmental risk assessment (HERA), life cycle assessment (LCA), ecological footprint assessment (EF), material flow analysis (MFA), physical input-output table (PIOT), ecological network analysis (ENA), multicriteria decision analysis (MCDA) among others. However, no consensus exists about which of those assessment methods are best to analyze the sustainability of these complex systems. Taking into account the weaknesses and needs identified, the CiiM - Circular Innovation Inter-Municipality project aims to define an uniform and globally accepted methodology through the integration of various methodologies and dynamic approaches to increase the efficiency of macroeconomic metabolisms and promoting entrepreneurship in a circular economy. The pilot territory considered in CiiM project has a total area of 969,428 ha, comprising a total of 897,256 inhabitants (about 41% of the population of the Center Region). The main economic activities in the pilot territory, which contribute to a gross domestic product of 14.4 billion euros, are: social support activities for the elderly; construction of buildings; road transport of goods, retailing in supermarkets and hypermarkets; mass production of other garments; inpatient health facilities; and the manufacture of other components and accessories for motor vehicles. The region's business network is mostly constituted of micro and small companies (similar to the Central Region of Portugal), with a total of 53,708 companies identified in the CIM Region of Coimbra (39 large companies), 28,146 in the CIM Viseu Dão Lafões (22 large companies) and 24,953 in CIM Beiras and Serra da Estrela (13 large companies). For the construction of the database was taking into account data available at the National Institute of Statistics (INE), General Directorate of Energy and Geology (DGEG), Eurostat, Pordata, Strategy and Planning Office (GEP), Portuguese Environment Agency (APA), Commission for Coordination and Regional Development (CCDR) and Inter-municipal Community (CIM), as well as dedicated databases. In addition to the collection of statistical data, it was necessary to identify and characterize the different stakeholder groups in the pilot territory that are relevant to the different metabolism components under analysis. The CIIM project also adds the potential of a Geographic Information System (GIS) so that it is be possible to obtain geospatial results of the territorial metabolisms (rural and urban) of the pilot region. This platform will be a powerful visualization tool of flows of products/services that occur within the region and will support the stakeholders, improving their circular performance and identifying new business ideas and symbiotic partnerships.Keywords: circular economy tools, life cycle assessment macroeconomic metabolism, multicriteria decision analysis, decision support tools, circular entrepreneurship, industrial and regional symbiosis
Procedia PDF Downloads 1015303 Evidence Based Medicine: Going beyond Improving Physicians Viewpoints, Usage and Challenges Upcoming
Authors: Peyman Rezaei Hachesu, Vahideh Zareh Gavgani, Zahra Salahzadeh
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To survey the attitudes, awareness, and practice of Evidence Based Medicine (EBM), and to determine the barriers that influence apply’ EBM in therapeutic process among clinical residents in Iran.We conducted a cross sectional survey during September to December 2012 at the teaching hospitals of Tehran University of Medical Sciences among 79 clinical residents from different medical specialties. A valid and reliable questionnaire consisted of five sections and 27 statements were used in this research. We applied Spearman and Mann Whitney test for correlation between variables. Findings showed that the knowledge of residents about EBM is low. Their attitude towards EBM was positive but their knowledge and skills in regard with the evidence based medical information resources were mostly limited to PubMed and Google scholar. The main barrier was the lack of enough time to practicing EBM. There was no significant correlation between residency grade and familiarity and use of electronic EBM resources (Spearman, P = 0.138). Integration of training approaches like journal clubs or workshops with clinical practice is suggested.Keywords: evidence-based medicine, clinical residents, decision-making, attitude, questionnaire
Procedia PDF Downloads 3765302 Pancreatic Lipase and Cholesterol Esterase Inhibitors from Thai Medicinal Plants
Authors: Kwanchai Ratanamanee, Pattra Ahmadi Pirshahid, Yaowaluk Khamphan, Sirinan Thubthimthad
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Obesity is a main global health problem. The obesity rated has continued to be higher and higher. It causes to serious systems, diabetes, coronary artery disease, stroke, and some types of cancer. Oristat is one of the best drugs worldwide used as a pancreatic lipase inhibitor. To develop the new therapeutic drugs from medicinal plant always explored. In this study, 24 medicinal plants were investigated for their pancreatic lipase and cholesterol esterase inhibitory effects with Fluorometer assay and oristat as a positive control. It showed that the ethanolic extract of pods of Acacia concinna (Willd.) D.C., possess pancreatic lipase and cholesterol esterase inhibitory activities of IC50 at 2.73 and 3.77 mg/ml respectively as well as oral acute toxicity of the extract (LD50) was 6,300 mg/kg body weight. The extract of A.concinna should be further investigated in animal testing. The results of pancreatic lipase and cholesterol esterase inhibitor of the extracts will lead us to utilize A.concinna for developing as obesity dietary supplement from a medicinal plant.Keywords: Acacia concinna (Willd.) D. C., cholesterol esterase, obesity, pancreatic lipase
Procedia PDF Downloads 4785301 The Degree Project-Course in Swedish Teacher Education – Deliberative and Transformative Perspectives on the Formative Assessment Practice
Authors: Per Blomqvist
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The overall aim of this study is to highlight how the degree project-course in teacher education has developed over time at Swedish universities, above all regarding changes in the formative assessment practices in relation to student's opportunities to take part in writing processes that can develop both their independent critical thinking, subject knowledge, and academic writing skills. Theoretically, the study is based on deliberative and transformative perspectives of teaching academic writing in higher education. The deliberative perspective is motivated by the fact that it is the universities and their departments' responsibility to give the students opportunities to develop their academic writing skills, while there is little guidance on how this can be implemented. The transformative perspective is motivated by the fact that education needs to be adapted to the student's prior knowledge and developed in relation to the student group. Given the academisation of education and the new student groups, this is a necessity. The empirical data consists of video recordings of teacher groups' conversations at three Swedish universities. The conversations were conducted as so-called collective remembering interviews, a method to stimulate the participants' memory through social interaction, and focused on addressing issues on how the degree project-course in teacher education has changed over time. Topic analysis was used to analyze the conversations in order to identify common descriptions and expressions among the teachers. The result highlights great similarities in how the degree project-course has changed over time, both from a deliberative and a transformative perspective. The course is characterized by a “strong framing,” where the teachers have great control over the work through detailed instructions for the writing process and detailed templates for the text. This is justified by the fact that the education has been adapted based on the student teachers' lack of prior subject knowledge. The strong framing places high demands on continuous discussions between teachers about, for example, which tools the students have with them and which linguistic and textual tools are offered in the education. The teachers describe that such governance often leads to conflicts between teachers from different departments because reading and writing are always part of cultural contexts and are linked to different knowledge, traditions, and values. The problem that is made visible in this study raises questions about how students' opportunities to develop independence and make critical judgments in academic writing are affected if the writing becomes too controlled and if passing students becomes the main goal of education.Keywords: formative assessment, academic writing, degree project, higher education, deliberative perspective, transformative perspective
Procedia PDF Downloads 655300 Calpains; Insights Into the Pathogenesis of Heart Failure
Authors: Mohammadjavad Sotoudeheian
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Heart failure (HF) prevalence, as a global cardiovascular problem, is increasing gradually. A variety of molecular mechanisms contribute to HF. Proteins involved in cardiac contractility regulation, such as ion channels and calcium handling proteins, are altered. Additionally, epigenetic modifications and gene expression can lead to altered cardiac function. Moreover, inflammation and oxidative stress contribute to HF. The progression of HF can be attributed to mitochondrial dysfunction that impairs energy production and increases apoptosis. Molecular mechanisms such as these contribute to the development of cardiomyocyte defects and HF and can be therapeutically targeted. The heart's contractile function is controlled by cardiomyocytes. Calpain, and its related molecules, including Bax, VEGF, and AMPK, are among the proteins involved in regulating cardiomyocyte function. Apoptosis is facilitated by Bax. Cardiomyocyte apoptosis is regulated by this protein. Furthermore, cardiomyocyte survival, contractility, wound healing, and proliferation are all regulated by VEGF, which is produced by cardiomyocytes during inflammation and cytokine stress. Cardiomyocyte proliferation and survival are also influenced by AMPK, an enzyme that plays an active role in energy metabolism. They all play key roles in apoptosis, angiogenesis, hypertrophy, and metabolism during myocardial inflammation. The role of calpains has been linked to several molecular pathways. The calpain pathway plays an important role in signal transduction and apoptosis, as well as autophagy, endocytosis, and exocytosis. Cell death and survival are regulated by these calcium-dependent cysteine proteases that cleave proteins. As a result, protein fragments can be used for various cellular functions. By cleaving adhesion and motility proteins, calcium proteins also contribute to cell migration. HF may be brought about by calpain-mediated pathways. Many physiological processes are mediated by the calpain molecular pathways. Signal transduction, cell death, and cell migration are all regulated by these molecular pathways. Calpain is activated by calcium binding to calmodulin. In the presence of calcium, calmodulin activates calpain. Calpains are stimulated by calcium, which increases matrix metalloproteinases (MMPs). In order to develop novel treatments for these diseases, we must understand how this pathway works. A variety of myocardial remodeling processes involve calpains, including remodeling of the extracellular matrix and hypertrophy of cardiomyocytes. Calpains also play a role in maintaining cardiac homeostasis through apoptosis and autophagy. The development of HF may be in part due to calpain-mediated pathways promoting cardiomyocyte death. Numerous studies have suggested the importance of the Ca2+ -dependent protease calpain in cardiac physiology and pathology. Therefore, it is important to consider this pathway to develop and test therapeutic options in humans that targets calpain in HF. Apoptosis, autophagy, endocytosis, exocytosis, signal transduction, and disease progression all involve calpain molecular pathways. Therefore, it is conceivable that calpain inhibitors might have therapeutic potential as they have been investigated in preclinical models of several conditions in which the enzyme has been implicated that might be treated with them. Ca 2+ - dependent proteases and calpains contribute to adverse ventricular remodeling and HF in multiple experimental models. In this manuscript, we will discuss the calpain molecular pathway's important roles in HF development.Keywords: calpain, heart failure, autophagy, apoptosis, cardiomyocyte
Procedia PDF Downloads 685299 Flow-Oriented Incentive Spirometry in the Reversal of Diaphragmatic Dysfunction in Bariatric Surgery Postoperative Period
Authors: Eli Maria Forti-Pazzianotto, Carolina Moraes Da Costa, Daniela Faleiros Berteli Merino, Maura Rigoldi Simões Da Rocha, Irineu Rasera-Junior
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There is no conclusive evidence to support the use of one type or brand of incentive espirometry over others. The decision as to which equipment is best, have being based on empirical assessment of patient acceptance, ease of use, and cost. The aim was to evaluate the effects of use of two methodologies of breathing exercises, performed by flow-oriented incentive spirometry, in the reversal of diaphragmatic dysfunction in postoperative bariatric surgery. 38 morbid obese women were selected. Respiratory muscle strength was evaluated through the nasal inspiratory pressure (NIP), and the respiratory muscles endurance, through incremental test by measurement of sustained maximal inspiratory pressure (SMIP). They were randomized in 2 groups: 1- Respiron® Classic (RC) the inspirations were slow, deep and sustained for as long as possible (5 sec). 2- Respiron® Athletic1 (RA1) - the inspirations were explosive, quick and intense, raising balls by the explosive way. 6 sets of 15 repetitions with intervals of 30 to 60 seconds were performed in groups. At the end of the intervention program (second PO), the volunteers were reevaluated. The groups were homogeneous with regard to initial assessment. However on reevaluating there was a significant decline of the variable PIN (p= < 0.0001) and SMIP (p=0.0004) in RC. In the RA1 group there was a maintenance of SMIP (p=0.5076) after surgery. The use of the Respiron Athletic 1, as well as the methodology of application used, can contribute positively to preserve the inspiratory muscle endurance and improve the diaphragmatic dysfunction in postoperative period.Keywords: bariatric surgery, incentive spirometry, respiratory muscle, physiotherapy
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