Search results for: learning methods
2281 A Double-Blind, Randomized, Controlled Trial on N-Acetylcysteine for the Prevention of Acute Kidney Injury in Patients Undergoing Allogeneic Hematopoietic Stem Cell Transplantation
Authors: Sara Ataei, Molouk Hadjibabaie, Amirhossein Moslehi, Maryam Taghizadeh-Ghehi, Asieh Ashouri, Elham Amini, Kheirollah Gholami, Alireza Hayatshahi, Mohammad Vaezi, Ardeshir Ghavamzadeh
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Acute kidney injury (AKI) is one of the complications of hematopoietic stem cell transplantation and is associated with increased mortality. N-acetylcysteine (NAC) is a thiol compound with antioxidant and vasodilatory properties that has been investigated for the prevention of AKI in several clinical settings. In the present study, we evaluated the effects of intravenous NAC on the prevention of AKI in allogeneic hematopoietic stem cell transplantation patients. A double-blind randomized placebo-controlled trial was conducted, and 80 patients were recruited to receive 100 mg/kg/day NAC or placebo as intermittent intravenous infusion from day -6 to day +15. AKI was determined on the basis of the Risk-Injury-Failure-Loss-Endstage renal disease and AKI Network criteria as the primary outcome. We assessed urine neutrophil gelatinase-associated lipocalin (uNGAL) on days -6, -3, +3, +9, and +15 as the secondary outcome. Moreover, transplant-related outcomes and NAC adverse reactions were evaluated during the study period. Statistical analysis was performed using appropriate parametric and non-parametric methods including Kaplan–Meier for AKI and generalized estimating equation for uNGAL. At the end of the trial, data from 72 patients were analyzed (NAC: 33 patients and placebo: 39 patients). Participants of each group were not different considering baseline characteristics. AKI was observed in 18% of NAC recipients and 15% of placebo group patients, and the occurrence pattern was not significantly different (p = 0.73). Moreover, no significant difference was observed between groups for uNGAL measures (p = 0.10). Transplant-related outcomes were similar for both groups, and all patients had successful engraftment. Three patients did not tolerate NAC because of abdominal pain, shortness of breath and rash with pruritus and were dropped from the intervention group before transplantation. However, the frequency of adverse reactions was not significantly different between groups. In conclusion, our findings could not show any clinical benefits from high-dose NAC particularly for AKI prevention in allogeneic hematopoietic stem cell transplantation patients.Keywords: acute kidney injury, N-acetylcysteine, hematopoietic stem cell transplantation, urine neutrophil gelatinase-associated lipocalin, randomized controlled trial
Procedia PDF Downloads 4272280 Efficacy of Single-Dose Azithromycin Therapy for the Treatment of Chlamydia trachomatis in Patients Evaluated for Child Sexual Abuse in an Urban Health Center 2006-16
Authors: Trenton Hubbard, Kenneth Soyemi, Emily Siffermann
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Introduction: According to the American Academy of Pediatrics (AAP) there are different weight-based recommendations for the treatment of Chlamydia trachomatis (CT) in patients who are being evaluated for sexual assault. Current AAP Red Book guidelines recommend that uncomplicated C. trachomatis anogenital infection in prepubertal patients weighing less than =<45 kg be treated with oral erythromycin 50 mg/kg/day QID for 14 days with no alternative therapies, and for patients whose weight => 45 kg are Azithromycin 1 gm PO once. Our study objective was to determine the efficacy of single-dose Azithromycin therapy for the treatment of Chlamydia trachomatis in patients weighing less than 50 kg who were evaluated for child sexual abuse in an urban setting. Methods: We conducted a retrospective chart review of historical medical records (paper and electronic) patients weighing less than 50 kg who were evaluated for child sexual abuse and subsequently treated for C. trachomatis infection with Azithromycin (20 mg/kg PO once up to a maximum 1 gm) and received a Test of Cure (TOC) from 2006-2016. Qualitative variables were expressed as percentages. Quantitative variables were expressed as mean values (+/- standard deviation [SD]) if they followed a normal distribution or as median values (interquartile range[IQR]) if they did not. Wilcoxson two-sample test was used to compare means of Azithromycin Dose, mg/kg, and TOC timing between treatment responders and non-responders. Results: We reviewed records of 34 patients, average age (SD) was 5.4 (2.0) years, 33 (97%) were treated for CT and 1(3%) for both GC and CT. 25 (74%) were females. Urine PCR was the most commonly used test at evaluation and as TOC with 13 (38%) patients completing both tests. The average (SD) dose of Azithromycin at treatment was 470 (136) mg and average (SD) mg/kg dose of 20 (1.9) mg/kg for all patients. Median (IQR) timing for TOC testing was 19 (14-26) days. Of the 33 with complete data 25 (74%) had a negative TOC. When compared with treatment non-responders (TOC failures), treatment responders received higher doses (average dose (SD) received 495 (139) vs 401(110), P 0.06)); similar average (SD) weight base dosing received (20.8(2.0) vs 19.7 (1.5), P 0.15)), and earlier average (SD)TOC test timing (18.8 (5.6) vs 32 (28.6) P 0.02)). Conclusion: Azithromycin dosing appears to be efficacious in the treatment of CT post sexual assault as majority of patients responded. Although treatment responders and non-responders received similar weight based doses, there is need for additional studies to understand variances and predictors of response.Keywords: child sexual abuse, chlmaydia trachmotis infection, single-dose azithromycin, weight less than or equal to 45 kilograms
Procedia PDF Downloads 2832279 Satellite Data to Understand Changes in Carbon Dioxide for Surface Mining and Green Zone
Authors: Carla Palencia-Aguilar
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In order to attain the 2050’s zero emissions goal, it is necessary to know the carbon dioxide changes over time either from pollution to attenuations in the mining industry versus at green zones to establish real goals and redirect efforts to reduce greenhouse effects. Two methods were used to compute the amount of CO2 tons in specific mining zones in Colombia. The former by means of NPP with MODIS MOD17A3HGF from years 2000 to 2021. The latter by using MODIS MYD021KM bands 33 to 36 with maximum values of 644 data points distributed in 7 sites corresponding to surface mineral mining of: coal, nickel, iron and limestone. The green zones selected were located at the proximities of the studied sites, but further than 1 km to avoid information overlapping. Year 2012 was selected for method 2 to compare the results with data provided by the Colombian government to determine range of values. Some data was compared with 2022 MODIS energy values and converted to kton of CO2 by using the Greenhouse Gas Equivalencies Calculator by EPA. The results showed that Nickel mining was the least pollutant with 81 kton of CO2 e.q on average and maximum of 102 kton of CO2 e.q. per year, with green zones attenuating carbon dioxide in 103 kton of CO2 on average and 125 kton maximum per year in the last 22 years. Following Nickel, there was Coal with average kton of CO2 per year of 152 and maximum of 188, values very similar to the subjacent green zones with average and maximum kton of CO2 of 157 and 190 respectively. Iron had similar results with respect to 3 Limestone sites with average values of 287 kton of CO2 for mining and 310 kton for green zones, and maximum values of 310 kton for iron mining and 356 kton for green zones. One of the limestone sites exceeded the other sites with an average value of 441 kton per year and maximum of 490 kton per year, eventhough it had higher attenuation by green zones than a close Limestore site (3.5 Km apart): 371 kton versus 281 kton on average and maximum 416 kton versus 323 kton, such vegetation contribution is not enough, meaning that manufacturing process should be improved for the most pollutant site. By comparing bands 33 to 36 for years 2012 and 2022 from January to August, it can be seen that on average the kton of CO2 were similar for mining sites and green zones; showing an average yearly balance of carbon dioxide emissions and attenuation. However, efforts on improving manufacturing process are needed to overcome the carbon dioxide effects specially during emissions’ peaks because surrounding vegetation cannot fully attenuate it.Keywords: carbon dioxide, MODIS, surface mining, vegetation
Procedia PDF Downloads 932278 The Impact of the Method of Extraction on 'Chemchali' Olive Oil Composition in Terms of Oxidation Index, and Chemical Quality
Authors: Om Kalthoum Sallem, Saidakilani, Kamiliya Ounaissa, Abdelmajid Abid
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Introduction and purposes: Olive oil is the main oil used in the Mediterranean diet. Virgin olive oil is valued for its organoleptic and nutritional characteristics and is resistant to oxidation due to its high monounsaturated fatty acid content (MUFAs), and low polyunsaturates (PUFAs) and the presence of natural antioxidants such as phenols, tocopherols and carotenoids. The fatty acid composition, especially the MUFA content, and the natural antioxidants provide advantages for health. The aim of the present study was to examine the impact of method of extraction on the chemical profiles of ‘Chemchali’ olive oil variety, which is cultivated in the city of Gafsa, and to compare it with chetoui and chemchali varieties. Methods: Our study is a qualitative prospective study that deals with ‘Chemchali’ olive oil variety. Analyses were conducted during three months (from December to February) in different oil mills in the city of Gafsa. We have compared ‘Chemchali’ olive oil obtained by continuous method to this obtained by superpress method. Then we have analyzed quality index parameters, including free fatty acid content (FFA), acidity, and UV spectrophotometric characteristics and other physico-chemical data [oxidative stability, ß-carotene, and chlorophyll pigment composition]. Results: Olive oil resulting from super press method compared with continuous method is less acid(0,6120 vs. 0,9760), less oxydazible(K232:2,478 vs. 2,592)(k270:0,216 vs. 0,228), more rich in oleic acid(61,61% vs. 66.99%), less rich in linoleic acid(13,38% vs. 13,98 %), more rich in total chlorophylls pigments (6,22 ppm vs. 3,18 ppm ) and ß-carotene (3,128 mg/kg vs. 1,73 mg/kg). ‘Chemchali’ olive oil showed more equilibrated total content in fatty acids compared with the varieties ’Chemleli’ and ‘Chetoui’. Gafsa’s variety ’Chemlali’ have significantly less saturated and polyunsaturated fatty acids. Whereas it has a higher content in monounsaturated fatty acid C18:2, compared with the two other varieties. Conclusion: The use of super press method had benefic effects on general chemical characteristics of ‘Chemchali’ olive oil, maintaining the highest quality according to the ecocert legal standards. In light of the results obtained in this study, a more detailed study is required to establish whether the differences in the chemical properties of oils are mainly due to agronomic and climate variables or, to the processing employed in oil mills.Keywords: olive oil, extraction method, fatty acids, chemchali olive oil
Procedia PDF Downloads 3762277 Phage Capsid for Efficient Delivery of Cytotoxic Drugs
Authors: Simona Dostalova, Dita Munzova, Ana Maria Jimenez Jimenez, Marketa Vaculovicova, Vojtech Adam, Rene Kizek
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The boom of nanomedicine in recent years has led to the development of numerous new nanomaterials that can be used as nanocarriers in the drug delivery. These nanocarriers can either be synthetic or natural-based. The disadvantage of many synthetic nanocarriers is their toxicity in patient’s body. Protein cages that can naturally be found in human body do not exhibit such disadvantage. However, the release of cargo from some protein cages in target cells can be problematic. As a special type of protein cages can serve the capsid of many viruses, including phage. Phages infect bacterial cells; therefore they are not harmful to human cells. The targeting of phage particles to cancer cells can be solved by producing of empty phage capsids during which the targeting moieties (e.g. peptides) can be cloned into genes of phage capsid to decorate its surface. Moreover, the produced capsids do not contain viral nucleic acid and are therefore not infectious to beneficial bacteria in the patient’s body. The protein cage composed of viral capsid is larger than other frequently used apoferritin cage but its size is still small enough to benefit from passive targeting by Enhanced Permeability and Retention effect. In this work, bacteriophage λ was used, both whole and its empty capsid for delivery of different cytotoxic drugs (cisplatin, carboplatin, oxaliplatin, etoposide and doxorubicin). Large quantities of phage λ were obtained from phage λ-producing strain of E. coli cultivated in medium with 0.2 % maltose. After killing of E. coli with chloroform and its removal by centrifugation, the phage was concentrated by ultracentrifugation at 130 000 g and 4 °C for 3 h. The encapsulation of the drugs was performed by infusion method and four different concentrations of the drugs were encapsulated (200; 100; 50; 25 µg/ml). Free molecules of drugs were removed by dialysis. The encapsulation was verified using spectrophotometric and electrochemical methods. The amount of encapsulated drug linearly increased with the amount of applied drug (determination coefficient R2=0.8013). 76% of applied drug was encapsulated in phage λ particles (concentration of 10 µg/ml), even with the highest applied concentration of drugs, 200 µg/ml. Only 1% of encapsulated drug was detected in phage DNA. Similar results were obtained with encapsulation in phage empty capsid. Therefore, it can be concluded that the encapsulation of drugs into phage particles is efficient and mostly occurs by interaction of drugs with protein capsid.Keywords: cytostatics, drug delivery, nanocarriers, phage capsid
Procedia PDF Downloads 4882276 Phytoremediation of Heavy Metals by the Perennial Tussock Chrysopogon Zizanioides Grown on Zn and Cd Contaminated Soil Amended with Biochar
Authors: Dhritilekha Deka, Deepak Patwa, Ravi K., Archana M. Nair
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Bioaccumulation of heavy metal contaminants due to intense anthropogenic interference degrades the environment and ecosystem functions. Conventional physicochemical methods involve energy-intensive and costly methodologies. Phytoremediation, on the other hand, provides an efficient nature-based strategy for the reclamation of heavy metal-contaminated sites. However, the slow process and adaptation to high-concentration contaminant sequestration often limit the efficiency of the method. This necessitates natural amendments such as biochar to improve phytoextraction and stabilize the green cover. Biochar is a highly porous structure with high carbon sequestration potential and containing negatively charged functional groups that provide binding sites for the positively charged metals. This study aims to develop and determine the synergy between sugarcane bagasse biochar content and phytoremediation. A 60-day pot experiment using perennial tussock vetiver grass (Chrysopogon zizanioides) was conducted for different biochar contents of 1%, 2%, and 4% for the removal of cadmium and zinc. A concentration of 500 ppm is maintained for the amended and unamended control (CK) samples. The survival rates of the plants, biomass production, and leaf area index were measured for the plant growth characteristics. Results indicate a visible change in the plant growth and the heavy metal concentration with the biochar content. The bioconcentration factor (BCF) in the plant improved significantly for the 4% biochar content by 57% in comparison to the control CK treatment in Cd-treated soils. The Zn soils indicated the highest reduction in the metal concentration by 50% in the 2% amended samples and an increase in the BCF in all the amended samples. The translocation from the rhizosphere to the shoots was low but not dependent on the amendment content and varied for each contaminant type. The root-to-shoot ratio indicates higher values compared to the control samples. The enhanced tolerance capacities can be attributed to the nutrients released by the biochar in the soil. The study reveals the high potential of biochar as a phytoremediation amendment, but its effect is dependent on the soil and heavy metal and accumulator species.Keywords: phytoextraction, biochar, heavy metals, chrysopogon zizanioides, bioaccumulation factor
Procedia PDF Downloads 592275 Assessment of Routine Health Information System (RHIS) Quality Assurance Practices in Tarkwa Sub-Municipal Health Directorate, Ghana
Authors: Richard Okyere Boadu, Judith Obiri-Yeboah, Kwame Adu Okyere Boadu, Nathan Kumasenu Mensah, Grace Amoh-Agyei
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Routine health information system (RHIS) quality assurance has become an important issue, not only because of its significance in promoting a high standard of patient care but also because of its impact on government budgets for the maintenance of health services. A routine health information system comprises healthcare data collection, compilation, storage, analysis, report generation, and dissemination on a routine basis in various healthcare settings. The data from RHIS give a representation of health status, health services, and health resources. The sources of RHIS data are normally individual health records, records of services delivered, and records of health resources. Using reliable information from routine health information systems is fundamental in the healthcare delivery system. Quality assurance practices are measures that are put in place to ensure the health data that are collected meet required quality standards. Routine health information system quality assurance practices ensure that data that are generated from the system are fit for use. This study considered quality assurance practices in the RHIS processes. Methods: A cross-sectional study was conducted in eight health facilities in Tarkwa Sub-Municipal Health Service in the western region of Ghana. The study involved routine quality assurance practices among the 90 health staff and management selected from facilities in Tarkwa Sub-Municipal who collected or used data routinely from 24th December 2019 to 20th January 2020. Results: Generally, Tarkwa Sub-Municipal health service appears to practice quality assurance during data collection, compilation, storage, analysis and dissemination. The results show some achievement in quality control performance in report dissemination (77.6%), data analysis (68.0%), data compilation (67.4%), report compilation (66.3%), data storage (66.3%) and collection (61.1%). Conclusions: Even though the Tarkwa Sub-Municipal Health Directorate engages in some control measures to ensure data quality, there is a need to strengthen the process to achieve the targeted percentage of performance (90.0%). There was a significant shortfall in quality assurance practices performance, especially during data collection, with respect to the expected performance.Keywords: quality assurance practices, assessment of routine health information system quality, routine health information system, data quality
Procedia PDF Downloads 692274 Attention and Creative Problem-Solving: Cognitive Differences between Adults with and without Attention Deficit Hyperactivity Disorder
Authors: Lindsey Carruthers, Alexandra Willis, Rory MacLean
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Introduction: It has been proposed that distractibility, a key diagnostic criterion of Attention Deficit Hyperactivity Disorder (ADHD), may be associated with higher creativity levels in some individuals. Anecdotal and empirical evidence has shown that ADHD is therefore beneficial to creative problem-solving, and the generation of new ideas and products. Previous studies have only used one or two measures of attention, which is insufficient given that it is a complex cognitive process. The current study aimed to determine in which ways performance on creative problem-solving tasks and a range of attention tests may be related, and if performance differs between adults with and without ADHD. Methods: 150 adults, 47 males and 103 females (mean age=28.81 years, S.D.=12.05 years), were tested at Edinburgh Napier University. Of this set, 50 participants had ADHD, and 100 did not, forming the control group. Each participant completed seven attention tasks, assessing focussed, sustained, selective, and divided attention. Creative problem-solving was measured using divergent thinking tasks, which require multiple original solutions for one given problem. Two types of divergent thinking task were used: verbal (requires written responses) and figural (requires drawn responses). Each task is scored for idea originality, with higher scores indicating more creative responses. Correlational analyses were used to explore relationships between attention and creative problem-solving, and t-tests were used to study the between group differences. Results: The control group scored higher on originality for figural divergent thinking (t(148)= 3.187, p< .01), whereas the ADHD group had more original ideas for the verbal divergent thinking task (t(148)= -2.490, p < .05). Within the control group, figural divergent thinking scores were significantly related to both selective (r= -.295 to -.285, p < .01) and divided attention (r= .206 to .290, p < .05). Alternatively, within the ADHD group, both selective (r= -.390 to -.356, p < .05) and divided (r= .328 to .347, p < .05) attention are related to verbal divergent thinking. Conclusions: Selective and divided attention are both related to divergent thinking, however the performance patterns are different between each group, which may point to cognitive variance in the processing of these problems and how they are managed. The creative differences previously found between those with and without ADHD may be dependent on task type, which to the author’s knowledge, has not been distinguished previously. It appears that ADHD does not specifically lead to higher creativity, but may provide explanation for creative differences when compared to those without the disorder.Keywords: ADHD, attention, creativity, problem-solving
Procedia PDF Downloads 4512273 Efficacy of Different Soil-Applied Fungicides to Manage Phytophthora Root Rot of Chili (Solanum annum) in Pakistan
Authors: Kiran Nawaz, Ahmad Ali Shahid, Sehrish Iftikhar, Waheed Anwar, Muhammad Nasir Subhani
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Chili (Solanum annum L.) attacks by many fungal pathogens, including members of Oomycetes which are responsible for root rot in different chili growing areas of the world. Oomycetes pathogens cause economic losses in different regions of the Pakistan. Most of the plant tissues, including roots, crowns, fruit, and leaves, are vulnerable to Phytophthora capsici. It is very difficult to manage the Phytophthora root rot of chili as many commercial varieties are tremendously vulnerable to P. capsici. The causal agent of the disease was isolated on corn meal agar (CMA) and identified on a morphological basis by using available taxonomic keys. The pathogen was also confirmed on the molecular basis through internal transcribed spacer region and with other molecular markers.The Blastn results showed 100% homology with already reported sequences of P. capsici in NCBI database. Most of the farmers have conventionally relied on foliar fungicide applications to control Phytophthora root rot in spite of their incomplete effectiveness. In this study, in vitro plate assay, seed soaking and foliar applications of 6 fungicides were evaluated against root rot of chili. In vitro assay revealed that significant inhibition of linear growth was obtained with Triflumizole at 7.0%, followed by Thiophanate methyl (8.9%), Etridiazole (6.0%), Propamocarb (5.9%) and 7.5% with Mefenoxam and Iprodione for P. capsici. The promising treatments of in vitro plate bioassay were evaluated in pot experiments under controlled conditions in the greenhouse. All fungicides were applied after at 6-day intervals. Results of pot experiment showed that all treatments considerably inhibited the percentage of P. capsici root rot incidence. In addition, application of seed soaking with all six fungicides combined with the foliar spray of the same components showed the significant reduction in root rot incidence. The combine treatments of all fungicides as in vitro bioassay, seed soaking followed by foliar spray is considered non-harmful control methods which have advantages and limitation. Hence, these applications proved effective and harmless for the management of soil-borne plant pathogens.Keywords: blastn, bioassay, corn meal agar(CMA), oomycetes
Procedia PDF Downloads 2332272 Loss of Control Eating as a Key Factor of the Psychological Symptomatology Related to Childhood Obesity
Authors: L. Beltran, S. Solano, T. Lacruz, M. Blanco, M. Rojo, M. Graell, A. R. Sepulveda
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Introduction and Objective: Given the difficulties of assessing Binge Eating Disorder during childhood, episodes of Loss of Control (LOC) eating can be a key symptom. The objective is to know the prevalence of food psychopathology depending on the type of evaluation and find out which psychological characteristics differentiate overweight or obese children who present LOC from those who do not. Material and Methods: 170 children from 8 to 12 years of age with overweight or obesity (P > 85) were evaluated through the Primary Care Centers of Madrid. Sociodemographic data and psychological measures were collected through the Kiddie-Schedule for Affective Disorders & Schizophrenia, Present & Lifetime Version (K-SADS-PL) diagnostic interview and self-applied questionnaires: Children's eating attitudes (ChEAT), depressive symptomatology (CDI), anxiety (STAIC), general self-esteem (LAWSEQ), body self-esteem (BES), perceived teasing (POTS) and perfectionism (CAPS). Results: 15.2% of the sample exceeded the ChEAT cut-off point, presenting a risk of pathological eating; 5.88% presented an Eating Disorder through the diagnostic interview (2.35% Binge Eating disorder), and 33.53% had LOC episodes. No relationship was found between the presence of LOC and clinical diagnosis of eating disorders according to DSM-V; however, the group with LOC presented a higher risk of eating psychopathology using the ChEAT (p < .02). Significant differences were found in the group with LOC (p < .02): higher z-BMI, lower body self-esteem, greater anxious symptomatology, greater frequency of teasing towards weight, and greater effect of teasing both towards weight and competitions; compared to their peers without LOC. Conclusion: According to previous studies in samples with overweight children, in this Spanish sample of children with obesity, we found a prevalence of moderate eating disorder and a high presence of LOC episodes, which is related to both eating and general psychopathology. These findings confirm that the exclusion of LOC episodes as a diagnostic criterion can underestimate the presence of eating psychopathology during this developmental stage. According to these results, it is highly recommended to promote school context programs that approach LOC episodes in order to reduce associated symptoms. This study is included in a Project funded by the Ministry of Innovation and Science (PSI2011-23127).Keywords: childhood obesity, eating psychopathology, loss-of-control eating, psychological symptomatology
Procedia PDF Downloads 992271 Prevalence of Hepatitis B Virus Infection and Its Determinants among Pregnant Women in East Africa: Systematic Review and Meta-Analysis
Authors: Bantie Getnet Yirsaw, Muluken Chanie Agimas, Gebrie Getu Alemu, Tigabu Kidie Tesfie, Nebiyu Mekonnen Derseh, Habtamu Wagnew Abuhay, Meron Asmamaw Alemayehu, Getaneh Awoke Yismaw
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Introduction: Hepatitis B virus (HBV) is one of the major public health problems globally and needs an urgent response. It is one of the most responsible causes of mortality among the five hepatitis viruses, and it affects almost every class of individuals. Thus, the main objective of this study was to determine the pooled prevalence and its determinants among pregnant women in East Africa. Methods: We searched studies using PubMed, Scopus, Embase, ScienceDirect, Google Scholar, and grey literature that were published between January 01/2020 to January 30/2024. The studies were assessed using the Newcastle Ottawa Scale (NOS) quality assessment scale. The random-effect (DerSimonian) model was used to determine the pooled prevalence and associated factors of HBV among pregnant women. Heterogeneity was assessed by I² statistic, sub-group analysis, and sensitivity analysis. Publication bias was assessed by the Egger test, and the analysis was done using STATA version 17. Result: A total of 45 studies with 35639 pregnant women were included in this systematic review and meta-analysis. The overall pooled prevalence of HBV among pregnant women in East Africa was 6.0% (95% CI: 6.0%−7.0%, I² = 89.7%). The highest prevalence of 8% ((95% CI: 6%, 10%), I² = 91.08%) was seen in 2021, and the lowest prevalence of 5% ((95% CI: 4%, 6%) I² = 52.52%) was observed in 2022. A pooled meta-analysis showed that history of surgical procedure (OR = 2.14 (95% CI: 1.27, 3.61)), having multiple sexual partners (OR = 3.87 (95% CI: 2.52, 5.95), history of body tattooing (OR = 2.55 (95% CI: 1.62, 4.01)), history of tooth extraction (OR = 2.09 (95% CI: 1.29, 3.39)), abortion history(OR = 2.20(95% CI: 1.38, 3.50)), history of sharing sharp material (OR = 1.88 (95% CI: 1.07, 3.31)), blood transfusion (OR = 2.41 (95% CI: 1.62, 3.57)), family history of HBV (OR = 4.87 (95% CI: 2.95, 8.05)) and history needle injury (OR = 2.62 (95% CI: 1.20, 5.72)) were significant risk factors associated with HBV infection among pregnant women. Conclusions: The pooled prevalence of HBV infection among pregnant women in East Africa was at an intermediate level and different across countries, ranging from 1.5% to 22.2%. The result of this pooled prevalence was an indication of the need for screening, prevention, and control of HBV infection among pregnant women in the region. Therefore, early identification of risk factors, awareness creation of the mode of transmission of HBV, and implementation of preventive measures are essential in reducing the burden of HBV infection among pregnant women.Keywords: hepatitis B virus, prevalence, determinants, pregnant women, meta-analysis, East Africa
Procedia PDF Downloads 262270 Rethinking the Value of Pancreatic Cyst CEA Levels from Endoscopic Ultrasound Fine-Needle Aspiration (EUS-FNA): A Longitudinal Analysis
Authors: Giselle Tran, Ralitza Parina, Phuong T. Nguyen
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Background/Aims: Pancreatic cysts (PC) have recently become an increasingly common entity, often diagnosed as incidental findings on cross-sectional imaging. Clinically, management of the lesions is difficult because of uncertainties in their potential for malignant degeneration. Prior series have reported that carcinoembryonic antigen (CEA), a biomarker collected from cyst fluid aspiration, has a high diagnostic accuracy for discriminating between mucinous and non-mucinous lesions, at the patient’s initial presentation. To the author’s best knowledge, no prior studies have reported PC CEA levels obtained from endoscopic ultrasound fine-needle aspiration (EUS-FNA) over years of serial EUS surveillance imaging. Methods: We report a consecutive retrospective series of 624 patients who underwent EUS evaluation for a PC between 11/20/2009 and 11/13/2018. Of these patients, 401 patients had CEA values obtained at the point of entry. Of these, 157 patients had two or more CEA values obtained over the course of their EUS surveillance. Of the 157 patients (96 F, 61 M; mean age 68 [range, 62-76]), the mean interval of EUS follow-up was 29.7 months [3.5-128]. The mean number of EUS procedures was 3 [2-7]. To assess CEA value fluctuations, we defined an appreciable increase in CEA as "spikes" – two-times increase in CEA on a subsequent EUS-FNA of the same cyst, with the second CEA value being greater than 1000 ng/mL. Using this definition, cysts with a spike in CEA were compared to those without a spike in a bivariate analysis to determine if a CEA spike is associated with poorer outcomes and the presence of high-risk features. Results: Of the 157 patients analyzed, 29 had a spike in CEA. Of these 29 patients, 5 had a cyst with size increase >0.5cm (p=0.93); 2 had a large cyst, >3cm (p=0.77); 1 had a cyst that developed a new solid component (p=0.03); 7 had a cyst with a solid component at any time during surveillance (p=0.08); 21 had a complex cyst (p=0.34); 4 had a cyst categorized as "Statistically Higher Risk" based on molecular analysis (p=0.11); and 0 underwent surgical resection (p=0.28). Conclusion: With serial EUS imaging in the surveillance of PC, an increase in CEA level defined as a spike did not predict poorer outcomes. Most notably, a spike in CEA did not correlate with the number of patients sent to surgery or patients with an appreciable increase in cyst size. A spike in CEA did not correlate with the development of a solid nodule within the PC nor progression on molecular analysis. Future studies should focus on the selected use of CEA analysis when patients undergo EUS surveillance evaluation for PCs.Keywords: carcinoembryonic antigen (CEA), endoscopic ultrasound (EUS), fine-needle aspiration (FNA), pancreatic cyst, spike
Procedia PDF Downloads 1362269 Application of Ground-Penetrating Radar in Environmental Hazards
Authors: Kambiz Teimour Najad
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The basic methodology of GPR involves the use of a transmitting antenna to send electromagnetic waves into the subsurface, which then bounce back to the surface and are detected by a receiving antenna. The transmitter and receiver antennas are typically placed on the ground surface and moved across the area of interest to create a profile of the subsurface. The GPR system consists of a control unit that powers the antennas and records the data, as well as a display unit that shows the results of the survey. The control unit sends a pulse of electromagnetic energy into the ground, which propagates through the soil or rock until it encounters a change in material or structure. When the electromagnetic wave encounters a buried object or structure, some of the energy is reflected back to the surface and detected by the receiving antenna. The GPR data is then processed using specialized software that analyzes the amplitude and travel time of the reflected waves. By interpreting the data, GPR can provide information on the depth, location, and nature of subsurface features and structures. GPR has several advantages over other geophysical survey methods, including its ability to provide high-resolution images of the subsurface and its non-invasive nature, which minimizes disruption to the site. However, the effectiveness of GPR depends on several factors, including the type of soil or rock, the depth of the features being investigated, and the frequency of the electromagnetic waves used. In environmental hazard assessments, GPR can be used to detect buried structures, such as underground storage tanks, pipelines, or utilities, which may pose a risk of contamination to the surrounding soil or groundwater. GPR can also be used to assess soil stability by identifying areas of subsurface voids or sinkholes, which can lead to the collapse of the surface. Additionally, GPR can be used to map the extent and movement of groundwater contamination, which is critical in designing effective remediation strategies. the methodology of GPR in environmental hazard assessments involves the use of electromagnetic waves to create high of the subsurface, which are then analyzed to provide information on the depth, location, and nature of subsurface features and structures. This information is critical in identifying and mitigating environmental hazards, and the non-invasive nature of GPR makes it a valuable tool in this field.Keywords: GPR, hazard, landslide, rock fall, contamination
Procedia PDF Downloads 702268 Laboratory Diagnostic Testing of Peste des Petits Ruminants in Georgia
Authors: Nino G. Vepkhvadze, Tea Enukidze
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Every year the number of countries around the world face the risk of the spread of infectious diseases that bring significant ecological and social-economic damage. Hence, the importance of food product safety is emphasized that is the issue of interest for many countries. To solve them, it’s necessary to conduct preventive measures against the diseases, have accurate diagnostic results, leadership, and management. The Peste des petits ruminants (PPR) disease is caused by a morbillivirus closely related to the rinderpest virus. PPR is a transboundary disease as it emerges and evolves, considered as one of the top most damaging animal diseases. The disease imposed a serious threat to sheep-breeding when the farms of sheep, goats are significantly growing within the country. In January 2016, PPR was detected in Georgia. Up to present the origin of the virus, the age relationship of affected ruminants and the distribution of PPRV in Georgia remains unclear. Due to the nature of PPR, and breeding practices in the country, reemerging of the disease in Georgia is highly likely. The purpose of the studies is to provide laboratories with efficient tools allowing the early detection of PPR emergence and re-emergences. This study is being accomplished under the Biological Threat Reduction Program project with the support of the Defense Threat Reduction Agency (DTRA). The purpose of the studies is to investigate the samples and identify areas at high risk of the disease. Georgia has a high density of small ruminant herds bred as free-ranging, close to international borders. Kakheti region, Eastern Georgia, will be considered as area of high priority for PPR surveillance. For this reason, in 2019, in Kakheti region investigated n=484 sheep and goat serum and blood samples from the same animals, utilized serology and molecular biology methods. All samples were negative by RT-PCR, and n=6 sheep samples were seropositive by ELISA-Ab. Future efforts will be concentrated in areas where the risk of PPR might be high such as international bordering regions of Georgia. For diagnostics, it is important to integrate the PPRV knowledge with epidemiological data. Based on these diagnostics, the relevant agencies will be able to control the disease surveillance.Keywords: animal disease, especially dangerous pathogen, laboratory diagnostics, virus
Procedia PDF Downloads 1122267 Clinical Risk Score for Mortality and Predictors of Severe Disease in Adult Patients with Dengue
Authors: Siddharth Jain, Abhenil Mittal, Surendra Kumar Sharma
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Background: With its recent emergence and re-emergence, dengue has become a major international public health concern, imposing significant financial burden especially in developing countries. Despite aggressive control measures in place, India experienced one of its largest outbreaks in 2015 with Delhi being most severely affected. There is a lack of reliable predictors of disease severity and mortality in dengue. The present study was carried out to identify these predictors during the 2015 outbreak. Methods: This prospective observational study conducted at an apex tertiary care center in Delhi, India included confirmed adult dengue patients admitted between August-November 2015. Patient demographics, clinical details, and laboratory findings were recorded in a predesigned proforma. Appropriate statistical tests were used to summarize and compare the clinical and laboratory characteristics and derive predictors of mortality and severe disease, while developing a clinical risk score for mortality. Serotype analysis was also done for 75 representative samples to identify the dominant serotypes. Results: Data of 369 patients were analyzed (mean age 30.9 years; 67% males). Of these, 198 (54%) patients had dengue fever, 125 (34%) had dengue hemorrhagic fever (DHF Grade 1,2)and 46 (12%) developed dengue shock syndrome (DSS). Twenty two (6%) patients died. Late presentation to the hospital (≥5 days after onset) and dyspnoea at rest were identified as independent predictors of severe disease. Age ≥ 24 years, dyspnoea at rest and altered sensorium were identified as independent predictors of mortality. A clinical risk score was developed (12*age + 14*sensorium + 10*dyspnoea) which, if ≥ 22, predicted mortality with a high sensitivity (81.8%) and specificity (79.2%). The predominant serotypes in Delhi (2015) were DENV-2 and DENV-4. Conclusion: Age ≥ 24 years, dyspnoea at rest and altered sensorium were identified as independent predictors of mortality. Platelet counts did not determine the outcome in dengue patients. Timely referral/access to health care is important. Development and use of validated predictors of disease severity and simple clinical risk scores, which can be applied in all healthcare settings, can help minimize mortality and morbidity, especially in resource limited settings.Keywords: dengue, mortality, predictors, severity
Procedia PDF Downloads 2992266 Investigation of Several New Ionic Liquids’ Behaviour during ²¹⁰PB/²¹⁰BI Cherenkov Counting in Waters
Authors: Nataša Todorović, Jovana Nikolov, Ivana Stojković, Milan Vraneš, Jovana Panić, Slobodan Gadžurić
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The detection of ²¹⁰Pb levels in aquatic environments evokes interest in various scientific studies. Its precise determination is important not only for the radiological assessment of drinking waters but also ²¹⁰Pb, and ²¹⁰Po distribution in the marine environment are significant for the assessment of the removal rates of particles from the ocean and particle fluxes during transport along the coast, as well as particulate organic carbon export in the upper ocean. Measurement techniques for ²¹⁰Pb determination, gamma spectrometry, alpha spectrometry, or liquid scintillation counting (LSC) are either time-consuming or demand expensive equipment or complicated chemical pre-treatments. However, one other possibility is to measure ²¹⁰Pb on an LS counter if it is in equilibrium with its progeny ²¹⁰Bi - through the Cherenkov counting method. It is unaffected by the chemical quenching and assumes easy sample preparation but has the drawback of lower counting efficiencies than standard LSC methods, typically from 10% up to 20%. The aim of the presented research in this paper is to investigate the possible increment of detection efficiency of Cherenkov counting during ²¹⁰Pb/²¹⁰Bi detection on an LS counter Quantulus 1220. Considering naturally low levels of ²¹⁰Pb in aqueous samples, the addition of ionic liquids to the counting vials with the analysed samples has the benefit of detection limit’s decrement during ²¹⁰Pb quantification. Our results demonstrated that ionic liquid, 1-butyl-3-methylimidazolium salicylate, is more efficient in Cherenkov counting efficiency increment than the previously explored 2-hydroxypropan-1-amminium salicylate. Consequently, the impact of a few other ionic liquids that were synthesized with the same cation group (1-butyl-3-methylimidazolium benzoate, 1-butyl-3-methylimidazolium 3-hydroxybenzoate, and 1-butyl-3-methylimidazolium 4-hydroxybenzoate) was explored in order to test their potential influence on Cherenkov counting efficiency. It was confirmed that, among the explored ones, only ionic liquids in the form of salicylates exhibit a wavelength shifting effect. Namely, the addition of small amounts (around 0.8 g) of 1-butyl-3-methylimidazolium salicylate increases the detection efficiency from 16% to >70%, consequently reducing the detection threshold by more than four times. Moreover, the addition of ionic liquids could find application in the quantification of other radionuclides besides ²¹⁰Pb/²¹⁰Bi via Cherenkov counting method.Keywords: liquid scintillation counting, ionic liquids, Cherenkov counting, ²¹⁰PB/²¹⁰BI in water
Procedia PDF Downloads 962265 Effectiveness of the Lacey Assessment of Preterm Infants to Predict Neuromotor Outcomes of Premature Babies at 12 Months Corrected Age
Authors: Thanooja Naushad, Meena Natarajan, Tushar Vasant Kulkarni
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Background: The Lacey Assessment of Preterm Infants (LAPI) is used in clinical practice to identify premature babies at risk of neuromotor impairments, especially cerebral palsy. This study attempted to find the validity of the Lacey assessment of preterm infants to predict neuromotor outcomes of premature babies at 12 months corrected age and to compare its predictive ability with the brain ultrasound. Methods: This prospective cohort study included 89 preterm infants (45 females and 44 males) born below 35 weeks gestation who were admitted to the neonatal intensive care unit of a government hospital in Dubai. Initial assessment was done using the Lacey assessment after the babies reached 33 weeks postmenstrual age. Follow up assessment on neuromotor outcomes was done at 12 months (± 1 week) corrected age using two standardized outcome measures, i.e., infant neurological international battery and Alberta infant motor scale. Brain ultrasound data were collected retrospectively. Data were statistically analyzed, and the diagnostic accuracy of the Lacey assessment of preterm infants (LAPI) was calculated -when used alone and in combination with the brain ultrasound. Results: On comparison with brain ultrasound, the Lacey assessment showed superior specificity (96% vs. 77%), higher positive predictive value (57% vs. 22%), and higher positive likelihood ratio (18 vs. 3) to predict neuromotor outcomes at one year of age. The sensitivity of Lacey assessment was lower than brain ultrasound (66% vs. 83%), whereas specificity was similar (97% vs. 98%). A combination of Lacey assessment and brain ultrasound results showed higher sensitivity (80%), positive (66%), and negative (98%) predictive values, positive likelihood ratio (24), and test accuracy (95%) than Lacey assessment alone in predicting neurological outcomes. The negative predictive value of the Lacey assessment was similar to that of its combination with brain ultrasound (96%). Conclusion: Results of this study suggest that the Lacey assessment of preterm infants can be used as a supplementary assessment tool for premature babies in the neonatal intensive care unit. Due to its high specificity, Lacey assessment can be used to identify those babies at low risk of abnormal neuromotor outcomes at a later age. When used along with the findings of the brain ultrasound, Lacey assessment has better sensitivity to identify preterm babies at particular risk. These findings have applications in identifying premature babies who may benefit from early intervention services.Keywords: brain ultrasound, lacey assessment of preterm infants, neuromotor outcomes, preterm
Procedia PDF Downloads 1352264 Development and Evaluation of a Calcium Rich Plant-Based Supplement on Bone Turnover of Peri and Post Menopausal Women
Authors: Gayathri.G, Hemamalini.A.J, Chandrasekaran.A
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Problem statement: Nutritional deficiency, especially calcium, may lead to poor bone formation and mineralization. Although there are plenty of synthetic supplements available, it is essential to make a calcium rich food supplement accessible to combat calcium deficiency that could be readily prepared at the household level. Thus the current study aimed to formulate and standardize an indigenous low-cost calcium-rich food supplement and to study the impact of supplementation on the bone resorption and formation markers. Methods: A Randomized controlled trial was conducted with 60 subjects distributed equally in control and experimental groups, including perimenopausal and postmenopausal women. A plant-based calcium-rich product was developed and supplemented in form of balls as a midmorning and evening snack by addition of optimized proportions of leaves of Sesbania Grandiflora, seeds of Sesamum indicum, Eleusine coracana, Glycine max, Vigna mungo for a period of 6 months. Postmenopausal and perimenopausal women received 1200mg and 800mg of calcium per day from the supplemented, respectively. Outcome measures like serum calcium; betacrosslaps (bone resorption marker) and total P1NP (bone absorption marker) were assessed after 3 months and after 6 months. Results: There were no significant changes seen in the serum calcium and total P1NP levels (bone formation marker) among the subjects during the supplementation period. The bone resorption marker (betacrosslaps) reduced in all the groups and the reduction (0.32 ± 0.130 ng/ml to 0.25 ± 0.130 ng/ml) was found to be statistically highly significant (p < 0.01) in experimental group of perimenopausal subjects and significant (p < 0.05) in experimental group of postmenopausal subjects (1.11 ± 0.290 ng/ml to 0.42 ± 0.263 ng/ml). Conclusion: With the current severe calcium deficiency in the Indian population, integrating low-cost, calcium-rich native foods that could be readily prepared at household level would be useful in raising the nutritional consumption of calcium, which would, in turn, decrease bone turnover.Keywords: calcium, sesbania grandiflora, sesamum indicum, eleusine coracana, glycine max, vigna mungo, postmenopause, perimenopause, bone resorption, bone absorption, betacrosslaps, total P1NP
Procedia PDF Downloads 1272263 Positive Disruption: Towards a Definition of Artist-in-Residence Impact on Organisational Creativity
Authors: Denise Bianco
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Several studies on innovation and creativity in organisations emphasise the need to expand horizons and take on alternative and unexpected views to produce something new. This paper theorises the potential impact artists can have as creative catalysts, working embedded in non-artistic organisations. It begins from an understanding that in today's ever-changing scenario, organisations are increasingly seeking to open up new creative thinking through deviant behaviours to produce innovation and that art residencies need to be critically revised in this specific context in light of their disruptive potential. On the one hand, this paper builds upon recent contributions made on workplace creativity and related concepts of deviance and disruption. Research suggests that creativity is likely to be lower in work contexts where utter conformity is a cardinal value and higher in work contexts that show some tolerance for uncertainty and deviance. On the other hand, this paper draws attention to Artist-in-Residence as a vehicle for epistemic friction between divergent and convergent thinking, which allows the creation of unparalleled ways of knowing in the dailiness of situated and contextualised social processes. In order to do so, this contribution brings together insights from the most relevant theories on organisational creativity and unconventional agile methods such as Art Thinking and direct insights from ethnographic fieldwork in the context of embedded art residencies within work organisations to propose a redefinition of Artist-in-Residence and their potential impact on organisational creativity. The result is a re-definition of embedded Artist-in-Residence in organisational settings from a more comprehensive, multi-disciplinary, and relational perspective that builds on three focal points. First the notion that organisational creativity is a dynamic and synergistic process throughout which an idea is framed by recurrent activities subjected to multiple influences. Second, the definition of embedded Artist-in-Residence as an assemblage of dynamic, productive relations and unexpected possibilities for new networks of relationality that encourage the recombination of knowledge. Third, and most importantly, the acknowledgment that embedded residencies are, at the very essence, bi-cultural knowledge contexts where creativity flourishes as the result of open-to-change processes that are highly relational, constantly negotiated, and contextualised in time and space.Keywords: artist-in-residence, convergent and divergent thinking, creativity, creative friction, deviance and creativity
Procedia PDF Downloads 902262 Oncological and Antiresorptive Treatment of Breast Cancer: Dental Assessment and Risk of MRONJ Development
Authors: Magdalena Korytowska, Gunnar Lengstrand, Cecilia Larsson Wexell
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Background: Breast cancer (BC) is the most common cancer among women worldwide, and cases are continuing to increase in Sweden. Bone is the most common metastatic site in breast cancer patients, where > 65-75% of women with advanced breast cancer develop bone metastases during their disease. To prevent the skeletal-related events of metastases (e.g., pathological fractures, bone loss, cancer-induced bone pain, and hypercalcemia bone), two different classes of antiresorptive medications (AR), bisphosphonate and denosumab are typically administered every 3 to 4 weeks. Since 2015, adjuvant bisphosphonate treatment has been used every six months for three to five years in postmenopausal women for the prevention of skeletal metastases and improved survival. Methods: A case-control study was conducted to test the hypotheses that patients treated with high-dose AR are at higher risk of developing MRONJ than breast cancer patients with adjuvant bisphosphonate treatment at a lower dose. Medical and odontological data was collected between 2015-2020. Assessment of oral health and dental care before and during oncological treatment took place at the specialist clinic for Orofacial medicine linked to the specific hospital. Results: In total, 220 patients were included, 101 patients in the high-dose group and 119 patients in the adjuvant BP-treatment group. MRONJ was diagnosed in 13 patients (14%) in the high-dose group. The mandible was affected in most of the cases (84.6%), with a mean duration of high-dose treatment of 19.7 months. In 46.2% of cases, no dental cause of MRONJ could be identified. Overall, estrogen receptor-positive (ER+) BC was the most representative type in 172 patients (78.2%). However, this was 83.9% in the high-dose cases group. The most used drug was denosumab. Twenty-five patients (26.9%) switched their medication from ZOL to denosumab during their oncological treatment. Patients with ER+ breast cancer were reported in 88 patients (87.8%) in the adjuvant group that was treated with ZOL. Conclusions: MRONJ was diagnosed only in the high-dose AR group. Dental assessment and care of patients in the adjuvant group should be considered, with a recommendation to potentially prolong ZOL treatment from 3 to 5 years, with concomitant use of hormonal therapy in patients diagnosed with ER+ breast cancer to prevent bone loss induced by oncological treatment. A new referral for dental assessment is very important in the case of bone metastases when treatment with high dose AR will be required since it is associated with a higher risk of MRONJ.Keywords: antiresorptive therapy, breast cancer, dental care, MRONJ
Procedia PDF Downloads 802261 Evaluation of the Irritation Potential of Three Topical Formulations of Minoxidil 5% Using Patch Test
Authors: Sule Pallavi, Shah Priyank, Thavkar Amit, Mehta Suyog, Rohira Poonam
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Minoxidil is used topically to help hair growth in the treatment of male androgenetic alopecia. The objective of this study is to compare irritation potential of three conventional formulation of minoxidil 5% topical solution of in human patch test. The study was a single centre, double blind, non-randomized controlled study in 56 healthy adult Indian subjects. Occlusive patch test for 24 hours was performed with three formulation of minoxidil 5% topical solution. Products tested included aqueous based minoxidil 5% (AnasureTM 5%, Sun Pharma, India – Brand A), alcohol based minoxidil 5% (Brand B) and aqueous based minoxidil 5% (Brand C). Isotonic saline 0.9% and 1% w/w sodium lauryl sulphate were included as negative control and positive control respectively. Patches were applied and removed after 24hours. The skin reaction was assessed and clinically scored 24 hours after the removal of the patches under constant artificial daylight source using Draize scale (0-4 points scale for erythema/wrinkles/dryness and for oedema). A combined mean score up to 2.0/8.0 indicates a product is “non-irritant” and score between 2.0/8.0 and 4.0/8.0 indicates “mildly irritant” and score above 4.0/8.0 indicates “irritant”. Follow-up was scheduled after one week to confirm recovery for any reaction. The procedure of the patch test followed the principles outlined by Bureau of Indian standards (BIS) (IS 4011:2018; Methods of Test for safety evaluation of Cosmetics-3rd revision). Fifty six subjects with mean age 30.9 years (27 males and 29 females) participated in the study. The combined mean score (± standard deviation) were: 0.13 ± 0.33 (Brand A), 0.39 ± 0.49 (Brand B), 0.22 ± 0.41 (Brand C), 2.91 ± 0.79 (Positive control) and 0.02 ± 0.13 (Negative control). The mean score of Brand A (Sun Pharma product) was significantly lower than Brand B (p=0.001) and was comparable with Brand C (p=0.21). The combined mean erythema score (± standard deviation) were: 0.09 ± 0.29 (Brand A), 0.27 ± 0.5 (Brand B), 0.18 ± 0.39 (Brand C), 2.02 ± 0.49 (Positive control) and 0.0 ± 0.0 (Negative control). The mean erythema score of Brand A was significantly lower than Brand B (p=0.01) and was comparable with Brand C (p=0.16). Any reaction observed at 24hours after patch removal subsided in a week. All the three topical formulation of minoxidil 5% were non-irritant. Brand A of 5% minoxidil (Sun Pharma) was found to be least irritant than Brand B and Brand C based on the combined mean score and mean erythema score in the human patch test as per the BIS, IS 4011;2018.Keywords: erythema, irritation, minoxidil, patch test
Procedia PDF Downloads 922260 Using Lean-Six Sigma Philosophy to Enhance Revenues and Improve Customer Satisfaction: Case Studies from Leading Telecommunications Service Providers in India
Authors: Senthil Kumar Anantharaman
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Providing telecommunications based network services in developing countries like India which has a population of 1.5 billion people, so that these services reach every individual, is one of the greatest challenges the country has been facing in its journey towards economic growth and development. With growing number of telecommunications service providers in the country, a constant challenge that has been faced by these providers is in providing not only quality but also delightful customer experience while simultaneously generating enhanced revenues and profits. Thus, the role played by process improvement methodologies like Six Sigma cannot be undermined and specifically in telecom service provider based operations, it has provided substantial benefits. Therefore, it advantages are quite comparable to its applications and advantages in other sectors like manufacturing, financial services, information technology-based services and Healthcare services. One of the key reasons that this methodology has been able to reap great benefits in telecommunications sector is that this methodology has been combined with many of its competing process improvement techniques like Theory of Constraints, Lean and Kaizen to give the maximum benefit to the service providers thereby creating a winning combination of organized process improvement methods for operational excellence thereby leading to business excellence. This paper discusses about some of the key projects and areas in the end to end ‘Quote to Cash’ process at big three Indian telecommunication companies that have been highly assisted by applying Six Sigma along with other process improvement techniques. While the telecommunication companies which we have considered, is primarily in India and run by both private operators and government based setups, the methodology can be applied equally well in any other part of developing countries around the world having similar context. This study also compares the enhanced revenues that can arise out of appropriate opportunities in emerging market scenarios, that Six Sigma as a philosophy and methodology can provide if applied with vigour and robustness. Finally, the paper also comes out with a winning framework in combining Six Sigma methodology with Kaizen, Lean and Theory of Constraints that will enhance both the top-line as well as the bottom-line while providing the customers a delightful experience.Keywords: emerging markets, lean, process improvement, six sigma, telecommunications, theory of constraints
Procedia PDF Downloads 1602259 A Review of Type 2 Diabetes and Diabetes-Related Cardiovascular Disease in Zambia
Authors: Mwenya Mubanga, Sula Mazimba
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Background: In Zambia, much of the focus on nutrition and health has been on reducing micronutrient deficiencies, wasting and underweight malnutrition and not on the rising global projections of trends in obesity and type 2 diabetes. The aim of this review was to identify and collate studies on the prevalence of obesity, diabetes and diabetes-related cardiovascular disease conducted in Zambia, to summarize their findings and to identify areas that need further research. Methods: The Medical Literature Analysis and Retrieval System (MEDLINE) database was searched for peer-reviewed articles on the prevalence of, and factors associated with obesity, type 2 diabetes, and diabetes-related cardiovascular disease amongst Zambian residents using a combination of search terms. The period of search was from 1 January 2000 to 31 December 2016. We expanded the search terms to include all possible synonyms and spellings obtained in the search strategy. Additionally, we performed a manual search for other articles and references of peer-reviewed articles. Results: In Zambia, the current prevalence of Obesity and Type 2 diabetes is estimated at 13%-16% and 2.0 – 3.0% respectively. Risk factors such as the adoption of western dietary habits, the social stigmatization associated with rapid weight loss due to Tuberculosis and/ or the human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) and rapid urbanization have all been blamed for fueling the increased risk of obesity and type 2 diabetes. However, unlike traditional Western populations, those with no formal education were less likely to be obese than those who attained secondary or tertiary level education. Approximately 30% of those surveyed were unaware of their diabetes diagnosis and more than 60% were not on treatment despite a known diabetic status. Socio-demographic factors such as older age, female sex, urban dwelling, lack of tobacco use and marital status were associated with an increased risk of obesity, impaired glucose tolerance and type 2 diabetes. We were unable to identify studies that specifically looked at diabetes-related cardiovascular disease. Conclusion: Although the prevalence of Obesity and Type 2 diabetes in Zambia appears low, more representative studies focusing on parts of the country outside of the main industrial zone need to be conducted. There also needs to be research on diabetes-related cardiovascular disease. National surveillance, monitoring and evaluation on all non-communicable diseases need to be prioritized and policies that address underweight, obesity and type 2 diabetes developed.Keywords: type 2 diabetes, Zambia, obesity, cardiovascular disease
Procedia PDF Downloads 2372258 Comparison of Iodine Density Quantification through Three Material Decomposition between Philips iQon Dual Layer Spectral CT Scanner and Siemens Somatom Force Dual Source Dual Energy CT Scanner: An in vitro Study
Authors: Jitendra Pratap, Jonathan Sivyer
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Introduction: Dual energy/Spectral CT scanning permits simultaneous acquisition of two x-ray spectra datasets and can complement radiological diagnosis by allowing tissue characterisation (e.g., uric acid vs. non-uric acid renal stones), enhancing structures (e.g. boost iodine signal to improve contrast resolution), and quantifying substances (e.g. iodine density). However, the latter showed inconsistent results between the 2 main modes of dual energy scanning (i.e. dual source vs. dual layer). Therefore, the present study aimed to determine which technology is more accurate in quantifying iodine density. Methods: Twenty vials with known concentrations of iodine solutions were made using Optiray 350 contrast media diluted in sterile water. The concentration of iodine utilised ranged from 0.1 mg/ml to 1.0mg/ml in 0.1mg/ml increments, 1.5 mg/ml to 4.5 mg/ml in 0.5mg/ml increments followed by further concentrations at 5.0 mg/ml, 7mg/ml, 10 mg/ml and 15mg/ml. The vials were scanned using Dual Energy scan mode on a Siemens Somatom Force at 80kV/Sn150kV and 100kV/Sn150kV kilovoltage pairing. The same vials were scanned using Spectral scan mode on a Philips iQon at 120kVp and 140kVp. The images were reconstructed at 5mm thickness and 5mm increment using Br40 kernel on the Siemens Force and B Filter on Philips iQon. Post-processing of the Dual Energy data was performed on vendor-specific Siemens Syngo VIA (VB40) and Philips Intellispace Portal (Ver. 12) for the Spectral data. For each vial and scan mode, the iodine concentration was measured by placing an ROI in the coronal plane. Intraclass correlation analysis was performed on both datasets. Results: The iodine concentrations were reproduced with a high degree of accuracy for Dual Layer CT scanner. Although the Dual Source images showed a greater degree of deviation in measured iodine density for all vials, the dataset acquired at 80kV/Sn150kV had a higher accuracy. Conclusion: Spectral CT scanning by the dual layer technique has higher accuracy for quantitative measurements of iodine density compared to the dual source technique.Keywords: CT, iodine density, spectral, dual-energy
Procedia PDF Downloads 1152257 Ionometallurgy for Recycling Silver in Silicon Solar Panel
Authors: Emmanuel Billy
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This work is in the CABRISS project (H2020 projects) which aims at developing innovative cost-effective methods for the extraction of materials from the different sources of PV waste: Si based panels, thin film panels or Si water diluted slurries. Aluminum, silicon, indium, and silver will especially be extracted from these wastes in order to constitute materials feedstock which can be used later in a closed-loop process. The extraction of metals from silicon solar cells is often an energy-intensive process. It requires either smelting or leaching at elevated temperature, or the use of large quantities of strong acids or bases that require energy to produce. The energy input equates to a significant cost and an associated CO2 footprint, both of which it would be desirable to reduce. Thus there is a need to develop more energy-efficient and environmentally-compatible processes. Thus, ‘ionometallurgy’ could offer a new set of environmentally-benign process for metallurgy. This work demonstrates that ionic liquids provide one such method since they can be used to dissolve and recover silver. The overall process associates leaching, recovery and the possibility to re-use the solution in closed-loop process. This study aims to evaluate and compare different ionic liquids to leach and recover silver. An electrochemical analysis is first implemented to define the best system for the Ag dissolution. Effects of temperature, concentration and oxidizing agent are evaluated by this approach. Further, a comparative study between conventional approach (nitric acid, thiourea) and the ionic liquids (Cu and Al) focused on the leaching efficiency is conducted. A specific attention has been paid to the selection of the Ionic Liquids. Electrolytes composed of chelating anions are used to facilitate the lixiviation (Cl, Br, I,), avoid problems dealing with solubility issues of metallic species and of classical additional ligands. This approach reduces the cost of the process and facilitates the re-use of the leaching medium. To define the most suitable ionic liquids, electrochemical experiments have been carried out to evaluate the oxidation potential of silver include in the crystalline solar cells. Then, chemical dissolution of metals for crystalline solar cells have been performed for the most promising ionic liquids. After the chemical dissolution, electrodeposition has been performed to recover silver under a metallic form.Keywords: electrodeposition, ionometallurgy, leaching, recycling, silver
Procedia PDF Downloads 2372256 Teicoplanin Derivatives with Antiviral Activity: Synthesis and Biological Evaluation
Authors: Zsolt Szucs, Viktor Kelemen, Son Le Thai, Magdolna Csavas, Erzsebet Roth, Gyula Batta, Annelies Stevaert, Evelien Vanderlinden, Aniko Borbas, Lieve Naesens, Pal Herczegh
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The approval of modern glycopeptide antibiotics such as dalbavancin and oritavancin which have excellent activity against Gram-positive bacteria, encouraged our research group to prepare semisynthetic compounds from several members of glycopeptides by various chemical methods. Derivatives from the aglycone of ristocetin, eremomycin, vancomycin and a pseudoaglycon of teicoplanin have been synthesized in a systematic manner. Interestingly, some of the aglycoristocetin derivatives displayed noteworthy anti-influenza activity. More recently our group has been focusing on the modifications of one of the pseudoaglycons of teicoplanin. The reaction of N-ethoxycarbonyl maleimide derivatives with the primary amino function, the copper-catalysed azide-alkyne click reaction and the sulfonylation of the N-terminus were utilized to obtain systematic series of compounds. All substituents provide a more lipophilic character to the new molecules compared to the parent antibiotics, which is known to be favourable for activity against resistant bacteria. Lipoglycopeptides are also known to have antiviral properties, which has been predominantly studied on HIV by others. The structure-activity relationship study of our compounds revealed the influence of a few structural elements on biological activity. In many cases, minimal changes in lipophilicity and structure produced great differences in efficacy and cytotoxicity. In vitro experiments showed that these compounds are not only active against glycopeptide resistant Gram-positive bacteria but in several cases they prevent the infection of cell cultures by different strains of influenza viruses. This is probably related to the inhibition of the viral entry into the host cell nucleus, of which the exact mechanism is unknown. In some instances, reasonably low concentrations were sufficient to observe this effect. Several derivatives were highly cytotoxic at the same time, but some of them displayed a good selectivity index. The antiviral properties of the compounds are not restricted to influenza viruses e.g., some of them showed good activity against Human Coronavirus 229E. This work could potentially lead to the development of antiviral drugs which possess the crucial structural motifs that are needed for antiviral activity, while missing those which contribute to the antibacterial effect.Keywords: antiviral, glycopeptide, semisynthetic, teicoplanin
Procedia PDF Downloads 1492255 Development of Chronic Obstructive Pulmonary Disease (COPD) Proforma (E-ICP) to Improve Guideline Adherence in Emergency Department: Modified Delphi Study
Authors: Hancy Issac, Gerben Keijzers, Ian Yang, Clint Moloney, Jackie Lea, Melissa Taylor
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Introduction: Chronic obstructive pulmonary disease guideline non-adherence is associated with a reduction in health-related quality of life in patients (HRQoL). Improving guideline adherence has the potential to mitigate fragmented care thereby sustaining pulmonary function, preventing acute exacerbations, reducing economic health burdens, and enhancing HRQoL. The development of an electronic proforma stemming from expert consensus, including digital guideline resources and direct interdisciplinary referrals is hypothesised to improve guideline adherence and patient outcomes for emergency department (ED) patients with COPD. Aim: The aim of this study was to develop consensus among ED and respiratory staff for the correct composition of a COPD electronic proforma that aids in guideline adherence and management in the ED. Methods: This study adopted a mixed-method design to develop the most important indicators of care in the ED. The study involved three phases: (1) a systematic literature review and qualitative interdisciplinary staff interviews to assess barriers and solutions for guideline adherence and qualitative interdisciplinary staff interviews, (2) a modified Delphi panel to select interventions for the proforma, and (3) a consensus process through three rounds of scoring through a quantitative survey (ED and Respiratory consensus) and qualitative thematic analysis on each indicator. Results: The electronic proforma achieved acceptable and good internal consistency through all iterations from national emergency department and respiratory department interdisciplinary experts. Cronbach’s alpha score for internal consistency (α) in iteration 1 emergency department cohort (EDC) (α = 0.80 [CI = 0.89%]), respiratory department cohort (RDC) (α = 0.95 [CI = 0.98%]). Iteration 2 reported EDC (α = 0.85 [CI = 0.97%]) and RDC (α = 0.86 [CI = 0.97%]). Iteration 3 revealed EDC (α = 0.73 [CI = 0.91%]) and RDC (α = 0.86 [CI = 0.95%]), respectively. Conclusion: Electronic proformas have the potential to facilitate direct referrals from the ED leading to reduced hospital admissions, reduced length of hospital stays, holistic care, improved health care and quality of life and improved interdisciplinary guideline adherence.Keywords: COPD, electronic proforma, modified delphi study, interdisciplinary, guideline adherence, COPD-X plan
Procedia PDF Downloads 522254 Femoral Neck Anteversion and Neck-Shaft Angles: Determination and Their Clinical Implications in Fetuses of Different Gestational Ages
Authors: Vrinda Hari Ankolekar, Anne D. Souza, Mamatha Hosapatna
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Introduction: Precise anatomical assessment of femoral neck anteversion (FNA) and the neck shaft angles (NSA) would be essential in diagnosing the pathological conditions involving hip joint and its ligaments. FNA of greater than 20 degrees is considered excessive femoral anteversion, whereas a torsion angle of fewer than 10 degrees is considered femoral retroversion. Excessive femoral torsion is not uncommon and has been associated with certain neurologic and orthopedic conditions. The enlargement and maturation of the hip joint increases at the 20th week of gestation and the NSA ranges from 135- 140◦ at birth. Material and methods: 48 femurs were tagged according to the GA and two photographs for each femur were taken using Nikon digital camera. Each femur was kept on a horizontal hard desk and end on an image of the upper end was taken for the estimation of FNA and a photograph in a perpendicular plane was taken to calculate the NSA. The images were transferred to the computer and were stored in TIFF format. Microsoft Paint software was used to mark the points and Image J software was used to calculate the angles digitally. 1. Calculation of FNA: The midpoint of the femoral head and the neck were marked and a line was drawn joining these two points. The angle made by this line with the horizontal plane was measured as FNA. 2. Calculation of NSA: The midpoint of the femoral head and the neck were marked and a line was drawn joining these two points. A vertical line was drawn passing through the tip of the greater trochanter to the inter-condylar notch. The angle formed by these lines was calculated as NSA. Results: The paired t-test for the inter-observer variability showed no significant difference between the values of two observers. (FNA: t=-1.06 and p=0.31; NSA: t=-0.09 and p=0.9). The FNA ranged from 17.08º to 33.97 º on right and 17.32 º to 45.08 º on left. The NSA ranged from 139.33 º to 124.91 º on right and 143.98 º to 123.8 º on left. Unpaired t-test was applied to compare the mean angles between the second and third trimesters which did not show any statistical significance. This shows that the FNA and NSA of femur did not vary significantly during the third trimester. The FNA and NSA were correlated with the GA using Pearson’s correlation. FNA appeared to increase with the GA (r=0.5) but the increase was not statistically significant. A decrease in the NSA was also noted with the GA (r=-0.3) which was also statistically not significant. Conclusion: The present study evaluates the FNA and NSA of the femur in fetuses and correlates their development with the GA during second and third trimesters. The FNA and NSA did not vary significantly during the third trimester.Keywords: anteversion, coxa antetorsa, femoral torsion, femur neck shaft angle
Procedia PDF Downloads 3062253 Meniere's Disease and its Prevalence, Symptoms, Risk Factors and Associated Treatment Solutions for this Disease
Authors: Amirreza Razzaghipour Sorkhab
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One of the most common disorders among humans is hearing impairment. This paper provides an evidence base that recovers understanding of Meniere’s disease and highlights the physical and mental health correlates of the disorder. Meniere's disease is more common in the elderly. The term idiopathic endolymphatic hydrops has been attributed to this disease by some in the previous. Meniere’s disease demonstrations a genetic tendency, and a family history is found in 10% of cases, with an autosomal dominant inheritance pattern. The COCH gene may be one of the hereditary factors contributing to Meniere’s disease, and the possibility of a COCH mutation should be considered in patients with Meniere’s disease symptoms. Should be considered Missense mutations in the COCH gene cause the autosomal dominant sensorineural hearing loss and vestibular disorder. Meniere’s disease is a complex, heterogeneous disorder of the inner ear and that is characterized by episodes of vertigo lasting from minutes to hours, fluctuating sensorineural hearing loss, tinnitus, and aural fullness. The existing evidence supports the suggestion that age and sleep disorder are risk factors for Meniere's disease. Many factors have been reported to precipitate the progress of Menier, including endolymphatic hydrops, immunology, viral infection, inheritance, vestibular migraine, and altered intra-labyrinthine fluid dynamics. Although there is currently no treatment that has a proven helpful effect on hearing levels or on the long-term evolution of the disease, however, in the primary stages, the hearing may improve among attacks, but a permanent hearing loss occurs in the majority of cases. Current publications have proposed a role for the intratympanic use of medicine, mostly aminoglycosides, for the control of vertigo. more than 85% of patients with Meniere's disease are helped by either changes in lifestyle and medical treatment or minimally aggressive surgical procedures such as intratympanic steroid therapy, intratympanic gentamicin therapy, and endolymphatic sac surgery. However, unilateral vestibular extirpation methods (intratympanic gentamicin, vestibular nerve section, or labyrinthectomy) are more predictable but invasive approaches to control the vertigo attacks. Medical therapy aimed at reducing endolymph volume, such as low-sodium diet, diuretic use, is the typical initial treatment.Keywords: meniere's disease, endolymphatic hydrops, hearing loss, vertigo, tinnitus, COCH gene
Procedia PDF Downloads 852252 Afrikan Natural Medicines: An Innovation-Based Model for Medicines Production, Curriculum Development and Clinical Application
Authors: H. Chabalala, A. Grootboom, M. Tang
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The innovative development, production, and clinical utilisation of African natural medicines requires frameworks from systematisation, innovation, registration. Afrika faces challenges when it comes to these sectors. The opposite is the case as is is evident in ancient Asian (Traditional Chinese Medicine and Indian Ayurveda and Siddha) medical systems, which are interfaced into their respective national health and educational systems. Afrikan Natural Medicines (ANMs) are yet to develop systematisation frameworks, i.e. disease characterisation and medicines classification. This paper explores classical medical systems drawn from Afrikan and Chinese experts in natural medicines. An Afrikological research methodology was used to conduct in-depth interviews with 20 key respondents selected through purposeful sampling technique. Data was summarised into systematisation frameworks for classical disease theories, patient categorisation, medicine classification, aetiology and pathogenesis of disease, diagnosis and prognosis techniques and treatment methods. It was discovered that ancient Afrika had systematic medical cosmologies, remnants of which are evident in most Afrikan cultural health practices. Parallels could be drawn from classical medical concepts of antiquity, like Chinese Taoist and Indian tantric health systems. Data revealed that both the ancient and contemporary ANM systems were based on living medical cosmologies. The study showed that African Natural Healing Systems have etiological systems, general pathogenesis knowledge, differential diagnostic techniques, comprehensive prognosis and holistic treatment regimes. Systematisation models were developed out of these frameworks, and this could be used for evaluation of clinical research, medical application including development of curriculum for high-education. It was envisaged that frameworks will pave way towards the development, production and commercialisation of ANMs. This was piloted in inclusive innovation, technology transfer and commercialisation of South African natural medicines, cosmeceuticals, nutraceuticals and health infusions. The central model presented here in will assist in curriculum development and establishment of Afrikan Medicines Hospitals and Pharmaceutical Industries.Keywords: African Natural Medicines, Indigenous Knowledge Systems, Medical Cosmology, Clinical Application
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