Search results for: undetected rate
6095 A Quadratic Model to Early Predict the Blastocyst Stage with a Time Lapse Incubator
Authors: Cecile Edel, Sandrine Giscard D'Estaing, Elsa Labrune, Jacqueline Lornage, Mehdi Benchaib
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Introduction: The use of incubator equipped with time-lapse technology in Artificial Reproductive Technology (ART) allows a continuous surveillance. With morphocinetic parameters, algorithms are available to predict the potential outcome of an embryo. However, the different proposed time-lapse algorithms do not take account the missing data, and then some embryos could not be classified. The aim of this work is to construct a predictive model even in the case of missing data. Materials and methods: Patients: A retrospective study was performed, in biology laboratory of reproduction at the hospital ‘Femme Mère Enfant’ (Lyon, France) between 1 May 2013 and 30 April 2015. Embryos (n= 557) obtained from couples (n=108) were cultured in a time-lapse incubator (Embryoscope®, Vitrolife, Goteborg, Sweden). Time-lapse incubator: The morphocinetic parameters obtained during the three first days of embryo life were used to build the predictive model. Predictive model: A quadratic regression was performed between the number of cells and time. N = a. T² + b. T + c. N: number of cells at T time (T in hours). The regression coefficients were calculated with Excel software (Microsoft, Redmond, WA, USA), a program with Visual Basic for Application (VBA) (Microsoft) was written for this purpose. The quadratic equation was used to find a value that allows to predict the blastocyst formation: the synthetize value. The area under the curve (AUC) obtained from the ROC curve was used to appreciate the performance of the regression coefficients and the synthetize value. A cut-off value has been calculated for each regression coefficient and for the synthetize value to obtain two groups where the difference of blastocyst formation rate according to the cut-off values was maximal. The data were analyzed with SPSS (IBM, Il, Chicago, USA). Results: Among the 557 embryos, 79.7% had reached the blastocyst stage. The synthetize value corresponds to the value calculated with time value equal to 99, the highest AUC was then obtained. The AUC for regression coefficient ‘a’ was 0.648 (p < 0.001), 0.363 (p < 0.001) for the regression coefficient ‘b’, 0.633 (p < 0.001) for the regression coefficient ‘c’, and 0.659 (p < 0.001) for the synthetize value. The results are presented as follow: blastocyst formation rate under cut-off value versus blastocyst rate formation above cut-off value. For the regression coefficient ‘a’ the optimum cut-off value was -1.14.10-3 (61.3% versus 84.3%, p < 0.001), 0.26 for the regression coefficient ‘b’ (83.9% versus 63.1%, p < 0.001), -4.4 for the regression coefficient ‘c’ (62.2% versus 83.1%, p < 0.001) and 8.89 for the synthetize value (58.6% versus 85.0%, p < 0.001). Conclusion: This quadratic regression allows to predict the outcome of an embryo even in case of missing data. Three regression coefficients and a synthetize value could represent the identity card of an embryo. ‘a’ regression coefficient represents the acceleration of cells division, ‘b’ regression coefficient represents the speed of cell division. We could hypothesize that ‘c’ regression coefficient could represent the intrinsic potential of an embryo. This intrinsic potential could be dependent from oocyte originating the embryo. These hypotheses should be confirmed by studies analyzing relationship between regression coefficients and ART parameters.Keywords: ART procedure, blastocyst formation, time-lapse incubator, quadratic model
Procedia PDF Downloads 3066094 Application of Electrochemical Impedance Spectroscopy to Monitor the Steel/Soil Interface During Cathodic Protection of Steel in Simulated Soil Solution
Authors: Mandlenkosi George Robert Mahlobo, Tumelo Seadira, Major Melusi Mabuza, Peter Apata Olubambi
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Cathodic protection (CP) has been widely considered a suitable technique for mitigating corrosion of buried metal structures. Plenty of efforts have been made in developing techniques, in particular non-destructive techniques, for monitoring and quantifying the effectiveness of CP to ensure the sustainability and performance of buried steel structures. The aim of this study was to investigate the evolution of the electrochemical processes at the steel/soil interface during the application of CP on steel in simulated soil. Carbon steel was subjected to electrochemical tests with NS4 solution used as simulated soil conditions for 4 days before applying CP for a further 11 days. A previously modified non-destructive voltammetry technique was applied before and after the application of CP to measure the corrosion rate. Electrochemical impedance spectroscopy (EIS), in combination with mathematical modeling through equivalent electric circuits, was applied to determine the electrochemical behavior at the steel/soil interface. The measured corrosion rate was found to have decreased from 410 µm/yr to 8 µm/yr between days 5 and 14 because of the applied CP. Equivalent electrical circuits were successfully constructed and used to adequately model the EIS results. The modeling of the obtained EIS results revealed the formation of corrosion products via a mixed activation-diffusion mechanism during the first 4 days, while the activation mechanism prevailed in the presence of CP, resulting in a protective film. The x-ray diffraction analysis confirmed the presence of corrosion products and the predominant protective film corresponding to the calcareous deposit.Keywords: carbon steel, cathodic protection, NS4 solution, voltammetry, EIS
Procedia PDF Downloads 646093 Novel Liposomal Nanocarriers For Long-term Tumor Imaging
Authors: Mohamad Ahrari, Kayvan Sadri, Mahmoud Reza Jafari
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PEGylated liposomes have a smaller volume of distribution and decreased clearance, consequently, due to their more prolonged presence in bloodstream and maintaining their stability during this period, these liposomes can be applied for imaging tumoral sites. The purpose of this study is to develop an appropriate radiopharmaceutical agent in long-term imaging for improved diagnosis and evaluation of tumors. In this study, liposomal formulations encapsulating albumin is synthesized by solvent evaporation method along with homogenization, and their characteristics were assessed. Then these liposomes labeled by Philips method and the rate of stability of labeled liposomes in serum, and ultimately the rate of biodistribution and gamma scintigraphy in C26-colon carcinoma tumor-bearing mice, were studied. The result of the study of liposomal characteristics displayed that capable of accumulating in tumor sites based of EPR phenomenon. these liposomes also have high stability for maintaining encapsulated albumin in a long time. In the study of biodistribution of these liposomes in mice, they accumulated more in the kidney, liver, spleen, and tumor sites, which, even after clearing formulations in the bloodstream, they existed in high levels in these organs up to 96 hours. In gamma scintigraphy also, organs with high activity accumulation from early hours up to 96 hours were visible in the form of hot spots. concluded that PEGylated liposomal formulation encapsulating albumin can be labeled with In-Oxine, and obtained stabilized formulation for long-term imaging, that have more favorable conditions for the evaluation of tumors and it will cause early diagnosis of tumors.Keywords: nano liposome, 111In-oxine, imaging, biodistribution, tumor
Procedia PDF Downloads 1136092 Fabrication of Uniform Nanofibers Using Gas Dynamic Virtual Nozzle Based Microfluidic Liquid Jet System
Authors: R. Vasireddi, J. Kruse, M. Vakili, M. Trebbin
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Here we present a gas dynamic virtual nozzle (GDVN) based microfluidic jetting devices for spinning of nano/microfibers. The device is fabricated by soft lithography techniques and is based on the principle of a GDVN for precise three-dimensional gas focusing of the spinning solution. The nozzle device is used to produce micro/nanofibers of a perfluorinated terpolymer (THV), which were collected on an aluminum substrate for scanning electron microscopy (SEM) analysis. The influences of air pressure, polymer concentration, flow rate and nozzle geometry on the fiber properties were investigated. It was revealed that surface properties are controlled by air pressure and polymer concentration while the diameter and shape of the fibers are influenced mostly by the concentration of the polymer solution and pressure. Alterations of the nozzle geometry had a negligible effect on the fiber properties, however, the jetting stability was affected. Round and flat fibers with differing surface properties from craters, grooves to smooth surfaces could be fabricated by controlling the above-mentioned parameters. Furthermore, the formation of surface roughness was attributed to the fast evaporation rate and velocity (mis)match between the polymer solution jet and the surrounding air stream. The diameter of the fibers could be tuned from ~250 nm to ~15 µm. Because of the simplicity of the setup, the precise control of the fiber properties, access to biocompatible nanofiber fabrication and the easy scale-up of parallel channels for high throughput, this method offers significant benefits compared to existing solution-based fiber production methods.Keywords: gas dynamic virtual nozzle (GDVN) principle, microfluidic device, spinning, uniform nanofibers
Procedia PDF Downloads 1506091 Absorption and Carrier Transport Properties of Doped Hematite
Authors: Adebisi Moruf Ademola
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Hematite (Fe2O3),commonly known as ‘rust’ which usually surfaced on metal when exposed to some climatic materials. This emerges as a promising candidate for photoelectrochemical (PEC) water splitting due to its favorable physiochemical properties of the narrow band gap (2.1–2.2 eV), chemical stability, nontoxicity, abundance, and low cost. However, inherent limitations such as short hole diffusion length (2–4 nm), high charge recombination rate, and slow oxygen evolution reaction kinetics inhibit the PEC performances of a-Fe2O3 photoanodes. As such, given the narrow bandgap enabling excellent optical absorption, increased charge carrier density and accelerated surface oxidation reaction kinetics become the key points for improved photoelectrochemical performances for a-Fe2O3 photoanodes and metal ion doping as an effective way to promote charge transfer by increasing donor density and improving the electronic conductivity of a-Fe2O3. Hematite attracts enormous efforts with a number of metal ions (Ti, Zr, Sn, Pt ,etc.) as dopants. A facile deposition-annealing process showed greatly enhanced PEC performance due to the increased donor density and reduced electron-hole recombination at the time scale beyond a few picoseconds. Zr doping was also found to enhance the PEC performance of a-Fe2O3 nanorod arrays by reducing the rate of electron-hole recombination. Slow water oxidation reaction kinetics, another main factor limiting the PEC water splitting efficiency of aFe2O3 as photoanodes, was previously found to be effectively improved by surface treatment.Keywords: deposition-annealing, hematite, metal ion doping, nanorod
Procedia PDF Downloads 2206090 Application of Observational Medical Outcomes Partnership-Common Data Model (OMOP-CDM) Database in Nursing Health Problems with Prostate Cancer-a Pilot Study
Authors: Hung Lin-Zin, Lai Mei-Yen
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Prostate cancer is the most commonly diagnosed male cancer in the U.S. The prevalence is around 1 in 8. The etiology of prostate cancer is still unknown, but some predisposing factors, such as age, black race, family history, and obesity, may increase the risk of the disease. In 2020, a total of 7,178 Taiwanese people were nearly diagnosed with prostate cancer, accounting for 5.88% of all cancer cases, and the incidence rate ranked fifth among men. In that year, the total number of deaths from prostate cancer was 1,730, accounting for 3.45% of all cancer deaths, and the death rate ranked 6th among men, accounting for 94.34% of the cases of male reproductive organs. Looking for domestic and foreign literature on the use of OMOP (Observational Medical Outcomes Partnership, hereinafter referred to as OMOP) database analysis, there are currently nearly a hundred literature published related to nursing-related health problems and nursing measures built in the OMOP general data model database of medical institutions are extremely rare. The OMOP common data model construction analysis platform is a system developed by the FDA in 2007, using a common data model (common data model, CDM) to analyze and monitor healthcare data. It is important to build up relevant nursing information from the OMOP- CDM database to assist our daily practice. Therefore, we choose prostate cancer patients who are our popular care objects and use the OMOP- CDM database to explore the common associated health problems. With the assistance of OMOP-CDM database analysis, we can expect early diagnosis and prevention of prostate cancer patients' comorbidities to improve patient care.Keywords: OMOP, nursing diagnosis, health problem, prostate cancer
Procedia PDF Downloads 696089 Assessment Using Copulas of Simultaneous Damage to Multiple Buildings Due to Tsunamis
Authors: Yo Fukutani, Shuji Moriguchi, Takuma Kotani, Terada Kenjiro
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If risk management of the assets owned by companies, risk assessment of real estate portfolio, and risk identification of the entire region are to be implemented, it is necessary to consider simultaneous damage to multiple buildings. In this research, the Sagami Trough earthquake tsunami that could have a significant effect on the Japanese capital region is focused on, and a method is proposed for simultaneous damage assessment using copulas that can take into consideration the correlation of tsunami depths and building damage between two sites. First, the tsunami inundation depths at two sites were simulated by using a nonlinear long-wave equation. The tsunamis were simulated by varying the slip amount (five cases) and the depths (five cases) for each of 10 sources of the Sagami Trough. For each source, the frequency distributions of the tsunami inundation depth were evaluated by using the response surface method. Then, Monte-Carlo simulation was conducted, and frequency distributions of tsunami inundation depth were evaluated at the target sites for all sources of the Sagami Trough. These are marginal distributions. Kendall’s tau for the tsunami inundation simulation at two sites was 0.83. Based on this value, the Gaussian copula, t-copula, Clayton copula, and Gumbel copula (n = 10,000) were generated. Then, the simultaneous distributions of the damage rate were evaluated using the marginal distributions and the copulas. For the correlation of the tsunami inundation depth at the two sites, the expected value hardly changed compared with the case of no correlation, but the damage rate of the ninety-ninth percentile value was approximately 2%, and the maximum value was approximately 6% when using the Gumbel copula.Keywords: copulas, Monte-Carlo simulation, probabilistic risk assessment, tsunamis
Procedia PDF Downloads 1436088 Computational Methods in Official Statistics with an Example on Calculating and Predicting Diabetes Mellitus [DM] Prevalence in Different Age Groups within Australia in Future Years, in Light of the Aging Population
Authors: D. Hilton
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An analysis of the Australian Diabetes Screening Study estimated undiagnosed diabetes mellitus [DM] prevalence in a high risk general practice based cohort. DM prevalence varied from 9.4% to 18.1% depending upon the diagnostic criteria utilised with age being a highly significant risk factor. Utilising the gold standard oral glucose tolerance test, the prevalence of DM was 22-23% in those aged >= 70 years and <15% in those aged 40-59 years. Opportunistic screening in Australian general practice potentially can identify many persons with undiagnosed type 2 DM. An Australian Bureau of Statistics document published three years ago, reported the highest rate of DM in men aged 65-74 years [19%] whereas the rate for women was highest in those over 75 years [13%]. If you consider that the Australian Bureau of Statistics report in 2007 found that 13% of the population was over 65 years of age and that this will increase to 23-25% by 2056 with a further projected increase to 25-28% by 2101, obviously this information has to be factored into the equation when age related diabetes prevalence predictions are calculated. This 10-15% proportional increase of elderly persons within the population demographics has dramatic implications for the estimated number of elderly persons with DM in these age groupings. Computational methodology showing the age related demographic changes reported in these official statistical documents will be done showing estimates for 2056 and 2101 for different age groups. This has relevance for future diabetes prevalence rates and shows that along with many countries worldwide Australia is facing an increasing pandemic. In contrast Japan is expected to have a decrease in the next twenty years in the number of persons with diabetes.Keywords: epidemiological methods, aging, prevalence, diabetes mellitus
Procedia PDF Downloads 3746087 Supply Chain Analysis with Product Returns: Pricing and Quality Decisions
Authors: Mingming Leng
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Wal-Mart has allocated considerable human resources for its quality assurance program, in which the largest retailer serves its supply chains as a quality gatekeeper. Asda Stores Ltd., the second largest supermarket chain in Britain, is now investing £27m in significantly increasing the frequency of quality control checks in its supply chains and thus enhancing quality across its fresh food business. Moreover, Tesco, the largest British supermarket chain, already constructed a quality assessment center to carry out its gatekeeping responsibility. Motivated by the above practices, we consider a supply chain in which a retailer plays the gatekeeping role in quality assurance by identifying defects among a manufacturer's products prior to selling them to consumers. The impact of a retailer's gatekeeping activity on pricing and quality assurance in a supply chain has not been investigated in the operations management area. We draw a number of managerial insights that are expected to help practitioners judiciously consider the quality gatekeeping effort at the retail level. As in practice, when the retailer identifies a defective product, she immediately returns it to the manufacturer, who then replaces the defect with a good quality product and pays a penalty to the retailer. If the retailer does not recognize a defect but sells it to a consumer, then the consumer will identify the defect and return it to the retailer, who then passes the returned 'unidentified' defect to the manufacturer. The manufacturer also incurs a penalty cost. Accordingly, we analyze a two-stage pricing and quality decision problem, in which the manufacturer and the retailer bargain over the manufacturer's average defective rate and wholesale price at the first stage, and the retailer decides on her optimal retail price and gatekeeping intensity at the second stage. We also compare the results when the retailer performs quality gatekeeping with those when the retailer does not. Our supply chain analysis exposes some important managerial insights. For example, the retailer's quality gatekeeping can effectively reduce the channel-wide defective rate, if her penalty charge for each identified de-fect is larger than or equal to the market penalty for each unidentified defect. When the retailer imple-ments quality gatekeeping, the change in the negotiated wholesale price only depends on the manufac-turer's 'individual' benefit, and the change in the retailer's optimal retail price is only related to the channel-wide benefit. The retailer is willing to take on the quality gatekeeping responsibility, when the impact of quality relative to retail price on demand is high and/or the retailer has a strong bargaining power. We conclude that the retailer's quality gatekeeping can help reduce the defective rate for consumers, which becomes more significant when the retailer's bargaining position in her supply chain is stronger. Retailers with stronger bargaining powers can benefit more from their quality gatekeeping in supply chains.Keywords: bargaining, game theory, pricing, quality, supply chain
Procedia PDF Downloads 2776086 Microstructure, Mechanical, Electrical and Thermal Properties of the Al-Si-Ni Ternary Alloy
Authors: Aynur Aker, Hasan Kaya
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In recent years, the use of the aluminum based alloys in the industry and technology are increasing. Alloying elements in aluminum have further been improving the strength and stiffness properties that provide superior compared to other metals. In this study, investigation of physical properties (microstructure, microhardness, tensile strength, electrical conductivity and thermal properties) in the Al-12.6wt.%Si-%2wt.Ni ternary alloy were investigated. Al-Si-Ni alloy was prepared in a graphite crucible under vacuum atmosphere. The samples were directionally solidified upwards with different growth rate (V) at constant temperature gradient G (7.73 K/mm). The microstructures (flake spacings, λ), microhardness (HV), ultimate tensile strength, electrical resistivity and thermal properties enthalpy of fusion and specific heat and melting temperature) of the samples were measured. Influence of the growth rate and flake spacings on microhardness, ultimate tensile strength and electrical resistivity were investigated and relationships between them were experimentally obtained by using regression analysis. According to results, λ values decrease with increasing V, but microhardness, ultimate tensile strength, electrical resistivity values increase with increasing V. Variations of electrical resistivity for cast samples with the temperature in the range of 300-1200 K were also measured by using a standard dc four-point probe technique. The enthalpy of fusion and specific heat for the same alloy was also determined by means of differential scanning calorimeter (DSC) from heating trace during the transformation from liquid to solid. The results obtained in this work were compared with the previous similar experimental results obtained for binary and ternary alloys.Keywords: electrical resistivity, enthalpy, microhardness, solidification, tensile stress
Procedia PDF Downloads 3766085 Double-Spear 1-H2-1 Oncolytic-Immunotherapy for Refractory and Relapsing High-Risk Human Neuroblastoma and Glioma
Authors: Lian Zeng
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Double-Spear 1-H2-1 (DS1-H2-1) is an oncolytic virus and an innovative biological drug candidate. The chemical composition of the drug product is a live attenuated West Nile virus (WNV) containing the human T cell costimulator (CD86) gene. After intratumoral injection, the virus can rapidly self-replicate in the injected site and lyse/kill the tumor by repeated infection among tumor cells. We also established xenograft tumor models in mice to evaluate the drug candidate's efficacy on those tumors. The results from preclinical studies on transplanted tumors in immunodeficient mice showed that DS1-H2-1 had significant oncolytic effects on human-origin cancers: it completely (100%) shrieked human glioma; limited human neuroblastoma growth reached as high as 95% growth inhibition rate (%TGITW). The safety data of preclinical animal experiments confirmed that DS1-H2-1 is safe as a biological drug for clinical use. In the preclinical drug efficacy experiment, virus-drug administration with different doses did not show abnormal signs and disease symptoms in more than 300 tested mice, and no side effects or death occurred through various administration routes. Intravenous administration did not cause acute infectious disease or other side effects. However, the replication capacity of the virus in tumor tissue via intravenous administration is only 1% of that of direct intratumoral administration. The direct intratumoral administration of DS1-H2-1 had a higher rate of viral replication. Therefore, choosing direct intratumoral injection can ensure both efficacy and safety.Keywords: oncolytic virus, WNV-CD86, immunotherapy drugs, glioma, neuroblastoma
Procedia PDF Downloads 1306084 Examining the Adoption Rate of the Japanese Method of Food Samples in the International Market
Authors: Marwa Abdulsalam, Osamu Suzuki, Wirawan Dony Dahana
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One of the remarkable and unique industries in Japan is the food samples industry which can be noticed in most of the restaurants located around Japan. However, the market is getting saturated, which has pushed Japanese food sample manufacturers to start exploring new international markets. Most of the markets they explored were in the East Asian region, such as China or Korea. In this research, we examine the feasibility and the potential adoption rate of food samples in the international market outside the East Asian region. The main focus of this study is on the Saudi Arabian market. Nonetheless, since Saudi Arabia is a big market, the study results could possibly be applied to the international market as well. The study has conducted a quantitative survey to test the potential of the food samples industry in Saudi Arabia especially in 4 major cities: Jeddah, Mecca, Riyadh, and Dammam. The survey also tests the willingness to purchase, the average price point that the consumer is willing to pay for food samples, and the factors that drive restaurant owners to adopt the food samples system. The study created a correlation analysis between different factors, such as the geographic factor and the size of the restaurant factor, to examine the effect of different aspects on the purchasing decision. The study has found that the Japanese food samples system is predicted to adapt successfully in the Saudi Arabian market and in the international market alike due to the high importance of the food culture and the existence of the communication challenges that the food samples can solve. Additionally, the market survey stated in this study indicated that 83% of the restaurants’ managers are willing to adopt this system in their restaurants.Keywords: food samples, innovative marketing, international market, marketing method
Procedia PDF Downloads 1096083 Socioeconomic Disparities in the Prevalence of Obesity in Adults with Diabetes in Israel
Authors: Yael Wolff Sagy, Yiska Loewenberg Weisband, Vered Kaufman Shriqui, Michal Krieger, Arie Ben Yehuda, Ronit Calderon Margalit
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Background: Obesity is both a risk factor and common comorbidity of diabetes. Obesity impedes the achievement of glycemic control, and enhances damage caused by hyperglycemia to blood vessels; thus it increases diabetes-related complications. This study assessed the prevalence of obesity and morbid obesity among Israeli adults with diabetes, and estimated disparities associated with sex and socioeconomic position (SEP). Methods: A cross-sectional study was conducted in the setting of the Israeli National Program for Quality Indicators in Community Healthcare. Data on all the Israeli population is retrieved from electronic medical records of the four health maintenance organizations (HMOs). The study population included all Israeli patients with diabetes aged 20-64 with documented body mass index (BMI) in 2016 (N=180,451). Diabetes was defined as the existence of one or more of the following criteria: (a) Plasma glucose level >200 mg% in at least two tests conducted at least one month apart in the previous year; (b) HbA1c>6.5% at least once in the previous year (c) at least three prescriptions of diabetes medications were dispensed during the previous year. Two measures were included: the prevalence of obesity (defined as last BMI≥ 30 kg/m2 and <35 kg/m2) and the prevalence of morbid obesity (defined as last BMI≥ 35 kg/m2) in individuals aged 20-64 with diabetes. The cut-off value for morbid obesity was set in accordance with the eligibility criteria for bariatric surgery in diabetics. Data were collected by the HMOs and aggregated by age, sex and SEP. SEP was based on statistical areas ranking by the Israeli Central Bureau of Statistics and divided into 4 categories, ranking from 1 (lowest) to 4 (highest). Results: BMI documentation among adults with diabetes was 84.9% in 2016. The prevalence of obesity in the study population was 30.5%. Although the overall rate was similar in both sexes (30.8% in females, 30.3% in males), SEP disparities were stronger in females (32.7% in SEP level 1 vs. 27.7% in SEP level 4; 18.1% relative difference) compared to males (30.6% in SEP level 1 vs. 29.3% in SEP level 4; 4.4% relative difference). The overall prevalence of morbid obesity in this population was 20.8% in 2016. The rate among females was almost double compared to the rate in males (28.1% and 14.6%, respectively). In both sexes, the prevalence of morbid obesity was strongly associated with lower SEP. However, in females, disparities between SEP levels were much stronger (34.3% in SEP level 1 vs. 18.7% in SEP level 4; 83.4% relative difference) compared to SEP-disparities in males (15.7% in SEP level 1 vs. 12.3% in SEP level 4; 27.6% relative difference). Conclusions: The overall prevalence of BMI≥ 30 kg/m2 among adults with diabetes in Israel exceeds 50%; and the prevalence of morbid obesity suggests that 20% meet the BMI-criteria for bariatric surgery. Prevalence rates show major SEP- and sex-disparities; especially strong SEP disparities in morbid obesity among females. These findings highlight the need for greater consideration of different population groups when implementing interventions.Keywords: diabetes, health disparities, health policy, obesity, socio-economic position
Procedia PDF Downloads 2156082 Greenlight Laser Prostatectomy: A Safe and Effective Day Case Option for Bladder Outlet Obstruction in the Elderly Population
Authors: Gordon Weight, Hermione Tsoi, Patrick Cutinha, Sanjay Rajpal
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Aim: Greenlight-laser prostatectomy (GLLP) is becoming a popular treatment option for bladder outlet obstruction and lower urinary tract symptoms (LUTS). In this retrospective study, we aim to explore the patient selection, perioperative morbidity, and functional outcomes of GLLP. Methods: Patients who underwent GLLP at a UK tertiary centre between June 2018 and November 2021 were included in this study. Retrospective data covering patient demographics, perioperative parameters and postoperative outcomes were collected using the electronic records systems. Results: 305 patients were included in this study with a mean age of 73 (range 30-90) years. The most common indication (62.6%) for the procedure was patient’s wish to be free from long-term catheters (LTC) or intermittent catheterisation (ISC), followed by failed medical therapy for LUTS (36.4%). 84.6% of patients had an ASA ≥2, and 32.1% took anticoagulant or antiplatelet therapy. Inpatient stays were minimal, with the majority (68.2%) of patients were performed as day case, and only 10.5% of patients requiring more than a single night admission. The 3-month readmission rate was 10.8%, with the most common causes being haematuria and urinary-tract infection. The successful TWOC rate at follow up was 91.2%. Amongst the 19 patients who failed TWOC, 14 had LTC prior to the procedure and 4 had been performing ISC. Conclusions: Our study shows that GLLP is a safe and effective day case treatment and can be suitable for elderly and comorbid patients. Patients requiring LTC or ISC pre-operatively should be counselled carefully about the risk of not being catheter-free post procedure.Keywords: urology, endourology, prostate, bladder outlet obstruction, laser
Procedia PDF Downloads 686081 Finite Element Model to Evaluate Gas Conning Phenomenon in Naturally Fractured Oil Reservoirs
Authors: Reda Abdel Azim
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Gas conning phenomenon considered one of the prevalent matter in oil field applications as it significantly affects the amount of produced oil, increase cost of production operation and it has a direct effect on oil reservoirs recovery efficiency as well. Therefore, evaluation of such phenomenon and study the reservoir mechanisms that may strongly affect invading gas to the producing formation is crucial. Gas conning is a result of an imbalance between two major forces controlling the oil production: gravitational and viscous forces especially in naturally fractured reservoirs where the capillary pressure forces are negligible. Once the gas invading the producing formation near the wellbore due to large producing oil rate, the oil gas contact will change and such reservoirs are prone to gas conning. Moreover, the oil volume expected to be produced requires the use of long horizontal perforated well. This work presents a numerical simulation study to predict and propose solutions to gas coning in naturally fractured oil reservoirs. The simulation work is based on discrete fractures and permeability tensors approaches. The governing equations are discretized using finite element approach and Galerkin’s least square technique (GLS) is employed to stabilize the equation solutions. The developed simulator is validated against Eclipse-100 using horizontal fractures. The matrix and fracture properties are modelled. Critical rate, breakthrough time and GOR are determined to be used in investigation of the effect of matrix and fracture properties on gas coning. Results show that fracture distribution in terms of diverse dip and azimuth has a great effect on conning occurring. In addition, fracture porosity, anisotropy ratio, and fracture aperture.Keywords: gas conning, finite element, fractured reservoirs, multiphase
Procedia PDF Downloads 1956080 A Bayesian Population Model to Estimate Reference Points of Bombay-Duck (Harpadon nehereus) in Bay of Bengal, Bangladesh Using CMSY and BSM
Authors: Ahmad Rabby
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The demographic trend analyses of Bombay-duck from time series catch data using CMSY and BSM for the first time in Bangladesh. During 2000-2018, CMSY indicates average lowest production in 2000 and highest in 2018. This has been used in the estimation of prior biomass by the default rules. Possible 31030 viable trajectories for 3422 r-k pairs were found by the CMSY analysis and the final estimates for intrinsic rate of population increase (r) was 1.19 year-1 with 95% CL= 0.957-1.48 year-1. The carrying capacity(k) of Bombay-duck was 283×103 tons with 95% CL=173×103 - 464×103 tons and MSY was 84.3×103tons year-1, 95% CL=49.1×103-145×103 tons year-1. Results from Bayesian state-space implementation of the Schaefer production model (BSM) using catch & CPUE data, found catchabilitiy coefficient(q) was 1.63 ×10-6 from lcl=1.27×10-6 to ucl=2.10×10-6 and r= 1.06 year-1 with 95% CL= 0.727 - 1.55 year-1, k was 226×103 tons with 95% CL=170×103-301×103 tons and MSY was 60×103 tons year-1 with 95% CL=49.9 ×103- 72.2 ×103 tons year-1. Results for Bombay-duck fishery management based on BSM assessment from time series catch data illustrated that, Fmsy=0.531 with 95% CL =0.364 - 0.775 (if B > 1/2 Bmsy then Fmsy =0.5r); Fmsy=0.531 with 95% CL =0.364-0.775 (r and Fmsy are linearly reduced if B < 1/2Bmsy). Biomass in 2018 was 110×103 tons with 2.5th to 97.5th percentile=82.3-155×103 tons. Relative biomass (B/Bmsy) in last year was 0.972 from 2.5th percentile to 97.5th percentile=0.728 -1.37. Fishing mortality in last year was 0.738 with 2.5th-97.5th percentile=0.525-1.37. Exploitation F/Fmsy was 1.39, from 2.5th to 97.5th percentile it was 0.988 -1.86. The biological reference points of B/BMSY was smaller than 1.0, while F/FMSY was higher than 1.0 revealed an over-exploitation of the fishery, indicating that more conservative management strategies are required for Bombay-duck fishery.Keywords: biological reference points, catchability coefficient, carrying capacity, intrinsic rate of population increase
Procedia PDF Downloads 1246079 Assessment of the Road Safety Performance in National Scale
Authors: Abeer K. Jameel, Harry Evdorides
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The Assessment of the road safety performance is a challengeable issue. This is not only because of the ineffective and unreliability of road and traffic crash data system but also because of its systematic character. Recent strategic plans and interventions implemented in some of the developed countries where a significant decline in the rate of traffic and road crashes considers that the road safety is a system. This system consists of four main elements which are: road user, road infrastructure, vehicles and speed in addition to other supporting elements such as the institutional framework and post-crash care system. To assess the performance of a system, it is required to assess all its elements. To present an understandable results of the assessment, it is required to present a unique term representing the performance of the overall system. This paper aims to develop an overall performance indicator which may be used to assess the road safety system. The variables of this indicators are the main elements of the road safety system. The data regarding these variables will be collected from the World Health Organization report. Multi-criteria analysis method is used to aggregate the four sub-indicators for the four variables. Two weighting methods will be assumed, equal weights and different weights. For the different weights method, the factor analysis method is used. The weights then will be converting to scores. The total score will be the overall indicator for the road safety performance in a national scale. This indicator will be used to compare and rank countries according to their road safety performance indicator. The country with the higher score is the country which provides most sustainable and effective interventions for successful road safety system. These indicator will be tested by comparing them with the aggregate real crash rate for each country.Keywords: factor analysis, Multi-criteria analysis, road safety assessment, safe system indicator
Procedia PDF Downloads 2706078 Development of a Novel Nanobiosystem for the Selective Nanophotothermolysis of Meticilin Resistant Staphyloccocous Aureus Using Anti-MRSA Antibody Functionalized Gold Nanoparticles
Authors: Lucian Mocan, Cristian Matea, Flaviu A. Tabaran, Teodora Mocan, Cornel Iancu
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Introduction: Due to antibiotic resistance, systemic infections caused by Meticilin resistant Staphyloccocous Aureus (MRSA) are the main cause of millions of deaths each year. Development of new active biomolecules that are highly effective and refractory to antibiotic resistance may open new avenues in the field of antimicrobial therapy. In this research, we have focused on the development of a novel nanobiosystem with high affinity for MRSA microorganism to mediate its selective laser thermal ablation. Materials and Methods: Gold nanoparticles (15nm in diameter) linked to a specific antibody against MRSA surface were selectively delivered (at various concentrations and incubation times) and internalized into MRSA microorganism following the treatment these multidrug-resistant bacteria were irradiated using a 2w, 808 nm LASER. Results and Discussions: The post-irradiation necrotic rate ranged from 51.2% (for 1 mg/L) to 87.3% (for 50 mg/L) at 60 seconds (p<0.001), while at 30 minute the necrotic rate increased from 64.3% (1 mg/L) to 92.1% (50 mg/L), p value<0.001. Significantly lower apoptotic rates were obtained in irradiated MRSA treated with GNPs only (control) treated for 60 seconds and 30 minutes at concentrations ranging from 1 mg/L to 50 mg/L. We show here that the optimal LASER mediated the necrotic effect of MRSA after incubation with anti-MRSA-Ab was obtained at a concentration of 50 mg/L. Conclusion: In the presented research, we obtained a very efficacious pulse laser mode treatment of individual MRSA agents with minimal effects on the surrounding medium, providing highly localized destruction only for MRSA microorganism.Keywords: MRSA, photothermolysis, antibiotic resistance, gold nanoparticles
Procedia PDF Downloads 4386077 Computer-Aided Diagnosis System Based on Multiple Quantitative Magnetic Resonance Imaging Features in the Classification of Brain Tumor
Authors: Chih Jou Hsiao, Chung Ming Lo, Li Chun Hsieh
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Brain tumor is not the cancer having high incidence rate, but its high mortality rate and poor prognosis still make it as a big concern. On clinical examination, the grading of brain tumors depends on pathological features. However, there are some weak points of histopathological analysis which can cause misgrading. For example, the interpretations can be various without a well-known definition. Furthermore, the heterogeneity of malignant tumors is a challenge to extract meaningful tissues under surgical biopsy. With the development of magnetic resonance imaging (MRI), tumor grading can be accomplished by a noninvasive procedure. To improve the diagnostic accuracy further, this study proposed a computer-aided diagnosis (CAD) system based on MRI features to provide suggestions of tumor grading. Gliomas are the most common type of malignant brain tumors (about 70%). This study collected 34 glioblastomas (GBMs) and 73 lower-grade gliomas (LGGs) from The Cancer Imaging Archive. After defining the region-of-interests in MRI images, multiple quantitative morphological features such as region perimeter, region area, compactness, the mean and standard deviation of the normalized radial length, and moment features were extracted from the tumors for classification. As results, two of five morphological features and three of four image moment features achieved p values of <0.001, and the remaining moment feature had p value <0.05. Performance of the CAD system using the combination of all features achieved the accuracy of 83.18% in classifying the gliomas into LGG and GBM. The sensitivity is 70.59% and the specificity is 89.04%. The proposed system can become a second viewer on clinical examinations for radiologists.Keywords: brain tumor, computer-aided diagnosis, gliomas, magnetic resonance imaging
Procedia PDF Downloads 2606076 Development of Site-Specific Colonic Drug Delivery System (Nanoparticles) of Chitosan Coated with pH Sensitive Polymer for the Management of Colonic Inflammation
Authors: Pooja Mongia Raj, Rakesh Raj, Alpana Ram
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Background: The use of multiparticulate drug delivery systems in preference to single unit dosage forms for colon targeting purposes dates back to 1985 when Hardy and co-workers showed that multiparticulate systems enabled the drug to reach the colon quickly and were retained in the ascending colon for a relatively long period of time. Methods: Site-specific colonic drug delivery system (nanoparticles) of 5-ASA were prepared and coated with pH sensitive polymer. Chitosan nanoparticles (CTNP) bearing 5-Amino salicylic acid (5-ASA) were prepared, by ionotropic gelation method. Nanoparticulate dosage form consisting of a hydrophobic core enteric coated with pH-dependent polymer Eudragit S-100 by solvent evaporation method, for the effective delivery of drug to the colon for treatment of ulcerative colitis. Results: The mean diameter of CTNP and ECTNP formulations were 159 and 661 nm, respectively. Also optimum value of polydispersity index was found to be 0.249 [count rate (kcps) was 251.2] and 0.170 [count rate (kcps) was 173.9] was obtained for both the formulations respectively. Conclusion: CTNP and Eudragit chitosan nanoparticles (ECTNP) was characterized for shape and surface morphology by scanning electron microscopy (SEM) appeared to be spherical in shape. The in vitro drug release was investigated using USP dissolution test apparatus in different simulated GIT fluids showed promising release. In vivo experiments are in further proceeding for fruitful results.Keywords: colon targeting, nanoparticles, polymer, 5-amino salicylic acid, edragit
Procedia PDF Downloads 4956075 Heat Transfer Analysis of a Multiphase Oxygen Reactor Heated by a Helical Tube in the Cu-Cl Cycle of a Hydrogen Production
Authors: Mohammed W. Abdulrahman
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In the thermochemical water splitting process by Cu-Cl cycle, oxygen gas is produced by an endothermic thermolysis process at a temperature of 530oC. Oxygen production reactor is a three-phase reactor involving cuprous chloride molten salt, copper oxychloride solid reactant and oxygen gas. To perform optimal performance, the oxygen reactor requires accurate control of heat transfer to the molten salt and decomposing solid particles within the thermolysis reactor. In this paper, the scale up analysis of the oxygen reactor that is heated by an internal helical tube is performed from the perspective of heat transfer. A heat balance of the oxygen reactor is investigated to analyze the size of the reactor that provides the required heat input for different rates of hydrogen production. It is found that the helical tube wall and the service side constitute the largest thermal resistances of the oxygen reactor system. In the analysis of this paper, the Cu-Cl cycle is assumed to be heated by two types of nuclear reactor, which are HTGR and CANDU SCWR. It is concluded that using CANDU SCWR requires more heat transfer rate by 3-4 times than that when using HTGR. The effect of the reactor aspect ratio is also studied and it is found that increasing the aspect ratio decreases the number of reactors and the rate of decrease in the number of reactors decreases by increasing the aspect ratio. Comparisons between the results of this study and pervious results of material balances in the oxygen reactor show that the size of the oxygen reactor is dominated by the heat balance rather than the material balance.Keywords: heat transfer, Cu-Cl cycle, hydrogen production, oxygen, clean energy
Procedia PDF Downloads 2616074 Fate of Sustainability and Land Use Array in Urbanized Cities
Authors: Muhammad Yahaya Ubale
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Substantial rate of urbanization as well as economic growth is the tasks and prospects of sustainability. Objectives of the paper are: to ascertain the fate of sustainability in urbanized cities and; to identify the challenges of land use array in urbanized cities. Methodology engaged in this paper employed the use of secondary data where articles, conference proceedings, seminar papers and literature materials were effectively used. The paper established the fact that while one thinks globally, it is reciprocal to act locally if at all sustainability should be achieved. The speed and scale of urbanization must be equal to natural and cost-effective deliberations. It also discovered a podium that allows a city to work together as an ideal conglomerate, engaging all city departments as a source of services, engaging residents, businesses, and contractors. It also revealed that city should act as a leader and partner within an urban region, engaging senior government officials, utilities, rural settlements, private sector stakeholders, NGOs, and academia. Cities should assimilate infrastructure system design and management to enhance efficiency of resource flows in an urban area. They should also coordinate spatial development; integrate urban forms and urban flows, combine land use, urban design, urban density, and other spatial attributes with infrastructural development. Finally, by 2050, urbanized cities alone could be consuming 140 billion tons of minerals, ores, fossil fuels and biomass annually (three times its current rate of consumption), sustainability can be accomplished through land use control, limited access to finite resources, facilities, utilities and services as well as property right and user charge.Keywords: sustainability, land use array, urbanized cities, fate of sustainability and perseverance
Procedia PDF Downloads 2726073 The Survival of Bifidobacterium longum in Frozen Yoghurt Ice Cream and Its Properties Affected by Prebiotics (Galacto-Oligosaccharides and Fructo-Oligosaccharides) and Fat Content
Authors: S. Thaiudom, W. Toommuangpak
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Yoghurt ice cream (YIC) containing prebiotics and probiotics seems to be much more recognized among consumers who concern for their health. Not only can it be a benefit on consumers’ health but also its taste and freshness provide people easily accept. However, the survival of such probiotic especially Bifidobacterium longum, found in human gastrointestinal tract and to be benefit to human gut, was still needed to study in the severe condition as whipping and freezing in ice cream process. Low and full-fat yoghurt ice cream containing 2 and 10% (w/w) fat content (LYIC and FYIC), respectively was produced by mixing 20% yoghurt containing B. longum into milk ice cream mix. Fructo-oligosaccharides (FOS) or galacto-oligosaccharides (GOS) at 0, 1, and 2% (w/w) were separately used as prebiotic in order to improve the survival of B. longum. Survival of this bacteria as a function of ice cream storage time and ice cream properties were investigated. The results showed that prebiotic; especially FOS could improve viable count of B. longum. The more concentration of prebiotic used, the more is the survival of B. Longum. These prebiotics could prolong the survival of B. longum up to 60 days, and the amount of survival number was still in the recommended level (106 cfu per gram). Fat content and prebiotic did not significantly affect the total acidity and the overrun of all samples, but an increase of fat content significantly increased the fat particle size which might be because of partial coalescence found in FYIC rather than in LYIC. However, addition of GOS or FOS could reduce the fat particle size, especially in FYIC. GOS seemed to reduce the hardness of YIC rather than FOS. High fat content (10% fat) significantly influenced on lowering the melting rate of YIC better than 2% fat content due to the 3-dimension networks of fat partial coalescence theoretically occurring more in FYIC than in LYIC. However, FOS seemed to retard the melting rate of ice cream better than GOS. In conclusion, GOS and FOS in YIC with different fat content can enhance the survival of B. longum and affect physical and chemical properties of such yoghurt ice cream.Keywords: Bifidobacterium longum, prebiotic, survival, yoghurt ice cream
Procedia PDF Downloads 1616072 Pyrolysis of Dursunbey Lignite and Pyrolysis Kinetics
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In this study, pyrolysis characteristics of Dursunbey-Balıkesir lignite and its pyrolysis kinetics are examined. The pyrolysis experiments carried out at three different heating rates are performed by using thermogravimetric method. Kinetic parameters are calculated by Coats & Redfern kinetic model and the degree of pyrolysis process is determined for each of the heating rate.Keywords: lignite, thermogravimetric analysis, pyrolysis, kinetics
Procedia PDF Downloads 3676071 Parametric Appraisal of Robotic Arc Welding of Mild Steel Material by Principal Component Analysis-Fuzzy with Taguchi Technique
Authors: Amruta Rout, Golak Bihari Mahanta, Gunji Bala Murali, Bibhuti Bhusan Biswal, B. B. V. L. Deepak
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The use of industrial robots for performing welding operation is one of the chief sign of contemporary welding in these days. The weld joint parameter and weld process parameter modeling is one of the most crucial aspects of robotic welding. As weld process parameters affect the weld joint parameters differently, a multi-objective optimization technique has to be utilized to obtain optimal setting of weld process parameter. In this paper, a hybrid optimization technique, i.e., Principal Component Analysis (PCA) combined with fuzzy logic has been proposed to get optimal setting of weld process parameters like wire feed rate, welding current. Gas flow rate, welding speed and nozzle tip to plate distance. The weld joint parameters considered for optimization are the depth of penetration, yield strength, and ultimate strength. PCA is a very efficient multi-objective technique for converting the correlated and dependent parameters into uncorrelated and independent variables like the weld joint parameters. Also in this approach, no need for checking the correlation among responses as no individual weight has been assigned to responses. Fuzzy Inference Engine can efficiently consider these aspects into an internal hierarchy of it thereby overcoming various limitations of existing optimization approaches. At last Taguchi method is used to get the optimal setting of weld process parameters. Therefore, it has been concluded the hybrid technique has its own advantages which can be used for quality improvement in industrial applications.Keywords: robotic arc welding, weld process parameters, weld joint parameters, principal component analysis, fuzzy logic, Taguchi method
Procedia PDF Downloads 1796070 An Infrared Inorganic Scintillating Detector Applied in Radiation Therapy
Authors: Sree Bash Chandra Debnath, Didier Tonneau, Carole Fauquet, Agnes Tallet, Julien Darreon
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Purpose: Inorganic scintillating dosimetry is the most recent promising technique to solve several dosimetric issues and provide quality assurance in radiation therapy. Despite several advantages, the major issue of using scintillating detectors is the Cerenkov effect, typically induced in the visible emission range. In this context, the purpose of this research work is to evaluate the performance of a novel infrared inorganic scintillator detector (IR-ISD) in the radiation therapy treatment to ensure Cerenkov free signal and the best matches between the delivered and prescribed doses during treatment. Methods: A simple and small-scale infrared inorganic scintillating detector of 100 µm diameter with a sensitive scintillating volume of 2x10-6 mm3 was developed. A prototype of the dose verification system has been introduced based on PTIR1470/F (provided by Phosphor Technology®) material used in the proposed novel IR-ISD. The detector was tested on an Elekta LINAC system tuned at 6 MV/15MV and a brachytherapy source (Ir-192) used in the patient treatment protocol. The associated dose rate was measured in count rate (photons/s) using a highly sensitive photon counter (sensitivity ~20ph/s). Overall measurements were performed in IBATM water tank phantoms by following international Technical Reports series recommendations (TRS 381) for radiotherapy and TG43U1 recommendations for brachytherapy. The performance of the detector was tested through several dosimetric parameters such as PDD, beam profiling, Cerenkov measurement, dose linearity, dose rate linearity repeatability, and scintillator stability. Finally, a comparative study is also shown using a reference microdiamond dosimeter, Monte-Carlo (MC) simulation, and data from recent literature. Results: This study is highlighting the complete removal of the Cerenkov effect especially for small field radiation beam characterization. The detector provides an entire linear response with the dose in the 4cGy to 800 cGy range, independently of the field size selected from 5 x 5 cm² down to 0.5 x 0.5 cm². A perfect repeatability (0.2 % variation from average) with day-to-day reproducibility (0.3% variation) was observed. Measurements demonstrated that ISD has superlinear behavior with dose rate (R2=1) varying from 50 cGy/s to 1000 cGy/s. PDD profiles obtained in water present identical behavior with a build-up maximum depth dose at 15 mm for different small fields irradiation. A low dimension of 0.5 x 0.5 cm² field profiles have been characterized, and the field cross profile presents a Gaussian-like shape. The standard deviation (1σ) of the scintillating signal remains within 0.02% while having a very low convolution effect, thanks to lower sensitive volume. Finally, during brachytherapy, a comparison with MC simulations shows that considering energy dependency, measurement agrees within 0.8% till 0.2 cm source to detector distance. Conclusion: The proposed scintillating detector in this study shows no- Cerenkov radiation and efficient performance for several radiation therapy measurement parameters. Therefore, it is anticipated that the IR-ISD system can be promoted to validate with direct clinical investigations, such as appropriate dose verification and quality control in the Treatment Planning System (TPS).Keywords: IR-Scintillating detector, dose measurement, micro-scintillators, Cerenkov effect
Procedia PDF Downloads 1826069 Trends in Use of Millings in Pavement Maintenance
Authors: Rafiqul Tarefder, Mohiuddin Ahmad, Mohammad Hossain
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While milling materials from old pavement surface can be an important component of cost effective maintenance operation, their use in maintenance projects are not uniform and well documented. This study documents the different maintenance practices followed by four transportation districts of New Mexico Department of Transportation (NMDOT) in an attempt to find whether millings are being used in maintenance projects by those districts. Based on existing literature, a questionnaire was developed related to six common maintenance practices. NMDOT district personal were interviewed face to face to discuss and get answers to that questionnaire. It revealed that NMDOT districts mainly use chip seal and patching. Other maintenance procedures such as sand seal, scrub seal, slurry seal, and thin overlay have limited use. Two out of four participating districts do not have any documents on chip sealing; rather they employ the experiences of the chip seal crew. All districts use polymer modified high float emulsion (HFE100P) for chip seal with an application rate ranging from 0.4 to 0.56 gallons per square yard. Chip application rate varies from 15 to 40 lb/ square yard. State wide, the thickness of chip seal varies from 3/8" to 1" and life varies from 3 to 10 years. NMDOT districts mainly use three type of patching: pothole, dig-out and blade patch. Pothole patches are used for small potholes and during emergency, dig-out patches are used for all type of potholes sometimes after pothole patching, and blade patch is used when a significant portion of the pavement is damaged. Pothole patches last as low as three days whereas, blade patch lasts as long as 3 years. It was observed that all participating districts use millings in maintenance projects.Keywords: chip seal, sand seal, scrub seal, slurry seal, overlay, patching, millings
Procedia PDF Downloads 3426068 Pregnancy Rate and Outcomes after Uterine Fibroid Embolization Single Centre Experience in the Middle East from the United Arab Emirates at Alain Hospital
Authors: Jamal Alkoteesh, Mohammed Zeki, Mouza Alnaqbi
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Objective: To evaluate pregnancy outcomes, complications and neonatal outcomes in women who had previously undergone uterine arterial embolization. Design: Retrospective study. In this study, most women opted for UFE as a fertility treatment after failure of myomectomy or in vitro fertilization, or because hysterectomy was the only suggested option. Background. Myomectomy is the standard approach in patients with fibroids desiring a future pregnancy. However, myomectomy may be difficult in cases of numerous interstitial and/or submucous fibroids.In these cases, UFE has the advantage of embolizing all fibroids in one procedure. This procedure is an accepted nonsurgical treatment for symptomatic uterine fibroids. Study Methods: A retrospective study of 210 patients treated with UFE for symptomatic uterine fibroids between 2011-2016 was performed. UFE was performed using ((PVA; Embozen, Beadblock) (500-900 µm in diameter). Pregnancies were identified using screening questionnaires and the study database. Of the 210 patients who received UFE treatment, 35 women younger than the age of 40 wanted to conceive and had been unable. All women in our study were advised to wait six months or more after UFE before attempting to become pregnant, of which the reported time range before attempting to conceive was seven to 33 months (average 20 months). RESULTS: In a retrospective chart review of patients younger than the age of 40 (35 patients,18 patients reported 23 pregnancies, of which five were miscarriages. Two more pregnancies were complicated by premature labor. Of the 23 pregnancies, 16 were normal full-term pregnancies, 15 women had conceived once, and four had become pregnant twice. The remaining patients did not conceive. In the study, there was no reported intrauterine growth retardation in the prenatal period, fetal distress during labor, or problems related to uterine integrity. Two patients reported minor problems during pregnancy that were borderline oligohydramnios and low-lying placenta. In the cohort of women who did conceive, overall, 16 out of 18 births proceeded normally without any complications (86%). Eight women delivered by cesarean section, and 10 women had normal vaginal delivery. In this study of 210 women, UFE had a fertility rate of 47%. Our group of 23 pregnancies was small, but did confirm successful pregnancy after UFE. The 45.7% pregnancy rate in women below the age of 40 years old who completed a term pregnancy compares favorably with women who underwent myomectomy via other method. Of the women in the cohort who did conceive, subsequent birth proceeded normally (86%). Conclusion: Pregnancy after UFE is well-documented. The risks of infertility following embolization, premature menopause, and hysterectomy are small, as is the radiation exposure during embolization. Fertility rates appear similar to patients undergoing myomectomy.UFE should not be contraindicated in patients who want to conceive and they should be able to choose between surgical options and UFE.Keywords: fibroid, pregnancy, therapeutic embolization, uterine artery
Procedia PDF Downloads 2286067 Numerical Assessment of Fire Characteristics with Bodies Engulfed in Hydrocarbon Pool Fire
Authors: Siva Kumar Bathina, Sudheer Siddapureddy
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Fires accident becomes even worse when the hazardous equipment like reactors or radioactive waste packages are engulfed in fire. In this work, large-eddy numerical fire simulations are performed using fire dynamic simulator to predict the thermal behavior of such bodies engulfed in hydrocarbon pool fires. A radiatively dominated 0.3 m circular burner with n-heptane as the fuel is considered in this work. The fire numerical simulation results without anybody inside the fire are validated with the reported experimental data. The comparison is in good agreement for different flame properties like predicted mass burning rate, flame height, time-averaged center-line temperature, time-averaged center-line velocity, puffing frequency, the irradiance at the surroundings, and the radiative heat feedback to the pool surface. Cask of different sizes is simulated with SS304L material. The results are independent of the material of the cask simulated as the adiabatic surface temperature concept is employed in this study. It is observed that the mass burning rate increases with the blockage ratio (3% ≤ B ≤ 32%). However, the change in this increment is reduced at higher blockage ratios (B > 14%). This is because the radiative heat feedback to the fuel surface is not only from the flame but also from the cask volume. As B increases, the volume of the cask increases and thereby increases the radiative contribution to the fuel surface. The radiative heat feedback in the case of the cask engulfed in the fire is increased by 2.5% to 31% compared to the fire without cask.Keywords: adiabatic surface temperature, fire accidents, fire dynamic simulator, radiative heat feedback
Procedia PDF Downloads 1266066 Association of Antibiotics Resistance with Efflux Pumps Genes among Multidrug-Resistant Klebsiella pneumonia Recovered from Hospital Waste Water Effluents in Eastern Cape, South Africa
Authors: Okafor Joan, Nwodo Uchechukwu
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Klebsiella pneumoniae (K. pneumoniae) is a significant pathogen responsible for opportunistic and nosocomial infection. One of the most significant antibiotic resistance mechanisms in K. pneumoniae isolates is efflux pumps. Our current study identified efflux genes (AcrAB, OqxAB, MacAB, and TolC) and regulatory genes (RamR and RarA) in multidrug-resistant (MDR) K. pneumoniae isolated from hospital effluents and investigated their relationship with antibiotic resistance. The sum of 145 K. pneumoniae isolates was established by PCR and screened for antibiotic susceptibility. PCR detected efflux pump genes, and their link with antibiotic resistance was statistically examined. However, 120 (83%) of the confirmed isolated were multidrug-resistant, with the largest percentage of resistance to ampicillin (88.3%) and the weakest rate of resistance to imipenem (5.5%). Resistance to the other antibiotics ranged from 11% to 76.6%. Molecular distribution tests show that AcrA, AcrB, MacA, oqxB oqxA, TolC, MacB were detected in 96.7%, 85%, 76.7%, 70.8%, 55.8%, 39.1%, and 29.1% respectively. However, 14.3% of the isolates harboured all seven genes screened. Efflux pump system AcrAB (83.2%) was the most commonly detected in K. pneumonia isolated across all the antibiotics class-tested. In addition, the frequencies of RamR and RarA were 46.2% and 31.4%, respectively. AcrAB and OqxAB efflux pump genes were significantly associated with fluoroquinolone, beta-lactam, carbapenem, and tetracycline resistance (p<0.05). The high rate of efflux genes in this study demonstrated that this resistance mechanism is the dominant way in K. pneumoniae isolates. Appropriate treatment must be used to reduce and tackle the burden of resistant Klebsiella pneumonia in hospital wastewater effluents.Keywords: Klebsiella pneumonia, efflux pumps, regulatory genes, multidrug-resistant, hospital, PCR
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