Search results for: wind incidence angles

Authors: Arman Kishan, Mark Haft, Kiyanna Thomas, Duc Nguyen, Dawn Laporte

Abstract:

Objective: Patients receiving anticoagulation therapy frequently experience increased rates of postoperative complications. Presently, limited data exist regarding the outcomes of patients undergoing carpal tunnel release surgery (CTR) while on anticoagulation. Our objective is to examine and compare the occurrence of complications in patients on anticoagulation who underwent either endoscopic CTR (ECTR) or open CTR (OCTR) for CTS. Methods: The Trinet X database was utilized to retrospectively identify patients who underwent OCTR or ECTR while concurrently on anticoagulation. Demographic data, medical comorbidities, and complication rates were analyzed. We used multivariable analysis to identify differences in postoperative complications, including wound infection within 90 days, wound dehiscence within 90 days, and intraoperative median nerve injury between the two surgical methods in patients on anticoagulation. Results: A total of 10,919 carpal tunnel syndrome patients on anticoagulation were included in the study, with 9082 and 1837 undergoing OCTR and ECTR, respectively. Among patients on anticoagulation, those undergoing ECTR exhibited a significantly lower occurrence of 90-day wound infection (p < 0.001) and nerve injury (p < 0.001) compared to those who underwent OCTR. However, there was no statistically significant difference in the risk of 90-day wound dehiscence between the two groups (p = 0.323). Conclusion:  In prior studies, ECTR demonstrated reduced rates of postoperative complications compared to OCTR in the general population. Our study demonstrates that among patients on anticoagulation, those undergoing ECTR experienced a significantly lower incidence of 90-day wound infection and nerve injury, with risk reductions of 35% and 40%, respectively. These findings support using ECTR as a preferred surgical method for patients with CTS who are on anticoagulation therapy.

Keywords: endoscopic treatment of carpal tunnel syndrome, open treatment of carpal tunnel syndrome, postoperative complications in patients on anticoagulation, carpal tunnel syndrome

Procedia PDF Downloads 52

Authors: Freda Halim

Abstract:

Endometriosis in bowel is rare condition, about 3-37% of endometriosis cases. Most of bowel endometriosis rising in the rectosigmoid (90% of bowel endometriosis). The incidence of caecal endometriosis is very low ( < 5% of bowel endometriosis) and almost never causing acute small bowel obstruction. The aim of this paper is to show that although bowel obstruction caused by caecal endometriosis is difficult to diagnose as it is rare, and may require laparotomy to make definite diagnosis, but it should be considered in infertile female patient. The case is 37 years old woman infertile woman with intestinal obstruction with pre-operative diagnosis total acute small bowel obstruction caused by right colonic mass, with sepsis as the complication. Before the acute small bowel obstruction, she complained of chronic right lower quadrant pain with chronic constipation alternate with chronic diarrhea, symptoms that happened both in bowel endometriosis and colorectal malignancy. She also complained of chronic pelvic pain and dysmenorrhea. She was married for 10 years with no child. The patient was never diagnosed with endometriosis and never seek medical attention for infertility and the chronic pelvic pain. The patient underwent Abdominal CT Scan, with results: massive small bowel obstruction, and caecal mass that causing acute small bowel obstruction. Diagnosis of acute small bowel obstruction due to right colonic mass was made, and exploratory laparotomy was performed in the patient. During the laparotomy, mass at caecum and ileocaecal that causing massive small bowel obstruction was found and standard right hemicolectomy and temporary ileostomy were performed. The pathology examination showed ectopic endometriosis lesions in caecum and ileocaecal valve. The histopathology also confirmed with the immunohistochemistry, in which positive ER, PR, CD 10 and CD7 was found the ileocaecal and caecal mass. In the second operation, reanastomosis of the ileum was done 3 months after the first operation. The chronic pelvic pain is decreasing dramatically after the first and second operation. In conclusion, although bowel obstruction caused by caecal endometriosis is a rare cause of intestinal obstruction, but it can be considered as a cause in infertile female patient

Keywords: acute, bowel obstruction, caecum, endometriosis

Procedia PDF Downloads 132

Authors: Aparna Lal, Ashwin Swaminathan, Teisa Holani

Abstract:

Background: Clostridium difficile infections (CDIs) have been on the rise globally. In Australia, rates of CDI in all States and Territories have increased significantly since mid-2011. Identifying risk factors for CDI in the community can help inform targeted interventions to reduce infection. Methods: We examine the role of neighbourhood socio-economic status, demography, testing practices and the number of residential aged care facilities on spatial patterns in CDI incidence in the Australian Capital Territory. Data on all tests conducted for CDI were obtained from ACT Pathology by postcode for the period 1st January 2004 through 31 December 2014. Distribution of age groups and the neighbourhood Index of Relative Socio-economic Advantage Disadvantage (IRSAD) were obtained from the Australian Bureau of Statistics 2011 National Census data. A Bayesian spatial conditional autoregressive model was fitted at the postcode level to quantify the relationship between CDI and socio-demographic factors. To identify CDI hotspots, exceedance probabilities were set at a threshold of twice the estimated relative risk. Results: CDI showed a positive spatial association with the number of tests (RR=1.01, 95% CI 1.00, 1.02) and the resident population over 65 years (RR=1.00, 95% CI 1.00, 1.01). The standardized index of relative socio-economic advantage disadvantage (IRSAD) was significantly negatively associated with CDI (RR=0.74, 95% CI 0.56, 0.94). We identified three postcodes with high probability (0.8-1.0) of excess risk. Conclusions: Here, we demonstrate geographic variations in CDI in the ACT with a positive association of CDI with socioeconomic disadvantage and identify areas with a high probability of elevated risk compared with surrounding communities. These findings highlight community-based risk factors for CDI.

Keywords: spatial, socio-demographic, infection, Clostridium difficile

Procedia PDF Downloads 302

Authors: Marouen Dghim, Mohsen Ferchichi

Abstract:

The effect of synthetic jet actuation on the roll-up and the development of a wing tip vortex downstream a square-tipped rectangular wing was investigated experimentally using hotwire anemometry. The wing is equipped with a hallow cavity designed to generate a high aspect ratio synthetic jets blowing at an angles with respect to the spanwise direction. The structure of the wing tip vortex under the effect of fluidic actuation was examined at a chord Reynolds number Re_c=8×10^4. An extensive qualitative study on the effect of actuation on the spanwise pressure distribution at c⁄4 was achieved using pressure scanner measurements in order to determine the optimal actuation parameters namely, the blowing momentum coefficient, Cμ, and the non-dimensionalized actuation frequency, F^+. A qualitative study on the effect of actuation parameters on the spanwise pressure distribution showed that optimal actuation frequencies of the synthetic jet were found within the range amplified by both long and short wave instabilities where spanwise pressure coefficients exhibited a considerable decrease by up to 60%. The vortex appeared larger and more diffuse than that of the natural vortex case. Operating the synthetic jet seemed to introduce unsteadiness and turbulence into the vortex core. Based on the ‘a priori’ optimal selected parameters, results of the hotwire wake survey indicated that the actuation achieved a reduction and broadening of the axial velocity deficit. A decrease in the peak tangential velocity associated with an increase in the vortex core radius was reported as a result of the accelerated radial transport of angular momentum. Peak vorticity level near the core was also found to be largely diffused as a direct result of the increased turbulent mixing within the vortex. The wing tip vortex a exhibited a reduced strength and a diffused core as a direct result of increased turbulent mixing due to the presence of turbulent small scale vortices within its core. It is believed that the increased turbulence within the vortex due to the synthetic jet control was the main mechanism associated with the decreased strength and increased size of the wing tip vortex as it evolves downstream. A comparison with a ‘non-optimal’ case was included to demonstrate the effectiveness of selecting the appropriate control parameters. The Synthetic Jet will be operated at various actuation configurations and an extensive parametric study is projected to determine the optimal actuation parameters.

Keywords: flow control, hotwire anemometry, synthetic jet, wing tip vortex

Procedia PDF Downloads 421

Authors: Nadia H. Mohammed, Anmar Al-Taie, Fadia H. Al-Sultany

Abstract:

Although breast cancer prevalence continues to increase, mortality has been decreasing as a result of early detection and improvement in adjuvant systemic therapy. Nevertheless, this disease required further efforts to understand and identify the associated potential risk factors that could play a role in the prevalence of this malignancy among Iraqi women. The objective of this study was to assess the perception of certain predictive risk factors on the prevalence of breast cancer types among a sample of Iraqi women diagnosed with breast cancer. This was a retrospective observational study carried out at National Cancer Research Center in College of Medicine, Baghdad University from November 2017 to January 2018. Data of 100 patients with breast cancer whose biopsies examined in the National Cancer Research Center were included in this study. Data were collected to structure a detailed assessment regarding the patients’ demographic, medical and cancer records. The majority of study participants (94%) suffered from ductal breast cancer with mean age 49.57 years. Among those women, 48.9% were obese with body mass index (BMI) 35 kg/m². 68.1% of them had positive family history of breast cancer and 66% had low parity. 40.4% had stage II ductal breast cancer followed by 25.5% with stage III. It was found that 59.6% and 68.1% had positive oestrogen receptor sensitivity and positive human epidermal growth factor (HER2/neu) receptor sensitivity respectively. In regard to the impact of prediction of certain variables on the incidence of ductal breast cancer, positive family history of breast cancer (P < 0.0001), low parity (P< 0.0001), stage I and II breast cancer (P = 0.02) and positive HER2/neu status (P < 0.0001) were significant predictive factors among the study participants. The results from this study provide relevant evidence for a significant positive and potential association between certain risk factors and the prevalence of breast cancer among Iraqi women.

Keywords: Ductal Breast Cancer, Hormone Sensitivity, Iraq, Risk Factors

Procedia PDF Downloads 118

Authors: Eliska Oberhofnerova, Milos Panek, Stepan Hysek, Martin Lexa

Abstract:

Nowadays the use of wood, both indoors and outdoors, is constantly increasing. However wood is a natural organic material and in the exterior is subjected to a degradation process caused by abiotic factors (solar radiation, rain, moisture, wind, dust etc.). This process affects only surface layers of wood but neglecting some of the basic rules of wood protection leads to increased possibility of biological agents attack and thereby influences a function of the wood element. The process of wood degradation can be decreased by proper surface treatment, especially in the case of less naturally durable wood species, as spruce. Modern coating systems are subjected to many requirements such as colour stability, hydrophobicity, low volatile organic compound (VOC) content, long service life or easy maintenance. The aim of this study is to evaluate the colour stability of spruce wood (Picea abies), as the basic parameter indicating the coating durability, treated with two layers of transparent natural oil wood stain and exposed to outdoor conditions. The test specimens were exposed for 2 years to natural weathering and 2000 hours to artificial weathering in UV-chamber. The colour parameters were measured before and during exposure to weathering by the spectrophotometer according to CIELab colour space. The comparison between untreated and treated wood and both testing procedures was carried out. The results showed a significant effect of coating on the colour stability of wood, as expected. Nevertheless, increasing colour changes of wood observed during the exposure to weathering differed according to applied testing procedure - natural and artificial.

Keywords: colour stability, natural and artificial weathering, spruce wood, transparent coating

Procedia PDF Downloads 208

Authors: María Reveles-Miranda, Daniella Pacheco-Catalán

Abstract:

Sierra Papacal commissary is located north of Merida, Yucatan, México, where the indigenous Maya population predominates. Due to its location, the region has an elevation of fewer than 4.5 meters above sea level, with a high risk of flooding associated with storms and hurricanes and a high vulnerability of infrastructure and housing in the presence of strong gusts of wind. In environmental contingencies, the challenge is providing an autonomous electrical supply using renewable energy sources that cover vulnerable populations' health, food, and water pumping needs. To address this challenge, a hybrid energy storage module is proposed for the emergency photovoltaic (PV) system of the community shelter in Sierra Papacal, Yucatán, which combines high-energy-density batteries and high-power-density supercapacitors (SC) in a single module, providing a quick response to energy demand, reducing the thermal stress on batteries and extending their useful life. Incorporating SC in energy storage modules can provide fast response times to power variations and balanced energy extraction, ensuring a more extended period of electrical supply to vulnerable populations during contingencies. The implemented control strategy increases the module's overall performance by ensuring the optimal use of devices and balanced energy exploitation. The operation of the module with the control algorithm is validated with MATLAB/Simulink® and experimental tests.

Keywords: batteries, community shelter, environmental contingencies, hybrid energy storage, isolated photovoltaic system, supercapacitors

Procedia PDF Downloads 65

Authors: G. Barański, P. Kacejko, M. Wendeker

Abstract:

The impact of the ignition advance control algorithms of the ASz-62IR-16X aircraft piston engine on a combustion process has been presented in this paper. This aircraft engine is a nine-cylinder 1000 hp engine with a special electronic control ignition system. This engine has two spark plugs per cylinder with an ignition advance angle dependent on load and the rotational speed of the crankshaft. Accordingly, in most cases, these angles are not optimal for power generated. The scope of this paper is focused on developing algorithms to control the ignition advance angle in an electronic ignition control system of an engine. For this type of engine, i.e. radial engine, an ignition advance angle should be controlled independently for each cylinder because of the design of such an engine and its crankshaft system. The ignition advance angle is controlled in an open-loop way, which means that the control signal (i.e. ignition advance angle) is determined according to the previously developed maps, i.e. recorded tables of the correlation between the ignition advance angle and engine speed and load. Load can be measured by engine crankshaft speed or intake manifold pressure. Due to a limited memory of a controller, the impact of other independent variables (such as cylinder head temperature or knock) on the ignition advance angle is given as a series of one-dimensional arrays known as corrective characteristics. The value of the ignition advance angle specified combines the value calculated from the primary characteristics and several correction factors calculated from correction characteristics. Individual cylinder control can proceed in line with certain indicators determined from pressure registered in a combustion chamber. Control is assumed to be based on the following indicators: maximum pressure, maximum pressure angle, indicated mean effective pressure. Additionally, a knocking combustion indicator was defined. Individual control can be applied to a single set of spark plugs only, which results from two fundamental ideas behind designing a control system. Independent operation of two ignition control systems – if two control systems operate simultaneously. It is assumed that the entire individual control should be performed for a front spark plug only and a rear spark plug shall be controlled with a fixed (or specific) offset relative to the front one or from a reference map. The developed algorithms will be verified by simulation and engine test sand experiments. This work has been financed by the Polish National Centre for Research and Development, INNOLOT, under Grant Agreement No. INNOLOT/I/1/NCBR/2013.

Keywords: algorithm, combustion process, radial engine, spark plug

Procedia PDF Downloads 277

Authors: Hao-Su Liu, Jun-Qing Lei

Abstract:

This study introduces the theory of modified particle swarm optimizer and its application in time-domain expressions for bridge self-excited aerodynamic forces. Based on the indicial function expression and the rational function expression in time-domain expression for bridge self-excited aerodynamic forces, the characteristics of the two methods, i.e. the modified particle swarm optimizer and conventional search method, are compared in flutter derivatives’ fitting process. Theoretical analysis and numerical results indicate that adopting whether the indicial function expression or the rational function expression, the fitting flutter derivatives obtained by modified particle swarm optimizer have better goodness of fit with ones obtained from experiment. As to the flutter derivatives which have higher nonlinearity, the self-excited aerodynamic forces, using the flutter derivatives obtained through modified particle swarm optimizer fitting process, are much closer to the ones simulated by the experimental. The modified particle swarm optimizer was used to recognize the parameters of time-domain expressions for flutter derivatives of an actual long-span highway-railway truss bridge with double decks at the wind attack angle of 0°, -3° and +3°. It was found that this method could solve the bounded problems of attenuation coefficient effectively in conventional search method, and had the ability of searching in unboundedly area. Accordingly, this study provides a method for engineering industry to frequently and efficiently obtain the time-domain expressions for bridge self-excited aerodynamic forces.

Keywords: time-domain expressions, bridge self-excited aerodynamic forces, modified particle swarm optimizer, long-span highway-railway truss bridge

Procedia PDF Downloads 303

Authors: Kazi Enamul Hoque

Abstract:

Initiatives on sustainable development are currently aggressively pursued throughout the world. The Malaysian government has developed key policies and strategies for over 30 years to achieve the nation’s policy objectives which are designed to mitigate the issues of security, energy efficiency and environmental impact to meet the rising energy demand. Malaysia’s current focus is on developing effective policies on renewable energy (RE) in order to reduce dependency on fossil fuel and contribute towards mitigating the effects of climate change. In this light mass awareness should be considered as the highest priority to protect the environment and to escape disaster due to climate change. Schools can be the reliable and effective foundation to prepare students to get familiar with environmental issues such as renewable and non-renewable energy sources. Teachers can play a vital role to create awareness among students about the advantages and disadvantages of using different renewable and nonrenewable energy resources. Thus, this study aims to investigate teachers’ knowledge, perceptions and attitudes towards renewable energy through a survey aiming a sustainable energy future. Five hundred sets of questionnaires were distributed to the school teachers in Malaysia. Total 420 questionnaires were returned of which 410 were complete to analyze. Finding shows that teachers are very familiar with the renewable energy like solar, wind and also geothermal. Most teachers were not sure about the Photovoltaics and biodiesel. Furthermore, teachers are also aware that primary energy in Malaysia is imported fossil fuels. Most teachers heard about the renewable energy in Malaysia and only few claims that they did not hear of such things and the others said that they never heard of it. The outcomes of the study will assist the energy policy makers to use teachers to create mass awareness of energy usages for future planning.

Keywords: Malaysia, non-renewable energy, renewable energy, school teacher

Procedia PDF Downloads 418

Authors: Srinivasa Reddy Mallampati, Min Hee Park, Soo Mim Cho, Sung Hyeon Yoon

Abstract:

One of the issues of End of Life Vehicles (ELVs) recycling promotion is technology for the appropriate treatment of automotive shredder residue (ASR). Owing to its high heterogeneity and variable composition (plastic (23–41%), rubber/elastomers (9–21%), metals (6–13%), glass (10–20%) and dust (soil/sand) etc.), ASR can be classified as ‘hazardous waste’, on the basis of the presence of heavy metals (HMs), PCBs, BFRs, mineral oils, etc. Considering their relevant concentrations, these metals and plastics should be properly recovered for recycling purposes before ASR residues are disposed of. Brominated flame retardant additives in ABS/HIPS and PVC may generate dioxins and furans at elevated temperatures. Moreover, these BFRs additives present in plastic materials may leach into the environment during landfilling operations. ASR thermal process removes some of the organic material but concentrates, the heavy metals and POPs present in the ASR residues. In the present study, Fe/Ca/CaO nanoparticle assisted ozone treatment has been found to selectively hydrophilize the surface of ABS/HIPS and PVC plastics, enhancing its wettability and thereby promoting its separation from ASR plastics by means of froth flotation. The water contact angles, of ABS/HIPS and PVC decreased, about 18.7°, 18.3°, and 17.9° in ASR respectively. Under froth flotation conditions at 50 rpm, about 99.5% and 99.5% of HIPS in ASR samples sank, resulting in a purity of 98% and 99%. Furthermore, at 150 rpm a 100% PVC separation in the settled fraction, with 98% of purity in ASR, respectively. Total recovery of non-ABS/HIPS and PVC plastics reached nearly 100% in the floating fraction. This process improved the quality of recycled ASR plastics by removing surface contaminants or impurities. Further, a hybrid ball-milling and with Fe/Ca/CaO nanoparticle froth flotation process was established for the recovery of HMs from ASR. After ball-milling with Fe/Ca/CaO nanoparticle additives, the flotation efficiency increased to about 55 wt% and the HMs recovery were also increased about 90% for the 0.25 mm size fractions of ASR. Coating with Fe/Ca/CaO nanoparticles associated with subsequent microbubble froth flotation allowed the air bubbles to attach firmly on the HMs. SEM–EDS maps showed that the amounts of HMs were significant on the surface of the floating ASR fraction. This result, along with the low HM concentration in the settled fraction, was confirmed by elemental spectra and semi-quantitative SEM–EDS analysis. Developed hybrid preferential hazardous plastics and metals separation process from ASR is a simple, highly efficient, and sustainable procedure.

Keywords: end of life vehicles shredder residue, hazardous plastics, nanoparticle froth flotation, separation process

Procedia PDF Downloads 260

Authors: Rajeev Kumar, Angad Singh Kushwaha, Amritanshu Pandey, S. K. Srivastava

Abstract:

Photonic crystals (PCs) have attracted much attention due to its electromagnetic properties and potential applications. In PCs, there is certain range of wavelength where electromagnetic waves are not allowed to pass are called photonic band gap (PBG). A localized defect mode will appear within PBG, due to change in the interference behavior of light, when we create a defect in the periodic structure. We can also create different types of defect structures by inserting or removing a layer from the periodic layered structure in two and three-dimensional PCs. We can design microcavity, waveguide, and perfect mirror by creating a point defect, line defect, and palanar defect in two and three- dimensional PC structure. One-dimensional and two-dimensional PCs with defects were reported theoretically and experimentally by Smith et al.. in conventional photonic band gap structure. In the present paper, we have presented the defect mode tunability in tilted non-graded photonic crystal (NGPC) and linearly graded photonic crystal (LGPC) using lead sulphide (PbS) and titanium dioxide (TiO2) in the infrared region. A birefringent defect layer is created in NGPC and LGPC using potassium titany phosphate (KTP). With the help of transfer matrix method, the transmission properties of proposed structure is investigated for transverse electric (TE) and transverse magnetic (TM) polarization. NGPC and LGPC without defect layer is also investigated. We have found that a photonic band gap (PBG) arises in the infrared region. An additional defect layer of KTP is created in NGPC and LGPC structure. We have seen that an additional transmission mode appers in PBG region. It is due to the addition of defect layer. We have also seen the effect, linear gradation in thickness, angle of incidence, tilt angle, and thickness of defect layer, on PBG and additional transmission mode. We have observed that the additional transmission mode and PBG can be tuned by changing the above parameters. The proposed structure may be used as channeled filter, optical switches, monochromator, and broadband optical reflector.

Keywords: defect modes, graded photonic crystal, photonic crystal, tilt angle

Procedia PDF Downloads 362

Authors: Jessica Ding

Abstract:

The field of global health is currently advocating for a resurgence in the use of traditional medicines to improve people-centered care. Healthcare policies are rapidly changing in response; in China, the increasing presence of TCM in the same spaces as biomedicine has led to a new term: integrative medicine. However, the existence of TCM as a part of integrative medicine creates a pressing paradoxical tension where TCM is both seen as a marginalized system within ‘modern’ hospitals and as a modality worth integrating. Additionally, the impact of such shifts has not been fully explored: the World Health Organization for one focuses only on three angles —practices, products, and practitioners— with regards to traditional medicines. Through ten weeks of fieldwork conducted at an urban hospital in Shanghai, China, this research expands the perspective of existing strategies by looking at integrative care through a fourth lens: patients and families. The understanding of self-care, health-seeking behavior, and non-professional caregiving structures are critical to grasping the significance of traditional medicine for people-centered care. Indeed, those individual and informal health care expectations align with the very spaces and needs that traditional medicine has filled before such ideas of integration. It specifically looks at this issue via three processes that operationalize experiences of care: (1) how aspects of TCM are valued within integrative medicine, (2) how negotiations of care occur between patients and doctors, and (3) how 'good quality' caregiving presents in integrative clinical spaces. This research hopes to lend insight into how culturally embedded traditions, bureaucratic and institutional rationalities, and social patterns of health-seeking behavior influence care to shape illness experiences at the intersection of two medical modalities. This analysis of patients’ clinical and illness experiences serves to enrich the narratives of integrative medical care’s ability to provide patient-centered care to determine how international policies are realized at the individual level. This anthropological study of the integration of Traditional Chinese medicine in local contexts can reveal the extent to which global strategies, as promoted by the WHO and the Chinese government actually align with the expectations and perspectives of patients receiving care. Ultimately, this ethnographic analysis of a local Chinese context hopes to inform global policies regarding the future use and integration of traditional medicines.

Keywords: emergent systems, global health, integrative medicine, traditional Chinese medicine, TCM

Procedia PDF Downloads 126

Authors: Debalke Dale, Bezabh Geneta, Yohannes Amene, Yordanos Bergene, Mohammed Yimam

Abstract:

Background: A drug therapy problem (DTP) is an event or circumstance that involves drug therapies that actually or potentially interfere with the desired outcome and requires professional judgment to resolve. Heart failure is an emerging worldwide threat whose prevalence and health loss burden constantly increase, especially in the young and in low-to-middle-income countries. There is a lack of population-based incidence and prevalence of heart failure (HF) studies in sub-Saharan African countries, including Ethiopia. Objective: The aim of this study was designed to assess drug therapy problems and associated factors among patients with HF in the medical ward of Arba Minch General Hospital(AGH), Ethiopia, from June 5 to August 20, 2022. Methods: A retrospective cross-sectional study was conducted among 180 patients with HF who were admitted to the medical ward of AGH. Data were collected from patients' cards by using questionnaires. The data were categorized and analyzed by using SPSS version 25.0 software, and data were presented in tables and words based on the nature of the data. Result: Out of the total, 85 (57.6%) were females, and 113 (75.3%) patients were aged over fifty years. Of the 150 study participants, 86 (57.3%) patients had at least one DTP identified, and a total of 116 DTPs were identified, which is 0.77 DTPs per patient. The most common types of DTP were unnecessary drug therapy (32%), followed by the need for additional drug therapy (36%), and dose too low (15%). Patients who used polypharmacy were 5.86 (AOR) times more likely to develop DTPs than those who did not (95% CI = 1.625–16.536, P = 0.005), and patients with more co-morbid conditions developed 3.68 (AOR) times more DTPs than those who had fewer co-morbidities (95% CI = 1.28–10.5, P = 0.015). Conclusion: The results of this study indicated that drug therapy problems were common among medical ward patients with heart failure. These problems are adversely affecting the treatment outcomes of patients, so it requires the special attention of healthcare professionals to optimize them.

Keywords: heart failure, drug therapy problems, Arba Minch general hospital, Ethiopia

Procedia PDF Downloads 84

Authors: Dyna Ann C. Sevilles, Noel J. Belonguel, Jarungchai Anton S. Vatanagul, Mary Jeanne O. Flordelis, Grace G. Anota

Abstract:

Guillain Barre syndrome is an acute inflammatory polyradiculoneuropathy causing progressive symmetrical weakness which can be debilitating to the patient. Early diagnosis is important especially in the acute phase when treatment favors good outcome and reduces the incidence of the need for mechanical ventilation. Electrodiagnostic studies aid in the evaluation of patients suspected with GBS. However, the characteristic electrical changes may not be evident until after several weeks. Thus, studies performed early in the course may give unclear results. The aim of this study is to associate the symptom onset of patients diagnosed with Guillain Barre syndrome with the EMG NCV results and determine the earliest time when there is evident findings supporting the diagnosis. This is a retrospective descriptive chart review study involving patients of >/= 18 years of age with GBS written on their charts in a Tertiaty hospital in Cebu City, Philippines from January 2000 to July 2014. Twenty patients showed electrodiagnostic findings suggestive of GBS. The mean day of illness when EMG NCV was carried out was 7 days. The earliest with suggestive findings was done on day 2 (10%) of illness. Moreover, the highest frequency with positive results was done on day 3 (20%) of illness. Based on the Dutch Guillain Barre Study group criteria, the most frequent variables noted were: prolonged distal motor latency in both median and ulnar nerves(65%) and both peroneal and tibial nerves (71%); and reduced CMAP in both median and ulnar nerves (65%) and both tibial and peroneal nerves (71%). The EMG NCV findings showed majority of demyelinating type (59%). Electrodiagnostic studies are helpful in aiding the physician in the diagnosis and treatment of the disease in the early stage. Based on this study, neurophysiologic evidence of GBS can be seen in as early as day 2 of clinical illness.

Keywords: Acute Inflammatory Demyelinating Polyneuropathy, electrophysiologic study, EMG NCV, Guillain Barre Syndrome

Procedia PDF Downloads 275

Authors: Ratih Julistina, M. Agoes Moelyadi

Abstract:

Innovation in aviation technology evolved rapidly by time to time for acquiring the most favorable value of utilization and is usually denoted by efficiency parameter. Nature always become part of inspiration, and for this sector, many researchers focused on studying the behavior of flying animal to comprehend the fundamental, one of them is birds. Experimental testing has already conducted by several researches to seek and calculate the efficiency by putting the object in wind tunnel. Hence, computational simulation is needed to conform the result and give more visualization which is based on Reynold Averaged Navier-Stokes equation solution for unsteady case in time-dependent viscous flow. By creating model from simplification of the real bird as a rigid body, those are Hawk which has low aspect ratio and Swift with high aspect ratio, subsequently generating the multi grid structured mesh to capture and calculate the aerodynamic behavior and characteristics. Mimicking the motion of downstroke and upstroke of bird flight which produced both lift and thrust, the sinusoidal function is used. Simulation is carried out for varied of flapping frequencies within upper and lower range of actual each bird’s frequency which are 1 Hz, 2.87 Hz, 5 Hz for Hawk and 5 Hz, 8.9 Hz, 13 Hz for Swift to investigate the dependency of frequency effecting the efficiency of aerodynamic characteristics production. Also, by comparing the result in different condition flights with the morphology of each bird. Simulation has shown that higher flapping frequency is used then greater aerodynamic coefficient is obtained, on other hand, efficiency on thrust production is not the same. The result is analyzed from velocity and pressure contours, mesh movement as to see the behavior.

Keywords: characteristics of aerodynamic, efficiency, flapping frequency, flapping wing, unsteady simulation

Procedia PDF Downloads 224

Authors: Ilze Pelece, Imants Ziemelis, Henriks Putans

Abstract:

Traditionally the solar energy has been used in southern countries, but it has been used also in northern ones. Most popular kind of use of solar energy in Latvia is solar collector for water heating. Traditionally flat-plate solar collectors are used because of simplicity of manufacturing. However, some peculiarities in use of solar energy in northern countries must be taken into account. In northern countries, there is lower irradiance, but longer day and longer path of the sun during summer. Therefore traditional flat-plate solar collectors are not appropriate enough in northern countries, but new forms must be developed. There are two forms of solar collectors - cylindrical and semi-spherical – proposed in this work. Such collectors can be made both for water or air heating. Theoretical calculations and measurements of energy gain from those two collectors have been done. Results show that daily energy sum received by the semi-spherical collector from the sun at the middle of summer is 1.43 times more than that of the flat one, but for the cylindrical collector, it is 1.74 times more than that of the flat one or equal to that of the tracking to sun flat-plate collector. The resulting difference in energy gain from collector will be not so large because of the difference in heat loses. Heat can be decreased by switching off the water circulation pump when the sun is covered by clouds. For this purpose solar batteries, powered pump can be used instead of complicated and expensive automatics. Even more important than overall energy gain is the fact that semi-spherical and cylindrical collectors work all day (17 hours in the middle of summer at 57 northern latitudes), while flat-plate collector only about 11 hours. Yearly energy sum received by the collector from the sun is 1.5 and 1.9 times larger for the semi-spherical and cylindrical collector respectively as for the flat one. The cylindrical solar collector is easier to manufacture, but semi-spherical one is more aesthetical and durable against the impact of the wind. Although solar collectors for water and air heating are studied in this article, main ideas are applicable also for solar batteries.

Keywords: cylindric, semi-spherical, solar collector, solar energy, water heating

Procedia PDF Downloads 248

Authors: Moetazza M. Alshafei, Ahmed M. Mabrouk, Emtenan M. Hanafi, Manal M. Ramadan, Reda M. S. Korany, Seham S. Kassem, Dina Mostafa Mohammed

Abstract:

Metabolic syndrome (MeS) is a major health problem with a high incidence of obese individuals worldwide. Increased related morbidity of diabetes, hypertension and fatty liver disease, and complicated cardiovascular disease are inevitable. Boswellia serrata gum (Bos) is a promising traditional medicinal plant; it has several pharmacological properties, including anti-inflammatory, antioxidant, and antilipase activities. Probiotics (Bac) supplements have good benefits on health and MeS, whether it is supplemented in combination with prebiotics or alone. Microencapsulation helps to mask unpalatable taste and odor and deliver active ingredients to targeted organs. Methodology MeS rat model was produced by feeding rats with a high fat, high CHO diet (HFD). Bos was extracted, and both Bos and the probiotic were microencapsulated with a spray drier. Female rats were divided into 5 groups (N8). HFD control, control normal receiving basic diet, HFD treated, from the start of the experiment, either with encapsulated Bos, Bac and Bos or Bac only, all treatments were received for eight weeks (after approval from NRC animal ethical committee). Serum was collected to analyze lipid profile, blood sugar, liver and kidney functions, antioxidants, leptin, and progesterone. Rat's organs and body fat were weighed and collected for histopathology. Statistical analysis was done by use of one way Anova test in the SPSS program. Results showed control of elevated body weight, lipid profile, and glucose levels as well as decrease of body fat index and improvement of histopathology of liver and heart, especially in combination. Conclusion: We concluded that both microencapsulated Bos and probiotics have a controlling effect on MeS parameters.

Keywords: metabolic syndrome, Boswellia serata, probiotic, micro-encapsulation, histopathology, liver steatosis

Procedia PDF Downloads 79

Authors: Rishab Das, Arnab Banerjee, Bappaditya Manna

Abstract:

Mono-pile foundations are often used in soft soils in order to support heavy mega-structures, whereby often these deep footings may undergo dynamic excitation due to many causes like earthquake, wind or wave loads acting on the superstructure, blasting, and unbalanced machines, etc. A comprehensive analytical study is performed to study the dynamics of the mono-pile system embedded in cohesion-less soil. The soil is considered homogeneous and visco-elastic in nature and is analytically modeled using complex springs. Considering the N number of the elements of the pile, the final global stiffness matrix is obtained by using the theories of the spectral element matrix method. Further, statically condensing the intermediate internal nodes of the global stiffness matrix results to a smaller sub matrix containing the nodes experiencing the external translation and rotation, and the stiffness and damping functions (impedance functions) of the embedded piles are determined. Proper plots showing the variation of the real and imaginary parts of these impedance functions with the dimensionless frequency parameter are obtained. The plots obtained from this study are validated by that provided by Novak,1974. Further, the dynamic analysis of the resonator impregnated pile is proposed within this study. Moreover, with the aid of Wood's 1g laboratory scaling law, a proper scaled-down resonator-pile model is 3D printed using PLA material. Dynamic analysis of the scaled model is carried out in the time domain, whereby the lateral loads are imposed on the pile head. The response obtained from the sensors through the LabView software is compared with the proposed theoretical data.

Keywords: mono-pile, visco-elastic, impedance, LabView

Procedia PDF Downloads 98

Authors: Patrick C. H. Morel, Ian W. Barugh, Kirsty L. Chidgey

Abstract:

The aim of this study was to quantify the level of piglet deaths in outdoor farrowing systems in New Zealand. A total of 14 farms were visited, the farmers interviewed, and data collected. A total of 10,154 sows were kept on those farms representing an estimated 33% of the NZ sow herd or 80% of the outdoor sow herd in 2016. Data from 25,911 litters was available for the different analyses. The characteristics and reproductive performance for the years 2015-2016 from the 14 farms surveyed in this study were analysed, and the following results were obtained. The average percentage of stillbirths was 7.1% ranging between 3.5 and 10.7%, and the average pre-weaning live-born mortality was 16.7% ranging between 3.7% and 23.6%. The majority of piglet deaths (89%) occurred during the first week after birth, with 81% of deaths occurring up to day three. The number of piglets born alive was 12.3 (8.0 to 14.0), and average number of piglets weaned per sow per year was 22.4, range 10.5-27.3. The average stocking rate per ha (number of sows and mated gilts) was 15.3 and ranged from 2.8 to 28.6. The sow to boar ratio average was 20.9:1 and the range was 7.1: 1 to 63:1. The sow replacement rate ranged between 37% and 78%. There was a large variation in the piglet live-born mortality both between months within a farm and between farms within a given month. The monthly recorded piglet mortality ranged between 7.7% and 31.5%, and there was no statistically significant difference between months on the number of piglets born, born alive, weaned or on pre-weaning piglet mortality. Twelve different types of hut/farrowing systems were used on the 14 farms. No difference in piglet mortality was observed between A-Frame, A-Frame Modified and for Box-shape huts. There was a positive relationship between the average number of piglets born per litter and the number of piglets born alive (r=0.975) or the number weaned per litter (r=0.845). Moreover, as the average number of piglets born-alive increases, both pre-weaning live-born mortality rate and the number of piglets weaned increased. An increase of 1 piglet in the number born alive corresponds to an increase of 2.9% in live-born mortality and an increase of 0.56 piglets weaned. Farmers reported that staff are the key to success with the key attributes being: good and reliable with attention to detail and skills with the stock.

Keywords: mortality, piglets, outdoor, pig farm

Procedia PDF Downloads 102

Authors: B. Vadiraj, S. N. Omkar, B. Kapil Bharadwaj, Yash Vardhan Gupta

Abstract:

During manned exploration of space, missions will require astronaut crewmembers to perform Extra Vehicular Activities (EVAs) for a variety of tasks. These EVAs take place after long periods of operations in space, and in and around unique vehicles, space structures and systems. Considering the remoteness and time spans in which these vehicles will operate, EVA system operations should utilize common worksites, tools and procedures as much as possible to increase the efficiency of training and proficiency in operations. All of the preparations need to be carried out based on studies of astronaut motions. Until now, development and training activities associated with the planned EVAs in Russian and U.S. space programs have relied almost exclusively on physical simulators. These experimental tests are expensive and time consuming. During the past few years a strong increase has been observed in the use of computer simulations due to the fast developments in computer hardware and simulation software. Based on this idea, an effort to develop a computational simulation system to model human dynamic motion for EVA is initiated. This study focuses on the simulation of an astronaut moving the orbital replaceable units into the worksites or removing them from the worksites. Our physics-based methodology helps fill the gap in quantitative analysis of astronaut EVA by providing a multisegment human arm model. Simulation work described in the study improves on the realism of previous efforts, incorporating joint stops to account for the physiological limits of range of motion. To demonstrate the utility of this approach human arm model is simulated virtually using ADAMS/LifeMOD® software. Kinematic mechanism for the astronaut’s task is studied from joint angles and torques. Simulation results obtained is validated with numerical simulation based on the principles of Newton-Euler method. Torques determined using mathematical model are compared among the subjects to know the grace and consistency of the task performed. We conclude that due to uncertain nature of exploration-class EVA, a virtual model developed using multibody dynamics approach offers significant advantages over traditional human modeling approaches.

Keywords: extra vehicular activity, biomechanics, inverse kinematics, human body modeling

Procedia PDF Downloads 324

Authors: Kateryna Zharan, Jan C. Bongaerts

Abstract:

Mining operations are energy intensive, and the share of energy costs in total costs is often quoted in the range of 40 %. Saving on energy costs is, therefore, a key element of any mine operator. With the improving reliability and security of renewable energy (RE) sources, and requirements to reduce carbon dioxide emissions, perspectives for using RE in mining operations emerge. These aspects are stimulating the mining companies to search for ways to substitute fossil energy with RE. Hereby, the main purpose of this study is to present the survey research assessment in matter of finding out the key issues related to the integration of RE into mining activities, based on the mining and renewable energy experts’ opinion. The purpose of the paper is to present the outcomes of a survey conducted among mining and renewable energy experts about the feasibility of RE in mining operations. The survey research has been developed taking into consideration the following categories: first of all, the mining and renewable energy experts were chosen based on the specific criteria. Secondly, they were offered a questionnaire to gather their knowledge and opinions on incentives for mining operators to turn to RE, barriers and challenges to be expected, environmental effects, appropriate business models and the overall impact of RE on mining operations. The outcomes of the survey allow for the identification of factors which favor and disfavor decision-making on the use of RE in mining operations. It concludes with a set of recommendations for further study. One of them relates to a deeper analysis of benefits for mining operators when using RE, and another one suggests that appropriate business models considering economic and environmental issues need to be studied and developed. The results of the paper will be used for developing a hybrid optimized model which might be adopted at mines according to their operation processes as well as economic and environmental perspectives.

Keywords: carbon dioxide emissions, mining industry, photovoltaic, renewable energy, survey research, wind generation

Procedia PDF Downloads 341

Authors: Silvano Salvador, Maryam Zarrinderakht, Alan Martin

Abstract:

Open pits, which are the result of mining, are filled by water over time until the water reaches the elevation of the local water table and generates mine pit lakes. There are several specific regulations about the water quality of pit lakes, and mining operations should keep the quality of groundwater above pre-defined standards. Therefore, an accurate, acceptable numerical model predicting pit lakes’ water balance and water quality is needed in advance of mine excavation. We carry on analyzing and developing the model introduced by Crusius, Dunbar, et al. (2002) for pit lakes. This model, called “PitMod”, simulates the physical and geochemical evolution of pit lakes over time scales ranging from a few months up to a century or more. Here, a lake is approximated as one-dimensional, horizontally averaged vertical layers. PitMod calculates the time-dependent vertical distribution of physical and geochemical pit lake properties, like temperature, salinity, conductivity, pH, trace metals, and dissolved oxygen, within each model layer. This model considers the effect of pit morphology, climate data, multiple surface and subsurface (groundwater) inflows/outflows, precipitation/evaporation, surface ice formation/melting, vertical mixing due to surface wind stress, convection, background turbulence and equilibrium geochemistry using PHREEQC and linking that to the geochemical reactions. PitMod, which is used and validated in over 50 mines projects since 2002, incorporates physical processes like those found in other lake models such as DYRESM (Imerito 2007). However, unlike DYRESM PitMod also includes geochemical processes, pit wall runoff, and other effects. In addition, PitMod is actively under development and can be customized as required for a particular site.

Keywords: pit lakes, mining, modeling, hydrology

Procedia PDF Downloads 128

Authors: Komal Vig

Abstract:

Cardiovascular disease (CVD)-related deaths occur in 17.3 million people globally each year, accounting for 30% of all deaths worldwide, with a predicted annual incidence of deaths to reach 23.3 million globally by 2030. Autologous bypass grafts remain an important therapeutic option for the treatment of CVD, but the poor quality of the donor patient’s blood vessels, the invasiveness of the resection surgery, and postoperative movement restrictions create issues. The present study is aimed to improve the endothelialization of intimal surface of graft by using low temperature plasma (LTP) to increase the cell attachment and proliferation. Polytetrafluoroethylene (PTFE) was treated with LTP. Air was used as the feed-gas, and the pressure in the plasma chamber was kept at 800 mTorr. Scaffolds were also modified with gelatin and collagen by dipping method. Human umbilical vein endothelial cells (HUVEC) were plated on the developed scaffolds, and cell proliferation was determined by the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay and by microscopy. mRNA expressions levels of different cell markers were investigated using quantitative real-time PCR (qPCR). XPS confirmed the introduction of oxygenated functionalities from LTP. HUVEC cells showed 80% seeding efficiency on the scaffold. Microscopic and MTT assays indicated increase in cell viability in LTP treated scaffolds, especially when treated with gelatin or collagen, compared to untreated scaffolds. Gene expression studies shows enhanced expression of cell adhesion marker Integrin- α 5 gene after LTP treatment. LTP treated scaffolds exhibited better cell proliferation and viability compared to untreated scaffolds. Protein treatment of scaffold increased cell proliferation. Based on our initial results, more scaffolds alternatives will be developed and investigated for cell growth and vascularization studies. Acknowledgments: This work is supported by the NSF EPSCoR RII-Track-1 Cooperative Agreement OIA-2148653.

Keywords: LTP, HUVEC cells, vascular graft, endothelialization

Procedia PDF Downloads 58

Authors: Piotr J. Skusiewicz, Johnathan Saul, Ijhar Rusli, Svetlana Aleksandrova, Stephen. F. Benjamin, Miroslaw Gall, Steve Pierson, Carol A. Roberts

Abstract:

The application of turbocharging in automotive engines leads to swirling flow entering the catalyst. The behaviour of this type of flow within the catalyst has yet to be adequately documented. This work discusses the effect of swirling flow on the flow distribution in automotive exhaust catalysts. Compressed air supplied to a moving-block swirl generator allowed for swirling flow with variable intensities to be generated. Swirl intensities were measured at the swirl generator outlet using single-sensor hot-wire probes. The swirling flow was fed into diffusers with total angles of 10°, 30° and 180°. Downstream of the diffusers, a wash-coated diesel oxidation catalyst (DOC) of length 143.8 mm, diameter 76.2 mm and nominal cell density of 400 cpsi was fitted. Velocity profiles were measured at the outlet sleeve about 30 mm downstream of the monolith outlet using single-sensor hot-wire probes. Wall static pressure was recorded using a multi-tube manometer connected to pressure taps positioned along the diffuser walls. The results show that as swirl is increased, more of the flow is directed towards the diffuser walls. The velocity decreases around the centre-line and maximum velocities are observed close to the outer radius of the monolith for all flow rates. At the maximum swirl intensity, reversed flow was recorded near the centre of the monolith. Wall static pressure measurements in the 180° diffuser indicated no pressure recovery as the flow enters the diffuser. This is indicative of flow separation at the inlet to the diffuser. To gain insight into the flow structure, CFD simulations have been performed for the 180° diffuser for a flow rate of 63 g/s. The geometry of the model consists of the complete assembly from the upstream swirl generator to the outlet sleeve. Modelling of the flow in the monolith was achieved using the porous medium approach, where the monolith with parallel flow channels is modelled as a porous medium that resists the flow. A reasonably good agreement was achieved between the experimental and CFD results downstream of the monolith. The CFD simulations allowed visualisation of the separation zones and central toroidal recirculation zones that occur within the expansion region at certain swirl intensities which are highlighted.

Keywords: catalyst, computational fluid dynamics, diffuser, hot-wire anemometry, swirling flow

Procedia PDF Downloads 293

Authors: Lara Al-Haddad, Mark Whittington

Abstract:

This paper aims to examine the impact of two influential internal corporate governance mechanisms, namely board characteristics and ownership structure on the use of real activities-based and accrual-based earnings management by Jordanian public firms. Using panel data from Jordanian public firms after the introduction of the Jordanian Corporate Governance Code (JCGC) in 2009, the study finds both institutional ownership and managerial ownership constrain the use of real and accrual earnings manipulations. On the other side, both independent directors and largest shareholders are found to exaggerate the incidence of using real and accrual earnings management. The study also examines the trade-off between real and accrual earnings management and found that Jordanian firms use a combination of real and accrual-based earnings management to obtain the greatest effect on earnings reporting strategies. For the purpose of this study, three types of real earnings management are considered: sales manipulation, overproduction, and the abnormal reduction of discretionary expenditures. The abnormal discretionary accrual is considered for accruals management. While for the internal corporate governance mechanisms; board characteristics are examined by using board independence, board size, and CEO-duality; and ownership structure is examined by using managerial ownership, institutional ownership, foreign ownership and largest shareholder ownership. To the best knowledge of the researchers, this study is the first to examine the relationship between board characteristics and real earnings management in Jordan. Further, it is the first to examine the relationship between corporate governance mechanisms and discretionary accruals after the introduction of the Jordanian Corporate Governance Code in 2009. Thus, the findings of this study have important policy implications for policymakers, regulators, standard setters, audit professional, and investors in their attempts to constrain the practice of earnings management, whether real or accrual, and to improve the financial reporting quality in Jordan.

Keywords: board characteristics, Jordan, ownership structure, real earnings management

Procedia PDF Downloads 327

Authors: Ali A. Bazzi, Ameer Hamza, Riley O’Hara, Kimberly Kado, Karen H. Hagglund, Lamia Fathallah, Robert T. Morris

Abstract:

Introduction: Endometrial Cancer is a common gynecologic malignancy primarily treated with complete surgical staging, which may include complete pelvic and para-aortic lymphadenectomy. The role of lymphadenectomy is controversial, especially the intraoperative indications for the procedure. Three factors are important in decision to proceed with lymphadenectomy: Myometrial invasion, maximum tumor dimension, and histology. Many institutions incorporate these criteria in varying degrees in the decision to proceed with lymphadenectomy. This investigation assesses the use of intraoperatively measured MTD with and without pre-operative histologic grade. Methods: This study compared retrospectively EEC patients with intraoperatively measured MTD ≤2 cm to those with MTD >2 cm from January 1, 2002 to August 31, 2017. This assessment compared those with MTD ≤ 2cm with endometrial biopsy (EB) grade 1-2 to patients with MTD > 2cm with EB grade 3. Lymph node metastasis (LNM), recurrence, and survival were compared in these groups. Results: This study reviewed 222 patient cases. In tumors > 2 cm, LNM occurred in 20% cases while in tumors ≤ 2 cm, LNM was found in 6% cases (p=0.04). Recurrence and mean survival based on last follow up visit in these two groups were not statistically different (p=0.78 and 0.36 respectively). Data demonstrated a trend that when combined with preoperative EB International Federation of Gynecology and Obstetrics (FIGO) grade, a higher proportion of patients with EB FIGO Grade 3 and MTD > 2 cm had LNM compared to those with EB FIGO Grade 1-2 and MTD ≤ 2 cm (43% vs, 11%, p=0.06). LNM was found in 15% of cases in which lymphadenectomy was performed based on current practices, whereas if the criteria of EB FIGO 3 and MTD > 2 cm were used the incidence of LNM would have been 44% cases. However, using this criterion, two patients would not have had their nodal metastases detected. Compared to the current practice, the sensitivity and specificity of the proposed criteria would be 60% and 81%, respectively. The PPV and NPV would be 43% and 90%, respectively. Conclusion: The results indicate that MTD combined with EB FIGO grade can detect LNM in a higher proportion of cases when compared to current practice. MTD combined with EB FIGO grade may eliminate the need of frozen section sampling in a substantial number of cases.

Keywords: endometrial cancer, FIGO grade, lymphadenectomy, tumor size

Procedia PDF Downloads 164

Authors: Randa M. Ali, Naguiba F. Loutfy, Osama M. Awad

Abstract:

Background: Leishmaniasis is a worldwide disease, affecting 88 countries, it is estimated that about 350 million people are at risk of leishmaniasis. Overall prevalence is 12 million people with annual mortality of about 60,000. Annual incidence is 1,500,000 cases of cutaneous leishmaniasis (CL) worldwide and half million cases of visceral Leishmaniasis (VL). Objectives: The objective of this study was to assess primary health care physicians knowledge (PHP) and attitude about leishmaniasis and to assess awareness of local inhabitants about the disease and its vector in four areas in west Alexandria, Egypt. Methods: This study was a cross sectional survey that was conducted in four PHC units in west Alexandria. All physicians currently working in these units during the study period were invited to participate in the study, only 20 PHP completed the questionnaire. 60 local inhabitant were selected randomly from the four areas of the study, 15 from each area; Data was collected through two different specially designed questionnaires. Results: 11(55%) percent of the physicians had satisfactory knowledge, they answered more than 9 (60%) questions out of a total 14 questions about leishmaniasis and sandfly. The second part of the questionnaire is concerned with attitude of the primary health care physicians about leishmaniasis, 17 (85%) had good attitude and 3 (15%) had poor attitude. The second questionnaire showed that the awareness of local inhabitants about leishmaniasis and sandly as a vector of the disease is poor and needs to be corrected. Most of the respondents (90%) had not heard about leishmaniasis, Only 3 (5%) of the interviewed inhabitants said they know sandfly and its role in transmission of leishmaniasis. Conclusions: knowledge and attitudes of physicians are acceptable. However, there is, room for improvement and could be done through formal training courses and distribution of guidelines. In addition to raising the awareness of primary health care physicians about the importance of early detection and notification of cases of lesihmaniasis. Moreover, health education for raising awareness of the public regarding the vector and the disease is necessary because related studies have demonstrated that if the inhabitants do not perceive mosquitoes to be responsible for diseases such as malaria they do not take enough measures to protect themselves against the vector.

Keywords: leishmaniasis, PHP, knowledge, attitude, local inhabitants

Procedia PDF Downloads 433

Authors: Tony Jehi, Sujatha Rajaram, Nader majzoub, Joan Sabate

Abstract:

Aging significantly increases the incidence of various cardiometabolic diseases, including cardiovascular disease (CVD). To combat CVD and its associated risk factors, it is imperative to adopt a healthy dietary pattern that is rife with beneficial nutrient and non-nutrient compounds. Unsaturated fats, specifically n-3 polyunsaturated fatty acids (n-3 PUFA), have cardio-protective effects; the opposite is true for saturated fatty acids. What role, if any, does the biomarker of fatty acid intake (specific fatty acids in the erythrocyte) play in predicting cardiometabolic risk among the elderly, a population highly susceptible to increased mortality and morbidity from CVD risk factors, remains unclear. This was a secondary analysis of the Walnuts and Healthy Aging Study. Briefly, elderly (n=192, mean age 69 y) participants followed their usual diet and were randomized into two groups to either eat walnuts daily or abstain from eating walnuts for a period of 2 years. The purpose was to identify potential associations between erythrocyte membrane fatty acids and cardiometabolic risk factors (body weight, blood pressure, blood lipids, and fasting glucose). Erythrocyte n-3 PUFA were inversely associated with total cholesterol (ß = -3.83; p= 0.02), triglycerides (ß = -7.66; p= <0.01), and fasting glucose (ß = -0.19; p=0.03). Specifically, erythrocyte ALA (ß= -1.59; P = 0.04) and DPA (ß= -0.62; P=0.04) were inversely associated with diastolic blood pressure and fasting glucose, respectively. N-6 PUFAs were positively associated with systolic blood pressure (ß=1.10; P=0.02). Mono-unsaturated fatty acids were positively associated with TAG (ß = 4.16; P=0.03). Total saturated fatty acids were not associated with any cardiometabolic risk factors. No association was found between any erythrocyte fatty acid and body weight. In conclusion, erythrocyte n-3 PUFA may be used as a biomarker to predict the cardiometabolic risk among healthy elders, providing support for the American Heart Association guidelines for including n-3 PUFA for preventing CVD.

Keywords: cardiometabolic diseases, erythrocyte fatty acids, elderly, n-3 PUFA

Procedia PDF Downloads 60

Authors: Seema Dutt Bandhu, Yashi Bansal, Tania Moudgil, Barinder Kaur

Abstract:

Introduction: Scleral perforation during the passage of suture needle is a known complication of strabismus surgery. The present study was conducted to evolve a safe and easy technique of passing the suture needle through the sclera. A scleral tunnel was created with a 26-guage needle through which the suture needle was passed. The rest of the steps of strabismus surgery were carried out as usual. Material and Methods: After taking clearance from the Institutional Ethics Committee, an interventional study was carried out on twenty patients. The scleral tunnel technique was performed on the patients of strabismus after taking written informed consent. Before passing the suture needle through the sclera during strabismus surgery, a tunnel through approximately half the thickness of the sclera was created with the help of a bent 26-gauge needle. The suture needle was then passed through this tunnel. Rest of the steps of the surgery were carried out in the conventional manner. In a control group of same number of patients, the surgery was performed in the conventional method. Both the groups were followed up for any complications. Ease of passing suture and surgeons’ satisfaction with the technique was noted on a 10-point Likert scale. Results: None of the patients in either group suffered from any complications. Four surgeons participated in the study. The average Likert scale score of the surgeons for satisfaction with the technique was 4.5 on a scale of 5. The score for ease of passage of suture needle was 5 on a score of 5. Discussion: Scleral perforation during passing the sutures through the sclera is a known complication of strabismus surgery. Incidence reported is 7.8% It occurs due to inappropriate engagement of the scleral tissue or passage of the suture needle along a wrong axis during the process of passing the suture needle. The needle track technique eases the passage of passing the suture needle through the sclera as the engagement of the scleral tissue can be done with greater control with a 26-guage needle. The surgeons have reported that they are highly satisfied with the technique and they have reported that the technique eased the passage of the suture needle through the sclera.

Keywords: suture, scleral tunnel, strabismus, scleral perforation

Procedia PDF Downloads 66