Search results for: dose intensity
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 3124

Search results for: dose intensity

904 Drug Therapy Problems and Associated Factors among Patients with Heart Failure in the Medical Ward of Arba Minch General Hospital, Ethiopia

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

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903 Modeling of Thermo Acoustic Emission Memory Effect in Rocks of Varying Textures

Authors: Vladimir Vinnikov

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The paper proposes a model of an inhomogeneous rock mass with initially random distribution of microcracks on mineral grain boundaries. It describes the behavior of cracks in a medium under the effect of thermal field, the medium heated instantaneously to a predetermined temperature. Crack growth occurs according to the concept of fracture mechanics provided that the stress intensity factor K exceeds the critical value of Kc. The modeling of thermally induced acoustic emission memory effects is based on the assumption that every event of crack nucleation or crack growth caused by heating is accompanied with a single acoustic emission event. Parameters of the thermally induced acoustic emission memory effect produced by cyclic heating and cooling (with the temperature amplitude increasing from cycle to cycle) were calculated for several rock texture types (massive, banded, and disseminated). The study substantiates the adaptation of the proposed model to humidity interference with the thermally induced acoustic emission memory effect. The influence of humidity on the thermally induced acoustic emission memory effect in quasi-homogeneous and banded rocks is estimated. It is shown that such modeling allows the structure and texture of rocks to be taken into account and the influence of interference factors on the distinctness of the thermally induced acoustic emission memory effect to be estimated. The numerical modeling can be used to obtain information about the thermal impacts on rocks in the past and determine the degree of rock disturbance by means of non-destructive testing.

Keywords: crack growth, cyclic heating and cooling, rock texture, thermo acoustic emission memory effect

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902 Effect of Built in Polarization on Thermal Properties of InGaN/GaN Heterostructures

Authors: Bijay Kumar Sahoo

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An important feature of InₓGa₁-ₓN/GaN heterostructures is strong built-in polarization (BIP) electric field at the hetero-interface due to spontaneous (sp) and piezoelectric (pz) polarizations. The intensity of this electric field reaches several MV/cm. This field has profound impact on optical, electrical and thermal properties. In this work, the effect of BIP field on thermal conductivity of InₓGa₁-ₓN/GaN heterostructure has been investigated theoretically. The interaction between the elastic strain and built in electric field induces additional electric polarization. This additional polarization contributes to the elastic constant of InₓGa₁-ₓN alloy. This in turn modifies material parameters of InₓGa₁-ₓN. The BIP mechanism enhances elastic constant, phonon velocity and Debye temperature and their bowing constants in InₓGa₁-ₓN alloy. These enhanced thermal parameters increase phonon mean free path which boost thermal conduction process. The thermal conductivity (k) of InxGa1-xN alloy has been estimated for x=0, 0.1, 0.3 and 0.9. Computation finds that irrespective of In content, the room temperature k of InₓGa₁-ₓN/GaN heterostructure is enhanced by BIP mechanism. Our analysis shows that at a certain temperature both k with and without BIP show crossover. Below this temperature k with BIP field is lower than k without BIP; however, above this temperature k with BIP field is significantly contributed by BIP mechanism leading to k with BIP field become higher than k without BIP field. The crossover temperature is primary pyroelectric transition temperature. The pyroelectric transition temperature of InₓGa₁-ₓN alloy has been predicted for different x. This signature of pyroelectric nature suggests that thermal conductivity can reveal pyroelectricity in InₓGa₁-ₓN alloy. The composition dependent room temperature k for x=0.1 and 0.3 are in line with prior experimental studies. The result can be used to minimize the self-heating effect in InₓGa₁-ₓN/GaN heterostructures.

Keywords: built-in polarization, phonon relaxation time, thermal properties of InₓGa₁-ₓN /GaN heterostructure, self-heating

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901 An Assessment into Impact of Regional Conflicts upon Socio-Political Sustainability in Pakistan

Authors: Syed Toqueer Akhter, Muhammad Muzaffar Abbas

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Conflicts in Pakistan are a result of a configuration of factors, which are directly related to the system of the state, the unstable regional setting, and the geo-strategic location of Pakistan at large. This paper examines the impact of regional conflict onto the socio-political sustainability of Pakistan. The magnitude of the spillover from a conflicted region is similar in size of the equivalent increase in domestic conflict. Pakistan has gone at war three times with India; the border with India is named as the tensest borderlines of the world. Disagreements with India and lack of dispute settlement mechanisms have negatively effected the peace in the region, influx of illegal weapons and refugees from Afghanistan as an outcome of 9/11 incidence, have exasperated the criticality of levels of internal conflict in Pakistan. Our empirical findings are based on the data collected on regional conflict levels, regional trade, global trade, comparative defence capabilities of the region in contrast to Pakistan and the government regime (Autocratic, Democratic) over 1972-2007. It has been proposed in this paper that the intent of domestic conflict is associated with the conflict in the region, regional trade, global trade and the government regime of Pakistan. The estimated model (OLS) implies that domestic conflict is effected positively and significantly with long term impact of conflict in the region. Also, if defence capabilities of the region are better than that of Pakistan it effects domestic conflict positively and significantly. Conflict in neighbouring countries are found as a source of domestic conflict in Pakistan, whereas the regional trade as well as type of government regimes in Pakistan lowered the intensity of domestic conflict significantly, while globalized trade imply risk of domestic conflict to be reduced but not significantly.

Keywords: conflict, regional trade, socio-politcal instability

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900 Application of a Compact Wastewater Treatment Unit in a Rural Area

Authors: Mohamed El-Khateeb

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Encompassing inventory, warehousing, and transportation management, logistics is a crucial predictor of firm performance. This has been extensively proven by extant literature in business and operations management. Logistics is also a fundamental determinant of a country's ability to access international markets. Available studies in international and transport economics have shown that limited transport infrastructure and underperforming transport services can severely affect international competitiveness. However, the evidence lacks the overall impact of logistics performance-encompassing all inventory, warehousing, and transport components- on global trade. In order to fill this knowledge gap, the paper uses a gravitational trade model with 155 countries from all geographical regions between 2007 and 2018. Data on logistics performance is obtained from the World Bank's Logistics Performance Index (LPI). First, the relationship between logistics performance and a country’s total trade is estimated, followed by a breakdown by the economic sector. Then, the analysis is disaggregated according to the level of technological intensity of traded goods. Finally, after evaluating the intensive margin of trade, the relevance of logistics infrastructure and services for the extensive trade margin is assessed. Results suggest that: (i) improvements in both logistics infrastructure and services are associated with export growth; (ii) manufactured goods can significantly benefit from these improvements, especially when both exporting and importing countries increase their logistics performance; (iii) the quality of logistics infrastructure and services becomes more important as traded goods are technology-intensive; and (iv) improving the exporting country's logistics performance is essential in the intensive margin of trade while enhancing the importing country's logistics performance is more relevant in the extensive margin.

Keywords: low-cost, recycling, reuse, solid waste, wastewater treatment

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899 Effect of UV-B Light Treatment on Nutraceutical Potential of an Indigenous Mushroom Calocybe Indica

Authors: Himanshi Rathore, Shalinee Prasad, Satyawati Sharma, Ajay Singh Yadav

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Medicinal mushrooms are acceptable all over the world not only because they have a unique flavour and texture but also due to the presence of great nutritional, nutraceutical and functional properties. High content of physiologically active substances like ergosterol, vitamin D, phenolic compounds, triterpenoids and steroids make these medicinal mushrooms a key source of nutraceuticals. Calocybe indica is a popular medicinal mushroom of India which is known to possess high amount of secondary metabolites including ergosterol (vitamin D2). The ergosterol gets converted to vitamin D in the presence of UV rays by a photochemical reaction. In lieu of the above facts the present study was undertaken to investigate the effect of UV-B light treatment on the vitamin D2 concentration, phenolic content and non volatile compounds in Calocybe indica. For this study, UV-B light source of intensity 5.3w/m2 was used to expose mushrooms for the time period of 0min, 30min, 60min and 90 min. It was found that the vitamin D2 concentration increased with the time duration i.e. 85±0.15 (0 min), 182±1.6 (30 min), 187±0.4 (60 min) and 182 ±0.8 (90 min) μg/g (dry weight). Highest concentration of vitamin D2 was found at 60 min duration. No discoloration in sliced mushrooms was observed during the exposure time. The results revealed that the exposure of mushrooms for a minimum of 30 min duration under UVB source can be a novel, convenient and cheapest way to increase the vitamin D content in mushrooms. This can be one of richest source to fulfil the recommended dietary allowances of vitamin D in our daily diets. The paper provides information on the enhancement of vitamin D content by UV lights and its effects on the non volatile (soluble sugars, free amino acids, 5′-nucleotides and phenolics) compounds will also be presented.

Keywords: Calocybe indica, ergosterol, nutraceutical, phenolics

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898 Time-Dependent Reliability Analysis of Corrosion Affected Cast Iron Pipes with Mixed Mode Fracture

Authors: Chun-Qing Li, Guoyang Fu, Wei Yang

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A significant portion of current water networks is made of cast iron pipes. Due to aging and deterioration with corrosion being the most predominant mechanism, the failure rate of cast iron pipes is very high. Although considerable research has been carried out in the past few decades, most are on the effect of corrosion on the structural capacity of pipes using strength theory as the failure criterion. This paper presents a reliability-based methodology for the assessment of corrosion affected cast iron pipe cracking failures. A nonlinear limit state function taking into account all three fracture modes is proposed for brittle metal pipes with mixed mode fracture. A stochastic model of the load effect is developed, and time-dependent reliability method is employed to quantify the probability of failure and predict the remaining service life. A case study is carried out using the proposed methodology, followed by sensitivity analysis to investigate the effects of the random variables on the probability of failure. It has been found that the larger the inclination angle or the Mode I fracture toughness is, the smaller the probability of pipe failure is. It has also been found that the multiplying and exponential coefficients k and n in the power law corrosion model and the internal pressure have the most influence on the probability of failure for cast iron pipes. The methodology presented in this paper can assist pipe engineers and asset managers in developing a risk-informed and cost-effective strategy for better management of corrosion-affected pipelines.

Keywords: corrosion, inclined surface cracks, pressurized cast iron pipes, stress intensity

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897 Efficacy and Safety of Inhaled Nebulized Chemotherapy in Treatment of Patients with Newly Diagnosed Pulmonary Tuberculosis in Comparison to Standard Antimycobacterial Therapy

Authors: M. Kuzhko, M. Gumeniuk, D. Butov, T. Tlustova, O. Denysov, T. Sprynsian

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Abstract: The objective of this work was to study the efficacy and safety of inhaled nebulized chemotherapy in the treatment of patients with newly diagnosed pulmonary tuberculosis in comparison with standard antimycobacterial therapy. Materials and methods: The study involved 68 patients aged between 20 and 70 years with newly diagnosed pulmonary tuberculosis. Patients were allocated to two groups. The first (main, n=21) group of patients received standard chemotherapy and further 0.15 g of isoniazid and rifampicin 0.15 g inhaled through a nebulizer, also they received salmeterol 50 mcg + fluticasone propionate 250 mcg at 2 breaths twice a day for 2 months. The second (control, n=47) group of patients received standard chemotherapy, consisting of orally administered isoniazid (0.3 g), rifampicin (0.6 g), pyrazinamide (2 g), ethambutol (1.2 g) with a dose reduction after the intensive phase of the therapy. The anti-TB drugs were procured through the Ukraine’s centralized national supply system. Results: Intoxication symptoms in the first group reduced following 1.39±0.18 months, whereas in the second group, intoxication symptoms reduced following 2.7±0.1 months, p<.001. Moreover, respiratory symptoms regression in the first group was observed following 1.6±0.2 months, whereas in the second group – following 2.5±0.2 months, p<0.05. Bacillary excretion period evaluated within 1 month was reduced, as it was shown by 66.6±10.5% in the main group compared to 27.6±6.5%, p<0.05, in the control group. In addition, period of cavities healing was reduced to 2.9±0.2 months in the main group compared to 3.7±0.1 months, p<0.05, in the control group. Residual radiological lung damage findings (large residual changes) were observed in 22 (23.8±9.5 %) patients of the main group versus 24 (51.0±7.2 %) patients in the control group, p<0.05. After completion of treatment scar stenosis of the bronchi II-III art. diagnosed in 3 (14.2±7.8%) patients in main group and 17 (68.0±6.8%) - control group, p<0.05. The duration of hospital treatment was 2.4±0.4 months in main group and 4.1±0.4 months in control group, p<0.05. Conclusion: Administration of of inhaled nebulized chemotherapy in patients with newly diagnosed pulmonary tuberculosis resulted in a comparatively quick reduction of disease manifestation.

Keywords: inhaled nebulized chemotherapy, pulmonary tuberculosis, tuberculosis, treatment of tuberculosis

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896 Farmers' Perspective on Soil Health in the Indian Punjab: A Quantitative Analysis of Major Soil Parameters

Authors: Sukhwinder Singh, Julian Park, Dinesh Kumar Benbi

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Although soil health, which is recognized as one of the key determinants of sustainable agricultural development, can be measured by a range of physical, chemical and biological parameters, the widely used parameters include pH, electrical conductivity (EC), organic carbon (OC), plant available phosphorus (P) and potassium (K). Soil health is largely affected by the occurrence of natural events or human activities and can be improved by various land management practices. A database of 120 soil samples collected from farmers’ fields spread across three major agro-climatic zones of Punjab suggested that the average pH, EC, OC, P and K was 8.2 (SD = 0.75, Min = 5.5, Max = 9.1), 0.27 dS/m (SD = 0.17, Min = 0.072 dS/m, Max = 1.22 dS/m), 0.49% (SD = 0.20, Min = 0.06%, Max = 1.2%), 19 mg/kg soil (SD = 22.07, Min = 3 mg/kg soil, Max = 207 mg/kg soil) and 171 mg/kg soil (SD = 47.57, Min = 54 mg/kg soil, Max = 288 mg/kg soil), respectively. Region-wise, pH, EC and K were the highest in south-western district of Ferozpur whereas farmers in north-eastern district of Gurdaspur had the best soils in terms of OC and P. The soils in the central district of Barnala had lower OC, P and K than the respective overall averages while its soils were normal but skewed towards alkalinity. Besides agro-climatic conditions, the size of landholding and farmer education showed a significant association with Soil Fertility Index (SFI), a composite index calculated using the aforementioned parameters’ normalized weightage. All the four stakeholder groups cited the current cropping patterns, burning of rice crop residue, and imbalanced use of chemical fertilizers for change in soil health. However, the current state of soil health in Punjab is unclear, which needs further investigation based on temporal data collected from the same field to see the short and long-term impacts of various crop combinations and varied cropping intensity levels on soil health.

Keywords: soil health, punjab agriculture, sustainability, soil fertility index

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895 Low-Cost Monitoring System for Hydroponic Urban Vertical Farms

Authors: Francesco Ruscio, Paolo Paoletti, Jens Thomas, Paul Myers, Sebastiano Fichera

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This paper presents the development of a low-cost monitoring system for a hydroponic urban vertical farm, enabling its automation and a quantitative assessment of the farm performance. Urban farming has seen increasing interest in the last decade thanks to the development of energy efficient and affordable LED lights; however, the optimal configuration of such systems (i.e. amount of nutrients, light-on time, ambient temperature etc.) is mostly based on the farmers’ experience and empirical guidelines. Moreover, even if simple, the maintenance of such systems is labor intensive as it requires water to be topped-up periodically, mixing of the nutrients etc. To unlock the full potential of urban farming, a quantitative understanding of the role that each variable plays in the growth of the plants is needed, together with a higher degree of automation. The low-cost monitoring system proposed in this paper is a step toward filling this knowledge and technological gap, as it enables collection of sensor data related to water and air temperature, water level, humidity, pressure, light intensity, pH and electric conductivity without requiring any human intervention. More sensors and actuators can also easily be added thanks to the modular design of the proposed platform. Data can be accessed remotely via a simple web interface. The proposed platform can be used both for quantitatively optimizing the setup of the farms and for automating some of the most labor-intensive maintenance activities. Moreover, such monitoring system can also potentially be used for high-level decision making, once enough data are collected.

Keywords: automation, hydroponics, internet of things, monitoring system, urban farming

Procedia PDF Downloads 156
894 Adobe Attenuation Coefficient Determination and Its Comparison with Other Shielding Materials for Energies Found in Common X-Rays Procedures

Authors: Camarena Rodriguez C. S., Portocarrero Bonifaz A., Palma Esparza R., Romero Carlos N. A.

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Adobe is a construction material that fulfills the same function as a conventional brick. Widely used since ancient times, it is present in an appreciable percentage of buildings in Latin America. Adobe is a mixture of clay and sand. The interest in the study of the properties of this material arises due to its presence in the infrastructure of hospital´s radiological services, located in places with low economic resources, for the attenuation of radiation. Some materials such as lead and concrete are the most used for shielding and are widely studied in the literature. The present study will determine the mass attenuation coefficient of Adobe. The minimum required thicknesses for the primary and secondary barriers will be estimated for the shielding of radiological facilities where conventional and dental X-rays are performed. For the experimental procedure, an X-ray source emitted direct radiation towards different thicknesses of an Adobe barrier, and a detector was placed on the other side. For this purpose, an UNFORS Xi solid state detector was used, which collected information on the difference of radiation intensity. The initial parameters of the exposure started at 45 kV; and then the tube tension was varied in increments of 5 kV, reaching a maximum of 125 kV. The X-Ray tube was positioned at a distance of 0.5 m from the surface of the Adobe bricks, and the collimation of the radiation beam was set for an area of 0.15 m x 0.15 m. Finally, mathematical methods were applied to determine the mass attenuation coefficient for different energy ranges. In conclusion, the mass attenuation coefficient for Adobe was determined and the approximate thicknesses of the most common Adobe barriers in the hospital buildings were calculated for their later application in the radiological protection.

Keywords: Adobe, attenuation coefficient, radiological protection, shielding, x-rays

Procedia PDF Downloads 155
893 Assessing Native Plant Presence and Maintenance Resource Allocations in New Zealand Backyards: A Nationwide Online Questionnaire

Authors: Megan Burfoot, Shanta Budha-Magar, Ali Ghaffarianhoseini, Amirhoseini Ghaffarianhoseini

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Domestic backyards offer a valuable opportunity to contribute to biodiversity conservation efforts and promote ecological sustainability by cultivating native plant species. This study focuses on assessing the presence and maintenance of native plants in New Zealand's residential gardens through an online questionnaire. The survey was designed to collect data on the presence of native, exotic, and lawn plants in New Zealand backyards, alongside the allocation of maintenance resources for each category. Targeting a diverse range of residents and property sizes from different regions of New Zealand, this study sought to gain essential insights into practices related to native plant cultivation. Results reveal there is a collective inclination to reduce lawn coverage and introduce a higher abundance of native and exotic species. A thorough analysis of maintenance practices reveals a significant portion of respondents embracing environmentally friendly gardening, characterized by low-intensity fertilizer usage. Homeowners, especially those residing in their properties, demonstrate proactive engagement in backyard maintenance. Native plants were found to require more time, money and fertilizer for maintenance than those of exotic and lawn species. The insights gained from this study can guide targeted efforts to enhance urban biodiversity, making a significant contribution to the preservation and enrichment of New Zealand's unique biodiversity and ecological heritage in urban settings.

Keywords: biodiversity, backyards, planting behaviour, backyard maintenance, native planting

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892 Pain Management Program in Helping Community-Dwelling Older Adults and Their Informal Caregivers to Manage Pain and Related Situations

Authors: Mimi My Tse

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The prevalence of chronic non-cancer pain is high among community-dwelling older adults. Pain affects physical and psychosocial abilities. Older adults tend to be less mobile and have a high tendency to fall risk. In addition, older adults with pain are depressed, anxious, and not too willing to join social activities. This will make them feel very lonely and social isolation. Instead of giving pain management education and programs to older adults/clients, both older adults and their caregivers, it is sad to find that the majority of existing services are given to older adults only. Given the importance of family members in increasing compliance with health-promoting programs, we proposed to offer pain management programs to both older adults with his/her caregiver as a “dyad.” We used the Health Promotion Model and implemented a dyadic pain management program (DPM). The DPM is an 8-week group-based program. The DPM comprises 4 weeks of center-based, face-to-face activities and 4 weeks of digital-based activities delivered via a WhatsApp group. There were 30 dyads (15 in the experimental group with DPM and 15 in the control group with pain education pamphlets). Upon the completion of DPM, pain intensity and pain interference were significantly lower in the intervention group as compared to the control group. At the same time, physical function showed significant improvement and lower depression scores in the intervention group. In conclusion, the study highlights the potential benefits of involving caregivers in the management of chronic pain for older adults. This approach should be widely promoted in managing chronic pain situations for community-dwelling older adults and their caregivers.

Keywords: pain, older adults, dyadic approach, education

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891 Supervised Machine Learning Approach for Studying the Effect of Different Joint Sets on Stability of Mine Pit Slopes Under the Presence of Different External Factors

Authors: Sudhir Kumar Singh, Debashish Chakravarty

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Slope stability analysis is an important aspect in the field of geotechnical engineering. It is also important from safety, and economic point of view as any slope failure leads to loss of valuable lives and damage to property worth millions. This paper aims at mitigating the risk of slope failure by studying the effect of different joint sets on the stability of mine pit slopes under the influence of various external factors, namely degree of saturation, rainfall intensity, and seismic coefficients. Supervised machine learning approach has been utilized for making accurate and reliable predictions regarding the stability of slopes based on the value of Factor of Safety. Numerous cases have been studied for analyzing the stability of slopes using the popular Finite Element Method, and the data thus obtained has been used as training data for the supervised machine learning models. The input data has been trained on different supervised machine learning models, namely Random Forest, Decision Tree, Support vector Machine, and XGBoost. Distinct test data that is not present in training data has been used for measuring the performance and accuracy of different models. Although all models have performed well on the test dataset but Random Forest stands out from others due to its high accuracy of greater than 95%, thus helping us by providing a valuable tool at our disposition which is neither computationally expensive nor time consuming and in good accordance with the numerical analysis result.

Keywords: finite element method, geotechnical engineering, machine learning, slope stability

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890 The Effects of Transcranial Direct Current Stimulation on Brain Oxygenation and Pleasure during Exercise

Authors: Alexandre H. Okano, Pedro M. D. Agrícola, Daniel G. Da S. Machado, Luiz I. Do N. Neto, Luiz F. Farias Junior, Paulo H. D. Nascimento, Rickson C. Mesquita, John F. Araujo, Eduardo B. Fontes, Hassan M. Elsangedy, Shinsuke Shimojo, Li M. Li

Abstract:

The prefrontal cortex is involved in the reward system and the insular cortex integrates the afferent inputs arriving from the body’ systems and turns into feelings. Therefore, modulating neuronal activity in these regions may change individuals’ perception in a given situation such as exercise. We tested whether transcranial direct current stimulation (tDCS) change cerebral oxygenation and pleasure during exercise. Fourteen volunteer healthy adult men were assessed into five different sessions. First, subjects underwent to a maximum incremental test on a cycle ergometer. Then, subjects were randomly assigned to a transcranial direct current stimulation (2mA for 15 min) intervention in a cross over design in four different conditions: anode and cathode electrodes on T3 and Fp2 targeting the insular cortex, and Fpz and F4 targeting prefrontal cortex, respectively; and their respective sham. These sessions were followed by 30 min of moderate intensity exercise. Brain oxygenation was measured in prefrontal cortex with a near infrared spectroscopy. Perceived exertion and pleasure were also measured during exercise. The asymmetry in prefrontal cortex oxygenation before the stimulation decreased only when it was applied over this region which did not occur after insular cortex or sham stimulation. Furthermore, pleasure was maintained during exercise only after prefrontal cortex stimulation (P > 0.7), while there was a decrease throughout exercise (P < 0.03) during the other conditions. We conclude that tDCS over the prefrontal cortex changes brain oxygenation in ventromedial prefrontal cortex and maintains perceived pleasure during exercise. Therefore, this technique might be used to enhance effective responses related to exercise.

Keywords: affect, brain stimulation, dopamine neuromodulation, pleasure, reward, transcranial direct current stimulation

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889 Comparing the Embodied Carbon Impacts of a Passive House with the BC Energy Step Code Using Life Cycle Assessment

Authors: Lorena Polovina, Maddy Kennedy-Parrott, Mohammad Fakoor

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The construction industry accounts for approximately 40% of total GHG emissions worldwide. In order to limit global warming to 1.5 degrees Celsius, ambitious reductions in the carbon intensity of our buildings are crucial. Passive House presents an opportunity to reduce operational carbon by as much as 90% compared to a traditional building through improving thermal insulation, limiting thermal bridging, increasing airtightness and heat recovery. Up until recently, Passive House design was mainly concerned with meeting the energy demands without considering embodied carbon. As buildings become more energy-efficient, embodied carbon becomes more significant. The main objective of this research is to calculate the embodied carbon impact of a Passive House and compare it with the BC Energy Step Code (ESC). British Columbia is committed to increasing the energy efficiency of buildings through the ESC, which is targeting net-zero energy-ready buildings by 2032. However, there is a knowledge gap in the embodied carbon impacts of more energy-efficient buildings, in particular Part 3 construction. In this case study, life cycle assessments (LCA) are performed on Part 3, a multi-unit residential building in Victoria, BC. The actual building is not constructed to the Passive House standard; however, the building envelope and mechanical systems are designed to comply with the Passive house criteria, as well as Steps 1 and 4 of the BC Energy Step Code (ESC) for comparison. OneClick LCA is used to perform the LCA of the case studies. Several strategies are also proposed to minimize the total carbon emissions of the building. The assumption is that there will not be significant differences in embodied carbon between a Passive House and a Step 4 building due to the building envelope.

Keywords: embodied carbon, energy modeling, energy step code, life cycle assessment

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888 Growth of Metal Oxide (Tio2/Ag) Thin Films Sputtered by Hipims Effective in Bacterial Inactivation: Plasma Chemistry and Energetic

Authors: O. Baghriche, A. Zertal, C. Pulgarin, J. Kiwi, R. Sanjines

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High-Power Impulse Magnetron Sputtering (HIPIMS) is a technology that belongs to the field of Ionized PVD of thin films. This study shows the first complete report on ultrathin TiO2/Ag nano-particulate films sputtered by highly ionized pulsed plasma magnetron sputtering (HIPIMS) leading to fast bacterial loss of viability. The Ag and the TiO2/Ag sputtered films induced complete Escherichia coli inactivation in the dark, which was not observed in the case of TiO2. When Ag was present, the bacterial inactivation was accelerated under low intensity solar simulated light and this has implications for a potential for a practical technology. The design, preparation, testing and surface characterization of these innovative films are described in this study. The HIPIMS sputtered composite films present an appreciable savings in metals compared to films obtained by conventional sputtering methods. HIPIMS sputtering induces a strong interaction with the rugous polyester 3-D structure due to the higher fraction of the Ag-ions (M+) attained in the magnetron chamber. The immiscibility of Ag and TiO2 in the TiO2/Ag films is shown by High Angular Dark Field (HAADF) microscopy. The ionization degree of the film forming species is significantly increased and film growth is assisted by an intense ion flux. Reports have revealed the significant enhancement of the film properties as the HIPIMS technology is used. However, a decrease of the deposition rate, as compared to the conventional DC magnetron sputtering Pulsed (DCMSP) process is commonly observed during HIPIMS.

Keywords: E. coli, HIPIMS, inactivation bacterial, sputtering

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887 Optimal Parameters of Two-Color Ionizing Laser Pulses for Terahertz Generation

Authors: I. D. Laryushin, V. A. Kostin, A. A. Silaev, N. V. Vvedenskii

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Generation of broadband intense terahertz (THz) radiation attracts reasonable interest due to various applications, such as the THz time-domain spectroscopy, the probing and control of various ultrafast processes, the THz imaging with subwavelength resolution, and many others. One of the most promising methods for generating powerful and broadband terahertz pulses is based on focusing two-color femtosecond ionizing laser pulses in gases, including ambient air. For this method, the amplitudes of terahertz pulses are determined by the free-electron current density remaining in a formed plasma after the passage of the laser pulse. The excitation of this residual current density can be treated as multi-wave mixing: Аn effective generation of terahertz radiation is possible only when the frequency ratio of one-color components in the two-color pulse is close to irreducible rational fraction a/b with small odd sum a + b. This work focuses on the optimal parameters (polarizations and intensities) of laser components for the strongest THz generation. The optimal values of parameters are found numerically and analytically with the use of semiclassical approach for calculating the residual current density. For frequency ratios close to a/(a ± 1) with natural a, the strongest THz generation is shown to take place when the both laser components have circular polarizations and equal intensities. For this optimal case, an analytical formula for the residual current density was derived. For the frequency ratios such as 2/5, the two-color ionizing pulses with circularly polarized components practically do not excite the residual current density. However, the optimal parameters correspond generally to specific elliptical (not linear) polarizations of the components and intensity ratios close to unity.

Keywords: broadband terahertz radiation, ionization, laser plasma, ultrashort two-color pulses

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886 Comparison Of Virtual Non-Contrast To True Non-Contrast Images Using Dual Layer Spectral Computed Tomography

Authors: O’Day Luke

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Purpose: To validate virtual non-contrast reconstructions generated from dual-layer spectral computed tomography (DL-CT) data as an alternative for the acquisition of a dedicated true non-contrast dataset during multiphase contrast studies. Material and methods: Thirty-three patients underwent a routine multiphase clinical CT examination, using Dual-Layer Spectral CT, from March to August 2021. True non-contrast (TNC) and virtual non-contrast (VNC) datasets, generated from both portal venous and arterial phase imaging were evaluated. For every patient in both true and virtual non-contrast datasets, a region-of-interest (ROI) was defined in aorta, liver, fluid (i.e. gallbladder, urinary bladder), kidney, muscle, fat and spongious bone, resulting in 693 ROIs. Differences in attenuation for VNC and TNV images were compared, both separately and combined. Consistency between VNC reconstructions obtained from the arterial and portal venous phase was evaluated. Results: Comparison of CT density (HU) on the VNC and TNC images showed a high correlation. The mean difference between TNC and VNC images (excluding bone results) was 5.5 ± 9.1 HU and > 90% of all comparisons showed a difference of less than 15 HU. For all tissues but spongious bone, the mean absolute difference between TNC and VNC images was below 10 HU. VNC images derived from the arterial and the portal venous phase showed a good correlation in most tissue types. The aortic attenuation was somewhat dependent however on which dataset was used for reconstruction. Bone evaluation with VNC datasets continues to be a problem, as spectral CT algorithms are currently poor in differentiating bone and iodine. Conclusion: Given the increasing availability of DL-CT and proven accuracy of virtual non-contrast processing, VNC is a promising tool for generating additional data during routine contrast-enhanced studies. This study shows the utility of virtual non-contrast scans as an alternative for true non-contrast studies during multiphase CT, with potential for dose reduction, without loss of diagnostic information.

Keywords: dual-layer spectral computed tomography, virtual non-contrast, true non-contrast, clinical comparison

Procedia PDF Downloads 136
885 Next Generation UK Storm Surge Model for the Insurance Market: The London Case

Authors: Iacopo Carnacina, Mohammad Keshtpoor, Richard Yablonsky

Abstract:

Non-structural protection measures against flooding are becoming increasingly popular flood risk mitigation strategies. In particular, coastal flood insurance impacts not only private citizens but also insurance and reinsurance companies, who may require it to retain solvency and better understand the risks they face from a catastrophic coastal flood event. In this context, a framework is presented here to assess the risk for coastal flooding across the UK. The area has a long history of catastrophic flood events, including the Great Flood of 1953 and the 2013 Cyclone Xaver storm, both of which led to significant loss of life and property. The current framework will leverage a technology based on a hydrodynamic model (Delft3D Flexible Mesh). This flexible mesh technology, coupled with a calibration technique, allows for better utilisation of computational resources, leading to higher resolution and more detailed results. The generation of a stochastic set of extra tropical cyclone (ETC) events supports the evaluation of the financial losses for the whole area, also accounting for correlations between different locations in different scenarios. Finally, the solution shows a detailed analysis for the Thames River, leveraging the information available on flood barriers and levees. Two realistic disaster scenarios for the Greater London area are simulated: In the first scenario, the storm surge intensity is not high enough to fail London’s flood defences, but in the second scenario, London’s flood defences fail, highlighting the potential losses from a catastrophic coastal flood event.

Keywords: storm surge, stochastic model, levee failure, Thames River

Procedia PDF Downloads 229
884 Temporal Transformation of Built-up Area and its Impact on Urban Flooding in Hyderabad, India

Authors: Subbarao Pichuka, Amar Balakrishna Tej, Vikas Vemula

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In recent years, the frequency and intensity of urban floods have increased due to climate change all over the world provoking a significant loss in terms of human lives and property. This study investigates the effect of Land Use and Land Cover (LULC) changes and population growth on the urban environmental conditions in the Indian metropolitan city namely Hyderabad. The centennial built-up area data have been downloaded from the Global Human Settlement Layer (GHSL) web portal for various periods (1975 to 2014). The ArcGIS version 10.8 software is employed to convert the GHSL data into shape files and also to calculate the amount of built-up area in the study locations. The decadal population data are obtained from the Census from 1971 to 2011 and forecasted for the required years (1975 and 2014) utilizing the Geometric Increase Method. Next, the analysis has been carried out with respect to the increase in population and the corresponding rise in the built-up area. Further the effects of extreme rainfall events, which exacerbate urban flooding have also been reviewed. Results demonstrate that the population growth was the primary cause of the increase in impervious surfaces in the urban regions. It in turn leads to the intensification of surface runoff and thereby leads to Urban flooding. The built-up area has been doubled from 1975 to 2014 and the population growth has been observed between 109.24% to 400% for the past four decades (1971 to 2014) in the study area (Hyderabad). Overall, this study provides the hindsight on the current urban flooding scenarios, and the findings of this study can be used in the future planning of cities.

Keywords: urban LULC change, urban flooding, GHSL built-up data, climate change, ArcGIS

Procedia PDF Downloads 79
883 A Review: Role of Chromium in Broiler

Authors: Naveed Zahra, Zahid Kamran, Shakeel Ahmad

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Heat stress is one of the most important environmental stressors challenging poultry production worldwide. The detrimental effect of heat stress results in reduction in the productive performance of poultry with high incidences of mortality. Researchers have made efforts to prevent such damage to poultry production through dietary manipulation. Supplementation with Chromium (Cr) might have some positive effects on some aspect of blood parameters and broilers performance. Chromium (Cr) the element whose trivalent Cr (III) organic state is present in trace amounts in animal feed and water is found to be a key element in evading heat stress and thus cutting down the heavy expenditure on air conditioning in broiler sheds. Chromium, along with other essential minerals is lost due to increased excretion during heat stress and thus its inclusion in broiler diet is kind of mandatory in areas of hot climate. Chromium picolinate in broiler diet has shown a hike in growth rate including muscle gain with body fat reduction under environmental stress. Fat reduction is probably linked to the ability of chromium to increase the sensitivity of the insulin receptors on tissues and thus the uptake of sugar from blood increases which decreases the amount of glucose to be converted to amino acids and stored in adipose tissue as triglycerides. Organic chromium has also shown to increase lymphocyte proliferation rate and antioxidant levels. So, the immune competency, muscle gain and fat reduction along with evasion of heat stress are good enough signs that indicate the fruitful inclusion of dietary chromium for broiler. This promising element may bring the much needed break in the local poultry industry. The task is now to set the exact dose of the element in the diet that would be useful enough and still not toxic to broiler. In conclusion there is a growing body of evidence which suggest that chromium may be an essential trace element for livestock and poultry. The nutritional requirement for chromium may vary with different species and physiological state within a species.

Keywords: broiler, chromium, heat stress, performance

Procedia PDF Downloads 277
882 Nanopriming Potential of Metal Nanoparticles against Internally Seed Borne Pathogen Ustilago triciti

Authors: Anjali Sidhu, Anju Bala, Amit Kumar

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Metal nanoparticles have the potential to revolutionize the agriculture owing to sizzling interdisciplinary nano-technological application domain. Numerous patents and products incorporating engineered nanoparticles (NPs) entered into agro-applications with the collective goal to promote proficiency as well as sustainability with lower input and generating meager waste than conventional products and approaches. Loose smut of wheat caused by Ustilago segetum tritici is an internally seed-borne pathogen. It is dormant in the seed unless the seed germinates and its symptoms are expressed at the reproductive stage of the plant only. Various seed treatment agents are recommended for this disease but due to the inappropriate methods of seed treatments used by farmers, each and every seed may not get treated, and the infected seeds escape the fungicidal action. The antimicrobial potential and small size of nanoparticles made them the material of choice as they could enter each seed and restrict the pathogen inside the seed due to the availability of more number of nanoparticles per unit volume of the nanoformulations. Nanoparticles of diverse nature known for their in vitro antimicrobial activity viz. ZnO, MgO, CuS and AgNPs were synthesized, surface modified and characterized by traditional methods. They were applied on infected wheat seeds which were then grown in pot conditions, and their mycelium was tracked in the shoot and leaf region of the seedlings by microscopic staining techniques. Mixed responses of inhibition of this internal mycelium were observed. The time and method of application concluded to be critical for application, which was optimised in the present work. The results implicated that there should be field trails to get final fate of these pot trails up to commercial level. The success of their field trials could be interpreted as a revolution to replace high dose organic fungicides of high residue behaviour.

Keywords: metal nanoparticles, nanopriming, seed borne pathogen, Ustilago segetum tritici

Procedia PDF Downloads 141
881 Identification of Toxic Metal Deposition in Food Cycle and Its Associated Public Health Risk

Authors: Masbubul Ishtiaque Ahmed

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Food chain contamination by heavy metals has become a critical issue in recent years because of their potential accumulation in bio systems through contaminated water, soil and irrigation water. Industrial discharge, fertilizers, contaminated irrigation water, fossil fuels, sewage sludge and municipality wastes are the major sources of heavy metal contamination in soils and subsequent uptake by crops. The main objectives of this project were to determine the levels of minerals, trace elements and heavy metals in major foods and beverages consumed by the poor and non-poor households of Dhaka city and assess the dietary risk exposure to heavy metal and trace metal contamination and potential health implications as well as recommendations for action. Heavy metals are naturally occurring elements that have a high atomic weight and a density of at least 5 times greater than that of water. Their multiple industrial, domestic, agricultural, medical and technological applications have led to their wide distribution in the environment; raising concerns over their potential effects on human health and the environment. Their toxicity depends on several factors including the dose, route of exposure, and chemical species, as well as the age, gender, genetics, and nutritional status of exposed individuals. Because of their high degree of toxicity, arsenic, cadmium, chromium, lead, and mercury rank among the priority metals that are of public health significance. These metallic elements are considered systemic toxicants that are known to induce multiple organ damage, even at lower levels of exposure. This review provides an analysis of their environmental occurrence, production and use, potential for human exposure, and molecular mechanisms of toxicity, and carcinogenicity.

Keywords: food chain, determine the levels of minerals, trace elements, heavy metals, production and use, human exposure, toxicity, carcinogenicity

Procedia PDF Downloads 279
880 Chemopreventive and Therapeutic Efficacy of Salsola inermis Extract against N-Nitrosodiethylamine-Initiated and Phenobarbital-Promoted Hepatocellular Carcinogenesis in Wistar Rats

Authors: Ahlam H. Mahmoud, Samir F. Zohny, Ibrahim H. Boraia, Faten S. Bayoumic, Eman Eissa

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Hepatocellular carcinoma is one of the most common cancers worldwide and is known to be resistant to conventional chemotherapy. Therefore, we aimed to assess the Salsola inermis extract as a novel chemopreventive and/or therapeutic agent against N-nitrosodiethylamine (DNE)/phenobarbital (PB)-induced hepatocarcinogenesis in rats. Adult male Wistar albino rats were divided into five groups: group1 rats were served as normal controls; group 2 rats were injected intraperitoneally with S. inermis extract (100 mg/kg body weight/day) for 20 weeks; group 3 rats were subjected to two-phase hepatocarcinogenic regimen (initiation of hepatocarcinogenesis was performed by a single intraperitoneal injection of DEN at a dose of 200 mg/kg body weight, 2 weeks later, the carcinogenic effect was promoted by supplementation of rats with 0.05% PB for 16 weeks); group 4 rats were injected intraperitoneally with S. inermis extract 2 weeks prior to the injection of DEN, the daily injection of S. inermis extract was then continued for 18 weeks along with two-phase hepatocarcinogenic regimen (chemoprevention group); and group 5 rats were subjected to the two-phase hepatocarcinogenic regimen, and then, the animals were injected intraperitoneally with S. inermis extract for 4 weeks (treatment group). The activities of serum liver enzymes and levels of total bilirubin, conjugated bilirubin, α-fetoprotein, vascular endothelial growth factor (VEGF) and soluble intercellular adhesion molecule-1 (sICAM-1) in serum were decreased in chemopreventive and treated rats compared with DEN/PB-administered rats. Interestingly, the serum levels of total protein and albumin were normalized in chemopreventive and treated rats. Moreover, the majority of chemopreventive and treated rats showed an almost normal histological pattern of liver. In conclusion, S. inermis extract possessed chemopreventive and therapeutic activities against hepatocarcinogenesis in rats partially through the inhibition of VEGF and sICAM-1.

Keywords: Salsola inermis extract, hepatocarcinogenesis, α–fetoprotein, VEGF, sICAM-1

Procedia PDF Downloads 365
879 Physical Activity, Exercise and Physical Fitness in Different Generation

Authors: Carl J. Caspersen, Kenneth E. Powell, Gregory M. Christenson, Kirupa V. Patel

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‘Physical activity’, ‘exercise’, and ‘physical fitness’ are terms that describe different concepts. However, they are often confused with one another, and the terms are sometimes used interchangeably. This paper proposes definitions to distinguish them. Physical activity is defined as any bodily movement produced by skeletal muscles that result in energy expenditure. The energy expenditure can be measured in kilocalories. Physical activity in daily life can be categorized into occupational, sports, Conditioning, household, or other activities. Exercise is a subset of physical activity that is planned, structured, and repetitive and has as a final or an intermediate objective the improvement or maintenance of physical fitness. Physical fitness is a set of attributes that are either health- or skill-related. The degree to which people have these attributes can be measured with specific tests. These definitions are offered as an interpretational framework for comparing studies that relate physical activity, exercise, and physical fitness to health. Physical activity is defined as any bodily movement produced by skeletal muscles that require energy expenditure. Physical inactivity has been identified as the fourth leading risk factor for global mortality causing an estimated 3.2 million deaths globally. Regular moderate intensity physical activity – such as walking, cycling, or participating in sports – has significant benefits for health. For instance, it can reduce the risk of cardiovascular diseases, diabetes, colon and breast cancer, and depression. Moreover, adequate levels of physical activity will decrease the risk of a hip or vertebral fracture and help control weight. Any bodily movement produced by the contraction of skeletal muscle that increases energy expenditure above a basal level. In these guidelines, physical activity generally refers to the subset of physical activity that enhances health.

Keywords: physical activity, exercise, physical fitness, sports

Procedia PDF Downloads 355
878 Peculiarities of Internal Friction and Shear Modulus in 60Co γ-Rays Irradiated Monocrystalline SiGe Alloys

Authors: I. Kurashvili, G. Darsavelidze, T. Kimeridze, G. Chubinidze, I. Tabatadze

Abstract:

At present, a number of modern semiconductor devices based on SiGe alloys have been created in which the latest achievements of high technologies are used. These devices might cause significant changes to networking, computing, and space technology. In the nearest future new materials based on SiGe will be able to restrict the A3B5 and Si technologies and firmly establish themselves in medium frequency electronics. Effective realization of these prospects requires the solution of prediction and controlling of structural state and dynamical physical –mechanical properties of new SiGe materials. Based on these circumstances, a complex investigation of structural defects and structural-sensitive dynamic mechanical characteristics of SiGe alloys under different external impacts (deformation, radiation, thermal cycling) acquires great importance. Internal friction (IF) and shear modulus temperature and amplitude dependences of the monocrystalline boron-doped Si1-xGex(x≤0.05) alloys grown by Czochralski technique is studied in initial and 60Co gamma-irradiated states. In the initial samples, a set of dislocation origin relaxation processes and accompanying modulus defects are revealed in a temperature interval of 400-800 ⁰C. It is shown that after gamma-irradiation intensity of relaxation internal friction in the vicinity of 280 ⁰C increases and simultaneously activation parameters of high temperature relaxation processes reveal clear rising. It is proposed that these changes of dynamical mechanical characteristics might be caused by a decrease of the dislocation mobility in the Cottrell atmosphere enriched by the radiation defects.

Keywords: internal friction, shear modulus, gamma-irradiation, SiGe alloys

Procedia PDF Downloads 137
877 High Aspect Ratio Sio2 Capillary Based On Silicon Etching and Thermal Oxidation Process for Optical Modulator

Authors: Nguyen Van Toan, Suguru Sangu, Tetsuro Saito, Naoki Inomata, Takahito Ono

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This paper presents the design and fabrication of an optical window for an optical modulator toward image sensing applications. An optical window consists of micrometer-order SiO2 capillaries (porous solid) that can modulate transmission light intensity by moving the liquid in and out of porous solid. A high optical transmittance of the optical window can be achieved due to refractive index matching when the liquid is penetrated into the porous solid. Otherwise, its light transmittance is lower because of light reflection and scattering by air holes and capillary walls. Silicon capillaries fabricated by deep reactive ion etching (DRIE) process are completely oxidized to form the SiO2 capillaries. Therefore, high aspect ratio SiO2 capillaries can be achieved based on silicon capillaries formed by DRIE technique. Large compressive stress of the oxide causes bending of the capillary structure, which is reduced by optimizing the design of device structure. The large stress of the optical window can be released via thin supporting beams. A 7.2 mm x 9.6 mm optical window area toward a fully integrated with the image sensor format is successfully fabricated and its optical transmittance is evaluated with and without inserting liquids (ethanol and matching oil). The achieved modulation range is approximately 20% to 35% with and without liquid penetration in visible region (wavelength range from 450 nm to 650 nm).

Keywords: thermal oxidation process, SiO2 capillaries, optical window, light transmittance, image sensor, liquid penetration

Procedia PDF Downloads 484
876 Sustainable Water Supply: Rainwater Harvesting as Flood Reduction Measures in Ibadan, Nigeria

Authors: Omolara Lade, David Oloke

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Ibadan City suffers serious water supply problems; cases of dry taps are common in virtually every part of the City. The scarcity of piped water has made communities find alternative water sources; groundwater sources being a ready source. These wells are prone to pollution due to the close proximity of septic tanks to wells, disposal of solid or liquid wastes in pits, abandoned boreholes or even stream channels and landfills. Storms and floods in Ibadan have increased with consequent devastating effects claiming over 120 lives and displacing 600 people on August 2011 alone. In this study, an analysis of the water demand and sources of supply for the city was carried out through questionnaire survey and collection of data from City’s main water supply - Water Corporation of Oyo State (WCOS), groundwater sources were explored and 30 years rainfall data were collected from Meteorological station in Ibadan. 1067 questionnaire were administered at household level with a response rate of 86.7 %. A descriptive analysis of the survey revealed that 77.1 % of the respondents did not receive water at all from WCOS while 83.8 % depend on groundwater sources. Analysis of data from WCOS revealed that main water supply is inadequate as < 10 % of the population water demand was met. Rainfall intensity is highest in June with a mean value of 188 mm, which can be harvested at community—based level and used to complement the population water demand. Rainwater harvesting if planned, and managed properly will become a valuable alternative source of managing urban flood and alleviating water scarcity in the city.

Keywords: Ibadan, rainwater harvesting, sustainable water, urban flooding

Procedia PDF Downloads 176
875 Management of Severe Asthma with Omalizumab in United Arab Emirates

Authors: Shanza Akram, Samir Salah, Imran Saleem, Jassim Abdou, Ashraf Al Zaabi

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Estimated prevalence of asthma in UAE is around 10% (900,000 people). Patients with persistent symptoms despite using high dose ICS plus a second controller +/- Oral steroids are considered to have severe asthma. Omalizumab (Xolair) is an anti-IgE monoclonal antibody approved as add-on therapy for severe allergic asthma. The objective of our study was to obtain baseline characteristics of our local cohort, to determine the efficacy of omalizumab based on clinical outcomes pre and post 52 weeks of treatment and to assess safety and tolerability. Medical records of patients receiving omalizumab therapy for asthma at Zayed Military Hospital, Abu Dhabi were retrospectively reviewed. Patients fulfilling the criteria for severe allergic asthma as per GINA guidelines were included. Asthma control over 12 months pre and post omalizumab were analyzed by taking into account the number of exacerbations, hospitalizations, maintenance of medication dosages, the need for reliever therapy and PFT’s. 21 patients (5 females) with mean age 41 years were included. The mean duration of therapy was 22 months. 19 (91%) patients had Allergic Rhinitis/Sinusitis. Mean serum total IgE level was 648 IU/ml (65-1859). 11 (52%) patients were on oral maintenance steroids pre-treatment. 7 patients managed to stop steroids on treatment while 4 were able to decrease the dosage. Mean exacerbation rate decreased from 5 per year pre-treatment to 1.36 while on treatment. The number of hospitalizations decreased from a mean of 2 per year to 0.9 per year. Reliever inhaler usage decreased from mean of 40 to 15 puffs per week.2 patients discontinued therapy, 1 due to lack of benefit (2 doses) and 2nd due to severe persistent side effects. Patient compliance was poor in some cases. Treatment with omalizumab reduced the number of exacerbations, hospitalizations, maintenance and reliever medications, and is generally well tolerated. Our results show that there is room for improved documentation in terms of symptom recording and use of rescue medication at our institution. There is also need for better patient education and counseling in order to improve compliance.

Keywords: asthma, exacerbations, omalizumab, IgE

Procedia PDF Downloads 368