Search results for: pulmonary ventilation

Authors: Shivakumar M, Leslie Edward S Lewis, Shashikala Devadiga, Sonia Khurana

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Introduction: Methylxanthines are used for the treatment of AOP, to facilitate extubation and as a prophylactic agent to prevent apnea. Though the popularity of Caffeine has risen, it is expensive in a resource constrained developing countries like India. Objective: To evaluate the cost-effectiveness of Caffeine compared with Aminophylline treatment for AOP with respect to additional ventilatory resource utilized in different birth weight categorization. Design, Settings and Participants – Single centered, retrospective economic evaluation was done. Participants included preterm newborns with < 34 completed weeks of gestation age that were recruited under an Indian Council of Medical Research funded randomized clinical trial. Per protocol data was included from Neonatal Intensive Care Unit, Kasturba Hospital, Manipal, India between April 2012 and December 2014. Exposure: Preterm neonates were randomly allocated to either Caffeine or Aminophylline as per the trial protocol. Outcomes and Measures – We assessed surfactant requirement, duration of Invasive and Non-Invasive Ventilation, Total Methylxanthine cost and additional cost for respiratory support bared by the payers per day during hospital stay. For the purpose of this study Newborns were stratified as Category A – < 1000g, Category B – 1001 to 1500g and Category C – 1501 to 2500g. Results: Total 146 (Caffeine -72 and Aminophylline – 74) babies with Mean ± SD gestation age of 29.63 ± 1.89 weeks were assessed. 32.19% constitute of Category A, 55.48% were B and 12.33% were C. The difference in median duration of additional NIV and IMV support was statistically insignificant. However 60% of neonates who received Caffeine required additional surfactant therapy (p=0.02). The total median (IQR) cost of Caffeine was significantly high with Rs.10535 (Q3-6317.50, Q1-15992.50) where against Aminophylline cost was Rs.352 (Q3-236, Q1-709) (p < 0.001). The additional costs spent on respiratory support per day in neonates on either Methylxanthines were found to be statistically insignificant in the entire weight based category of our study. Whereas in Category B, the median O2 charges per day were found to have more in Caffeine treated newborns (p=0.05) with border line significance. In category A, providing one day NIV or IMV support significantly increases the unit log cost of Caffeine by 13.6% (CI – 95% ranging from 4 to 24; p=0.005) over log cost of Aminophylline. Conclusion: Cost of Caffeine is expensive than Aminophylline. It was found to be equally efficacious in reducing the number duration of NIV or IMV support. However adjusted with the NIV and IMV days of support, neonates fall in category A and category B who were on Caffeine pays excess amount of respiratory charges per day over aminophylline. In perspective of resource poor settings Aminophylline is cost saving and economically approachable.

Keywords: methylxanthines include caffeine and aminophylline, AOP (apnea of prematurity), IMV (invasive mechanical ventilation), NIV (non invasive ventilation), category a – <1000g, category b – 1001 to 1500g and category c – 1501 to 2500g

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Authors: Authors: A. Lakhal, M. Bahalou, A. Khattabi

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Introduction: Tuberculosis is one of the world's deadliest infectious diseases. In Morocco, a total of 30,636 cases of Tuberculosis, all forms combined, were reported in 2015, representing an incidence of 89 cases per 100,000 population. The number of deaths from tuberculosis (TB) was 656 cases. In the prefecture of Meknes, its incidence remains high compared to the national level. The objective of this work is to describe the epidemiological profile of tuberculosis in the prefecture of Meknes. Methods: It is a descriptive analysis of TB cases reported between 2016 and 2020 at the regional diagnostic center of tuberculosis and respiratory diseases. We performed analysis by using Microsoft Excel and EpiInfo 7. Results: Epidemiological data from 2016 to 2020 report a total of 4100 new cases of all forms of tuberculosis, with an average of 820 new cases per year. The median age is 32 years. There is a clear male predominance, on average 58% of cases are male and 42% female. The incidence rate of bacteriologically confirmed tuberculosis per 100,000 inhabitants has increased from 35 cases per 100,000 inhabitants in 2016 to 39.4 cases per 100,000 inhabitants in 2020. The confirmation rate for pulmonary tuberculosis decreased from 84% in 2016 to 75% in 2020. Pulmonary involvement predominates by an average of 46%, followed by lymph node involvement 29%and pleural involvement by an average of 10%. Digestive, osteoarticular, genitourinary, and meningeal involvement occurs in 8% of cases. Primary tuberculosis infection occurs in an average of 0.5% of cases. The proportion of HIV-TB co-infections was 2.8 in 2020. Conclusion: The incidence of tuberculosis in Meknes remains high compared to the national level. Thus, it is imperative to reinforce the earlier detection; improve the contact tracing, detection methods of cases for their confirmation and treatment, and to reduce the proportion of the lost to follow up as well.

Keywords: tuberculosis, epidemiological profile, meknes, morocco

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Authors: Williams A. Adu, Cynthia A. Danquah, Paul P. S. Ossei, Selase Ativui, Michael Ofori, James Asenso, George Owusu

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Background Silicosis is an occupational disease of the lung that is caused by chronic exposure to silica dust. There is a higher frequency of co-existence of silicosis with tuberculosis (TB), ultimately resulting in lung fibrosis and respiratory failure. Chronic intake of synthetic drugs has resulted in undesirable side effects. Diosgenin is a steroidal saponin that has been shown to exert a therapeutic effect on lung injury. Therefore, we investigated the ability of diosgenin to reduce the susceptibility of silica-induced TB in rats. Method Silicosis was induced by intratracheal instillation of 50 mg/kg crystalline silica in Sprague Dawley rats. Different doses of diosgenin (1, 10, and 100 mg/kg), Mycobacterium smegmatis and saline were administered for 30 days. Afterwards, 5 of the rats from each group were sacrificed, and the 5 remaining rats in each group, except the control, received Mycobacterium smegmatis. Treatment of diosgenin continued until the 50th day, and the rats were sacrificed at the end of the experiment. The result was analysed using a one-way analysis of variance (ANOVA) with a Graph-pad prism Result At a half-maximal inhibition concentration of 48.27 µM, diosgenin inhibited the growth of Mycobacterium smegmatis. There was a marked decline in the levels of immune cell infiltration and cytokines production. Lactate dehydrogenase and total protein levels were significantly reduced compared to control. There was an increase in the survival rate of the treatment group compared to the control. Conclusion Diosgenin ameliorated silica-induced pulmonary tuberculosis by declining the levels of inflammatory and pro-inflammatory cytokines and, in effect, significantly reduced the susceptibility of rats to pulmonary TB.

Keywords: silicosis, tuberculosis, diosgenin, fibrosis, crystalline silica

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Authors: Pegah Ebrahimi, Farshad Oveissi, Iman Manavi-Tehrani, Sina Naficy, David F. Fletcher, Fariba Dehghani, David S. Winlaw

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Despite advances in modern surgery, congenital heart disease remains a medical challenge and a major cause of infant mortality. Cardiovascular prostheses are routinely used in surgical procedures to address congenital malformations, for example establishing a pathway from the right ventricle to the pulmonary arteries in pulmonary valvar atresia. Current off-the-shelf options including human and adult products have limited biocompatibility and durability, and their fixed size necessitates multiple subsequent operations to upsize the conduit to match with patients’ growth over their lifetime. Non-physiological blood flow is another major problem, reducing the longevity of these prostheses. These limitations call for better designs that take into account the hemodynamical and anatomical characteristics of different patients. We have integrated tissue engineering techniques with modern medical imaging and image processing tools along with mathematical modeling to optimize the design of cardiovascular grafts in a patient-specific manner. Computational Fluid Dynamics (CFD) analysis is done according to models constructed from each individual patient’s data. This allows for improved geometrical design and achieving better hemodynamic performance. Tissue engineering strives to provide a material that grows with the patient and mimic the durability and elasticity of the native tissue. Simulations also give insight on the performance of the tissues produced in our lab and reduce the need for costly and time-consuming methods of evaluation of the grafts. We are also developing a methodology for the fabrication of the optimized designs.

Keywords: computational fluid dynamics, cardiovascular grafts, design optimization, tissue engineering

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Authors: Shyan-Lung Lin, Cheng-Yi Huang, Tung-Yi Lin

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Physical fitness is the adaptability of the body to physical work and the environment, and is generally known to include cardiopulmonary-fitness, muscular-fitness, body flexibility, and body composition. This paper is aimed to study the ventilatory and cardiovascular activity under various exercise intensities for subjects at distinct ends of cardiopulmonary fitness norm. Three graded upright biking exercises, light, moderate, and vigorous exercise, were designed for subjects at distinct ends of cardiopulmonary fitness norm from their physical education classes. The participants in the experiments were 9, 9, and 11 subjects in the top 20%, middle 20%, and bottom 20%, respectively, among all freshmen of the Feng Chia University in the academic year of 2015. All participants were requested to perform 5 minutes of upright biking exercise to attain 50%, 65%, and 85% of their maximum heart rate (HRmax) during the light, moderate, and vigorous exercise experiment, respectively, and 5 minutes of recovery following each graded exercise. The cardiovascular and ventilatory signals, including breathing frequency (f), tidal volume (VT), heart rate (HR), mean arterial pressure (MAP), and ECG signals were recorded during rest, exercise, and recovery periods. The physiological signals of three groups were analyzed based on their recovery, recovery rate, and percentage variation from rest. Selected time domain parameters, SDNN and RMSSD, were computed and spectral analysis was performed to study the hear rate variability from collected ECG signals. The comparison studies were performed to examine the correlations between physical fitness norm and cardio-pulmonary signals during graded exercises and exercise recovery. No significant difference was found among three groups with VT during all levels of exercise intensity and recovery. The top 20% group was found to have better performance in heart recovery (HRR), frequency recovery rate (fRR) and percentage variation from rest (Δf) during the recovery period of vigorous exercise. The top 20% group was also found to achieve lower mean arterial pressure MAP only at rest but showed no significant difference during graded exercises and recovery periods. In time-domain analysis of HRV, the top 20% group again seemed to have better recovery rate and less variation in terms of SDNN during recovery period of light and vigorous exercises. Most assessed frequency domain parameters changed significantly during the experiment (p<0.05, ANOVA). The analysis showed that the top 20% group, in comparison with middle and bottom 20% groups, appeared to have significantly higher TP, LF, HF, and nHF index, while the bottom 20% group showed higher nLF and LF/HF index during rest, three graded levels of exercises, and their recovery periods.

Keywords: physical fitness, cardio-pulmonary signals, graded exercise, exercise recovery

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Authors: Eli Maria Pazzianotto-Forti, Patrícia Brigatto, Letícia Baltieri, Carolina Moraes Da Costa, Maura Rigoldi Simoes Da Rocha, Irineu Rasera Jr

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The application of positive pressure in airway can contribute to the restoration of lung volumes, capacities and prevent respiratory complications. The aim was to investigate the use of Bilevel Positive Airway Pressure (BIPAP) in morbidly obese in two moments in postoperative bariatric surgery: In the post-anesthetic recovery (PAR) and on the 1st postoperative day (1stPO). Twenty morbidly obese, aged between 25 and 55 years, underwent pulmonary function test and chest X-ray preoperatively and on the day of discharge (2nd day after surgery). They were randomly allocated in groups. GPAR: received BIPAP treatment in PAR, for an hour and G1stPO: received BIPAP for one hour, on the 1stPO. There were significant reductions in slow vital capacity (SVC) (p=0.0007), inspiratory reserve volume (IRV) (p=0.0016) and forced vital capacity (FVC) (p=0.0013) in the postoperative in GPAR and the expiratory reserve volume (ERV) remained (p=0.4446). In the G1stPO, there were significant reductions for: SVC p=<0.0001, ERV p=0.0191, IRV p= 0.0026 and FVC p=<0.0001. Comparing between groups, the SVC (p=0.0027) and FVC (p=0.0028) showed significant difference between the treatments. However, the GPAR showed fewer declines of these capacities. To the ERV (p= 0.1646) and IRV (p=0.3973) there was no significant difference between groups. The atelectasis prevalence was 10% for the GPAR and 30% for G1stPO, with significant difference between the proportions (p = 0.0027). The lowest reduction in SVC and FVC happens when positive pressure is applied in PAR. Thus, the use of BIPAP in the PAR can promote a restoration of ERV and contribute to the reduction of atelectasis. FAPESP 2013/06334-8.

Keywords: atelectasis, bariatric surgery, physiotherapy, pulmonary function, positive pressure

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Authors: Sung-Jun Yoo, Kazuhide Ito

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In this study, a comprehensive computer simulated person (CSP) that integrates computational human model (virtual manikin) and respiratory tract model (virtual airway), was applied for estimation of indoor environmental quality. Moreover, an inclusive prediction method was established by integrating computational fluid dynamics (CFD) analysis with advanced CSP which is combined with physiologically-based pharmacokinetic (PBPK) model, unsteady thermoregulation model for analysis targeting micro-climate around human body and respiratory area with high accuracy. This comprehensive method can estimate not only the contaminant inhalation but also constant interaction in the contaminant transfer between indoor spaces, i.e., a target area for indoor air quality (IAQ) assessment, and respiratory zone for health risk assessment. This study focused on the usage of the CSP as an air/thermal quality sensor in indoors, which means the application of comprehensive model for assessment of IAQ and thermal environmental quality. Demonstrative analysis was performed in order to examine the applicability of the comprehensive model to the heating, ventilation, air conditioning (HVAC) control scheme. CSP was located at the center of the simple model room which has dimension of 3m×3m×3m. Formaldehyde which is generated from floor material was assumed as a target contaminant, and flow field, sensible/latent heat and contaminant transfer analysis in indoor space were conducted by using CFD simulation coupled with CSP. In this analysis, thermal comfort was evaluated by thermoregulatory analysis, and respiratory exposure risks represented by adsorption flux/concentration at airway wall surface were estimated by PBPK-CFD hybrid analysis. These Analysis results concerning IAQ and thermal comfort will be fed back to the HVAC control and could be used to find a suitable ventilation rate and energy requirement for air conditioning system.

Keywords: CFD simulation, computer simulated person, HVAC control, indoor environmental quality

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Authors: Fathia Ehmouda Zaid, Reim Abudelnbi

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Cardiovascular disease is a major cause of morbidity and mortality in patients with systemic lupus erythematosus (SLE). Patients and method: Cross-section study (68) patients diagnosed as systemic lupus erythematosus (SLE), who visited the outpatient clinic of rheumatology, these patients were interviewed with a structured questionnaire about their past and current clinically for presence of Cardiovascular disease in systemic lupus and use SLEDAI, specific tests [ECG –ECHO –CXRAY] the data are analyzed statistically by Pearson's correlation coefficient was calculated and statistical significance was defined as P< 0.05,during period (2013-2014). Objective: Estimation Cardiovascular disease manifestation of systemic lupus erythematosus, correlation with disease activity, morbidity, and mortality. Result: (68) Patients diagnosed as systemic lupus erythematosus' age range from (18-48 years), M=(13±29Y), Sex were female 66/68 (97.1%), male 2/68 (2.9%),duration of disease range[1-15year], M =[7±8y], we found Cardiovascular disease manifestation of systemic lupus erythematosus 32/68 (47.1%), correlation with disease activity use SLEDAI,(r= 476** p=0.000),Morbidity,(r= .554**; p=0.000) and mortality (r=.181; p=.139), Cardiovascular disease manifestations of systemic lupus erythematosus are pericarditis 8/68 (11.8%), pericardial effusion 6/68 (8.8%), myocarditis 4/68 (5.9 %), valvular lesions (endocarditis) 1/68 (1.5%), pulmonary hypertension (PAH) 12/68 (17.6%), coronary artery disease 1/68 (1.5%), none of patients have conduction abnormalities involvement. Correlation with disease activity use SLEDAI, pericarditis (r= .210, p=.086), pericardial effusion (r= 0.079, p=.520), myocarditis (r= 272*, p=.027), valvular lesions (endocarditis) (r= .112, p= .362), pulmonary hypertension (PAH) (r= .257*, p=.035) and coronary artery disease (r=.075, p=.544) correlation between cardiovascular disease manifestations of systemic lupus erythematosus and specific organ involvement we found Mucocutaneous (r=.091 p= .459), musculoskeletal (MSK) (r=.110 p=.373), Renal disease (r=.278*, p=.022), neurologic disease (r=.085, p=.489) and Hematologic disease (r=-.264*, p=.030). Conclusion: Cardiovascular manifestation is more frequent symptoms with systemic lupus erythematosus (SLE) is 47 % correlation with disease activity and morbidity but not with mortality. Recommendations: Focus research to evaluation and an adequate assessment of cardiovascular complications on the morbidity and mortality of the patients with SLE are still required.

Keywords: cardiovascular disease, systemic lupus erythematosus, disease activity, mortality

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Authors: Sutinon Yuchomsuk, Satchachon Changthom, Pruet Areesawangvong, Monsiri Jinapen

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Background: Esophageal squamous cell carcinoma can be presented with many symptoms, such as dysphagia or weight loss. However, in some circumstances, rare presentations can be found, e.g., dyspnea, which is more common in pulmonary malignancy. And dyspnea is also one of the most common presentations of COVID-19 infection. So, in this case, we can learn from many points in patient symptoms and findings leading to the diagnosis of esophageal squamous cell carcinoma. Method: This research is a case-report study including one patient from Mahasarakham Hospital, Thailand. Data were collected during December 2021. Result: A 55-year-old Thai male patient with an unknown past medical history presented with dyspnea and shortness of breath for the duration of three days prior to admission. His symptom also included cough, fever, and sore throat. Laboratory results indicated that the patient had COVID-19 pneumonia. Further investigation showed that he had cardiac tamponade and suspected pulmonary/esophageal cancer. Lung biopsy and pericardiocentesis were done, which were positive for carcinoma from pericardial effusion but negative for malignancy from the lung biopsy. Later esophagogastroduodenoscopy was done with endoscopic tissue biopsy; the result was positive for squamous cell carcinoma of the esophagus. Conclusion: Most commonly, esophageal cancer is presented with dysphagia or weight loss. However, in some rare cases, patients can also be presented with dyspnea due to cardiac tamponade. And in recent years, COVID-19 has become a pandemic all over the world, sometimes masking symptoms of other diseases. Such as in this case, the patient didn’t improve after the pneumonia was resolved, which led to the final diagnosis of metastatic esophageal cancer.

Keywords: esophageal cancer, cardiac tamponade, metastatic squamous cell carcinoma, COVID-19 infection

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Authors: Shalini Saini, Sharmila Ahuja

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Anaesthesia for caesarean section poses challenges unique to the obstetric patient due to changes in the airway and respiratory system. The choice of anaesthesia for caesarean section depends on various factors however general anaesthesia (GA) is necessary for certain situations. Supraglottic airway devices are an emerging method to secure airway, especially in difficult situations. Of these devices, proseal –LMA (PLMA) is designed to provide better protection of the airway. The use of PLMA has been reported successfully as a rescue device in difficult intubation situations and in patients undergoing elective caesarean section without any complications. The study was prospective and randomised and was designed to compare PLMA in patients undergoing elective lower segment caesarean section (LSCS) with the endotracheal tube (ETT). Patients undergoing LSCS under GA belonging to ASA grade 1 and 2 were included. Patients with the history of fewer than 6 hrs of fasting, known/predicted difficult airway, obesity, gastroesophageal reflux disease, hypertensive disorder were excluded. A standard anaesthesia protocol was followed. All patients received aspiration prophylaxis. The airway was secured with either PLMA or ETT. Parameters noted were- ease of insertion, adequacy of ventilation, hemodynamic changes at insertion and removal of device, incidence of regurgitation and aspiration. Data was analysed by unpaired t- test, Chi-square /Fisher’s test. The findings of our study indicated that PLMA was easy to insert (20.67±6.835 sec) with comparable insertion time to TT (18.33 ± 4.971, p 0.136) and adequate ventilation was achieved with very minimal hemodynamic changes seen with PLMA as compared to ETT at insertion and removal of devices (p 0.01). There was no incidence of regurgitation with the use of PLMA. The incidence of a postoperative sore throat was minimal (6.7%) with PLMA (p<0.05). PLMA appears to be a safe alternative to ETT for selected obstetric patients undergoing elective LSCS. Further study with a larger group of patients is required to establish the safety of PLMA in obstetric patients.

Keywords: caesarean section, general anaesthesia, proseal LMA, endotracheal tube

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Authors: L. Marcos Domínguez, Nils Rage, Ongun B. Kazanci, Bjarne W. Olesen

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Thermally Activated Building Systems (TABS) have proven to be an energy-efficient solution to provide buildings with an optimal indoor thermal environment. This solution uses the structure of the building to store heat, reduce the peak loads, and decrease the primary energy demand. TABS require the heated or cooled surfaces to be as exposed as possible to the indoor space, but exposing the bare concrete surfaces has a diminishing effect on the acoustic qualities of the spaces in a building. Acoustic solutions capable of providing optimal acoustic comfort and allowing the heat exchange between the TABS and the room are desirable. In this study, the effects of free-hanging units on the cooling performance of TABS and the occupants’ thermal comfort was measured in a full-scale TABS laboratory. Investigations demonstrate that the use of free-hanging sound absorbers are compatible with the performance of TABS and the occupant’s thermal comfort, but an appropriate acoustic design is needed to find the most suitable solution for each case. The results show a reduction of 11% of the cooling performance of the TABS when 43% of the ceiling area is covered with free-hanging horizontal sound absorbers, of 23% for 60% ceiling coverage ratio and of 36% for 80% coverage. Measurements in actual buildings showed an increase of the room operative temperature of 0.3 K when 50% of the ceiling surface is covered with horizontal panels and of 0.8 to 1 K for a 70% coverage ratio. According to numerical simulations using a new TRNSYS Type, the use of comfort ventilation has a considerable influence on the thermal conditions in the room; if the ventilation is removed, then the operative temperature increases by 1.8 K for a 60%-covered ceiling.

Keywords: acoustic comfort, concrete core activation, full-scale measurements, thermally activated building systems, TRNSys

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Authors: Enjie Xu, Zhen Huang, Kunpeng Zhu, Jianping Hu, Xiaolong Ma, Yongjie Wang, Jiazhuang Zhu, Chunlin Zhang

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Abstract: Hypoxia and dedifferentiation of osteosarcoma (OS) cells leads to poor prognosis. We plan to identify the role of hypoxia on dedifferentiation and the associated signaling pathways. We performed a sphere formation assay and determined spheroid cells as dedifferentiated cells by detecting stem cell-like markers. RNAi assay was used to explore the expression relationship between hypoxia inducible factor 1 subunit alpha (HIF1A) and platelet derived growth factor receptor beta (PDGFRB). We obtained PDGFRB knockdown and overexpression cells through lentiviral infection experiments and the effects of PDGFRB on cytoskeleton rearrangement and cell adhesion were explored by immunocytochemistry. Wound-healing experiments, transwell assays, and animal trials were employed to investigate the effect of PDGFRB on OS metastasis. Dedifferentiated OS cells were found to exhibit high expression of HIF1A and PDGFRB, and HIF1A promoted the expression of PDGFRB, subsequently activated ras homolog family member A (RhoA), and increased the phosphorylation of myosin light chain (MLC). PDGFRB also enhanced the phosphorylation of focal adhesion kinase (FAK). The OS cell morphology and vinculin distribution were altered by PDGFRB. PDGFRB also promoted cell dedifferentiation and had a significant impact on the metastasis of OS cells both in vitro and in vivo. Our results demonstrated that HIF1A up-regulated PDGFRB under hypoxic conditions, and PDGFRB regulated the actin cytoskeleton by activating RhoA and subsequently phosphorylating MLC, thereby promoting OS dedifferentiation and pulmonary metastasis.

Keywords: osteosarcoma, dedifferentiation, metastasis, cytoskeleton rearrangement, PDGFRB, hypoxia

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Authors: Osayomwanbor E. Oghama, John O. Olomukoro

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The school environment, apart from home, is probably the most important indoor environment for children. Children spend as much as 80-90% of their indoor time either at school or at home; an average of 35 - 40 hours per week in schools, hence are at the risk of indoor air pollutants such as volatile organic compounds (VOCs). Concentrations of VOCs vary widely but are generally higher indoors than outdoors. This research was, therefore, carried out to evaluate the levels of VOCs in secondary school classrooms in Benin City, Edo State. Samples were obtained from a total of 18 classrooms in 6 secondary schools. Samples were collected 3 times from each school and from 3 different classrooms in each school using Draeger ORSA 5 tubes. Samplers were left to stay for a school-week (5 days). The VOCs detected and analyzed were benzene, ethlybenzene, isopropylbenzene, naphthalene, n-butylbenzene, n-propylbenzene, toluene, m-xylene, p-xylene, o-xylene, styrene, chlorobenzene, chloroform, 1,2-dichloropropane, 2,2-dichloropropane, tetrachloroethane, tetrahydrofuran, isopropyl acetate, α-pinene, and camphene. The results showed that chloroform, o-xylene, and styrene were the most abundant while α-pinene and camphene were the least abundant. The health risk assessment was done in terms of carcinogenic (CRI) and non-carcinogenic risks (THR). The CRI values of the schools ranged from 1.03 × 10-5 to 1.36 × 10-5 μg/m³ (a mean of 1.16 × 10-5 μg/m³) with School 6 and School 3 having the highest and lowest values respectively. The THR values of the study schools ranged from 0.071-0.086 μg/m³ (a mean of 0.078 μg/m³) with School 3 and School 2 having the highest and lowest values respectively. The results show that all the schools pose a potential carcinogenic risks having CRI values greater than the recommended limit of 1 × 10-6 µg/m³ and no non-carcinogenic risk having THR values less than the USEPA hazard quotient of 1 µg/m³. It is recommended that school authorities should ensure adequate ventilation in their schools, supplementing natural ventilation with mechanical sources, where necessary. In addition, indoor air quality should be taken into consideration in the design and construction of classrooms.

Keywords: carcinogenic risk indicator, health risk, indoor air, non-carcinogenic risk indicator, secondary schools, volatile organic compounds

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Authors: Habtamu Wolde Engudai

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Background: Sedation can be provided to facilitate a procedure or to stabilize patients admitted in pediatric intensive care unit (PICU). Sedation is often necessary to maintain optimal care for critically ill children requiring mechanical ventilation. However, if sedation is too deep or too light, it has its own adverse effects, and hence, it is important to monitor the level of sedation and maintain an optimal level. Objectives: The objective is to assess the level of sedation and associated factors among intubated critically ill children admitted to PICU of JUMC, Jimma. Methods: A prospective observation study was conducted in the PICU of JUMC in September 2021 in 105 patients who were going to be admitted to the PICU aged less than 14 and with GCS >8. Data was collected by residents and nurses working in PICU. Data entry was done by Epi data manager (version 4.6.0.2). Statistical analysis and the creation of charts is going to be performed using SPSS version 26. Data was presented as mean, percentage and standard deviation. The assumption of logistic regression and the result of the assumption will be checked. To find potential predictors, bi-variable logistic regression was used for each predictor and outcome variable. A p value of <0.05 was considered as statistically significant. Finally, findings have been presented using figures, AOR, percentages, and a summary table. Result: in this study, 105 critically ill children had been involved who were started on continuous or intermittent forms of sedative drugs. Sedation level was assessed using a comfort scale three times per day. Based on this observation, we got a 44.8% level of suboptimal sedation at the baseline, a 36.2% level of suboptimal sedation at eight hours, and a 24.8% level of suboptimal sedation at sixteen hours. There is a significant association between suboptimal sedation and duration of stay with mechanical ventilation and the rate of unplanned extubation, which was shown by P < 0.05 using the Hosmer-Lemeshow test of goodness of fit (p> 0.44).

Keywords: level of sedation, critically ill children, Pediatric intensive care unit, Jimma university

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Authors: Aastha Agarwal, Veena Sharma

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N-nitrosopyrollidine or NPYR is a tobacco-specific nitrosamine which upon intoxicated causes abnormal production of Reactive Oxygen Species disrupt the endogenous antioxidant system. The study was designed to evaluate the histological changes in lung tissue of Mus musculus in NPYR administered lungs and effect of isolated flavonoid 3,6-dihydroxy-(3’,4’,7’-trimethoxyphenyl)-chromen-4-one-7-glucoside (ITC) from experimental plant Indigofera tinctorial. Post treatment with isolated compound significantly restored the abnormal symptoms and changes in pulmonary tissue. Transverse section of mouse lung in control animals appeared as a thin lace. Histologically, most of the lung was arranged as alveoli which were thin walled structures made up of single layered squamous epithelial cells. In the transverse section of lung at 100 X will clearly show the component of alveoli, surround by a thin layer of connective tissue and blood vessels. Smaller bronchioles were lined by cuboidal epithelial cells while larger bronchioles were lined by ciliated columnar epithelium layer while in NPYR intoxicated lungs signs of vast pulmonary damages and carcinogenesis as alveolar damage, necrosis, DADs or defused alveolar damages hyperplasia, metaplasia, dysplasia and next stage of carcinogenesis were revealed. Treatment with ITC showed the significant positive changes in the lung tissue due to the side hydroxyl and methoxy groups in its structure which help in combating oxidative injuries and give protection from the free radicals generated during the metabolism of NPYR in body. Thus, histopathological analysis confirms the development of the cancerous conditions in the lung tissue in mice model and the protective effects of ITC.

Keywords: flavonoid, histopathology, Indigofera tinctoria, lung

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Authors: S. Moustafa El Shanawany, I. Labib Salem, F. Mohamed Magdy Badr El Dine, H. Tag El Deen Abd Allah

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Thermal injuries remain a global health problem and a common issue encountered in forensic pathology. They are a devastating cause of morbidity and mortality in children and adults especially in developing countries, causing permanent disfigurement, scarring and grievous hurt. Burns have always been a matter of legal concern in cases of suicidal burns, self-inflicted burns for false accusation and homicidal attempts. Assessment of burn injuries as well as rating permanent disabilities and disfigurement following thermal injuries for the benefit of compensation claims represents a challenging problem. This necessitates the development of reliable scoring systems to yield an expected likelihood of permanent disability or fatal outcome following burn injuries. The study was designed to identify the risk factors of mortality in acute burn patients and to evaluate the applicability of FLAMES (Fatality by Longevity, APACHE II score, Measured Extent of burn, and Sex) and BOBI (Belgian Outcome in Burn Injury) model scores in predicting the outcome. The study was conducted on 100 adult patients with acute burn injuries admitted to the Burn Unit of Alexandria Main University Hospital, Egypt from October 2014 to October 2015. Victims were examined after obtaining informed consent and the data were collected in specially designed sheets including demographic data, burn details and any associated inhalation injury. Each burn patient was assessed using both BOBI and FLAMES scoring systems. The results of the study show the mean age of patients was 35.54±12.32 years. Males outnumbered females (55% and 45%, respectively). Most patients were accidently burnt (95%), whereas suicidal burns accounted for the remaining 5%. Flame burn was recorded in 82% of cases. As well, 8% of patients sustained more than 60% of total burn surface area (TBSA) burns, 19% of patients needed mechanical ventilation, and 19% of burnt patients died either from wound sepsis, multi-organ failure or pulmonary embolism. The mean length of hospital stay was 24.91±25.08 days. The mean BOBI score was 1.07±1.27 and that of the FLAMES score was -4.76±2.92. The FLAMES score demonstrated an area under the receiver operating characteristic (ROC) curve of 0.95 which was significantly higher than that of the BOBI score (0.883). A statistically significant association was revealed between both predictive models and the outcome. The study concluded that both scoring systems were beneficial in predicting mortality in acutely burnt patients. However, the FLAMES score could be applied with a higher level of accuracy.

Keywords: BOBI, burns, FLAMES, scoring systems, outcome

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Authors: Nathalie Bolding, Marta Montero, Joaquim Cevallos, Juan F. Martin-Lazaro

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Background: Inhaled epoprostenol (iEPO) have been shown to improve PaO2:FiO2 (PF) in combination with bronchodilators (BD). However, there is not an available device to deliver these two therapies concomitantly. We describe a new method to provide this therapy successfully. Objective: To evaluate the response to continuous nebulization of iEPO and intermittent nebulization of Salbutamol/Ipratropium bromide in adults with severe respiratory failure through a double mesh nebulisation in tandem. Methods: This observational study included two mechanical ventilated adults under hourly ventilatory, gasometrical and clinical measurements during 48h. Both had severe respiratory failure treated with continuous iEPO (50 – 200 micrograms/h) and BD (Salbutamol 2.5 mg and Ipratropium bromide 500 mcg every 6 hours) through double mesh nebulisation (Aerogen solo®) placed in tandem in the dry side of the humidificator. The primary endpoints were the variables associated with a positive response to this tandem nebulised therapy (PaFiO2 index, ROX index). Secondary endpoints were laboratory (ABG) clinical and ventilatory variables. Statistical analysis (SPSS v29) included linear regression and ANOVA. Results: The patients included (n=2) survived, both extubated, one after ECMO therapy. Severe acute respiratory failure had a positive response rate to continuous iEPO and intermittent BD: PaFiO2 increased (7.40 to 30.91; P75: 27%) as well as ROX index (2.91 to 11.43; P75: 33%). There was a linear correlation of improvement between iEPO with PaFiO2 (ANOVA, r=0.393, p<0.002) and ROX (r=0.419, p<0.001). iEPO+BD therapy did not show any complications. Conclusion: Continuous and intermittent mesh tandem nebulisation can be effectively delivered with this method with a positive effect in ventilatory parameters without observed complications. Randomised studies will be able to provide reassurance in this new therapy.

Keywords: tandem, mesh, nebulisers, pulmonary, vasoldilators, bronchodilators, respiratory, failure

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Authors: Saboor Saeed, Chunming Jiang

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Eosinophilic Granulomatosis with polyangiitis (EGPA), formerly known as Churg-Strauss syndrome, is a rare systemic vasculitis of small and medium-sized vessels that primarily develops in middle-aged individuals. It is characterized by asthma, blood eosinophilia, and extra pulmonary manifestations. In childhood, EGPA is extremely rare. Pulmonary and cardiac involvement is predominant in pediatric EGPA, and mortality is substantial. Generally, EGPA will develop in three stages: a) The allergic phase is commonly associated with asthma, allergic rhinitis, and sinusitis, b) the eosinophilic phase, in which the main pathology is related to the infiltration of eosinophilic organs, i.e., lung, heart, and gastrointestinal system, c) vasculitis phase involved purpura, peripheral neuropathy, and some constitutional symptoms. The key to the treatment of EGPA lies in the early diagnosis of the disease. Early application of glucocorticoids and immunosuppressants can improve symptoms and the overall prognosis of EGPA. Case Description: We presented a case of an 8-year-old boy with a history of short asthma, marked eosinophilia, and multi-organ involvement. The extremely high eosinophil level in the blood (72.50%) prompted the examination of eosinophilic leukemia before EGPA diagnosis was made. Subsequently, this disease was successfully treated. This case report shows a typical case of CSS in childhood because of the extreme eosinophilia. It emphasizes the importance of EGPA is a life-threatening cause of children's eosinophilia. Conclusion: EGPA in children has unique clinical, imaging, and histological characteristics different from those of adults. In pediatric patients, the development and diagnosis of systemic symptoms are often delayed, mainly occurring in the eosinophilic phase, which will lead to specific manifestations. At the same time, we cannot detect a genetic relationship related to EGPA.

Keywords: Churg Strauss syndrome, asthma, vasculitis, hypereosinophilia, eosinophilic granulomatosis polyangiitis

Procedia PDF Downloads 165

Authors: Staci McGill, Morgan Hayes, Robert Coleman, Kimberly Tumlin

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The interaction and relationships between horses and humans have been shown to be positive for physical, mental, and emotional wellbeing, however equine spaces where these interactions occur do include some environmental risks. There are 1.7 million jobs associated with the equine industry in the United States in addition to recreational riders, owners, and volunteers who interact with horses for substantial amounts of time daily inside built structures. One specialized facility, an “indoor arena” is a semi-indoor structure used for exercising horses and exhibiting skills during competitive events. Typically, indoor arenas have a sand or sand mixture as the footing or surface over which the horse travels, and increasingly, silica sand is being recommended due to its durable nature. It was previously identified in a semi-qualitative survey that the majority of individuals using indoor arenas have environmental concerns with dust. 27% (90/333) of respondents reported respiratory issues or allergy-like symptoms while riding with 21.6% (71/329) of respondents reporting these issues while standing on the ground observing or teaching. Frequent headaches and/or lightheadedness was reported in 9.9% (33/333) of respondents while riding and in 4.3% 14/329 while on the ground. Horse respiratory health is also negatively impacted with 58% (194/333) of respondents indicating horses cough during or after time in the indoor arena. Instructors who spent time in indoor arenas self-reported more respiratory issues than those individuals who identified as smokers, highlighting the health relevance of understanding these unique structures. To further elucidate environmental concerns and self-reported health issues, 35 facility assessments were conducted in a cross-sectional sampling design in the states of Kentucky and Ohio (USA). Data, including air speeds, were collected in a grid fashion at 15 points within the indoor arenas and then mapped spatially using krigging in ARCGIS. From the spatial maps, standard variances were obtained and differences were analyzed using multivariant analysis of variances (MANOVA) and analysis of variances (ANOVA). There were no differences for the variance of the air speeds in the spaces for facility orientation, presence and type of roof ventilation, climate control systems, amount of openings, or use of fans. Variability of the air speeds in the indoor arenas was 0.25 or less. Further analysis yielded that average air speeds within the indoor arenas were lower than 100 ft/min (0.51 m/s) which is considered still air in other animal facilities. The lack of air movement means that dust clearance is reliant on particle size and weight rather than ventilation. While further work on respirable dust is necessary, this characterization of the semi-indoor environment where animals and humans interact indicates insufficient air flow to eliminate or reduce respiratory hazards. Finally, engineering solutions to address air movement deficiencies within indoor arenas or mitigate particulate matter are critical to ensuring exposures do not lead to adverse health outcomes for equine professionals, volunteers, participants, and horses within these spaces.

Keywords: equine, indoor arena, ventilation, particulate matter, respiratory health

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Authors: Paras Agarwal

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Background: Initially believed to be rare, metastases to the eye are the most common ocular malignancy. The choroid’s high perfusion rate not only makes it the most susceptible ocular site for tumour seeding, but also promotes its growth. The cancers most frequently responsible for choroidal metastases originate from the breast and lung, although a significant proportion have unidentified primaries at the time of presentation. Case Presentation: This case report describes a 34 year old female presenting to the ophthalmology department with a one month history of painless distorted vision. On fundus examination, she was noted to have bilateral choroidal lesionsand subsequently underwent a comprehensive diagnostic work-up. The patient was diagnosed with metastatic pulmonary adenocarcinoma, despite lacking conventional risk factors. As she was found to have a mutation in EGFR, the patient was commenced on tyrosine-kinase inhibition with afatinib. The choroidal lesions regressed with a significant improvement in visual acuity and a dramatic anatomical reduction of the choroidal masses. Conclusions: Our case demonstrates the importance of considering metastases as a differential diagnosis for choroidal lesions. Appropriate and thorough history-taking, examination and investigations may be required in order to deduce the underlying cause. Our case is unusual in view of the choroidal lesion being the primary manifestation of metastatic lung cancer in a young patient with no known risk factors. Early recognition of choroidal metastases is important as it is often the first sign of tumour dissemination and will prompt earlier treatment with systemic medications such as chemotherapy, immunotherapy, targeted therapy or hormonal therapy. Our case report also demonstrates the efficacy of afatinib for the treatment of choroidal metastases, with morphological and functional improvements observed with regard to the choroidal metastatic tumour.

Keywords: choroidal neoplasm, choroidal naevus, pulmonary adenocarcinoma, metastases, lung cancer

Procedia PDF Downloads 117

Authors: Sharique Ahmed, Khushtar Anwar Salman

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Alpha-1-antitrypsin (AAT) is a major plasma serine protease inhibitor (SERPIN). Hereditary AAT deficiency is one of the common diseases in some part of the world. AAT is mainly produced in the liver and functions to protect the lung against proteolytic damage (e.g., from neutrophil elastase) acting as the major inhibitor for neutrophil elastase. α (1)-Antitrypsin (AAT) deficiency is an under recognized genetic condition that affects approximately 1 in 2,000 to 1 in 5,000 individuals and predisposes to liver disease and early-onset emphysema. Not only does α-1-antitrypsin deficiency lead to disabling syndrome of pulmonary emphysema, there are other disorders too which include ANCA (antineutrophilic cytoplasmic antibody) positive Wegener's granulomatosis, diffuse bronchiectasis, necrotizing panniculitis in α-1-antitrypsin phenotype (S), idiopathic pulmonary fibrosis and steroid dependent asthma. Augmentation therapy with alpha-1 antitrypsin (AAT) from human plasma has been available for specific treatment of emphysema due to AAT deficiency. Apart from this several observations have also suggested a role for endogenous suppressors of HIV-1, alpha-1 antitrypsin (AAT) has been identified to be one of those. In view of its varied important role in humans, serum from a mammalian source was chosen for the isolation and purification. Studies were performed on the homogeneous fraction. This study suggests that the buffalo serum α-1-antritrypsin has characteristics close to ovine, dog, horse and more importantly to human α-1-antritrypsin in terms of its hydrodynamic properties such as molecular weight, carbohydrate content, etc. The similarities in the hydrodynamic properties of buffalo serum α-1-antitrypsin with other sources of mammalian α-1-antitrypsin mean that it can be further studied and be a potential source for "augmentation therapy", as well as a source of AAT replacement therapy to raise serum levels above the protective threshold. Other parameters like the amino acid sequence, the effect of denaturants, and the thermolability or thermostability of the inhibitor will be the interesting basis of future studies on buffalo serum alpha-1 antitrypsin (AAT).

Keywords: α-1-antitrypsin, augmentation therapy , hydrodynamic properties, serine protease inhibitor

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Authors: Isomar Lima da Silva, Alcilene Batalha Pontes, Aristeu Jonatas Leite de Oliveira, Roberto Maia Augusto

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Context: Mechanical ventilators are medical devices that help provide oxygen and ventilation to patients with respiratory difficulties. This equipment consists of a manual breathing unit that can be operated by a doctor or nurse and a mechanical ventilator that controls the airflow and pressure in the patient's respiratory system. This type of ventilator is commonly used in emergencies and intensive care units where it is necessary to provide breathing support to critically ill or injured patients. Objective: In this context, this work aims to develop a reliable and low-cost mechanical ventilator to meet the demand of hospitals in treating people affected by Covid-19 and other severe respiratory diseases, offering a chance of treatment as an alternative to mechanical ventilators currently available in the market. Method: The project presents the development of a low-cost auxiliary ventilator with a controlled ventilatory system assisted by integrated hardware and firmware for respiratory cycle control in non-invasive mechanical ventilation treatments using a manual artificial respiration unit. The hardware includes pressure sensors capable of identifying positive expiratory pressure, peak inspiratory flow, and injected air volume. The embedded system controls the data sent by the sensors. It ensures efficient patient breathing through the operation of the sensors, microcontroller, and actuator, providing patient data information to the healthcare professional (system operator) through the graphical interface and enabling clinical parameter adjustments as needed. Results: The test data of the developed mechanical ventilator presented satisfactory results in terms of performance and reliability, showing that the equipment developed can be a viable alternative to commercial mechanical ventilators currently available, offering a low-cost solution to meet the increasing demand for respiratory support equipment.

Keywords: mechanical fans, breathing, medical equipment, COVID-19, intensive care units

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Authors: Ambrish Tiwari, Sudhasini Panda, Archana Singh, Kalpana Luthra, S. K. Sharma

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Introduction: On the basis of available literature we know that various host factors play a role in outcome of Tuberculosis (TB) infection by modulating innate immunity. One such factor is Inducible Nitric Oxide Synthase enzyme (iNOS) which help in the production of Nitric Oxide (NO), an antimicrobial agent. Expression of iNOS is in control of various host factors in which Vitamin D along with its nuclear receptor Vitamin D receptor (VDR) is one of them. Vitamin D along with its receptor also produces cathelicidin (antimicrobicidal agent). With this background, we attempted to investigate the levels of Vitamin D and NO along with their associated molecules in tuberculosis patients and household contacts as compared to healthy controls and assess the implication of these findings in susceptibility to tuberculosis (TB). Study subjects and methods: 100 active TB patients, 75 household contacts, and 70 healthy controls were taken. VDR and iNOS mRNA levels were studied using real-time PCR. Serum VDR, cathelicidin, iNOS levels were measured using ELISA. Serum Vitamin D levels were measured in serum samples using chemiluminescence based immunoassay. NO was measured using colorimetry based kit. Results: VDR and iNOS mRNA levels were found to be lower in active TB group compared to household contacts and healthy controls (P=0.0001 and 0.005 respectively). The serum levels of Vitamin D were also found to be lower in active TB group as compared to healthy controls (P =0.001). Levels of cathelicidin and NO was higher in patient group as compared to other groups (p=0.01 and 0.5 respectively). However, the expression of VDR and iNOS and levels of vitamin D was significantly (P < 0.05) higher in household contacts compared to both active TB and healthy control groups. Inference: Higher levels of Vitamin D along with VDR and iNOS expression in household contacts as compared to patients suggest that vitamin D might have a protective role against TB which prevents activation of the disease. From our data, we can conclude that decreased vitamin D levels could be implicated in disease progression and we can use cathelicidin and NO as a biomarker for early diagnosis of pulmonary tuberculosis.

Keywords: vitamin D, VDR, iNOS, tuberculosis

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Authors: Gabrielle Peck, Ryan Hayes

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Four façade systems were tested using a reduced height BS 8414-2 (5 m) test rig. An L-shaped masonry test wall was clad with three types of insulation and an aluminum composite panel with a non-combustible filling (meeting Euroclass A2). A large (3 MW) wooden crib was ignited in a recess at the base of the L, and the fire was allowed to burn for 30 minutes. Air velocity measurements and gas samples were taken from the main ventilation duct and also a small additional ventilation duct, like those in an apartment bathroom or kitchen. This provided a direct route of travel for smoke from the building façade to a theoretical room using a similar design to many high-rise buildings where the vent is connected to (approximately) 30 m³ rooms. The times to incapacitation and lethality of the effluent were calculated for both the main exhaust vent and for a vent connected to a theoretical 30 m³ room. The rainscreen façade systems tested were the common combinations seen in many tower blocks across the UK. Three tests using ACM A2 with Stonewool, Phenolic foam, and Polyisocyanurate (PIR) foam. A fourth test was conducted with PIR and ACM-PE (polyethylene core). Measurements in the main exhaust duct were representative of the effluent from the burning wood crib. FEDs showed incapacitation could occur up to 30 times quicker with combustible insulation than non-combustible insulation, with lethal gas concentrations accumulating up to 2.7 times faster than other combinations. The PE-cored ACM/PIR combination produced a ferocious fire, resulting in the termination of the test after 13.5 minutes for safety reasons. Occupants of the theoretical room in the PIR/ACM A2 test reached a FED of 1 after 22 minutes; for PF/ACM A2, this took 25 minutes, and for stone wool, a lethal dose measurement of 0.6 was reached at the end of the 30-minute test. In conclusion, when measuring smoke toxicity in the exhaust duct, there is little difference between smoke toxicity measurements between façade systems. Toxicity measured in the main exhaust is largely a result of the wood crib used to ignite the façade system. The addition of a vent allowed smoke toxicity to be quantified in the cavity of the façade, providing a realistic way of measuring the toxicity of smoke that could enter an apartment from a façade fire.

Keywords: smoke toxicity, large-scale testing, BS8414, FED

Procedia PDF Downloads 37

Authors: Maryam Radan, Fereshteh Nejad Dehbashi, Vahid Bayati, Mahin Dianat, Seyyed Ali Mard, Zahra Mansouri

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Pulmonary emphysema is a pathological respiratory condition identified by alveolar destruction which leads to limitation of airflow and diminished lung function. A substantial body of evidence suggests that mesenchymal stem cells (MSCs) have the ability to induce tissue repair primarily through a paracrine effect. In this study, we aimed to determine the efficacy of Intratracheal adipose-derived mesenchymal stem cells (ADSCs) therapy in comparison to this approach with that of Intravenous (Systemic) therapy. Fifty adult male Sprague–Dawley rats weighing between 180 and 200 g were used in this experiment. The animals were randomized to Control groups (Intratracheal or Intravenous vehicle), Elastase group (intratracheal administration of porcine pancreatic elastase; 25 U/kg on day 0 and day 10th), Elastase+Intratracheal ADSCs therapy (1x107 Cells, on day 28) and Elastase+Systemic ADSCs therapy (1x107 Cells, on day 28). The rats which not subjected to any treatment, considered as the control. All rats were sacrificed 3 weeks later. Morphometric findings in lung tissues (Mean linear intercept) confirmed the establishment of the emphysema model via alveolar disruption. Contrarily, ADSCs administration partially restored alveolar architecture. These results were associated with improving arterial oxygenation, reducing lung edema, and decreasing lung inflammation with higher significant effects in the Intratracheal therapy route. These results documented that the efficacy of intratracheal ADSCs was comparable with intravenous ADSCs therapy. Accordingly, the obtained data suggested that intratracheal delivery of ADSCs would enhance lung repair in pulmonary emphysema. Moreover, this method provides benefits over a systemic administration, such as the reduction of cell number and the low risk to engraft other organs.

Keywords: mesenchymal stem cell, emphysema, Intratracheal, systemic

Procedia PDF Downloads 185

Authors: Miguel Chen Austin, Denis Bruneau, Alain Sempey, Laurent Mora, Alain Sommier

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An experimental study in a Plus Energy House (PEH) prototype was conducted in August 2016. It aimed to highlight the energy charge and discharge of a concrete-slab floor submitted to the day-night-cycles heat exchanges in the southwestern part of France and to identify the heat transfer phenomena that take place in both processes: charge and discharge. The main features of this PEH, significant to this study, are the following: (i) a non-active slab covering the major part of the entire floor surface of the house, which include a concrete layer 68 mm thick as upper layer; (ii) solar window shades located on the north and south facades along with a large eave facing south, (iii) large double-glazed windows covering the majority of the south facade, (iv) a natural ventilation system (NVS) composed by ten automatized openings with different dimensions: four are located on the south facade, four on the north facade and two on the shed roof (north-oriented). To highlight the energy charge and discharge processes of the non-active slab, heat flux and temperature measurement techniques were implemented, along with airspeed measurements. Ten “measurement-poles” (MP) were distributed all over the concrete-floor surface. Each MP represented a zone of measurement, where air and surface temperatures, and convection and radiation heat fluxes, were intended to be measured. The airspeed was measured only at two points over the slab surface, near the south facade. To identify the heat transfer phenomena that take part in the charge and discharge process, some relevant dimensionless parameters were used, along with statistical analysis; heat transfer phenomena were identified based on this analysis. Experimental data, after processing, had shown that two periods could be identified at a glance: charge (heat gain, positive values) and discharge (heat losses, negative values). During the charge period, on the floor surface, radiation heat exchanges were significantly higher compared with convection. On the other hand, convection heat exchanges were significantly higher than radiation, in the discharge period. Spatially, both, convection and radiation heat exchanges are higher near the natural ventilation openings and smaller far from them, as expected. Experimental correlations have been determined using a linear regression model, showing the relation between the Nusselt number with relevant parameters: Peclet, Rayleigh, and Richardson numbers. This has led to the determination of the convective heat transfer coefficient and its comparison with the convective heat coefficient resulting from measurements. Results have shown that forced and natural convection coexists during the discharge period; more accurate correlations with the Peclet number than with the Rayleigh number, have been found. This may suggest that forced convection is stronger than natural convection. Yet, airspeed levels encountered suggest that it is natural convection that should take place rather than forced convection. Despite this, Richardson number values encountered indicate otherwise. During the charge period, air-velocity levels might indicate that none air motion occurs, which might lead to heat transfer by diffusion instead of convection.

Keywords: heat flux measurement, natural ventilation, non-active concrete slab, plus energy house

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Authors: Vandana Mohan, Ashwani Koul

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Aim: To evaluate the potential of Aqueous Tinospora cordifolia stem extract (Aq.Tc) and Arabinogalactan (AG) on pulmonary carcinogenesis and associated tumor markers. Background: Lung cancer is one of the most frequent malignancy with high mortality rate due to limitation of early detection resulting in low cure rates. Current research effort focuses on identifying some blood-based biomarkers like CEA, ctDNA and LDH which may have potential to detect cancer at an early stage, evaluation of therapeutic response and its recurrence. Medicinal plants and their active components have been widely investigated for their anticancer potentials. Aqueous preparation of T. Cordifolia extract is enriched in the polysaccharide fraction i.e., AG when compared with other types of extract. Moreover, reports are available of polysaccharide fraction of T. Cordifolia in in vitro lung cancer models which showed profound anti-metastatic activity against these cell lines. However, not much has been explored about its effect in in vivo lung cancer models and the underlying mechanism involved. Experimental Design: Mice were randomly segregated into six groups. Group I animals served as control. Group II animals were administered with Aq. Tc extract (200 mg/kg b.w.) p.o.on the alternate days. Group III animals were fed with AG (7.5 mg/kg b.w.) p.o. on the alternate days (thrice a week). Group IV animals were installed with Benzo(a)pyrene (50 mg/kg b.w.), i.p. twice within an interval of two weeks. Group V animals received Aq. Tc extract as in group II along with it B(a)P was installed after two weeks of Aq. Tc administration following the same protocol as for group IV. Group VI animals received AG as in group III along with it B(a)P was installed after two weeks of AG administration. Results: Administration of B(a)P to mice resulted in increased tumor incidence, multiplicity and pulmonary somatic index with concomitant increase in serum/plasma markers like CEA, ctDNA, LDH and TNF-α.Aq.Tc and AG supplementation significantly attenuated these alterations at different stages of tumorigenesis thereby showing potent anti-cancer effect in lung cancer. A pronounced decrease in serum/plasma markers were observed in animals treated with Aq.Tc as compared to those fed with AG. Also, extensive hyperproliferation of alveolar epithelium was prominent in B(a)P induced lung tumors. However, treatment of Aq.Tc and AG to lung tumor bearing mice exhibited reduced alveolar damage evident from decreased number of hyperchromatic irregular nuclei. A direct correlation between the concentration of tumor markers and the intensity of lung cancer was observed in animals bearing cancer co-treated with Aq.Tc and AG. Conclusion: These findings substantiate the chemopreventive potential of Aq.Tc and AG against lung tumorigenesis. Interestingly, Aq.Tc was found to be more effective in modulating the cancer as reflected by various observations which may be attributed to the synergism offered by various components of Aq.Tc. Further studies are in progress to understand the underlined mechanism in inhibiting lung tumorigenesis by Aq.Tc and AG.

Keywords: Arabinogalactan, Benzo(a)pyrene B(a)P, carcinoembryonic antigen (CEA), circulating tumor DNA (ctDNA), lactate dehydrogenase (LDH), Tinospora cordifolia

Procedia PDF Downloads 162

Authors: Nicholas Bayfield, Liam Bibo, Charley Budgeon, Robert Larbalestier, Tom Briffa

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Introduction: Stress hyperglycaemia is common following cardiac surgery. Its optimal management is uncertain and may differ by diabetic status. This study assesses the in-hospital glycaemic management of cardiac surgery patients and associated postoperative outcomes. Methods: A retrospective cohort analysis of all patients undergoing cardiac surgery at Fiona Stanley Hospital from February 2015 to May 2019 was undertaken. Management and outcomes of hyperglycaemia following cardiac surgery were assessed. Follow-up was assessed to 1 year postoperatively. Multivariate regression modelling was utilised. Results: 1050 non-diabetic patients and 689 diabetic patients were included. In the non-diabetic cohort, patients with mild (peak blood sugar level [BSL] < 14.3), transient stress hyperglycaemia managed without insulin were not at an increased risk of wound-related morbidity (P=0.899) or mortality at 1 year (P=0.483). Insulin management was associated with wound-related readmission to hospital (P=0.004) and superficial sternal wound infection (P=0.047). Prolonged or severe stress hyperglycaemia was predictive of hospital re-admission (P=0.050) but not morbidity or mortality (P=0.546). Diabetes mellitus was an independent risk factor 1-year mortality (OR; 1.972 [1.041–3.736], P=0.037), graft harvest site wound infection (OR; 1.810 [1.134–2.889], P=0.013) and wound-related readmission (OR; 1.866 [1.076–3.236], P=0.026). In diabetics, postoperative peak BSL > 13.9mmol/L was predictive of graft harvest site infections (OR; 3.528 [1.724-7.217], P=0.001) and wound-related readmission OR; 3.462 [1.540-7.783], P=0.003) regardless of modality of management. A peak BSL of 10.0-13.9 did not increase the risk of morbidity/mortality compared to a peak BSL of < 10.0 (P=0.557). Diabetics with a peak BSL of 13.9 or less did not have significantly increased morbidity/mortality outcomes compared to non-diabetics (P=0.418). Conclusion: In non-diabetic patients, transient mild stress hyperglycaemia following cardiac surgery does not uniformly require treatment. In diabetic patients, postoperative hyperglycaemia with peak BSL exceeding 13.9mmol/L was associated with wound-related morbidity and hospital readmission following cardiac surgery.

Keywords: cardiac surgery, pulmonary embolism, pulmonary embolectomy, cardiopulmonary bypass

Procedia PDF Downloads 136

Authors: Uliana N. Tumanova, Sergey M. Voevodin, Veronica A. Sinitsyna, Alexandr I. Shchegolev

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An important part of forensic and autopsy research in perinatology is the answer to the question of life and stillbirth. Postmortem magnetic resonance imaging (MRI) is an objective non-invasive research method that allows to store data for a long time and not to exhume the body to clarify the diagnosis. The purpose of the research is to study the possibilities of a postmortem MRI to determine the stillbirth and death of a newborn who had spontaneous breathing and died on the first day after birth. MRI and morphological data of a study of 23 stillborn bodies, prenatally dead at a gestational age of 22-39 weeks (Group I) and the bodies of 16 newborns who died from 2 to 24 hours after birth (Group II) were compared. Before the autopsy, postmortem MRI was performed on the Siemens Magnetom Verio 3T device in the supine position of the body. The control group for MRI studies consisted of 7 live newborns without lung disease (Group III). On T2WI in the sagittal projection was measured MR-signal intensity (SI) in the lung tissue (L) and shoulder muscle (M). During the autopsy, a pulmonary swimming test was evaluated, and macro- and microscopic studies were performed. According to the postmortem MRI, the highest values of mean SI of the lung (430 ± 27.99) and of the muscle (405.5 ± 38.62) on T2WI were detected in group I and exceeded the corresponding value of group II by 2.7 times. The lowest values were found in the control group - 77.9 ± 12.34 and 119.7 ± 6.3, respectively. In the group II, the lung SI was 1.6 times higher than the muscle SI, whereas in the group I and in the control group, the muscle SI was 2.1 times and 1.8 times larger than the lung. On the basis of clinical and morphological data, we calculated the formula for determining the breathing index (BI) during postmortem MRI: BI = SIL x SIM / 100. The mean value of BI in the group I (1801.14 ± 241.6) (values ranged from 756 to 3744) significantly higher than the corresponding average value of BI in the group II (455.89 ± 137.32, p < 0.05) (305-638.4). In the control group, the mean BI value was 91.75 ± 13.3 (values ranged from 53 to 154). The BI with the results of pulmonary swimming tests and microscopic examination of the lungs were compared. The boundary value of BI for the differential diagnosis of stillborn and newborn death was 700. Using the postmortem MRI allows to differentiate the stillborn with the death of the breathing newborn.

Keywords: lung, newborn, postmortem MRI, stillborn

Procedia PDF Downloads 105

Authors: J. G. Batista, K. N. Sousa, ¬J. L. Nunes, R. L. S. Sousa, G. A. P. Thé

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This work deals with parameter identification of permanent magnet motors, a class of ac motor which is particularly important in industrial automation due to characteristics like applications high performance, are very attractive for applications with limited space and reducing the need to eliminate because they have reduced size and volume and can operate in a wide speed range, without independent ventilation. By using experimental data and genetic algorithm we have been able to extract values for both the motor inductance and the electromechanical coupling constant, which are then compared to measured and/or expected values.

Keywords: modeling, AC servomotor, permanent magnet synchronous motor-PMSM, genetic algorithm, vector control, robotic manipulator, control

Procedia PDF Downloads 432