Search results for: surgical safety checklist

Authors: Maria Medeiros, Suren Surenthiran, Abitha Muralithar, Soushma Seeburuth, Mohammed Mohammed

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Introduction: Appendicitis is the most common surgical emergency globally and can have devastating consequences. Diagnostic imaging in acute appendicitis has become increasingly common in aiding the diagnosis of acute appendicitis. Computerized tomography (CT) and ultrasound (US) are the most commonly used imaging modalities for diagnosing acute appendicitis. Pre-operative imaging has contributed to a reduction of negative appendicectomy rates from between 10-29% to 5%. Literature report CT scan has a diagnostic sensitivity of 94% in acute appendicitis. This clinical audit was conducted to establish if the CT scan's diagnostic yield for acute appendicitis matches the literature. CT scan has a high sensitivity and specificity for diagnosing acute appendicitis and its use can result in a lower negative appendicectomy rate. The aim of this study is to compare the pre-operative imaging findings from CT scans to the histopathology results post-operatively and establish the accuracy of CT scans in aiding the diagnosis of acute appendicitis. Methods: This was a retrospective study focusing on adult presentations to the general surgery department in a district general hospital in central London with an impression of acute appendicitis. We analyzed all patients from July 2022 to December 2022 who underwent a CT scan preceding appendicectomy. Pre-operative CT findings and post-operative histopathology findings were compared to establish the efficacy of CT scans in diagnosing acute appendicitis. Our results were also cross-referenced with pre-existing literature. Data was collected and anonymized using CERNER and analyzed in Microsoft Excel. Exclusion criteria: Children, age <16. Results: 65 patients had CT scans in which the report stated acute appendicitis. Of those 65 patients, 62 patients underwent diagnostic laparoscopies. 100% of patients who underwent an appendicectomy with a pre-operative CT scan showing acute appendicitis had acute appendicitis in histopathology analysis. 3 of the 65 patients who had a CT scan showing appendicitis received conservative treatment. Conclusion: CT scans positive for acute appendicitis had 100% sensitivity and a positive predictive value, which matches published research studies (sensitivity of 94%). The use of CT scans in the diagnostic work-up for acute appendicitis can be extremely helpful in a) confirming the diagnosis and b) reducing the rates of negative appendicectomies and consequently reducing unnecessary operative-associated risks for patients, reducing costs and reducing pressure on emergency theatre lists.

Keywords: acute apendicitis, CT scan, general surgery, imaging

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Authors: Bikas Chandra Bhattarai

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Child labour is the serious issue all over the world. In Nepal, many children are working in different structured and unstructured sector. Metal fabrication is one of the sectors where many children are involved. The present study is carried out to focus on the overall socio-economic condition, psychological aspect, working environment condition and welfare of the child labour. Metal fabrication factories from Kirtipur, Chovar Area, Gongabu, Sitapaila and Sankhamul area of Kathmandu municipality were selected for the study. The structured questionnaire was prepared, and overall 55 children under age 16 were interviewed. Working in metal fabrication factory is risky job for children. The main reason behind child labour is poverty. The working environment in the metal fabrication factory was not found satisfactory. Children are exposed to various types of physical and chemical hazards. Factories are not paying proper attention to safety condition at the workplace. Large number of children is attracted towards smoking and drinking alcohol leading to unnecessary expense of their income. There should be the provision of regular health check up and insurance to the working children. Monitoring from the government level should be implemented for the betterment of working children.

Keywords: child labour, Kathmandu, Nepal, metal fabrication

Procedia PDF Downloads 331

Authors: Prem Kumar, Anuj Tyagi, Harsh Panwar, Vaneet Inder Kaur

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Though aquaculture started as an occupation for poor and weak farmers for livelihood, it has now acquired the shape of one of the biggest industry to grow live protein in the form of aquatic organisms. Industrialization of the aquaculture sector has led to intensification resulting in stress on aquatic organisms and frequent disease outbreaks leading to huge economic impacts. Indiscriminate use of antibiotics as growth promoter and prophylactic agent in aquaculture has resulted in rapid emergence and spread of antibiotic resistance in bacterial pathogens. Over the past few years, use of probiotics (as an alternative of antibiotics) in aquaculture has gained attention due to their immunostimulant and growth promoting properties. It has now well known that after administration, a probiotic bacterium has to compete and establish itself against native microbiota to show its eventual beneficial properties. Due to their non-fish origin, commercial probiotics sometimes may display poor probiotic functionalities and antagonistic effects. Thus, isolation and characterization of probiotic bacteria from same fish host is very much necessary. In this study, attempts were made to isolate potent probiotic lactic acid bacteria (LAB) from intestinal microflora of rohu fish. Twenty-five experimental rohu fishes (mean weight 400 ± 20gm, mean standard length 20 ± 3cm) were used in the study to collect fish gut after dissection in a sterile condition. A total of 150 tentative LAB isolates from selective agar media (de Man-Rogosa-Sharpe (MRS)) were screened for their antimicrobial activity against Aeromonas hydrophila and Microccocus leuteus. A total of 17 isolates, identified as Lactobacillus plantarum and Lactococcus lactis, identified by biochemical tests and PCR amplification and sequencing of 16S rRNA gene fragment, displayed promising antimicrobial activity against both the pathogens. Two isolates from each species (FLB1, FLB2 from L. plantarum; and FLC1, FLC2 from L. lactis) were subjected to downstream probiotic potential characterization. These isolates were compared in vitro for their hemolytic activity, acid and bile tolerance for growth kinetics, auto-aggregation, cell-surface hydrophobicity against xylene, and chloroform, tolerance to phenol, cell adhesion, and safety parameters (by intraperitoneal and intramuscular injections). None of the tested isolates showed any hemolytic activity indicating their potential safety. Moreover, these isolates were tolerant to 0.3% bile (75-82% survival), phenol stress (96-99% survival) with 100% viability at pH 3 over a period of 3 h. Antibiotic sensitivity test revealed that all the tested LAB isolates were resistant to vancomycin, gentamicin, streptomycin, and erythromycin and sensitive to Erythromycin, Chloramphenicol, Ampicillin, Trimethoprim, and Nitrofurantoin. Tetracycline resistance was found in L. plantarum (FLB1 and FLB2 isolates), whereas L. lactis were susceptible to it. Intramuscular and intraperitoneal challenges to fingerlings of rohu fish (5 ± 1gm weight) with FLB1 showed no pathogenicity and occurrence of disease symptoms in fishes over an observation period of 7 days. The results revealed FLB1 as a potential probiotic candidate for aquaculture application among other isolates.

Keywords: aquaculture, Lactobacillus plantarum, Lactococcus lactis, probiotics

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Authors: Kgantsi B. T., Ochwelwang A. R., Mathuthu M., Jegede O. A.

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Anthropogenic activities near water bodies contribute to poor water quality, which degrades the condition of the biota and elevates the risk to human health. The Vaal River is essential in supplying Gauteng and neighboring regions of South Africa with portable water for a variety of consumers and industries. Consequently, it is necessary to monitor and assess the radioactive risk in relation to the river's water quality. This study used an inductive coupled plasma mass spectrometer (ICPMS) to analyze the radionuclide activity concentration in the Vaal River, South Africa. Along with thorium and potassium, the total uranium concentration was calculated using the isotopic content of uranium. The elemental concentration of ²³⁸U, ²³⁵U, ²³⁴U, ²³²Th, and 40K were translated into activity concentrations. To assess the water safety for all users and consumers, all values were compared to world average activity concentrations 35, 30, and 400 Bqkg⁻¹ for ²³⁸U, ²³⁴Th, and ⁴⁰K, respectively, according to the UNSCEAR report. The results will serve as a database for further monitoring and evaluation of the radionuclide from the river, taking cognisance of potential health hazards.

Keywords: Val Rivers, ICPMS, uranium, risks

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Authors: Negar Sartipzadeh

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The historic buildings are generally the ones which have been built by materials like brick, mud, stone, and wood. Some phenomena such as severe earthquakes can be tremendously detrimental to the structures, imposing serious effects and losses on such structures. Hence, it matters a lot to ascertain safety and reliability of the structures under such circumstances. It has been asserted that the major reason for the collapse of Unreinforced Masonry (URM) in various earthquakes is the incapability of resisting the forces and vice versa because such URMs are meant for the gravity load and they fail to withstand the shear forces inside the plate and the bending forces outside the plate. For this reason, restrengthening such structures is a key factor in lowering the seismic loss in developing countries. Seismic reinforcement of the historic buildings with regard to their cultural value on one hand, and exhaustion and damage of many of the structural elements on the other hand, have brought in restricting factors which necessitate the seismic reinforcement methods meant for such buildings to be maximally safe, non-destructive, effective, and non-obvious. Henceforth, it is pinpointed that making use of diverse technologies such as active controlling, Energy dampers, and seismic separators besides the current popular methods would be justifiable for such buildings, notwithstanding their high imposed costs.

Keywords: masonry buildings, seismic reinforcement, Unreinforced Masonry (URM), earthquake

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Authors: Wilailak Siripornadulsil, Siriyanapat Tasaku, Jutamas Buahorm, Surasak Siripornadulsil

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The objectives of this study were to isolate LAB from various sources, dietary supplement, Thai traditional fermented food, and freshwater fish and to characterize their potential as probiotic cultures. Out of 1,558 isolates, 730 were identified as LAB based on isolation on MRS agar supplemented with a bromocresol purple indicator and CaCO3 and gram-positive, catalase and oxidase negative characteristics. Eight isolates showed the potential probiotic properties including tolerance to acid, bile salt and heat, proteolytic, amylolytic and lipolytic activities and oxalate-degrading capability. They all showed the antimicrobial activity against some Gram-negative and Gram-positive pathogenic bacteria. Based on 16S rDNA sequence analysis, they were identified as Enterococcus faecalis BT2 and MG30, Leconostoc mesenteroides SW64 and Pediococcus pentosaceous BD33, CF32, NP6, PS34 and SW5. The health beneficial effects and food safety will be further investigated and developed as a probiotic or protective culture used in Nile tilapia belly flap meat fermentation.

Keywords: probiotic, lactic acid bacteria, pathogen, protective culture

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Authors: Heba A. Hazzah, Ragwa M. Farid, Maha M. A. Nasra, Mennatallah Zakria, Magda A. El Massik, Ossama Y. Abdallah

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Introduction: Curcumin (Cur) is a polyphenol derived from the herbal remedy and dietary spice turmeric. It possesses diverse anti-inflammatory and anti-cancer properties following oral or topical administration. The buccal delivery of curcumin can be useful for both systemic and local disease treatments such as gingivitis, periodontal diseases, oral carcinomas, and precancerous oral lesions. Despite of its high activity, it suffers a limited application due to its low oral bioavailability, poor aqueous solubility, and instability. Aim: Preparation and characterization of curcumin solid lipid nanoparticles with a high loading capacity into a mucoadhesive gel for buccal application. Methodology: Curcumin was formulated as nanoparticles using different lipids, namely Gelucire 39/01, Gelucire 50/13, Precirol, Compritol, and Polaxomer 407 as a surfactant. The SLN were dispersed in a mucoadhesive gel matrix to be applied to the buccal mucosa. All formulations were evaluated for their content, entrapment efficiency, particle size, in vitro drug dialysis, ex vivo mucoadhesion test, and ex vivo permeation study using chicken buccal mucosa. Clinical evaluation was conducted on 15 cases suffering oral erythroplakia and erosive lichen planus. Results: The results showed high entrapment efficiency reaching almost 90 % using Gelucire 50, the loaded gel with Cur-SLN showed good adhesion property and 25 minutes in vivo residence time. In addition to stability enhancement for the Cur powder. All formulae did not show any drug permeated however, a significant amount of Cur was retained within the mucosal tissue. Pain and lesion sizes were significantly reduced upon topical treatment. Complete healing was observed after 6 weeks of treatment. Conclusion: These results open a room for the pharmaceutical technology to optimize the use of this golden magical powder to get the best out of it. In addition, the lack of local anti-inflammatory compounds with reduced side effects intensifies the importance of studying natural products for this purpose.

Keywords: curcumin, erythroplakia, mucoadhesive, pain, solid lipid nanoparticles

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Authors: A. Ghadbane, M. N. Bouaziz, S. Hanini, B. Baggoura, M. Abbaci

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The spacer grids are used to fix the rods bundle in a nuclear reactor core also act as turbulence-enhancing devices to improve the heat transfer from the hot surfaces of the rods to the surrounding coolant stream. Therefore, the investigation of thermal-hydraulic characteristics inside the rod bundles is important for optima design and safety operation of a nuclear reactor power plant. This contribution presents a feasibility study to use the ribbed spacer grids as mixing devices. The present study evaluates the effects of different ribbed spacer grids configurations on flow pattern and heat transfer in the downstream of the mixing devices in a 2 x 2 rod bundle array. This is done by obtaining velocity and pressure fields, turbulent intensity and the heat transfer coefficient using a three-dimensional CFD analysis. Numerical calculations are performed by employing K-ε turbulent model. The computational results obtained are promising and the comparison with standard spacer grids shows a clear difference which required the experimental approach to validate.

Keywords: PWR fuel assembly, spacer grid, mixing vane, swirl flow, turbulent heat transfer, CFD

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Authors: Esmael Makarian, Ayub Elyasi, Fatemeh Saberi, Olusegun Stanley Tomomewo

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Rock mechanical investigation is one of the most crucial activities in underground operations, especially in surveys related to hydrocarbon exploration and production, geothermal reservoirs, energy storage, mining, and geotechnics. There is a wide range of traditional methods for driving, collecting, and analyzing rock mechanics data. However, these approaches may not be suitable or work perfectly in some situations, such as fractured zones. Cutting-edge technologies have been provided to solve and optimize the mentioned issues. Internet of Things (IoT), Edge, and Cloud Computing technologies (ECt & CCt, respectively) are among the most widely used and new artificial intelligence methods employed for geomechanical studies. IoT devices act as sensors and cameras for real-time monitoring and mechanical-geological data collection of rocks, such as temperature, movement, pressure, or stress levels. Structural integrity, especially for cap rocks within hydrocarbon systems, and rock mass behavior assessment, to further activities such as enhanced oil recovery (EOR) and underground gas storage (UGS), or to improve safety risk management (SRM) and potential hazards identification (P.H.I), are other benefits from IoT technologies. EC techniques can process, aggregate, and analyze data immediately collected by IoT on a real-time scale, providing detailed insights into the behavior of rocks in various situations (e.g., stress, temperature, and pressure), establishing patterns quickly, and detecting trends. Therefore, this state-of-the-art and useful technology can adopt autonomous systems in rock mechanical surveys, such as drilling and production (in hydrocarbon wells) or excavation (in mining and geotechnics industries). Besides, ECt allows all rock-related operations to be controlled remotely and enables operators to apply changes or make adjustments. It must be mentioned that this feature is very important in environmental goals. More often than not, rock mechanical studies consist of different data, such as laboratory tests, field operations, and indirect information like seismic or well-logging data. CCt provides a useful platform for storing and managing a great deal of volume and different information, which can be very useful in fractured zones. Additionally, CCt supplies powerful tools for predicting, modeling, and simulating rock mechanical information, especially in fractured zones within vast areas. Also, it is a suitable source for sharing extensive information on rock mechanics, such as the direction and size of fractures in a large oil field or mine. The comprehensive review findings demonstrate that digital transformation through integrated IoT, Edge, and Cloud solutions is revolutionizing traditional rock mechanical investigation. These advanced technologies have empowered real-time monitoring, predictive analysis, and data-driven decision-making, culminating in noteworthy enhancements in safety, efficiency, and sustainability. Therefore, by employing IoT, CCt, and ECt, underground operations have experienced a significant boost, allowing for timely and informed actions using real-time data insights. The successful implementation of IoT, CCt, and ECt has led to optimized and safer operations, optimized processes, and environmentally conscious approaches in underground geological endeavors.

Keywords: rock mechanical studies, internet of things, edge computing, cloud computing, underground surveys, geological operations

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Authors: Mohammad Y. Abualhoul, Edgar Talavera Munoz, Fawzi Nashashibi

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The new emerging Visible Light Communication (VLC) technology has been subjected to intensive investigation, evaluation, and lately, deployed in the context of convoy-based applications for Intelligent Transportations Systems (ITS). The technology limitations were defined and supported by different solutions proposals to enhance the crucial alignment and mobility limitations. In this paper, we propose the incorporation of VLC technology and Lane-Centering (LC) technique to assure the VLC-connectivity by keeping the autonomous vehicle aligned to the lane center using vision-based lane detection in a convoy-based formation. Such combination can ensure the optical communication connectivity with a lateral error less than 30 cm. As soon as the road lanes are detectable, the evaluated system showed stable behavior independently from the inter-vehicle distances and without the need for any exchanged information of the remote vehicles. The evaluation of the proposed system is verified using VLC prototype and an empirical result of LC running application over 60 km in Madrid M40 highway.

Keywords: visible light communication, lane-centerin, platooning, intelligent transportation systems, road safety applications

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Authors: B. Karabuluter, O. Karaduman

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Connected-Vehicles consists of intelligent vehicles, each of which can communicate with each other. Smart Cities are the most prominent application area of intelligent vehicles that can communicate with each other. The most important goal that is desired to be realized in Smart Cities planned for facilitating people's lives is to make transportation more comfortable and safe with intelligent/autonomous/driverless vehicles communicating with each other. In order to ensure these, the city must have communication infrastructure in the first place, and the vehicles must have the features to communicate with this infrastructure and with each other. In this context, intelligent transport studies to solve all transportation and traffic problems in classical cities continue to increase rapidly. In this study, current connected-vehicle applications developed for smart cities are considered in terms of communication techniques, vehicular networking, IoT, urban transportation implementations, intelligent traffic management, road safety, self driving. Taxonomies and assessments performed in the work show the trend of studies in inter-vehicle communication systems in smart cities and they are contributing to by ensuring that the requirements in this area are revealed.

Keywords: smart city, connected vehicles, infrastructures, VANET, wireless communication, intelligent traffic management

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Authors: Marzieh Ebrahimi, Vahid Changizi, Mohammad Reza Kardan, Seyed Mahdi Hosseini Pooya, Parham Geramifar

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Radiation exposure to the patient's family members is one of the major concerns during thyroid cancer radionuclide therapy. The aim of this study was to measure the total effective dose of the family members by means of thermoluminescence personal dosimeter, and compare with those calculated by analytical methods. Eighty-five adult family members of fifty-one patients volunteered to participate in this research study. Considering the minimum and maximum range of dose rate from 15 µsv/h to 120 µsv/h at patients' release time, the calculated mean and median dose values of family members were 0.45 mSv and 0.28 mSv, respectively. Moreover, almost all family members’ doses were measured to be less than the dose constraint of 5 mSv recommended by Basic Safety Standards. Considering the influence parameters such as patient dose rate and administrated activity, the total effective doses of family members were calculated by TEDE and NRC formulas and compared with those of experimental results. The results indicated that, it is fruitful to use the quantitative calculations for releasing patients treated with I-131 and correct estimation of patients' family doses.

Keywords: effective dose, thermoluminescence, I-131, thyroid cancer

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Authors: Azin Shakibabarough, Mojtaba Valinejadshoubi, Ashutosh Bagchi

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Structural vibration means repetitive motion that causes fatigue and reduction of the performance of a structure. An earthquake may release high amount of energy that can have adverse effect on all components of a structure. Therefore, decreasing of vibration or maintaining performance of structures such as bridges, dams, roads and buildings is important for life safety and reducing economic loss. When earthquake or any vibration happens, investigation on parts of a structure which sustain the seismic loads is mandatory to provide a safe condition for the occupants. One of the solutions for reducing the earthquake vibration in a structure is using of vibration control devices such as dampers and base isolators. The objective of this study is to investigate the optimal positions of friction dampers and base isolators for better seismic response of 2D frame. For this purpose, a two bay and six story frame with different distribution formats was modeled and some of their responses to earthquake such as inter-story drift, max joint displacement, max axial force and max bending moment were determined and compared using non-linear dynamic analysis.

Keywords: fast nonlinear analysis, friction damper, base isolator, seismic vibration control, seismic response

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Authors: Gajaanuja Megalathan, Banuka Athuraliya

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Crime is one of our society's most intimidating and threatening challenges. With the majority of the population residing in cities, many experts and data provided by local authorities suggest a rapid increase in the number of crimes committed in these cities in recent years. There has been an increasing graph in the crime rates. People living in Sri Lanka have the right to know the exact crime rates and the crime rates in the future of the place they are living in. Due to the current economic crisis, crime rates have spiked. There have been so many thefts and murders recorded within the last 6-10 months. Although there are many sources to find out, there is no solid way of searching and finding out the safety of the place. Due to all these reasons, there is a need for the public to feel safe when they are introduced to new places. Through this research, the author aims to develop a mobile application that will be a solution to this problem. It is mainly targeted at tourists, and people who recently relocated will gain advantage of this application. Moreover, the Arima Model combined with ANN is to be used to predict crime rates. From the past researchers' works, it is evidently clear that they haven’t used the Arima model combined with Artificial Neural Networks to forecast crimes.

Keywords: arima model, ANN, crime prediction, data analysis

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Authors: Mutadi

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Pipes laying on an unstable slope of soft soil are prone to movement. Pipelines that are buried in unstable slope areas will move due to lateral loads from soil movement, which can cause damage to the pipeline. A small-scale laboratory model of the reinforcement system of piles supported by retaining walls was conducted to investigate the effect of lateral load on the reinforcement. In this experiment, the lateral forces of 0.3 kN, 0.35 kN, and 0.4 kN and vertical force of 0.05 kN, 0.1 kN, and 0.15 kN were used. Lateral load from the electric jack is equipped with load cell and vertical load using the cement-steel box. To validate the experimental result, a finite element program named 2-D Plaxis was used. The experimental results showed that with an increase in lateral loading, the displacement of the reinforcement system increased. For a Vertical Load, 0.1 kN and versus a lateral load of 0.3 kN causes a horizontal displacement of 0.35 mm and an increase of 2.94% for loading of 0.35 kN and an increase of 8.82% for loading 0.4 kN. The pattern is the same in the finite element method analysis, where there was a 6.52% increase for 0.35 kN loading and an increase to 23.91 % for 0.4 kN loading. In the same Load, the Reinforcement System is reliable, as shown in Safety Factor on dry conditions were 3.3, 2.824 and 2.474, and on wet conditions were 2.98, 2.522 and 2.235.

Keywords: soft soil, deflection, wall, pipeline

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Authors: Kamal Hammad, Alexey Fedorenko, Ivan Sergeichev

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This study uses analytical modeling, experimental testing, and explicit numerical simulations to evaluate failure and spall damage in Carbon Fiber-Reinforced Polymer (CFRP) composite confinement vessels. It investigates the response of composite materials to explosive loading dynamic impact, revealing varied failure modes. Hashin damage was used to model inplane failure, while the Virtual Crack Closure Technique (VCCT) modeled inter-laminar damage. Results show moderate agreement between simulations and experiments regarding free surface velocity and failure stresses, with discrepancies due to wire alignment imperfections and wave reverberations in the experimental test. The findings can improve design and risk-reduction strategies in high-risk scenarios, leading to enhanced safety and economic efficiency in material assessment and structural design processes.

Keywords: explicit, numerical, spall, damage, CFRP, composite, vessels, explosive, dynamic, impact, Hashin, VCCT

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Authors: Imas Istiani

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The concept of home is usually closely related to the place of safety and security. For people who have travelled far and long, they long to be united with home to feel safe, secure and comfortable. However, for some people, especially for veterans, home cannot offer them those feelings, on the contrary, it can give them the sense of insecurity as well as guilty. Thus, its juxtaposed concept can also put home as an uncanny place that represses and haunt its occupant. As for veterans, 'survivor guilt' overpowers them in the way that it will be hard for them to embrace the comfort that home offers. In Home, Toni Morrison poignantly depicts Frank’s life upon returning from the war. Burdened with his traumatic experiences, Frank finds home full with terror, guilt, fear, grief, and loss. Using Dominick laCapra’s 'Trauma Theory,' the study finds that Frank works through his trauma by being able to distinguish between past and present so that he can overcome those repressed feelings. Aside from his inner healing power, Frank digests the process of working through with the help of home and community, as proposed by Evelyn Jaffe Schreiber claiming that community can help survivors to heal from traumatic experiences. Thus, Home has two juxtaposed functions; both as traumatizing and healing place.

Keywords: trauma, healing, home, trauma theory

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Authors: Abdulaziz Alakeel, Abdulrahman Alomair, Mohammed Fouda

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Introduction: Methotrexate (MTX) is an antimetabolite used to treat multiple conditions, including neoplastic diseases, severe psoriasis, and rheumatoid arthritis. Skin cancer is the out-of-control growth of abnormal cells in the epidermis, the outermost skin layer, caused by unrepaired DNA damage that triggers mutations. These mutations lead the skin cells to multiply rapidly and form malignant tumors. The aim of this review is to evaluate the risk of skin cancer associated with the use of methotrexate and to suggest regulatory recommendations if required. Methodology: Signal Detection team at Saudi Food and Drug Authority (SFDA) performed a safety review using National Pharmacovigilance Center (NPC) database as well as the World Health Organization (WHO) VigiBase, alongside with literature screening to retrieve related information for assessing the causality between skin cancer and methotrexate. The search conducted in July 2020. Results: Four published articles support the association seen while searching in literature, a recent randomized control trial published in 2020 revealed a statistically significant increase in skin cancer among MTX users. Another study mentioned methotrexate increases the risk of non-melanoma skin cancer when used in combination with immunosuppressant and biologic agents. In addition, the incidence of melanoma for methotrexate users was 3-fold more than the general population in a cohort study of rheumatoid arthritis patients. The last article estimated the risk of cutaneous malignant melanoma (CMM) in a cohort study shows a statistically significant risk increase for CMM was observed in MTX exposed patients. The WHO database (VigiBase) searched for individual case safety reports (ICSRs) reported for “Skin Cancer” and 'Methotrexate' use, which yielded 121 ICSRs. The initial review revealed that 106 cases are insufficiently documented for proper medical assessment. However, the remaining fifteen cases have extensively evaluated by applying the WHO criteria of causality assessment. As a result, 30 percent of the cases showed that MTX could possibly cause skin cancer; five cases provide unlikely association and five un-assessable cases due to lack of information. The Saudi NPC database searched to retrieve any reported cases for the combined terms methotrexate/skin cancer; however, no local cases reported up to date. The data mining of the observed and the expected reporting rate for drug/adverse drug reaction pair is estimated using information component (IC), a tool developed by the WHO Uppsala Monitoring Centre to measure the reporting ratio. Positive IC reflects higher statistical association, while negative values translated as a less statistical association, considering the null value equal to zero. Results showed that a combination of 'Methotrexate' and 'Skin cancer' observed more than expected when compared to other medications in the WHO database (IC value is 1.2). Conclusion: The weighted cumulative pieces of evidence identified from global cases, data mining, and published literature are sufficient to support a causal association between the risk of skin cancer and methotrexate. Therefore, health care professionals should be aware of this possible risk and may consider monitoring any signs or symptoms of skin cancer in patients treated with methotrexate.

Keywords: methotrexate, skin cancer, signal detection, pharmacovigilance

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Authors: Amber Dhoot, Tarush Gupta, Andrea Gurr, William Jenkins, Sandro Pietrunti, Alexis Tang

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Background: The COVID-19 pandemic has driven pharmacovigilance towards a new paradigm. Nowadays, more people than ever before are recognising and reporting adverse reactions from medications, treatments, and vaccines. In the modern era, with over 3.8 billion users, social media has become the most accessible medium for people to voice their opinions and so provides an opportunity to engage with more patient-centric and accessible pharmacovigilance. However, the pharmaceutical industry has been slow to incorporate social media into its modern pharmacovigilance strategy. This project aims to make social media a more effective tool in pharmacovigilance, and so reduce drug costs, improve drug safety and improve patient outcomes. This will be achieved by firstly uncovering and categorising the barriers facing the widespread adoption of social media in pharmacovigilance. Following this, the potential opportunities of social media will be explored. We will then propose realistic, practical recommendations to make social media a more effective tool for pharmacovigilance. Methodology: A comprehensive systematic literature review was conducted to produce a categorised summary of these barriers. This was followed by conducting 11 semi-structured interviews with pharmacovigilance experts to confirm the literature review findings whilst also exploring the unpublished and real-life challenges faced by those in the pharmaceutical industry. Finally, a survey of the general public (n = 112) ascertained public knowledge, perception, and opinion regarding the use of their social media data for pharmacovigilance purposes. This project stands out by offering perspectives from the public and pharmaceutical industry that fill the research gaps identified in the literature review. Results: Our results gave rise to several key analysis points. Firstly, inadequacies of current Natural Language Processing algorithms hinder effective pharmacovigilance data extraction from social media, and where data extraction is possible, there are significant questions over its quality. Social media also contains a variety of biases towards common drugs, mild adverse drug reactions, and the younger generation. Additionally, outdated regulations for social media pharmacovigilance do not align with new, modern General Data Protection Regulations (GDPR), creating ethical ambiguity about data privacy and level of access. This leads to an underlying mindset of avoidance within the pharmaceutical industry, as firms are disincentivised by the legal, financial, and reputational risks associated with breaking ambiguous regulations. Conclusion: Our project uncovered several barriers that prevent effective pharmacovigilance on social media. As such, social media should be used to complement traditional sources of pharmacovigilance rather than as a sole source of pharmacovigilance data. However, this project adds further value by proposing five practical recommendations that improve the effectiveness of social media pharmacovigilance. These include: prioritising health-orientated social media; improving technical capabilities through investment and strategic partnerships; setting clear regulatory guidelines using multi-stakeholder processes; creating an adverse drug reaction reporting interface inbuilt into social media platforms; and, finally, developing educational campaigns to raise awareness of the use of social media in pharmacovigilance. Implementation of these recommendations would speed up the efficient, ethical, and systematic adoption of social media in pharmacovigilance.

Keywords: adverse drug reaction, drug safety, pharmacovigilance, social media

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Authors: Ksenia Siadkowska, Tytus Tulwin, Rafał Sochaczewski

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Selecting appropriate materials is presently a complex task as material databases cover tens of thousands of different types of materials. Product designing proceeds in numerous stages and in most of them there are open questions with not only one correct solution but better and worse ones. This paper overviews the Diesel engine body construction materials mentioned in the literature and discusses a certain practical method to select materials for a cylinder head and a Diesel engine block as a prototype. The engine body, depending on its purpose, is most frequently iron or aluminum. If it is important to optimize parts to achieve low weight, aluminum alloys are usually applied, especially in the automotive and aviation industries. In the latter case, weight is even more important so new types of magnesium alloys which are even lighter than aluminum ones are developed and used. However, magnesium alloys are, for example, more flammable and not enough strong so, for safety reasons, this type of material is not used solely in engine bodies. Acknowledgement: This work has been realized in the cooperation with The Construction Office of WSK "PZL-KALISZ" S.A." and is part of Grant Agreement No. POIR.01.02.00-00-0002/15 financed by the Polish National Centre for Research and Development.

Keywords: aluminum alloy, cylinder head, Diesel engine, materials selection

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Authors: Dewi Hardiningtyas Sugiono

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Concerning towards the quality of air comfort and safety to pedestrians in the University area should be increased as Indonesia economics booming. Hence, the University management needs guidelines of thermal comfort to innovate a new layout building. The objectives of this study is to investigate and then to evaluate the distribution of thermal comfort which is indicated by predicted mean vote (PMV) index at the University of Brawijaya (UB), Malang. The PMV figures are used to evaluate and to redesign the UB layout. The research is started with study literature and early survey to collect all information of building layout and building shape at the University of Brawijaya. The information is used to create a 3D model in CAD software. The model is simulated by Computational Fluid Dynamic (CFD) software to measure the PMV factors of air temperature, relative humidity and air speed in some locations. Validation is done by comparing between PMV value from observation and PMV value from simulation. The resuls of the research shows the most sensitive of microclimatic factors is air temperature surrounding the UB building. Finally, the research is successfully figure out the UB layout and provides further actions to increase the thermal comfort.

Keywords: thermal comfort, heat index (HI), CFD, layout

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Authors: Rammah Abdlbagi, Egmen Tazcan, Kiriti Tripathi, Vinayagam Sudhakar, Thomas Swallow, Aakash Pai

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Introduction and Objectives: MRI has an increasing role in the diagnosis and staging of prostate cancer. Multiparametric MRI includes multiple sequences, including T2 weighting, diffusion weighting, and dynamic contrast enhancement (DCE). Administration of DCE is expensive, time-consuming, and requires medical supervision due to the risk of anaphylaxis. Biparametric MRI (bpMRI), without DCE, overcomes many of these issues; however, there is conflicting data on its accuracy. Furthermore, data on the concordance between bpMRI lesion and pathology specimen, as well as the rates of cancer stage upgrading after surgery, is limited within the available literature. This study aims to examine the diagnostic test accuracy of bpMRI in the diagnosis of prostate cancer and radiological assessment of prostate cancer staging. Specifically, we aimed to evaluate the ability of bpMRI to accurately localise malignant lesions to better understand its accuracy and application in MRI-targeted biopsies. Materials and Methods: One hundred and forty patients who underwent bpMRI prior to radical prostatectomy (RP) were retrospectively reviewed from a single institution. Histological grade from the prostate biopsy was compared with surgical specimens from RP. Clinically significant prostate cancer (csPCa) was defined as Gleason grade group ≥2. bpMRI staging was compared with RP histology. Results: Overall sensitivity of bpMRI in diagnosing csPCa independent of location and staging was 98.87%. Of the 140 patients, 29 (20.71%) had their prostate biopsy histology upgraded at RP. 61 (43.57%) patients had csPca noted on RP specimens in areas that were not identified on the bpMRI. 55 (39.29%) had upstaging after RP from the original staging with bpMRI. Conclusions: Whilst the overall sensitivity of bpMRI in predicting any clinically significant cancer was good, there was notably poor concordance in the location of the tumour between bpMRI and eventual RP specimen. The results suggest that caution should be exercised when using bpMRI for targeted prostate biopsies and validates the continued role of systemic biopsies. Furthermore, a significant number of patients were upstaged at RP from their original staging with bpMRI. Based on these findings, bpMRI results should be interpreted with caution and can underestimate TNM stage, requiring careful consideration of treatment strategy.

Keywords: biparametric MRI, Ca prostate, staging, post prostatectomy histology

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Authors: John Onyima, Ikechukwu Ezepue

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Virtualization and cloud computing are among the fast-growing computing innovations in recent times. Organisations all over the world are moving their computing services towards the cloud this is because of its rapid transformation of the organization’s infrastructure and improvement of efficient resource utilization and cost reduction. However, this technology brings new security threats and challenges about safety, reliability and data confidentiality. Evidently, no single security technique can guarantee security or protection against malicious attacks on a cloud computing network hence an integrated model of intrusion detection and prevention system has been proposed. Anomaly-based and signature-based detection techniques will be integrated to enable the network and its host defend themselves with some level of intelligence. The anomaly-base detection was implemented using the local deviation factor graph-based (LDFGB) algorithm while the signature-based detection was implemented using the snort algorithm. Results from this collaborative intrusion detection and prevention techniques show robust and efficient security architecture for cloud computing networks.

Keywords: anomaly-based detection, cloud computing, intrusion detection, intrusion prevention, signature-based detection

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Authors: A. Kolendo

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Pacific Islands are one of the most vulnerable areas to climate change. Sea level rise and accelerating storm surge continuously threaten the communities' habitats on low-lying atolls. With scientific predictions of encroaching tides on their land, the Islanders have been informed about the need for future relocation planning. However, some communities oppose such retreat strategies through the reasoning that comprehends current climatic changes through the lenses of the biblical ark of Noah. This parable states God's promise never to flood the Earth again and never deprive people of their land and habitats. Several interpretations of this parable emerged in Oceania, prompting either climate action or denial. Resistance to relocation planning expressed through Christian thoughts led religion to be perceived as a barrier to dialogue between the Islanders and scientists. Since climate change concerns natural processes, the attitudes towards environmental stewardship prompt the communities' responses to it; some Christian teachings indicate humanity's responsibility over the environment, whereas others ascertain the people's dominion, which prompts resistance and sometimes denial. With church denominations and their various environmental standpoints, competing responses to climate change emerged in Oceania. Before miss-ionization, traditional knowledge had guided the environmental sphere, influencing current Christian teachings. Each atoll characterizes a distinctive manner of traditional knowledge; however, the unique relationship with nature unites all islands. The interconnectedness between the land, sea and people indicates the integrity between the communities and their environments. Such a factor influences the comprehension of Noah's story in the context of climate change that threatens their habitats. Pacific Islanders experience climate change through the slow disappearance of their homelands. However, the Western world perceives it as a global issue that will affect the population in the long-term perspective. Therefore, the Islanders seek to comprehend this global phenomenon in a local context that reads climate change as the Great Deluge. Accordingly, the safety measures that this parable promotes compensate for the danger of climate change. The rainbow covenant gives hope in God's promise never to flood the Earth again. At the same time, Noah's survival relates to the Islanders' current situation. Since these communities have the lowest carbon emissions rate, their contribution to anthropogenic climate change is scarce. Therefore, the lack of environmental sin would contextualize them as contemporary Noah with the ultimate survival of sea level rise. This study aims to defy religion constituting a barrier through secondary data analysis from a risk compensation perspective. Instead, religion is portrayed as a source of knowledge that enables comprehension of the communities' situation. By demonstrating that the Pacific Islanders utilize Noah's story as a vessel for coping with the danger of climate change, the study argues that religion provides safety measures that compensate for the future projections of land's disappearance. The purpose is to build a bridge between religious communities and scientific bodies and ultimately bring an understanding of two diverse perspectives. By addressing the practical challenges of interdisciplinary research with faith-based systems, this study uplifts the voices of communities and portrays their experiences expressed through Christian thoughts.

Keywords: Christianity, climate change, existential threat, Pacific Islands, story of Noah

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Authors: Ezgi Yurdakul, Klaus-Alexander Rieder, Richard Sibbick

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Most of the shotcrete projects require compliance with meeting a specified early-age strength target (e.g., reaching 1 MPa in 1 hour) that is selected based on the underground conditions. To meet the desired early-age performance characteristics, accelerators are commonly used as they increase early-age strength development rate and accelerate the setting thereby reducing sagging and rebound. The selection of accelerator type and its dosage is made by the setting time and strength required for the shotcrete application. While alkaline and alkali-free accelerators are the two main types used in wet-mix shotcrete; alkali-free admixtures increasingly substitute the alkaline accelerators to improve the performance and working safety. This paper aims to evaluate the impact of alkali-free accelerators in wet-mix on various tests including set time, early and later-age compressive strength, boiled absorption, and electrical resistivity. Furthermore, the comparison between accelerated and non-accelerated samples will be made to demonstrate the interaction between cement and accelerators. Scanning electron microscopy (SEM), fluorescent resin impregnated thin section and cut and polished surface images will be used to understand the microstructure characterization of mixes in the presence of accelerators.

Keywords: accelerators, chemical admixtures, shotcrete, sprayed concrete

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Authors: Nigatu Tadesse, Ying Liu, Juan Li, Hong Ming Liu

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Gastric carcinogenesis is a lengthy process of histopathological transition from normal to atrophic gastritis (AG) to intestinal metaplasia (GIM), dysplasia toward gastric cancer (GC). The stage of GIM identified as precancerous lesions with resistance to H-pylori eradication and recurrence after endoscopic surgical resection therapies. GIM divided in to two morphologically distinct phenotypes such as complete GIM bearing intestinal type morphology whereas the incomplete type has colonic type morphology. The incomplete type GIM considered to be the greatest risk factor for the development of GC. Studies indicated the expression of the caudal type homeobox 2 (CDX2) gene is responsible for the development of complete GIM but its progressive downregulation from incomplete metaplasia toward advanced GC identified as the risk for IM progression and neoplastic transformation. The downregulation of CDX2 gene have promoted cell growth and proliferation in gastric and colon cancers and ascribed in chemo-treatment inefficacies. CDX2 downregulated through promoter region hypermethylation in which the methylation frequency positively correlated with the dietary history of the patients, suggesting the role of diet as methyl carbon donor sources such as methionine. However, the metabolism of exogenous methionine is yet unclear. Targeting exogenous methionine metabolism has become a promising approach to limits tumor cell growth, proliferation and progression and increase treatment outcome. This review article discusses molecular alterations that could shed light on the potential of exogenous methionine metabolisms, such as gut microbiota alteration as sources of methionine to host cells, metabolic pathway signaling via PI3K/AKt/mTORC1-c-MYC to rewire exogenous methionine and signature of increased gene methylation index, cell growth and proliferation in GIM, with insights to new treatment avenue via targeting methionine metabolism, and the need for future integrated studies on molecular alterations and metabolomics to uncover altered methionine metabolism and characterization of CDX2 methylation in gastric intestinal metaplasia for potential therapeutic exploitation.

Keywords: altered methionine metabolism, Intestinal metaplesia, CDX2 gene, gastric cancer

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Authors: Jiawei Chen, Jia Qu, Dianwei Ju

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316L stainless steel has good mechanical and technological properties, has been widely used in shipbuilding and aerospace manufacturing. In order to understand the effect of strain rate on the yield limit of 316L stainless steel and the constitutive relationship of the materials at different strain rates, this paper used the INSTRON-4505 electronic universal testing machine to study the mechanical properties of the tensile specimen under quasi-static conditions. Meanwhile, the Zwick-Roell RKP450 intelligent oscillometric impact tester was used to test the tensile specimens at different strain rates. Through the above two kinds of experimental researches, the relationship between the true stress-strain and the engineering stress-strain at different strain rates is obtained. The result shows that the tensile yield point of 316L stainless steel increases with the increase of strain rate, and the real stress-strain curve of the 316L stainless steel has a better normalization than that of the engineering stress-strain curve. The real stress-strain curves can be used in the practical engineering of impact stretch to improve its safety.

Keywords: impact stretch, 316L stainless steel, strain rate, real stress-strain, normalization

Procedia PDF Downloads 280

Authors: Emanuela Chiarella, Clelia Nisticò, Nicola Lombardo, Giovanna Lucia Piazzetta, Nadia Lobello, Maria Mesuraca

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Killian’s Antrochoanal Polyp is a benign lesion of the maxillary sinus characterized by unilateral nasal obstruction, pus discharge, and headache. It affects, more commonly children and young adults. Although its etiology still remains unclear, chronic inflammation, autoreactivity, allergies, and viral infections are strongly associated with its formation and development, resulting in nasal tissue remodeling. We aimed to investigate the stem cells components which reside in this pathological tissue. In particular, we adopted a protocol for the isolation and culturing of mesenchymal stem cells from surgical biopsies of three Killian nasal polyp patients (KNP-MSCs) as well as from their healthy nasal tissue (HNT-MSCs) that were used as controls. The immunophenotype profile of HNT-MSCs and KNP-MSCs was more similar, with a marked positivity for CD73, CD90, and CD105 expression, while being negative for CD34 and CD14 haematopoietic genes. Cell proliferation assay showed that KNP-MSCs had a replicative disadvantage compared to HNT-MSCs, as evidenced by the significantly lower number of cells in the S-phase of the cell cycle. KNP-MSCs also took longer to close a wound than HNT-MSCs, indicating a partial epithelial phenotype in which low levels of ICAM-1 mRNA and a significant increase in E-CAD transcript were detectable. Subsequently, the differentiation potential of both MSCs populations was analyzed by inducing osteoblastic or adipocyte differentiation for up to 20 days. KNP-MSCs showed the ability to differentiate into osteoblasts, although ALP activity as well as the number and size of calcium deposits were lower than osteogenic induced-HNT-MSCs. Also, mRNA levels of osteoblastic marker genes (OCN, OPN, OSX, RUNX2) resulted lower compared to control cell population. Instead, the analysis of the adipogenic differentiation potential showed a similar behavior between KNP-MSCs and HNT-MSCs considering that the amount of lipid droplets, the expression of adipocyte-specific genes (FABP4, AdipoQ, PPARγ2, LPL) and the content of triacylglycerols were almost overlapping. Taken together, these results first demonstrated that Killian's nasal polyp is a source of mesenchymal stem cells with self-renewal and multi-differentiative capabilities.

Keywords: Mesenchymal stem cells, adipogenic differentiation, osteogenic differentiation, EMT

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Authors: Babar Khan, Wang Zhijie

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Machine Vision has been playing a significant role in Industrial Automation, to imitate the wide variety of human functions, providing improved safety, reduced labour cost, the elimination of human error and/or subjective judgments, and the creation of timely statistical product data. Despite the intensive research, there have not been any attempts to classify fabric prints based on printed texture and colour, most of the researches so far encompasses only black and white or grey scale images. We proposed a biologically inspired processing architecture to classify fabrics w.r.t. the fabric print texture and colour. We created a texture descriptor based on the HMAX model for machine vision, and incorporated colour descriptor based on opponent colour channels simulating the single opponent and double opponent neuronal function of the brain. We found that our algorithm not only outperformed the original HMAX algorithm on classification of fabric print texture and colour, but we also achieved a recognition accuracy of 85-100% on different colour and different texture fabric.

Keywords: automatic classification, texture descriptor, colour descriptor, opponent colour channel

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Authors: Syed Zameer, Mohamed Haneef

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Hip joint plays very important role in human beings as it takes up the whole body forces generated due to various activities. These loads are repetitive and fluctuating depending on the activities such as standing, sitting, jogging, stair casing, climbing, etc. which may lead to failure of Hip joint. Hip joint modification and replacement are common in old aged persons as well as younger persons. In this research study static and Fatigue analysis of Hip joint model was carried out using finite element software ANSYS. Stress distribution obtained from result of static analysis, material properties and S-N curve data of fabricated Ultra High molecular weight polyethylene / 50 wt% short E glass fibres + 40 wt% TiO2 Polymer matrix composites specimens were used to estimate fatigue life of Hip joint using stiffness Degradation model for polymer matrix composites. The stress distribution obtained from static analysis was found to be within the acceptable range.The factor of safety calculated from linear Palmgren linear damage rule is less than one, which indicates the component is safe under the design.

Keywords: hip joint, polymer matrix composite, static analysis, fatigue analysis, stress life approach

Procedia PDF Downloads 356