Search results for: disseminated intravascular coagulation (DIC)

Authors: Kai-Shiang Chang, Shiao-Shing Chen, Saikat Sinha Ray, Hung-Te Hsu

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In recent years, membrane bioreactors (MBR) have been widely utilized as it can effectively replace conventional activated sludge process (CAS). Membrane bioreactor (MBR) is found to be more effective technology compared to other conventional activated sludge process and advanced membrane separation technique. Additionally, as far as the MBR is concerned, it is having excellent control of sludge retention time (SRT) and hydraulic retention time (HRT) and conducive to the retention of high concentration of sludge biomass. The membrane bioreactor (MBR) can effectively reduce footprint in terms of area and omit the secondary processing procedures in the conventional activated sludge process (CAS). Currently, as per the membrane technology, the ceramic membrane is found to have highly strong anti-acid-base properties, and it is more suitable than polymeric membrane while using for backwash and chemical cleaning. This study is based upon the treatment of Cutting Fluid wastewater, as the Cutting Fluid is widely used in the cutting equipment. However, the Cutting Fluid wastewater is very difficult to treat. In this study, the ceramic membrane was used and combine with of MBR system to treat the Cutting Fluid wastewater. In this present study, different kind of chemical coagulants have been utilized for pretreatment purpose in order to get the supernatant and simultaneously this wastewater (supernatant) was treated by MBR process. Nevertheless, ceramic membrane has three advantages such as high mechanical strength, drug resistance and reuse. During the experiment, the backwash technique was used for every interval of 10 minutes in order to avoid fouling of the membrane. In this study, during pretreatment the Chemical Oxygen Demand (COD) removal efficiency was found to be 71-86% and oil removal efficiency was analyzed to be 83-92%. This pretreatment study suggests that it is quiet effective methodology to reduce COD and oil concentration. Finally, In the MBR system when the HRT is more than 7.5 hour, the COD removal efficiency was found to be 87-93% and could achieve 100% oil removal efficiency. Coagulation test series were seen in Refs coagulants for the treatment of wastewater containing cutting oil with better oil and COD removal efficiency. The results also showed that the oil removal efficiency in the MBR system could reduce the oil content to less than 1 mg / L when the oil quality was 126 mg / L. Therefore, in this paper, the performance of membrane bioreactor by utilizing ceramic membrane has been demonstrated for treatment of Cutting Fluid wastewater.

Keywords: membrane bioreactor, cutting fluid, oil, chemical oxygen demand

Procedia PDF Downloads 316

Authors: Merrick Lopez, Aashish Abraham, Melissa Egge, Marissa Hood, Jui Shah

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A 3 year old male with unknown medical history presented initially with encephalopathy, intubated for respiratory failure, and admitted to the pediatric intensive care unit (PICU) with refractory shock. During resuscitation in the emergency department, he was found to be in severe metabolic acidosis with a pH of 7.03 and escalated on vasopressor drips for hypotension. His initial sodium was 174. He was noted to have burn injuries to his scalp, forehead, right axilla, bilateral arm creases and lower legs. He had rhabdomyolysis (initial creatinine kinase 5,430 U/L with peak levels of 62,340 normal <335 U/L), cardiac injury (initial troponin 88 ng/L with peak at 145 ng/L, normal <15ng/L), hypernatremia (peak 174, normal 140), hypocalcemia, liver injury, acute kidney injury, and neuronal loss on magnetic resonance imaging (MRI). Soft restraints and a shock collar were found in the home. He was critically ill for 8 days, but was gradually weaned off drips, extubated, and started on feeds. Discussion Electrical injury, specifically lightning injury is an uncommon but devastating cause of injury in pediatric patients. This patient with suspected abusive use of a dog shock collar presented similar to a lightning strike. Common entrance points include the hands and head, similar to our patient with linear wounds on his forehead. When current enters, it passes through tissues with the least resistance. Nerves, blood vessels, and muscles, have high fluid and electrolyte content and are commonly affected. Exit points are extremities: our child who had circumferential burns around his arm creases and ankles. Linear burns preferentially follow areas of high sweat concentration, and are thought to be due to vaporization of water on the skin’s surface. The most common cause of death from a lightning strike is due to cardiopulmonary arrest. The massive depolarization of the myocardium can result in arrhythmias and myocardial necrosis. The patient presented in cardiogenic shock with evident cardiac damage. Electricity going through vessels can lead to vaporization of intravascular water. This can explain his severe hypernatremia. He also sustained other internal organ injuries (adrenal glands, pancreas, liver, and kidney). Electrical discharge also leads to direct skeletal muscle injury in addition to prolonged muscular spasm. Rhabdomyolysis, the acute damage of muscle, leads to release of potentially toxic components into the circulation which could lead to acute renal failure. The patient had severe rhabdomyolysis and renal injury. Early hypocalcemia has been consistently demonstrated in patients with rhabdomyolysis. This was present in the patient and led to increased vasopressor needs. Central nervous system injuries are also common which can include encephalopathy, hypoxic injury, and cerebral infarction. The patient had evidence of brain injury as seen on MRI. Conclusion Electrical injuries due to lightning strikes and abusive use of a dog shock collar are rare, but can both present in similar ways with respiratory failure, shock, hypernatremia, rhabdomyolysis, brain injury, and multiorgan damage. Although rare, it is essential for early identification and prompt management for acute and chronic complications in these children.

Keywords: cardiogenic shock, dog shock collar, lightning strike, rhabdomyolysis

Procedia PDF Downloads 89

Authors: Dedjo Yao Simon, Takahiro Saito, Norikazu Inuzuka, Ikuo Sugiyama

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Abidjan city (Republic of Ivory Coast) is an emerging megacity and an urban coastal area where the number of floods reported is on a rapid increase due to climate change and unplanned urbanization. However, comprehensive disaster mitigation plans, policies, and financial resources are still lacking as the population ignores the extent and location of the flood zones; making them unprepared to mitigate the damages. Considering the existing condition, this paper aims to discuss an approach for flood risk reduction in Cocody Commune through value capture strategy and flood risk communication. Using geospatial techniques and hydrological simulation, we start our study by delineating flood zones and depths under several return periods in the study area. Then, through a questionnaire a field survey is conducted in order to validate the flood maps, to estimate the flood risk and to collect some sample of the opinion of residents on how the flood risk information disclosure could affect the values of property located inside and outside the flood zones. The results indicate that the study area is highly vulnerable to 5-year floods and more, which can cause serious harm to human lives and to properties as demonstrated by the extent of the 5-year flood of 2014. Also, it is revealed there is a high probability that the values of property located within flood zones could decline, and the values of surrounding property in the safe area could increase when risk information disclosure commences. However in order to raise public awareness of flood disaster and to prevent future housing promotion in high-risk prospective areas, flood risk information should be disseminated through the establishment of an early warning system. In order to reduce the effect of risk information disclosure and to protect the values of property within the high-risk zone, we propose that property tax increments in flood free zones should be captured and be utilized for infrastructure development and to maintain the early warning system that will benefit people living in flood prone areas. Through this case study, it is shown that combination of value capture strategy and risk communication could be an effective tool to educate citizen and to invest in flood risk reduction in emerging countries.

Keywords: Cocody-Abidjan, flood, geospatial techniques, risk communication, value capture

Procedia PDF Downloads 279

Authors: Siti Aisya Gany, Swee Ching Tan, Sook Yee Gan

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Diminished antioxidant defense or increased production of reactive oxygen species in the biological system can result in oxidative stress which may lead to various neurodegenerative diseases including Alzheimer’s disease (AD). Microglial activation also contributes to the progression of AD by producing several pro-inflammatory cytokines, nitric oxide (NO), and prostaglandin E2 (PGE2). Oxidative stress and inflammation have been reported to be possible pathophysiological mechanisms underlying AD. In addition, the cholinergic hypothesis postulates that memory impairment in patient with AD is also associated with the deficit of cholinergic function in the brain. Although a number of drugs have been approved for the treatment of AD, most of these synthetic drugs have diverse side effects and yield relatively modest benefits. Marine algae have great potential in pharmaceutical and biomedical applications as they are valuable sources of bioactive properties such as anti-coagulation, anti-microbial, anti-oxidative, anti-cancer and anti-inflammatory. Hence, this study aimed to provide an overview of the properties of Malaysian seaweeds (Padina australis, Sargassum polycystum and Caulerpa racemosa) in inhibiting oxidative stress, neuroinflammation and cholinesterase enzymes. All tested samples significantly exhibit potent DPPH and moderate Superoxide anion radical scavenging ability (P<0.05). Hexane and methanol extracts of S. polycystum exhibited the most potent radical scavenging ability with IC50 values of 0.1572 ± 0.004 mg/ml and 0.8493 ± 0.02 for DPPH and ABTS assays, respectively. Hexane extract of C. racemosa gave the strongest superoxide radical inhibitory effect (IC50 of 0.3862± 0.01 mg/ml). Most seaweed extracts significantly inhibited the production of cytokine (IL-6, IL-1 β, TNFα) and NO in a concentration-dependent manner without causing significant cytotoxicity to the lipopolysaccharide (LPS)-stimulated microglia cells (P<0.05). All extracts suppressed cytokine and NO level by more than 80% at the concentration of 0.4mg/ml. In addition, C. racemosa and S. polycystum also showed anti-acetylcholinesterase activities with the IC50 values ranging from 0.086-0.115 mg/ml. Moreover, C. racemosa and P. australis were also found to be active against butyrylcholinesterase with IC50 values ranging from 0.118-0.287 mg/ml.

Keywords: anti-cholinesterase, anti-oxidative, neuroinflammation, seaweeds

Procedia PDF Downloads 663

Authors: Apoorva D. R.

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INTRODUCTION: Hemophagocytic lymphohistiocytosis (HLH) is a severe, potentially fatal syndrome in which there is excessive immune activation. The disease is seen in children and people of all ages, but infants from birth to 18 months are most frequently affected. HLH is a sporadic or familial condition that can be triggered by various events that disturb immunological homeostasis. In cases with a genetic predisposition and sporadic occurrences, infection is a frequent trigger. Because of the rarity of this disease, the diverse clinical presentation, and the lack of specificity in the clinical and laboratory results, prompt treatment is essential, but the biggest obstacle to a favorable outcome is frequently a delay in identification. CASE REPORT: Here we report a case of a 6-month-old male infant who presented to the dermatology outpatient with disseminated skin lesions present over the face, abdomen, scalp, and bilateral upper and lower limbs for the past month. The lesions were insidious in onset, initially started over the abdomen, and gradually progressed to involve other body parts. The patient also had a history of fever which was moderate in grade, on and off in nature for 1 month. There were no significant complaints in the past, family, or drug history. There was no history of feeding difficulties in the baby. Parents gave a history of developmental milestones appropriate for age. Examination findings include multiple well-defined monomorphic erythematous papules with a central crater present over bilateral cheeks. Few lichenoid shiny papules present over bilateral arms, legs, and abdomen. Ultrasound of the abdomen and pelvis showed mild degree hepatosplenomegaly, intraabdominal lymphadenopathy, and bilateral inguinal lymphadenopathy. Routine blood investigations showed anemia and lymphopenia. Multiple X-rays of the skull, chest, and bilateral upper and lower limbs were done and were normal. Histopathology features were suggestive of non-Langerhans cell cutaneous histiocytosis. CONCLUSION: HLH is a fatal and rare disease. A high level of suspicion and an interdisciplinary approach among experienced clinicians, pathologists, and microbiologists to define the diagnosis and causative disease are key to diagnosing this case. Early detection and treatment can reduce patient morbidity and mortality.

Keywords: histiocytosis, non langerhans cell, case report, fatal, rare

Procedia PDF Downloads 91

Authors: Klazina T. Havinga, Hilde R. H. de Geus

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Introduction: Pre-operative coagulation management of Apixaban prescribed patients, a new oral anticoagulant (a factor Xa inhibitor), is difficult, especially when chronic kidney disease (CKD) causes drug overdose. Apixaban is not dialyzable due to its high level of protein binding. An antidote, Andexanet α, is available but expensive and has an unfavorable short half-life. We report the successful extracorporeal removal of Apixaban prior to emergency surgery with the CytoSorb® Hemoadsorption device. Methods: A 89-year-old woman with CKD, with an Apixaban prescription for atrial fibrillation, was presented at the ER with traumatic rib fractures, a flail chest, and an unstable spinal fracture (T12) for which emergency surgery was indicated. However, due to very high Apixaban levels, this surgery had to be postponed. Based on the Apixaban-specific anti-factor Xa activity (AFXaA) measurements at admission and 10 hours later, complete clearance was expected after 48 hours. In order to enhance the Apixaban removal and reduce the time to operation, and therefore reduce pulmonary complications, CRRT with CytoSorb® cartridge was initiated. Apixaban-specific anti-factor Xa activity (AFXaA) was measured frequently as a substitute for Apixaban drug concentrations, pre- and post adsorber, in order to calculate the adsorber-related clearance. Results: The admission AFXaA concentration, as a substitute for Apixaban drug levels, was 218 ng/ml, which decreased to 157 ng/ml after ten hours. Due to sustained anticoagulation effects, surgery was again postponed. However, the AFXaA levels decreased quickly to sub-therapeutic levels after CRRT (Multifiltrate Pro, Fresenius Medical Care, Blood flow 200 ml/min, Dialysate Flow 4000 ml/h, Prescribed renal dose 51 ml-kg-h) with Cytosorb® connected in series into the circuit was initiated (within 5 hours). The adsorber-related (indirect) Apixaban clearance was calculated every half hour (Cl=Qe * (AFXaA pre- AFXaA post/ AFXaA pre) with Qe=plasma flow rate calculated with Ht=0.38 and system blood flow rate 200 ml-min): 100 ml/min, 72 ml/min and 57 ml/min. Although, as expected, the adsorber-related clearance decreased quickly due to saturation of the beads, still the reduction rate achieved resulted in a very rapid decrease in AFXaA levels. Surgery was ordered and possible within 5 hours after Cytosorb initiation. Conclusion: The CytoSorb® Hemoadsorption device enabled rapid correction of Apixaban associated anticoagulation.

Keywords: Apixaban, CytoSorb, emergency surgery, Hemoadsorption

Procedia PDF Downloads 158

Authors: Nazlı Çetindağ, Pelin Yılmaz Çetiner, Metin Mert İlgün, Emine Birci, Gizemnur Yıldız Uysal, Özcan Hatipoğlu, Ehsan Tuzcuoğlu, Gökhan Sır

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Water scarcity is an unavoidable issue impacting an increasing number of individuals daily, representing a global crisis stemming from swift population growth, urbanization, and excessive resource exploitation. Consequently, solutions that involve the reclamation of wastewater are considered essential. In this context, household wastewater, categorized as greywater, plays a significant role in freshwater used for residential purposes and is attributed to washing. This type of wastewater comprises diverse elements, including organic substances, soaps, detergents, solvents, biological components, and inorganic elements such as certain metal ions and particles. The physical characteristics of wastewater vary depending on its source, whether commercial, domestic, or from a hospital setting. Consequently, the treatment strategy for this wastewater type necessitates comprehensive investigation and appropriate handling. The advanced oxidation process (AOP) emerges as a promising technique associated with the generation of reactive hydroxyl radicals highly effective in oxidizing organic pollutants. This method takes precedence over others like coagulation, flocculation, sedimentation, and filtration due to its avoidance of undesirable by-products. In the current study, the focus was on exploring the feasibility of the AOP for treating actual household wastewater. To achieve this, a laboratory-scale device was designed to effectively target the formed radicals toward organic pollutants, resulting in lower organic compounds in wastewater. Then, the number of microorganisms present in treated wastewater, in addition to the chemical content of the water, was analyzed to determine whether the lab-scale device eliminates microbial accumulation with AOP. This was also an important parameter since microbes can indirectly affect human health and machine hygiene. To do this, water samples were taken from treated and untreated conditions and then inoculated on general purpose agar to track down the total plate count. Analysis showed that AOP might be an option to treat household wastewater and lower microorganism growth.

Keywords: usage of household water, advanced oxidation process, water reuse, modelling

Procedia PDF Downloads 50

Authors: T. Rakhi, Thrivikram Shenoy

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Esophageal atresia is a disorder of maldevelopment of esophagus with or without a connection to the trachea. Radiological reviews are needed in consultation with the pediatric surgeon and neonatologist and we report a rare case of esophageal atresia associated with atrial septal defect-patent ductus arteriosus complex. A 2-day old female baby born at term, weighing 3.010kg, admitted to the Neonatal Intensive Care Unit with respiratory distress and excessive oral secretions. On examination, continuous murmur and cyanosis were seen. Esophageal atresia was suspected, after a failed attempt to pass a nasogastric tube. Chest radiograph showed coiling of the nasogastric tube and absent gas shadow in the abdomen. Echocardiography confirmed Patent Ductus Arteriosus with Atrial Septal Defect not in failure and was diagnosed with esophageal atresia with suspected fistula posted for surgical repair. After preliminary management with oxygenation, suctioning in prone position and antibiotics, investigations revealed Hb 17gms serum biochemistry, coagulation profile and C-Reactive Protein Test normal. The baby was premedicated with 5mcg of fentanyl and 100 mcg of midazolam and a rapid awake laryngoscopy was done to rule out difficult airway followed by induction with o2 air, sevo and atracurium 2 mg. Placement of a 3.5 tube was uneventful at first attempt and after confirming bilateral air entry positioned in the lateral position for Right thoracotomy. A pulse oximeter, Echocardiogram, Non-invasive Blood Pressure, temperature and a precordial stethoscope in left axilla were essential monitors. During thoracotomy, both the ends of the esophagus and the fistula could not be located after thorough search suggesting an on table finding of type A esophageal atresia. The baby was repositioned for gastrostomy, and cervical esophagostomy ventilated overnight and extubated uneventful. Absent gas shadow was overlooked and the purpose of this presentation is to create an awareness between the neonatologist, pediatric surgeons and anesthesiologist regarding variation of typing of Tracheoesophageal fistula pre and intraoperatively. A need for imaging modalities warranted for a definitive diagnosis in the presence of a gasless stomach.

Keywords: anesthetic, atrial septal defects, esophageal atresia, patent ductus arteriosus, perioperative, chest x-ray

Procedia PDF Downloads 179

Authors: Jiancheng Zheng

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When metals are released into water from mining activities, they undergo changes chemically, physically and biologically and then may become more mobile and transportable along the waterway from their original sites. Natural colloids, including both organic and inorganic entities, are naturally occurring in any aquatic environment with sizes in the nanometer range. Natural colloids in a water system play an important role, quite often a key role, in binding and transporting compounds. When assessing and evaluating metals in natural waters, their sources, mobility, fate, and distribution patterns in the system are the major concerns from the point of view of assessing environmental contamination and pollution during resource development. There are a few ways to quantify colloids and accordingly study how metals distribute on different sizes of colloids. Current research results show that the presence of colloids can enhance the transport of some heavy metals in water, while heavy metals may also have an influence on the transport of colloids when cations in the water system change colloids and/or the ion strength of the water system changes. Therefore, studies into the relationship between different sizes of colloids and different metals in a water system are necessary and needed as natural colloids in water systems are complex mixtures of both organic and inorganic as well as biological materials. Their stability could be sensitive to changes in their shapes, phases, hardness and functionalities due to coagulation and deposition et al. and chemical, physical, and biological reactions. Because metal contaminants’ adsorption on surfaces of colloids is closely related to colloid properties, it is desired to fraction water samples as soon as possible after a sample is taken in the natural environment in order to avoid changes to water samples during transportation and storage. For this reason, this study carried out groundwater sample processing in the field, using Prep/Scale tangential flow filtration systems with 3-level cartridges (1 kDa, 10 kDa and 100 kDa). Groundwater samples from seven sites at Fort MacMurray, Alberta, Canada, were fractionated during the 2015 field sampling season. All samples were processed within 3 hours after samples were taken. Preliminary results show that although the distribution pattern of metals on colloids may vary with different samples taken from different sites, some elements often tend to larger colloids (such as Fe and Re), some to finer colloids (such as Sb and Zn), while some of them mainly in the dissolved form (such as Mo and Be). This information is useful to evaluate and project the fate and mobility of different metals in the groundwaters and possibly in environmental water systems.

Keywords: metal, colloid, groundwater, mobility, fractionation, sorption

Procedia PDF Downloads 363

Authors: Valeria T. Dilcheva, Svetlozara L. Petkova, Ivelin Vladov

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Trichinellosis is a food-borne parasitic disease caused by nematodes of the genus Trichinella which are zoonotic parasites with cosmopolitan distribution and major socio-economic importance. Human infection is acquired through consumption of undercooked meat from domestic or wild animal. Penetration of Trichinella larvae into striated skeletal muscle cells results in ultrastructural and metabolic changes. Migration of larvae causes the typical symptoms and signs of the disease. The severity of the symptoms depends on the number of ingested Trichinella larvae and the immune response of the host. Eosinophilia is present, with few exceptions, in most cases of human trichinellosis, inasmuch as it is the earliest and most important host response. Even in human asymptomatic cases, increases in eosinophilia of up to 15% have been observed. Eosinophilia appears at an early stage of infection between the second and fifth weeks of infection. By 2005 it was considered that only two species of Trichinella genus were found in the country. After routine trichinelloscopy procedure disseminated single muscle larvae in samples of wild boars and badger were PCR-identified as T. pseudospiralis. The study aimed to observed hematological changes occurring during experimentally induced infection with Trichinella spiralis, T. britovi and T. pseudospiralis in mice. We performed hematological blood profile, tracking 15 blood indicators. In statistical analysis made by Two-way ANOVA, there were significant differences of HGB, MCHC, PLT, Lymph%, Gran% in all three types of trichinellosis compared to control animals. Capsule-forming T. spiralis showed statistically significant differences in HGB, MCHC, Lymph% and PLT compared to the other two species. Non capsule-forming T. pseudospiralis showed statistically significant differences in Lymph%, Gran% relative to the control and in Gran% relative to T. spiralis. It appears rather substantial the process of capsule formation for prolonged immune response and retention of high content of percentage of lymphocytes(Lymph%) and low of granulocyte(Gran%) in T. pseudospiralis, which is contrary to studies for T. spiralis and eosinophilia. Studies and analyzes of some specific blood profile parameters can provide additional data in favor of early diagnosis and adequate treatment as well as provide a better understanding of acute and chronic trichinosis.

Keywords: hematological test, T. britovi, T. spiralis, T. pseudospiralis

Procedia PDF Downloads 173

Authors: Tomasz Łęga, Marta Sosnowska, Mirosława Panasiuk, Lilit Hovhannisyan, Beata Gromadzka, Marcin Olszewski, Sabina Zoledowska, Dawid Nidzworski

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Toxic heavy metal ion contamination of industrial wastewater has recently become a significant environmental concern in many regions of the world. Although the majority of heavy metals are naturally occurring elements found on the earth's surface, anthropogenic activities such as mining and smelting, industrial production, and agricultural use of metals and metal-containing compounds are responsible for the majority of environmental contamination and human exposure. The permissible limits (ppm) for heavy metals in food, water and soil are frequently exceeded and considered hazardous to humans, other organisms, and the environment as a whole. Human exposure to highly nickel-polluted environments causes a variety of pathologic effects. In 2008, nickel received the shameful name of “Allergen of the Year” (GILLETTE 2008). According to the dermatologist, the frequency of nickel allergy is still growing, and it can’t be explained only by fashionable piercing and nickel devices used in medicine (like coronary stents and endoprostheses). Effective remediation methods for removing heavy metal ions from soil and water are becoming increasingly important. Among others, methods such as chemical precipitation, micro- and nanofiltration, membrane separation, conventional coagulation, electrodialysis, ion exchange, reverse and forward osmosis, photocatalysis and polymer or carbon nanocomposite absorbents have all been investigated so far. The importance of environmentally sustainable industrial production processes and the conservation of dwindling natural resources has highlighted the need for affordable, innovative biosorptive materials capable of recovering specific chemical elements from dilute aqueous solutions. The use of combinatorial phage display techniques for selecting and recognizing material-binding peptides with a selective affinity for any target, particularly inorganic materials, has gained considerable interest in the development of advanced bio- or nano-materials. However, due to the limitations of phage display libraries and the biopanning process, the accuracy of molecular recognition for inorganic materials remains a challenge. This study presents the isolation, identification and characterisation of metal binding phage clones that preferentially recover nickel.

Keywords: Heavy metal recovery, cleaning water, phage display, nickel

Procedia PDF Downloads 99

Authors: Bambang Antoro, Lasito Soebari, Geoffrey de Jong, Fernandy Meiriyanto, Michael Siahaan, Eko Wibowo, Pormando Silalahi, Ruswanto, Adi Budirumantyo

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The Ertsberg East Skarn System (EESS) is located in the Ertsberg Mining District, Papua, Indonesia. EESS is a sub-vertical zone of copper-gold mineralization hosted in both diorite (vein-style mineralization) and skarn (disseminated and vein style mineralization). Deep Mill Level Zone (DMLZ) is a mining zone in the lower part of East Ertsberg Skarn System (EESS) that product copper and gold. The Deep Mill Level Zone deposit is located below the Deep Ore Zone deposit between the 3125m to 2590m elevation, measures roughly 1,200m in length and is between 350 and 500m in width. DMLZ planned start mined on Q2-2015, being mined at an ore extraction rate about 60,000 tpd by the block cave mine method (the block cave contain 516 Mt). Mineralization and associated hydrothermal alteration in the DMLZ is hosted and enclosed by a large stock (The Main Ertsberg Intrusion) that is barren on all sides and above the DMLZ. Late porphyry dikes that cut through the Main Ertsberg Intrusion are spatially associated with the center of the DMLZ hydrothermal system. DMLZ orebody hosted in diorite and skarn, both dominantly by vein style mineralization. Percentage Material Mined at DMLZ compare with current Reserves are diorite 46% (with 0.46% Cu; 0.56 ppm Au; and 0.83% EqCu); Skarn is 39% (with 1.4% Cu; 0.95 ppm Au; and 2.05% EqCu); Hornfels is 8% (with 0.84% Cu; 0.82 ppm Au; and 1.39% EqCu); and Marble 7 % possible mined waste. Correlation between Ertsberg intrusion, major structure, and vein style mineralization is important to determine characteristic orebody in DMLZ Mine. Generally Deep Mill Level Zone has 2 type of vein filling mineralization from both hosted (diorite and skarn), in diorite hosted the vein system filled by chalcopyrite-bornite-quartz and pyrite, in skarn hosted the vein filled by chalcopyrite-bornite-pyrite and magnetite without quartz. Based on orientation the stockwork vein at diorite hosted and shallow vein in skarn hosted was generally NW-SE trending and NE-SW trending with shallow-moderate dipping. Deep Mill Level Zone control by two main major faults, geologist founded and verified local structure between major structure with NW-SE trending and NE-SW trending with characteristics slickenside, shearing, gauge, water-gas channel, and some has been re-healed.

Keywords: copper-gold, DMLZ, skarn, structure

Procedia PDF Downloads 502

Authors: Arul Ayyaswami, Vidhya Ramalingam

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Per- and polyfluoroalkyl substances (PFAS) have emerged as a significant environmental concern due to their ubiquity and persistence in the environment. Their chemical characteristics and adverse effects on human health demands more effective and sustainable solutions in remediation of the PFAS. The work presented here encompasses an overview of treatment technologies with two case studies that utilize effective approaches in addressing PFAS contaminated media. Currently the options for treatment of PFAS compounds include Activated carbon adsorption, Ion Exchange, Membrane Filtration, Advanced oxidation processes, Electrochemical treatment, and Precipitation and Coagulation. In the first case study, a pilot study application of colloidal activated carbon (CAC) was completed to address PFAS from aqueous film-forming foam (AFFF) used to extinguish a large fire. The pilot study was used to demonstrate the effectiveness of a CAC in situ permeable reactive barrier (PRB) in effectively stopping the migration of PFOS and PFOA, moving from the source area at high concentrations. Before the CAC PRB installation, an injection test using - fluorescein dye was conducted to determine the primary fracture-induced groundwater flow pathways. A straddle packer injection delivery system was used to isolate discrete intervals and gain resolution over the 70 feet saturated zone targeted for treatment. Flow rates were adjusted, and aquifer responses were recorded for each interval. The results from the injection test were used to design the pilot test injection plan using CAC PRB. Following the CAC PRB application, the combined initial concentration 91,400 ng/L of PFOS and PFOA were reduced to approximately 70 ng/L (99.9% reduction), after only one month following the injection event. The results demonstrate the remedy's effectiveness to quickly and safely contain high concentrations of PFAS in fractured bedrock, reducing the risk to downgradient receptors. The second study involves developing a reductive defluorination treatment process using UV and electron acceptor. This experiment indicates a significant potential in treatment of PFAS contaminated waste media such as landfill leachates. The technology also shows a promising way of tacking these contaminants without the need for secondary waste disposal or any additional pre-treatments.

Keywords: per- and polyfluoroalkyl substances (PFAS), colloidal activated carbon (CAC), destructive PFAS treatment technology, aqueous film-forming foam (AFFF)

Procedia PDF Downloads 61

Authors: S. Mohd Afzal, R. O'Connell

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Kaposi's sarcoma (KS) is the most common HIV-related cancer, and ocular manifestations constitute at least 25% of all KS cases. However, ocular presentations often occur in the context of systemic KS, and isolated lesions are rare. We report a unique case of ocular KS masquerading as subconjunctival haemorrhage, and only developing systemic manifestations after initiation of HIV treatment. Case: A 49-year old man with previous hypertensive stroke and newly diagnosed HIV infection presented with an acutely red left eye following repeated bouts of coughing. Given the convincing history of poorly controlled hypertension and cough, a diagnosis of subconjunctival haemorrhage was made. Over the next week, his ocular lesion began to improve and he subsequently started anti-retroviral therapy. Prior to receiving anti-retroviral therapy, his CD4+ lymphocyte count was 194 cells/mm3 with HIV viral load greater than 1 million/ml. This rapidly improved to a viral load of 150 copies/ml within 2 weeks of starting treatment. However, a few days after starting HIV treatment, his ocular lesion recurred. Ophthalmic examination was otherwise normal. He also developed widespread lymphadenopathy and multiple dark lesions on his torso. Histology and virology confirmed KS, systemically triggered by Immune Reconstitution Syndrome (KS-IRIS). The patient has since undergone chemotherapy successfully. Discussion: Kaposi's sarcoma is an atypical tumour caused by human herpesvirus 8 (HHV-8), also known as Kaposi’s sarcoma-associated herpesvirus (KSHV). In immunosuppressed patients, KSHV can also cause lymphoproliferative disorders such as primary effusion lymphoma and Castleman's disease (in our patient’s case, this was excluded through histological analysis of lymph nodes). KSHV is one of the seven currently known human oncoviruses, and its pathogenesis is poorly understood. Up to 13% of patients with HIV-related KS experience worsening of the disease after starting anti-retroviral treatment, due to a sudden increase in CD4 cell counts. Histology remains the diagnostic gold standard. Current British HIV Association (BHIVA) guidelines recommend treatment using anti-retroviral drugs, with either intralesional vinblastine for local disease or systemic chemotherapy for disseminated KS. Conclusion: This case is unique as ocular KS as initial presentation is rare and our patient's diagnosis was only made after systemic lesions were triggered by immune reconstitution. KS should be considered as an important differential diagnosis for red eyes in all patients at risk of acquiring HIV infection.

Keywords: human herpesvirus 8, human immunodeficiency virus, immune reconstitution syndrome, Kaposi’s sarcoma, Kaposi’s sarcoma-associated herpesvirus

Procedia PDF Downloads 337

Authors: Nasra Idilbi, Jalal Tarabeia, Layalleh Masalha, Heiam Shoufani Kassis, Gizell Green

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Background: Healthcare professionals working in underground facilities face unique challenges affecting their physical and mental health and team effectiveness. We aimed to examine how an underground work environment affects the physical and mental health and effectiveness of a multi-professional medical team in a medical center under continuous war threats and the contribution of various demographic and professional characteristics. Methods: A cross-sectional survey was disseminated electronically. The questionnaire assessed team effectiveness, the quality of the work, and the health symptoms reported by the team while working in the underground complex. Results: In total, 270 healthcare workers (mean age 40 years, 75.6% females, 88.4% nurses) completed the questionnaire. Women reported statistically significantly higher mean scores of physical strain, fatigue, and eye irritation associated with the work environment compared to men. Multiple regression analysis revealed that psychological distress, noise, and lighting in the underground compound significantly influenced team effectiveness. The qualitative analysis revealed two key themes: the mental health impact of working in an underground environment and the effects of noise and lighting on staff performance. Nurses reported feelings of suffocation, claustrophobia, and difficulty concentrating due to the enclosed space, with some expressing heightened stress levels that impaired their ability to work effectively and safely. Female staff reported more pronounced symptoms of physical strain, fatigue, and eye irritation. Additionally, the underground complex’s poor noise absorption created a highly disruptive work environment, while inadequate lighting hindered accurate patient assessments, leading to potential errors. These challenges were exacerbated by physical symptoms like headaches and nausea, which further impacted job performance. The findings underscore the significant role of environmental factors in influencing both mental health and operational effectiveness, aligning with quantitative data on the predictors of team performance. Conclusions: The underground work environment is crucial in influencing healthcare team effectiveness, with psychological distress, noise, and lighting as key factors. The study highlights the importance of creating a comfortable work environment to foster team efficiency. The findings provide valuable insights for managers in underground healthcare facilities to optimize team performance and well-being.

Keywords: team effectiveness, underground settings, healthcare, environmental factors, a mixed-methods study

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Authors: Tan Hui Ying Renee, Stella Rizalina Sasha, Farah Safdar Husain

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Introduction: Menopause Hormone Therapy (MHT) is an effective drug indicated for the treatment of menopausal symptoms and as replacement therapy in women who undergo premature menopause. In 2020, less than 8.8% of perimenopausal Singaporean women are on hormonal therapy, as compared to the Western population, where up to 50% may be on MHT. Factors associated with MHT utilization have been studied from patient characteristics, but the impact of locally prescribing physicians resulting in low MHT utilization has yet to be evaluated. The aim of the study is to determine the level of knowledge physicians in the Obstetrics and Gynaecology specialty have and their attitudes toward MHT. We believe that knowledge of MHT is lacking and that negative attitudes towards MHT may influence its use and undermine the benefits MHT may have for women. This paper is a part of a larger study on Singaporean physicians’ knowledge and attitudes towards MHT. Methods: This is a cross-sectional study intended to assess the knowledge and attitudes of physicians toward Menopausal Hormone Therapy. An anonymous questionnaire was disseminated via institutional internal circulations to optimize reach to physicians who may prescribe MHT, particularly in the fields of Gynaecology, Family Medicine and Endocrinology. Responses were completed voluntarily. Physicians had the option for each question to declare that they were ‘unsure’ or that the question was ‘beyond their expertise’. 21 knowledge questions tested factual recall on indications, contraindications, and risks of MHT. The remaining 6 questions were clinical scenarios crafted with the intention of testing specific principles related to the use of MHT. These questions received face validation from experts in the field. 198 responses were collected, 79 of which were from physicians in the Obstetrics and Gynaecology specialty. The data will be statistically analyzed to investigate areas that can be improved to increase the overall benefits of MHT for the Singaporean population. Results: Preliminary results show that the prevailing factors that limit Singaporean gynecologists and obstetricians from prescribing MHT are a lack of knowledge of MHT and a lack of confidence in prescribing MHT. Risks and indications of MHT were not well known by many physicians, with the majority of the questions having more than 25% incorrect and ‘unsure’ as their reply. The clinical scenario questions revealed significant shortcomings in knowledge on how to navigate real-life challenges in MHT use, with 2 of 6 questions with more than 50% incorrect or ‘beyond their expertise’ as their reply. The portion of the questionnaire that investigated the attitudes of physicians showed that though a large majority believed MHT to be an effective drug, only 40.5% were confident in prescribing it. Conclusion: Physicians in the Obstetrics and Gynaecology specialty lack knowledge and confidence in MHT. Therefore, it is imperative to formulate solutions on both the individual and institutional levels to fill these gaps and ensure that MHT is used appropriately and prescribed to the patients who need it.

Keywords: menopause, menopause hormone therapy, physician factors, obstetrics and gynecology, menopausal symptoms, Singapore

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Authors: Rahul Jain, Jagdish Chander, Anish Gupta

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Introduction: Laparoscopic common bile duct exploration (LCBDE) allows cholecystectomy and the removal of common bile duct (CBD) stones to be performed during the same sitting, thereby decreasing hospital stay. CBD exploration through choledochotomy can be closed primarily with an absorbable suture material, but can lead to biliary leakage postoperatively. In this study we tried to find a solution to further lower the incidence of bile leakage by using fibrin glue to reinforce the sutures put on choledochotomy suture line. It has haemostatic and sealing action, through strengthening the last step of the physiological coagulation and biostimulation, which favours the formation of new tissue matrix. Methodology: This study was conducted at a tertiary care teaching hospital in New Delhi, India, from 2011 to 2013. 20 patients with CBD stones documented on MRCP with CBD diameter of 9 mm or more were included in this study. Patients were randomized into two groups namely Group A in which choledochotomy was closed with polyglactin 4-0 suture and suture line reinforced with fibrin glue, and Group ‘B’ in which choledochotomy was closed with polyglactin 4-0 suture alone. Both the groups were evaluated and compared on clinical parameters such as operative time, drain content, drain output, no. of days drain was required, blood loss & transfusion requirements, length of postoperative hospital stay and conversion to open surgery. Results: The operative time for Group A ranged from 60 to 210 min (mean 131.50 min) and Group B 65 to 300 min (mean 140 minutes). The blood loss in group A ranged from 10 to 120 ml (mean 51.50 ml), in group B it ranged from 10 to 200 ml (mean 53.50 ml). In Group A, there was no case of bile leak but there was bile leak in 2 cases in Group B, minimum 0 and maximum 900 ml with a mean of 97 ml and p value of 0.147 with no statistically significant difference in bile leak in test and control groups. The minimum and maximum serous drainage in Group A was nil & 80 ml (mean 11 ml) and in Group B was nil & 270 ml (mean 72.50 ml). The p value came as 0.028 which is statistically significant. Thus serous leakage in Group A was significantly less than in Group B. The drains in Group A were removed from 2 to 4 days (mean: 3 days) while in Group B from 2 to 9 days (mean: 3.9 days). The patients in Group A stayed in hospital post operatively from 3 to 8 days (mean: 5.30) while in Group B it ranged from 3 to 10 days with a mean of 5 days. Conclusion: Fibrin glue application on CBD decreases bile leakage but in statistically insignificant manner. Fibrin glue application on CBD can significantly decrease post operative serous drainage after LCBDE. Fibrin glue application on CBD is safe and easy technique without any significant adverse effects and can help less experienced surgeons performing LCBDE.

Keywords: bile leak, fibrin glue, LCBDE, serous leak

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Authors: Henry O. Chibudike, Olubamike A. Adeyoju, Bolanle O. Oluwole, Kayode O. Adebowale, Bamidele I. Olu-Owolabi, Chinedum E. Chibudike

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Studies on the Mineral Content of Solojo Flour and Protein Isolates from the two varieties (DAS and BS) of Nigeria cultivated solojo cowpeas were conducted to determine their nutritional value. These inorganic elements or minerals were classified into 3 categories: the ultra-trace minerals, which are the third category; the microelements, also known as the trace minerals, in the second category; while the first category is the macro elements, also known as major minerals. Some of the macro-elements are Ca, P, Na and Cl; the second category, micro-elements include iron, copper, cobalt, potassium, magnesium, iodine, zinc, manganese, molybdenum, F, Cr, Se and S. Results show that the proportion of Sodium (Na) which is ingested into the body in the form of NaCl through food intake maintenance of body pH and to retain water ranged from 728.97 to 253.37 ppm (72.90 to 25.34 mg/100 g); 715.24 to 235.45 ppm; 735.28 to 270.37 ppm; 726.59 to 264.35ppm, for FFDAS, FFBS, DAS and BS respectively with all values of the germinated samples all bellow the control. While FFDAS iron content ranged from 4.25 to 13.50 mg/100 g; FFBS ranged from 3.15 to 12.56 mg/100 g; DAS ranged from 3.81 to 12.90 mg/100g; BS ranged from 3.42 to 9.40 mg/100 g. The values of the germinated flours were all greater than the ungerminated flour. Iron helps to transport oxygen round the body and also helps in red blood cells building and to convert food into needed energy by the body. While Manganese an element that is needed in micro quantity but necessary to convert food into energy, is also crucial for healthy bone and cartilage creation. Results also show that zinc quantity increased as germination proceeded, and the values ranged from 38.80 ppm to 230.00 ppm (3.880 mg/100 g to 23.00 mg/100 g; 0.003880% to 0.0230%); 40.84 to 250.01 ppm; 32.85 to 93.41 ppm; 37.07 to 115.00 ppm, for FFDAS, FFBS, DAS and BS respectively. The Ca content improved significantly (p<0.05) with sprouting; the value extended from 250.56 ppm to 760.03 ppm (25.056 to 76.00 mg/100g or 0.0251 to 0.0760 %); 400.40 to 998.22 ppm; 116.87 to 195.69 ppm; 113.48 to 220.75 ppm, for FFDAS, FFBS, DAS and BS respectively. Zinc element although needed at the micro level in the body, is essential for a strong immune system to keep the body in good health. It is also crucial for the maintenance of a healthy sense of taste and odor, while Calcium is critical for strong bones and teeth, blood coagulation, and muscle tightening and relaxation. Magnesium is needed to build enzymes and antioxidants and also for healthy bones, while Potassium is needed to maintain water balance, muscle movement, and nerve impulses. It functions in conjunction with Na to regulate blood pressure.

Keywords: Solojo cowpea, underutilized legumes, protein isolates, BS, DAS, ungerminated

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Authors: Enrico Dorigatti

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The growing pile of hazardous e-waste produced especially by those developed and wealthy countries gets relentlessly bigger, composed of the EEDs (Electric and Electronic Device) that are often thrown away although still well functioning, mainly due to (programmed) obsolescence. As a consequence, e-waste has taken, over the last years, the shape of a frightful, uncontrollable, and unstoppable phenomenon, mainly fuelled by market policies aiming to maximize sales—and thus profits—at any cost. Against it, governments and organizations put some efforts in developing ambitious frameworks and policies aiming to regulate, in some cases, the whole lifecycle of EEDs—from the design to the recycling. Incidentally, however, such regulations sometimes make the disposal of the devices economically unprofitable, which often translates into growing illegal e-waste trafficking—an activity usually undertaken by criminal organizations. It seems that nothing, at least in the near future, can stop the phenomenon of e-waste production and accumulation. But while, from a practical standpoint, a solution seems hard to find, much can be done regarding people's education, which translates into informing and promoting good practices such as reusing and repurposing. This research argues that circuit bending—an activity rooted in neo-materialist philosophy and post-digital aesthetic, and based on repurposing EEDs into novel music instruments and sound generators—could have a great potential in this. In particular, it asserts that circuit bending could expose ecological, environmental, and social criticalities related to the current market policies and economic model. Not only thanks to its practical side (e.g., sourcing and repurposing devices) but also to the artistic one (e.g., employing bent instruments for ecological-aware installations, performances). Currently, relevant literature and debate lack interest and information about the ecological aspects and implications of the practical and artistic sides of circuit bending. This research, therefore, although still at an early stage, aims to fill in this gap by investigating, on the one side, the ecologic potential of circuit bending and, on the other side, its capacity of sensitizing people, through artistic practice, about e-waste-related issues. The methodology will articulate in three main steps. Firstly, field research will be undertaken—with the purpose of understanding where and how to source, in an ecologic and sustainable way, (discarded) EEDs for circuit bending. Secondly, artistic installations and performances will be organized—to sensitize the audience about environmental concerns through sound art and music derived from bent instruments. Data, such as audiences' feedback, will be collected at this stage. The last step will consist in realising workshops to spread an ecologically-aware circuit bending practice. Additionally, all the data and findings collected will be made available and disseminated as resources.

Keywords: circuit bending, ecology, sound art, sustainability

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Authors: C. S. Chen, F. Y. Hui, B. S. Farhana, J. De Leon

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Introduction: Stroke can lead to long-term disability, affecting one’s quality of life. Providing stroke education to patient and family members is essential to optimize stroke recovery and prevent recurrent stroke. Currently, nurses conduct stroke education by handing out pamphlets and explaining their contents to patients. However, this is not always effective as nurses have varying levels of knowledge and depth of content discussed with the patient may not be consistent. With the advancement of information technology, health education is increasingly being disseminated via electronic software and studies have shown this to have benefitted patients. Hence, a multi-disciplinary team consisting of doctors, nurses and allied health professionals was formed to create the stroke journey map software to deliver consistent and concise stroke education. Research Objectives: To evaluate the effectiveness of using a stroke journey map software in improving patients’ perceived knowledge in the acute stroke unit during hospitalization. Methods: Patients admitted to the acute stroke unit were given stroke journey map software during patient education. The software consists of 31 interactive slides that are brightly coloured and 4 videos, based on input provided by the multi-disciplinary team. Participants were then assessed with pre-and-post survey questionnaires before and after viewing the software. The questionnaire consists of 10 questions with a 5-point Likert scale which sums up to a total score of 50. The inclusion criteria are patients diagnosed with ischemic stroke and are cognitively alert and oriented. This study was conducted between May 2017 to October 2017. Participation was voluntary. Results: A total of 33 participants participated in the study. The results demonstrated that the use of a stroke journey map as a stroke education medium was effective in improving patients’ perceived knowledge. A comparison of pre- and post-implementation data of stroke journey map revealed an overall mean increase in patients’ perceived knowledge from 24.06 to 40.06. The data is further broken down to evaluate patients’ perceived knowledge in 3 domains: (1) Understanding of disease process; (2) Management and treatment plans; (3) Post-discharge care. Each domain saw an increase in mean score from 10.7 to 16.2, 6.9 to 11.9 and 6.6 to 11.7 respectively. Project Impact: The implementation of stroke journey map has a positive impact in terms of (1) Increasing patient’s perceived knowledge which could contribute to greater empowerment of health; (2) Reducing need for stroke education material printouts making it environmentally friendly; (3) Decreasing time nurses spent on giving education resulting in more time to attend to patients’ needs. Conclusion: This study has demonstrated the benefit of using stroke journey map as a platform for stroke education. Overall, it has increased patients’ perceived knowledge in understanding their disease process, the management and treatment plans as well as the discharge process.

Keywords: acute stroke, education, ischemic stroke, knowledge, stroke

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Authors: Samar Mousa, Ryan Kerstein, Mohanad Adam

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Regional anaesthesia has been associated with favourable outcomes in patients undergoing a wide range of surgeries. Beneficial effects have been demonstrated in terms of postoperative respiratory and cardiovascular endpoints, 7-day survival, time to ambulation and hospital discharge, and postoperative analgesia. Our project aimed at assessing the regional anaesthesia practice in the plastic surgery department of Buckinghamshire trust and finding out ways to improve the service in collaboration with the anaesthesia team. It is a retrospective study associated with a questionnaire filled out by plastic surgeons and anaesthetists to get the full picture behind the numbers. The study period was between 1/3/2022 and 23/5/2022 (12 weeks). The operative notes of all patients who had an operation under plastic surgery, whether emergency or elective, were reviewed. The criteria of suitable candidates for the regional block were put by the consultant anaesthetists as follows: age above 16, single surgical site (arm, forearm, leg, foot), no drug allergy, no pre-existing neuropathy, no bleeding disorders, not on ant-coagulation, no infection to the site of the block. For 12 weeks, 1061 operations were performed by plastic surgeons. Local cases were excluded leaving 319 cases. Of the 319, 102 patients were suitable candidates for regional block after applying the previously mentioned criteria. However, only seven patients had their operations under the regional block, and the rest had general anaesthesia that could have been easily avoided. An online questionnaire was filled out by both plastic surgeons and anaesthetists of different training levels to find out the reasons behind the obvious preference for general over regional anaesthesia, even if this was against the patients’ interest. The questionnaire included the following points: training level, time taken to give GA or RA, factors that influence the decision, percentage of RA candidates that had GA, reasons behind this percentage, recommendations. Forty-four clinicians filled out the questionnaire, among which were 23 plastic surgeons and 21 anaesthetists. As regards the training level, there were 21 consultants, 4 associate specialists, 9 registrars, and 10 senior house officers. The actual percentage of patients who were good candidates for RA but had GA instead is 93%. The replies estimated this percentage as between 10-30%. 29% of the respondents thought that this percentage is because of surgeons’ preference to have GA rather than RA for their operations without medical support for the decision. 37% of the replies thought that anaesthetists prefer giving GA even if the patient is a suitable candidate for RA. 22.6% of the replies thought that patients refused to have RA, and 11.3% had other causes. The recommendations were in 5 main accesses, which are protocols and pathways for regional blocks, more training opportunities for anaesthetists on regional blocks, providing a separate block room in the hospital, better communication between surgeons and anaesthetists, patient education about the benefits of regional blocks.

Keywords: regional anaesthesia, regional block, plastic surgery, general anaesthesia

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Authors: Mitakshara Sharma, S. K. Nema, Sanjeev Narang

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Diabetes mellitus (DM) is a group of metabolic disorders characterized by metabolic abnormalities, chronic hyperglycaemia and long term macrovascular & microvascular complications. Vascular complications are due to platelet hyperactivity and dysfunction, increased inflammation, altered coagulation and endothelial dysfunction. Large proportion of patients with Type II DM suffers from preventable vascular angiopathies, and there is need to develop risk factor modifications and interventions to reduce impact of complications. These complications are attributed to platelet activation, recognised by increase in Platelet Volume Indices (PVI) including Mean Platelet Volume (MPV) and Platelet Distribution Width (PDW). The current study is prospective analytical study conducted over 2 years. Out of 1100 individuals, 930 individuals fulfilled inclusion criteria and were segregated into three groups on basis of glycosylated haemoglobin (HbA1C): - (a) Diabetic, (b) Non-Diabetic and (c) Subjects with Impaired fasting glucose (IFG) with 300 individuals in IFG and non-diabetic groups & 330 individuals in diabetic group. Further, diabetic group was divided into two groups on the basis of presence or absence of known diabetes related vascular complications. Samples for HbA1c and PVI were collected using Ethylene diamine tetraacetic acid (EDTA) as anticoagulant and processed on SYSMEX-X-800i autoanalyser. The study revealed gradual increase in PVI from non-diabetics to IFG to diabetics. PVI were markedly increased in diabetic patients. MPV and PDW of diabetics, IFG and non diabetics were (17.60 ± 2.04)fl, (11.76 ± 0.73)fl, (9.93 ± 0.64)fl and (19.17 ± 1.48)fl, (15.49 ± 0.67)fl, (10.59 ± 0.67)fl respectively with a significant p value 0.00 and a significant positive correlation (MPV-HbA1c r = 0.951; PDW-HbA1c r = 0.875). MPV & PDW of subjects with diabetes related complications were higher as compared to those without them and were (17.51±0.39)fl & (15.14 ± 1.04)fl and (20.09 ± 0.98) fl & (18.96 ± 0.83)fl respectively with a significant p value 0.00. There was a significant positive correlation between PVI and duration of diabetes across the groups (MPV-HbA1c r = 0.951; PDW-HbA1c r = 0.875). However, a significant negative correlation was found between glycaemic levels and total platelet count (PC- HbA1c r =-0.164). This is multi-parameter and comprehensive study with an adequately powered study design. It can be concluded from our study that PVI are extremely useful and important indicators of impending vascular complications in all patients with deranged glycaemic control. Introduction of automated cell counters has facilitated the availability of PVI as routine parameters. PVI is a useful means for identifying larger & active platelets which play important role in development of micro and macro angiopathic complications of diabetes leading to mortality and morbidity. PVI can be used as cost effective markers to predict and prevent impending vascular events in patients with Diabetes mellitus especially in developing countries like India. PVI, if incorporated into protocols for management of diabetes, could revolutionize care and curtail the ever increasing cost of patient management.

Keywords: diabetes, IFG, HbA1C, MPV, PDW, PVI

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Authors: Mathieu Hemono, Sophie Puig-Malet, Patrick Zylberman, Avner Bar-Hen, Rainer Sauerborn, Stefanie Schütte, Niamh Herlihi, Antoine Flahault et Anneliese Depoux

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Since the IPCC released its first report in 1990, an increasing number of peer-reviewed publications have reported the health risks associated with climate change. Although there is a large body of evidence supporting the association between climate change and poor health outcomes, the media is inconsistent in the attention it pays to the subject matter. This study aims to analyze the modalities and rhetoric in the media concerning the impact of climate change on health in order to better understand its role in information dissemination. A review was conducted of articles published between 1990 and 2015 in the francophone newspapers Le Monde and Jeune Afrique. A detailed search strategy including specific climate and health terminology was used to search the newspapers’ online databases. 1202 articles were identified as having referenced the terms climate change and health. Inclusion and exclusion criteria were applied to narrow the search to articles referencing the effects of climate change on human health and 160 articles were included in the final analysis. Data was extracted and categorized to create a structured database allowing for further investigation and analysis. The review indicated that although 66% of the selected newspaper articles reference scientific evidence of the impact of climate change on human health, the focus on the topic is limited major political events or is circumstances relating to public health crises. Main findings also include that among the many direct and indirect health outcomes, infectious diseases are the main health outcome highlighted in association with climate change. Lastly, the articles suggest that while developed countries have caused most of the greenhouse effect, the global south is more immediately affected. Overall, the reviewed articles reinforce the need for international cooperation in finding a solution to mitigate the effects of climate change on health. The manner in which scientific results are communicated and disseminated, impact individual and collective perceptions of the topic in the public sphere and affect political will to shape policy. The results of this analysis will underline the modalities of the rhetoric of transparency and provide the basis for a perception study of media discourses. This study is part of an interdisciplinary project called 4CHealth that confronts results of the research done on scientific, political and press literature to better understand how the knowledge on climate changes and health circulates within those different fields and whether and how it is translated to real world change.

Keywords: climate change, health, health impacts, communication, media, rhetoric, awareness, Global South, Africa

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Authors: Mehak Burza

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As we pause to observe the Holocaust Remembrance Day each year on 27 January, it becomes important to consider how the Holocaust is witnessed, and its education is perceived across the globe. The dissemination of knowledge of the Holocaust becomes more pertinent in the countries that were not directly affected by it. The Holocaust education is not widespread in Asian countries and is thus not mandatory as an academic discipline for school and university students. One such Asian country that often considers Holocaust as an isolated event is India. Though the struggle for freedom began with the 1857 mutiny (the first war of Indian independence) but the freedom revolts gained momentum specifically during the years 1944-1947, when India was steeped in a battery of rebellions. However, freedom for the Indian subcontinent from the domination of British Raj came at the cost of partition of India that resulted in widespread bloodshed and immigration. For India, it is this backdrop of her freedom struggle that always outweighs the incidents of the Second World War, including the catastrophic event of the Holocaust. As a result, the knowledge about the Holocaust is available through secondary sources such as Holocaust documentaries and movies. Besides Anne Frank’s diary, the knowledge about the Holocaust is disseminated through the course readings in the universities. The most common literary acquaintances with the Jewish faith for university students are when they come across the Jewish characters in their course readings. The Prioress’s Tale in Geoffrey Chaucer’s Canterbury Tales, the character of Shylock in William Shakespeare’s The Merchant of Venice, and the Jewish protagonist, Barabas, in Christopher Marlow’s Jew of Malta. Apart from this, the school textbooks mention a detailed chapter on Holocaust and Hitler, which is an encouraging turn. However, there still exists a yawning gap between dissemination and sensitization of Holocaust education owing to different geographical locales. My paper presentation aims to trace the intersectional elements between India and the Holocaust that can serve as the required pivotal stand-board to foster sensitization towards Holocaust education in the Indian subcontinent. For instance, Maharaja Jam SahebDigvijaysinhjiRanjitsinhji, the ruler of Nawanagar, a princely state in British India, helped save thousand Polish Jewish children in 1945 at the time when India herself was steeped in its struggle for freedom. Famously known as the ‘Indian Oskar Schindler’ Polish government has named a street after him in Krakow, Poland. Another example that deserves mention is the spy princess, Noor Inayat Khan, a descendent of Tipu Sultan, who became the most celebrated British spyand fought against the Nazis. Additionally, by offering refuge to Jews, India has proved to be a distant haven for them. Researching further the domain of Jewish refugees in India will not only illuminate a dull/gray zone of investigation but also enable the educators to provide appropriate entry points for introducing the subject of Shoah/Holocaust in India, a subject which unfortunately hitherto is either seldom discussed or is equated with the Partition of India.

Keywords: awareness, dissemination, holocaust, India

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Authors: E. Nakamachi, S. Tanaka, K. Yamamoto, Y. Morita

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In this study, we developed a three-dimensional (3D) direct current electric field (DCEF) stimulation bio-reactor for axonal outgrowth enhancement to generate the neural network of the central nervous system (CNS). By using our newly developed 3D DCEF stimulation bio-reactor, we cultured the rat pheochromocytoma cells (PC12) and investigated the effects on the axonal extension enhancement and network generation. Firstly, we designed and fabricated a 3D bio-reactor, which can load DCEF stimulation on PC12 cells embedded in the collagen gel as extracellular environment. The connection between the electrolyte and the medium using salt bridges for DCEF stimulation was introduced to avoid the cell death by the toxicity of metal ion. The distance between the salt bridges was adopted as the design variable to optimize a structure for uniform DCEF stimulation, where the finite element (FE) analyses results were used. Uniform DCEF strength and electric flux vector direction in the PC12 cells embedded in collagen gel were examined through measurements of the fabricated 3D bio-reactor chamber. Measurement results of DCEF strength in the bio-reactor showed a good agreement with FE results. In addition, the perfusion system was attached to maintain pH 7.2 ~ 7.6 of the medium because pH change was caused by DCEF stimulation loading. Secondly, we disseminated PC12 cells in collagen gel and carried out 3D culture. Finally, we measured the morphology of PC12 cell bodies and neurites by the multiphoton excitation fluorescence microscope (MPM). The effectiveness of DCEF stimulation to enhance the axonal outgrowth and the neural network generation was investigated. We confirmed that both an increase of mean axonal length and axogenesis rate of PC12, which have been exposed 5 mV/mm for 6 hours a day for 4 days in the bioreactor. We found following conclusions in our study. 1) Design and fabrication of DCEF stimulation bio-reactor capable of 3D culture nerve cell were completed. A uniform electric field strength of average value of 17 mV/mm within the 1.2% error range was confirmed by using FE analyses, after the structure determination through the optimization process. In addition, we attached a perfusion system capable of suppressing the pH change of the culture solution due to DCEF stimulation loading. 2) Evaluation of DCEF stimulation effects on PC12 cell activity was executed. The 3D culture of PC 12 was carried out adopting the embedding culture method using collagen gel as a scaffold for four days under the condition of 5.0 mV/mm and 10mV/mm. There was a significant effect on the enhancement of axonal extension, as 11.3% increase in an average length, and the increase of axogenesis rate. On the other hand, no effects on the orientation of axon against the DCEF flux direction was observed. Further, the network generation was enhanced to connect longer distance between the target neighbor cells by DCEF stimulation.

Keywords: PC12, DCEF stimulation, 3D bio-reactor, axonal extension, neural network generation

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Authors: Omwoyo Bosire Onyancha

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The Journal Citation Reports (JCR) of the Thomson Reuters has, for decades, provided the data for bibliometrically assessing the impact of journals. In their criticism of the journal impact factor (JIF), a number of scholars such as Priem, Taraborelli, Groth and Neylon (2010) observe that the “JIF is often incorrectly used to assess the impact of individual articles. It is troubling that the exact details of the JIF are a trade secret, and that significant gaming is relatively easy”. The emergence of alternative metrics (Altmetrics) has introduced another dimension of re-assessing how the impact of journals (and other units such as articles and even individual researchers) can be measured. Altmetrics is premised upon the fact that research is increasingly being disseminated through social network sites such as ResearchGate, Mendeley, Twitter, Facebook, LinkedIn, and ImpactStory, among others. This paper adopts informetrics (including altmetrics) techniques to report on the findings of a study conducted to investigate and compare the social media impact of 274 South Africa Post Secondary Education (SAPSE)-accredited journals, which are recognized and accredited by the Department of Higher Education and Training (DHET) of South Africa (SA). We used multiple sources to extract data for the study, namely Altmetric.com and the Thomson Reuters’ Journal Citation Reports. Data was analyzed in order to determine South African journals’ presence and impact on social media as well as contrast the social media impact with Thomson Reuters’ citation impact. The Spearman correlation test was performed to compare the journals’ social media impact and JCR citation impact. Preliminary findings reveal that a total of 6360 articles published in 96 South African journals have received some attention in social media; the most commonly used social media platform was Twitter, followed by Mendeley, Facebook, News outlets, and CiteULike; there were 29 SA journals covered in the JCR in 2008 and this number has grown to 53 journals in 2014; the journals indexed in the Thomson Reuters performed much better, in terms of their altmetrics, than those journals that are not indexed in Thomson Reuters databases; nevertheless, there was high correlation among journals that featured in both datasets; the journals with the highest scores in Altmetric.com included the South African Medical Journal, African Journal of Marine Science, and Transactions of the Royal Society of South Africa while the journals with high impact factors in JCR were South African Medical Journal, Onderstepoort: Journal of Veterinary Research, and Sahara: Journal of Social Aspects of HIV-AIDS; and that Twitter has emerged as a strong avenue of sharing and communicating research published in the South African journals. Implications of the results of the study for the dissemination of research conducted in South Africa are offered. Discussions based on the research findings as well as conclusions and recommendations are offered in the full text paper.

Keywords: altmetrics, citation impact, journal citation reports, journal impact factor, journals, research, scholarly publishing, social media impact, South Africa

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Authors: S. D. N. K. Bathige, G. I. Godahewa, Navaneethaiyer Umasuthan, Jehee Lee

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Kunitz-type serine protease inhibitors (KTIs) are identified in various organisms including animals, plants and microbes. These proteins shared single or multiple Kunitz inhibitory domains link together or associated with other types of domains. Characteristic Kunitz type domain composed of around 60 amino acid residues with six conserved cysteine residues to stabilize by three disulfide bridges. KTIs are involved in various physiological processes, such as ion channel blocking, blood coagulation, fibrinolysis and inflammation. In this study, two Kunitz-type domain containing protein was identified from rock bream database and designated as RbKunitz. The coding sequence of RbKunitz encoded for 507 amino acids with 56.2 kDa theoretical molecular mass and 5.7 isoelectric point (pI). There are several functional domains including MANEC superfamily domain, PKD superfamily domain, and LDLa domain were predicted in addition to the two characteristic Kunitz domain. Moreover, trypsin interaction sites were also identified in Kunitz domain. Homology analysis revealed that RbKunitz shared highest identity (77.6%) with Takifugu rubripes. Completely conserved 28 cysteine residues were recognized, when comparison of RbKunitz with other orthologs from different taxonomical groups. These structural evidences indicate the rigidity of RbKunitz folding structure to achieve the proper function. The phylogenetic tree was constructed using neighbor-joining method and exhibited that the KTIs from fish and non-fish has been evolved in separately. Rock bream was clustered with Takifugu rubripes. The SYBR Green qPCR was performed to quantify the RbKunitz transcripts in different tissues and challenged tissues. The mRNA transcripts of RbKunitz were detected in all tissues (muscle, spleen, head kidney, blood, heart, skin, liver, intestine, kidney and gills) analyzed and highest transcripts level was detected in gill tissues. Temporal transcription profile of RbKunitz in rock bream blood tissues was analyzed upon LPS (lipopolysaccharide), Poly I:C (Polyinosinic:polycytidylic acid) and Edwardsiella tarda challenge to understand the immune responses of this gene. Compare to the unchallenged control RbKunitz exhibited strong up-regulation at 24 h post injection (p.i.) after LPS and E. tarda injection. Comparatively robust expression of RbKunits was observed at 3 h p.i. upon Poly I:C challenge. Taken together all these data indicate that RbKunitz may involve into to immune responses upon pathogenic stress, in order to protect the rock bream.

Keywords: Kunitz-type, rock bream, immune response, serine protease inhibitor

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Authors: Paola Montenegro, Maria de los Angeles Balaguera Villa

Abstract:

Contraceptive methods play a fundamental role in preventing unwanted pregnancies and protecting users from sexually transmitted infections (STIs). Despite being known to almost the entire population of reproductive age living in Colombia, there are barriers, practices and complex notions about contraceptives that affect their desired mass use and effectiveness. This work aims to analyse some of the perceptions and practices discussed with young people (13-28 years old) living in Colombia regarding the use of contraceptives in their daily lives, preferences, needs and perceived side effects. This research also examines the perceived paradox in autonomy that young people experience regarding contraceptive use: in one hand, its use (or lack of it) is interpreted as an act of self-determination and primary example of reproductive agency, on the other hand, it was frequently associated with coercion and limited autonomy derived from the gaps in reliable information available for young people, the difficulty of accessing certain preferred methods, and sometimes the experienced coercion exercise by doctors, partners and/or family members. The data and analysis discussed in this work stems from a research project whose objective was to provide information about needs and preferences in sexual and reproductive health of young people living in Colombia in relation to a possible telehealth service that could close the gap in access to quality care and safe information. Through a mixed methods approach, this study collected 5.736 responses to a virtual survey disseminated nationwide in Colombia and 47 inperson interviews (24 of them with people who were assigned female at birth and 21 with local key stakeholders in the abortion ecosystem). Quantitative data was analyzed using Stata SE Version 16.0 and qualitative analysis was completed through NVivo using thematic analysis. Key findings on contraception use in young people living in Colombia reveal that 85,8% of participants had used a contraceptive method in the last two years, and that the most commonly used methods were condoms, contraceptive pills, the morning-after pill and the method of interruption. The remaining 14,2% of respondents who declared to not have used contraceptives in the last two years expressed that the main four barriers to access were: "Lack of knowledge about contraceptive methods and where to obtain information and/or access them (13.9%)", "Have had sex with people who have vaginas (10.2%)", "Cost of contraceptive method (8.4%)" and "Difficulties in obtaining medical authorisations (7.6%)". These barriers coincided with the ones used to explain the non-use of contraceptives in young people, which reveals that limitations in information, cost, and quality care represent structural issues that need to be address in programmes, services, and public policy. Finally, interviews showed that young people perceive contraceptive use and non-use as an example of reaffirming reproductive agency and limitations to this can be explained through the widespread incomplete knowledge about how methods work and the prevalence of other social representations of contraception associated with trust, fidelity, and partner preferences, that in the end create limitations to young people’s autonomy.

Keywords: contraception, family planning, premarital fertility, unplanned pregnancy

Procedia PDF Downloads 77

Authors: Z. Karahaliloğlu, C. Hacker, M. Demirbilek, G. Seide, E. B. Denkbaş, T. Gries

Abstract:

Currently, textile industry has played an important role in world’s economy, especially in developing countries. Dyes and pigments used in textile industry are significant pollutants. Most of theirs are azo dyes that have chromophore (-N=N-) in their structure. There are many methods for removal of the dyes from wastewater such as chemical coagulation, flocculation, precipitation and ozonation. But these methods have numerous disadvantages and alternative methods are needed for wastewater decolorization. Titanium-mediated photodegradation has been used generally due to non-toxic, insoluble, inexpensive, and highly reactive properties of titanium dioxide semiconductor (TiO2). Melt electrospinning is an attractive manufacturing process for thin fiber production through electrospinning from PP (Polyprophylene). PP fibers have been widely used in the filtration due to theirs unique properties such as hydrophobicity, good mechanical strength, chemical resistance and low-cost production. In this study, we aimed to investigate the effect of titanium nanoparticle localization and amine modification on the dye degradation. The applicability of the prepared chemical activated composite and pristine fabrics for a novel treatment of dyeing wastewater were evaluated.In this study, a photocatalyzer material was prepared from nTi (titanium dioxide nanoparticles) and PP by a melt-electrospinning technique. The electrospinning parameters of pristine PP and PP/nTi nanocomposite fabrics were optimized. Before functionalization with nTi, the surface of fabrics was activated by a technique using glutaraldehyde (GA) and polyethyleneimine to promote the dye degredation. Pristine PP and PP/nTi nanocomposite melt-electrospun fabrics were characterized using scanning electron microscopy (SEM) and X-Ray Photon Spectroscopy (XPS). Methyl orange (MO) was used as a model compound for the decolorization experiments. Photocatalytic performance of nTi-loaded pristine and nanocomposite melt-electrospun filters was investigated by varying initial dye concentration 10, 20, 40 mg/L). nTi-PP composite fabrics were successfully processed into a uniform, fibrous network of beadless fibers with diameters of 800±0.4 nm. The process parameters were determined as a voltage of 30 kV, a working distance of 5 cm, a temperature of the thermocouple and hotcoil of 260–300 ºC and a flow rate of 0.07 mL/h. SEM results indicated that TiO2 nanoparticles were deposited uniformly on the nanofibers and XPS results confirmed the presence of titanium nanoparticles and generation of amine groups after modification. According to photocatalytic decolarization test results, nTi-loaded GA-treated pristine or nTi-PP nanocomposite fabric filtern have superior properties, especially over 90% decolorization efficiency at GA-treated pristine and nTi-PP composite PP fabrics. In this work, as a photocatalyzer for wastewater treatment, surface functionalized with nTi melt-electrospun fabrics from PP were prepared. Results showed melt-electrospun nTi-loaded GA-tretaed composite or pristine PP fabrics have a great potential for use as a photocatalytic filter to decolorization of wastewater and thus, requires further investigation.

Keywords: titanium oxide nanoparticles, polyprophylene, melt-electrospinning

Procedia PDF Downloads 267

Authors: Arzu Firlarer, Duygu Gocmen, Gokhan Uysal

Abstract:

There is currently a growing trend among universities towards blended learning. Blended learning is becoming increasingly important in higher education, with the aims of better accomplishing course learning objectives, meeting students’ changing needs and promoting effective learning both in a theoretical and practical dimension like interior architecture discipline. However, the practical dimension of the discipline cannot be supported in the university environment. During the undergraduate program, the practical training which is tried to be supported by two different internship programs cannot fully meet the requirements of the blended learning. The lack of education program frequently expressed by our graduates and employers is revealed in the practical knowledge and skills dimension of the profession. After a series of meetings for curriculum studies, interviews with the chambers of profession, meetings with interior architects, a gap between the theoretical and practical training modules is seen as a problem in all interior architecture departments. It is thought that this gap can be solved by a new education model which is formed by the cooperation of University-Industry in the concept of blended learning. In this context, it is considered that theoretical and applied knowledge accumulation can be provided by the creation of industry-supported educational environments at the university. In the application process of the Interior Architecture discipline, the use of materials and technical competence will only be possible with the cooperation of industry and participation of students in the production/manufacture processes as observers and practitioners. Wood manufacturing is an important part of interior architecture applications. Wood productions is a sustainable structural process where production details, material knowledge, and process details can be observed in the most effective way. From this point of view, after theoretical training about wooden materials, wood applications and production processes are given to the students, practical training for production/manufacture planning is supported by active participation and observation in the processes. With this blended model, we aimed to develop a training model in which theoretical and practical knowledge related to the production of wood works will be conveyed in a meaningful, lasting way by means of university-industry cooperation. The project is carried out in Ankara with Arcora Architecture and Furniture Company and Başkent University Department of Interior Design where university-industry cooperation is realized. Within the scope of the project, every week the video of that week’s lecture is recorded and prepared to be disseminated by digital medias such as Udemy. In this sense, the program is not only developed by the project participants, but also other institutions and people who are trained and practiced in the field of design. Both academicians from University and at least 15-year experienced craftsmen in the wood metal and dye sectors are preparing new training reference documents for interior architecture undergraduate programs. These reference documents will be a model for other Interior Architecture departments of the universities and will be used for creating an online education module.

Keywords: blended learning, interior design, sustainable training, effective learning.

Procedia PDF Downloads 136