Search results for: exam length

Authors: Mokhlisur Rahman

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Consumers have developed a sense of responsibility in the past decade, reflecting on their purchasing behavior after viewing an advertisement. Consumers tend to buy ideal products that enable them to be judged by their close network in the opinion world. In such value considerations, any information that feeds consumers' desire for social status helps, which becomes capital for educating consumers on the importance of purchasing green products for manufacturing companies. Companies' effort in manufacturing green products to get high conversion demands a good deal of promotion with quality information and engaging representation. Additionally, converting people from traditional to eco-friendly products requires innovative alternatives to replace the existing product. Considering consumers' understanding of products and their purchasing behavior, it becomes essential for the brands to know the extent to which consumers' level of awareness of the ecosystem is to make them more responsive to green products. Another is brand image plays a vital role in consumers' perception regarding the credibility of the claim regarding the product. Brand image is a significant positive influence on the younger generation, and younger generations tend to engage more in pro-environmental behavior, including purchasing sustainable products. For example, Adidas senses the necessity of satisfying consumers with something that brings more profits and serves the planet. Several of their eco-friendly products are already in the market, and one is UltraBOOST DNA parley, made from 3D-printed recycled ocean waste. As a big brand image, Adidas has leveraged an interest among the younger generation by incorporating sustainability into its advertising. Therefore, influential brands' effort in the sustainable revolution through engaging advertisement makes it more prominent by educating consumers about the reason behind launching the product. This study investigates younger consumers' attitudes toward sustainability, brand recognition, exposure to green advertising, willingness to receive more green advertising, purchasing green products, and motivation. The study conducts a market experiment by creating two video advertisements: a sustainable product video advertisement and a non-sustainable product video advertisement. Both the videos have similar content design and the same length of 2 minutes, but the messages are different based on the identical product type college bags. The first video advertisement promotes eco-friendly college bags made from biodegradable raw materials, and the second promotes non-sustainable college bags made from plastics. After viewing the videos, consumers make purchasing decisions and complete an online survey to collect their attitudes toward sustainable products. The study finds the importance of a sense of responsibility to the consumers for climate change issues. Also, it empowers people to take a step, even small, and increases environmental awareness. This study provides companies with the knowledge to participate in sustainable product launches by collecting consumers' perceptions and attitudes toward green products. Also, it shows how important it is to build a brand's image for the younger generation.

Keywords: brand-image, environment, green-advertising, sustainability, younger-consumer

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Authors: Komal Rathore, Kiesha Pierre, Kyle Cogswell, Aaron Driscoll, Andres Tejada Martinez, Gita Iranipour, Luke Mulford, Aydin Sunol

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Modeling of Biological Wastewater Treatment Plants requires several parameters for kinetic rate expressions, thermo-physical properties, and hydrodynamic behavior. The kinetics and associated mechanisms become complex due to several biological processes taking place in wastewater treatment plants at varying times and spatial scales. A dynamic process model that incorporated the complex model for activated sludge kinetics was developed using the BioWin software platform for an Advanced Wastewater Treatment Plant in Valrico, Florida. Due to the extensive number of tunable parameters, an experimental design was employed for judicious selection of the most influential parameter sets and their bounds. The model was tuned using both the influent and effluent plant data to reconcile and rectify the forecasted results from the BioWin Model. Amount of mixed liquor suspended solids in the oxidation ditch, aeration rates and recycle rates were adjusted accordingly. The experimental analysis and plant SCADA data were used to predict influent wastewater rates and composition profiles as a function of time for extended periods. The lumped dynamic model development process was coupled with Computational Fluid Dynamics (CFD) modeling of the key units such as oxidation ditches in the plant. Several CFD models that incorporate the nitrification-denitrification kinetics, as well as, hydrodynamics was developed and being tested using ANSYS Fluent software platform. These realistic and verified models developed using BioWin and ANSYS were used to plan beforehand the operating policies and control strategies for the biological wastewater plant accordingly that further allows regulatory compliance at minimum operational cost. These models, with a little bit of tuning, can be used for other biological wastewater treatment plants as well. The BioWin model mimics the existing performance of the Valrico Plant which allowed the operators and engineers to predict effluent behavior and take control actions to meet the discharge limits of the plant. Also, with the help of this model, we were able to find out the key kinetic and stoichiometric parameters which are significantly more important for modeling of biological wastewater treatment plants. One of the other important findings from this model were the effects of mixed liquor suspended solids and recycle ratios on the effluent concentration of various parameters such as total nitrogen, ammonia, nitrate, nitrite, etc. The ANSYS model allowed the abstraction of information such as the formation of dead zones increases through the length of the oxidation ditches as compared to near the aerators. These profiles were also very useful in studying the behavior of mixing patterns, effect of aerator speed, and use of baffles which in turn helps in optimizing the plant performance.

Keywords: computational fluid dynamics, flow-sheet simulation, kinetic modeling, process dynamics

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Authors: Ezzi Olfa, Bouafia Nabiha, Ammar Asma, Ben Cheikh Asma, Mahjoub Mohamed, Bannour Wadiaa, Achour Bechir, Khelif Abderrahim, Njah Mansour

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Background: In hematology/oncology, health care improvement has allowed increasingly aggressive management in diagnostic and therapeutic procedures. Nevertheless, these intensified procedures have been associated with higher risk of healthcare associated infections (HAIs). We undertook this study to estimate the burden of HAIs in the cancer patients in an onco -hematology unit in a Tunisian university hospital. Materials/Methods: A prospective, observational study, based on active surveillance for a period of 06 months from Mars through September 2016, was undertaken in the department of onco-hematology in a university hospital in Tunisia. Patients, who stayed in the unit for ≥ 48 h, were followed until hospital discharge. The Centers for Disease Control and Prevention criteria (CDC) for site-specific infections were used as standard definitions for HAIs. Results: One hundred fifty patients were included in the study. The gender distribution was 33.3% for girls and 66.6% boys. They have a mean age of 23.12 years (SD = 18.36 years). The main patient’s diagnosis is: Acute Lymphoblastic Leukemia (ALL): 48.7 %( n=73). The mean length of stay was 21 days +/- 18 days. Almost 8% of patients had an implantable port (n= 12), 34.9 % (n=52) had a lumber puncture and 42.7 % (n= 64) had a medullary puncture. Chemotherapy was instituted in 88% of patients (n=132). Eighty (53.3%) patients had neutropenia at admission. The incidence rate of HAIs was 32.66 % per patient; the incidence density was 15.73 per 1000 patient-days in the unit. Mortality rate was 9.3% (n= 14), and 50% of cases of death were caused by HAIs. The most frequent episodes of infection were: infection of skin and superficial mucosa (5.3%), pulmonary aspergillosis (4.6%), Healthcare associated pneumonia (HAP) (4%), Central venous catheter associated infection (4%), digestive infection (5%), and primary bloodstream infection (2.6%). Finally, fever of unknown origin (FUO) incidence rate was 14%. In case of skin and superficial infection (n= 8), 4 episodes were documented, and organisms implicated were Escherichia.coli, Geotricum capitatum and Proteus mirabilis. For pulmonary aspergillosis, 6 cases were diagnosed clinically and radiologically, and one was proved by positive aspergillus antigen in bronchial aspiration. Only one patient died due this infection. In HAP (6 cases), four episodes were diagnosed clinically and radiologically. No bacterial etiology was established in these cases. Two patients died due to HAP. For primary bloodstream infection (4 cases), implicated germs were Enterobacter cloacae, Geotricum capitatum, klebsiella pneumoniae, and Streptococcus pneumoniae. Conclusion: This type of prospective study is an indispensable tool for internal quality control. It is necessary to evaluate preventive measures and design control guides and strategies aimed to reduce the HAI’s rate and the morbidity and mortality associated with infection in a hematology/oncology unit.

Keywords: cohort prospective studies, healthcare associated infections, hematology oncology department, incidence

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Authors: Kinyas Aydin, Fatih Erguney, Tolga Ceper, Serap Ozay, Ipar N. Uzun, Sebnem Kemaloglu Dogan, Deniz Tunc

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In order to meet high growth rates in baby diaper industry worldwide, the high-speed textile backsheet lamination lines have recently been introduced to the market for non-woven/film lamination applications. It is a process where two substrates are bonded to each other via hotmelt adhesive (HMA). Nonwoven (NW) lamination system basically consists of 4 components; polypropylene (PP) nonwoven, polyethylene (PE) film, HMA and applicator system. Each component has a substantial effect on the process efficiency of continuous line and final product properties. However, for a precise subject cover, we will be addressing only the main challenges and possible solutions in this paper. The NW is often produced by spunbond method (SSS or SMS configuration) and has a 10-12 gsm (g/m²) basis weight. The NW rolls can have a width and length up to 2.060 mm and 30.000 linear meters, respectively. The PE film is the 2ⁿᵈ component in TBS lamination, which is usually a 12-14 gsm blown or cast breathable film. HMA is a thermoplastic glue (mostly rubber based) that can be applied in a large range of viscosity ranges. The main HMA application technology in TBS lamination is the slot die application in which HMA is spread on the top of the NW along the whole width at high temperatures in the melt form. Then, the NW is passed over chiller rolls with a certain open time depending on the line speed. HMAs are applied at certain levels in order to provide a proper de-lamination strength in cross and machine directions to the entire structure. Current TBS lamination line speed and width can be as high as 800 m/min and 2100 mm, respectively. They also feature an automated web control tension system for winders and unwinders. In order to run a continuous trouble-free mass production campaign on the fast industrial TBS lines, rheological properties of HMAs and micro-properties of NWs can have adverse effects on the line efficiency and continuity. NW fiber orientation and fineness, as well as spun/melt blown composition fabric micro-level properties, are the significant factors to affect the degree of “HMA bleed through.” As a result of this problem, frequent line stops are observed to clean the glue that is being accumulated on the chiller rolls, which significantly reduces the line efficiency. HMA rheology is also important and to eliminate any bleed through the problem; one should have a good understanding of rheology driven potential complications. So, the applied viscosity/temperature should be optimized in accordance with the line speed, line width, NW characteristics and the required open time for a given HMA formulation. In this study, we will show practical aspects of potential preventative actions to minimize the HMA bleed through the problem, which may stem from both HMA rheological properties and NW spun melt/melt blown fiber characteristics.

Keywords: breathable, hotmelt, nonwoven, textile backsheet lamination, spun/melt blown

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Authors: Isabel Latz, Mark Lusk, Josiah Heyman

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The rise of restrictive U.S. immigration policies and their strengthened enforcement has reportedly caused concerns among providers about their inadvertent effects on service utilization among Latinx and immigrant communities. This study presents perceptions on this issue from twenty service providers in health care, mental health, nutrition assistance, legal assistance, and immigrant advocacy in El Paso, Texas. All participants were experienced professionals, with fifteen in CEO, COO, executive director, or equivalent positions, and based at organizations that provide services for immigrant and/or low-income populations in a bi-national border community. Quantitative and qualitative data were collected by two primary investigators via semi-structured telephone interviews with an average length of 20 minutes. A survey script with closed and open-ended questions inquired about participants’ demographic information and perceptions of impacts of immigration enforcement policies under the current federal administration on their work and patient or client populations. Quantitative and qualitative data were analyzed to produce descriptive statistics and identify salient themes, respectively. Nearly all respondents stated that their work has been negatively (N=13) or both positively and negatively (N=5) affected by current immigration enforcement policies. Negative effects were most commonly related to immigration enforcement-related fear and uncertainty among patient or client populations. Positive effects most frequently referred to a sense of increased community organizing and greater cooperation among organizations. Similarly, the majority of service providers either reported an increase (N=8) or decrease (N=6) in service utilization due to changes in immigration enforcement policies. Increased service needs were primarily related to a need for public education about immigration enforcement policy changes, information about how new policies impact individuals’ service eligibility, legal status, and civil rights, as well as a need to correct misinformation. Decreased service utilization was primarily related to fear-related service avoidance. While providers observed changes in service utilization among undocumented immigrants and mixed-immigration status families, in particular, participants also noted ‘spillover’ effects on the larger Latinx community, including legal permanent and temporary residents, refugees or asylum seekers, and U.S. citizens. This study reveals preliminary insights into providers’ widespread concerns about the effects of current immigration enforcement policies on health, social, and legal service utilization among Latinx individuals. Further research is necessary to comprehensively assess impacts of immigration enforcement policies on service utilization in Latinx and immigrant communities. This information is critical to address gaps in service utilization and prevent an exacerbation of health disparities among Latinx, immigrant, and border populations. In a global climate of rising nationalism and xenophobia, it is critical for policymakers to be aware of the consequences of immigration enforcement policies on the utilization of essential services to protect the well-being of minority and immigrant communities.

Keywords: immigration enforcement, immigration policy, provider perceptions, service utilization

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Authors: Kotaro Sasai, Daijiro Mizutani, Kiyoyuki Kaito

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Expressways in Japan have been built in an accelerating manner since the 1960s with the aid of rapid economic growth. About 40 percent in length of expressways in Japan is now 30 years and older and has become superannuated. Time-related deterioration has therefore reached to a degree that administrators, from a standpoint of operation and maintenance, are forced to take prompt measures on a large scale aiming at repairing inner damage deep in pavements. These measures have already been performed for bridge management in Japan and are also expected to be embodied for pavement management. Thus, planning methods for the measures are increasingly demanded. Deterioration of layers around road surface such as surface course and binder course is brought about at the early stages of whole pavement deterioration process, around 10 to 30 years after construction. These layers have been repaired primarily because inner damage usually becomes significant after outer damage, and because surveys for measuring inner damage such as Falling Weight Deflectometer (FWD) survey and open-cut survey are costly and time-consuming process, which has made it difficult for administrators to focus on inner damage as much as they have been supposed to. As expressways today have serious time-related deterioration within them deriving from the long time span since they started to be used, it is obvious the idea of repairing layers deep in pavements such as base course and subgrade must be taken into consideration when planning maintenance on a large scale. This sort of maintenance requires precisely predicting degrees of deterioration as well as grasping the present situations of pavements. Methods for predicting deterioration are determined to be either mechanical or statistical. While few mechanical models have been presented, as far as the authors know of, previous studies have presented statistical methods for predicting deterioration in pavements. One describes deterioration process by estimating Markov deterioration hazard model, while another study illustrates it by estimating Proportional deterioration hazard model. Both of the studies analyze deflection data obtained from FWD surveys and present statistical methods for predicting deterioration process of layers around road surface. However, layers of base course and subgrade remain unanalyzed. In this study, data collected from FWD surveys are analyzed to predict deterioration process of layers deep in pavements in addition to surface layers by a means of estimating a deterioration hazard model using continuous indexes. This model can prevent the loss of information of data when setting rating categories in Markov deterioration hazard model when evaluating degrees of deterioration in roadbeds and subgrades. As a result of portraying continuous indexes, the model can predict deterioration in each layer of pavements and evaluate it quantitatively. Additionally, as the model can also depict probability distribution of the indexes at an arbitrary point and establish a risk control level arbitrarily, it is expected that this study will provide knowledge like life cycle cost and informative content during decision making process referring to where to do maintenance on as well as when.

Keywords: deterioration hazard model, falling weight deflectometer, inner damage, load bearing capacity, pavement

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Authors: Pauline Calleja, Brooke Alexander

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In 2010 the College of Emergency Nursing Australasia (CENA) undertook sole administration of the Trauma Nursing Program (TNP) across Australia. The original TNP was developed from recommendations by the Review of Trauma and Emergency Services-Victoria. While participant and faculty feedback about the program was positive, issues were identified that were common for industry training programs in Australia. These issues included didactic approaches, with many lectures and little interaction/activity for participants. Participants were not necessarily encouraged to undertake deep learning due to the teaching and learning principles underpinning the course, and thus participants described having to learn by rote, and only gain a surface understanding of principles that were not always applied to their working context. In Australia, a trauma or emergency nurse may work in variable contexts that impact on practice, especially where resources influence scope and capacity of hospitals to provide trauma care. In 2011, a program review was undertaken resulting in major changes to the curriculum, teaching, learning and assessment approaches. The aim was to improve learning including a greater emphasis on pre-program preparation for participants, the learning environment and clinically applicable contextualized outcomes participants experienced. Previously if participants wished to undertake assessment, they were given a take home examination. The assessment had poor uptake and return, and provided no rigor since assessment was not invigilated. A new assessment structure was enacted with an invigilated examination during course hours. These changes were implemented in early 2012 with great improvement in both faculty and participant satisfaction. This presentation reports on a comparison of participant evaluations collected from courses post implementation in 2012 and in 2015 to evaluate if positive changes were sustained. Methods: Descriptive statistics were applied in analyzing evaluations. Since all questions had more than 20% of cells with a count of <5, Fisher’s Exact Test was used to identify significance (p = <0.05) between groups. Results: A total of fourteen group evaluations were included in this analysis, seven CENA TNP groups from 2012 and seven from 2015 (randomly chosen). A total of 173 participant evaluations were collated (n = 81 from 2012 and 92 from 2015). All course evaluations were anonymous, and nine of the original 14 questions were applicable for this evaluation. All questions were rated by participants on a five-point Likert scale. While all items showed improvement from 2012 to 2015, significant improvement was noted in two items. These were in regard to the content being delivered in a way that met participant learning needs and satisfaction with the length and pace of the program. Evaluation of written comments supports these results. Discussion: The aim of redeveloping the CENA TNP was to improve learning and satisfaction for participants. These results demonstrate that initial improvements in 2012 were able to be maintained and in two essential areas significantly improved. Changes that increased participant engagement, support and contextualization of course materials were essential for CENA TNP evolution.

Keywords: emergency nursing education, industry training programs, teaching and learning, trauma education

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Authors: Anugrah Tripathi, H. S. Ginwal, Charul Kainthola

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Bamboos are considered as valuable resources which have the potential of meeting current economic, environmental and social needs. Bamboo has played a key role in humankind and its livelihood since ancient time. Distributed in diverse areas across the globe, bamboo makes an important natural resource for hundreds of millions of people across the world. In some of the Asian countries and northeast part of India, bamboo is the basis of life on many horizons. India possesses the largest bamboo-bearing area across the world and a great extent of species richness, but this rich genetic resource and its diversity have dwindled in the natural forest due to forest fire, over exploitation, lack of proper management policies, and gregarious flowering behavior. Bamboos which are well known for their peculiar, extraordinary morphology, show a lot of variation in many scales. Among the various bamboo species, Dendrocalamus strictus is the most abundant bamboo resource in India, which is a deciduous, solid, and densely tufted bamboo. This species can thrive in wide gradients of geographical as well as climatic conditions. Due to this, it exhibits a significant amount of variation among the populations of different origins for numerous morphological features. Morphological parameters are the front-line criteria for the selection and improvement of any forestry species. Study on the diversity among eight important morphological characters of D. strictus was carried out, covering 16 populations from wide geographical locations of India following INBAR standards. Among studied 16 populations, three populations viz. DS06 (Gaya, Bihar), DS15 (Mirzapur, Uttar Pradesh), and DS16 (Bhogpur, Pinjore, Haryana) were found as superior populations with higher mean values for parametric characters (clump height, no. of culms/ clump, circumference of clump, internode diameter and internode length) and with the higher sum of ranks in non-parametric characters (straightness, disease, and pest incidence and branching pattern). All of these parameters showed an ample amount of variations among the studied populations and revealed a significant difference among the populations. Variation in morphological characters is very common in a species having wide distribution and is usually evident at various levels, viz., between and within the populations. They are of paramount importance for growth, biomass, and quick production gains. Present study also gives an idea for the selection of the population on the basis of these morphological parameters. From this study on morphological parameters and their variation, we may find an overview of best-performing populations for growth and biomass accumulation. Some of the studied parameters also provide ideas to standardize mechanisms of selecting and sustainable harvesting of the clumps by applying simpler silvicultural systems so that they can be properly managed in homestead gardens for the community utilization as well as by commercial growers to meet the requirement of industries and other stakeholders.

Keywords: Dendrocalamus strictus, homestead garden, gregarious flowering, stakeholders, INBAR

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Authors: Zeina Nasr, Bashar Merheb

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The honey bee is a social insect that had driven the human interest much more than any other organism. Beekeeping practices dated the appearance of Man on earth and now it provides a hobby or a secondary work that contributes to the family revenue and requires a little time engagement and money investment. Honey production is not the only contribution of honey bees to the economy, since honey bees play an important role in the pollination. Bee keeping in Lebanon is an important part of the agricultural economy. However, a growing concern about bees is spreading globally, due to an accelerated decline of bees colonies. This raises the alert to preserve and protect local bee strains against uncontrolled introduction of foreign strains and invasive parasitic species. Mitochondrial DNA (mtDNA) markers are commonly used in studying genetic variation in the Apis mellifera species. The DraI-COI-COII test is based on the analysis of the intergenic region between the two genes COI and COII. The different honey bee strains differ in the presence or absence of the p sequence and the number of Q sequences present. A. m. syriaca belonging to the lineage Z, is the native honey bee subspecies in Lebanon, Syria, Jordan, and Palestine. A. m. syriaca is known for its high defensiveness, even though it has many important advantages. However, commercial breeder strains, such as the Italian (A. m. ligustica), and Carniolan (A. m. carnica) strains, have been introduced by beekeepers and regularly used for honey production. This raises worries about the disappearance of the local subspecies. It is obvious that identifying A. m. syriaca colonies and protecting them against uncontrolled mating with other bee strains is a crucial step to protect and improve the original local strain. This study aims to reveal the existing sub-species of honey bee in Akkar – Lebanon and to assess the influence of introgression on the hybridization of the local strain. This will help to identify areas of pure A.m. syriaca population over this district to be considered in choosing syriaca reserves. We collected samples of bees from different regions of Akkar district in order to perform mtDNA analysis. We determined the restriction fragments length of the intergenic region COI-COII, using the restriction enzyme DraI. The results showed both the C and the Z lineages. Four restriction patterns were identified among the restriction maps of the studied samples. The most abundant mitochondrial lineage is the Z lineage constituting about 60% of the identified samples. Al-Dreib region reported the lowest introgression with foreign mtDNA of 21% making it the most suitable area for a genetic reserve of syriaca in Akkar based on its lowest introgression and suitable environment in addition to the attitude of local beekeepers to conserve the local strain. Finally, this study is the first step in constructing conservation programs for the preservation of the local strain and should be generalized to the whole Lebanese population, consistent with the effort done in neighboring countries.

Keywords: Akkar Lebanon, Apis millefera syriaca, DraI-COI-COII test, mitochondrial DNA

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Authors: David L. Knott, Robert Kingsland, Alistair Hitchon

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The proposed Newcastle Light Rail is a key part of the revitalisation of Newcastle, NSW and will provide a frequent and reliable travel option throughout the city centre, running from Newcastle Interchange at Wickham to Pacific Park in Newcastle East, a total of 2.7 kilometers in length. Approximately one-third of the route, along Hunter and Scott Streets, is subject to potential shallow underground mine workings. The extent of mining and seams mined is unclear. Convicts mined the Yard Seam and overlying Dudley (Dirty) Seam in Newcastle sometime between 1800 and 1830. The Australian Agricultural Company mined the Yard Seam from about 1831 to the 1860s in the alignment area. The Yard Seam was about 3 feet (0.9m) thick, and therefore, known as the Yard Seam. Mine maps do not exist for the workings in the area of interest and it was unclear if both or just one seam was mined. Information from 1830s geological mapping and other data showing shaft locations were used along Scott Street and information from the 1908 Royal Commission was used along Hunter Street to develop an investigation program. In addition, mining was encountered for several sites to the south of the alignment at depths of about 7 m to 25 m. Based on the anticipated depths of mining, it was considered prudent to assess the potential for sinkhole development on the proposed alignment and realigned underground utilities and to obtain approval for the work from Subsidence Advisory NSW (SA NSW). The assessment consisted of a desktop study, followed by a subsurface investigation. Four boreholes were drilled along Scott Street and three boreholes were drilled along Hunter Street using HQ coring techniques in the rock. The placement of boreholes was complicated by the presence of utilities in the roadway and traffic constraints. All the boreholes encountered the Yard Seam, with conditions varying from unmined coal to an open void, indicating the presence of mining. The geotechnical information obtained from the boreholes was expanded by using various downhole techniques including; borehole camera, borehole sonar, and downhole geophysical logging. The camera provided views of the rock and helped to explain zones of no recovery. In addition, timber props within the void were observed. Borehole sonar was performed in the void and provided an indication of room size as well as the presence of timber props within the room. Downhole geophysical logging was performed in the boreholes to measure density, natural gamma, and borehole deviation. The data helped confirm that all the mining was in the Yard Seam and that the overlying Dudley Seam had been eroded in the past over much of the alignment. In summary, the assessment allowed the potential for sinkhole subsidence to be assessed and a mitigation approach developed to allow conditional approval by SA NSW. It also confirmed the presence of mining in the Yard Seam, the depth to the seam and mining conditions, and indicated that subsidence did not appear to have occurred in the past.

Keywords: downhole investigation techniques, drilling, mine subsidence, yard seam

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Authors: Meitham Amereh, Mohsen Akbari, Ben Nadler

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Cancer has been recognized as one of the most challenging problems in biology and medicine. Aggressive tumors are a lethal type of cancers characterized by high genomic instability, rapid progression, invasiveness, and therapeutic resistance. Their behavior involves complicated molecular biology and consequential dynamics. Although tremendous effort has been devoted to developing therapeutic approaches, there is still a huge need for new insights into the dark aspects of tumors. As one of the key requirements in better understanding the complex behavior of tumors, mathematical modeling and continuum physics, in particular, play a pivotal role. Mathematical modeling can provide a quantitative prediction on biological processes and help interpret complicated physiological interactions in tumors microenvironment. The pathophysiology of aggressive tumors is strongly affected by the extracellular cues such as stresses produced by mechanical forces between the tumor and the host tissue. During the tumor progression, the growing mass displaces the surrounding extracellular matrix (ECM), and due to the level of tissue stiffness, stress accumulates inside the tumor. The produced stress can influence the tumor by breaking adherent junctions. During this process, the tumor stops the rapid proliferation and begins to remodel its shape to preserve the homeostatic equilibrium state. To reach this, the tumor, in turn, upregulates epithelial to mesenchymal transit-inducing transcription factors (EMT-TFs). These EMT-TFs are involved in various signaling cascades, which are often associated with tumor invasiveness and malignancy. In this work, we modeled the tumor as a growing hyperplastic mass and investigated the effects of mechanical stress from surrounding ECM on tumor invasion. The invasion is modeled as volume-preserving inelastic evolution. In this framework, principal balance laws are considered for tumor mass, linear momentum, and diffusion of nutrients. Also, mechanical interactions between the tumor and ECM is modeled using Ciarlet constitutive strain energy function, and dissipation inequality is utilized to model the volumetric growth rate. System parameters, such as rate of nutrient uptake and cell proliferation, are obtained experimentally. To validate the model, human Glioblastoma multiforme (hGBM) tumor spheroids were incorporated inside Matrigel/Alginate composite hydrogel and was injected into a microfluidic chip to mimic the tumor’s natural microenvironment. The invasion structure was analyzed by imaging the spheroid over time. Also, the expression of transcriptional factors involved in invasion was measured by immune-staining the tumor. The volumetric growth, stress distribution, and inelastic evolution of tumors were predicted by the model. Results showed that the level of invasion is in direct correlation with the level of predicted stress within the tumor. Moreover, the invasion length measured by fluorescent imaging was shown to be related to the inelastic evolution of tumors obtained by the model.

Keywords: cancer, invasion, mathematical modeling, microfluidic chip, tumor spheroids

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Authors: H. I. Obadiah, S. N. Wieser, E. A. Omudu, B. O. Atu, O. Byanet, L. Schnittger, M. Florin-Christensen

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Sarcocystis sp. are Apicomplexan protozoan parasites with a life cycle that involves a predator and a prey as final and intermediate hosts, respectively. In tissues of the intermediate hosts, the parasites produce sarcocysts that vary in size and morphology according to the species. When a suitable predator ingests sarcocyst-containing meat, the parasites are released in the intestine and undergo sexual reproduction producing infective sporocysts, which are excreted with the feces into the environment. The cycle is closed when a prey ingests sporocyst-contaminated water or pasture; the parasites gain access to the circulation, and eventually invade tissues and reproduce asexually yielding sarcocysts. Pig farming is a common practice in Nigeria as well as in many countries around the world. In addition to its importance as protein source, pork is also a source of several pathogens relevant to humans. In the case of Sarcocystis, three species have been described both in domestic and wild pigs, namely, S. miescheriana, S. porcifelis and S. suihominis. Humans can act both as final and aberrant intermediate hosts of S. suihominis, after ingesting undercooked sarcocyst-infested pork. Infections are usually asymptomatic but can be associated with inappetence, nausea, vomiting and diarrhea, or with muscle pain, fever, eosinophilia and bronchospasm, in humans acting as final or intermediate hosts, respectively. Moreover, excretion of infective forms with human feces leads to further dissemination of the infection. In this study, macroscopic sarcocysts of white color, oval shape and a size range of approximately 3-5 mm were observed in the skeletal muscle of a slaughtered pig in an abattoir in Makurdi, Benue State, Nigeria, destined to human consumption. Sarcocysts were excised and washed in distilled water, and genomic DNA was extracted using a commercial kit. The near-complete length of the 18S rRNA gene was analyzed after PCR amplification of two overlapping fragments, each of which were submitted to direct sequencing. In addition, the mitochondrial cytochrome oxidase (cox-1) gene was PCR-amplified and directly sequenced. Two phylogenetic trees containing the obtained sequences along with available relevant 18S rRNA and cox-1 sequences were constructed by neighbor joining after alignment, using the corresponding sequences of Toxoplasma gondii as outgroup. The results showed in both cases that the analyzed sequences grouped with S. suihominis with high bootstrap value, confirming the identity of this macroscopic sarcocyst-forming parasite as S. suihominis. To the best of our knowledge, these results represent the first demonstration of this parasite in pigs of Nigeria and the largest sarcocysts described so far for S. suihominis. The close proximity between pigs and humans in pig farms, and the frequent poor sanitary conditions in human dwellings strongly suggest that the parasite undergoes the sexual stages of its life cycle in humans as final hosts. These findings provide an important reference for the examination and control of Sarcocystis species in pigs of Nigeria.

Keywords: nigeria, pork, sarcocystis suihominis, zoonotic parasite

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Authors: Wang Hong, Liu Chang Kui, Zhao Bing Jing, Hu Min

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Objection We observed the repairment effection of canine mandibular defect with meshy Ti6Al4V scaffold fabricated by electron beam melting (EBM) combined with bone marrow mesenchymal stem cells (BMMSCs) encapsulated in chitosan hydrogel. Method Meshy titanium scaffolds were prepared by EBM of commercial Ti6Al4V power. The length of scaffolds was 24 mm, the width was 5 mm and height was 8mm. The pore size and porosity were evaluated by scanning electron microscopy (SEM). Chitosan /Bio-Oss hydrogel was prepared by chitosan, β- sodium glycerophosphate and Bio-Oss power. BMMSCs were harvested from canine iliac crests. BMMSCs were seeded in titanium scaffolds and encapsulated in Chitosan /Bio-Oss hydrogel. The validity of BMMSCs was evaluated by cell count kit-8 (CCK-8). The osteogenic differentiation ability was evaluated by alkaline phosphatase (ALP) activity and gene expression of OC, OPN and CoⅠ. Combination were performed by injecting BMMSCs/ Chitosan /Bio-Oss hydrogel into the meshy Ti6Al4V scaffolds and solidified. 24 mm long box-shaped bone defects were made at the mid-portion of mandible of adult beagles. The defects were randomly filled with BMMSCs/ Chitosan/Bio-Oss + titanium, Chitosan /Bio-Oss+titanium, titanium alone. Autogenous iliac crests graft as control group in 3 beagles. Radionuclide bone imaging was used to monitor the new bone tissue at 2, 4, 8 and 12 weeks after surgery. CT examination was made on the surgery day and 4 weeks, 12 weeks and 24 weeks after surgery. The animals were sacrificed in 4, 12 and 24 weeks after surgery. The bone formation were evaluated by histology and micro-CT. Results: The pores of the scaffolds was interconnected, the pore size was about 1 mm, the average porosity was about 76%. The pore size of the hydrogel was 50-200μm and the average porosity was approximately 90%. The hydrogel were solidified under the condition of 37℃in 10 minutes. The validity and the osteogenic differentiation ability of BMSCs were not affected by titanium scaffolds and hydrogel. Radionuclide bone imaging shown an increasing tendency of the revascularization and bone regeneration was observed in all the groups at 2, 4, 8 weeks after operation, and there were no changes at 12weeks.The tendency was more obvious in the BMMSCs/ Chitosan/Bio-Oss +titanium group and autogenous group. CT, Micro-CT and histology shown that new bone formed increasingly with the time extend. There were more new bone regenerated in BMMSCs/ Chitosan /Bio-Oss + titanium group and autogenous group than the other two groups. At 24 weeks, the autogenous group was achieved bone union. The BMSCs/ Chitosan /Bio-Oss group was seen extensive new bone formed around the scaffolds and more new bone inside of the central pores of scaffolds than Chitosan /Bio-Oss + titanium group and titanium group. The difference was significantly. Conclusion: The titanium scaffolds fabricated by EBM had controlled porous structure, good bone conduction and biocompatibility. Chitosan /Bio-Oss hydrogel had injectable plasticity, thermosensitive property and good biocompatibility. The meshy Ti6Al4V scaffold produced by EBM combined BMSCs encapsulated in chitosan hydrogel had good capacity on mandibular bone defect repair.

Keywords: mandibular reconstruction, tissue engineering, electron beam melting, titanium alloy

Procedia PDF Downloads 444

Authors: Oibar Martinez, Clara Oliver, Jose Miguel Miranda

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In this paper, we discuss the standard improvements which can be made to reduce the earth resistance in difficult terrains for optimum lightning protection, what are the practical limitations, and how the modeling can be refined for accurate diagnostics and ground resistance minimization. Ground resistance minimization can be made via three different approaches: burying vertical electrodes connected in parallel, burying horizontal conductive plates or meshes, or modifying the own terrain, either by changing the entire terrain material in a large volume or by adding earth-enhancing compounds. The use of vertical electrodes connected in parallel pose several practical limitations. In order to prevent loss of effectiveness, it is necessary to keep a minimum distance between each electrode, which is typically around five times larger than the electrode length. Otherwise, the overlapping of the local equipotential lines around each electrode reduces the efficiency of the configuration. The addition of parallel electrodes reduces the resistance and facilitates the measurement, but the basic parallel resistor formula of circuit theory will always underestimate the final resistance. Numerical simulation of equipotential lines around the electrodes overcomes this limitation. The resistance of a single electrode will always be proportional to the soil resistivity. The electrodes are usually installed with a backfilling material of high conductivity, which increases the effective diameter. However, the improvement is marginal, since the electrode diameter counts in the estimation of the ground resistance via a logarithmic function. Substances that are used for efficient chemical treatment must be environmentally friendly and must feature stability, high hygroscopicity, low corrosivity, and high electrical conductivity. A number of earth enhancement materials are commercially available. Many are comprised of carbon-based materials or clays like bentonite. These materials can also be used as backfilling materials to reduce the resistance of an electrode. Chemical treatment of soil has environmental issues. Some products contain copper sulfate or other copper-based compounds, which may not be environmentally friendly. Carbon-based compounds are relatively inexpensive and they do have very low resistivities, but they also feature corrosion issues. Typically, the carbon can corrode and destroy a copper electrode in around five years. These compounds also have potential environmental concerns. Some earthing enhancement materials contain cement, which, after installation acquire properties that are very close to concrete. This prevents the earthing enhancement material from leaching into the soil. After analyzing different configurations, we conclude that a buried conductive ring with vertical electrodes connected periodically should be the optimum baseline solution for the grounding of a large size structure installed on a large resistivity terrain. In order to show this, a practical example is explained here where we simulate the ground resistance of a conductive ring buried in a terrain with a resistivity in the range of 1 kOhm·m.

Keywords: grounding improvements, large scale scientific instrument, lightning risk assessment, lightning standards

Procedia PDF Downloads 137

Authors: Indra Bahadur Chand

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This paper will focus on the need for development and application of global protocols and policy in planning, designing, development, and management of systems of eco-towns and eco-villages so that sustainable development will be assured from the perspective of environmental, economical, peace, and harmonized social dynamics. This perspective is essential for the development of civilized and eco-friendly human settlements in the town and rural areas of the nation that will be a milestone for developing a happy and sustainable lifestyle of rural and urban communities of the nation. The urban population of most of the town of developing economies has been tremendously increasing, whereas rural people have been tremendously migrating for the past three decades. Consequently, the urban lifestyle in most towns has stressed in terms of environmental pollution, water crisis, congested traffic, energy crisis, food crisis, and unemployment. Eco-towns and villages should be developed where lifestyle of all residents is sustainable and happy. Built up environment of settlement should reduce and minimize the problems of non ecological CO2 emissions, unbalanced utilization of natural resources, environmental degradation, natural calamities, ecological imbalance, energy crisis, water scarcity, waste management, food crisis, unemployment, deterioration of cultural heritage, social, the ratio among the public and private land ownership, ratio of land covered with vegetation and area of settlement, the ratio of people in the vehicles and foot, the ratio of people employed outside of town and village, ratio of resources recycling of waste materials, water consumption level, the ratio of people and vehicles, ratio of the length of the road network and area of town/villages, a ratio of renewable energy consumption with total energy, a ratio of religious/recreational area out of the total built-up area, the ratio of annual suicide case out of total people, a ratio of annual injured and death out of total people from a traffic accident, a ratio of production of agro foods within town out of total food consumption will be used to assist in designing and monitoring of each eco-towns and villages. An eco-town and villages should be planned and developed to offer sustainable infrastructure and utilities that maintain CO2 level in individual homes and settlements, home energy use, transport, food and consumer goods, water supply, waste management, conservation of historical heritages, healthy neighborhood, conservation of natural landscape, conserving bio-diversity and developing green infrastructures. Eco-towns and villages should be developed on the basis of master planning and architecture that affect and define the settlement and its form. Master planning and engineering should focus in delivering the sustainability criteria of eco towns and eco village. This will involve working with specific landscape and natural resources of locality.

Keywords: eco-town, ecological habitation, master plan, sustainable development

Procedia PDF Downloads 178

Authors: Dahna Alkahtani, Faryal Suraya, Fadah Alanazi

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Background: Buccal mucosal graft for urethral augmentation has surpassed other grafting options, and is now considered the standard of choice for substitution Urethroplasty. The graft has gained its popularity due to its excellent short and long-term results, easy harvesting as well as its ability in withstanding wet environments. However, although Buccal mucosal grafts are an excellent option, it is not free of complications, potential intraoral complications are bleeding, pain, swelling, injury to the nerve resulting in numbness, lip deviation or retraction. Objectives: The current study aims to evaluate the intraoral complications of buccal mucosa grafts harvested from one cheek, and used in Augmentation Urethroplasty. Methodology: The study was conducted retrospectively using the medical records of patients who underwent open augmentation urethroplasty with a buccal mucosa graft at King Khalid University Hospital, Saudi Arabia. Data collection of demographics included the type of graft used, presence or absence of strictures and its etiological factors. Pre-operative and post-operative evaluations were carried out on the subjects including the medical history, physical examination, uroflowmetry, retrograde urethrography, voiding cystourethrography and urine cultures were also noted. Further, the quality of life and complications of the procedure including the presence or occurrence of bleeding within 3-days post-procedure, the severity of pain, oral swelling after grafting, length of return to normal daily diet, painful surgical site, intake of painkillers, presence or absence of speech disturbance, numbness in the cheeks and lips were documented. Results: Thirty-two male subjects with ages ranging from 15 years to 72 years were included in the current study. Following the procedure, a hundred percent of the subjects returned to their normal daily diet by the sixth postoperative day. Further, the majority of the patients reported experiencing mild pain accounting for 61.3%, and 90.3% of the subjects reported using painkillers to control the pain. Surgical wound Pain was reportedly more common at the perineal site as 48.4% of the subjects experienced it; on the other hand, 41.9% of the patients experienced pain in the oral mucosa. The presence of speech disorders, as assessed through medical history, was found to be present in 3.2% of patients. The presence of numbness in the cheeks and lips was found in 3.2% of patients. Other complications such as parotid duct injury, delayed wound healing, non-healing wound and suture granuloma were rare as 90.3% of the subjects denied experiencing any of them, there were nonetheless reports of parotid duct injury by 6.5% of the patients, and non-healing wound by the 3.2% of patients. Conclusion: Buccal Mucosa Graft in Augmentation Urethroplasty is an ideal source of allograft, although not entirely painless; it is considerably safe with minimal intra-oral complication and undetectable strain on the patients’ quality of life.

Keywords: augmentation, buccal, graft, oral

Procedia PDF Downloads 176

Authors: Michal Pachocki

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This study investigates the effects of mobility in the context of a different environment and work culture through analysing the learners perception of their international work experience. Since this kind of professional training abroad is becoming more popular in Europe, mainly due to the EU funding opportunities, it is of paramount importance to assess its long-term impact on educational and career paths of former students. Moreover, the tracer study aimed at defining what professional, social and intercultural competencies were gained or developed by the interns and to which extent those competences proved to be useful meeting the labor market requirements. Being a populous EU member state which actively modernizes its vocational education system (also with European funds), Poland can serve as an illustrative case study to investigate the above described research problems. However, the examined processes are most certainly universal, wherever mobility is included in the learning process. The target group of this research was the former mobility participants and the study was conducted using quantitative and qualitative methods, such as the online survey with over 2 600 questionnaires completed by the former mobility participants; -individual in-depth interviews (IDIs) with 20 Polish graduates already present in the labour market; - 5 focus group interviews (FGIs) with 60 current students of the Polish vocational schools, who have recently returned from the training abroad. As the adopted methodology included a data triangulation, the collected findings have also been supplemented with data obtained by the desk research (mainly contextual information and statistical summary of mobility implementation). The results of this research – to be presented in full scope within the conference presentation – include the participants’ perception of their work mobility. The vast majority of graduates agrees that such an experience has had a significant impact on their professional careers and claims that they would recommend training abroad to persons who are about to enter the labor market. Moreover, in their view, such form of practical training going beyond formal education provided them with an opportunity to try their hand in the world of work. This allowed them – as they accounted for them – to get acquainted with a work system and context different from the ones experienced in Poland. Although the work mobility becomes an important element of the learning process in the growing number of Polish schools, this study reveals that many sending institutions suffer from a lack of the coherent strategy for planning domestic and foreign training programmes. Nevertheless, the significant number of graduates claims that such a synergy improves the quality of provided training. Despite that, the research proved that the transnational mobilities exert an impact on their future careers and personal development. However, such impact is, in their opinion, dependant on other factors, such as length of the training period, the nature and extent of work, recruitment criteria and the quality of organizational arrangement and mentoring provided to learners. This may indicate the salience of the sending and receiving institutions organizational capacity to deal with mobility.

Keywords: learning mobility, transnational training, vocational education and training graduates, tracer study

Procedia PDF Downloads 96

Authors: Galatee Levadoux, Trevor Benson, Chris Worrall

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With the rise of public awareness on climate change comes an increasing demand for renewable sources of energy. As a result, the wind power sector is striving to manufacture longer, more efficient and reliable wind turbine blades. Currently, one of the leading causes of blade failure in service is improper cure of the resin during manufacture. The infusion process creating the main part of the composite blade structure remains a critical step that is yet to be monitored in real time. This stage consists of a viscous resin being drawn into a mould under vacuum, then undergoing a curing reaction until solidification. Successful infusion assumes the resin fills all the voids and cures completely. Given that the electrical properties of the resin change significantly during its solidification, both the filling of the mould and the curing reaction are susceptible to be followed using dieletrometry. However, industrially available dielectrics sensors are currently too small to monitor the entire surface of a wind turbine blade. The aim of the present research project is to scale up the dielectric sensor technology and develop a device able to monitor the manufacturing process of large composite structures, assessing the conformity of the blade before it even comes out of the mould. An array of flat copper wires acting as electrodes are embedded in a polymer matrix fixed in an infusion mould. A multi-frequency analysis from 1 Hz to 10 kHz is performed during the filling of the mould with an epoxy resin and the hardening of the said resin. By following the variations of the complex admittance Y*, the filling of the mould and curing process are monitored. Results are compared to numerical simulations of the sensor in order to validate a virtual cure-monitoring system. The results obtained by drawing glycerol on top of the copper sensor displayed a linear relation between the wetted length of the sensor and the complex admittance measured. Drawing epoxy resin on top of the sensor and letting it cure at room temperature for 24 hours has provided characteristic curves obtained when conventional interdigitated sensor are used to follow the same reaction. The response from the developed sensor has shown the different stages of the polymerization of the resin, validating the geometry of the prototype. The model created and analysed using COMSOL has shown that the dielectric cure process can be simulated, so long as a sufficient time and temperature dependent material properties can be determined. The model can be used to help design larger sensors suitable for use with full-sized blades. The preliminary results obtained with the sensor prototype indicate that the infusion and curing process of an epoxy resin can be followed with the chosen configuration on a scale of several decimeters. Further work is to be devoted to studying the influence of the sensor geometry and the infusion parameters on the results obtained. Ultimately, the aim is to develop a larger scale sensor able to monitor the flow and cure of large composite panels industrially.

Keywords: composite manufacture, dieletrometry, epoxy, resin infusion, wind turbine blades

Procedia PDF Downloads 165

Authors: Ani Eda Njwe

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Cameroon is a bilingual and bijural country in West and Central Africa. The current president has been in power since 1982, which makes him the longest-serving president in the world. The length of his presidency is one of the major causes of the ongoing political instability in the country. The preamble of the Cameroonian constitution commits Cameroon to respect international law and human rights. It provides that these laws should be translated into national laws, and respected by all spheres of government and public service. Cameroon is a signatory of several international human rights laws and conventions. In theory, the citizens of Cameroon have adequate legal protection against the violation of their human rights for political reasons. The ongoing political crisis in Cameroon erupted after the Anglophone lawyers and teachers launched a protest against the hiring of Francophone judges in Anglophone courts; and the hiring of Francophone teachers in Anglophone schools. In retaliation, the government launched a military crackdown on protesters and civilians, conducted arbitrary arrests on Anglophones, raped and maimed civilians, and declared a state of emergency in the Anglophone provinces. This infuriated the Anglophone public, causing them to create a secessionist movement, requesting the Independence of Anglophone Cameroon and demanding a separate country called Ambazonia. The Ambazonian armed rebel forces have ever since launched guerrilla attacks on government troops. This fighting has deteriorated into a war between the Ambazonians and the Cameroon government. The arbitrary arrests and unlawful imprisonments have continued, causing the closure of Anglophone schools since November 2016. In October 2018, Cameroon held presidential elections. Before the electoral commission announced the results, the opposition leader, a Francophone, declared himself winner, following a leak of the polling information. This led to his imprisonment. This research has the objective of finding out whether the government’s reactions to protesters and opposition is lawful, under national and international laws. This research will also verify if the prison conditions of political prisoners meet human rights standards. Furthermore, this research seeks detailed information obtained from current political prisoners and detainees on their experiences. This research also aims to highlight the effort being made internationally, towards bringing awareness and finding a resolution to the war in Cameroon. Finally, this research seeks to elucidate on the efforts which human rights organisations have made, towards overseeing the respect of human rights in Cameroon. This research adopts qualitative methods, whereby data were collected using semi-structured interviews of political detainees, and questionnaires. Also, data was collected from secondary sources such as; scholarly articles, newspaper articles, web sources, and human rights reports. From the data collected, the findings were analysed using the content analysis research technique. From the deductions, recommendations have been made, which human rights organisations, activists, and international bodies can implement, to cause the Cameroonian government to stop unlawful arrests and reinstate the respect of human rights and the rule of law in Cameroon.

Keywords: arbitrary arrests, Cameroon, human rights, political

Procedia PDF Downloads 122

Authors: Samar Saadeldin Abdelmotalab Omer, Ikram Mohamed Eltayeb Elsiddig, Saad Mohammed Hussein Ayoub

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A variety of herbal medicinal plants are known to confer beneficial effects in regards to modification of cardiovascular ri’=sk factors. The anti-hypercholesterolaemic and antioxidant activities of the crude ethanolic extracts of Citrus reticulate fruit peel, Zingiber officinale rhizome and Sesamum indicum seed extracts have been demonstrated. These plants are assumed to possess biologically active principles, which impart their pharmacologic activities. GC-MS analysis of the ethanolic extracts was carried out to identify the active principles and their percentages of occurrence in the analytes. Analysis of the extracts was carried out using (GS-MS QP) type Schimadzu 2010 equipped with a capillary column RTX-50 (restec), (length 30mm, diameter 0.25mm, and thickness 0.25mm). Helium was used as a carrier gas, the temperature was programmed at 200°C for 5 minutes at a rate of 15ml/minute, and the extracts were injected using split injection mode. The identification of different components was achieved from their Mass Spectra and Retention time, compared with those in the NIST library. The results revealed the presence of 80 compounds in Sudanese locally grown C. reticulata fruit peel extract, most of which were monoterpenoid compounds including Limonene (3.03%), Alpha & Gamma - terpinenes (2.61%), Linalool (1.38%), Citral (1.72%) which are known to have profound antioxidant effects. The Sesquiterpenoids Humulene (0.26%) and Caryophyllene (1.97%) were also identified, the latter known to have profound anti-anxiety and anti-depressant activity in addition to the beneficiary effects in lipid regulation. The analysis of the locally grown S. indicum oily and water soluble portions of seed extract revealed the presence of a total of 64 compounds with considerably high percentage of the mono-unsaturated fatty acid ester methyl oleate (66.99%) in addition to methyl stearate (9.35%) and palmitate (15.71%) of oil portion, whereas, plant sterols including Gamma-sitosterol (13.5%), fucosterol (2.11%) and stigmasterol (1.95%) in addition to gamma-tocopherol (1.16%) were detected in extract water-soluble portion. The latter indicate various principles known to have valuable pharmacological benefits including antioxidant activities and beneficiary effects on intestinal cholesterol absorption and regulation of serum cholesterol levels. Z. officinale rhizome extract analysis revealed the presence of 93 compounds, the most abundant were alpha-zingeberine (16.5%), gingerol (9.25%), alpha-sesquiphellandrene (8.3%), zingerone (6.78%), beta-bisabolene (4.19%), alpha-farnesene (3.56%), ar-curcumene (3.29%), gamma-elemene (1.25%) and a variety of other compounds. The presence of these active principles reflected on the activity of the extract. Activity could be assigned to a single or a combination of two or more extract components. GC-MS analysis concluded the occurrence of compounds known to possess antioxidant activity and lipid profile effects.

Keywords: gas chromatography, indicum, officinale, reticulata

Procedia PDF Downloads 372

Authors: Elizaveta S. Prokofyeva, Svetlana V. Maltseva, Roman D. Zaitsev

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Rapidly evolving modern data analysis technologies in healthcare play a large role in understanding the operation of the system and its characteristics. Nowadays, one of the key tasks in urban healthcare is to optimize the resource allocation. Thus, the application of data analysis in medical institutions to solve optimization problems determines the significance of this study. The purpose of this research was to establish the dependence between the indicators of the effectiveness of the medical institution and its resources. Hospital discharges by diagnosis; hospital days of in-patients and in-patient average length of stay were selected as the performance indicators and the demand of the medical facility. The hospital beds by type of care, medical technology (magnetic resonance tomography, gamma cameras, angiographic complexes and lithotripters) and physicians characterized the resource provision of medical institutions for the developed models. The data source for the research was an open database of the statistical service Eurostat. The choice of the source is due to the fact that the databases contain complete and open information necessary for research tasks in the field of public health. In addition, the statistical database has a user-friendly interface that allows you to quickly build analytical reports. The study provides information on 28 European for the period from 2007 to 2016. For all countries included in the study, with the most accurate and complete data for the period under review, predictive models were developed based on historical panel data. An attempt to improve the quality and the interpretation of the models was made by cluster analysis of the investigated set of countries. The main idea was to assess the similarity of the joint behavior of the variables throughout the time period under consideration to identify groups of similar countries and to construct the separate regression models for them. Therefore, the original time series were used as the objects of clustering. The hierarchical agglomerate algorithm k-medoids was used. The sampled objects were used as the centers of the clusters obtained, since determining the centroid when working with time series involves additional difficulties. The number of clusters used the silhouette coefficient. After the cluster analysis it was possible to significantly improve the predictive power of the models: for example, in the one of the clusters, MAPE error was only 0,82%, which makes it possible to conclude that this forecast is highly reliable in the short term. The obtained predicted values of the developed models have a relatively low level of error and can be used to make decisions on the resource provision of the hospital by medical personnel. The research displays the strong dependencies between the demand for the medical services and the modern medical equipment variable, which highlights the importance of the technological component for the successful development of the medical facility. Currently, data analysis has a huge potential, which allows to significantly improving health services. Medical institutions that are the first to introduce these technologies will certainly have a competitive advantage.

Keywords: data analysis, demand modeling, healthcare, medical facilities

Procedia PDF Downloads 144

Authors: Euripides Antoniades

Abstract:

In 1821 the Greek Revolution movement, under the political influence that arose from the French revolution, and the corresponding movements in Italy, Germany and America, requested the liberation of the nation and the establishment of an independent national state. Published topics in the British press regarding the Greek Revolution, focused on : a) the right of the Greeks to claim their freedom from Turkish domination in order to establish an independent state based on the principle of national autonomy, b) criticism regarding Turkish rule as illegal and the power of the Ottoman Sultan as arbitrary, c) the recognition of the Greek identity and its distinction from the Turkish one and d) the endorsement Greeks as the descendants of ancient Greeks. The advantage of newspaper as a media is sharing information and ideas and dealing with issues in greater depth and detail, unlike other media, such as radio or television. The London Times is a print publication that presents, in chronological or thematic order, the news, opinions or announcements about the most important events that have occurred in a place during a specified period of time. This paper employs the rich archive of The London Times archive by quoting extracts from publications of that period, to convey the British public perspective regarding the Greek Revolution from its beginning until the London Protocol of 1828. Furthermore, analyses the publications of the British newspaper in terms of the number of references to the Greek revolution, front page and editorial references as well as the size of publications on the revolution during the period 1821-1828. A combination of qualitative and quantitative content analysis was applied. An attempt was made to record Greek Revolution references along with the usage of specific words and expressions that contribute to the representation of the historical events and their exposure to the reading public. Key finds of this research reveal that a) there was a frequency of passionate daily articles concerning the events in Greece, their length, and context in The London Times, b) the British public opinion was influenced by this particular newspaper and c) the newspaper published various news about the revolution by adopting the role of animator of the Greek struggle. For instance, war events and the battles of Wallachin and Moldavia, Hydra, Crete, Psara, Mesollogi, Peloponnese were presented not only for informing the readers but for promoting the essential need for freedom and the establishment of an independent Greek state. In fact, this type of news was the main substance of the The London Times’ structure, establishing a positive image about the Greek Revolution contributing to the European diplomatic development such as the standpoint of France, - that did not wish to be detached from the conclusions regarding the English loans and the death of Alexander I of Russia and his succession by the ambitious Nicholas. These factors offered a change in the attitude of the British and Russians respectively assuming a positive approach towards Greece. The Great Powers maintained a neutral position in the Greek-Ottoman conflict, same time they engaged in Greek power increasement by offering aid.

Keywords: Greece, revolution, newspaper, the London times, London, great britain, mass media

Procedia PDF Downloads 89

Authors: Chui-Hsin Chen, Yu-Ting Chen

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Special concentrically braced frames is one of the seismic load resisting systems, which dissipates seismic energy when bracing members within the frames undergo yielding and buckling while sustaining their axial tension and compression load capacities. Most of the inelastic deformation of a buckling bracing member concentrates in the mid-length region. While experiencing cyclic loading, the region dissipates most of the seismic energy being input into the frame. Such a concentration makes the braces vulnerable to failure modes associated with low-cycle fatigue. In this research, a strategy to improve the cyclic behavior of the conventional steel bracing member is proposed by filling the Hollow Structural Shape (HSS) member with reinforcement. It prevents the local section from concentrating large plastic deformation caused by cyclic loading. The infill helps spread over the plastic hinge region into a wider area hence postpone the initiation of local buckling or even the rupture of the braces. The finite element method is introduced to simulate the complicated bracing member behavior and member-versus-infill interaction under cyclic loading. Fifteen 3-D-element-based models are built by ABAQUS software. The verification of the FEM model is done with unreinforced (UR) HSS bracing members’ cyclic test data and aluminum honeycomb plates’ bending test data. Numerical models include UR and filled HSS bracing members with various compactness ratios based on the specification of AISC-2016 and AISC-1989. The primary variables to be investigated include the relative bending stiffness and the material of the filling reinforcement. The distributions of von Mises stress and equivalent plastic strain (PEEQ) are used as indices to tell the strengths and shortcomings of each model. The result indicates that the change of relative bending stiffness of the infill is much more influential than the change of material in use to increase the energy dissipation capacity. Strengthen the relative bending stiffness of the reinforcement results in additional energy dissipation capacity to the extent of 24% and 46% in model based on AISC-2016 (16-series) and AISC-1989 (89-series), respectively. HSS members with infill show growth in 𝜂Local Buckling, normalized energy cumulated until the happening of local buckling, comparing to UR bracing members. The 89-series infill-reinforced members have more energy dissipation capacity than unreinforced 16-series members by 117% to 166%. The flexural rigidity of infills should be less than 29% and 13% of the member section itself for 16-series and 89-series bracing members accordingly, thereby guaranteeing the spread over of the plastic hinge and the happening of it within the reinforced section. If the parameters are properly configured, the ductility, energy dissipation capacity, and fatigue-life of HSS SCBF bracing members can be improved prominently by the infill-reinforced method.

Keywords: special concentrically braced frames, HSS, cyclic loading, infill reinforcement, finite element analysis, PEEQ

Procedia PDF Downloads 92

Authors: Elodie Niemiec, Philippe Champagne, Jean-Francois Blach, Philippe Moreau, Anthony Thuault, Arnaud Tricoteaux

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Hygiene of equipment in contact with users is an important issue in the railroad industry. The numerous cleanings to eliminate bacteria and dirt cost a lot. Besides, mechanical solicitations on contact parts are observed daily. It should be interesting to elaborate on a self-cleaning and antibacterial coating with sufficient adhesion and good resistance against mechanical and chemical solicitations. Thus, a Hauts-de-France and Maubeuge Val-de-Sambre conurbation authority co-financed Ph.D. thesis has been set up since October 2017 based on anterior studies carried by the Laboratory of Ceramic Materials and Processing. To accomplish this task, a soft chemical route has been implemented to bring a lotus effect on metallic substrates. It involves nanometric liquid zinc oxide synthesis under 100°C. The originality here consists in a variation of surface texturing by modification of the synthesis time of the species in solution. This helps to adjust wettability. Nanostructured zinc oxide has been chosen because of the inherent photocatalytic effect, which can activate organic substance degradation. Two methods of heating have been compared: conventional and microwave assistance. Tested subtracts are made of stainless steel to conform to transport uses. Substrate preparation was the first step of this protocol: a meticulous cleaning of the samples is applied. The main goal of the elaboration protocol is to fix enough zinc-based seeds to make them grow during the next step as desired (nanorod shaped). To improve this adhesion, a silica gel has been formulated and optimized to ensure chemical bonding between substrate and zinc seeds. The last step consists of deposing a wide carbonated organosilane to improve the superhydrophobic property of the coating. The quasi-proportionality between the reaction time and the nanorod length will be demonstrated. Water Contact (superior to 150°) and Roll-off Angle at different steps of the process will be presented. The antibacterial effect has been proved with Escherichia Coli, Staphylococcus Aureus, and Bacillus Subtilis. The mortality rate is found to be four times superior to a non-treated substrate. Photocatalytic experiences were carried out from different dyed solutions in contact with treated samples under UV irradiation. Spectroscopic measurements allow to determinate times of degradation according to the zinc quantity available on the surface. The final coating obtained is, therefore, not a monolayer but rather a set of amorphous/crystalline/amorphous layers that have been characterized by spectroscopic ellipsometry. We will show that the thickness of the nanostructured oxide layer depends essentially on the synthesis time set in the hydrothermal growth step. A green, easy-to-process and control coating with self-cleaning and antibacterial properties has been synthesized with a satisfying surface structuration.

Keywords: antibacterial, biomimetism, soft-chemistry, zinc oxide

Procedia PDF Downloads 140

Authors: Matej Komanec, Tomas Nemecek, Dmytro Suslov, Petr Chvojka, Stanislav Zvanovec

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Nonlinear phenomena in the near- and mid-infrared region are attracting scientific attention mainly due to the supercontinuum generation possibilities and subsequent utilizations for ultra-wideband applications like e.g. absorption spectroscopy or optical coherence tomography. Thulium-based fiber lasers provide access to high-power ultrashort pump pulses in the vicinity of 2000 nm, which can be easily exploited for various nonlinear applications. The paper presents a simulation and experimental study of a pulsed thulium laser based for near-infrared (NIR) and mid-infrared (MIR) nonlinear applications in specialty optical fibers. In the first part of the paper the thulium laser is discussed. The thulium laser is based on a gain-switched seed-laser and a series of amplification stages for obtaining output peak powers in the order of kilowatts for pulses shorter than 200 ps in full-width at half-maximum. The pulsed thulium laser is first studied in a simulation software, focusing on seed-laser properties. Afterward, a pre-amplification thulium-based stage is discussed, with the focus of low-noise signal amplification, high signal gain and eliminating pulse distortions during pulse propagation in the gain medium. Following the pre-amplification stage a second gain stage is evaluated with incorporating a thulium-fiber of shorter length with increased rare-earth dopant ratio. Last a power-booster stage is analyzed, where the peak power of kilowatts should be achieved. Examples of analytical study are further validated by the experimental campaign. The simulation model is further corrected based on real components – parameters such as real insertion-losses, cross-talks, polarization dependencies, etc. are included. The second part of the paper evaluates the utilization of nonlinear phenomena, their specific features at the vicinity of 2000 nm, compared to e.g. 1550 nm, and presents supercontinuum modelling, based on the thulium laser pulsed output. Supercontinuum generation simulation is performed and provides reasonably accurate results, once fiber dispersion profile is precisely defined and fiber nonlinearity is known, furthermore input pulse shape and peak power must be known, which is assured thanks to the experimental measurement of the studied thulium pulsed laser. The supercontinuum simulation model is put in relation to designed and characterized specialty optical fibers, which are discussed in the third part of the paper. The focus is placed on silica and mainly on non-silica fibers (fluoride, chalcogenide, lead-silicate) in their conventional, microstructured or tapered variants. Parameters such as dispersion profile and nonlinearity of exploited fibers were characterized either with an accurate model, developed in COMSOL software or by direct experimental measurement to achieve even higher precision. The paper then combines all three studied topics and presents a possible application of such a thulium pulsed laser system working with specialty optical fibers.

Keywords: nonlinear phenomena, specialty optical fibers, supercontinuum generation, thulium laser

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Authors: Samrat Paul, Satyajit Pahari, Krishnendu Basak, Amitava Roy

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Fishing is one of the pivotal livelihood activities, especially in developing countries. Today it is considered an important occupation for human society from the era of human settlement began. In simple terms, non-target catches of any species during fishing can be considered as ‘bycatch,’ and fishing bycatch is neither a new fishery management issue nor a new problem. Sundarban is one of the world’s largest mangrove land expanding up to 10,200 sq. km in India and Bangladesh. This largest mangrove biome resource is used by the local inhabitants commercially to run their livelihood, especially by forest fringe villagers (FFVs). In Sundarban, over-fishing, especially post larvae collection of wild Penaeus monodon, is one of the major concerns, as during the collection of P. monodon, different aquatic species are destroyed as a result of bycatch mortality which changes in productivity and may negatively impact entire biodiversity, of the ecosystem. Wild prawn seed collection gear like a small mesh sized net poses a serious threat to aquatic stocks, where the collection isn’t only limited to prawn seed larvae. As prawn seed collection processes are inexpensive, require less monetary investment, and are lucrative; people are easily engaged here as their source of income. Wildlife Trust of India’s (WTI) intervention in selected forest fringe villages of Sundarban Tiger Reserve (STR) was to estimate and reduce the mortality of aquatic bycatches by involving local communities in newly developed release method and their time engagement in prawn seed collection (PSC) by involving them in Alternate Income Generation (AIG). The study was conducted for their taxonomic identification during the period of March to October 2019. Collected samples were preserved in 70% ethyl alcohol for identification, and all the preserved bycatch samples were identified morphologically by the expertise of the Zoological Survey of India (ZSI), Kolkata. Around 74 different aquatic species, where 11 different species are molluscs, 41 fish species, out of which 31 species were identified, and 22 species of crustacean collected, out of which 18 species were identified. Around 13 different species belong to a different order, and families were unable to identify them morphologically as they were collected in the juvenile stage. The study reveals that for collecting one single prawn seed, eight individual life of associated faunas are being lost. Zero bycatch mortality is not practical; rather, collectors should focus on bycatch reduction by avoiding capturing, allowing escaping, and mortality reduction, and must make changes in their fishing method by increasing net mesh size, which will avoid non-target captures. But as the prawns are small in size (generally 1-1.5 inches in length), thus increase net size making economically less or no profit for collectors if they do so. In this case, returning bycatches is considered one of the best ways to a reduction in bycatch mortality which is a more sustainable practice.

Keywords: bycatch mortality, biodiversity, mangrove biome resource, sustainable practice, Alternate Income Generation (AIG)

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Authors: Sıdıka Kaya, Gülay Sain Güven, Seda Karsavuran, Onur Toka

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This study is part of an ongoing research project supported by the Scientific and Technological Research Council of Turkey (TUBITAK) under Project Number 114K404, and participation to this conference was supported by Hacettepe University Scientific Research Coordination Unit under Project Number 10243. Evaluation of hospital readmissions is gaining importance in terms of quality and cost, and is becoming the target of national policies. In Turkey, the topic of hospital readmission is relatively new on agenda and very few studies have been conducted on this topic. The aim of this study was to determine 30-day readmission rates and risk factors for readmission. Whether readmission was planned, related to the prior admission and avoidable or not was also assessed. The study was designed as a ‘prospective cohort study.’ 472 patients hospitalized in internal medicine departments of a university hospital in Turkey between February 1, 2015 and April 30, 2015 were followed up. Analyses were conducted using IBM SPSS Statistics version 22.0 and SPSS Modeler 16.0. Average age of the patients was 56 and 56% of the patients were female. Among these patients 95 were readmitted. Overall readmission rate was calculated as 20% (95/472). However, only 31 readmissions were unplanned. Unplanned readmission rate was 6.5% (31/472). Out of 31 unplanned readmission, 24 was related to the prior admission. Only 6 related readmission was avoidable. To determine risk factors for readmission we constructed Chi-square automatic interaction detector (CHAID) decision tree algorithm. CHAID decision trees are nonparametric procedures that make no assumptions of the underlying data. This algorithm determines how independent variables best combine to predict a binary outcome based on ‘if-then’ logic by portioning each independent variable into mutually exclusive subsets based on homogeneity of the data. Independent variables we included in the analysis were: clinic of the department, occupied beds/total number of beds in the clinic at the time of discharge, age, gender, marital status, educational level, distance to residence (km), number of people living with the patient, any person to help his/her care at home after discharge (yes/no), regular source (physician) of care (yes/no), day of discharge, length of stay, ICU utilization (yes/no), total comorbidity score, means for each 3 dimensions of Readiness for Hospital Discharge Scale (patient’s personal status, patient’s knowledge, and patient’s coping ability) and number of daycare admissions within 30 days of discharge. In the analysis, we included all 95 readmitted patients (46.12%), but only 111 (53.88%) non-readmitted patients, although we had 377 non-readmitted patients, to balance data. The risk factors for readmission were found as total comorbidity score, gender, patient’s coping ability, and patient’s knowledge. The strongest identifying factor for readmission was comorbidity score. If patients’ comorbidity score was higher than 1, the risk for readmission increased. The results of this study needs to be validated by other data–sets with more patients. However, we believe that this study will guide further studies of readmission and CHAID is a useful tool for identifying risk factors for readmission.

Keywords: decision tree, hospital, internal medicine, readmission

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Authors: Mariana Durana Pinto, Thierry Aubry, Eduarda Vieira

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The Côa River is one of the tributaries of the Douro River, which in turn connects two Portuguese regions: Beira-Alta (Serra das Mesas, Sabugal) and Trás-os-Montes (Douro River, Vila Nova de Foz Côa). The river, which is approximately 140 kilometres in length, is surrounded by characteristic Northern-Estearn Portugal landscape. The dominant flora in the region includes olive and almond trees and vines, which provide habitat for a diverse range of native species. These include mammals such as the lynx and Iberian wolf, as well as birds of prey such as the Egyptian vulture and the griffon vulture. Additionally, herbivorous species such as red deer and roe deer also inhabit the region. However, the Vale Côa is inextricably linked with the rocky outcrops bearing the emblematic open-air Upper Palaeolithic rock art, indeed, it houses the world's largest collection of prehistoric open-air rock art, inscribed on the World Heritage list by UNESCO in 1998. From the initial discovery of the first engravings in 1991 to the present day, approximally 1,500 panels with rock art, mostly engravings and carving, but also some paintings, have been discovered, inventoried and recorded spanning from earlu Upper Paleolithic to the 20th century. The study and interpretation of the engravings and its geoarchaeological context, allow the construction of a chronological timeline of the human occupation and graphical production in this region. The area has been inhabited since the Early Palaeolithic, with human communities exploiting the diversity of the natural resources of the environment and adapting it to their needs. This led to the creation of an archaeological and historical cultural landscape.The region is currently inhabited by rural communities whose primary source of income is derived from agricultural activities, with a particular focus on olive oil and wine production, including the emblematic Vinho do Porto. Additionally, the region is distinguished by activities such as stone exploration and extraction (e.g. schist and granite quarries) and tourism. The latter has progressively assumed a role in the promotion and development of the region, primarily due to the engravings of the Côa Valley itself, as well as the Alto Douro Wine Region. Furthermore, this cultural landscape has been inscribed in the UNESCO World Heritage Site in 2001. The aforementioned factors give rise to a series of challenges and issues pertaining to the management and safeguarding of rock art on a daily basis. These include: I) the management of conflicts between cultural heritage and economic activity (between Rock art and vineyards, both classified as World Heritage Sites); II) the management of land-use planning in areas where the engravings are located (since the areas with engravings are larger than those identified as buffer zones by UNESCO); III) the absence of the legal figure of an 'archaeological park' and the need to solve this issue; IV) the management of tourist pressure and unauthorised visits; and V) the management of vandalism (as a consequence of misinformation and denial).

Keywords: Douro and Côa Valleys, archaeological cultural landscapes, rock art, Douro wine, conservation challenges

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Authors: Muccifora S., Rinallo C., Bellani L.

Abstract:

Calcium (Ca²+) is an element essential to the plant being involved in plant growth and development. At high concentrations, it is toxic and can influence every stage, process and cellular activity of plant life. Given its toxicity, cells implement mechanisms to compartmentalize calcium in a vacuole, endoplasmic reticulum, mitochondria, plastids and cell wall. One of the most effective mechanisms to reduce the excess of calcium, thus avoiding cellular damage, is its complexation with oxalic acid to form calcium oxalate crystals that are no longer osmotically or physiologically active. However, the sequestered calcium can be mobilized when the plant needs it. Calcium crystals can be accumulated in the vacuole of specialized sink-cells called idioblasts, with different crystalline forms (druse, raphyde and styloid) of diverse physiological meanings. Actinidia deliciosa cv. Hayward presents raphydes and styloid localized in idioblasts in cells of photosynthetic and non-photosynthetic tissues. The purpose of this work was to understand if there is a relationship between the age of Actinidia leaves and the presence, distribution, dimension and shape of oxalate crystals by means of light, fluorescent, polarized and transmission electron microscopy. Three vines from female plants were chosen at the beginning of the season and used throughout the study. The leaves with petioles were collected at various stages of development from the bottom to the shoot of the plants monthly from April to July. The samples were taken in corresponding areas of the central and lateral parts of the leaves and of the basal portion of the petiole. The results showed that in the leaves, the number of raphyde idioblasts decreased with the progress of the growing season, while the styloid idioblasts increased progressively, becoming very numerous in the upper nodes of July. In June and in July samples, in the vacuoles of the highest nodes, a portion regular in shape strongly stained with rubeanic acid was present. Moreover, the chlortetracycline (CTC) staining for localization of free calcium marked the wall of the idioblasts and the wall of the cells near vascular bundles. In April petiole samples, moving towards the youngest nodes, the raphydes idioblast decreased in number and in the length of the single raphydes. Besides, crystals stained with rubeanic acid appeared in the vacuoles of some cells. In June samples, numerous raphyde idioblasts oriented parallel to vascular bundles were evident. Under the electron microscope, numerous idioblasts presented not homogeneous electrondense aggregates of material, in which a few crystals (styloids) in the form of regular holes were scattered. In July samples, an increase in the number of styloid idioblasts in the youngest nodes and little masses stained with CTC near styloids were observed. Peculiar cells stained with rubeanic acid were detected and hypothesized to be involved in the formation of the idioblasts. In conclusion, in Actinidia leaves and petioles, it seems to confirm the hypothesis that the formation of styloid idioblasts can be correlated to increasing calcium levels in growing tissues.

Keywords: calcium oxalate crystals, actinidia deliciosa, light and electron microscopy, idioblasts

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Authors: Bar Y. Ainuz, Harry M. Salinas, Aleeza Ali, Eli B. Levitt, Austin J. Pourmoussa, Antoun Bouz, Miguel A. Medina

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Introduction: Breast conservation therapy remains the mainstay surgical treatment for early breast cancer. Oncoplastic techniques, in conjunction with lumpectomy and adjuvant radiotherapy, have been demonstrated to achieve good aesthetic results without adversely affecting cancer outcomes in the treatment of patients with macromastia or significant ptosis. In our patient population, many women present for breast conservation with pre-existing cosmetic implants or with breast volumes too small for soft tissue, only oncoplastic techniques. Our study evaluated a consecutive series of patients presenting for breast conservation undergoing concomitant oncoplastic-augmentation-mastopexy (OAM) with a contralateral augmentation-mastopexy for symmetry. Methods: OAM surgical technique involves simultaneous lumpectomy with exchange or placement of implants, oncoplastic mastopexy, and concomitant contralateral augmentation mastopexy for symmetry. Patients undergoing lumpectomy for breast conservation as outpatients were identified via retrospective chart review at a high volume private academic affiliated community-based cancer center. Patients with ptosis and either pre-existing breast implants or insufficient breast volume undergoing oncoplastic implant placement (or exchange) and mastopexy were included in the study. Operative details, aesthetic outcomes, and complications were assessed. Results: Over a continuous three-year period, with a two-surgeon cohort, 30 consecutive patients (56 breasts, 4 unilateral procedures) were identified. Patients had an average age of 52.5 years and an average BMI of 27.5, with 40% smokers or former smokers. The average operative time was 2.5 hours, the average implant size removed was 352 cc, and the average implant size placed was 300 cc. All new implants were smooth silicone, with the majority (92%) placed in a retropectoral fashion. 40% of patients received chemotherapy, and 80% of patients received whole breast adjuvant photon radiotherapy with a total radiation dose of either 42.56 or 52.56 Gy. The average and median length of follow-up were both 8.2 months. Of the 24 patients that received radiotherapy, 21% had asymmetry due to capsular contracture. A total of 7 patients (29.2%) underwent revisions for either positive margins (12.5%), capsular contracture (8.3%), implant loss (4.2%), or cosmetic concerns (4.2%). One patient developed a pulmonary embolism in the acute postoperative period and was treated with anticoagulant therapy. Conclusion: Oncoplastic augmentation mastopexy is a safe technique with good aesthetic outcomes and acceptable complication rates for ptotic patients with breast cancer and a paucity of breast volume or pre-existing implants who wish to pursue breast-conserving therapy. The revision rates compare favorably with single-stage cosmetic augmentation procedures as well as other oncoplastic techniques described in the literature. The short-term capsular contracture rates seem lower than the rates in patients undergoing radiation after mastectomy and implant-based reconstruction. Long term capsular contractures and revision rates are too early to know in this cohort.

Keywords: breast conserving therapy, oncoplastic augmentation mastopexy, capsular contracture, breast reconstruction

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