Search results for: methadone maintenance treatment

Authors: L. Kashyap, S. Jha, D. Shende, V. K. Mohan, P. Khanna, A. Aravindan, S. Kashyap, L. Singh, S. Aggarwal

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Obesity is associated with a chronic inflammatory state. During surgery, there is an interplay between anaesthetic and surgical stress vis-a-vis the already present complex immune state. Moreover, the postoperative period is dictated by inflammation, which is crucial for wound healing and regeneration. An excess of inflammatory response might hamper recovery besides increasing the risk for infection and complications. There is definite evidence of the immunosuppressive role of inhaled anaesthetic agents. This immune modulation may be brought into effect directly by influencing the innate and adaptive immunity cells. The effects of propofol on immune mechanisms in has been widely elucidated because of its popularity. It reduces superoxide generation, elastase release, and chemotaxis. However, there is no unequivocal proof of one’s superiority over the other. Hence, an anaesthetic regimen with lesser inflammatory potential and specific to the obese patient is needed. OBESITA trial protocol (2019) by Sousa and co-workers in progress aims to test the hypothesis that anaesthesia with sevoflurane results in a weaker proinflammatory response compared to propofol, as evidenced by lower IL-6 and other biomarkers and an increased macrophage differentiation into M2 phenotype in adipose tissue. IL-6 was used as the objective parameter to evaluate inflammation as it is regulated by both surgery and anesthesia. It is the most sensitive marker of the inflammatory response to tissue damage since it is released within minutes by blood leukocytes. We hypothesized that maintenance of anaesthesia with propofol would lead to less inflammation than that with desflurane. Aims: The effect of two anaesthetic techniques, total intravenous anaesthesia (TIVA) with propofol and desflurane, on surgical stress response was evaluated. The primary objective was to compare serum interleukin-6 (IL-6) levels before and after surgery. Methods: In this prospective single-blinded randomized controlled trial undertaken, 30 obese patients (BMI>30 kg/m2) undergoing laparoscopic bariatric surgery under general anaesthesia were recruited. Patients were randomized to receive desflurane or TIVA using a target-controlled infusion for maintenance of anaesthesia. As a marker of inflammation, pre-and post-surgery IL-6 levels were compared. Results: After surgery, IL-6 levels increased significantly in both groups. The rise in IL-6 was less with TIVA than with desflurane; however, it did not reach significance. IL-6 rise post-surgery correlated positively with the complexity of procedure and duration of surgery and anaesthesia, rather than anaesthetic technique. Both groups did not differ in terms of intra-operative hemodynamic and respiratory variables, time to awakening, postoperative pulmonary complications, and duration of hospital stay. The incidence of nausea was significantly higher with desflurane than with TIVA. Conclusion: Inflammatory response did not differ as a function of anaesthetic technique when propofol and desflurane were compared. Also, patient and surgical variables dictated post-operative inflammation more than the anaesthetic factors. Further, larger sample size is needed to confirm or refute these findings.

Keywords: bariatric, biomarkers, inflammation, laparoscopy

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Authors: Yaxian Chen, Yeonhee Park

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Driven by evolving FDA recommendations, modern clinical trials demand innovative designs that strike a balance between statistical rigor and ethical considerations. Covariate-adjusted response-adaptive (CARA) designs bridge this gap by utilizing patient attributes and responses to skew treatment allocation in favor of the treatment that is best for an individual patient’s profile. However, existing CARA designs for survival outcomes often hinge on specific parametric models, constraining their applicability in clinical practice. In this article, we address this limitation by introducing a CARA design for survival outcomes (CARAS) based on the Cox model and a variance estimator. This method addresses issues of model misspecification and enhances the flexibility of the design. We also propose a group sequential overlapweighted log-rank test to preserve type I error rate in the context of group sequential trials using extensive simulation studies to demonstrate the clinical benefit, statistical efficiency, and robustness to model misspecification of the proposed method compared to traditional randomized controlled trial designs and response-adaptive randomization designs.

Keywords: cox model, log-rank test, optimal allocation ratio, overlap weight, survival outcome

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Authors: Ahmed Cherif Megri, HossamEldin ElSherif

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In a power plant, the header pipe plays a pivotal role in optimizing the performance of diverse systems by serving as a central conduit for the collection and distribution of steam within the plant. This paper investigates the significance of header pipes within power plant setups, highlighting their critical influence on reliability, efficiency, and the performance of the power plant as a whole. The concept of shape optimization emerges as a crucial factor in power plant design and operation, with the potential to maximize performance while minimizing the use of materials. Shape optimization not only enhances efficiency but also contributes to reducing the environmental footprint of power plant installations. In this paper, we initially developed a methodology designed for optimizing header shapes with the primary goal of reducing the usage of costly new alloy materials and lowering the overall maintenance operation expenses. Secondly, we conducted a case study based on an authentic header sourced from an operational power plant.

Keywords: shape optimization, header, power plant, inconel alloy, CFD, structural optimization

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Authors: Shih-Ping Liu, Cheng-Hsuan Chang, Yu-Chuen Huang, Shih-Yin Chen, Woei-Cherng Shyu

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Embryonic stem cells (ES) and induced pluripotnet stem cells (iPS) are both pluripotent stem cells. For mouse stem cells culture technology, leukemia inhibitory factor (LIF) was used to maintain the pluripotency of stem cells in vitro. However, LIF is an expensive reagent. The goal of this study was to find out a pure compound extracted from Chinese herbal medicine that could maintain stem cells pluripotency to replace LIF and improve the iPS generation efficiency. From 20 candidates traditional Chinese medicine we found that Cordycepsmilitaris triggered the up-regulation of stem cells activating genes (Oct4 and Sox2) expression levels in MEF cells. Cordycepin, a major active component of Cordycepsmilitaris, also could up-regulate Oct4 and Sox2 gene expression. Furthermore, we used ES and iPS cells and treated them with different concentrations of Cordycepin (replaced LIF in the culture medium) to test whether it was useful to maintain the pluripotency. The results showed higher expression levels of several stem cells markers in 10 μM Cordycepin-treated ES and iPS cells compared to controls that did not contain LIF, including alkaline phosphatase, SSEA1, and Nanog. Embryonic body formation and differentiation confirmed that 10 μM Cordycepin-containing medium was capable to maintain stem cells pluripotency after four times passages. For mechanism analysis, microarray analysis indicated extracellular matrix and Jak/Stat signaling pathway as the top two deregulated pathways. In ECM pathway, we determined that the integrin αVβ5 expression levels and phosphorylated Src levels increased after Cordycepin treatment. In addition, the phosphorylated Jak2 and phosphorylated Sat3 protein levels were increased after Cordycepin treatment and suppressed with the Jak2 inhibitor, AG490. The expression of cytokines associated with Jak2/Stat3 signaling pathway were also up-regulated by Q-PCR and ELISA assay. Lastly, we used Oct4-GFP MEF cells to test iPS generation efficiency following Cordycepin treatment. We observed that 10 Μm Cordycepin significantly increased the iPS generation efficiency in day 21. In conclusion, we demonstrated Cordycepin could maintain the pluripotency of stem cells through both of ECM and Jak2/Stat3 signaling pathway and improved iPS generation efficiency.

Keywords: cordycepin, iPS cells, Jak2/Stat3 signaling pathway, molecular biology

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Authors: Amir E. Amirzadeh, Richard K. Strand

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Moisture-induced problems are a significant concern for building owners, architects, construction managers, and building engineers, as they can have substantial impacts on building enclosures' durability and performance. Computational analyses, such as hygrothermal and thermal analysis, can provide valuable information and demonstrate the expected relative performance of building enclosure systems but are not grounded in absolute certainty. This paper evaluates the hygrothermal performance of common enclosure systems in hospitals in cold climates. The study aims to investigate the impact of exterior wall systems on hospitals, focusing on factors such as durability, construction deficiencies, and energy performance. The study primarily examines the impact of air leakage and vapor retarding layers relative to energy consumption. While these factors have been studied in residential and commercial buildings, there is a lack of information on their impact on hospitals in a holistic context. The study integrates various research studies and professional experience in hospital building design to achieve its objective. The methodology involves surveying and observing exterior wall assemblies, reviewing common exterior wall assemblies and details used in hospital construction, performing simulations and numerical analyses of various variables, validating the model and mechanism using available data from industry and academia, visualizing the outcomes of the analysis, and developing a mechanism to demonstrate the relative performance of exterior wall systems for hospitals under specific conditions. The data sources include case studies from real-world projects and peer-reviewed articles, industry standards, and practices. This research intends to integrate and analyze the in-situ and as-designed performance and durability of building enclosure assemblies with numerical analysis. The study's primary objective is to provide a clear and precise roadmap to better visualize and comprehend the correlation between the durability and performance of common exterior wall systems used in the construction of hospitals and the energy consumption of these buildings under certain static and dynamic conditions. As the construction of new hospitals and renovation of existing ones have grown over the last few years, it is crucial to understand the effect of poor detailing or construction deficiencies on building enclosure systems' performance and durability in healthcare buildings. This study aims to assist stakeholders involved in hospital design, construction, and maintenance in selecting durable and high-performing wall systems. It highlights the importance of early design evaluation, regular quality control during the construction of hospitals, and understanding the potential impacts of improper and inconsistent maintenance and operation practices on occupants, owner, building enclosure systems, and Heating, Ventilation, and Air Conditioning (HVAC) systems, even if they are designed to meet the project requirements.

Keywords: hygrothermal analysis, building enclosure, hospitals, energy efficiency, optimization and visualization, uncertainty and decision making

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Authors: Humayun R. H. Kabir

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A reinforced concrete dome-built 60 years ago- of circular shape of diameter of 30 m was in distressed conditions due to adverse weathering effects, such as high temperature, wind, and poor maintenance. It was decided to restore the dome to its full strength for future use. A full material strength and durability check including petrography test were conducted. It was observed that the concrete strength was in acceptable range, while bars were corroded more than 40% to their original configurations. Widespread cracks were almost in every meter square. A strengthening program with filling the cracks by injection method, and carbon fiber layup and wrap was considered. Ultra Sound Pulse Velocity (UPV) test was conducted to observe crack depth. Ground Penetration Radar (GPR) test was conducted to observe internal bar conditions and internal cracks. Finally, a load test was conducted to certify the carbon fiber effectiveness, injection method procedure and overall behavior of dome.

Keywords: dome, strengthening program, carbon fiber, load test

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Authors: Nik Azmah Nik Yusuff, Faridah Hassan Basri, Rosnidar Mansor

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The purpose of the study is to find out the effectiveness of using Graphic calculators (GC) with Calculator Based Laboratory 2 (CBL2) in teaching and learning of form four biology for these topics: Nutrition, Respiration and Dynamic Ecosystem. Sixty form four science stream students were the participants of this study. The participants were divided equally into the treatment and control groups. The treatment group used GC with CBL2 during experiments while the control group used the ordinary conventional laboratory apparatus without using GC with CBL2. Instruments in this study were a set of pre-test and post-test and a questionnaire. T-Test was used to compare the student’s biology achievement while a descriptive statistic was used to analyze the outcome of the questionnaire. The findings of this study indicated the use of GC with CBL2 in biology had significant positive effect. The highest mean was 4.43 for item stating the use of GC with CBL2 had saved collecting experiment result’s time. The second highest mean was 4.10 for item stating GC with CBL2 had saved drawing and labelling graphs. The outcome from the questionnaire also showed that GC with CBL2 were easy to use and save time. Thus, teachers should use GC with CBL2 in support of efforts by Malaysia Ministry of Education in encouraging technology-enhanced lessons.

Keywords: biology experiments, Calculator-Based Laboratory 2 (CBL2), graphic calculators, Malaysia Secondary School, teaching/learning

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Authors: Murray David Schane

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Though years of clinical encounters with patients with autism spectrum disorders and those with a schizoid personality the many defining diagnostic features shared between these conditions have been explored and current neurobiological differences have been reviewed; and, critical and different treatment strategies for each have been devised. The paper compares and contrasts the apparent similarities between autism spectrum disorders and the schizoid personality are found in these DSM descriptive categories: restricted range of social-emotional reciprocity; poor non-verbal communicative behavior in social interactions; difficulty developing and maintaining relationships; detachment from social relationships; lack of the desire for or enjoyment of close relationships; and preference for solitary activities. In this paper autism, fundamentally a communicative disorder, is revealed to present clinically as a pervasive aversive response to efforts to engage with or be engaged by others. Autists with the Asperger presentation typically have language but have difficulty understanding humor, irony, sarcasm, metaphoric speech, and even narratives about social relationships. They also tend to seek sameness, possibly to avoid problems of social interpretation. Repetitive behaviors engage many autists as a screen against ambient noise, social activity, and challenging interactions. Also in this paper, the schizoid personality is revealed as a pattern of social avoidance, self-sufficiency and apparent indifference to others as a complex psychological defense against a deep, long-abiding fear of appropriation and perverse manipulation. Neither genetic nor MRI studies have yet located the explanatory data that identifies the cause or the neurobiology of autism. Similarly, studies of the schizoid have yet to group that condition with those found in schizophrenia. Through presentations of clinical examples, the treatment of autists of the Asperger type is revealed to address the autist’s extreme social aversion which also precludes the experience of empathy. Autists will be revealed as forming social attachments but without the capacity to interact with mutual concern. Empathy will be shown be teachable and, as social avoidance relents, understanding of the meaning and signs of empathic needs that autists can recognize and acknowledge. Treatment of schizoids will be shown to revolve around joining empathically with the schizoid’s apprehensions about interpersonal, interactive proximity. Models of both autism and schizoid personality traits have yet to be replicated in animals, thereby eliminating the role of translational research in providing the kind of clues to behavioral patterns that can be related to genetic, epigenetic and neurobiological measures. But as these clinical examples will attest, treatment strategies have significant impact.

Keywords: autism spectrum, schizoid personality traits, neurobiological implications, critical diagnostic distinctions

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Authors: Seon Soon Choi

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The fatigue crack growth is stochastic because of the fatigue behavior having an uncertainty and a randomness. Therefore, it is necessary to determine the probability distribution of a grown crack size at a specific fatigue crack propagation life for maintenance of structure as well as reliability estimation. The essential purpose of this study is to present the good probability distribution fit for the grown crack size at a specified fatigue life in a rolled magnesium alloy under different specimen thickness conditions. Fatigue crack propagation experiments are carried out in laboratory air under three conditions of specimen thickness using AZ31 to investigate a stochastic crack growth behavior. The goodness-of-fit test for probability distribution of a grown crack size under different specimen thickness conditions is performed by Anderson-Darling test. The effect of a specimen thickness on variability of a grown crack size is also investigated.

Keywords: crack size, fatigue crack propagation, magnesium alloys, probability distribution, specimen thickness

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Authors: Bayan Almofty, Yuto Yamaki, Tadamasa Terai, Sadahito Uto

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Myopathy (muscles disease) treatment are expected in the field of regenerative medicine and applied research of cultured muscle to bio actuator is performed in Biomedical Engineering as applied research of cultured muscle. This study is about cultured myoblast C2C12 from mouse skeletal muscle and a mechanism of cultured muscle contraction by electric stimulation is investigated. Grayanotoxins (GTXs) belong to neurotoxins known to enhance the permeability of cell membrane for Na ions. Grayanotoxins are extracted from a famous Pieris japonica and Ericaceae as a phytotoxin. We investigated the functional role of GTXs on muscle cells (C2C12) contraction and membrane potential. A change in membrane potential is measured using a micro glass tube electrode contraction of myotubes is induced by applying an external electrical stimulation. The contraction and membrane potential change induced by injection of current using the micro glass electrode are also measured. From the result, contraction and membrane potential of muscle cells was affected by GTXs treatment, suggesting that the diverse chemical structures of GTXs are responsible for contraction and membrane potential of muscle cells.

Keywords: skeletal muscle, C2C12, myoblast, myotubes, contraction, Grayanotoxins, membrane potential, neurotoxins, phytotoxin

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Authors: Maha Salah, Hanaa Hashem, Mahmoud M. Alsagheir, Mohammed Salah

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Acute respiratory distress syndrome (ARDS) represents a complex clinical syndrome and carries a high risk for mortality. The severity of the clinical course, the uncertainty of the outcome, and the reliance on the full spectrum of critical care resources for treatment mean that the entire health care team is challenged. Researchers and clinicians have investigated the nature of the pathological process and explored treatment options with the goal of improving outcome. Through this application of research to practice, we know that some previous strategies have been ineffective, and innovations in mechanical ventilation, sedation, nutrition, and pharmacological intervention remain important research initiatives. Developed Clinical pathway is multidisciplinary plans of best clinical practice for this specified groups of patients that aid in the coordination and delivery of high quality care. They are a documented sequence of clinical interventions that help a patient to move, progressively through a clinical experience to a desired outcome. Although there is a lot of heterogeneity in patients with ARDS, this suggested developed clinical pathway with alternatives was built depended on a lot of researches and evidence based medicine and nursing practices which may be helping these patients to improve outcomes, quality of life and decrease mortality.

Keywords: acute respiratory distress syndrome (ARDS), clinical pathway, clinical syndrome

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Authors: Fernanda Conforto de Oliveira

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The International Monetary Fund (IMF) has a central role in global financial governance as the world’s leading crisis lender. Its practice of conditional lending – conditioning loans on the implementation of economic policy adjustments – is the primary lever by which the institution interacts with and influences the policy choices of member countries and has been a key topic of interest to scholars and public opinion. However, empirical evidence about the economic and (geo)political determinants of IMF lending behavior remains inconclusive, and no model that explains IMF policies has been identified. This research moves beyond panel analysis to focus on financial negotiations for the first IMF programs in Argentina and Brazil in the early post-war period. It seeks to understand why negotiations achieved distinct objectives: Argentinean officials cooperated and complied with IMF policies, whereas their Brazilian counterparts hesitated. Using qualitative and automated text analysis, this paper analyses the hypothesis about whether a differential IMF treatment could help to explain these distinct outcomes. This paper contributes to historical studies on IMF-Latin America relations and the broader literature in international policy economy about IMF policies.

Keywords: international monetary fund, international history, financial history, Latin American economic history, natural language processing, sentiment analysis

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Authors: Rika Susanti, Eryati Darwin, Dedi Afandi, Yanwirasti, Syahruddin Said, Noverika Windasari, Zelly Dia Rofinda

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Introduction: Blunt head trauma is one of the leading causes of death associated with murders and other deaths involved in criminal acts. Creatine kinase (CKBB) levels have been used as a biomarker for blunt head trauma. Therefore, it is now used as an alternative to an autopsy. The aim of this study is to investigate CKBB levels in cerebrospinal fluid (CSF) and post-mortem serum in order to deduce the cause and time of death. Method: This investigation was conducted through post-test–only group design involving deaths caused by blunt head trauma, which was compared to deaths caused by ketamine poisoning. Results: There were eight treatment groups, each consisting of six adult rats (Rattus norvegicus) Sprague-Dawley strain. Examinations were done at 0 hours, 1 hour, 2 hours, and 3 hours post-mortem, which followed by brain tissue observation. Data were then analyzed statistically with a repeated-measures general linear model. Conclusion: There were increases in the level of CKBB in CSF and postmortem serum in both blunt head trauma and ketamine poisoning treatment groups. However, there were no significant differences between these two groups.

Keywords: blunt head trauma, CKBB, the cause of death, estimated time of death

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Authors: Ashleigh Dawn Moeller

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This is a comparative case study which examines the language attitudes and behaviors of descendants of Volga German immigrants in North America and how these attitudes combined with surrounding social conditions have caused their heritage language to develop differently within each community. Of particular interest for this study are the accounts of second- and third-generation descendants in Oregon, Kansas, and North Dakota regarding their parents’ and grandparents’ attitudes toward their language and how this correlates with the current sentiment as well as visibility of their heritage language and culture. This study discusses the point at which cultural identity could diverge from language identity and what elements play a role in this development, establishing the potential for environments (linguistic landscapes) which uphold their heritage yet have detached from the language itself. Emigrating from Germany in the 1700s, these families settled for over a hundred years along the Volga Region of Imperial Russia. Subsequently, many descendants of these settlers immigrated to the Americas in the 1800-1900s. Identifying neither as German nor Russian, they called themselves Wolgadeutche (Volga Germans). During their time in Russia, the German language was maintained relatively homogenously, yet the use and status of their heritage language diverged considerably upon settlement across the Americas. Data shows that specific conditions, such as community isolation, size, religion, location as well as language policy established prior to and following the Volga German immigration to North America have had a substantial impact on the maintenance of their heritage language—causing complete loss in some areas and peripheral use or even full rebirth in others. These past conditions combined with the family accounts correlate directly with the general attitudes and ideologies of the descendants toward their heritage language. Data also shows that in many locations, despite a strong presence of German within the linguistic landscape, minimal to no German is spoken nor understood; the attitude toward the language is indifferent while a staunch holding to the heritage is maintained and boasted. Data for this study was gathered from historical accounts, archived records and newspapers, and published biographies as well as from formal interviews with second- and third-generation descendants of Volga German immigrants conducted in Oregon and Kansas. Through the interviews, members of the community have shared and provided their family genealogies as well as biographies published by family members. These have helped to trace their relatives back to specific locations, thus allowing for comparisons within the same families residing in distinctly different areas of North America. This study is part of a larger ongoing project which researches the immigration of Volga and Black Sea Germans to North America and diachronically examines the over-arching sociological factors which have directly impacted the maintenance, loss, or rebirth of their heritage language. This project follows specific families who settled in areas of Colorado, Kansas, Nebraska, Illinois, Minnesota, North and South Dakota, Saskatchewan, and Manitoba, and who later had relatives move west to areas of Oregon and Washington State. Interviews for the larger project will continue into the following year.

Keywords: heritage language, immigrant language, language change, language contact, linguistic landscape, Volga Germans, Wolgadeutsche

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Authors: Feng-Tsai Weng, Rick Wang, Yan-Cong Liao

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Passivation is a kind of surface treatment for material to reinforce the corrosion resistance specially the stainless alloy. Passive film, is to getting more potential compared to their status before passivation. An oxidation film can be formed on the surface of stainless steel, which has a strong corrosion resistance ability after passivation treatment. In this research, a new passivation technology is proposed for a special stainless alloy which contains a 12-14% Chromium. This method includes the A-A-A (alkaline-acid-alkaline) process basically, which was developed by Carpenter that can neutralize trapped acid. Besides, a corrosion resistant coating layer was obtained by immersing the parts in a water bath of mineral oil at high temperature. Salt spray test ASTM B368 was conducted to investigated performance of corrosion resistant of the passivated stainless steel alloy parts. Results show much better corrosion resistant that followed a coating process after A-A-A Passivation process, than only using A-A-A process. The passivation time is with more than 380 hours of salt spray test ASTM B368, which is equal to 3000 hours of Salt spray test ASTM B117. Proposed passivation method of stainless steel can be completed in about 3 hours.

Keywords: passivation, alkaline-acid-alkaline, stainless steel, salt spray test

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Authors: T. T. Naas, Y. Lasbet, C. Kezrane

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The thermal control in many systems is widely accomplished applying mixed convection process due to its low cost, reliability and easy maintenance. Typical applications include the aircraft electronic equipment, rotating-disc heat exchangers, turbo machinery, and nuclear reactors, etc. Natural convection in an inclined square enclosure heated via wall heater has been studied numerically. Finite volume method is used for solving momentum and energy equations in the form of stream function–vorticity. The right and left walls are kept at a constant temperature, while the other parts are adiabatic. The range of the inclination angle covers a whole revolution. The method is validated for a vertical cavity. A general power law dependence of the Nusselt number with respect to the Rayleigh number with the coefficient and exponent as functions of the inclination angle is presented. For a fixed Rayleigh number, the inclination angle increases or decreases is found.

Keywords: natural convection in enclosure, inclined enclosure, Nusselt number, entropy generation analyze

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Authors: Madhumita Sahu, S. S. Tiwary

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The Radiotherapy of Carcinoma Lung has always been difficult and a matter of great concern. The significant movement due to fractional motion caused due to non-rhythmic respiratory motion poses a great challenge for the treatment of Lung cancer using Ionizing Radiation. The present study compares the accuracy in the measurement of Target Volume using Slow-CT and 4DCT Imaging in SBRT for Lung Tumor. The experimental samples were extracted from patients with Lung Cancer who underwent SBRT. Slow-CT and 4DCT images were acquired under free breathing for each patient. PTV were delineated on Slow CT images. Similarly, ITV was also delineated on each of the 4DCT volumes. Volumetric and Statistical analysis were performed for each patient by measuring corresponding PTV and ITV volumes. The study showed (1) The Maximum Deviation observed between Slow-CT-based PTV and 4DCT imaging-based ITV is 248.58 cc. (2) The Minimum Deviation observed between Slow-CT-based PTV and 4DCT imaging-based ITV is 5.22 cc. (3) The Mean Deviation observed between Slow-CT-based PTV and 4DCT imaging-based ITV is 63.21 cc. The present study concludes that irradiated volume ITV with 4DCT is less as compared to the PTV with Slow-CT. A better and more precise treatment could be given more accurately with 4DCT Imaging by sparing 63.21 CC of mean body volume.

Keywords: CT imaging, 4DCT imaging, lung cancer, statistical analysis

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Authors: Nazedah Ain Ibrahim, Mohamed Mansor Manan

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Treatment of suspected early onset neonatal sepsis (EONS) in Neonatal Intensive Care Unit (NICU) is essential. However, information regarding EONS pathogens may vary between regions. Global perspectives showed Group B Streptococcal (GBS) as the most common causative pathogens, but the widespread use of intrapartum antibiotics has changed the pathogens pattern towards gram negative microorganisms, especially E. coli. Objective of this study is to describe the pathogens isolated, to assess current treatment and risk of EONS. Records of 899 neonates born in three General Hospitals between 2009 until 2012 were retrospectively reviewed. The inclusion criteria were neonates with blood culture taken prior to empiric antibiotics administration and within 72 hours of life. Of the study group, a total of 734 (82%) cases had documented blood culture that met the inclusion criteria. Proven EONS (as confirmed by positive blood culture) was found in 22 (3%) neonates. The majority was isolated with gram positive organisms, 17 (2.3%). In addition, other common gram positive organism isolated were Coagulase negative staphylococci (7) followed by Bacillus sp. (5) and Streptococcus pneumonia (2), and only one case isolated with GBS, Streptococcus spp. and Enterococcus sp. Meanwhile, only five cases of gram negative organisms [Stenotropomonas (xantho) maltophi (1), Haemophilus influenza (1), Spingomonas paucimobilis (1), Enterobacter gergoviae (1) and E. coli (1)] were isolated. A total of 286 (39%) cases were exposed to intrapartum antibiotics and of those, 157 (21.4%) were administered prior to delivery. All grams positive and most gram negative organisms showed sensitivity to the tested antibiotics. Only two rare gram negative organisms showed total resistant. Male, surfactant, caesarean delivery and prolonged rapture of membrane >18hours were a possible risk of proven EONS. Although proven EONS remains uncommon in Malaysia, nonetheless, the effect of intrapartum antibiotics still required continuous surveillance. However, by analyzing isolated pathogens it can be used as treatment guidance in managing suspected EONS.

Keywords: early onset neonatal sepsis, neonates, pathogens, gram positive, gram negative

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Authors: Sina Mahdavi

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Background and Objective: Multiple sclerosis (MS) is the most common inflammatory autoimmune disease of the central nervous system (CNS) that affects the myelination process in the CNS. Complex interactions of various "environmental or infectious" factors may act as triggers in autoimmunity and disease progression. The association between viral infections, especially the John Cunningham virus (JCV) and MS is one potential cause that is not well understood. This study aims to summarize the available data on JCV infection in MS disease progression. Materials and Methods: For this study, the keywords "Multiple sclerosis", " John Cunningham virus ", and "central nervous system" in the databases PubMed, Google Scholar, Sid, and MagIran between 2019 and 2022 were searched, and 12 articles were chosen, studied, and analyzed. Results: MS patients are candidates for natalizumab therapy, which inhibits lymphocyte migration and increases the risk of progressive multifocal leukoencephalopathy (PML), a rare lytic infection of glial cells caused by JCV. Oligodendrocytes may be the target of JCV infection in the central nervous system (CNS). Conclusion: There is a high expression of JCV during the natalizumab treatment period for MS patients, suggesting that the virus may play a role in the development of MS by inducing an inflammatory state. Therefore, it is necessary to evaluate anti-JCV antibody serum as an important risk factor for the development of PML before deciding on the treatment course for these patients.

Keywords: multiple sclerosis, John Cunningham virus, central nervous system, autoimmunity

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Authors: Ayedh Alqahtani, Andrew Whyte

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Life Cycle Cost (LCC) is one of the goals and key pillars of the construction management science because it comprises many of the functions and processes necessary, which assist organisations and agencies to achieve their goals. It has therefore become important to design and control assets during their whole life cycle, from the design and planning phase through to disposal phase. LCCA is aimed to improve the decision making system in the ownership of assets by taking into account all the cost elements including to the asset throughout its life. Current application of LCC approach is impractical during misunderstanding of the advantages of LCC. This main objective of this research is to show a different relationship between capital cost and long-term running costs. One hundred and thirty eight actual building projects in United Kingdom (UK) were used in order to achieve and measure the above-mentioned objective of the study. The result shown that LCC is one of the most significant tools should be considered on the decision making process.

Keywords: building projects, capital cost, life cycle cost, maintenance costs, operation costs

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Authors: G. Kontochristopoulos, T. Spiliopoulos, V. Markantoni, E. Platsidaki, A. Kouris, E. Balamoti, C. Bokotas, G. Haidemenos

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Introduction: There is a high patient demand for periorbital rejuvenation since the facial area is often the first to show visible signs of aging. With advancing age, there are sometimes marked changes that occur in the skin, fat, muscle and bone of the periorbital region, resulting to wrinkles and skin laxity. These changes are among the easiest areas to correct using several minimally invasive techniques, which have become increasingly popular over the last decade. Lasers, radiofrequency, botulinum toxin, fat grafting and fillers are available treatments sometimes in combination to traditional blepharoplasty. This study attempts to show the benefits of a minimally invasive approach to periorbital wrinkles and skin laxity that combine microneedling and 10% trichloroacetic acid (TCA) peels. Method: Eleven female patients aged 34-72 enrolled in the study. They all gave informed consent after receiving detailed information regarding the treatment procedure. Exclusion criteria in the study were previous treatment for the same condition in the past six months, pregnancy, allergy or hypersensitivity to the components, infection, inflammation and photosensitivity on the affected region. All patients had diffuse periorbital wrinkles and mild to moderate upper or lower eyelid skin laxity. They were treated with Automatic Microneedle Therapy System-Handhold and topical application of 10% trichloroacetic acid solution to each periorbital area for five minutes. Needling at a 0,25 mm depth was performed in both latelar (x-y) directions. Subsequently, the peeling agent was applied to each periorbital area for five minutes. Patients were subjected to the above combination every two weeks for a series of four treatments. Subsequently they were followed up regularly every month for two months. The effect was photo-documented. A Physician's and a Patient's Global Assessment Scale was used to evaluate the efficacy of the treatment (0-25% indicated poor response, 25%-50% fair, 50%-75% good and 75%-100% excellent response). Safety was assessed by monitoring early and delayed adverse events. Results: At the end of the study, almost all patients demonstrated significant aesthetic improvement. Physicians assessed a fair and a good improvement in 9(81.8% of patients) and 2(18.1% of patients) participants respectively. Patients Global Assessment rated a fair and a good response in 6 (54.5%) and 5 (45.4%) participants respectively. The procedure was well tolerated and all patients were satisfied. Mild discomfort and transient erythema were quite common during or immediately after the procedure, however only temporary. During the monthly follow up, no complications or scars were observed. Conclusions: Microneedling is known as a simple, office–based collagen induction therapy. Low concentration TCA solution applied to the epidermis that has been more permeable by microneedling, can reach the dermis more effectively. In the present study, chemical peels with 10% TCA acted as an adjuvant to microneedling, as it causes controlled skin damage, promoting regeneration and rejuvenation of tissues. This combined therapy improved periorbital fine lines, wrinkles, and overall appearance of the skin. Thus it constitutes an alternative treatment of periorbital skin aging, with encouraging results and minor side-effects.

Keywords: chemical peels, microneedling, periorbital wrinkles, skin laxity

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Authors: Karen Koellner, Nanette Seago, Jennifer Jacobs, Helen Garnier

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Although studies of teacher professional development (PD) are prevalent, surprisingly most have only produced incremental shifts in teachers’ learning and their impact on students. There is a critical need to understand what teachers take up and use in their classroom practice after attending PD and why we often do not see greater changes in learning and practice. This paper is based on a mixed methods efficacy study of the Learning and Teaching Geometry (LTG) video-based mathematics professional development materials. The extent to which the materials produce a beneficial impact on teachers’ mathematics knowledge, classroom practices, and their students’ knowledge in the domain of geometry through a group-randomized experimental design are considered. Included is a close-up examination of a small group of teachers to better understand their interpretations of the workshops and their classroom uptake. The participants included 103 secondary mathematics teachers serving grades 6-12 from two US states in different regions. Randomization was conducted at the school level, with 23 schools and 49 teachers assigned to the treatment group and 18 schools and 54 teachers assigned to the comparison group. The case study examination included twelve treatment teachers. PD workshops for treatment teachers began in Summer 2016. Nine full days of professional development were offered to teachers, beginning with the one-week institute (Summer 2016) and four days of PD throughout the academic year. The same facilitator-led all of the workshops, after completing a facilitator preparation process that included a multi-faceted assessment of fidelity. The overall impact of the LTG PD program was assessed from multiple sources: two teacher content assessments, two PD embedded assessments, pre-post-post videotaped classroom observations, and student assessments. Additional data were collected from the case study teachers including additional videotaped classroom observations and interviews. Repeated measures ANOVA analyses were used to detect patterns of change in the treatment teachers’ content knowledge before and after completion of the LTG PD, relative to the comparison group. No significant effects were found across the two groups of teachers on the two teacher content assessments. Teachers were rated on the quality of their mathematics instruction captured in videotaped classroom observations using the Math in Common Observation Protocol. On average, teachers who attended the LTG PD intervention improved their ability to engage students in mathematical reasoning and to provide accurate, coherent, and well-justified mathematical content. In addition, the LTG PD intervention and instruction that engaged students in mathematical practices both positively and significantly predicted greater student knowledge gains. Teacher knowledge was not a significant predictor. Twelve treatment teachers self-selected to serve as case study teachers to provide additional videotapes in which they felt they were using something from the PD they learned and experienced. Project staff analyzed the videos, compared them to previous videos and interviewed the teachers regarding their uptake of the PD related to content knowledge, pedagogical knowledge and resources used. The full paper will include the case study of Ana to illustrate the factors involved in what teachers take up and use from participating in the LTG PD.

Keywords: geometry, mathematics professional development, pedagogical content knowledge, teacher learning

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Authors: Chang Su Woo, Hyun Sung Park

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Useful lifetime evaluations of rail-pads were very important in design procedure to assure the safety and reliability. It is, therefore, necessary to establish a suitable criterion for the replacement period of rail pads. In this study, we performed properties and accelerated heat aging tests of rail pads considering degradation factors and all environmental conditions including operation, and then derived a lifetime prediction equation according to changes in hardness, thickness, and static spring constants in the Arrhenius plot to establish how to estimate the aging of rail pads. With the useful lifetime prediction equation, the lifetime of e-clip pads was 2.5 years when the change in hardness was 10% at 25°C; and that of f-clip pads was 1.7 years. When the change in thickness was 10%, the lifetime of e-clip pads and f-clip pads is 2.6 years respectively. The results obtained in this study to estimate the useful lifetime of rail pads for high speed trains can be used for determining the maintenance and replacement schedule for rail pads.

Keywords: rail pads, accelerated test, Arrhenius plot, useful lifetime prediction, mechanical engineering design

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Authors: Timmis W., Simms M., Thomas C.

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This case discusses the management of two floors of mouth (FOM) Squamous Cell Carcinomas (SCC) not identified upon initial biopsy. A 51 year-old male presented with right FOM erythroleukoplakia. Relevant medical history included alcoholic dependence syndrome and alcoholic liver disease. Relevant drug therapy encompassed acamprosate, folic acid, hydroxocobalamin and thiamine. The patient had a 55.5 pack-year smoking history and alcohol dependence from age 14, drinking 16 units/day. FOM incisional biopsy and histopathological analysis diagnosed Carcinoma in situ. Treatment involved wide local excision. Specimen analysis revealed two separate foci of pT1 moderately differentiated SCCs. Carcinoma staging scans revealed no pathological lymphadenopathy, no local invasion or metastasis. SCCs had been excised in completion with narrow margins. MDT discussion concluded that in view of the field changes it would be difficult to identify specific areas needing further excision, although techniques such as Lugol’s Iodine were considered. Further surgical resection, surgical neck management and sentinel lymph node biopsy was offered. The patient declined intervention, primary management involved close monitoring alongside alcohol and smoking cessation referral. Narrow excisional margins can increase carcinoma recurrence risk. Biopsy failed to identify SCCs, despite sampling an area of clinical concern. For gross field change multiple incisional biopsies should be considered to increase chance of accurate diagnosis and appropriate treatment. Coupling of tobacco and alcohol has a synergistic effect, exponentially increasing the relative risk of oral carcinoma development. Tobacco and alcoholic control is fundamental in reducing treatment‑related side effects, recurrence risk and second primary cancer development.

Keywords: alcohol dependence, biopsy, oral carcinoma, tobacco

Procedia PDF Downloads 108

Authors: Andreia Cortes, Carla Pimentel-Rodrigues, Joao Almeida, Myriam Kanoun-Boule, Carla Carvalho, Antonio Tadeu, Armando Silva-Afonso

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The adoption of green infrastructure is nowadays encouraged as an essential measure of urban planning and territorial development whenever it offers a better alternative, or is complementary, to current solutions. Green walls and living facades often provide healthy alternatives to traditional grey infrastructures, offering many benefits for both citizens and cities. Beyond the ability to improve environmental conditions and quality of life, they can augment the energy efficiency of buildings, enhance biodiversity and deliver a range of ecosystem services such as water purification, reduction of the urban heat island effect, improvement of air quality and climate change adaptation. For this communication, a systematic survey of the existing green walls and living facades in Portugal was carried out. Different systems were analyzed and compared in terms of dimensions, constructive solutions, vegetative species, maintenance necessities and environmental aspects.

Keywords: green buildings, green walls, living facades, sustainability construction

Procedia PDF Downloads 420

Authors: Rafia S. Al-lamki, Jun Wang, Simon Pacey, Jordan Pober, John R. Bradley

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Tumor necrosis factor alpha (TNF), signaling through TNFR2, may act an autocrine growth factor for renal tubular epithelial cells. Clear cell renal carcinomas (ccRCC) contain cancer stem cells (CSCs) that give rise to progeny which form the bulk of the tumor. CSCs are rarely in cell cycle and, as non-proliferating cells, resist most chemotherapeutic agents. Thus, recurrence after chemotherapy may result from the survival of CSCs. Therapeutic targeting of both CSCs and the more differentiated bulk tumor populations may provide a more effective strategy for treatment of RCC. In this study, we hypothesized that TNFR2 signaling will induce CSCs in ccRCC to enter cell cycle so that treatment with ligands that engage TNFR2 will render CSCs susceptible to chemotherapy. To test this hypothesis, we have utilized wild-type TNF (wtTNF) or specific muteins selective for TNFR1 (R1TNF) or TNFR2 (R2TNF) to treat either short-term organ cultures of ccRCC and adjacent normal kidney (NK) tissue or cultures of CD133+ cells isolated from ccRCC and adjacent NK, hereafter referred to as stem cell-like cells (SCLCs). The effect of cyclophosphamide (CP), currently an effective anticancer agent, was tested on CD133+SCLCs from ccRCC and NK before and after R2TNF treatment. Responses to TNF were assessed by flow cytometry (FACS), immunofluorescence, and quantitative real-time PCR, TUNEL, and cell viability assays. Cytotoxic effect of CP was analyzed by Annexin V and propidium iodide staining with FACS. In addition, we assessed the effect of TNF on isolated SCLCs differentiation using a three-dimensional (3D) culture system. Clinical samples of ccRCC contain a greater number SCLCs compared to NK and the number of SCSC increases with higher tumor grade. Isolated SCLCs show expression of stemness markers (oct4, Nanog, Sox2, Lin28) but not differentiation markers (cytokeratin, CD31, CD45, and EpCAM). In ccRCC organ cultures, wtTNF and R2TNF increase CD133 and TNFR2 expression and promote cell cycle entry whereas wtTNF and R1TNF increase TNFR1 expression and promote cell death of SCLCs. Similar findings are observed in SCLCs isolated from NK but the effect was greater in SCLCs isolated from ccRCC. Application of CP distinctly triggered apoptotic and necrotic cell death in SLCSs pre-treatment with R2TNF as compared to CP treatment alone, with SCLCs from ccRCC more sensitive to CP compared to SLCS from NK. Furthermore, TNF promotes differentiation of SCLCs to an epithelial phenotype in 3D cultures, confirmed by cytokeratin expression and loss of stemness markers Nanog and Sox2. The differentiated cells show positive expression of TNF and TNFR2. These findings provide evidence that selective engagement of TNFR2 drive CSCs to cell proliferation/differentiation, and targeting of cycling cells with TNFR2 agonist in combination with anti-cancer agents may be a potential therapy for RCC.

Keywords: cancer stem cells, ccRCC, cell cycle, cell death, TNF, TNFR1, TNFR2, CD133

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Authors: Muhammad Tariq, Bushra Siddique, Muhammad Naeem, Asim Gulzar

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The chemical ecology of natural enemies can play a pivotal role in any Integrated Pest Management (IPM) program. Different chemical cues help to correspond in the diversity of associations between prey and host plant species. Coccinellaseptempunctata and Diaeretiellarapae have the abilities to explore several chemical cues released by plants under herbivore attack that may enhance their efficiency of foraging. In this study, the behavioral responses of Coccinellaseptempunctata and Diaeretiellarapae were examined under the application of two semiochemicals and a plant extract and their combinations using four-arm olfactometer. The bioassay was consists of a pairwise treatment comparison. Data pertaining to the preference of C. septempunctata and D. rapae after treatment application were recorded and analyzed statistically. The mean number of entries and time spent of Coccinellaseptempunctata and D. rapaewere greater in arms treated with E-β-Farnesene. However, the efficacy of E-β-Farnesene was enhanced when combined with β-pinene. Thus, the mean number of entries and time spent of C. septempunctata and D. rapaewere highest in arms treated with the combination of E-β-Farnesene x β-pinene as compared with other treatments. The current work has demonstrated that the insect-derived semiochemicals may enhance the efficacy of natural enemies when applied in combination.

Keywords: olfectometer, parasitoid, predator, preference

Procedia PDF Downloads 136

Authors: Rundong Li, Peng Wu, Junfeng Zhang, Zhipeng Ren, Chen Yang, Jiahui Gan, Lu Feng, Haibo Tong, Xuemei Xiao, Yuying Chen

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The research of Beidou-3 satellite navigation is on the rise, but in actual work, it is inevitable that satellite data is insecure, research and development is inefficient, and there is no ability to deal with failures in advance. Digital twin technology has obvious advantages in the simulation of life cycle models of aerospace satellite navigation products. In order to meet the increasing demand, this paper builds a Beidou-3 satellite navigation digital twin platform (BDSDTP). The basic establishment of BDSDTP was completed by establishing a digital twin double, Beidou-3 comprehensive digital twin design, predictive maintenance (PdM) mathematical model, and visual interaction design. Finally, this paper provides a time application case of the platform, which provides a reference for the application of BDSDTP in various fields of navigation and provides obvious help for extending the full cycle life of Beidou-3 satellite navigation.

Keywords: BDS-3, digital twin, visualization, PdM

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Authors: J. Naalamle Amissah, Dorcas Osei‐Safo, C. M. Asare, Benjamin Missah‐Assihene, Eric. Y. Danquah, Ivan Addae‐Mensah

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Medicinal plants serve as a reservoir of active ingredients for the treatment of common ailments such as cancer, malaria and diabetes. With the recent wave of health consciousness and reliance on plant based medicines, the demand for medicinal plants has increased considerably. This surge in medicinal plant use has raised great concern amongst key players (herbalist, collectors, conservationist and researchers) along the value chain about the sustainability of the raw material. The over reliance on wild crafting as a means to obtain the raw material spells doom for several of Africa’s native medicinal plant species. In this study domestication protocols for the cultivation of Cryptolepis sanguinolenta (CS), a medicinal plant used in the treatment of malaria were developed. Initial surveys were conducted, using questionnaires comprising of open and close ended questions, to gather information that would inform the domestication and cultivation of the species. A field study was then conducted to determine the plant’s cropping cycle and the effect of staking and plant age on the active ingredient (cryptolepine) concentration in its roots. Results of the survey confirmed the demand for the raw material and threw more light on the harvesting methods and intensity of CS collection from the wild. Cryptolepine concentration was found to be highest (~1.84 mg/100 mg of root material) at 289 days after planting (DAP) which coincided with the peak of root dry weight (52.8 g), signifying the best time for root harvest. Staking was found to be important for seed production. The first 105 DAP were characterized by low yields of root dry weight (13.5 g), followed by a period of rapid growth in which the root dry weight increased almost linearly until 289 DAP. Although dry matter partitioned to the vines increased towards the end of the experimental period (60%), dry matter partitioned to the roots remained fairly constant (30%) throughout the experimental period. Cryptolepine was found to increase as the plant aged and the practice of staking CS promoted pod formation. A suitable cropping cycle for the cultivation of CS was also developed.

Keywords: domestication, staking, conservation, wild harvesting

Procedia PDF Downloads 378

Authors: Seyed Mohammadbagher Jafari, Elahe Mahdizadeh, Masomeh Ghahremani

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Nowadays almost all organizations depend on information systems to run their businesses. Investment on information systems and their maintenance to keep them always in best situation to support firm business is one of the main issues for every organization. The new concept of cloud computing was developed as a technical and economic model to address this issue. In cloud computing the computing resources, including networks, applications, hardwares and services are configured as needed and are available at the moment of request. However, migration to cloud is not an easy task and there are many issues that should be taken into account. This study tries to provide a comprehensive model to assess a firm readiness to implement cloud computing. By conducting a systematic literature review, four dimensions of readiness were extracted which include technological, human, organizational and environmental dimensions. Every dimension has various criteria that have been discussed in details. This model provides a framework for cloud computing readiness assessment. Organizations that intend to migrate to cloud can use this model as a tool to assess their firm readiness before making any decision on cloud implementation.

Keywords: cloud computing, human readiness, organizational readiness, readiness assessment model

Procedia PDF Downloads 390