Search results for: diagnosis and treatment intervals
7028 Sonodynamic Activity of Porphyrins-SWCNT
Authors: F. Bosca, F. Foglietta, F. Turci, E. Calcio Gaudino, S. Mana, F. Dosio, R. Canaparo, L. Serpe, A. Barge
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In recent years, medical science has improved chemotherapy, radiation therapy and adjuvant therapy and has developed newer targeted therapies as well as refining surgical techniques for removing cancer. However, the chances of surviving the disease depend greatly on the type and location of the cancer and the extent of the disease at the start of treatment. Moreover, mainstream forms of cancer treatment have side effects which range from the unpleasant to the fatal. Therefore, the continuation of progress in anti-cancer therapy may depend on placing emphasis on other existing but less thoroughly investigated therapeutic approaches such as Sonodynamic Therapy (SDT). SDT is based on the local activation of a so called 'sonosensitizer', a molecule able to be excited by ultrasound, the radical production as a consequence of its relaxation processes and cell death due to different mechanisms induced by radical production. The present work deals with synthesis, characterization and preliminary in vitro test of Single Walled Carbon Nanotubes (SWCNT) decorated with porphyrins and biological vectors. The SWCNT’s surface was modified exploiting 1, 3-dipolar cycloaddition or Dies Alder reactions. For this purpose, different porphyrins scaffolds were ad-hoc synthesized using also non-conventional techniques. To increase cellular specificity of porphyrin-conjugated SWCNTs and to improve their ability to be suspended in aqueous solution, the modified nano-tubes were grafted with suitable glutamine or hyaluronic acid derivatives. These nano-sized sonosensitizers were characterized by several methodologies and tested in vitro on different cancer cell lines.Keywords: sonodynamic therapy, porphyrins synthesis and modification, SWNCT grafting, hyaluronic acid, anti-cancer treatment
Procedia PDF Downloads 3847027 A Retrospective Cross-Sectional Study on the Prevalence and Factors Associated with Virological Non-Suppression among HIV-Positive Adult Patients on Antiretroviral Therapy in Woliso Town, Oromia, Ethiopia
Authors: Teka Haile, Behailu Hawulte, Solomon Alemayehu
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Background: HIV virological failure still remains a problem in HV/AIDS treatment and care. This study aimed to describe the prevalence and identify the factors associated with viral non-suppression among HIV-positive adult patients on antiretroviral therapy in Woliso Town, Oromia, Ethiopia. Methods: A retrospective cross-sectional study was conducted among 424 HIV-positive patient’s attending antiretroviral therapy (ART) in Woliso Town during the period from August 25, 2020 to August 30, 2020. Data collected from patient medical records were entered into Epi Info version 2.3.2.1 and exported to SPSS version 21.0 for analysis. Logistic regression analysis was done to identify factors associated with viral load non-suppression, and statistical significance of odds ratios were declared using 95% confidence interval and p-value < 0.05. Results: A total of 424 patients were included in this study. The mean age (± SD) of the study participants was 39.88 (± 9.995) years. The prevalence of HIV viral load non-suppression was 55 (13.0%) with 95% CI (9.9-16.5). Second-line ART treatment regimen (Adjusted Odds Ratio (AOR) = 8.98, 95% Confidence Interval (CI): 2.64, 30.58) and routine viral load testing (AOR = 0.01, 95% CI: 0.001, 0.02) were significantly associated with virological non-suppression. Conclusion: Virological non-suppression was high, which hinders the achievement of the third global 95 target. The second-line regimen and routine viral load testing were significantly associated with virological non-suppression. It suggests the need to assess the effectiveness of antiretroviral drugs for epidemic control. It also clearly shows the need to decentralize third-line ART treatment for those patients in need.Keywords: virological non-suppression, HIV-positive, ART, Woliso town, Ethiopia
Procedia PDF Downloads 1397026 Performance Evaluation of On-Site Sewage Treatment System (Johkasou)
Authors: Aashutosh Garg, Ankur Rajpal, A. A. Kazmi
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The efficiency of an on-site wastewater treatment system named Johkasou was evaluated based on its pollutant removal efficiency over 10 months. This system was installed at IIT Roorkee and had a capacity of treating 7 m3/d of sewage water, sufficient for a group of 30-50 people. This system was fed with actual wastewater through an equalization tank to eliminate the fluctuations throughout the day. Methanol and ammonium chloride was added into this equalization tank to increase the Chemical Oxygen Demand (COD) and ammonia content of the influent. The outlet from Johkasou is sent to a tertiary unit consisting of a Pressure Sand Filter and an Activated Carbon Filter for further treatment. Samples were collected on alternate days from Monday to Friday and the following parameters were evaluated: Chemical Oxygen Demand (COD), Biochemical Oxygen Demand (BOD), Total Suspended Solids (TSS), and Total Nitrogen (TN). The Average removal efficiency for Chemical Oxygen Demand (COD), Biochemical Oxygen Demand (BOD), Total Suspended Solids (TSS), and Total Nitrogen (TN) was observed as 89.6, 97.7, 96, and 80% respectively. The cost of treating the wastewater comes out to be Rs 23/m3 which includes electricity, cleaning and maintenance, chemical, and desludging costs. Tests for the coliforms were also performed and it was observed that the removal efficiency for total and fecal coliforms was 100%. The sludge generation rate is approximately 20% of the BOD removal and it needed to be removed twice a year. It also showed a very good response against the hydraulic shock load. We performed vacation stress analysis on the system to evaluate the performance of the system when there is no influent for 8 consecutive days. From the result of stress analysis, we concluded that system needs a recovery time of about 48 hours to stabilize. After about 2 days, the system returns again to original conditions and all the parameters in the effluent become within the limits of National Green Tribunal (NGT) standards. We also performed another stress analysis to save the electricity in which we turned the main aeration blower off for 2 to 12 hrs a day and the results showed that we can turn the blower off for about 4-6 hrs a day and this will help in reducing the electricity costs by about 25%. It was concluded that the Johkasou system can remove a sufficient amount of all the physiochemical parameters tested to satisfy the prescribed limit set as per Indian Standard.Keywords: on-site treatment, domestic wastewater, Johkasou, nutrient removal, pathogens removal
Procedia PDF Downloads 1077025 Islamic Banking Recovery Process and Its Parameters: A Practitioner’s Viewpoints in the Light of Humanising Financial Services
Authors: Muhammad Izzam Bin Mohd Khazar, Nur Adibah Binti Zainudin
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Islamic banking as one of the financial institutions is highly required to maintain a prudent approach to ensure that any financing given is able to generate income to their respective shareholders. As the default payment of customers is probably occurred in the financing, having a prudent approach in the recovery process is a must to ensure that financing losses are within acceptable limits. The objective of this research is to provide the best practice of recovery which is anticipated to benefit both bank and customers. This study will address arising issue on the current practice of recovery process and followed by providing humanising recovery solutions in the light of the Maqasid Shariah. The study identified main issues pertaining to Islamic recovery process which can be categorized into knowledge crisis, process issues, specific treatment cases and system issues. Knowledge crisis is related to direct parties including judges, solicitors and salesperson, while the recovery process issues include the process of issuance of reminder, foreclosure and repossession of asset. Furthermore, special treatment for particular cases also should be observed since different contracts in Islamic banking products will need different treatment. Finally, issues in the system used in the recovery process are still unresolved since the existing technology is still young in this area to embraced Islamic finance requirements and nature of calculation. In order to humanize the financial services in Islamic banking recovery process, we have highlighted four main recommendation to be implemented by Islamic Financial Institutions namely; 1) early deterrent by improving the awareness, 2) improvement of the internal process, 3) reward mechanism, and 4) creative penalty to provide awareness to all stakeholders.Keywords: humanizing financial services, Islamic Finance, Maqasid Syariah, recovery process
Procedia PDF Downloads 1907024 Role of Selenium and Vitamin E in Occupational Exposure to Heavy Metals (Mercury, Lead and Cadmium): Impact of Working in Lamp Factory
Authors: Tarek Elnimr, Rabab El-kelany
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Heavy metals are environmental contaminants that may pose long-term health risks. Unfortunately, the consequent implementation of preventive measures was generally delayed, causing important negative effects to the exposed populations. The objective of this study was to determine whether co-consumption of nutritional supplements as selenium and vitamin E would treat the hazardous effects of exposure to mercury, lead and cadmium. 108 workers (60 males and 48 females) were the subject of this study, their ages ranged from 19-63 years, (M = 29.5±10.12). They were working in lamp factory for an average of 0.5-40 years (M= 5.3±8.8). Twenty control subjects matched for age and gender were used for comparison. All workers were subjected to neuropsychiatric evaluation. General Health Questionnaire (GHQ-28) revealed that 44.4% were complaining of anxiety, 52.7% of depression, 41.6% of social dysfunction and 22.2% of somatic symptoms. Cognitive tests revealed that long-term memory was not affected significantly when compared with controls, while short term memory and perceptual ability were affected significantly. Blood metal levels were measured by Inductively Coupled Plasma – optical emission spectrometry(ICP-OES), and revealed that the mean blood mercury, lead and cadmium concentrations before treatment were 1.6 mg/l, 0.39 mg/l and 1.7 µg/l, while they decreased significantly after treatment to 1.2 mg/l, 0.29 mg/l and 1.3 µg/l respectively. Anti-oxidative enzymes (paraoxonase and catalase) and lipid peroxidation product (malondialdehyde) were measured before and after treatment with selenium and vitamin E, and showed significant improvement. It could be concluded that co-consumption of selenium and vitamin E produces significant decrease in mercury, lead and cadmium levels in blood.Keywords: mercury, lead, cadmium, neuropsychiatric impairment, selenium, vitamin E
Procedia PDF Downloads 3427023 Pragmatic Development of Chinese Sentence Final Particles via Computer-Mediated Communication
Authors: Qiong Li
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This study investigated in which condition computer-mediated communication (CMC) could promote pragmatic development. The focal feature included four Chinese sentence final particles (SFPs), a, ya, ba, and ne. They occur frequently in Chinese, and function as mitigators to soften the tone of speech. However, L2 acquisition of SFPs is difficult, suggesting the necessity of additional exposure to or explicit instruction on Chinese SFPs. This study follows this line and aims to explore two research questions: (1) Is CMC combined with data-driven instruction more effective than CMC alone in promoting L2 Chinese learners’ SFP use? (2) How does L2 Chinese learners’ SFP use change over time, as compared to the production of native Chinese speakers? The study involved 19 intermediate-level learners of Chinese enrolled at a private American university. They were randomly assigned to two groups: (1) the control group (N = 10), which was exposed to SFPs through CMC alone, (2) the treatment group (N = 9), which was exposed to SFPs via CMC and data-driven instruction. Learners interacted with native speakers on given topics through text-based CMC over Skype. Both groups went through six 30-minute CMC sessions on a weekly basis, with a one-week interval after the first two CMC sessions and a two-week interval after the second two CMC sessions (nine weeks in total). The treatment group additionally received a data-driven instruction after the first two sessions. Data analysis focused on three indices: token frequency, type frequency, and acceptability of SFP use. Token frequency was operationalized as the raw occurrence of SFPs per clause. Type frequency was the range of SFPs. Acceptability was rated by two native speakers using a rating rubric. The results showed that the treatment group made noticeable progress over time on the three indices. The production of SFPs approximated the native-like level. In contrast, the control group only slightly improved on token frequency. Only certain SFPs (a and ya) reached the native-like use. Potential explanations for the group differences were discussed in two aspects: the property of Chinese SFPs and the role of CMC and data-driven instruction. Though CMC provided the learners with opportunities to notice and observe SFP use, as a feature with low saliency, SFPs were not easily noticed in input. Data-driven instruction in the treatment group directed the learners’ attention to these particles, which facilitated the development.Keywords: computer-mediated communication, data-driven instruction, pragmatic development, second language Chinese, sentence final particles
Procedia PDF Downloads 4127022 The Relations between Seismic Results and Groundwater near the Gokpinar Damp Area, Denizli, Turkey
Authors: Mahmud Gungor, Ali Aydin, Erdal Akyol, Suat Tasdelen
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The understanding of geotechnical characteristics of near-surface material and the effects of the groundwater is very important problem in such as site studies. For showing the relations between seismic data and groundwater we selected about 25 km2 as the study area. It has been presented which is a detailed work of seismic data and groundwater depths of Gokpinar Damp area. Seismic waves velocity (Vp and Vs) are very important parameters showing the soil properties. The seismic records were used the method of the multichannel analysis of surface waves near area of Gokpinar Damp area. Sixty sites in this area have been investigated with survey lines about 60 m in length. MASW (Multichannel analysis of surface wave) method has been used to generate one-dimensional shear wave velocity profile at locations. These shear wave velocities are used to estimate equivalent shear wave velocity in the study area at every 2 and 5 m intervals up to a depth of 45 m. Levels of equivalent shear wave velocity of soil are used the classified of the study area. After the results of the study, it must be considered as components of urban planning and building design of Gokpinar Damp area, Denizli and the application and use of these results should be required and enforced by municipal authorities.Keywords: seismic data, Gokpinar Damp, urban planning, Denizli
Procedia PDF Downloads 2837021 Optical Characterization of Anisotropic Thiophene-Phenylene Co-Oligomer Micro Crystals by Spectroscopic Imaging Ellipsometry
Authors: Christian Röling, Elena Y. Poimanova, Vladimir V. Bruevich
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Here we demonstrate a non-destructive optical technique to localize and characterize single crystals of semiconductive organic materials – Spectroscopic Imaging Ellipsometry. With a combination of microscopy and ellipsometry, it is possible to characterize even micro-sized thin film crystals on plane surface regarding anisotropy, optical properties, crystalline domains and thickness. The semiconducting thiophene-phenylene co-oligomer 1,4-bis(5'-hexyl-[2,2'-bithiophen]-5-yl)benzene (dHex-TTPTT) crystals were grown by solvent based self-assembly technique on silicon substrate with 300 nm thermally silicon dioxide. The ellipsometric measurements were performed with an Ep4-SE (Accurion). In an ellipsometric high-contrast image of the complete sample, we have localized high-quality single crystals. After demonstrating the uniaxial anisotropy of the crystal by using Müller-Matrix imaging ellipsometry, we determined the optical axes by rotating the sample and performed spectroscopic measurements (λ = 400-700 nm) in 5 nm intervals. The optical properties were described by using a Lorentz term in the Ep4-Model. After determining the dispersion of the crystals, we converted a recorded Delta and Psi-map into a 2D thickness image. Based on a quantitative analysis of the resulting thickness map, we have calculated the height of a molecular layer (3.49 nm).Keywords: anisotropy, ellipsometry, SCFET, thin film
Procedia PDF Downloads 2427020 Effects of Grape Seed Oil on Postharvest Life and Quality of Some Grape Cultivars
Authors: Zeki Kara, Kevser Yazar
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Table grapes (Vitis vinifera L.) are an important crop worldwide. Postharvest problems like berry shattering, decay and stem dehydration are some of the important factors that limit the marketing of table grapes. Edible coatings are an alternative for increasing shelf-life of fruits, protecting fruits from humidity and oxygen effects, thus retarding their deterioration. This study aimed to compare different grape seed oil applications (GSO, 0.5 g L-1, 1 g L-1, 2 g L-1) and SO2 generating pads effects (SO2-1, SO2-2). Treated grapes with GSO and generating pads were packaged into polyethylene trays and stored at 0 ± 1°C and 85-95% moisture. Effects of the applications were investigated by some quality and sensory evaluations with intervals of 15 days. SO2 applications were determined the most effective treatments for minimizing weight loss and changes in TA, pH, color and appearance value. Grape seed oil applications were determined as a good alternative for grape preservation, improving weight losses and °Brix, TA, the color values and sensory analysis. Commercially, ‘Alphonse Lavallée’ clusters were stored for 75 days and ‘Antep Karası’ clusters for 60 days. The data obtained from GSO indicated that it had a similar quality result to SO2 for up to 40 days storage.Keywords: postharvest, quality, sensory analyses, Vitis vinifera L.
Procedia PDF Downloads 1627019 Randomized Trial of Tian Jiu Therapy in San Fu Days for Patients with Chronic Asthma
Authors: Libing Zhu, Waichung Chen, Kwaicing Lo, Lei Li
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Background: Tian Jiu Therapy (a medicinal vesiculation therapy according to traditional Chinese medicine theory) in San Fu Days (the three hottest days in a year is calculated by the Chinese ancient calendar) is widely used by patients with chronic asthma in China although from modern medicine perspective there is insufficient evidence of its effectiveness and safety issues. We investigated the efficacy and safety of Tian Jiu Therapy compared with placebo in patients with chronic asthma. Methods: Patients with chronic asthma were randomly assigned to Tian Jiu treatment group (n=165), placebo control group (n=158). Registered Chinese Medicine practitioners, in Orthopedics-Traumatology, Acupuncture, and Tui-na Clinical Centre for Teaching and Research, School of Chinese Medicine, The University of Hong Kong, administered Tian Jiu Therapy and placebo treatment in 3 times over 2 months. Patients completed questionnaires and lung function test before treatment and after treatment, 3, 6, 9, and 11 months, respectively. The primary outcome was the no of asthma-related sub-healthy symptoms and the percentage of patients with twenty-three symptoms. Results: 451 patients were recruited totally, 111 patients refused or did not participate according the appointment time and 17 did not meet the inclusion criteria. Consequently, 323 of eligible patients were enrolled. There was nothing difference between Tian Jiu Therapy group and placebo control group at the end of all treatments neither primary nor secondary outcomes. While Tian Jiu Therapy as compared with placebo significantly reduced the percentage of participants who are susceptible waken up by asthma symptoms from 27% to 14% at 2nd follow-up (P < 0.05). Similarly, Tian Jiu Therapy significantly reduced the proportion of participants who had the symptom of running nose and sneezing before onset from 18% to 8% at 2nd follow-up (P < 0.05). Additionally, Tian Jiu Therapy significantly reduced the level of asthma, the proportion of participants who don’t need to processed during asthma attack increased from 6% to 15% at 1st follow-up and 0% to 7% at 3rd follow-up (P < 0.05). Improvements also occurred with Tian Jiu Therapy group, it reduced the proportion of participants who were spontaneously sweating at 3rd follow up and diarrhea after intake of oily food at 4th follow-up (P < 0.05). Conclusion: When added to a regimen of foundational therapy for chronic asthma participants, Tian Jiu Therapy further reduced the need for medications to control asthma, improved the quality of participants’ life, and significantly reduced the level of asthma. What is more, this benefit seems to have an accumulative effect over time was in accordance with the TCM theory of 'winter disease is being cured in summer'.Keywords: asthma, Tian Jiu Therapy, San Fu Days, triaditional Chinese medicine, clinical trial
Procedia PDF Downloads 3077018 The Effect of Fermented Organic Feed into Nutritive Contents of Kampong Chicken Meat
Authors: Wahyu Widodo, Imbang Dwi Rahayu, Adi Sutanto
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The purpose of this research was to analyze the effect of the fermented organic feed to dry matter, ash, organic matter, protein, fat and crude fiber contents of kampong chicken meat. The research had conducted at January until June, 2016. One hundreds chickens were used in this research. Experimental method and completely randomized design were used to support this research. We had 4 treatment namely P0: organic feed without fermentation, P1: Organic feed with fermented rice bran, P2: Organic feed with fermented corn, P3: Organic feed with fermented rice bran and corn with 5 replication. The conclusion was the treatment had not a significant effect in the dry matter, ash, organic matter and protein contents of chicken meat. On the other hand, it had a significant effect in the fat and crude fiber contents of chicken meat.Keywords: corn, fermented organic feed, nutritive contents, rice bran
Procedia PDF Downloads 3097017 The Impact of Information Technology Monitoring on Employee Theft and Productivity
Authors: Ajayi Oluwasola Felix
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This paper examines how firm investments in technology-based employee monitoring impact both misconduct and productivity. We use unique and detailed theft and sales data from 392 restaurant locations from five firms that adopt a theft monitoring information technology (IT) product. We use difference-in-differences (DD) models with staggered adoption dates to estimate the treatment effect of IT monitoring on theft and productivity. We find significant treatment effects in reduced theft and improved productivity that appear to be primarily driven by changed worker behavior rather than worker turnover. We examine four mechanisms that may drive this productivity result: economic and cognitive multitasking, fairness-based motivation, and perceived increases of general oversight. The observed productivity results represent substantial financial benefits to both firms and the legitimate tip-based earnings of workers. Our results suggest that employee misconduct is not solely a function of individual differences in ethics or morality, but can also be influenced by managerial policies that can benefit both firms and employees.Keywords: information technology, monitoring, misconduct, employee theft
Procedia PDF Downloads 4107016 The Impact of Childhood Cancer on Young Adult Survivors: A Life Course Perspective
Authors: Bridgette Merriman, Wen Fan
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Background: Existing cancer survivorship literature explores varying physical, psychosocial, and psychological late effects experienced by survivors of childhood cancer. However, adolescent and young adult (AYA) survivors of childhood cancer are understudied compared to their adult and pediatric cancer counterparts. Furthermore, existing quality of life (QoL) research fails to account for how cancer survivorship affects survivors across the lifespan. Given that prior research suggests positive cognitive appraisals of adverse events - such as cancer - mitigate detrimental psychosocial symptomologies later in life; it is crucial to understand cancer’s impacts on AYA survivors of childhood malignancies across the life course in order to best support these individuals and prevent maladaptive psychosocial outcomes. Methods: This qualitative study adopted the life-course perspective to investigate the experiences of AYA survivors of childhood malignancies. Eligible patients included AYA 21-30 years old who were diagnosed with cancer <18 years old and off active treatment for >2 years. Participants were recruited through social media posts. Study fulfillment included taking part in one semi-structured video interview to explore areas of survivorship previously identified as being specific to AYA survivors. Interviews were transcribed, coded, and analyzed in accordance with narrative analysis and life-course theory. This study was approved by the Boston College Institutional Review Board. Results: Of 28 individuals who met inclusion criteria and expressed interest in the study, nineteen participants (12 women, 7 men, mean age 25.4 years old) completed the study. Life course theory analysis revealed that events relating to childhood cancer are interconnected throughout the life course rather than isolated events. This “trail of survivorship” includes age at diagnosis, transitioning to life after cancer, and relationships with other childhood survivors. Despite variability in objective characteristics surrounding these events, participants recalled positive experiences regarding at least one checkpoint, ultimately finding positive meaning from their cancer experience. Conclusions: These findings suggest that favorable subjective experiences at these checkpoints are critical in fostering positive conceptions of childhood malignancy for AYA survivors of childhood cancer. Ultimately, healthcare professionals and communities may use these findings to guide support resources and interventions for childhood cancer patients and AYA survivors, therein minimizing detrimental psychosocial effects and maximizing resiliency.Keywords: medical sociology, pediatric oncology, survivorship, qualitative, life course perspective
Procedia PDF Downloads 637015 Studies of Carbohydrate, Antioxidant, Nutrient and Genomic DNA Characterization of Fresh Olive Treated with Alkaline and Acidic Solvent: An Innovation
Authors: A. B. M. S. Hossain, A. Abdelgadir, N. A. Ibrahim
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Fresh ripen olive cannot be consumed immediately after harvest due to the excessive bitterness having polyphenol as antioxidant. Industrial processing needs to be edible the fruit. The laboratory processing technique has been used to make it edible by using acid (vinegar, 5% acetic acid) and alkaline solvent (NaOH). Based on the treatment and consequence, innovative data have been found in this regard. The experiment was conducted to investigate biochemical content, nutritional and DNA characterization of olive fruit treated with alkaline (Sodium chloride anhydrous) and acidic solvent (5% acetic acid, vinegar). The treatments were used as control (no water), water control, 10% sodium chloride anhydrous (NaOH), vinegar (5% acetic acid), vinegar + NaOH and vinegar + NaOH + hot water treatment. Our results showed that inverted sugar and glucose content were higher in the vinegar and NaOH treated olive than in other treatments. Fructose content was the highest in vinegar + NaOH treated fruit. Nutrient contents NO3 K, Ca and Na were found higher in the treated fruit than the control fruit. Moreover, maximum K content was observed in the case of all treatments compared to the other nutrient content. The highest acidic (lower pH) condition (sour) was found in treated fruit. DNA yield was found higher in water control than acid and alkaline treated olives. DNA band was wider in the olive treated water control compared to the NaOH, vinegar, vinegar + NaOH and vinegar + NaOH + Hot water treatment. Finally, results suggest that vinegar + NaOH treated olive fruit was the best for fresh olive homemade processing after harvesting for edible purpose.Keywords: olive, vinegar, sugars, DNA band, bioprocess biotechnology
Procedia PDF Downloads 1807014 The Reproducibility and Repeatability of Modified Likelihood Ratio for Forensics Handwriting Examination
Authors: O. Abiodun Adeyinka, B. Adeyemo Adesesan
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The forensic use of handwriting depends on the analysis, comparison, and evaluation decisions made by forensic document examiners. When using biometric technology in forensic applications, it is necessary to compute Likelihood Ratio (LR) for quantifying strength of evidence under two competing hypotheses, namely the prosecution and the defense hypotheses wherein a set of assumptions and methods for a given data set will be made. It is therefore important to know how repeatable and reproducible our estimated LR is. This paper evaluated the accuracy and reproducibility of examiners' decisions. Confidence interval for the estimated LR were presented so as not get an incorrect estimate that will be used to deliver wrong judgment in the court of Law. The estimate of LR is fundamentally a Bayesian concept and we used two LR estimators, namely Logistic Regression (LoR) and Kernel Density Estimator (KDE) for this paper. The repeatability evaluation was carried out by retesting the initial experiment after an interval of six months to observe whether examiners would repeat their decisions for the estimated LR. The experimental results, which are based on handwriting dataset, show that LR has different confidence intervals which therefore implies that LR cannot be estimated with the same certainty everywhere. Though the LoR performed better than the KDE when tested using the same dataset, the two LR estimators investigated showed a consistent region in which LR value can be estimated confidently. These two findings advance our understanding of LR when used in computing the strength of evidence in handwriting using forensics.Keywords: confidence interval, handwriting, kernel density estimator, KDE, logistic regression LoR, repeatability, reproducibility
Procedia PDF Downloads 1197013 Sulfamethaxozole (SMX) Removal by Microwave-Assisted Heterogenous Fenton Reaction Involving Synthetic Clay (LDHS)
Authors: Chebli Derradji, Abdallah Bouguettoucha, Zoubir Manaa, S. Nacef, A. Amrane
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Antibiotics are major pollutants of wastewater not only due to their stability in biological systems, but also due to their impact on public health. Their degradation by means of hydroxyl radicals generated through the application of microwave in the presence of hydrogen peroxide and two solid catalysts, iron-based synthetic clay (LDHs) and goethite (FeOOH) have been examined. A drastic reduction of the degradation yield was observed above pH 4, and hence the optimal conditions were found to be a pH of 3, 0.1 g/L of clay, a somewhat low amount of H2O2 (1.74 mmol/L) and a microwave intensity of 850 W. It should be observed that to maintain an almost constant temperature, a cooling with cold water was always applied between two microwaves running; and hence the ratio between microwave heating time and cooling time was 1. The obtained SMX degradation was 98.8 ± 0.2% after 30 minutes of microwave treatment. It should be observed that in the absence of the solid catalyst, LDHs, no SMX degradation was observed. From this, the use of microwave in the presence of a solid source of iron (LDHs) appears to be an efficient solution for the treatment of wastewater containing SMX.Keywords: microwave, fenton, heterogenous fenton, degradation, oxidation, antibiotics
Procedia PDF Downloads 2727012 The Underestimate of the Annual Maximum Rainfall Depths Due to Coarse Time Resolution Data
Authors: Renato Morbidelli, Carla Saltalippi, Alessia Flammini, Tommaso Picciafuoco, Corrado Corradini
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A considerable part of rainfall data to be used in the hydrological practice is available in aggregated form within constant time intervals. This can produce undesirable effects, like the underestimate of the annual maximum rainfall depth, Hd, associated with a given duration, d, that is the basic quantity in the development of rainfall depth-duration-frequency relationships and in determining if climate change is producing effects on extreme event intensities and frequencies. The errors in the evaluation of Hd from data characterized by a coarse temporal aggregation, ta, and a procedure to reduce the non-homogeneity of the Hd series are here investigated. Our results indicate that: 1) in the worst conditions, for d=ta, the estimation of a single Hd value can be affected by an underestimation error up to 50%, while the average underestimation error for a series with at least 15-20 Hd values, is less than or equal to 16.7%; 2) the underestimation error values follow an exponential probability density function; 3) each very long time series of Hd contains many underestimated values; 4) relationships between the non-dimensional ratio ta/d and the average underestimate of Hd, derived from continuous rainfall data observed in many stations of Central Italy, may overcome this issue; 5) these equations should allow to improve the Hd estimates and the associated depth-duration-frequency curves at least in areas with similar climatic conditions.Keywords: central Italy, extreme events, rainfall data, underestimation errors
Procedia PDF Downloads 1847011 Parkinson's Disease and Musculoskeletal Problems
Authors: Ozge Yilmaz Kusbeci, Ipek Inci
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Aim: Musculoskeletal problems are very common in Parkinson’s disease (PD). They affect quality of life and cause disabilities. However they are under-evaluated, and under-treated. The aim of this study is to evaluate the prevalence and clinical features of musculoskeletal problems in patients with Parkinson disease (PD) compared to controls. Methods: 50 PD patients and 50 age and sex matched controls were interviewed by physicians about their musculoskeletal problems. Results: The prevalence of musculoskeletal problems was significantly higher in the PD group than in the control group (p < 0.05). Commonly involved body sites were the shoulder, low back, and knee. The shoulder and low back was more frequently involved in the PD group than in the control group. However, the knee was similarly involved in both groups. Among the past diagnoses associated with musculoskeletal problems, frozen shoulder, low back pain and osteoporosis more common in the PD group than in the control group (p < 0.05). Furthermore, musculoskeletal problems in the PD group tended to receive less treatment than that of the control group. Conclusion: Musculoskeletal problems were more common in the PD group than in the controls. Therefore assessment and treatment of musculoskeletal problems could improve quality of life in PD patients.Keywords: parkinson disease, musculoskeletal problems, quality of life, PD disease
Procedia PDF Downloads 3897010 An Investigation the Effectiveness of Emotion Regulation Training on the Reduction of Cognitive-Emotion Regulation Problem in Patients with Multiple Sclerosis
Authors: Mahboobeh Sadeghi, Zahra Izadi Khah, Mansour Hakim Javadi, Masoud Gholamali Lavasani
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Background: Since there is a relation between psychological and physiological factors, the aim of this study was to examine the effect of Emotion Regulation training on cognitive emotion regulation problem in patients with Multiple Sclerosis(MS) Method: In a randomized clinical trial thirty patients diagnosed with Multiple Sclerosis referred to state welfare organization were selected. The sample group was randomized into either an experimental group or a nonintervention control group. The subjects participated in 75-minute treatment sessions held three times a week for 4weeks (12 sessions). All 30 individuals were administered with Cognitive Emotion Regulation questionnaire (CERQ). Participants completed the questionnaire in pretest and post-test. Data obtained from the questionnaire was analyzed using Mancova. Results: Emotion Regulation significantly decreased the Cognitive Emotion Regulation problems patients with Multiple sclerosis (p < 0.001). Conclusions: Emotion Regulation can be used for the treatment of cognitive-emotion regulation problem in Multiple sclerosis.Keywords: Multiple Sclerosis, cognitive-emotion regulation, emotion regulation, MS
Procedia PDF Downloads 4527009 An Optimization Model for Waste Management in Demolition Works
Authors: Eva Queheille, Franck Taillandier, Nadia Saiyouri
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Waste management has become a major issue in demolition works, because of its environmental impact (energy consumption, resource consumption, pollution…). However, improving waste management requires to take also into account the overall demolition process and to consider demolition main objectives (e.g. cost, delay). Establishing a strategy with these conflicting objectives (economic and environment) remains complex. In order to provide a decision-support for demolition companies, a multi-objective optimization model was developed. In this model, a demolition strategy is computed from a set of 80 decision variables (worker team composition, machines, treatment for each type of waste, choice of treatment platform…), which impacts the demolition objectives. The model has experimented on a real-case study (demolition of several buildings in France). To process the optimization, different optimization algorithms (NSGA2, MOPSO, DBEA…) were tested. Results allow the engineer in charge of this case, to build a sustainable demolition strategy without affecting cost or delay.Keywords: deconstruction, life cycle assessment, multi-objective optimization, waste management
Procedia PDF Downloads 1467008 Nutritional Education in Health Resort Institutions in the Face of Demographic and Epidemiological Changes in Poland
Authors: J. Woźniak-Holecka, T. Holecki, S. Jaruga
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Spa treatment is an important area of the health care system in Poland due to the increasing needs of the population and the context of historical conditions for this form of therapy. It extends the range of financing possibilities of the outlets and increases the potential of spa services, which is very important in the context of demographic and epidemiological changes. The main advantages of spa treatment services include its relatively wide availability, low risk of side effects, good patient tolerance, long-lasting curative effect and a relatively low cost. In addition, patients should be provided with a proper diet and enable participation in health education and health promotion classes aimed at health problems consistent with the treatment profile. Challenges for global health care systems include a sharp increase in spending on benefits, dynamic development of health technologies and growing social expectations. This requires extending the competences of health resort facilities for health promotion. Within each type of health resort institutions in Poland, nutritional education services are implemented, aimed at creating and consolidating proper eating habits. Choosing the right diet can speed up recovery or become one of the methods to alleviate the symptoms of chronic diseases. During spa treatment patient learns the principles of rational nutrition and adequate dietotherapy to his diseases. The aim of the project is to assess the frequency and quality of nutritional education provided to patients in health resort facilities in a nationwide perspective. The material for the study will be data obtained as part of an in-depth interview conducted among Heads of Nutrition Departments of selected institutions. The use of nutritional education in a health resort may be an important goal of implementing the state health policy as a useful tool to reduce the risk of diet-related diseases. Recognizing nutritional education in health resort institutions as a type of full-value health service can be effective system support for health policy, including seniors, due to demographic changes currently occurring in the Polish population. Furthermore, it is necessary to increase the interest and motivation of patients to follow the recommendations of nutritional education, because it will bring tangible benefits for the long-term effects of therapy and care should be taken for the form and methodology of nutrition education implemented in health resort institutions. Finally it is necessary to construct an educational offer in terms of selected groups of patients with the highest health needs: the elderly and the disabled. In conclusion, it can be said that the system of nutritional education implemented in polish health resort institutions should be subjected to global changes and strong systemic correction.Keywords: health care system, nutritional education, public health, spa and treatment
Procedia PDF Downloads 1097007 Diagnosis of Static Eccentricity in 400 kW Induction Machine Based on the Analysis of Stator Currents
Authors: Saleh Elawgali
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Current spectrums of a four pole-pair, 400 kW induction machine were calculated for the cases of full symmetry and static eccentricity. The calculations involve integration of 93 electrical plus four mechanical ordinary differential equations. Electrical equations account for variable inductances affected by slotting and eccentricities. The calculations were followed by Fourier analysis of the stator currents in steady state operation. Zooms of the current spectrums, around the 50 Hz fundamental harmonic as well as of the main slot harmonic zone, were included. The spectrums included refer to both calculated and measured currents.Keywords: diagnostic, harmonic, induction machine, spectrum
Procedia PDF Downloads 5177006 Kinetics of Phytochemicals and Antioxidant Activity during Thermal Treatment of Cape Gooseberry (Physalis peruviana L)
Authors: Mary-Luz Olivares-Tenorio, Ruud Verkerk, Matthijs Dekker, Martinus A. J. S. van Boekel
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Cape gooseberry, the fruit of the plant Physalis peruviana L. has gained interest in research given its contents of promising health-promoting compounds like contents. The presence of carotenoids, ascorbic acid, minerals, polyphenols, vitamins and antioxidants. This project aims to study thermal stability of β-carotene, ascorbic acid, catechin and epicatechin and antioxidant activity in the matrix of the Cape Gooseberry. Fruits were obtained from a Colombian field in Cundinamarca. Ripeness stage was 4 (According to NTC 4580, corresponding to mature stage) at the moment of the experiment. The fruits have been subjected to temperatures of 40, 60, 80, 100 and 120°C for several times. β-Carotene, ascorbic acid, catechin and epicatechin content were assessed with HPLC and antioxidant activity with the DPPH method. β-Carotene was stable upon 100°C, and showed some degradation at 120°C. The same behavior was observed for epicatechin. Catechin increased during treatment at 40°C, at 60°C it remained stable and it showed degradation at 80°C, 100°C and 120°C that could be described by a second order kinetic model. Ascorbic acid was the most heat-sensitive of the analyzed compounds. It showed degradation at all studied temperatures, and could be described by a first order model. The activation energy for ascorbic acid degradation in cape gooseberry was 46.0 kJ/mol and its degradation rate coefficient at 100 °C was 6.53 x 10-3 s-1. The antioxidant activity declined for all studied temperatures. Results from this study showed that cape gooseberry is an important source of different health-promoting compounds and some of them are stable to heat. That makes this fruit a suitable raw material for processed products such as jam, juices and dehydrated fruit, giving the consumer a good intake of these compounds.Keywords: goldenberry, health-promoting compounds, phytochemical, processing, heat treatment
Procedia PDF Downloads 4467005 Neurotoxic Effects Assessment of Metformin in Danio rerio
Authors: Gustavo Axel Elizalde-Velázquez
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Metformin is the first line of oral therapy to treat type II diabetes and is also employed as a treatment for other indications, such as polycystic ovary syndrome, cancer, and COVID-19. Recent data suggest it is the aspirin of the 21st century due to its antioxidant and anti-aging effects. However, increasingly current articles indicate its long-term consumption generates mitochondrial impairment. Up to date, it is known metformin increases the biogenesis of Alzheimer's amyloid peptides via up-regulating BACE1 transcription, but further information related to brain damage after its consumption is missing. Bearing in mind the above, this work aimed to establish whether or not chronic exposure to metformin may alter swimming behavior and induce neurotoxicity in Danio rerio adults. For this purpose, 250 Danio rerio grown-ups were assigned to six tanks of 50 L of capacity. Four of the six systems contained 50 fish, while the remaining two had 25 fish (≈1 male:1 female ratio). Every system with 50 fish was allocated one of the three metformin treatment concentrations (1, 20, and 40 μg/L), with one system as the control treatment. Systems with 25 fish, on the other hand, were used as positive controls for acetylcholinesterase (10 μg/L of Atrazine) and oxidative stress (3 μg/L of Atrazine). After four months of exposure, a mean of 32 fish (S.D. ± 2) per group of MET treatment survived, which were used for the evaluation of behavior with the Novel Tank test. Moreover, after the behavioral assessment, we aimed to collect the blood and brains of all fish from all treatment groups. For blood collection, fish were anesthetized with an MS-222 solution (150 mg/L), while for brain gathering, fish were euthanized using the hypothermic shock method (2–4 °C). Blood was employed to determine CASP3 activity and the percentage of apoptotic cells with the TUNEL assay, and brains were used to evaluate acetylcholinesterase activity, oxidative damage, and gene expression. After chronic exposure, MET-exposed fish exhibited less swimming activity when compared to control fish. Moreover, compared with the control group, MET significantly inhibited the activity of AChE and induced oxidative damage in the brain of fish. Concerning gene expression, MET significantly upregulated the expression of Nrf1, Nrf2, BAX, p53, BACE1, APP, PSEN1, and downregulated CASP3 and CASP9. Although MET did not overexpress the CASP3 gene, we saw a meaningful rise in the activity of this enzyme in the blood of fish exposed to MET compared to the control group, which we then confirmed by a high number of apoptotic cells in the TUNEL assay. To the best of our understanding, this is the first study that delivers evidence of oxidative impairment, apoptosis, AChE alteration, and overexpression of B- amyloid-related genes in the brain of fish exposed to metformin.Keywords: AChE inhibition, CASP3 activity, NovelTank test, oxidative damage, TUNEL assay
Procedia PDF Downloads 797004 Evaluating Urban Land Expansion Using Geographic Information System and Remote Sensing in Kabul City, Afghanistan
Authors: Ahmad Sharif Ahmadi, Yoshitaka Kajita
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With massive population expansion and fast economic development in last decade, urban land has increasingly expanded and formed high informal development territory in Kabul city. This paper investigates integrated urbanization trends in Kabul city since the formation of the basic structure of the present city using GIS and remote sensing. This study explores the spatial and temporal difference of urban land expansion and land use categories among different time intervals, 1964-1978 and 1978-2008 from 1964 to 2008 in Kabul city. Furthermore, the goal of this paper is to understand the extent of urban land expansion and the factors driving urban land expansion in Kabul city. Many factors like population expansion, the return of refugees from neighboring countries and significant economic growth of the city affected urban land expansion. Across all the study area urban land expansion rate, population expansion rate and economic growth rate have been compared to analyze the relationship of driving forces with urban land expansion. Based on urban land change data detected by interpreting land use maps, it was found that in the entire study area the urban territory has been expanded by 14 times between 1964 and 2008.Keywords: GIS, Kabul city, land use, urban land expansion, urbanization
Procedia PDF Downloads 3277003 A Hybrid of BioWin and Computational Fluid Dynamics Based Modeling of Biological Wastewater Treatment Plants for Model-Based Control
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
Procedia PDF Downloads 2027002 Biocompatible Hydrogel Materials Containing Cytostatics for Cancer Treatment
Authors: S. Kudlacik-Kramarczyk, M. Kedzierska, B. Tyliszczak
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Recently, the continuous development of medicine and related sciences has been observed. Particular emphasis is directed on the development of biomaterials, i.e., non-toxic, biocompatible and biodegradable materials that may improve the effectiveness of treatment as well as the comfort of patients. This is particularly important in the case of cancer treatment. Currently, there are many methods of cancer treatment based primarily on chemotherapy and the surgical removal of the tumor, but it is worth noting that these therapies also cause many side effects. Among women, the most common cancer is breast cancer. It may be completely cured, but the consequence of treatment is partial or complete breast mastectomy and radiation therapy, which results in severe skin burns. The skin of the patient after radiation therapy is very burned, and therefore requires intensive care and high frequency of dressing changes. The traditional dressing adheres to the burn wounds and does not absorb adequate amount of exudate from injuries and the patient is forced to change the dressing every 2 hours. Therefore, the main purpose was to develop an innovative combination of dressing material with drug carriers that may be used in anti-cancer therapy. The innovation of this solution is the combination of these two products into one system, i.e., a transdermal system with the possibility of a controlled release of the drug- cytostatic. Besides, the possibility of modifying the hydrogel matrix with aloe vera juice provides this material with new features favorable from the point of view of healing processes of burn wounds resulting from the radiation therapy. In this study, hydrogel materials containing protein spheres with the active substance have been obtained as a result of photopolymerization process. The reaction mixture consisting of the protein (albumin) spheres incorporated with cytostatic, chitosan, adequate crosslinking agent and photoinitiator has been subjected to the UV radiation for 2 minutes. Prepared materials have been subjected to the numerous studies including the analysis of cytotoxicity using murine fibroblasts L929. Analysis was conducted based on the mitochondrial activity test (MTT reduction assay) which involves the determining the number of cells characterized by proper metabolism. Hydrogel materials obtained using different amount of crosslinking agents have been subjected to the cytotoxicity analysis. According to the standards, tested material is defined as cytotoxic when the viability of cells after 24 h incubation with this material is lower than 70%. In the research, hydrogel polymer materials containing protein spheres incorporated with the active substance, i.e. a cytostatic, have been developed. Such a dressing may support the treatment of cancer due to the content of the anti-cancer drug - cytostatic, and may also provide a soothing effect on the healing of the burn wounds resulted from the radiation therapy due to the content of aloe vera juice in the hydrogel matrix. Based on the conducted cytotoxicity studies, it may be concluded that the obtained materials do not adversely affect the tested cell lines, therefore they can be subjected to more advanced analyzes.Keywords: hydrogel polymers, cytostatics, drug carriers, cytotoxicity
Procedia PDF Downloads 1267001 Ozone Therapy for Disc Herniation: A Non-surgical Option
Authors: Shahzad Karim Bhatti
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Background: Ozone is a combination of oxygen and can be used in treatment of low back pain due to herniated disc. It is a minimally invasive procedure using biochemical properties of ozone resulting in reduced volume of disc and inflammation resulting in significant pain relief. Aim: The purpose of this study was to evaluate the effectiveness of ozone therapy in combination with peri-ganglionic injection of local anesthetic and corticosteroid. Material and Methods: This retrospective study was done at the Interventional Radiology Department of Mayo Hospital, Lahore. A total of 49000 patients were included from January 2008 to March 2022. All the patients presented with clinical signs and symptoms of lumber disc herniation, which was confirmed by a MRI scan of the lumbar sacral spine. The pain reduction was calculated using modified MacNab method. All the patients underwent percutaneous injection of ozone at a concentration of 27 micrograms/ml to lumber disc under fluoroscopic guidance with combination of local anesthetic and corticosteroid in peri-ganglionic space. Results were evaluated by two expert observers who were blinded to patient treatment. Results A satisfactory therapeutic outcome was obtained. 55% of the patients showed complete recovery with resolution of symptoms. 20% of the patients complained of occasional episodic pain with no limitation of occupational activity. 15% of cases showed insufficient improvement. 5% of cases had insufficient improvement and went for surgery. 10% of cases never turned up after the first visit. Conclusion Intradiscal ozone for the treatment of herniated discs has revolutionized percutaneous approach to nerve root compression making it safer, economical and easier to repeat without any side effects than treatments currently used in Pakistan.Keywords: pain, prolapse, Ozone, backpain
Procedia PDF Downloads 177000 Genistein Suppresses Doxorubicin Associated Genotoxicity in Human Lymphocytes
Authors: Tanveer Beg, Yasir H. Siddique, Gulshan Ara, Asfar S. Azmi, Mohammad Afzal
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Doxorubicin is a well-known DNA intercalating chemotherapy drug that is widely used for treatment of different cancers. Its clinical utility is limited due to the observed genotoxic side effects on healthy cells suggesting that newer combination and genoprotective regimens are urgently needed for the management of doxorubicin chemotherapy. Some dietary phytochemicals are well known for their protective mechanism of action and genistein from soy is recognized as an anti-oxidant with similar properties. Therefore, the present study investigates the effect of genistein against the genotoxic doses of doxorubicin by assessing chromosomal aberrations, sister chromatid exchanges, cell cycle kinetics, cell viability, apoptosis, and DNA damage markers in cultured human lymphocytes. Our results reveal that genistein treatment significantly suppresses genotoxic damage induced by doxorubicin. It is concluded that genistein has the potential to reduce the genotoxicity induced by anti-cancer drugs, thereby reducing the chances of developing secondary tumors during the therapy.Keywords: apoptosis, DNA damage markers, doxorubicin, genistein, genotoxicity, human lymphocyte culture
Procedia PDF Downloads 3546999 Cutaneous Crohn’s Disease in a Child: Atypical Axillary Involvement
Authors: A. Al Yousef, A. Toulon, L. Petit, S. Fraitag, F. Ruemmele, S. Hadj-Rabia, C. Bodemer
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Cutaneous Crohn’s disease (CCD) refers to an extremely rare granulomatous inflammation of the skin that is non-contiguous to the bowel tract. These cutaneous lesions can occur prior to, concurrent with, or after the gastrointestinal manifestations. In adults, CCD most frequently occurs in the setting of well-documented intestinal disease. Only 20% of cases occur prior to its development. Review of CCD in children, reveals that 86% of cases (24 of 28) occurring in patients without a known diagnosis of intestinal Crohn’s disease. Overall, the genitalia was the most commonly involved location, representing 21 of the 28 cases with 16 vulvar and 5 penile/scrotal lesions.Keywords: Crohn’s disease, cutaneous manifestations, children, atypical axillary involvement
Procedia PDF Downloads 276