Search results for: combined surgery

Authors: Ibrahim M Hassan, Lorna Que, Michael Rutland

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Type I SOD is usually diagnosed by anatomical imaging such as ultrasound, CT and MRCP. However, the types II and III SOD yield negative results despite the presence of significant symptoms. In particular, the type III is difficult to diagnose due to the absence of significant biochemical or anatomical abnormalities. Nuclear Medicine can aid in this diagnostic dilemma by demonstrating functional changes in the bile flow. Low dose Morphine (0.04mg/Kg) stimulates the tone of the sphincter of Oddi (SO) and its usefulness has been shown in diagnosing SOD by causing a delay in bile flow when compared to a non morphine provoked - baseline scan. This work expands on that process by using sublingual GTN at 60 minutes post tracer and morphine injection to relax the SO and induce an improvement in bile outflow, and in some cases show immediate relief of morphine induced abdominal pain. The criteria for positive SOD are as follows: if during the first hour of the morphine provocation showed (1) delayed intrahepatic biliary ducts tracer accumulation; plus (2) delayed appearance but persistent retention of activity in the common bile duct, and (3) delayed bile flow into the duodenum. In addition, patients who required GTN within the first hour to relieve abdominal pain were regarded as highly supportive of the diagnosis. Retrospective analysis of 85 patients (pts) (78F and 6M) referred for suspected SOD (type III) who had been intensively investigated because of recurrent right upper quadrant or abdominal pain post cholecystectomy. 99mTc-HIDA scan with morphine-provocation is performed followed by GTN at 60 minutes post tracer injection and a further thirty minutes of dynamic imaging are acquired. 30 pts were negative. 55 pts were regarded as positive for SOD and 38/55 (60%) of these patients with an abnormal result were further evaluated with a baseline 99mTc-HIDA. As expected, all 38 pts showed better bile flow characteristics than during the morphine provocation. 20/55 (36%) patients were treated by ERCP sphincterotomy and the rest were managed conservatively by medical therapy. In all cases regarded as positive for SOD, the sublingual GTN at 60 minutes showed immediate improvement in bile flow. 11/55(20%) who developed severe post-morphine abdominal pain were relieved by GTN almost instantaneously. We propose that GTN is a useful agent in the diagnosis of SOD when performing 99mTc-HIDA scan and that the satisfactory response to the sublingual GTN could offer additional information in patients who have severe pain at the time the procedure or when presenting to the emergency unit because of biliary pain. And also in determining whether a trial of medical therapy may be used before considering surgery.

Keywords: GTN, HIDA, MORPHINE, SOD

Procedia PDF Downloads 296

Authors: Racheli Magnezi, Inbal Gazit, Michal Rassin, Joseph Barr, Orna Tal

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An effective process for transmitting patient critical information is essential for patient safety and for improving communication among healthcare staff. Previous studies have discussed handover tools such as SBAR (Situation, Background, Assessment, Recommendation) or SOFI (Short Observational Framework for Inspection). Yet, these formats lack flexibility, and require special training. In addition, nurses and physicians have different procedures for handing over information. The objectives of this study were to establish a universal, structured tool for handover, for both physicians and nurses, based on parameters that were defined as ‘important’ and ‘appropriate’ by the medical team, and to implement this tool in various hospital departments, with flexibility for each ward. A questionnaire, based on established procedures and on the literature, was developed to assess attitudes towards the most important information for effective handover between shifts (Cronbach's alpha 0.78). It was distributed to 150 senior physicians and nurses in 62 departments. Among senior medical staff, 12 physicians and 66 nurses responded to the questionnaire (52% response rate). Based on the responses, a handover form suitable for all hospital departments was designed and implemented. Important information for all staff included: Patient demographics (full name and age); Health information (diagnosis or patient complaint, changes in hemodynamic status, new medical treatment or equipment required); and Social Information (suspicion of violence, mental or behavioral changes, and guardianship). Additional information relevant to each unit included treatment provided, laboratory or imaging required, and change in scheduled surgery in surgical departments. ICU required information on background illnesses, Pediatrics required information on diet and food provided and Obstetrics required the number of days after cesarean section. Based on the model described, a flexible tool was developed that enables handover of both common and unique information. In addition, it includes general logistic information that must be transmitted to the next shift, such as planned disruptions in service or operations, staff training, etc. Development of a simple, clear, comprehensive, universal, yet flexible tool designed for all medical staff for transmitting critical information between shifts was challenging. Physicians and nurses found it useful and it was widely implemented. Ongoing research is needed to examine the efficiency of this tool, and whether the enthusiasm that accompanied its initial use is maintained.

Keywords: handover, nurses, hospital, critical information

Procedia PDF Downloads 243

Authors: Ahmad Lutfi, Nikolas Dhega

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The Malala deposit in northwest Sulawesi is the only known porphyry molybdenum and the only source for rhenium, occurrence in Indonesia. The neural network method produces results that correspond very closely to those of the knowledge-based fuzzy logic method and weights of evidence method. This method required data of solid geology, regional faults, airborne magnetic, gamma-ray survey data and GIS data. This interpretation of the network output fits with the intuitive notion that a prospective area has characteristics that closely resemble areas known to contain mineral deposits. Contrasts with the weights of evidence and fuzzy logic methods, where, for a given grid location, each input-parameter value automatically results in an increase in the prospective estimated. Malala District indicated molybdenum anomalies in stream sediments from in excess of 15 km2 were obtained, including the Takudan Fault as most prominent structure with striking 40̊ to 60̊ over a distance of about 30 km and in most places weakly at anomaly B, developed over an area of 4 km2, with a ‘shell’ up to 50 m thick at the intrusive contact with minor mineralization occurring in the Tinombo Formation. Series of NW trending, steeply dipping fracture zones, named the East Zone has an estimated resource of 100 Mt at 0.14% MoS2 and minimum target of 150 Mt 0.25%. The Malala porphyries occur as stocks and dykes with predominantly granitic, with fluorine-poor class of molybdenum deposits and belongs to the plutonic sub-type. Unidirectional solidification textures consisting of subparallel, crenulated layers of quartz that area separated by layers of intrusive material textures. The deuteric nature of the molybdenum mineralization and the dominance of carbonate alteration.The nature of the Stage I with alteration barren quartz K‐feldspar; and Stage II with alteration quartz‐K‐feldspar‐apatite-molybdenite veins combined with the presence of disseminated molybdenite with primary biotite in the host intrusive.

Keywords: molybdenite, Malala, porphyries, anomaly B

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Authors: Ayman Mutahar Alrassas, Shaoran Ren, Renyuan Ren, Hung Vo Thanh, Mohammed Hail Hakimi, Zhenliang Guan

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The significant effect of CO₂ on global climate and the environment has gained more concern worldwide. Enhance oil recovery (EOR) associated with sequestration of CO₂ particularly into the depleted oil reservoir is considered the viable approach under financial limitations since it improves the oil recovery from the existing oil reservoir and boosts the relation between global-scale of CO₂ capture and geological sequestration. Consequently, practical measurements are required to attain large-scale CO₂ emission reduction. This paper presents an integrated modeling workflow to construct an accurate 3D reservoir geological model to estimate the storage capacity of CO₂ under geological uncertainty in an unconventional oil reservoir of the Paleogene Shahejie Formation (Es1) in the block Nv32, Shenvsi oilfield, China. In this regard, geophysical data, including well logs of twenty-two well locations and seismic data, were combined with geological and engineering data and used to construct a 3D reservoir geological modeling. The geological modeling focused on four tight reservoir units of the Shahejie Formation (Es1-x1, Es1-x2, Es1-x3, and Es1-x4). The validated 3D reservoir models were subsequently used to calculate the theoretical CO₂ storage capacity in the block Nv32, Shenvsi oilfield. Well logs were utilized to predict petrophysical properties such as porosity and permeability, and lithofacies and indicate that the Es1 reservoir units are mainly sandstone, shale, and limestone with a proportion of 38.09%, 32.42%, and 29.49, respectively. Well log-based petrophysical results also show that the Es1 reservoir units generally exhibit 2–36% porosity, 0.017 mD to 974.8 mD permeability, and moderate to good net to gross ratios. These estimated values of porosity, permeability, lithofacies, and net to gross were up-scaled and distributed laterally using Sequential Gaussian Simulation (SGS) and Simulation Sequential Indicator (SIS) methods to generate 3D reservoir geological models. The reservoir geological models show there are lateral heterogeneities of the reservoir properties and lithofacies, and the best reservoir rocks exist in the Es1-x4, Es1-x3, and Es1-x2 units, respectively. In addition, the reservoir volumetric of the Es1 units in block Nv32 was also estimated based on the petrophysical property models and fund to be between 0.554368

Keywords: CO₂ storage capacity, 3D geological model, geological uncertainty, unconventional oil reservoir, block Nv32

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Authors: P. R. Chauhan, S. K. Tyagi

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Adsorption refrigeration technology offers a sustainable and energy-efficient cooling alternative over traditional refrigeration technologies for meeting the fast-growing cooling demands. With its ability to utilize natural refrigerants, low-grade heat sources, and modular configurations, it has the potential to revolutionize the cooling industry. Despite these benefits, the commercial viability of this technology is hampered by several fundamental limiting constraints, including its large size, low uptake capacity, and poor performance as a result of deficient heat and mass transfer characteristics. The primary cause of adequate heat and mass transfer characteristics and magnitude of exergy loss in various real processes of adsorption cooling system can be assessed by the entropy generation rate analysis, i. e. Second law of Thermodynamics. Therefore, this article presents the second law of thermodynamic-based investigation in terms of entropy generation rate (EGR) to identify the energy losses in various processes of the HPCC-based adsorption system using MATLAB R2021b software. The adsorption technology-based cooling system consists of two beds made up of silica gel and arranged in a single stage, while the water is employed as a refrigerant, coolant, and hot fluid. The variation in process-wise EGR is examined corresponding to cycle time, and a comparative analysis is also presented. Moreover, the EGR is also evaluated in the external units, such as the heat source and heat sink unit used for regeneration and heat dump, respectively. The research findings revealed that the combination of adsorber and desorber, which operates across heat reservoirs with a higher temperature gradient, shares more than half of the total amount of EGR. Moreover, the EGR caused by the heat transfer process is determined to be the highest, followed by a heat sink, heat source, and mass transfer, respectively. in case of heat transfer process, the operation of the valve is determined to be responsible for more than half (54.9%) of the overall EGR during the heat transfer. However, the combined contribution of the external units, such as the source (18.03%) and sink (21.55%), to the total EGR, is 35.59%. The analysis and findings of the present research are expected to pinpoint the source of the energy waste in HPCC based adsorption cooling systems.

Keywords: adsorption cooling cycle, heat transfer, mass transfer, entropy generation, silica gel-water

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Authors: Xianghong Lu, Yuejun Wang, Chengshi Gan, Xin Qian

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The North Sulawesi Arc, located on the east of Indonesia and to the south of the Celebes Sea, is the north part of the K-shape of Sulawesi Island and has a complex tectonic history since the Cenozoic due to the convergence of three plates (Eurasia, India-Australia and Pacific plates). Published rock records contain less precise chronology, mostly using K-Ar dating, and rare geochemistry data, which limit the understanding of the regional tectonic setting. This study presents detailed zircon U-Pb geochronological and Hf-O isotope and whole-rock geochemical analyses for the Na-rich granites from the North Sulawesi Arc. Zircon U-Pb geochronological analyses of three representative samples yield weighted mean ages of 30.4 ± 0.4 Ma, 29.5 ± 0.2 Ma, and 27.3 ± 0.4 Ma, respectively, revealing the Oligocene magmatism in the North Sulawesi Arc. The samples have high Na₂O and low K₂O contents with high Na₂O/K₂O ratios, belonging to Low-K tholeiitic Na-rich granites. The Na-rich granites are characterized by high SiO₂ contents (75.05-79.38 wt.%) and low MgO contents (0.07-0.91 wt.%) and show arc-like trace elemental signatures. They have low (⁸⁷Sr/⁸⁶Sr)i ratios (0.7044-0.7046), high εNd(t) values (from +5.1 to +6.6), high zircon εHf(t) values (from +10.1 to +18.8) and low zircon δ18O values (3.65-5.02). They show an Indian-Ocean affinity of Pb isotopic compositions with ²⁰⁶Pb/²⁰⁴Pb ratio of 18.16-18.37, ²⁰⁷Pb/²⁰⁴Pb ratio of 15.56-15.62, and ²⁰⁸Pb/²⁰⁴Pb ratio of 38.20-38.66. These geochemical signatures suggest that the Oligocene Na-rich granites from the North Sulawesi Arc formed by partial melting of the juvenile oceanic crust with sediment-derived fluid-related metasomatism in a subducting setting and support an intra-oceanic arc origin. Combined with the published study, the emergence of extensive calc-alkaline felsic arc magmatism can be traced back to the Early Oligocene period, subsequent to the Eocene back-arc basalts (BAB) that share similarity with the Celebes Sea basement. Since the opening of the Celebes Sea started from the Eocene (42~47 Ma) and stopped by the Early Oligocene (~32 Ma), the geodynamical mechanism of the formation of the Na-rich granites from the North Sulawesi Arc during the Oligocene might relate to the subduction of the Indian Ocean.

Keywords: North Sulawesi Arc, oligocene, Na-rich granites, in-situ zircon Hf–O analysis, intra-oceanic origin

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Authors: Mitesh Rathod, Jungho Ahn, Noo Li Jeon, Junghoon Lee

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Endothelial cells respond to cues from both biochemical as well as micro mechanical environment. Significant effort has been directed to understand the effects of biochemical signaling, however, relatively little is known about regulation of endothelial cell biology by the micro mechanical environment. Numerous studies have been performed to understand how physical forces regulate endothelial cell behavior. In this regard, past studies have majorly focused on exploring how fluid shear stress governs endothelial cell behavior. Parallel plate flow chambers and rectangular microchannels are routinely employed for applying fluid shear force on endothelial cells. However, these studies fall short in mimicking the in vivo like micro environment from topological aspects. Few studies have only used circular microchannels to replicate in vivo like condition. Seldom efforts have been directed to elucidate the combined effect of topology, substrate rigidity and fluid shear stress on endothelial cell response. In this regard, we demonstrate a facile fabrication process to develop a hybrid polydimethylsiloxane microfluidic platform to study endothelial cell biology. On a single chip microchannels with different cross sections i.e., circular, rectangular and square have been fabricated. In addition, our fabrication approach allows variation in the substrate rigidity along the channel length. Two different variants of polydimethylsiloxane, namely Sylgard 184 and Sylgard 527, were utilized to achieve the variation in rigidity. Moreover, our approach also enables in creating Y bifurcation circular microchannels. Our microfluidic platform thus facilitates for conducting studies pertaining to endothelial cell morphology with respect to change in topology, substrate rigidity and fluid flow on a single chip. The hybrid platform was tested by culturing Human Umbilical Vein Endothelial Cells in circular microchannels with varying substrate rigidity, and exposed to fluid shear stress of 12 dynes/cm² and static conditions. Results indicate the cell area response to flow induced shear stress was governed by the underlying substrate mechanics.

Keywords: hybrid, microfluidic platform, PDMS, shear flow, substrate rigidity

Procedia PDF Downloads 268

Authors: H. Kamide, T. Arai

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This study aims to clarify factors of courtesy to things and the effect of courtesy on a sense of unity with things based on the teaching of Buddha. The teaching of Buddha explains when dealing with things in a courteous manner carefully, the border between selves and the external world disappears, then both are united. This is an example in Buddhist way that explains the connections with all existences, and in the modern world, it is also a lesson that humans should not let matters go to waste and treat them politely. In order to reveal concrete ways to practice courtesy to things, we clarify the factors of courtesy (Study 1) and examine the effect of courtesy on the sense of unity with the things (Study 2). In Study 1, 100 Japanese (mean age=54.39, SD=15.04, 50% female) described freely about what is courtesy to things that they use daily. These descriptions were classified, and 25 items were made asking for the degree of courtesy to the things. Then different 678 Japanese (mean age=44.72, SD=13.14, 50% female) answered the 25 items on 7-point about tools they use daily. An exploratory factor analysis revealed two factors. The first factor (α=.97) includes 'I deal with the thing carefully' and 'I clean up the thing after use'. This factor reflects how gently people care about things. The second factor (α=.96) includes 'A sense of self-control has come to me through using the thing' and 'I have got inner strength by taking care of the thing'. The second factor reflects how people learn by dealing with things carefully. In this Study 2, 200 Japanese (mean age=49.39, SD=11.07, 50% female) answered courtesy about things they use daily and the degree of sense of unity with the things using the inclusion of other in the self scale, replacing 'Other' with 'Your thing'. The ANOVA was conducted to examine the effect of courtesy (high/low level of two factors) on the score of sense of unity. The results showed the main effect of care level. People with a high level of care have a stronger sense of unity with the thing. The tendency of an interaction effect is also found. The condition with a high level of care and a high level of learning enhances the sense of unity more than the condition of a low level of care and high level in learning. Study 1 found that courtesy is composed of care and learning. That is, courtesy is not only active care to the things but also to learn the meaning of the things and grow personally with the things. Study 2 revealed that people with a high level of care feel a stronger sense of unity and also people with both a high level of care and learn tend to do so. The findings support the idea of the teaching of Buddha. In the future, it is necessary to examine a combined effect of care and learning.

Keywords: courtesy, things, sense of unity, the teaching of Buddha

Procedia PDF Downloads 146

Authors: Alena O. Stepanova, Vera S. Chernonosova, Tatyana S. Godovikova, Konstantin A. Bulatov, Andrey Y. Patrushev, Pavel P. Laktionov

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Trauma and arthrosis, not to mention cartilage destruction in overweight and elders put hyaline cartilage lesion among the most frequent diseases of locomotor system. These problems combined with low regeneration potential of the cartilage make regeneration of articular cartilage a high-priority task of tissue engineering. Many types of matrices, the procedures of their installation and autologous chondrocyte implantation protocols were offered, but certain aspects including adhesion of the implant with surrounding cartilage/bone, prevention of the ossification and fibrosis were not resolved. Simplification and acceleration of the procedures resulting in restoration of normal cartilage are also required. We have demonstrated that human chondroblasts can be successfully cultivated at the surface of electrospun scaffolds and produce extracellular matrix components in contrast to chondroblasts grown in homogeneous hydrogels. To restore cartilage we offer to use stacks of electrospun scaffolds fixed with photopolymerized solution of prepared from gelatin and chondroitin-4-sulfate both modified by glycidyl methacrylate and non-toxic photoinitator Darocur 2959. Scaffolds were prepared from nylon 6, polylactide-co-glicolide and their mixtures with modified gelatin. Illumination of chondroblasts in photopolymerized solution using 365 nm LED light had no effect on cell viability at compressive strength of the gel less than0,12 MPa. Stacks of electrospun scaffolds provide good compressive strength and have the potential for substitution with cartilage when biodegradable scaffolds are used. Vascularization can be prevented by introduction of biostable scaffolds in the layers contacting the subchondral bone. Studies of two-component materials (2-3 sheets of electrospun scaffold) implanted in the knee-joints of rabbits and fixed by photopolymerization demonstrated good crush resistance, biocompatibility and good adhesion of the implant with surrounding cartilage. Histological examination of the implants 3 month after implantation demonstrates absence of any inflammation and signs of replacement of the biodegradable scaffolds with normal cartilage. The possibility of intraoperative population of the implants with autologous cells is being investigated.

Keywords: chondroblasts, electrospun scaffolds, hyaline cartilage, photopolymerized gel

Procedia PDF Downloads 275

Authors: Farnia Nayar Parshi, Mohammad Shariful Islam

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Though earth construction is an ancient technology, researchers are working on increasing its strength by adding different types of stabilizers. Ordinary Portland cement for sandy soil and lime for clayey soil is very popular practice as well as recommended by various authorities for making stabilized blocks for satisfactory performance. The addition of these additives improves compressive strength but fails to improve ductility. The addition of both synthetic and natural fibers increases both compressive strength and ductility. Studies are conducted to make earth blocks more cost-effective, energy-efficient and sustainable. In this experiment, an agricultural waste banana fiber and biochar is used to study the compressive stress-strain behavior of earth blocks made with four types of soil low plastic clay, sandy low plastic clay, very fine sand and medium to fine sand. Biochar is a charcoal-like carbon usually produced from organic or agricultural waste in high temperatures through a controlled condition called pyrolysis. In this experimental study, biochar was collected from BBI (Bangladesh Biochar Initiative) produced from wood flakes around 400 deg. Celsius. Locally available PPC (Portland Pozzolana Cement) is used. 5 cm × 5 cm × 5 cm earth blocks were made with eight different combinations such as bare soil, soil with 6% cement, soil with 6% cement and 5% biochar, soil with 6% cement, 5% biochar and 1% fiber, soil with 1% fiber, soil with 5% biochar and 1% fiber and soil with 6% cement and 1% fiber. All samples were prepared with 10-12% water content. Uniaxial compressive strength tests were conducted on 21 days old earth blocks. Stress-strain diagram shows that the addition of banana fiber improved compressive strength drastically, but the combined effect of fiber and biochar is different based on different soil types. For clayey soil, 6% cement and 1% fiber give maximum compressive strength of 991 kPa, and for very fine sand, a combination of 5% biochar, 6% cement and 1% fiber gives maximum compressive strength of 522 kPa as well as ductility. For medium-to-find sand, 6% cement and 1% fiber give the best result, 1530 kPa, among other combinations. The addition of fiber increases not only ductility but also compressive strength as well. The effect of biochar with fiber varies with the soil type.

Keywords: banana fiber, biochar, cement, compressed stabilized earth blocks, compressive strength

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Authors: Rajish Shil, Mohammad Ali Houri, Mohammad Milad Ismail, Fatimah Al Kaabi

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The clinical presentation of Primary hyperparathyroidism can vary from simple asymptomatic hypercalcemia to severe life-threatening hypercalcemic crisis with multi-organ dysfunction, which can be due to parathyroid adenoma or sometimes with malignant cancer. This cascade of clinical presentation can lead to a diagnostic and therapeutic challenge for treating the disease. We are presenting a case of severe hypercalcemic crisis due to parathyroid adenoma with an emphasis on early management, diagnosis, and interventions to prevent any lifelong complications and any permanent organ dysfunction. A 30 years old female with a history of primary Infertility, admitted to Al Ain Hospital critical care unit with Acute Severe Necrotizing Pancreatitis. She initially had a 1-month history of abdominal pain on and off, for which she was treated conservatively with no much improvement, and later on, she developed life-threatening severe pancreatitis, which required her to be admitted to the critical care unit. She was transferred from a private healthcare facility, where she was found to have a very high level of calcium up to 15mmol/L. She received systemic Zoledronic Acid, which lowered her calcium level transiently and later was increased again. She went on to develop multiple end-organ damages along with multiple electrolytes disturbances. She was found to have high levels of Parathyroid hormone, which was correlated with a parathyroid mass on the neck via radiological imaging. After a long course of medical treatment to lower the calcium to a near-normal level, parathyroidectomy was done, which showed parathyroid adenoma on histology. She developed hungry bone syndrome after the surgery and pancreatic pseudocyst after resolving of pancreatitis. She required aggressive treatment with Intravenous calcium for her hypocalcemia as she received zoledronic acid at the beginning of the disease. Later on, she was discharged on long term calcium and other electrolytes supplements. In patients presenting with hypercalcemia, it is prudent to investigate and start treatment early to prevent complications and end-organ damage from hypercalcemia and also to treat the primary cause of the hypercalcemia, with conscious follow up to prevent hypocalcemic complications after treatment. It is important to follow up patients with parathyroid adenomas for a long period in order to detect any recurrence of the tumor or to make sure if the primary tumor is either benign or malignant.

Keywords: hypercalcemia, pancreatitis, hypocalcemia, hyperparathyroidism

Procedia PDF Downloads 118

Authors: Amanda J. Burridge, Keith J. Edwards, Paul A. Wilkinson, Tom Batstone, Erik H. Murchie, Lorna McAusland, Ana Elizabete Carmo-Silva, Ivan Jauregui, Tracy Lawson, Silvere R. M. Vialet-Chabrand

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The rate of genetic progress in wheat production must be improved to meet global food security targets. However, past selection for domestication traits has reduced the genetic variation in modern wheat cultivars, a fact that could severely limit the future rate of genetic gain. The genetic variation in agronomically important traits for the wild relatives and progenitors of wheat is far greater than that of the current domesticated cultivars, but transferring these traits into modern cultivars is not straightforward. Between the elite cultivars of wheat, photosynthetic capacity is a key trait for which there is limited variation. Early screening of wheat wild relative and progenitors has shown differences in photosynthetic capacity and efficiency not only between wild relative species but marked differences between the accessions of each species. By identifying wild relative accessions with improved photosynthetic traits and characterising the genetic variation responsible, it is possible to incorporate these traits into advanced breeding programmes by wide crossing and introgression programmes. To identify the potential variety of photosynthetic capacity and efficiency available in the secondary and tertiary genepool, a wide scale survey was carried out for over 600 accessions from 80 species including those from the genus Aegilops, Triticum, Thinopyrum, Elymus, and Secale. Genotype data were generated for each accession using a ‘Wheat Wild Relative’ Single Nucleotide Polymorphism (SNP) genotyping array composed of 35,000 SNP markers polymorphic between wild relatives and elite hexaploid wheat. This genotype data was combined with phenotypic measurements such as gas exchange (CO₂, H₂O), chlorophyll fluorescence, growth, morphology, and RuBisCO activity to identify potential breeding material with enhanced photosynthetic capacity and efficiency. The data and associated analysis tools presented here will prove useful to anyone interested in increasing the genetic diversity in hexaploid wheat or the application of complex genotyping data to plant breeding.

Keywords: wheat, wild relatives, pre-breeding, genomics, photosynthesis

Procedia PDF Downloads 211

Authors: Jacques Cuenca, Claudio Colangeli, Agnieszka Mroz, Karl Janssens, Gunther Riexinger, Antonio D'Antuono, Giuseppe Pandarese, Milena Martarelli, Gian Marco Revel, Carlos Barcena Martin

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This study presents an on-site acoustic inspection methodology for quality and performance evaluation of building components. The work focuses on global and detailed sound source localisation, by successively performing acoustic beamforming and sound intensity measurements. A portable experimental setup is developed, consisting of an omnidirectional broadband acoustic source and a microphone array and sound intensity probe. Three main acoustic indicators are of interest, namely the sound pressure distribution on the surface of components such as walls, windows and junctions, the three-dimensional sound intensity field in the vicinity of junctions, and the sound transmission loss of partitions. The measurement data is post-processed and converted into a three-dimensional numerical model of the acoustic indicators with the help of the simultaneously acquired geolocation information. The three-dimensional acoustic indicators are then integrated into an augmented reality platform superimposing them onto a real-time visualisation of the spatial environment. The methodology thus enables a measurement-supported inspection process of buildings and the correction of errors during construction and refurbishment. Two experimental validation cases are shown. The first consists of a laboratory measurement on a full-scale mockup of a room, featuring a prefabricated panel. The latter is installed with controlled defects such as lack of insulation and joint sealing material. It is demonstrated that the combined acoustic and augmented reality tool is capable of identifying acoustic leakages from the building defects and assist in correcting them. The second validation case is performed on a prefabricated room at a near-completion stage in the factory. With the help of the measurements and visualisation tools, the homogeneity of the partition installation is evaluated and leakages from junctions and doors are identified. Furthermore, the integration of acoustic indicators together with thermal and geometrical indicators via the augmented reality platform is shown.

Keywords: acoustic inspection, prefabricated building components, augmented reality, sound source localization

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Authors: Suleman Maliha, Suleman Sidra

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Obstructive sleep apnea (OSA) is a sleep disorder that can result in behavioral and psychomotor impairments in children. The classical treatment modalities for OSA have been continuous positive airway pressure and adenotonsillectomy. However, orthodontic intervention through rapid maxillary expansion (RME) has also been commonly used to manage skeletal transverse maxillary discrepancies. Aim and objectives: The aim of this study is to determine the efficacy of rapid maxillary expansion in paediatric patients with obstructive sleep apnea by assessing pre and post-treatment mean apnea-hypopnea index (AHI) and oxygen saturations. Methodology: Literature was identified through a rigorous search of the Embase, Pubmed, and CINAHL databases. Articles published from 2012 onwards were selected. The inclusion criteria consisted of patients aged 18 years and under with no systemic disease, adenotonsillar surgery, or hypertrophy who are undergoing RME with AHI measurements before and after treatment. In total, six suitable papers were identified. Results: Three studies assessed patients pre and post-RME at 12 months. The first study consisted of 15 patients with an average age of 7.5 years. Following treatment, they found that RME resulted in both higher oxygen saturations (+ 5.3%) and improved AHI (- 4.2 events). The second study assessed 11 patients aged 5–8 years and also noted improvements, with mean AHI reduction from 6.1 to 2.4 and oxygen saturations increasing from 93.1% to 96.8%. The third study reviewed 14 patients aged 6–9 years and similarly found an AHI reduction from 5.7 to 4.4 and an oxygen saturation increase from 89.8% to 95.5%. All modifications noted in these studies were statistically significant. A long-term study reviewed 23 patients aged 6–12 years post-RME treatment on an annual basis for 12 years. They found that the mean AHI reduced from 12.2 to 0.4, with improved oxygen saturations from 78.9% to 95.1%. Another study assessed 19 patients aged 9-12 years at two months into RME and four months post-treatment. Improvements were also noted at both stages, with an overall reduction of the mean AHI from 16.3 to 0.8 and an overall increase in oxygen saturations from 77.9% to 95.4%. The final study assessed 26 children aged 7-11 years on completion of individual treatment and found an AHI reduction from 6.9 to 5.3. However, the oxygen saturation remained stagnant at 96.0%, but this was not clinically significant. Conclusion: Overall, the current evidence suggests that RME is a promising treatment option for paediatric patients with OSA. It can provide efficient and conservative treatment; however, early diagnosis is crucial. As there are various factors that could be contributing to OSA, it is important that each case is treated on its individual merits. Going forward, there is a need for more randomized control trials with larger cohorts being studied. Research into the long-term effects of RME and potential relapse amongst cases would also be useful.

Keywords: orthodontics, sleep apnea, maxillary expansion, review

Procedia PDF Downloads 76

Authors: Shameel Pervez, Saad Aziz Durrani, Ibatsam Khokhar

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Pectinase is an enzyme that breaks down pectin, a compound responsible for structural integrity of the plant. Pectin is difficult to break down mechanically and the cost is very high, that is why many industries including food industries use pectinase enzyme produced by microbes for pectin breakdown. Apple (Malus domestica) is an important fruit in terms of market value. Every year, millions of apples are wasted due to post-harvest rot caused by fungi. Fungi are natural decomposers of our ecosystem and are infamous for post-harvest rot of apple fruit but at the same time they are prized for their high production of valuable extracellular enzymes such as pectinase. In this study, fungi belonging to different genus were isolated from rotten apples. Rotten samples of apple were picked from different markets of Lahore. After surface sterilization, the rotten parts were cut into small pieces and placed onto MEA media plates for three days. Afterwards, distinct colonies were picked and purified by sub-culturing. The isolates were identified to genus level through the study of basic colony morphology and microscopic features. The isolates were then subjected to screening for pectinase activity on MS media to compare pectinase production and were then subsequently tested for pathogenic activity through wound suspension method to evaluate the pathogenic activity of isolates in comparison with their pectinolytic activity. A total of twelve fungal strains were isolates from rotten apples. They were belonging to genus Penicillium, Alternaria, Paecilomyces and Rhizopus. Upon screening for pectinolytic activity, isolates Pen 1, Pen 4, and Rz showed high pectinolytic activity and were further subjected to DNA isolation and partial sequencing for species identification. The results of partial sequencing were combined with in-depth study of morphological features revealing Pen 1 as Penicillium janthinellum, Pen 4 as Penicillium griseofulvum, and Rz as Rhizopus microsporus. Pathogenic activity of all twelve isolates was evaluated. Penicillium spp. were highly pathogenic and destructive and same was the case with Paecilomyces sp. and Rhizopus sp. However, Alternaria spp. were found to be more consistent in their pathogenic activity, on all types of apples.

Keywords: apple, pectinase, fungal pathogens, penicillium, rhizopus

Procedia PDF Downloads 56

Authors: Ruth Diego, Luis M. Romeo, Antonio Morán

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In the present work, a study of the coupling of a Bioelectrochemical System together with an oxy-combustion boiler is carried out; specifically, it proposes to connect the combustion gas outlet of a boiler with a microbial electrolysis cell (MEC) where the CO2 from the gases are transformed into methane in the cathode chamber, and the oxygen produced in the anode chamber is recirculated to the oxy-combustion boiler. The MEC mainly consists of two electrodes (anode and cathode) immersed in an aqueous electrolyte; these electrodes are separated by a proton exchange membrane (PEM). In this case, the anode is abiotic (where oxygen is produced), and it is at the cathode that an electroactive biofilm is formed with microorganisms that catalyze the CO2 reduction reactions. Real data from an oxy-combustion process in a boiler of around 20 thermal MW have been used for this study and are combined with data obtained on a smaller scale (laboratory-pilot scale) to determine the yields that could be obtained considering the system as environmentally sustainable energy storage. In this way, an attempt is made to integrate a relatively conventional energy production system (oxy-combustion) with a biological system (microbial electrolysis cell), which is a challenge to be addressed in this type of new hybrid scheme. In this way, a novel concept is presented with the basic dimensioning of the necessary equipment and the efficiency of the global process. In this work, it has been calculated that the efficiency of this power-to-gas system based on MEC cells when coupled to industrial processes is of the same order of magnitude as the most promising equivalent routes. The proposed process has two main limitations, the overpotentials in the electrodes that penalize the overall efficiency and the need for storage tanks for the process gases. The results of the calculations carried out in this work show that certain real potentials achieve an acceptable performance. Regarding the tanks, with adequate dimensioning, it is possible to achieve complete autonomy. The proposed system called OxyMES provides energy storage without energetically penalizing the process when compared to an oxy-combustion plant with conventional CO2 capture. According to the results obtained, this system can be applied as a measure to decarbonize an industry, changing the original fuel of the oxy-combustion boiler to the biogas generated in the MEC cell. It could also be used to neutralize CO2 emissions from industry by converting it to methane and then injecting it into the natural gas grid.

Keywords: microbial electrolysis cells, oxy-combustion, co2, power-to-gas

Procedia PDF Downloads 102

Authors: Anuschka Curran, Sandra Barnard

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Coral reefs are of the most diverse and productive ecosystems on the planet, but due to the impact of climate change, these infrastructures are dying off primarily through coral bleaching. Coral bleaching can be described as the process by which zooxanthellae (algal endosymbionts) are expelled from the gastrodermal cavity of the respective coral host, causing increased coral whitening. The general consensus is that mass coral bleaching is due to the dysfunction of photosynthetic processes in the zooxanthellae as a result of the combined action of elevated temperature and light-stress. The question then is, do zooxanthellae have the potential to play a key role in the future of coral reef restoration through genetic engineering? The aim of this study is firstly to review the different zooxanthellae taxa and their traits with respect to environmental stress, and secondly, to review the information available on the protective mechanisms present in zooxanthellae cells when experiencing temperature fluctuations, specifically concentrating on heat shock proteins and the antioxidant stress response of zooxanthellae. The eight clades (A-H) previously recognized were redefined into seven genera. Different zooxanthellae taxa exhibit different traits, such as their photosynthetic stress responses to light and temperature. Zooxanthellae have the ability to determine the amount and type of heat shock proteins (hsps) present during a heat response. The zooxanthellae can regulate both the host’s respective hsps as well as their own. Hsps, generally found in genotype C3 zooxanthellae, such as Hsp70 and Hsp90, contribute to the thermal stress response of the respective coral host. Antioxidant activity found both within exposed coral tissue, and the zooxanthellae cells can prevent coral hosts from expelling their endosymbionts. The up-regulation of gene expression, which may mitigate thermal stress induction of any of the physiological aspects discussed, can ensure stable coral-zooxanthellae symbiosis in the future. It presents a viable alternative strategy to preserve reefs amidst climate change. In conclusion, despite their unusual molecular design, genetic engineering poses as a useful tool in understanding and manipulating variables and systems within zooxanthellae and therefore presents a solution that can ensure stable coral-zooxanthellae symbiosis in the future.

Keywords: antioxidant enzymes, genetic engineering, heat-shock proteins, Symbiodinium

Procedia PDF Downloads 183

Authors: Petr Slobodian, Pavel Riha, Jiri Matyas, Robert Olejnik, Nuri Karakurt

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Thermoelectric devices generate an electrical current when there is a temperature gradient between the hot and cold junctions of two dissimilar conductive materials typically n-type and p-type semiconductors. Consequently, also the polymeric semiconductors composed of polymeric matrix filled by different forms of carbon nanotubes with proper structural hierarchy can have thermoelectric properties which temperature difference transfer into electricity. In spite of lower thermoelectric efficiency of polymeric thermoelectrics in terms of the figure of merit, the properties as stretchability, flexibility, lightweight, low thermal conductivity, easy processing, and low manufacturing cost are advantages in many technological and ecological applications. Polyethylene-octene copolymer based highly elastic composites filled with multi-walled carbon nanotubes (MWCTs) were prepared by sonication of nanotube dispersion in a copolymer solution followed by their precipitation pouring into non-solvent. The electronic properties of MWCNTs were moderated by different treatment techniques such as chemical oxidation, decoration by Ag clusters or addition of low molecular dopants. In this concept, for example, the amounts of oxygenated functional groups attached on MWCNT surface by HNO₃ oxidation increase p-type charge carriers. p-type of charge carriers can be further increased by doping with molecules of triphenylphosphine. For partial altering p-type MWCNTs into less p-type ones, Ag nanoparticles were deposited on MWCNT surface and then doped with 7,7,8,8-tetracyanoquino-dimethane. Both types of MWCNTs with the highest difference in generated thermoelectric power were combined to manufacture polymeric based thermoelectric module generating thermoelectric voltage when the temperature difference is applied between hot and cold ends of the module. Moreover, it was found that the generated voltage by the thermoelectric module at constant temperature gradient was significantly affected when exposed to vapors of different volatile organic compounds representing then a self-powered thermoelectric sensor for chemical vapor detection.

Keywords: carbon nanotubes, polymer composites, thermoelectric materials, self-powered gas sensor

Procedia PDF Downloads 145

Authors: Anis Al-Yakhiri

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Introduction: The World Health Organization (WHO) classifies malignant epithelial thyroid tumors into four major groups (papillary, follicular, medullar and undifferentiated) . Papillary thyroid carcinoma (PTC) is the most common type, for about eight out of ten thyroid cancers belong to this histological type. Radioactive iodine (RAI) is considered effective for patients with total or nearly total thyroidectomy, but the beneficial effects of RAI are still controversial. War conditions forced us to study alternative methods of using radioactive iodine in the treatment of patients with PTC. Material and methods: Between January 2014 and June 2021, in Al-Yakhiri hospital, 57 Total Thyroidectomy with Radical BilateralNeckDissection (RBND) were performed, 50 for malignant disease,7 for false positive cytology.RBND involves surgical clearance of Levels II-VI. Mean age was 40.7 years old and 92% of the patients were female. 7(14%) patients had hypothyroidism which required preoperative thyroid hormone treatment. The Thyroid Stimulating Hormone- Suppression Therapy (TSH-ST) immediately started after RBND for mostpatients on the first day. It consisted in reducing the level of TSH< 0.1 mIU/L. Results: The Apron flap was used on most operations (40)80% and with lateral extensions had 10(20%). RBND involves surgical clearance of Levels II-VI performed in all operated patients, besides that, 4(8%) of them had resection of sternocleidomastoid muscle (SCM) and accessory nerve (XIn) and internal jugular vein (IJV) withclearance of Levels IB. The PTC was the most common 80.9% (38 patients from 47)by histopathological report. and 4(8%) patients of 50 had resection of sternocleidomastoid muscle (SCM) and accessory nerve (XIn) and internal jugular vein (IJV). The postoperative mortality rate not observed (0%). The postoperative morbidity rate was 22.8% (n =13).Seroma(8.7%),Hypocalcimia(7%), Wound infection(5.3%), Bleeding(1.8%). To suppress TSH and growth of any residual thyroid theTSH-ST (levothyroxine150 – 600mcg)was performed in all patients 57(100%) on the first day afterRBND. We tracked the results of treatment for two years in 30 patients with PTC, only 3 of them received radioactive iodine abroad. Biennial Recurrence rate for PTC appeared in one woman (2%), who had RAI postoperatively in the form of neck lymph nodes metastasis. Conclusion: For patients with PTC, thyroidectomy plus prophylacticRBND is a safe and efficient procedure and it results in lower recurrence rate. Postoperative treatment with exogenous thyroid hormone in doses sufficient to suppress TSH (not less than 150mcg), decreases incidence of recurrence. Total Thyroidectomy with RBND followed by TSH-ST, in our opinion, applicable optimal treatment scheme care for this patient population.

Keywords: thyroid cancer, Yemen war, absence of radioactive iodine, neck dissection, surgery results

Procedia PDF Downloads 70

Authors: Mastewal Endeshaw Getnet

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Imunization is one of the most cost-effective and extensively adopted public health strategies for preventing child disability and mortality. Expanded Program on Immunization (EPI) was launched in 1974 with the goal of providing life-saving vaccines to all children in all and building on the success of the global smallpox eradication program. According to World Health Organization report, by 2020, all countries should have achieved 90% vaccination coverage. Many developing countries still have not achieved the goal. Ethiopia is one of Africa's developing countries. The Ethiopian Ministry of health (MoH) launched the EPI program in 1980, with the goal of achieving 90% coverage among children under the age of 1 year by 1990. Among children aged 12-23 months, complete immunization coverage was 47% based on the Ethiopian Demographic and Health Survey (EDAS) 2019 report. The coverage varies depending on the administrative region, ranging from 21% in Afar region to 89% in Amhara region, Ethiopia. Therefore, identifying risk factors for incomplete immunization among children is a key challenge, particularly in Ethiopia, which has a large geographical diversity and a predicted with 119.96 million projected population size in the year 2022. Despite its critical and challenging issue, this issue is still open and has not yet been fully investigated. Recently, a few previous studies have been conducted on the assessment of incomplete children immunization determinants. However, the majority of the studies were cross-sectional surveys that assessed only EPI coverage. Motivated by the above investigation, this study focuses on investigating determinants associated with incomplete immunization among Ethiopian children to facilitate the rate of full immunization coverage. Moreover, we consider both individual immunization and service performance-related factors to investigate incomplete children's determinants. Consequently, we adopted an ecological model in this study. Individual and environmental factors are combined in the Ecological model, which provides multilevel framework for exploring different determinants related with health behaviors. The Ethiopian Demographic and Health Survey will be used as a source of data from 2021 to achieve the objective of this study. The findings of this study will be useful to the Ethiopian government and other public health institutes to improve the coverage score of childhood immunization based on the identified risk determinants.

Keywords: incomplete immunization, children, ethiopia, ecological model

Procedia PDF Downloads 17

Authors: Shiying Fan, Xinyong Li

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The development of highly efficient multifunctional catalytic materials towards HER, ORR and Photo-fuel cell applications in terms of combined electrochemical and photo-electrochemical principles have currently confronted with dire challenges. In this study, novel palladium (Pd) and ruthenium (Ru) Bimetal Quantum Dots (BQDs) co-anchored on Titania nanotube (NTs) arrays electrodes have been successfully constructed by facial two-step electrochemical strategy. Double Schottky junctions with superior performance in electrocatalytic (EC) hydrogen generations and solar fuel cell energy conversions (PE) have been found. Various physicochemical techniques including UV-vis spectroscopy, TEM/EDX/HRTEM, SPV/TRV and electro-chemical strategy including EIS, C-V, I-V, and I-T, etc. were chronically utilized to systematically characterize the crystal-, electronic and micro-interfacial structures of the composites with double Schottky junction, respectively. The characterizations have implied that the marvelous enhancement of separation efficiency of electron-hole pairs generations is mainly caused by the Schottky-barriers within the nanocomposites, which would greatly facilitate the interfacial charge transfer for H₂ generations and solar fuel cell energy conversions. Moreover, the DFT calculations clearly indicated that the oriented growth of Ru and Pd bimetal atoms at the anatase (101) surface is mainly driven by the interaction between Ru/Pd and surface atoms, and the most active site for bimetal Ru and Pd adatoms on the perfect TiO₂ (101) surface is the 2cO-6cTi-3cO bridge sites and the 2cO-bridge sites with the highest adsorption energy of 9.17 eV. Furthermore, the electronic calculations show that in the nanocomposites, the number of impurity (i.e., co-anchored Ru-Pd BQDs) energy levels near Fermi surface increased and some were overlapped with original energy level, promoting electron energy transition and reduces the band gap. Therefore, this work shall provide a deeper insight for the molecular design of Bimetal Quantum Dots (BQDs) assembled onto Tatiana NTs composites with superior performance for electrocatalytic hydrogen productions and solar fuel cell energy conversions (PE) simultaneously.

Keywords: eletrocatalytic, Ru-Pd bimetallic quantum dots, titania nanotube arrays, double Schottky junctions, hydrogen production

Procedia PDF Downloads 138

Authors: Jane E. A. Lewis, Paul Williams, Jane H. Davies

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Introduction: There is, at present, a clear and recognized need to optimize the diagnosis of peripheral arterial disease (PAD), particularly in non-specialist settings such as primary care, and this arises from several key facts. Firstly, PAD is a highly prevalent condition. In 2010, it was estimated that globally, PAD affected more than 202 million people and furthermore, this prevalence is predicted to further escalate. The disease itself, although frequently asymptomatic, can cause considerable patient suffering with symptoms such as lower limb pain, ulceration, and gangrene which, in worse case scenarios, can necessitate limb amputation. A further and perhaps the most eminent consequence of PAD arises from the fact that it is a manifestation of systemic atherosclerosis and therefore is a powerful predictor of coronary heart disease and cerebrovascular disease. Objective: This cross sectional study aimed to individually and cumulatively compare sensitivity and specificity of the (i) ankle brachial index (ABI) and (ii) pulse volume waveform (PVW) recorded by the same automated device, with the presence or absence of peripheral arterial disease (PAD) being verified by an Ultrasound Duplex Scan (UDS). Methods: Patients (n = 205) referred for lower limb arterial assessment underwent an ABI and PVW measurement using volume plethysmography followed by a UDS. Presence of PAD was recorded for ABI if < 0.9 (noted if > 1.30) if PVW was graded as 2, 3 or 4 or a hemodynamically significant stenosis > 50% with UDS. Outcome measure was agreement between measured ABI and interpretation of the PVW for PAD diagnosis, using UDS as the reference standard. Results: Sensitivity of ABI was 80%, specificity 91%, and overall accuracy 88%. Cohen’s kappa revealed good agreement between ABI and UDS (k = 0.7, p < .001). PVW sensitivity 97%, specificity 81%, overall accuracy 84%, with a good level of agreement between PVW and UDS (k = 0.67, p < .001). The combined sensitivity of ABI and PVW was 100%, specificity 76%, and overall accuracy 85% (k = 0.67, p < .001). Conclusions: Combing these two diagnostic modalities within one device provided a highly accurate method of ruling out PAD. Such a device could be utilized within the primary care environment to reduce the number of unnecessary referrals to secondary care with concomitant cost savings, reduced patient inconvenience, and prioritization of urgent PAD cases.

Keywords: ankle brachial index, peripheral arterial disease, pulse volume waveform, ultrasound duplex scan

Procedia PDF Downloads 157

Authors: Svenja Pieritz, Jakab Pilaszanovich

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Collaborative Problem Solving (CPS) is recognized as being one of the most important skills of the 21st century with having a potential impact on education, job selection, and collaborative systems design. Therefore, CPS has been adopted in several standardized tests, including the Programme for International Student Assessment (PISA) in 2015. A significant challenge of evaluating CPS is the underlying interplay of cognitive and social skills, which requires a more holistic assessment. However, the majority of the existing tests are using a questionnaire-based assessment, which oversimplifies this interplay and undermines ecological validity. Two major difficulties were identified: Firstly, the creation of a controllable, real-time environment allowing natural behaviors and communication between at least two people. Secondly, the development of an appropriate method to collect and synthesize both cognitive and social metrics of collaboration. This paper proposes a more holistic and automated approach to the assessment of CPS. To address these two difficulties, a multiplayer problem-solving game called Sea of Light was developed: An environment allowing students to deploy a variety of measurable collaborative strategies. This controlled environment enables researchers to monitor behavior through the analysis of game actions and chat. The according solution for the statistical model is a combined approach of Natural Language Processing (NLP) and Bayesian network analysis. Social exchanges via the in-game chat are analyzed through NLP and fed into the Bayesian network along with other game actions. This Bayesian network synthesizes evidence to track and update different subdimensions of CPS. Major findings focus on the correlations between the evidences collected through in- game actions, the participants’ chat features and the CPS self- evaluation metrics. These results give an indication of which game mechanics can best describe CPS evaluation. Overall, Sea of Light gives test administrators control over different problem-solving scenarios and difficulties while keeping the student engaged. It enables a more complete assessment based on complex, socio-cognitive information on actions and communication. This tool permits further investigations of the effects of group constellations and personality in collaborative problem-solving.

Keywords: bayesian network, collaborative problem solving, game-based assessment, natural language processing

Procedia PDF Downloads 125

Authors: Lee Bih Ni, Zulfhikar Rabe, Nurul Asyikin Hassan

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The Ministry of Education Malaysia dynamically and drastically made the subject of History mandatory to be in force in 2013. This is in recognition of the nation's heritage and treasures in maintaining true facts and information for future generations of the State. History reveals the civilization of a nation and the fact of national cultural heritage. Civilization needs to be preserved as a legacy of sovereign heritage. Today's generation is the catalyst for future heirs who will support the principle and direction of the country. In line with the National Education Philosophy that aims to shape the potential development of individuals holistically and uniquely in order to produce a balanced and harmonious student in terms of intellectual, spiritual, emotional and physical. Hence, understanding the importance of studying the history subject as a pillar of identity and the history of nationhood is to be a priority in the pursuit of knowledge and empowering the spirit of statehood that is nurtured through continuous learning at school. Judging from the aspect of teacher leadership role in integrating history in a combined way based on Teacher Education Philosophy. It empowers the teaching profession towards the teacher to support noble character. It also supports progressive and scientific views. Teachers are willing to uphold the State's aspirations and celebrate the country's cultural heritage. They guarantee individual development and maintain a united, democratic, progressive and disciplined society. Teacher's role as a change and leadership agent in education begins in the classroom through formal or informal educational processes. This situation is expanded in schools, communities and countries. The focus of this paper is on the role of teacher leadership influencing the effectiveness of teaching and learning history in the classroom environment. Leadership guides to teachers' perceptions on the role of teacher leadership, teaching leadership, and the teacher leadership role and effective teacher leadership role. Discussions give emphasis on aspects of factors affecting the classroom environment, forming the classroom agenda, effective classroom implementation methods, suitable climate for historical learning and teacher challenges in implicating the effectiveness of teaching and learning processes.

Keywords: teacher leadership, leadership lessons, effective classroom, effective teacher

Procedia PDF Downloads 278

Authors: Nuruddin Mohammod Zahangir, Syed Tanvir Ahmady, Firoz Ahmed, Mainul Kabir, Tamjid Mohammad Najmus Sakib Khan, Nazmul Hossain, Niaz Ahmed, Madhava Janardhan Naik

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The management of combined Coronary Artery Disease and Peripheral Vascular Disease is a challenge and brings with it numerous clinical dilemmas.The 56 year old gentleman presented to our department with significant triple vessel disease with occluded lower end of aorta just before bifurcation and bilateral superficial femoral arteries. Operation was done on 11.03.14. The The Left Internal Mammary Artery (LIMA) and the Right Internal Mammary Artery (RIMA) were harvested in skeletonized manner. The free RIMA was then anastomosed with LIMA to make LIMA-RIMA Y. Cardio Pulmonary Bypass was then established and coronary artery bypass grafts performed. LIMA was anastomosed to the Left Anterior Descending artery. RIMA was anastomosed to Posterior Descending Artery, 1st and 2nd Obtuse Marginal arteries in a sequential manner. Abdomen was opened by midline incision. The infrarenal aorta exposed and was found to be severely diseased. A Vascular Clamp was applied infrarenally, aortotomy done and limited endarterectomy performed. An end-to-side anastomosis was done with upper end of PTFE synthetic Y-graft (14/7 mm) to the infarenal Aorta and the Clamp released. Good flow noted in both limbs of the graft. Patient was then slowly weaned off from Cardio Pulmonary Bypass without difficulty. The distal two limbs of the Y graft were passed to the groin through retroperitoneal tunnels and anastomosed end-to-side with the common femoral arteries. Saphenous vein was interposed between common femoral and popliteal arteries bilaterally through subfascial tunnels in both thigh. On 12th postoperative day he was discharged from hospital in good general condition. Follow up after 3 months of operation the patient is doing good and free of chest pain and claudication pain.

Keywords: total arterial, coronary revascularization, aorto-bifemoral bypass, bifemoro-bipopliteal bypass

Procedia PDF Downloads 464

Authors: Neeraj Vij, Christian Leber, Kenneth Schmidt

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Introduction: Total knee arthroplasty is a common procedure. It is well known that the biomechanics of the knee do not fully return to their normal state. Motion analysis has been used to study the biomechanics of the knee after total knee arthroplasty. The purpose of this scoping review is to summarize the current use of gait analysis in total knee arthroplasty and to identify the preoperative motion analysis parameters for which a systematic review aimed at determining the reliability and validity may be warranted. Materials and Methods: This IRB-exempt scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist strictly. Five search engines were searched for a total of 279 articles. Articles underwent a title and abstract screening process followed by full-text screening. Included articles were placed in the following sections: the role of gait analysis as a research tool for operative decisions, other research applications for motion analysis in total knee arthroplasty, gait analysis as a tool in predicting radiologic outcomes, gait analysis as a tool in predicting clinical outcomes. Results: Eleven articles studied gait analysis as a research tool in studying operative decisions. Motion analysis is currently used to study surgical approaches, surgical techniques, and implant choice. Five articles studied other research applications for motion analysis in total knee arthroplasty. Other research applications for motion analysis currently include studying the role of the unicompartmental knee arthroplasty and novel physical therapy protocols aimed at optimizing post-operative care. Two articles studied motion analysis as a tool for predicting radiographic outcomes. Preoperative gait analysis has identified parameters than can predict postoperative tibial component migration. 15 articles studied motion analysis in conjunction with clinical scores. Conclusions: There is a broad range of applications within the research domain of total knee arthroplasty. The potential application is likely larger. However, the current literature is limited by vague definitions of ‘gait analysis’ or ‘motion analysis’ and a limited number of articles with preoperative and postoperative functional and clinical measures. Knee adduction moment, knee adduction impulse, total knee range of motion, varus angle, cadence, stride length, and velocity have the potential for integration into composite clinical scores. A systematic review aimed at determining the validity, reliability, sensitivities, and specificities of these variables is warranted.

Keywords: motion analysis, joint replacement, patient-reported outcomes, knee surgery

Procedia PDF Downloads 86

Authors: Ana Beltran Sanahuja, A. Valdés García, Saray Lopez De Pablo Gallego, Maria Soledad Prats Moya

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Tomato consumption has greatly increased worldwide in the last few years, mostly due to a growing demand for products like sofrito. In this sense, regular consumption of tomato-based products has been consistently associated with a reduction in the incidence of chronic degenerative diseases. The sofrito is a homemade tomato sauce typical of the Mediterranean area, which contains as main ingredients: tomato, onion, garlic and olive oil. There are also sofrito’s variations by adding other spices which bring at the same time not only color, flavor, smell and or aroma; they also provide medicinal properties, due to their antioxidant power. This protective effect has mainly been attributed to the predominant bioactive compounds present in sofrito, such as lycopene and other carotenoids as well as more than 40 different polyphenols. Regarding the cooking process, it is known that it can modify the properties and the availability of nutrients in sofrito; however, there is not enough information regarding this issue. For this reason, the aim of the present work is to evaluate the cooking effect on the antioxidant capacity of different variants of tomato-based sofrito combined with other spices, through the analysis of total phenols content (TPC) and to evaluate the antioxidant capacity by using the method of free radical 2,2-diphenyl-1-picrylhydrazyl (DPPH). Based on the results obtained, it can be confirmed that the basic sofrito composed of tomato, onion, garlic and olive oil and the sofrito with 1 g of rosemary added, are the ones with the highest content of phenols presenting greater antioxidant power than other industrial sofrito, and that of other variables of sofrito with added thyme or higher amounts of garlic. Moreover, it has been observed that in the elaboration of the tomato-based sofrito, it is possible to cook until 60 minutes, since the cooking process increases the bioavailability of the carotenoids when breaking the cell walls, which weakens the binding forces between the carotenoids and increases the levels of antioxidants present, confirmed both with the TPC and DPPH methods. It can be concluded that the cooking process of different variants of tomato-based sofrito, including spices, can improve the antioxidant capacity. The synergistic effects of different antioxidants may have a greater protective effect; increasing, also, the digestibility of proteins. In addition, the antioxidants help to deactivate the free radicals of diseases such as atherosclerosis, aging, immune suppression, cancer, and diabetes.

Keywords: antioxidants, cooking process, phenols sofrito

Procedia PDF Downloads 133

Authors: Ranjan Banerjee, W. D. Gunawardana

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The free vibration and flutter analysis plays a major part in aircraft design which is indeed, a mandatory requirement. In particular, high aspect ratio transport airliner wings are prone to free vibration and flutter problems that must be addressed during the design process as demanded by the airworthiness authorities. The purpose of this paper is to carry out a detailed free vibration and flutter analysis for a wide range of high aspect ratio aircraft wings and generate design curves to provide useful visions and understandings of aircraft design from an aeroelastic perspective. In the initial stage of the investigation, the bending and torsional stiffnesses of a number of transport aircraft wings are looked at and critically examined to see whether it is possible to express the stiffness distributions in polynomial form, but in a sufficiently accurate manner. A similar attempt is made for mass and mass moment of inertia distributions of the wing. Once the choice of stiffness and mass distributions in polynomial form is made, the high aspect ratio wing is idealised by a series of bending-torsion coupled beams from a structural standpoint. Then the dynamic stiffness method is applied to compute the natural frequencies and mode shape of the wing. Next the wing is idealised aerodynamically and to this end, unsteady aerodynamic of Theodorsen type is employed to represent the harmonically oscillating wing. Following this step, a normal mode method through the use of generalised coordinates is applied to formulate the flutter problem. In essence, the generalised mass, stiffness and aerodynamic matrices are combined to obtain the flutter matrix which is subsequently solved in the complex domain to determine the flutter speed and flutter frequency. In the final stage of the investigation, an exhaustive parametric study is carried out by varying significant wing parameters to generate design curves which help to predict the free vibration and flutter behaviour of high aspect ratio transport aircraft wings in a generic manner. It is in the aeroelastic context of aircraft design where the results are expected to be most useful.

Keywords: high-aspect ratio wing, flutter, dynamic stiffness method, free vibration, aeroelasticity

Procedia PDF Downloads 278

Authors: Bollu Mounica

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Background: Nowadays drug related problems were seen very commonly within the health care practice. These could result in the medication errors, adverse events, drug interactions and harm to patients. Pharmacist has an identified role in minimizing and preventing such type of problems. Objectives: To detect the incidence of drug related problems for the hospitalized patient, and to analyze the clinical pharmacist interventions performed during the review of prescription orders of the general medicine, psychiatry, surgery, pediatrics, gynaecology units of a large tertiary care teaching hospital. Methods: It was a retrospective, observational and interventional study. The analysis took place daily with the following parameters: dose, rate of administration, presentation and/or dosage form, presence of inappropriate/unnecessary drugs, necessity of additional medication, more proper alternative therapies, presence of relevant drug interactions, inconsistencies in prescription orders, physical-chemical incompatibilities/solution stability. From this evaluation, the drug therapy problems were classified, as well as the resulting clinical interventions. For a period starting November 2012 until December 2014, the inpatient medication charts and orders were identified and rectified by ward and practicing clinical pharmacists within the inpatient pharmacy services in a tertiary care teaching hospital on routine daily activities. Data was collected and evaluated. The causes of this problem were identified. Results: A total of 360 patients were followed. Male (71.66%) predominance was noted over females (28.33%). Drug related problems were more commonly seen in patients aged in between 31-60. Most of the DRP observed in the study resulted from the dispensing errors (26.11%), improper drug selection (17.22%), followed by untreated indications (14.4%) Majority of the clinical pharmacist recommendations were on need for proper dispensing (26.11%), and drug change (18.05%). Minor significance of DRPs were noted high (41.11 %), whereas (35.27 %) were moderate and (23.61 %) were major. The acceptance rate of intervening clinical pharmacist recommendation and change in drug therapy was found to be high (86.66%). Conclusion: Our study showed that the prescriptions reviewed had some drug therapy problem and the pharmacist interventions have promoted positive changes needed in the prescriptions. In this context, routine participation of clinical pharmacists in clinical medical rounds facilitates the identification of DRPs and may prevent their occurrence.

Keywords: drug related problems, clinical pharmacist, drug prescriptions, drug related problems, intervention

Procedia PDF Downloads 301

Authors: Dorothea Voß, Tobias Esser, Michael Huber, Jakob Albert

Abstract:

The growing world population and the associated increase in demand for energy and consumer goods, as well as increasing waste production, requires the development of sustainable processes. In addition, the increasing environmental awareness of our society is a driving force for the requirement that processes must be as resource and energy efficient as possible. In this context, the use of polyoxometalate catalysts (POMs) has emerged as a promising approach for the development of green processes. POMs are bifunctional polynuclear metal-oxo-anion cluster characterized by a strong Brønsted acidity, a high proton mobility combined with fast multi-electron transfer and tunable redox potential. In addition, POMs are soluble in many commonly known solvents and exhibit resistance to hydrolytic and oxidative degradation. Due to their structure and excellent physicochemical properties, POMs are efficient acid and oxidation catalysts that have attracted much attention in recent years. Oxidation processes with molecular oxygen are worth mentioning here. However, the fact that the POM catalysts are homogeneous poses a challenge for downstream processing of product solutions and recycling of the catalysts. In this regard, nanofiltration membranes have gained increasing interest in recent years, particularly due to their relative sustainability advantage over other technologies and their unique properties such as increased selectivity towards multivalent ions. In order to establish an efficient downstream process for the highly selective separation of homogeneous POM catalysts from aqueous solutions using nanofiltration membranes, a laboratory-scale membrane system was designed and constructed. By varying various process parameters, a sensitivity analysis was performed on a model system to develop an optimized method for the recovery of POM catalysts. From this, process-relevant key figures such as the rejection of various system components were derived. These results form the basis for further experiments on other systems to test the transferability to serval separation tasks with different POMs and products, as well as for recycling experiments of the catalysts in processes on laboratory scale.

Keywords: downstream processing, nanofiltration, polyoxometalates, homogeneous catalysis, green chemistry

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