Search results for: Ilyas Bozkurt

Authors: Ibrahim Sengor, Sumeyye Cesur, Ilyas Kartal, Faik Nuzhet Oktar, Nazmi Ekren, Ahmet Talat Inan, Oguzhan Gunduz

Abstract:

In recent years, many researchers focused on nano-size fiber production. Nanofibers have been studied due to their different and superior physical, chemical and mechanical properties. Poly (lactic acid) (PLA), is a type of biodegradable thermoplastic polyester derived from renewable sources used in biomedical owing to its biocompatibility and biodegradability. In addition, zinc oxide is an antibacterial material and hazelnut shell powder is a filling material. In this study, nanofibers were obtained by adding of different ratio Zinc oxide, (ZnO) and hazelnut shell powder at different concentration into Poly (lactic acid) (PLA) by using electrospinning method which is the most common method to obtain nanofibers. After dissolving the granulated polylactic acids in % 1,% 2,% 3 and% 4 with chloroform solvent, they are homogenized by adding tween and hazelnut shell powder at different ratios and then by electrospinning, nanofibers are obtained. Scanning electron microscope (SEM), Fourier transform infrared spectroscopy (FTIR), Differential scanning calorimeter (DSC) and physical analysis such as density, electrical conductivity, surface tension, viscosity measurement and antimicrobial test were carried out after production process. The resulting structures of the nanofiber possess antimicrobial and antiseptic properties, which are attractive for biomedical applications. The resulting structures of the nanofiber possess antimicrobial, non toxic, self-cleaning and rigid properties, which are attractive for biomedical applications.

Keywords: electrospinning, hazelnut shell powder, nanofibers, poly (lactic acid), zinc oxide

Procedia PDF Downloads 139

Authors: Adey Nigatu Mersha, Ilyas Masih, Charlotte de Fraiture, Tena Alamirew

Abstract:

Conflicts over water are increasing mainly as a result of water scarcity in response to higher water demand and climatic variability. There is often not enough water to meet all demands for different uses. Thus, decisions have to be made as to how the available resources can be managed and utilized. Correspondingly water allocation goals, practically national water policy goals, need to be revised accordingly as the pressure on water increases from time to time. A case study is conducted in the Upper Awash Basin, Ethiopia, to assess and evaluate prioritized comprehensive water demand management options based on the framework of integrated water resources management in account of stakeholders’ knowledge and preferences as well as practical prominence within the Upper Awash Basin. Two categories of alternative management options based on policy analysis and stakeholders' consultation were evaluated against the business-as-usual scenario by using WEAP21 model as an analytical tool. Strong effects on future (unmet) demands are observed with major socio-economic assumptions and forthcoming water development plans. Water management within the basin will get more complex with further abstraction which may lead to an irreversible damage to the ecosystem. It is further confirmed through this particular study that efforts to maintain users’ preferences alone cannot insure economically viable and environmentally sound development and vice versa. There is always a tradeoff between these factors. Hence, all of these facets must be analyzed separately, related with each other in equal footing, and ultimately taken up in decision making in order for the whole system to function properly.

Keywords: water demand, water availability, WEAP21, scenarios

Procedia PDF Downloads 253

Authors: Arda Ozkurt, Ozlem Bozkurt

Abstract:

Brain-computer interfaces (BCIs) are devices that output commands by interpreting the data collected from the brain. Electroencephalography (EEG) is a non-invasive method to measure the brain's electrical activity. Since it was invented by Hans Berger in 1929, it has led to many neurological discoveries and has become one of the essential components of non-invasive measuring methods. Despite the fact that it has a low spatial resolution -meaning it is able to detect when a group of neurons fires at the same time-, it is a non-invasive method, making it easy to use without possessing any risks. In EEG, electrodes are placed on the scalp, and the voltage difference between a minimum of two electrodes is recorded, which is then used to accomplish the intended task. The recordings of EEGs include, but are not limited to, the currents along dendrites from synapses to the soma, the action potentials along the axons connecting neurons, and the currents through the synaptic clefts connecting axons with dendrites. However, there are some sources of noise that may affect the reliability of the EEG signals as it is a non-invasive method. For instance, the noise from the EEG equipment, the leads, and the signals coming from the subject -such as the activity of the heart or muscle movements- affect the signals detected by the electrodes of the EEG. However, new techniques have been developed to differentiate between those signals and the intended ones. Furthermore, an EEG device is not enough to analyze the data from the brain to be used by the BCI implication. Because the EEG signal is very complex, to analyze it, artificial intelligence algorithms are required. These algorithms convert complex data into meaningful and useful information for neuroscientists to use the data to design BCI devices. Even though for neurological diseases which require highly precise data, invasive BCIs are needed; non-invasive BCIs - such as EEGs - are used in many cases to help disabled people's lives or even to ease people's lives by helping them with basic tasks. For example, EEG is used to detect before a seizure occurs in epilepsy patients, which can then prevent the seizure with the help of a BCI device. Overall, EEG is a commonly used non-invasive BCI technique that has helped develop BCIs and will continue to be used to detect data to ease people's lives as more BCI techniques will be developed in the future.

Keywords: BCI, EEG, non-invasive, spatial resolution

Procedia PDF Downloads 45

Authors: Aliseydi Bozkurt

Abstract:

Objectives: Benign prostatic hyperplasia (BPH) is the most common benign disease, and prostate cancer (PC) is malign disease of the prostate gland. Transrectal ultrasound-guided biopsy (TRUS-bx) is one of the most important diagnostic tools in PC diagnosis. Identifying men at increased risk for having a biopsy detectable prostate cancer should consider prostate specific antigen density (PSAD), f/t PSA Ratio, an estimate of prostate volume. Method: We retrospectively studied 269 patients who had a prostate specific antigen (PSA) score of 4 or who had suspected rectal examination at any PSA level and received TRUS-bx between January 2015 and June 2018 in our clinic. TRUS-bx was received by 12 experienced urologists with 12 quadrants. Prostate volume was calculated prior to biopsy together with TRUS. Patients were classified as malignant and benign at the end of pathology. Age, PSA value, prostate volume in transrectal ultrasonography, corpuscle biopsy, biopsy pathology result, the number of cancer core and Gleason score were evaluated in the study. The success rates of PV, PSAD, and f/tPSA were compared in all patients and those with PSA 2.5-10 ng/mL and 10.1-30 ng/mL tp foresee prostate cancer. Result: In the present study, in patients with PSA 2.5-10 ng/ml, PV cut-off value was 43,5 mL (n=42 < 43,5 mL and n=102 > 43,5 mL) while in those with PSA 10.1-30 ng/mL prostate volüme (PV) cut-off value was found 61,5 mL (n=31 < 61,5 mL and n=36 > 61,5 mL). Total PSA values in the group with PSA 2.5-10 ng/ml were found lower (6.0 ± 1.3 vs 6.7 ± 1.7) than that with PV < 43,5 mL, this value was nearly significant (p=0,043). In the group with PSA value 10.1-30 ng/mL, no significant difference was found (p=0,117) in terms of total PSA values between the group with PV < 61,5 mL and that with PV > 61,5 mL. In the group with PSA 2.5-10 ng/ml, in patients with PV < 43,5 mL, f/t PSA value was found significantly lower compared to the group with PV > 43,5 mL (0.21 ± 0.09 vs 0.26 ± 0.09 p < 0.001 ). Similarly, in the group with PSA value of 10.1-30 ng/mL, f/t PSA value was found significantly lower in patients with PV < 61,5 mL (0.16 ± 0.08 vs 0.23 ± 0.10 p=0,003). In the group with PSA 2.5-10 ng/ml, PSAD value in patients with PV < 43,5 mL was found significantly higher compared to those with PV > 43,5 mL (0.17 ± 0.06 vs 0.10 ± 0.03 p < 0.001). Similarly, in the group with PSA value 10.1-30 ng/mL PSAD value was found significantly higher in patients with PV < 61,5 mL (0.47 ± 0.23 vs 0.17 ± 0.08 p < 0.001 ). The biopsy results suggest that in the group with PSA 2.5-10 ng/ml, in 29 of the patients with PV < 43,5 mL (69%) cancer was detected while in 13 patients (31%) no cancer was detected. While in 19 patients with PV > 43,5 mL (18,6%) cancer was found, in 83 patients (81,4%) no cancer was detected (p < 0.001). In the group with PSA value 10.1-30 ng/mL, in 21 patients with PV < 61,5 mL (67.7%) cancer was observed while only in10 patients (32.3%) no cancer was seen. In 5 patients with PV > 61,5 mL (13.9%) cancer was found while in 31 patients (86.1%) no cancer was observed (p < 0.001). Conclusions: Identifying men at increased risk for having a biopsy detectable prostate cancer should consider PSA, f/t PSA Ratio, an estimate of prostate volume. Prostate volume in PC was found lower.

Keywords: prostate cancer, prostate volume, prostate specific antigen, free/total PSA ratio

Procedia PDF Downloads 123

Authors: Lara Ann Türeli, Özlem Bozkurt

Abstract:

There is a biochemical component to listening to music. The type of music listened to can lead to different levels of neurotransmitter and biochemical activity within the brain, resulting in brain stimulation and different moods. Therefore, music plays an important role in neuromarketing and consumer behavior. The quality of a commercial can be measured by the effect the music has on its audience. Thus, understanding how music can affect the brain can provide better marketing strategies for all businesses. The type of music used plays an important role in how a person responds to certain experiences. In the context of marketing and consumer behavior, music can determine whether a person will be intrigued to buy something. Depending on the type of music listened to by an individual; the music may trigger the release of pleasurable neurotransmitters such as dopamine. Dopamine is a neurotransmitter that plays an important role in reward pathways in the brain. When an individual experiences a pleasurable activity, increased levels of dopamine are produced, eventually leading to the formation of new reward pathways. Consequently, the increased dopamine activity within the brain triggered by music can result in new reward pathways along the dopamine pathways in the brain. Selecting pleasurable music for commercials can result in long-term brain stimulation, increasing consumerism. The effect of music on consumerism should be considered not only in commercials but also in the atmosphere it creates within stores. The type of music played in a store can affect consumer behavior and intention. Specifically, the rhythm, pitch, and pace of music can contribute to the mood of the song. The background music in a store can determine the consumer’s emotional presence and consequently affect their intentions. In conclusion, understanding the physiological, psychological, and neurochemical basis of the effect of music on brain stimulation is essential to understand consumer behavior. The role of dopamine in the formation of reward pathways as a result of music directly contributes to consumer behavior and the tendency of a commercial or store to leave a long-term effect on the consumer. The careful consideration of the pitch, pace, and rhythm of a song in the selection of music can not only help companies predict the behavior of a consumer but also determine the behavior of a consumer.

Keywords: sensory processing, neuropsychology, dopamine, neuromarketing

Procedia PDF Downloads 48

Authors: Harika Atmaca, Emir Bozkurt, Latife Merve Oktay, Selim Uzunoglu, Ruchan Uslu, Burçak Karaca

Abstract:

Microarrays have been developed for highly parallel enzyme-linked immunosorbent assay (ELISA) applications. The most common protein arrays are produced by using multiple monoclonal antibodies, since they are robust molecules which can be easily handled and immobilized by standard procedures without loss of activity. Protein expression profiling with protein array technology allows simultaneous analysis of the protein expression pattern of a large number of proteins. Trabectedin, a tetrahydroisoquinoline alkaloid derived from a Caribbean tunicate, Ecteinascidia turbinata, has been shown to have antitumor effects. Here, we used a novel proteomic approach to explore the mechanism of action of trabectedin in prostate cancer cell line PC-3 by apoptosis antibody microarray. XTT cell proliferation kit and Cell Death Detection Elisa Plus Kit (Roche) was used for measuring cytotoxicity and apoptosis. Human Apoptosis Protein Array (R&D Systems) which consists of 35 apoptosis related proteins was used to assess the omic protein expression pattern. Trabectedin induced cytotoxicity and apoptosis in prostate cancer cells in a time and concentration-dependent manner. The expression levels of the death receptor pathway molecules, TRAIL-R1/DR4, TRAIL R2/DR5, TNF R1/TNFRSF1A, FADD were significantly increased by 4.0-, 21.0-, 4.20- and 11.5-fold by trabectedin treatment in PC-3 cells. Moreover, mitochondrial pathway related pro-apoptotic proteins Bax, Bad, Cytochrome c, and Cleaved Caspase-3 expressions were induced by 2.68-, 2.07-, 2.8-, and 4.5-fold and the expression levels of anti-apoptotic proteins Bcl-2 and Bcl-XL were reduced by 3.5- and 5.2-fold in PC-3 cells. Proteomic (antibody microarray) analysis suggests that the mechanism of action of trabectedin may be exerted via the induction of both intrinsic and extrinsic apoptotic pathways. The antibody microarray platform can be utilised to explore the molecular mechanism of action of novel anticancer agents.

Keywords: trabectedin, prostate cancer, omic protein expression profile, apoptosis

Procedia PDF Downloads 417

Authors: Nurunnahar Akter, Elena Kulinskaya, Nicholas Steel, Ilyas Bakbergenuly

Abstract:

Although Hormone Replacement Therapy (HRT) is an effective treatment in ameliorating menopausal symptoms, it has mixed effects on different health outcomes, increasing, for instance, the risk of breast cancer. Because of this, many symptomatic women are left untreated. Untreated menopausal symptoms may result in other health issues, which eventually put an extra burden and costs to the health care system. All-cause mortality analysis may explain the net benefits and risks of the HRT therapy. However, it received far less attention in HRT studies. This study investigated the impact of HRT on all-cause mortality using electronically recorded primary care data from The Health Improvement Network (THIN) that broadly represents the female population in the United Kingdom (UK). The study entry date for this study was the record of the first HRT prescription from 1984, and patients were followed up until death or transfer to another GP practice or study end date, which was January 2017. 112,354 HRT users (cases) were matched with 245,320 non-users by age at HRT initiation and general practice (GP). The hazards of all-cause mortality associated with HRT were estimated by a parametric Weibull-Cox model adjusting for a wide range of important medical, lifestyle, and socio-demographic factors. The multilevel multiple imputation techniques were used to deal with missing data. This study found that during 32 years of follow-up, combined HRT reduced the hazard ratio (HR) of all-cause mortality by 9% (HR: 0.91; 95% Confidence Interval, 0.88-0.94) in women of age between 46 to 65 at first treatment compared to the non-users of the same age. Age-specific mortality analyses found that combined HRT decreased mortality by 13% (HR: 0.87; 95% CI, 0.82-0.92), 12% (HR: 0.88; 95% CI, 0.82-0.93), and 8% (HR: 0.92; 95% CI, 0.85-0.98), in 51 to 55, 56 to 60, and 61 to 65 age group at first treatment, respectively. There was no association between estrogen-only HRT and women’s all-cause mortality. The findings from this study may help to inform the choices of women at menopause and to further educate the clinicians and resource planners.

Keywords: hormone replacement therapy, multiple imputations, primary care data, the health improvement network (THIN)

Procedia PDF Downloads 146

Authors: Hamide Aydin, Banu Karaman, Ayhan Bozkurt, Umran Kurtan

Abstract:

Recently, Proton Conducting Gel Polymer Electrolytes (GPEs) have drawn much attention in supercapacitor applications due to their physical and electrochemical characteristics and stability conditions for low temperatures. In this research, PVA-H2SO4-H3BO3 GPE has been used for electric-double layer capacitor (EDLCs) application, in which electrospun free-standing carbon nanofibers are used as electrodes. Introduced PVA-H2SO4-H3BO3 GPE behaves as both separator and the electrolyte in the supercapacitor. Symmetric Swagelok cells including GPEs were assembled via using two electrode arrangements and the electrochemical properties were searched. Electrochemical performance studies demonstrated that PVA-H2SO4-H3BO3 GPE had a maximum specific capacitance (Cs) of 134 F g-1 and showed great capacitance retention (%100) after 1000 charge/discharge cycles. Furthermore, PVA-H2SO4-H3BO3 GPE yielded an energy density of 67 Wh kg-1 with a corresponding power density of 1000 W kg-1 at a current density of 1 A g-1. PVA-H2SO4 based polymer electrolyte was produced according to following procedure; Firstly, 1 g of commercial PVA was dissolved in distilled water at 90°C and stirred until getting transparent solution. This was followed by addition of the diluted H2SO4 (1 g of H2SO4 in a distilled water) to the solution to obtain PVA-H2SO4. PVA-H2SO4-H3BO3 based polymer electrolyte was produced by dissolving H3BO3 in hot distilled water and then inserted into the PVA-H2SO4 solution. The mole fraction was arranged to ¼ of the PVA repeating unit. After the stirring 2 h at RT, gel polymer electrolytes were obtained. The final electrolytes for supercapacitor testing included 20% of water in weight. Several blending combinations of PVA/H2SO4 and H3BO3 were studied to observe the optimized combination in terms of conductivity as well as electrolyte stability. As the amount of boric acid increased in the matrix, excess sulfuric acid was excluded due to cross linking, especially at lower solvent content. This resulted in the reduction of proton conductivity. Therefore, the mole fraction of H3BO3 was chosen as ¼ of PVA repeating unit. Within this optimized limits, the polymer electrolytes showed better conductivities as well as stability.

Keywords: electrical double layer capacitor, energy density, gel polymer electrolyte, ultracapacitor

Procedia PDF Downloads 183

Authors: Deniz Erçelen, Özlem Selcuk Bozkurt

Abstract:

The course of daily human life calls for the need for memories and remembering the time and place for certain events. Recalling memories takes up a substantial amount of time for an individual. Unfortunately, scientists lack the proper technology to fully understand and observe different brain regions that interact to form or retrieve memories. The hippocampus, a complex brain structure located in the temporal lobe, plays a crucial role in memory. The hippocampus forms memories as well as allows the brain to retrieve them by ensuring that neurons fire together. This process is called “neural synchronization.” Sadly, the hippocampus is known to deteriorate often with age. Proteins and hormones, which repair and protect cells in the brain, typically decline as the age of an individual increase. With the deterioration of the hippocampus, an individual becomes more prone to memory loss. Many memory loss starts off as mild but may evolve into serious medical conditions such as dementia and Alzheimer’s disease. In their quest to fully comprehend how memories work, scientists have created many different kinds of technology that are used to examine the brain and neural pathways. For instance, Magnetic Resonance Imaging - or MRI- is used to collect detailed images of an individual's brain anatomy. In order to monitor and analyze brain functions, a different version of this machine called Functional Magnetic Resonance Imaging - or fMRI- is used. The fMRI is a neuroimaging procedure that is conducted when the target brain regions are active. It measures brain activity by detecting changes in blood flow associated with neural activity. Neurons need more oxygen when they are active. The fMRI measures the change in magnetization between blood which is oxygen-rich and oxygen-poor. This way, there is a detectable difference across brain regions, and scientists can monitor them. Electroencephalography - or EEG - is also a significant way to monitor the human brain. The EEG is more versatile and cost-efficient than an fMRI. An EEG measures electrical activity which has been generated by the numerous cortical layers of the brain. EEG allows scientists to be able to record brain processes that occur after external stimuli. EEGs have a very high temporal resolution. This quality makes it possible to measure synchronized neural activity and almost precisely track the contents of short-term memory. Science has come a long way in monitoring memories using these kinds of devices, which have resulted in the inspections of neurons and neural pathways becoming more intense and detailed.

Keywords: brain, EEG, fMRI, hippocampus, memories, neural pathways, neurons

Procedia PDF Downloads 49

Authors: Sultan Çağırıcı, Arsida Bajrami, Beyza Aslan, Hacı Ali Erdoğan, Nejla Sözer Topçular, Dilek Bozkurt, Vildan Yayla

Abstract:

Objective: Corticobasal syndrome (CBS) is phenotypically characterized by asymmetric rigidity, apraxia, alien-limb phenomenon, cortical sensory loss, dystonia and myoclonus. The underlying pathologies consists of corticobasal degeneration (CBD), progressive supra nuclear palsy, Alzheimer's, Creutzfeldt-Jakob and frontotemporal degeneration. CBD is a degenerative disease with clinical symptoms related to the prominent involvement of cerebral cortex and basal ganglia. CBD is a pathological diagnosis and antemortem clinical diagnosis may change many times. In this paper, we described the clinical features and discussed a cases diagnosed with symmetric CBS because of its rarity. Case: Seventy-five-year-old woman presented with a three years history of difficulty in speaking and reading. Involuntary hand jerks and slowness of movement also had began in the last six months. In the neurological examination the patient was alert but not fully oriented. The speech was non-fluent, word finding difficulties were present. Bilateral limited upgaze, bradimimia, bilateral positive cogwheel' rigidity but prominent in the right side, postural tremor and negative myoclonus during action on the left side were detected. Receptive language was normal but expressive language and repetition were impaired. Acalculia, alexia, agraphia and apraxia were also present. CSF findings were unremarkable except for elevated protein level (75 mg/dL). MRI revealed bilateral symmetric cortical atrophy prominent in the frontoparietal region. PET showed hypometabolism in the left caudate nucleus. Conclusion: The increase of data related to neurodegenerative disorders associated with dementia, movement disorders and other findings results in an expanded range of diagnosis and transitions between clinical diagnosis. When considered the age of onset, clinical symptoms, imaging findings and prognosis of this patient, clinical diagnosis was CBS and pathologic diagnosis as probable CBD. Imaging of CBD usually consist of typical asymmetry between hemispheres. Still few cases with clinical appearance of CBD may show symmetrical cortical cerebral atrophy. It is presented this case who was diagnosed with CBD although we found symmetrical cortical cerebral atrophy in MRI.

Keywords: symmetric cortical atrophy, corticobasal degeneration, corticobasal syndrome

Procedia PDF Downloads 428

Authors: Yskak Nabi, Onolkan Umankulova, Ilyas Seitov

Abstract:

Tempus project about “Central Asian network for quality assurance – CANQA” had been implemented in 2009-2012. As the result of the project, two accreditation agencies were established: the agency for quality assurance in the field of education, “EdNet” in Kyrgyzstan, center of progressive technologies in Tajikistan. The importance of the research studies of the project is supported by the idea that the creation of Central-Asian network for quality assurance in education is still relevant, and results of the International forum “Global in regional: Kazakhstan in Bologna process and EU projects,” that was held in Nur-Sultan in October 2020, proves this. At the same time, the previous experience of the partnership between accreditation agencies of Central Asia shows that recommendations elaborated within the CANQA project were not theoretically justified. But there are a number of facts and arguments that prove the practical appliance of these recommendations. In this respect, joint activities of accreditation agencies of Kyrgyzstan and Kazakhstan are representative. For example, independent Kazakh agency of accreditation and rating successfully conducts accreditation of Kyrgyz universities; based on the memorandum about joint activity between the agency for quality assurance in the field of education “EdNet” (Kyrgyzstan) and Astana accreditation agency (Kazakhstan), the last one provides its experts for accreditation procedures in EdNet. Exchange of experience among the agencies shows an effective approach towards adaptation of European standards to the reality of education systems of Central Asia with consideration of not only a legal framework but also from the point of European practices view. Therefore, the relevance of the research is identified as there is a practical partnership between accreditation agencies of Central Asian countries, but the absence of theoretical justification of integrational processes in the accreditation field. As a result, the following hypothesis was put forward: “if to develop theoretical aspects for harmonization of accreditation standards, then integrational processes would be improved since the implementation of Bologna process principles would be supported with wider possibilities, and particularly, students and academic mobility would be improved.” Indeed, for example, in Kazakhstan, the total share of foreign students was 5,04% in 2020, and most of them are coming from Kyrgyzstan, Tajikistan, and Uzbekistan, and if integrational processes will be improved, then this share can increase.

Keywords: accreditation standards in education, Central Asian countries, pedagogical theory, model

Procedia PDF Downloads 173

Authors: Padma Chutoo, Elena Kulinskaya, Ilyas Bakbergenuly, Nicholas Steel, Dmitri Pchejetski

Abstract:

Transient ischaemic attacks (TIAs) are warning signs for future strokes. TIA patients are at increased risk of stroke and cardio-vascular events after a first episode. A majority of studies on TIA focused on the occurrence of these ancillary events after a TIA. Long-term mortality after TIA received only limited attention. We undertook this study to determine the long-term hazards of all-cause mortality following a first episode of a TIA using anonymised electronic health records (EHRs). We used a retrospective case-control study using electronic primary health care records from The Health Improvement Network (THIN) database. Patients born prior to or in year 1960, resident in England, with a first diagnosis of TIA between January 1986 and January 2017 were matched to three controls on age, sex and general medical practice. The primary outcome was all-cause mortality. The hazards of all-cause mortality were estimated using a time-varying Weibull-Cox survival model which included both scale and shape effects and a random frailty effect of GP practice. 20,633 cases and 58,634 controls were included. Cases aged 39 to 60 years at the first TIA event had the highest hazard ratio (HR) of mortality compared to matched controls (HR = 3.04, 95% CI (2.91 - 3.18)). The HRs for cases aged 61-70 years, 71-76 years and 77+ years were 1.98 (1.55 - 2.30), 1.79 (1.20 - 2.07) and 1.52 (1.15 - 1.97) compared to matched controls. Aspirin provided long-term survival benefits to cases. Cases aged 39-60 years on aspirin had HR of 0.93 (0.84 - 1.00), 0.90 (0.82 - 0.98) and 0.88 (0.80 - 0.96) at 5 years, 10 years and 15 years, respectively, compared to cases in the same age group who were not on antiplatelets. Similar beneficial effects of aspirin were observed in other age groups. There were no significant survival benefits with other antiplatelet options. No survival benefits of antiplatelet drugs were observed in controls. Our study highlights the excess long-term risk of death of TIA patients and cautions that TIA should not be treated as a benign condition. The study further recommends aspirin as the better option for secondary prevention for TIA patients compared to clopidogrel recommended by NICE guidelines. Management of risk factors and treatment strategies should be important challenges to reduce the burden of disease.

Keywords: dual antiplatelet therapy (DAPT), General Practice, Multiple Imputation, The Health Improvement Network(THIN), hazard ratio (HR), Weibull-Cox model

Procedia PDF Downloads 118

Authors: Mia Bahar, Özlem Bozkurt

Abstract:

Obsessive-compulsive disorder (OCD) is a typical, persistent, and long-lasting mental health condition in which a person experiences uncontrollable, recurrent thoughts (or "obsessions") and/or activities (or "compulsions") that they feel compelled to engage in repeatedly. Obsessive-compulsive disorder is both underdiagnosed and undertreated. It frequently manifests in a variety of medical settings and is persistent, expensive, and burdensome. Obsessive-compulsive neurosis was long believed to be a condition that offered valuable insight into the inner workings of the unconscious mind. Obsessive-compulsive disorder is now recognized as a prime example of a neuropsychiatric condition susceptible to particular pharmacotherapeutic and psychotherapy therapies and mediated by pathology in particular neural circuits. An obsessive-compulsive disorder which is called OCD, usually has two components, one cognitive and the other behavioral, although either can occur alone. Obsessions are often repetitive and intrusive thoughts that invade consciousness. These obsessions are incredibly hard to control or dismiss. People who have OCD often engage in rituals to reduce anxiety associated with intrusive thoughts. Once the ritual is formed, the person may feel extreme relief and be free from anxiety until the thoughts of contamination intrude once again. These thoughts are strengthened through a manifestation of negative reinforcement because they allow the person to avoid anxiety and obscurity. These thoughts are described as autogenous, meaning they most likely come from nowhere. These unwelcome thoughts are related to actions which we can describe as Thought Action Fusion. The thought becomes equated with an action, such as if they refuse to perform the ritual, something bad might happen, and so people perform the ritual to escape the intrusive thought. In almost all cases of OCD, the person's life gets extremely disturbed by compulsions and obsessions. Studies show OCD is an estimated 1.1% prevalence, making it a challenging issue with high co-morbidities with other issues like depressive episodes, panic disorders, and specific phobias. The first to reveal brain anomalies in OCD were numerous CT investigations, although the results were inconsistent. A few studies have focused on the orbitofrontal cortex (OFC), anterior cingulate gyrus (AC), and thalamus, structures also implicated in the pathophysiology of OCD by functional neuroimaging studies, but few have found consistent results. However, some studies have found abnormalities in the basal ganglion. There have also been some discussions that OCD might be genetic. OCD has been linked to families in studies of family aggregation, and findings from twin studies show that this relationship is somewhat influenced by genetic variables. Some Research has shown that OCD is a heritable, polygenic condition that can result from de novo harmful mutations as well as common and unusual variants. Numerous studies have also presented solid evidence in favor of a significant additive genetic component to OCD risk, with distinct OCD symptom dimensions showing both common and individual genetic risks.

Keywords: compulsions, obsessions, neuropsychiatric, genetic

Procedia PDF Downloads 46

Authors: Ilyas Khan. Liliane Pintelon, Harry Martin, Michael Shömig

Abstract:

The increasing costs of healthcare on one hand, and the rise in aging population and associated chronic disease, on the other hand, are putting increasing burden on the current health care system in many Western countries. For instance, chronic kidney disease (CKD) is a common disease and in Europe, the cost of renal replacement therapy (RRT) is very significant to the total health care cost. However, the recent advancement in healthcare technology, provide the opportunity to treat patients at home in their own comfort. It is evident that home healthcare offers numerous advantages apparently, low costs and high patients’ quality of life. Despite these advantages, the intake of home hemodialysis (HHD) therapy is still low in particular in Germany. Many factors are accounted for the low number of HHD intake. However, this paper is focusing on patients’ safety-related factors of current HHD practices in Germany. The aim of this paper is to analyze the current HHD practices in Germany and to identify risks related factors if any exist. A case study has been conducted in a dialysis center which consists of four dialysis centers in the south of Germany. In total, these dialysis centers have 350 chronic dialysis patients, of which, four patients are on HHD. The centers have 126 staff which includes six nephrologists and 120 other staff i.e. nurses and administration. The results of the study revealed several risk-related factors. Most importantly, these centers do not offer allied health services at the pre-dialysis stage, the HHD training did not have an established curriculum; however, they have just recently developed the first version. Only a soft copy of the machine manual is offered to patients. Surprisingly, the management was not aware of any standard available for home assessment and installation. The home assessment is done by a third party (i.e. the machines and equipment provider) and they may not consider the hygienic quality of the patient’s home. The type of machine provided to patients at home is similar to the one in the center. The model may not be suitable at home because of its size and complexity. Even though portable hemodialysis machines, which are specially designed for home use, are available in the market such as the NxStage series. Besides the type of machine, no assistance is offered for space management at home in particular for placing the machine. Moreover, the centers do not offer remote assistance to patients and their carer at home. However, telephonic assistance is available. Furthermore, no alternative is offered if a carer is not available. In addition, the centers are lacking medical staff including nephrologists and renal nurses.

Keywords: home hemodialysis, home hemodialysis practices, patients’ related risks in the current home hemodialysis practices, patient safety in home hemodialysis

Procedia PDF Downloads 95

Authors: Padma Chutoo, Elena Kulinskaya, Ilyas Bakbergenuly, Nicholas Steel, Dmitri Pchejetski

Abstract:

Stroke is associated with a significant risk of morbidity and mortality. There is scarcity of research on the long-term survival after first-ever ischaemic stroke (IS) events in England with regards to effects of different medical therapies and comorbidities. The objective of this study was to model the all-cause mortality after an IS diagnosis in the adult population of England. Using a retrospective case-control design, we extracted the electronic medical records of patients born prior to or in year 1960 in England with a first-ever ischaemic stroke diagnosis from January 1986 to January 2017 within the Health and Improvement Network (THIN) database. Participants with a history of ischaemic stroke were matched to 3 controls by sex and age at diagnosis and general practice. The primary outcome was the all-cause mortality. The hazards of the all-cause mortality were estimated using a Weibull-Cox survival model which included both scale and shape effects and a shared random effect of general practice. The model included sex, birth cohort, socio-economic status, comorbidities and medical therapies. 20,250 patients with a history of IS (cases) and 55,519 controls were followed up to 30 years. From 2008 to 2015, the one-year all-cause mortality for the IS patients declined with an absolute change of -0.5%. Preventive treatments to cases increased considerably over time. These included prescriptions of statins and antihypertensives. However, prescriptions for antiplatelet drugs decreased in the routine general practice since 2010. The survival model revealed a survival benefit of antiplatelet treatment to stroke survivors with hazard ratio (HR) of 0.92 (0.90 – 0.94). IS diagnosis had significant interactions with gender and age at entry and hypertension diagnosis. IS diagnosis was associated with high risk of all-cause mortality with HR= 3.39 (3.05-3.72) for cases compared to controls. Hypertension was associated with poor survival with HR = 4.79 (4.49 - 5.09) for hypertensive cases relative to non-hypertensive controls, though the detrimental effect of hypertension has not reached significance for hypertensive controls, HR = 1.19(0.82-1.56). This study of English primary care data showed that between 2008 and 2015, the rates of prescriptions of stroke preventive treatments increased, and a short-term all-cause mortality after IS stroke declined. However, stroke resulted in poor long-term survival. Hypertension, a modifiable risk factor, was found to be associated with poor survival outcomes in IS patients. Antiplatelet drugs were found to be protective to survival. Better efforts are required to reduce the burden of stroke through health service development and primary prevention.

Keywords: general practice, hazard ratio, health improvement network (THIN), ischaemic stroke, multiple imputation, Weibull-Cox model.

Procedia PDF Downloads 142

Authors: Brady Manescau, Ilyas Sellami, Khaled Chetehouna, Charles De Izarra, Rachid Nait-Said, Fati Zidani

Abstract:

During a fire in an oil and gas refinery, several thermal accidents can occur and cause serious damage to people and environment. Among these accidents, the BLEVE (Boiling Liquid Expanding Vapor Explosion) is most observed and remains a major concern for risk decision-makers. It corresponds to a violent vaporization of explosive nature following the rupture of a vessel containing a liquid at a temperature significantly higher than its normal boiling point at atmospheric pressure. Their effects on the environment generally appear in three ways: blast overpressure, radiation from the fireball if the liquid involved is flammable and fragment hazards. In order to estimate the potential damage that would be caused by such an explosion, risk decision-makers often use quantitative risk analysis (QRA). This analysis is a rigorous and advanced approach that requires a reliable data in order to obtain a good estimate and control of risks. However, in most cases, the data used in QRA are obtained from the empirical correlations. These empirical correlations generally overestimate BLEVE effects because they are based on simplifications and do not take into account real parameters like the geometry effect. Considering that these risk analyses are based on an assessment of BLEVE effects on human life and plant equipment, more precise and reliable data should be provided. From this point of view, the CFD modeling of BLEVE effects appears as a solution to the empirical law limitations. In this context, the main objective is to develop a numerical tool in order to predict BLEVE thermal effects using the CFD code FDS version 6. Simulations are carried out with a mesh size of 1 m. The fireball source is modeled as a vertical release of hot fuel in a short time. The modeling of fireball dynamics is based on a single step combustion using an EDC model coupled with the default LES turbulence model. Fireball characteristics (diameter, height, heat flux and lifetime) issued from the large scale BAM experiment are used to demonstrate the ability of FDS to simulate the various steps of the BLEVE phenomenon from ignition up to total burnout. The influence of release parameters such as the injection rate and the radiative fraction on the fireball heat flux is also presented. Predictions are very encouraging and show good agreement in comparison with BAM experiment data. In addition, a numerical study is carried out on an operational propane accumulator in an Algerian gas processing plant of SONATRACH company located in the Hassi R’Mel Gas Field (the largest gas field in Algeria).

Keywords: BLEVE effects, CFD, FDS, fireball, LES, QRA

Procedia PDF Downloads 157