Search results for: Jackson Andrade

Authors: Bianca W. O. Silva, Adriana C. M. Andrade, Gustavo C. M. Lucena, Virna M. S. Lima

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Introduction: Basic life support (BLS) involves the immediate recognition of cardiopulmonary arrest. Each year, 359.400 and 275.000 individuals with cardiac arrest are attended in emergency departments in USA and Europe. Brazilian data shows that 200.000 cardiac arrests occur every year, and half of them out of the hospital. Medical schools around the world teach BLS in the first years of the course, but studies show that there is a decline of the knowledge as the years go by, affecting the chain of survival. The objective was to analyze the knowledge of medical students about BLS and the retention of this learning throughout the course. Methods: This study included 150 students who were at the second and third year of a medical school in Salvador, Bahia, Brazil. The instrument of data collection was a structured questionnaire composed of 20 questions based on the 2015 American Heart Association guideline. The Pearson Chi-square test was used in order to study the association between previous training, sex and semester with the degree of knowledge of the students. The Kruskal-Wallis test was used to evaluate the different yields obtained between the various semesters. The number of correct answers was described by average and quartiles. Results: Regarding the degree of knowledge, 19.6% of the female students reached the optimal classification, a better outcome than the achieved by the male participants. Of those with previous training, 33.33% were classified as good and optimal, none of the students reached the optimal classification and only 2.2% of them were classified as bad (those who did not have 52.6% of correct answers). The analysis of the degree of knowledge related to each semester revealed that the 5th semester had the highest outcome: 30.5%. However, the acquaintance presented by the semesters was generally unsatisfactory, since 50% of the students, or more, demonstrated knowledge levels classified as bad or regular. When confronting the different semesters and the achieved scores, the value of p was 0.831. Conclusion: It is important to focus on the training of medical professionals that are capable of facing emergency situations, improving the systematization of care, and thereby increasing the victims' possibility of survival.

Keywords: basic life support, cardiopulmonary ressucitacion, education, medical students

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Authors: Maurício N. Kleinberg, Ana P. R. N. Barroso, Frederico R. Silva, Natasha l. Gomes, Rodrigo F. Guimarães, Marcelo M. V. Parente, Jackson Q. Malveira

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Increased production of biofuels, especially biodiesel, as an option to replace the diesel derived from oil is already a reality in countries seeking a renewable and environmentally friendly fuel, as is the case in Brazil. However, it is known that the use of fuels, renewable or not, implies that it is in contact with various metallic materials which may cause corrosion. In the search for more corrosion resistant materials has been experimentally observed that the addition of molybdenum in ferritic steels increases their protective character without significantly burdening the cost of production. In order to evaluate the effect of adding molybdenum, samples of commercial steel (austenitic, ferritic and carbon steel) and the experimental ferritic alloy with a high molybdenum content (5.3%) were immersed separately into biodiesel derived from transesterification of soy oil to monitor the corrosion process of these metal samples, and in parallel to analyze the oxidative degradation of biodiesel itself. During the immersion time of 258 days, biodiesel samples were taken for analysis of acidity, kinematic viscosity, density and refraction. Likewise, the metal samples were taken from the biodiesel to be weighed and microstructurally analyzed by light microscopy. The results obtained at the end of 258 days shown that biodiesel presented a considerable increase on the values of the studied parameters for all the samples. However, this increase was not able to produce significant mass loss in metallic samples. As regards the microstructural analysis, it showed the onset of surface oxidation on the carbon steel sample. As for the other samples, no significant surface changes were shown. These results are consistent with literature for short immersion times. It is concluded that the increase in the values of the studied parameters is not significant yet, probably due to the low time of immersion and exposure of the samples. Thus, it is necessary to continue the tests so that the objectives of this work are achieved.

Keywords: biodiesel, corrosion, immersion, experimental alloy

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Authors: Tarcisio F. Leao, Bruno Utiyama, Jeison Fonseca, Eduardo Bock, Aron Andrade

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This work presents a blood flow estimator based in Look-Up-Table (LUT) for control of Left Ventricular Assist Device (LVAD). This device has been used as bridge to transplantation or as destination therapy to treat patients with heart failure (HF). Destination Therapy application requires a high performance LVAD; thus, a stable control is important to keep adequate interaction between heart and device. LVAD control provides an adequate cardiac output while sustaining an appropriate flow and pressure blood perfusion, also described as physiologic control. Because thrombus formation and system reliability reduction, sensors are not desirable to measure these variables (flow and pressure blood). To achieve this, control systems have been researched to estimate blood flow. LVAD used in the study is composed by blood centrifugal pump, control, and power supply. This technique used pump and actuator (motor) parameters of LVAD, such as speed and electric current. Estimator relates electromechanical torque (motor or actuator) and hydraulic power (blood pump) via LUT. An in vitro Mock Loop was used to evaluate deviations between blood flow estimated and actual. A solution with glycerin (50%) and water was used to simulate the blood viscosity with hematocrit 45%. Tests were carried out with variation hematocrit: 25%, 45% and 58% of hematocrit, or 40%, 50% and 60% of glycerin in water solution, respectively. Test with bovine blood was carried out (42% hematocrit). Mock Loop is composed: reservoir, tubes, pressure and flow sensors, and fluid (or blood), beyond LVAD. Estimator based in LUT is patented, number BR1020160068363, in Brazil. Mean deviation is 0.23 ± 0.07 L/min for mean flow estimated. Larger mean deviation was 0.5 L/min considering hematocrit variation. This estimator achieved deviation adequate for physiologic control implementation. Future works will evaluate flow estimation performance in control system of LVAD.

Keywords: blood pump, flow estimator, left ventricular assist device, look-up-table

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Authors: Yannay Casas-Ledon, Cinthya A. Andrade, Camila E. Salazar, Mauricio Aguayo

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The sustainable management of available natural resources is a crucial question for policy-makers, economists, and the research community. Among several, land constitutes one of the most critical resources, which is being intensively appropriated by human activities producing ecological stresses and reducing ecosystem services. In this context, net primary production (NPP) has been considered as a feasible proxy indicator for estimating the impacts of human interventions on land-uses intensity. Accordingly, the human appropriation of NPP (HANPP) was calculated for the south-central regions of Chile between 2007 and 2014. The HANPP was defined as the difference between the potential NPP of the naturally produced vegetation (NPP0, i.e., the vegetation that would exist without any human interferences) and the NPP remaining in the field after harvest (NPPeco), expressed in gC/m² yr. Other NPP flows taken into account in HANPP estimation were the harvested (NPPh) and the losses of NPP through land conversion (NPPluc). The ArcGIS 10.4 software was used for assessing the spatial and temporal HANPP changes. The differentiation of HANPP as % of NPP0 was estimated by each landcover type taken in 2007 and 2014 as the reference years. The spatial results depicted a negative impact on land use efficiency during 2007 and 2014, showing negative HANPP changes for the whole region. The harvest and biomass losses through land conversion components are the leading causes of loss of land-use efficiency. Furthermore, the study depicted higher HANPP in 2014 than in 2007, representing 50% of NPP0 for all landcover classes concerning 2007. This performance was mainly related to the higher volume of harvested biomass for agriculture. In consequence, the cropland depicted the high HANPP followed by plantation. This performance highlights the strong positive correlation between the economic activities developed into the region. This finding constitutes the base for a better understanding of the main driving force influencing biomass productivity and a powerful metric for supporting the sustainable management of land use.

Keywords: human appropriation, land-use changes, land-use impact, net primary productivity

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Authors: Louise Jones, Rafael De Andrade Moral, John C. Stephens

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Background: Minerals are an essential component of correct nutrition. Conserved hay/haylage is an important component of many horse's diets. Variations in the mineral content of conserved forage should be considered when assessing dietary intake. Objectives: This study describes the levels and differences in 15 commonly analysed minerals in conserved forage fed to horses in the United Kingdom (UK), Ireland (IRL), and France (FRA). Methods: Hay (FRA n=92, IRL n=168, UK n=152) and haylage samples (UK n=287, IRL n=49) were collected during 2017-2020. Mineral analysis was undertaken using inductively coupled plasma-mass spectrometry (ICP-MS). Statistical analysis was performed using beta regression, Gaussian, or gamma models, depending on the nature of the response variable. Results: There are significant differences in the mineral content of the UK, IRL, and FRA conserved forage samples. FRA hay samples had a significantly higher (p < 0.05) levels of Sulphur (0.16 ± 0.0051 %), Calcium (0.56 ± 0.0342%), Magnesium (0.16 ± 0.0069 mg/ kg DM), Iron (194 ± 23.0 mg/kg DM), Cobalt (0.21 ± 0.0244 mg/kg DM) and Copper (4.94 ± 0.196 mg/kg DM) content compared to hay from the other two countries. UK hay samples had significantly less (p < 0.05) Selenium (0.07 ± 0.0084 mg/kg DM), whilst IRL hay samples were significantly (p < 0.05) higher in Chloride (0.9 ± 0.026mg/kg DM) compared to hay from the other two countries. IRL haylage samples were significantly (p < 0.05) higher in Phosphorus (0.26 ± 0.0102 %), Sulphur (0.17 ± 0.0052 %), Chloride (1.01 ± 0.0519 %), Calcium (0.54 ± 0.0257 %), Selenium (0.17 ± 0.0322 mg/kg DM) and Molybdenum (1.47 ± 0.137 mg/kg DM) compared to haylage from the UK. Main Limitations: Forage samples were obtained from professional yards and may not be reflective of forages fed by most horse owners. Information regarding soil type, species of grass, fertiliser treatment, harvest, or storage conditions were not included in this study. Conclusions: At a DM intake of 2% body weight, conserved forage as sampled in this study will be insufficient to meet Zinc, Iodine, and Copper NRC maintenance requirements, and Se intake will also be insufficient for horses fed the UK conserved forage. Many horses receive hay/haylage as the main component of their diet; this study highlights the need to consider forage analysis when making dietary recommendations.

Keywords: conserved forage, hay, haylage, minerals

Procedia PDF Downloads 190

Authors: Nelson F. F. Ebecken, Gilberto C. Pereira, Lucio P. de Andrade

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Bays, estuaries and coastal ecosystems are some of the most used and threatened natural systems globally. Its deterioration is due to intense and increasing human activities. This paper aims to monitor the socio-ecological in Brazil, model and simulate it through a multilayer network representing a DPSIR structure (Drivers, Pressures, States-Impacts-Responses) considering the concept of Management based on Ecosystems to support decision-making under the National/State/Municipal Coastal Management policy. This approach considers several interferences and can represent a significant advance in several scientific aspects. The main objective of this paper is the coupling of three different types of complex networks, the first being an ecological network, the second a social network, and the third a network of economic activities, in order to model the marine ecosystem. Multilayer networks comprise two or more "layers", which may represent different types of interactions, different communities, different points in time, and so on. The dependency between layers results from processes that affect the various layers. For example, the dispersion of individuals between two patches affects the network structure of both samples. A multilayer network consists of (i) a set of physical nodes representing entities (e.g., species, people, companies); (ii) a set of layers, which may include multiple layering aspects (e.g., time dependency and multiple types of relationships); (iii) a set of state nodes, each of which corresponds to the manifestation of a given physical node in a layer-specific; and (iv) a set of edges (weighted or not) to connect the state nodes among themselves. The edge set includes the intralayer edges familiar and interlayer ones, which connect state nodes between layers. The applied methodology in an existent case uses the Flow cytometry process and the modeling of ecological relationships (trophic and non-trophic) following fuzzy theory concepts and graph visualization. The identification of subnetworks in the fuzzy graphs is carried out using a specific computational method. This methodology allows considering the influence of different factors and helps their contributions to the decision-making process.

Keywords: marine ecosystems, complex systems, multilayer network, ecosystems management

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Authors: Santiago Silva de Andrade

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In recent decades, Marx's ecological theory of the value-form and the theory of metabolic rift have represented fundamental methodological innovations for social scientists interested in environmental transformations and their relationships with the development of the capital system. However, among Latin American environmental historians, such theoretical and methodological instruments have been used infrequently and very cautiously. This investigation aims to demonstrate how the concepts of metabolic rift and ecological value-form are important for understanding the environmental, economic and social transformations in the Amazon region between the second half of the 19th century and the end of the 20th century. Such transformations manifested themselves mainly in two dimensions: the first concerns the link between the manufacture of tropical substances for export and scientific developments in the fields of botany, chemistry and agriculture. This link was constituted as a set of social, intellectual and economic relations that condition each other, configuring an asymmetrical field of exchanges and connections between the demands of the industrialized world - personified in scientists, naturalists, businesspeople and bureaucrats - and the agencies of local social actors, such as indigenous people, riverside dwellers and quilombolas; the second dimension concerns the imperative link between the historical development of the capitalist world-system and the restructuring of the natural world, its landscapes, biomes and social relations, notably in peripheral colonial areas. The environmental effects of capitalist globalization were not only seen in the degradation of exploited environments, although this has been, until today, its most immediate and noticeable aspect. There was also, in territories subject to the logic of market accumulation, the reformulation of patterns of authority and institutional architectures, such as property systems, political jurisdictions, rights and social contracts, as a result of the expansion of commodity frontiers between the 16th and 21st centuries. . This entire set of transformations produced impacts on the ecological landscape of the Amazon. This demonstrates the need to investigate the histories of local configurations of power, spatial and ecological - with their institutions and social actors - and their role in structuring the capitalist world-system , under the lens of the ecological theory of value-form and metabolic rift.

Keywords: amazon, ecology, form-value, metabolic rift

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Authors: Macie Matta, Ahmad Jabri, Stephanie Jackson

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Introduction: In the absence of hypotension, pulmonary embolism (PE) causing right ventricular dysfunction or strain, whether confirmed by imaging or cardiac biomarkers, is deemed to be an intermediate-risk category. Urgent treatment of intermediate-risk PE can prevent progression to hemodynamic instability and death. Management options include thrombolysis, thrombectomy, or systemic anticoagulation. We aim to evaluate the short-term outcomes of a half-dose tissue plasminogen activator (tPA) for the management of intermediate-risk PE. Methods: We retrospectively identified adult patients diagnosed with intermediate-risk PE between the years 2000 and 2021. Demographic data, lab values, imaging, treatment choice, and outcomes were all obtained through chart review. Primary outcomes measured include major bleeding events and in-hospital mortality. Patients on standard systemic anticoagulation without receiving thrombolysis or thrombectomy served as controls. Patient data were analyzed using SAS®️ Software (version 9.4; Cary, NC) to compare individuals that received half-dose tPA with controls, and statistical significance was set at a p-value of 0.05. Results: We included 57 patients in our final analysis, with 19 receiving tPA. Patient characteristics and comorbidities were comparable between both groups. There was a significant difference between PE location, presence of acute deep vein thrombosis, and peak troponin level between both groups. The thrombolytic cohort was more likely to demonstrate a 60/60 sign and thrombus in transit finding on echocardiography than controls. The thrombolytic group was more likely to have major bleeding (17% vs 7.9%, p= 0.4) and in-hospital mortality (5.3% vs 0%, p=0.3); however, this was not statistically significant. Patients who received half-dose tPA had non-significantly higher rates of major bleeding and in-hospital mortality. Larger scale, randomized control trials are needed to establish the benefit and safety of thrombolytics in patients with intermediate-risk PE.

Keywords: pulmonary embolism, half dose thrombolysis, tissue plasminogen activator, cardiac biomarkers, echocardiographic findings, major bleeding event

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Authors: Todd Jackson

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In this randomized control trial, we tested the effectiveness of a peer-facilitated version of the Body Project (BP) intervention among body-dissatisfied young women in China. Participants were randomly assigned to a peer-facilitator BP condition (N = 94) versus an educational video minimal intervention control condition (N = 89). Questionnaire measures of two primary outcomes (i.e., disordered eating and body dissatisfaction) and six secondary outcomes (thin-ideal internalization, pressure to be thin, negative affect, body surveillance, body shame, body appreciation and interest in cosmetic surgery) were administered at a pre-treatment baseline, a post-treatment assessment, and at a 12-month follow-up. A series of 2 (Group) x 2 (Time) analyses of variance indicated women in the peer-facilitated BP condition reported significant improvements in primary outcome measures of disordered eating and body dissatisfaction compared to women in the educational video control condition following treatment and at the 12-month follow-up. Furthermore, women in the peer-facilitated BP condition reported significant improvements in measures of body surveillance, body shame and body appreciation) compared to educational video controls that extended to the 12-month follow-up. Finally, although women in the peer-facilitated BP condition showed significant post-treatment improvements in thin-ideal internalization, negative affect, perceived pressure to be thin, and interest in cosmetic surgery compared to video controls, these differences were no longer statistically significant at the 12-month follow-up. In conclusion, findings supported the overall effectiveness of a peer-facilitated group version of the BP as an intervention for reducing disordered eating and several associated risk factors among at-risk young women in China.

Keywords: body project, disordered eating, body dissatisfaction, risk factors, prevention, China

Procedia PDF Downloads 35

Authors: Ursula D. C. Resende, Yan G. Santos, Lucas M. de O. Andrade

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The recent and fast development of the internet, wireless, telecommunication technologies and low-power electronic devices has led to an expressive amount of electromagnetic energy available in the environment and the smart applications technology expansion. These applications have been used in the Internet of Things devices, 4G and 5G solutions. The main feature of this technology is the use of the wireless sensor. Although these sensors are low-power loads, their use imposes huge challenges in terms of an efficient and reliable way for power supply in order to avoid the traditional battery. The radio frequency based energy harvesting technology is especially suitable to wireless power sensors by using a rectenna since it can be completely integrated into the distributed hosting sensors structure, reducing its cost, maintenance and environmental impact. The rectenna is an equipment composed of an antenna and a rectifier circuit. The antenna function is to collect as much radio frequency radiation as possible and transfer it to the rectifier, which is a nonlinear circuit, that converts the very low input radio frequency energy into direct current voltage. In this work, a set of rectennas, mounted on a paper substrate, which can be used for the inner coating of buildings and simultaneously harvest electromagnetic energy from the environment, is proposed. Each proposed individual rectenna is composed of a 2.45 GHz patch antenna and a voltage doubler rectifier circuit, built in the same paper substrate. The antenna contains a rectangular radiator element and a microstrip transmission line that was projected and optimized by using the Computer Simulation Software (CST) in order to obtain values of S11 parameter below -10 dB in 2.45 GHz. In order to increase the amount of harvested power, eight individual rectennas, incorporating metamaterial cells, were connected in parallel forming a system, denominated Electromagnetic Wall (EW). In order to evaluate the EW performance, it was positioned at a variable distance from the internet router, and a 27 kΩ resistive load was fed. The results obtained showed that if more than one rectenna is associated in parallel, enough power level can be achieved in order to feed very low consumption sensors. The 0.12 m2 EW proposed in this work was able to harvest 0.6 mW from the environment. It also observed that the use of metamaterial structures provide an expressive growth in the amount of electromagnetic energy harvested, which was increased from 0. 2mW to 0.6 mW.

Keywords: electromagnetic energy harvesting, metamaterial, rectenna, rectifier circuit

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Authors: N. Dunleavy, E. Lovemore, K. Siljeur, D. Jackson, M. Hendricks, M. Hoosain, N. Plastow, S. Marais

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Background: The work requirements of sewing machine operators cause physical and emotional strain. Past ergonomic interventions have been provided to alleviate physical concerns; however, a holistic, multimodal intervention was needed to improve these factors. Aim: The study aimed to examine the effect of an occupational therapy programme on sewing machine operators’ pain, mental health, and productivity within a factory in the South African context. Methods: A pilot randomised control trial was conducted with 22 sewing machine operators within a single factory. Stratified randomisation was used to determine the experimental (EG) and control groups (CG), using measures for pain intensity, level of depression (mental health), and productivity rates as stratification variables. The EG received the multimodal intervention, incorporating education, seating adaptations, and mental health intervention. In three months, the CG will receive the same intervention. Pre- and post-intervention testing have occurred with upcoming three- and six-month follow-ups. Results: Immediate results indicate a statistically significant decrease in pain in both experimental and control groups; no change in productivity scores and depression between the two groups. This may be attributed to external factors. The values for depression further showed no statistical significance between the two groups and within pre-and post-test results. The Statistical Program for Social Sciences (SPSS) version-24 was used as the data analysis testing, where all the tests will be evaluated at a 5% significance level. Contribution of research: The research adds to the body of knowledge informing the Occupational Therapy role in work settings, providing evidence on the effectiveness of workplace-based multimodal interventions. Conclusion: The study provides initial data on the effectiveness of a pilot randomised control trial on pain and mental health in South Africa. Results indicated no quantitative change between the experimental and control groups; however, qualitative data suggest a clinical significance of the findings.

Keywords: ergonomics programme, occupational therapy, sewing machine operators, workplace-based multimodal interventions

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Authors: Jackson Andreas Theo Pola, Leksono Mucharam, Hari Oetomo, Budi Susanto, Wisnu Nugraha

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About half of the world oil reserves are located in carbonate reservoirs, where 65% of the total carbonate reservoirs are oil wet and 12% intermediate wet [1]. Oil recovery in oil wet or mixed wet carbonate reservoirs can be increased by dissolving surfactant to injected water to change the rock wettability from oil wet to more water wet. The Wakamuk Field operated by PetroChina International (Bermuda) Ltd. and PT. Pertamina EP in Papua, produces from main reservoir of Miocene Kais Limestone. First production commenced on August, 2004 and the peak field production of 1456 BOPD occurred in August, 2010. It was found that is a complex reservoir system and until 2014 cumulative oil production was 2.07 MMBO, less than 9% of OOIP. This performance is indicative of presence of secondary porosity, other than matrix porosity which is of low average porosity 13% and permeability less than 7 mD. Implementing chemical EOR in this case is the best way to increase oil production. However, the selected chemical must be able to lower the interfacial tension (IFT), reduce oil viscosity, and alter the wettability; thus a special chemical treatment named SeMAR has been proposed. Numerous laboratory tests such as phase behavior test, core compatibility test, mixture viscosity, contact angle measurement, IFT, imbibitions test and core flooding were conducted on Wakamuk field samples. Based on the spontaneous imbibitions results for Wakamuk field core, formulation of SeMAR with compositional S12A gave oil recovery 43.94% at 1wt% concentration and maximum percentage of oil recovery 87.3% at 3wt% concentration respectively. In addition, the results for first scenario of core flooding test gave oil recovery 60.32% at 1 wt% concentration S12A and the second scenario gave 96.78% of oil recovery at concentration 3 wt% respectively. The soaking time of chemicals has a significant effect on the recovery and higher chemical concentrations affect larger areas for wettability and therefore, higher oil recovery. The chemical that gives best overall results from laboratory tests study will also be a consideration for Huff and Puff injections trial (pilot project) for increasing oil recovery from Wakamuk Field

Keywords: Wakamuk field, chemical treatment, oil recovery, viscosity

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Authors: Isalira Peroba Ramos, Cherley Borba Vieira de Andrade, Grazielle Suhett, Camila Salata, Paulo Cesar Canary, Guilherme Visconde Brasil, Antonio Carlos Campos de Carvalho, Regina Coeli dos Santos Goldenberg

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Background: The therapeutic options for patients with cancer now include increasingly complex combinations of medications, radiation therapy (RT), and surgical intervention. Many of these treatments have important potential adverse cardiac effects and are likely to have significant effects on patient outcomes. Cell therapy appears to be promising for the treatment of chronic and degenerative diseases, including cardiomyopathy induced by RT, as the current therapeutic options are insufficient. Aims: To evaluate the potential of bone marrow mesenchymal cells (BMMCs) in radioinduced cardiac damage Methods: Female Wistar rats, 3 months old (Ethics Committee 054/14), were divided into 2 groups, non-treated irradiated group (IR n=15) and irradiated and BMMC treated (IRT n=10). Echocardiography was performed to evaluate heart function. After euthanasia, 3 months post treatment; the left ventricle was removed and prepared for RT-qPCR (VEGF and Pro Collagen I) and histological (picrosirius) analysis. Results: In both groups, 45 days after irradiation, ejection fraction (EF) was in the normal range for these animals (> 70%). However, the BMMC treated group had EF (83.1%±2.6) while the non-treated IR group showed a significant reduction (76.1%±2.6) in relation to the treated group. In addition, we observed an increase in VEGF gene expression and a decrease in Pro Collagen I in IRT when compared to IR group. We also observed by histology that the collagen deposition was reduced in IRT (10.26%±0.83) when compared to IR group (25.29%±0.96). Conclusions: Treatment with BMMCs was able to prevent ejection fraction reduction and collagen deposition in irradiated animals. The increase of VEGF and the decrease of pro collagen I gene expression might explain, at least in part, the cell therapy benefits. All authors disclose no financial or personal relationships with individuals or organizations that could be perceived to bias their work. Sources of funding: FAPERJ, CAPES, CNPq, MCT.

Keywords: mesenchymal cells, radioation, cardiotoxicity, bone marrow

Procedia PDF Downloads 229

Authors: G. Dottavio, M. F. Andrade, F. Renard, V. Cheutet, A.-L. Ladier, S. Vercraene, P. Hoang, S. Briet, R. Dachicourt, Y. Baizet

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An important number of technological equipment and high-skilled workers over long periods of time have to be mobilized during nuclear decommissioning processes. The related operations generate complex flows of waste and high inventory levels, associated to information flows of heterogeneous types. Taking into account that more than 10 decommissioning operations are on-going in France and about 50 are expected toward 2025: A big challenge is addressed today. The management of decommissioning and dismantling of nuclear installations represents an important part of the nuclear-based energy lifecycle, since it has an environmental impact as well as an important influence on the electricity cost and therefore the price for end-users. Bringing new technologies and new solutions into decommissioning methodologies is thus mandatory to improve the quality, cost and delay efficiency of these operations. The purpose of our project is to improve decommissioning management efficiency by developing a decision-support framework dedicated to plan nuclear facility decommissioning operations and to optimize waste evacuation by means of a logistic approach. The target is to create an easy-to-handle tool capable of i) predicting waste flows and proposing the best decommissioning logistics scenario and ii) managing information during all the steps of the process and following the progress: planning, resources, delays, authorizations, saturation zones, waste volume, etc. In this article we present our results from waste nuclear flows simulation during decommissioning process, including discrete-event simulation supported by FLEXSIM 3-D software. This approach was successfully tested and our works confirms its ability to improve this type of industrial process by identifying the critical points of the chain and optimizing it by identifying improvement actions. This type of simulation, executed before the start of the process operations on the basis of a first conception, allow ‘what-if’ process evaluation and help to ensure quality of the process in an uncertain context. The simulation of nuclear waste flows before evacuation from the site will help reducing the cost and duration of the decommissioning process by optimizing the planning and the use of resources, transitional storage and expensive radioactive waste containers. Additional benefits are expected for the governance system of the waste evacuation since it will enable a shared responsibility of the waste flows.

Keywords: nuclear decommissioning, logistical optimization, decision-support framework, waste management

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Authors: Cleto J. Sauer Jr., Rita C. Sauer, Chaider G. Andrade, Doris F. Rabelo

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Introduction: Endotracheal Intubation (ETI) is a procedure for clinical management of patients with severe clinical presentation of COVID-19 disease. Realistic simulation (RS) is an active learning methodology utilized for clinical skill's improvement. To improve ETI skills of public health network's physicians from Recôncavo da Bahia region in Brazil, during COVID-19 outbreak, RS training was planned and carried out. Training scenario included the Nasco Lifeform realistic simulator, and three actions were simulated: ETI procedure, sedative drugs management, and bougie guide utilization. Training intervention occurred between May and June 2020, as an interinstitutional cooperation between the Health's Department of Bahia State and the Federal University from Recôncavo da Bahia. Objective: The main objective is to report the effects on participants' self-confidence perception for ETI procedure after RS based training. Methods: This is a descriptive study, with secondary data extracted from questionnaires applied throughout RS training. Priority workplace, time from last intubation, and knowledge about bougie were reported on a preparticipation questionnaire. Additionally, participants completed pre- and post-training qualitative self-assessment (10-point Likert scale) regarding self-confidence perception in performing each of simulated actions. Distribution analysis for qualitative data was performed with Wilcoxon Signed Rank Test, and self-confidence increase analysis in frequency contingency tables with Fisher's Exact Test. Results: 36 physicians participated of training, 25 (69%) from primary care setting, 25 (69%) performed ETI over a year ago, and only 4 (11%) had previous knowledge about the bougie guide utilization. There was an increase in self-confidence medians for all three simulated actions. Medians (variation) for self-confidence before and after training, for each simulated action were as follows: ETI [5 (1-9) vs. 8 (6-10) (p < 0.0001)]; Sedative drug management [5 (1-9) vs. 8 (4-10) (p < 0.0001)]; Bougie guide utilization [2.5 (1-7) vs. 8 (4-10) (p < 0.0001)]. Among those who performed ETI over a year ago (n = 25), an increase in self-confidence greater than 3 points for ETI was reported by 23 vs. 2 physicians (p = 0.0002), and by 21 vs. 4 (p = 0.03) for sedative drugs management. Conclusions: RS training contributed to self-confidence increase in performing ETI. Among participants who performed ETI over a year, there was a significant association between RS training and increase of more than 3 points in self-confidence, both for ETI and sedative drug management. Training with RS methodology is suitable for ETI confidence enhancement during COVID-19 outbreak.

Keywords: confidence, COVID-19, endotracheal intubation, realistic simulation

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Authors: Petr Daniel Edward Kovarik, Malcolm Jackson, Charles Kelly, Rahul Patil, Shahid Iqbal

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Introduction: Recognition of the presence of extra capsular spread (ECS) has been a major change in the TNM 8th edition published by the American Joint Committee on Cancer in 2018. Irrespective of the size or number of lymph nodes, the presence of ECS makes N3b disease a stage IV disease. The objective of this retrospective observational study was to conduct a comparative analysis of survival outcomes in patients with lymph node-positive cutaneous head and neck squamous cell carcinoma (CHNSCC) based on their TNM 7th and TNM 8th editions classification. Materials and Methods: From January 2010 to December 2020, 71 patients with CHNSCC were identified from our centre’s database who were treated with radical surgery and adjuvant radiotherapy. All histopathological reports were reviewed, and comprehensive nodal mapping was performed. The data were collected retrospectively and survival outcomes were compared using TNM 7th and 8th editions. Results: The median age of the whole group of 71 patients was 78 years, range 54 – 94 years, 63 were male and 8 female. In total, 2246 lymph nodes were analysed; 195 were positive for cancer. ECS was present in 130 lymph nodes, which led to a change in TNM staging. The details on N-stage as per TNM 7th edition was as follows; pN1 = 23, pN2a = 14, pN2b = 32, pN2c = 0, pN3 = 2. After incorporating the TNM 8th edition criterion (presence of ECS), the details on N-stage were as follows; pN1 = 6, pN2a = 5, pN2b = 3, pN2c = 0, pN3a = 0, pN3b = 57. This showed an increase in overall stage. According to TNM 7th edition, there were 23 patients were with stage III and remaining 48 patients, stage IV. As per TNM 8th edition, there were only 6 patients with stage III as compared to 65 patients with stage IV. For all patients, 2-year disease specific survival (DSS) and overall survival (OS) were 70% and 46%. 5-year DSS and OS rates were 66% and 20% respectively. Comparing the survival between stage III and stage IV of the two cohorts using both TNM 7th and 8th editions, there is an obvious greater survival difference between the stages if TNM 8th staging is used. However, meaningful statistics were not possible as the majority of patients (n = 65) were with stage IV and only 6 patients were stage III in the TNM 8th cohort. Conclusion: Our study provides a comprehensive analysis on lymph node data mapping in this specific patient population. It shows a better differentiation between stage III and stage IV in the TNM 8th edition as compared to TNM 7th however meaningful statistics were not possible due to the imbalance of patients in the sub-cohorts of the groups.

Keywords: cutaneous head and neck squamous cell carcinoma, extra capsular spread, neck lymphadenopathy, TNM 7th and 8th editions

Procedia PDF Downloads 68

Authors: Nelson Ponce Jr., Jonas R. Gazoli, Alessandro Sete, Roberto M. G. Velásquez, Valério L. Borges, Moacir A. S. de Andrade

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The search for increased efficiency in generation systems has been of great importance in recent years to reduce the impact of greenhouse gas emissions and global warming. For clean energy sources, such as the generation systems that use concentrated solar power technology, this efficiency improvement impacts a lower investment per kW, improving the project’s viability. For the specific case of parabolic trough solar concentrators, their performance is strongly linked to their geometric precision of assembly and the individual efficiencies of their main components, such as parabolic mirrors and receiver tubes. Thus, for accurate efficiency analysis, it should be conducted empirically, looking for mounting and operating conditions like those observed in the field. The Brazilian power generation and distribution company Eletrobras Furnas, through the R&D program of the National Agency of Electrical Energy, has developed a plant for testing parabolic trough concentrators located in Aparecida de Goiânia, in the state of Goiás, Brazil. The main objective of this test plant is the characterization of the prototype concentrator that is being developed by the company itself in partnership with Eudora Energia, seeking to optimize it to obtain the same or better efficiency than the concentrators of this type already known commercially. This test plant is a closed pipe system where a pump circulates a heat transfer fluid, also calledHTF, in the concentrator that is being characterized. A flow meter and two temperature transmitters, installed at the inlet and outlet of the concentrator, record the parameters necessary to know the power absorbed by the system and then calculate its efficiency based on the direct solar irradiation available during the test period. After the HTF gains heat in the concentrator, it flows through heat exchangers that allow the acquired energy to be dissipated into the ambient. The goal is to keep the concentrator inlet temperature constant throughout the desired test period. The developed plant performs the tests in an autonomous way, where the operator must enter the HTF flow rate in the control system, the desired concentrator inlet temperature, and the test time. This paper presents the methodology employed for design and operation, as well as the instrumentation needed for the development of a parabolic trough test plant, being a guideline for standardization facilities.

Keywords: parabolic trough, concentrated solar power, CSP, solar power, test plant, energy efficiency, performance characterization, renewable energy

Procedia PDF Downloads 87

Authors: A. G. Cunha, M. Inácio, M. C. Freitas, C. Antunes, T. Silva, C. Andrade, V. Lopes

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Saltmarshes are essential ecosystems both from an ecological and biological point of view. Furthermore, they constitute an important social niche, providing valuable economic and protection functions. Thus, understanding their rates and patterns of sedimentation is critical for functional management and rehabilitation, especially in an SLR scenario. The Sado estuary is located 40 km south of Lisbon. It is a bar built estuary, separated from the sea by a large sand spit: the Tróia barrier. Caldeira de Tróia is located on the free edge of this barrier, and encompasses a salt marsh with ca. 21,000 m². Sediment cores were collected in the high and low marshes and in the mudflat area of the North bank of Caldeira de Tróia. From the low marsh core, fifteen samples were chosen for ²¹⁰Pb and ¹³⁷Cs determination at University of Geneva. The cores from the high marsh and the mudflat are still being analyzed. A sedimentation rate of 2.96 mm/year was derived from ²¹⁰Pb using the Constant Flux Constant Sedimentation model. The ¹³⁷Cs profile shows a peak in activity (1963) between 15.50 and 18.50 cm, giving a 3.1 mm/year sedimentation rate for the past 53 years. The adopted sea level rise scenario was based on a model built with the initial rate of SLR of 2.1 mm/year in 2000 and an acceleration of 0.08 mm/year². Based on the harmonic analysis of Setubal-Tróia tide gauge of 2005 data, the tide model was estimated and used to build the tidal tables to the period 2000-2016. With these tables, the average mean water levels were determined for the same time span. A digital terrain model was created from LIDAR scanning with 2m horizontal resolution (APA-DGT, 2011) and validated with altimetric data obtained with a DGPS-RTK. The response model calculates a new elevation for each pixel of the DTM for 2050 and 2100 based on the sedimentation rates specific of each environment. At this stage, theoretical values were chosen for the high marsh and the mudflat (respectively, equal and double the low marsh rate – 2.92 mm/year). These values will be rectified once sedimentation rates are determined for the other environments. For both projections, the total surface of the marsh decreases: 2% in 2050 and 61% in 2100. Additionally, the high marsh coverage diminishes significantly, indicating a regression in terms of maturity.

Keywords: ¹³⁷Cs, ²¹⁰Pb, saltmarsh, sea level rise, response model

Procedia PDF Downloads 225

Authors: Joseph Mwiti Marangu, Joseph Karanja Thiong'o, Jackson Muthengia Wachira

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The mechanical performance of hydrated cements mortars mainly depends on its compressive strength and setting time. These properties are crucial in the construction industry. Pozzolana based cements are mostly characterized by low 28 day compressive strength and long setting times. These are some of the major impediments to their production and diverse uses despite numerous technological and environmental benefits associated with them. The study investigated the effects of potential chemical activators on calcined clay- Portland cement blends with an aim to achieve high early compressive strength and shorter setting times in cement mortar. In addition, standard consistency, soundness and insoluble residue of all cement categories was determined. The test cement was made by blending calcined clays with Ordinary Portland Cement (OPC) at replacement levels from 35 to 50 percent by mass of the OPC to make test cement labeled PCC for the purposes of this study. Mortar prisms measuring 40mmx40mmx160mm were prepared and cured in accordance with KS EAS 148-3:2000 standard. Solutions of Na2SO4, NaOH, Na2SiO3 and Na2CO3 containing 0.5- 2.5M were separately added during casting. Compressive strength was determined at 2rd, 7th, 28th and 90th day of curing. For comparison purposes, commercial Portland Pozzolana cement (PPC) and Ordinary Portland Cement (OPC) were also investigated without activators under similar conditions. X-Ray Florescence (XRF) was used for chemical analysis while X-Ray Diffraction (XRD) and Fourier Transform Infrared Spectroscopy (FTIR) were used for mineralogical analysis of the test samples. The results indicated that addition of activators significantly increased the 2nd and 7th day compressive strength but minimal increase on the 28th and 90th day compressive strength. A relatively linear relationship was observed between compressive strength and concentration of activator solutions up to 28th of curing. Addition of the said activators significantly reduced both initial and final setting time. Standard consistency and soundness varied with increased amount of clay in the test cement and concentration of activators. Amount of insoluble residues increased with increased replacement of OPC with calcined clays. Mineralogical studies showed that N-A-S-H is formed in addition to C-S-H. In conclusion, the concentration of 2 molar for all activator solutions produced the optimum compressive strength and greatly reduced the setting times for all cement mortars.

Keywords: activators, admixture, cement, clay, pozzolana

Procedia PDF Downloads 229

Authors: Pamela R. Jackson, Andrea Hawkins-Daarud, Cassandra R. Rickertsen, Kamala Clark-Swanson, Scott A. Whitmire, Kristin R. Swanson

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Glioblastoma Multiforme (GBM), the most common primary brain tumor, often presents with hyperintensity on T2-weighted or T2-weighted fluid attenuated inversion recovery (T2/FLAIR) magnetic resonance imaging (MRI). This hyperintensity corresponds with vasogenic edema, however there are likely many infiltrating tumor cells within the hyperintensity as well. While MRIs do not directly indicate tumor cells, MRIs do reflect the microenvironmental water abnormalities caused by the presence of tumor cells and edema. The inherent heterogeneity and resulting MRI features of GBMs complicate assessing disease response. To understand how hyperintensity on T2/FLAIR MRI may correlate with edema in the extracellular space (ECS), a multi-compartmental MRI signal equation which takes into account tissue compartments and their associated volumes with input coming from a mathematical model of glioma growth that incorporates edema formation was explored. The reasonableness of two possible extracellular space schema was evaluated by varying the T2 of the edema compartment and calculating the possible resulting T2s in tumor and peripheral edema. In the mathematical model, gliomas were comprised of vasculature and three tumor cellular phenotypes: normoxic, hypoxic, and necrotic. Edema was characterized as fluid leaking from abnormal tumor vessels. Spatial maps of tumor cell density and edema for virtual tumors were simulated with different rates of proliferation and invasion and various ECS expansion schemes. These spatial maps were then passed into a multi-compartmental MRI signal model for generating simulated T2/FLAIR MR images. Individual compartments’ T2 values in the signal equation were either from literature or estimated and the T2 for edema specifically was varied over a wide range (200 ms – 9200 ms). T2 maps were calculated from simulated images. T2 values based on simulated images were evaluated for regions of interest (ROIs) in normal appearing white matter, tumor, and peripheral edema. The ROI T2 values were compared to T2 values reported in literature. The expanding scheme of extracellular space is had T2 values similar to the literature calculated values. The static scheme of extracellular space had a much lower T2 values and no matter what T2 was associated with edema, the intensities did not come close to literature values. Expanding the extracellular space is necessary to achieve simulated edema intensities commiserate with acquired MRIs.

Keywords: extracellular space, glioblastoma multiforme, magnetic resonance imaging, mathematical modeling

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Authors: Barrera C. Monserrat, Sierra-Alvarez Reyes, Pat-Espadas Aurora, Moreno Andrade Ivan

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Antimony is a toxic and carcinogenic metalloid considered a pollutant of priority interest by the United States Environmental Protection Agency. It is present in the environment in two oxidation states: antimonite (Sb (III)) and antimony (Sb (V)). Sb (III) is toxic to several aquatic organisms, but the potential inhibitory effect of Sb species for microorganisms has not been extensively evaluated. The fate and possible toxic impact of antimony on aerobic and anaerobic wastewater treatment systems are unknown. For this reason, the objective of this study was to evaluate the microbial toxicity of Sb (V) and Sb (III) in aerobic and anaerobic environments. Sb(V) and Sb(III) were used as potassium hexahydroxoantimonate (V) and potassium antimony tartrate, respectively (Sigma-Aldrich). The toxic effect of both Sb species in anaerobic environments was evaluated on methanogenic activity and the inhibition of hydrogen production of microorganisms from a wastewater treatment bioreactor. For the methanogenic activity, batch experiments were carried out in 160 mL serological bottles; each bottle contained basal mineral medium (100 mL), inoculum (1.5 g of VSS/L), acetate (2.56 g/L) as substrate, and variable concentrations of Sb (V) or Sb (III). Duplicate bioassays were incubated at 30 ± 2°C on an orbital shaker (105 rpm) in the dark. Methane production was monitored by gas chromatography. The hydrogen production inhibition tests were carried out in glass bottles with a working volume of 0.36 L. Glucose (50 g/L) was used as a substrate, pretreated inoculum (5 g VSS/L), mineral medium and varying concentrations of the two species of antimony. The bottles were kept under stirring and at a temperature of 35°C in an AMPTSII device that recorded hydrogen production. The toxicity of Sb on aerobic microorganisms (from a wastewater activated sludge treatment plant) was tested with a Microtox standardized toxicity test and respirometry. Results showed that Sb (III) is more toxic than Sb (V) for methanogenic microorganisms. Sb (V) caused a 50% decrease in methanogenic activity at 250 mg/L. In contrast, exposure to Sb (III) resulted in a 50% inhibition at a concentration of only 11 mg/L, and an almost complete inhibition (95%) at 25 mg/L. For hydrogen-producing microorganisms, Sb (III) and Sb (V) inhibited 50% of this production with 12.6 mg/L and 87.7 mg/L, respectively. The results for aerobic environments showed that 500 mg/L of Sb (V) do not inhibit the Allivibrio fischeri (Microtox) activity or specific oxygen uptake rate of activated sludge. In the case of Sb (III), this caused a loss of 50% of the respiration of the microorganisms at concentrations below 40 mg/L. The results obtained indicate that the toxicity of the antimony will depend on the speciation of this metalloid and that Sb (III) has a significantly higher inhibitory potential compared to Sb (V). It was shown that anaerobic microorganisms can reduce Sb (V) to Sb (III). Acknowledgments: This work was funded in part by grants from the UA-CONACYT Binational Consortium for the Regional Scientific Development and Innovation (CAZMEX), the National Institute of Health (NIH ES- 04940), and PAPIIT-DGAPA-UNAM (IN105220).

Keywords: aerobic inhibition, antimony reduction, hydrogen inhibition, methanogenic toxicity

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Authors: Ariyan S. Araghi, Guy C. Jackson, Stephen J. Bonsor

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Materials & Methods: A systematic literature search was undertaken using pre-determined inclusion and exclusion criteria. This review followed the Preferred Reporting Items for Systemic Reviews and Meta-Analysis (PRISMA) statement. Several databases were used to search for randomised control trials and longitudinal cohort studies, which were published less than thirty years ago. A total of 54 studies met the predefined inclusion criteria. Four studies reviewed the success, survival, and failure characteristics of zirconia framework resin retained bridges, whilst two reviewed non-precious metal resin retained bridges. Results: The analysis of the studies revealed an overall survival rate of 95.9% for zirconia-based restorations compared to 90.7% for non-precious metal frameworks. Non-precious metal resin retained bridges displayed a higher overall failure rate of 11.9% compared to 4.6% for zirconia-based restorations in the analysed papers. The most frequent complications were wing debonding for the non-precious metal wing group, whereas substructure fracture and veneering ceramic fracture were more prevalent for the zirconia arm of the study. Conclusion: Both types of resin retained bridges provide effective medium to long-term survival. Zirconia-based frameworks will provide marginally increased success and survival and greatly improved aesthetics. However, catastrophic failure is more likely with zirconia-based restorations. Non-precious metal is time tested but performs worse than its zirconia counterpart with regards to longevity; it does not exhibit the same framework fractures as zirconia. Cement choice and attention to the adhesive bonding systems used appear to be paramount to restoration longevity with both restoration subtypes. Furthermore, improved longevity can be seen when air particle abrasion is incorporated into the adhesive protocol. Within the limitations of this study, it has been determined that zirconia-based resin retained bridges can be effectively used in anterior cantilever bridges. Clinical Significance: Zirconia-based resin retained bridges have been demonstrating promising results in terms of improved success and survival characteristics, together with improved aesthetics when compared to non-precious metal winged resin retained bridges. Their popularity is increasing in the age of digital dentistry as many restorations are manufactured using such technology. It is essential that clinicians understand the limitations of each material type and principles of adhesion to ensure restoration longevity.

Keywords: resin retained bridge, fixed partial denture, zirconia bridge, adhesive bridge

Procedia PDF Downloads 59

Authors: D. Hilton

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The importance and significance of this research is based upon the fundamental knowledge reported in the scientific literature that physical activity is inversely associated with obesity. In addition, it is recognized there is a global epidemic of sedentariness while at the same time it is known that morbidity and mortality are associated with physical inactivity and as a result of overweight or obesity. Hence this small study in school students is an important area of research in our community. An application submitted in 2005 for the inaugural Public Health Education Research Trust [PHERT] Post Graduate Research Scholarship scheme organized by the Public Health Association of Australia [PHAA] was awarded 3rd place within Australia. The author and title was: D. Hilton, Methods to increase physical activity in school aged children [literature review, a trial using pedometers and a policy paper]. Third place is a good result, however this did not secure funding for the project, as only first place received $5000 funding. Some years later within Australia, a program commenced called the Global Children's Challenge [GCC]. Given details of the 2005 award above were included an application submission prepared for Parkhill Primary School [PPS] which is located in Victoria, Australia was successful. As a result, an excited combined grade 3/ 4 class at the school [27 students] in 2012 became recipients of these free pedometers. Ambassadors for the program were Mrs Catherine Freeman [OAM], Olympic Gold Medalist – Sydney 2000 [400 meters], while another ambassador was Mr Colin Jackson [CBE] who is a Welsh former sprint and hurdling athlete. In terms of PPS and other schools involved in 2012, website details show that the event started on 19th Sep 2012 and students were to wear the pedometer every day for 50 days [at home and at school] aiming for the recommended 15,000 steps/day recording steps taken in a booklet provided. After the finish, an analysis of the average step count for this school showed that the average steps taken / day was 14, 003 [however only a small percentage of students returned the booklets and units] as unfortunately the dates for the program coincided with school holidays so some students either forgot or misplaced the units / booklets. Unfortunately funding for this program ceased in 2013, however the lasting impact of the trial on student’s knowledge and awareness remains and in fact becomes a good grounding for students in how to monitor basic daily physical activity using a method that is easy, fun, low cost and readily accessible.

Keywords: walking, physical activity, exercise, Australian school

Procedia PDF Downloads 275

Authors: Christi Jackson, Chuka Onaga

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Introduction: We report a case of delayed diagnosis of extra-pulmonary INH-mono-resistant Tuberculosis (TB) in a South African patient with drug-resistant HIV. Case Presentation: A 36-year old male was initiated on 1st line (NNRTI-based) anti-retroviral therapy (ART) in September 2009 and switched to 2nd line (PI-based) ART in 2011, according to local guidelines. He was following up at the outpatient wellness unit of a public hospital, where he was diagnosed with Protease Inhibitor resistant HIV in March 2016. He had an HIV viral load (HIVVL) of 737000 copies/mL, CD4-count of 10 cells/µL and presented with complaints of productive cough, weight loss, chronic diarrhoea and a septic buttock wound. Several investigations were done on sputum, stool and pus samples but all were negative for TB. The patient was treated with antibiotics and the cough and the buttock wound improved. He was subsequently started on a 3rd-line ART regimen of Darunavir, Ritonavir, Etravirine, Raltegravir, Tenofovir and Emtricitabine in May 2016. He continued losing weight, became too weak to stand unsupported and started complaining of abdominal pain. Further investigations were done in September 2016, including a urine specimen for Line Probe Assay (LPA), which showed M. tuberculosis sensitive to Rifampicin but resistant to INH. A lymph node biopsy also showed histological confirmation of TB. Management and outcome: He was started on Rifabutin, Pyrazinamide and Ethambutol in September 2016, and Etravirine was discontinued. After 6 months on ART and 2 months on TB treatment, his HIVVL had dropped to 286 copies/mL, CD4 improved to 179 cells/µL and he showed clinical improvement. Pharmacy supply of his individualised drugs was unreliable and presented some challenges to continuity of treatment. He successfully completed his treatment in June 2017 while still maintaining virological suppression. Discussion: Several laboratory-related factors delayed the diagnosis of TB, including the unavailability of urine-lipoarabinomannan (LAM) and urine-GeneXpert (GXP) tests at this facility. Once the diagnosis was made, it presented a treatment dilemma due to the expected drug-drug interactions between his 3rd-line ART regimen and his INH-resistant TB regimen, and specialist input was required. Conclusion: TB is more difficult to diagnose in patients with severe immunosuppression, therefore additional tests like urine-LAM and urine-GXP can be helpful in expediting the diagnosis in these cases. Patients with non-standard drug regimens should always be discussed with a specialist in order to avoid potentially harmful drug-drug interactions.

Keywords: drug-resistance, HIV, line probe assay, tuberculosis

Procedia PDF Downloads 133

Authors: Juliana C. Salvadori, Jose Carlos Felix

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This paper aims at discussing the role literary translation has played in Brazilian Concrete Poetry Movement – an aesthetic, critical and pedagogical project which conceived translation as poiesis, i.e., as both creative and critic work in which the potency (dynamic) of literary work is unfolded in the interpretive and critic act (energeia) the translating practice demands. We argue that translation, for concrete poets, is conceived within the framework provided by the reinterpretation –or deglutition– of Oswald de Andrade’s anthropophagy – a carefully selected feast from which the poets pick and model their Paideuma. As a case study, we propose to approach and analyze two of Augusto de Campos’s long-term translation projects: the translation of Emily Dickinson’s and E. E. Cummings’s works to Brazilian readers. Augusto de Campos is a renowned poet, translator, critic and one of the founding members of Brazilian Concrete Poetry movement. Since the 1950s he has produced a consistent body of translated poetry from English-speaking poets in which the translator has explored creative translation processes – transcreation, as concrete poets have named it. Campos’s translation project regarding E. E. Cummings’s poetry comprehends a span of forty years: it begins in 1956 with 10 poems and unfolds in 4 works – 20 poem(a)s, 40 poem(a)s, Poem(a)s, re-edited in 2011. His translations of Dickinson’s poetry are published in two works: O Anticrítico (1986), in which he translated 10 poems, and Emily Dickinson Não sou Ninguém (2008), in which the poet-translator added 35 more translated poems. Both projects feature bilingual editions: contrary to common sense, Campos translations aim at being read as such: the target readers, to fully enjoy the experience, must be proficient readers of English and, also, acquainted with the poets in translation – Campos expects us to perform translation criticism, as Antoine Berman has proposed, by assessing the choices he, as both translator and poet, has presented in order to privilege aesthetic information (verse lines, word games, etc.). To readers not proficient in English, his translations play a pedagogycal role of educating and preparing them to read both the target poet works as well as concrete poetry works – the detailed essays and prefaces in which the translator emphasizes the selection of works translated and strategies adopted enlighten his project as translator: for Cummings, it has led to the oblieraton of the more traditional and lyrical/romantic examples of his poetry while highlighting the more experimental aspects and poems; for Dickinson, his project has highligthed the more hermetic traits of her poems. To the domestic canons of both poets in Brazilian literary system, we analyze Campos’ contribution in this work.

Keywords: translation criticism, Augusto de Campos, E. E. Cummings, Emily Dickinson

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Authors: Mark Jackson

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Description: This paper is based on an theoretical analysis of the efficacy of the dominant model of policing in western jurisdictions. Those results are then compared with a similar analysis of a traditional reactive model. It is found that neither model provides for optimal delivery of services. Instead optimal service can be achieved by a synchronous hybrid model, termed the Convectory Policing approach. Methodology and Findings: For over three decades problem oriented policing (PO) has been the dominant model for western police agencies. Initially based on the work of Goldstein during the 1970s the problem oriented framework has spawned endless variants and approaches, most of which embrace a problem solving rather than a reactive approach to policing. This has included the Area Policing Concept (APC) applied in many smaller jurisdictions in the USA, the Scaled Response Policing Model (SRPM) currently under trial in Western Australia and the Proactive Pre-Response Approach (PPRA) which has also seen some success. All of these, in some way or another, are largely based on a model that eschews a traditional reactive model of policing. Convectory Policing (CP) is an alternative model which challenges the underpinning assumptions which have seen proliferation of the PO approach in the last three decades and commences by questioning the economics on which PO is based. It is argued that in essence, the PO relies on an unstated, and often unrecognised assumption that resources will be available to meet demand for policing services, while at the same time maintaining the capacity to deploy staff to develop solutions to the problems which were ultimately manifested in those same calls for service. The CP model relies on the observations from a numerous western jurisdictions to challenge the validity of that underpinning assumption, particularly in fiscally tight environment. In deploying staff to pursue and develop solutions to underpinning problems, there is clearly an opportunity cost. Those same staff cannot be allocated to alternative duties while engaged in a problem solution role. At the same time, resources in use responding to calls for service are unavailable, while committed to that role, to pursue solutions to the problems giving rise to those same calls for service. The two approaches, reactive and PO are therefore dichotomous. One cannot be optimised while the other is being pursued. Convectory Policing is a pragmatic response to the schism between the competing traditional and contemporary models. If it is not possible to serve either model with any real rigour, it becomes necessary to taper an approach to deliver specific outcomes against which success or otherwise might be measured. CP proposes that a structured roster-driven approach to calls for service, combined with the application of what is termed a resource-effect response capacity has the potential to resolve the inherent conflict between traditional and models of policing and the expectations of the community in terms of community policing based problem solving models.

Keywords: policing, reactive, proactive, models, efficacy

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Authors: Lenon M. Pereira, Helen J. Khoury, Marcos E. A. Andrade, Dean L. Cutajar, Vinicius S. M. Barros, Anatoly B. Rozenfeld

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With the increase of beam widths and the advent of multiple-slice and helical scanners, concerns related to the current dose measurement protocols and instrumentation in computed tomography (CT) have arisen. The current methodology of dose evaluation, which is based on the measurement of the integral of a single slice dose profile using a 100 mm long cylinder ionization chamber (Ca,100 and CPPMA, 100), has been shown to be inadequate for wide beams as it does not collect enough of the scatter-tails to make an accurate measurement. In addition, a long ionization chamber does not offer a good representation of the dose profile when tube current modulation is used. An alternative approach has been suggested by translating smaller detectors through the beam plane and assessing the accumulated dose trough the integral of the dose profile, which can be done for any arbitrary length in phantoms or in the air. For this purpose, a MOSFET dosimeter of small dosimetric volume was used. One of its recently designed versions is known as the MOSkin, which is developed by the Centre for Medical Radiation Physics at the University of Wollongong, and measures the radiation dose at a water equivalent depth of 0.07 mm, allowing the evaluation of skin dose when placed at the surface, or internal point doses when placed within a phantom. Thus, the aim of this research was to characterize the response of the MOSkin dosimeter for X-ray CT beams and to evaluate its application for the accumulated dose assessment. Initially, tests using an industrial x-ray unit were carried out at the Laboratory of Ionization Radiation Metrology (LMRI) of Federal University of Pernambuco, in order to investigate the sensitivity, energy dependence, angular dependence, and reproducibility of the dose response for the device for the standard radiation qualities RQT 8, RQT 9 and RQT 10. Finally, the MOSkin was used for the accumulated dose evaluation of scans using a Philips Brilliance 6 CT unit, with comparisons made between the CPPMA,100 value assessed with a pencil ionization chamber (PTW Freiburg TW 30009). Both dosimeters were placed in the center of a PMMA head phantom (diameter of 16 cm) and exposed in the axial mode with collimation of 9 mm, 250 mAs and 120 kV. The results have shown that the MOSkin response was linear with doses in the CT range and reproducible (98.52%). The sensitivity for a single MOSkin in mV/cGy was as follows: 9.208, 7.691 and 6.723 for the RQT 8, RQT 9 and RQT 10 beams qualities respectively. The energy dependence varied up to a factor of ±1.19 among those energies and angular dependence was not greater than 7.78% within the angle range from 0 to 90 degrees. The accumulated dose and the CPMMA, 100 value were 3,97 and 3,79 cGy respectively, which were statistically equivalent within the 95% confidence level. The MOSkin was shown to be a good alternative for CT dose profile measurements and more than adequate to provide accumulated dose assessments for CT procedures.

Keywords: computed tomography dosimetry, MOSFET, MOSkin, semiconductor dosimetry

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Authors: Taurino S. R. Neto, Epitácio D. S. Neto, Flávio Signorelli, Gustavo G. M. Balbi, Alex H. Higashi, Mário Luiz R. Monteiro, Eloisa Bonfá, Danieli C. O. Andrade, Leandro C. Zacharias

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Purpose: To perform a multimodal evaluation, including the use of Optical Coherence Angiotomography (OCTA), in patients with primary antiphospholipid syndrome (PAPS) without ocular complaints and to compare them with healthy individuals. Methods: A complete structural and functional ophthalmological evaluation using OCTA and microperimetry (MP) exam in patients with PAPS, followed at a tertiary rheumatology outpatient clinic, was performed. All ophthalmologic manifestations were recorded and then statistical analysis was performed for comparative purposes; p <0.05 was considered statistically significant. Results: 104 eyes of 52 subjects (26 patients with PAPS without ocular complaints and 26 healthy individuals) were included. Among PAPS patients, 21 were female (80.8%) and 21 (80.8%) were Caucasians. Thrombotic PAPS was the main clinical criteria manifestation (100%); 65.4% had venous and 34.6% had arterial thrombosis. Obstetrical criteria were present in 34.6% of all thrombotic PAPS patients. Lupus anticoagulant was present in all patients. 19.2% of PAPS patients presented ophthalmologic findings against none of the healthy individuals. The most common retinal change was paracentral acute middle maculopathy (PAMM) (3 patients, 5 eyes), followed by drusen-like deposits (1 patient, 2 eyes) and pachychoroid pigment epitheliopathy (1 patient, 1 eye). Systemic hypertension and hyperlipidaemia were present in 100% of the PAPS patients with PAMM, while only six patients (26.1%) with PAPS without PAMM presented these two risk factors together. In the quantitative OCTA evaluation, we found significant differences between PAPS patients and controls in both the superficial vascular complex (SVC) and deep vascular complex (DVC) in the high-speed protocol, as well as in the SVC in the high-resolution protocol. In the analysis of the foveal avascular zone (FAZ) parameters, the PAPS group had a larger area of FAZ in the DVC using the high-speed method compared to the control group (p=0.047). In the quantitative analysis of the MP, the PAPS group had lower central (p=0.041) and global (p<0.001) retinal sensitivity compared to the control group, as well as in the sector analysis, with the exception of the inferior sector. In the quantitative evaluation of fixation stability, there was a trend towards worse stability in the PAPS subgroup with PAMM in both studied methods. Conclusions: PAMM was observed in 11.5% of PAPS patients with no previous ocular complaints. Systemic hypertension concomitant with hyperlipidemia was the most commonly associated risk factor for PAMM in patients with PAPS. PAPS patients present lower vascular density and retinal sensitivity compared to the control group, even in patients without PAMM.

Keywords: antiphospholipid syndrome, optical coherence angio tomography, optical coherence tomography, retina

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Authors: Sharon Jackson, Lynn Kelly

Abstract:

This paper proposes a conceptual review of the interdisciplinary literature which has theorised the concept of ‘children’s voices’. The primary aim is to identify and consider the theoretical relevance of conceptual thought on ‘children’s voices’ for research and practice in child protection contexts. Attending to the ‘voice of the child’ has become a core principle of social work practice in contemporary child protection contexts. Discourses of voice permeate the legislative, policy and practice frameworks of child protection practices within the UK and internationally. Voice is positioned within a ‘child-centred’ moral imperative to ‘hear the voices’ of children and take their preferences and perspectives into account. This practice is now considered to be central to working in a child-centered way. The genesis of this call to voice is revealed through sociological analysis of twentieth-century child welfare reform as rooted inter alia in intersecting political, social and cultural discourses which have situated children and childhood as cites of state intervention as enshrined in the 1989 United Nations Convention on the Rights of the Child ratified by the UK government in 1991 and more specifically Article 12 of the convention. From a policy and practice perspective, the professional ‘capturing’ of children’s voices has come to saturate child protection practice. This has incited a stream of directives, resources, advisory publications and ‘how-to’ guides which attempt to articulate practice methods to ‘listen’, ‘hear’ and above all – ‘capture’ the ‘voice of the child’. The idiom ‘capturing the voice of the child’ is frequently invoked within the literature to express the requirements of the child-centered practice task to be accomplished. Despite the centrality of voice, and an obsession with ‘capturing’ voices, evidence from research, inspection processes, serious case reviews, child abuse and death inquires has consistently highlighted professional neglect of ‘the voice of the child’. Notable research studies have highlighted the relative absence of the child’s voice in social work assessment practices, a troubling lack of meaningful engagement with children and the need to more thoroughly examine communicative practices in child protection contexts. As a consequence, the project of capturing ‘the voice of the child’ has intensified, and there has been an increasing focus on developing methods and professional skills to attend to voice. This has been guided by a recognition that professionals often lack the skills and training to engage with children in age-appropriate ways. We argue however that the problem with ‘capturing’ and [re]representing ‘voice’ in child protection contexts is, more fundamentally, a failure to adequately theorise the concept of ‘voice’ in the ‘voice of the child’. For the most part, ‘The voice of the child’ incorporates psychological conceptions of child development. While these concepts are useful in the context of direct work with children, they fail to consider other strands of sociological thought, which position ‘the voice of the child’ within an agentic paradigm to emphasise the active agency of the child.

Keywords: child-centered, child protection, views of the child, voice of the child

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Authors: Laura Helena Caicedo Lopez, Luis Miguel Contreras Medina, Ramon Gerardo Guevara Gonzales, Juan E. Andrade

Abstract:

In this study, we evaluated the effect of three different hydric stress conditions: Low (LHS), medium (MHS), and high (HHS) on capsaicinoid content and enzyme regulation of C. annuum plants. Five main peaks were detected using a 2 Hz resolution vibrometer laser (Polytec-B&K). These peaks or “characteristic frequencies” were used as acoustic emissions (AEs) treatment, transforming these signals into audible sound with the frequency (Hz) content of each hydric stress. Capsaicinoids (CAPs) are the main, secondary metabolites of chili pepper plants and are known to increase during hydric stress conditions or short drought-periods. The AEs treatments were applied in two plant stages: the first one was in the pre-anthesis stage to evaluate the genes that encode the transcription of enzymes responsible for diverse metabolic activities of C. annuum plants. For example, the antioxidant responses such as peroxidase (POD), superoxide dismutase (Mn-SOD). Also, phenyl-alanine ammonia-lyase (PAL) involved in the biosynthesis of the phenylpropanoid compounds. The chalcone synthase (CHS) related to the natural defense mechanisms and species-specific aquaporin (CAPIP-1) that regulate the flow of water into and out of cells. The second stage was at 40 days after flowering (DAF) to evaluate the biochemical effect of AEs related to hydric stress on capsaicinoids production. These two experiments were conducted to identify the molecular responses of C. annuum plants to AE. Moreover, to define AEs could elicit any increase in the capsaicinoids content after a one-week exposition to AEs treatments. The results show that all AEs treatment signals (LHS, MHS, and HHS) were significantly different compared to the non-acoustic emission control (NAE). Also, the AEs induced the up-regulation of POD (~2.8, 2.9, and 3.6, respectively). The gene expression of another antioxidant response was particularly treatment-dependent. The HHS induced and overexpression of Mn-SOD (~0.23) and PAL (~0.33). As well, the MHS only induced an up-regulation of the CHs gene (~0.63). On the other hand, CAPIP-1 gene gas down-regulated by all AEs treatments LHS, MHS, and HHS ~ (-2.4, -0.43 and -6.4, respectively). Likewise, the down-regulation showed particularities depending on the treatment. LHS and MHS induced downregulation of the SOD gene ~ (-1.26 and -1.20 respectively) and PAL (-4.36 and 2.05, respectively). Correspondingly, the LHS and HHS showed the same tendency in the CHs gene, respectively ~ (-1.12 and -1.02, respectively). Regarding the elicitation effect of AE on the capsaicinoids content, additional treatment controls were included. A white noise treatment (WN) to prove the frequency-selectiveness of signals and a hydric stressed group (HS) to compare the CAPs content. Our findings suggest that WN and NAE did not present differences statically. Conversely, HS and all AEs treatments induced a significant increase of capsaicin (Cap) and dihydrocapsaicin (Dcap) after one-week of a treatment. Specifically, the HS plants showed an increase of 8.33 times compared to the NAE and WN treatments and 1.4 times higher than the MHS, which was the AEs treatment with a larger induction of Capsaicinoids among treatments (5.88) and compared to the controls.

Keywords: acoustic emission, capsaicinoids, elicitors, hydric stress, plant signaling

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