Search results for: acute phase

Authors: Alex Kiselyov, Suehyun Cho, Darrell Harrington; Florent Cros, Olin Palmer, John Caputo, Michael Kardosh, Eran Oren, William Loudon, Michael Shpigelmacher

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Despite the most aggressive surgical and adjuvant therapeutic strategies, treatment of both pediatric and adult brainstem tumors remains problematic. Novel strategies, including targeted biologics, immunotherapy, and specialized delivery systems such as convection-enhanced delivery (CED), have been proposed. While some of these novel treatments are entering phase I trials, the field is still in need of treatment(s) that exhibits dramatically enhanced potency with optimal therapeutic ratio. Bionaut Labs has developed a modular microrobotic platform for performing localized delivery of diverse therapeutics in vivo. Our biocompatible particles (Bionauts™) are externally propelled and visualized in real-time. Bionauts™ are specifically designed to enhance the effect of radiation therapy via anatomically precise delivery of a radiosensitizing agent, as exemplified by temozolomide (TMZ) and Avastin™ to the brainstem gliomas of diverse origin. The treatment protocol is designed to furnish a better therapeutic outcome due to the localized (vs systemic) delivery of the drug to the neoplastic lesion(s) for use as a synergistic combination of radiation and radiosensitizing agent. In addition, the procedure is minimally invasive and is expected to be appropriate for both adult and pediatric patients. Current progress, including platform optimization, selection of the lead radiosensitizer as well as in vivo safety studies of the Bionauts™ in large animals, specifically the spine and the brain of porcine and ovine models, will be discussed.

Keywords: Bionaut, brainstem, glioma, local delivery, micro-robot, radiosensitizer

Procedia PDF Downloads 136

Authors: Elsayed Amer, Tarek Essam, Abdullah Hella, Mohammed Al-Ajmi

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Hydrocarbon production decline in mature gas fields is inevitable, and mitigating these circumstances is essential to ensure a longer production period. Production decline is not only influenced by reservoir pressure and wellbore integrity; however, associated liquids in the reservoir rock have a considerable impact on the production process. The associated liquid may result in liquid loading, near wellbore damage, condensate banking, fine sand migration, and wellhead pressure depletion. Consequently, the producing well will suffocate, and the liquid column will seize the well from flowing. A common solution in such circumstances is reducing the surface pressure by opening the well to the atmospheric pressure and flaring the produced liquids. This practice may not be applicable to many cases since the atmospheric pressure is not low enough to create a sufficient driving force to flow the well. In addition, flaring the produced hydrocarbon is solving the issue on account of the environment, which is against the world's efforts to mitigate the impact of climate change. This paper presents a novel approach and a case study that utilizes a multi-phase mobile wellhead gas compression unit (MMWGC) to reduce surface pressure to the sub-atmospheric level and transfer the produced hydrocarbons to the sales line. As a result, the liquid column will unload in a zero-flaring manner, and the life of the producing well will extend considerably. The MMWGC unit was able to successfully kick off a dead well to produce up to 10 MMSCFD after reducing the surface pressure for 3 hours. Applying such novelty on a broader scale will not only extend the life of the producing wells yet will also provide a zero-flaring, economically and environmentally preferred solution.

Keywords: petroleum engineering, zero-flaring, liquid loading, well revival

Procedia PDF Downloads 77

Authors: Tomasz Smolinski, Irena Herdzik-Koniecko, Marta Pyszynska, M. Rogowski

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Old electronic components can be easily found nowadays. Significant quantities of valuable metals such as gold, silver or copper are used for the production of advanced electronic devices. Old useless electronic device slowly became a new source of precious metals, very often more efficient than natural. For example, it is possible to recover more gold from 1-ton personal computers than seventeen tons of gold ore. It makes urban mining industry very profitable and necessary for sustainable development. For the recovery of metals from waste of electronic equipment, various treatment options based on conventional physical, hydrometallurgical and pyrometallurgical processes are available. In this group hydrometallurgy processes with their relatively low capital cost, low environmental impact, potential for high metal recoveries and suitability for small scale applications, are very promising options. Institute of Nuclear Chemistry and Technology has great experience in hydrometallurgy processes especially focused on recovery metals from industrial and agricultural wastes. At the moment, urban mining project is carried out. The method of effective recovery of valuable metals from central processing units (CPU) components has been developed. The principal processes such as acidic leaching and solvent extraction were used for precious metals recovery from old processors and graphic cards. Electronic components were treated by acidic solution at various conditions. Optimal acid concentration, time of the process and temperature were selected. Precious metals have been extracted to the aqueous phase. At the next step, metals were selectively extracted by organic solvents such as oximes or tributyl phosphate (TBP) etc. Multistage mixer-settler equipment was used. The process was optimized.

Keywords: electronic waste, leaching, hydrometallurgy, metal recovery, solvent extraction

Procedia PDF Downloads 111

Authors: David C. Ni

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Contemporary models for N-body systems are based on temporal, two-body, and mass point representation of Newtonian mechanics. Other mainstream models include 2D and 3D Ising models based on local neighborhood the lattice structures. In Quantum mechanics, the theories of collective modes are for superconductivity and for the long-range quantum entanglement. However, these models are still mainly for the specific phenomena with a set of designated parameters. We are therefore motivated to develop a new construction directly from the complex-variable N-body systems based on the extended Blaschke functions (EBF), which represent a non-temporal and nonlinear extension of Lorentz transformation on the complex plane – the normalized momentum spaces. A point on the complex plane represents a normalized state of particle momentums observed from a reference frame in the theory of special relativity. There are only two key parameters, normalized momentum and nonlinearity for modelling. An algorithm similar to Jenkins-Traub method is adopted for solving EBF iteratively. Through iteration, the solution sets show a form of σ + i [-t, t], where σ and t are the real numbers, and the [-t, t] shows various distributions, such as 1-peak, 2-peak, and 3-peak etc. distributions and some of them are analog to the canonical distributions. The results of the numerical analysis demonstrate continuum-to-discreteness transitions, evolutional invariance of distributions, phase transitions with conjugate symmetry, etc., which manifest the construction as a potential candidate for the unification of statistics. We hereby classify the observed distributions on the finite convergent domains. Continuous and discrete distributions both exist and are predictable for given partitions in different regions of parameter-pair. We further compare these distributions with canonical distributions and address the impacts on the existing applications.

Keywords: blaschke, lorentz transformation, complex variables, continuous, discrete, canonical, classification

Procedia PDF Downloads 277

Authors: Kuniyoshi Abe

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Bi-conjugate gradient (Bi-CG) is a well-known method for solving linear equations Ax = b, for x, where A is a given n-by-n matrix, and b is a given n-vector. Typically, the dimension of the linear equation is high and the matrix is sparse. A number of hybrid Bi-CG methods such as conjugate gradient squared (CGS), Bi-CG stabilized (Bi-CGSTAB), BiCGStab2, and BiCGstab(l) have been developed to improve the convergence of Bi-CG. Bi-CGSTAB has been most often used for efficiently solving the linear equation, but we have seen the convergence behavior with a long stagnation phase. In such cases, it is important to have Bi-CG coefficients that are as accurate as possible, and the stabilization strategy, which stabilizes the computation of the Bi-CG coefficients, has been proposed. It may avoid stagnation and lead to faster computation. Motivated by a large number of processors in present petascale high-performance computing hardware, the scalability of Krylov subspace methods on parallel computers has recently become increasingly prominent. The main bottleneck for efficient parallelization is the inner products which require a global reduction. The resulting global synchronization phases cause communication overhead on parallel computers. The parallel variants of Krylov subspace methods reducing the number of global communication phases and hiding the communication latency have been proposed. However, the numerical stability, specifically, the convergence speed of the parallel variants of Bi-CGSTAB may become worse than that of the standard Bi-CGSTAB. In this paper, therefore, we compare the convergence speed between the standard Bi-CGSTAB and the parallel variants by numerical experiments and show that the convergence speed of the standard Bi-CGSTAB is faster than the parallel variants. Moreover, we propose the stabilization strategy for the parallel variants.

Keywords: bi-conjugate gradient stabilized method, convergence speed, Krylov subspace methods, linear equations, parallel variant

Procedia PDF Downloads 138

Authors: Zuzana Tatarkova, Ivana Pilchova, Michal Cibulka, Martin Kolisek, Peter Racay, Peter Kaplan

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Introduction: Normal functioning of mitochondria is crucial for cardiac performance. Mitochondria undergo mitophagy and biogenesis, and mitochondrial proteins are subject to extensive post-translational modifications. The state of mitochondrial homeostasis reflects overall cellular fitness and longevity. Perturbed mitochondria produce less ATP, release greater amounts of reactive molecules, and are more prone to apoptosis. Therefore mitochondrial turnover is an integral aspect of quality control in which dysfunctional mitochondria are selectively eliminated through mitophagy. Currently, the progressive deterioration of physiological functions is seen as accumulation of modified/damaged proteins with limiting regenerative ability and disturbance of such affected protein-protein communication throughout aging in myocardial cells. Methodologies: For our study was used immunohistochemistry, biochemical methods: spectrophotometry, western blotting, immunodetection as well as more sophisticated 2D electrophoresis and mass spectrometry for evaluation protein-protein interactions and specific post-translational modification. Results and Discussion: Mitochondrial stress response to reactive species was evaluated as electron transport chain (ETC) complexes, redox-active molecules, and their possible communication. Protein-protein interactions revealed a strong linkage between age and ETC protein subunits. Redox state was strongly affected in senescent mitochondria with shift in favor of more pro-oxidizing condition within cardiomyocytes. Acute myocardial ischemia and ischemia-reperfusion (IR) injury affected ETC complexes I, II and IV with no change in complex III. Ischemia induced decrease in total antioxidant capacity, MnSOD, GSH and catalase activity with recovery in some extent during reperfusion. While MnSOD protein content was higher in IR group, activity returned to 95% of control. Nitric oxide is one of the biological molecules that can out compete MnSOD for superoxide and produce peroxynitrite. This process is faster than dismutation and led to the 10-fold higher production of nitrotyrosine after IR injury in adult with higher protection in senescent ones. 2D protein profiling revealed 140 mitochondrial proteins, 12 of them with significant changes after IR injury and 36 individual nitrotyrosine-modified proteins further identified by mass spectrometry. Linking these two groups, 5 proteins were altered after IR as well as nitrated, but only one showed massive nitration per lowering content of protein after IR injury in adult. Conclusions: Senescent cells have greater proportion of protein content, which might be modulated by several post-translational modifications. If these protein modifications are connected to functional consequences and protein-protein interactions are revealed, link may lead to the solution. Assume all together, dysfunctional proteostasis can play a causative role and restoration of protein homeostasis machinery is protective against aging and possibly age-related disorders. This work was supported by the project VEGA 1/0018/18 and by project 'Competence Center for Research and Development in the field of Diagnostics and Therapy of Oncological diseases', ITMS: 26220220153, co-financed from EU sources.

Keywords: aging heart, mitochondria, proteomics, redox state

Procedia PDF Downloads 142

Authors: Wiqar Hussain Shah

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The electrical and thermal properties of the doped Tellurium Telluride (Tl10Te6) chalcogenide nano-particles are mainly characterized by a competition between metallic (hole doped concentration) and semi-conducting state. We have studied the effects of Sn doping on the electrical and thermoelectric properties of Tl10-xSnxTe6 (1.00 ≤x≤ 2.00), nano-particles, prepared by solid state reactions in sealed silica tubes and ball milling method. Structurally, all these compounds were found to be phase pure as confirmed by the x-rays diffractometery (XRD) and energy dispersive X-ray spectroscopy (EDS) analysis. Additionally crystal structure data were used to model the data and support the findings. The particles size was calculated from the XRD data by Scherrer’s formula. The EDS was used for an elemental analysis of the sample and declares the percentage of elements present in the system. The thermo-power or Seebeck co-efficient (S) was measured for all these compounds which show that S increases with increasing temperature from 295 to 550 K. The Seebeck coefficient is positive for the whole temperature range, showing p-type semiconductor characteristics. The electrical conductivity was investigated by four probe resistivity techniques revealed that the electrical conductivity decreases with increasing temperature, and also simultaneously with increasing Sn concentration. While for Seebeck coefficient the trend is opposite which is increases with increasing temperature. These increasing behavior of Seebeck coefficient leads to high power factor which are increases with increasing temperature and Sn concentration except For Tl8Sn2Te6 because of lowest electrical conductivity but its power factor increases well with increasing temperature.

Keywords: Sn doping in Tellurium Telluride nano-materials, electron holes competition, Seebeck co-efficient, effects of Sn doping on Electrical conductivity, effects on Power factor

Procedia PDF Downloads 21

Authors: Fenni Sim

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Background: The application of systemic family therapy approaches to community health cases have not gathered traction. In National Kidney Foundation, Singapore, the belief is that community support has great potential in helping End Stage Renal Failure (ESRF) patients manage the demands of their treatment regime, whether Hemodialysis (HD) or Peritoneal Dialysis(PD) and sustain them on the treatment. However, the current community support does not include family interventions and is largely nursing based. Although nursing support is well provided to patients, and their family members in issues related to treatment and compliance, complex family issues and dynamics arising from caregiver strain or pre-dialysis relationship strain might deter efforts in managing the challenges of the treatment. Objective: The objective of the study is to understand the potential scope of work provided by a social worker who is trained in systemic family therapy and the effects of these interventions. Methodology: 3 families on HD and 3 families on PD who have been receiving family intervention for the past 6 months would be chosen for the study. A qualitative interview would be conducted to review the effectiveness for the family. Scales such as SCORE-15, PHQ-9, and Zarit Burden were used to measure family functioning, depression, and caregiver’s burden for the families. Results: The research is still in preliminary phase. Conclusion: The study highlights the importance of family intervention for families with multiple stressors on different treatment modalities who might have different needs and challenges. Nursing support needs to be complemented with family-based support to manage complex family issues in order to achieve better health outcomes and improved family coping.

Keywords: complementing nursing support, end stage renal failure, healthcare, systemic approaches

Procedia PDF Downloads 181

Authors: R. Akbari, M. A. Ehyaei, R. Shahi Shavvon

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Nowadays, solar energy is used for energy purposes such as the use of thermal energy for domestic, industrial and power applications, as well as the conversion of the sunlight into electricity by photovoltaic cells. In this study, the thermodynamic simulation of the solar Rankin cycle with phase change material (paraffin) was first studied. Then energy and exergy analyses were performed. For optimization, a single and multi-objective genetic optimization algorithm to maximize thermal and exergy efficiency was used. The parameters discussed in this paper included the effects of input pressure on turbines, input mass flow to turbines, the surface of converters and collector angles on thermal and exergy efficiency. In the organic Rankin cycle, where solar energy is used as input energy, the fluid selection is considered as a necessary factor to achieve reliable and efficient operation. Therefore, silicon oil is selected for a high-temperature cycle and water for a low-temperature cycle as an operating fluid. The results showed that increasing the mass flow to turbines 1 and 2 would increase thermal efficiency, while it reduces and increases the exergy efficiency in turbines 1 and 2, respectively. Increasing the inlet pressure to the turbine 1 decreases the thermal and exergy efficiency, and increasing the inlet pressure to the turbine 2 increases the thermal efficiency and exergy efficiency. Also, increasing the angle of the collector increased thermal efficiency and exergy. The thermal efficiency of the system was 22.3% which improves to 33.2 and 27.2% in single-objective and multi-objective optimization, respectively. Also, the exergy efficiency of the system was 1.33% which has been improved to 1.719 and 1.529% in single-objective and multi-objective optimization, respectively. These results showed that the thermal and exergy efficiency in a single-objective optimization is greater than the multi-objective optimization.

Keywords: exergy analysis, genetic algorithm, rankine cycle, single and multi-objective function

Procedia PDF Downloads 108

Authors: Ogbuagu Josephat Okechukwu, Okeke Abuchi Princewill, Arinze Rosemary Uche, Tabugbo Ifeyinwa Blessing, Ogbuagu Adaora Stellamaris

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Phthalates or Phthalate esters (PAEs), categorized as an endocrine disruptor and persistent organic pollutants, are known for their environmental contamination and toxicological effects. In this study, the concentration of selected phthalates was determined across the sampling site to investigate their occurrence and the ecological and health risk assessment they pose to the environment. Water and sediment samples were collected following standard procedures. Solid phase and ultrasonic methods were used to extract seven different PAEs, which were analyzed by Gas Chromatography with Mass Detector (GCMS). The analytical average recovery was found to be within the range of s83.4% ± 2.3%. The results showed that PAEs were detected in six out of seven samples with a high percentage of detection rate in water. Di-n-butyl phthalate (DPB) and diisobutyl phthalates (DiBP) showed greater detection rate compared to other PAEs monomers. The concentration of PEs was found to be higher in the sediment samples compared to the water samples due to the fact that sediments serve as a sink for most persistent organic pollutants. The concentrations of PAEs in water samples and sediments ranged from 0.03 ± 0.01 to 0.29 ± 0.002 ppm and 3.99 ± 0.43 to 6.04 ± 1.25 ppm, respectively. Ecological risk assessment using the risk quotient method (RQ) reveals that the estimated environmental risk caused by phthalates lies within the moderate level as RQ ranges from 0.1 to 1.0, whereas the health risk assessment caused by phthalates on estimating the average daily dose reveals that the ingestion of phthalates was found to be high which can cause serious carcinogenic occurrence in the human system with time due to excess accumulation.

Keywords: phthaletes, assessment, marine pollution, endocrine

Procedia PDF Downloads 29

Authors: Adane Kassa Shikur

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Today’s supply chains (SC) have become vulnerable to unexpected and ever-intensifying disruptions from myriad sources. Consequently, the concept of supply chain resilience (SCRes) has become crucial to complement the conventional risk management paradigm, which has failed to cope with unexpected SC disruptions, resulting in severe consequences affecting SC performances and making business continuity questionable. Advancements in cutting-edge technologies like artificial intelligence (AI) and their potential to enhance SCRes by improving critical antecedents in the different phases have attracted the attention of scholars and practitioners. The research from academia and the practical interest of the industry have yielded significant publications at the nexus of AI and SCRes during the last two decades. However, the applications and examinations have been primarily conducted independently, and the extant literature is dispersed into research streams despite the complex nature of SCRes. To close this research gap, this study conducts a systematic literature review of 106 peer-reviewed articles by curating, synthesizing, and consolidating up-to-date literature and presents the state-of-the-art development from 2010 to 2022. Bayesian networks are the most topical ones among the 13 AI techniques evaluated. Concerning the critical antecedents, visibility is the first ranking to be realized by the techniques. The study revealed that AI techniques support only the first 3 phases of SCRes (readiness, response, and recovery), and readiness is the most popular one, while no evidence has been found for the growth phase. The study proposed an AI-SCRes framework to inform research and practice to approach SCRes holistically. It also provided implications for practice, policy, and theory as well as gaps for impactful future research.

Keywords: ANNs, risk, Bauesian networks, vulnerability, resilience

Procedia PDF Downloads 45

Authors: P. Chang, C. Lopez, C. Burbano

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Flood protection zones are riparian buffers that are formed to manage and mitigate the impact of flooding, and in turn, protect local populations. The purpose of this study was to evaluate the Guía Técnica de Criterios para el Acotamiento de las Rondas Hídricas in Colombia against international regulations in Canada and Spain, in order to determine its limitations and contribute to its improvement. The need to establish a specific corridor that allows for the dynamic development of a river is clear; however, limitations present in the Colombian Technical Guide are identified. The study shows that international regulations provide similar concepts as used in Colombia, but additionally integrate aspects such as regionalization that allows for a better characterization of the channel way, and incorporate the frequency of flooding and its probability of occurrence in the concept of risk when determining the protection zone. The case study analyzed in Dosquebradas - Risaralda aimed at comparing the application of the different standards through hydraulic modeling. It highlights that the current Colombian standard does not offer sufficient details in its implementation phase, which leads to a false sense of security related to inaccuracy and lack of data. Furthermore, the study demonstrates how the Colombian norm is ill-adapted to the conditions of Dosquebradas typical of the Andes region, both in the social and hydraulic aspects, and does not reduce the risk, nor does it improve the protection of the population. Our study considers it pertinent to include risk estimation as an integral part of the methodology when establishing protect flood zone, considering the particularity of water systems, as they are characterized by an heterogeneous natural dynamic behavior.

Keywords: environmental corridor, flood zone determination, hydraulic domain, legislation flood protection zone

Procedia PDF Downloads 89

Authors: Aarti Muley, S. J. Dhoblae

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CaF₂ and BaF₂ doped with cerium were prepared by slow precipitation method with different molar concentration and different cerium concentration. Both the samples were also prepared by direct method for comparison. The XRD of BaF₂:Ce shows that it crystallizes to BCC structure. The peak matches with JCPDS file no. 4-0452. Also, The XRD pattern of CaF₂:Ce matches well with the JCPDS file number 75- 0363 and crystallized to BCC phase. In CaF₂, the double-humped photoluminescence spectra were observed at 320nm and 340nm when the sample was prepared by the direct precipitation method, and the ratio between these peaks is unity. However when the sample prepared by slow precipitation method the double-humped emission spectra of CaF₂:Ce was observed at 323nm and 340nm. The ratio between these peaks is 0.58, and the optimum concentration is obtained for 0.1 molar CaF₂ with Ce concentration 1.5%. When the cerium concentration is increased by 2% the peak at 323nm vanishes, and the emission was observed at 342nm with the shoulder at 360nm. In this case, the intensity reduces drastically. The excitation is observed at 305nm with a small peak at 254nm. One molar BaF₂ doped with 0.1% of cerium was synthesized by direct precipitation method gives double humped spectra at 308nm and 320nm, when it is prepared with slow precipitation method with the cerium concentration 0.05m%, 0.1m%, 0.15m%, 0.2m% the broad emission is observed around 325nm with the shoulder at 350nm. The excitation spectra are narrow and observed at 290nm. As the percentage of cerium is increased further again shift is observed. The emission spectra were observed at 360nm with a small peak at 330nm. The phenomenon of shifting of emission spectra at low concentration of cerium can directly relate with the particle size and reported for nanomaterials also.

Keywords: calcium fluoride, barium fluoride, photoluminescence, slow precipitation method

Procedia PDF Downloads 82

Authors: Natalia Fijol, Aji P. Mathew

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We present the processing and characterisation of three-dimensional (3D) monolith filters based on polylactic acid (PLA) reinforced with various nature-derived nanospecies such as hydroxyapatite, modified cellulose fibers and chitin fibers. The nanospecies of choice were dispersed in PLA through Thermally Induced Phase Separation (TIPS) method. The biocomposites were developed via solvent-assisted blending and the obtained pellets were further single-screw extruded into 3D-printing filaments and processed into various geometries using Fused Deposition Modelling (FDM) technique. The printed prototypes included cubic, cylindrical and hour-glass shapes with diverse patterns of printing infill as well as varying pore structure including uniform and multiple level gradual pore structure. The pores and channel structure as well as overall shape of the prototypes were designed in attempt to optimize the flux and maximize the adsorption-active time. FDM is a cost and energy-efficient method, which does not require expensive tools and elaborated post-processing maintenance. Therefore, FDM offers the possibility to produce customized, highly functional water purification filters with tuned porous structures suitable for removal of wide range of common water pollutants. Moreover, as 3D printing becomes more and more available worldwide, it allows producing portable filters at the place and time where they are most needed. The study demonstrates preparation route for the PLA-based, fully biobased composite and their processing via FDM technique into water purification filters, addressing water treatment challenges on an industrial scale.

Keywords: fused deposition modelling, water treatment, biomaterials, 3D printing, nanocellulose, nanochitin, polylactic acid

Procedia PDF Downloads 92

Authors: M. Skibinska, A. Rajewska-Rager, M. Dmitrzak-Weglarz, N. Lepczynska, P. Sibilski, P. Kapelski, J. Pawlak, J. Twarowska-Hauser

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Introduction: Neurotrophic factors have been implicated in neuropsychiatric disorders. Brain-Derived Neurotrophic Factor (BDNF) influences neuron differentiation in development as well as synaptic plasticity and neuron survival in adulthood. BDNF is widely studied in mood disorders and has been proposed as a biomarker for depression. BDNF is synthesized as precursor protein – proBDNF. Both forms are biologically active and exert opposite effects on neurons. Aim: The aim of the study was to examine the serum levels of BDNF and proBDNF in unipolar and bipolar young patients below 24 years old during hypo/manic, depressive episodes and in remission compared to healthy control group. Methods: In a prospective 2 years follow-up study, we investigated alterations in levels of BDNF and proBDNF in 79 patients (23 males, mean age 19.08, SD 3.3 and 56 females, mean age 18.39, SD 3.28) diagnosed with mood disorders: unipolar and bipolar disorder compared with 35 healthy control subjects (7 males, mean age 20.43, SD 4.23 and 28 females, mean age 21.25, SD 2.11). Clinical characteristics including mood, comorbidity, family history, and treatment, were evaluated during control visits and clinical symptoms were rated using the Hamilton Depression Rating Scale and Young Mania Rating Scale. Serum BDNF and proBDNF concentrations were determined by Enzyme-Linked Immunosorbent Assays (ELISA) method. Serum BDNF and proBDNF levels were analysed with covariates: sex, age, age > 18 and < 18 years old, family history of affective disorders, drug-free vs. medicated status. Normality of the data was tested using Shapiro-Wilk test. Levene’s test was used to calculate homogeneity of variance. Non-parametric Tests: Mann-Whitney U test, Kruskal-Wallis ANOVA, Friedman’s ANOVA, Wilcoxon signed rank test, Spearman correlation coefficient were applied in analyses The statistical significance level was set at p < 0.05. Results: BDNF and proBDNF serum levels did not differ between patients at baseline and controls as well as comparing patients in acute episode of depression/hypo/mania at baseline and euthymia (at month 3 or 6). Comparing BDNF and proBDNF levels between patients in euthymia and control group no differences have been found. Increased BDNF level in women compared to men at baseline (p=0.01) have been observed. BDNF level at baseline was negatively correlated with depression and mania occurence at 24 month (p=0.04). BDNF level at 12 month was negatively correlated with depression and mania occurence at 12 month (p=0.01). Correlation of BDNF level with sex have been detected (p=0.01). proBDNF levels at month 3, 6 and 12 negatively correlated with disease status (p=0.02, p=0.008, p=0.009, respectively). No other correlations of BDNF and proBDNF levels with clinical and demographical variables have been detected. Discussion: Our results did not show any differences in BDNF and proBDNF levels between depression, mania, euthymia, and controls. Imbalance in BDNF/proBDNF signalling may be involved in pathogenesis of mood disorders. Further studies on larger groups are recommended. Grant was founded by National Science Center in Poland no 2011/03/D/NZ5/06146.

Keywords: bipolar disorder, Brain-Derived Neurotrophic Factor (BDNF), proBDNF, unipolar depression

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Authors: Rajinikanth Siddalingam, Poonguzhali Subramanian

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The present study aims to prepare and evaluate the self-nano emulsifying drug delivery (SNEDDS) system to enhance the dissolution rate of a poorly soluble drug dutasteride. The formulation was prepared using capryol PGMC, Cremophor EL, and polyethylene glycol (PEG) 400 as oil, surfactant and co-surfactant, respectively. The pseudo-ternary phase diagrams with presence and absence of drug were plotted to find out the nano emulsification range and also to evaluate the effect of dutasteride on the emulsification behavior of the phases. Prepared SNEDDS formulations were evaluated for its particle size distribution, nano emulsifying properties, robustness to dilution, self-emulsification time, turbidity measurement, drug content and in-vitro dissolution. The optimized formulations are further evaluated for heating cooling cycle, centrifugation studies, freeze-thaw cycling, particle size distribution and zeta potential were carried out to confirm the stability of the formed SNEDDS formulations. The particle size, zeta potential and polydispersity index of the optimized formulation found to be 35.45 nm, -15.45 and 0.19, respectively. The in vitro results are revealed that the prepared formulation enhanced the dissolution rate of dutasteride significantly as compared with pure drug. The in vivo studies in was conducted using rats and the results are revealed that SNEDDS formulation has enhanced the bioavailability of dutasteride drug significantly as compared with raw drug. Based the results, it was concluded that the dutasteride-loaded SNEDDS shows potential to enhance the dissolution of dutasteride, thus improving the bioavailability and therapeutic effects.

Keywords: self-emulsifying drug delivery system, dutasteride, enhancement of bioavailability, dissolution enhancement

Procedia PDF Downloads 242

Authors: Yuan-Chung Tsai, Masao Kamimura, Kohei Soga, Hsin-Cheng Chiu

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In order to enhance the photodynamic/photothermal therapeutic efficacy on glioblastoma, the functionized upconversion nanoparticles with the capability of converting the deep tissue penetrating near-infrared light into visible wavelength for activating photochemical reaction were developed. The drug-loaded nanoparticles (NPs) were obtained from the self-assembly of oleic acid-coated upconversion nanoparticles along with maleimide-conjugated poly(ethylene glycol)-cholesterol (Mal-PEG-Chol), as the NP stabilizer, and hydrophobic photosensitizers, IR-780 (for photothermal therapy, PTT) and mTHPC (for photodynamic therapy, PDT), in aqueous phase. Both the IR-780 and mTHPC were loaded into the hydrophobic domains within NPs via hydrophobic association. The peptide targeting ligand, angiopep-2, was further conjugated with the maleimide groups at the end of PEG adducts on the NP surfaces, enabling the affinity coupling with the low-density lipoprotein receptor-related protein-1 of tumor endothelial cells and malignant astrocytes. The drug-loaded NPs with the size of ca 80 nm in diameter exhibit a good colloidal stability in physiological conditions. The in vitro data demonstrate the successful targeting delivery of drug-loaded NPs toward the ALTS1C1 cells (murine astrocytoma cells) and the pronounced cytotoxicity elicited by combinational effect of PDT and PTT. The in vivo results show the promising brain orthotopic tumor targeting of drug-loaded NPs and sound efficacy for brain tumor dual-modality treatment. This work shows great potential for improving photodynamic/photothermal therapeutic efficacy of brain cancer.

Keywords: drug delivery, orthotopic brain tumor, photodynamic/photothermal therapies, upconversion nanoparticles

Procedia PDF Downloads 164

Authors: Gonzalo Ortiz de Elguea-Culebras, Raúl Sánchez-Vioquea, Adela Mena-Morales, Manuel Alaiz, Enrique Melero-Bravo, Esteban García-Romero, Javier Vioque, Lourdes Marchante-Cuevas, Julio Girón-Calle

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Saffron (Crocus sativus L.) is a highly valued crop for the manufacture of spice that consists of the dried stigma of the flowers. This is in contrast to other underutilized parts of the saffron plant as leaves, which represent abundant biomass whose use might help to enhance the sustainability of the saffron crop. Saffron leaves contain significant amounts of phenolic compounds, 7.8 equivalent grams of gallic acid per 100g of extract, and are very promising compounds in terms of exploring novel uses of saffron leaves. Given that phenolic compounds have numerous effects on cancer-related biological pathways, we have investigated the in vitro antiproliferative effect of saffron leaf polyphenols against human colon adenocarcinoma cells (Caco-2). Polyphenols were extracted from leaves with 70% ethanol, defatted with hexane, and purified by solid phase extraction using C18 silica gel and then silica gel 60. Analysis of polyphenols was performed by HPLC-ESI-MS. Di-, tri-, and tetrahexosides of quercetin, kaempferol, and isorhamnetin, as well as C-hexosides like isoorientin and vitexin, were tentatively identified. Polyphenols strongly inhibited the proliferation of Caco-2 cells, which is consistent with model studies in which several of the polyphenols identified in saffron leaves have demonstrated their potential as chemopreventive agents in cancer. Due to the low profitability that saffron leaf currently represents, we consider these results very encouraging and that this by-product deserves further investigation as a potential source of active molecules against colorectal cancer.

Keywords: saffron leaves, agricultural by-products, polyphenols, antiproliferative effect, human colon adenocarcinoma cells

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Authors: Shariffah Dawood

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During the past decade, workplace bullying has attracted increasing attention from researchers internationally as it is reported to be a major social problem and has severe consequences towards the job satisfaction and health of victims and towards the organization. It is characterized by “systematic aggression or violence targeted towards one or more individuals by one individual or by a group, consists of repeated and enduring acts, and the target is or ends up in an inferior position from which it is difficult to defend oneself.” Despite the seriousness of workplace bullying, not all sectors have received the same degree of scholarly attention. Most studies have been undertaken in the public and private sectors, such as, in hospitals, universities, retail industry, local council, and restaurant kitchens. The nonprofit sector has received limited attention despite its significant economic and social role in the society. In order to understand the nature of workplace bullying in non-profit sector, this research explored 29 British nonprofit organizations through surveys and interviews. Despite the nonprofit sector’s emphasis on an egalitarianism ethos, their reputation to be the defenders of the most vulnerable/disadvantaged and the perception that they are protected from such negative behaviors in the workplace, the findings uncovered pertinent factors that make this sector highly vulnerable towards workplace bullying. Overall, the study identifies some organizational factors which need to be addressed in order to curb bullying in this sector: management commitment towards a zero-tolerance bullying policy; management training in areas such as conflict resolution, organizational changes, and maintenance of the commitment of a conscientious workforce. The researcher further recommends that the nonprofit organizations work towards improving relationships with voluntary board members and funding bodies. The researcher will also outline the second phase of the study, which aims to investigate bullying in the nonprofit sector across cultures (the USA, Malaysia and Japan), and implications for the research will be identified.

Keywords: nonprofit sector, workplace bullying, harassment, management, HRM

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Authors: Vishnu A., Ashesh Saha

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The operation of high-speed rotating machinery in industries is accompanied by rotor vibrations due to many factors. One of the primary instability mechanisms in a rotor system is the centrifugal force induced due to the eccentricity of the center of mass away from the center of rotation. These unwanted vibrations may lead to catastrophic fatigue failure. So, there is a need to control these rotor vibrations. In this work, control of rotor vibrations by using a 4-pole Radial Active Magnetic Bearing (RAMB) as an actuator is analysed. A continuous rotor system model is considered for the analysis. Several important factors, like the gyroscopic effect and rotary inertia of the shaft and disc, are incorporated into this model. The large deflection of the shaft and the restriction to axial motion of the shaft at the bearings result in nonlinearities in the system governing equation. The rotor system is modeled in such a way that the system dynamics can be related to the geometric and material properties of the shaft and disc. The mathematical model of the rotor system is developed by incorporating the control forces generated by the RAMB. A simple PD controller is used for the attenuation of system vibrations. An analytical expression for the amplitude and phase equations is derived using the Method of Multiple Scales (MMS). Analytical results are verified with the numerical results obtained using an ‘ode’ solver in-built into MATLAB Software. The control force is found to be effective in attenuating the system vibrations. The multi-valued solutions leading to the jump phenomenon are also eliminated with a proper choice of control gains. Most interestingly, the shape of the backbone curves can also be altered for certain values of control parameters.

Keywords: rotor dynamics, continuous rotor system model, active magnetic bearing, PD controller, method of multiple scales, backbone curve

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Authors: Mehran Nasiri, Ardeshir Poornemat

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The aim of this study was to investigate the current and ideal situations of the process of talent identification in Iranian football from the point of view of Iranian instructors of the Asian Football Confederation (AFC). This research was a descriptive-analytical study; in data collection phase a questionnaire was used, whose face validity was confirmed by experts of Physical Education and Sports Science. The reliability of questionnaire was estimated through the use of Cronbach's alpha method (0.91). This study involved 122 participants of Iranian instructors of the AFC who were selected based on stratified random sampling method. Descriptive statistics were used to describe the variables and inferential statistics (Chi-square) were used to test the hypotheses of the study at significant level (p ≤ 0.05). The results of Chi-square test related to the point of view of Iranian instructors of the AFC showed that the grass-roots scientific method was the best way to identify football players (0.001), less than 10 years old were the best ages for talent identification (0.001), the Football Federation was revealed to be the most important organization in talent identification (0.002), clubs were shown to be the most important institution in developing talents (0.001), trained scouts of Football Federation were demonstrated to be the best and most appropriate group for talent identification (0.001), and being referred by the football academy coaches was shown to be the best way to attract talented football players in Iran (0.001). It was also found that there was a huge difference between the current and ideal situation of the process of talent identification in Iranian football from the point of view of Iranian instructors of the AFC. Hence, it is recommended that the policy makers of talent identification for Iranian football provide a comprehensive, clear and systematic model of talent identification and development processes for the clubs and football teams, so that the talent identification process helps to nurture football talents more efficiently.

Keywords: current situation, talent finding, ideal situation, instructors (AFC)

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Authors: Yu-Jen Shih, Juan-Zhang Lou

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Nitrogenous compounds, such as NH4+/NH3 and NO3-, have become important contaminants in water resources. Excessive concentration of NH3 leads to eutrophication, which poses a threat to aquatic organisms in the environment. Electrochemical oxidation emerged as a promising water treatment technology, offering advantages such as simplicity, small-scale operation, and minimal reliance on additional chemicals. In this study, a nickel-based metal-organic framework (Ni-MOF) was synthesized using 2-amino terephthalic acid (BDC-NH2) and nickel nitrate. The Ni-MOF was further carbonized as derived nickel oxide and nitrogen-carbon composite, Ni/NiOx/NC. The nickel oxide within the 2D porous carbon texture served as active sites for ammonia oxidation. Results of characterization showed that the Ni-MOF was a hexagonal and flaky nanoparticle. With increasing carbonization temperature, the nickel ions in the organic framework re-crystallized as NiO clusters on the surfaces of the 2D carbon. The electrochemical surface area of Ni/NiOx/NC significantly increased as to improve the efficiency of ammonia oxidation. The phase transition of Ni(OH)2⇌NiOOH at around +0.8 V was the primary mediator of electron transfer. Batch electrolysis was conducted under constant current and constant potential modes. The electrolysis parameters included pyrolysis temperatures, pH, current density, initial feed concentration, and electrode potential. The constant current batch experiments indicated that via carbonization at 800 °C, Ni/NiOx/NC(800) was able to decrease the ammonium nitrogen of 50 mg-N/L to below 1 ppm within 4 hours at a current density of 3 mA/cm2 and pH 11 with negligible oxygenated nitrogen formation. The constant potential experiments confirmed that N2 nitrogen selectivity was enhanced up to 90% at +0.8 V.

Keywords: electrochemical oxidation, nickel oxyhydroxide, metal-organic framework, ammonium, nitrate

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Authors: Javier Romera, Alberto Justo, Ignacio Fidalgo, Joshue Perez, Javier Araluce

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Nowadays, individuals with mobility needs face a significant challenge when docking vehicles. In many cases, after parking, they encounter insufficient space to exit, leading to two undesired outcomes: either avoiding parking in that spot or settling for improperly placed vehicles. To address this issue, the following paper presents a parking control system employing gestural teleoperation. The system comprises three main phases: capturing body markers, interpreting gestures, and transmitting orders to the vehicle. The initial phase is centered around the MediaPipe framework, a versatile tool optimized for real-time gesture recognition. MediaPipe excels at detecting and tracing body markers, with a special emphasis on hand gestures. Hands detection is done by generating 21 reference points for each hand. Subsequently, after data capture, the project employs the MultiPerceptron Layer (MPL) for indepth gesture classification. This tandem of MediaPipe's extraction prowess and MPL's analytical capability ensures that human gestures are translated into actionable commands with high precision. Furthermore, the system has been trained and validated within a built-in dataset. To prove the domain adaptation, a framework based on the Robot Operating System (ROS), as a communication backbone, alongside CARLA Simulator, is used. Following successful simulations, the system is transitioned to a real-world platform, marking a significant milestone in the project. This real vehicle implementation verifies the practicality and efficiency of the system beyond theoretical constructs.

Keywords: gesture detection, mediapipe, multiperceptron layer, robot operating system

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Authors: Paula Salazar, Rodrigo Henríquez, Pablo Zerega

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The textile, food and pharmaceutical industries are expanding daily worldwide, and they are located within the most polluting industries due to the fact that wastewater is discharged into watercourses with high concentrations of dyes and traces of drugs. Many of these compounds are stable to light and biodegradation, being considered as emerging organic contaminants. Advanced oxidation processes (AOPs) emerge as an effective alternative for the removal and elimination of this type of contaminants. Heterogeneous photocatalysis has been extensively studied as it is an efficient, low-cost and durable method. As the main photocatalyst, TiO₂ has been used for the degradation of a large number of dyes and drugs. The disadvantage of TiO₂ is its absorption in the UV region of the solar spectrum. On the other hand, quaternary chalcogenides based on Cu₂SnZnX₄ (X = S, Se) are a possible alternative due to their narrow bandgap (ca. between 0.8 to 1.5 eV depending on the phase considered), low cost, an abundance of its constituent elements in the earth's crust and its low toxicity. The objective of this research was to synthesize Cu₂SnZnS₄ (CZTS) through of a low-cost hydrothermal method and evaluate it as a potential photo-catalyst in the photo-degradation process of Congo Red. The synthesis of the nanoparticle in suspension and film onto fluorine-doped tin oxide coated glass (FTO) was carried out using a mixture of: 2 mmol CuCl₂, 1 mmol ZnCl₂, 1 mmol SnCl₂ and 4 mmol CH4N₂S in a Teflon reactor at 180⁰C for 72 h. Characterization was performed through scanning electron microscopy (SEM), X-ray diffraction (XRD) and UV VIS spectroscopy. Photo-degradation monitoring was carried out employing a UV VIS spectrophotometer. The results show that photodegradation of 55% of the dye can be obtained after 4h of exposure to polychromatic light, it should be noted that the Congo Red dye is being studied for the first time.

Keywords: CZTS, hydrothermal, photocatalysis, dye

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Authors: Farzaneh Badinlou, Reza Kormi-Nouri, Monika Knopf

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Enacted tasks are typically remembered better than when the same task materials are only verbally encoded, a robust finding referred to as the enactment effect. It has been assumed that enactment effect is independent of object presence but the size of enactment effect can be increased by providing objects at study phase in adults. To clarify the issues in children, free recall and cued recall performance of action phrases with or without using real objects were compared in 410 school-aged children from four age groups (8, 10, 12 and 14 years old). In this study, subjects were instructed to learn a series of action phrases under three encoding conditions, participants listened to verbal action phrases (VTs), performed the phrases (SPTs: subject-performed tasks), and observed the experimenter perform the phrases (EPTs: experimenter-performed tasks). Then, free recall and cued recall memory tests were administrated. The results revealed that the real object compared with imaginary objects improved recall performance in SPTs and EPTs, but more so in VTs. It was also found that the object presence was not necessary for the occurrence of the enactment effect but it was changed the size of enactment effect in all age groups. The size of enactment effect was more pronounced for imaginary objects than the real object in both free recall and cued recall memory tests in children. It was discussed that SPTs and EPTs deferentially facilitate item-specific and relation information processing and providing the objects can moderate the processing underlying the encoding conditions.

Keywords: action memory, enactment effect, item-specific processing, object, relational processing, school-aged children

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Authors: Kanu Priya Mohan

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Innovation in education is one of the essential pathways to achieve both educational, and development goals in today’s dynamically changing world. Over the last decade, coaching and mentoring have been applied in the field of education as positive intervention techniques for fostering teaching and learning reforms in the developed countries. The context of this research was Thailand’s educational reform process, wherein a project on coaching and mentoring (C&M) was launched in 2014. The C&M project endeavored to support the professional development of the school teachers in the various provinces of Thailand, and to also enable them to apply C&M for teaching innovative instructional techniques. This research aimed to empirically investigate the learning outcomes for the master trainers, who trained for coaching and mentoring as the first step in the process to train the school teachers. A mixed method study was used for evaluating the learning outcomes of training in terms of cognitive- behavioral-affective dimensions. In the first part of the research a quantitative research design was incorporated to evaluate the effects of learner characteristics and instructional techniques, on the learning outcomes. In the second phase, a qualitative method of in-depth interviews was used to find details about the training outcomes, as well as the perceived barriers and enablers of the training process. Sample size constraints were there, yet these exploratory results, integrated from both methods indicated the significance of evaluating training outcomes from the three dimensions, and the perceived role of other factors in the training. Findings are discussed in terms of their implications for the training of C&M, and also their impact in fostering positive education through innovative educational techniques in the developing countries.

Keywords: cognitive-behavioral-affective learning outcomes, mixed method research, teachers in Thailand, training evaluation

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Authors: Siti Rajaah Binti Sayed Sultan

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Managing the code blue event is stressful for nurses, the patient, and the patient's families. The rapid response from the first and second responders in the code blue event will improve patient outcomes and prevent tissue hypoxia that leads to brain injury and other organ failures. Providing 1 minute for the cardiac massage and 2 minutes for defibrillation will significantly improve patient outcomes. As we know, the American Heart Association came out with guidelines for managing cardiac arrest patients. The hospital must provide competent staff to manage this situation. It can be achieved when the staff is well equipped with the skill, attitude, and knowledge to manage this situation with well-planned strategies, i.e., clear guidelines for managing the code blue event, competent staff, and functional equipment. The code blue simulation (CBS) was chosen in the training program for code blue management because it can mimic real scenarios. Having the code blue simulation module will allow the staff to appreciate what they will face during the code blue event, especially since it rarely happens in that area. This CBS module training will help the staff familiarize themselves with the activities that happened during actual events and be able to operate the equipment accordingly. Being challenged and independent in managing the code blue in the early phase gives the patient a better outcome. The CBS module will help the assessor and the hospital management team with the proper tools and guidelines for managing the code blue drill accordingly. As we know, prompt action will benefit the patient and their family. It also indirectly increases the confidence and job satisfaction among the nurses, increasing the standard of care, reducing the complication and hospital burden, and enhancing cost-effective care.

Keywords: code blue simulation module, development of code blue simulation module, code blue response time, code blue drill, cardiorespiratory arrest, managing code blue

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Authors: Matthias Feiner, Francisco Javier Fernández García, Michael Arneman, Martin Kipfmüller

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To ensure reliability in miniaturized devices or processes with increased heat fluxes, very efficient cooling methods have to be employed in order to cope with small available cooling surfaces. To address this problem, a certain type of evaporator/heat exchanger was developed: It is called a swirl evaporator due to its flow characteristic. The swirl evaporator consists of a concentrically eroded screw geometry in which a capillary tube is guided, which is inserted into a pocket hole in components with high heat load. The liquid refrigerant R32 is sprayed through the capillary tube to the end face of the blind hole and is sucked off against the injection direction in the screw geometry. Its inner diameter is between one and three millimeters. The refrigerant is sprayed into the pocket hole via a small tube aligned in the center of the bore hole and is sucked off on the front side of the hole against the direction of injection. The refrigerant is sucked off in a helical geometry (twisted flow) so that it is accelerated against the hot wall (centrifugal acceleration). This results in an increase in the critical heat flux of up to 40%. In this way, more heat can be dissipated on the same surface/available installation space. This enables a wide range of technical applications. To optimize the design for the needs in various fields of industry, like the internal tool cooling when machining nickel base alloys like Inconel 718, a correlation-based model of the swirl-evaporator was developed. The model is separated into 3 subgroups with overall 5 regimes. The pressure drop and heat transfer are calculated separately. An approach to determine the locality of phase change in the capillary and the swirl was implemented. A test stand has been developed to verify the simulation.

Keywords: helically-shaped, oil-free, R-32, swirl-evaporator, twist-flow

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Authors: Jan C. Droste, Justine Burns, Nithin Narayan

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Introduction: Life-threatening detrimental effects of inappropriate adrenaline (epinephrine) administration, e.g., by giving the wrong dose, in the context of anaphylaxis management is well documented in the medical literature. Half of the fatal anaphylactic reactions in the UK are iatrogenic, and the median time to a cardio-respiratory arrest can be as short as 5 minutes. It is therefore imperative that hospital doctors of all grades have active and accurate knowledge of the correct route, site, and dosage of administration of adrenaline. Given this time constraint and the potential fatal outcome with inappropriate management of anaphylaxis, it is alarming that surveys over the last 15 years have repeatedly shown only a minority of doctors to have accurate knowledge of adrenaline administration as recommended by the UK Resuscitation Council guidelines (2008 updated 2012). This comparison of survey results of the medical workforce over several years in a small NHS District General Hospital was conducted in order to establish the effect of the employment of multiple educational methods regarding adrenaline administration in anaphylaxis in adults. Methods: Between 2010 and 2017, several education methods and tools were used to repeatedly inform the medical workforce (doctors and advanced clinical practitioners) in a single district general hospital regarding the treatment of anaphylaxis in adults. Whilst the senior staff remained largely the same cohort, junior staff had changed fully in every survey. Examples included: (i) Formal teaching -in Grand Rounds; during the junior doctors’ induction process; advanced life support courses (ii) In-situ simulation training performed by the clinical skills simulation team –several ad hoc sessions and one 3-day event in 2017 visiting 16 separate clinical areas performing an acute anaphylaxis scenario using actors- around 100 individuals from multi-disciplinary teams were involved (iii) Hospital-wide distribution of the simulation event via the Trust’s Simulation Newsletter (iv) Laminated algorithms were attached to the 'crash trolleys' (v) A short email 'alert' was sent to all medical staff 3 weeks prior to the survey detailing the emergency treatment of anaphylaxis (vi) In addition, the performance of the surveys themselves represented a teaching opportunity when gaps in knowledge could be addressed. Face to face surveys were carried out in 2010 ('pre-intervention), 2015, and 2017, in the latter two occasions including advanced clinical practitioners (ACP). All surveys consisted of convenience samples. If verbal consent to conduct the survey was obtained, the medical practitioners' answers were recorded immediately on a data collection sheet. Results: There was a sustained improvement in the knowledge of the medical workforce from 2010 to 2017: Answers improved regarding correct drug by 11% (84%, 95%, and 95%); the correct route by 20% (76%, 90%, and 96%); correct site by 40% (43%, 83%, and 83%) and the correct dose by 45% (27%, 54%, and 72%). Overall, knowledge of all components -correct drug, route, site, and dose-improved from 13% in 2010 to 62% in 2017. Conclusion: This survey comparison shows knowledge of the medical workforce regarding adrenaline administration for treatment of anaphylaxis in adults can be considerably improved by employing a variety of educational methods.

Keywords: adrenaline, anaphylaxis, epinephrine, medical education, patient safety

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Authors: Aniqa Jabeen

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The aim of this study was to evaluate the effectiveness of Tc-99m MIBI (Technetium 99-methoxy-iso-butyl-isonitrile) scintigraphy to differentiate malignancies from benign lesions, which were detected on planar bone scans. Materials and Methods: 59 patients with bone lesions were enrolled in the study. The scintigraphic findings were compared with the clinical, radiological and the histological findings. Each patient initially underwent a three-phase bone scan with Tc-99m MDP (Methylene Diphosphonate) and if evidence of lesion found, the patient then underwent a dynamic and static MIBI scintigraphy after three to four days. The MDP and MIBI scans were evaluated visually and quantitatively. For quantitative analysis count ratios of lesions and contralateral normal side (L/C) were taken by region of interests drawn on scans. The Student T test was applied to assess the significant difference between benign and malignant lesions p-value < 0.05 was considered significant. Result: The MDP scans showed the increase tracer uptake, but there was no significant difference between benign and malignant uptake of the radiotracer. However significant difference (p-value 0.015), in uptake was seen in malignant (L/C = 3.51 ± 1.02) and benign lesion (L/C = 2.50±0.42) on MIBI scan. Three of thirty benign lesions did not show significant MIBI uptake. Seven malignant appeared as false negatives. Specificity of the scan was 86.66%, and its Negative Predictive Value (NPV) was 81.25% whereas the sensitivity of scan was 79.31%. In excluding the axial metastasis from the lesions, the sensitivity of MIBI scan increased to 91.66% and the NPV also increased to 92.85%. Conclusion: MIBI scintigraphy provides its usefulness by distinguishing malignant from benign lesions. MIBI also correctly identifies metastatic lesions. The negative predictive value of the scan points towards its ability to accurately diagnose the normal (benign) cases. However, biopsy remains the gold standard and a definitive diagnostic modality in musculoskeletal tumors. MIBI scan provides useful information in preoperative assessment and in distinguishing between malignant and benign lesions.

Keywords: benign, malignancies, MDP bone scan, MIBI scintigraphy

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