Search results for: clinical assessment

Authors: Alireza Pirkhaefi

Abstract:

Background: Multiple sclerosis (MS) is one of the most common diseases of the central nervous system (brain and spinal cord). Given the importance of cognitive disorders in patients with multiple sclerosis, the present study was in order to compare cognitive functions (Working memory, Attention and Centralization, and Visual-spatial perception) in patients with relapsing- remitting multiple sclerosis (RRMS) and secondary progressive multiple sclerosis (SPMS). Method: Present study was performed as a retrospective study. This research was conducted with Ex-Post Facto method. The samples of research consisted of 60 patients with multiple sclerosis (30 patients relapsing-retrograde and 30 patients secondary progressive), who were selected from Tehran Community of MS Patients Supported as convenience sampling. 30 normal persons were also selected as a comparison group. Montreal Cognitive Assessment (MOCA) was used to assess cognitive functions. Data were analyzed using multivariate analysis of variance. Results: The results showed that there were significant differences among cognitive functioning in patients with RRMS, SPMS, and normal individuals. There were not significant differences in working memory between two groups of patients with RRMS and SPMS; while significant differences in these variables were seen between the two groups and normal individuals. Also, results showed significant differences in attention and centralization and visual-spatial perception among three groups. Conclusions: Results showed that there are differences between cognitive functions of RRMS and SPMS patients so that the functions of RRMS patients are better than SPMS patients. These results have a critical role in improvement of cognitive functions; reduce the factors causing disability due to cognitive impairment, and especially overall health of society.

Keywords: multiple sclerosis, cognitive function, secondary-progressive, normal subjects

Procedia PDF Downloads 214

Authors: Kristian Bugeja, Upeshala A. Jayawardena, Clarissa Fenech, Mark Zammit Vincenti

Abstract:

Introduction: Biliary colic, acute cholecystitis, and gallstone pancreatitis are some of the most common surgical presentations at Gozo General Hospital (GGH). National Institute for Health and Care Excellence (NICE) guidelines advise that suitable patients with acute biliary problems should be offered a laparoscopic cholecystectomy within one week of diagnosis. There has traditionally been difficulty in achieving this mainly due to the reluctance of some surgeons to operate in the acute setting, limited, timely access to MRCP and ERCP, and organizational issues. Methodology: A retrospective study was performed involving all biliary pathology-related admissions to GGH during the two-year period of 2019 and 2020. Patients’ files and electronic case summary (ECS) were used for data collection, which included demographic data, primary diagnosis, co-morbidities, management, waiting time to surgery, length of stay, readmissions, and reason for readmissions. NICE clinical guidance 188 – Gallstone disease were used as the standard. Results: 51 patients were included in the study. The mean age was 58 years, and 35 (68.6%) were female. The main diagnoses on admission were biliary colic in 31 (60.8%), acute cholecystitis in 10 (19.6%). Others included gallstone pancreatitis in 3 (5.89%), chronic cholecystitis in 2 (3.92%), gall bladder malignancy in 4 (7.84%), and ascending cholangitis in 1 (1.97%). Management included laparoscopic cholecystectomy in 34 (66.7%); conservative in 8 (15.7%) and ERCP in 6 (11.7%). The mean waiting time for laparoscopic cholecystectomy for patients with acute cholecystitis was 74 days – range being between 3 and 146 days since the date of diagnosis. Only one patient who was diagnosed with acute cholecystitis and managed with laparoscopic cholecystectomy was done so within the 7-day time frame. Hospital re-admissions were reported in 5 patients (9.8%) due to vomiting (1), ascending cholangitis (1), and gallstone pancreatitis (3). Discussion: Guidelines were not met for patients presenting to Gozo General Hospital with acute biliary pathology. This resulted in 5 patients being re-admitted to hospital while waiting for definitive surgery. The local issues resulting in the delay to surgery need to be identified and steps are taken to facilitate the provision of urgent cholecystectomy for suitable patients.

Keywords: biliary colic, acute cholecystits, laparoscopic cholecystectomy, conservative management

Procedia PDF Downloads 121

Authors: Shravani Itkelwar, Deepak Tewari, Bhaskar Natarajan

Abstract:

The energy consumption data plays a vital role in energy efficiency policy design, implementation, and impact assessment. Any demand-side energy management intervention's success relies on the availability of accurate, comprehensive, granular, and up-to-date data on energy consumption. The Building sector, including residential and commercial, is one of the largest consumers of energy in India after the Industrial sector. With economic growth and increasing urbanization, the building sector is projected to grow at an unprecedented rate, resulting in a 5.6 times escalation in energy consumption till 2047 compared to 2017. Therefore, energy efficiency interventions will play a vital role in decoupling the floor area growth and associated energy demand, thereby increasing the need for robust data. In India, multiple institutions are involved in the collection and dissemination of data. This paper focuses on energy consumption data management in the building sector in India for both residential and commercial segments. It evaluates the robustness of data available through administrative and survey routes to estimate the key performance indicators and identify critical data gaps for making informed decisions. The paper explores several issues in the data, such as lack of comprehensiveness, non-availability of disaggregated data, the discrepancy in different data sources, inconsistent building categorization, and others. The identified data gaps are justified with appropriate examples. Moreover, the paper prioritizes required data in order of relevance to policymaking and groups it into "available," "easy to get," and "hard to get" categories. The paper concludes with recommendations to address the data gaps by leveraging digital initiatives, strengthening institutional capacity, institutionalizing exclusive building energy surveys, and standardization of building categorization, among others, to strengthen the management of building sector energy consumption data.

Keywords: energy data, energy policy, energy efficiency, buildings

Procedia PDF Downloads 162

Authors: Rubab Ammad, Abdelgadir Abuelgasim

Abstract:

UAE typically lies in one of the aridest regions of the world and is thus home to geologic features common to such climatic conditions including vast open deserts, sand dunes, saline soils, inland Sabkha and coastal Sabkha. Sabkha are characteristic salt flats formed in arid environment due to deposition and precipitation of salt and silt over sand surface because of low laying water table and rates of evaporation exceeding rates of precipitation. The study area, which comprises of western UAE, is heavily concentrated with inland Sabkha. Remote sensing is conventionally used to study the soil salinity of agriculturally degraded lands but not so broadly for Sabkha. The focus of this study was to identify these highly saline Sabkha areas on remotely sensed data, using salinity indices. The existing salinity indices in the literature have been designed for agricultural soils and they have not frequently used the spectral response of short-wave infra-red (SWIR1 and SWIR2) parts of electromagnetic spectrum. Using Landsat 8 OLI data and field ground truthing, this study formulated indices utilizing NIR-SWIR parts of spectrum and compared the results with existing salinity indices. Most indices depict reasonably good relationship between salinity and spectral index up until a certain value of salinity after which the reflectance reaches a saturation point. This saturation point varies with index. However, the study findings suggest a role of incorporating near infra-red and short-wave infra-red in salinity index with a potential of showing a positive relationship between salinity and reflectance up to a higher salinity value, compared to rest.

Keywords: Sabkha, salinity index, saline soils, Landsat 8, SWIR1, SWIR2, UAE desert

Procedia PDF Downloads 175

Authors: Nuchjaree Kidjawan, Orapan Thosingha, Pawinee Vaipatama, Prakrankiat Youngkong, Sirinapha Malangputhong, Kitti Thamrongaphichartkul, Phatcharaporn Phetcharat

Abstract:

NPI uses technology sensorization of things and processed by AI system. The main features are an individual interface pressure sensor system in contact with the mattress and a position management system where the sensor detects the determined pressure with automatic pressure reduction and distribution. The role of NPI is to monitor, identify the risk and manage the interface pressure automatically when the determined pressure is detected. This study aims to evaluate the effects of “Never Pressure Injury (NPI),” an innovative mattress, on the incidence of pressure injuries in critically ill patients. An observational case-control study was employed to compare the incidence of pressure injury between the case and the control group. The control group comprised 80 critically ill patients admitted to a critical care unit of Phyathai3 Hospital, receiving standard care with the use of memory foam according to intensive care unit guidelines. The case group comprised 80 critically ill patients receiving standard care and with the use of the Never Pressure Injury (NPI) innovation mattress. The patients who were over 20 years old and showed scores of less than 18 on the Risk Assessment Pressure Ulcer Scale – ICU and stayed in ICU for more than 24 hours were selected for the study. The patients’ skin was assessed for the occurrence of pressure injury once a day for five consecutive days or until the patients were discharged from ICU. The sample comprised 160 patients with ages ranging from 30-102 (mean = 70.1 years), and the Body Mass Index ranged from 13.69- 49.01 (mean = 24.63). The case and the control group were not different in their sex, age, Body Mass Index, Pressure Ulcer Risk Scores, and length of ICU stay. Twenty-two patients (27.5%) in the control group had pressure injuries, while no pressure injury was found in the case group.

Keywords: pressure injury, never pressure injury, innovation mattress, critically ill patients, prevent pressure injury

Procedia PDF Downloads 84

Authors: L. Nathaniel-Wurie

Abstract:

The Sellick manoeuvre a.k.a the application of cricoid force (CF), was first described by Brian Sellick in 1961. CF is the application of digital pressure against the cricoid cartilage with the intention of posterior force causing oesophageal compression against the vertebrae. This is designed to prevent passive regurgitation of gastric contents, which is a major cause of morbidity and mortality during emergency airway management inside and outside of the hospital. To the authors knowledge, there is no universally standardised training modality and, therefore, no reliable way to examine if there are appropriate outcomes. If force is not measured during training, how can one surmise that appropriate, accurate, or precise amounts of force are being used routinely. Poor homogeneity in teaching and untested outcomes will correlate with reduced efficacy and increased adverse effects. For this study, the accuracy of force delivery in trained professionals was tested, and outcomes contrasted against a novice control and a novice study group. In this study, 20 operating department practitioners were tested (with a mean experience of 5.3years of performing CF). Subsequent contrast with 40 novice students who were randomised into one of two arms. ‘Arm A’ were explained the procedure, then shown the procedure then asked to perform CF with the corresponding force measurement being taken three times. Arm B had the same process as arm A then before being tested, they had 10, and 30 Newtons applied to their hands to increase intuitive understanding of what the required force equated to, then were asked to apply the equivalent amount of force against a visible force metre and asked to hold that force for 20 seconds which allowed direct visualisation and correction of any over or under estimation. Following this, Arm B were then asked to perform the manoeuvre, and the force generated measured three times. This study shows that there is a wide distribution of force produced by trained professionals and novices performing the procedure for the first time. Our methodology for teaching the manoeuvre shows an improved accuracy, precision, and homogeneity within the group when compared to novices and even outperforms trained practitioners. In conclusion, if this methodology is adopted, it may correlate with higher clinical outcomes, less adverse events, and more successful airway management in critical medical scenarios.

Keywords: airway, cricoid, medical education, sellick

Procedia PDF Downloads 46

Authors: Lou J. Pino, Mark Campbell, Matthew J. Kennedy, Ashleigh C. Kennedy

Abstract:

A concussion is complex and nuanced, with cognitive rest being a key component of recovery. Cognitive overexertion during rehabilitation from a concussion is associated with delayed recovery. However, daily living imposes cognitive demands that may be unavoidable and difficult to quantify. Therefore, a portable tool capable of alerting patients before cognitive overexertion occurs could allow patients to maintain their quality of life while preventing symptoms and recovery setbacks. EEG allows for a sensitive measure of cognitive exertion. Clinical 32-lead EEG headsets are not practical for day-to-day concussion rehabilitation management. However, there are now commercially available and affordable portable EEG headsets. Thus, these headsets can potentially be used to continuously monitor cognitive exertion during mental tasks to alert the wearer of overexertion, with the aim of preventing the occurrence of symptoms to speed recovery times. The objective of this study was to test an algorithm for predicting cognitive exertion from EEG data collected from a portable headset. EEG data were acquired from 10 participants (5 males, 5 females). Each participant wore a portable 4 channel EEG headband while completing 10 tasks: rest (eyes closed), rest (eyes open), three levels of the increasing difficulty of logic puzzles, three levels of increasing difficulty in multiplication questions, rest (eyes open), and rest (eyes closed). After each task, the participant was asked to report their perceived level of cognitive exertion using the NASA Task Load Index (TLX). Each participant then completed a second session on a different day. A customized machine learning model was created using data from the first session. The performance of each model was then tested using data from the second session. The mean correlation coefficient between TLX scores and predicted cognitive exertion was 0.75 ± 0.16. The results support the efficacy of the algorithm for predicting cognitive exertion. This demonstrates that the algorithms developed in this study used with portable EEG devices have the potential to aid in the concussion recovery process by monitoring and warning patients of cognitive overexertion. Preventing cognitive overexertion during recovery may reduce the number of symptoms a patient experiences and may help speed the recovery process.

Keywords: cognitive activity, EEG, machine learning, personalized recovery

Procedia PDF Downloads 196

Authors: Leora Branfield Day, Stephanie Saunders, Leah Steinberg, Shiphra Ginsburg, Christine Soong

Abstract:

Introduction: Discordance between patients expressed and documented preferences at the end of life is common. Although junior trainees frequently lead goals of care (GOC) conversations, lack of training can result in poor communication. Based on a needs assessment, we developed an interactive electronic learning module (eModule) for conducting patient-centred GOC discussions. The purpose of this study was to evaluate the impact of the eModule on residents’ attitudes towards GOC conversations. Methods: First-year internal medicine residents (n=11) from the University of Toronto selected using purposive sampling underwent semi-structured interviews before and after completing a GOC eModule. Interviews were anonymized, transcribed and open-coded using NVivo. Using a constructivist grounded theory approach, we developed a framework to understand the attitudes of residents to GOC conversations before and after viewing the module. Results: Before the module, participants described limited training and negative emotions towards GOC conversations. Many focused on code status and procedure choices (e.g., ventilation) instead of eliciting patient-centered values. Pressure to “get the DNR" led to conflicting feelings and distress. After the module, participants’ approached conversations with a greater focus on patient values and process. They felt more prepared and comfortable, recognizing the complexity of conversations and the importance of patient-centeredness. Conclusions: A novel GOC eModule allowed residents to develop a patient-centered and standardized approach to GOC conversations while improving confidence and preparedness. This resource could be an effective strategy toward attaining a critical communication competency among learners with the potential to enhance accurate GOC documentation.

Keywords: goals of care conversations, communication skills, emodule, medical education

Procedia PDF Downloads 116

Authors: S. Begum, T. Biswas, M. A. Islam

Abstract:

The present research investigates the distribution and contamination of heavy metals in core sediments collected from three locations of the Sundarbans mangrove forest. In this research, quality of the analysis is evaluated by analyzing certified reference materials IAEA-SL-1 (lake sediment), IAEA-Soil-7, and NIST-1633b (coal fly ash). Total concentrations of 28 heavy metals (Na, Al, K, Ca, Sc, Ti, V, Cr, Mn, Fe, Co, Zn, Ga, As, Sb, Cs, La, Ce, Sm, Eu, Tb, Dy, Ho, Yb, Hf, Ta, Th, and U) have determined in core sediments of the Sundarbans mangrove by neutron activation analysis (NAA) technique. When compared with upper continental crustal (UCC) values, it is observed that mean concentrations of K, Ti, Zn, Cs, La, Ce, Sm, Hf, and Th show elevated values in the research area is high. In this research, the assessments of metal contamination levels using different environmental contamination indices (EF, Igeo, CF) indicate that Ti, Sb, Cs, REEs, and Th have minor enrichment of the sediments of the Sundarbans. The modified degree of contamination (mCd) of studied samples of the Sundarbans ecosystem show low contamination. The pollution load index (PLI) values for the cores suggested that sampling points are moderately polluted. The possible sources of the deterioration of the sediment quality can be attributed to the different chemical carrying cargo accidents, port activities, ship breaking, agricultural and aquaculture run-off of the area. Pearson correlation matrix (PCM) established relationships among elements. The PCM indicates that most of the metal's distributions have been controlled by the same factors such as Fe-oxy-hydroxides and clay minerals, and also they have a similar origin. The poor correlations of Ca with most of the elements in the sediment cores indicate that calcium carbonate has a less significant role in this mangrove sediment. Finally, the data from this research will be used as a benchmark for future research and help to quantify levels of metal pollutions, as well as to manage future ecological risks of the vulnerable mangrove ecosystem, the Sundarbans.

Keywords: contamination, core sediment, trace element, sundarbans, vulnerable

Procedia PDF Downloads 94

Authors: Isomar Lima da Silva, Alcilene Batalha Pontes, Aristeu Jonatas Leite de Oliveira, Roberto Maia Augusto

Abstract:

Context: Mechanical ventilators are medical devices that help provide oxygen and ventilation to patients with respiratory difficulties. This equipment consists of a manual breathing unit that can be operated by a doctor or nurse and a mechanical ventilator that controls the airflow and pressure in the patient's respiratory system. This type of ventilator is commonly used in emergencies and intensive care units where it is necessary to provide breathing support to critically ill or injured patients. Objective: In this context, this work aims to develop a reliable and low-cost mechanical ventilator to meet the demand of hospitals in treating people affected by Covid-19 and other severe respiratory diseases, offering a chance of treatment as an alternative to mechanical ventilators currently available in the market. Method: The project presents the development of a low-cost auxiliary ventilator with a controlled ventilatory system assisted by integrated hardware and firmware for respiratory cycle control in non-invasive mechanical ventilation treatments using a manual artificial respiration unit. The hardware includes pressure sensors capable of identifying positive expiratory pressure, peak inspiratory flow, and injected air volume. The embedded system controls the data sent by the sensors. It ensures efficient patient breathing through the operation of the sensors, microcontroller, and actuator, providing patient data information to the healthcare professional (system operator) through the graphical interface and enabling clinical parameter adjustments as needed. Results: The test data of the developed mechanical ventilator presented satisfactory results in terms of performance and reliability, showing that the equipment developed can be a viable alternative to commercial mechanical ventilators currently available, offering a low-cost solution to meet the increasing demand for respiratory support equipment.

Keywords: mechanical fans, breathing, medical equipment, COVID-19, intensive care units

Procedia PDF Downloads 38

Authors: Meril Kate Mariano, Billy Joel Almarinez Divina Amalin, Jose Isagani Janairo

Abstract:

The scale insects Aspidiotus destructor and Aspidiotus rigidus exhibit notable scale covers made of wax which provides protection against water loss and is capable to resist wetting, thus making them a desirable model for biomimetic designs. Their waxy covers enable them to infest mainly leaves of coconut trees despite the harsh wind and rain. This study aims to describe and compare the micro morphological characters on the surfaces of their scale covers consequently, how these micro structures affect their wetting properties. Scanning electron microscope was used for the surface characterization while an optical contact angle meter was employed in the wetting measurement. The scale cover of A. destructor is composed of multiple overlapping layers of wax that is arranged regularly while that of A. rigidus is composed of a uniform layer of wax with much more prominent wax ribbons irregularly arranged compared to the former. The protrusions found on the two organisms are formed by the wax ribbons that differ in arrangement with their height being A. destructor (3.57+1.29) < A. rigidus (4.23+1.22) and their density A. destructor (15+2.94) < A. rigidus (18.33+2.64). These morphological measurements could affect the contact angle (CA θ) measurement of A. destructor (102.66+9.78°) < A. rigidus (102.77 + 11.01°) wherein the assessment that the interaction of the liquid to the microstructures of the substrate is a large factor in the wetting properties of the insect scales is realized. The calculated surface free energy of A. destructor (38.47 mJ/m²) > A. rigidus (31.02 mJ/m²) shows inverse proportionality with the CA measurement. The dispersive interaction between the surface and liquid is more prevalent compared to the polar interaction for both Aspidiotus species, which was observed using the Fowkes method. The results of this study have possible applications to be a potential biomimetic design for various industries such as textiles and coatings.

Keywords: Aspidiotus spp., biomimetics, contact angle, surface characterization, wetting behavior

Procedia PDF Downloads 93

Authors: Claudia Martínez-Araneda, Mariella Gutiérrez, Pedro Gómez, Diego Maldonado, Alejandra Segura, Christian Vidal-Castro

Abstract:

The purpose of this document is to showcase the preliminary work in developing an EduChatbot-type tool and measuring the effects of its use aimed at providing effective feedback to students in programming courses. This bot, hereinafter referred to as tutorBot+, was constructed based on chatGPT and is tasked with assisting and delivering timely positive feedback to students in the field of computer science at the Universidad Católica de Concepción. The proposed working method consists of four stages: (1) Immersion in the domain of Large Language Models (LLMs), (2) Development of the tutorBot+ prototype and integration, (3) Experiment design, and (4) Intervention. The first stage involves a literature review on the use of artificial intelligence in education and the evaluation of intelligent tutors, as well as research on types of feedback for learning and the domain of chatGPT. The second stage encompasses the development of tutorBot+, and the final stage involves a quasi-experimental study with students from the Programming and Database labs, where the learning outcome involves the development of computational thinking skills, enabling the use and measurement of the tool's effects. The preliminary results of this work are promising, as a functional chatBot prototype has been developed in both conversational and non-conversational versions integrated into an open-source online judge and programming contest platform system. There is also an exploration of the possibility of generating a custom model based on a pre-trained one tailored to the domain of programming. This includes the integration of the created tool and the design of the experiment to measure its utility.

Keywords: assessment, chatGPT, learning strategies, LLMs, timely feedback

Procedia PDF Downloads 35

Authors: Seung Chul Lee, Jooyeong Kim, Ki Ok Ahn, Juok Park

Abstract:

Background: Injuries caused by motorcycle crashes are one of the major public health burdens leading to high mortality, functional disability. The risk of death among motorcyclists is 30 times greater than that among car drivers, with head injuries the leading cause of death. The motorcycle helmet is crucial protective equipment for motorcyclists. Aims: This study aimed to measure the protective effect of motorcycle helmet use on intracranial injury and mortality and to compare the preventive effect in drivers and passengers. Methods: This is a cross-sessional study based on the Emergency Department (ED)–based Injury In-depth Surveillance (EDIIS) database from 23 EDs in Korea. All of the trauma patients injured in motorcycle crashes between January 1, 2013 and December 31, 2016 were eligible, excluding cases with unknown helmet use and outcomes. The primary and secondary outcomes were intracranial injury and in-hospital mortality. We calculated adjusted odds ratios (AORs) of helmet use for study outcomes after adjusting for potential confounders. Using interaction models, we compared the protective effect of helmet use on outcomes across driving status (driver and passenger). Results: Among 17,791 eligible patients, 10,668 (60.0%) patients were wearing helmets at the time of the crash, 2,128 (12.0%) patients had intracranial injuries and 331 (1.9%) patients had in-hospital death. 16,381 (92.1%) patients were drivers and 1410 (7.9%) patients were passengers. 62.6% of drivers and 29.1% of passengers were wearing helmets at the time of the crash. Compared to un-helmeted group, the helmeted group was less likely to have an intracranial injury(8.0% vs. 17.9%, AOR: 0.43 (0.39-0.48)) and in-hospital mortality (1.0% vs. 3.2%, AOR: 0.29 (0.22-0.37)).In the interaction model, AORs (95% CIs) of helmet use for intracranial injury were 0.42 (0.38-0.47) in drivers and 0.61(0.41-0.90) in passengers, respectively. There was a significant preventive effect of helmet use on in-hospital mortality in drivers (AOR: 0.26(0.21–0.34)). Discussion and conclusions: Wearing helmets in motorcycle crashes reduced intracranial injuries and in-hospital mortality. The preventive effect of motorcycle helmet use on intracranial injury was stronger in drivers than in passengers. There was a significant preventive effect of helmet use on in-hospital mortality in driver but not in passengers. Public health efforts to increase motorcycle helmet use are needed to reduce health burden from injuries caused by motorcycle crashes.

Keywords: intracranial injury, helmet, mortality, motorcycle crashes

Procedia PDF Downloads 155

Authors: Omer Altaf, Liam Wotherspoon, Rolando Orense

Abstract:

The Wairau Plains are located in the northeast of the South Island of New Zealand, with alluvial deposits of fine-grained silts and sands combined with low-lying topography suggesting the presence of liquefiable deposits over significant portions of the region. Liquefaction manifestations were observed in past earthquakes, including the 1848 Marlborough and 1855 Wairarapa earthquakes, and more recently during the 2013 Lake Grassmere and 2016 Kaikōura earthquakes. Therefore, a good understanding of the deposits that may be susceptible to liquefaction is important for land use planning in the region and to allow developers and asset owners to appropriately address their risk. For this purpose, multiple approaches have been employed to develop regional-scale maps showing the liquefaction vulnerability categories for the region. After applying semi-qualitative criteria linked to geologic age and deposit type, the higher resolution surface mapping of geomorphologic characteristics encompassing the Wairau River and the Opaoa River was used for screening. A detailed basin geologic model developed for groundwater modelling was analysed to provide a higher level of resolution than the surface-geology based classification. This is used to identify the thickness of near-surface gravel deposits, providing an improved understanding of the presence or lack of potentially non-liquefiable crust deposits. This paper describes the methodology adopted for this project and focuses on the influence of geomorphic characteristics and analysis of the detailed geologic basin model on the liquefaction classification of the Lower Wairau Plains.

Keywords: liquefaction, earthquake, cone penetration test, mapping, liquefaction-induced damage

Procedia PDF Downloads 150

Authors: A. Raj Kumar, S. Bilaloglu

Abstract:

Stroke is a leading cause of adult disability worldwide. We depend on our hands for our activities of daily living(ADL). Although many patients regain the ability to walk, they continue to experience long-term hand motor impairments. As the number of individuals with young stroke is increasing, there is a critical need for effective approaches for rehabilitation of hand function post-stroke. Motor relearning for dexterity requires task-specific kinesthetic, tactile and visual feedback. However, when a stroke results in both sensory and motor impairment, it becomes difficult to ascertain when and what type of sensory substitutions can facilitate motor relearning. In an ideal situation, real-time task-specific data on the ability to learn and data-driven feedback to assist such learning will greatly assist rehabilitation for dexterity. We have found that kinesthetic and tactile information from the unaffected hand can assist patients re-learn the use of optimal fingertip forces during a grasp and lift task. Measurement of fingertip grip force (GF), load forces (LF), their corresponding rates (GFR and LFR), and other metrics can be used to gauge the impairment level and progress during learning. Currently ATI mini force-torque sensors are used in research settings to measure and compute the LF, GF, and their rates while grasping objects of different weights and textures. Use of the ATI sensor is cost prohibitive for deployment in clinical or at-home rehabilitation. A cost effective mechatronic device is developed to quantify GF, LF, and their rates for stroke rehabilitation purposes using off-the-shelf components such as load cells, flexi-force sensors, and an Arduino UNO microcontroller. A salient feature of the device is its integration with an interactive gaming environment to render a highly engaging user experience. This paper elaborates the integration of kinesthetic and tactile sensing through computation of LF, GF and their corresponding rates in real time, information processing, and interactive interfacing through augmented reality for visual feedback.

Keywords: feedback, gaming, kinesthetic, rehabilitation, tactile

Procedia PDF Downloads 219

Authors: Asaiel Mubark Al Hadi

Abstract:

Background: A frequent anorectal condition known as hemorrhoids, sometimes known as piles, is characterized by a weakening of the anal cushion and the supporting tissue as well as spasms of the internal sphincter. Hemorrhoids are most frequently identified by painless bright red bleeding, prolapse, annoying grape-like tissue prolapse, itching, or a combination of symptoms. digital rectal examination (DRE) and anoscope are used to diagnose it. Constipation, a low-fiber diet, a high body- mass index (BMI), pregnancy, and a reduced physical activity are among the factors that are typically thought to increase the risk of hemorrhoids. Golighers is the most commonly used hemorrhoid classification scheme It is 4 degrees, which determines the degree of the event. The purpose of this study is to assess knowledge and awareness level of the causes and stages of Hemorrhoids in the public of Saudi Arabia. Method: This cross-sectional study was conducted in the Saudi Arabia between Oct 2022- Dec 2022. The study group included at least 384 aged above 18 years. The outcomes of this study were analyzed using the SPSS program using a pre-tested questionnaire. Results: The study included 1410 participants, 69.9% of them were females and 30.1% were males. 53.7% of participants aged 20- 30 years old. 17% of participants had hemorrhoids and 42% had a relative who had hemorrhoids. 42.8% of participants could identify stage 1 of hemorrhoids correctly, 44.7% identified stage 2 correctly, 46.7% identified stage 3 correctly and 58.1% identified stage 4 correctly. Only 28.9% of participants had high level of knowledge about hemorrhoids, 62.7% had moderate knowledge and 8.4% had low knowledge. Conclusion: In conclusion, Saudi general population has poor knowledge of hemorrhoids, their causes and their management approach. There was a significant association between knowledge scores of hemorrhoids with age, gender, residence area and employment.

Keywords: hemorrhoids, external hemorrhoid, internal hemorrhoid, anal fissure, hemorrhoid stages, prolapse, rectal bleeding

Procedia PDF Downloads 57

Authors: Anita Paddy, Millicent Obodai, Lebbaeus Asamani

Abstract:

The management of sickle cell disease requires a multidisciplinary team for better outcomes. Thus, literature on the application of the biopsychosocial model for the management and explanation of chronic pain in sickle cell disease (SCD) and other chronic diseases abound. However, there is limited research on the use of the biopsychosocial model, together with a spiritual component (biopsychosocial-spiritual model). The study investigated the extent to which healthcare providers utilized the biopsychosocial-spiritual model in the management of chronic pain to improve the quality of life (QoL) of patients with SCD. This study employed the descriptive survey design involving a consecutive sampling of 261 patients with SCD who were between the ages of 18 to 79 years and were accessing hematological services at the Clinical Genetics Department of the Korle Bu Teaching Hospital. These patients willingly consented to participate in the study by appending their signatures. The theory of integrated quality of life, the gate control theory of pain and the biopsychosocial(spiritual) model were tested. An instrument for the biopsychosocial-spiritual model was developed, with a basis from the literature reviewed, while the World Health Organisation Quality of Life BREF (WHOQoLBref) and the spirituality rating scale were adapted and used for data collection. Data were analyzed using descriptive statistics (means, standard deviations, frequencies, and percentages) and partial least square structural equation modeling. The study revealed that healthcare providers had a great leaning toward the biological domain of the model compared to the other domains. Hence, participants’ QoL was not fully improved as suggested by the biopsychosocial(spiritual) model. Again, the QoL and spirituality of patients with SCD were quite high. A significant negative impact of spirituality on QoL was also found. Finally, the biosocial domain of the biopsychosocial-spiritual model was the most significant predictor of QoL. It was recommended that policymakers train healthcare providers to integrate the psychosocial-spiritual component in health services. Also, education on SCD and its resultant impact from the domains of the model should be intensified while health practitioners consider utilizing these components fully in the management of the condition.

Keywords: biopsychosocial (spritual), sickle cell disease, quality of life, healthcare, accra

Procedia PDF Downloads 47

Authors: Omolara Lade, David Oloke

Abstract:

The approach to water management worldwide is currently in transition, with a shift from centralised infrastructures to greater consideration of decentralised technologies, such as rainwater harvesting (RWH). However, in Nigeria, implementation of sustainable water management, such as RWH systems, is inefficient and social, environmental and technical barriers, concerns and knowledge gaps exist, which currently restrict its widespread utilisation. This inefficiency contributes to water scarcity, water-borne diseases, and loss of lives and property due to flooding. Meanwhile, several RWH technologies have been developed to improve SWM through both demand and storm-water management. Such technologies involve the use of reinforced concrete cement (RCC) storage tanks, surface water reservoirs and ground-water recharge pits as storage systems. A framework was developed to assess the significance and extent of water management problems, match the problems with existing RWH-based solutions and develop a robust ready-to-use decision support tool that can quantify the costs and benefits of implementing several RWH-based storage systems. The methodology adopted was the mixed method approach, involving a detailed literature review, followed by a questionnaire survey of household respondents, Nigerian Architects and Civil Engineers and focus group discussion with stakeholders. 18 selection attributes have been defined and three alternatives have been identified in this research. The questionnaires were analysed using SPSS, excel and selected statistical methods to derive weightings of the attributes for the tool. Following this, three case studies were modelled using RainCycle software. From the results, the MDA model chose RCC tank as the most appropriate storage system for RWH.

Keywords: rainwater harvesting, modelling, hydraulic assessment, whole life cost, decision support system

Procedia PDF Downloads 353

Authors: Miseri Roeslan Afany, Nur Ainun Pulungan

Abstract:

The unique characteristics of Andisol differentiate them from other soils. These characteristics become a guideline in determining management and usage with regards to agriculture. Especially in the tropical area, Andisols may have fast mineral alteration due to intensive water movement in the soils. Four soil chemical tests were conducted for evaluating soils in the study area. Al/Fe humus, allophane, pH, and P retention were used to differentiate Andisols under different practices. Non-cultivation practice (e.g. natural forest) and cultivation practices (e.g. horticulture systems and intensive farming systems) are compared in this study. We applied Blackmore method for P retention analysis. The aims of this study are: (i) to analyze the specific behavior of Al/Fe humus, pH, and allophane towards P retention in order (ii) to evaluate the effect of cultivation practices on their behavior changes among Andisols, and (iii) to gain the sustainable agriculture through proposing an appropriate soil managements in the study area. 5 observation sites were selected, and 75 soil sampling were analyzed in this study. The results show that the cultivation decreases P retention in all sampling sites. There is a declining from ±90% to ±50% of P retention in the natural forest where shifts into cultivated land. The average of P retention under 15 years of cultivation down into 63%, whereas, the average of P retention more than 15 years of cultivation down into 54%. Many factors affect the retention of P in the soil such as: (1) type and amount of clay, (2) allophone and/or imogolit, (3) Al/Fe humus, (4) soil pH, (5) type and amount of organic material, (6) Exchangeable bases (Ca, Mg, Na, K), (7) forms and solubility of Al/Fe. To achieve the sustainable agriculture in the study area, conventional agriculture practices should be preserved and intensive fertilizing practices should be applied in order to increase the soil pH, to maintain the organic matter of andisols, to maintain microba activities, and to release Al/Fe humus complex, and thus increase available P in the soils.

Keywords: Andisols, cultivation, P retention, sustainable agriculture

Procedia PDF Downloads 249

Authors: Diane Ghanem, Whitney Kagabo, Rebecca Engels, Uma Srikumaran, Babar Shafiq

Abstract:

Hospitalist co-management of orthopaedic surgery patients is a growing trend across the country. It was created as a collaborative effort to provide overarching care to patients with the goal of improving their postoperative care and decreasing in-hospital medical complications. The aim of this project is to provide a guide for implementing and optimizing a hospitalist co-management service in orthopaedic surgery. Key leaders from the hospitalist team, orthopaedic team and quality, safety and service team were identified. Multiple meetings were convened to discuss the comanagement service and determine the necessary building blocks behind an efficient and well-designed co-management framework. After meticulous deliberation, a consensus was reached on the final service agreement and a written guide was drafted. Fundamental features of the service include the identification of service stakeholders and leaders, frequent consensus meetings, a well-defined framework, with goals, program metrics and unified commands, and a regular satisfaction assessment to update and improve the program. Identified pearls for co-managing orthopaedic surgery patients are standardization, timing, adequate patient selection, and two-way feedback between hospitalists and orthopaedic surgeons to optimize the protocols. Developing a service agreement is a constant work in progress, with meetings, discussions, revisions, and multiple piloting attempts before implementation. It is a partnership created to provide hospitals with a streamlined admission process where at-risk patients are identified early, and patient care is optimized regardless of the number or nature of medical comorbidities. A wellestablished hospitalist co-management service can increase patient care quality and safety, as well as health care value.

Keywords: co-management, hospitalist co-management, implementation, orthopaedic surgery, quality improvement

Procedia PDF Downloads 50

Authors: Hami Ashraf, Mohammad Heydarnejad

Abstract:

Introduction: The landscape of cancer treatment has been revolutionized by immunotherapy, offering novel therapeutic avenues for diverse cancer types. Animal models play a pivotal role in the development and elucidation of these therapeutic modalities. Nevertheless, the manifestation of Graft-versus-Host Disease (GVHD) in such models poses significant challenges, muddling the interpretation of experimental data within the ambit of cancer immunotherapy. This study is dedicated to scrutinizing the role of GVHD as a confounding factor in animal models used for cancer immunotherapy, alongside proposing viable strategies to mitigate this complication. Method: Employing a systematic review framework, this study undertakes a comprehensive literature survey including academic journals in PubMed, Embase, and Web of Science databases and conference proceedings to collate pertinent research that delves into the impact of GVHD on animal models in cancer immunotherapy. The acquired studies undergo rigorous analysis and synthesis, aiming to assess the influence of GVHD on experimental results while identifying strategies to alleviate its confounding effects. Results: Findings indicate that GVHD incidence significantly skews the reliability and applicability of experimental outcomes, occasionally leading to erroneous interpretations. The literature surveyed also sheds light on various methodologies under exploration to counteract the GVHD dilemma, thereby bolstering the experimental integrity in this domain. Conclusion: GVHD's presence critically affects both the interpretation and validity of experimental findings, underscoring the imperative for strategies to curtail its confounding impacts. Current research endeavors are oriented towards devising solutions to this issue, aiming to augment the dependability and pertinence of experimental results. It is incumbent upon researchers to diligently consider and adjust for GVHD's effects, thereby enhancing the translational potential of animal model findings to clinical applications and propelling progress in the arena of cancer immunotherapy.

Keywords: graft-versus-host disease, cancer immunotherapy, animal models, preclinical model

Procedia PDF Downloads 27

Authors: Chandrakala Varatharajoo, Adelina Binti Asmawi, Nabeel Abdallah Mohammad Abedalaziz

Abstract:

This study investigated the impact of inflectional and derivational morphemic analysis awareness on ESL secondary school students’ vocabulary learning strategy. The quasi-experimental study was conducted with 106 low proficiency secondary school students in two experimental groups (inflectional and derivational) and one control group. The students’ vocabulary acquisition was assessed through two measures: Morphemic Analysis Test and Vocabulary- Morphemic Test in the pretest and posttest before and after an intervention programme. Results of ANCOVA revealed that both the experimental groups achieved a significant score in Morphemic Analysis Test and Vocabulary-Morphemic Test. However, the inflectional group obtained a fairly higher score than the derivational group. Thus, the results indicated that ESL low proficiency secondary school students performed better on inflectional morphemic awareness as compared to derivatives. The results also showed that the awareness of inflectional morphology contributed more on the vocabulary acquisition. Importantly, learning inflectional morphology can help ESL low proficiency secondary school students to develop both morphemic awareness and vocabulary gain. Theoretically, these findings show that not all morphemes are equally useful to students for their language development. Practically, these findings indicate that morphological instruction should at least be included in remediation and instructional efforts with struggling learners across all grade levels, allowing them to focus on meaning within the word before they attempt the text in large for better comprehension. Also, by methodologically, by conducting individualized intervention and assessment this study provided fresh empirical evidence to support the existing literature on morphemic analysis awareness and vocabulary learning strategy. Thus, a major pedagogical implication of the study is that morphemic analysis awareness strategy is a definite boon for ESL secondary school students in learning English vocabulary.

Keywords: ESL, instruction, morphemic analysis, vocabulary

Procedia PDF Downloads 371

Authors: Erna Judith Roach, Nalini Bhaskaranand

Abstract:

Background & Significance: Asthma is the most common chronic disease among children. Education is the cornerstone of management of asthma to help the affected children. In India there are about 1.5- 3.0 million asthmatic children in the age group of 5-11 years. Many parents face management dilemmas in administration of medications to their children. Mothers being primary caregivers of children are often responsible for administering medications to them. The purpose of the study was to develop an educational package on techniques of drug administration for mothers of asthmatic children and determine its effectiveness in terms of improvement in skill in drug administration. Methodology: A quasi- experimental time series pre-test post -test control group design was used. Mothers of asthmatic children attending paediatric outpatient departments of selected hospitals along with their children between 5 and 12 years were included. Sample size consisted of 40 mothers in the experimental and 40 mothers in the control groups. Block randomization was used to assign samples to both the groups. The data collection instruments used were Baseline Proforma, Clinical Proforma, Daily asthma drug intake and symptoms diary and Observation Rating Scales on technique of using a metered dose inhaler with spacer; metered dose inhaler with facemask; metered dose inhaler alone and dry powder inhaler. The educational package consisted of a video and booklet on techniques of drug administration. Data were collected at baseline, 1, 3 and 6 months. Findings: The mean post-test scores in techniques of drug administration were higher than the mean pre-test scores in the experimental group in all techniques. The Friedman test (p < 0.01), Wilcoxon Signed Rank test (p < 0.008) and Mann Whitney U (p < 0.01) showed statistically significant difference in the experimental group than the control group. There was significant decrease in the average number of symptom days (11 Vs. 4 days/ month) and hospital visits (5 to 1 per month) in the experimental group when compared to the control group. Conclusion: The educational package was found to be effective in improving the skill of mothers in drug administration in all the techniques, especially with using the metered dose inhaler with spacer.

Keywords: childhood asthma, drug administration, mothers of children, inhaler

Procedia PDF Downloads 396

Authors: Radka Sefcu, Vaclava Antuskova, Ivana Turkova

Abstract:

A growing market with modern artworks of a high price leads to the creation and selling of artwork counterfeits. Material analysis is an important part of the process of assessment of authenticity. Knowledge of materials and techniques used by original authors is also necessary. The contribution presents possibilities of non-invasive methods of structural analysis in research on paintings. It was proved that unambiguous identification of many art materials is feasible without sampling. The combination of Raman spectroscopy with FTIR-external reflection enabled the identification of pigments and binders on selected artworks of prominent Czech painters from the first half of the 20th century – Josef Čapek, Emil Filla, Václav Špála and Jan Zrzavý. Raman spectroscopy confirmed the presence of a wide range of white pigments - lead white, zinc white, titanium white, barium white and also Freeman's white as a special white pigment of painting. Good results were obtained for red, blue and most of the yellow areas. Identification of green pigments was often impossible due to strong fluorescence. Oil was confirmed as a binding medium on most of the analyzed artworks via FTIR - external reflection. Collected data present the valuable background for the determination of art materials characteristic for each painter (his palette) and its development over time. Obtained results will further serve as comparative material for the authentication of artworks. This work has been financially supported by the project of the Ministry of the Interior of the Czech Republic: The Development of a Strategic Cluster for Effective Instrumental Technological Methods of Forensic Authentication of Modern Artworks (VJ01010004).

Keywords: non-invasive analysis, Raman spectroscopy, FTIR-external reflection, forgeries

Procedia PDF Downloads 146

Authors: Yousef M. Al-Roomi, Kaneez Fatema Hussain

Abstract:

This work evaluates the thermal degradation kinetic parameters of CaSO₄-complex isolated after the inhibition effect of maleic-anhydride based polymer (YMR-polymers). Pyrolysis experiments were carried out at four heating rates (5, 10, 15 and 20°C/min). Several analytical model-free methods were used to determine the kinetic parameters, including Friedman, Coats and Redfern, Kissinger, Flynn-Wall-Ozawa and Kissinger-Akahira–Sunose methods. The Criado model fitting method based on real mechanism followed in thermal degradation of the complex has been applied to explain the degradation mechanism of CaSO₄-complex. In addition, a simple dynamic model was proposed over two temperature ranges for successive decomposition of CaSO₄-complex which has a combination of organic and inorganic part (adsorbed polymer + CaSO₄.2H₂O scale). The model developed enabled the assessment of pre-exponential factor (A) and apparent activation-energy (Eₐ) for both stages independently using a mathematical developed expression based on an integral solution. The unique reaction mechanism approach applied in this study showed that (Eₐ₁-160.5 kJ/mole) for organic decomposition (adsorbed polymer stage-I) has been lower than Eₐ₂-388 kJ/mole for the CaSO₄ decomposition (inorganic stage-II). Further adsorbed YMR-antiscalant not only reduced the decomposition temperature of CaSO₄-complex compared to CaSO₄-blank (CaSO₄.2H₂O scales in the absence of YMR-polymer) but also distorted the crystal lattice of the organic complex of CaSO₄ precipitates, destroying their compact and regular crystal structures observed from XRD and SEM studies.

Keywords: CaSO₄-complex, maleic-anhydride polymers, thermal degradation kinetics and mechanism, XRD and SEM studies

Procedia PDF Downloads 92

Authors: Noorulain Khalid, Unsaar Hayat, Muhammad Chaudhary, Christos Iosifidis, Felipe Dhawahir-Scala, Fiona Carley

Abstract:

Dry eye disease (DED) is a common condition seen in the emergency eye department (EED) at Manchester Royal Eye Hospital (MREH). However, there is variability in the prescription of lubricating eye drops among different healthcare providers. The aim of this study was to develop an up-to-date, standardized algorithm for the prescription of lubricating eye drops in the EED at MREH based on international and national guidelines. The study also aimed to assess the impact of implementing the guideline on the rate of inappropriate lubricant prescriptions. Primarily, the impact was to be assessed in the form of the appropriateness of prescriptions for patients’ DED. The impact was secondary to be assessed through analysis of the cost to the hospital. Data from 845 patients who attended the EED over a 3-month period were analyzed, and 157 patients met the inclusion and exclusion criteria. After conducting a review of the literature and collaborating with the corneal team, an algorithm for the prescription of lubricants in the EED was developed. Three plan-do-study-act (PDSA) cycles were conducted, with interventions such as emails, posters, in-person reminders, and education for incoming trainees. The appropriateness of prescriptions was evaluated against the guidelines. Data were collected from patient records and analyzed using statistical methods. The appropriateness of prescriptions was assessed by comparing them to the guidelines and by clinical correlation with a specialized registrar. The study found a substantial improvement in the number of appropriate prescriptions, with an increase from 55% to 93% over the three PDSA cycles. There was additionally a 51% reduction in expenditure on lubricant prescriptions, resulting in cost savings for the hospital (approximate saving of £50/week). Theoretical importance: Appropriate prescription of lubricating eye drops improves disease management for patients and reduces costs for the hospital. The development and implementation of a standardized guideline facilitate the achievement of these goals. Conclusion: This study highlights the inconsistent management of DED in the EED and the potential lack of training in this area for healthcare providers. The implementation of a standardized, easy-to-follow guideline for lubricating eye drops can help to improve disease management while also resulting in cost savings for the hospital.

Keywords: lubrication, dry eye disease, guideline, prescription

Procedia PDF Downloads 33

Authors: Emanuela Zilli, Antonio Madia, Milvia Marchiori, Paola Anello, Chiara Cabbia, Emanuela Velo, Delia Campagnolo, Michele Scomazzon, Emanuela Salvatico, S. Tikvina, Antonio Miotti

Abstract:

Hepatitis C is an inflammation of the liver caused by the hepatitis C virus (HCV). Antiviral medicines can cure more than 95% of cases of hepatitis C infection, but access to diagnosis and treatment remains low. The ULSS 6 Euganea – Health Trust has implemented a campaign to eradicate hepatitis C in the province of Padua (North-East of Italy), which can be subdivided into three areas: North (300.000 inhabitants), Centre (400.000) and South (300.000). In September 2021, the project was launched in the Northern area; a set of brochures was distributed in outpatient services, general practitioners’ clinics and offices, community pharmacy services, social health districts, and through social networks. The Hepatology Service contacted 460 patients selected by the Clinical Laboratory (positivity for HCV antibodies): 83 patients (18.0%) had been already cured of HCV infection, missing or deceased; 377 patients (82.0%) met the criteria to be eligible for HCV eradication therapy and were therefore included in a Day Service specific agenda and followed by a multidisciplinary team of healthcare professionals, with a dedicated telephone line. Haemato-chemical tests, general medical check-ups and ultrasound tests with fibroscan were performed. Patients were tested for Sars-CoV-2 positivity; those not yet vaccinated against Covid-19 were encouraged to complete the vaccination scheme. All 377 patients (100%) received HCV eradication therapy at the community pharmacy service; a detailed explanation of how to take their medication was provided. At the end of the first phase, Covid-19 vaccination rate was 100% (377/377), including patients already vaccinated and new-vaccinated. Check-up appointments were arranged after 2 or 3 months, according to the treatment plan. The awareness campaign and the organization of HCV eradication therapy service by ULSS 6 Euganea are proving to be effective; the project is now going to be applied to Central and Southern areas of the province (1.132 patients).

Keywords: public health, HCV-eradication, Covid-19 emergency, health communication strategies

Procedia PDF Downloads 75

Authors: Franca De Sarno, Alfonso Maria Ponsiglione, Enza Torino

Abstract:

Recent advances in diagnostic imaging technology have significantly contributed to a better understanding of specific changes associated with diseases progression. Among different imaging modalities, Magnetic Resonance Imaging (MRI) represents a noninvasive medical diagnostic technique, which shows low sensitivity and long acquisition time and it can discriminate between healthy and diseased tissues by providing 3D data. In order to improve the enhancement of MRI signals, some imaging exams require intravenous administration of contrast agents (CAs). Recently, emerging research reports a progressive deposition of these drugs, in particular, gadolinium-based contrast agents (GBCAs), in the body many years after multiple MRI scans. These discoveries confirm the need to have a biocompatible system able to boost a clinical relevant Gd-chelate. To this aim, several approaches based on engineered nanostructures have been proposed to overcome the common limitations of conventional CAs, such as the insufficient signal-to-noise ratios due to relaxivity and poor safety profile. In particular, nanocarriers, labeling or loading with CAs, capable of carrying high payloads of CAs have been developed. Currently, there’s no a comprehensive understanding of the thermodynamic contributions enable of boosting the efficacy of conventional CAs by using biopolymers matrix. Thus, considering the importance of MRI in diagnosing diseases, here it is reported a successful example of the next generation of these drugs where the commercial gadolinium chelate is incorporate into a biopolymer nanostructure, formed by cross-linked hyaluronic acid (HA), with improved relaxation properties. In addition, they are highlighted the basic principles ruling biopolymer-CA interactions in the perspective of their influence on the relaxometric properties of the CA by adopting a multidisciplinary experimental approach. On the basis of these discoveries, it is clear that the main point consists in increasing the rigidification of readily-available Gd-CAs within the biopolymer matrix by controlling the water dynamics, the physicochemical interactions, and the polymer conformations. In the end, the acquired knowledge about polymer-CA systems has been applied to develop of Gd-based HA nanoparticles with enhanced relaxometric properties.

Keywords: biopolymers, MRI, nanoparticles, contrast agent

Procedia PDF Downloads 120

Authors: A. Elmethnani, A. Jroud

Abstract:

This coastal crude oil refinery is situated north of a big city west of Tripoli; the city then could be highly prone to downwind refinery emissions where the NNE wind direction is prevailing through most seasons of the year. Furthermore, due to the absence of an air quality monitoring network and scarce emission data available for the neighboring community, nearby residents have serious worries about the impacts of the oil refining operations on local air quality. In responding to these concerns, a short term survey has performed for three consecutive days where a semi-continues mobile monitoring approach has developed effectively in this study; the monitoring station (Compact AQM 65 AeroQual) was mounted on a vehicle to move quickly between locations, measurements of 10 minutes averaging of 60 seconds then been taken at each fixed sampling point. The downwind ambient concentration of CO, H₂S, NOₓ, NO₂, SO₂, PM₁, PM₂.₅ PM₁₀, and TSP were measured at carefully chosen sampling locations, ranging from 200m nearby the fence-line passing through the city center up to 4.7 km east to attain best spatial coverage. Results showed worrying levels of PM₂.₅ PM₁₀, and TSP at one sampling location in the city center, southeast of the refinery site, with an average mean of 16.395μg/m³, 33.021μg/m³, and 42.426μg/m³ respectively, which could be attributed to road traffic. No significant concentrations have been detected for other pollutants of interest over the study area, as levels observed for CO, SO₂, H₂S, NOₓ, and NO₂ haven’t respectively exceeded 1.707 ppm, 0.021ppm, 0.134 ppm, 0.4582 ppm, and 0.0018 ppm, which was at the same sampling locations as well. Although it wasn’t possible to compare the results with the Libyan air quality standards due to the difference in the averaging time period, the technique was adequate for the baseline air quality screening procedure. Overall, findings primarily suggest modeling of dispersion of the refinery emissions to assess the likely impact and spatial-temporal distribution of air pollutants.

Keywords: air quality, mobil monitoring, oil refinery

Procedia PDF Downloads 69

Authors: Rossana Taravella, Gilberto M. Cellura, Giuseppe Cirrincione, Salvatore Asciutto, Marco Caruso, Massimo Benedetto, Renato Ciofalo, Giuliana Pace, Salvatore Novo

Abstract:

Objectives: This retrospective analysis sought to evaluate 1-month outcomes and therapy effectiveness of a population of patients treated with MitraClip therapy. We describe in this article the preliminary results of primary effectiveness endpoint. Background: Percutaneous Mitral Repair is being developed to treat severe mitral regurgitation (MR), with increasing real-world cases of functional MR (FMR). In the EVEREST (Endovascular Valve Edge-to-Edge Repair Study)II trial, the percutaneous device showed superior safety but less reduction in MR at 1year. 4-year outcomes from EVEREST II trial showed no difference in the prevalence of moderate-severe and severe MR or mortality at 4years between surgical mitral repair and percutaneous approach. Methods: We analysed retrospectively collected data from one center experience in Italy enrolled from January 2011 to December 2016. The study included 62 patients [mean age 74±11years, 43 men (69%)] with MR of at least grade3+. Most of the patients had functional MR, were in New York Heart Association (NYHA) functional class III or IV, with a large portion (78%) of mild-to-moderate Tricuspid Regurgitation (TR). One or more clips were implanted in 67 procedures (62 patients). Results and Conclusions: Severity of MR was reduced in all successfully treated patients,54(90%) were discharged with MR≤2+ (primary effectiveness endpoint). Clinical 1-month follow-up data showed an improvement in NYHA functional class (42 patients (70%) in NYHA class I-II). 60 of 62 (97 %) successfully treated patients were free from death and mitral valve surgery at 1-month follow-up. MitraClip therapy reduces functional MR with acute MR reduction to <2+ in the great majority of patients, with a large freedom from death, surgery or recurrent MR in a great portion of patients.

Keywords: MitraClip, mitral regurgitation, heart valves, catheter-based therapy

Procedia PDF Downloads 268