Search results for: total extra peritoneal (TEP)

Authors: Zainab A. Alaghbri, Labiba A., Esam A.

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Tuberculosis (TB) is the fourth leading cause of death in Yemen and is considered a major priority by the Ministry of Public Health. The war in Yemen has led to the emergence of one of the worst humanitarian crises in the world. These circumstances may lead to exacerbate the situation of tuberculosis. This study aims to describe the trend and incidence of TB in north and east governorates, Yemen 2019-2021 and provide recommendations for interventions. A descriptive analysis was conducted during July to September 2022. Data of TB cases were obtained from the national tuberculosis program as soft copy. The Data included the TB case collected and diagnosed during 2019-2021. The data contains the following variables: Sex, age, governorates, smear-positive cases, extra-pulmonary cases, and treatment outcomes. 16791 TB cases were notified for an overall case notification rate 65.5/100000 for all forms (smear positive and Extra-pulmonary), There was a slightly declined in 2020 and 2021 by 1%. Both the pulmonary smear positive and Extra pulmonary rates were slightly decreased from 8.8 to 7.7 and 13.5 to 12.8 / 100, 000 populations respectively. For Tuberculosis cases by type of patient, the incidence of extra-pulmonary was the highest (12,9, 11.3 and 12,2/100000) over the three years. However, the incidence of pulmonary failure was the lowest. The majority of cases were in the age group 25-34. The overall treatment success rate for smear-positive patients was 88%. Of the 627 patients with documented unsuccessful outcomes (e.g., failure, death, and default), 165 (23%) died, 52 (8.3%) failed treatment, and 410 (65%) defaulted. Overall, the magnitude of tuberculosis decreased over the periods reviewed. The proportion of Extra-pulmonary TB was the highest. The success rate achieved after treatment was below the levels established by the WHO End Tuberculosis Strategy (90%). Failure to complete treatment may be responsible for the low success rate. Monitoring and addressing the risk factors that were associated with treatment outcomes and duration may help improve the likelihood of achieving favorable outcomes among cases of smear-positive pulmonary TB.

Keywords: tuberculosis, trend, incidence, yemen

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Authors: Dilupa Nakandala, Henry Lau

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Ever increasing demand for cost efficiency and customer satisfaction through reliable delivery have been a mandate for logistics practitioners to continually improve inventory management processes. With the cost optimization objectives, this study considers an extended scenario where sourcing from the same echelon of the supply chain, known as lateral transshipment which is instantaneous but more expensive than purchasing from regular suppliers, is considered by warehouses not only to re-actively fulfill the urgent outstanding retailer demand that could not be fulfilled by stock on hand but also for preventively reduce back-order cost. Such extra lateral trans-shipments as preventive responses are intended to meet the expected demand during the supplier lead time in a periodic review ordering policy setting. We develop decision rules to assist logistics practitioners to make cost optimized selection between back-ordering and combined reactive and proactive lateral transshipment options. A method for determining the optimal quantity of extra lateral transshipment is developed considering the trade-off between purchasing, holding and backorder cost components.

Keywords: lateral transshipment, warehouse inventory management, cost optimization, preventive transshipment

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Authors: Gi Ryung Song, Kyoung Seok Kim

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This study reviewed the literature that focused on similarity of various characteristics such as values, personality, or demographics between employee and other elements in its organization for example employee with leader, job, and organization. We divided a body of this study into two parts and organized and demonstrated recent studies in first part. Three issues appeared in this part, which are statistical ways of measuring similarity, supervisor-subordinate similarity, and person-organization fit with person-job fit. In the latter part, based on the three issues of recent studies, we suggested three propositions about points that the recent studies missed or the studies did not orient. First proposition argued about the direction of similarity, which could also be interpreted as there is causal relation between employee and its workplace environments. Second, we suggested a consideration of eliminating common variance buried in one’s characteristics or its profiles. Third proposition was about the similarity of extra role behavior between individual and organization, and we treated this organization’s level of extra role behavior as a kind of its culture. In doing so, similarity of individual’s extra role behavior and organization’s has the meaning that individual’s congruence against their organization culture.

Keywords: similarity, person-organization fit, supervisor-subordinate similarity, literature review

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Authors: Ayda Youssef, Mohammed Ali Khalaf, Tarek Rafaat

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Background: Langerhans cell histiocytosis (LCH) is a rare multi-systemic disease that shows an abnormal proliferation of these kinds of cells associated with a granular infiltration that affects different structures of the human body, including the lung, liver, spleen, lymph nodes, brain, mucocutaneous, soft tissue (head and neck), and salivary glands. Evaluation of the extent of disease is one of the major predictors of patient outcome. Objectives: To recognize the pathogenesis of Langerhans cell histiocytosis (LCH), describe the radiologic criteria that are suggestive of LCH in different organs rather than the bones and to illustrate the appropriate differential diagnoses for LCH in each of the common extra-osseous sites. Material and methods: A retrospective study was done on 150 biopsy-proven LCH patients from 2007 to 2012. All patients underwent imaging studies, mostly US, CT, and MRI. These patients were reviewed to assess the extra-skeletal manifestations of LCH. Results: In 150 patients with biopsy-proven LCH, There were 33 patients with liver affection, 5 patients with splenic lesions, 55 patients with enlarged lymph nodes, 9 patient with CNS disease and 11 patients with lung involvement. Conclusions: Because of the frequent LCH children and evaluation of the extent of disease is one of the major predictors of patient outcome. Radiologist need to be familiar with its presentation in different organs and regions of body outside the commonest site of affection (bones). A high-index suspicion should be raised a biopsy is recommended in the presence of radiological suspicion. Chemotherapy is the preferred therapeutic modality.

Keywords: langerhans cell histiocytosis, extra-skeletal, pediatrics, radiology

Procedia PDF Downloads 412

Authors: Maurice Ntahobari, Levin Kuhlmann, Mario Boley, Zhinoos Razavi Hesabi

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For machine learning based epileptic seizure prediction, it is important for the model to be implemented in small implantable or wearable devices that can be used to monitor epilepsy patients; however, current state-of-the-art methods are complex and computationally intensive. We use Shapley Additive Explanation (SHAP) to find relevant intracranial electroencephalogram (iEEG) features and improve the computational efficiency of a state-of-the-art seizure prediction method based on the extra trees classifier while maintaining prediction performance. Results for a small contest dataset and a much larger dataset with continuous recordings of up to 3 years per patient from 15 patients yield better than chance prediction performance (p < 0.004). Moreover, while the performance of the SHAP-based model is comparable to that of the benchmark, the overall training and prediction time of the model has been reduced by a factor of 1.83. It can also be noted that the feature called zero crossing value is the best EEG feature for seizure prediction. These results suggest state-of-the-art seizure prediction performance can be achieved using efficient methods based on optimal feature selection.

Keywords: machine learning, seizure prediction, extra tree classifier, SHAP, epilepsy

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Authors: Niyati Sharma, Om Anand, Sanjeev Kumar Prasad

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Assuming future sale value for any of the organizations is one of the major essential characteristics of tactical development. Walmart Sales Forecasting is the finest illustration to work with as a beginner; subsequently, it has the major retail data set. Walmart uses this sales estimate problem for hiring purposes also. We would like to analyzing how the internal and external effects of one of the largest companies in the US can walk out their Weekly Sales in the future. Demand forecasting is the planned prerequisite of products or services in the imminent on the basis of present and previous data and different stages of the market. Since all associations is facing the anonymous future and we do not distinguish in the future good demand. Hence, through exploring former statistics and recent market statistics, we envisage the forthcoming claim and building of individual goods, which are extra challenging in the near future. As a result of this, we are producing the required products in pursuance of the petition of the souk in advance. We will be using several machine learning models to test the exactness and then lastly, train the whole data by Using linear regression and fitting the training data into it. Accuracy is 8.88%. The extra trees regression model gives the best accuracy of 97.15%.

Keywords: random forest algorithm, linear regression algorithm, extra trees classifier, mean absolute error

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Authors: Narendra Nath Patra

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Several recent studies reinforce the existence of a thick molecular disc in galaxies along with the dynamically cold thin disc. Assuming a two-component molecular disc, we model the disc of NGC 6946 as a four-component system consists of stars, HI, thin disc molecular gas, and thick disc molecular gas in vertical hydrostatic equilibrium. Following, we set up the joint Poisson-Boltzmann equation of hydrostatic equilibrium and solve it numerically to obtain a three-dimensional density distribution of different baryonic components. Using the density solutions and the observed rotation curve, we further build a three-dimensional dynamical model of the molecular disc and consecutively produce simulated CO spectral cube and spectral width profile. We find that the simulated spectral width profiles distinguishably differs for different assumed thick disc molecular gas fraction. Several CO spectral width profiles are then produced for different assumed thick disc molecular gas fractions and compared with the observed one to obtain the best fit thick disc molecular gas fraction profile. We find that the thick disc molecular gas fraction in NGC 6946 largely remains constant across its molecular disc with a mean value of 0.70 +/- 0.09. We also estimate the amount of extra-planar molecular gas in NGC 6946. We find 60% of the total molecular gas is extra-planar at the central region, whereas this fraction reduces to ~ 35% at the edge of the molecular disc. With our method, for the first time, we estimate the thick disc molecular gas fraction as a function of radius in an external galaxy with sub-kpc resolution.

Keywords: galaxies: kinematics and dynamic, galaxies: spiral, galaxies: structure , ISM: molecules, molecular data

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Authors: Angelis P. Barlampas

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Theoretical background Disorders of fixation and rotation of the large intestine, result in the existence of its parts in ectopic anatomical positions. In case of symptomatology, the clinical picture is complicated by the possible symptomatology of the neighboring anatomical structures and a differential diagnostic problem arises. Target The purpose of this work is to demonstrate the difficulty of revealing the real cause of abdominal pain, in cases of anatomical variants and the decisive contribution of imaging and especially that of computed tomography. Methods A patient came to the emergency room, because of acute pain in the right hypochondrium. Clinical examination revealed tenderness in the gallbladder area and a positive Murphy's sign. An ultrasound exam depicted a normal gallbladder and the patient was referred for a CT scan. Results Flexible, unfixed ascending colon and cecum, located in the anatomical region of the right mesentery. Opacities of the surrounding peritoneal fat and a small linear concentration of fluid can be seen. There was an appendix of normal anteroposterior diameter with the presence of air in its lumen and without clear signs of inflammation. There was an impression of possible inflammatory swelling at the base of the appendix, (DD phenomenon of partial volume; e.t.c.). Linear opacities of the peritoneal fat in the region of the second loop of the duodenum. Multiple diverticula throughout the colon. Differential Diagnosis The differential diagnosis includes the following: Inflammation of the base of the appendix, diverticulitis of the cecum-ascending colon, a rare case of second duodenal loop ulcer, tuberculosis, terminal ileitis, pancreatitis, torsion of unfixed cecum-ascending colon, embolism or thrombosis of a vascular intestinal branch. Final Diagnosis There is an unfixed cecum-ascending colon, which is exhibiting diverticulitis.

Keywords: unfixed cecum-ascending colon, abdominal pain, malrotation, abdominal CT, congenital anomalies

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Authors: Monica Rosa Loizzo, Tiziana Falco, Marco Bonesi, Maria Concetta Tenuta, Mariarosaria Leporini, Rosa Tundis

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Extra Virgin Olive Oil (EVOO) is a major source of fat in the Mediterranean diet and its nutritional properties are the main reason for the increment of its consumption all over the world in recent years. In terms of olive oil production, Italy ranks the second in the world. EVOO is obtained exclusively by physical methods from the fruit of Olea europea L. Frantoio cv is spread in all the Italian territory. The aim of this work is to identify the phenolic and fatty acids profile of EVOO from Frantoio cv growing in different area of Calabria (Italy). The phenolic profile was obtained by HPLC coupled to a diode array detector and mass spectrometry. Analyses revealed the presence of phenolic alcohols, phenolic acid, several secoiridoids, and two flavones as main components. Hydroxytyrosol and tyrosol are present in reasonable content. Fatty acids were monitored by gas chromatography. Oleic acid was the most abundant compounds. A moderate level of linoleic acid, in accordance with the general observations for oils derived from Mediterranean countries, was also found.

Keywords: extra virgin olive oils, frantoio cv, phenolic compounds, fatty acids

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Authors: Awais Naeem, Osama Shakeel, Aamir Ali Syed, Shahid Khattak

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Introduction: Laparoscopic right hemicolectomy is an advanced cancer surgery in today's era. The aim of this study was to evaluate the surgical and initial oncological outcomes after curative, laparoscopic resection of right sided colonic tumors. Also to compare our results with those of previous randomized trials. Methods And Procedures: We retrospectively analyzed the medical record files of all the patients who presented to our hospital with the diagnosis of right sided colon carcinoma from January 2012 to December 2017 and underwent laparoscopic right hemicolectomy. Demographics, operative findings and histopathological reports were all recorded on a preformed data sheet. All the analysis was performed on SPSS 20. Results: Total of 48 patients were included. There were 37 male and 11 female patients with mean age of 49.7 (range from 25 – 82). Mean hospital stay was 8.25 ± 3.17 days. Blood loss was 80mls and operative mean time was 240 minutes. Eighteen patients had extended right hemicolectomy. Median length of the specimen retrieved was 31cm (range, 14-59cm). Mean size of tumor was 6.44cm + 2.53. Total number of lymph nodes removed was 20.5 + 8.3. All had R0 resection. Post-operatively 2 patients had pelvic collection and there was no 30 day mortality. In 33 patients there was T3 disease, 5 had T2 and 10 had T4 disease. There was distant recurrence in 4 patients with peritoneal metastasis in 3 and liver metastasis in 1 patient. Forty-six patients are still alive and 44 are disease free. The mean follow-up period was 25.31 (12 to 60) months. Conclusion: Our early experience with Laparascopic Right hemicolectomy as a safe and oncologically feasible surgical option. We attained comparable surgical results with curative intent.

Keywords: right hemicolectomy, right sided colonic tumors, laparoscopic, curative intent

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Authors: Omer Akkaya, Nurullah Ekmekcı, Muammer Zerenler

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Innovation for businesses means a new product and service and sometimes a new implementation. Total Quality Management is a management philosophy which focus on customer, process and system.There is a certain relationship between principles of Total Quality Management and innovation performance. Main aim of this study is to show how the implementation and principles of Total Quality Management (TQM) affect a firm's innovation performance. Also, this paper discusses positive and negative affects of Total Quality Management on innovation performance and demonstrates some examples.

Keywords: innovation, innovation types, total quality management, principles of total quality management

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Authors: Lívia Pimentel Sant'ana Dourado, Raquel Das Neves Almeida, Luís Henrique Costa Corrêa Neto, Nayara Soares, Kelly Grace Magalhães

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Introduction: Obesity and high-fat diet intake have a crucial impact on immune cells and inflammatory profile, highlighting an emerging realization that obesity is an inflammatory disease. In the present work, we aimed to characterize the role of caspase-1/11 and NLRP3 inflammasome in the establishment of mice obesity and modulation of inflammatory lipid metabolism induced by high fat diet intake. Methods and results: Wild type, caspase-1/11 and NLRP3 knockout mice were fed with standard fat diet (SFD) or high fat diet (HFD) for 90 days. The weight of animals was measured weekly to monitor the weight gain. After 90 days, the blood, peritoneal lavage cells, heart and liver were collected from mice studied here. Cytokines were measured in serum by ELISA and analyzed in spectrophotometry. Lipid antigen presentation molecule CD1d expression, reactive oxygen species (ROS) generation and lipid droplets biogenesis were analyzed in cells from mice peritoneal cavity by flow cytometry. Liver histopathology was performed for morphological evaluation of the organ. The absence of caspase-1/11, but not NLRP3, in mice fed with HFD favored the mice weight gain, increased liver size, induced development of hepatic steatosis and IL-12 secretion in mice compared to mice fed with SFD. In addition, caspase-1/11 knockout mice fed with HFD presented an increased CD1d molecule expression, as well as higher levels of lipid droplets biogenesis and ROS generation compared to wild type mice also fed with HFD. Conclusion: Our data suggest that caspase-1/11 knockout mice have greater susceptibility to obesity as well as increased activation of lipid metabolism and inflammatory markers.

Keywords: caspase 1, caspase 11, inflamassome, obesity, lipids

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Authors: Cristian Baldini

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‘Diabesity’ is a term for diabetes occurring in the context of obesity. The positive effect of LCHF diets (low-carb, high-fat diets) is well documented: LCHF diets are at least as effective as other dietary strategies for reducing body weight, improving glycaemic control, and reducing both hyperinsulinaemia and blood glucose (reduction of HbA1c) in type 2 diabetes and have unique positive effects on blood lipid concentrations and cardiovascular risk factors. Also, in obese insulin-resistant women, food fried in extra-virgin olive oil significantly reduced both insulin and C-peptide responses after a meal. This case study shows that if combined, both dietary strategies produce a strong effect on blood glucose, resulting in a “forced” reduction of exogenous insulin injection to avoid the problem of hypoglycaemia. Blood tests after three months of this dietary treatment show how HbA1c, triglycerides, and blood lipid profile (LDL, HDL, Total Cholesterol) are improved despite the reduction of exogenous insulin injection of 80% with a parallel body weight decrease of 15%. For continuous glucose monitoring (CGM), the patient used FreeStyle Libre before and after the dietary treatment. In order to check general body functions and glycosuria, the patient used the urine test Multistix 10 SG Siemens.

Keywords: diabetes, obesity, diabesity, fat, fried foods

Procedia PDF Downloads 40

Authors: Sih-Li Chen, Chih-Hao Chen, Chi-Tong Chan

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Poor ventilation and high carbon dioxide (CO2) concentrations lead to the formation of sick buildings. This problem cannot simply be resolved by introducing fresh air from outdoor environments because this creates extra loads on indoor air-conditioning systems. Desiccants are widely used in air conditioning systems in tropical and subtropical regions with high humidity to reduce the latent heat load from fresh air. Desiccants are usually used as a packed-bed type, which is low cost, to combine with air-conditioning systems. Nevertheless, the pressure drop of a packed bed is too high, and the heat of adsorption caused by the adsorption process lets the temperature of the outlet air increase, bringing about an extra heat load, so the high pressure drop and the increased temperature of the outlet air are energy consumption sources needing to be resolved. For this reason, the gas-solid fluidised beds that have high heat and mass transfer rates, uniform properties and low pressure drops are very suitable for use in air-conditioning systems.This study experimentally investigates the performance of silica gel fluidized bed device which applying to an air conditioning system. In the experiments, commercial silica gel particles were filled in the two beds and to form a fixed packed bed and a fluidized bed. The results indicated that compared to the fixed packed bed device, the total adsorption and desorption by amounts of fluidized bed for 40 minutes increased 20.6% and 19.9% respectively when the bed height was 10 cm and superficial velocity was set to 2 m/s. In addition, under this condition, the pressure drop and outlet air temperature raise were reduced by 36.0% and 30.0%. Given the above results, application of the silica gel fluidized bed to air conditioning systems has great energy-saving potential.

Keywords: fluidized bed, packed bed, silica gel, adsorption, desorption, pressure drop

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Authors: Ekrem Erdem, Can Tansel Tugcu

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Improved resource efficiency of production is a key requirement for sustainable growth, worldwide. In this regards, by considering the energy and tourism as the extra inputs to the classical Coub-Douglas production function, this study aims at investigating the efficiency changes in the North African countries. To this end, the study uses panel data for the period 1995-2010 and adopts the Malmquist index based on the data envelopment analysis. Results show that tourism increases technical and scale efficiencies, while it decreases technological and total factor productivity changes. On the other hand, when the production function is augmented by the energy input, technical efficiency change decreases, while the technological change, scale efficiency change and total factor productivity change increase. Thus, in order to satisfy the needs for sustainable growth, North African governments should take some measures for increasing the contribution that the tourism makes to economic growth and some others for efficient use of resources in the energy sector.

Keywords: data envelopment analysis, economic efficiency, North African countries, sustainable growth

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Authors: Pawan S. Nagda, Purnank S. Bhatt, Mit K. Shah

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Earing defect in drawing process is highly undesirable not only because it adds on an additional trimming operation but also because the uneven material flow demands extra care. The objective of this work is to study the earing problem in the Deep Drawing of circular cup and to optimize the blank shape to reduce the earing. A finite element model is developed for 3-D numerical simulation of cup forming process in ABAQUS. Extra-deep-drawing (EDD) steel sheet has been used for simulation. Properties and tool design parameters were used as input for simulation. Earing was observed in the simulated cup and it was measured at various angles with respect to rolling direction. To reduce the earing defect initial blank shape was modified with the help of anisotropy coefficient. Modified blanks showed notable reduction in earing.

Keywords: anisotropy, deep drawing, earing, finite element simulation

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Authors: Dipendra Kumar Yadav, Nabaraj Paudel, Anjana Yadav

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Background: Low Birth weight (LBW) is defined as the weight at birth less than 2500 grams, irrespective of the period of their gestation. LBW is an important indicator of general health status of population and is considered as the single most important predictors of infant mortality especially of deaths within the first month of life that is birth weight determines the chances of newborn survival. Objective of this study was to identify the maternal risk factors associated with low birth weight neonates. Materials and Methods: A hospital based case-control study was conducted in maternity ward of Manipal Teaching Hospital, Pokhara, Nepal from 23 September 2014 to 12 November 2014. During study period 59 cases were obtained and twice number of control group were selected with frequency matching of the mother`s age with ± 3 years and total controls were 118. Interview schedule was used for data collection along with record review. Data were entered in Epi-data program and analysis was done with help of SPSS software program. Results: From bivariate logistic regression analysis, eighteen variables were found significantly associated with LBW and these were place of residence, family monthly income, education, previous still birth, previous LBW, history of STD, history of vaginal bleeding, anemia, ANC visits, less than four ANC visits, de-worming status, counseling during pregnancy, CVD, physical workload, stress, extra meal during pregnancy, smoking and alcohol consumption status. However after adjusting confounding variables, only six variables were found significantly associated with LBW. Mothers who had family monthly income up to ten thousand rupees were 4.83 times more likely to deliver LBW with CI (1.5-40.645) and p value 0.014 compared to mothers whose family income NRs.20,001-60,000. Mothers who had previous still birth were 2.01 times more likely to deliver LBW with CI (0.69-5.87) and p value 0.02 compared to mothers who did not has previous still birth. Mothers who had previous LBW were 5.472 times more likely to deliver LBW with CI (1.2-24.93) and p value 0.028 compared to mothers who did not has previous LBW. Mothers who had anemia during pregnancy were 3.36 times more likely to deliver LBW with CI (0.77-14.57) and p value 0.014 compared to mothers who did not has anemia. Mothers who delivered female newborn were 2.96 times more likely to have LBW with 95% CI (1.27-7.28) and p value 0.01 compared to mothers who deliver male newborn. Mothers who did not get extra meal during pregnancy were 6.04 times more likely to deliver LBW with CI (1.11-32.7) and p value 0.037 compared to mothers who getting the extra meal during pregnancy. Mothers who consumed alcohol during pregnancy were 4.83 times more likely to deliver LBW with CI (1.57-14.83) and p value 0.006 compared to mothers who did not consumed alcohol during pregnancy. Conclusions: To reduce low birth weight baby through economic empowerment of family and individual women. Prevention and control of anemia during pregnancy is one of the another strategy to control the LBW baby and mothers should take full dose of iron supplements with screening of haemoglobin level. Extra nutritional food should be provided to women during pregnancy. Health promotion program will be focused on avoidance of alcohol and strengthen of health services that leads increasing use of maternity services.

Keywords: low birth weight, case-control, risk factors, hospital based study

Procedia PDF Downloads 275

Authors: Zety Shakila Binti Mohd Yusof, Muhammad Adib Bin Ishak, Hajah Fatimah Binti Hussein

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The international shipping business is related to numerous controls or regulations of export and import shipments. It is costly and time consuming, and when something goes wrong or when the buyer or seller fails to comply with the regulations, it can result in penalties, delays, and unexpected costs etc. For the focus of this study, the researchers have selected a local forwarder that provides forwarding and clearance services, Nexus Zone Logistics. It was identified that this company currently has many extra costs to be paid including local and detention charges, which negatively impacts the flow of income and reduces overall stability. Two variables have been identified as factors of extra charges; loaded containers entering the port by exceeded closing time and late delivery of empty containers to the container yard. This study is a qualitative in nature and the secondary data collected was analyzed using self-administered observation. The findings of this study were covered by one selected case for each export and import shipment between July and December 2014. The data were analyzed using frequency analysis based on tables and graphs. The researcher recommends Nexus Zone Logistics impose a 1% deposit payment per container for each shipment (export and import) to its customers.

Keywords: international shipping, export and import, detention charges, container shipment

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Authors: Leonore Robieux, Franck Zenasni, Marc Pocard, Clarisse Eveno

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Empirical data in health psychology studies show the necessity to consider the doctor-patient communication and its positive impact on outcomes such as patients’ satisfaction, treatment adherence, physical and psychological wellbeing. In this line, the present research aims to define the role and determinants of an effective doctor–patient communication during the treatment of patients with serious illness (peritoneal carcinomatosis). We carried out a prospective longitudinal study including patients treated for peritoneal carcinomatosis of various origins. From November 2016, to date, data were collected using validated questionnaires at two times of evaluation: one month before the surgery (T0) and one month after (T1). Thus, patients reported their (a) anxiety and depression levels, (b) standardized and individualized quality of life and (c) how they perceived communication, attitude and empathy of the surgeon. 105 volunteer patients (Mean age = 58.18 years, SD = 10.24, 62.2% female) participated to the study. PC arose from rare diseases (14%), colorectal (38%), eso-gastric (24%) and ovarian (8%) cancer. Three groups are defined according to the severity of their pathology and the treatment offered to them: (1) important surgical treatment with the goal of healing (53%), (2) repeated palliative surgical treatment (17%), and (3) the patients recused for surgical treatment, only palliative approach (30%). Results are presented according to Baron and Kenny recommendations. The regressions analyses show that only depression and anxiety are sensitive to the communication and empathy of surgeon. The main results show that a good communication and high level of empathy at T0 and T1 limit depression and anxiety of the patients in T1. Results also indicate that the severity of the disease modulates this positive impact of communication: better is the communication the less are the level of depression and anxiety of the patients. This effect is higher for patients treated for the more severe disease. These results confirm that, even in the case severe disease a good communication between patient and physician remains a significant factor in promoting the well-being of patients. More specific training need to be developed to promote empathic care.

Keywords: clinical empathy, determinants, healthcare, psychological wellbeing

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Authors: Ali Zefeiti

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There has always been a debate on critical versus pragmatic approach to learning English. Different elements of teaching take different shapes in the two approaches. This study concerns itself with the students who are the main pillar of the teaching/learning operation. Students have always been placed into classrooms to learn what the curricula of different courses offer. There is little room for students to state their own learning needs as they often have to conform with the group requirement. This study focuses on an extra-curricular activity students did alongside their mainstream learning. The students come from different colleges and different EAP courses. They are united by their passion for the task and learning many things along the way. The data are collected through interviews and students' journals. The study was concerned with the effect of this extra-curricular activity on students' main learning trajectory. The students were engaged in the task of film production over the period of their English Language course. The findings show that students are able to set their own agenda for learning and have actually had a lot of skills and vocabulary to take to class.

Keywords: critical EAP, pragmatic EAP, self-directed learning, teaching methods

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Authors: Chantana Insra

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The research objective focuses on creating a prototype media of the tactile texture of muscles for educational institutes to help visually impaired students learn massage extra learning materials further than the ordinary curriculum. This media is designed as an extra learning material. The population in this study was 30 blinded students between 4th - 6th grades who were able to read Braille language. The research was conducted during the second semester in 2012 at The Bangkok School for the Blind. The method in choosing the population in the study was purposive sampling. The methodology of the research includes collecting data related to visually impaired people, the production of the tactile texture media, human anatomy and Thai traditional massage from literature reviews and field studies. This information was used for analyzing and designing 14 tactile texture pictures presented to experts to evaluate and test the media.

Keywords: blind, tactile texture, muscle, visual arts and design

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Authors: Ageliki I. Katsarou, Andriana C. Kaliora, Antonia Chiou, Apostolos Papalois, Nick Kalogeropoulos, Nikolaos K. Andrikopoulos

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Chronic inflammation plays a pivotal role in CVD development, while phytochemicals have been shown to reduce CVD risk. Several studies have correlated olive oil consumption with CVD prevention and CVD risk reduction. However, the effect of individual olive oil macro- or micro-constituents and possible synergisms among them needs to be further elucidated. Herein, extra virgin olive oil (EVOO) lipidic and polar phenolics fractions were evaluated for their effect on inflammatory markers in cholesterol-fed rats. Oils combining different characteristics as to their polar phenolic content and lipid profile were used. Male Wistar rats were fed for 9 weeks on either a high-cholesterol diet (HCD) or a HCD supplemented with oils, either commercially available, i.e. EVOO, sunflower oil (SO), or modified as to their polar phenol content, i.e. phenolics deprived-EVOO (EVOOd), SO enriched with the EVOO phenolics (SOe). Post-intervention, aorta and blood samples were collected. HCD induced dyslipidemia, manifested by serum total cholesterol and low-density lipoprotein cholesterol elevation. Additionally, HCD resulted in higher adhesion molecules’ levels in rat aorta. In the case of E-selectin, this increase was attenuated by HCD supplementation with EVOO and EVOOd, while no alterations were observed in SO and SOe groups. No differences were observed between pairs of commercial and modified oils, indicating that oleates may be the components responsible for aorta E-selectin levels lowering. The same was true for vascular adhesion molecule-1 (VCAM-1); augmentation in cholesterol-fed animals was attenuated by EVOO and EVOOd diets, highlighting oleates effect. In addition, VCAM-1 levels were higher in SO group compared to the respective SOe, indicating that in the presence of phenolic compounds linoleic acid have become less prone to oxidation. Intercellular adhesion molecule-1 (ICAM-1) levels were higher in cholesterol-fed rats, however not affected by any of the oils supplemented during the intervention. Overall, EVOO was found superior in regulating adhesion molecule levels in rat aorta compared to SO. EVOO and EVOOd exhibited analogous effects on all adhesion molecules assessed, indicating that EVOO major constituents (oleates) improve E-selectin and VCAM-1 levels in rat aorta, independently from phenolics presence. Further research is needed to elucidate the effect of phenolics and oleates in other tissues.

Keywords: extra virgin olive oil, cholesterol-fed rats, polar phenolics, adhesion molecules

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Authors: Rebin Mzhda Mohammed, Hoshmand Ali Hama Agha

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Excess skin, often consequential to substantial weight loss or the aging process, introduces physical discomfort, obstructs daily activities, and undermines an individual's self-esteem. As these challenges become increasingly prevalent, the need to explore viable solutions grows in significance. Extra skin removal surgery, colloquially known as body contouring surgery, has emerged as a compelling intervention to ameliorate the physical and psychological burdens of excess skin. This study undertakes a comprehensive review to illuminate the intricacies of extra skin removal surgery, encompassing its diverse procedures, associated risks, benefits, and psychological implications on patients. The methodological approach adopted involves a systematic and exhaustive review of pertinent scholarly literature sourced from reputable databases, including PubMed, Google Scholar, and specialized cosmetic surgery journals. Articles are meticulously curated based on their relevance, credibility, and recency. Subsequently, data from these sources are synthesized and categorized, facilitating a comprehensive understanding of the subject matter. Qualitative analysis serves to unravel the nuanced psychological effects, while quantitative data, where available, are harnessed to underpin the study's conclusions. In terms of major findings, the research underscores the manifold advantages of extra skin removal surgery. Patients experience a notable improvement in physical comfort, amplified mobility, enhanced self-confidence, and a newfound ability to don clothing comfortably. Nonetheless, the benefits are juxtaposed with potential risks, encompassing infection, scarring, hematoma, delayed healing, and the challenge of achieving symmetry. A salient discovery is the profound psychological impact of the surgery, as patients consistently report elevated body image satisfaction, heightened self-esteem, and a substantial enhancement in overall quality of life. In summation, this research accentuates the pivotal role of extra skin removal surgery in ameliorating the intricate interplay of physical and psychological difficulties posed by excess skin. By elucidating the diverse procedures, associated risks, and psychological outcomes, the study contributes to a comprehensive and informed comprehension of the surgery's multifaceted effects. Therefore, individuals contemplating this transformative surgical option are equipped with comprehensive insights, ultimately fostering informed decision-making, guided by the expertise of medical professionals.

Keywords: extra skin removal surgery, body contouring, abdominoplasty, brachioplasty, thigh lift, body lift, benefits, risks, psychological effects

Procedia PDF Downloads 34

Authors: Ageliki I. Katsarou, Andriana C. Kaliora, Antonia Chiou, Apostolos Papalois, Nick Kalogeropoulos, Nikolaos K. Andrikopoulos

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Oxidative stress is a major mechanism underlying CVDs while inflammation, an intertwined process with oxidative stress, is also linked to CVDs. Extra virgin olive oil (EVOO) is widely known to play a pivotal role in CVD prevention and CVD reduction. However, in most studies, olive oil constituents are evaluated individually and not as part of the native food, hence potential synergistic effects as drivers of EVOO beneficial properties may be underestimated. In this study, EVOO lipidic and polar phenolics fractions were evaluated for their effect on inflammatory (TNF-alpha) and oxidation (malondialdehyde/MDA) markers, in cholesterol-fed rats. Thereat, oils with discernible lipidic profile and polar phenolic content were used. Wistar rats were fed on either a high-cholesterol diet (HCD) or a HCD supplemented with oils, either commercially available, i.e. EVOO, sunflower oil (SO), or modified as to their polar phenol content, i.e. phenolics deprived-EVOO (EVOOd), SO enriched with the EVOO phenolics (SOe). After 9 weeks of dietary intervention, heart and blood samples were collected. HCD induced dylipidemia shown by increase in serum total cholesterol, low-density lipoprotein cholesterol (LDL-c) and triacylglycerols. Heart tissue has been affected by dyslipidemia; oxidation was indicated by increase in MDA in cholesterol-fed rats and inflammation by increase in TNF-alpha. In both cases, this augmentation was attenuated in EVOO and SOe diets. With respect to oxidation, SO enrichment with the EVOO phenolics brought its lipid peroxidation levels as low as in EVOO-fed rats. This suggests that phenolic compounds may act as antioxidant agents in rat heart. A possible mechanism underlying this activity may be the protective effect of phenolics in mitochondrial membrane against oxidative damage. This was further supported by EVOO/EVOOd comparison with the former presenting lower heart MDA content. As for heart inflammation, phenolics naturally present in EVOO as well as phenolics chemically added in SO, exhibited quenching abilities in heart TNF-alpha levels of cholesterol-fed rats. TNF-alpha may have played a causative role in oxidative stress induction while the opposite may have also happened, hence setting up a vicious cycle. Overall, diet supplementation with EVOO or SOe attenuated hypercholesterolemia-induced increase in MDA and TNF-alpha in Wistar rat hearts. This is attributed to phenolic compounds either naturally existing in olive oil or as fortificants in seed oil.

Keywords: extra virgin olive oil, hypercholesterolemic rats, MDA, polar phenolics, TNF-alpha

Procedia PDF Downloads 468

Authors: Yifang Gong

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Pulse diagnosis is one of the most important diagnosis methods in traditional Chinese medicine. It is also the trickiest method to learn. It is known as that it can only to be sensed not explained. This becomes a serious threat to the survival of this diagnostic method. However, there are a large amount of experiences accumulated during the several thousand years of practice of Chinese doctors. A pulse pattern called 'Slippery pulse' is one of the indications of pregnancy. A simple fluid dynamic model is proposed to simulate the effects of the existence of a placenta. The placenta is modeled as an extra plenum in an extremely simplified fluid network model. It is found that because of the existence of the extra plenum, indeed the pulse pattern shows a secondary peak in one pulse period. As for the author’s knowledge, this work is the first time to show the link between Pulse diagnoses and basic physical principle. Key parameters which might affect the pattern are also investigated.

Keywords: Chinese medicine, flow network, pregnancy, pulse

Procedia PDF Downloads 348

Authors: Seyyed Masoud Seyyedoshohadaei, Borhanuddin Mohd Ali

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To support group mobility, the NEMO Basic Support Protocol has been standardized as an extension of Mobile IP that enables an entire network to change its point of attachment to the Internet. Using NEMO in IEEE 802.16e (WiMax) networks causes latency in handover procedure and affects seamless communication of real-time applications. To decrease handover latency and service disruption time, an integrated scheme named Optimized Fast NEMO (OFNEMO) was introduced by authors of this paper. In OFNEMO a pre-establish multi tunnels concept, cross function optimization and cross layer design are used. In this paper, an analytical model is developed to evaluate total cost consisting of signaling and packet delivery costs of the OFNEMO compared with RFC3963. Results show that OFNEMO increases probability of predictive mode compared with RFC3963 due to smaller handover latency. Even though OFNEMO needs extra signalling to pre-establish multi tunnel, it has less total cost thanks to its optimized algorithm. OFNEMO can minimize handover latency for supporting real time application in moving networks.

Keywords: fast mobile IPv6, handover latency, IEEE802.16e, network mobility

Procedia PDF Downloads 164

Authors: Jyh-Ping Chen, Chia-Lin Sheu

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In this study, we propose to use electrospinning to fabricate porous nanofibrous membranes as postsurgical anti-adhesion barriers and to improve the properties of current post-surgical anti-adhesion products. We propose to combine FDA-approved biomaterials with anti-adhesion properties, polycaprolactone (PCL), polyethylene glycol (PEG), hyaluronic acid (HA) with silver nanoparticles (Ag) and ibuprofen (IBU), to produce anti-adhesion barrier nanofibrous membranes. For this purpose, PEG/PCL/Ag/HA/IBU core-shell nanofibers were prepared. The shell layer contains PEG + PCL to provide mechanical supports and Ag was added to the outer PEG-PCL shell layer during electrospinning to endow the nanofibrous membrane with anti-bacterial properties. The core contains HA to exert anti-adhesion and IBU to exert anti-inflammation effects, respectively. The nanofibrous structure of the membranes can reduce cell penetration while allowing nutrient and waste transports to prevent postsurgical adhesion. Nanofibers with different core/shell thickness ratio were prepared. The nanofibrous membranes were first characterized for their physico-chemical properties in detail, followed by in vitro cell culture studies for cell attachment and proliferation. The HA released from the core region showed extended release up to 21 days for prolonged anti-adhesion effects. The attachment of adhesion-forming fibroblasts is reduced using the nanofibrous membrane from DNA assays and confocal microscopic observation of adhesion protein vinculin expression. The Ag released from the shell showed burst release to prevent E Coli and S. aureus infection immediately and prevent bacterial resistance to Ag. Minimum cytotoxicity was observed from Ag and IBU when fibroblasts were culture with the extraction medium of the nanofibrous membranes. The peritendinous anti-adhesion model in rabbits and the peritoneal anti-adhesion model in rats were used to test the efficacy of the anti-adhesion barriers as determined by gross observation, histology, and biomechanical tests. Within all membranes, the PEG/PCL/Ag/HA/IBU core-shell nanofibers showed the best reduction in cell attachment and proliferation when tested with fibroblasts in vitro. The PEG/PCL/Ag/HA/IBU nanofibrous membranes also showed significant improvement in preventing both peritendinous and peritoneal adhesions when compared with other groups and a commercial adhesion barrier film.

Keywords: anti-adhesion, electrospinning, hyaluronic acid, ibuprofen, nanofibers

Procedia PDF Downloads 154

Authors: O.F. Akinmoladun, F.N. Fon, C.T. Mpendulo, O. Okoh

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The sustainability of livestock production is under threat as a result of water scarcity, fluctuating precipitation, and high environmental temperature. These combined stressors have impacted negatively on general animal production and welfare, necessitating a very reliable and cost-effective management practices, especially in arid and water-limited regions of the world. Instead of the above, this study was designed to investigate the growth performance and physiological response of water-restricted Xhosa ear-lobe goats fed diets supplemented with single or multiple vitamin C (VC) during summer. The total forty-eight goats used for the experiment were balanced for body weight and randomly assigned to the seven treatment groups (seven goats/treatment): GI (W100%); GII (W70%); GIII (W50%); GIV (W70%+3g/day VC); GV ((W50% +3g/day VC); GVI (W70%+3g/d VC+extra 5g on every eight-day); GVII (W50%+3g/d VC+extra 5g on every eight-day). The design was a complete randomized design and VC was administered per os. At the end of the 75-day feeding trial, GIII (W50%) animals were the most affected (P<0.05) and the effect was more pronounced in their body condition scores (BCs). Weight loss and depression in feed intake due to water restriction (P<0.05) were attenuated by VC treated groups (GIV-GVII). Changes in body thermal gradient (BTG) and rectal temperature (RcT) were similar (P>0.05) across the various experimental groups. The attenuation effect of VC was significant in responses to respiratory rate (RR) and cortisol. Supplementation of VC (either single or multiple) did not significantly (P>0.05) improve water restriction effect on body condition scores (BCs) and FAMACHA©. The current study found out that Xhosa ear lobe goats can adapt to the prevailing bioclimatic changes and limited water intake. However, supplementation of vitamin C can be beneficial at modulating these stressful stimuli. Continuous consistencies in the outcome of vitamin C on water-stressed animals can help validate recommendations especially to farmers in the arid and water-limited regions across the globe.

Keywords: vitamin C, Xhosa ear-lobe, thermotolerance, water stress

Procedia PDF Downloads 99

Authors: Marwa Elkalla, E. Ali Abdelfadil, Ali. Mohamed. M. Sami, Ali M. Abdel-Monem

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To assess the impact of the blood collection technique on clinical pathology markers and to establish reference intervals, a study was performed using normal, healthy C57BL/6 mice. Both sexes were employed, and they were randomly assigned to different groups depending on the phlebotomy technique used. The blood was drawn in one of four ways: intracardiac (IC), caudal vena cava (VC), caudal vena cava (VC) plus a peritoneal collection of any extravasated blood, or retroorbital phlebotomy (RO). Several serum biochemistries, such as a liver function test, a complete blood count with differentials, and a platelet count, were analysed from the blood and serum samples analysed. Red blood cell count, haemoglobin (p >0.002), hematocrit, alkaline phosphatase, albumin, total protein, and creatinine were all significantly greater in female mice. Platelet counts, specific white blood cell numbers (total, neutrophil, lymphocyte, and eosinophil counts), globulin, amylase, and the BUN/creatinine ratio were all greater in males. The VC approach seemed marginally superior to the IC approach for the characteristics under consideration and was linked to the least variation among both sexes. Transaminase levels showed the greatest variation between study groups. The aspartate aminotransferase (AST) values were linked with decreased fluctuation for the VC approach, but the alanine aminotransferase (ALT) values were similar between the IC and VC groups. There was a lot of diversity and range in transaminase levels between the MC and RO groups. We found that the RO approach, the only one tested that allowed for repeated sample collection, yielded acceptable ALT readings. The findings show that the test results are significantly affected by the phlebotomy technique and that the VC or IC techniques provide the most reliable data. When organising a study and comparing data to reference ranges, the ranges supplied here by collection method and sex can be utilised to determine the best approach to data collection. The authors suggest establishing norms based on the procedures used by each individual researcher in his or her own lab.

Keywords: clinical, pathology, blood, effect

Procedia PDF Downloads 67

Authors: H. R. Fazlollahi

Abstract:

Dark Energy origin is unknown and so describing this mysterious component in large scale structure needs to manipulate our theories in general relativity. Although in most models, dark energy arises from extra terms through modifying Einstein-Hilbert action, maybe its origin traces back to fundamental aspects of ground energy of space-time given in quantum mechanics. Hence, diluting space-time in general relativity with quantum mechanics properties leads to the Karolyhazy relation corresponding energy density of quantum fluctuations of space-time. Through generalized uncertainty principle and an eye to Karolyhazy approach in this study we extend energy density of quantum fluctuations of space-time. Also, the application of this idea is considered in late time evolution and we have shown how extra term in generalized uncertainty principle plays as a plausible interaction term role in suggested model.

Keywords: generalized uncertainty principle, karolyhazy approach, agegraphic dark energy, cosmology

Procedia PDF Downloads 47