Search results for: hospital acquired acute bacterial meningitis

Authors: Priscilla Adoley Moffat

Abstract:

This study explored perceptions rooted in and acquired from the cultures of many developing countries and how they impact applicants’ preferences and choices of STEM programs. The context of developing countries was chosen for this study because gender role socialization continues to maintain an important place in most of these cultures. This study’s relevance rests in the fact that, as the world takes steps to encourage and promote the choice and study of STEM programs, especially among females, there is a need for efforts towards understanding various cultural perceptions towards some programs of study, particularly STEM programs, which have diverse gender attributions in many developing cultures. Also, as the world strives to achieve gender equity in education, such a study comes in handy, as it provides a useful understanding of the underlying cultural factors that affect study program preferences of applicants, particularly in developing countries like Ghana as well as others in Africa. The study analyzed the admission application data of five public universities in Ghana. 1600 randomly-sampled final-year students of 32 randomly-selected senior high schools from the 16 regions of Ghana were interviewed. Since parents and teachers often guide and influence the study program choices of applicants, the study examined the perceptions of 180 teachers and 360 parents. The study found, among other things, that STEM programs are commonly perceived to pose much more difficulty to females than they do to males. As a result, many female applicants are discouraged from choosing these programs. While nursing programs are perceived more as programs for females, with the justification that females are better caregivers, males are perceived to be better medical doctors, engineers, and computer technicians. Thus, many females are less encouraged to choose Technology and Engineering programs.

Keywords: culture, perceptions, STEM, choice, preference

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Authors: Yılmaz Uçar, Fatih Ozogul, Mustafa Durmuş, Yesim Ozogul, Ali Rıza Köşker, Esmeray Kuley Boğa, Deniz Ayas

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The aim of this study was to purified eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), that are essential oils from trout oil, using high-performance liquid chromatography (HPLC) method, bioconverted EPA and DHA into bioconverted EPA (bEPA), bioconverted DHA (bDHA) extracts by P. aeruginosa PR3. Moreover, in vitro antibacterial activity of bEPA and bDHA was investigated using disc diffusion methods and minimum inhibitory concentration (MIC). EPA and DHA concentration of 11.1% and 15.9% in trout oil increased in 58.64% and 40.33% after HPLC optimisation, respectively. In this study, EPA and DHA enriched products were obtained which are to be used as valuable supplements for food and pharmaceutical purposes. The bioconverted EPA and DHA exhibited antibacterial activities against two Gram-positive bacteria (Listeria monocytogenes ATCC 7677 and Staphylococcus aureus ATCC 29213) and six Gram-negative bacteria (Pseudomonas aeruginosa ATCC 27853, Escherichia coli ATCC 25922, Klebsiella pneumoniae ATCC700603, Enterococcus faecalis ATCC 29212, Aeromonas hydrophila NCIMB 1135, and Salmonella Paratyphi A NCTC 13). Inhibition zones and MIC value of bEPA and bDHA against bacterial strains ranged from 7 to 12 mm and from 350 to 2350 μg/mL, respectively. Our results suggested that the crude extracts of bioconversion of EPA and DHA by P. aeruginosa PR3 can be considered as promising antimicrobials in improving food safety by controlling foodborne pathogens.

Keywords: High-Performance Liquid Chromatography (HPLC), docosahexaenoic acid, DHA, eicosapentaenoic acid, EPA, minimum inhibitory concentration, MIC, Pseudomonas aeruginosa PR3

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Authors: Ganesh K. Maurya, Reema Chaudhary, Neha Pandey, Hari S. Misra

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PprA, a pleiotropic protein participating in radioresistance, has been reported for its roles in DNA replication initiation, genome segregation, cell division and DNA repair in polyextremophile Deinococcus radiodurans. Interestingly, expression of deinococcal PprA in E. coli suppresses its growth by reducing the number of colony forming units and provides better resistance against γ-radiation than control. We employed different biochemical and cell biology studies using PprA and its DNA binding/polymerization mutants (K133E & W183R) in E. coli. Cells expressing wild type PprA or its K133E mutant showed reduction in the amount of genomic DNA as well as chromosome copy number in comparison to W183R mutant of PprA and control cells, which suggests the role of PprA protein in regulation of DNA replication initiation in E. coli. Further, E. coli cells expressing PprA or its mutants exhibited different impact on cell morphology than control. Expression of PprA or K133E mutant displayed a significant increase in cell length upto 5 folds while W183R mutant showed cell length similar to uninduced control cells. We checked the interaction of deinococcal PprA and its mutants with E. coli DnaA using Bacterial two-hybrid system and co-immunoprecipitation. We observed a functional interaction of EcDnaA with PprA and K133E mutant but not with W183R mutant of PprA. Further, PprA or K133E mutant has suppressed the ATPase activity of EcDnaA but W183R mutant of PprA failed to do so. These observations suggested that PprA protein regulates DNA replication initiation and cell morphology of surrogate E. coli.

Keywords: DNA replication, radioresistance, protein-protein interaction, cell morphology, ATPase activity

Procedia PDF Downloads 69

Authors: Sihana Ahmeti Lika, Merita Dauti, Ledjan Malaj

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The objective of this study is to analyze the prophylactic usage of low molecular weight heparine (LMWH) along pregnancy and the correlation between their usage and month/week of pregnancy, in the Department of Gynecology and Obstetrics, at Clinical Hospital in Tetovo. A retrospective study was undertaken during 01 January–31 December 2012. Over of one year, the total number of patients was 4636. Among the 1447 (32.21%) pregnant women, 298 (20.59%) of them were prescribed LMWH. The majority of patients given LMWH, 119 (39.93%) were diagnosed hypercoagulable. The age group with the highest attendance was 25-35, 141 patients (47.32%). For 195 (65.44%) patients, this was their first pregnancy. Earliest stage of using LMWH was the second month of pregnancy 4 (1.34%) cases. The most common patients, were 70 women along the seventh month (23.49%), followed by 68 in the ninth month of pregnancy (22.81%). Women in the 28th gestational week, were found to be the most affected, a total of 55 (78.57%) were in that week. Clexane 2000 and Fraxiparine 0.3 were the most common for which low molecular weight heparine was prescribed. The number of patients which received Clexane 2000 was 84 (28.19%), followed by those with Fraxiparine 0.3 81 (27.18%). The administration of LMWH is associated with long hospitalization (median 14,6 days).

Keywords: hypercoagulable state, low moleculare weight heparine, month of pregnancy, pregnant women

Procedia PDF Downloads 349

Authors: Yael Shai, Dror L. Angel, Dror Zurel, Peleg Astrahan, Maxim Rubin-Blum, Eyal Rahav

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The high demand for oil and its by-products is symptomatic of the 21st century and occasionally leads to oil spills and pollution of coastal waters. Marine oil pollution may originate from a variety of sources -urban runoff, tanker cleaning, drilling activities, and oil spills. These events may release large amounts of highly toxic polycyclic aromatic hydrocarbons (PAHs) and other pollutants to coastal water, thereby threatening local marine life. Here, we investigated the effects of crude oil on the temporal dynamics of phytoplankton and heterotrophic bacteria in Israeli coastal waters. To this end, we added crude oil (500 µm thick layer, with and without additional nutrients; NO₃ and PO₄) to mesocosms (1m³ bags) containing oligotrophic surface coastal water collected near Haifa during summer and winter. Changes in phytoplankton biomass, activity and diversity were monitored daily for 5-6 days. Our results demonstrate that crude oil addition resulted in a pronounced decrease in phytoplankton biomass and production rates, while heterotrophic bacterial production increased significantly. Importantly, a few days post addition we found that the oil-degrading bacteria, Oleibacter sp. and Oleispira sp. appeared in the mesocosms and that the addition of nutrients (along with the crude oil) further increased this trend. This suggests that oil-degrading bacteria may be NO₃ and PO₄ limited in Israeli coastal waters. The results of this study should enable us to establish improved science-based environmental policy with respect to handling crude oil pollution in this region.

Keywords: heterotrophic bacteria, nutrients, mesocosm, oil pollution, oligotrophic, phytoplankton

Procedia PDF Downloads 159

Authors: Ganesh K. Maurya, Reema Chaudhary, Neha Pandey, Hari S. Misra

Abstract:

PprA, a pleiotropic protein participating in radioresistance, has been reported for its roles in DNA replication initiation, genome segregation, cell division and DNA repair in polyextremophile Deinococcus radiodurans. Interestingly, expression of deinococcal PprA in E. coli suppresses its growth by reducing the number of colony forming units and provide better resistance against γ-radiation than control. We employed different biochemical and cell biology studies using PprA and its DNA binding/polymerization mutants (K133E & W183R) in E. coli. Cells expressing wild type PprA or its K133E mutant showed reduction in the amount of genomic DNA as well as chromosome copy number in comparison to W183R mutant of PprA and control cells, which suggests the role of PprA protein in regulation of DNA replication initiation in E. coli. Further, E. coli cells expressing PprA or its mutants exhibited different impact on cell morphology than control. Expression of PprA or K133E mutant displayed a significant increase in cell length upto 5 folds while W183R mutant showed cell length similar to uninduced control cells. We checked the interaction of deinococcal PprA and its mutants with E. coli DnaA using Bacterial two-hybrid system and co-immunoprecipitation. We observed a functional interaction of EcDnaA with PprA and K133E mutant but not with W183R mutant of PprA. Further, PprA or K133E mutant has suppressed the ATPase activity of EcDnaA but W183R mutant of PprA failed to do so. These observations suggested that PprA protein regulates DNA replication initiation and cell morphology of surrogate E. coli.

Keywords: DNA replication, radioresistance, protein-protein interaction, cell morphology, ATPase activity

Procedia PDF Downloads 70

Authors: Onuoha Gideon

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The preliminary studies on the potentials of Bambara nut and pigeon pea as imitation milk were investigated. Bambara nut and Pigeon pea milk were produced from two separate unit operations; Bambara nut seed was cooked, dehulled, milled and strained to milk (BCM) and another batch was toasted at moderate temperature, dehulled, milled and strained to milk (BTM). Pigeon pea seed was cooked, dehulled, milled and strained to milk (PCM) and another batch was toasted at moderate temperature, dehulled, milled and strained to milk (PTM). The result of the proximate analysis on the milk samples on wet basis showed that the protein content ranged from 28.56 – 26.77, the crude fibre ranged from 6.28 – 1.85, the ash content ranged from 5.22 – 1.17, the fat content ranged from 2.71 – 1.12, the moisture content ranged from 95.93 – 93.83, the carbohydrate content ranged from 67.62 – 58.83. The functional analysis on the milk samples showed that emulsification capacity ranged from 43.21 – 38.66, emulsion stability ranged from 34.10 – 25.00, the specific gravity ranged from 997.50 – 945.00, the foaming capacity ranged from 3,500 to 2,250, the measurement of viscosity ranged from 0.017 – 0.007, the pH range from 5.55 – 5.25, the measurement of dispersibility range from 11.00 – 7.00, the total soluble solid ranged from 4.00 to 1.75, the total titratable acidity ranged from 0.314 – 0.328. The sensory evaluation report showed that in terms of flavor, sample BCM and PCM value were significantly different from sample BTM and PTM. In terms of colour, sample BCM showed a significant difference from samples BTM, PCM and PTM. In term of texture, sample BCM was significantly different from samples BTM, PCM and PTM. The general acceptability shows that sample BCM was significantly different from other the samples and was the most accepted. The microbial analysis indicated that the microbial load increases with time. Bacterial count ranged from 1.3 x 105 – 1.20 x 106 to 1.6 x 105 – 1.06 x 106, fungal count ranged from 4.0 x 105 – 8.0 x 105 to 4.0 x 105 – 7.0 x 105. The studies showed that BCM was the most preferred.

Keywords: imitation milk, Bambara nut, Pigeon pea, proximate composition

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Authors: Won Young Choi, Kwan Kyu Park

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Recently, the road depression happening in the urban area is different from the cause of the sink hole and the generation mechanism occurring in the limestone area. The main cause of sinkholes occurring in the city center is the loss of soil due to the damage of old underground buried materials and groundwater discharge due to large underground excavation works. The method of detecting the sinkhole in the urban area is mostly using the Ground Penetration Radar (GPR). However, it is challenging to implement compact system and detecting watery state since it is based on electromagnetic waves. Although many ultrasonic underground detection studies have been conducted, near-ground detection (several tens of cm to several meters) has been developed for bulk systems using geophones as a receiver. The goal of this work is to fabricate a miniaturized sinkhole detecting system based on low-cost ultrasonic transducers of 40 kHz resonant frequency with high transmission pressure and receiving sensitivity. Motived by biomedical ultrasonic imaging methods, we detect air layers below the ground such as asphalt through the pulse-echo method. To improve image quality using multi-channel, linear array system is implemented, and image is acquired by classical synthetic aperture imaging method. We present the successful feasibility test of multi-channel sinkhole detector based on ultrasonic transducer. In this work, we presented and analyzed image results which are imaged by single channel pulse-echo imaging, synthetic aperture imaging.

Keywords: road depression, sinkhole, synthetic aperture imaging, ultrasonic transducer

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Authors: Nasir Yusoff, Ahmad Adamu Adamu, Tahamina Begum, Faruque Reza

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The P300 from Event related potential (ERP) explains the psycho-physiological phenomenon in human body. The present study aims to identify the differences of amplitude and latency of P300 component from auditory stimuli, between ambiversion and extraversion types of personality. Ambivert (N=20) and extravert (N=20) undergoing ERP recording at the Hospital Universiti Sains Malaysia (HUSM) laboratory. Electroencephalogram data was recorded with oddball paradigm, counting auditory standard and target tones, from nine electrode sites (Fz, Cz, Pz, T3, T4, T5, T6, P3 and P4) by using the 128 HydroCel Geodesic Sensor Net. The P300 latency of the target tones at all electrodes were insignificant. Similarly, the P300 latency of the standard tones were also insignificant except at Fz and T3 electrode. Likewise, the P300 amplitude of the target and standard tone in all electrode sites were insignificant. Extravert and ambivert indicate similar characteristic in cognition processing from auditory task.

Keywords: amplitude, event related potential, p300 component, latency

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Authors: Malsawmtluanga, J. Malsawma, R. P. Tiwari, V. K. Gahalaut

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North East India is seismically one of the six most active regions of the world. It is placed in Zone V, the highest zone in the seismic zonation of India. It lies at the junction of Himalayan arc to the north and the Burmese arc to the east. The region has witnessed at least 18 large earthquakes including two great earthquakes Shillong (1987, M=8.7) and the Assam Tibet border (1950, M=8.7).The prominent Chite fault lies at the heart of Aizawl, the capital of Mizoram state and this hilly city is the home to about 2 million people. Geologically the area is a part of the Indo-Burmese Wedge and is prone to natural and man-made disasters. Unplanned constructions and urban dwellings on a rapid scale have lead to numerous unsafe structures adversely affecting the ongoing development and welfare projects of the government and they pose a huge threat for earthquakes. Crustal deformation measurements using campaign mode GPS were undertaken across this fault. Campaign mode GPS data were acquired and were processed with GAMIT-GLOBK software. The study presents the current velocity estimates at all the sites in ITRF 2008 and also in the fixed Indian reference frame. The site motion showed that there appears to be no differential motion anywhere across the fault area, thus confirming presently the fault is neither accumulating strain nor slipping aseismically. From the geological and geomorphological evidence, supported by geodetic measurements, lack of historic earthquakes, the Chite fault favours aseismic behaviour in this part of the Indo Burmese Arc (IBA).

Keywords: Chite fault, crustal deformation, geodesy, GPS, IBA

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Authors: Ren Moses, Emmanuel Kidando, Eren Ozguven, Yassir Abdelrazig

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Although older drivers (defined as those of age 65 and above) are less involved with speeding, alcohol use as well as night driving, they are more vulnerable to severe crashes. The major contributing factors for severe crashes include frailty and medical complications. Several studies have evaluated the contributing factors on severity of crashes. However, few studies have established the impact of travel time reliability (TTR) on road safety. In particular, the impact of TTR on senior adults who face several challenges including hearing difficulties, decreasing of the processing skills and cognitive problems in driving is not well established. Therefore, this study focuses on determining possible impacts of TTR on the traffic safety with focus on elderly drivers. Historical travel speed data from freeway links in the study area were used to calculate travel time and the associated TTR metrics that is, planning time index, the buffer index, the standard deviation of the travel time and the probability of congestion. Four-year information on crashes occurring on these freeway links was acquired. The binary logit model estimated using the Markov Chain Monte Carlo (MCMC) sampling technique was used to evaluate variables that could be influencing elderly crash severity. Preliminary results of the analysis suggest that TTR is statistically significant in affecting the severity of a crash involving an elderly driver. The result suggests that one unit increase in the probability of congestion reduces the likelihood of the elderly severe crash by nearly 22%. These findings will enhance the understanding of TTR and its impact on the elderly crash severity.

Keywords: highway safety, travel time reliability, elderly drivers, traffic modeling

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Authors: Serin Darwish, Hakim Saibi, Amir Gabr

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The United Arab Emirates (UAE) is situated within an arid zone where the climate is arid and the recharge of the groundwater is very low. Groundwater is the primary source of water in the United Arab Emirates. However, rapid expansion, population growth, agriculture, and industrial activities have negatively affected these limited water resources. The shortage of water resources has become a serious concern due to the over-pumping of groundwater to meet demand. In addition to the deficit of groundwater, the UAE has one of the highest per capita water consumption rates in the world. In this study, a combination of time-lapse measurements of microgravity and depth to groundwater level in selected wells in Al Ain city was used to estimate the variations in groundwater storage. Al-Ain is the second largest city in Abu Dhabi Emirates and the third largest city in the UAE. The groundwater in this region has been overexploited. Relative gravity measurements were acquired using the Scintrex CG-6 Autograv. This latest generation gravimeter from Scintrex Ltd provides fast, precise gravity measurements and automated corrections for temperature, tide, instrument tilt and rejection of data noise. The CG-6 gravimeter has a resolution of 0.1μGal. The purpose of this study is to measure the groundwater storage changes in the shallow aquifers based on the application of microgravity method. The gravity method is a nondestructive technique that allows collection of data at almost any location over the aquifer. Preliminary results indicate a possible relationship between microgravity and water levels, but more work needs to be done to confirm this. The results will help to develop the relationship between monthly microgravity changes with hydrological and hydrogeological changes of shallow phreatic. The study will be useful in water management considerations and additional future investigations.

Keywords: Al-Ain, arid region, groundwater, microgravity

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Authors: Iveta Bryjova

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Recording of viscoelastic strain-vs-time curves with the aid of the suction method and a follow-up analysis, resulting into evaluation of standard viscoelastic parameters, is a significant technique for non-invasive contact diagnostics of mechanical properties of skin and assessment of its conditions, particularly in acute burns, hypertrophic scarring (the most common complication of burn trauma) and reconstructive surgery. For elimination of the skin thickness contribution, usable viscoelastic parameters deduced from the strain-vs-time curves are restricted to the relative ones (i.e. those expressed as a ratio of two dimensional parameters), like grosselasticity, net-elasticity, biological elasticity or Qu’s area parameters, in literature and practice conventionally referred to as R2, R5, R6, R7, Q1, Q2, and Q3. With the exception of parameters R2 and Q1, the remaining ones substantially depend on the position of inflection point separating the elastic linear and viscoelastic segments of the strain-vs-time curve. The standard algorithm implemented in commercially available devices relies heavily on the experimental fact that the inflection time comes about 0.1 sec after the suction switch-on/off, which depreciates credibility of parameters thus obtained. Although the Qu’s US 7,556,605 patent suggests a method of improving the precision of the inflection determination, there is still room for nonnegligible improving. In this contribution, a novel method of inflection point determination utilizing the advantageous properties of the Savitzky–Golay filtering is presented. The method allows computation of derivatives of smoothed strain-vs-time curve, more exact location of inflection and consequently more reliable values of aforementioned viscoelastic parameters. An improved applicability of the five inflection-dependent relative viscoelastic parameters is demonstrated by recasting a former study under the new method, and by comparing its results with those provided by the methods that have been used so far.

Keywords: Savitzky–Golay filter, scarring, skin, viscoelasticity

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Authors: Indu Bhushan Sharma, Rashmi Saraswat

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The thermotolerant, solvent stable and alkalophilic lipase producing bacterial strain was isolated from the water sample of the foothills of Trikuta Mountain in Kakryal (Reasi district) in Jammu and Kashmir, India. The lipase-producing microorganisms were screened using tributyrin agar plates. The selected microbe was optimized for maximum lipase production by subjecting to various carbon and nitrogen sources, incubation period and inoculum size. The selected strain was identified as Bacillus subtilis strain kakrayal_1 (BSK_1) using 16S rRNA sequence analysis. Effect of pH, temperature, metal ions, detergents and organic solvents were studied on lipase activity. Lipase was found to be stable over a pH range of 6.0 to 9.0 and exhibited maximum activity at pH 8. Lipolytic activity was highest at 37°C and the enzyme activity remained at 60°C for 24hrs, hence, established as thermo-tolerant. Production of lipase was significantly induced by vegetable oil and the best nitrogen source was found to be peptone. The isolated Bacillus lipase was stimulated by pre-treatment with Mn2+, Ca2+, K+, Zn2+, and Fe2+. Lipase was stable in detergents such as triton X 100, tween 20 and Tween 80. The 100% ethyl acetate enhanced lipase activity whereas, lipase activity were found to be stable in Hexane. The optimization resulted in 4 fold increase in lipase production. Bacillus lipases are ‘generally recognized as safe’ (GRAS) and are industrially interesting. The inducible alkaline, thermo-tolerant lipase exhibited the ability to be stable in detergents and organic solvents. This could be further researched as a potential biocatalyst for industrial applications such as biotransformation, detergent formulation, bioremediation and organic synthesis.

Keywords: bacillus, lipase, thermotolerant, alkalophilic

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Authors: Andrea Treviño Gavito, Diego Klabjan, Sanjiv J. Shah

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Echocardiograms serve as pivotal resources for clinicians in diagnosing cardiac conditions, offering non-invasive insights into a heart’s structure and function. When echocardiographic studies are conducted, no standardized labeling of the acquired views is performed. Employing machine learning algorithms for automated echocardiogram view detection has emerged as a promising solution to enhance efficiency in echocardiogram use for diagnosis. However, existing approaches predominantly rely on supervised learning, necessitating labor-intensive expert labeling. In this paper, we introduce a fully unsupervised echocardiographic view detection framework that leverages convolutional autoencoders to obtain lower dimensional representations and the K-means algorithm for clustering them into view-related groups. Our approach focuses on discriminative patches from echocardiographic frames. Additionally, we propose a trainable inverse average layer to optimize decoding of average operations. By integrating both public and proprietary datasets, we obtain a marked improvement in model performance when compared to utilizing a proprietary dataset alone. Our experiments show boosts of 15.5% in accuracy and 9.0% in the F-1 score for frame-based clustering, and 25.9% in accuracy and 19.8% in the F-1 score for view-based clustering. Our research highlights the potential of unsupervised learning methodologies and the utilization of open-sourced data in addressing the complexities of echocardiogram interpretation, paving the way for more accurate and efficient cardiac diagnoses.

Keywords: artificial intelligence, echocardiographic view detection, echocardiography, machine learning, self-supervised representation learning, unsupervised learning

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Authors: Gholamreza Madad

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The role of medical equipment in modern advanced hospitals is irrefutable. Despite limited financial resources, developing countries have taken an uncontrollable manner to the purchase of complex and expensive equipment, although they have not taken good maintenance to keep these huge capitals. In our country, limited studies have indicated that the irregularities exist in the management of medical equipment maintenance. Research method: The research was done as a cross-sectional one, and in this study, a questionnaire was used to collect data in 10 hospitals. After distributing and collecting questionnaires in person, the collected data were analyzed using descriptive statistics and SPSS software. Research findings: According to the obtained results from the four dimensions of the management of medical equipment maintenance, only (maintenance planning) was in a moderate position and other components with a score of less than 50% were at a low level. There was a direct relationship between the total score of maintenance management and guidance points and coordination of medical equipment maintenance, and as well as the age of hospital managers. Discussion and conclusion: In sum, we can say that problems such as lack of skilled staff in medical engineering departments of hospitals, lack of funds and unaware of the authorities of medical engineering units to their duties have caused that the maintenance situation of medical equipment maintenance is in poor condition (near average). The low inexperience of the authorities of the unit has also contributed to this problem.

Keywords: equipment, maintenance, medical equipment, hospitals

Procedia PDF Downloads 162

Authors: Claude Takenga, Rolf-Dietrich Berndt, Erling Si, Markus Diem, Guohui Qiao, Melanie Gau, Michael Brandstoetter, Martin Kampel, Michael Dworzak

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In patients with acute lymphoblastic leukaemia (ALL), treatment response is increasingly evaluated with minimal residual disease (MRD) analyses. Flow Cytometry (FCM) is a fast and sensitive method to detect MRD. However, the interpretation of these multi-parametric data requires intensive operator training and experience. This paper presents a pipeline-software, as a ready-to-use FCM-based MRD-assessment tool for the daily clinical practice for patients with ALL. The new tool increases accuracy in assessment of FCM-MRD in samples which are difficult to analyse by conventional operator-based gating since computer-aided analysis potentially has a superior resolution due to utilization of the whole multi-parametric FCM-data space at once instead of step-wise, two-dimensional plot-based visualization. The system developed as a telemedical network reduces the work-load and lab-costs, staff-time needed for training, continuous quality control, operator-based data interpretation. It allows dissemination of automated FCM-MRD analysis to medical centres which have no established expertise for the benefit of an even larger community of diseased children worldwide. We established a telemedical network system for analysis and clinical follow-up and treatment monitoring of Leukaemia. The system is scalable and adapted to link several centres and laboratories worldwide.

Keywords: data security, flow cytometry, leukaemia, telematics platform, telemedicine

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Authors: Aref Zribi, Sonia Ben Nasr, Sana Fendri, Mahdi Balti, Abderazzek Haddaoui

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Background: Despite their benefit, Endocrine therapies (ET) are known to have substantial adverse events (AEs) such as hot flashes, mood disorders and osteoarticular pain. ET induced alopecia(EIA) is less frequently noted by patients and is less reported in the literature. The aim of our study was to report ET alopecia characteristics and their influence on patient and treatment observance. Method: We conducted a retrospective study including luminal BC patients treated in the oncology department of the military hospital of Tunis between January 2015 and December 2020. Patients treated with previous chemotherapy-inducing alopecia were excluded. Results: 145 female patients were included. The median age was 59 years. EIA was reported in 44% of cases. Alopecia was attributed to aromatase inhibitors in 53% and tamoxifen in 21%. Severity was grade 1 in 80% and grade 2 in the remaining cases. ET discontinuation because of alopecia was noted in 6.5 % of patients. Moderate improvement of alopecia was observed with topical minoxidil and Thallium metallicum 9CH homeopathy during ET in 60% of patients. Conclusions: EIA is frequent in BC patients and should be considered to improve treatment observance and patients’ quality of life.

Keywords: endocrine therapy, alopecia, breast cancer, Tunisia

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Authors: Kelli G. Thorup, Kristopher A. Blee

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Climate change enhances the occurrence of extreme weather: wildfires, drought, rising summer temperatures, all of which dramatically decline forest growth and increase tree mortality in the mixed-conifer forests of Sierra Nevada, California. However, microbiota living in mutualistic relations with plant rhizospheres have been found to mitigate the effects of suboptimal environmental conditions. The goal of this research is to isolate native beneficial bacteria, plant-growth promoting rhizobacteria (PGPR), that can alleviate heat stress in Pinus ponderosa seedlings. Bacteria were isolated from the rhizosphere of Pinus ponderosa juveniles located in mixed-conifer stand and further characterized for PGP potential based on their ability to produce key growth regulatory phytohormones including auxin, cytokinin, and gibberellic acid. Out of ten soil samples taken, sixteen colonies were isolated and qualitatively confirmed to produce indole-3-acetic acid (auxin) using Salkowski’s reagent. Future testing will be conducted to quantitatively assess phytohormone production in bacterial isolates. Furthermore, bioassays will be performed to determine isolates abilities to increase tolerance in heat-stressed Pinus ponderosa seedlings. Upon completion of this research, a PGPR could be utilized to support the growth and transplantation of conifer seedlings as summer temperatures continue to rise due to the effects of climate change.

Keywords: conifer, heat-stressed, phytohormones, Pinus ponderosa, plant-growth promoting rhizobacteria

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Authors: Vineeta Kaushik, Manisha Goel

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Chaperones are proteins that help other proteins fold correctly, and are found in all domains of life i.e., prokaryotes, eukaryotes and archaea. Various comparative genomic studies have suggested that the archaeal protein folding machinery appears to be highly similar to that found in eukaryotes. In case of protein folding; slow rotation of peptide prolyl-imide bond is often the rate limiting step. Formation of the prolyl-imide bond during the folding of a protein requires the assistance of other proteins, termed as peptide prolyl cis-trans isomerases (PPIases). Cyclophilins constitute the class of peptide prolyl isomerases with a wide range of biological function like protein folding, signaling and chaperoning. Most of the cyclophilins exhibit PPIase enzymatic activity and play active role in substrate protein folding which classifies them as a category of molecular chaperones. Till date, there is not very much data available in the literature on archaeal cyclophilins. We aim to compare the structural and biochemical features of the cyclophilin protein from within the three domains to elucidate the features affecting their stability and enzyme activity. In the present study, we carry out in-silico analysis of the cyclophilin proteins to predict their conserved residues, sites under positive selection and compare these proteins to their bacterial and eukaryotic counterparts to predict functional divergence. We also aim to clone and express these proteins in heterologous system and study their biophysical characteristics in detail using techniques like CD and fluorescence spectroscopy. Overall we aim to understand the features contributing to the folding, stability and dynamics of the archaeal cyclophilin proteins.

Keywords: biophysical characterization, x-ray crystallography, chaperone-like activity, cyclophilin, PPIase activity

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Authors: Minna K. Miller, Chantel. E. Canessa, Suzanna V. McRae, Susan Shumay, Alissa Collingridge

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Primary care provides the first point of contact and access to health care services. For the pediatric population, the goal is to help healthy children stay healthy and to help those that are sick get better. Primary care facilitates regular well baby/child visits; health promotion and disease prevention; investigation, diagnosis and management of acute and chronic illnesses; health education; both consultation and collaboration with, and referral to other health care professionals. There is a protective association between regular well-child visit care and preventable hospitalization. Further, low adherence to well-child care and poor continuity of care are independently associated with increased risk of hospitalization. With a declining number of family physicians caring for children, and only a portion of pediatricians providing primary care services, it is becoming increasingly difficult for children and their families to access primary care. Nurse practitioners are in a unique position to improve access to primary care and improve health outcomes for children. Limited literature is available on the nurse practitioner role in primary care pediatrics. The purpose of this paper is to describe the development, implementation and evaluation of a Nurse Practitioner-led pediatric primary care clinic in a tertiary care setting. Utilizing the participatory, evidence-based, patient-focused process for advanced practice nursing (PEPPA framework), this paper highlights the results of the initial needs assessment/gap analysis, the new service delivery model, populations served, and outcome measures.

Keywords: access, health outcomes, nurse practitioner, pediatric primary care, PEPPA framework

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Authors: Raphael M. Ritti-Dias, Marilia A. Correia, Wagner J. R. Domingues, Aline C. Palmeira, Paulo Longano, Nelson Wolosker, Lauro C. Vianna, Gabriel G. Cucato

Abstract:

Patients with peripheral arterial disease (PAD) have a high prevalence of hypertension, which contributes to a high risk of acute cardiovascular events and cardiovascular mortality. Strategies to reduce cardiovascular risk of these patients are needed. Meta-analysis studies have shown that isometric handgrip training promotes reductions in clinical blood pressure in normotensive, pre-hypertensive and hypertensive individuals. However, the effect of this exercise training on other cardiovascular function indicators in PAD patients remains unknown. Thus, the aim of this study was to analyze the effects of isometric handgrip training on blood pressure in patients with PAD. In this clinical trial, 28 patients were randomly allocated into two groups: isometric handgrip training (HG) and control (CG). The HG conducted the unilateral handgrip training three days per week (four sets of two minutes, with 30% of maximum voluntary contraction with an interval of four minutes between sets). CG was encouraged to increase their physical activity levels. At baseline and after eight weeks blood pressure and heart rate were obtained. ANOVA two-way for repeated measures with the group (GH and GC) and time (pre- and post-intervention) as factors was performed. After 8 weeks of training there were no significant changes in systolic blood pressure (HG pre 141 ± 24.0 mmHg vs. HG post 142 ± 22.0 mmHg; CG pre 140 ± 22.1 mmHg vs. CG post 146 ± 16.2 mmHg; P=0.18), diastolic blood pressure (HG pre 74 ± 10.4 mmHg vs. HG post 74 ± 11.9 mmHg; CG pre 72 ± 6.9 mmHg vs. CG post 74 ± 8.0 mmHg; P=0.22) and heart rate (HG pre 61 ± 10.5 bpm vs. HG post 62 ± 8.0 bpm; CG pre 64 ± 11.8 bpm vs. CG post 65 ± 13.6 bpm; P=0.81). In conclusion, our preliminary data indicate that isometric handgrip training did not modify blood pressure and heart rate in patients with PAD.

Keywords: blood pressure, exercise, isometric, peripheral artery disease

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Authors: J. Bravo, F. Cabrera Suárez, B. Vega, L. Román, M. Martel, F. Acosta

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Ciguatera fish poisoning (CFP) is the most common non-bacterial intoxication in the world caused by ingestion of fish with bio-accumulated ciguatoxins (CTXs). It is typical in tropical and subtropical areas, mainly affecting the Caribbean Sea, Polynesia and other areas in the Pacific and Indian Oceans. Interest in Europe by the CFP is increasing in recent years as more and more cases in European hospitals are appearing, usually by people who have consumed ciguatoxin imported fish or have travelled to areas of risk for this poisoning. Since 2004 a series of poisonings raised the question of a possible occurrence of ciguatoxin in Europe, especially in the area of Macaronesia in the East Atlantic temperate zone. Furthermore, some studies have identified the presence of Gambierdiscus spp. in waters surrounding the Canary Islands and Madeira, a toxic dinoflagellate related to this poisoning. The toxin accumulates and concentrates through the food chain and affects to the end of the chain, the human consumer. Fish were collected from the Canary Islands waters and the toxin has been extracted and purified by using acetone and liquid/liquid partition in order to eliminate the excess of fatty acids that may interfere with the detection of the toxin. The fish extracts were inoculated in Neuroblastoma (neuro-2a) cells. After 24-h cell viability was used as an endpoint for cytotoxic effects measurement. Since 2011 our laboratory is collecting data for species such Seriola spp., Epinephelus spp., Makaira spp., Pomatomus spp., Xiphias spp., and Acantocybium spp., from all islands and including the sports fishing and professional activities, we obtained a 8% of fish that have ciguatoxin in their muscle. With these results, we conclude that the island where fishing and fish size affects the probability of catching a fish with the ciguatoxin.

Keywords: Canary Islands, ciguatera fish poisoning, ciguatoxin, Europe

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Authors: Sangeeta Pilkhwal Sah, C. S. Mathela, Kanwaljit Chopra

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Valeriana wallichii DC, an ayurvedic traditional medicine, popularly named as Indian valerian exist as three chemotypes. GC-MS analysis of V. wallichii essential oil in present study showed maaliol as the major constituent followed by the presence of β-gurjunene, acoradiene, guaiol and α-santalene. The results thus confirmed it to be a maaliol chemotype. Further, the antidepressant-like effect of root essential oil (10, 20 and 40 mg/kg p.o.) was investigated in both acute and chronic treatment study using forced swim test in mice. Single administration of different doses produced an inverted U shaped curve and significantly inhibited the immobility period (39.7% and 58%) at doses 10 and 40 mg/kg respectively. Standard drug imipramine significantly decreased immobility period (59.8%). None of the doses altered locomotor activity except a significant decrease of 44.9% was observed with 40 mg/kg (p < 0.05). Similarly, daily administration of essential oil for 14 days produced a dose dependent effect with significantly reduced immobility period (70.9%) at 40 mg/kg dose only whereas imipramine produced 86% decrease (p < 0.05). The neurotransmitter levels in mouse brain were estimated on day 14 after the behavioral study. Significant increase in the level of norepinephrine (10%) and dopamine (23%) (p < 0.05) was found at 40 mg/kg dose, while no change was observed at 10 and 20 mg/kg doses. The antidepressant-like effect of essential oil (40 mg/kg) was prevented by pretreatment of mice with L-arginine (750 mg/kg i.p.) and sildenafil (5 mg/kg i.p). On the contrary, pretreatment of mice with L-NAME (10 mg/kg i.p.) or methylene blue (10 mg/kg i.p.) potentiated the antidepressant action of essential oil (20 mg/kg). The findings thus demonstrated that nitric oxide pathway is involved in mediating antidepressant like effect of essential oil from this chemotype.

Keywords: Valeriana wallichii DC chemotype, essential oil, forced swim test, nitric oxide modulators, neurotransmitters

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Authors: Shivani Kuttuva, Bridget Fergie, Andrew Mishreki, Shovkat Mir, Fintan Bergin

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Diaphragm disease (DD) of the small bowel is a condition wherein the bowel lumen is divided into a series of short compartments by multiple circumferential membranes of mucosa and submucosa, leading to pinhole lumen and subsequent obstruction. It is a rare condition commonly attributed to non-steroidal anti-inflammatory drugs (NSAIDs) usage. Herein we present a 31-yr-old-female with a history of NSAIDs usage for one year following neurosurgery, who presented with recurrent idiopathic small bowel obstruction, recalcitrant anaemia, and impaction of capsule endoscope on investigating for anaemia. The capsule endoscopy images demonstrated multiple circumferential strictures with ulcers at its tip and villous atrophy in the proximal bowel, suggestive of NSAIDs related damage. However, due to the lack of awareness of the detrimental effects of NSAIDs on bowel mucosa distal to the duodenum, the underlying aetiology of this clinical presentation remained a mystery for a significant duration. The patient had to undergo repeated laparotomies in order to relieve the symptoms of recurring acute small bowel obstruction. Upon examining the resected specimen under microscopy, the histopathological hallmark of expanded, fibrotic, and congested submucosa was picked up, leading to the confirmation of diaphragm disease. Thus, this case report aims to widen the awareness among clinicians and aid surgeons in devising a management plan for young individuals presenting with recurring episodes of obstruction due to Diaphragm disease.

Keywords: capsule endoscopy, diaphragm disease, NSAIDs, recurrent small bowel obstruction

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Authors: Eheneden Iyobosa, Rongchang Wang, Adesina Odunayo Blessing, Gaoxiang Chen, Haijing Ren, Jianfu Zhao

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In the treatment of ammonium-rich wastewater with 500 μg/L sulfamethoxazole (SMX) antibiotic by a Microalgae-Bacteria Consortium, diverse parameters were monitored to assess treatment efficacy. Over 14 days, residual SMX concentrations decreased markedly from 500 μg/L to 45.6 μg/L, and removal rates declined from 102.4 to 9.9 μg/L/day. Biomass exhibited consistent growth, reaching a peak of 542.6 mg/L on day 10. Chlorophyll-a, chlorophyll-b, and carotenoid levels varied over time, reflecting fluctuations in microalgal activity. Extracellular polymeric substances (EPS) production showed temporal variations, with protein content ranging from 69.4 to 162.3 mg/g Dry cell weight (DCW) and polysaccharides content from 50.6 to 82.8 mg/g DCW. Ammonium nitrogen concentration decreased steadily from 300 mg/L to 5 mg/L throughout the treatment period. The bacterial community composition was significantly altered in the presence of antibiotics, with notable increases in Bacteroidota and Proteobacteria. Community richness and diversity indices were higher in the antibiotics-treated group than in the control group, as evidenced by the Chao index (258 compared to 181), Shannon index (1.8085 compared to 1.1545), and Simpson index (0.5032 compared to 0.6478), indicating notable shifts in microbial community structure. These findings demonstrate the efficacy of the Microalgae-Bacteria Consortium in removing SMX from wastewater and suggest its potential to mitigate antibiotic pollution while maintaining microbial diversity.

Keywords: ammonium-rich wastewater, microalgae-bacteria consortium, sulfamethoxazole removal, microbial community diversity, biomass growth

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Authors: Luciano Tarantino

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Gas gangrene is a rare, severe infection with a very high mortality rate caused by Clostridium species. The infection causes a non-suppurative localized producing gas lesion from which harmful toxins that impair the inflammatory response cause vessel damage and multiple organ failure. Gas gangrene of the liver is very rare and develops suddenly, often as a complication of abdominal surgery and liver transplantation. The present paper deals with a case of gas gangrene of the liver that occurred after percutaneous MW ablation of hepatocellular carcinoma, resulting in progressive liver necrosis and multi-organ failure in spite of specific antibiotics administration. The patient was successfully treated with percutaneous Radiofrequency ablation. Case report: Female, 76 years old, Child A class cirrhosis, treated with synchronous insertion of 3 MW antennae for large HCC (5.5 cm) in the VIII segment. 24 hours after treatment, the patient was asymptomatic and left the hospital . 2 days later, she complained of fever, weakness, abdominal swelling, and pain. Abdominal US detected a 2.3 cm in size gas-containing area, eccentric within the large (7 cm) ablated area. The patient was promptly hospitalized with the diagnosis of anaerobic liver abscess and started antibiotic therapy with Imipenem/cilastatine+metronidazole+teicoplanine. On the fourth day, the patient was moved to the ICU because of dyspnea, congestive heart failure, atrial fibrillation, right pleural effusion, ascites, and renal failure. Blood tests demonstrated severe leukopenia and neutropenia, anemia, increased creatinine and blood nitrogen, high-level FDP, and high INR. Blood cultures were negative. At US, unenhanced CT, and CEUS, a progressive enlargement of the infected liver lesion was observed. Percutaneous drainage was attempted, but only drops of non-suppurative brownish material could be obtained. Pleural and peritoneal drainages gave serosanguineous muddy fluid. The Surgeon and the Anesthesiologist excluded any indication of surgical resection because of the high perioperative mortality risk. Therefore, we asked for the informed consent of the patient and her relatives to treat the gangrenous liver lesion by percutaneous Ablation. Under conscious sedation, percutaneous RFA of GG was performed by double insertion of 3 cool-tip needles (Covidien LDT, USA ) into the infected area. The procedure was well tolerated by the patient. A dramatic improvement in the patient's condition was observed in the subsequent 24 hours and thereafter. Fever and dyspnea disappeared. Normalization of blood tests, including creatinine, was observed within 4 days. Heart performance improved, 10 days after the RFA the patient left the hospital and was followed-up with weekly as an outpatient for 2 months and every two months thereafter. At 18 months follow-up, the patient is well compensated (Child-Pugh class B7), without any peritoneal or pleural effusion and without any HCC recurrence at imaging (US every 3 months, CT every 6 months). Percutaneous RFA could be a valuable therapy of focal GG of the liver in patients non-responder to antibiotics and when surgery and liver transplantation are not feasible. A fast and early indication is needed in case of rapid worsening of patient's conditions.

Keywords: liver tumor ablation, interventional ultrasound, liver infection, gas gangrene, radiofrequency ablation

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Authors: Mohammed Almohammedali, David Edgar, Duncan Peter

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The aim of this exploratory research is to further understand how organisations can evaluate their activities, which generate knowledge creation, to meet changing stakeholder expectations. A Scale of Knowledge (SoK) Framework is proposed which links knowledge management and organisational activities to changing stakeholder expectations. The framework was informed by the knowledge management literature, as well as empirical work conducted via a single case study of a multi-site hospital organisation in Saudi Arabia. Eight in-depth semi-structured interviews were conducted with managers from across the organisation regarding current and future stakeholder expectations, organisational strategy/activities and knowledge management. Data were analysed using thematic analysis and a hierarchical value map technique to identify activities that can produce further knowledge and consequently impact on how stakeholder expectations are met. The SoK Framework developed may be useful to practitioners as an analytical aid to determine if current organisational activities produce organisational knowledge which helps them meet (increasingly higher levels of) stakeholder expectations. The limitations of the research and avenues for future development of the proposed framework are discussed.

Keywords: knowledge creation, knowledge management, organisational knowledge, analytical aid, stakeholders

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Authors: Akumeyam Elvis Akum, Njanjo Thecla Anyongo Mukete, Fonkeng George Epah

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Globally, the goal of higher education is to enhance graduate employability skills. Paradoxically, Cameroon’s graduate employability rate is far below the graduation rate. This worrisome situation caused the researcher to hypothesize that the teaching and learning experiences account for this increasing disparity. The study sought to investigate the effect on graduate employability of the teaching of organizational, problem-solving, innovation, and risk management skills on graduate employability. The study adopted a descriptive survey design with a quantitative approach. Data was collected by quantitative techniques from a random sample of 385 graduates using closed-ended structured questionnaire. Generally, findings revealed that entrepreneurship education does not sufficiently enhance graduate employability in the University of Buea. Specifically, the teaching of organizational skills does not significantly enhance their employability, as an average of 55% of graduates indicated that the course did not sufficiently help them develop skills for planning, management of limited resources, collaboration, and the setting of priorities. Also, 60% of the respondents indicated that the teaching of problem-solving skills does not significantly enhance graduate employability at the University of Buea. Contrarily, 57% of the respondents agreed that through their experiences in entrepreneurship education, their innovation skills were improved. The study recommended that a practical approach to teaching should be adopted, with attention to societal needs. A framework to ensure the teaching of entrepreneurship to students at the undergraduate level is recommended, such that those who do not continue with university studies after their Bachelor’s degree would have acquired the needed skills for employability.

Keywords: employability, entrepreneurship education, graduate, innovative skills, organizational skills, problem-solving skills, risk management skills

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Authors: Munish Garg, Vinni Ahuja

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In the past few years, the high consumption of soft drinks has attracted negative attention world-wide due to its possible adverse effects, leading the health conscious people to find alternative nutraceutical or herbal health drinks. In the present study, a nutraceutical soft drink was developed utilizing some easily available and well known traditional herbs having nutritional potential. The key ingredients were selected as bael, amla, lemon juice, ashwagandha and poppy seeds based on their household routine use in the summer with proven refreshing, cooling and energetic feeling since ages. After several trials made, the final composition of nutraceutical summer soft drink was selected as most suitable combination based on the taste, physicochemical, microbial and organoleptic point of view. The physicochemical analysis of the prepared drink found to contain optimum level of titratable acidity, total soluble solids and pH which were in accordance of the commercial recommendations. There were no bacterial colonies found in the product therefore found within limits. During the nine point’s hedonic scale sensory evaluation, the drink was strongly liked for colour, taste, flavour and texture. The formulation was found to contain flavonoids (80mg/100ml), phenolics (103mg/100ml), vitamin C (250mg/100ml) and has antioxidant potential (75.52%) apart from providing several other essential vitamins, minerals and healthy components. The developed nutraceutical drink provides an economical and feasible option for the consumers with very good taste combined with potential health benefits. The present drink is potentially capable to replace the synthetic soft drinks available in the market.

Keywords: herbal drink, summer drink, nutraceuticals, soft drink

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