Search results for: schema mode therapy
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4043

Search results for: schema mode therapy

923 PLGA Nanoparticles Entrapping dual anti-TB drugs of Amikacin and Moxifloxacin as a Potential Host-Directed Therapy for Multidrug Resistant Tuberculosis

Authors: Sharif Abdelghany

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Polymeric nanoparticles have been widely investigated as a controlled release drug delivery platform for the treatment of tuberculosis (TB). These nanoparticles were also readily internalised into macrophages, leading to high intracellular drug concentration. In this study two anti-TB drugs, amikacin and moxifloxacin were encapsulated into PLGA nanoparticles. The novelty of this work appears in: (1) the efficient encapsulation of two hydrophilic second-line anti-TB drugs, and (2) intramacrophage delivery of this synergistic combination potentially for rapid treatment of multi-drug resistant TB (MDR-TB). Two water-oil-water (w/o/w) emulsion strategies were employed in this study: (1) alginate coated PLGA nanoparticles, and (2) alginate entrapped PLGA nanoparticles. The average particle size and polydispersity index (PDI) of the alginate coated PLGA nanoparticles were found to be unfavourably high with values of 640 ± 32 nm and 0.63 ± 0.09, respectively. In contrast, the alginate entrapped PLGA nanoparticles were within the desirable particle size range of 282 - 315 nm and the PDI was 0.08 - 0.16, and therefore were chosen for subsequent studies. Alginate entrapped PLGA nanoparticles yielded a drug loading of over 10 µg/mg powder for amikacin, and more than 5 µg/mg for moxifloxacin and entrapment efficiencies range of approximately 25-31% for moxifloxacin and 51-59% for amikacin. To study macrophage uptake efficiency, the nanoparticles of alginate entrapped nanoparticle formulation were loaded with acridine orange as a marker, seeded to THP-1 derived macrophages and viewed under confocal microscopy. The particles were readily internalised into the macrophages and highly concentrated in the nucleus region. Furthermore, the anti-mycobacterial activity of the drug-loaded particles was evaluated using M. tuberculosis-infected macrophages, which revealed a significant reduction (4 log reduction) of viable bacterial count compared to the untreated group. In conclusion, the amikacin-moxifloxacin alginate entrapped PLGA nanoparticles are promising for further in vivo studies.

Keywords: moxifloxacin and amikacin, nanoparticles, multidrug resistant TB, PLGA

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922 Capacity Oversizing for Infrastructure Sharing Synergies: A Game Theoretic Analysis

Authors: Robin Molinier

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Industrial symbiosis (I.S) rely on two basic modes of cooperation between organizations that are infrastructure/service sharing and resource substitution (the use of waste materials, fatal energy and recirculated utilities for production). The former consists in the intensification of use of an asset and thus requires to compare the incremental investment cost to be incurred and the stand-alone cost faced by each potential participant to satisfy its own requirements. In order to investigate the way such a cooperation mode can be implemented we formulate a game theoretic model integrating the grassroot investment decision and the ex-post access pricing problem. In the first period two actors set cooperatively (resp. non-cooperatively) a level of common (resp. individual) infrastructure capacity oversizing to attract ex-post a potential entrant with a plug-and-play offer (available capacity, tariff). The entrant’s requirement is randomly distributed and known only after investments took place. Capacity cost exhibits sub-additive property so that there is room for profitable overcapacity setting in the first period under some conditions that we derive. The entrant willingness-to-pay for the access to the infrastructure is driven by both her standalone cost and the complement cost to be incurred in case she chooses to access an infrastructure whose the available capacity is lower than her requirement level. The expected complement cost function is thus derived, and we show that it is decreasing, convex and shaped by the entrant’s requirements distribution function. For both uniform and triangular distributions optimal capacity level is obtained in the cooperative setting and equilibrium levels are determined in the non-cooperative case. Regarding the latter, we show that competition is deterred by the first period investor with the highest requirement level. Using the non-cooperative game outcomes which gives lower bounds for the profit sharing problem in the cooperative one we solve the whole game and describe situations supporting sharing agreements.

Keywords: capacity, cooperation, industrial symbiosis, pricing

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921 Hyponatremia in Community-Acquired Pneumonia

Authors: Emna Ketata, Wafa Farhat

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Introduction: Hyponatremia is defined by a blood sodium level of ≤ 136 mmol/L; it is associated with a high risk of morbidity and mortality in the emergency room. This was explained by transit disorders, including diarrhea and inappropriate antidiuretic hormone secretion (Syndrome of inappropriate antidiuretic hormone secretion). Pneumonia can cause dyspnea, stress-causing SIADH and digestive symptoms (diarrhea and vomiting). Aim: The purpose of this study was to determine the link between pneumonia and hyponatremia as a predictor of patient’s prognosis and intra-hospital mortality. Methodology: This is a prospective observational study over a period of 3 years in the emergency department. Inclusion :patients (age > 14 years), with clinical signs in favor of pneumonia. Natremia was measured. Natremia was classified as mild to moderate with a blood sodium level between 121 and 135 mmol/L and as severe with a blood sodium level ≤ 120 mmol/L. Results: This study showed an average serum sodium value of 135 mmol/L (range 114–159 mmol/L) in these patients. Hyponatremia was observed in 123 patients (43.6%), 115 patients (97,8%) had mild to moderate hyponatremia and 2,8% had severe hyponatremia. The mean age was 65±17 years with a sex ratio of 1.05. The main reason for consultation in patients with hyponatremia was cough in 58 patients (47.2%), and digestive symptoms were present in 25 patients (20.3. An altered state of consciousness was observed in 11 patients (3%). Patients with hyponatremia had greater heart rate (p=0.02),white blood cell count (p=0.009) , plasmatic lactate (p=0.002) and higher rate of pneumonia recurrence (p=0.001) .In addition, 80% of them have a positive CURB65 score (>=2). hyponatremia had higher rates of use of oxygen therapy compared to patients with normo-natremia (54% vs. 45%). The analytical study showed that hyponatremia is significantly associated with intra-hospital mortality with( p=0.01), severe hyponatremia p=0.04. Conclusion: Hyponatremia is a predictor of mortality and worse prognosis. Recognition of the pathophysiological mechanisms of hyponatremia in pneumonia will probably allow better management of it.

Keywords: oxygenotherapy, mortality, recurrence, positif curb65

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920 Biomimetic Strategies to Design Non-Toxic Antimicrobial Textiles

Authors: Isabel Gouveia

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Antimicrobial textile materials may significantly reduce the risk of infections and because they are able to absorb substances from the skin and release therapeutic compounds to the skin, they can also find applications as complementary therapy of skin-diseases as part of standard management. Although functional textiles may be a promising area in skin disease/injury management, as part of standard management, few offer complementary treatment even though they are well known to reduce scratching and aiding emollient absorption, reducing infection, and alleviating pruritus. The reason for this may rely on the low quality of supporting evidence and negative effect that antimicrobial agents may exert on skin microbiome, as for example additional irritation of the vulnerable skin, and by causing resistant bacteria. Several antimicrobial agents have been tested in textiles: quaternary ammonium compounds, silver, polyhexamethylene-biguanides and triclosan have been used, with success. They have powerful bactericidal activity but the majority have a reduce spectrum of microbial inhibition and may cause skin irritation, ecotoxicity and bacteria resistance. Furthermore, the rising flow of strains resistant to last-resort antibiotics rekindles interest in alternative strategies. In this regard, new functional textiles incorporating highly specific antimicrobial agents towards pathogenic bacteria, are required. Recent research has been conducted on naturally occurring antimicrobials as novel alternatives to antibiotics. Conscious of this need our team firstly reported new approaches using L-cysteine and antimicrobial peptides (AMP). Briefly, we were able to develop different immobilization processes towards 6 Log Reduction against bacteria such as S. aureus and K. pneumoniae. Therefore, here we present several innovative antimicrobial textiles incorporating AMP and L-Cysteine which may open new avenues for the medical textiles market and biomaterials in general. Team references will be discussed as an overview and for comparison purposes in terms of potential therapeutic applications.

Keywords: Antimicrobials, Antimicrobial Textiles, Biomedical Textiles, Biomimetic surface functionalization

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919 Developing VR-Based Neurorehabilitation Support Tools: A Step-by-Step Approach for Cognitive Rehabilitation and Pain Distraction during Invasive Techniques in Hospital Settings

Authors: Alba Prats-Bisbe, Jaume López-Carballo, David Leno-Colorado, Alberto García Molina, Alicia Romero Marquez, Elena Hernández Pena, Eloy Opisso Salleras, Raimon Jané Campos

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Neurological disorders are a leading cause of disability and premature mortality worldwide. Neurorehabilitation (NRHB) is a clinical process aimed at reducing functional impairment, promoting societal participation, and improving the quality of life for affected individuals. Virtual reality (VR) technology is emerging as a promising NRHB support tool. Its immersive nature fosters a strong sense of agency and embodiment, motivating patients to engage in meaningful tasks and increasing adherence to therapy. However, the clinical benefits of VR interventions are challenging to determine due to the high heterogeneity among health applications. This study explores a stepwise development approach for creating VR-based tools to assist individuals with neurological disorders in medical practice, aiming to enhance reproducibility, facilitate comparison, and promote the generalization of findings. Building on previous research, the step-by-step methodology encompasses: Needs Identification– conducting cross-disciplinary meetings to brainstorm problems, solutions, and address barriers. Intervention Definition– target population, set goals, and conceptualize the VR system (equipment and environments). Material Selection and Placement– choose appropriate hardware and software, place the device within the hospital setting, and test equipment. Co-design– collaboratively create VR environments, user interfaces, and data management strategies. Prototyping– develop VR prototypes, conduct user testing, and make iterative redesigns. Usability and Feasibility Assessment– design protocols and conduct trials with stakeholders in the hospital setting. Efficacy Assessment– conduct clinical trials to evaluate outcomes and long-term effects. Cost-Effectiveness Validation– assess reproducibility, sustainability, and balance between costs and benefits. NRHB is complex due to the multifaceted needs of patients and the interdisciplinary healthcare architecture. VR has the potential to support various applications, such as motor skill training, cognitive tasks, pain management, unilateral spatial neglect (diagnosis and treatment), mirror therapy, and ecologically valid activities of daily living. Following this methodology was crucial for launching a VR-based system in a real hospital environment. Collaboration with neuropsychologists lead to develop A) a VR-based tool for cognitive rehabilitation in patients with acquired brain injury (ABI). The system comprises a head-mounted display (HTC Vive Pro Eye) and 7 tasks targeting attention, memory, and executive functions. A desktop application facilitates session configuration, while database records in-game variables. The VR tool's usability and feasibility were demonstrated in proof-of-concept trials with 20 patients, and effectiveness is being tested through a clinical protocol with 12 patients completing 24-session treatment. Another case involved collaboration with nurses and paediatric physiatrists to create B) a VR-based distraction tool during invasive techniques. The goal is to alleviate pain and anxiety associated with botulinum toxin (BTX) injections, blood tests, or intravenous placements. An all-in-one headset (HTC Vive Focus 3) deploys 360º videos to improve the experience for paediatric patients and their families. This study presents a framework for developing clinically relevant and technologically feasible VR-based support tools for hospital settings. Despite differences in patient type, intervention purpose, and VR system, the methodology demonstrates usability, viability, reproducibility and preliminary clinical benefits. It highlights the importance approach centred on clinician and patient needs for any aspect of NRHB within a real hospital setting.

Keywords: neurological disorders, neurorehabilitation, stepwise development approach, virtual reality

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918 Morphology and Permeability of Biomimetic Cellulose Triacetate-Impregnated Membranes: in situ Synchrotron Imaging and Experimental Studies

Authors: Amira Abdelrasoul

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This study aimed to ascertain the controlled permeability of biomimetic cellulose triacetate (CTA) membranes by investigating the electrical oscillatory behavior across impregnated membranes (IM). The biomimetic CTA membranes were infused with a fatty acid to induce electrical oscillatory behavior and, hence, to ensure controlled permeability. In situ synchrotron radiation micro-computed tomography (SR-μCT) at the BioMedical Imaging and Therapy (BMIT) Beamline at the Canadian Light Source (CLS) was used to evaluate the main morphology of IMs compared to neat CTA membranes to ensure fatty acid impregnation inside the pores of the membrane matrices. A monochromatic beam at 20 keV was used for the visualization of the morphology of the membrane. The X-ray radiographs were recorded by means of a beam monitor AA-40 (500 μm LuAG scintillator, Hamamatsu, Japan) coupled with a high-resolution camera, providing a pixel size of 5.5 μm and a field of view (FOV) of 4.4 mm × 2.2 mm. Changes were evident in the phase transition temperatures of the impregnated CTA membrane at the melting temperature of the fatty acid. The pulsations of measured voltages were related to changes in the salt concentration of KCl in the vicinity of the electrode. Amplitudes and frequencies of voltage pulsations were dependent on the temperature and concentration of the KCl solution, which controlled the permeability of the biomimetic membranes. The presented smart biomimetic membrane successfully combined porous polymer support and impregnating liquid not only imitate the main barrier properties of the biological membranes but could be easily modified to achieve some new properties, such as facilitated and active transport, regulation by chemical, physical and pharmaceutical factors. These results open new frontiers for the facilitation and regulation of active transport and permeability through biomimetic smart membranes for a variety of biomedical and drug delivery applications.

Keywords: biomimetic, membrane, synchrotron, permeability, morphology

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917 Non-Thyroidal Illness Syndrome and Its Prognostic Significance in Pediatric Septic Shock: A Cross-Sectional Analysis

Authors: Ankita Sharma, Satish Kumar Meena, Neha Kawatra Madan

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Background and Aims: Pediatric septic shock, a life-threatening condition, is associated with significant morbidity and mortality. Dysregulation of thyroid function, presenting as Non-Thyroidal Illness Syndrome (NTIS), is a common observation in critically ill patients and may impact clinical outcomes. This study investigates the thyroid hormone profile in pediatric septic shock and its correlation with disease outcomes. Methods: A cross-sectional study was conducted in the Pediatric Department of VMMC and Safdarjung Hospital, New Delhi. Ninety-one children, aged 1 month to 12 years, diagnosed with septic shock were included. Thyroid function tests (Total T3, Total T4, Free T3, Free T4, and TSH) were measured upon admission. Outcomes were categorized as favorable (shock reversal within 24 hours, ICU stay <7 days) or unfavorable (prolonged shock, ICU stay >7 days, multiorgan dysfunction syndrome [MODS], or death). Statistical analysis included logistic regression and receiver operating characteristic (ROC) curve evaluation. Results: Thyroid hormone abnormalities were prevalent, with low Total T3 (84.6%), low Total T4 (70.3%), and low Free T3 (76.9%) being the most common findings. Significant associations were observed between low levels of Total T3, Total T4, Free T3, and Free T4 with unfavorable outcomes (p<0.001 for all). ROC analysis identified Free T3 as the strongest predictor of unfavorable outcomes, with an AUROC of 0.842. Conclusions: Thyroid hormone levels, particularly Free T3, are critical prognostic markers in pediatric septic shock. Timely monitoring of thyroid function could aid in risk stratification and therapeutic decision-making. Future research should focus on the potential benefits of thyroid hormone replacement therapy in this population.

Keywords: pediatric septic shock, thyroid function, non-thyroidal illness syndrome, prognostic markers, free T3

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916 Sudanese Dietitian’s Role in the Provision of Parenteral Nutrition: The Past, Present, and Future

Authors: Reem Osama Yousif Ali, Osama Yousif Ali Al Gibali

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Introduction: Balanced nutrition is undeniably essential for maintaining health, body functions, and integrity of cell metabolism; however, some sick patients cannot tolerate oral or enteral feeding to meet their nutritional needs, so partial or total parenteral nutrition (PN) may be the most suitable alternative route in such situations. Dietitians are fundamental personnel among the medical team to ensure the proper provision of PN service, which was introduced in Sudan in the 1980s. Objective: The study aimed to recognize the dietitians' awareness of parenteral nutrition and their role in providing this service in Sudan – Khartoum State. Methodology: Formulated questionnaire forms composed of twelve questions were distributed to the dietitians working in four tertiary level hospitals. Results: The majority (75%) of the responded dietitians had reasonable knowledge about the importance of PN, its advantages, and its indications. Sixty percent of them were mindful of the PN side effects. Most of the dietitians were aware of the different assessment measurements and PN calculations and were exposed in their clinical practice to patients who were in need of PN, but only a few of them (about 30%) had the actual chance to participate in the formulation and application of PN therapy. The unavailability of the multidisciplinary team, lack of the required equipment and financial support, and associated complications were basic obstacles to the provision of long-term PN service in Khartoum state hospitals. Conclusion: Although dietitians in Khartoum state hospitals have good information about PN definition, indications, accesses, and assessment measures, they do not have enough knowledge and clinical exposure that make them confident to provide the PN service. Establishing a few models of parenteral nutrition units in tertiary hospitals will be of great help, as well as providing the dietitian's training in the area of parenteral nutrition. Further study can explore more requirements to run this service.

Keywords: nutrition support, dietitian, Sudan, parenteral nutrition, nutrition support team

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915 Improvement of Environment and Climate Change Canada’s Gem-Hydro Streamflow Forecasting System

Authors: Etienne Gaborit, Dorothy Durnford, Daniel Deacu, Marco Carrera, Nathalie Gauthier, Camille Garnaud, Vincent Fortin

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A new experimental streamflow forecasting system was recently implemented at the Environment and Climate Change Canada’s (ECCC) Canadian Centre for Meteorological and Environmental Prediction (CCMEP). It relies on CaLDAS (Canadian Land Data Assimilation System) for the assimilation of surface variables, and on a surface prediction system that feeds a routing component. The surface energy and water budgets are simulated with the SVS (Soil, Vegetation, and Snow) Land-Surface Scheme (LSS) at 2.5-km grid spacing over Canada. The routing component is based on the Watroute routing scheme at 1-km grid spacing for the Great Lakes and Nelson River watersheds. The system is run in two distinct phases: an analysis part and a forecast part. During the analysis part, CaLDAS outputs are used to force the routing system, which performs streamflow assimilation. In forecast mode, the surface component is forced with the Canadian GEM atmospheric forecasts and is initialized with a CaLDAS analysis. Streamflow performances of this new system are presented over 2019. Performances are compared to the current ECCC’s operational streamflow forecasting system, which is different from the new experimental system in many aspects. These new streamflow forecasts are also compared to persistence. Overall, the new streamflow forecasting system presents promising results, highlighting the need for an elaborated assimilation phase before performing the forecasts. However, the system is still experimental and is continuously being improved. Some major recent improvements are presented here and include, for example, the assimilation of snow cover data from remote sensing, a backward propagation of assimilated flow observations, a new numerical scheme for the routing component, and a new reservoir model.

Keywords: assimilation system, distributed physical model, offline hydro-meteorological chain, short-term streamflow forecasts

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914 Autonomous Exploration, Navigation and Mapping Payload Integrated on a Quadruped Robot

Authors: Julian Y. Raheema, Michael R. Hess, Raymond C. Provost, Mark Bilinski

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The world is rapidly moving towards advancing and utilizing artificial intelligence and autonomous robotics. The ground-breaking Boston Dynamics quadruped robot, SPOT, was designed for industrial and commercial tasks requiring limited autonomous navigation. Out of the box, SPOT has route memorization and playback – it can repeat a path that it has been manually piloted through, but it cannot autonomously navigate an area that has not been previously explored. The presented SPOT payload package is built on ROS framework to support autonomous navigation and mapping of an unexplored environment. The package is fully integrated with SPOT to take advantage of motor controls and collision avoidance that comes natively with the robot. The payload runs all computations onboard, takes advantage of visual odometry SLAM and uses an Intel RealSense depth camera and Velodyne LiDAR sensor to generate 2D and 3D maps while in autonomous navigation mode. These maps are fused into the navigation stack to generate a costmap to enable the robot to safely navigate the environment without causing damage to the surroundings or the robot. The operator defines the operational zone and start location and then sends the explore command to have SPOT explore, generate 2D and 3D maps of the environment and return to the start location to await the operator's next command. The benefit of the presented package is that it is much lighter weight and less expensive than previous approaches and, importantly, operates in GPS-denied scenarios, which is ideal for indoor mapping. There are numerous applications that are hazardous to humans for SPOT enhanced with the autonomy payload, including disaster response, nuclear inspection, mine inspection, and so on. Other less extreme uses cases include autonomous 3D and 2D scanning of facilities for inspection, engineering and construction purposes.

Keywords: autonomous, SLAM, quadruped, mapping, exploring, ROS, robotics, navigation

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913 The Role of Vernacular Radio Stations in Enhancing Agricultural Development in Kenya; A Case of KASS FM

Authors: Thomas Kipkurgat, Silahs Chemwaina

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Communication and ICT is a crucial component in realization of vision 2030, radio has played a key role in dissemination of information to mass audience. Since time immemorial, mass media has played a vital role in passing information on agricultural development issues both locally and internationally. This paper aimed at assessing the role of community radio stations in enhancing agricultural development in Kenya. The paper sought to identify the main contributions of KASS FM radio in the agricultural development especially in rural areas, the study also aimed to establish the appropriate adjustments in editorial policies of KASS FM radio in helping to promote agricultural development related programmes in rural areas. Despite some weaknesses in radio programming and the mode of interaction with the rural people, the findings of this study showed that the rural communities are better off today than in the old days when FM radios were non-existent. KASS FM has come up with different developmental programmes that have positively contributed to changing the rural people’s ways of life. These programmes include farming, health, marital values, environment, cultural issues, human rights, democracy, religious teachings, peace and reconciliation. Such programmes feature experts, professionals and opinion leaders who address numerous topics of interest to the community. The local people participate in the production of these programmes through letters to the editor, and phone-ins, among others. Programmes such as political talk shows, which feature in KASS FM, has become one of the most important ways of community participation. The interpretation and conclusions are based on the empirical data analysis and the theories of development advanced by international development communication scholars, as presented in the paper. The study ends with some recommendations on how KASS FM can best serve the interests of the poor people in rural areas, and helps improve their lives.

Keywords: agriculture, development, communication, KASS FM, radio, rural areas, Kenya

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912 Integrated Mass Rapid Transit System for Smart City Project in Western India

Authors: Debasis Sarkar, Jatan Talati

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This paper is an attempt to develop an Integrated Mass Rapid Transit System (MRTS) for a smart city project in Western India. Integrated transportation is one of the enablers of smart transportation for providing a seamless intercity as well as regional level transportation experience. The success of a smart city project at the city level for transportation is providing proper integration to different mass rapid transit modes by way of integrating information, physical, network of routes fares, etc. The methodology adopted for this study was primary data research through questionnaire survey. The respondents of the questionnaire survey have responded on the issues about their perceptions on the ways and means to improve public transport services in urban cities. The respondents were also required to identify the factors and attributes which might motivate more people to shift towards the public mode. Also, the respondents were questioned about the factors which they feel might restrain the integration of various modes of MRTS. Furthermore, this study also focuses on developing a utility equation for respondents with the help of multiple linear regression analysis and its probability to shift to public transport for certain factors listed in the questionnaire. It has been observed that for shifting to public transport, the most important factors that need to be considered were travel time saving and comfort rating. Also, an Integrated MRTS can be obtained by combining metro rail with BRTS, metro rail with monorail, monorail with BRTS and metro rail with Indian railways. Providing a common smart card to transport users for accessing all the different available modes would be a pragmatic solution towards integration of the available modes of MRTS.

Keywords: mass rapid transit systems, smart city, metro rail, bus rapid transit system, multiple linear regression, smart card, automated fare collection system

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911 A Study on the Urban Design Path of Historical Block in the Ancient City of Suzhou, China

Authors: Yan Wang, Wei Wu

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In recent years, with the gradual change of Chinese urban development mode from 'incremental development' to 'stock-based renewal', the urban design method of ‘grand scene’ in the past could only cope with the planning and construction of incremental spaces such as new towns and new districts, while the problems involved in the renewal of the stock lands such as historic blocks of ancient cities are more complex. 'Simplified' large-scale demolition and construction may lead to the damage of the ancient city's texture and the overall cultural atmosphere; thus it is necessary to re-explore the urban design path of historical blocks in the conservation context of the ancient city. Through the study of the cultural context of the ancient city of Suzhou in China and the interpretation of its current characteristics, this paper explores the methods and paths for the renewal of historical and cultural blocks in the ancient city. It takes No. 12 and No. 13 historical blocks in the ancient city of Suzhou as examples, coordinating the spatial layout and the landscape and shaping the regional characteristics to improve the quality of the ancient city's life. This paper analyses the idea of conservation and regeneration from the aspects of culture, life, business form, and transport. Guided by the planning concept of ‘block repair and cultural infiltration’, it puts forward the urban design path of ‘conservation priority, activation and utilization, organic renewal and strengthening guidance’, with a view to continuing the cultural context and stimulating the vitality of ancient city, so as to realize the integration of history, modernity, space and culture. As a rare research on urban design in the scope of Suzhou ancient city, the paper expects to explore the concepts and methods of urban design for the historic blocks on the basis of the conservation of the history, space, and culture and provides a reference for other similar types of urban construction.

Keywords: historical block, Suzhou ancient city, stock-based renewal, urban design

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910 Comparative Efficacy of Vasodilators on Internal Mammary Artery Flow in Coronary Artery Bypass Grafting (CABG): A Systematic Review and Network Meta-Analysis

Authors: Umm E. Aimen Minhas, Sameen Tahira, Haneen Kamran, Syed Saad Ul Hassan, Haris Bin Khalid, Hadia Nadeem, Ahmed Sanan

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In coronary artery bypass grafting (CABG) patients, vasodilators play a key role in optimizing graft patency by preventing vasospasm and enhancing blood flow. Limited literature is available comparing the effectiveness of various vasodilators on IMA flow in CABG patients. Thus, the rationale for conducting this Network-meta-analysis is to identify the most efficacious vasodilator for increasing IMA flow in CABG patients. A systematic search of 3 databases yielded 357 studies, with 19 meeting inclusion criteria (18 RCTs, 1 observational study). The primary outcome was IMA flow, with secondary outcomes including central venous pressure (CVP) and mean arterial pressure (MAP). Analyses were conducted on an intention-to-treat basis using the net meta package in R. A frequentist random-effects model was employed, with consistency assessed via node-splitting and heterogeneity evaluated. The risk of bias was assessed using RoB 2 and ROBINS-I tools. Out of 92 possible pairwise comparisons, 11 were direct, and 3 included both direct and indirect evidence. Network ranking identified milrinone as the most effective vasodilator for improving IMA flow (SMD: 1.12; 95% CI: 0.36–1.87), followed by nitroglycerin (SMD: 0.51; 95% CI: 0.01–1.00). On the contrary, CO₂ insufflation significantly reduced IMA flow (SMD: -1.17; 95% CI: -2.28 to -0.06). Dobutamine significantly increased CVP, favoring placebo, with no notable differences in MAP across interventions. This analysis positions milrinone as a potentially superior agent for enhancing IMA flow in CABG, warranting its consideration as a first-line therapy. However, moderate to high heterogeneity and limited direct evidence highlight the need for more head-to-head trials.

Keywords: IMA flow, vasodilators, CABG, milrinone, cardiac outcomes

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909 Decomposition of Solidification Carbides during Cyclic Thermal Treatments in a Co-Based Alloy Deposit Applied to Stainless Steel

Authors: Sellidj Abdelaziz, Lebaili Soltane

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A cobalt-based alloy type Co-Cr-Ni-WC was deposited by plasma transferred arc projection (PTA) on a stainless steel valve. The alloy is characterized at the equilibrium by a solid solution Co (γ) mainly dendritic, and eutectic carbides M₇C₃ and ηM₆C. At the deposit/substrate interface, this microstructure is modified by the fast cooling mode of the alloy when applied in the liquid state on the relatively cold steel substrate. The structure formed in this case is heterogeneous and metastable phases can occur and evolve over temperature service. Coating properties and reliability are directly related to microstructures formed during deposition. We were interested more particularly in this microstructure formed during the solidification of the deposit in the region of the interface joining the soldered couple and its evolution during cyclic heat treatments at temperatures similar to those of the thermal environment of the valve. The characterization was carried out by SEM-EDS microprobe CAMECA, XRD, and micro hardness profiles. The deposit obtained has a linear and regular appearance that is free of cracks and with little porosity. The morphology of the microstructure represents solidification stages that are relatively fast with a temperature gradient high at the beginning of the interface by forming a plane front solid solution Co (γ). It gradually changes with the decreasing temperature gradient by getting farther from the junction towards the outer limit of the deposit. The matrix takes the forms: cellular, mixed (cells and dendrites) and dendritic. Dendritic growth is done according to primary ramifications in the direction of the heat removal which takes place in the direction perpendicular to the interface, towards the external surface of the deposit, following secondary and tertiary undeveloped arms. The eutectic carbides M₇C₃ and ηM₆C formed are very thin and are located in the intercellular and interdendritic spaces of the solid solution Co (γ).

Keywords: Co-Ni-Cr-W-C alloy, solid deposit, microstructure, carbides, cyclic heat treatment

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908 The Effect of Antibiotic Use on Blood Cultures: Implications for Future Policy

Authors: Avirup Chowdhury, Angus K. McFadyen, Linsey Batchelor

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Blood cultures (BCs) are an important aspect of management of the septic patient, identifying the underlying pathogen and its antibiotic sensitivities. However, while the current literature outlines indications for initial BCs to be taken, there is little guidance for repeat sampling in the following 5-day period and little information on how antibiotic use can affect the usefulness of this investigation. A retrospective cohort study was conducted using inpatients who had undergone 2 or more BCs within 5 days between April 2016 and April 2017 at a 400-bed hospital in the west of Scotland and received antibiotic therapy between the first and second BCs. The data for BC sampling was collected from the electronic microbiology database, and cross-referenced with data from the hospital electronic prescribing system. Overall, 283 BCs were included in the study, taken from 92 patients (mean 3.08 cultures per patient, range 2-10). All 92 patients had initial BCs, of which 83 were positive (90%). 65 had a further sample within 24 hours of commencement of antibiotics, with 35 positive (54%). 23 had samples within 24-48 hours, with 4 (17%) positive; 12 patients had sampling at 48-72 hours, 12 at 72-96 hours, and 10 at 96-120 hours, with none positive. McNemar’s Exact Test was used to calculate statistical significance for patients who received blood cultures in multiple time blocks (Initial, < 24h, 24-120h, > 120h). For initial vs. < 24h-post BCs (53 patients tested), the proportion of positives fell from 46/53 to 29/53 (one-tailed P=0.002, OR 3.43, 95% CI 1.48-7.96). For initial vs 24-120h (n=42), the proportions were 38/42 and 4/42 respectively (P < 0.001, OR 35.0, 95% CI 4.79-255.48). For initial vs > 120h (n=36), these were 33/36 and 2/36 (P < 0.001,OR ∞). These were also calculated for a positive in initial or < 24h vs. 24-120h (n=42), with proportions of 41/42 and 4/42 (P < 0.001, OR 38.0, 95% CI 5.22-276.78); and for initial or < 24h vs > 120h (n=36), with proportions of 35/36 and 2/36 respectively (P < 0.001, OR ∞). This data appears to show that taking an initial BC followed by a BC within 24 hours of antibiotic commencement would maximise blood culture yield while minimising the risk of false negative results. This could potentially remove the need for as many as 46% of BC samples without adversely affecting patient care. BC yield decreases sharply after 48 hours of antibiotic use, and may not provide any clinically useful information after this time. Further multi-centre studies would validate these findings, and provide a foundation for future health policy generation.

Keywords: antibiotics, blood culture, efficacy, inpatient

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907 The Effect of the Adhesive Ductility on Bond Characteristics of CFRP/Steel Double Strap Joints Subjected to Dynamic Tensile Loadings

Authors: Haider Al-Zubaidy, Xiao-Ling Zhao, Riadh Al-Mahaidi

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In recent years, the technique adhesively-bonded fibre reinforced polymer (FRP) composites has found its way into civil engineering applications and it has attracted a widespread attention as a viable alternative strategy for the retrofitting of civil infrastructure such as bridges and buildings. When adopting this method, adhesive has a significant role and controls the general performance and degree of enhancement of the strengthened and/or upgraded structures. This is because the ultimate member strength is highly affected by the failure mode which is considerably dependent on the utilised adhesive. This paper concerns with experimental investigations on the effect of the adhesive used on the bond between CFRP patch and steel plate under medium impact tensile loading. Experiment were conducted using double strap joints and these samples were prepared using two different types of adhesives, Araldite 420 and MBrace saturant. Drop mass rig was used to carry out dynamic tests at impact speeds of 3.35, 4.43 and m/s while quasi-static tests were implemented at 2mm/min using Instrone machine. In this test program, ultimate load-carrying capacity and failure modes were examined for all loading speeds. For both static and dynamic tests, the adhesive type has a significant effect on ultimate joint strength. It was found that the double strap joints prepared using Araldite 420 showed higher strength than those prepared utilising MBrace saturant adhesive. Failure mechanism for joints prepared using Araldite 420 is completely different from those samples prepared utilising MBrace saturant. CFRP failure is the most common failure pattern for joints with Araldite 420, whereas the dominant failure for joints with MBrace saturant adhesive is adhesive failure.

Keywords: CFRP/steel double strap joints, adhesives of different ductility, dynamic tensile loading, bond between CFRP and steel

Procedia PDF Downloads 236
906 Determinants of Cessation of Exclusive Breastfeeding in Ankesha Guagusa Woreda, Awi Zone, Northwest Ethiopia: A Cross-Sectional Study

Authors: Tebikew Yeneabat, Tefera Belachew, Muluneh Haile

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Background: Exclusive breast-feeding (EBF) is the practice of feeding only breast milk (including expressed breast milk) during the first six months and no other liquids and solid foods except medications. The time to cessation of exclusive breast-feeding, however, is different in different countries depending on different factors. Studies showed the risk of diarrhea morbidity and mortality is higher among none exclusive breast-feeding infants, common during starting other foods. However, there is no study that evaluated the time to cessation of exclusive breast-feeding in the study area. The aim of this study was to show time to cessation of EBF and its predictors among mothers of index infants less than twelve months old. Methods: We conducted a community-based cross-sectional study from February 13 to March 3, 2012 using both quantitative and qualitative methods. This study included a total of 592 mothers of index infant using multi-stage sampling method. Data were collected by using interviewer administered structured questionnaire. Bivariate and multivariate Cox regression analyses were performed. Results: Cessation of exclusive breast-feeding occurred in 392 (69.63%) cases. Among these, 224 (57.1%) happened before six months, while 145 (37.0%) and 23 (5.9%) occurred at six months and after six months of age of the index infant respectively. The median time for infants to stay on exclusive breast-feeding was 6.36 months in rural and 5.13 months in urban, and this difference was statistically significant on a Log rank (Cox-mantel) test. Maternal and paternal occupation, place of residence, postnatal counseling on exclusive breast-feeding, mode of delivery, and birth order of the index infant were significant predictors of cessation of exclusive breast-feeding. Conclusion: Providing postnatal care counseling on EBF, routine follow-up and support of those mothers having infants stressing for working mothers can bring about implementation of national strategy on infant and young child feeding.

Keywords: exclusive breastfeeding, cessation, median duration, Ankesha Guagusa Woreda

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905 Minimal Invasive Esophagectomy for Esophageal Cancer: An Institutional Review From a Dedicated Centre of Pakistan

Authors: Nighat Bakhtiar, Ali Raza Khan, Shahid Khan Khattak, Aamir Ali Syed

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Introduction: Chemoradiation followed by resection has been the standard therapy for resectable (cT1-4aN0-3M0) esophageal carcinoma. The optimal surgical approach remains a matter of debate. Therefore, the purpose of this study was to share our experiences of minimal invasive esophagectomies concerning morbidity, mortality and oncological quality. This study aims to enlighten the world about the surgical outcomes after minimally invasive esophagectomy at Shaukat Khanum Hospital Lahore. Objective: The purpose of this study is to review an institutional experience of Surgical outcomes of Minimal Invasive esophagectomies for esophageal cancer. Methodology: This retrospective study was performed after ethical approval at Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH&RC) Pakistan. Patients who underwent Minimal Invasive esophagectomies for esophageal cancer from March 2018 to March 2023 were selected. Data was collected through the human information system (HIS) electronic database of SKMCH&RC. Data was described using mean and median with minimum and maximum values for quantitative variables. For categorical variables, a number of observations and percentages were reported. Results: A total of 621 patients were included in the study, with the mean age of the patient was 39 years, ranging between 18-58 years. Mean Body Mass Index of patients was 21.2.1±4.1. Neo-adjuvant chemoradiotherapy was given to all patients. The mean operative time was 210.36 ± 64.51 minutes, and the mean blood loss was 121 milliliters. There was one mortality in 90 days, while the mean postoperative hospital stay was 6.58 days with a 4.64 standard deviation. The anastomotic leak rate was 4.2%. Chyle leak was observed in 12 patients. Conclusion: The minimal invasive technique is a safe approach for esophageal cancers, with minimal complications and fast recovery.

Keywords: minimal invasive, esophagectomy, laparscopic, cancer

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904 An Approach for Ensuring Data Flow in Freight Delivery and Management Systems

Authors: Aurelija Burinskienė, Dalė Dzemydienė, Arūnas Miliauskas

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This research aims at developing the approach for more effective freight delivery and transportation process management. The road congestions and the identification of causes are important, as well as the context information recognition and management. The measure of many parameters during the transportation period and proper control of driver work became the problem. The number of vehicles per time unit passing at a given time and point for drivers can be evaluated in some situations. The collection of data is mainly used to establish new trips. The flow of the data is more complex in urban areas. Herein, the movement of freight is reported in detail, including the information on street level. When traffic density is extremely high in congestion cases, and the traffic speed is incredibly low, data transmission reaches the peak. Different data sets are generated, which depend on the type of freight delivery network. There are three types of networks: long-distance delivery networks, last-mile delivery networks and mode-based delivery networks; the last one includes different modes, in particular, railways and other networks. When freight delivery is switched from one type of the above-stated network to another, more data could be included for reporting purposes and vice versa. In this case, a significant amount of these data is used for control operations, and the problem requires an integrated methodological approach. The paper presents an approach for providing e-services for drivers by including the assessment of the multi-component infrastructure needed for delivery of freights following the network type. The construction of such a methodology is required to evaluate data flow conditions and overloads, and to minimize the time gaps in data reporting. The results obtained show the possibilities of the proposing methodological approach to support the management and decision-making processes with functionality of incorporating networking specifics, by helping to minimize the overloads in data reporting.

Keywords: transportation networks, freight delivery, data flow, monitoring, e-services

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903 Role of Intralesional Tranexamic Acid in Comparison of Oral Tranexamic Acid in the Treatment of Melasma

Authors: Lubna Khondker

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Background: Melasma is a common pigmentary dermatosis, manifested by hyperpigmented macules or patches on the face, commonly occurring in females due to an acquired disorder in the melanogenesis process. Although several treatments are currently used, it remains a great challenge due to recurrence and refractory nature. It was recently reported that tranexamic acid (TA-plasmin inhibitor) is an effective treatment for melasma. Objective: This study aims to compare the efficacy and side effects of intralesional injection of Tranexamic acid with oral Tranexamic acid in the treatment of melasma. Methods: A clinical trial was done in the Department of Dermatology and Venereology, Bangabandhu Sheikh Mujib Medical University, for a period of 4 years. A total of 100 patients with melasma who did not respond to topical therapy were included in the study as group A and group B. Group A Patients were administered intralesional injection (10 mg/ml) of Tranexamic acid( TA) weekly for 6 weeks, and group B patients were treated with oral tranexamic acid 250 mg 12 hourly for 12 weeks after taking informed consent. The severity and extent of pigmentation were assessed by the modified melasma area severity index (MASI). The response to treatment was assessed by MASI at 4 weeks, 8 weeks, and 12 weeks after stopping treatment. Results: The study showed the MASI scores at the baseline, 4 weeks, 8 weeks, and 12 weeks in group A were 18.23±1.22, 6.14±3.26, 3.21±2.14 and 2.11±2.01 respectively, and in group B, 17.87±1.12, 11.21±6.25, 6.57±4.26 and 6.41±4.17 respectively. The mean MASI significantly reduced in group A compared to group B in the 4th, 8th, and 12th weeks. The present study showed that among group A patients, 56% rated excellent (>75% reduction) in outcome, 32% good (50-75% reduction), 8% moderate (25-50% reduction) and only 4% (<25% reduction) was unsatisfactory and among group B patients, 14% rated excellent in outcome, 28% good, 36% moderate and 22% was unsatisfactory. Overall improvement in our study in group A was 96% and in group B 78%. Side effects were negligible, and all the patients tolerated the treatment well. Conclusion: Based on our results, intralesional Tranexamic acid (10 mg/ml) is more effective and safer than oral Tranexamic acid in the treatment of melasma.

Keywords: intralesional tranexamic acid, melasma, oral tranexamic acid, MASI score

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902 Production of Single-Chain Antibodies against Common Epitopes of ErbB1 and ErbB2 Using Phage Display Antibody Library

Authors: Gholamreza Hashemitabr, Reza Valadan, Alireza Rafiei, Mohammad Reza Bassami

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Breast cancer is the most common malignancy among women worldwide. Cancer cells use a complex multilayer network of epidermal growth factor receptors (EGFRs) signaling pathways to support their survival and growth. The overlapping networks of EGFRs signaling pathways account for the failure of most ErbB-targeted therapies. The aim of this study was to enrich a pool of recombinant antibody fragments against common epitopes of ErbB1 and ErbB2 in order to simultaneous blockade of ErbBs signaling pathways. ErbB1 and ErbB2 were expressed stably in VERO cells. Selection of recombinant antibodies was performed on live cells expressing either of ErbB1 and ErbB2 receptors using subtractive phage display approach. The results of PCR and DNA fingerprinting in the last round of panning showed that most clones contained insert (80% and 85% for ErbB1 and ErbB2 respectively) with an identical restriction pattern. The selected clones showed positive reaction to both ErbB1 and ErbB2 receptors in phage-ELISA test. Furthermore, the resulting soluble antibody fragments recognized common epitopes of both immunoprecipitated ErbB1 and ErbB2 in western blot. Additionally, the antibodies directed against the dimerization domain of ErbB1 demonstrated a significant absorbance in EGF-stimulated VERO/ErbB1 cells than non-stimulated cells (1.91 and 1.09 respectively). Moreover, the results of dimerization inhibition test showed that these antibodies blocked ErbB1 and ErbB2 dimerization on the surface of ErbB1 and ErbB2 expressing VERO cells. Regarding the importance of pan-ErbB approach to cancer therapy, the antibodies developed here might provide novel therapeutics for simultaneous blockade of ErbBs signaling pathways.

Keywords: breast cancer, single-chain antibody, ErbB1, ErbB2, epitope

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901 Prospective Analysis of Micromobility in the City of Medellín

Authors: Saúl Rivero, Estefanya Marín, Katherine Bolaño, Elena Urán, Juan Yepes, Andrés Cossio

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Medellín is the Colombian city with the best public transport systems in the country, which is made up of two metro lines, five metrocables, two BRT-type bus lines, and a tram. But despite the above, the Aburrá Valley, the area in which the city is located, has about 3000 km of roads, which for the existing population of 3.2 million inhabitants, gives an indicator of 900 meters of road per 1000 inhabitants, which is lower than the country's average, which is approximately 3900 meters. In addition, given that in Medellín, there is approximately one vehicle for every three inhabitants, the problems of congestion and environmental pollution have worsened over the years. In this sense, due to the limitations of physical space, the low public investment in road infrastructure, it is necessary to opt for mobility alternatives according to the above. Among the options for the city, there is what is known as micromobility. Micromobility is understood to be those small and light means of transport that are used for short distances, that use electrical energy, such as skateboards and bicycles. Taking into account the above, in this work, the current state and future of micromobility in the city of Medellín were analyzed, carrying out a prospective analysis, supported by a PEST analysis, but also of the crossed impact matrices; of influence and dependence; and the technique of the actor's game. The analysis was carried out for two future scenarios: one normal and one optimistic. Result of the analysis, it was determined that micromobility as an alternative social practice to mobility in the city of Medellín has favorable conditions since the local government has adopted strategies such as the Metropolitan Bicycle Master Plan of Valle de Aburrá and the plan " Bicycle paths in the city: more public spaces for life,” where a projection of 400 kilometers of bicycle paths was estimated by the year 2030, as for that same year it is expected that 10% of all trips in the region will be in bike mode. The total trip indicator is an achievable goal, while that of the number of kilometers of bike paths would be close to being met.

Keywords: electric vehicles, micromobilty, public transport, sustainable transport

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900 Initiation of Paraptosis-Like PCD Pathway in Hepatocellular Carcinoma Cell Line by Hep88 mAb through the Binding of Mortalin (HSPA9) and Alpha-Enolase

Authors: Panadda Rojpibulstit, Suthathip Kittisenachai, Songchan Puthong, Sirikul Manochantr, Pornpen Gamnarai, Sasichai Kangsadalampai, Sittiruk Roytrakul

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Hepatocellular carcinoma (HCC) is the most primary hepatic cancer worldwide. Nowadays a targeted therapy via monoclonal antibodies (mAbs) specific to tumor-associated antigen is continually developed in HCC treatment. In this regard, after establishing and consequently exploring Hep88 mAb’s tumoricidal effect on hepatocellular carcinoma cell line (HepG2 cell line), the Hep88 mAb’s specific Ag from both membrane and cytoplasmic fractions of HepG2 cell line was identified by 2-D gel electrophoresis and western blot analysis. After in-gel digestion and subsequent analysis by liquid chromatography-mass spectrometry (LC-MS), mortalin (HSPA9) and alpha-enolase were identified. The recombinant proteins specific to Hep88 mAb were cloned and expressed in E.coli BL21 (DE3). Moreover, alteration of HepG2 and Chang liver cell line after being induced by Hep88 mAb for 1-3 days was investigated using a transmission electron microscope. The result demonstrated that Hep88 mAb can bind to the recombinant mortalin (HSPA9) andalpha-enolase. In addition, gradual appearance of mitochondria vacuolization and endoplasmic reticulum dilatation were observed. Taken together, paraptosis-like programmed cell death (PCD) of HepG2 is induced by binding of mortalin (HSPA9) and alpha-enolase to Hep88 mAb. Mortalin depletion by formation of Hep88 mAb-mortalin (HSPA9) complex might initiate transcription-independent of p53-mediated apoptosis. Additionally, Hep88 mAb-alpha-enolase complex might initiate HepG2 cells energy exhaustion by glycolysis pathway obstruction. These results imply that Hep88 mAb might be a promising tool for development of an effective treatment of HCC in the next decade.

Keywords: Hepatocellular carcinoma, Monoclonal antibody, Paraptosis-like program cell death, Transmission electron microscopy, mortalin (HSPA9), alpha-enolase

Procedia PDF Downloads 361
899 The Transcutaneous Auricular Vagus Nerve Stimulation in Treatment of Depression and Anxiety Disorders in Recovery Patient with Feeding and Eating Disorders

Authors: Y. Melis, E. Apicella, E. Dozio, L. Mendolicchio

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Introduction: Feeding and Eating Disorders (FED) represent the psychiatric pathology with the highest mortality rate and one of the major disorders with the highest psychiatric and clinical comorbidity. The vagus nerve represents one of the main components of the sympathetic and parasympathetic nervous system and is involved in important neurophysiological functions. In FED, there is a spectrum of symptoms which with TaVNS (Transcutaneous Auricular Vagus Nerve Stimulation) therapy, is possible to have a therapeutic efficacy. Materials and Methods: Sample subjects are composed of 15 female subjects aged > 18 ± 51. Admitted to a psychiatry community having been diagnosed according to DSM-5: anorexia nervosa (AN) (N= 9), bulimia nervosa (BN) (N= 5), binge eating disorder (BED) (N= 1). The protocol included 9 weeks of Ta-VNS stimulation at a frequency of 1.5-3.5 mA for 4 hours per day. The variables detected are the following: Heart Rate Variability (HRV), Hamilton Depression Rating Scale (HAMD-HDRS-17), Body Mass Index (BMI), Beck Anxiety Index (BAI). Results: Data analysis showed statistically significant differences between recording times (p > 0.05) in HAM-D (t0 = 18.28 ± 5.31; t4 = 9.14 ± 7.15), in BAI (t0 = 24.7 ± 10.99; t4 = 13.8 ± 7.0). The reported values show how during (T0-T4) the treatment there is a decay of the degree in the depressive state, in the state of anxiety, and an improvement in the value of BMI. In particular, the BMI in the AN-BN sub-sample had a minimum gain of 5% and a maximum of 11%. The analysis of HRV did not show a clear change among subjects, thus confirming the discordance of the activity of the sympathetic and parasympathetic nervous system in FED. Conclusions: Although the sample does not possess a relevant value to determine long-term efficacy of Ta-VNS or on a larger population, this study reports how the application of neuro-stimulation in FED may become a further approach therapeutic. Indeed, substantial improvements are highlighted in the results and confirmed hypotheses proposed by the study.

Keywords: feeding and eating disorders, neurostimulation, anxiety disorders, depression

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898 Three-Dimensional Computer Graphical Demonstration of Calcified Tissue and Its Clinical Significance

Authors: Itsuo Yokoyama, Rikako Kikuti, Miti Sekikawa, Tosinori Asai, Sarai Tsuyoshi

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Introduction: Vascular access for hemodialysis therapy is often difficult, even for experienced medical personnel. Ultrasound guided needle placement have been performed occasionally but is not always helpful in certain cases with complicated vascular anatomy. Obtaining precise anatomical knowledge of the vascular structure is important to prevent access-related complications. With augmented reality (AR) device such as AR glasses, the virtual vascular structure is shown superimposed on the actual patient vessels, thus enabling the operator to maneuver catheter placement easily with free both hands. We herein report our method of AR guided vascular access method in dialysis treatment Methods: Three dimensional (3D) object of the arm with arteriovenous fistula is computer graphically created with 3D software from the data obtained by computer tomography, ultrasound echogram, and image scanner. The 3D vascular object thus created is viewed on the screen of the AR digital display device (such as AR glass or iPad). The picture of the vascular anatomical structure becomes visible, which is superimposed over the real patient’s arm, thereby the needle insertion be performed under the guidance of AR visualization with ease. By this method, technical difficulty in catheter placement for dialysis can be lessened and performed safely. Considerations: Virtual reality technology has been applied in various fields and medical use is not an exception. Yet AR devices have not been widely used among medical professions. Visualization of the virtual vascular object can be achieved by creation of accurate three dimensional object with the help of computer graphical technique. Although our experience is limited, this method is applicable with relative easiness and our accumulating evidence has suggested that our method of vascular access with the use of AR can be promising.

Keywords: abdominal-aorta, calcification, extraskeletal, dialysis, computer graphics, 3DCG, CT, calcium, phosphorus

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897 Decisional Regret in Men with Localized Prostate Cancer among Various Treatment Options and the Association with Erectile Functioning and Depressive Symptoms: A Moderation Analysis

Authors: Caren Hilger, Silke Burkert, Friederike Kendel

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Men with localized prostate cancer (PCa) have to choose among different treatment options, such as active surveillance (AS) and radical prostatectomy (RP). All available treatment options may be accompanied by specific psychological or physiological side effects. Depending on the nature and extent of these side effects, patients are more or less likely to be satisfied or to struggle with their treatment decision in the long term. Therefore, the aim of this study was to assess and explain decisional regret in men with localized PCa. The role of erectile functioning as one of the main physiological side effects of invasive PCa treatment, depressive symptoms as a common psychological side effect, and the association of erectile functioning and depressive symptoms with decisional regret were investigated. Men with localized PCa initially managed with AS or RP (N=292) were matched according to length of therapy (mean 47.9±15.4 months). Subjects completed mailed questionnaires assessing decisional regret, changes in erectile functioning, depressive symptoms, and sociodemographic variables. Clinical data were obtained from case report forms. Differences among the two treatment groups (AS and RP) were calculated using t-tests and χ²-tests, relationships of decisional regret with erectile functioning and depressive symptoms were computed using multiple regression. Men were on average 70±7.2 years old. The two treatment groups differed markedly regarding decisional regret (p<.001, d=.50), changes in erectile functioning (p<.001, d=1.2), and depressive symptoms (p=.01, d=.30), with men after RP reporting higher values, respectively. Regression analyses showed that after adjustment for age, tumor risk category, and changes in erectile functioning, depressive symptoms were still significantly associated with decisional regret (B=0.52, p<.001). Additionally, when predicting decisional regret, the interaction of changes in erectile functioning and depressive symptoms reached significance for men after RP (B=0.52, p<.001), but not for men under AS (B=-0.16, p=.14). With increased changes in erectile functioning, the association of depressive symptoms with decisional regret became stronger in men after RP. Decisional regret is a phenomenon more prominent in men after RP than in men under AS. Erectile functioning and depressive symptoms interact in their prediction of decisional regret. Screening and treating depressive symptoms might constitute a starting point for interventions aiming to reduce decisional regret in this target group.

Keywords: active surveillance, decisional regret, depressive symptoms, erectile functioning, prostate cancer, radical prostatectomy

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896 Description of the Process Which Determine the Criterion Validity of Semi-Structured Interview PARA-SCI.CZ

Authors: Jarmila Štěpánová, Martin Kudláček, Lukáš Jakubec

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The people with spinal cord injury are one of the least sport active members of our society. Their hypoactivity is determined by primary injury, i.e., the loss of motor function, the injured part of the body is connected with health complications and social handicap. Study performs one part of the standardization process of semi-structured interview PARA-SCI.CZ (Czech version of the Physical Activity Recall Assessment for People with Spinal Cord Injury), which measures the type, frequency, duration, and intensity of physical activity of people with spinal cord injury. The study focused on persons with paraplegia who use a wheelchair as their primary mode of mobility. The aim of this study was to perform a process to determine the criterion validity of PARA-SCI.CZ. The actual physical activity of wheelchair users was monitored during three days by using accelerometers Actigraph GT3X fixed on the non-dominant wrist, and semi-structured interview PARA-SCI.CZ. During the PARA-SCI.CZ interview, participants were asked to recall activities they had done over the past 3 days, starting with the previous day. PARA-SCI.CZ captured frequency, duration, and intensity (low, moderate, and heavy) of two categories of physical activity (leisure time physical activity and activities of a usual day). Accelerometer Actigraph GT3X captured duration and intensity (low and moderate + heavy) of physical activity during three days and nights. The study presented three potential recalculations of measured data. Standardization process of PARA-SCI.CZ is essential to critically approach issues of health and active lifestyle of persons with spinal cord injury in the Czech Republic. Standardized PARA-SCI.CZ can be used in practice by physiotherapists and sports pedagogues from the field of adapted physical activities.

Keywords: physical activity, lifestyle, paraplegia, semi-structure interview, accelerometer

Procedia PDF Downloads 326
895 Screening of Lactic Acid Bacteria Isolated from Traditional Fermented Products: Potential Probiotic Bacteria with Antimicrobial and Cytotoxic Activities

Authors: Genesis Julyus T. Agcaoili, Esperanza C. Cabrera

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Thirty (30) isolates of lactic acid bacteria (LAB) from traditionally-prepared fermented products specifically fermented soy-bean paste, fermented mustard and fermented rice-fish mixture were studied for their in vitro antimicrobial and cytotoxic activities. Seventeen (17) isolates were identified as Lactobacillus plantarum, while 13 isolates were identified as Enterococcus spp using 16s rDNA sequences. Disc diffusion method was used to determine the antibacterial activity of LAB against Staphylococcus aureus (ATCC 25923) and Escherichia coli (ATCC 25922), while the modified agar overlay method was used to determine the antifungal activity of LAB isolates on the yeast Candida albicans, and the dermatophytes Microsporum gypseum, Trichophyton rubrum and Epidermophyton floccosum. The filter-sterilized LAB supernatants were evaluated for their cytotoxicity to mammalian colon cancer cell lines (HT-29 and HCT116) and normal human dermal fibrolasts (HDFn) using resazurin assay (PrestoBlueTM). Colchicine was the positive control. No antimicrobial activity was observed against the bacterial test organisms and the yeast Candida albicans. On the other hand, all of the tested LAB strains were fungicidal for all the test dermatophytes. Cytotoxicity index profiles of the supernatants of the 15 randomly picked LABs and negative control (brain heart infussion broth) suggest nontoxicity to the cells when compared to colchicine, whereas all LAB supernatants were found to be cytotoxic to HT-29 and HCT116 colon cancer cell lines. Results provide strong support for the role of the lactic acid bacteria studied in antimicrobial treatment and anticancer therapy.

Keywords: antimicrobial, fermented products, fungicidal activity, lactic acid bacteria, probiotics

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894 Correlation between Flexible Flatfoot and Lumbosacral Angle

Authors: Moustafa Elwan, Sohier Shehata, Fatma Sedek, Manar Hussine

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One of the most risky factors that lead to a foot injury during physical activities are both high and low arched feet. Normally the medial longitudinal arch of the foot develops in the first 10 years of life, so flexible flat foot has an inversely relationship with age in the first decade, all over the world, the prevalence of flat foot is increasing. In approximately 15% of foot deformities cases, the deformity does not disappear and remains throughout adulthood, 90% of the clinical cases are complaining from foot problems are due to flatfoot. Flatfoot creates subtalar over pronation, which creates tibial and femoral medial rotation, and that is accompanied with increases of pelvic tilting anteriorly, which may influence the lumbar vertebrae alignment by increasing muscle tension and rotation. Objective: To study the impact of the flexible flatfoot on lumbosacral angle (angle of Ferguson). Methods: This experiment included 40 volunteers (14 females &26 males) gathered from the Faculty of Physical Therapy, Modern University of Technology and Information, Cairo, Egypt, for each participant, four angles were measured in the foot( talar first metatarsal angle, lateral talocalcaneal angle, , Calcaneal first metatarsal angle, calcaneal inclination angle) and one angle in the lumbar region (lumbosacral angle). Measurement of these angles was conducted by using Surgimap Spine software (version 2.2.9.6). Results: The results demonstrated that there was no significant correlation betweenFerguson angle and lateral talocalcaneal (r=0.164, p=0.313). Also, there was no significant correlation between Ferguson angle and talo first metatarsal “Meary’s angle" (r=0.007, p=0.968). Moreover, there was no significant correlation between Ferguson angle and calcaneal-first metatarsal angle (r=0.083, p=0.612). Also, there was no significant correlation between Ferguson angle and calcaneal inclination angle (r= 0.032, p= 0.846). Conclusion: It can be concluded that there is no significant correlation between the flexible flat foot and lumbosacral angle So, more study should be conducted in large sample and different ages and conditions of foot problems.

Keywords: calcaneal first metatarsal, calcaneal inclination, flatfoot, ferguson’s angle, lateral talocalcaneal angle, lumbosacral angle, and talar first metatarsal angle

Procedia PDF Downloads 136