Search results for: adverse drug events
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4911

Search results for: adverse drug events

1701 Prevalence of Extended Spectrum of Beta Lactamase Producers among Gram Negative Uropathogens

Authors: Y. V. S. Annapurna, V. V. Lakshmi

Abstract:

Urinary tract infection (UTI) is one of the most common infectious diseases at the community level with a high rate of morbidity . This is further augmented by increase in the number of resistant and multi resistant strains of bacteria particularly by those producing Extended spectrum of beta lactamases. The present study was aimed at analysis of antibiograms of E.coli and Klebsiella sp causing urinary tract infections. Between November 2011 and April 2013, a total of 1120 urine samples were analyzed,. Antibiotic sensitivity testing was done with 542(48%) isolates of E.coli and 446(39%) of Klebsiella sp using the standard disc diffusion method against eleven commonly used antibiotics .Organisms showed high susceptibility to Amikacin and Netilimicin and low susceptibility to Cephalosporins. MAR index was calculated for the multidrug resistant strains. Maximum MAR index detected among the isolates was 0.9. Phenotypic identification for ESBL production was confirmed by double disk synergy test (DDST) according to CLSI guidelines. Plasmid profile of the isolates was carried out using alkaline hydrolysis method. Agarose-gel electrophoresis showed presence of high-molecular weight plasmid DNA among the ESBL strains. This study emphasizes the importance of indiscriminate use of antibiotics which if discontinued, in turn would prevent further development of bacterial drug resistance. For this, a proper knowledge of susceptibility pattern of uropathogens is necessary before prescribing empirical antibiotic therapy and it should be made mandatory.

Keywords: escherichia coli, extended spectrum of beta lactamase, Klebsiella spp, Uropathogens

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1700 Ameliorative Effect of Martynia annua Linn. on Collagen-Induced Arthritis via Modulating Cytokines and Oxidative Stress in Mice

Authors: Alok Pal Jain, Santram Lodhi

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Martynia annua Linn. (Martyniaccae) is traditionally used in inflammation and applied locally to tuberculosis glands of camel’s neck. The leaves used topically to bites of venomous insects and wounds of domestic animals. Chemical examination of Martynia annua leaves revealed the presence of glycosides, tannins, proteins, phenols and flavonoids. The present study was aimed to evaluate the anti-arthritic activity of methanolic extract of Martynia annua leaves. Methanolic extract of Martynia annua leaves was tested by using in vivo collagen-induced arthritis mouse model to investigate the anti-rheumatoid arthritis activity. In addition, antioxidant effect of methanolic extract was determined by the estimation of antioxidants level in joint tissues. The severity of arthritis was assessed by arthritis score and edema. Levels of cytokines TNF-α and IL-6, in the joint tissue homogenate were measured using ELISA. A high dose (250 mg/kg) of methanolic extract was significantly reduced the degree of inflammation in mice as compared with reference drug. Antioxidants level and malondialdehyde (MDA) in joint tissue homogenate found significantly (p < 0.05) higher. Methanolic extract at dose of 250 mg/kg modulated the cytokines production and suppressed the oxidative stress in the mice with collagen-induced arthritis. This study suggested that Martynia annua might be alternative herbal medicine for the management of rheumatoid arthritis.

Keywords: Martynia annua, collagen, rheumatoid arthritis, antioxidants

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1699 Use of Amaranthus Roxburghianus Root Extract in the Treatment of Ulcerative Colitis in Mice

Authors: S. A. Nirmal, J. M. Ingale, G. S. Asane, S. C. Pal, Subhash C. Mandal

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The present work was undertaken to determine the effects of Amaranthus roxburghianus Nevski. (Amaranthaceae) root alone and in combination with piperine in treating ulcerative colitis (UC) in mice. Swiss albino mice were divided into seven groups (n = 6). Standard group received prednisolone (5 mg/kg, i.p.). Treatment groups received hydroalcoholic extract of roots of A. roxburghianus (50 and 100 mg/kg, p.o.) and a combination of hydroalcoholic extract of roots of A. roxburghianus (50 and 100 mg/kg, p.o.) and piperine (5 mg/kg, p.o.). Ulcer index, colitis severity, myeloperoxidase (MPO), malondialdehyde and glutathione were estimated from blood and tissue. Column chromatography of the extract was done and purified fractions were analyzed by gas chromatography-mass spectroscopy (GC-MS). Treatment with the combination of hydroalcoholic extract of A. roxburghianus and piperine showed minimal ulceration, hemorrhage, necrosis and leucocyte infiltration by histopathological observation. Acetic acid increased MPO levels in blood and colon tissue to 355 U/mL and 385 U/mg, respectively. The combination of hydroalcoholic extract (100 mg/kg) and piperine (5 mg/kg) significantly decreased MPO in blood and tissue to 182 U/mL and 193 U/mg, respectively. Similarly, this combination significantly reduced MPO and increased glutathione levels in blood and tissue. Various phytoconstituents were detected by GC-MS. The combination of hydroalcoholic extract and piperine is effective in the treatment of UC and the effects are comparable with the standard drug prednisolone. 4H-pyran-4-one, 2,3-dihydro-3,5-dihydroxy-6-methyl, eugenol and benzene, and 1-(1,5-dimethyl-4-hexenyl)-4-methyl are reported having analgesic, anti-inflammatory, and antioxidant properties; they may play a role in the biological activity of A. roxburghianus root.

Keywords: Amaranthus roxburghianus, ulcerative colitis, anti-inflammatory, ulcerative colitis

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1698 Understanding the Mechanisms of Salmonella typhimurium Resistance to Cannabidiol

Authors: Iddrisu Ibrahim, Joseph Atia Ayariga, Junhuan Xu, Daniel Abugri, Boakai Robertson, Olufemi S. Ajayi

Abstract:

The emergence of multidrug resistance poses a huge risk to public health globally. Yet these recalcitrant pathogens continue to rise in incidence rate, with resistance rates significantly outpacing the speed of antibiotic development. This, therefore, presents an aura of related health issues such as untreatable nosocomial infections arising from organ transplants and surgeries, as well as community-acquired infections that are related to people with compromised immunity, e.g., diabetic and HIV patients, etc. There is a global effort to fight multidrug-resistant pathogens spearheaded by the World Health Organization, thus calling for research into novel antimicrobial agents to fight multiple drug resistance. Previously, our laboratory demonstrated that Cannabidiol (CBD) was an effective antimicrobial against Salmonella typhimurium (S. typhimurium). However, we observed resistance development over time. To understand the mechanisms S. typhimurium uses to develop resistance to Cannabidiol (CBD), we studied the abundance of bacteria lipopolysaccharide (LPS) and membrane sterols of both susceptible and resistant S. typhimurium. Using real-time quantitative polymerase chain reaction (RT-qPCR), we also analyzed the expression of selected genes known for aiding resistance development in S. typhimurium. We discovered that there was a significantly higher expression of blaTEM, fimA, fimZ, and integrons in the CBD-resistant bacteria, and these were also accompanied by a shift in abundance in cell surface molecules such as lipopolysaccharide (LPS) and sterols.

Keywords: antimicrobials, resistance, cannabidiol, gram-negative bacteria, integrons, blaTEM, Fim, LPS, ergosterols

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1697 On the Principles of Self-determination, Remedial Secession, and Responsibility to Protect: The Case of Nagorno Karabakh

Authors: Sara Melkonyan

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Over the past decades, the political (and partly legal) doctrine of remedial secession has emerged on the basis of the development of internationally recognized human rights and rights of peoples stemming from various multilateral treaties, which stipulates that aggrieved and persecuted nations have the right to secede from the parent state as a remedy for their continuous and unstoppable grievances. The 44-day war in Nagorno-Karabakh and the following events posed severe challenges for Nagorno-Karabakh and its people. Constant aggression and threat, the humanitarian crisis caused by the closure of the Lachin Corridor, the persistent threat of ethnic cleansing of Artsakhi Armenians, and the state policy that has been executed towards Artsakhi people by the Azerbaijani authorities come to prove that the Artsakhi people cannot survive under Azerbaijani control and secession may be the last resort for ending oppression. The paper tries to make parallels with similar cases and discuss the doctrine of remedial secession applied selectively among different cases. This paper aims to figure out why in some cases the secessionist movements succeeded to gain independence based on the doctrine of remedial secession, in other cases, they refused to gain recognition from the international community. Through analyzing the domestic-level and then international-level factors, the study concluded that the doctrine of remedial secession is inherently in the political realm and almost impossible to draw substantial “recipes” for warranting secession, and the latter is not applied similarly among the cases, so its success mainly depends on the geopolitical interests of the great powers involved.

Keywords: R2P, remedial secession, self-determination, conflicts

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1696 Phytoplankton Diversity and Abundance in Burullus Lagoon, Southern Mediterranean Coast, Egypt

Authors: Shymaa S. Zaher, Hesham M. Abd El-Fatah, Dina M. Ali

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Burullus Lagoon is the second largest lake, along the Mediterranean seashore. It exposed to over nutrient enrichment from fish farming and agricultural drainage wastes. This study assesses the present status phytoplankton response to different flow events, including domestic, agricultural, industrial, and fish farms discharge in the three main sectors of Burullus Lagoon, to focus on the influence of environmental variables on phytoplankton species composition inhabiting the Lagoon. Twelve sites representing the eastern, central, and western basin were selected during winter and summer 2018. Among the most abundant group, Chlorophyceae came in the first rank by 37.9% of the total phytoplankton densities, Bacillariophyceae (29.31%), Cyanophyceae (20.7%), Euglenophyceae (8.63%) and Dinophyceae (3.4%). Cyclotella menenghiana was the most abundant diatoms, while Scenedesmus quadricauda, S. acuminatus, and S. bijuga were highly recorded nearby the drains (in the middle sector). Phytoplankton in Burullus Lagoon attained the lowest values during the winter season and the highest ones during the summer season. The total count of phytoplankton in the middle and western basin of the lake was higher than that of the eastern part. Excessive use of chemical fertilizers, pesticides, and washing out of nutrients loaded to the drainage water, leading to a significant pronounced decrease in community composition and standing crop of phytoplankton in Burullus Lake from year to year, hold the danger of shifting the lagoon ecosystem.

Keywords: Burullus Lagoon, environmental variables, phytoplankton, water pollution

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1695 Design Considerations for the Construction of an Open Decontamination Facility for Managing Civil Emergencies

Authors: Sarmin, S., Ologuin, R.S.

Abstract:

Background: Rapid population growth and land constraints in Singapore results in a possible situation in which we face a higher number of casualties and lack of operational space in healthcare facilities during disasters and HAZMAT events, collectively known as Civil Emergencies. This creates a need for available working space within hospital grounds to be amphibious or multi-functional, to ensure the institution’s capability to respond efficiently to Civil Emergencies. The Emergency Department (ED) mitigates this issue by converting the Ambulance Assembly Area used during peacetime into an Open Decontamination Facility (ODF) during Civil Emergency Response, for decontamination of casualties before they proceed to treatment areas into Ambulance Assembly Area used during peacetime. Aims: To effectively operationalize the Open Decontamination Facility (ODF) through the reduction of manual handling. Methods: From past experiences on Civil Emergency exercises, it was labor-intensive for staff to set up the Open Decontamination Facility (ODF). Manual handling to set up the Decontamination lanes by bringing down the curtains and supply of water was required to be turned on. Conclusion: The effectiveness of the design construction of an Open Decontamination Facility (ODF) is based on the use of automation of bringing down the curtains on the various lanes. The use of control panels for water supply to decontaminate patients. Safety within the ODF was considered with the installation of panic buttons, intercom for staff communication, and perimeter curtains were installed with stability arm to manage the condition with high wind velocity.

Keywords: civil emergencies, disaster, emergency department, Hazmat

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1694 Projections of Climate Change in the Rain Regime of the Ibicui River Basin

Authors: Claudineia Brazil, Elison Eduardo Bierhals, Francisco Pereira, José Leandro Néris, Matheus Rippel, Luciane Salvi

Abstract:

The global concern about climate change has been increasing, since the emission of gases from human activities contributes to the greenhouse effect in the atmosphere, indicating significant impacts to the planet in the coming years. The study of precipitation regime is fundamental for the development of research in several areas. Among them are hydrology, agriculture, and electric sector. Using the climatic projections of the models belonging to the CMIP5, the main objective of the paper was to present an analysis of the impacts of climate change without rainfall in the Uruguay River basin. After an analysis of the results, it can be observed that for the future climate, there is a tendency, in relation to the present climate, for larger numbers of dry events, mainly in the winter months, changing the pluviometric regime for wet summers and drier winters. Given this projected framework, it is important to note the importance of adequate management of the existing water sources in the river basin, since the value of rainfall is reduced for the next years, it may compromise the dynamics of the ecosystems in the region. Facing climate change is fundamental issue for regions and cities all around the world. Society must improve its resilience to phenomenon impacts, and spreading the knowledge among decision makers and citizens is also essential. So, these research results can be subsidies for the decision-making in planning and management of mitigation measures and/or adaptation in south Brazil.

Keywords: climate change, hydrological potential, precipitation, mitigation

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1693 Towards a Reinvented Cash Management Function: Mobilising Innovative Advances for Enhanced Performance and Optimised Cost Management: Insights from Large Moroccan Companies in the Casablanca-Settat Region

Authors: Badrane Nohayla, Bamousse Zineb

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Financial crises, exchange rate volatility, fluctuations in commodity prices, increased competitive pressures, and environmental issues are all threats that businesses face. In light of these diverse challenges, proactive, agile, and innovative cash management becomes an indispensable financial shield, allowing companies to thrive despite the adverse conditions of the global environment. In the same spirit, uncertainty, turbulence, volatility, and competitiveness continue to disrupt economic environments, compelling companies to swiftly master innovative breakthroughs that provide added value. In such a context, innovation emerges as a catalytic vector for performance, aiming to reduce costs, strengthen growth, and ultimately ensure the sustainability of Moroccan companies in the national arena. Moreover, innovation in treasury management promises to be one of the key pillars of financial stability, enabling companies to navigate the tumultuous waters of a globalized environment. Therefore, the objective of this study is to better understand the impact of innovative treasury management on cost optimization and, by extension, performance improvement. To elucidate this relationship, we conducted an exploratory qualitative study with 20 large Moroccan companies operating in the Casablanca-Settat region. The results highlight that innovation at the heart of treasury management is a guarantee of sustainability against the risks of failure and stands as a true pivot of the performance of Moroccan companies, an important parameter of their financial balance and a catalytic vector of their growth in the national economic landscape. In this regard, the present study aims to explore the extent to which innovation at the core of the treasury function serves as an indispensable tool for boosting performance while optimising costs in large Moroccan companies.

Keywords: innovative cash management, artificial intelligence, financial performance, risk management, cost savings

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1692 Modulation of Fish Allergenicity towards the Production of a Low Allergen Farmed Fish

Authors: Denise Schrama, Claudia Raposo, Pedro Rodrigues

Abstract:

Background: Food allergies are conducted by a hypersensitive response of the immune system. These allergies are a global concern for the public health. Consumption of fish is increasing worldwide as it is a healthy meat with high nutritional value. Unfortunately, fish can cause adverse immune-mediate reactions, affecting part of the population with higher incidence in children. β-parvalbumin, a small, highly conserved stable, calcium or magnesium binding muscle protein is the main fish allergen. In fish-allergic patients, cross-reactivity between different fish species exist due to recognition of highly identical protein regions. Enolases, aldolases, or fish gelatin are other identified fish allergens in some fish species. With no available cure for fish allergies, clinical management is only based on an avoidance diet aiming at the total exclusion of offending food. Methods: Mediterranean fish (S. aurata and D. labrax) were fed specifically designed diets, enriched in components that target the expression or inactivation of parvalbumin (creatine and EDTA, respectively). After 90 days fish were sampled and biological tissues were excised. Proteomics was used to access fish allergens characterization and expression in muscle while IgE assays to confirm the lower allergenic potential are conducted in patients with history of fish allergies. Fish welfare and quality of flesh were established with biochemical, texture and sensorial analysis. Results: Fish welfare shows no major impact between diets. In case of creatine supplementation in D. labrax proteomic analysis show a slight decrease in parvalbumin expression. No accumulation of this compound was found in muscle. For EDTA supplementation in S. aurata IgE assay show a slight decrease in allergenicity when using sera of fish allergic patients. Conclusion: Supplementation with these two compounds seems to change slightly the allergenicity of the two mean Mediterranean species.

Keywords: fish allergies, fish nutrition, proteomics, aquaculture

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1691 Hydrological Modeling and Climate Change Impact Assessment Using HBV Model, A Case Study of Karnali River Basin of Nepal

Authors: Sagar Shiwakoti, Narendra Man Shakya

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The lumped conceptual hydrological model HBV is applied to the Karnali River Basin to estimate runoff at several gauging stations and to analyze the changes in catchment hydrology and future flood magnitude due to climate change. The performance of the model is analyzed to assess its suitability to simulate streamflow in snow fed mountainous catchments. Due to the structural complexity, the model shows difficulties in modeling low and high flows accurately at the same time. It is observed that the low flows were generally underestimated and the peaks were correctly estimated except for some sharp peaks due to isolated precipitation events. In this study, attempt has been made to evaluate the importance of snow melt discharge in the runoff regime of the basin. Quantification of contribution of snowmelt to annual, summer and winter runoff has been done. The contribution is highest at the beginning of the hot months as the accumulated snow begins to melt. Examination of this contribution under conditions of increased temperatures indicate that global warming leading to increase in average basin temperature will significantly lead to higher contributions to runoff from snowmelt. Forcing the model with the output of HadCM3 GCM and the A1B scenario downscaled to the station level show significant changes to catchment hydrology in the 2040s. It is observed that the increase in runoff is most extreme in June - July. A shift in the hydrological regime is also observed.

Keywords: hydrological modeling, HBV light, rainfall runoff modeling, snow melt, climate change

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1690 Management of Urban Watering: A Study of Appliance of Technologies and Legislation in Goiania, Brazil

Authors: Vinicius Marzall, Jussanã Milograna

Abstract:

The urban drainwatering remains a major challenge for most of the Brazilian cities. Not so different of the most part, Goiania, a state capital located in Midwest of the country has few legislations about the subject matter and only one registered solution of compensative techniques for drainwater. This paper clam to show some solutions which are adopted in other Brazilian cities with consolidated legislation, suggesting technics about detention tanks in a building sit. This study analyzed and compared the legislation of Curitiba, Porto Alegre e Sao Paulo, with the actual legislation and politics of Goiania. After this, were created models with adopted data for dimensioning the size of detention tanks using the envelope curve method considering synthetic series for intense precipitations and building sits between 250 m² and 600 m², with an impermeabilization tax of 50%. The results showed great differences between the legislation of Goiania and the documentation of the others cities analyzed, like the number of techniques for drainwatering applied to the reality of the cities, educational actions to awareness the population about care the water courses and political management by having a specified funds for drainwater subjects, for example. Besides, the use of detention tank showed itself practicable, have seen that the occupation of the tank is minor than 3% of the building sit, whatever the size of the terrain, granting the exit flow to pre-occupational taxes in extreme rainfall events. Also, was developed a linear equation to measure the detention tank based in the size of the building sit in Goiania, making simpler the calculation and implementation for non-specialized people.

Keywords: clean technology, legislation, rainwater management, urban drainwater

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1689 Ovarian Hormones and Antioxidants Biomarkers in Dromedary Camels Synchronized with Controlled Intravaginal Drug Release/Ovsynch GPG Program during Breeding Season

Authors: Heba Hozyen, Ragab Mohamed, Amal Abd El Hameed, Amal Abo El-Maaty

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This study aimed to investigate the effect of CIDR and ovsynch (Gonadotropin-prostaglandine-gonadotropin GPG) protocols for synchronization of follicular waves of dromedary camels on ovarian hormones, oxidative stress and conception during breeding season. Twelve dark colored dromedary camels were divided into two equal groups. The first group was subjected to CIDR insertion for 7 days and blood samples were collected each other day from the day of CIDR insertion (day 0) till day 21. The other group was subjected to GPG system (Ovsynch) and blood samples were collected daily for 11 days. Progesterone (P4) and estradiol were assayed using commercial ELISA diagnostic EIA kits. Catalase (CAT), total antioxidants capacity (TAC), glutathione reduced (GHD), lipid peroxide product (malondialdehyde, MDA) and nitric oxide (NO) were measured colorimetrically using spectrophotometer. Results revealed that CIDR treated camels had significantly high P4 (P= 0.0001), estradiol (P= 0.0001), CAT (P= 0.034), NO (P= 0.016) and TAC (P= 0.04) but significantly low MDA (P= 0.001) and GHD (P= 0.003) compared to GPG treated ones. Camels inserted with CIDR had higher conception rate (66.7%) compared to those treated with GPG (33%). In conclusion, camels treated with CIDR had higher hormonal response and antioxidant capacity than those synchronized with GPG which positively reflected on their conception rate. The better response of camels to CIDR and the higher conception compared to GPG protocol recommends its use for future reproductive management in camels.

Keywords: antioxidants, camel, CIDR, season, steroid hormones

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1688 Power and Representation in Female Autobiographies

Authors: Shafag Dadashova

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The study discusses relativity of perception and interpretation of power, its interdependence with conformity level of an individual. It describes an autobiography as a form of epiphany. It is suggested that life-writing helps the author analyze the past and define the borders of his personal power and sources of empowerment. As all life-writings deal with behaviors, values, attitudes, relationships and emotions, their investigation requires qualitative methods to understand social norms, gender roles, religion, and their role in empowerment and disempowerment of the author. The study consists of two parts. The first part is theoretical and interrogates the notion of personal power and how writing the own life can bring to conscious empowerment. The second part presents two autobiographies by female authors from two different Muslim cultures who negotiate between the larger nationalist agenda and their own personal concerns. These autobiographies (Tehmina Durrani, Pakistani author ‘My Feudal Lord’, Banine, Azerbaijani writer 'Caucasian days' and 'Parisian days') are the end of their authors’ long silence, their revolt against the conventional norms, their decision to have an agency to confess and protest. These autobiographies are the authors’ attempts to break the established matrix of perceptions, imposed norms, and gain power to build the real picture of their identity. The study sums up with the conclusion that in spite of very similar motifs of female authors to get empowered through self-analysis, different cultures and time create specific subjectivities associated with particular historical events and geographical location.

Keywords: conformity level, empowerment, female autobiography, self-identity

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1687 Synthesis, Crystal Structure Characterization, Hirshfeld Surface Analysis and Biological Activities of Two Schiff Base Polymorphs Derived From 2-Aminobenzonitrile

Authors: Nesrine Benarous, Hassiba Bougueria, Nabila Moussa Slimane, Aouatef Cherouana

Abstract:

Crystal polymorphism is important for the synthesis of more potent and bioactive pharmaceutical compounds, including their different properties, such as packing arrangement and conformation. In fact, polymorphism plays a vital role in drug development. Different parameters affect the crystallization and give their degree of freedom. Severalproperties affected polymorphism, like kinetics, thermodynamics, spectroscopy, and mechanical property. Various techniques are used for characterizing polymorphs, are crystallography, morphology, phase transitions, molecular motion, and chemical environment. In this work, crystal structures of two polymorphs (I and II) of the Schiff base (SB) title compound were prepared by condensation reaction. The crystal structures of both polymorphs were determined by single X-ray analysis. The two polymorphs crystallize in two different space groups: P21/c for I and Pbca for II. The dihedral angles between the two phenyl rings are 4.81º for I and 82.27º for II. Both crystal structures are built on the basis of moderate and weak hydrogen bonds, 𝜋-stacking, and halogen⋯halogeninteractions. On the other hand, Hirshfeld surface (HS) analysis indicates that the most important contributions to the crystal packing for the two polymorphs are from Cl⋯H/H⋯Cl, H⋯H, and N⋯H/H⋯N contacts. These are followed by C⋯H/H⋯C for compound I and C⋯C and by C⋯H/H⋯C contacts for compound II. Afterwards, the in vitro antibacterial activity revealed that the SB have been found effective against G- bacteria Klebsiella pneumonia andG+ bacteria Staphylococcus aureuswith MIC value of14.37μg/mL. Moreover, the SBexhibited moderate toxicity against Brine Shrimp with LC50 value of 44.19μg/mL.

Keywords: polymorph, crystal structure, hirshfeld surface analysis, in vitro antibacterial activity, toxicity

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1686 Crystalline Silica Exposure in Tunnel Construction: Identifying Barriers to Safe Practices

Authors: Frederick Anlimah, Vinod Gopaldasani, Catherine MacPhail, Brian Davies

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Aim: This study aims to identify the barriers and challenges hindering the implementation of effective controls and the adoption of safe work practices to protect workers from respirable crystalline silica (RCS) exposure. Problem or Situation: Tunnelling is one of many occupations that expose workers to the harmful effects of respirable crystalline silica. Despite various control measures, such as engineering controls and personal protective equipment, exposures remain inadequately controlled, leading to incurable silicosis and other severe illnesses, such as lung cancer. Methods: The research involved surveying tunnel construction workers, conducting interviews, and facilitating focus group discussions. Additionally, site observations and content analysis of work procedures and instructions were performed. Results: Preliminary data analysis reveals notable findings. While there is a commendable level of knowledge and commitment among management and workers concerning RCS exposure in tunnelling, there is a striking lack of prioritization regarding dust control. Moreover, the risks associated with dust exposure are not sufficiently acknowledged. Additionally, the data suggests that engineers and supervisors responsible for implementing dust controls often possess limited knowledge regarding the factors influencing the effectiveness of these measures. These findings emphasise the need for a paradigm shift, including higher prioritisation of dust control, adoption of holistic dust reduction strategies, and enhanced knowledge about effective control measures. Conclusion: This research shed light on tunnel construction workers' barriers and challenges in protecting themselves from RCS exposure. This knowledge will be essential in developing interventions and strategies to enhance dust exposure and prevent the adverse health effects of respirable crystalline silica exposure in tunnelling and similar industries.

Keywords: respirable crystalline silica, dust control, worker practices, exposure prevention, silicosis

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1685 Dietary Exposure of Heavy Metals through Cereals Commonly Consumed by Dhaka City Residents

Authors: A. Md. Bayejid Hosen, B. M Zakir Hossain Howlader, C. Yearul Kabir

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Contamination of soil and agricultural products by heavy metals resulting from rapid industrial development has caused major concern. Dietary exposure to heavy metals has been associated with toxic and adverse health effects. The main threats to human health from heavy metals are associated with exposure to Pb, Cd and Hg. The aim of this study was to monitor the presence of heavy metals in cereals collected from different wholesale markets of Dhaka City. One hundred and sixty cereal samples were collected and analyzed for determination of heavy metals. Heavy metals were analyzed by inductively coupled plasma mass spectrometry (ICP-MS). A total of six heavy metals– lead, chromium, cadmium, mercury, arsenic and antimony were estimated. The average concentrations of heavy metals in cereals fall within the safe limit established by regulatory organizations except for Pb (152.4 μg/100g) and Hg (15.13 μg/100g) which exceeded the safe limits. BARI gom-26 was the highest source of Pb (304.1 μg/100g) whereas Haski-29 rice variety contained the highest amount of Hg (60.85 μg/100g). Though all the cereal varieties contained approximately same amount of Cr the naizer sail varieties contained huge amount of Cr (171.8 μg/100g). Among all the cereal samples miniket rice varieties contained the least amount of heavy metals. The concentration of Cr (63.24 μg/100g), Cd (5.54 μg/100g) and As (3.26 μg/100g) in all cereals were below the safe limits. The daily intake of heavy metals was determined using the total weight of cereals consumed each day multiplied by the concentrations of heavy metals in cereals. The daily intake was compared with provisional maximum tolerable daily intake set by different regulatory organizations. The daily intake of Cd (23.0 μg), Hg (63.0 μg) and as (13.6 μg) through cereals were below the risk level except for Pb (634.0 μg) and Cr (263.1 μg). As the main meal of average Bangladeshi people is boiled rice served with some sorts of vegetables, our findings indicate that the residents of Dhaka City are at risk from Pb and Cr contamination. Potential health risks from exposure to heavy metals in self-planted cereals need more attention.

Keywords: contamination, dietary exposure, heavy metals, human health, ICP-MS

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1684 Planning and Urban Climate Change Adaptation: Italian Literature Review

Authors: Mara Balestrieri

Abstract:

Climate change has long been the focus of attention for the growing impact of extreme weather events and global warming in many areas of the planet and the evidence of economic, social, and environmental damage caused by global warming. Nowadays, climate change is recognized as a critical global problem. Several initiatives have been undertaken over time to enhance the long theoretical debate and field experience in order to reduce Co2 emissions and contain climate alteration. However, the awareness that climate change is already taking place has led to a growing demand for adaptation. It is certainly a matter of anticipating the negative effects of climate change but, at the same time, implementing appropriate actions to prevent climate change-related damage, minimize the problems that may result, and also seize any opportunities that may arise. Consequently, adaptation has become a core element of climate policy and research. However, the attention to this issue has not developed in a uniform manner across countries. Some countries are further ahead than others. This paper examines the literature on climate change adaptation developed until 2018 in Italy, considering the urban dimension, to provide a framework for it, and to identify main topics and features. The papers were selected from Scopus and were analyzed through a matrix that we propose. Results demonstrate that adaptation to climate change studies attracted increasing attention from Italian scientific communities in the last years, although Italian scientific production is still quantitatively lower than in other countries and describes strengths and weaknesses in line with international panorama with respect to objectives, sectors, and problems.

Keywords: adaptation, bibliometric literature, climate change, urban studies

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1683 Risk Factors for Post-Induction Hypotension Among Elderly Patients Undergoing Elective Non-Cardiac Surgery Under General Anesthesia

Authors: Karuna Sutthibenjakul, Sunisa Chatmongkolchart

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Background: Postinduction hypotension is common and occurs more often in elderly patients. We aimed to determine risk factors for hypotension after induction among elderly patients (aged 65 years and older) who underwent elective non-cardiac surgery under general anesthesia. Methods: This cohort study analyzed from 580 data between December 2017 and July 2018 at a tertiary university hospital in south of Thailand. Hypotension is defined as more than 30% decrease mean arterial pressure from baseline after induction within 20 minutes or the use of vasopressive agent to treat low blood pressure. Intraoperative parameters were blood pressure and heart rate at T0, TEI, T5, T10, T15 and T20 (immediately after arrival at operating room, time after intubation, 5, 10, 15 and 20 minutes after intubation) respectively. Results: The median age was 72.5 (68, 78) years. A prevalence of post-induction hypotension was 64.8%. The highest prevalence (39.7%) was at 15 minutes after intubation. The association of post-induction hypotension is rising with diuretic drug as preoperative medication (P-value=0.016), hematocrit level (P-value=0.031) and the degree of hypertension immediately after arrival at operating room (P-value<0.001). Increasing fentanyl dosage during induction was associated with hypotension at intubation time (P-value<0.01) and 5 minutes after intubation (P-value<0.001). There was no statistically significant difference in the increasing propofol dosage. Conclusion: The degree of hypertension immediately after arrival at operating room and increasing fentanyl dosage were a significant risk factors for postinduction hypotension in elderly patients.

Keywords: risk factors, post-induction, hypotension, elderly

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1682 Sustainable Radiation Curable Palm Oil-Based Products for Advanced Materials Applications

Authors: R. Tajau, R. Rohani, M. S. Alias, N. H. Mudri, K. A. Abdul Halim, M. H. Harun, N. Mat Isa, R. Che Ismail, S. Muhammad Faisal, M. Talib, M. R. Mohamed Zin

Abstract:

Bio-based polymeric materials are increasingly used for a variety of applications, including surface coating, drug delivery systems, and tissue engineering. These polymeric materials are ideal for the aforementioned applications because they are derived from natural resources, non-toxic, low-cost, biocompatible, and biodegradable, and have promising thermal and mechanical properties. The nature of hydrocarbon chains, carbon double bonds, and ester bonds allows various sources of oil (edible), such as soy, sunflower, olive, and oil palm, to fine-tune their particular structures in the development of innovative materials. Palm oil can be the most eminent raw material used for manufacturing new and advanced natural polymeric materials involving radiation techniques, such as coating resins, nanoparticles, scaffold, nanotubes, nanocomposites, and lithography for different branches of the industry in countries where oil palm is abundant. The radiation technique is among the most versatile, cost-effective, simple, and effective methods. Crosslinking, reversible addition-fragmentation chain transfer (RAFT), polymerisation, grafting, and degradation are among the radiation mechanisms. Exposure to gamma, EB, UV, or laser irradiation, which are commonly used in the development of polymeric materials, is used in these mechanisms. Therefore, this review focuses on current radiation processing technologies for the development of various radiation-curable bio-based polymeric materials with a promising future in biomedical and industrial applications. The key focus of this review is on radiation curable palm oil-based products, which have been published frequently in recent studies.

Keywords: palm oil, radiation processing, surface coatings, VOC

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1681 Molecular Interactions between Vicia Faba L. Cultivars and Plant Growth Promoting Rhizobacteria (PGPR), Utilized as Yield Enhancing 'Plant Probiotics'

Authors: Eleni Stefanidou, Nikolaos Katsenios, Ioanna Karamichali, Aspasia Efthimiadou, Panagiotis Madesis

Abstract:

The excessive use of pesticides and fertilizers has significant environmental and human health-related negative effects. In the frame of the development of sustainable agriculture practices, especially in the context of extreme environmental changes (climate change), it is important to develop alternative practices to increase productivity and biotic and abiotic stress tolerance. Beneficial bacteria, such as symbiotic bacteria in legumes (rhizobia) and symbiotic or free-living Plant Growth Promoting Rhizobacteria (PGPR), which could act as "plant probiotics", can promote plant growth and significantly increase the resistance of crops under adverse environmental conditions. In this study, we explored the symbiotic relationships between Faba bean (Vicia faba L.) cultivars with different PGPR bacteria, aiming to identify the possible influence on yield and biotic-abiotic phytoprotection benefits. Transcriptomic analysis of root and whole plant samples was executed for two Vicia faba L. cultivars (Polikarpi and Solon) treated with selected PGPR bacteria (6 treatments: B. subtilis + Rhizobium-mixture, A. chroococcum + Rhizobium-mixture, B. subtilis, A. chroococcum and Rhizobium-mixture). Preliminary results indicate a significant yield (Seed weight and Total number of pods) increase in both varieties, ranging around 25%, in comparison to the control, especially for the Solon cultivar. The increase was observed for all treatments, with the B. subtilis + Rhizobium-mixture treatment being the highest performing. The correlation of the physiological and morphological data with the transcriptome analysis revealed molecular mechanisms and molecular targets underlying the observed yield increase, opening perspectives for the use of nitrogen-fixing bacteria as a natural, more ecological enhancer of legume crop productivity.

Keywords: plant probiotics, PGPR, legumes, sustainable agriculture

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1680 A Comparative Assessment of the FoodSupply Vulnerability to Large-Scale Disasters in OECD Countries

Authors: Karolin Bauer, Anna Brinkmann

Abstract:

Vulnerabilities in critical infrastructure can cause significant difficulties for the affected population during crises. Securing the food supply as part of the critical infrastructure in crisis situations is an essential part of public services and a ground stone for a successful concept of civil protection. In most industrialized countries, there are currently no comparative studies regarding the food supply of the population during crisis and disaster events. In order to mitigate the potential impact in case of major disasters in Germany, it is absolutely necessary to investigate how the food supply can be secured. The research project aims to provide in-depth research on the experiences gathered during past large-scale disasters in the 34 OECD member countries in order to discover alternatives for an updated civil protection system in Germany. The basic research question is: "Which international approaches and structures of civil protection have been proven and would be useful to modernize the German civil protection with regards to the critical infrastructure and food supply?" Research findings should be extracted from an extensive literature review covering the entire research period as well as from personal and online-based interviews with experts and responsible persons from involved institutions. The capability of the research project insists on the deliberate choice to investigate previous large-scale disasters to formulate important and practical approaches to modernize civil protection in Germany.

Keywords: food supply, vulnerabilty, critical infratstructure, large-scale disaster

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1679 Genetic Diversity and Molecular Basis of Carbapenem Resistance in Acinetobacter Baumannii Isolates from Cattle

Authors: Minhas Alam, Muhammad Hidayat Rasool, Mohsin Khurshid, Bilal Aslam

Abstract:

Acinetobacter baumannii is a notorious bacterial pathogen that is an emerging nightmare in clinical settings and is mainly involved in severe nosocomial infections. However, the data related to carbapenem-resistant A. baumannii (CRAB) from veterinary settings is limited, especially in developing countries like Pakistan. To investigate the genetic diversity and molecular basis of carbapenem resistance in Acinetobacter baumannii isolates from Cattle, a total of 1960 samples were collected from cattle from Punjab, Pakistan. The isolates were analyzed by routine microbiological procedures and confirmed by polymerase chain reaction (PCR). The isolates were further screened for antimicrobial susceptibility and the presence of multiple antimicrobial-resistant determinants by PCR. Multilocus sequence typing (MLST) was performed. The results of the current study revealed that the overall prevalence of A. baumannii in cattle was 3.28% (65/1980). Among cattle 27.7% (18/65) were found CRAB strains. The CRAB isolates harbor class D β- lactamases genes, e-g, blaOXA-23 and blaOXA-51, 94.4% (17/18). CRAB isolates carry class B β- lactamases gene blaIMP, and only one isolate carries the blaNDM-1 gene. The MLST results of CRAB isolates from cattle demonstrated 5 STs and one new ST. The commonly found sequence types in CRAB isolates were ST2 (n=10, 55.5%), followed by ST642 (n=5, 27.8%) and ST600 & ST889 (n=1, 5.55%). The presence of CRAB isolates in cattle indicates an alarming situation in Punjab, Pakistan. Immediate control measures should be taken to stop the transmission of CRAB isolates within cattle, to the environment, and to clinical settings.

Keywords: acinetobacter baumannii, carbapenemases, veterinary, drug resistance

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1678 A Large Ion Collider Experiment (ALICE) Diffractive Detector Control System for RUN-II at the Large Hadron Collider

Authors: J. C. Cabanillas-Noris, M. I. Martínez-Hernández, I. León-Monzón

Abstract:

The selection of diffractive events in the ALICE experiment during the first data taking period (RUN-I) of the Large Hadron Collider (LHC) was limited by the range over which rapidity gaps occur. It would be possible to achieve better measurements by expanding the range in which the production of particles can be detected. For this purpose, the ALICE Diffractive (AD0) detector has been installed and commissioned for the second phase (RUN-II). Any new detector should be able to take the data synchronously with all other detectors and be operated through the ALICE central systems. One of the key elements that must be developed for the AD0 detector is the Detector Control System (DCS). The DCS must be designed to operate safely and correctly this detector. Furthermore, the DCS must also provide optimum operating conditions for the acquisition and storage of physics data and ensure these are of the highest quality. The operation of AD0 implies the configuration of about 200 parameters, from electronics settings and power supply levels to the archiving of operating conditions data and the generation of safety alerts. It also includes the automation of procedures to get the AD0 detector ready for taking data in the appropriate conditions for the different run types in ALICE. The performance of AD0 detector depends on a certain number of parameters such as the nominal voltages for each photomultiplier tube (PMT), their threshold levels to accept or reject the incoming pulses, the definition of triggers, etc. All these parameters define the efficiency of AD0 and they have to be monitored and controlled through AD0 DCS. Finally, AD0 DCS provides the operator with multiple interfaces to execute these tasks. They are realized as operating panels and scripts running in the background. These features are implemented on a SCADA software platform as a distributed control system which integrates to the global control system of the ALICE experiment.

Keywords: AD0, ALICE, DCS, LHC

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1677 Phytochemistry and Biological Activity of Extracts of the Red Raspberry Rubus rosifolius

Authors: Theresa Campbell, Camille Bowen-Forbes, William Aalbersberg

Abstract:

Differences in the sensory properties of two subtly distinct varieties of Rubus rosifolius lead to the examination of their anthocyanin, essential oil and polyphenol profiles. In both cases, notable differences were identified. Pelargonidin-3-rhutinoside (17.2 mg/100 g FW) and Cyanidin-3-glucoside (66.2 mg/100g FW) proved to be the dominant anthocyanins in the red and wine red varieties respectively. Linalool and terpineol were the major constituents of the essential oil from the red variety; however, those of the wine red variety are unidentified. In regard to phenolic compounds, caffeic acid and quercetin were in a higher concentration in the red variety (1.85 and 0.73 mg/100g FW respectively, compared to 1.22 and 0.34 mg/100g FW respectively in the wine red fruits); while ellagic acid and ferulic acid were of a higher concentration in the wine red variety (0.92 and 0.84mg/100g FW respectively, compared to 0.15 and 0.48 mg/100g FW respectively in the red variety). The methanol extract of both fruit varieties showed great antioxidant activity. Analysis of the antimicrobial activity of the fruit extracts against the growth of drug resistant pathogens revealed that they are active against methicillin resistant S. aureus (MRSA), rifampicin resistant S. aureus (RRSA), wild-type S. aureus (WTSA) and vancomycin-resistant Enterococcus faecium (VREF). Activity was also reported against several food-borne pathogens including two strains of E. coli, L. monocytogenes and Enterobacter aerogenes. The cytotoxicity of the various extracts was assessed and the essential oil extracts exhibited superior activity. The phenolic composition and biological activity of the fruits indicate that their consumption is beneficial to health and also that their incorporation into functional foods and nutraceuticals should be considered.

Keywords: phytochemicals, antimicrobial, cytotoxic, Rubus rosifolius

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1676 School Administrators’ Perspectives on Child Neglect and Abuse and Intervention Methods

Authors: Eylem G. Cengiz, Ersin Çilek, Gözde Başkaya, Havva Nur Taş

Abstract:

It is possible to define the abuse and neglect of the child as a social problem. Such adverse experiences of the child are witnessed by wider social circles as well as his or her immediate environment. The most effective institution among these social circles is the school. The awareness of teachers, administrators, and even auxiliary personnel on this issue can act as a protective and preventive buffer because teachers have the opportunity to be with children every day and constantly observe them; therefore, they can notice the physical and mental changes in students. Furthermore, school administrators have an undeniable role in recognizing and responding to the risk of neglect and abuse. This study aims to evaluate the awareness of school administrators on the risk factors, clues, and ways of intervention towards abuse and neglect through the scenarios given to them. Data were collected from 37 primary, secondary, and high school administrators working in various provinces of Turkey through descriptive and scenario-based questions to determine their general knowledge of the concepts of neglect and abuse and their general tendencies towards practice. Descriptive questions were evaluated with content analysis, and scenario-based questions were evaluated with numerical qualitative data analysis. Concepts and themes were tried to be reached by content analysis from the descriptive data collected. When the results are evaluated in general, it is striking that the concept of child abuse means only sexual abuse for some school administrators. There is an important uncertainty for school administrators in the content of the idea of neglect. When the views on the causes of neglect and abuse are examined, the family factor was seen as the primary source of both neglect and abuse. In addition, among the prevention strategies applied by school administrators, intervention for the family -interviewing and informing- was recommended by only 9 (29%) out of 31 administrators. When the responses to the physical, emotional, and sexual abuse scenarios are examined, it is revealed that the administrators generally realize the abuse but fail to develop an appropriate/whole intervention method. The research results show that school administrators' awareness should be increased. Although administrators have sensitivity towards children, they should be empowered to recognize all types of neglect and abuse and develop appropriate intervention tools.

Keywords: assessment child abuse and neglect, child abuse, child neglect, school administrators

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1675 Prospective Study to Determine the Efficacy of Day Hospital Care to Improve Treatment Adherence for Hospitalized Schizophrenic Patients

Authors: Jin Hun Choi, So Hyun Ahn, Seong Keun Wang, Ik-Seung Chee, Jung Lan Kim, Sun Woo Lee

Abstract:

Objectives: The purpose of the study is to investigate the effects of day hospital care in hospitalized schizophrenic patients in terms of treatment adherence and treatment outcomes. Methods: Among schizophrenic patients hospitalized between 2011 and 2012, 23 day hospital care patient and 40 control subjects were included in the study. All candidates underwent Beck Cognitive Insight Scale, Drug Attitude Inventory, World Health Organization Quality of Life Assessment and Psychological Well-Being Scale when their symptoms were stabilized during hospitalization, and after being discharged, 23 patients received day hospital care for two months and then changed to out-patient care while 40 patients received out-patient care immediately after discharge. At the point of two months of out-patient care, the treatment adherence of the two groups was evaluated; tracking observation was performed until February, 2013, and survival rates were compared between the two groups. Results: Treatment adherence was higher in the day hospital care group than in the control group. Kaplan-Meier survival analysis showed a higher survival rate for the day hospital care group compared to the control group. Levels of cognitive insight and quality of life were higher after day hospital care than before day hospital care in the day hospital care group. Conclusions: Through the study, it was confirmed that when hospitalized schizophrenic patients received continuous day hospital care after being discharged, they received further out-patient care more faithfully. The study is considered to aid in the understanding regarding schizophrenic patients’ treatment adherence issues and improvement of treatment outcomes.

Keywords: schizophrenia, day hospital care, adherence, outcomes

Procedia PDF Downloads 347
1674 Analysis of Ionospheric Variations over Japan during 23rd Solar Cycle Using Wavelet Techniques

Authors: C. S. Seema, P. R. Prince

Abstract:

The characterization of spatio-temporal inhomogeneities occurring in the ionospheric F₂ layer is remarkable since these variations are direct consequences of electrodynamical coupling between magnetosphere and solar events. The temporal and spatial variations of the F₂ layer, which occur with a period of several days or even years, mainly owe to geomagnetic and meteorological activities. The hourly F₂ layer critical frequency (foF2) over 23rd solar cycle (1996-2008) of three ionosonde stations (Wakkanai, Kokunbunji, and Okinawa) in northern hemisphere, which falls within same longitudinal span, is analyzed using continuous wavelet techniques. Morlet wavelet is used to transform continuous time series data of foF2 to a two dimensional time-frequency space, quantifying the time evolution of the oscillatory modes. The presence of significant time patterns (periodicities) at a particular time period and the time location of each periodicity are detected from the two-dimensional representation of the wavelet power, in the plane of scale and period of the time series. The mean strength of each periodicity over the entire period of analysis is studied using global wavelet spectrum. The quasi biennial, annual, semiannual, 27 day, diurnal and 12 hour variations of foF2 are clearly evident in the wavelet power spectra in all the three stations. Critical frequency oscillations with multi-day periods (2-3 days and 9 days in the low latitude station, 6-7 days in all stations and 15 days in mid-high latitude station) are also superimposed over large time scaled variations.

Keywords: continuous wavelet analysis, critical frequency, ionosphere, solar cycle

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1673 Development of Pediatric Medical Trauma Stress (PMTS) Among Children at Risk

Authors: Amichai Ben ari, Daniella Margalit

Abstract:

Medical procedures, such as surgery, may have traumatic significance for some children. This study examines the relationship between maltreatment in children and the development Pediatric Medical Traumatic Stress (PMTS). To this end, differences in the level of distress of children after surgery were examined between two groups: children who were maltreated ("children at risk") and children from the control group ("children who are not at risk"). The study involved 230 parents of children who came to the hospital to undergo surgery. Parents filled out demographic questionnaires to measure socioeconomic variables and psychological questionnaires to measure the distress of the child and parent before surgery. After 6 months from the time of surgery, the parents again filled in the questionnaire measuring the child's distress. The results of the study showed that the level of distress experienced by children at risk after surgery was significantly higher relative to children who are not at risk. It was also found that the level of distress experienced by parents of children at risk in relation to their child’s surgery is significantly higher compared to parents of children who are not at risk. Finally, it was found that the variables: (1) pre-morbid psychological functioning of the child. (2) Parental and family functioning in daily life. (3) Exposure of the child to traumatic events. (4) Support factors for the family. Are variables that predict the development of PMTS in children after surgery, but only for children at risk and not for children who are not at risk. The significance of the findings in relation to the need to identify at-risk populations in the hospitals and the policies derived from them were discussed, and several directions were raised for further research.

Keywords: children at risk, pediatric medical traumatic stress (PMTS), PTSD, medical procedures

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1672 Membrane-Localized Mutations as Predictors of Checkpoint Blockade Efficacy in Cancer

Authors: Zoe Goldberger, Priscilla S. Briquez, Jeffrey A. Hubbell

Abstract:

Tumor cells have mutations resulting from genetic instability that the immune system can actively recognize. Immune checkpoint immunotherapy (ICI) is commonly used in the clinic to re-activate immune reactions against mutated proteins, called neoantigens, resulting in tumor remission in cancer patients. However, only around 20% of patients show durable response to ICI. While tumor mutational burden (TMB) has been approved by the Food and Drug Administration (FDA) as a criterion for ICI therapy, the relevance of the subcellular localizations of the mutated proteins within the tumor cell has not been investigated. Here, we hypothesized that localization of mutations impacts the effect of immune responsiveness to ICI. We analyzed publicly available tumor mutation sequencing data of ICI treated patients from 3 independent datasets. We extracted the subcellular localization from the UniProtKB/Swiss-Prot database and quantified the proportion of membrane, cytoplasmic, nuclear, or secreted mutations per patient. We analyzed this information in relation to response to ICI treatment and overall survival of patients showing with 1722 ICI-treated patients that high mutational burden localized at the membrane (mTMB), correlate with ICI responsiveness, and improved overall survival in multiple cancer types. We anticipate that our results will ameliorate predictability of cancer patient response to ICI with potential implications in clinical guidelines to tailor ICI treatment. This would not only increase patient survival for those receiving ICI, but also patients’ quality of life by reducing the number of patients enduring non-effective ICI treatments.

Keywords: cancer, immunotherapy, membrane neoantigens, efficacy prediction, biomarkers

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