Search results for: clinical recovery

Authors: Habib Alah Dadgar, Nasim Norouzbeigi

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The precise definition margin of high and low-grade gliomas is crucial for treatment. We aimed to assess the feasibility of assessment of the resection legions with post-operative positron emission tomography (PET) using [18F]O-(2-[18F]-fluoroethyl)-L-tyrosine ([18F]FET). Four patients with the suspicion of high and low-grade were enrolled. Patients underwent post-operative [18F]FET-PET, pre-operative magnetic resonance imaging (MRI) and CT for clinical evaluations. In our study, three patients had negative response to recurrence and progression and one patient indicated positive response after surgery. [18F]FET-PET revealed a legion of increased radiotracer uptake in the dura in the craniotomy site for patient 1. Corresponding to the patient history, the study was negative for recurrence of brain tumor. For patient 2, there was a lesion in the right parieto-temporal with slightly increased uptake in its posterior part with SUVmax = 3.79, so the study was negative for recurrence evaluation. In patient 3 there was no abnormal uptake with negative result for recurrence of brain tumor. Intense radiotracer uptake in the left parietal lobe where in the MRI there was a lesion with no change in enhancement in the post-contrast image is indicated in patient 4. Assessment of the resection legions in high and low-grade gliomas with [18F]FET-PET seems to be useful.

Keywords: FET-PET, CT, glioma, MRI

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Authors: Simin Zarea Karizi, Somaye Fatahi, Amirhossein Hosseni

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Background: There are conflicting findings regarding the effect of vitamin D supplementation on obesity-related factors. This study aimed to investigate the effect of vitamin D supplementation on changes in anthropometric indicators of adiposity and fat distribution in children and adolescents. Methods: Original databases were searched using standard keywords to identify all controlled trials investigating the effects of vitamin D supplementation on obesity-related factors in children and adolescents. Pooled weighted mean difference and 95% confidence intervals were achieved by random-effects model analysis. Results: Fourteen treatment arms were included in this systematic review and meta-analysis. The quantitative meta-analysis revealed no significant effect of vitamin D supplement on BMI (-0.01 kg/m2; 95% CI: -0.09, 0.12; p= 0.74; I2=0.0%), BMI z score (0.02; 95% CI: -0.04, 0.07; p= 0.53; I2=0.0%) and fat mass (0.07%; 95% CI: -0.09 to 0.24; p= 0.38; I2=31.2%). However, the quantitative meta-analysis displayed a significant effect of vitamin D supplementation on WC compared with the control group (WMD=-1.17 cm, 95% CI: -2.05, -0.29, p=0.009; I2=32.0 %). It seems that this effect was greater in healthy children with duration>12 weeks, dose<=400 IU and baseline less than 50 nmol/l vitamin D than others. Conclusions: Our findings suggest that vitamin D supplementation may be a protective factor of abdominal obesity and should be evaluated on an individual basis in clinical practice.

Keywords: weight loss, vitamin D, anthropometry, children, adolescent

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Authors: Snezana Mugosa, Zoran Todorovic, Zoran Bukumiric, Ivan Radosavljevic, Natasa Djordjevic

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Introduction: Various studies have shown that the frequency of clopidogrel resistance ranges from 4-40%. The aim of this study was to provide in depth analysis of genetic and non-genetic factors that influence clopidogrel resistance in cardiology patients. Methods: We have conducted a prospective study in 200 hospitalized patients hospitalized at Cardiology Centre of the Clinical Centre of Montenegro. CYP2C19 genetic testing was conducted, and the PREDICT score was calculated in 102 out of 200 patients treated with clopidogrel in order to determine the influence of genetic and non-genetic factors on outcomes of interest. Adverse cardiovascular events and adverse reactions to clopidogrel were assessed during 12 months follow up period. Results: PREDICT score and CYP2C19 enzymatic activity were found to be statistically significant predictors of expressing lack of therapeutic efficacy of clopidogrel by multivariate logistic regression, without multicollinearity or interaction between the predictors (p = 0.002 and 0.009, respectively). Conclusions: Pharmacogenetics analyses that were done in the Montenegrin population of patients for the first time suggest that these analyses can predict patient response to the certain therapy. Stepwise approach could be used in assessing the clopidogrel resistance in cardiology patients, combining the PREDICT score, platelet aggregation test, and genetic testing for CYP2C19 polymorphism.

Keywords: clopidogrel, pharmacogenetics, pharmacotherapy, PREDICT score

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Authors: Florge Francis A. Sy

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Acute pancreatitis (AP) is an inflammatory condition of the pancreas with local and systemic complications. Severe acute pancreatitis (SAP) has a higher mortality rate. Laboratory parameters like the neutrophil-to-lymphocyte ratio (NLR), red cell distribution width (RDW), and mean platelet volume (MPV) have been associated with SAP but with conflicting results. This study aims to determine the predictive value of these parameters on the severity and in-hospital mortality of AP. This retrospective, cross-sectional study was done in a private hospital in Cebu City, Philippines. One-hundred five patients were classified according to severity based on the modified Marshall scoring. The admitting hemogram, including the NLR, RDW, and MPV, was obtained from the complete blood count (CBC). Cut-off values for severity and in-hospital mortality were derived from the ROC. Association between NLR, RDW, and MPV with SAP and mortality were determined with a p-value of < 0.05 considered significant. The mean age for AP was 47.6 years, with 50.5% being male. Most had an unknown cause (49.5%), followed by a biliary cause (37.1%). Of the 105 patients, 23 patients had SAP, and 4 died. Older age, longer in-hospital duration, congestive heart failure, elevated creatinine, urea nitrogen, and white blood cell count were seen in SAP. The NLR was associated with in-hospital mortality using a cut-off of > 10.6 (OR 1.133, 95% CI, p-value 0.003) with 100% sensitivity, 70.3% specificity, 11.76% PPV and 100% NPV (AUC 0.855). The NLR was not associated with SAP. The RDW and MPV were not associated with SAP and mortality. The admitting NLR is, therefore, an easily accessible parameter that can predict in-hospital mortality in acute pancreatitis. Although the present study did not show an association of NLR with SAP nor RDW and MPV with both SAP and mortality, further studies are suggested to establish their clinical value.

Keywords: acute pancreatitis, mean platelet volume, neutrophil-lymphocyte ratio, red cell distribution width

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Authors: Huong M. T. Nguyen, Hoa A. P. Nguyen, Chi V. Phan, Mai P. T. Nguyen, Ngoc D. Ngo, Van T. Ta, Hai T. Le

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Wilson’s disease is an autosomal recessive disorder of copper metabolism, which is caused by mutation in copper- transporting P-type ATPase (ATP7B). The mechanism of this disease is a failure of hepatic excretion of copper to the bile, and it leads to copper deposits in the liver and other organs. Most clinical symptoms of Wilson’s disease can present as liver disease and/or neurologic disease. Objective: The goal of the study is prenatal diagnosis for pregnant women at high risk of Wilson’s disease in Northern Vietnam. Material and method: Three probands with clinically diagnosed liver disease were detected in the mutations of 21 exons and exon-intron boundaries of the ATP7B gene by direct Sanger-sequencing. Prenatal diagnoses were performed by amniotic fluid sampling from pregnant women in the 16th-18th weeks of pregnancy after the genotypes of parents with the probands were identified. Result: A total of three different mutations of the probands, including of S105*, P1052L, P1273G, were detected. Among three fetuses which underwent prenatal genetic testing, one fetus was homozygote; two fetuses were carriers. Conclusion: Genetic testing provided a useful method for prenatal diagnosis, and is a basis for genetic counseling.

Keywords: ATP7B gene, genetic testing, prenatal diagnosis, pedigree, Wilson disease

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Authors: Bilal Ahmad

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Alzheimer’s disease (AD) is one of the most common neurodegenerative illnesses. However, how Gut-microbiota plays a role in the pathogenesis of AD is not well elucidated. The purpose of this literature review is to summarize and understand the current findings that may elucidate the gut microbiota's role in the development of AD. Methods: A literature review of all the relevant papers known to the author was conducted. Relevant articles, abstracts and research papers were collected from well-accepted web sources like PubMed, PMC, and Google Scholar. Results: Recent studies have shown that Gut-microbiota has an important role in the progression of AD via Gut-Microbiota-Brain Axis. The onset of AD supports the ‘Hygiene Hypothesis’, which shows that AD might begin in the Gut, causing dysbiosis, which interferes with the intestinal barrier by releasing pro-inflammatory cytokines and making its way up to the brain via the blood-brain barrier (BBB). Molecular mechanisms lipopolysaccharides and serotonin kynurenine (tryptophan) pathways have a direct association with inflammation, the immune system, neurodegeneration, and AD. Conclusion: The studies helped to analyze the molecular basis of AD, other neurological conditions like depression, autism, and Parkinson's disease and how they are linked to Gut-microbiota. Further, studies to explore the therapeutic effects of probiotics in AD and cognitive enhancement should be warranted to provide significant clinical and practical value.

Keywords: gut-microbiota, Alzheimer’s disease, second brain aging, lipopolysaccharides, short-chain fatty acids

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Authors: Yehia Manawi, Ahmad Kayvanifard

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Membrane distillation is an emerging technology which has been used to produce freshwater and purify different types of aqueous mixtures. Qatar is an arid country where almost 100% of its freshwater demand is supplied through the energy-intensive thermal desalination process. The country’s need for water has reached an all-time high which stipulates finding an alternative way to augment freshwater without adding any drastic affect to the environment. The objective of this paper was to investigate the potential of using the industrial low grade waste heat to produce freshwater using membrane distillation. The main part of this work was conducting a heat audit on selected Qatari chemical industries to estimate the amounts of freshwater produced if such industrial waste heat were to be recovered. By the end of this work, the main objective was met and the heat audit conducted on the Qatari chemical industries enabled us to estimate both the amounts of waste heat which can be potentially recovered in addition to the amounts of freshwater which can be produced if such waste heat were to be recovered. By the end, the heat audit showed that around 605 Mega Watts of waste heat can be recovered from the studied Qatari chemical industries which resulted in a total daily production of 5078.7 cubic meter of freshwater. This water can be used in a wide variety of applications such as human consumption or industry. The amount of produced freshwater may look small when compared to that produced through thermal desalination plants; however, one must bear in mind that this water comes from waste and can be used to supply water for small cities or remote areas which are not connected to the water grid. The idea of producing freshwater from the two widely-available wastes (thermal rejected brine and waste heat) seems promising as less environmental and economic impacts will be associated with freshwater production which may in the near future augment the conventional way of producing freshwater currently being thermal desalination. This work has shown that low grade waste heat in the chemical industries in Qatar and perhaps the rest of the world can contribute to additional production of freshwater using membrane distillation without significantly adding to the environmental impact.

Keywords: membrane distillation, desalination, heat recovery, environment

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Authors: Mallem Leila, Aiche Mohamed Amine, Boulakoud Mohamed Salah

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A number of chemical compounds are being used to protect agricultural crops from diseases. Residues of these chemicals lead to environmental pollution and pose some threat to non target organisms, human and animal. The aim of this study is to detect the toxicity of these fungicides and their mixtures in the fertility and biochemical’s parameters in the rat. The male of rats (28) were used, they were divided in four groups (7 rats of each group) and one group was used as control. Rats were dosed orally with propiconazole (60 mg/kg body weight/day), propinebe (100 mg/Kg body weight/day) and their mixture (50:50) for 4 weeks. Animals were observed for clinical toxicity. At the end of treatment period, animals of all groups were scarified and samples of different organs were fixed in the formol 10% for histopathological study, and blood was collected for hematological and biochemical’s analysis. The results indicated that the fungicide and their mixture of fungicides were toxic in the treated animals. The semen study showed a decrease in the count, mobility and speed of spermatozoa in all treated group especially those dosed with the mixture and Propiconazole, it was also a decrease in the weight of the testis and epidydimis in the treated group as compared with control. Remarquable histological changes were observed in the testis and epidydimis and liver in the group treated with mixture.

Keywords: fungicides, mixture, fertility, hematological, biochemical's parameters

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Authors: Chloe T. Cohen, Sarah Johnson

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Psychoanalytic literature has traditionally focused on the theoretical explanations of psychological phenomena rather than empirical research to support those ideas. Many clinicians assume a lack of empirical verification of the theories that underpin psychoanalytic treatment disqualifies psychoanalytic psychotherapy as an effective clinical technique. One such theory is Lacan’s ‘Name of the Father’, which extended Freud’s idea of the importance of a successful resolution of the Oedipal problem, situating it even earlier in psychological development. Lacan posited that the Name of the Father construct (establishing psychological structure and preventing psychosis) was best represented in language use, metaphor, and linguistic structure. However, no study to date has empirically examined the Name of the Father construct. The current study attempts to measure Lacan’s ‘Name of the Father’ construct through linguistic structure and metaphor use and to compare it with Freud’s ‘original introject’. We will then investigate whether they relate to adult personality functioning (measured using the Rorschach Inkblot Test). We aim to contribute to the empirical study of psychoanalytic concepts by operationalizing and validating the Name of the Father empirically. We also aim to examine the relationship of the Name of the Father construct to Freud’s concept of the original introject and to adult pathology. We hypothesize that measures of the original introject will mediate the pathway between linguistic indicators of Lacan’s Name of the Father construct and personality functioning.

Keywords: Lacan, Name of the Father, original introject, personality functioning, psychoanalysis

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Authors: Elias L. Souza, Noeli Sellin, Cintia Marangoni, Ozair Souza

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Among the different forms of reuse and recovery of agro-residual waste is the production of biofuels. The production of second-generation ethanol has been evaluated and proposed as one of the technically viable alternatives for this purpose. This research work employed the banana pseudostem as biomass. Two different chemical pre-treatment methods (acid hydrolisis with H2SO4 2% w/w and alkaline hydrolysis with NaOH 3% w/w) of dry and milled biomass (70 g/L of dry matter, ms) were assessed, and the corresponding reducing sugars yield, AR, (YAR), after enzymatic saccharification, were determined. The effect on YAR by increasing the dry matter (ms) from 70 to 100 g/L, in dry and milled biomass and also fresh, were analyzed. Changes in cellulose crystallinity and in biomass surface morphology due to the different chemical pre-treatments were analyzed by X-ray diffraction and scanning electron microscopy. The acid pre-treatment resulted in higher YAR values, whether related to the cellulose content under saccharification (RAR = 79,48) or to the biomass concentration employed (YAR/ms = 32,8%). In a comparison between alkaline and acid pre-treatments, the latter led to an increase in the cellulose content of the reaction mixture from 52,8 to 59,8%; also, to a reduction of the cellulose crystallinity index from 51,19 to 33,34% and increases in RAR (43,1%) and YAR/ms (39,5%). The increase of dry matter (ms) bran from 70 to 100 g/L in the acid pre-treatment, resulted in a decrease of average yields in RAR (43,1%) and YAR/ms (18,2%). Using the pseudostem fresh with broth removed, whether for 70 g/L concentration or 100 g/L in dry matter (ms), similarly to the alkaline pre-treatment, has led to lower average values in RAR (67,2% and 42,2%) and in YAR/ms (28,4% e 17,8%), respectively. The acid pre-treated and saccharificated biomass broth was detoxificated with different activated carbon contents (1,2 and 4% w/v), concentrated up to AR = 100 g/L and fermented by Saccharomyces cerevisiae. The yield values (YP/AR) and productivity (QP) in ethanol were determined and compared to those values obtained from the fermentation of non-concentrated/non-detoxificated broth (AR = 18 g/L) and concentrated/non-detoxificated broth (AR = 100 g/L). The highest average value for YP/AR (0,46 g/g) was obtained from the fermentation of non-concentrated broth. This value did not present a significant difference (p<0,05) when compared to the YP/RS related to the broth concentrated and detoxificated by activated carbon 1% w/v (YP/AR = 0,41 g/g). However, a higher ethanol productivity (QP = 1,44 g/L.h) was achieved through broth detoxification. This value was 75% higher than the average QP determined using concentrated and non-detoxificated broth (QP = 0,82 g/L.h), and 22% higher than the QP found in the non-concentrated broth (QP = 1,18 g/L.h).

Keywords: biofuels, biomass, saccharification, bioethanol

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Authors: Pietro Mortini, Marco Losa

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Objective: Resection of large lesions growing into the third ventricle remains a demanding surgery, sometimes at risk of severe post-operative complications. Transcallosal and transcortical routes were considered as approaches of choice to access the third ventricle, however neurological consequences like memory loss have been reported. We report clinical results of the previously described combined interhemispheric sub-commissural translaminaterminalis approach (CISTA) for the resection of large lesions located in the third ventricle. Methods: Authors conducted a retrospective analysis on 10 patients, who were operated through the CISTA, for the resection of lesions growing into the third ventricle. Results: Total resection was achieved in all cases. Cognitive worsening occurred only in one case. No perioperative deaths were recorded and, at last follow-up, all patients were alive. One year after surgery 80% of patients had an excellent outcome with a KPS 100 and Glasgow Outcome score (GOS) Conclusion: The CISTA represents a safe and effective alternative to transcallosal and transcortical routes to resect lesions growing into the third ventricle. It allows for a multiangle trajectory to access the third ventricle with a wide working area free from critical neurovascular structures, without any section of the corpus callosum, the anterior commissure and the fornix.

Keywords: craniopharingioma, surgery, sub-commissural translaminaterminalis approach (CISTA),

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Authors: Tarek Duzan

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Fractures are a fundamental property of most reservoirs. Despite their abundance, they remain difficult to detect and quantify. The most effective characterization of fractured reservoirs is accomplished by integrating geological, geophysical, and engineering data. Detection of fractures and defines their relative contribution is crucial in the early stages of exploration and later in the production of any field. Because fractures could completely change our thoughts, efforts, and planning to produce a specific field properly. From the structural point of view, all reservoirs are fractured to some point of extent. North Gialo field is thought to be a naturally fractured reservoir to some extent. Historically, natural fractured reservoirs are more complicated in terms of their exploration and production efforts, and most geologists tend to deny the presence of fractures as an effective variable. Our aim in this paper is to determine the degree of fracturing, and consequently, our evaluation and planning can be done properly and efficiently from day one. The challenging part in this field is that there is no enough data and straightforward well testing that can let us completely comfortable with the idea of fracturing; however, we cannot ignore the fractures completely. Logging images, available well testing, and limited core studies are our tools in this stage to evaluate, model, and predict possible fracture effects in this reservoir. The aims of this study are both fundamental and practical—to improve the prediction and diagnosis of natural-fracture attributes in N. Gialo hydrocarbon reservoirs and accurately simulate their influence on production. Moreover, the production of this field comes from 2-phase plan; a self depletion of oil and then gas injection period for pressure maintenance and increasing ultimate recovery factor. Therefore, well understanding of fracturing network is essential before proceeding with the targeted plan. New analytical methods will lead to more realistic characterization of fractured and faulted reservoir rocks. These methods will produce data that can enhance well test and seismic interpretations, and that can readily be used in reservoir simulators.

Keywords: natural fracture, sandstone reservoir, geological, geophysical, and engineering data

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Authors: Abu Yousuf, Maksudur Rahman Khan, Ahasanul Karim, Amirul Islam, Minhaj Uddin Monir, Sharmin Sultana, Domenico Pirozzi

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Traditional biodiesel feedstock like edible oils or plant oils, animal fats and cooking waste oil have been replaced by microbial oil in recent research of biodiesel synthesis. The well-known community of microbial oil producers includes microalgae, oleaginous yeast and seaweeds. Conventional transesterification of microbial oil to produce biodiesel is lethargic, energy consuming, cost-ineffective and environmentally unhealthy. This process follows several steps such as microbial biomass drying, cell disruption, oil extraction, solvent recovery, oil separation and transesterification. Therefore, direct transesterification of biodiesel synthesis has been studying for last few years. It combines all the steps in a single reactor and it eliminates the steps of biomass drying, oil extraction and separation from solvent. Apparently, it seems to be cost-effective and faster process but number of difficulties need to be solved to make it large scale applicable. The main challenges are microbial cell disruption in bulk volume and make faster the esterification reaction, because water contents of the medium sluggish the reaction rate. Several methods have been proposed but none of them is up to the level to implement in large scale. It is still a great challenge to extract maximum lipid from microbial cells (yeast, fungi, algae) investing minimum energy. Electroporation technique results a significant increase in cell conductivity and permeability caused due to the application of an external electric field. Electroporation is required to alter the size and structure of the cells to increase their porosity as well as to disrupt the microbial cell walls within few seconds to leak out the intracellular lipid to the solution. Therefore, incorporation of electroporation techniques contributed in direct transesterification of microbial lipids by increasing the efficiency of biodiesel production rate.

Keywords: biodiesel, electroporation, microbial lipids, transesterification

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Authors: Yen-Hsia Lin, Ya-Fang Cheng, Hui-Zhu Chen, Chi-Hui Tiao

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This is a case study of a 70-year-old man suffering from Type 2 diabetes mellitus and hyperglycemia hyperosmolarity state. He was admitted into the intensive care unit from the 20th to 26th of October, 2015. After receiving relevant information through open-ended conversations, observation, and physical assessment, as well as the psychological, social and spiritual holistic nursing assessment, several clinical health problems such as unstable blood sugar, impaired skin integrity and lack of self-care management knowledge were identified by the author. During the period of care, the patient was encouraged to share and express his feelings, an active listening and initiating approach from the nursing team had led to the understanding of why the patient refused to use insulin. This knowledge enabled the nursing team to manage patient care by educating the patient with self-care management skills, such as foot wound care and insulin injection skills to slow the deterioration of complications. Also, the implementation of appropriate diet and exercise routine to improve patients’ style. By enhancing self-care ability in diabetic patients, they are able to return home with the skill to improve better quality life style.

Keywords: hyperglycemia hyperosmolar state, type2 diabetes Mellitu, diabetes Mellitu foot care, intensive care

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Authors: Dhurgham Al-Karawi, Nisreen Polus, Shakir Al-Zaidi, Sabah Jassim

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The management of COVID-19 patients based on chest imaging is emerging as an essential tool for evaluating the spread of the pandemic which has gripped the global community. It has already been used to monitor the situation of COVID-19 patients who have issues in respiratory status. There has been increase to use chest imaging for medical triage of patients who are showing moderate-severe clinical COVID-19 features, this is due to the fast dispersal of the pandemic to all continents and communities. This article demonstrates the development of machine learning techniques for the test of COVID-19 patients using Chest X-Ray (CXR) images in nearly real-time, to distinguish the COVID-19 infection with a significantly high level of accuracy. The testing performance has covered a combination of different datasets of CXR images of positive COVID-19 patients, patients with viral and bacterial infections, also, people with a clear chest. The proposed AI scheme successfully distinguishes CXR scans of COVID-19 infected patients from CXR scans of viral and bacterial based pneumonia as well as normal cases with an average accuracy of 94.43%, sensitivity 95%, and specificity 93.86%. Predicted decisions would be supported by visual evidence to help clinicians speed up the initial assessment process of new suspected cases, especially in a resource-constrained environment.

Keywords: COVID-19, chest x-ray scan, artificial intelligence, texture analysis, local binary pattern transform, Gabor filter

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Authors: Sabah Mohammed, Jinan Fiaidhi, Darien Sawyer

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Data integration of health through connected services can save lives in the event of a medical emergency or provide efficient and effective interventions for the benefit of the patients through the integration of bedside and bench side clinical research. Such integration will support all wind of change in healthcare by being predictive, pre-emptive, personalized, problem-oriented and participatory. Prototyping a healthcare system that enables data integration has been a big challenge for healthcare for a long time. However, an innovative solution started to emerge by focusing on problem lists where everything can connect the problem list forming a growing graph. This notion was introduced by Dr. Lawrence Weed in early 70’s, but the enabling technologies weren’t mature enough to provide a successful implementation prototype. In this article, we are describing our efforts in prototyping Dr. Lawrence Weed's problem-oriented medical record (POMR) and his patient case schema (SOAP) to shape a prototype for connected health. For this, we are using the TypeGraphQL API and our enterprise-based QL4POMR to describe a Web-Based gateway for healthcare services connectivity. Our prototype has reported success in connecting to the HL7 FHIR medical record and the OpenTarget biomedical repositories.

Keywords: connected health, problem-oriented healthcare record, SOAP, QL4POMR, typegraphQL

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Authors: Olha Yarova

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This study is a collaborative project between the American University of Central Asia and parent association of children with Down syndrome ‘Sunterra’ that took place in Bishkek, Kyrgyzstan. The purpose of the study was to explore whether principles and techniques of applied behavior analysis (ABA) could be used to teach children with Down syndrome socially significant behaviors. ABA is considered to be one of the most effective treatment for children with autism, but little research is done on the particularity of using ABA to children with Down syndrome. The data for the study was received during clinical observations; work with children with Down syndrome and interviews with their mothers. The results show that many ABA principles make the work with children with Down syndrome more effective. Although such children very rarely demonstrate aggressive behavior, they show a lot of escape-driven and attention seeking behaviors that are reinforced by their parents and educators. Thus functional assessment can be done to assess the function of problem behavior and to determine appropriate treatment. Prompting and prompting fading should be used to develop receptive and expressive language skills, and enhance motor development. Even though many children with Down syndrome work for praise, it is still relevant to use tangible reinforcement and to know how to remove them. Based on the results of the study, the training for parents of children with Down syndrome will be developed in Kyrgyzstan, country, where children with Down syndrome are not accepted to regular kindergartens and where doctors in maternity hospitals tell parents that their child will never talk, walk and recognize them

Keywords: down syndrome, applied behavior analysis, functional assessment, problem behavior, reinforcement

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Authors: Li-Ching Chen

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The case-control design has been widely applied in clinical and epidemiological studies to investigate the association between risk factors and a given disease. The retrospective design can be easily implemented and is more economical over prospective studies. To adjust effects for confounding factors, methods such as stratification at the design stage and may be adopted. When some major confounding factors are difficult to be quantified, a matching design provides an opportunity for researchers to control the confounding effects. The matching effects can be parameterized by the intercepts of logistic models and the conditional logistic regression analysis is then adopted. This study demonstrates an information-matrix-based goodness-of-fit statistic to test the validity of the logistic regression model for matched case-control data. The asymptotic null distribution of this proposed test statistic is inferred. It needs neither to employ a simulation to evaluate its critical values nor to partition covariate space. The asymptotic power of this test statistic is also derived. The performance of the proposed method is assessed through simulation studies. An example of the real data set is applied to illustrate the implementation of the proposed method as well.

Keywords: conditional logistic model, goodness-of-fit, information matrix, matched case-control studies

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Authors: Carolina Morales, Ricardo Castro-Huerta, Enrique A. Mundaca

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The edaphic fauna is the main factor involved in the transformation of nutrients and soil decomposition processes. Edaphic organisms are highly sensitive to soil disturbances, which normally causes changes in the composition and abundance of such organisms. Fire is known to be a disturbing factor since it affects the physical, chemical and biological properties of the soil and the whole ecosystem. During the summer (December-March) of 2017, Chile suffered the major fire events recorded in its modern history, which affected a vast area and a number of ecosystem types. The objective of this study was first to use remote sensing satellite images and GIS (Geographic Information Systems) to assess and identify levels of fire severity in disturbed areas and to compare the responses of the soil mesofauna diversity among such areas. We identified four areas (treatments) with an ascending level of severity, namely: mild, medium, high severity, and free of fire. A non-affected patch of forest was established as a control. Three samples from each treatment were collected in the form of a soil cube (10x10x10 cm). Edaphic mesofauna was obtained from each sample through the Berlese-Tullgren funnel method. Collected specimens were quantified and identified, using the RTU (Recognisable Taxonomic Unit) criterion. Diversity was analysed using inferential statistics to compare Simpson and Shannon-Wiener indexes across treatments. As predicted, the unburned forest patch (control) exhibited higher diversity values than the treatments. Significantly higher diversity values were recorded in those treatments subjected to lower fire severity. We conclude that remote sensing zoning is an adequate tool to identify different levels of fire severity and that an edaphic mesofauna is a group of organisms that qualify as good bioindicators for monitoring soil recovery after fire events.

Keywords: bioindicator, Chile, fire severity level, soil

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Authors: Karissa A. Graham

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Pyoderma gangrenosum (PG) is a prototypic autoinflammatory neutrophilic dermatosis that is a rare disorder. It presents a diagnostic challenge owing to its variable presentation, clinical overlap with other conditions, it is often associated with other systemic conditions, and there is no definitive histological or laboratory characteristic. The Delphai consensus for PG includes the presence of at least one ulcer on the anterior lower limb. Systemic corticosteroids and immunosuppressive therapies are the mainstay treatment for PG. We describe a case report of delayed diagnosis of ulcerative pyoderma gangrenosum in a 44-year-old male on his forearm. The patient presented with an infected ulcer on his right forearm that had been present for over three years. The patient was a Type 2 Diabetic with no personal or family history of inflammatory bowel disease or other autoimmune diseases. The patient was initially investigated for malignancy, but biopsies returned as chronic inflammatory tissue with neutrophilic infiltrate and no malignancy. The patient was commenced on systemic prednisone for the treatment of pyoderma gangrenosum. The diagnosis of ulcerative PG poses a challenge given the vast differential diagnosis for a cutaneous ulcer (i.e., malignant, vascular, autoimmune, trauma, infective, etc.). Diagnostic accuracy is important given that the treatment for PG with steroids does not go without risks and indeed may be contraindicated in other potential causes of the ulcer. Indeed, more common and more sinister causes of ulcers should be investigated first, as death from PG is quite rare.

Keywords: dermatological diagnosis, dermatosis, pyoderma gangrenosum, rare presentation

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Authors: S. J. Sirima, C. Thirawan, R.Puntharikorn, K. Ungsumalin, J. Kaemwich

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Acinetobacter spp. is a gram negative bacterium causing the high incidence of multi-drug resistance in patients admitted to an intensive care unit. A hundred isolates of Imipenem-resistant Acinetobacter spp. isolated from patients admitted at tertiary health care center, Northeastern region, Ubon Ratchathani, Thailand, were subjected to modified Hodge test and combined disc test in order to evaluate the production of carbapenemases. The results revealed that about 35% of isolates were found to be carbapenemases producers. In addition, multiplex polymerase chain reactions were performed to detect blaOXA-like genes. It showed that 92% of isolates possess blaOXA-51-like and blaOXA-23-like genes. However, blaOXA-58-like gene was detected in only 8 isolates. No detection of blaOXA-24-like gene was observed in all isolates. In conclusion, an ability to produce carbepenemases would be an important mechanism of multi-drug resistance among clinical isolates of Acinetobacter spp. at tertiary health care center, Northeastern region, Ubon Ratchathani, Thailand. Furthermore, it was likely that the class D carbapenemases genes, blaOXA-51-like and blaOXA-23-like, might contribute to imipenem-resistance exhibiting among isolates.

Keywords: Acinetobacter spp., blaOXA-like genes, carbapenemases, tertiary health care center

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Authors: Siyabonga Aubrey Mhlongo, Linda Lunga Sibali, Phumlane Selby Mdluli, Peter Papoh Ndibewu, Kholofelo Clifford Malematja

Abstract:

This paper reports on the successful extraction and quantification of an antibacterial and antifungal agent present in some consumer products (Triclosan: C₁₂H₇Cl₃O₂)generally found in wastewater or effluents using molecularly imprinted membrane adsorbent (MIMs) followed by quantification and removal on a high-performance liquid chromatography (HPLC). Triclosan is an antibacterial and antifungal agent present in some consumer products like toothpaste, soaps, detergents, toys, and surgical cleaning treatments. The MIMs was fabricated usingpolyvinylidene fluoride (PVDF) polymer with selective micro composite particles known as molecularly imprinted polymers (MIPs)via a phase inversion by immersion precipitation technique. This resulted in an improved hydrophilicity and mechanical behaviour of the membranes. Wastewater samples were collected from the Umbogintwini Industrial Complex (UIC) (south coast of Durban, KwaZulu-Natal in South Africa). central UIC effluent treatment plant and pre-treated before analysis. Experimental parameters such as sample size, contact time, stirring speed were optimised. The resultant MIMs had an adsorption efficiency of 97% of TCS with reference to NIMs and bare membrane, which had 92%, 88%, respectively. The analytical method utilized in this review had limits of detection (LoD) and limits of quantification (LoQ) of 0.22, 0.71µgL-1 in wastewater effluent, respectively. The percentage recovery for the effluent samples was 68%. The detection of TCS was monitored for 10 consecutive days, where optimum TCS traces detected in the treated wastewater was 55.0μg/L inday 9 of the monitored days, while the lowest detected was 6.0μg/L. As the concentrations of analytefound in effluent water samples were not so diverse, this study suggested that MIMs could be the best potential adsorbent for the development and continuous progress in membrane technologyand environmental sciences, lending its capability to desalination.

Keywords: molecularly imprinted membrane, triclosan, phase inversion, wastewater

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Authors: Sofiqul Islam, V. Murugan, Prema Kumari, Hari

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Gentamicin is a broad spectrum water-soluble aminoglycoside antibiotics produced by the fermentation process of microorganism known as Micromonospora purpurea. It is widely used for the treatment of infection caused by both gram positive and gram negative bacteria. Gentamicin consists of a mixture of aminoglycoside components like C1, C1a, C2a, and C2. The molecular structure of Gentamicin and its related substances showed that it has lack of presence of chromophore group in the molecule due to which the detection of such components were quite critical and challenging. In this study, a simple Reversed Phase-High Performance Liquid Chromatographic (RP-HPLC) method using ultraviolet (UV) detector was developed and validated for quantification of the related substances present in Gentamicin drug substances. The method was achieved by using Thermo Scientific Hypersil Gold analytical column (150 x 4.6 mm, 5 µm particle size) with isocratic elution composed of methanol: water: glacial acetic acid: sodium hexane sulfonate in the ratio 70:25:5:3 % v/v/v/w as a mobile phase at a flow rate of 0.5 mL/min, column temperature was maintained at 30 °C and detection wavelength of 330 nm. The four components of Gentamicin namely Gentamicin C1, C1a, C2a, and C2 were well separated along with the related substance present in Gentamicin. The Limit of Quantification (LOQ) values were found to be at 0.0075 mg/mL. The accuracy of the method was quite satisfactory in which the % recovery was resulted between 95-105% for the related substances. The correlation coefficient (≥ 0.995) shows the linearity response against concentration over the range of Limit of Quantification (LOQ). Precision studies showed the % Relative Standard Deviation (RSD) values less than 5% for its related substance. The method was validated in accordance with the International Conference of Harmonization (ICH) guideline with various parameters like system suitability, specificity, precision, linearity, accuracy, limit of quantification, and robustness. This proposed method was easy and suitable for use for the quantification of related substances in routine analysis of Gentamicin formulations.

Keywords: reversed phase-high performance liquid chromatographic (RP-HPLC), high performance liquid chromatography, gentamicin, isocratic, ultraviolet

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Authors: Mohsin Ali Baloch, Saira Baloch

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Objective: The aim of this study was to evaluate the levels of serum lipid profiles in Urban and Rural Population of Sindh, to indicate the existing risk of cardiovascular diseases. Material and Methods: Study was conducted at Liaquat University of Medical & Health Sciences, in the cities of Jamshoro and Hyderabad of Sindh. Blood samples from 300 healthy individuals were collected in fasting condition, out them 100 were from rural population, 100 were urban while 100 were used as control group. The biochemistry of these samples was obtained by the analysis of total Cholesterol, high density lipoprotein Cholesterol (HDL), low-density lipoprotein Cholesterol (LDL) and Triglycerides using kit method on Analyzer Clinical Chemistry. Results and Conclusion: Serum levels of total cholesterol, Triglycerides, and LDL cholesterol were significantly raised in the rural and urban males, whereas HDL cholesterol was decreased as compared to the Healthy controls that indicated significant risk of CVD. Urban population was with more risk of CVD and male gender in both groups was at more risk. The worst lipid profile in gender wise distribution was observed in male gender of urban population with highest Total Cholesterol/HDL Ratio while female gender also shown moderate risk of CVD with highest LDL/HDL Ratio.

Keywords: cardiovascular diseases, lipid profiles, urban and rural population, LDL/HDL Ratio

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Authors: Pritika Ramharack, Mahmoud E. S. Soliman

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The re-emerging Zika virus is an arthropod-borne virus that has been described to have explosive potential as a worldwide pandemic. The initial transmission of the virus was through a mosquito vector, however, evolving modes of transmission has allowed the spread of the disease over continents. The virus already been linked to irreversible chronic central nervous system (CNS) conditions. The concerns of the scientific and clinical community are the consequences of Zika viral mutations, thus suggesting the urgent need for viral inhibitors. There have been large strides in vaccine development against the virus but there are still no FDA-approved drugs available. Rapid rational drug design and discovery research is fundamental in the production of potent inhibitors against the virus that will not just mask the virus, but destroy it completely. In silico drug design allows for this prompt screening of potential leads, thus decreasing the consumption of precious time and resources. This study demonstrates an optimized and proven screening technique in the discovery of two potential small molecule inhibitors of Zika virus Methyltransferase and RNA-dependent RNA polymerase. This in silico “per-residue energy decomposition pharmacophore” virtual screening approach will be critical in aiding scientists in the discovery of not only effective inhibitors of Zika viral targets, but also a wide range of anti-viral agents.

Keywords: NS5 protein inhibitors, per-residue decomposition, pharmacophore model, virtual screening, Zika virus

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Authors: Ahmad Shukri Mohd Noor, Emma Ahmad Sirajudin, Rabiei Mamat

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Pertaining to a particular Marine interest, the process of data sampling could take years before a study can be concluded. Therefore, the need for a robust backup system for the data is invariably implicit. In recent advancement of Marine applications, more functionalities and tools are integrated to assist the work of the researchers. It is anticipated that this modality will continue as research scope widens and intensifies and at the same to follow suit with current technologies and lifestyles. The convenience to collect and share information these days also applies to the work in Marine research. Therefore, Marine system designers should be aware that high availability is a necessary attribute in Marine repository applications as well as a robust backup system for the data. In this paper, the approach to high availability is related both to hardware and software but the focus is more on software. We consider a NABTIC repository system that is primitively built on a single server and does not have replicated components. First, the system is decomposed into separate modules. The modules are placed on multiple servers to create a distributed system. Redundancy is added by placing the copies of the modules on different servers using Neighbor Caring Environment System(NCES) technique. NCER is utilizing parallel replication components mechanism. A background monitoring is established to check servers’ heartbeats to confirm their aliveness. At the same time, a critical adaptive threshold is maintained to make sure a failure is timely detected using Adaptive Fault Detection (AFD). A confirmed failure will set the recovery mode where a selection process will be done before a fail-over server is instructed. In effect, the Marine repository service is continued as the fail-over masks a recent failure. The performance of the new prototype is tested and is confirmed to be more highly available. Furthermore, the downtime is not noticeable as service is immediately restored automatically. The Marine repository system is said to have achieved fault tolerance.

Keywords: availability, fault detection, replication, fault tolerance, marine application

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Authors: Nevila Alliu, Saimir Heta, Ilma Robo, Vera Ostreni

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Periodontitis as an oral pathology caused by specific bacterial flora functions as a focal infection for the onset and aggravation of arteriosclerosis. These two distant pathologies, since they affect organs at a distance from each other, communicate with each other with correlation at the level of markers of inflammation in the blood. Fluctuations in the level of fibrinogen in the blood, depending on the active or passive phase of the existing periodontitis, affect the promotion of arteriosclerosis. The study is of the review type to analyze the effect of non-surgical periodontal treatment on fluctuations in the level of fibrinogen in the blood. The reduction of fibrinogen levels in the blood after non-surgical periodontal treatment of periodontitis in the patient's cavity is visible data and supported by literature sources. Also, the influence of a high amount of fibrinogen in the blood on the occurrence of arteriosclerosis is also another important data that again relies on many sources of literature. Conclusions: Thromboembolism and arteriosclerosis, as risk factors expressed in clinical data, have temporary bacteremia in the blood, which can occur significantly and often between phases of non-surgical periodontal treatment of periodontitis, treatments performed with treatment phases and protocols of predetermined treatment. Arterial thromboembolism has a significant factor, such as high levels of fibrinogen in the blood, which are significantly reduced during the period of non-surgical periodontal treatment.

Keywords: fibrinogen, refractory periodontitis, atherosclerosis, non-surgical, periodontal treatment

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Authors: Aulina R. Rahmi, Farid Yuristiawan, Annisa Ibifadillah, Ummu H. Amri, Hidayati Gunawan

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Glass ionomer cement is one of the filling material that often used on the field of dentistry because it is relatively less expensive and mostly available. Restoration materials could undergo changes in their clinical properties such as changes in roughness of the restoration`s surface. An increase of surface roughness accelerates bacterial colonization and plaque maturation. In the oral cavity, GIC was exposed to various substances, such as toothpaste, an oral care product used during toothbrushing. One of the popular toothpaste is whitening toothpaste. Abrasive and chemical agents such as hydrogen peroxide in whitening toothpaste could increase the surface roughness of restorative materials. Objective: To determine the differences on the surface roughness of glass ionomer cement that was brushed with whitening and conventional toothpaste. Method: This study was done using experimental laboratory method with pre and post test design. There were 36 samples which were divided into 2 groups. The first group was brushed with whitening toothpaste and the second group was brushed with conventional toothpaste, each for 2 minutes. Surface roughness value of the specimens was measured by using Roughness Tester test. Result: The data was analyzed by using independent t-test and the result of this study showed there was a significant difference between the surface of glass ionomer cement which was brushed with whitening and conventional toothpaste (p=0,000). Conclusion: Glass ionomer cement that was brushed with whitening toothpaste produced more roughness than conventional toothpaste.

Keywords: glass ionomer cement, surface roughness, toothpaste, roughness tester

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Authors: Jay Ananth

Abstract:

The drug discovery process currently requires numerous years of clinical testing as well as money just for a single drug to earn FDA approval. For drugs that even make it this far in the process, there is a very slim chance of receiving FDA approval, resulting in detrimental hurdles to drug accessibility. To minimize these inefficiencies, numerous studies have implemented computational methods, although few computational investigations have focused on a crucial feature of drugs: lipophilicity. Lipophilicity is a physical attribute of a compound that measures its solubility in lipids and is a determinant of drug efficacy. This project leverages Artificial Intelligence to predict the impact of a drug’s lipophilicity on its performance by accounting for factors such as binding affinity and toxicity. The model predicted lipophilicity and binding affinity in the validation set with very high R² scores of 0.921 and 0.788, respectively, while also being applicable to a variety of target receptors. The results expressed a strong positive correlation between lipophilicity and both binding affinity and toxicity. The model helps in both drug development and discovery, providing every pharmaceutical company with recommended lipophilicity levels for drug candidates as well as a rapid assessment of early-stage drugs prior to any testing, eliminating significant amounts of time and resources currently restricting drug accessibility.

Keywords: drug discovery, lipophilicity, ligand-receptor interactions, machine learning, drug development

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Authors: Giuliana Murfet, Heidi Behrens

Abstract:

Chronic disease is Australia’s biggest health concern and obesity the leading risk factor for many. Obesity and chronic disease have a higher representation in rural Tasmania, where levels of socio-disadvantage are also higher. People living outside major cities have less access to health services and poorer health outcomes. To help primary healthcare professionals manage obesity, the Australian NHMRC evidence-based clinical practice guidelines for management of overweight and obesity in adults were developed. They include recommendations for practice and models for obesity management. To our knowledge there has been no research conducted that investigates translation of these guidelines into practice in rural-regional areas; where implementation can be complicated by limited financial and staffing resources. Also, the systematic review that informed the guidelines revealed a lack of evidence for chronic disease models of obesity care. The aim was to establish and evaluate a multidisciplinary model for obesity management in a group of adult people with type 2 diabetes in a dispersed rural population in Australia. Extensive stakeholder engagement was undertaken to both garner support for an obesity clinic and develop a sustainable model of care. A comprehensive nurse practitioner-led outpatient model for obesity care was designed. Multidisciplinary obesity clinics for adults with type 2 diabetes including a dietitian, psychologist, physiotherapist and nurse practitioner were set up in the north-west of Tasmania at two geographically-rural towns. Implementation was underpinned by the NHMRC guidelines and recommendations focused on: assessment approaches; promotion of health benefits of weight loss; identification of relevant programs for individualising care; medication and bariatric surgery options for obesity management; and, the importance of long-term weight management. A clinical pathway for adult weight management is delivered by the multidisciplinary team with recognition of the impact of and adjustments needed for other comorbidities. The model allowed for intensification of intervention such as bariatric surgery according to recommendations, patient desires and suitability. A randomised controlled trial is ongoing, with the aim to evaluate standard care (diabetes-focused management) compared with an obesity-related approach with additional dietetic, physiotherapy, psychology and lifestyle advice. Key barriers and enablers to guideline implementation were identified that fall under the following themes: 1) health care delivery changes and the project framework development; 2) capacity and team-building; 3) stakeholder engagement; and, 4) the research project and partnerships. Engagement of not only local hospital but also state-wide health executives and surgical services committee were paramount to the success of the project. Staff training and collective development of the framework allowed for shared understanding. Staff capacity was increased with most taking on other activities (e.g., surgery coordination). Barriers were often related to differences of opinions in focus of the project; a desire to remain evidenced based (e.g., exercise prescription) without adjusting the model to allow for consideration of comorbidities. While barriers did exist and challenges overcome; the development of critical partnerships did enable the capacity for a potential model of obesity care for rural regional areas. Importantly, the findings contribute to the evidence base for models of diabetes and obesity care that coordinate limited resources.

Keywords: diabetes, interdisciplinary, model of care, obesity, rural regional

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