Search results for: combined modality therapy

Authors: Bahatti̇n Ki̇mençe, Uğur Ki̇mençe

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In this study, the purpose of obtaining the influence functions of the displacement discontinuity in an anisotropic elastic medium is to produce the boundary element equations. A Displacement Discontinuous Method formulation (DDM) is presented with the aim of modeling two-dimensional elastic fracture problems. This formulation is found by analytical integration of the fundamental solution along a straight-line crack. With this purpose, Kelvin's fundamental solutions for anisotropic media on an infinite plane are used to form dipoles from singular loads, and the various combinations of the said dipoles are used to obtain the influence functions of displacement discontinuity. This study introduces a technique for coupling Fictitious Stress Method (FSM) and DDM; the reason for applying this technique to some examples is to demonstrate the effectiveness of the proposed coupling method. In this study, displacement discontinuity equations are obtained by using dipole solutions calculated with known singular force solutions in an anisotropic medium. The displacement discontinuities method obtained from the solutions of these equations and the fictitious stress methods is combined and compared with various examples. In this study, one or more crack problems with various geometries in rectangular plates in finite and infinite regions, under the effect of tensile stress with coupled FSM and DDM in the anisotropic environment, were examined, and the effectiveness of the coupled method was demonstrated. Since crack problems can be modeled more easily with DDM, it has been observed that the use of DDM has increased recently. In obtaining the displacement discontinuity equations, Papkovitch functions were used in Crouch, and harmonic functions were chosen to satisfy various boundary conditions. A comparison is made between two indirect boundary element formulations, DDM, and an extension of FSM, for solving problems involving cracks. Several numerical examples are presented, and the outcomes are contrasted to existing analytical or reference outs.

Keywords: displacement discontinuity method, fictitious stress method, crack problems, anisotropic material

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Authors: M. Reza Roshandel, Tannaz Aghaei Badr, Batoul Khoundabi, Sara C. Lewis, Soroush Rais-Bahrami, John Sfakianos, Reza Mehrazin, Ash K. Tewari

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Introduction: Prostate biopsy is the most reliable diagnostic method for choosing the appropriate management of prostate cancer. However, discrepancies between Gleason grade groups (GG) of different biopsies remain a significant concern. This study aims to assess the association of the radiological factors with GG discrepancies in patients with index Prostate Imaging Reporting and Data System (PI-RADS) 3 lesions, using radical prostatectomy (RP) specimens as the most accurate and informative pathology. Methods: This single-institutional retrospective study was performed on a total of 2289 consecutive prostate cancer patients with combined targeted and systematic prostate biopsy followed by radical prostatectomy (RP). The database was explored for patients with the index PI-RADS 3 lesions version 2 and 2.1. Cancers with PI-RADS 4 or 5 scoring were excluded from the study. Patient characteristics and radiologic features were analyzed by multivariable logistic regression. Number-density of lesions was defined as the number of lesions per prostatic volume. Results: Of the 151 prostate cancer cases with PI-RADS 3 index lesions, 27% and 17% had upgrades and downgrades at RP, respectively. Analysis of grade changes showed no significant associations between discrepancies and the number or the number density of PI-RADS 3 lesions. Moreover, the study showed no significant association of the GG changes with race, age, location of the lesions, or prostate volume. Conclusions: This study demonstrated that in PI-RADS 3 cancerous nodules, the chance of the pathology changes in the final pathology of RP specimens was low. Furthermore, having multiple PI-RADS 3 nodules did not change the conclusion, as the possibility of grade changes in patients with multiple nodules was similar to those with solitary lesions.

Keywords: prostate, adenocarcinoma, multiparametric MRI, Gleason score, robot-assisted surgery

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Authors: Surachart Koyadun

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Currently, Plasmodium knowlesi malaria has spread to almost all countries in Southeast Asia. This research aimed to 1) describe the epidemiology of Plasmodium knowlesi malaria, 2) examine the clinical symptoms of P. knowlesi malaria patients 3) analyze the ecology, animal reservoir and entomology of P. knowlesi malaria. 4) summarize the diagnosis, blood parasites, and treatment of P. knowlesi malaria. The study design was a case report combined with retrospective descriptive survey research. A total of 34 study subjects were patients with a confirmed diagnosis of P. knowlesi malaria who received treatment at hospitals and vector-borne disease control units in Songkhla Province during 2021 – 2022. The results of the epidemiological study unveiled the majority of the samples were male, had a history of staying overnight in the forest before becoming sick, the source of the infection was in the forest, and the season during which they were sick was mostly summer. The average length of time from the onset of illness until receiving a blood test was 3.8 days. The average length of hospital stay was 4 days. Patients were treated with Chloroquine Phosphate, Primaquine, Artesunate, Quinine, and Dihydroartemisinin-piperaquine (40 mg DHA-320 mg PPQ). One death was seen in 34 P. knowlesi malaria patients. All remaining patients recovered and responded to treatment. All symptoms improved after drug administration. No treatment failures were found. Analyses of ecological, zoonotic and entomological data revealed an association between infected patients and forested, monkey-hosted and mosquito-transmitted areas. The recommendation from this study was that the Polymerase Chain Reaction (PCR) method should be used in conjunction with the Thick/Thin Film test and blood parasite test (Parasitaemia) for the specificity of the infection, accuracy of diagnosis, leading to treatment of disease in a timely manner and be effective in disease control.

Keywords: human malaria, Plasmodium knowlesi, zoonotic disease, diagnosis and treatment, epidemiology, ecology

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Authors: Godwin Ojochogu Adejo, Evelyn UnekwuOjo Adejo, Sunday UnenwOjo Adejo

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The mainstream contemporary approach to controlling the impact of diseases among poultry birds rely largely on curative measures through the administration of drugs to infected birds. Most times as observed in the deep liter poultry farming system, entire flocks including uninfected birds receive the treatment they do not need. As such, unguarded use of chemical drugs and antibiotics has led to wastage and accumulation of chemical residues in poultry products with associated health hazards to humans. However, wanton and frequent drug usage in poultry is avoidable if feeding and drinking equipment are designed to curb infection transmission among birds. Using toxicological assays as guide and with efficiency and simplicity in view, two newly field-tested and recently patented equipments called 'healthy liquid drinking trough (HDT)' and 'healthy feeding trough (HFT)' that systematically eliminate contamination of the feeding and drinking channels, thereby, curbing wide-spread infection and transmission of diseases in the (intensive) deep litter poultry farming system were designed. Upon combined usage, they automatically and drastically reduced both the amount and frequency of antibiotics use in poultry by over > 50%. Additionally, they conferred optimization of feed and water utilization/elimination of wastage by > 80%, reduced labour by > 70%, reduced production cost by about 15%, and reduced chemical residues in poultry meat or eggs by > 85%. These new and cheap technologies which require no energy input are likely to elevate safety of poultry products for consumers' health, increase marketability locally and for export, and increase output and profit especially among poultry farmers and poor people who keep poultry or inevitably utilize poultry products in developing countries.

Keywords: healthy, trough, toxicological, assay-guided, poultry

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Authors: Anthony I. Otuonye, Juliet N. Odii, Perpetual N. Ibe

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The obvious challenges faced by most commercial bank customers while using the services of ATMs (Automated Teller Machines) across developing countries have triggered the need for an improved system with better security features. Current ATM systems are password-based, and research has proved the vulnerabilities of these systems to heinous attacks and manipulations. We have discovered by research that the security of current ATM-assisted banking services in most developing countries of the world is easily broken and maneuvered by fraudsters, majorly because it is quite difficult for these systems to identify an impostor with privileged access as against the authentic bank account owner. Again, PIN (Personal Identification Number) code passwords are easily guessed, just to mention a few of such obvious limitations of traditional ATM operations. In this research work also, we have developed a system of fingerprint biometrics with PIN code Authentication that seeks to improve the security features of traditional ATM installations as well as other Banking Services. The aim is to ensure better security at all ATM installations and raise the confidence of bank customers. It is hoped that our system will overcome most of the challenges of the current password-based ATM operation if properly applied. The researchers made use of the OOADM (Object-Oriented Analysis and Design Methodology), a software development methodology that assures proper system design using modern design diagrams. Implementation and coding were carried out using Visual Studio 2010 together with other software tools. Results obtained show a working system that provides two levels of security at the client’s side using a fingerprint biometric scheme combined with the existing 4-digit PIN code to guarantee the confidence of bank customers across developing countries.

Keywords: fingerprint biometrics, banking operations, verification, ATMs, PIN code

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Authors: I. C. Cho, W. H. Wen, H. Y. Tsai, T. C. Chao, C. J. Tung

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Tissue-equivalent proportional counter (TEPC) is a useful instrument used to measure radiation single-event energy depositions in a subcellular target volume. The quantity of measurements is the microdosimetric lineal energy, which determines the relative biological effectiveness, RBE, for radiation therapy or the radiation-weighting factor, WR, for radiation protection. TEPC is generally used in a mixed radiation field, where each component radiation has its own RBE or WR value. To reduce the pile-up effect during radiotherapy measurements, a miniature TEPC (mini TEPC) with cavity size in the order of 1 mm may be required. In the present work, a homemade mini TEPC with a cylindrical cavity of 1 mm in both the diameter and the height was constructed to measure the lineal energy spectrum of a mixed radiation field with high- and low-LET radiations. Instead of using external radiation beams to penetrate the detector wall, mixed radiation fields were produced by the interactions of neutrons with TEPC walls that contained small plugs of different materials, i.e. Li, B, A150, Cd and N. In all measurements, mini TEPC was placed at the beam port of the Tsing Hua Open-pool Reactor (THOR). Measurements were performed using the propane-based tissue-equivalent gas mixture, i.e. 55% C3H8, 39.6% CO2 and 5.4% N2 by partial pressures. The gas pressure of 422 torr was applied for the simulation of a 1 m diameter biological site. The calibration of mini TEPC was performed using two marking points in the lineal energy spectrum, i.e. proton edge and electron edge. Measured spectra revealed high lineal energy (> 100 keV/m) peaks due to neutron-capture products, medium lineal energy (10 – 100 keV/m) peaks from hydrogen-recoil protons, and low lineal energy (< 10 keV/m) peaks of reactor photons. For cases of Li and B plugs, the high lineal energy peaks were quite prominent. The medium lineal energy peaks were in the decreasing order of Li, Cd, N, A150, and B. The low lineal energy peaks were smaller compared to other peaks. This study demonstrated that internally produced mixed radiations from the interactions of neutrons with different plugs in the TEPC wall provided a useful approach for TEPC measurements of lineal energies.

Keywords: TEPC, lineal energy, microdosimetry, radiation quality

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Authors: Mengjie Qu, Yi Wang, Jiawei Ding, Siyu Chen, Yanan Di

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Marine ecosystem is facing intensified multiple stresses caused by environmental contaminants from human activities. Xenobiotics, such as benzo(α)pyrene (BaP) have been discharged into marine environment and cause hazardous impacts on both marine organisms and human beings. As a filter-feeder, marine mussels, Mytilus spp., has been extensively used to monitor the marine environment. However, their genomic alterations induced by such xenobiotics are still kept unknown. In the present study, gills, as the first defense barrier in mussels, were selected to evaluate the genetic instability alterations induced by the exposure to BaP both in vivo and in vitro. Both random amplified polymorphic DNA (RAPD) assay and comet assay were applied as the rapid tools to assess the environmental stresses due to their low money- and time-consumption. All mussels were identified to be the single species of Mytilus coruscus before used in BaP exposure at the concentration of 56 μg/l for 1 & 3 days (in vivo exposure) or 1 & 3 hours (in vitro). Both RAPD and comet assay results were showed significantly increased genomic instability with time-specific altering pattern. After the recovery period in 'in vivo' exposure, the genomic status was as same as control condition. However, the relative higher genomic instabilities were still observed in gill cells after the recovery from in vitro exposure condition. Different repair mechanisms or signaling pathway might be involved in the isolated gill cells in the comparison with intact tissues. The study provides the robust and rapid techniques to exam the genomic stability in marine organisms in response to marine environmental changes and provide basic information for further mechanism research in stress responses in marine organisms.

Keywords: genotoxic impacts, in vivo/vitro exposure, marine mussels, RAPD and comet assay

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Authors: Isabel Lopez-Oliva, Akshay Paropkari, Shweta Saraswat, Stefan Serban, Paola de Pablo, Karim Raza, Andrew Filer, Iain Chapple, Thomas Dietrich, Melissa Grant, Purnima Kumar

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Objective: We aimed to explicate the role of the subgingival microbiome in the causal link between rheumatoid arthritis (RA) and periodontitis (PD). Methods: Subjects with/without RA and with/without PD were randomized for treatment with scaling and root planing (SRP) or oral hygiene instructions. Subgingival biofilm, gingival crevicular fluid, and serum were collected at baseline and at 3- and 6-months post-operatively. Correlations were generated between 72 million 16S rDNA sequences, immuno-inflammatory mediators, circulating antibodies to oral microbial antigens, serum inflammatory molecules, and clinical metrics of RA. The dynamics of inter-microbial and host-microbial interactions were modeled using differential network analysis. Results: RA superseded periodontitis as a determinant of microbial composition, and DAS28 score superseded the severity of periodontitis as a driver of microbial assemblages (p=0.001, ANOSIM). RA subjects evidenced higher serum anti-PPAD (p=0.0013), anti-Pg-enolase (p=0.0031), anti-RPP3, anti- Pg-OMP and anti- Pi-OMP (p=0.001) antibodies than non-RA controls (with and without periodontitis). Following SRP, bacterial networks anchored by IL-1b, IL-4, IL-6, IL-10, IL-13, MIP-1b, and PDGF-b underwent ≥5-fold higher rewiring; and serum antibodies to microbial antigens decreased significantly. Conclusions: Our data suggest a circular relationship between RA and PD, beginning with an RA-influenced dysbiosis within the healthy subgingival microbiome that leads to exaggerated local inflammation in periodontitis and circulating antibodies to periodontal pathogens and positive correlation between severity of periodontitis and RA activity. Periodontal therapy restores host-microbial homeostasis, reduces local inflammation, and decreases circulating microbial antigens. Our data highlights the importance of integrating periodontal care into the management of RA patients.

Keywords: rheumatoid arthritis, periodontal, subgingival, DNA sequence analysis, oral microbiome

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Authors: Christen Kutz

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Objective: The aim of this study is to review a case series of 4 high-level Olympic and Division 1 wrestlers who experienced debilitating posterior circulation ischemic strokes during or after a competitive wrestling event and to identify risk factors, etiology and outcomes of stroke in young, healthy elite wrestlers. Background: Stroke occurs in one in 10,000 people under age 64. In young adults, the most common causes of stroke are cardiac embolism, hypercoagulable state, and vasculopathy. One-third of these strokes occur in young, fit individuals. There is little published literature about ischemic strokes that occur in wrestlers. Based on the nature of wrestling, the risk of injury or dissection to neurovascular structures may be a possible theory, but very few case reports exist. Methodology: 4 wrestlers under the age of 44 with a known history of ischemic stroke participated in individual interviews either in person or virtually. Each of the wrestlers provided their demographic information, wrestling background, clinical presentation at the time of stroke, imaging results, identification of potential risk factors, acute treatment and recovery. Results: 3 white male Division 1 wrestlers (2 Lehigh University, 1 Lock Haven University) and 1 black male 2008 Olympian experienced posterior circulation strokes. Case #1 felt a “pop” while wrestling (lateral medullary infarct, possible vertebral artery dissection); Case #2 awoke with severe vertigo, sweating, and vomiting after wrestling the previous day (left cerebellar infarct, (+) protein S deficiency); Case #3 severe vertigo, ataxia, and sensation of impending doom after wrestling earlier that week (left cerebellar infarct, hypoplastic left vertebral artery (+) anti-cardiolipin antibodies). Case #4 severe dizziness, confusion (left cerebellar stroke, vertebral artery dissection, small PFO). Conclusion: 3 wrestlers were started on anti-platelet therapy, risk factors were modified, and returned to their sport. 1 wrestler was placed on anti-coagulation and retired from competition.

Keywords: stroke, wrestling, Olympic, posterior circulation

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Authors: Nicholas Bayfield, Liam Bibo, Kaushelandra Rathore, Lucas Sanders, Mark Newman

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INTRODUCTION: Surgical pulmonary embolectomy is an established therapy for acute pulmonary embolism causing right heart dysfunction and haemodynamic instability. Massive intraoperative airway haemorrhage is a rare complication of pulmonary embolectomy. We present our institutional experience with massive airway haemorrhage complicating pulmonary embolectomy and discuss optimal therapeutic strategies. METHODS: A retrospective review of emergent surgical pulmonary embolectomy patients was undertaken. Cases complicated by massive intra-operative airway haemorrhage were identified. Intra- and peri-operative management strategies were analysed and discussed. RESULTS: Of 76 patients undergoing emergent or salvage pulmonary embolectomy, three cases (3.9%) of massive intraoperative airway haemorrhage were identified. Haemorrhage always began on weaning from cardiopulmonary bypass. Successful management strategies involved intraoperative isolation of the side of bleeding, occluding the affected airway with an endobronchial blocker, institution of veno-arterial (VA) extracorporeal membrane oxygenation (ECMO) and reversal of anticoagulation. Running the ECMO without heparinisation allows coagulation to occur. Airway haemorrhage was controlled within 24 hours of operation in all patients, allowing re-institution of dual lung ventilation and decannulation from ECMO. One case in which positive end-expiratory airway pressure was trialled initially was complicated by air embolism. Although airway haemorrhage was controlled successfully in all cases, all patients died in-hospital for reasons unrelated to the airway haemorrhage. CONCLUSION: Massive intraoperative airway haemorrhage during pulmonary embolectomy is a rare complication with potentially catastrophic outcomes. Re-perfusion alveolar and capillary injury is the likely aetiology. With a systematic approach to management, airway haemorrhage can be well controlled intra-operatively and often resolves within 24 hours. Stopping blood flow to the pulmonary arteries and support of oxygenation by the institution of VA ECMO is important. This management has been successful in our 3 cases.

Keywords: pulmonary embolectomy, cardiopulmonary bypass, cardiac surgery, pulmonary embolism

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Authors: Tuba Tekin, Nurcan Baglam, Emine Dincer

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This study aimed to examine the effects of nutrition education received by university students on sustainable healthy eating behaviors and adherence to the Mediterranean diet. The 2nd, 3rd, and 4th-grade university students studying at the Faculty of Health Sciences, Nutrition and Dietetics, Midwifery, Nursing, Physical Therapy, and Rehabilitation departments of universities in Turkey were included in the study. Students' adherence to the Mediterranean diet was evaluated using the Mediterranean Diet Adherence Scale, and their sustainable and healthy eating behaviors were evaluated using the Sustainable and Healthy Eating Behaviors Scale. In addition, the body weight and height of the students were measured by the researchers, and the Body Mass Index (BMI) value was calculated. A total of 181 students, 85 of whom were studying in the Department of Nutrition and Dietetics and 96 of whom were educated in other departments, were included in the study. 75.7% of the students in the sample are female, while 24.3% are male. The average body weight of the students was 61.17±10.87 kg, and the average BMI was 22.04±3.40 kg/m2. While the mean score of the Mediterranean Diet Adherence Scale was 6.72±1.84, in the evaluation of adherence to the Mediterranean diet, it was determined that 25.4% of the students had poor adherence and 66.9% needed improvement. When the adherence scores of students who received and did not receive nutrition education were compared, it was discovered that the students who received nutrition education had a higher score (p<0.05). Students who received nutrition education had a higher total score on the Sustainable and Healthy Eating Behaviors scale (p<0.05). A moderately positive correlation was found between the Sustainable and Healthy Eating Behaviors scale total score and the Mediterranean Diet Adherence scores (p<0.05). As a result of the linear regression analysis, it was revealed that a 1-unit increase in the Mediterranean diet adherence score would result in a 1.3-point increase in the total score of the Sustainable and Healthy Eating Behaviors scale. Sustainable and healthy diets are important for improving and developing health and the prevention of diseases. The Mediterranean diet is defined as a sustainable diet model. The findings revealed the relationship between the Mediterranean diet and sustainable nutrition and showed that nutrition education increased knowledge and awareness about sustainable nutrition and increased adherence to the Mediterranean diet. For this reason, courses or seminars on sustainable nutrition can be organized during educational periods.

Keywords: healthy eating, Mediterranean diet, nutrition education, sustainable nutrition

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Authors: Shabnam Abdi, Behzad Toosi

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Background: Melanoma is the most lethal type of malignant skin cancer in humans and dogs since it spreads rapidly throughout the body. Despite significant advances in treatment, cancer at an advanced stage has a poor prognosis. Hence, more effective treatments are needed to enhance outcomes with fewer side effects. Erythropoietin-producing hepatocellular receptors are the largest family of receptor tyrosine kinases and are divided into two subfamilies, EphA and EphB, both of which play a significant role in disease, especially cancer. Due to their association with proliferation and invasion in many aggressive types of cancer, Eph receptor tyrosine kinases (Eph RTKs) are promising cancer therapy molecules. Because these receptors have not been studied in canine melanoma, we investigated how EphA2 influences survival and tumorigenicity of melanoma cells. Methods: Expression of EphA2 protein in canine melanoma cell lines and human melanoma cell line was evaluated by Western blot. Melanoma cells were transduced with lentiviral particles encoding Eph-targeting shRNAs or non-silencing shRNAs (control) for silencing the expression of EphA2 receptor, and silencing was confirmed by Western blotting and immunofluorescence. The effect of siRNA treatment on cellular proliferation, colony formation, tumorsphere assay, invasion was analyzed by Resazurin assay Matrigel invasion assay, respectively. Results: Expression of EphA2 was detected in canine and human melanoma cell lines. Moreover, stably silencing EphA2 by specific shRNAs significantly and consistently decreased the expression of EphA2 protein in both human and canine melanoma cells. Proliferation, colony formation, tumorsphere and invasion of melanoma cells were significantly decreased in EphA2 siRNA-treated cells compared to control. Conclusion: Our data provide the first functional evidence that the EphA2 receptor plays a critical role in the malignant cellular behavior of melanoma in both human and dogs.

Keywords: ephA2, targeting, melanoma, human, canine

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Authors: Moses Obenade, Henry U. Okeke, Francis I. Okpiliya, Eugene J. Aniah

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Population growth in Eleme has been rapid over the past 75 years with its attendant pressure on the natural resources of the area. Between 1937 and 2006 the population of Eleme grew from 2,528 to 190,194 and is projected to be above 265,707 in 2016 based on an annual growth rate of 3.4%. Using the combined technologies of Geographic Information Systems (GIS), remote sensing (RS) and Demography techniques as its methodology, this paper examines the environmental implications of rapid population growth on land use dynamics in Eleme between 1986 and 2015. The study reveals that between 1986 and 2006, Built-up area and Farmland increased by 72.67 and 12.77% respectively, while light and thick vegetation recorded a decrease of -6.92 and -61.64% respectively. Water body remains fairly constant with minimal changes. Also, between 2006 and 2015 covering a period of 9 years, Built-up area further increased by 53% with an annual growth rate of 2.32 km2 gaining more land area on the detriment of other land uses. Built-up area has an annual growth rate of 2.32km2 and is expected to increase from 18.67km2 in 2006 to 41.87km2 in 2016.The observed Land used/Land cover dynamics is derived by the demographic characteristics of the Study area. Eleme has a total area of 138km2 out of which the Federal Government of Nigeria compulsorily acquired an estimated area of 59.34km2 for industrial purposes excluding acquisitions by the Rivers State Government. It is evident from the findings of this study that the carrying capacity of Eleme ecosystem is under threat due to the current population growth and land consumption rates. Therefore, measures such as use of appropriate technologies in farming techniques, waste management; investment in family planning and female empowerment, maternal health and education, afforestation programs; and amendment of Land Use Act of 1978 are recommended.

Keywords: population growth, Eleme, land use, GIS and remote sensing

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Authors: Sadaf Moeez, Madiha Khalid, Zoya Khalid, Sania Shaheen, Sumbul Khalid

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Background: Inter-individual variation in response to metformin, which has been considered as a first line therapy for T2DM treatment is considerable. In the current study, it was aimed to investigate the impact of two genetic variants Leu125Phe (rs77474263) and Gly64Asp (rs77630697) in gene SLC47A1 on the clinical efficacy of metformin in T2DM Pakistani patients. Methods: The study included 800 T2DM patients (400 metformin responders and 400 metformin non-responders) along with 400 ethnically matched healthy individuals. The genotypes were determined by allele-specific polymerase chain reaction. In-silico analysis was done to confirm the effect of the two SNPs on the structure of genes. Association was statistically determined using SPSS software. Results: Minor allele frequency for rs77474263 and rs77630697 was 0.13 and 0.12. For SLC47A1 rs77474263 the homozygotes of one mutant allele ‘T’ (CT) of rs77474263 variant were fewer in metformin responders than metformin non-responders (29.2% vs. 35.5 %). Likewise, the efficacy was further reduced (7.2% vs. 4.0 %) in homozygotes of two copies of ‘T’ allele (TT). Remarkably, T2DM cases with two copies of allele ‘C’ (CC) had 2.11 times more probability to respond towards metformin monotherapy. For SLC47A1 rs77630697 the homozygotes of one mutant allele ‘A’ (GA) of rs77630697 variant were fewer in metformin responders than metformin non-responders (33.5% vs. 43.0 %). Likewise, the efficacy was further reduced (8.5% vs. 4.5%) in homozygotes of two copies of ‘A’ allele (AA). Remarkably, T2DM cases with two copies of allele ‘G’ (GG) had 2.41 times more probability to respond towards metformin monotherapy. In-silico analysis revealed that these two variants affect the structure and stability of their corresponding proteins. Conclusion: The present data suggest that SLC47A1 Leu125Phe (rs77474263) and Gly64Asp (rs77630697) polymorphisms were associated with the therapeutic response of metformin in T2DM patients of Pakistan.

Keywords: diabetes, T2DM, SLC47A1, Pakistan, polymorphism

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Authors: My Hachem Aouragh, Hind Ragragui, Abdellah El-Hmaidi, Ali Essahlaoui, Abdelhadi El Ouali

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This study investigates soil erosion susceptibility in the Oued Mikkes watershed, located in the Meknes-Fez region of northern Morocco, utilizing advanced techniques such as deep learning algorithms and remote sensing integrated within Geographic Information Systems (GIS). Spanning approximately 1,920 km², the watershed is characterized by a semi-arid Mediterranean climate with irregular rainfall and limited water resources. The waterways within the watershed, especially the Oued Mikkes, are vital for agricultural irrigation and potable water supply. The research assesses the extent of erosion risk upstream of the Sidi Chahed dam while developing a spatial model of soil loss. Several important factors, including topography, land use/land cover, and climate, were analyzed, with data on slope, NDVI, and rainfall erosivity processed using deep learning models (DLNN, CNN, RNN). The results demonstrated excellent predictive performance, with AUC values of 0.92, 0.90, and 0.88 for DLNN, CNN, and RNN, respectively. The resulting susceptibility maps provide critical insights for soil management and conservation strategies, identifying regions at high risk for erosion across 24% of the study area. The most high-risk areas are concentrated on steep slopes, particularly near the Ifrane district and the surrounding mountains, while low-risk areas are located in flatter regions with less rugged topography. The combined use of remote sensing and deep learning offers a powerful tool for accurate erosion risk assessment and resource management in the Mikkes watershed, highlighting the implications of soil erosion on dam siltation and operational efficiency.

Keywords: soil erosion, GIS, remote sensing, deep learning, Mikkes Watershed, Morocco

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Authors: P. Gayathri, G. P. Jeyanthi

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The bark of Polyalthia longifolia is used in ayurvedic system of medicine for the manangement of various ailments including diabetes mellitus. The bark of P. longifolia extracts was extracted using various polar and non-polar solvents and tested for inhibition of alpha-amylase and alpha-glucosidase among which the ethanolic extracts were found to be more potent. The ethanolic extracts of the bark were tested for the in vitro inhibition of alpha-amylase using starch as substrate and alpha-glucosidase using p-nitro phenyl alpha-D-gluco pyranoside as substrate to establish its in vitro antidiabetic effect. The mechanism of inhibition was determined by Dixon plot and Cornish-Bowden plot. The cytotoxic effect of the extract was tested on L6 and Vero cell-lines. The extract was partially purified by TLC. The individual effect of the ethanolic extract, TLC fractions and its combinatorial effect with insulin and glibenclamide on glucose uptake by rat hemi-diaphragm were studied.Results revealed that the ethanolic extracts of Polyalthia longifolia bark exhibited competitive inhibition of alpha-amylase and alpha-glucosidase. The extracts were also found not to be cytotoxic at the highest dose of 1 mg/mL. Glucose uptake study revealed that the extract alone and when combined with insulin, decreased the glucose uptake when compared to insulin control, however the purified TLC fractions exhibited significantly higher (p<0.05) glucose uptake by the rat hemi-diaphragm when compared to insulin. The study shows various possible mechanism of in vitro antidiabetic effect of the P. longifolia bark.

Keywords: alpha-amylase, alpha-glucosidase, dixon, cornish-bowden, L6 , Vero cell-lines, glucose uptake, polyalthia longifolia bark, ethanolic extract, TLC fractions

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Authors: Thomas Wetere

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Background: The coronavirus disease 2019 (COVID-19) pandemic (COVID-19) virus infection is a severe infectious disease with the highly transmissible variant, which become the global public health treat now. It has taken the life of more than 4 million people so far. What makes the disease the worst of all is no specific effective treatment available, its dynamics is not much researched and understood. Methodology: To end the global COVID-19 pandemic, implementation of multiple population-wide strategies, including vaccination, environmental factors, Government action, testing, and contact tracing, is required. In this article, a new mathematical model incorporating both temperature and government action to study the dynamics of the COVID-19 pandemic has been developed and comprehensively analysed. The model considers eight stages of infection: susceptible (S), infected Asymptomatic and Undetected(IAU ), infected Asymptomatic and detected(IAD), infected symptomatic and Undetected(ISU ), infected Symptomatic and detected(ISD), Hospitalized or threatened(H), Recovered(R) and Died(D). Results: The existence as well as non-negativity of the solution to the model is also verified, and the basic reproduction number is calculated. Besides, stability conditions are also checked, and finally, simulation results are compared with real data. The results demonstrates that effective government action will need to be combined with vaccination to end the ongoing COVID-19 pandemic. Conclusion: Vaccination and Government action are highly the crucial measures to control the COVID-19 pandemic. Besides, as the cost of vaccination might be high, we recommend an optimal control to reduce the cost and number of infected individuals. Moreover, in order to prevent COVID-19 pandemic, through the analysis of the model, the government must strictly manage the policy on COVID-19 and carry it out. This, in turn, helps for health campaigning and raising health literacy which plays a role to control the quick spread of the disease. We finally strongly believe that our study will play its own role in the current effort of controlling the pandemic.

Keywords: modeling, COVID-19, MCMC, stability

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Authors: Gaye Demi̇rtaş Adli

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Research: It was conducted to determine the factors affecting the fear of self-injection and self-pricking of fingers of diabetic individuals.The study was conducted as a cross-sectional, relation-seeking, and descriptive study. The study was conducted on 122 patients who had just started insulin therapy. Data were obtained through The Descriptive Patient Form, The Diabetic Self-Injection, and the Fear of Testing Questionnaire Form (D-FISQ). Descriptive statistical methods used in the evaluation of data are the Mann-Whitney U test, Kruskal-Wallis H test, and the Spearman correlation. The factors affecting the scale scores were evaluated with multiple linear regression analysis. The value of P<0.05 was considered statistically significant. Study group: 56.6% of the patients are male patients. Fear of self-injection (injection), fear of self-testing (test), and total fear (total) scores of women were found to be statistically higher than men (p<0.001). Age, gender, and pain experience were important variables that affected patients' fear of injections. With a one-unit increase in age, the injection fear score decreased by 0.13 points, and the mean injection fear score of women was 2.11 points higher than that of men. It was determined that the patient's age, gender, living with whom, and blood donation history were important variables affecting the fear of self-testing. It is seen that the fear test score decreases by 0.18 points with an increase in age by one unit, and the fear test scores of women compared to men are on average 3,358 points, the fear test scores of those living alone are 4,711 points compared to those living with family members, and the fear test scores of those who do not donate blood are 2,572 compared to those who donate blood score, it was determined that those with more pain experience were 3,156 points higher on average than those with less fear of injection. As a result, it was seen that the most important factors affecting the fear of insulin injection and finger punching in individuals with diabetes were age, gender, pain experience, living with whom, and blood donation history.

Keywords: diabetes, needle phobia, fear of injection, insulin injection

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Authors: Justin P. Pool, Haruyo Yoshida

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This research focuses on the effects of creating an English as a foreign language curriculum that combines online learning and classroom teaching in a complementary manner. Through pre- and post-test results, teacher observation, and learner reflection, it will be shown that learners can benefit from online programs focusing on receptive skills if combined with a communicative classroom environment that encourages learners to develop their productive skills. Much research has lamented the fact that many modern mobile assisted language learning apps do not take advantage of the affordances of modern technology by focusing only on receptive skills rather than inviting learners to interact with one another and develop communities of practice. This research takes into account the realities of the state of such apps and focuses on how to best create a curriculum that complements apps which focus on receptive skills. The research involved 15 adult learners working for a business in Japan simultaneously engaging in 1) a commercial online English language learning application that focused on reading, listening, grammar, and vocabulary and 2) a 15-week class focused on communicative language teaching, presentation skills, and mitigation of error aversion tendencies. Participants of the study experienced large gains on a standardized test, increased motivation and willingness to communicate, and asserted that they felt more confident regarding English communication. Moreover, learners continued to study independently at higher rates after the study than they had before the onset of the program. This paper will include the details of the program, reveal the improvement in test scores, share learner reflections, and critically view current evaluation models for mobile assisted language learning applications.

Keywords: adult learners, communicative language teaching, mobile assisted language learning, motivation

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Authors: Kairat Uteulin, Azhar Iskakova, Serik Mukhambetzhanov, Bayan Yesbolayeva, Gabit Bari, Aslan Zheksenbai, Kabyl Zhambakin, Chingis Dzhabykbayev, Vladimir Piven, Izbasar Rakhimbaiev

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To explore the potential for in vitro rapid regeneration of Russian dandelion (Taraxacum kok-saghyz Rodin), different concentrations of 6-Benzylaminopurine (BAP), 2,4-Dichlorophenoxyacetic acid (2.4-D) and BAP combined with Indole-3-acetic acid (IAA) were evaluated for their effects on the induction of somatic embryos from leaf, seed stem and root explants. Different explants were cultured on MS medium supplemented with various concentrations (0, 0.5, 1, 1.5, 2, 2.5 and 3 mg/l) of each kind of hormone. Callus induction percentage, fresh weight, color and texture of the callus were assessed after 14 and 28 days of culture. The optimum medium for the proliferation of embryogenic calli from leaf and root explants was MS supplemented with 2.5 mg/L BAP and 0.5 mg/L 2.4-D. Concentrations of 2.5 mg/L BAP and 1.5 mg/L IAA also had a remarkable effect on root and stem explants. The best concentration to produce callus from stem explants was 0.5 mg/L BAP and 1 mg/L IAA. Results of mean comparison showed that BAP and 2.4-D were more effective on different explants than BAP and IAA. Results of the double staining method proved that somatic embryogenesis occurred in the most concentrations of BAP and 2.4-D. Under microscopic observations, the different developmental stages of the embryos (globular, heart, torpedo and cotyledonary) were revealed together in callus cells, indicating that the most tested hormone combinations were effective for somatic embryogenesis formation in this species. Seed explants formed torpedo and cotyledonary stages faster than leaf and root explants in the most combinations. Most calli from seed explants were cream colored and friable, while calli were compact and light green from leaf and root explants. Some combinations gave direct regeneration and (3 mg/L BAP and 2 mg/L IAA) in seed explants and (0.5 mg/L BAP and 2.5 mg/L IAA) in leaf explants had the highest number of shoots with average of 21 and 27 shoots per callus. The developed protocol established the production of different callus types from seed, leaf, and root explants and plant regeneration through somatic embryogenesis.

Keywords: taraxacum kok-saghyz Rodin, callus, somatic embryogenesis

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Authors: Yichen Lin, Hsiao-Han Chen, Chi-Chen Jan

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Since 1990, the research area of Integrated Marketing Communications (IMC) has been presented from a different perspective. With advances in information technology and the rise of consumer consciousness, businesses are in a competitive environment. There is an urgent need to adopt more profitable and effective integrated marketing strategies to increase core competitiveness. The goal of the company's sustainable management is to increase consumers' willingness to purchase and to maximize profits. This research uses six aspects of IMC, which includes awareness integration, unified image, database integration, customer-based integration, stakeholders-based integration, and evaluation integration to examine the role of marketing strategies in the strengths and weaknesses of the six components of integrated marketing communications, their effectiveness, the most important components and the most important components that need improvement. At the same time, social media such as FaceBook, Instagram, Youtube, Line, or even TikTok have become marketing tools which firms adopt them more and more frequently in the marketing strategy. In the end of 2019, the outbreak of COVID-19 did really affect the global industries. Lockdown policies also accelerated closure of brick-mentor stores worldwide. Online purchases rose dramatically. Hence, the effectiveness of online marketing will be essential to maintain the business. This study uses multiple-case studies to extend the effects of social media and IMC. Moreover, the study would also explore the differences of social media and IMC during COVID-19. Through literature review and multiple-case studies, it is found that using social media combined with IMC did really help companies expand their business and make good connections with stakeholders. One of previous studies also used system theory to explore the interrelationship among Integrated Marketing Communication, collaborative marketing, and global brand building. Even during pandemic, firms could still maintain the operation and connect with their customers more tightly.

Keywords: integration marketing communications, multiple-case studies, social media, system theory

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Authors: L. Ebralidze, A. Tsertsvadze, D. Berashvili, A. Bakuridze

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Current cancer therapy strategies are based on surgery, radiotherapy and chemotherapy. The problems associated with chemotherapy are one of the biggest challenges for clinical medicine. These include: low specificity, broad spectrum of side effects, toxicity and development of cellular resistance. Therefore, anti-cance drugs need to be develop urgently. Particularly, in order to increase efficiency of anti-cancer drugs and reduce their side effects, scientists work on formulation of nano-drugs. The objective of this study was to develop composition and technology of vincristine nanoparticles using high-molecular carbohydrates of plant origin. Plant polysacharides, particularly, soy bean seed polysaccharides, flaxseed polysaccharides, citrus pectin, gum arabic, sodium alginate were used as objects. Based on biopharmaceutical research, vincristine containing nanoparticle formulations were prepared. High-energy emulsification and solvent evaporation methods were used for preparation of nanosystems. Polysorbat 80, polysorbat 60, sodium dodecyl sulfate, glycerol, polyvinyl alcohol were used in formulation as emulsifying agent and stabilizer of the system. The ratio of API and polysacharides, also the type of the stabilizing and emulsifying agents are very effective on the particle size of the final product. The influence of preparation technology, type and concentration of stabilizing agents on the properties of nanoparticles were evaluated. For the next stage of research, nanosystems were characterized. Physiochemical characterization of nanoparticles: their size, shape, distribution was performed using Atomic force microscope and Scanning electron microscope. The present study explored the possibility of production of NPs using plant polysaccharides. Optimal ratio of active pharmaceutical ingredient and plant polysacharids, the best stabilizer and emulsifying agent was determined. The average range of nanoparticles size and shape was visualized by SEM.

Keywords: nanoparticles, target delivery, natural high molecule carbohydrates, surfactants

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Authors: N. Harun, E. E. Masiren, W. H. W. Ibrahim, F. Adam

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Amine absorption process is an approach for mitigation of CO2 from flue gas that produces from power plant. This process is the most common system used in chemical and oil industries for gas purification to remove acid gases. On the challenges of this process is high energy requirement for solvent regeneration to release CO2. In the past few years, mixed alkanolamines have received increasing attention. In most cases, the mixtures contain N-methyldiethanolamine (MDEA) as the base amine with the addition of one or two more reactive amines such as PZ. The reason for the application of such blend amine is to take advantage of high reaction rate of CO2 with the activator combined with the advantages of the low heat of regeneration of MDEA. Several experimental and simulation studies have been undertaken to understand this process using blend MDEA/PZ solvent. Despite those studies, the mechanism of CO2 absorption into the aqueous MDEA is not well understood and available knowledge within the open literature is limited. The aim of this study is to investigate the intermolecular interaction of the blend MDEA/PZ using Molecular Dynamics (MD) simulation. MD simulation was run under condition 313K and 1 atm using NVE ensemble at 200ps and NVT ensemble at 1ns. The results were interpreted in term of Radial Distribution Function (RDF) analysis through two system of interest i.e binary and tertiary. The binary system will explain the interaction between amine and water molecule while tertiary system used to determine the interaction between the amine and CO2 molecule. For the binary system, it was observed that the –OH group of MDEA is more attracted to water molecule compared to –NH group of MDEA. The –OH group of MDEA can form the hydrogen bond with water that will assist the solubility of MDEA in water. The intermolecular interaction probability of –OH and –NH group of MDEA with CO2 in blended MDEA/PZ is higher than using single MDEA. This findings show that PZ molecule act as an activator to promote the intermolecular interaction between MDEA and CO2.Thus, blend of MDEA with PZ is expecting to increase the absorption rate of CO2 and reduce the heat regeneration requirement.

Keywords: amine absorption process, blend MDEA/PZ, CO2 capture, molecular dynamic simulation, radial distribution function

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Authors: Policarpio Jr. Joves

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Physicians in most teaching hospitals are commonly promoted into managerial roles, yet their training is mostly in clinical and scientific skills but not in leadership competencies. When they shift into roles of physician leadership, the majority hold on to their primary identity of physicians. These conflicting roles affect their identity and eventually their work. The physician leaders also face additional challenges related to academics which include incorporation of new knowledge into the existing curriculum, use of technology in the delivery of teaching, the need to train medical students outside of hospital wards, etc. The study aims to explore how physician leaders in teaching hospitals of private medical schools enact their leadership roles and how they face the challenges as physician leaders. The study setting shall be teaching hospitals of three private medical schools situated in the National Capital Region, Philippines. A multiple case study design shall be adopted in this research. Physicians shall be eligible to participate in the study if they are practicing clinicians limited to the five major clinical specialty: Internal Medicine, Pediatrics, Family Medicine, Surgery, Obstetrics and Gynecology. They must be teaching in the College of Medicine prior to their appointments as physician leaders in both medical school and teaching hospital. Semi-structured face-to-face interviews shall be utilized as a means of data collection, with open-ended questions, enabling physician leaders to present narratives about their identity, role enactment, conflicts, reaction of colleagues, and the challenges encountered in their day-to-day work as physician leaders. Interviews shall be combined with observations and review of records to gain more insights into how the physician leaders are 'doing' management. Within-case analysis shall be done initially followed by a thematic analysis across the cases, referred to as cross–case analysis or cross-case synthesis.

Keywords: academic leaders, academic managers, physician leaders, physician managers

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Authors: Emmanuel Chinaguh, Kehinde Adeosun

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Nigerians die untimely, with 55.75 years of life expectancy, which is 17.45 below the world average of 73.2 (Worldometer, 2020). This is due, among other factors, to the country's limited access to high-quality healthcare. To increase access to good and affordable healthcare services, the National Health Insurance Authority (NHIA) Bill 2022 – which repealed the National Health Insurance Scheme Act 2004 – was passed into law. Applying Jacob Mey’s (2001) pragmatics act (pract) theory, this study explores how NHIA seeks to actualise these healthcare goals by characterising the general situational prototype or pragmemes and pragmatic acts in institutional communications. Data was sourced from the NHIA operational guidelines, which has 147 pages and four sections, and shared posters on NHIA Nigeria Twitter Handle with 14,200 followers. Digital humanities tools, like AntConc and Voyant, were engaged in the data analysis for text encoding and data visualisation. This study identifies these discourse tokens in the data: advertisement and programmes, standards and accreditation, records and information, and offences and penalties. Advertisement and programmes pract facilitating, propagating, prospecting, advising and informing; standards and accreditation, and records and information pract stating, informing and instructing; and offences and penalties pract stating and sanctioning. These practs combined to advance the goals of affordable care and universal accessibility to quality healthcare services. The pragmatic acts were marked by these pragmatic tools: shared situational knowledge (SSK), relevance (REL), reference (REF) and inference (INF). This paper adds to the understanding of health insurance discourse in Nigeria as a mediated social practice that promotes the health of Nigerians.

Keywords: affordable care, NHIA, Nigeria’s health insurance discourse, pragmatic acts.

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Authors: Marianna Ciaccia, Gennaro Agrimi, Isabella Pisano, Maurizio Bettiga, Silvia Rapacioli, Giulia Mensa, Monica Marzagalli

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Objective: Untargeted metabolomic analysis of extracellular metabolites is a powerful approach that focuses on comprehensively profiling in the extracellular space. In this study, we applied extracellular metabolomic analysis to investigate the metabolism of two probiotic microorganisms with health benefits that extend far beyond the digestive tract and the immune system. Methods: Analytical techniques employed in extracellular metabolomic analysis encompass various technologies, including mass spectrometry (MS), which enables the identification of metabolites present in the fermentation media, as well as the comparison of metabolic profiles under different experimental conditions. Multivariate statistical analysis techniques like principal component analysis (PCA) or partial least squares-discriminant analysis (PLS-DA) play a crucial role in uncovering metabolic signatures and understanding the dynamics of metabolic networks. Results: Different types of supernatants from fermentation processes, such as dairy-free, not dairy-free media and media with no cells or pasteurized, were subjected to metabolite profiling, which contained a complex mixture of metabolites, including substrates, intermediates, and end-products. This profiling provided insights into the metabolic activity of the microorganisms. The integration of advanced software tools has facilitated the identification and characterization of metabolites in different fermentation conditions and microorganism strains. Conclusions: In conclusion, untargeted extracellular metabolomic analysis, combined with software tools, allowed the study of the metabolites consumed and produced during the fermentation processes of probiotic microorganisms. Ongoing advancements in data analysis methods will further enhance the application of extracellular metabolomic analysis in fermentation research, leading to improved bioproduction and the advancement of sustainable manufacturing processes.

Keywords: biotechnology, metabolomics, lactic bacteria, probiotics, postbiotics

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Authors: Daniel Aberdam

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Haploinsufficiency of PAX6 in humans is the main cause of congenital aniridia, a rare eye disease characterized by reduced visual acuity. Patients have also progressive disorders including cataract, glaucoma and corneal abnormalities making their condition very challenging to manage. Aniridia-related keratopathy (ARK), caused by a combination of factors including limbal stem-cell deficiency, impaired healing response, abnormal differentiation, and infiltration of conjunctival cells onto the corneal surface, affects up to 95% of patients. It usually begins in the first decade of life resulting in recurrent corneal erosions, sub-epithelial fibrosis with corneal decompensation and opacification. Unfortunately, current treatment options for aniridia patients are currently limited. Although animal models partially recapitulate this disease, there is no in vitro cellular model of AKT needed for drug/therapeutic tools screening and validation. We used genome editing (CRISPR/Cas9 technology) to introduce a nonsense mutation found in patients into one allele of the PAX6 gene into limbal stem cells. Resulting mutated clones, expressing half of the amount of PAX6 protein and thus representative of haploinsufficiency were further characterized. Sequencing analysis showed that no off-target mutations were induced. The mutated cells displayed reduced cell proliferation and cell migration but enhanced cell adhesion. Known PAX6 targets expression was also reduced. Remarkably, addition of soluble recombinant PAX6 protein into the culture medium was sufficient to activate endogenous PAX6 gene and, as a consequence, rescue the phenotype. It strongly suggests that our in vitro model recapitulates well the epithelial defect and becomes a powerful tool to identify drugs that could rescue the corneal defect in patients. Furthermore, we demonstrate that the homeotic transcription factor Pax6 is able to be uptake naturally by recipient cells to function into the nucleus.

Keywords: Pax6, crispr/cas9, limbal stem cells, aniridia, gene therapy

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Authors: Rym Saidi, Pape Alioune Ndiaye, Ibnyasser Ammar, Zineb Rchiad, Khalid Daoui, Issam Kadmiri Meftahi, Adnane Bargaz

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Chickpea (Cicer arietinum L.) is an important leguminous crop grown worldwide and plays a significant role in humans’ dietary consumption. Alongside nitrogen (N), low phosphorus (P) availability within agricultural soils is one of the major factors limiting chickpea growth and productivity. The combined application of beneficial bacterial inoculants and Rock P-fertilizer could boost chickpea performance and productivity, increasing P-utilization efficiency and minimizing nutrient losses under P-deficiency conditions. A greenhouse experiment was conducted to evaluate the response of chickpeas to two P-fertilizer forms (RP and TSP) under N2-fixer and P-solubilizer consortium inoculation to improve biological N fixation and P nutrition under P-deficient conditions. Under inoculation, chickpea chlorophyll content and chlorophyll fluorescence (RP+I and TSP+I) were increased compared to uninoculated treatments. The RP+I treatment increased both shoot and root dry weights by 48,80% and 72,68%, respectively, compared to the uninoculated RP fertilized control. Indeed, the bacterial consortium contributed to enhancing root morphological traits (e.g., root volume, surface area, and diameter) of all inoculated treatments versus the uninoculated treatments. Furthermore, soil available P and root inorganic P were significantly improved in RP+I by 162,84% and 73,24%, respectively, compared to uninoculated RP control. Our research outcomes suggest that the co-inoculation of chickpeas with N2-fixing, and P-solubilizing bacteria improves biomass yield and nutrient uptake. Eventually, enhancing chickpea agrophysiological performance, especially in restricted P-availability conditions.

Keywords: chickpea, consortium, beneficial bacterial inoculants, phosphorus deficiency, rock p-fertilizer, nutrient uptake

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Authors: Faran Chaudhry, Anser Daud, Doris Braunstein, Oleg Safir, Allan Gross, Paul Kuzyk

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Background: Acetabular reconstruction in the context of massive acetabular bone loss is challenging. In rare scenarios where the extent of bone loss precludes shell placement (cup-cage), reconstruction at our center consisted of a cage combined with highly porous metal augments. This study evaluates survivorship, complications, and functional outcomes using this technique. Methods: A total of 131 cup-cage implants (129 patients) were included in our retrospective review of revisions of total hip arthroplasty from January 2003 to January 2022. Among these cases, 100/131 (76.3%) were women, the mean age at surgery time was 68.7 years (range, 29.0 to 92.0; SD, 12.4), and the mean follow-up was 7.7 years (range, 0.02 to 20.3; SD, 5.1). Kaplan-Meier survivorship analysis was conducted with failure defined as revision surgery and/or failure of the cup-cage reconstruction. Results: A total of 30 implants (23%) reached the study endpoint involving all-cause revision. Overall survivorship was 74.8% at 10 years and 69.8% at 15 years. Reasons for revision included infection 12/131 (9.1%), dislocation 10/131 (7.6%), aseptic loosening of cup and/or cage 5/131 (3.8%), and aseptic loosening of the femoral stem 2/131 (1.5%). The mean LLD improved from 12.2 ± 15.9 mm to 3.9 ± 11.8 (p<0.05). The horizontal and vertical hip centres on plain film radiographs were significantly improved (p<0.05). Functionally, there was a decrease in the number of patients requiring the use of gait aids, with fewer patients (34, 25.9%) using a cane, walker, or wheelchair post-operatively compared to pre-operatively (58, 44%). There was a significant increase in the number of independent ambulators from 24 to 47 (36%). Conclusion: The cup-cage construct is a reliable treatment option for the treatment of various acetabular defects. There are favourable survivorship, clinical and radiographic outcomes, with a satisfactory complication rate.

Keywords: revision total hip arthroplasty, acetabular defect, pelvic discontinuity, trabecular metal augment, cup-cage

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Authors: Yu-Ching Cheng, Yi-Kai Juan, Daniel Castro

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Energy consumption of buildings has been an increasing concern for researchers and practitioners in the last decade. Sustainable building renovation can reduce energy consumption and carbon dioxide emissions; meanwhile, it also can extend existing buildings useful life and facilitate environmental sustainability while providing social and economic benefits to the society. School buildings are different from other designed spaces as they are more crowded and host the largest portion of daily activities and occupants. Strategies that focus on reducing energy use but also improve the students’ learning environment becomes a significant subject in sustainable school buildings development. A decision model is developed in this study to solve complicated and large-scale combinational, discrete and determinate problems such as school renovation projects. The task of this model is to automatically search for the most cost-effective (lower cost and higher quality) renovation strategies. In this study, the search process of optimal school building renovation solutions is by nature a large-scale zero-one programming determinate problem. A* is suitable for solving deterministic problems due to its stable and effective search process, and genetic algorithms (GA) provides opportunities to acquire global optimal solutions in a short time via its indeterminate search process based on probability. These two algorithms are combined in this study to consider trade-offs between renovation cost and improved quality, this decision model is able to evaluate current school environmental conditions and suggest an optimal scheme of sustainable school buildings renovation strategies. Through adoption of this decision model, school managers can overcome existing limitations and transform school buildings into spaces more beneficial to students and friendly to the environment.

Keywords: decision model, school buildings, sustainable renovation, genetic algorithm, A* search algorithm

Procedia PDF Downloads 118