Search results for: clinically relevant

Authors: Zakia Belhadj, Bing He, Hua Zhang, Xueqing Wang, Wenbing Dai, Qiang Zhang

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Mononuclear phagocyte system (MPS) forms an abominable obstacle hampering the tumor delivery efficiency of nanoparticles. Passively targeted nanocarriers have received clinical approval over the past 20 years. However, none of the actively targeted nanocarriers have entered clinical trials. Thus it is important to endue effective targeting ability to actively targeted approaches by overcoming biological barriers to nanoparticle drug delivery. Here, it presents that an Esomeprazole-based preconditioning strategy for regulating nanocarrier-MPS interaction to substantially prolong circulation time and enhance tumor targeting of nanoparticles. In vitro, the clinically approved proton pump inhibitor Esomeprazole “ESO” was demonstrated to reduce interactions between macrophages and subsequently injected targeted vesicles by interfering with their lysosomal trafficking. Of note, in vivo studies demonstrated that ESO pretreatment greatly decreased the liver and spleen uptake of c(RGDm7)-modified vesicles, highly enhanced their tumor accumulation, thereby provided superior therapeutic efficacy of c(RGDm7)-modified vesicles co-loaded with Doxorubicin (DOX) and Gefitinib (GE). This MPS-preconditioning strategy using ESO provides deeper insights into regulating nanoparticles interaction with the phagocytic system and enhancing their cancer cells' accessibility for anticancer therapy.

Keywords: esomeprazole (ESO), mononuclear phagocyte system (MPS), preconditioning strategy, targeted lipid vesicles

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Authors: Nashwa Moheyeldine

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Education for sustainable development (ESD) aims to preserve the rights of the present and future generations as well as preserving the globe, both humans and nature. ESD should aim not only to bring about consciousness of the current and future issues, but also to foster student agency to bring about change at schools, communities and nations. According to the Freirian concept of conscientização, (conscientization) — “learning to perceive social, political, and economic contradictions, and to take action against the oppressive elements of reality”, education aims to liberate people to understand and act upon their worlds. Social justice is greatly intertwined with a nation’s social, political and economic rights, and thus, should be targeted through ESD. “Literacy researchers have found that K-12 students who engage in social justice inquiries develop vital academic knowledge and skills, critical understandings about oppression in the world, and strong dispositions to continue working toward social justice beyond the initial inquiries they conduct”. Education for social justice greatly equips students with the critical thinking skills and sense of agency, that are required for responsible decision making that would ensure a sustainable world. In fact teaching for social justice is intersecting with many of the pedagogies such as multicultural education, cultural relevant pedagogy, education for sustainable development, critical theory pedagogy, (local and global) citizenship education, all of which aim to prepare students for awareness, responsibility and agency. Social justice pedagogy has three specific goals, including helping students develop 1) a sociopolitical consciousness - an awareness of the symbiotic relationship between the social and political factors that affect society, 2) a sense of agency, the freedom to act on one’s behalf and to feel empowered as a change agent, and 3) positive social and cultural identities. The keyword to social justice education is to expose the realities to the students, and challenge the students not only to question , but also to change. Social justice has been usually discussed through the subjects of history and social sciences, however, an interdisciplinary approach is essential to enhance the students’ understanding of their world. Teaching social justice through various subjects is also important, as it make students’ learning relevant to their lives. The main question that this paper seeks to answer is ‘How could social justice be taught through different subjects and tools, such as mathematics, literature through story-telling, geography, and service learning will be shown in this paper. Also challenges to education for social justice will be described. Education is not a neutral endeavor, but is either oriented toward the cause of liberation or in support of domination. In fact , classrooms can be “a microcosm of the emancipatory societies we seek to encourage”, education for the 21st century should be relevant to students' lives where it exposes life's realities to them. Education should also provide students with the basics of school subjects with the bigger goal of helping them make the world a better, more just place to live in.

Keywords: teaching for social justice, student agency, citizenship education, education

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Authors: Menouni Aziza, Chbihi Kaoutar, El Jaafari Samir

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There is strong evidence connecting epidemics with the disruption of the human-animal-environment interaction. Despite the fact that several cases of emerging and endemic zoonotic diseases indifferent parts of Africa have been documented, there is limited data regarding which specific interventions are effective in preventing and managing the associated risks using a One Health approach. The aim of this study is to better understand perceptions and ongoing research related to interventions in Africa through the implementation of suitable projects and policies. A bibliometric review of the scientific literature on one health studies with a focus on African countries was conducted, followed by a qualitative survey among stakeholders involved in fields related to One Health research or management in the Africa, including veterinary experts, public health professionals, environmentalists and policy makers, to learn about determinants of their perceptions, as well as barriers to and promoters of successful interventions and governance. The project was concluded with an international workshop in March 2023, where a broad range of topics relevant to One Health were discussed. 94% of the respondents were aware of the importance of the One Health approach and strongly endorse it within their respective countries. The top reported barriers to One Health development in Africa included paucity of data, weak linkages and institutional communication between the different departments and the lack of funding. Key areas of improvement identified were the impact evaluation of current initiatives, awareness raising campaigns among citizens targeted at behavioral changes, capacity building of relevant professionals and stakeholders, as well as the implementation of adequate policies and enforcement of national and continental regulations, allowing for better coordination on the African level. All One Health sectors in Africa require strong governance and leadership, as well as inter-ministerial, inter-sectoral, and interdisciplinary cooperation.

Keywords: one health, perceptions, governance, Africa

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Authors: Carlos Alberto Ríos Reyes, Andrés Felipe Mejía Durán, Oscar Mauricio Castellanos Alarcón

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There is no doubt of great importance to make it known that planet Earth is an entity in constant change and transformation; processes such as construction and destruction are part of the evolution of the territory. Geoeducation workshops represent a significant contribution to the search for educational projects focused on teaching relevant geoscience topics to make natural threats known in schools through recreational and didactic activities. This initiative represents an educational alternative that must be developed with the participation of primary and secondary schools, universities, and local communities. The methodology is based on several phases, which include: diagnosis to know the best teaching method for basic concepts and establish a starting point for the topics to be taught, as well as to identify areas and concepts that need to be reinforced and/or deepened; design of activities that involve all students regardless of their ability or level; use of accessible materials and experimentation to support clear and concise explanations for all students; adaptation of the teaching-learning process to individual needs; sensitization about natural threats; and evaluation and feedback. It is expected to offer a series of activities and materials as a significant contribution to the search for educational projects focused on teaching relevant geoscientific topics such as natural threats associated with earthquakes, volcanic eruptions, floods, landslides, etc. The major findings of this study are the pedagogical strategies that primary and secondary school teachers can appropriate to face the challenge of transferring geological knowledge and to advise decision-makers and citizens on the importance of geosciences for daily life. We conclude that the knowledge of the natural threats to our planet is very important to contribute to mitigating their risk.

Keywords: workshops, geoeducation, curriculum, geosciences, natural threats

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Authors: Riaz A. Agha, Ishani Barai, Shivanchan Rajmohan, Seon Lee, Mohammed O. Anwar, Alex J. Fowler, Dennis P. Orgill, Douglas G. Altman

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Introduction: Medical knowledge is growing fast. Evidence-based medicine works best if the evidence is reported well. Past studies have shown reporting quality to be lacking in the field of surgery. Reporting guidelines are an important tool for authors to optimize the reporting of their research. The objective of this study was to analyse the frequency and strength of recommendation for such reporting guidelines within surgical journals. Methods: A systematic review of the 198 journals within the Journal Citation Report 2014 (surgery category) published by Thomson Reuters was undertaken. The online guide for authors for each journal was screened by two independent groups and results were compared. Data regarding the presence and strength of recommendation to use reporting guidelines was extracted. Results: 193 journals were included (as five appeared twice having changed their name). These had a median impact factor of 1.526 (range 0.047 to 8.327), with a median of 145 articles published per journal (range 29-659), with 34,036 articles published in total over the two-year window 2012-2013. The majority (62%) of surgical journals made no mention of reporting guidelines within their guidelines for authors. Of the journals (38%) that did mention them, only 14% (10/73) required the use of all relevant reporting guidelines. The most frequently mentioned reporting guideline was CONSORT (46 journals). Conclusion: The mention of reporting guidelines within the guide for authors of surgical journals needs improvement. Authors, reviewers and editors should work to ensure that research is reported in line with the relevant reporting guidelines. Journals should consider hard-wiring adherence to them. This will allow peer-reviewers to focus on what is present, not what is missing, raising the level of scholarly discourse between authors and the scientific community and reducing frustration amongst readers.

Keywords: CONSORT, guide for authors, PRISMA, reporting guidelines, journal impact factor, citation analysis

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Authors: Kuplevatsky V., Kuplevatskay, Cherkashin M., Berezina N.

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After 6 months, a violation of the differentiation of the structure of the gland due to edema in 100%. 20% retained signs of a tumor according to DWI/ADC data. By 12 months, the reduction in the size of the gland is 100%. In all cases, no diffusion restriction was observed. The study after 18 months showed no significant changes in all (100%) patients. In the study, 24 months after treatment, the size of the gland was stable in all cases (+/- up to 5%). Diffuse decrease in T2VI signals from peripheral zones, without signs of diffusion restriction in 100%. After 30 months, signs of recovery of adenomatous changes in the transient zone were revealed in 85%. After 36 and 42 months, the restoration of organ differentiation was observed in 93% of patients. In 4 patients, by the 48th month, signs of biochemical relapse were clinically noted. According to the MRI data, signs of a local relapse were revealed. After 48 months, there were signs of restoration of organ differentiation, which allowed the use of PI-RADS criteria. The study after 54 months showed no changes compared to the control. 60 months after treatment, 97% of patients showed a restoration of differentiation of the gland structure, which allows evaluating the organ according to PI-RADS criteria Conclusions: The beginning of restoration of the structure of the prostate gland began 24 months after proton radiation therapy, the PI-RADS criteria can be fully applied after 48 months of treatment. Control studies every 6 months without clinical signs of relapse are not advisable. Local control of the prostate tumor after proton radiation therapy was achieved in 95% of patients during the entire follow-up period ( 60 months).

Keywords: proton therapy, prostate cancer, MRI imaging, PI-RADS

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Authors: Bavneet Kaur Sidhu, Manoj Tiwari

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Global Developmental Delay (GDD) is a common pediatric condition. Etiologies of GDD might, however, differ in developing countries. In the last decade, sporadic families are being reported in various countries. As to the author’s best knowledge, many risk factors and their correlation with the prevalence of GDD have been studied but its statistical correlation has not been done. Thus we propose the present study by targeting the risk factor, prevalence and their statistical correlation with GDD. FMR1 gene was studied to confirm the disease and its penetrance. A complete questionnaire-based performance was designed for the statistical studies having a personal, past and present medical history along with their socio-economic status as well. Methods: We distributed the children’s age in 4 different age groups having 5-year intervals and applied structural equation modeling (SEM) techniques, Spearman’s rank correlation coefficient, Karl Pearson correlation coefficient, and chi-square test.Result: A total of 1100 families were enrolled for this study; among them, 330 were clinically and biologically confirmed (radiological studies) for the disease, 204 were males (61.8%), 126 were females (38.18%). We found that 27.87% were genetic and 72.12 were sporadic, out of 72.12 %, 43.277% cases from urban and 56.72% from the rural locality, the mothers' literacy rate was 32.12% and working women numbers were 41.21%. Conclusions: There is a significant association between mothers' age and GDD prevalence, which is also followed by mothers' literacy rate and mothers' occupation, whereas there was no association between fathers' age and GDD.

Keywords: global developmental delay, FMR1 gene, spearman’ rank correlation coefficient, structural equation modeling

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Authors: Sonia Lachowska, Agnieszka Antonczyk, Joanna Tunikowska, Pawel Kucharski, Bartlomiej Liszka

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Isoflurane is one of the most commonly used anaesthetic gases in veterinary medicine. Due to its numerous side effects, intravenous anaesthesia is more often used. The combination of tiletamine with zolazepam has proved to be a safe and pharmacologically beneficial combination. Analgesic effect, fast induction time, effective myorelaxation, and smooth recovery are the main advantages of this combination of drugs. In the following study, the authors verified the necessity of isoflurane to maintain anaesthesia in dogs after the use of tiletamine-zolazepam for induction. 12 dogs were selected to the group with the inclusion criteria: ASA (American Society of Anaesthesiology) I or II. Each dog received premedication intramuscularly with medetomidine-butorfanol (10 μg/kg, 0,1 mg/kg respectively). 15 minutes from premedication, preoxygenation lasting 5 minutes was started. Anaesthesia was induced with tiletamine-zolazepam at the dose of 5 mg/kg. Then the dogs were intubated and anaesthesia was maintained with isoflurane. Initially, MAC (Minimum Alveolar Concentration) was set to 0.7 vol.%. After 15 minutes equilibration, MAC was determined using Dixon’s up-and-down method. Painful stimulation including compressions of paw pad, phalange, groin area, and clamping Backhaus on skin. Hemodynamic and ventilation parameters were measured and noted in 2 minutes intervals. In this method, the positive or negative response to the noxious stimulus is estimated and then used to determine the concentration of isoflurane for next patient. The response is only assessed once in each patient. The results show that isoflurane is not necessary to maintain anaesthesia after tiletamine-zolazepam induction. This is clinically important because the side effects resulting from using isoflurane are eliminated.

Keywords: anaesthesia, dog, Isoflurane, The Dixon's up-and-down method, Tiletamine, Zolazepam

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Authors: Moshmi Sangavarapu

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The US healthcare industry has undergone tremendous digital transformation in recent years, but critical care access to lower-income ethnicities is still in its nascency. This population has historically showcased substantial hesitation to seek any medical assistance. While the lack of sufficient financial resources plays a critical role, the existing cultural and knowledge barriers also contribute significantly to widening the access gap. It is imperative to break these barriers to ensure timely access to therapeutic procedures that can save important lives! Based on ongoing research, healthcare access barriers can be best addressed by tapping the untapped potential of caregiver communities first. They play a critical role in patients’ diagnoses, building healthcare knowledge and instilling confidence in required therapeutic procedures. Recent technological advancements have opened many avenues by developing smart ways of reaching the large caregiver community. A digitized go-to-market strategy featuring connected media coupled with smart IoT devices and geo-location targeting can be collectively leveraged to reach this key audience group. AI/ML algorithms can be thoroughly trained to identify relevant data signals from users' location and browsing behavior and determine useful marketing touchpoints. The web behavior can be further assimilated with natural language processing to identify contextually relevant interest topics and decipher potential caregivers on digital avenues to serve that brand message. In conclusion, grasping the true health access journey of any lower-income ethnic group is important to design beneficial touchpoints that can alleviate patients’ concerns and allow them to break their own access barriers and opt for timely and quality healthcare.

Keywords: healthcare access, market access, diversity barriers, patient journey

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Authors: Mohamed Majrashi, Patricia Connolly, Terry Gourlay

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Cardiopulmonary bypass is known to cause inflammatory response during open heart surgery. It includes the initiation of different cascades such as coagulation, complement system and cytokines. Although the immune system is body’s key defense mechanism against external assault, when overexpressed, it can be injurious to the patient, particularly in a cohort of patients in which there is a heightened and uncontrolled response. The inflammatory response develops in these patients to an exaggerated level resulting in an autoimmune injury and may lead to poor postoperative outcomes (systemic inflammatory response syndrome and multi-organs failure). Previous studies by this group have suggested a correlation between the level of IL6 measured in patient’s blood before surgery and after polymeric activation and the observed inflammatory response during surgery. Based upon these findings, the present work is aimed at using this response to develop a test which can be used prior to the open heart surgery to identify the high-risk patients before their operation. The work will be accomplished via three main clinical phases including some pilot in-vitro studies, device development and clinical investigation. Current findings from studies using animal blood, employing DEHP and DEHP plasticized PVC materials as the activator, support the earlier results in patient samples. Having established this relationship, ongoing work will focus on developing an activated lateral flow strip technology as a screening device for heightened inflammatory propensity.

Keywords: cardiopulmonary bypass, cytokines, inflammatory response, overexpression

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Authors: P. T. Ngan

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Purpose: The study aims to answer the question what are motivational conditions that have great influences on employees’ innovative work behaviors by investigating the case of SATAMANKULMA/ Anya Productions Ky in Kuopio, Finland. Design/methodology: The main methodology utilized was the qualitative single case study research, analysis was conducted with an adapted thematic content analysis procedure, created from empirical material that was collected through interviews, observation and document review. Findings: The paper highlights the significance of combining relevant synergistic extrinsic and intrinsic motivations into the organizational motivation system. The findings show that intrinsic drives are essential for the initiation phases while extrinsic drives are more important for the implementation phases of innovative work behaviors. The study also offers the IDEA motivation model-interpersonal relationships & networks, development opportunities, economic constituent and application supports as an ideal tool to optimize business performance. Practical limitations/ implications: The research was only conducted from the perspective of SATAMANKULMA/Anya Productions Ky, with five interviews, a few observations and with several reviewed documents. However, further research is required to include other stakeholders, such as the customers, partner companies etc. Also the study does not offer statistical validity of the findings; an extensive case study or a qualitative multiple case study is suggested to compare the findings and provide information as to whether IDEA model relevant in other types of firms. Originality/value: Neither the innovation nor the human resource management field provides a detailed overview of specific motivational conditions might use to stimulate innovative work behaviors of individual employees. This paper fills that void.

Keywords: employee innovative work behaviors, extrinsic motivation, intrinsic motivation, organizational innovativeness

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Authors: Jamie R. Chua, Christina Irene D. Mejia, Regina P. Berba

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Disseminated tuberculosis is an infectious disease caused by Mycobacterium tuberculosis involving two or more non-contiguous sites identified through bacteriologic confirmation or clinical diagnosis. Over the five year period included in the study, the UP-PGH TB DOTS clinic had total of 3,967 referrals, and the prevalence of disseminated tuberculosis is 1% (68/3967). The mean age was 33.9 years (range 19-64 years) with a male: female ratio of 1:1. 67% (52 patients) had no predisposing comorbid illness or immune disorder. The most common presenting symptoms were abdominal pain (19%), back pain (13%), abdominal enlargement (11%) and mass (10.2%). Anemia, leukocytosis, hypoalbuminemia, and high-normal serum calcium were common biochemical and hematologic findings. Around 36% (25) of patients were diagnosed clinically with disseminated tuberculosis despite lacking bacteriologic evidence of multi-organ involvement. The lungs (86%) is still the most commonly involved site, followed by intestinal (22%), vertebral/Pott’s (27%), and pelvic/genital (19%). The mean time from presentation to initiation of therapy was 22 days (SD 32.7). Only 18 patients (29.3%) were properly recorded to have been referred to local TB DOTs facilities. Of the 68 patients, only 16% (11 patients) continued follow-up at PGH, and all had documented treatment completion. Treatment outcomes of the remaining were unknown. Due to the variety of involved sites, a high index of suspicion is required. Knowledge on clinical features, common radiographic findings, and histopathologic characteristics of disseminated TB is important as bacteriologic evidence of infection is not always apparent.

Keywords: disseminated tuberculosis, Mycobacterium tuberculosis, miliary tuberculosis, tuberculosis

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Authors: Boshra Mozaffar, Arash Ardavani, Iskandar Idris

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Food taste and flavor affect food choice and acceptance, which are essential to maintain good health and quality of life. Reduced circulating zinc levels have been shown to adversely affect taste which can result in reduced appetite, weight loss and psychological problems, but the efficacy of Zinc supplementation to treat disorders of taste remains unclear. In this systematic review and meta-analysis, we aimed to examine the efficacy of zinc supplementation in the treatment of taste disorders. We searched four electronic bibliographical databases; Ovid MEDLINE, Ovid Embase, Ovid AMAD and PubMed. Article bibliographies were also searched, which yielded additional relevant studies. To facilitate the collection and identification of all available and relevant articles published before 7 December 2020, there were no restrictions on the publication date. We performed a systematic review and meta-analysis according to the PRISMA Statement. This review was registered at PROSPERO and given the identification number CRD42021228461. In total, we included 12 randomized controlled trials with 938 subjects. Intervention includes zinc (sulfate, gluconate, picolinate, polaprezinc and acetate); the pooled results of the meta-analysis indicate that improvements in taste disorder occurred more frequently in the intervention group compared to the control group (RR = 1.8; 95% CI:1.27 -2.57, p=0.009). The doses are equivalent to 17 mg- 86.7 mg of elemental zin for three to six months. Zinc supplementation is an effective treatment for taste disorders in patients with zinc deficiency or idiopathic taste disorders when given in high doses ranging from 68–86.7 mg/d for up to three months. However, we did not find sufficient evidence to determine the effectiveness of zinc supplementation in patients with taste disorders induced by chronic renal failure.

Keywords: taste change, taste disorder, zinc, zinc sulfate or Zn, deficiency, supplementation.

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Authors: Mihai Gheorghe

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Freelancing in IT has seen an increased popularity during the last years mainly because of the fast Internet adoption in the countries with emerging economies, correlated with the continuous seek for reduced development costs as well with the rise of online platforms which address planning, coordination, and various development tasks. This paper conducts an overview of the most relevant Freelance Marketplaces available and studies the market structure, distribution of the workforce and trends in IT freelancing.

Keywords: freelancing in IT, freelance marketplaces, freelance market structure, globalization, online staffing, trends in freelancing

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Authors: Slavica P. Petrovic

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One of the key dimensions of management problems in organizations refers to the relations between stakeholders. The management problems that are characterized by conflict and coercion, in which participants do not agree on the ends and means, in which different groups, i.e., individuals, strive to – using the power they have – impose on others their favoured strategy and decisions represent the relevant research subject. Creatively managing the coercive problems in organizations, in which the sources of power can be identified, implies the emancipatory paradigm and the use of corresponding systems methodology. The main research aim is to critically reassess the theoretical foundations and methodological and methodical development of Critical Systems Heuristics (CSH) – as a valid representative of the emancipatory paradigm – in order to determine the conditions, ways, and achievements of its application in managing the coercive problems in organizations. The basic hypothesis is that CSH, as the emancipatory methodology, given its own theoretical foundations and methodological-methodical development, can be employed in a scientifically based and practically useful manner in creative addressing the coercive problems. The scientific instrumentarium corresponding to this research aim is critical systems thinking with its three key commitments to: a) Critical awareness of the strengths and weaknesses of each research instrument (theory, methodology, method, technique, model) for structuring the problem situations in organizations, b) Improvement of managing the coercive problems in organizations, and c) Pluralism – respect the different perceptions and interpretations of problem situations, and enable the combined use of research instruments. The relevant research result is that CSH – considering its theoretical foundations, methodological and methodical development – enables to reveal the normative content of the proposed or existing designs of organizational systems. Accordingly, it can be concluded that through the use of critically heuristic categories and dialectical debate between those involved and those affected by the designs, but who are not included in designing organizational systems, CSH endeavours to – in the application – support the process of improving position of all stakeholders.

Keywords: coercion and conflict in organizations, creative management, critical systems heuristics, the emancipatory systems methodology

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Authors: Aliro Villacorta, Laura Rubio, Mohamed Alaraby, Montserrat López Mesas, Victor Fuentes-Cebrian, Oscar H. Moriones, Ricard Marcos, Alba Hernández.

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Micro and nano plastics (MNPLs) are emergent environmental pollutants requiring urgent information on their potential risks to human health. One of the problems associated with the evaluation of their undesirable effects is the lack of real samples matching those resulting from the environmental degradation of plastic wastes. To such end, we propose an easy method to obtain polyethylene terephthalate nano plastics from water plastic bottles (PET-NPLs) but, in principle, applicable to any other plastic goods sources. An extensive characterization indicates that the proposed process produces uniform samples of PET-NPLs of around 100 nm, as determined by using a multi-angle and dynamic light scattering methodology. An important point to be highlighted is that to avoid the metal contamination resulting from methods using metal blades/burrs for milling, trituration, or sanding, we propose to use diamond burrs to produce metal-free samples. To visualize the toxicological profile of the produced PET-NPLs, we have evaluated their ability to be internalized by cells, their cytotoxicity, and their ability to induce oxidative stress and induce DNA damage. In this preliminary approach, we have detected their cellular uptake, but without the induction of significant biological effects. Thus, no relevant increases in toxicity, reactive oxygen species (ROS) induction, or DNA damage -as detected with the comet assay- have been observed. The use of real samples, as produced in this study, will generate relevant data in the discussion about the potential health risks associated with MNPLs exposures.

Keywords: nanoplastics, polyethylene terephthalate, physicochemical characterization, cell uptake, cytotoxicity

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Authors: M. Fayez Al Homsi, Reem Al Homsi

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Renal disease is a major cause of morbidity and mortality. Glomerular diseases make a small portion of the renal disease. Lupus glomerulonephritis (GN) is the commonest among the GN of systemic diseases. More than a hundred and eighty-eight consecutive renal biopsies are performed and evaluated for clinically suspected glomerular diseases over a period of two years. As in a standard practice after receiving the ultrasound-guided renal biopsies, the fresh biopsy is divided to three parts, one part is frozen for immunofluorescence evaluation, the second part is placed in 4% glutaraldehyde for electron microscopic evaluation, and the third part is placed in 10% buffered formalin for light microscopic evaluation. Primary glomerular diseases are detected in 83 biopsies; glomerulonephritis (GN) of systemic diseases are identified in 88, glomerular lesions in vascular diseases in 3, glomerular lesions in metabolic diseases in 7, hereditary nephropathies in 2, end-stage kidney in 2, and glomerular lesions in transplantation in 3 biopsies. Among the primary lesions, focal segmental glomerulosclerosis (28) and mesangial proliferative GN (26) were the most common. Lupus GN (67) and Ig A nephropathy (20) were the most common of the GN of systemic diseases. Lupus nephritis biopsies included one biopsy diagnosed as class 1 (normal), 17 biopsies class 2 (mesangial proliferation), 5 biopsies class 3 (focal proliferative GN), 39 biopsies class 4 diffuse proliferative GN), 3 biopsies class 5 (membranous GN), and 2 biopsies class 6 (crescentic GN). Lupus GN is the most common among GN of systemic diseases. While diabetes is very common here, diabetic GN (3 biopsies) is not as common as might one expects. Most likely this is due to sampling and reluctance on part of nephrologists and patients in sampling the kidney in diabetes mellitus.

Keywords: diabetes, glomerulonephritis, lupus, mesangial proliferation, nephropathy

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Authors: Wooseok Byon, Eunyoung Kim, Junseong Kwon, Byung Joo Song, Chan Heun Park

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Purpose: 18F Fluorodeoxyglucose Positron Emission Tomography (FDG-PET) is a noninvasive imaging modality that can identify nodal metastases in women with primary breast cancer. The aim of this study was to compare the accuracy of FDG-PET with MRI and sonography scanning to determine axillary lymph node status in patients with breast cancer undergoing sentinel lymph node biopsy or axillary lymph node dissection. Patients and Methods: Between January and December 2012, ninety-nine patients with breast cancer and clinically negative axillary nodes were evaluated. All patients underwent FDG-PET, MRI, ultrasound followed by sentinel lymph node biopsy (SLNB) or axillary lymph node dissection (ALND). Results: Using axillary lymph node assessment as the gold standard, the sensitivity and specificity of FDG-PET were 51.4% (95% CI, 41.3% to 65.6%) and 92.2% (95% CI, 82.7% to 97.4%) respectively. The sensitivity and specificity of MRI and ultrasound were 57.1% (95% CI, 39.4% to 73.7%), 67.2% (95% CI, 54.3% to 78.4%) and 42.86% (95% CI, 26.3% to 60.7%), 92.2% (95% CI, 82.7% to 97.4%). Stratification according to hormone receptor status showed an increase in specificity when negative (FDG-PET: 42.3% to 77.8%, MRI 50% to 77.8%, ultrasound 34.6% to 66.7%). Also, positive HER2 status was associated with an increase in specificity (FDG-PET: 42.9% to 85.7%, MRI 50% to 85.7%, ultrasound 35.7% to 71.4%). Conclusions: The sensitivity and specificity of FDG-PET compared with MRI and ultrasound was high. However, FDG-PET is not sufficiently accurate to appropriately identify lymph node metastases. This study suggests that FDG-PET scanning cannot replace histologic staging in early-stage breast cancer, but might have a role in evaluating axillary lymph node status in hormone receptor negative or HER-2 overexpressing subtypes.

Keywords: axillary lymph node metastasis, FDG-PET, MRI, ultrasound

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Authors: Mohammed N. Al Kindi, Mazin Al Khabouri, Khalsa Al Lamki, Tommasso Pappuci, Giovani Romeo, Nadia Al Wardy

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Hereditary hearing loss is a heterogeneous group of complex disorders with an overall incidence of one in every five hundred newborns presented as syndromic and non-syndromic forms. Cadherin-related 23 (CDH23) is one of the listed deafness causative genes. CDH23 is found to be expressed in the stereocilia of hair cells and the retina photoreceptor cells. Defective CDH23 has been associated mostly with prelingual severe-to-profound sensorineural hearing loss (SNHL) in either syndromic (USH1D) or non-syndromic SNHL (DFNB12). An Omani family diagnosed clinically with severe-profound sensorineural hearing loss was genetically analysed by whole exome sequencing technique. A novel homozygous missense variant, c.A7451C (p.D2484A), in exon 53 of CDH23 was detected. One hundred and thirty control samples were analysed where all were negative for the detected variant. The variant was analysed in silico for pathogenicity verification using several mutation prediction software. The variant proved to be a pathogenic mutation and is reported for the first time in Oman and worldwide. It is concluded that in silico mutation prediction analysis might be used as a useful molecular diagnostics tool benefiting both genetic counseling and mutation verification. The aspartic acid 2484 alanine missense substitution might be the main disease-causing mutation that damages CDH23 function and could be used as a genetic hearing loss marker for this particular Omani family.

Keywords: Cdh23, d2484a, in silico, Oman

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Authors: Roni Ramon-Gonen, Amir Dori, Shahar Shelly

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Background and objectives: Healthcare professionals produce abundant textual information in their daily clinical practice. The extraction of insights from all the gathered information, mainly unstructured and lacking in normalization, is one of the major challenges in computational medicine. In this respect, text mining assembles different techniques to derive valuable insights from unstructured textual data, so it has led to being especially relevant in Medicine. Neurological patient’s history allows the clinician to define the patient’s symptoms and along with the result of the nerve conduction study (NCS) and electromyography (EMG) test, assists in formulating a differential diagnosis. Past medical history (PMH) helps to direct the latter. In this study, we aimed to identify relevant PMH, understand which PMHs are common among patients in the referral cohort and documented by the medical staff, and examine the differences by sex and age in a large cohort based on textual format notes. Methods: We retrospectively identified all patients with abnormal NCS between May 2016 to February 2022. Age, gender, and all NCS attributes reports were recorded, including the summary text. All patients’ histories were extracted from the text report by a query. Basic text cleansing and data preparation were performed, as well as lemmatization. Very popular words (like ‘left’ and ‘right’) were deleted. Several words were replaced with their abbreviations. A bag of words approach was used to perform the analyses. Different visualizations which are common in text analysis, were created to easily grasp the results. Results: We identified 5282 unique patients. Three thousand and five (57%) patients had documented PMH. Of which 60.4% (n=1817) were males. The total median age was 62 years (range 0.12 – 97.2 years), and the majority of patients (83%) presented after the age of forty years. The top two documented medical histories were diabetes mellitus (DM) and surgery. DM was observed in 16.3% of the patients, and surgery at 15.4%. Other frequent patient histories (among the top 20) were fracture, cancer (ca), motor vehicle accident (MVA), leg, lumbar, discopathy, back and carpal tunnel release (CTR). When separating the data by sex, we can see that DM and MVA are more frequent among males, while cancer and CTR are less frequent. On the other hand, the top medical history in females was surgery and, after that, DM. Other frequent histories among females are breast cancer, fractures, and CTR. In the younger population (ages 18 to 26), the frequent PMH were surgery, fractures, trauma, and MVA. Discussion: By applying text mining approaches to unstructured data, we were able to better understand which medical histories are more relevant in these circumstances and, in addition, gain additional insights regarding sex and age differences. These insights might help to collect epidemiological demographical data as well as raise new hypotheses. One limitation of this work is that each clinician might use different words or abbreviations to describe the same condition, and therefore using a coding system can be beneficial.

Keywords: abnormal studies, healthcare analytics, medical history, nerve conduction studies, text mining, textual analysis

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Authors: Huajuan Shi

Abstract:

Background: The biopsy of the preimplantation embryo may increase the potential risk and concern of embryo viability. Clinically discarded spent embryo medium (SEM) has entered the view of researchers, sparking an interest in noninvasive embryo screening. However, one of the major restrictions is the extremelty low quantity of cf-RNA, which is difficult to efficiently and unbiased amplify cf-RNA using traditional methods. Hence, there is urgently need to an efficient and low bias amplification method which can comprehensively and accurately obtain cf-RNA information to truly reveal the state of SEM cf-RNA. Result: In this present study, we established an agarose PCR amplification system, and has significantly improved the amplification sensitivity and efficiency by ~90 fold and 9.29 %, respectively. We applied agarose to sequencing library preparation (named AG-seq) to quantify and characterize cf-RNA in SEM. The number of detected cf-RNAs (3533 vs 598) and coverage of 3' end were significantly increased, and the noise of low abundance gene detection was reduced. The increasing percentage 5' end adenine and alternative splicing (AS) events of short fragments (< 400 bp) were discovered by AG-seq. Further, the profiles and characterizations of cf-RNA in spent cleavage medium (SCM) and spent blastocyst medium (SBM) indicated that 4‐mer end motifs of cf-RNA fragments could remarkably differentiate different embryo development stages. Significance: This study established an efficient and low-cost SEM amplification and library preparation method. Not only that, we successfully described the characterizations of SEM cf-RNA of preimplantation embryo by using AG-seq, including abundance features fragment lengths. AG-seq facilitates the study of cf-RNA as a noninvasive embryo screening biomarker and opens up potential clinical utilities of trace samples.

Keywords: cell-free RNA, agarose, spent embryo medium, RNA sequencing, non-invasive detection

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Authors: S. Curtin, A. Trace

Abstract:

Introduction: As patients can often be ambivalent about or resistant to any change in their smoking behavior the traditional ‘5 A’ model may be limited as it assumes that patients are ready and motivated to change. However, there is a stage model that is helpful to give guidance for dental students: the Transtheoretical Model (TTM). This model allows students to understand the tasks and goals for the pre-contemplation stage. The TTM was introduced in early stages as a core component of a smoking cessation programme that was integrated into a Behavioral Science programme as applied to dentistry. The aim of the present study is to evaluate and illustrate the students’ current level of knowledge from the questions the students generated in order to engage patients in the tasks and goals of the pre-contemplation stage. Method: N=47 responses of fifth-year undergraduate dental students. These responses were the data set for this study and related to their knowledge base of appropriate questions for a dentist to ask at the pre-contemplation stage of change. A deductive -descriptive analysis was conducted on the data. The goals and tasks of the pre-contemplation stage of the TTM provided a template for this deductive analysis. Results: 51% of students generated relevant, open, exploratory questions for the pre-contemplation stage, whilst 100% of students generated closed questions. With regard to those questions appropriate for the pre-contemplation stage, 19% were open and exploratory, while 66% were closed questions. A deductive analysis of the open exploratory questions revealed that 53% of the questions addressed increased concern about the current pattern of behavior, 38% of the questions concerned increased awareness of a need for change and only 8% of the questions dealt with the envisioning of the possibility of change. Conclusion: All students formulated relevant questions for the pre-contemplation stage, and half of the students generated the open, exploratory questions that increased patients’ awareness of the need to change. More training is required to facilitate a shift in the formulation from closed to open questioning, especially given that, traditionally, smoking cessation was modeled on the ‘5 As’, and that the general training for dentists supports an advisory and directive approach.

Keywords: behaviour change, pre-contemplation stage, trans-theoretical model, undergraduate dentistry students

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Authors: Naif A. Haddad

Abstract:

Greek, Hellenistic and Roman theatre heritage are exposed to multiple risks at varied times or simultaneously. There is no single reason why a theatre building becomes ‘at risk’, as each case has different circumstances which have led to the theatre building decay. There are complicated processes of destruction and distress that show divergence in theatre building materials' decay. Theatre modern use for cultural performances causes much of the risks concerning the physical structure and authenticity of theatre sites. In addition, there are some deterioration and deformations due to previous poor quality restorations and interventions through related excavation and conservation programmes as also risks to authenticity due to new additions. For preventive conservation, theatre natural and anthropogenic risks management can provide a framework for decision making. These risks to ancient theatre heritage may stem from exposure to one or more risk or synergy of many factors. We, therefore, need to link the theatre natural risks to the risks that come from anthropogenic factors associated with social and economic development. However, this requires a holistic approach, and systematic methodology for understanding these risks from various sources while incorporating specific actions, planning and strategies for each specific risk. Elaborating on recent relevant studies, and ERATO and ATHENA EU projects for ancient theaters and odea and general surveys, this paper attempts to discuss the main aspects of the ancient Greek, Hellenistic and Roman theatres risk related issues. Relevant case studies shall also be discussed and investigated to examine frameworks for risk mitigation, and related guidelines and recommendations that provide a systematic approach for sustainable management and planning in relation mainly to ‘compatible use’ of theatre sites.

Keywords: cultural heritage management, European ancient theatres projects, Anthropogenic risks mitigation, sustainable management and planning, preventive conservation, modern use, compatible use

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Authors: Sana Ilyas

Abstract:

Parry-Romberg syndrome is a rare condition clinically defined by slowly progressive atrophy of the skin and soft tissues. This usually effects one side of the face, although a few cases have been documented of bilateral presentation. It is more prevalent in females and usually affects the left side of the face. The syndrome can also be accompanied by neurological abnormalities. It usually occurs in the first two decades of life with a variable rate of progression. The aetiology is unknown, and the disease eventually stabilises. The treatment options usually involve surgical management. The least invasive of these options is the management of facial asymmetry, associated with Parry Romberg syndrome, through the use of tissue fillers. This paper will review the existing literature on the management of Parry Romberg syndrome with tissue filler. Aim: The aim of the study is to explore the current published literature for the management of Parry Romberg syndrome with fillers. It is to assess the development that has been made in this method of management, its benefits and limitations, and its effectiveness for the management of Parry Romberg syndrome. Methodology: There was a thorough assessment of the current literature published on this topic. PubMed database was used for search of the published literature on this method of the management. Papers were analysed and compared with one another to assess the success and limitation of the management of Parry Romberg with dermal fillers Results and Conclusion: Case reports of the use of tissue fillers discuss the varying degrees of success with the treatment. However, this procedure has it’s limitation, which are discussed in the paper in detail. However, it is still the least invasive of all the surgical options for the management of Parry Romberg Syndrome, and therefore, it is important to explore this option with patients, as they may be more comfortable with pursuingtreatment that is less invasive and can still improve their facial asymmetry

Keywords: dermal fillers, facial asymmetry, parry romberg syndrome, tissue fillers

Procedia PDF Downloads 83

Authors: James Jin, Weisi Xia, Runzhe Gao, Alain Vandal, Darren Svirkis, Andrew Hill

Abstract:

Background: Post-haemorrhoidectomy pain is concerned by patients/clinicians. Minimizing the postoperation pain is highly interested clinically. Combinations of topical cream targeting three hypothesised post-haemorrhoidectomy pain mechanisms were developed and their effectiveness were evaluated. Specifically, a multi-centred double-blinded randomized clinical trial (RCT) was conducted in adults undergoing excisional haemorrhoidectomy. The primary analysis was conveyed on the data collected to evaluate the effectiveness of the combinations of topical cream targeting three hypothesized pain mechanisms after the operations. Methods: 192 patients were randomly allocated to 4 arms (each arm has 48 patients), and each arm was provided with pain cream 10% metronidazole (M), M and 2% diltiazem (MD), M with 4% lidocaine (ML), or MDL, respectively. Patients were instructed to apply topical treatments three times a day for 7 days, and record outcomes for 14 days after the operations. The primary outcome was VAS pain on day 4. Covariates and models were selected in the blind review stage. Multiple imputations were applied for the missingness. LMER, GLMER models together with natural splines were applied. Sandwich estimators and Wald statistics were used. P-values < 0.05 were considered as significant. Conclusions: The addition of topical lidocaine or diltiazem to metronidazole does not add any benefit. ML had significantly better pain and recovery scores than combination MDL. Multimodal topical analgesia with ML after haemorrhoidectomy could be considered for further evaluation. Further trials considering only 3 arms (M, ML, MD) might be worth exploring.

Keywords: RCT, primary analysis, multiple imputation, pain scores, haemorrhoidectomy, analgesia, lmer

Procedia PDF Downloads 111

Authors: Luiz Carlos Wrobel, Matjaz Hribersek, Jure Marn, Jurij Iljaz

Abstract:

Dynamic thermography has been clinically proven to be a valuable diagnostic technique for skin tumor detection as well as for other medical applications such as breast cancer diagnostics, diagnostics of vascular diseases, fever screening, dermatological and other applications. Thermography for medical screening can be done in two different ways, observing the temperature response under steady-state conditions (passive or static thermography), and by inducing thermal stresses by cooling or heating the observed tissue and measuring the thermal response during the recovery phase (active or dynamic thermography). The numerical modelling of heat transfer phenomena in biological tissue during dynamic thermography can aid the technique by improving process parameters or by estimating unknown tissue parameters based on measured data. This paper presents a nonlinear numerical model of multilayer skin tissue containing a skin tumor, together with the thermoregulation response of the tissue during the cooling-rewarming processes of dynamic thermography. The model is based on the Pennes bioheat equation and solved numerically by using a subdomain boundary element method which treats the problem as axisymmetric. The paper includes computational tests and numerical results for Clark II and Clark IV tumors, comparing the models using constant and temperature-dependent thermophysical properties, which showed noticeable differences and highlighted the importance of using a local thermoregulation model.

Keywords: boundary element method, dynamic thermography, static thermography, skin tumor diagnostic

Procedia PDF Downloads 101

Authors: Huajuan Shi

Abstract:

Background: The biopsy of the preimplantation embryo may increase the potential risk and concern of embryo viability. Clinically discarded spent embryo medium (SEM) has entered the view of researchers, sparking an interest in noninvasive embryo screening. However, one of the major restrictions is the extremelty low quantity of cf-RNA, which is difficult to efficiently and unbiased amplify cf-RNA using traditional methods. Hence, there is urgently need to an efficient and low bias amplification method which can comprehensively and accurately obtain cf-RNA information to truly reveal the state of SEM cf-RNA. Result: In this present study, we established an agarose PCR amplification system, and has significantly improved the amplification sensitivity and efficiency by ~90 fold and 9.29 %, respectively. We applied agarose to sequencing library preparation (named AG-seq) to quantify and characterize cf-RNA in SEM. The number of detected cf-RNAs (3533 vs 598) and coverage of 3' end were significantly increased, and the noise of low abundance gene detection was reduced. The increasing percentage 5' end adenine and alternative splicing (AS) events of short fragments (< 400 bp) were discovered by AG-seq. Further, the profiles and characterizations of cf-RNA in spent cleavage medium (SCM) and spent blastocyst medium (SBM) indicated that 4‐mer end motifs of cf-RNA fragments could remarkably differentiate different embryo development stages. Significance: This study established an efficient and low-cost SEM amplification and library preparation method. Not only that, we successfully described the characterizations of SEM cf-RNA of preimplantation embryo by using AG-seq, including abundance features fragment lengths. AG-seq facilitates the study of cf-RNA as a noninvasive embryo screening biomarker and opens up potential clinical utilities of trace samples.

Keywords: cell-free RNA, agarose, spent embryo medium, RNA sequencing, non-invasive detection

Procedia PDF Downloads 62

Authors: Vidhula Ahire, Amit Kumar, K. P. Mishra, Gauri Kulkarni

Abstract:

Herbal polyphenols have gained significance because of their increasing promise in prevention and treatment of cancer. Therefore, development of a dietary compound as an effective radiosensitizer and a radioprotector is highly warranted for cervical cancer patients undergoing therapy. This study describes the cytotoxic effects of the flavonoid, ellagic acid (EA) when administered either alone or in combination with gamma radiation on cervical cancer HeLa cells in vitro. Apoptotic index and proliferation were measured by using trypan blue assay. Reproductive cell death was analyzed by clonogenic assay. Propidium iodide staining for flowcytometry was performed to analyze cell cycle modulation. Nuclear and mitochondrial changes were studied with specific dyes. DNA repair kinetics was analyzed by immunofluorescence assay. Evaluation and comparison of EA effects were performed with other clinically used breast cancer drugs. When tumor cells were exposed to 2 and 4 Gy of irradiation in presence of EA (10 μM), it yielded a synergistic cytotoxic effect on cervical cancer cells whereas in NIH3T3 cells it reversed the injury caused by irradiation and abetted in the regaining of normal healthy cells. At 24h ~25foci/cell was observed and 2.6 fold decrease in the mitochondrial membrane potential. Up to 40% cell were arrested in the G1 phase and 20-36% cells exhibited apoptosis. Our results demonstrate the role of increased apoptosis and cell cycle modulation in the mechanism of EA mediated radiosensitization of cervical cancer cells and thus advocating EA as an adjuvant for preclinical trials in cancer chemo- radiotherapy.

Keywords: cervical cancer, ellagic acid, sensitization, radiation therapy

Procedia PDF Downloads 318

Authors: Mamunur Rashid, Jialin Yan

Abstract:

The current years have witnessed a rapid evolution and integration of artificial intelligence (AI) in various fields, prominently influencing the education industry. Acknowledging this transformative wave, AI tools like ChatGPT and Grammarly have undeniably introduced perspectives and skills, enriching the educational experiences of higher education students. The prevalence of AI utilization in higher education also drives an increasing number of researchers' attention in various dimensions. Departments, offices, and professors in universities also designed and released a set of policies and guidelines on using AI effectively. In regard to this, the study targets exploring and analyzing graduate students' perspectives regarding AI guidelines set by teachers. A mixed-methods study will be mainly conducted in this study, employing in-depth interviews and focus groups to investigate and collect students' perspectives. Relevant materials, such as syllabi and course instructions, will also be analyzed through the documentary analysis to facilitate understanding of the study. Surveys will also be used for data collection and students' background statistics. The integration of both interviews and surveys will provide a comprehensive array of student perspectives across various academic disciplines. The study is anchored in the theoretical framework of self-determination theory (SDT), which emphasizes and explains the students' perspective under the AI guidelines through three core needs: autonomy, competence, and relatedness. This framework is instrumental in understanding how AI guidelines influence students' intrinsic motivation and sense of empowerment in their learning environments. Through qualitative analysis, the study reveals a sense of confusion and uncertainty among students regarding the appropriate application and ethical considerations of AI tools, indicating potential challenges in meeting their needs for competence and autonomy. The quantitative data further elucidates these findings, highlighting a significant communication gap between students and educators in the formulation and implementation of AI guidelines. The critical findings of this study mainly come from two aspects: First, the majority of graduate students are uncertain and confused about relevant AI guidelines given by teachers. Second, this study also demonstrates that the design and effectiveness of course materials, such as the syllabi and instructions, also need to adapt in regard to AI policies. It indicates that certain of the existing guidelines provided by teachers lack consideration of students' perspectives, leading to a misalignment with students' needs for autonomy, competence, and relatedness. More emphasize and efforts need to be dedicated to both teacher and student training on AI policies and ethical considerations. To conclude, in this study, graduate students' perspectives on teacher-provided AI guidelines are explored and reflected upon, calling for additional training and strategies to improve how these guidelines can be better disseminated for their effective integration and adoption. Although AI guidelines provided by teachers may be helpful and provide new insights for students, educational institutions should take a more anchoring role to foster a motivating, empowering, and student-centered learning environment. The study also provides some relevant recommendations, including guidance for students on the ethical use of AI and AI policy training for teachers in higher education.

Keywords: higher education policy, graduate students’ perspectives, higher education teacher, AI guidelines, AI in education

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Authors: Funmilayo Sarah Eguakun, Peter Oluremi Adesoye

Abstract:

One of the major problems being faced by human society is that the global temperature is believed to be rising due to human activity that releases carbon IV oxide (CO2) to the atmosphere. Carbon IV oxide is the most important greenhouse gas influencing global warming and possible climate change. With climate change becoming alarming, reducing CO2 in our atmosphere has become a primary goal of international efforts. Forest landsare major sink and could absorb large quantities of carbon if the trees are judiciously managed. The study aims at estimating the carbon sequestration capacity of Pinus caribaea (pine)and Tectona grandis (Teak) under the prevailing environmental conditions and exploring tree growth variables that influencesthe carbon sequestration capacity in Omo Forest Reserve, Ogun State, Nigeria. Improving forest management by manipulating growth characteristics that influences carbon sequestration could be an adaptive strategy of forestry to climate change. Random sampling was used to select Temporary Sample Plots (TSPs) in the study area from where complete enumeration of growth variables was carried out within the plots. The data collected were subjected to descriptive and correlational analyses. The results showed that average carbon stored by Pine and Teak are 994.4±188.3 Kg and 1350.7±180.6 Kg respectively. The difference in carbon stored in the species is significant enough to consider choice of species relevant in climate change adaptation strategy. Tree growth variables influence the capacity of the tree to sequester carbon. Height, diameter, volume, wood density and age are positively correlated to carbon sequestration. These tree growth variables could be manipulated by the forest manager as an adaptive strategy for climate change while plantations of high wood density speciescould be relevant for management strategy to increase carbon storage.

Keywords: adaptation, carbon sequestration, climate change, growth variables, wood density

Procedia PDF Downloads 376