Search results for: radiation therapy enhancement
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 4570

Search results for: radiation therapy enhancement

670 Transport Properties of Alkali Nitrites

Authors: Y. Mateyshina, A.Ulihin, N.Uvarov

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Electrolytes with different type of charge carrier can find widely application in different using, e.g. sensors, electrochemical equipments, batteries and others. One of important components ensuring stable functioning of the equipment is electrolyte. Electrolyte has to be characterized by high conductivity, thermal stability, and wide electrochemical window. In addition to many advantageous characteristic for liquid electrolytes, the solid state electrolytes have good mechanical stability, wide working range of temperature range. Thus search of new system of solid electrolytes with high conductivity is an actual task of solid state chemistry. Families of alkali perchlorates and nitrates have been investigated by us earlier. In literature data about transport properties of alkali nitrites are absent. Nevertheless, alkali nitrites MeNO2 (Me= Li+, Na+, K+, Rb+ and Cs+), except for the lithium salt, have high-temperature phases with crystal structure of the NaCl-type. High-temperature phases of nitrites are orientationally disordered, i.e. non-spherical anions are reoriented over several equivalents directions in the crystal lattice. Pure lithium nitrite LiNO2 is characterized by ionic conductivity near 10-4 S/cm at 180°C and more stable as compared with lithium nitrate and can be used as a component for synthesis of composite electrolytes. In this work composite solid electrolytes in the binary system LiNO2 - A (A= MgO, -Al2O3, Fe2O3, CeO2, SnO2, SiO2) were synthesized and their structural, thermodynamic and electrical properties investigated. Alkali nitrite was obtained by exchange reaction from water solutions of barium nitrite and alkali sulfate. The synthesized salt was characterized by X-ray powder diffraction technique using D8 Advance X-Ray Diffractometer with Cu K radiation. Using thermal analysis, the temperatures of dehydration and thermal decomposition of salt were determined.. The conductivity was measured using a two electrode scheme in a forevacuum (6.7 Pa) with an HP 4284A (Precision LCR meter) in a frequency range 20 Hz < ν < 1 MHz. Solid composite electrolytes LiNO2 - A A (A= MgO, -Al2O3, Fe2O3, CeO2, SnO2, SiO2) have been synthesized by mixing of preliminary dehydrated components followed by sintering at 250°C. In the series of nitrite of alkaline metals Li+-Cs+, the conductivity varies not monotonically with increasing radius of cation. The minimum conductivity is observed for KNO2; however, with further increase in the radius of cation in the series, the conductivity tends to increase. The work was supported by the Russian Foundation for Basic research, grant #14-03-31442.

Keywords: conductivity, alkali nitrites, composite electrolytes, transport properties

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669 Rooibos Extract Antioxidants: In vitro Models to Assess Their Bioavailability

Authors: Ntokozo Dambuza, Maryna Van De Venter, Trevor Koekemoer

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Oxidative stress contributes to the pathogenesis of many diseases and consequently antioxidant therapy has attracted much attention as a potential therapeutic strategy. Regardless of the quantities ingested, antioxidants need to reach the diseased tissues at concentrations sufficient to combat oxidative stress. Bioavailability is thus a defining criterion for the therapeutic efficacy of antioxidants. In addition, therapeutic antioxidants must possess biologically relevant characteristics which can target the specific molecular mechanisms responsible for disease related oxidative stress. While many chemical antioxidant assays are available to quantify antioxidant capacity, they relate poorly to the biological environment and provide no information as to the bioavailability. The present comparative study thus aims to characterise green and fermented rooibos extracts, well recognized for their exceptional antioxidant capacity, in terms of antioxidant bioavailability and efficacy in a disease relevant cellular setting. Chinese green tea antioxidant activity was also evaluated. Chemical antioxidant assays (FRAP, DPPH and ORAC) confirmed the potent antioxidant capacity of both green and fermented rooibos, with green rooibos possessing antioxidant activity superior to that of fermented rooibos and Chinese green tea. Bioavailability was assessed using the PAMPA assay and the results indicate that green and fermented rooibos have a permeation coefficient of 5.7 x 10-6 and 6.9 x 10-6 cm/s, respectively. Chinese green tea permeability coefficient was 8.5 x 10-6 cm/s. These values were comparable to those of rifampicin, which is known to have a high permeability across intestinal epithelium with a permeability coefficient of 5 x 10 -6 cm/s. To assess the antioxidant efficacy in a cellular context, U937 and red blood cells were pre-treated with rooibos and Chinese green tea extracts in the presence of a dye DCFH-DA and then exposed to oxidative stress. Green rooibos exhibited highest activity with an IC50 value of 29 μg/ml and 70 μg/ml, when U937 and red blood cells were exposed oxidative stress, respectively. Fermented rooibos and Chinese green tea had IC50 values of 61 μg/ml and 57 μg/ml for U937, respectively, and 221 μg/ml and 405 μg/ml for red blood cells, respectively. These results indicate that fermented and green rooibos extracts were able to permeate the U937 cells and red blood cell membrane and inhibited oxidation of DCFH-DA to a fluorescent DCF within the cells.

Keywords: rooibos, antioxidants, permeability, bioavailability

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668 Therapeutic Nihilism: Challenging Aging Diseases in Cameroon

Authors: Chick Loveline Ayoh Epse Ndi

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Our cultural stance has deep implications for the psychological and physical well-being of the old. Cameroon is still rooted on the traditional belief that stipulates that; the aged are best catered for in the family setting where the children and grandchildren are supposed to give in return for services invested on them by the former. This is why up till date, there are no “Rest Homes” or “Convalescent hospitals” despite the rising challenges faced by the aged in this context. Beside the special measure set aside to cater for the aged, such as “Rest Homes” for the healthy, “Convalescent hospitals” are created set to cater for the health of the aged in the Western context with other facilities such as geriatric units. The health care practitioners are aware of aging diseases and have trained human resources like Gerontologists to cater for the aged and aging diseases. Meanwhile, in Africa and Cameroon in particular, such infrastructural and human resources are still to be considered in the health care system. It can be assumed that the aged and aging diseases are still to be considered in the health care system in this context. This is why we talk of therapeutic nihilism, where the aged are mixed up with other categories of patients with no special attention given to them. This qualitative study carried out in the Yaounde, the capital city of Cameroon, with their best referent hospitals, reveal that; the aged and aging diseases are still a myth in this context. Data collected in both private and public health institutions show that there is only one public institution in Cameroon that has a geriatric unit with no specialists. Patients who aretreated in this unit are considered as aged with terminal diseases that need palliative care and not intensive care. Cameroon is still lacking in terms of health care to the aged and ageing diseases. Like other patients, the aged are treated with a lot of laxity and no value. There is an emergency to create special health care units for geriatrics and and train gerontologist. Mentally or physically ill aged faced medical rational with psychodynamic treatment considered as waste of time. The aged are less likely to be regarded salvageable when they enter a hospital in serious conditions due to the lack of specialists and geriatric units for them. The implication of this study is to sensitization the stake holders for an urgent need to extend special care units for the aged and aging diseases in this context.

Keywords: challeng, therapy, agtng, diseases cameroon

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667 Self-Assembling Layered Double Hydroxide Nanosheets on β-FeOOH Nanorods for Reducing Fire Hazards of Epoxy Resin

Authors: Wei Wang, Yuan Hu

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Epoxy resins (EP), one of the most important thermosetting polymers, is widely applied in various fields due to its desirable properties, such as excellent electrical insulation, low shrinkage, outstanding mechanical stiffness, satisfactory adhesion and solvent resistance. However, like most of the polymeric materials, EP has the fatal drawbacks including inherent flammability and high yield of toxic smoke, which restricts its application in the fields requiring fire safety. So, it is still a challenge and an interesting subject to develop new flame retardants which can not only remarkably improve the flame retardancy, but also render modified resins low toxic gases generation. In recent work, polymer nanocomposites based on nanohybrids that contain two or more kinds of nanofillers have drawn intensive interest, which can realize performance enhancements. The realization of previous hybrids of carbon nanotubes (CNTs) and molybdenum disulfide provides us a novel route to decorate layered double hydroxide (LDH) nanosheets on the surface of β-FeOOH nanorods; the deposited LDH nanosheets can fill the network and promote the work efficiency of β-FeOOH nanorods. Moreover, the synergistic effects between LDH and β-FeOOH can be anticipated to have potential applications in reducing fire hazards of EP composites for the combination of condense-phase and gas-phase mechanism. As reported, β-FeOOH nanorods can act as a core to prepare hybrid nanostructures combining with other nanoparticles through electrostatic attraction through layer-by-layer assembly technique. In this work, LDH nanosheets wrapped β-FeOOH nanorods (LDH-β-FeOOH) hybrids was synthesized by a facile method, with the purpose of combining the characteristics of one dimension (1D) and two dimension (2D), to improve the fire resistance of epoxy resin. The hybrids showed a well dispersion in EP matrix and had no obvious aggregation. Thermogravimetric analysis and cone calorimeter tests confirmed that LDH-β-FeOOH hybrids into EP matrix with a loading of 3% could obviously improve the fire safety of EP composites. The plausible flame retardancy mechanism was explored by thermogravimetric infrared (TG-IR) and X-ray photoelectron spectroscopy. The reasons were concluded: condense-phase and gas-phase. Nanofillers were transferred to the surface of matrix during combustion, which could not only shield EP matrix from external radiation and heat feedback from the fire zone, but also efficiently retard transport of oxygen and flammable pyrolysis.

Keywords: fire hazards, toxic gases, self-assembly, epoxy

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666 Global Modeling of Drill String Dragging and Buckling in 3D Curvilinear Bore-Holes

Authors: Valery Gulyayev, Sergey Glazunov, Elena Andrusenko, Nataliya Shlyun

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Enhancement of technology and techniques for drilling deep directed oil and gas bore-wells are of essential industrial significance because these wells make it possible to increase their productivity and output. Generally, they are used for drilling in hard and shale formations, that is why their drivage processes are followed by the emergency and failure effects. As is corroborated by practice, the principal drilling drawback occurring in drivage of long curvilinear bore-wells is conditioned by the need to obviate essential force hindrances caused by simultaneous action of the gravity, contact and friction forces. Primarily, these forces depend on the type of the technological regime, drill string stiffness, bore-hole tortuosity and its length. They can lead to the Eulerian buckling of the drill string and its sticking. To predict and exclude these states, special mathematic models and methods of computer simulation should play a dominant role. At the same time, one might note that these mechanical phenomena are very complex and only simplified approaches (‘soft string drag and torque models’) are used for their analysis. Taking into consideration that now the cost of directed wells increases essentially with complication of their geometry and enlargement of their lengths, it can be concluded that the price of mistakes of the drill string behavior simulation through the use of simplified approaches can be very high and so the problem of correct software elaboration is very urgent. This paper deals with the problem of simulating the regimes of drilling deep curvilinear bore-wells with prescribed imperfect geometrical trajectories of their axial lines. On the basis of the theory of curvilinear flexible elastic rods, methods of differential geometry, and numerical analysis methods, the 3D ‘stiff-string drag and torque model’ of the drill string bending and the appropriate software are elaborated for the simulation of the tripping in and out regimes and drilling operations. It is shown by the computer calculations that the contact and friction forces can be calculated and regulated, providing predesigned trouble-free modes of operation. The elaborated mathematic models and software can be used for the emergency situations prognostication and their exclusion at the stages of the drilling process design and realization.

Keywords: curvilinear drilling, drill string tripping in and out, contact forces, resistance forces

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665 The Potential of Acanthaster Plancii Fractions as Anti-Atherosclerotic Agent by Inhibiting the Expression of Proprotein Convertase Subtilisin-Kexin Type 9

Authors: Nurjannatul Naim Kamaruddin, Tengku Sifziuzl Tengku Muhammad, Aina Farahiyah Abdul Manan, Habsah Mohamad

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Atherosclerosis which leads to cardiovascular diseases such as myocardial infarction, unstable angina (ischemic heart pain), sudden cardiac death and stroke is the principal cause of death worldwide. It has been a very critical issue as current common drug treatment, statin therapy has left bad side effects like rhabdomyolysis, atrial fibrillation, liver disease, abdominal and chest pain. Interestingly, the discoveries of proprotein convertase subtilisin-kexin type 9 have paved a new way in the treatment of atherosclerosis. This serine protease is believed to involve in the regulation of LDL- uptake by LDL-receptor. Therefore, this study was conducted to evaluate the potential of Acanthaster plancii fractions to reduce the transcriptional activity of the PCSK9 promoter. In this study, the marine organism which is Acanthaster plancii has been used as the source for marine compounds in inhibiting PCSK9. The cytotoxicity activity of ten fractions from the methanol extracts of Acanthaster plancii was investigated on HepG2 cell lines using MTS assay and dual glo luciferase assay was carried out later to analyses the effects of the samples in reducing the transcriptional activity of the PCSK9 promoter. Both assays used fractions with five different concentrations, 3.13µg/mL, 6.25µg/mL, 12.5µg/mL, 25µg/mL, and 50µg/mL. MTS assay indicated that the fractions are non-cytotoxic towards HepG2 cell lines as their IC50 value is greater than 30µg/mL. Whilst, for the dual glo luciferase assay, among all the fractions, Enhance Fraction 2 (EF2) showed the best potential in reducing the transcriptional activity of the PCSK9 promoter. The results indicated that this EF2 gave the lowest PCSK9 promoter expression at low concentration which is 0.2 fold change at 6.25µg/mL. This finding suggested that further analysis should be done to validate the potential of Acanthaster plancii as the source of anti-atherosclerotic agent.

Keywords: Acanthaster plancii, atherosclerosis, luciferase assay, PCSK9

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664 Application of Free Living Nitrogen Fixing Bacteria to Increase Productivity of Potato in Field

Authors: Govinda Pathak

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In modern agriculture, the sustainable enhancement of crop productivity while minimizing environmental impacts remains a paramount challenge. Plant Growth Promoting Rhizobacteria (PGPR) have emerged as a promising solution to address this challenge. The rhizosphere, the dynamic interface between plant roots and soil, hosts intricate microbial interactions crucial for plant health and nutrient acquisition. PGPR, a subset of rhizospheric microorganisms, exhibit multifaceted beneficial effects on plants. Their abilities to stimulate growth, confer stress tolerance, enhance nutrient availability, and suppress pathogens make them invaluable contributors to sustainable agriculture. This work examines the pivotal role of free living nitrogen fixer in optimizing agricultural practices. We delve into the intricate mechanisms underlying PGPR-mediated plant-microbe interactions, encompassing quorum sensing, root exudate modulation, and signaling molecule exchange. Furthermore, we explore the diverse strategies employed by PGPR to enhance plant resilience against abiotic stresses such as drought, salinity, and metal toxicity. Additionally, we highlight the role of PGPR in augmenting nutrient acquisition and soil fertility through mechanisms such as nitrogen fixation, phosphorus solubilization, and mineral mobilization. Furthermore, we discuss the potential of PGPR in minimizing the reliance on chemical fertilizers and pesticides, thereby contributing to environmentally friendly agriculture. However, harnessing the full potential of PGPR requires a comprehensive understanding of their interactions with host plants and the surrounding microbial community. We also address challenges associated with PGPR application, including formulation, compatibility, and field efficacy. As the quest for sustainable agriculture intensifies, harnessing the remarkable attributes of PGPR offers a holistic approach to propel agricultural productivity while maintaining ecological balance. This work underscores the promising prospect of free living nitrogen fixer as a panacea for addressing critical agricultural challenges regarding chemical urea in an era of sustainable and resilient food production.

Keywords: PGPR, nitrogen fixer, quorum sensing, Rhizobacteria, pesticides

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663 Oral Versus Iontophoresis Nonsteroidal Anti-Inflammatory Drugs in Tennis Elbow

Authors: Moustafa Ali Elwan, Ibrahim Salem Abdelrafa, Ashraf Moharm

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Nonsteroidal anti-inflammatory drugs (NSAIDs) are among the most commonly prescribed oral and topical drugs worldwide. Moreover, NSAIDs are responsible for most of all adverse drug reactions. For several decades, there are numerous attempts to use the cutaneous layers as a gate into the body for the local delivery of the therapeutic agent. Transdermal drug delivery is a validated technology contributing significantly to global pharmaceutical care. Transdermal Drug Delivery systems can be improved by using therapeutic agents. Moreover, Transdermal Drug Delivery systems can be improved by using chemical enhancers like ultrasound or iontophoresis. Iontophoresis provides a mechanism to enhance the penetration of hydrophilic and charged molecules across the skin. Objective: to compare the drug administration by ‘iontophoresis’ versus the oral rule. Methods: This study was conducted at the Faculty of Physical Therapy, Modern University for technology and information, Cairo, Egypt, on 20 participants (8 female & 12 male) who complained of tennis elbow. Their mean age was (25.45 ± 3.98) years, and all participants were assessed in many aspects: Pain threshold was assessed by algometer. Range of motion was assessed by electro goniometer, and isometric strength was assessed by a portable hand-held dynamometer. Then Participants were randomly assigned into two groups: group A was treated with oral NSAID (diclofenac) while group B was treated via administration of NSAIDs (diclofenac) via an iontophoresis device. All the participants were subjected to blood samples analysis in both pre-administration of the drug and post-administration of the drug for 24 hours (sample/every 6 hours). Results: The results demonstrated that there was a significant improvement in group b, “iontophoresis NSAIDs group,” more than in group B,” oral NSAIDs group,” in all measurements ‘ pain threshold, strength, and range of motion. Also, the iontophoresis method shows higher maximum plasma concentrations (Cmax) and concentration-time curves than the oral method.

Keywords: diclofenac, iontophoresis, NSAIDs, oral, tennis elbow

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662 Expert Opinions about Barriers to Physical Activity among Ghanaian Adults with Type 2 Diabetes Mellitus: A Qualitative Descriptive Study

Authors: Mohammed Amin, Debra Kerr, Yacoba Atiase, Andrea Driscoll

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Background: Physical activity (PA) is a major component of diabetes self-care management; although this is often stressed to patients, many adults with Type 2 Diabetes Mellitus (T2DM)lead sedentary lifestyles, and barriers exist for uptake of PA. Aim: To explore opinions of healthcare professionals about barriers to PA for adults with T2DM in Ghana. Methods: This qualitative descriptive study included 13healthcare professionals (3 Physiotherapists, 3 exercise physiologists, 3 nurses, and 4 physicians) who provide care to individuals with T2DM in Ghana. Data was collected by semi-structured interviews. The social cognitive theory guided the design of the interview schedule. Data was analysed using thematic analysis. Results: Four main themeswere identified: 1) Individual-related factors, 2) Interpersonal factors, 3) Environment-related factors, and 4) Health system-related factors. Fear of injury, existing co-morbidities, and lack of time make it difficult for people with T2DM to engage in PA. Lack of family support, fear of social ridicule, and cultural beliefs prevent uptake of PA. Poorly designed community spaces, including safe walkways and lack of exercise facilities, inhibit PA participation. Few physical therapists and physical therapy centres exist to support PA participation among people with T2DM. Some nurses and doctors lack adequate knowledge to deliver proper PA education to clients, thereby making clients lack the needed support. Conclusion: Adults with T2DM may be restricted from partaking in PA arising from personal and external factors. This study has identified that barriers to exercise need consideration when designing PA programs that aim to improve health outcomes for people with T2DM in Ghana.

Keywords: type 2 diabetes, physical activity, exercise, ghana, qualitative, barriers

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661 Development of Methotrexate Nanostructured Lipid Carriers for Topical Treatment of Psoriasis: Optimization, Evaluation, and in vitro Studies

Authors: Yogeeta O. Agrawal, Hitendra S. Mahajan, Sanjay J. Surana

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Methotrexate is effective in controlling recalcitrant psoriasis when administered by the oral or parenteral route long-term. However, the systematic use of this drug may provoke any of a number of side effects, notably hepatotoxic effects. To reduce these effects, clinical studies have been done with topical MTx. It is useful in treating a number of cutaneous conditions, including psoriasis. A major problem in topical administration of MTx currently available in market is that the drug is hydrosoluble and is mostly in the dissociated form at physiological pH. Its capacity for passive diffusion is thus limited. Localization of MTx in effected layers of skin is likely to improve the role of topical dosage form of the drug as a supplementary to oral therapy for treatment of psoriasis. One of the possibilities for increasing the penetration of drugs through the skin is the use of Nanostructured lipid Carriers. The objective of the present study was to formulate and characterize Methotrexate loaded Nanostructured Lipid Carriers (MtxNLCs), to understand in vitro drug release and evaluate the role of the developed gel in the topical treatment of psoriasis. MtxNLCs were prepared by solvent diffusion technique using 3(2) full factorial design.The mean diameter and surface morphology of MtxNLC was evaluated. MtxNLCs were lyophilized and crystallinity of NLC was characterized by Differential Scanning Calorimtery (DSC) and powder X-Ray Diffraction (XRD). The NLCs were incorporated in 1% w/w Carbopol 934 P gel base and in vitro skin deposition studies in Human Cadaver Skin were conducted. The optimized MtxNLCs were spherical in shape, with average particle size of 253(±9.92)nm, zeta potential of -30.4 (±0.86) mV and EE of 53.12(±1.54)%. DSC and XRD data confirmed the formation of NLCs. Significantly higher deposition of Methotrexate was found in human cadaver skin from MtxNLC gel (71.52 ±1.23%) as compared to Mtx plain gel (54.28±1.02%). Findings of the studies suggest that there is significant improvement in therapeutic index in treatment of psoriasis by MTx-NLCs incorporated gel base developed in this investigation over plain drug gel currently available in the market.

Keywords: methotrexate, psoriasis, NLCs, hepatotoxic effects

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660 Understanding Childhood Sexual Abuse and Its Association with Psychological Traumatization, Re-Traumatization, and Shame in Adult South Asian Women: A Scoping Review

Authors: Manisha Massey, Mariette Berndsen, Helen McLaren

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The existing body of literature concerning the incidence, prevalence, and experiences of childhood sexual abuse (CSA) lacked cultural inclusivity, primarily reflecting Euro-centric perspectives. This study investigated and reviewed the existing literature to understand the experiences of women of color from South Asia, addressing the gap in understanding how culture and diversity impact CSA. While individualist cultures emphasize autonomy, collectivist societies prioritize interdependence. South Asia's diverse intersections, including gender, caste, religion, and class, have intensified child sexual exploitation, challenging assumed homogeneity and safety. Additionally, the power exploitation in the space of abuse and grooming supplementing with the prevalence of honor violence makes disclosures of sexual abuse for children daunting and unsafe in these cultures. This scoping review examined the connection between CSA, psychological trauma, re-traumatization, and shame among adult South Asian women from India, Pakistan, and Bangladesh. Despite distinct borders, these countries share historical, linguistic, and traditional ties. Following PRISMA guidelines, the review employed thematic analysis. Findings underscored cultural factors' influence on CSA incidence, help-seeking barriers, and treatment challenges. The pivotal role of shame (sharam) and honor (izzat) in disclosure and healing processes was highlighted. The study emphasized the need for culturally sensitive interventions while noting limited literature on re-traumatisation. Incorporating a culturally informed perspective, this research aims to decolonize trauma therapy by contributing to the CSA discourse, shedding light on its intricate interaction with trauma, shame, and healing among South Asian women.

Keywords: Childhood sexual abuse, decolonizing psychology, trauma, re-trauma, shame

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659 The Effect of the COVID-19 Pandemic on Frailty, Sarcopenia, and Other Comorbidities in Liver Transplant Candidates: A Retrospective Review of an Extensive Frailty Database

Authors: Sohaib Raza, Parvez Mantry

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Frailty is a multi-system impairment associated with stressors such as age, disease, and invasive surgical procedures. This multi-system impairment can lead to increased post-transplant mortality and functional decline. Additionally, the prevalence and/or severity of frailty increases when patient pre-habilitation is unsatisfactory or lacking. We conducted a retrospective study to examine whether the COVID-19 Pandemic, and subsequent lack of patient access to pre-habilitation and physical therapy resources, led to an increase in the prevalence and severity of frailty, sarcopenia, and other comorbidities including diabetes, hypertension, and COPD. Secondarily, we examined the correlation between patient survival rate and liver frailty index as well as muscle wasting/sarcopenia. Data were analyzed in order to correlate variables associated with these parameters. Three hundred sixty-nine liver transplant candidates at Methodist Dallas Medical Center were administered pre-transplant frailty assessments, which consisted of chair stands, grip strength, and position balance time. A frailty score less than 3.2 indicated a robust condition, a score from 3.3 to 4.4 indicated a pre-frail condition, and a score greater than 4.5 indicated a frail condition. Greater than 50 percent of patients were found to have muscle wasting in the COVID-19 period (March 13, 2020 to February 28, 2022), an increase of 16.5 percent from the pre-COVID period (April 1st, 2018 to March 12, 2020). Additionally, sarcopenia was associated with a two-fold increase in patient mortality rate. Furthermore, high liver frailty index scores were associated with increased patient mortality. However, there was no significant difference in liver frailty index or number of comorbidities between patients in the two cohorts. Conclusion: The COVID-19 Pandemic exacerbated sarcopenia-related muscle wasting in liver transplant candidates, and patient survival rate was directly correlated with liver frailty index score and the presence of sarcopenia.

Keywords: frailty, sarcopenia, covid-19, patient mortality, pre-habilitation, liver transplant candidates

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658 Computational and Experimental Determination of Acoustic Impedance of Internal Combustion Engine Exhaust

Authors: A. O. Glazkov, A. S. Krylova, G. G. Nadareishvili, A. S. Terenchenko, S. I. Yudin

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The topic of the presented materials concerns the design of the exhaust system for a certain internal combustion engine. The exhaust system can be divided into two parts. The first is the engine exhaust manifold, turbocharger, and catalytic converters, which are called “hot part.” The second part is the gas exhaust system, which contains elements exclusively for reducing exhaust noise (mufflers, resonators), the accepted designation of which is the "cold part." The design of the exhaust system from the point of view of acoustics, that is, reducing the exhaust noise to a predetermined level, consists of working on the second part. Modern computer technology and software make it possible to design "cold part" with high accuracy in a given frequency range but with the condition of accurately specifying the input parameters, namely, the amplitude spectrum of the input noise and the acoustic impedance of the noise source in the form of an engine with a "hot part". Getting this data is a difficult problem: high temperatures, high exhaust gas velocities (turbulent flows), and high sound pressure levels (non-linearity mode) do not allow the calculated results to be applied with sufficient accuracy. The aim of this work is to obtain the most reliable acoustic output parameters of an engine with a "hot part" based on a complex of computational and experimental studies. The presented methodology includes several parts. The first part is a finite element simulation of the "cold part" of the exhaust system (taking into account the acoustic impedance of radiation of outlet pipe into open space) with the result in the form of the input impedance of "cold part". The second part is a finite element simulation of the "hot part" of the exhaust system (taking into account acoustic characteristics of catalytic units and geometry of turbocharger) with the result in the form of the input impedance of the "hot part". The next third part of the technique consists of the mathematical processing of the results according to the proposed formula for the convergence of the mathematical series of summation of multiple reflections of the acoustic signal "cold part" - "hot part". This is followed by conducting a set of tests on an engine stand with two high-temperature pressure sensors measuring pulsations in the nozzle between "hot part" and "cold part" of the exhaust system and subsequent processing of test results according to a well-known technique in order to separate the "incident" and "reflected" waves. The final stage consists of the mathematical processing of all calculated and experimental data to obtain a result in the form of a spectrum of the amplitude of the engine noise and its acoustic impedance.

Keywords: acoustic impedance, engine exhaust system, FEM model, test stand

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657 Comparison of 18F-FDG and 11C-Methionine PET-CT for Assessment of Response to Neoadjuvant Chemotherapy in Locally Advanced Breast Carcinoma

Authors: Sonia Mahajan Dinesh, Anant Dinesh, Madhavi Tripathi, Vinod Kumar Ramteke, Rajnish Sharma, Anupam Mondal

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Background: Neo-adjuvant chemotherapy plays an important role in treatment of breast cancer by decreasing the tumour load and it offers an opportunity to evaluate response of primary tumour to chemotherapy. Standard anatomical imaging modalities are unable to accurately reflect the response to chemotherapy until several cycles of drug treatment have been completed. Metabolic imaging using tracers like 18F-fluorodeoxyglucose (FDG) as a marker of glucose metabolism or amino acid tracers like L-methyl-11C methionine (MET) have potential role for the measurement of treatment response. In this study, our objective was to compare these two PET tracers for assessment of response to neoadjuvant chemotherapy, in locally advanced breast carcinoma. Methods: In our prospective study, 20 female patients with histology proven locally advanced breast carcinoma underwent PET-CT imaging using FDG and MET before and after three cycles of neoadjuvant chemotherapy (CAF regimen). Thereafter, all patients were taken for MRM and the resected specimen was sent for histo-pathological analysis. Tumour response to the neoadjuvant chemotherapy was evaluated by PET-CT imaging using PERCIST criteria and correlated with histological results. Responses calculated were compared for statistical significance using paired t- test. Results: Mean SUVmax for primary lesion in FDG PET and MET PET was 15.88±11.12 and 5.01±2.14 respectively (p<0.001) and for axillary lymph nodes was 7.61±7.31 and 2.75±2.27 respectively (p=0.001). Statistically significant response in primary tumour and axilla was noted on both FDG and MET PET after three cycles of NAC. Complete response in primary tumour was seen in only 1 patient in FDG and 7 patients in MET PET (p=0.001) whereas there was no histological complete resolution of tumor in any patient. Response to therapy in axillary nodes noted on both PET scans were similar (p=0.45) and correlated well with histological findings. Conclusions: For the primary breast tumour, FDG PET has a higher sensitivity and accuracy than MET PET and for axilla both have comparable sensitivity and specificity. FDG PET shows higher target to background ratios so response is better predicted for primary breast tumour and axilla. Also, FDG-PET is widely available and has the advantage of a whole body evaluation in one study.

Keywords: 11C-methionine, 18F-FDG, breast carcinoma, neoadjuvant chemotherapy

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656 Effect of Blood Sugar Levels on Short Term and Working Memory Status in Type 2 Diabetics

Authors: Mythri G., Manjunath ML, Girish Babu M., Shireen Swaliha Quadri

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Background: The increase in diabetes among the elderly is of concern because in addition to the wide range of traditional diabetes complications, evidence has been growing that diabetes is associated with increased risk of cognitive decline. Aims and Objectives: To find out if there is any association between blood sugar levels and short-term and working memory status in patients of type 2 diabetes. Materials and Methods: The study was carried out in 200 individuals aged between 40-65 years consisting of 100 diagnosed cases of Type 2 Diabetes Mellitus and 100 non-diabetics from OPD of Mc Gann Hospital, Shivamogga. Rye’s Auditory Verbal Learning Test, Verbal Fluency Test and Visual Reproduction Test, Working Digit Span Test and Validation Span Test were used to assess short-term and working memory. Fasting and Post Prandial blood sugar levels were estimated. Statistical analysis was done using SPSS 21. Results: Memory test scores of type 2 diabetics were significantly reduced (p < 0.001) when compared to the memory scores of age and gender matched non-diabetics. Fasting blood sugar levels were found to have a negative correlation with memory scores for all 5 tests: AVLT (r=-0.837), VFT (r=-0.888), VRT(r=-0.787), WDST (r=-0.795) and VST (r=-0.943). Post- Prandial blood sugar levels were found to have a negative correlation with memory scores for all 5 tests: AVLT (r=-0.922), VFT (r=-0.848), VRT(r=-0.707),WDST (r=-0.729) and VST (r=-0.880) Memory scores in all 5 tests were found to be negatively correlated with the FBS and PPBS levels in diabetic patients (p < 0.001). Conclusion: The decreased memory status in diabetic patients may be due to many factors like hyperglycemia, vascular disease, insulin resistance, amyloid deposition and also some of the factor combine to produce additive effects like, type of diabetes, co-morbidities, age of onset, duration of the disease and type of therapy. These observed effects of blood sugar levels of diabetics on memory status are of potential clinical importance because even mild cognitive impairment could interfere with todays’ activities.

Keywords: diabetes, cognition, diabetes, HRV, respiratory medicine

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655 Reducing Unnecessary CT Aorta Scans in the Emergency Department

Authors: Ibrahim Abouelkhir

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Background: Prior to this project, the number of CT aorta requests from our Emergency Department (ED) was reported by the radiology department to be high with a low positive event rate: only 1- 2% of CT aortas performed were positive for acute aortic syndrome. This trend raised concerns about the time required to process and report these scans, potentially impacting the timely reporting of other high-priority imaging, such as trauma-related scans. Other harms identified were unnecessary radiation, patients spending longer in ED contributing to overcrowding, and, most importantly, the patient not getting the right care the first time. The radiology department also raised the problem of reporting bias because they expected our CT aortas to be normal. Aim: The main aim of this project was to reduce the number of unnecessary CT aortas requested, which would be shown by 1. Number of CT aortas requested and 2. Positive event rate. Methodology: This was a quality improvement project carried out in the ED at Frimley Park Hospital, UK. Starting from 1 st January 2024, we recorded the number of days required to reach 35 CT aorta requests. We looked at all patients presenting to the ED over the age of 16 for whom a CT aorta was requested by the ED team. We looked at how many of these scans were positive for acute aortic syndrome. The intervention was a change in practice: all CT aortas should be approved by an ED consultant or ST4+ registrar (5th April 2024). We then reviewed the number of days it took to reach a total of 35 CT aorta requests following the intervention and again reviewed how many were positive. Results: Prior to the intervention, 35 CT Aorta scans were performed over a 20-day period. Following the implementation of the ED senior doctor vetting process, the same number of CT Aorta scan requests was observed over 50 days - more than twice the pre-intervention period. This indicates a significant reduction in the rate of CT Aorta scans being requested. During the pre-intervention phase, there were two positive cases of acute aortic syndrome. In the post-intervention period, there were zero. Conclusion: The mandatory review of CT Aorta scan requested by the ED consultant effectively reduced the number of scans requested. However, this intervention did not lead to an increase in positive scan results. We noted that post-intervention, approximately 50% of scans had been approved by registrar-grade doctors and, only 50% had been approved by ED consultants, and the majority were not in-person reviews. We wonder if restricting the approval to consultant grade only might improve the results, and furthermore, in person reviews should be the gold standard.

Keywords: quality improvement project, CT aorta scans, emergency department, radiology department, aortic dissection, scan request vetting, clinical outcomes, imaging efficiency

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654 Effectiveness of Project Grit in Building Resilience among At-Risk Adolescents: A Case Study

Authors: Narash Narasimman, Calvin Leong Jia Jun, Raksha Karthik, Paul Englert

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Background: Project Grit, a 12-week youth resilience program implemented by Impart and Spartans Boxing Club, aimed to help at-risk adolescents develop resilience through psychoeducation and mental health techniques for dealing with everyday stressors and adversity. The programme consists of two parts-1.5 hours of group therapy followed by 1 hour of boxing. Due to the novelty of the study, 6 male participants, aged 13 to 18, were recruited to participate in the study. Aim: This case study aims to examine the effectiveness of Project Grit in building resilience among at-risk adolescents. Methods: A case study design was employed to capture the complexity and uniqueness of the intervention, without oversimplifying or generalizing it. A 15-year-old male participant with a history of behavioural challenges, delinquency and gang involvement was selected for the study. Teacher, parent and child versions of the Strengths and Difficulties Questionnaire (SDQ) were administered to the facilitators, parents and participants respectively before and after the programme. Relevant themes from the qualitative interviews will be discussed. Results: Scores from all raters revealed improvements in most domains of the SDQ. Total difficulties scores across all raters improved from “very high” to “close to average”. High interrater reliability was observed (κ= .81). The participant reported learning methods to effectively deal with his everyday concerns using healthy coping strategies, developing a supportive social network, and building on his self efficacy. Themes from the subject’s report concurred with the improvement in SDQ scores. Conclusions: The findings suggest that Project Grit is a promising intervention for promoting resilience among at-risk adolescents. The teleological behaviourism framework and the combination of sports engagement and future orientation may be particularly effective in fostering resilience among this population. Further studies need to be conducted with a larger sample size to further validate the effectiveness of Project Grit.

Keywords: resilience, project grit, adolescents, at-risk, boxing, future orientation

Procedia PDF Downloads 61
653 Autophagy Suppresses Bladder Tumor Formation in a Mouse Orthotopic Bladder Tumor Formation Model

Authors: Wan-Ting Kuo, Yi-Wen Liu, Hsiao-Sheng Liu

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Annual incidence of bladder cancer increases in the world and occurs frequently in the male. Most common type is transitional cell carcinoma (TCC) which is treated by transurethral resection followed by intravesical administration of agents. In clinical treatment of bladder cancer, chemotherapeutic drugs-induced apoptosis is always used in patients. However, cancers usually develop resistance to chemotherapeutic drugs and often lead to aggressive tumors with worse clinical outcomes. Approximate 70% TCC recurs and 30% recurrent tumors progress to high-grade invasive tumors, indicating that new therapeutic agents are urgently needed to improve the successful rate of overall treatment. Nonapoptotic program cell death may assist to overcome worse clinical outcomes. Autophagy which is one of the nonapoptotic pathways provides another option for bladder cancer patients. Autophagy is reported as a potent anticancer therapy in some cancers. First of all, we established a mouse orthotopic bladder tumor formation model in order to create a similar tumor microenvironment. IVIS system and micro-ultrasound were utilized to noninvasively monitor tumor formation. In addition, we carried out intravesical treatment in our animal model to be consistent with human clinical treatment. In our study, we carried out intravesical instillation of the autophagy inducer in mouse orthotopic bladder tumor to observe tumor formation by noninvasive IVIS system and micro-ultrasound. Our results showed that bladder tumor formation is suppressed by the autophagy inducer, and there are no significant side effects in the physiology of mice. Furthermore, the autophagy inducer upregulated autophagy in bladder tissues of the treated mice was confirmed by Western blot, immunohistochemistry, and immunofluorescence. In conclusion, we reveal that a novel autophagy inducer with low side effects suppresses bladder tumor formation in our mouse orthotopic bladder tumor model, and it provides another therapeutic approach in bladder cancer patients.

Keywords: bladder cancer, transitional cell carcinoma, orthotopic bladder tumor formation model, autophagy

Procedia PDF Downloads 176
652 Remote Sensing-Based Prediction of Asymptomatic Rice Blast Disease Using Hyperspectral Spectroradiometry and Spectral Sensitivity Analysis

Authors: Selvaprakash Ramalingam, Rabi N. Sahoo, Dharmendra Saraswat, A. Kumar, Rajeev Ranjan, Joydeep Mukerjee, Viswanathan Chinnasamy, K. K. Chaturvedi, Sanjeev Kumar

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Rice is one of the most important staple food crops in the world. Among the various diseases that affect rice crops, rice blast is particularly significant, causing crop yield and economic losses. While the plant has defense mechanisms in place, such as chemical indicators (proteins, salicylic acid, jasmonic acid, ethylene, and azelaic acid) and resistance genes in certain varieties that can protect against diseases, susceptible varieties remain vulnerable to these fungal diseases. Early prediction of rice blast (RB) disease is crucial, but conventional techniques for early prediction are time-consuming and labor-intensive. Hyperspectral remote sensing techniques hold the potential to predict RB disease at its asymptomatic stage. In this study, we aimed to demonstrate the prediction of RB disease at the asymptomatic stage using non-imaging hyperspectral ASD spectroradiometer under controlled laboratory conditions. We applied statistical spectral discrimination theory to identify unknown spectra of M. Oryzae, the fungus responsible for rice blast disease. The infrared (IR) region was found to be significantly affected by RB disease. These changes may result in alterations in the absorption, reflection, or emission of infrared radiation by the affected plant tissues. Our research revealed that the protein spectrum in the IR region is impacted by RB disease. In our study, we identified strong correlations in the region (Amide group - I) around X 1064 nm and Y 1300 nm with the Lambda / Lambda derived spectra methods for protein detection. During the stages when the disease is developing, typically from day 3 to day 5, the plant's defense mechanisms are not as effective. This is especially true for the PB-1 variety of rice, which is highly susceptible to rice blast disease. Consequently, the proteins in the plant are adversely affected during this critical time. The spectral contour plot reveals the highly correlated spectral regions 1064 nm and Y 1300 nm associated with RB disease infection. Based on these spectral sensitivities, we developed new spectral disease indices for predicting different stages of disease emergence. The goal of this research is to lay the foundation for future UAV and satellite-based studies aimed at long-term monitoring of RB disease.

Keywords: rice blast, asymptomatic stage, spectral sensitivity, IR

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651 Establishing Community-Based Pro-Biodiversity Enterprise in the Philippines: A Climate Change Adaptation Strategy towards Agro-Biodiversity Conservation and Local Green Economic Development

Authors: Dina Magnaye

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In the Philippines, the performance of the agricultural sector is gauged through crop productivity and returns from farm production rather than the biodiversity in the agricultural ecosystem. Agricultural development hinges on the overall goal of increasing productivity through intensive agriculture, monoculture system, utilization of high yielding varieties in plants, and genetic upgrading in animals. This merits an analysis of the role of agro-biodiversity in terms of increasing productivity, food security and economic returns from community-based pro-biodiversity enterprises. These enterprises conserve biodiversity while equitably sharing production income in the utilization of biological resources. The study aims to determine how community-based pro-biodiversity enterprises become instrumental in local climate change adaptation and agro-biodiversity conservation as input to local green economic development planning. It also involves an assessment of the role of agrobiodiversity in terms of increasing productivity, food security and economic returns from community-based pro-biodiversity enterprises. The perceptions of the local community members both in urban and upland rural areas on community-based pro-biodiversity enterprises were evaluated. These served as a basis in developing a planning modality that can be mainstreamed in the management of local green economic enterprises to benefit the environment, provide local income opportunities, conserve species diversity, and sustain environment-friendly farming systems and practices. The interviews conducted with organic farmer-owners, entrepreneur-organic farmers, and organic farm workers revealed that pro-biodiversity enterprise such as organic farming involved the cyclic use of natural resources within the carrying capacity of a farm; recognition of the value of tradition and culture especially in the upland rural area; enhancement of socio-economic capacity; conservation of ecosystems in harmony with nature; and climate change mitigation. The suggested planning modality for community-based pro-biodiversity enterprises for a green economy encompasses four (4) phases to include community resource or capital asset profiling; stakeholder vision development; strategy formulation for sustained enterprises; and monitoring and evaluation.

Keywords: agro-biodiversity, agro-biodiversity conservation, local green economy, organic farming, pro-biodiversity enterprise

Procedia PDF Downloads 362
650 Geothermal Resources to Ensure Energy Security During Climate Change

Authors: Debasmita Misra, Arthur Nash

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Energy security and sufficiency enables the economic development and welfare of a nation or a society. Currently, the global energy system is dominated by fossil fuels, which is a non-renewable energy resource, which renders vulnerability to energy security. Hence, many nations have begun augmenting their energy system with renewable energy resources, such as solar, wind, biomass and hydro. However, with climate change, how sustainable are some of the renewable energy resources in the future is a matter of concern. Geothermal energy resources have been underexplored or underexploited in global renewable energy production and security, although it is gaining attractiveness as a renewable energy resource. The question is, whether geothermal energy resources are more sustainable than other renewable energy resources. High-temperature reservoirs (> 220 °F) can produce electricity from flash/dry steam plants as well as binary cycle production facilities. Most of the world’s high enthalpy geothermal resources are within the seismo-tectonic belt. However, exploration for geothermal energy is of great importance in conventional geothermal systems in order to improve its economic viability. In recent years, there has been an increase in the use and development of several exploration methods for geo-thermal resources, such as seismic or electromagnetic methods. The thermal infrared band of the Landsat can reflect land surface temperature difference, so the ETM+ data with specific grey stretch enhancement has been used to explore underground heat water. Another way of exploring for potential power is utilizing fairway play analysis for sites without surface expression and in rift zones. Utilizing this type of analysis can improve the success rate of project development by reducing exploration costs. Identifying the basin distribution of geologic factors that control the geothermal environment would help in identifying the control of resource concentration aside from the heat flow, thus improving the probability of success. The first step is compiling existing geophysical data. This leads to constructing conceptual models of potential geothermal concentrations which can then be utilized in creating a geodatabase to analyze risk maps. Geospatial analysis and other GIS tools can be used in such efforts to produce spatial distribution maps. The goal of this paper is to discuss how climate change may impact renewable energy resources and how could a synthesized analysis be developed for geothermal resources to ensure sustainable and cost effective exploitation of the resource.

Keywords: exploration, geothermal, renewable energy, sustainable

Procedia PDF Downloads 154
649 Microbial Resource Research Infrastructure: A Large-Scale Research Infrastructure for Microbiological Services

Authors: R. Hurtado-Ortiz, D. Clermont, M. Schüngel, C. Bizet, D. Smith, E. Stackebrandt

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Microbiological resources and their derivatives are the essential raw material for the advancement of human health, agro-food, food security, biotechnology, research and development in all life sciences. Microbial resources, and their genetic and metabolic products, are utilised in many areas such as production of healthy and functional food, identification of new antimicrobials against emerging and resistant pathogens, fighting agricultural disease, identifying novel energy sources on the basis of microbial biomass and screening for new active molecules for the bio-industries. The complexity of public collections, distribution and use of living biological material (not only living but also DNA, services, training, consultation, etc.) and service offer, demands the coordination and sharing of policies, processes and procedures. The Microbial Resource Research Infrastructure (MIRRI) is an initiative within the European Strategy Forum Infrastructures (ESFRI), bring together 16 partners including 13 European public microbial culture collections and biological resource centres (BRCs), supported by several European and non-European associated partners. The objective of MIRRI is to support innovation in microbiology by provision of a one-stop shop for well-characterized microbial resources and high quality services on a not-for-profit basis for biotechnology in support of microbiological research. In addition, MIRRI contributes to the structuring of microbial resources capacity both at the national and European levels. This will facilitate access to microorganisms for biotechnology for the enhancement of the bio-economy in Europe. MIRRI will overcome the fragmentation of access to current resources and services, develop harmonised strategies for delivery of associated information, ensure bio-security and other regulatory conditions to bring access and promote the uptake of these resources into European research. Data mining of the landscape of current information is needed to discover potential and drive innovation, to ensure the uptake of high quality microbial resources into research. MIRRI is in its Preparatory Phase focusing on governance and structure including technical, legal governance and financial issues. MIRRI will help the Biological Resources Centres to work more closely with policy makers, stakeholders, funders and researchers, to deliver resources and services needed for innovation.

Keywords: culture collections, microbiology, infrastructure, microbial resources, biotechnology

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648 Combining the Production of Radiopharmaceuticals with the Department of Radionuclide Diagnostics

Authors: Umedov Mekhroz, Griaznova Svetlana

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In connection with the growth of oncological diseases, the design of centers for diagnostics and the production of radiopharmaceuticals is the most relevant area of healthcare facilities. The design of new nuclear medicine centers should be carried out from the standpoint of solving the following tasks: the availability of medical care, functionality, environmental friendliness, sustainable development, improving the safety of drugs, the use of which requires special care, reducing the rate of environmental pollution, ensuring comfortable conditions for the internal microclimate, adaptability. The purpose of this article is to substantiate architectural and planning solutions, formulate recommendations and principles for the design of nuclear medicine centers and determine the connections between the production and medical functions of a building. The advantages of combining the production of radiopharmaceuticals and the department of medical care: less radiation activity is accumulated, the cost of the final product is lower, and there is no need to hire a transport company with a special license for transportation. A medical imaging department is a structural unit of a medical institution in which diagnostic procedures are carried out in order to gain an idea of the internal structure of various organs of the body for clinical analysis. Depending on the needs of a particular institution, the department may include various rooms that provide medical imaging using radiography, ultrasound diagnostics, and the phenomenon of nuclear magnetic resonance. The production of radiopharmaceuticals is an object intended for the production of a pharmaceutical substance containing a radionuclide and intended for introduction into the human body or laboratory animal for the purpose of diagnosis, evaluation of the effectiveness of treatment, or for biomedical research. The research methodology includes the following subjects: study and generalization of international experience in scientific research, literature, standards, teaching aids, and design materials on the topic of research; An integrated approach to the study of existing international experience of PET / CT scan centers and the production of radiopharmaceuticals; Elaboration of graphical analysis and diagrams based on the system analysis of the processed information; Identification of methods and principles of functional zoning of nuclear medicine centers. The result of the research is the identification of the design principles of nuclear medicine centers with the functions of the production of radiopharmaceuticals and the department of medical imaging. This research will be applied to the design and construction of healthcare facilities in the field of nuclear medicine.

Keywords: architectural planning solutions, functional zoning, nuclear medicine, PET/CT scan, production of radiopharmaceuticals, radiotherapy

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647 A Brief Trauma Treatment Program for Survivors of Trauma: A Single-Case Design

Authors: Duane Booysen, Ashraf Kagee

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There is a high prevalence of violent crime and trauma exposure in South African society. Considering the prevalence of continuous violent crimes and traumatization in South Africa, the public mental health sector is required to combat the burgeoning effect of traumatic stress in South Africa. Trauma counselors, especially, provide important mental health services at primary health care to persons affected by traumatic events. Therefore, the evaluation and implementation of evidence-based trauma therapies is essential at a primary health care level in treating traumatic stress. A single-case design was used to evaluate the treatment effect of a Brief Trauma Treatment Programme treating persons who present with symptoms of posttraumatic stress disorder at a primary care trauma centre in Cape Town, South Africa. The sample consisted of six adult participants who presented with symptoms of posttraumatic stress and were assessed at baseline, during treatment, post-intervention and at 3-month follow. All participants received six sessions of trauma therapy. Assessment measures included the posttraumatic stress disorder symptom scale interviews for Diagnostic and Statistical Manual fifth edition (DSM5), the posttraumatic disorder checklist for DSM5, Beck Depression Inventory and Beck Anxiety Inventory. Results demonstrate that participants had noticeable reduced symptoms for traumatic stress, anxiety and depression despite living in contexts of violent crime and trauma. In conclusion, the article critically reflects on the need to evaluate and implement evidence-based treatments for the South African context, and how evidence-based treatments are used in developing socio-economic and cultural diverse contexts with continuous levels of violence and traumatization.

Keywords: psychological interventions, public mental health, traumatic stress, single-case design

Procedia PDF Downloads 155
646 Rheumatoid Arthritis, Periodontitis and the Subgingival Microbiome: A Circular Relationship

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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645 Enhancement of Shelflife of Malta Fruit with Active Packaging

Authors: Rishi Richa, N. C. Shahi, J. P. Pandey, S. S. Kautkar

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Citrus fruits rank third in area and production after banana and mango in India. Sweet oranges are the second largest citrus fruits cultivated in the country. Andhra Pradesh, Maharashtra, Karnataka, Punjab, Haryana, Rajasthan, and Uttarakhand are the main sweet orange-growing states. Citrus fruits occupy a leading position in the fruit trade of Uttarakhand, is casing about 14.38% of the total area under fruits and contributing nearly 17.75 % to the total fruit production. Malta is grown in most of the hill districts of the Uttarakhand. Malta common is having high acceptability due to its attractive colour, distinctive flavour, and taste. The excellent quality fruits are generally available for only one or two months. However due to its less shelf-life, Malta can not be stored for longer time under ambient conditions and cannot be transported to distant places. Continuous loss of water adversely affects the quality of Malta during storage and transportation. Method of picking, packaging, and cold storage has detrimental effects on moisture loss. The climatic condition such as ambient temperature, relative humidity, wind condition (aeration) and microbial attack greatly influences the rate of moisture loss and quality. Therefore, different agro-climatic zone will have different moisture loss pattern. The rate of moisture loss can be taken as one of the quality parameters in combination of one or more parameter such as RH, and aeration. The moisture contents of the fruits and vegetables determine their freshness. Hence, it is important to maintain initial moisture status of fruits and vegetable for prolonged period after the harvest. Keeping all points in views, effort was made to store Malta at ambient condition. In this study, the response surface method and experimental design were applied for optimization of independent variables to enhance the shelf life of four months stored malta. Box-Benkhen design, with, 12 factorial points and 5 replicates at the centre point were used to build a model for predicting and optimizing storage process parameters. The independent parameters, viz., scavenger (3, 4 and 5g), polythene thickness (75, 100 and 125 gauge) and fungicide concentration (100, 150 and 200ppm) were selected and analyzed. 5g scavenger, 125 gauge and 200ppm solution of fungicide are the optimized value for storage which may enhance life up to 4months.

Keywords: Malta fruit, scavenger, packaging, shelf life

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644 Endotracheal Intubation Self-Confidence: Report of a Realistic Simulation Training

Authors: Cleto J. Sauer Jr., Rita C. Sauer, Chaider G. Andrade, Doris F. Rabelo

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Introduction: Endotracheal Intubation (ETI) is a procedure for clinical management of patients with severe clinical presentation of COVID-19 disease. Realistic simulation (RS) is an active learning methodology utilized for clinical skill's improvement. To improve ETI skills of public health network's physicians from Recôncavo da Bahia region in Brazil, during COVID-19 outbreak, RS training was planned and carried out. Training scenario included the Nasco Lifeform realistic simulator, and three actions were simulated: ETI procedure, sedative drugs management, and bougie guide utilization. Training intervention occurred between May and June 2020, as an interinstitutional cooperation between the Health's Department of Bahia State and the Federal University from Recôncavo da Bahia. Objective: The main objective is to report the effects on participants' self-confidence perception for ETI procedure after RS based training. Methods: This is a descriptive study, with secondary data extracted from questionnaires applied throughout RS training. Priority workplace, time from last intubation, and knowledge about bougie were reported on a preparticipation questionnaire. Additionally, participants completed pre- and post-training qualitative self-assessment (10-point Likert scale) regarding self-confidence perception in performing each of simulated actions. Distribution analysis for qualitative data was performed with Wilcoxon Signed Rank Test, and self-confidence increase analysis in frequency contingency tables with Fisher's Exact Test. Results: 36 physicians participated of training, 25 (69%) from primary care setting, 25 (69%) performed ETI over a year ago, and only 4 (11%) had previous knowledge about the bougie guide utilization. There was an increase in self-confidence medians for all three simulated actions. Medians (variation) for self-confidence before and after training, for each simulated action were as follows: ETI [5 (1-9) vs. 8 (6-10) (p < 0.0001)]; Sedative drug management [5 (1-9) vs. 8 (4-10) (p < 0.0001)]; Bougie guide utilization [2.5 (1-7) vs. 8 (4-10) (p < 0.0001)]. Among those who performed ETI over a year ago (n = 25), an increase in self-confidence greater than 3 points for ETI was reported by 23 vs. 2 physicians (p = 0.0002), and by 21 vs. 4 (p = 0.03) for sedative drugs management. Conclusions: RS training contributed to self-confidence increase in performing ETI. Among participants who performed ETI over a year, there was a significant association between RS training and increase of more than 3 points in self-confidence, both for ETI and sedative drug management. Training with RS methodology is suitable for ETI confidence enhancement during COVID-19 outbreak.

Keywords: confidence, COVID-19, endotracheal intubation, realistic simulation

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643 Posterior Circulation Ischemic Strokes in Olympic and Division 1 Wrestlers

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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642 Strategies For Management Of Massive Intraoperative Airway Haemorrhage Complicating Surgical Pulmonary Embolectomy

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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641 Spatial Architecture Impact in Mediation Open Circuit Voltage Control of Quantum Solar Cell Recovery Systems

Authors: Moustafa Osman Mohammed

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The photocurrent generations are influencing ultra-high efficiency solar cells based on self-assembled quantum dot (QD) nanostructures. Nanocrystal quantum dots (QD) provide a great enhancement toward solar cell efficiencies through the use of quantum confinement to tune absorbance across the solar spectrum enabled multi-exciton generation. Based on theoretical predictions, QDs have potential to improve systems efficiency in approximate regular electrons excitation intensity greater than 50%. In solar cell devices, an intermediate band formed by the electron levels in quantum dot systems. The spatial architecture is exploring how can solar cell integrate and produce not only high open circuit voltage (> 1.7 eV) but also large short-circuit currents due to the efficient absorption of sub-bandgap photons. In the proposed QD system, the structure allows barrier material to absorb wavelengths below 700 nm while multi-photon processes in the used quantum dots to absorb wavelengths up to 2 µm. The assembly of the electronic model is flexible to demonstrate the atoms and molecules structure and material properties to tune control energy bandgap of the barrier quantum dot to their respective optimum values. In terms of energy virtual conversion, the efficiency and cost of the electronic structure are unified outperform a pair of multi-junction solar cell that obtained in the rigorous test to quantify the errors. The milestone toward achieving the claimed high-efficiency solar cell device is controlling the edge causes of energy bandgap between the barrier material and quantum dot systems according to the media design limits. Despite this remarkable potential for high photocurrent generation, the achievable open-circuit voltage (Voc) is fundamentally limited due to non-radiative recombination processes in QD solar cells. The orientation of voltage recovery system is compared theoretically with experimental Voc variation in mediation upper–limit obtained one diode modeling form at the cells with different bandgap (Eg) as classified in the proposed spatial architecture. The opportunity for improvement Voc is valued approximately greater than 1V by using smaller QDs through QD solar cell recovery systems as confined to other micro and nano operations states.

Keywords: nanotechnology, photovoltaic solar cell, quantum systems, renewable energy, environmental modeling

Procedia PDF Downloads 156