Search results for: early recovery

Authors: Mujahid Ali, Wasif Mohammed Ali, Meraj Ahmad

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Background: Perforation peritonitis is the most common surgical emergency encountered by surgeons all over the world as well as in India. The etiology of perforation peritonitis in India continues to be different from its western counterparts. The aim of this study is to evaluate the spectrum of cases of perforation peritonitis at our hospital. Methods: A prospective study conducted includes three hundred thirtysix patients of perforation peritonitis at J. N. Medical College from October 2015 to July 2017. The patients were admitted, resuscitated and underwent emergency laparotomy. Data were collected in terms of demographic profile, clinical presentations, site of perforations, causes and surgical outcomes. Results: In this study, the most common cause of perforation peritonitis was peptic ulcer disease (43%), followed by enteric perforation (12.8%), tubercular perforation (12.5%), traumatic perforation (11.9%), appendicular perforation (9.8%), amoebic caecal perforation (3%), malignant perforation (1.5%), etc. The sites of perforations were stomach in majority (38.3%), ileum (31%), appendix (8%), duodenum (5.%), caecum (4.4%) ,colon (3%), jejunum (8.5%) and gall bladder (2%). The overall mortality was 21% in our study. Age >50 years (p= <0.0001, OR= 3.9260, CI= 2.2 to 6.9), organ failure (p= <0.0001, OR= 29.2, CI= 14.8 to 57.6), shock (p=<0.0001, OR=20.20, CI= 10.56 to 38.6), diffuse peritonitis (p<0.0015, OR= 6.8810, CI= 2.09 to 22.57) and faecal exudates (p<0.0001) were found to be significant factors affecting mortality. The most common complication associated was superficial wound infection (40%), followed by burst abdomen seen in 21% cases, intra-abdominal sepsis in 18% cases, electrolyte imbalances in 15% cases, anastomotic leak in 6% cases. Conclusion: In this study, stomach is the most common site of perforation with peptic ulcer disease being the most common etiology. Older age, presence of shock, organ failure and faecal peritonitis were the risk factors affecting the mortality of the patients. Early recognition, adequate resuscitation and referral of patients can influence outcome and reduces mortality as well as morbidity.

Keywords: etiology, mortality, perforation, spectrum

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Authors: Dovilė Bačėninaitė, Karina Džermeikaitė, Justinas Kirvela, Ramūnas Antanaitis

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Bacteria are often present in the mouth of cattle. Some of them can cause abscesses. Starting with severe swelling of the mouth, muscle spasm, or locked jaw, it can lead to inability to open its mouth, move the neck, cause pain while eating. While the calf is unable to eat properly, it becomes more susceptible to infectious diseases, lower weight gain can be observed. Abscesses can be considered as a continuum of oral disease, whereby early stages of the lumpy jaw could proceed from gingivitis to periodontal disease. In the event of tissue damage, bacteria can enter the bloodstream, even cause sepsis. The most common lesions occur when animals eat sharp grass, coarse fodder, sharp, piercing foreign bodies (this is especially common for calves when they are trying to eat inedible objects). A crossbred Holstein calf presented with a history of proliferative outgrowth in the mandibular region. On clinical examination, needle aspiration, mandibular swelling revealed sticky, white curd-like fluid containing. Pus bacteriology revealed gram-negative cocci. They were sensitive to amoxicillin, cephalexin, enrofloxacin, ceftiofur. Blood morphology was in physiological ranges. The calf was treated surgically. The growth was excised, the puss drained and the wound was flushed with potassium permanganate solution (0,01%). A week after clinical surgery examination was performed. The swelling was decreased. Superficial bacterial infections are often associated with poor hygiene, which should be improved before treatment is commenced. Clipping away dirty hair and gently washing affected areas of skin daily with solutions such as povidone-iodine, potassium permanganate is effective. Appropriate antibiotic therapy, based on sensitivity testing, may be used where there is evidence of systemic illness.

Keywords: calf, abscess, lumpy jaw, pus, Streptococcus, Staphylococcus, Actinobacillus, infection

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Authors: Rohit Kothari, Muneer Mohamed, Vivekanandh K., Sunmeet Sandhu, Preema Sinha, Anuj Bhatnagar

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Introduction: Hyper-IgE syndrome is a rare primary immunodeficiency syndrome characterised by triad of severe atopic dermatitis, recurrent pulmonary infections, and recurrent staphylococcal skin infections. The diagnosis requires a high degree of suspicion, typical clinical features, and not mere rise in serum-IgE levels, which may be seen in multiple conditions. Genetic studies are not always possible in a resource poor setting. This study highlights various presentations of Hyper-IgE syndrome in skin of color children. Case-series: Our study had six children of Hyper-IgE syndrome aged twomonths to tenyears. All had onset in first ten months of life except one with a late-onset at two years. All had recurrent eczematoid rash, which responded poorly to conventional treatment, secondary infection, multiple episodes of hospitalisation for pulmonary infection, and raised serum IgE levels. One case had occasional vesicles, bullae, and crusted plaques over both the extremities. Genetic study was possible in only one of them who was found to have pathogenic homozygous deletions of exon-15 to 18 in DOCK8 gene following which he underwent bone marrow transplant (BMT), however, succumbed to lower respiratory tract infection two months after BMT and rest of them received multiple courses of antibiotics, oral/ topical steroids, and cyclosporine intermittently with variable response. Discussion: Our study highlights various characteristics, presentation, and management of this rare syndrome in children. Knowledge of these manifestations in skin of color will facilitate early identification and contribute to optimal care of the patients as representative data on the same is limited in literature.

Keywords: absolute eosinophil count, atopic dermatitis, eczematous rash, hyper-immunoglobulin E syndrome, pulmonary infection, serum IgE, skin of color

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Authors: Priscilla Akua Agyapong

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Background: In a country of nearly 34 million people, Ghana suffers from rapidly growing pediatric CHD cases and not enough pediatric specialists to attend to the burgeoning needs of these children. Most of the cases are either missed or diagnosed late, resulting in increased mortality. According to the National Cardiothoracic Centre, 1 in every 100,000 births in Ghana has CHD; however, there is limited data on the clinical presentation and its management, one of the many reasons I decided to do this case study coupled with the loss my 2 month old niece to multiple Ventricular Septal Defect 3 years ago due late diagnoses. Method: A retrospective cohort study was performed at the child health clinic of one of Ghana’s public tertiary Institutions using data from their electronic health record (EHR) from February 2021 to April 2022. All suspected or provisionally diagnosed cases were included in the analysis. Results: Records of over 3000 children were reviewed with an approximate male to female ratio of 1:1.53 cases diagnosed during the period of study, most of whom were less than 5 years of age. 25 cases had complete clinical records, with acyanotic septal defects being the most diagnosed. 62.5% of the cases were ventricular septal defects, followed by Patent Ductus Arteriosus (23%) and Atrial Septal Defects (4.5%). Tetralogy of Fallot was the most predominant and complex cyanotic CHD with 10%. Conclusion: The indeterminate coronary anatomy of infants makes it difficult to use only echocardiography and other conventional clinical methods in screening for CHDs. There are rising modernizations and new innovative ways that can be employed in Ghana for early detection, hence preventing the delay of a potential surgical repair. It is, therefore, imperative to create the needed awareness about these “SILENT CRISES” and help save the Ghanaian child’s life.

Keywords: congenital heart defect(CHD), ventricular septal defect(VSD), atrial septal defect(ASD), patent ductus arteriosus(PDA)

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Authors: Nadia H. Mohammed, Anmar Al-Taie, Fadia H. Al-Sultany

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Although breast cancer prevalence continues to increase, mortality has been decreasing as a result of early detection and improvement in adjuvant systemic therapy. Nevertheless, this disease required further efforts to understand and identify the associated potential risk factors that could play a role in the prevalence of this malignancy among Iraqi women. The objective of this study was to assess the perception of certain predictive risk factors on the prevalence of breast cancer types among a sample of Iraqi women diagnosed with breast cancer. This was a retrospective observational study carried out at National Cancer Research Center in College of Medicine, Baghdad University from November 2017 to January 2018. Data of 100 patients with breast cancer whose biopsies examined in the National Cancer Research Center were included in this study. Data were collected to structure a detailed assessment regarding the patients’ demographic, medical and cancer records. The majority of study participants (94%) suffered from ductal breast cancer with mean age 49.57 years. Among those women, 48.9% were obese with body mass index (BMI) 35 kg/m². 68.1% of them had positive family history of breast cancer and 66% had low parity. 40.4% had stage II ductal breast cancer followed by 25.5% with stage III. It was found that 59.6% and 68.1% had positive oestrogen receptor sensitivity and positive human epidermal growth factor (HER2/neu) receptor sensitivity respectively. In regard to the impact of prediction of certain variables on the incidence of ductal breast cancer, positive family history of breast cancer (P < 0.0001), low parity (P< 0.0001), stage I and II breast cancer (P = 0.02) and positive HER2/neu status (P < 0.0001) were significant predictive factors among the study participants. The results from this study provide relevant evidence for a significant positive and potential association between certain risk factors and the prevalence of breast cancer among Iraqi women.

Keywords: Ductal Breast Cancer, Hormone Sensitivity, Iraq, Risk Factors

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Authors: Hamed Karimian, Noraziah Nordin, Mohamad Ibrahim Noordin, Syam Mohan, Mahboubeh Razavi, Najihah Mohd Hashim, Happipah Mohd Ali

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Satureja bachtiarica Bunge is a perennial medicinal plant belonging to the Lamiaceae family and endemic species in Iran. Satureja bachtiarica Bunge with the local name of Marzeh koohi is edible vegetable use as flavoring agent, anti-bacterial and to relieve cough and indigestion. In this study, the anti-cancer effect of Satureja bachtiarica Bunge on the MDA-MB-231 cell line as an Breast cancer cell model has been analyzed for the first time. Satureja bachtiarica Bunge was extracted using different solvents in the order of increasing polarity. Cytotoxicity activity of hexane extract of Satureja bachtiarica Bunge (SBHE) was observed using MTT assay. Acridine orange/Propidium iodide staining was used to detect early apoptosis; Annexin-V-FITC assay was carried out to observe the detection of cell-surface Phosphatidylserine (PS), with Annexin-Vserving as a marker for apoptotic cells. Caspase 3/7, 8 and-9 assays showed significantly activation of caspase-9 where lead intrinsic mitochondrial pathway. Bcl-2/Bax expressions and cell cycle arrest were also investigated. SBHE had exhibited significantly higher cytotoxicity against MDA-MB-231 Cell line compare to other cell lines. A significant increase in chromatin condensation in the cell nucleus was observed by fluorescence analysis. Treatment of MDA-MB-231 cells with SBHE encouraged apoptosis, by down-regulating Bcl-2 and up-regulating Bax, which lead the activation of caspase 9. Moreover, SBHE treatment significantly arrested MDA-MB-231 cells in the G1 phase. Together, the results presented in this study demonstrated that SBHE inhibited the proliferation of MDA-MB-231 cells, leading cell cycle arrest and programmed cell death, which was confirmed to be through the mitochondrial pathway.

Keywords: Satureja bachtiarica Bunge, MDA-MB-231, apoptosis, annexin-V, cell cycle

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Authors: Chi-Ying Yu

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In real life, the occurrence of disasters is always dreadful and heartbreaking, yet paradoxically, disaster film is a genre that has been popular at periodic intervals in motion picture history. This study attempts to compare the disaster film cycles of the 1970s, 1990s, and the early 21st century. Two research questions are addressed: First, how this genre has responded to the existing conditions of society in different periods in terms of the disaster proposition? Second, how this genre reflects a certain eternal substance of the human mind in light of its lasting appeal? Through cinematic textual analysis and literature review, this study finds that the emergence of disaster films in the 1970s reflected the turmoil in international relations and domestic politics situation in contemporary American society, and cinema screens showed such disaster stories as shipwrecks, air accidents, and skyscraper blazes due to human negligence. The 1990s saw the fervor of millennial apocalypse legends, and the awakening of environmental consciousness, which, together with the rapid advances in digital technology, once again gave rise to a frenzy of disaster films, with natural disasters and threats from aliens as the major themes of disasters. Since the beginning of the 21st century, the 911 Incident and natural disasters around the world have generated a consciousness of imminent crisis. Cinematic images simulated actual disasters, while aesthetic techniques focused on creating a kind of ‘empathetic’ experience in their exploration of the essence of the disaster experience. At the same time, post-apocalypse films that focus on post-disaster reconstruction have become an even more popular theme. Taking the approach of Jungian/post-Jungian film study, this study also reviews and interprets the commonly exhibited subliminal feelings in the disaster films of the three different periods. The imagination of disaster seems to serve as an underlying state of the human mind.

Keywords: disaster film, Jungian/post-Jungian film studies, stimulation, sublime

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Authors: Yi Shan Cheng, Ya Hui Yeh, Hsiao Wen Hsu

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Delirium is an acute state of confusion, which is mainly the result of the interaction of many factors, including: age>65 years, comorbidity, cognitive function and visual/auditory impairment, dehydration, pain, sleep disorder, pipeline retention, general anesthesia and major surgery… etc. Researches show the prevalence of delirium in hospitalized elderly patients over 50%. If it doesn't improve in time, may cause cognitive decline or impairment, not only prolong the length of hospital stay but also increase mortality. Some studies have shown that multiple nonpharmacological interventions are the most effective and common strategies, which are reorientation, early mobility, promoting sleep and nutritional support (including water intake), could improve or prevent delirium in the hospitalized elderly. In Taiwan, only one research to compare the delirium incidence of the older patients who have received orthopedic surgery between multi-nonpharmacological interventions and general routine care. Therefore, the purpose of this study is to address the prevention or improvement of delirium incidence density in medical hospitalized elderly, provide clinical nurses as a reference for clinical implementation, and develop follow-up related research. This study is a quasi-experimental design using purposive sampling. Samples are from two wards: the geriatric ward and the general medicine ward at a medical center in central Taiwan. The sample size estimated at least 100, and then the data will be collected through a self-administered structured questionnaire, including: demographic and professional evaluation items. Case recruiting from 5/13/2023. The research results will be analyzed by SPSS for Windows 22.0 software, including descriptive statistics and inferential statistics: logistic regression、Generalized Estimating Equation(GEE)、multivariate analysis of variance(MANOVA).

Keywords: multiple nonpharmacological interventions, hospitalized elderly, delirium incidence, delirium

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Authors: Juan Alfredo Guevara Carrio, Swamy Toolahalli Thipperudra, Riddhi Naik Dharmeshbhai, Sergio Graniero Echeverrigaray, Jose Vitorio Emiliano, Antonio Helio Castro

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In order to advance the hydrogen economy, several industrial sectors can potentially benefit from the trillions of stimulus spending for post-coronavirus. Blending hydrogen into natural gas pipeline networks has been proposed as a means of delivering it during the early market development phase, using separation and purification technologies downstream to extract the pure H₂ close to the point of end-use. This first step has been mentioned around the world as an opportunity to use existing infrastructures for immediate decarbonisation pathways. Among current technologies used to extract hydrogen from mixtures in pipelines or liquid carriers, membrane separation can achieve the highest selectivity. The most efficient approach for the separation of H₂ from other substances by membranes is offered from the research of 2D layered materials due to their exceptional physical and chemical properties. Graphene-based membranes, with their distribution of pore sizes in nanometers and angstrom range, have shown fundamental and economic advantages over other materials. Their combination with the structure of ceramic and geopolymeric materials enabled the synthesis of nanocomposites and the fabrication of membranes with long-term stability and robustness in a relevant range of physical and chemical conditions. Versatile separation modules have been developed for hydrogen separation, which adaptability allows their integration in industrial prototypes for applications in heavy transport, steel, and cement production, as well as small installations at end-user stations of pipeline networks. The developed membranes and prototypes are a practical contribution to the technological challenge of supply pure H₂ for the mentioned industries as well as hydrogen energy-based fuel cells.

Keywords: graphene nano-composite membranes, hydrogen separation and purification, separation modules, indsutrial prototype

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Authors: Victor Birikorang Danquah

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Ghana's primary energy supply is heavily reliant on petroleum, biomass, and hydropower. Currently, Ghana gets its energy from hydropower (Akosombo and Bui), thermal power plants powered by crude oil, natural gas, and diesel, solar power, and imports from La Cote d'Ivoire. Until the early 2000s, large hydroelectric dams dominated Ghana's electricity generation. Due to unreliable weather patterns, Ghana increased its reliance on thermal power. However, thermal power contributes the highest percentage in terms of electricity generation in Ghana and is predominantly supplied by Independent Power Producers (IPPs). Ghana's electricity industry operates the corporate utility model as its business model. This model is typically' vertically integrated,' with a single corporation selling the majority of power generated by its generation assets to its retail business, which then sells the electricity to retail market consumers. The corporate utility model has a straightforward value proposition that is based on increasing the number of energy units sold. The unit volume business model drives the entire energy value chain to increase throughput, locking system users into unsustainable practices. This report uses the qualitative research approach to explore the electricity industry in Ghana. There is a need for increasing renewable energy, such as wind and solar, in electricity generation. The research recommends two critical business models for the penetration of renewable energy in Ghana's power sector. The first model is the peer-to-peer electricity trading model, which relies on a software platform to connect consumers and generators in order for them to trade energy directly with one another. The second model is about encouraging local energy generation, incentivizing optimal time-of-use behaviour, and allowing any financial gains to be shared among the community members.

Keywords: business model innovation, electricity generation, renewable energy, solar energy, sustainability, wind energy

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Authors: Muhamad Aris Burhanudin, Angga Firmansyas, Bagus Jaya Santosa

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Earthquakes are natural hazard that can trigger the most dangerous hazard, tsunami. 26 December 2004, a giant earthquake occurred in north-west Andalas Island. It made giant tsunami which crushed Sumatra, Bangladesh, India, Sri Lanka, Malaysia and Singapore. More than twenty thousand people dead. The occurrence of earthquake and tsunami can not be avoided. But this hazard can be mitigated by earthquake forecasting. Early preparation is the key factor to reduce its damages and consequences. We aim to investigate quantitatively on pattern of earthquake. Then, we can know the trend. We study about earthquake which has happened in Andalas island, Indonesia one last decade. Andalas is island which has high seismicity, more than a thousand event occur in a year. It is because Andalas island is in tectonic subduction zone of Hindia sea plate and Eurasia plate. A tsunami forecasting is needed to mitigation action. Thus, a Tsunami Forecasting Method is presented in this work. Neutral Network has used widely in many research to estimate earthquake and it is convinced that by using Backpropagation Method, earthquake can be predicted. At first, ANN is trained to predict Tsunami 26 December 2004 by using earthquake data before it. Then after we get trained ANN, we apply to predict the next earthquake. Not all earthquake will trigger Tsunami, there are some characteristics of earthquake that can cause Tsunami. Wrong decision can cause other problem in the society. Then, we need a method to reduce possibility of wrong decision. Fuzzy TOPSIS is a statistical method that is widely used to be decision seconder referring to given parameters. Fuzzy TOPSIS method can make the best decision whether it cause Tsunami or not. This work combines earthquake prediction using neural network method and using Fuzzy TOPSIS to determine the decision that the earthquake triggers Tsunami wave or not. Neural Network model is capable to capture non-linear relationship and Fuzzy TOPSIS is capable to determine the best decision better than other statistical method in tsunami prediction.

Keywords: earthquake, fuzzy TOPSIS, neural network, tsunami

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Authors: Thomas S. Abia II

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Intel Chandler Site has internally developed its first-of-kind (FOK) facility-scale wastewater treatment system to achieve multi-metal ion exchange. The process was carried out using a serial process train of carbon filtration, pH / ORP adjustment, and cationic exchange purification to treat dilute metal wastewater (DMW) discharged from a substrate packaging factory. Spanning a trial period of 10 months, a total of 3,271 samples were collected and statistically analyzed (average baseline + standard deviation) to evaluate the performance of a 95-gpm, multi-reactor continuous copper ion exchange treatment system that was consequently retrofitted for manganese ion exchange to meet environmental regulations. The system is also equipped with an inline acid and hot caustic regeneration system to rejuvenate exhausted IX resins and occasionally remove surface crud. Data generated from lab-scale studies was transferred to system operating modifications following multiple trial-and-error experiments. Despite the DMW treatment system failing to meet internal performance specifications for manganese output, it was observed to remove the cation notwithstanding the prevalence of copper in the waste stream. Accordingly, the average manganese output declined from 6.5 + 5.6 mg¹L⁻¹ at pre-pilot to 1.1 + 1.2 mg¹L⁻¹ post-pilot (83% baseline reduction). This milestone was achieved regardless of the average influent manganese to DMW increasing from 1.0 + 13.7 mg¹L⁻¹ at pre-pilot to 2.1 + 0.2 mg¹L⁻¹ post-pilot (110% baseline uptick). Likewise, the pre-trial and post-trial average influent copper values to DMW were 22.4 + 10.2 mg¹L⁻¹ and 32.1 + 39.1 mg¹L⁻¹, respectively (43% baseline increase). As a result, the pre-trial and post-trial average copper output values were 0.1 + 0.5 mg¹L⁻¹ and 0.4 + 1.2 mg¹L⁻¹, respectively (300% baseline uptick). Conclusively, the operating pH range upstream of treatment (between 3.5 and 5) was shown to be the largest single point of influence for optimizing manganese uptake during multi-metal ion exchange. However, the high variability of the influent copper-to-manganese ratio was observed to adversely impact the system functionality. The journal herein intends to discuss the operating parameters such as pH and oxidation-reduction potential (ORP) that were shown to influence the functional versatility of the ion exchange system significantly. The literature also proposes to discuss limitations of the treatment system such as influent copper-to-manganese ratio variations, operational configuration, waste by-product management, and system recovery requirements to provide a balanced assessment of the multi-metal ion exchange process. The take-away from this literature is intended to analyze the overall feasibility of ion exchange for metals manufacturing facilities that lack the capability to expand hardware due to real estate restrictions, aggressive schedules, or budgetary constraints.

Keywords: copper, industrial wastewater treatment, multi-metal ion exchange, manganese

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Authors: Sally Naji, Julie Gwilliam

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Climate change remains a challenging matter for the human and the built environment in the 21st century, where the need to consider adaptation to climate change in the development process is paramount. However, there remains a lack of information regarding how we should prepare responses to this issue, such as through developing organized and sophisticated tools enabling the adaptation process. This study aims to build a systematic framework approach to investigate the potentials that Neighborhood Sustainability Assessment tools (NSA) might offer in enabling both the analysis of the emerging adaptive capacity to climate change. The analysis of the framework presented in this paper aims to discuss this issue in three main phases. The first part attempts to link sustainability and climate change, in the context of adaptive capacity. It is argued that in deciding to promote sustainability in the context of climate change, both the resilience and vulnerability processes become central. However, there is still a gap in the current literature regarding how the sustainable development process can respond to climate change. As well as how the resilience of practical strategies might be evaluated. It is suggested that the integration of the sustainability assessment processes with both the resilience thinking process, and vulnerability might provide important components for addressing the adaptive capacity to climate change. A critical review of existing literature is presented illustrating the current lack of work in this field, integrating these three concepts in the context of addressing the adaptive capacity to climate change. The second part aims to identify the most appropriate scale at which to address the built environment for the climate change adaptation. It is suggested that the neighborhood scale can be considered as more suitable than either the building or urban scales. It then presents the example of NSAs, and discusses the need to explore their potential role in promoting the adaptive capacity to climate change. The third part of the framework presents a comparison among three example NSAs, BREEAM Communities, LEED-ND, and CASBEE-UD. These three tools have been selected as the most developed and comprehensive assessment tools that are currently available for the neighborhood scale. This study concludes that NSAs are likely to present the basis for an organized framework to address the practical process for analyzing and yet promoting Adaptive Capacity to Climate Change. It is further argued that vulnerability (exposure & sensitivity) and resilience (Interdependence & Recovery) form essential aspects to be addressed in the future assessment of NSA’s capability to adapt to both short and long term climate change impacts. Finally, it is acknowledged that further work is now required to understand impact assessment in terms of the range of physical sectors (Water, Energy, Transportation, Building, Land Use and Ecosystems), Actor and stakeholder engagement as well as a detailed evaluation of the NSA indicators, together with a barriers diagnosis process.

Keywords: adaptive capacity, climate change, NSA tools, resilience, sustainability

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Authors: Paras Agarwal

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Background: Initially believed to be rare, metastases to the eye are the most common ocular malignancy. The choroid’s high perfusion rate not only makes it the most susceptible ocular site for tumour seeding, but also promotes its growth. The cancers most frequently responsible for choroidal metastases originate from the breast and lung, although a significant proportion have unidentified primaries at the time of presentation. Case Presentation: This case report describes a 34 year old female presenting to the ophthalmology department with a one month history of painless distorted vision. On fundus examination, she was noted to have bilateral choroidal lesionsand subsequently underwent a comprehensive diagnostic work-up. The patient was diagnosed with metastatic pulmonary adenocarcinoma, despite lacking conventional risk factors. As she was found to have a mutation in EGFR, the patient was commenced on tyrosine-kinase inhibition with afatinib. The choroidal lesions regressed with a significant improvement in visual acuity and a dramatic anatomical reduction of the choroidal masses. Conclusions: Our case demonstrates the importance of considering metastases as a differential diagnosis for choroidal lesions. Appropriate and thorough history-taking, examination and investigations may be required in order to deduce the underlying cause. Our case is unusual in view of the choroidal lesion being the primary manifestation of metastatic lung cancer in a young patient with no known risk factors. Early recognition of choroidal metastases is important as it is often the first sign of tumour dissemination and will prompt earlier treatment with systemic medications such as chemotherapy, immunotherapy, targeted therapy or hormonal therapy. Our case report also demonstrates the efficacy of afatinib for the treatment of choroidal metastases, with morphological and functional improvements observed with regard to the choroidal metastatic tumour.

Keywords: choroidal neoplasm, choroidal naevus, pulmonary adenocarcinoma, metastases, lung cancer

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Authors: Akhila Potluru

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Worldwide, more than 250 bodies of water are transboundary, meaning they cross the political boundaries of multiple countries. This creates a system of hydrological, economic, and social interdependence between communities reliant on these water sources. Transboundary water conflicts can occur as a result of this intense interdependence. Many factors contribute to the sparking of transboundary water conflicts, ranging from natural hydrological factors to hydro-political interactions. Previous attempts to predict transboundary water conflicts by analysing changes or trends in the contributing factors have typically failed because patterns in the data are hard to identify. However, there is potential for artificial intelligence and machine learning to fill this gap and identify future ‘hotspots’ up to a year in advance by identifying patterns in data where humans can’t. This research determines the extent to which AI can be used to predict and prevent transboundary water conflicts. This is done via a critical literature review of previous case studies and datasets where AI was deployed to predict water conflict. This research not only delivered a more nuanced understanding of previously undervalued factors that contribute toward transboundary water conflicts (in particular, culture and disinformation) but also by detecting conflict early, governance bodies can engage in processes to de-escalate conflict by providing pre-emptive solutions. Looking forward, this gives rise to significant policy implications and water-sharing agreements, which may be able to prevent water conflicts from developing into wide-scale disasters. Additionally, AI can be used to gain a fuller picture of water-based conflicts in areas where security concerns mean it is not possible to have staff on the ground. Therefore, AI enhances not only the depth of our knowledge about transboundary water conflicts but also the breadth of our knowledge. With demand for water constantly growing, competition between countries over shared water will increasingly lead to water conflict. There has never been a more significant time for us to be able to accurately predict and take precautions to prevent global water conflicts.

Keywords: artificial intelligence, machine learning, transboundary water conflict, water management

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Authors: Yasuyuki Takahashi, Hirotaka Shimada, Kyoko Saito

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Bone scintigraphy is widely used as a screening tool for bone metastases. However, the 180 to 240 minutes (min) waiting time after the intravenous (i.v.) injection of the tracer is both long and tiresome. To solve this shortcoming, a bone scan with a shorter waiting time is needed. In this study, we applied the Maximum Intensity Projection (MIP) and triple energy window (TEW) scatter correction to a whole body bone SPECT (Merged SPECT) and investigated shortening the waiting time. Methods: In a preliminary phantom study, hot gels of 99mTc-HMDP were inserted into sets of rods with diameters ranging from 4 to 19 mm. Each rod set covered a sector of a cylindrical phantom. The activity concentration of all rods was 2.5 times that of the background in the cylindrical body of the phantom. In the human study, SPECT images were obtained from chest to abdomen at 30 to 180 min after 99mTc- hydroxymethylene diphosphonate (HMDP) injection of healthy volunteers. For both studies, MIP images were reconstructed. Planar whole body images of the patients were also obtained. These were acquired at 200 min. The image quality of the SPECT and the planar images was compared. Additionally, 36 patients with breast cancer were scanned in the same way. The delectability of uptake regions (metastases) was compared visually. Results: In the phantom study, a 4 mm size hot gel was difficult to depict on the conventional SPECT, but MIP images could recognize it clearly. For both the healthy volunteers and the clinical patients, the accumulation of 99mTc-HMDP in the SPECT was good as early as 90 min. All findings of both image sets were in agreement. Conclusion: In phantoms, images from MIP with TEW scatter correction could detect all rods down to those with a diameter of 4 mm. In patients, MIP reconstruction with TEW scatter correction could improve the detectability of hot lesions. In addition, the time between injection and imaging could be shortened from that conventionally used for whole body scans.

Keywords: merged SPECT, MIP, TEW scatter correction, 99mTc-HMDP

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Authors: Zengda Li

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The tectonic evolution of the Beishan orogen, which forms part of the Central Asian Orogenic Belt, remains debated. This study reports the identification of three Triassic granitic plutons representing two distinct stages of magmatism in southern Beishan orogen. Zircon U–Pb dating constrains the early stage as 238–237 Ma and the late stage as 229–227 Ma. The granitoids belong to high-K calc-alkaline and shoshonitic series and exhibit alkalic-calcic and calc-alkalic features, and are weakly peraluminous rocks. Most of these granitoids are highly fractionated I-type and A-type granites. They have relatively high Isr values (0.7049–0.7086) and weak negative εNd(t) values of −1.5 to −2.1, with young Nd model ages of 1.04–0.91 Ga, indicating a crustal contribution. They also show markedly positive zircon εHf(t) values (+3.4 to +11.8) and two-stage Hf model ages of 1.06–0.69 Ga, indicating a mixture of mantle and crustal components. The lithospheric mantle beneath this region incorporating older subducted materials was metasomatized by fluids or melts. Partial melting of the metasomatized lithospheric mantle resulted in underplated magmas, which provided the heat and material input to generate the granitoids. The Middle Triassic granitic plutons show moderate negative Eu anomalies, enrichment of LILEs and depletion in Nb, Ta, and Ti suggesting partial melting of crustal components in response to the underplated mantle-derived magmas, probably linked to lithospheric delamination and asthenospheric upwelling. The Late Triassic granitic plutons show characteristics of post-orogenic granite with strong negative anomalies of Eu, Ba, Nb, Sr, P, and Ti, indicating fractional crystallization and crustal contamination during the emplacement process.

Keywords: Triassic, magmatism, geochronology, petrogenesis, Beishan orogen

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Authors: Suneeta Gireesh Panicker

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Aim: Aminopeptidase P (APP) is an enzyme that has specificity for proline, can specifically cleave Xaa-Proline peptides and is a metallo-aminopeptidase. The bonds nearby to the imino acid proline are tough to cleave by many peptidases, but APP can specifically break peptide bonds engaged with proline. Membrane-bound form and a cytosolic form are the two forms in which this enzyme exists. The exact physiological function of APP remains unclear and hence the present work attempts to determine it. Methods: In the present study, the expression pattern of cytosolic Aminopeptidase P (DAP) was determined in all the embryonic stages and larval stages of wild-type Drosophila by using polyclonal monospecific antibodies. To show the presence of DAP RNA in embryonic and larval stages, RNA in situ hybridization was performed. DAP promoter-LacZ fusion reporter gene vector was used to construct transgenic embryos to study the regulation pattern of DAP. To study the DAP expression profile, a transgenic fly consisting of a DAP promoter with β-gal and GFP reporter genes in front of it was constructed. Results: DAP protein expression was observed in neuroectodermal cells, posterior midgut primordium, proctodeum, ventral neuroblast and primordial stomatogastric nervous system. It was observed in the ventral cord and midgut in stage 12. The completely developed embryos showed the intense occurrence of it in the ventral cord and gut region. The eye-antennal disc, wing disc and leg disc also showed the presence of DAP protein. LacZ expression in transgenic embryos also showed the same pattern. Conclusion: Similar to various known multiple-functional proteins, DAP could be one with different functions at different stages and in different cells. Data presented here designates DAP functions in the early embryonic and imaginal dics differentiation and development, suggesting that it may be required for the metabolism of proteins like neuropeptides and tachykinins.

Keywords: aminopeptidase P, in situ hybridization, transgenic fly, embryonic stages

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Authors: J. Woźniak-Holecka, T. Holecki, S. Jaruga

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Spa treatment is an important area of the health care system in Poland due to the increasing needs of the population and the context of historical conditions for this form of therapy. It extends the range of financing possibilities of the outlets and increases the potential of spa services, which is very important in the context of demographic and epidemiological changes. The main advantages of spa treatment services include its relatively wide availability, low risk of side effects, good patient tolerance, long-lasting curative effect and a relatively low cost. In addition, patients should be provided with a proper diet and enable participation in health education and health promotion classes aimed at health problems consistent with the treatment profile. Challenges for global health care systems include a sharp increase in spending on benefits, dynamic development of health technologies and growing social expectations. This requires extending the competences of health resort facilities for health promotion. Within each type of health resort institutions in Poland, nutritional education services are implemented, aimed at creating and consolidating proper eating habits. Choosing the right diet can speed up recovery or become one of the methods to alleviate the symptoms of chronic diseases. During spa treatment patient learns the principles of rational nutrition and adequate dietotherapy to his diseases. The aim of the project is to assess the frequency and quality of nutritional education provided to patients in health resort facilities in a nationwide perspective. The material for the study will be data obtained as part of an in-depth interview conducted among Heads of Nutrition Departments of selected institutions. The use of nutritional education in a health resort may be an important goal of implementing the state health policy as a useful tool to reduce the risk of diet-related diseases. Recognizing nutritional education in health resort institutions as a type of full-value health service can be effective system support for health policy, including seniors, due to demographic changes currently occurring in the Polish population. Furthermore, it is necessary to increase the interest and motivation of patients to follow the recommendations of nutritional education, because it will bring tangible benefits for the long-term effects of therapy and care should be taken for the form and methodology of nutrition education implemented in health resort institutions. Finally it is necessary to construct an educational offer in terms of selected groups of patients with the highest health needs: the elderly and the disabled. In conclusion, it can be said that the system of nutritional education implemented in polish health resort institutions should be subjected to global changes and strong systemic correction.

Keywords: health care system, nutritional education, public health, spa and treatment

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Authors: Fendouli Ines, Zaafrane Nesrine, Mhamdi Hana, Knani Leila, Ghorbel Mohamed

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Introduction: Ocular infiltration of leukemia can involve orbit, uveal tract, retina and optic nerve. It may result from direct ocular infiltration by leukemic cells or indirect ocular involvement resulting from secondary hematologic changes, opportunistic infections and complications of various modalities of therapy. We here in report a case of central venous retinal occlusion associated to optic nerve infiltration as presenting signs of a relapse of acute lymphoblastic leukemia. Case Report: A twelve-year-old male -patient of acute B lymphoblastic leukemia presented with headaches and bilateral blurred vision in the left ee. Ophthalmic examination showed a visual acuity reduced to counting fingers in the right eye and no light perception in the left eye. Funduscopy revealed a voluminous disc edema surrounded by retinal haemorrhages in the right eye, and venous tortusities, papillary edema, and hemorrages suggesting central retinal venous occlusion in the LE. Swept source optical coherence tomography revealed a serous retinal detachment in the RE and .hyperreflective inner layers with macular edema in the left eye. Cerebro-orbital MRI showed bilateral thickened left optic nerve. There were no radiological signs of true papillary edema due to intracranial hypertension secondary to central nervous system involvement. Myelogram and lumbar punction demonstrated blast infiltration and confirmed ocular relapse of the leukemia. Conclusion: Ocular involvement lymphoblastic acute leukemias decreased since the introduction of a systematic prophylactic treatment of central nervous system. Periodic ophthalmic examination is necessary to allow early diagnosis and treatment.

Keywords: acute leukemia, optic nerve, infiltration, relapse

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Authors: Kawar Salih

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It has been proven that designing sustainable buildings starts from early stages of urban design. The design of urban blocks specifically, is considered as one of the pragmatic strategies of sustainable urbanism. There have been previous studies that focused on the impact of urban block design and regulation on the outdoor thermal comfort in the semi-arid regions. However, no studies have been found that concentrated on that impact on the internal behavior of buildings of those regions specifically the daylight quality and energy performance. Further, most studies on semi-arid regions are focusing only on the cooling load reduction, neglecting the heating load. The study has focused on two parameters of urban block distribution which are the block orientation and the surface-to-volume ratio with the consideration of both heating and cooling loads of buildings. In Duhok (a semi-arid city in Kurdistan region of Iraq), energy consumption and daylight quality of different types of residential blocks have been examined using dynamic simulation. The findings suggest that there is a considerable higher energy load for heating than cooling, contradicting many previous studies about these regions. The results also highlight that the orientation of urban blocks can vary the energy consumption to 8%. Regarding the surface-to-volume ratio (S/V), it was observed that after the twice enlargement of the S/V, the energy consumption increased 15%. Though, the study demonstrates as well that there are opportunities for reducing energy consumption with the increase of the S/V which contradicts many previous research on S/V impacts on energy consumption. These results can help to design urban blocks with the bigger S/V than existing blocks in the city which it can provide better indoor daylight and relatively similar energy consumption.

Keywords: blocke orienation, building energy consumption, urban block design, semi-arid regions, surfacet-to-volume ratio

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Authors: A. N. Ghafar, O. A. Chaudhari, W. Oettel, P. Fontana

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This study is a part of the EU project GEOCOND-Advanced materials and processes to improve performance and cost-efficiency of shallow geothermal systems and underground thermal storage. In heat exchange boreholes, to improve the heat transfer between the pipes and the surrounding ground, the space between the pipes and the borehole wall is normally filled with geothermal grout. Traditionally, bentonite has been a crucial component in most commercially available geothermal grouts to assure the required stability and impermeability. The investigations conducted in the early stage of this project during the benchmarking tests on some commercial grouts showed considerable sensitivity of the rheological properties of the tested grouts to the mixing parameters, i.e., mixing time and velocity. Further studies on this matter showed that bentonite, which has been one of the important constituents in most grout mixes, was probably responsible for such behavior. Apparently, proper amount of shear should be applied during the mixing process to sufficiently activate the bentonite. The higher the amount of applied shear the more the activation of bentonite, resulting in change in the grout rheology. This explains why, occasionally in the field applications, the flow properties of the commercially available geothermal grouts using different mixing conditions (mixer type, mixing time, mixing velocity) are completely different than expected. A series of tests were conducted on the grout mixes, with and without bentonite, using different mixing protocols. The aim was to eliminate/reduce the sensitivity of the rheological properties of the geothermal grouts to the mixing parameters by replacing bentonite with polymeric (non-clay) stabilizers. The results showed that by replacing bentonite with a proper polymeric stabilizer, the sensitivity of the grout mix on mixing time and velocity was to a great extent diminished. This can be considered as an alternative for the developers/producers of geothermal grouts to provide enhanced materials with less uncertainty in obtained results in the field applications.

Keywords: flow properties, geothermal grout, mixing time, mixing velocity, rheological properties

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Authors: Rajlekha Sil

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This paper aims to investigate Ray’s portrayal of liminality and the female gaze in ‘Charulata’ (1964) and ‘Ghare Baire’ (1984), both of which primarily articulates the stories of two women (Charu and Bimala respectively), entangled within the cobwebs of their seething, unfulfilled sexuality, amidst a newly-globalised urban culture, punctuated with political turmoils and ideological conflicts. Their tempestuous interactions with the societal space, both tangible and intangible, that surrounds them, and the men in their lives makes them dwell in a liminal space, filled with an ambiguous sense of virtue. In Ray’s films, this sexual ambivalence is characterised by the liminality between the scenic and extrascenic spaces, which, in turn, defines the female gaze as the director’s lenses paint a picture of the new wave of socio-political and socio-cultural movements in early twentieth-century Bengal. Brinda Bose’s essay on ‘Modernity, Globality, Sexuality, and the City: A Reading of Indian Cinema’, analyses the ‘necessary’ process of urbanisation as a marker of ‘moral degeneracy of the nation easily analogous with female sexual transgression/ promiscuity with the nation personified as a woman, by using the concept of the liminal space, a site of both empowerment through transgression and containment through regulation.’ My paper, however, would focus on the liminal space propagated by Ray through his contrasting depiction of scenic and extrascenic spaces to satiate the equivocal voices in Charu and Bimala, along with their way of ‘gazing’ into an equally disheveled society - a gaze that helps them transcend the barriers of politics and urbanization into a state of universal uniformity, symmetrical with their sexual immorality. The first section of the paper would explore Ray’s usage of these theatrical spaces through his character sketches, shots and dialogues, while the second section of the paper would delve into the ‘female gaze’ on a newly revolutionised society.

Keywords: satyajit ray, space, gaze, female sexuality, charulata, ghare baire

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Authors: S. Curtin, A. Trace

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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: Malab Sana Balouch, Meenakshi Nayar

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Hemispatial Neglect is a common disorder primarily associated with right hemispheric stroke, in the acute phase of which it can occur up to 82% of the time. Such individuals fail to acknowledge or respond to people and objects in their left field of vision due to deficits in attention and awareness. Persistent hemispatial neglect significantly impedes post-stroke recovery, leading to longer hospital stays post-stroke, increased functional dependency, longer-term disability in ADLs and increased risk of falls. Recently, evidence has emerged for the use of dopamine agonist Rotigotine in neglect. The aim of our Quality Improvement Project (QIP) is to evaluate and better the current protocols and practice in assessment, documentation and management of neglect and rotigotine use at the Neurorehabilitation unit at Charing Cross Hospital (CNRU). In addition, it brings light to rotigotine use in the management of hemispatial neglect and paves the way for future research in the field. Our QIP was based in the CNRU. All patients admitted to the CNRU suffering from a right-sided stroke from 2nd of February 2018 to the 2nd of February 2021 were included in the project. Each patient’s multidisciplinary team report and hospital notes were searched for information, including bio-data, fulfilment of the inclusion criteria (having hemispatial neglect) and data related to rotigotine use. This includes whether or not the drug was administered, any contraindications to drug in patients that did not receive it, and any therapeutic benefits(subjective or objective improvement in neglect) in those that did receive the rotigotine. Data was simultaneously entered into excel sheet and further statistical analysis was done on SPSS 20.0. Out of 80 patients suffering from right sided strokes, 72.5% were infarcts and 27.5% were hemorrhagic strokes, with vast majority of both types of strokes were in the middle cerebral artery territory (MCA). A total of 31 (38.8%) of our patients were noted to have hemispatial neglect, with the highest number of cases being associated with MCA strokes. Almost half of our patients with MCA strokes suffered from neglect. Neglect was more common in male patients. Out of the 31 patients suffering from visuospatial neglect, only 16% actually received rotigotine and 80% of them were noted to have an objective improvement in their neglect tests and 20% revealed subjective improvement. After thoroughly going through neglect-associated documentation, the following recommendations/plans were put in place for the future. We plan to liaise with the occupational therapy team at our rehab unit to set a battery of tests that would be done on all patients presenting with neglect and recommend clear documentation of outcomes of each neglect screen under it. Also to create two proformas; one for the therapy team to aid in systematic documentation of neglect screens done prior to and after rotigotine administration and a second proforma for the medical team with clear documentation of rotigotine use, its benefits and any contraindications if not administered.

Keywords: hemispatial Neglect, right hemispheric stroke, rotigotine, neglect, dopamine agonist

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Authors: A. S. Lunev, A. A. Larenkov, O. E. Klementyeva, G. E. Kodina

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Background and aims: 68Ga-citrate is one of prospective radiopharmaceutical for PET-imaging of inflammation and infection. 68Ga-citrate is 67Ga-citrate analogue using since 1970s for SPECT-imaging. There's known rebinding reaction occurs past Ga-citrate injection and gallium (similar iron Fe3+) binds with blood transferrin. Then radiolabeled protein complex is delivered to pathological foci (inflammation/infection sites). But excessive gallium bindings with transferrin are cause of slow blood clearance, long accumulation time in foci (24-72 h) and exception of application possibility of the short-lived gallium-68 (T½ = 68 min). Injection of additional chemical agents (e.g. Fe3+ compounds) competing with radioactive gallium to the blood transferrin joining (blocking of its metal binding capacity) is one of the ways to solve formulated problem. This phenomenon can be used for correction of 68Ga-citrate pharmacokinetics for increasing of the blood clearance and accumulation in foci. The aim of real studying is research of effect of stable Fe-citrate on 68Ga-citrate tissue distribution. Materials and methods: 68Ga-citrate without/with extra injection of stable Fe-citrate (III) was injected nonlinear mice with inflammation models (aseptic soft tissue inflammation, lung infection, osteomyelitis). PET/X-RAY Genisys4 (Sofie Bioscience, USA) was used for non-invasive PET imaging (for 30, 60, 120 min past injection 68Ga-citrate) with subsequent reconstruction of imaging and their analysis (value of clearance, distribution volume). Scanning time is 10 min. Results and conclusions: I. v. injection of stable Fe-citrate blocks the metal-binding capability of transferrin serum and allows decreasing gallium-68 radioactivity in blood significantly and increasing accumulation in inflammation (3-5 time). It allows receiving more informative PET-images of inflammation early (for 30-60 min after injection). Pharmacokinetic parameters prove it. Noted there is no statistically significant difference between 68Ga-citrate accumulation for different inflammation model because PET imaging is indication of pathological processes and is not their identification.

Keywords: 68Ga-citrate, Fe-citrate, PET imaging, mice, inflammation, infection

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Authors: Sharique Ahmed, Khushtar Anwar Salman

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Alpha-1-antitrypsin (AAT) is a major plasma serine protease inhibitor (SERPIN). Hereditary AAT deficiency is one of the common diseases in some part of the world. AAT is mainly produced in the liver and functions to protect the lung against proteolytic damage (e.g., from neutrophil elastase) acting as the major inhibitor for neutrophil elastase. α (1)-Antitrypsin (AAT) deficiency is an under recognized genetic condition that affects approximately 1 in 2,000 to 1 in 5,000 individuals and predisposes to liver disease and early-onset emphysema. Not only does α-1-antitrypsin deficiency lead to disabling syndrome of pulmonary emphysema, there are other disorders too which include ANCA (antineutrophilic cytoplasmic antibody) positive Wegener's granulomatosis, diffuse bronchiectasis, necrotizing panniculitis in α-1-antitrypsin phenotype (S), idiopathic pulmonary fibrosis and steroid dependent asthma. Augmentation therapy with alpha-1 antitrypsin (AAT) from human plasma has been available for specific treatment of emphysema due to AAT deficiency. Apart from this several observations have also suggested a role for endogenous suppressors of HIV-1, alpha-1 antitrypsin (AAT) has been identified to be one of those. In view of its varied important role in humans, serum from a mammalian source was chosen for the isolation and purification. Studies were performed on the homogeneous fraction. This study suggests that the buffalo serum α-1-antritrypsin has characteristics close to ovine, dog, horse and more importantly to human α-1-antritrypsin in terms of its hydrodynamic properties such as molecular weight, carbohydrate content, etc. The similarities in the hydrodynamic properties of buffalo serum α-1-antitrypsin with other sources of mammalian α-1-antitrypsin mean that it can be further studied and be a potential source for "augmentation therapy", as well as a source of AAT replacement therapy to raise serum levels above the protective threshold. Other parameters like the amino acid sequence, the effect of denaturants, and the thermolability or thermostability of the inhibitor will be the interesting basis of future studies on buffalo serum alpha-1 antitrypsin (AAT).

Keywords: α-1-antitrypsin, augmentation therapy , hydrodynamic properties, serine protease inhibitor

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Authors: Behrang Ekrami, Amin Tamadon, Iman Razeghian Jahromi, Darioush Moghadas, Mehdi Ghahremani-Seno, Mostafa Ghaderi-Zefrehei, Ahmad Sodagar Amiri, Taheri Reza

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Persian fallow deer (Dama dama mesopotamica) is belonging to the family Cervidae and is only found in a few protected areas in the northwest, north, and southwest of Iran. The aims of this study were analysis of inbreeding and morphometric parameters of semen in male Persian fallow deer to investigate the cause of reduced fertility of this endangered species in Dasht-e-Naz National Refuge, Sari, Iran. The Persian fallow deer semen was collected from four adult bucks randomly during the breeding and non-breeding season from five dehorned and horned deer's by an artificial vagina. Twelve blood samples was taken from Persian fallow deer and mitochondrial DNA was extracted, amplified, extracted, sequenced and then were considered for genetic analysis. The Persian fallow deer semen, both with normal and abnormal spermatozoa, is similar to that of domestic ruminants but very smaller and difficult to observe at the primary observation. The post-mating season collected ejaculates contained abnormal spermatozoa, debris and secretion of accessory glands in horned bucks and accessory glands secretion free of any spermatozoa in dehorned or early velvet budding bucks. Microscopic evaluation in all four bucks during the mating season showed the mean concentration of 9×106 spermatozoa/ml. The mean ± SD of age, testes length and testes width was 4.60 ± 1.52 years, 3.58 ± 0.32 and 1.86 ± 0.09 cm, respectively. The results identified 1120 loci (assuming each nucleotide as locus) in which 377 were polymorphic. In conclusion, reduced fertility of male Persian fallow deer may be caused by inbreeding of the protected herd in a limited area of Dasht-e-Naz National Refuge.

Keywords: Persian fallow deer, genetic analysis, spermatozoa, reproductive characteristics

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Authors: Radka Gorejova, Ivana Sisolakova, Jana Shepa, Frederika Chovancova, Renata Orinakova

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Diabetes mellitus (DM) is a serious metabolic disease characterized by chronic hyperglycemia. Often, the symptoms are not sufficiently observable at early stages, and so hyperglycemia causes pathological and functional changes before the diagnosis of the DM. Therefore, the development of an electrochemical sensor that will be fast, accurate, and instrumentally undemanding is currently needful. Screen-printed carbon electrodes (SPCEs) can be considered as the most suitable matrix material for insulin sensors because of the small size of the working electrode. It leads to the analyst's volume reduction to only 50 µl for each measurement. The surface of bare SPCE was modified by a combination of chitosan, multi-walled carbon nanotubes (MWCNTs), and zinc nanoparticles (ZnNPs) to obtain better electrocatalytic activity towards insulin oxidation. ZnNPs were electrochemically deposited on the chitosan-MWCNTs/SPCE surface using the pulse deposition method. Thereafter, insulin was determined on the prepared electrode using chronoamperometry and electrochemical impedance spectroscopy (EIS). The chronoamperometric measurement was performed by adding a constant amount of insulin in 0.1 M NaOH and PBS (2 μl) with the concentration of 2 μM, and the current response of the system was monitored after a gradual increase in concentration. Subsequently, the limit of detection (LOD) of the prepared electrode was determined via the Randles-Ševčík equation. The LOD was 0.47 µM. Prepared electrodes were studied also as the impedimetric sensors for insulin determination. Therefore, various insulin concentrations were determined via EIS. Based on the performed measurements, the ZnNPs/chitosan-MWCNTs/SPCE can be considered as a potential candidate for novel electrochemical sensor for insulin determination. Acknowledgments: This work has been supported by the projects Visegradfund project number 22020140, VEGA 1/0095/21 of the Slovak Scientific Grant Agency, and APVV-PP-COVID-20-0036 of the Slovak Research and Development Agency.

Keywords: zinc nanoparticles, insulin, chronoamperometry, electrochemical impedance spectroscopy

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Authors: M. Karzhauov, А. Mukhambetova, M. Sarsenova, E. Raimagambetov, V. Ogay

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Regeneration of injured articular cartilage remains one of the most difficult and unsolved problems in traumatology and orthopedics. Currently, for the treatment of cartilage defects surgical techniques for stimulation of the regeneration of cartilage in damaged joints such as multiple microperforation, mosaic chondroplasty, abrasion and microfractures is used. However, as shown by clinical practice, they can not provide a full and sustainable recovery of articular hyaline cartilage. In this regard, the current high hopes in the regeneration of cartilage defects reasonably are associated with the use of tissue engineering approaches to restore the structural and functional characteristics of damaged joints using stem cells, growth factors and biopolymers or scaffolds. The purpose of the present study was to investigate the effects of chondroinductive growth factors and synovium-derived mesenchymal stem cells (SD-MSCs) on the regeneration of cartilage defects in rabbits. SD-MSCs were isolated from the synovium membrane of Flemish giant rabbits, and expanded in complete culture medium α-MEM. Rabbit SD-MSCs were characterized by CFU-assay and by their ability to differentiate into osteoblasts, chondrocytes and adipocytes. The effects of growth factors (TGF-β1, BMP-2, BMP-4 and IGF-I) on MSC chondrogenesis were examined in micromass pellet cultures using histological and biochemical analysis. Articular cartilage defect (4mm in diameter) in the intercondylar groove of the patellofemoral joint was performed with a kit for the mosaic chondroplasty. The defect was made until subchondral bone plate. Delivery of SD-MSCs and growth factors was conducted in combination with hyaloronic acid (HA). SD-MSCs, growth factors and control groups were compared macroscopically and histologically at 10, 30, 60 and 90 days aftrer intra-articular injection. Our in vitro comparative study revealed that TGF-β1 and BMP-4 are key chondroinductive factors for both the growth and chondrogenesis of SD-MSCs. The highest effect on MSC chondrogenesis was observed with the synergistic interaction of TGF-β1 and BMP-4. In addition, biochemical analysis of the chondrogenic micromass pellets also revealed that the levels of glycosaminoglycans and DNA after combined treatment with TGF-β1 and BMP-4 was significantly higher in comparison to individual application of these factors. In vivo study showed that for complete regeneration of cartilage defects with intra-articular injection of SD-MSCs with HA takes time 90 days. However, single injection of SD-MSCs in combiantion with TGF-β1, BMP-4 and HA significantly promoted regeneration rate of the cartilage defects in rabbits. In this case, complete regeneration of cartilage defects was observed in 30 days after intra-articular injection. Thus, our in vitro and in vivo study demonstrated that combined application of rabbit SD-MSC with chondroinductive growth factors and HA results in strong synergistic effect on the chondrogenesis significantly enhancing regeneration of the damaged cartilage.

Keywords: Mesenchymal stem cells, synovium, chondroinductive factors, TGF-β1, BMP-2, BMP-4, IGF-I

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