Search results for: traumatic stress disorder

Authors: Midiya Khademi, Ali Nikoo, Shabnam Rahimnezhad Baghche Jooghi

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Cardiovascular diseases (CVDs) are the main cause of death globally. Most CVDs can be prevented by avoiding habitual risk factors. Separate from the habitual risk factors, there are some inherent factors in each individual that can increase the risk potential of CVDs. Vessel shapes and geometry are influential factors, having great impact on the blood flow and the hemodynamic behavior of the vessels. In the present study, the influence of bifurcation angle on blood flow characteristics is studied. In order to approach this topic, by simplifying the details of the bifurcation, three models with angles 30°, 45°, and 60° were created, then by using CFD analysis, the response of these models for stable flow and pulsatile flow was studied. In the conducted simulation in order to eliminate the influence of other geometrical factors, only the angle of the bifurcation was changed and other parameters remained constant during the research. Simulations are conducted under dynamic and stable condition. In the stable flow simulation, a steady velocity of 0.17 m/s at the inlet plug was maintained and in dynamic simulations, a typical LAD flow waveform is implemented. The results show that the bifurcation angle has an influence on the maximum speed of the flow. In the stable flow condition, increasing the angle lead to decrease the maximum flow velocity. In the dynamic flow simulations, increasing the bifurcation angle lead to an increase in the maximum velocity. Since blood flow has pulsatile characteristics, using a uniform velocity during the simulations can lead to a discrepancy between the actual results and the calculated results.

Keywords: coronary artery, cardiovascular disease, bifurcation, atherosclerosis, CFD, artery wall shear stress

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Authors: Sijie Chen, Xiaofang Chen, Juan Wang, Yingying Zhang, Yu Hong, Wanyu Zhuang, Xinxin Huang, Ping Ou, Longsheng Huang

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Purpose: Autistic symptom improvement can be observed in children treated with acupuncture, but the mechanism is still being explored. In the present study, we used scalp acupuncture to treat autism rat model, and then their improvement in the abnormal behaviors and specific mechanisms behind were revealed by detecting animal behaviors, analyzing the RNA sequencing of the prefrontal cortex(PFC), and observing the ultrastructure of PFC neurons under the transmission electron microscope. Methods: On gestational day 12.5, Wistar rats were given valproic acid (VPA) by intraperitoneal injection, and their offspring were considered to be reliable rat models of autism. They were randomized to VPA or VPA-acupuncture group (n=8). Offspring of Wistar pregnant rats that were simultaneously injected with saline were randomly selected as the wild-type group (WT). VPA_acupuncture group rats received acupuncture intervention at 23 days of age for 4 weeks, and the other two groups followed without intervention. After the intervention, all experimental rats underwent behavioral tests. Immediately afterward, they were euthanized by cervical dislocation, and their prefrontal cortex was isolated for RNA sequencing and transmission electron microscopy. Results: The main results are as follows: 1. Animal behavioural tests: VPA group rats showed more anxiety-like behaviour and repetitive, stereotyped behaviour than WT group rats. While VPA group rats showed less spatial exploration ability, activity level, social interaction, and social novelty preference than WT group rats. It was gratifying to observe that acupuncture indeed improved these abnormal behaviors of autism rat model. 2. RNA-sequencing: The three groups of rats differed in the expression and enrichment pathways of multiple genes related to synaptic function, neural signal transduction, and circadian rhythm regulation. Our experiments indicated that acupuncture can alleviate the major symptoms of ASD by improving these neurological abnormalities. 3. Under the transmission electron microscopy, several lysosomes and mitochondrial structural abnormalities were observed in the prefrontal neurons of VPA group rats, which were manifested as atrophy of the mitochondrial membran, blurring or disappearance of the mitochondrial cristae, and even vacuolization. Moreover, the number of synapses and synaptic vesicles was relatively small. Conversely, the mitochondrial structure of rats in the WT group and VPA_acupuncture was normal, and the number of synapses and synaptic vesicles was relatively large. Conclusion: Acupuncture effectively improved the abnormal behaviors of autism rat model and the ultrastructure of the PFC neurons, which might worked by improving their abnormal synaptic function, synaptic plasticity and promoting neuronal signal transduction.

Keywords: autism spectrum disorder, acupuncture, animal behavior, RNA sequencing, transmission electron microscope

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Authors: Aynur Aker, Hasan Kaya

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In recent years, the use of the aluminum based alloys in the industry and technology are increasing. Alloying elements in aluminum have further been improving the strength and stiffness properties that provide superior compared to other metals. In this study, investigation of physical properties (microstructure, microhardness, tensile strength, electrical conductivity and thermal properties) in the Al-12.6wt.%Si-%2wt.Ni ternary alloy were investigated. Al-Si-Ni alloy was prepared in a graphite crucible under vacuum atmosphere. The samples were directionally solidified upwards with different growth rate (V) at constant temperature gradient G (7.73 K/mm). The microstructures (flake spacings, λ), microhardness (HV), ultimate tensile strength, electrical resistivity and thermal properties enthalpy of fusion and specific heat and melting temperature) of the samples were measured. Influence of the growth rate and flake spacings on microhardness, ultimate tensile strength and electrical resistivity were investigated and relationships between them were experimentally obtained by using regression analysis. According to results, λ values decrease with increasing V, but microhardness, ultimate tensile strength, electrical resistivity values increase with increasing V. Variations of electrical resistivity for cast samples with the temperature in the range of 300-1200 K were also measured by using a standard dc four-point probe technique. The enthalpy of fusion and specific heat for the same alloy was also determined by means of differential scanning calorimeter (DSC) from heating trace during the transformation from liquid to solid. The results obtained in this work were compared with the previous similar experimental results obtained for binary and ternary alloys.

Keywords: electrical resistivity, enthalpy, microhardness, solidification, tensile stress

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Authors: Frank Dorrian, Aniket Adhikari

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The placenta accreta spectrum (PAS), which includes placenta accreta, increta, and percreta, is characterized by the abnormal implantation of placental chorionic villi beyond the decidua basalis. Key risk factors include placenta previa, prior cesarean sections, advanced maternal age, uterine surgeries, multiparity, pelvic radiation, and in vitro fertilization (IVF). The incidence of PAS has increased tenfold over the past 50 years, largely due to rising cesarean rates. PAS is associated with significant peripartum and postpartum hemorrhage. Magnetic resonance imaging (MRI) and ultrasound assist in the evaluation of PAS, enabling a multidisciplinary approach to mitigate morbidity and mortality. This study retrospectively analyzed PAS cases at Royal Prince Alfred Hospital, Sydney, Australia. Using the SAR-ESUR joint consensus statement, seven imaging signs were reassessed for their sensitivity and specificity in predicting PAS, with histopathological correlation. The standardized MRI protocols for PAS at the institution were also reviewed. Data were collected from the picture archiving and communication system (PACS) records from 2010 to July 2024, focusing on cases where MR imaging and confirmed histopathology or operative notes were available. This single-center, observational study provides insights into the reliability of MRI for PAS detection and the optimization of imaging protocols for accurate diagnosis. The findings demonstrate that intraplacental dark bands serve as highly sensitive markers for diagnosing PAS, achieving sensitivities of 88.9%, 85.7%, and 100% for placenta accreta, increta, and percreta, respectively, with a combined specificity of 42.9%. Sensitivity for abnormal vascularization was lower (33.3%, 28.6%, and 50%), with a specificity of 57.1%. The placenta bulge exhibited sensitivities of 55.5%, 57.1%, and 100%, with a specificity of 57.1%. Loss of the T2 hypointense interface had sensitivities of 66.6%, 85.7%, and 100%, with 42.9% specificity. Myometrial thinning showed high sensitivity across PAS conditions (88.9%, 71.4%, and 100%) and a specificity of 57.1%. Bladder wall thinning was sensitive only for placenta percreta (50%) but had a specificity of 100%. Focal exophytic mass displayed variable sensitivity (22.9%, 42.9%, and 100%) with a specificity of 85.7%. These results highlight the diagnostic variability among markers, with intraplacental dark bands and myometrial thinning being useful in detecting abnormal placentation, though they lack high specificity. The literature and the results of our study highlight that while no single feature can definitively diagnose PAS, the presence of multiple features -especially when combined with elevated clinical risk- significantly increases the likelihood of an underlying PAS. A thorough understanding of the range of MRI findings associated with PAS, along with awareness of the clinical significance of each sign, helps the radiologist more accurately diagnose the condition and assist in surgical planning, ultimately improving patient care.

Keywords: placenta, accreta, spectrum, MRI

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Authors: Chengcao Sun, Cuili Yang, Shujun Li, Ruilin Xue, Yongyong Xi, Liang Wang, Dejia Li

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Backgrounds: Inflammation is widely distributed in patients with Duchenne muscular dystrophy (DMD), and ultimately leads to progressive deterioration of muscle function with the co-effects of chronic muscle damage, oxidative stress, and reduced oxidative capacity. NF-E2-related factor 2 (Nrf2) plays a critical role in defending against inflammation in different tissues via activation of phase II enzymes, heme oxygenase-1 (HO-1). However, whether Nrf2/HO-1 pathway can attenuate muscle inflammation on DMD remains unknown. The purpose of this study was to determine the anti-inflammatory effects of Sulforaphane (SFN) on DMD. Methods: 4-week-old male mdx mice were treated with SFN by gavage (2 mg/kg body weight per day) for 4 weeks. Gastrocnemius, tibial anterior and triceps brachii muscles were collected for related analysis. Immune cell infiltration in skeletal muscles was analyzed by H&E staining and immuno-histochemistry. Moreover, the expressions of inflammatory cytokines,pro-inflammatory cytokines and Nrf2/HO-1 pathway were detected by western blot, qRT-PCR, immunohistochemistry and immunofluorescence assays. Results: Our results demonstrated that SFN treatment increased the expression of muscle phase II enzymes HO-1 in Nrf2 dependent manner. Inflammation in mdx skeletal muscles was reduced by SFN treatment as indicated by decreased immune cell infiltration and lower expressions of the inflammatory cytokines CD45, pro-inflammatory cytokines tumour necrosis factor-α and interleukin-6 in the skeletal muscles of mdx mice. Conclusions: Collectively, these results show that SFN can ameliorate muscle inflammation in mdx mice by Nrf2/HO-1 pathway, which indicates Nrf2/HO-1 pathway may represent a new therapeutic target for DMD.

Keywords: sulforaphane, Nrf2, HO-1, inflammation

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Authors: Niloofar Bahramian, Mohammad Atai, Mohammad Reza Naimi-Jamal

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Rule of mixtures is the simple analytical model is used to predict various properties of composites before design. The aim of this study was to demonstrate the benefits and limitations of the Rule-of-Mixtures (ROM) for predicting bending modulus of a continuous and unidirectional fiber reinforced composites using in dental applications. The Composites were fabricated from light curing resin (with and without silica nanoparticles) and modified and non-modified fibers. Composite samples were divided into eight groups with ten specimens for each group. The bending modulus (flexural modulus) of samples was determined from the slope of the initial linear region of stress-strain curve on 2mm×2mm×25mm specimens with different designs: fibers corona treatment time (0s, 5s, 7s), fibers silane treatment (0%wt, 2%wt), fibers volume fraction (41%, 33%, 25%) and nanoparticles incorporation in resin (0%wt, 10%wt, 15%wt). To study the fiber and matrix interface after fracture, single edge notch beam (SENB) method and scanning electron microscope (SEM) were used. SEM also was used to show the nanoparticles dispersion in resin. Experimental results of bending modulus for composites made of both physical (corona) and chemical (silane) treated fibers were in reasonable agreement with linear ROM estimates, but untreated fibers or non-optimized treated fibers and poor nanoparticles dispersion did not correlate as well with ROM results. This study shows that the ROM is useful to predict the mechanical behavior of unidirectional dental composites but fiber-resin interface and quality of nanoparticles dispersion play important role in ROM accurate predictions.

Keywords: bending modulus, fiber reinforced composite, fiber treatment, rule-of-mixtures

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Authors: María Reveles-Miranda, Daniella Pacheco-Catalán

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Sierra Papacal commissary is located north of Merida, Yucatan, México, where the indigenous Maya population predominates. Due to its location, the region has an elevation of fewer than 4.5 meters above sea level, with a high risk of flooding associated with storms and hurricanes and a high vulnerability of infrastructure and housing in the presence of strong gusts of wind. In environmental contingencies, the challenge is providing an autonomous electrical supply using renewable energy sources that cover vulnerable populations' health, food, and water pumping needs. To address this challenge, a hybrid energy storage module is proposed for the emergency photovoltaic (PV) system of the community shelter in Sierra Papacal, Yucatán, which combines high-energy-density batteries and high-power-density supercapacitors (SC) in a single module, providing a quick response to energy demand, reducing the thermal stress on batteries and extending their useful life. Incorporating SC in energy storage modules can provide fast response times to power variations and balanced energy extraction, ensuring a more extended period of electrical supply to vulnerable populations during contingencies. The implemented control strategy increases the module's overall performance by ensuring the optimal use of devices and balanced energy exploitation. The operation of the module with the control algorithm is validated with MATLAB/Simulink® and experimental tests.

Keywords: batteries, community shelter, environmental contingencies, hybrid energy storage, isolated photovoltaic system, supercapacitors

Procedia PDF Downloads 91

Authors: Anny Zambrano, German Gonzalez, Yair Quintero

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The continuum damage concept is used to study the interaction between hydraulic fractures and natural fractures, the objective is representing the path and relation among this two fractures types and predict its complex behavior without the need to pre-define their direction as occurs in other finite element applications, providing results more consistent with the physical behavior of the phenomenon. The approach uses finite element simulations through Abaqus software to model damage fracturing, the fracturing process by damage propagation in a rock. The modeling the phenomenon develops in two dimensional (2D) so that the fracture will be represented by a line and the crack front by a point. It considers nonlinear constitutive behavior, finite strain, time-dependent deformation, complex boundary conditions, strain hardening and softening, and strain based damage evolution in compression and tension. The complete governing equations are provided and the method is described in detail to permit readers to replicate all results. The model is compared to models that are published and available. Comparisons are focused in five interactions between natural fractures (NF) and hydraulic fractures: Fractured arrested at NF, crossing NF with or without offset, branching at intersecting NFs, branching at end of NF and NF dilation due to shear slippage. The most significant new finding is, that is not necessary to use pre-defined addresses propagation and stress condition can be evaluated as a dominant factor in the process. This is important because it can model in a more real way the generated complex hydraulic fractures, and be a valuable tool to predict potential problems and different geometries of the fracture network in the process of fracturing due to fluid injection.

Keywords: continuum damage, hydraulic fractures, natural fractures, complex fracture network, stiffness

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Authors: A. B. Chehreh, M. Grätzel, M. Klein, J. P. Bergmann, F. Walther

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Friction stir welding (FSW) is an advantageous method in the thermal joining processes, featuring the welding of various dissimilar and similar material combinations, joining temperatures below the melting point which prevents irregularities such as pores and hot cracks as well as high strengths mechanical joints near the base material. The FSW process consists of a rotating tool which is made of a shoulder and a probe. The welding process is based on a rotating tool which plunges in the workpiece under axial pressure. As a result, the material is plasticized by frictional heat which leads to a decrease in the flow stress. During the welding procedure, the material is continuously displaced by the tool, creating a firmly bonded weld seam behind the tool. However, the mechanical properties of the weld seam are affected by the design and geometry of the tool. These include in particular microstructural and surface properties which can favor crack initiation. Following investigation compares the dynamic properties of FSW weld seams with conventional and stationary shoulder geometry based on load increase test (LIT). Compared to classical Woehler tests, it is possible to determine the fatigue strength of the specimens after a short amount of time. The investigations were carried out on a robotized welding setup on 2 mm thick EN AW 5754 aluminum alloy sheets. It was shown that an increased tensile and fatigue strength can be achieved by using the stationary shoulder concept. Furthermore, it could be demonstrated that the LIT is a valid method to describe the fatigue behavior of FSW weld seams.

Keywords: aluminum alloy, fatigue performance, fracture, friction stir welding

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Authors: Shadia Al-Bahlani, Khadija Al-Bulushi, Zuweina Al-Hadidi, Buthaina Al-Dhahl, Nadia Al-Abri

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Breast cancer is the most common cancer in women worldwide. Triple-Negative Breast Cancer (TNBC) is an aggressive type of breast cancer, which is defined by the absence of Estrogen (ER), Progesterone (PR) and human epidermal growth factor (Her-2) receptors. The calpain system plays an important role in many cellular processes including apoptosis, necrosis, cell signaling and proliferation. However, the role of calpain in cisplatin (CDDP)-induced apoptosis in TNBC cells is not fully understood. Here, TNBC (MDA-MB231) cells were treated with different concentration of CDDP (0, 20 & 40 µM) and calpain activation and apoptosis were measured by western blot and Hoechst Stain respectively. In addition, calpain modulation by either activation and/or inhibition and its effect on CDDP-induced apoptosis were assessed by the same above approaches. Our findings showed that CDDP induced endoplasmic reticulum stress and thus Calcium release and subsequently activate calpain α-fodrin cleavage indicated by the increase in GRP78 and Calmodulin protein expression and respectively in MDA-MB231 cells. It also induced apoptosis as measured by Hoechst stain and caspase-12 cleavage. Calpain activation by both Cyclopiazonic acid and Thapsigargin showed similar effect and enhanced the sensitivity of these cells to CDDP treatment. On the other hand, calpain inhibition by either specific siRNA and/or exogenous inhibitor (Calpeptin) had an adverse effect where it attenuated calpain activation and thus CDDP- induced apoptosis in these cells. Altogether, these findings suggested that calpain activation play an essential role in sensitizing the TNBC cells to CDDP-induced apoptosis. This might lead to the discovery of novel treatment to over this aggressive type of breast cancer.

Keywords: calpain, cisplatin, apoptosis, breast cancer

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Authors: Henry Venter, Murali Thyloth, Alceu Casseb

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Historically, mental and substance use disorders were not a global health priority. Since the 1993 World Development Report, the importance of the contribution of mental health and substance abuse on the relative global burden associated with disease morbidity has been recognized with 300 million people worldwide suffering from depression alone. This led to an international effort to improve the mental health of populations around the world. Despite these efforts some countries remain at the top of the list of countries with the highest rate of mental illness. Important research questions were asked: Would there be commonalities regarding mental health between these countries; would there be common factors leading to the high prevalence of mental illness; and how prepared are these countries with mental health delivery? Findings from this research can aid organizations and institutions preparing mental health service providers to focus training and preparation to address specific needs revealed by the study. Methods: Researchers decided to compare three distinctly different countries at the top of the list of countries with the highest rate of mental illness, the USA, India and Brazil, situated on three different continents with different economies and lifestyles. Data were collected using archival research methodology, reviewing records and findings of international and national health and mental health studies to subtract and compare data and findings. Results: The findings indicated that India is the most depressed country in the world, followed by the USA (and China) with Brazil in Latin America with the greatest number of depressed individuals. By 2020 roughly 20% of India, acountry of over one billion citizens, will suffer from some form of mental illnees, yet there are less than 4,000 experts available. In the USA 164.8 million people were substance abusers and an estimate of 47.6 million adults, 18 or older, had any mental illness in 2018. That means that about one in five adults in the USA experiences some form of mental illness each year, but only 41% of those affected received mental health care or services in the past year. Brazil has the greatest number of depressed individuals, in Latin America. Adults living in Sao Paulo megacity has prevalence of mental disorders at greater levels than similar surveys conducted in other areas of the world with more than one million adults with serious impairment levels. Discussion: The results show that, despite the vast socioeconomic differences between the three countries, there are correlations regarding mental health prevalence and difficulty to provide adequate services including a lack of awareness of how serious mental illness is, stigma for seeking mental illness, with comorbidity a common phenomenon, and a lack of partnership between different levels of service providers, which weakens mental health service delivery. The findings also indicate that mental health training institutions have a monumental task to prepare personnel to address the future mental health needs in each of the countries compared, which will constitute the next phase of the research.

Keywords: mental health epidemiology, mental health disorder, mental health prevalence, mental health treatment

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Authors: I. C. Orabueze, A. A. Amudalat, S. A. Adesegun, A. A. Usman

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Dental and associated oral diseases are increasingly affecting a considerable portion of the population and are considered some of the major causes of tooth loss, discomfort, mouth odor and loss of confidence. This study focused on the ethnobotanical survey of medicinal plants used in oral therapy and evaluation of the antimicrobial activities of methanolic extracts of two selected plants from the survey for their efficacy against dental microorganisms. The ethnobotanical survey was carried out in six herbal markets in Lagos State, Nigeria by oral interviewing and information obtained from an old family manually complied herbal medication book. Methanolic extracts of Olax subscorpioidea (stem bark) and Bridelia ferruginea (stem bark) were assayed for their antimicrobial activities against clinical oral isolates (Aspergillus fumigatus, Candida albicans, Streptococcus spp, Staphylococcus aureus, Lactobacillus acidophilus and Pseudomonas aeruginosa). In vitro microbial technique (agar well diffusion method and minimum inhibitory concentration (MIC) assay) were employed for the assay. Chlorhexidine gluconate was used as the reference drug for comparison with the extract results. And the preliminary phytochemical screening of the constituents of the plants were done. The ethnobotanical survey produced plants (28) of diverse family. Different parts of plants (seed, fruit, leaf, root, bark) were mentioned but 60% mentioned were either the stem or the bark. O. subscorpioidea showed considerable antifungal activity with zone of inhibition ranging from 2.650 – 2.000 cm against Aspergillus fumigatus but no such encouraging inhibitory activity was observed in the other assayed organisms. B. ferruginea showed antibacterial sensitivity against Streptococcus spp, Staphylococcus aureus, Lactobacillus acidophilus and Pseudomonas aeruginosa with zone of inhibitions ranging from 3.400 - 2.500, 2.250 - 1.600, 2.700 - 1.950, 2.225 – 1.525 cm respectively. The minimum inhibitory concentration of O. subscorpioidea against Aspergillus fumigatus was 51.2 mg ml-1 while that of B. ferruginea against Streptococcus spp was 0.1mg ml-1 and for Staphylococcus aureus, Lactobacillus acidophilus and Pseudomonas aeruginosa were 25.6 mg ml-1. A phytochemical analysis reveals the presence of alkaloids, saponins, cardiac glycoside, tannins, phenols and terpenoids in both plants, with steroids only in B. ferruginea. No toxicity was observed among mice given the two methanolic extracts (1000 mg Kg-1) after 21 days. The barks of both plants exhibited antimicrobial properties against periodontal diseases causing organisms assayed, thus up-holding their folkloric use in oral disorder management. Further research could be done viewing these extracts as combination therapy, checking for possible synergistic value in toothpaste and oral rinse formulations for reducing oral bacterial flora and fungi load.

Keywords: antimicrobial activities, Bridelia ferruginea, dental disinfection, methanolic extract, Olax subscorpioidea, ethnobotanical survey

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Authors: Janaki Rama Raju Patchamatla, Emani Pavan Kumar

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The idea of increasing the existing train speeds and introduction of the high-speed trains in India as a part of Vision-2020 is really challenging from both economic viability and technical feasibility. More than economic viability, technical feasibility has to be thoroughly checked for safe operation and execution. Trains moving at high speeds need a well-established firm and safe track thoroughly tested against vibration effects. With increased speeds of trains, the track structure and layered soil-structure interaction have to be critically assessed for vibration and displacements. Physical establishment of track, testing and experimentation is a costly and time taking process. Software-based modelling and simulation give relatively reliable, cost-effective means of testing effects of critical parameters like sleeper design and density, properties of track and sub-grade, etc. The present paper reports the applicability of infinite elements in reducing the unrealistic stress-wave reflections from so-called soil-structure interface. The influence of the infinite elements is quantified in terms of the displacement time histories of adjoining soil and the deformation pattern in general. In addition, the railhead response histories at various locations show that the numerical model is realistic without any aberrations at the boundaries. The numerical model is quite promising in its ability to simulate the critical parameters of track design.

Keywords: high speed railway track, finite element method, Infinite elements, vibration analysis, soil-structure interface

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Authors: Kevin Giraldo, Juan A. Gallego, Uriel Zapata, Fanny L. Casado

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Compliant mechanisms are designed to deform in a controlled manner in response to external forces, utilizing the flexibility of their components to store potential elastic energy during deformation, gradually releasing it upon returning to its original form. This article explores the design of a knee orthosis intended to assist users during stand-up motion. The orthosis makes use of a compliant mechanism to balance the user’s weight, thereby minimizing the strain on leg muscles during standup motion. The primary function of the compliant mechanism is to store and exchange potential energy, so when coupled with the gravitational potential of the user, the total potential energy variation is minimized. The design process for the semi-rigid knee orthosis involved material selection and the development of a numerical model for the compliant mechanism seen as a spring. Geometric properties are obtained through the numerical modeling of the spring once the desired stiffness and safety factor values have been attained. Subsequently, a 3D finite element analysis was conducted. The study demonstrates a strong correlation between the maximum stress in the mathematical model (250.22 MPa) and the simulation (239.8 MPa), with a 4.16% error. Both analyses safety factors: 1.02 for the mathematical approach and 1.1 for the simulation, with a consistent 7.84% margin of error. The spring’s stiffness, calculated at 90.82 Nm/rad analytically and 85.71 Nm/rad in the simulation, exhibits a 5.62% difference. These results suggest significant potential for the proposed device in assisting patients with knee orthopedic restrictions, contributing to ongoing efforts in advancing the understanding and treatment of knee osteoarthritis.

Keywords: biomechanics, complaint mechanisms, gonarthrosis, orthoses

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Authors: Ramandeep Kaur M. Malhi, Prashant K. Srivastava, G.Sandhya Kiran

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Quantitative estimates of foliar biochemicals, namely chlorophyll content (CC), serve as key information for the assessment of plant productivity, stress, and the availability of nutrients. This also plays a critical role in predicting the dynamic response of any vegetation to altering climate conditions. The advent of hyperspectral data with an enhanced number of available wavelengths has increased the possibility of acquiring improved information on CC. Retrieval of CC is extensively carried through well known spectral indices derived from hyperspectral data. In the present study, an attempt is made to develop hyperspectral indices by identifying optimum bands for CC estimation in Butea monosperma (Lam.) Taub growing in forests of Shoolpaneshwar Wildlife Sanctuary, Narmada district, Gujarat State, India. 196 narrow bands of EO-1 Hyperion images were screened, and the best optimum wavelength from blue, green, red, and near infrared (NIR) regions were identified based on the coefficient of determination (R²) between band reflectance and laboratory estimated CC. The identified optimum wavelengths were then employed for developing 12 hyperspectral indices. These spectral index values and CC values were then correlated to investigate the relation between laboratory measured CC and spectral indices. Band 15 of blue range and Band 22 of green range, Band 40 of the red region, and Band 79 of NIR region were found to be optimum bands for estimating CC. The optimum band based combinations on hyperspectral data proved to be the most effective indices for quantifying Butea CC with NDVI and TVI identified as the best (R² > 0.7, p < 0.01). The study demonstrated the significance of band characterization in the development of the best hyperspectral indices for the chlorophyll estimation, which can aid in monitoring the vitality of forests.

Keywords: band, characterization, chlorophyll, hyperspectral, indices

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Authors: K. Shimola, M. Krishnaveni

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This paper examines vulnerability assessment of water resources in a semi-arid basin using the 4-step approach. The vulnerability assessment framework is developed to study the water resources vulnerability which includes the creation of GIS-based vulnerability maps. These maps represent the spatial variability of the vulnerability index. This paper introduces the 4-step approach to assess vulnerability that incorporates a new set of indicators. The approach is demonstrated using a framework composed of a precipitation data for (1975–2010) period, temperature data for (1965–2010) period, hydrological model outputs and the water resources GIS data base. The vulnerability assessment is a function of three components such as exposure, sensitivity and adaptive capacity. The current water resources vulnerability is assessed using GIS based spatio-temporal information. Rainfall Coefficient of Variation, monsoon onset and end date, rainy days, seasonality indices, temperature are selected for the criterion ‘exposure’. Water yield, ground water recharge, evapotranspiration (ET) are selected for the criterion ‘sensitivity’. Type of irrigation and storage structures are selected for the criterion ‘Adaptive capacity’. These indicators were mapped and integrated in GIS environment using overlay analysis. The five sub-basins, namely Arjunanadhi, Kousiganadhi, Sindapalli-Uppodai and Vallampatti Odai, fall under medium vulnerability profile, which indicates that the basin is under moderate stress of water resources. The paper also explores prioritization of sub-basinwise adaptation strategies to climate change based on the vulnerability indices.

Keywords: adaptive capacity, exposure, overlay analysis, sensitivity, vulnerability

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Authors: Recep Duzsoz, Ozlem Gormez, Umit Memis, Selma Demer, Hikmet Orhan

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Stylohyoid ligament is a connective tissue extending from apex of the styloid process to small horn of the hyoid bone. The normal length of styloid process ranges from 20 to 30 mm and measurements more than 30 mm is named stylohyoid ligament calcification (SLC). Fluorosis is a health problem that arises in individuals who intake large amounts of fluor long periods of time. The aim of this study was to investigate the effects of fluorosis on SLC. This study has been conducted on 100 patients who had SLC detected on panoramic radiograph. The study group was consisted of 50 patients with dental fluorosis and control group was consisted of 50 patients without dental fluorosis. Length and thickness of SLC were measured and the type of SLC was determined on panoramic radiographs. There was no statistically significant differences between the study and control group for SLC length, thickness and type. The thickness of left and right SLC of severe dental fluorosis group was statistically significant higher than moderate dental fluorosis group (p < 0,05). Cervicopharyngeal trauma, tonsillectomy, endocrine disease in menopause, persistent mesenchymal tissue, mechanical stress have reported as etiology of SLC in the literature and studies are still ongoing. It was reported that fluorosis as a factor on calcification of some ligaments in body (posterior longitudunal ligament, ligamentum flavum and transverse atlantal ligament) previously but relationship between fluorosis with SLC was not investigated. Our study is unique because it is the first study on SLC thickness measurements on panoramic radiographs and the relationship between fluorosis and SLC to our knowledge. According to the obtained results, it is thought that fluorosis may have an effect on SLC in thickness due to the relationship between dental fluorosis severity with SLC thickness and this study will contribute to the progress of the future studies.

Keywords: calcification, fluorosis, ligament, stylohyoid

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Authors: Gunendra Rathnawali Kumarihamy Dissanayake

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Research on parenting of both perpetrators and victims of domestic violence (DV) is growing but limited. Further, much of this research in the Asian context is limited to explorations of victim mothers' parenting capacities, not shedding much light on the parenting of the perpetrator fathers. The current qualitative study aimed to explore how both the perpetrators and victims of DV engaged in parenting in the Sri Lankan cultural context. Twenty case studies were conducted with a sample of help-seeking women aged 20 to 40 years representing working to upper-middle social class. Participants have interviewed about their own as well as their partners´ parenting behaviors. The majority of women reported that their partners were often aggressive, controlling and authoritarian, less consistent, and engaged in a variety of manipulative behaviors intending to harm the relationship between their child and them. Further, victim mothers' styles of parenting and authority as parents have been severely undermined by their partners through frequent criticism, ridicule, and insulting in front of the children. As a result, mothers experienced great difficulty specifically trying to discipline their adolescent children as the children have started to disregard the mothers' authority. Most of the children also have shown treatment similar to that of their fathers', treating the mother as a personal servant not worthy of being listened to, thereby increasing the mothers' parenting stress. The mothers were often blamed and held responsible for the problems of the children by their partners, encouraging the children to disrespect and blame the mother for their problems leading them to take the side of the father who had more power. Findings are similar to those of the western context. This study highlights the intersection between domestic violence and parenting, and specific implications and recommendations for DV service providers are offered.

Keywords: parenting, domestic violence, impact, children

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Authors: Paula Pascoal-Faria, Rúben Pereira, Elodie Pinto, Miguel Belbut, Ana Rosa, Inês Sousa, Nuno Alves

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Apple bruise damage from harvesting, handling, transporting and sorting is considered to be the major source of reduced fruit quality, resulting in loss of profits for the entire fruit industry. The three factors which can physically cause fruit bruising are vibration, compression load and impact, the latter being the most common source of bruise damage. Therefore, prediction of the level of damage, stress distribution and deformation of the fruits under external force has become a very important challenge. In this study, experimental and numerical methods were used to better understand the impact caused when an apple is dropped from different heights onto a plastic surface and a conveyor belt. Results showed that the extent of fruit damage is significantly higher for plastic surface, being dependent on the height. In order to support the development of a biomimetic electronic device for the determination of fruit damage, the mechanical properties of the apple fruit were determined using mechanical tests. Preliminary results showed different values for the Young’s modulus according to the zone of the apple tested. Along with the mechanical characterization of the apple fruit, the development of the first two prototypes is discussed and the integration of the results obtained to construct the final element model of the apple is presented. This work will help to reduce significantly the bruise damage of fruits or vegetables during the entire processing which will allow the introduction of exportation destines and consequently an increase in the economic profits in this sector.

Keywords: apple, fruit damage, impact during crop and post-crop, mechanical characterization of the apple, numerical evaluation of fruit damage, electronic device

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Authors: E. Tarantino, G. Disciglio, G. Gatta, L. Frabboni, A. Libutti, A. Tarantino

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Worldwide, about two-thirds of industrial and domestic wastewater effluent is discharged without treatment, which can cause contamination and eutrophication of the water. In particular, for Mediterranean countries, irrigation with treated wastewater would mitigate the water stress and support the agricultural sector. Changing global weather patterns will make the situation worse, due to increased susceptibility to drought, which can cause major environmental, social, and economic problems. The study was carried out in open field in an intensive agricultural area of the Apulian region in Southern Italy where freshwater resources are often scarce. As well as providing a water resource, irrigation with treated wastewater represents a significant source of nutrients for soil–plant systems. However, the use of wastewater might have further effects on soil. This study thus investigated the long-term impact of irrigation with reclaimed agro-industrial wastewater on the chemical characteristics of the soil. Two crops (processing tomato and broccoli) were cultivated in succession in Stornarella (Foggia) over four years from 2012 to 2016 using two types of irrigation water: groundwater and tertiary treated agro-industrial wastewater that had undergone an activated sludge process, sedimentation filtration, and UV radiation. Chemical analyses were performed on the irrigation waters and soil samples. The treated wastewater was characterised by high levels of several chemical parameters including TSS, EC, COD, BOD₅, Na⁺, Ca²⁺, Mg²⁺, NH₄-N, PO₄-P, K⁺, SAR and CaCO₃, as compared with the groundwater. However, despite these higher levels, the mean content of several chemical parameters in the soil did not show relevant differences between the irrigation treatments, in terms of the chemical features of the soil.

Keywords: agro-industrial wastewater, broccoli, long-term re-use, tomato

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Authors: Rasheed Amao Busari, Ahmed Ibrahim

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The engineering properties of giant palms are crucial for the reasonable design of the processing and handling systems. The research was conducted to investigate some engineering properties of giant palm seeds in relation to their oil potential. The ripe giant palm fruit was sourced from some parts of Zaria in Kaduna State and Ado Ekiti in Ekiti State, Nigeria. The mesocarps of the fruits collected were removed to obtain the nuts, while the collected nuts were dried under ambient conditions for several days. The actual moisture content of the nuts at the time of the experiment was determined using KT100S Moisture Meter, with moisture content ranged 17.9% to 19.15%. The physical properties determined are axial dimension, geometric mean diameter, arithmetic mean diameter, sphericity, true and bulk densities, porosity, angles of repose, and coefficients of friction. The nuts were measured using a vernier caliper for physical assessment of their sizes. The axial dimensions of 100 nuts were taken and the result shows that the size ranges from 7.30 to 9.32cm for major diameter, 7.2 to 8.9 cm for intermediate diameter, and 4.2 to 6.33 for minor diameter. The mechanical properties determined were compressive force, compressive stress, and deformation both at peak and break using Instron hydraulic universal tensile testing machine. The work also revealed that giant palm seed can be classified as an oil-bearing seed. The seed gave 18% using the solvent extraction method. The results obtained from the study will help in solving the problem of equipment design, handling, and further processing of the seeds.

Keywords: giant palm seeds, engineering properties, oil potential, moisture content, and giant palm fruit

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Authors: Daina Jonkus, Liga Paura, Tatjana Sjakste, Kristina Dokane

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The aim of this study was to analyse PRKAG3 and RYR1 gene and genotypes frequencies in Latvian White pigs’ breed. Genotypes of RYR1 gene two loci (rs196953058 and rs323041392) in 89 exon and PRKAG3 gene two loci (rs196958025 and rs344045190) in gene promoter were detected in 103 individuals of Latvian white pigs’ breed. Analysis of RYR1 gene loci rs196953058 shows all individuals are homozygous by T allele and all animals are with genotypes TT, its mean - in 2769 position is Phenylalanine. Analysis of RYR1 gene loci rs323041392 shows all individuals are homozygous by G allele and all animals are with genotypes GG, its mean - in 4119 positions is Asparagine. In loci rs196953058 and rs323041392, there were no gene polymorphisms. All analysed individuals by two loci rs196953058-rs323041392 have TT-GG genotypes or Phe-Asp amino acids. In PRKAG3 gene loci rs196958025 and rs344045190 there was gene polymorphisms. In both loci frequencies for A allele was higher: 84.6% for rs196958025 and 73.0% for rs344045190. Analysis of PRKAG3 gene loci rs196958025 shows 74% of individuals are homozygous by An allele and animals are with genotypes AA. Only 4% of individuals are homozygous by G allele and animals are with genotypes GG, which is associated with pale meat colour and higher drip loss. Analysis of PRKAG3 gene loci rs344045190 shows 46% of individuals are homozygous with genotypes AA and 54% of individuals are heterozygous with genotypes AG. There are no individuals with GG genotypes. According to the results, in Latvian white pigs population there are no rs344435545 (RYR1 gene) CT heterozygous or TT recessive homozygous genotypes, which is related to the meat quality and pigs’ stress syndrome; and there are 4% rs196958025 (PRKAG3 gene) GG recessive homozygote genotypes, which is related to the meat quality. Acknowledgment: the investigation is supported by VPP 2014-2017 AgroBioRes Project No. 3 LIVESTOCK.

Keywords: genotype frequencies, pig, PRKAG3, RYR1

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Authors: Muna Khethier Abbass, Khairia Salman Hussan, Huda Mohummed AbdudAlaziz

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This work aims to study the effect of shot peening on the mechanical properties of welded joints which performed by two different welding processes: Tungsten inert gas (TIG) welding and friction stir welding (FSW) processes of aluminum alloy 6061 T6. Arc welding process (TIG) was carried out on the sheet with dimensions of (100x50x6 mm) to obtain many welded joints with using electrode type ER4043 (AlSi5) as a filler metal and argon as shielding gas. While the friction stir welding process was carried out using CNC milling machine with a tool of rotational speed (1000 rpm) and welding speed of (20 mm/min) to obtain the same butt welded joints. The welded pieces were tested by X-ray radiography to detect the internal defects and faulty welded pieces were excluded. Tensile test specimens were prepared from welded joints and base alloy in the dimensions according to ASTM17500 and then subjected to shot peening process using steel ball of diameter 0.9 mm and for 15 min. All specimens were subjected to Vickers hardness test and micro structure examination to study the effect of welding process (TIG and FSW) on the micro structure of the weld zones. Results showed that a general decay of mechanical properties of TIG and FSW welded joints comparing with base alloy while the FSW welded joint gives better mechanical properties than that of TIG welded joint. This is due to the micro structure changes during the welding process. It has been found that the surface hardening by shot peening improved the mechanical properties of both welded joints, this is due to the compressive residual stress generation in the weld zones which was measured using X-Ray diffraction (XRD) inspection.

Keywords: friction stir welding, TIG welding, mechanical properties, shot peening

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Authors: Ehsan Alishahi, Chuang Deng

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Commercial applications of bulk metallic glasses (BMGs) were restricted due to the sudden brittle failure mode which was the main drawback in these new class of materials. Therefore, crystalline-amorphous (C-A) composites were introduced as a toughening strategy in BMGs. In spite of numerous researches in the area of metallic C-A composites, the fundamental structure-property relation in these composites that are not exactly known yet. In this study, it is aimed to investigate the fundamental properties of crystalline-amorphous interface in a model system of Cu/CuZr by using molecular dynamics simulations. Several parameters including interface energy and mechanical properties were investigated by means of atomic models and employing Embedded Atom Method (EAM) potential function. It is found that the crystalline-amorphous interfacial energy weakly depends on the orientation of the crystalline layer, which is in stark contrast to that in a regular crystalline grain boundary. Additionally, the results showed that the interface controls the yielding of the crystalline-amorphous composites during uniaxial tension either by serving as sources for dislocation nucleation in the crystalline layer or triggering local shear transformation zones in amorphous layer. The critical resolved shear stress required to nucleate the first dislocation is also found to strongly depend on the crystalline orientation. Furthermore, it is found that the interaction between dislocations and shear localization at the crystalline-amorphous interface oriented in different directions can lead to a change in the deformation mode. For instance, while the dislocation and shear banding are aligned to each other in {0 0 1} interface plane, the misorientation angle between these failure mechanisms causing more homogeneous deformation in {1 1 0} and {1 1 1} crystalline-amorphous interfaces. These results should help clarify the failure mechanism of crystalline-amorphous composites under various loading conditions.

Keywords: crystalline-amorphous, composites, orientation, plasticity

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Authors: Mark Linden, Michael Brown, Lynne Marsh, Maria Truesdale, Stuart Todd, Nathan Hughes, Trisha Forbes, Rachel Leonard

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Background: The COVID-19 pandemic exacerbated the already significant strain placed on family carers of people with profound and multiple intellectual disabilities (PMID), given the withdrawal of many services during lockdown. The aim of this study was to explore the experiences of family carers of people with PMID during the COVID-19 pandemic. Methods: Online focus groups were conducted with family carers (n=126) from across the UK and the Republic of Ireland. Participants were asked about their experiences of the COVID-19 pandemic, coping strategies, and challenges faced. Focus groups were audio recorded, transcribed verbatim and analyzed through thematic analysis. Findings: Three themes emerged from our analysis of the data: (i) COVID-19 as a double-edged sword, (ii) The struggle for support (iii) the Constant nature of caring. These included 11 subthemes: (i) ‘COVID-19 as a catalyst for change’, ‘Challenges during COVID-19: dealing with change’, ‘Challenges during COVID-19: fear of COVID-19’, ‘The online environment: the new normal’ (ii) ‘Invisibility of male carers’, ‘Carers supporting carers’, ‘The only service you get is lip service: non-existent services’, ‘Knowing your rights’ (iii) ‘Emotional response to the caring role: Feeling devalued’, ‘Emotional response to the caring role: Desperation of caring’, ‘Multiple demands of the caring role.’ Conclusions: Poor or inconsistent access to services and support has been an ongoing difficulty for many family carers. The COVID-19 pandemic has only further intensified these difficulties, increasing family carers' stress. There is an urgent need to design services, such as online support programs, in partnership with family carers that adequately address their needs.

Keywords: intellectual disabilities, family carer, COVID-19, disability

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Authors: Georgi Y. Georgiev, Matthew Brouillet

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This research applies the power of agent-based modeling to a pivotal question at the intersection of biology, computer science, physics, and complex systems theory about the self-organization processes in open, complex, non-equilibrium thermodynamic systems. Central to this investigation is the principle of Maximum Entropy Production (MEP). This principle suggests that such systems evolve toward states that optimize entropy production, leading to the formation of structured environments. It is hypothesized that guided by the least action principle, open thermodynamic systems identify and follow the shortest paths to transmit energy and matter, resulting in maximal entropy production, internal structure formation, and a decrease in internal entropy. Concurrently, it is predicted that there will be an increase in system information as more information is required to describe the developing structure. To test this, an agent-based model is developed simulating an ant colony's formation of a path between a food source and its nest. Utilizing the Netlogo software for modeling and Python for data analysis and visualization, self-organization is quantified by calculating the decrease in system entropy based on the potential states and distribution of the ants within the simulated environment. External entropy production is also evaluated for information increase and efficiency improvements in the system's action. Simulations demonstrated that the system begins at maximal entropy, which decreases as the ants form paths over time. A range of system behaviors contingent upon the number of ants are observed. Notably, no path formation occurred with fewer than five ants, whereas clear paths were established by 200 ants, and saturation of path formation and entropy state was reached at populations exceeding 1000 ants. This analytical approach identified the inflection point marking the transition from disorder to order and computed the slope at this point. Combined with extrapolation to the final path entropy, these parameters yield important insights into the eventual entropy state of the system and the timeframe for its establishment, enabling the estimation of the self-organization rate. This study provides a novel perspective on the exploration of self-organization in thermodynamic systems, establishing a correlation between internal entropy decrease rate and external entropy production rate. Moreover, it presents a flexible framework for assessing the impact of external factors like changes in world size, path obstacles, and friction. Overall, this research offers a robust, replicable model for studying self-organization processes in any open thermodynamic system. As such, it provides a foundation for further in-depth exploration of the complex behaviors of these systems and contributes to the development of more efficient self-organizing systems across various scientific fields.

Keywords: complexity, self-organization, agent based modelling, efficiency

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Authors: Melissa K. Hord, Stephen P. Whiteside

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With lifetime prevalence rates ranging from 6% to 15%, anxiety disorders are among the most common childhood mental health diagnoses. Anxiety disorders diagnosed in childhood generally show an unremitting course, lead to additional psychopathology and interfere with social, emotional, and academic development. Effective evidence-based treatments include cognitive-behavioral therapy (CBT) and selective serotonin reuptake inhibitors (SSRI’s). However, if anxious children receive any treatment, it is usually through primary care, typically consists of medication, and very rarely includes evidence-based psychotherapy. Despite the high prevalence of anxiety disorders, there have only been two independent research labs that have investigated long-term results for CBT treatment for all childhood anxiety disorders and two for specific anxiety disorders. Generally, the studies indicate that the majority of youth maintain gains up to 7.4 years after treatment. These studies have not been replicated. In addition, little is known about the additional mental health care received by these patients in the intervening years after anxiety treatment, which seems likely to influence maintenance of gains for anxiety symptoms as well as the development of additional psychopathology during the subsequent years. The original sample consisted of 335 children ages 7 to 17 years (mean 13.09, 53% female) diagnosed with an anxiety disorder in 2010. Medical record review included provider billing records for mental health appointments during the five years after anxiety treatment. The subsample for this study was classified into three groups: 64 children who received CBT in an anxiety disorders clinic, 56 who received treatment from a psychiatrist, and 10 who were seen in a primary care setting. Chi-square analyses resulted in significant differences in mental health care utilization across the five years after treatment. Youth receiving treatment in primary care averaged less than one appointment each year and the appointments continued at the same rate across time. Children treated by a psychiatrist averaged approximately 3 appointments in the first two years and 2 in the subsequent three years. Importantly, youth treated in the anxiety clinic demonstrated a gradual decrease in mental health appointments across time. The nuanced differences will be presented in greater detail. The results of the current study have important implications for developing dissemination materials to help guide parents when they are selecting treatment for their children. By including all mental health appointments, this study recognizes that anxiety is often comorbid with additional diagnoses and that receiving evidence-based treatment may have long-term benefits that are associated with improvements in broader mental health. One important caveat might be that the acuity of mental health influenced the level of care sought by patients included in this study; however, taking this possibility into account, it seems those seeking care in a primary care setting continued to require similar care at the end of the study, indicating little improvement in symptoms was experienced.

Keywords: anxiety, children, mental health, outcomes

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Authors: Mina Ganji Morad, Maziar Azadisoleimanieh, Sina Ganji Morad

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A green roof is formed by green plants alive and has many positive impacts in the regional climatic, as well as indoor. Green roof system to prevent solar radiation plays a role in the cooling space. The cooling is done by reducing thermal fluctuations on the exterior of the roof and by increasing the roof heat capacity which cause to keep the space under the roof cool in the summer and heating rate increases during the winter. A roof garden is one of the recommended ways to reduce energy consumption in large cities. Despite the scale of the city green roofs have effective functions, such as beautiful view of city and decontaminating the urban landscape and reduce mental stress, and in an exchange of energy and heat from outside to inside spaces. This article is based on a review of 20 articles and 10 books and valid survey results on the positive effects of green roofs to prevent energy waste in the building. According to these publications, three of the conventional roof, green roof typical and green roof with certain administrative details (layers of glass) and the use of resistant plants and shrubs have been analyzed and compared their heat transfer. The results of these studies showed that one of the best green roof systems for mountainous climate is tree and shrub system that in addition to being resistant to climate change in mountainous regions, will benefit from the other advantages of green roof. Due to the severity of climate change in mountainous areas it is essential to prevent the waste of buildings heating and cooling energy. Proper climate design can greatly help to reduce energy.

Keywords: green roof, heat transfer, reducing energy consumption, mountainous areas, sustainable architecture

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Authors: Paula I. Buonfiglio, Carlos David Bruque, Lucia Salatino, Vanesa Lotersztein, Sebastián Menazzi, Paola Plazas, Ana Belén Elgoyhen, Viviana Dalamón

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Hearing loss (HL) is the most prevalent sensorineural disorder affecting about 10% of the global population, with more than half due to genetic causes. About 1 in 500-1000 newborns present congenital HL. Most of the patients are non-syndromic with an autosomal recessive mode of inheritance. To date, more than 100 genes are related to HL. Therefore, the Whole-exome sequencing (WES) technique has become a cost-effective alternative approach for molecular diagnosis. Nevertheless, new challenges arise from the detection of novel variants, in particular missense changes, which can lead to a spectrum of genotype-to-phenotype correlations, which is not always straightforward. In this work, we aimed to identify the genetic causes of HL in isolated and familial cases by designing a multistep approach to analyze target genes related to hearing impairment. Moreover, we performed in silico and in vivo analyses in order to further study the effect of some of the novel variants identified in the hair cell function using the zebrafish model. A total of 650 patients were studied by Sanger Sequencing and Gap-PCR in GJB2 and GJB6 genes, respectively, diagnosing 15.5% of sporadic cases and 36% of familial ones. Overall, 50 different sequence variants were detected. Fifty of the undiagnosed patients with moderate HL were tested for deletions in STRC gene by Multiplex ligation-dependent probe amplification technique (MLPA), leading to 6% of diagnosis. After this initial screening, 50 families were selected to be analyzed by WES, achieving diagnosis in 44% of them. Half of the identified variants were novel. A missense variant in MYO6 gene detected in a family with postlingual HL was selected to be further analyzed. A protein modeling with AlphaFold2 software was performed, proving its pathogenic effect. In order to functionally validate this novel variant, a knockdown phenotype rescue assay in zebrafish was carried out. Injection of wild-type MYO6 mRNA in embryos rescued the phenotype, whereas using the mutant MYO6 mRNA (carrying c.2782C>A variant) had no effect. These results strongly suggest the deleterious effect of this variant on the mobility of stereocilia in zebrafish neuromasts, and hence on the auditory system. In the present work, we demonstrated that our algorithm is suitable for the sequential multigenic approach to HL in our cohort. These results highlight the importance of a combined strategy in order to identify candidate variants as well as the in silico and in vivo studies to analyze and prove their pathogenicity and accomplish a better understanding of the mechanisms underlying the physiopathology of the hearing impairment.

Keywords: diagnosis, genetics, hearing loss, in silico analysis, in vivo analysis, WES, zebrafish

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Authors: Bill D. Geis

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Suicide wrongful death forensic cases are the fastest rising tort in mental health law. It is estimated that suicide-related cases have accounted for 15% of U.S. malpractice claims since 2006. Most suicide-related personal injury claims fall into the legal category of “wrongful death.” Though mental health experts may be called on to address a range of forensic questions in wrongful death cases, the central consultation that most experts provide is about the negligence element—specifically, the issue of whether the clinician met the clinical standard of care in assessing, treating, and managing the deceased person’s mental health care. Standards of care, varying from U.S. state to state, are broad and address what a reasonable clinician might do in a similar circumstance. This fact leaves the issue of the suicide standard of care, in each case, up to forensic experts to put forth a reasoned estimate of what the standard of care should have been in the specific case under litigation. Because the general state guidelines for standard of care are broad, forensic experts are readily retained to provide scientific and clinical opinions about whether or not a clinician met the standard of care in their suicide assessment, treatment, and management of the case. In the past and in much of current practice, the assessment of suicide has centered on the elicitation of verbalized suicide ideation. Research in recent years, however, has indicated that the majority of persons who end their lives do not say they are suicidal at their last medical or psychiatric contact. Near-term risk assessment—that goes beyond verbalized suicide ideation—is needed. Our previous research employed structural equation modeling to predict lethal suicide risk--eight negative thought patterns (feeling like a burden on others, hopelessness, self-hatred, etc.) mediated by nine transdiagnostic clinical factors (mental torment, insomnia, substance abuse, PTSD intrusions, etc.) were combined to predict acute lethal suicide risk. This structural equation model, the Lethal Suicide Risk Pattern (LSRP), Acute model, had excellent goodness-of-fit [χ2(df) = 94.25(47)***, CFI = .98, RMSEA = .05, .90CI = .03-.06, p(RMSEA = .05) = .63. AIC = 340.25, ***p < .001.]. A further SEQ analysis was completed for this paper, adding a measure of Acute Suicide Ideation to the previous SEQ. Acceptable prediction model fit was no longer achieved [χ2(df) = 3.571, CFI > .953, RMSEA = .075, .90% CI = .065-.085, AIC = 529.550].This finding suggests that, in this additional study, immediate verbalized suicide ideation information was unhelpful in the assessment of lethal risk. The LSRP and other dynamic, near-term risk models (such as the Acute Suicide Affective Disorder Model and the Suicide Crisis Syndrome Model)—going beyond elicited suicide ideation—need to be incorporated into current clinical suicide assessment training. Without this training, the standard of care for suicide assessment is out of sync with current research—an emerging dilemma for the forensic evaluation of suicide wrongful death cases.

Keywords: forensic evaluation, standard of care, suicide, suicide assessment, wrongful death

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