Search results for: diagnosis and treatment

Authors: Rafael Ricieri, Rogerio Barros

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Objective: This study is to report a case of massive necrotizing enterocolitis in a six-month-old patient, requiring ileostomy and protective jejunostomy as a damage control measure in the first exploratory laparotomy surgery in massive enterocolitis without a previous diagnosis. Methods: This study is a case report of success in making and closing a protective jejunostomy. However, the low number of publications on this staged and risky measure of surgical resolution encouraged the team to study the indication and especially the correct time for closing the patient's protective jejunostomy. The main study instrument will be the six-month-old patient's medical record. Results: Based on the observation of the case described, it was observed that the time for the closure of the described procedure (protective jejunostomy) varies according to the level of compromise of the health status of your patient and of an individual of each person. Early closure, or failure to close, can lead to a favorable problem for the patient since several problems can result from this closure, such as new intestinal perforations, hydroelectrolyte disturbances. Despite the risk of new perforations, we suggest closing the protective jejunostomy around the 14th day of the procedure, thus keeping the patient on broad-spectrum antibiotic therapy and absolute fasting, thus reducing the chances of new intestinal perforations. Associated with the closure of the jejunostomy, a gastric tube for decompression is necessary, and care in an intensive care unit and electrolyte replacement is necessary to maintain the stability of the case.

Keywords: jejunostomy, ileostomy, enterocolitis, pediatric surgery, gastric surgery

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Authors: Oren Shtayermman

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The current investigation expended on research among parents caring for a child who is diagnosed with an autism spectrum disorder (ASD). An online web survey was used to collect data from 253 parents caring for a child with a diagnosis of ASD. Both parents reported on elevated levels of parental stress associated with caring for the child on the spectrum. In addition, lower levels of marital satisfaction were found in both parents. About 13% of the parents in the sample met the diagnostic criteria for Major Depressive Disorder and About 15% of the parents met the diagnostic criteria for Generalized Anxiety Disorder. Although the majority of the sample was females (94%) significant differences were found between males and females in relation to meeting the diagnostic criteria for Major Depressive Disorder and for Generalized Anxiety Disorder. Higher levels of stress were associated with higher number of Generalized Anxiety Disorder symptoms and higher number of Major Depressive Disorder symptoms. Findings from this study indicate how vulnerable parents and especially females are in relation to caring to a child diagnosed with ASD. Educational Objectives: At the conclusion of the paper, the readers should be able to: -Identify levels of stress and marital satisfaction among parents caring for a child diagnosed with autism spectrum disorder, -Recognize the impact of stress on the development of mental health issues, -Name the two most common mood and anxiety related disorders associated with caring for a child diagnosed with an autism spectrum disorder.

Keywords: autism, stress, parents, children

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Authors: Mile Vuković, Lana Jerkić Rajić

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Introduction: Broca's aphasia is a non-fluent type of aphasic syndrome, which is primarily manifested by impairment of language production. In connected speech, patients with this type of aphasia produce short sentences in which they often omit function words and morphemes or choose inadequate forms. Aim: This research was conducted to examine the morphosyntactic abilities of people with Broca's aphasia, comparing them with neurologically healthy subjects without a language disorder. Method: The sample included 15 patients with Broca's post-stroke aphasia, who had the relatively intact ability of auditory comprehension. The diagnosis of aphasia was based on the Boston Diagnostic Aphasia Examination. The control group comprised 16 neurologically healthy subjects without data on the presence of disorders in speech and language development. The patients' mother tongue was Serbian. The new Serbian Morphosyntactic Abilities Test (SMAT) was used. Descriptive (frequency, percentage, mean, SD, min, max) and inferential (Mann-Whitney U-test) statistics were used in data processing. Results: We noticed statistically significant differences between people with Broca's aphasia and neurotypical subjects on the SMAT (U = 1.500, z = -4.982, p = 0.000). The results showed that people with Broca's aphasia had achieved low scores on the SMAT, regardless of age (ρ = -0.045, p = 0.873) and time post onset (ρ = 0.330, p = 0.229). Conclusion: Preliminary results show that the SMAT has the potential to detect morphosyntactic deficits in Serbian speakers with Broca's aphasia.

Keywords: Broca’s aphasia, morphosyntactic abilities, agrammatism, Serbian language

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Authors: Tamrat Girma Biru

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Multidrug-resistant tuberculosis (MDR-TB) is defined as resistant to at least Refampicin and Isoniazed: the most two power full TB drugs. It is a leading cause of high rates of morbidity and mortality, and increasing psychosocial challenges to patients, especially when co-infected with Human Immunodeficiency Virus (HIV). Ethiopia faces the highest rates of MDR-TB infection in the world. Objectives: The main objective of this study was to identify the psychosocial challenges of MDR-TB patients, to investigate the extent of the psychosocial challenges on (self-esteem, depression, and stigma) that MDR-TB patients encounter, to examine whether there is a sex difference in experiencing psychosocial challenges and assess the counseling needs of MDR-TB patients. Methodology: A cross-sectional study was conducted at St. Peter TB Specialized Hospital, Addis Ababa on 40 patients (25 males and 15 females) who are hospitalized for treatment. The patients were identified by using purposive sampling and made fill a questionnaire measuring their level of self-esteem, depression and stigma. Besides, data were collected from 16 participants, 28 care providers and 8 guardians, using semi-structured interview. The obtained data were analyzed using SPSS statistical program, descriptive statistics, independent t-test, and qualitative description. Results and Discussion: The results of the study showed that the majority (80%) of the respondents had suffered psychological challenges and social discriminations. Thus, the significance of MDR-TB and its association with HIV/AIDS problems is considered. Besides the psychosocial challenges, various aggravating factors such as length of treatment, drug burden and insecurity in economy together highly challenges the life of patients. In addition, 60% of participants showed low level of self-esteem. The patients also reported that they experienced high self-stigma and stigma by other members of the society. The majority of the participants (75%) showed moderate and severe level of depression. In terms of sex there is no difference between the mean scores of males and females in the level of depression and stigmatization by others and by themselves. But females showed lower level of self-esteem than males. The analysis of the t-test also shows that there were no statistically significant sex difference on the level of depression and stigma. Based on the qualitative data MDR-TB patients face various challenges in their life sphere such as: Psychological (depression, low self value, lowliness, anxiety), social (stigma, isolation from social relations, self-stigmatization,) and medical (drug side effect, drug toxicity, drug burden, treatment length, hospital stays). Recommendations: Based on the findings of this study possible recommendations were forwarded: develop and extend MDR-TB disease awareness creation through by media (printing and electronic), school net TB clubs, and door to door community education. Strengthen psychological wellbeing and social relationship of MDR-TB patients using proper and consistent psychosocial support and counseling. Responsible bodies like Ministry of Health (MOH) and its stakeholders and Non Governmental Organizations (NGOs) need to assess the challenges of patients and take measures on this pressing issue.

Keywords: psychosocial challenges, counseling, multi-drug resistant tuberculosis (MDR-TB), tuberculosis therapy

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Authors: Itamir de Morais Barroca Filho, Cephas A. S. Barreto, Ramon Malaquias, Cezar Miranda Paula de Souza, Arthur Costa Gorgônio, João C. Xavier-Júnior, Mateus Firmino, Fellipe Matheus Costa Barbosa

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Information and Communication Technologies (ICT) in healthcare are crucial for efficiently delivering medical healthcare services to patients. These ICTs are also known as e-health and comprise technologies such as electronic record systems, telemedicine systems, and personalized devices for diagnosis. The focus of e-health is to improve the quality of health information, strengthen national health systems, and ensure accessible, high-quality health care for all. All the data gathered by these technologies make it possible to help clinical staff with automated decisions using machine learning. In this context, we collected patient data, such as heart rate, oxygen saturation (SpO2), blood pressure, respiration, and others. With this data, we were able to develop machine learning models for patients’ risk of death and estimate the length of stay in ICU beds. Thus, this paper presents the methodology for applying machine learning techniques to develop these models. As a result, although we implemented these models on an IoT healthcare platform, helping clinical staff in healthcare in an ICU, it is essential to create a robust clinical validation process and monitoring of the proposed models.

Keywords: ICT, e-health, machine learning, ICU, healthcare

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Authors: Branimir Skoric

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Over the past two decades, number of international travels rose significantly in the United Kingdom and Worldwide in the shape of business travels and holiday travels as well. The fact that elderly people travel a lot, more than ever before increased the needs for medical evacuations (repatriations) back home if they fell ill abroad or had any kind of accident. This paper concerns medical evacuations of patients on the way back home to the United Kingdom (United Kingdom Residents) and their specific medical needs during short-haul or long-haul commercial scheduled flight and ground transportation to the final destination regardless whether it was hospital or usual place of residence. Particular medical need during medical evacuations is oxygen supply and it can be supplied via portable oxygen concentrator, pulse flow oxygenator or continuous free flow oxygenator depending on the main diagnosis and patient’s comorbidities. In this retrospective study, patients were divided into two groups. One group was consisted of patients suffering from cardio-respiratory diagnoses as primary illness. Another Group consisted of patients suffering from noncardiac illnesses who have other problems including any kind of physical injury. Needs for oxygen and type of supply were carefully considered in regards of duration of the flight, standard airline cabin pressure and results described in this retrospective study.

Keywords: commercial flight, elderly travellers, medical evacuations, oxygen

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Authors: Kina Kim

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Background: There are two types of interferon-gamma release assays (IGRAs) in use for the detection of latent tuberculosis infection (LTBI), QuantiFERON-TB Gold In-tube (QFT-GIT) and T-SPOT.TB. There are some reports that IGRA results are affected by the patient's age. This study aims to compare the results of both IGRA tests according to age groups. Methods: We reviewed 54,882 samples referred to an independent reference laboratory (Seegene Medical Foundation, Seoul, Korea) for the diagnosis of LTBI from January 1, 2021, to December 31, 2021. This retrospective study enrolled 955 patients tested using QFT-GIT and 53,927 patients tested using T-SPOT.TB. The results of both IGRAs were divided in three age groups (0-9, 10-17, and ≥18-year old). The positive rates and the indeterminate rates between QFT-GIT and T-SPOT.TB were compared. We also evaluated the differences in positive and indeterminate rates by age-group. Results: The positive rate of QFT-GIT was 20.1% (192/955) and that of T-SPOT.TB was 8.7% (4704/53927) in overall patients. The positive rates of QFT-GIT in individuals aged 0-9, 10-17, and over 18-year old were 15.4%, 13.3%, and 22.0%, respectively. The positive rates of T-SPOT.TB were 8.9%, 2.0% and 8.8%,in each agegroup, respectively.The overall prevalence of indeterminate results was 2.1% (20/955) of QFT-GIT and 0.5% (270/53927) of T-SPOT.TB. The indeterminate rates of QFT-GIT in individuals aged 0-9, 10-17, and over 18 years were 0.4%, 6.7%, and 2.6%, respectively. The indeterminate rate of T-SPOT.TB were 0.5%, 0.7% and 0.5%,in each age group, respectively. Conclusion: Our findings suggest that T-SPOT.TB has a lower rate of positive results in overall patients and a lower rate of indeterminate results than those of QFT-GIT. The highest positive rate was found in the over 18 years group for QFT-GIT, but the positive rates of T-SPOT.TB was not significantly different among groups by age. QFT-GIT showed variable and higher indeterminate rates according to age group, but T-SPOT.TB showed lower rates in all age groups(<1%).

Keywords: LTBI, IGRA, QFT-GIT, T-SPOT. TB

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Authors: Mariana Floria, Elena-Diana Năfureanu, Diana-Mihaela Gălăţanu, Anca-Ecaterina Grumeza, Cristina Gorea-Bocîncă, Diana-Elena Iov, Aurelian-Corneliu Moraru, Dragoș-Marian Popescu

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SARS-CoV-2 is the most deadly and devastating virus of the last one hundred years, being more highly contagious than EBOLA, HIV, Swine Influenza, Severe Acute Respiratory Syndrome, or Middle Eastern Respiratory Syndrome. After two years of pandemic, planning and budgeting for use of healthcare resources and services is very important. The aim of this study was to analyze the costs for hospital stay in patients with predominantly moderate forms of COVID-19 in a support military hospital located in Nord-East of Romania. Inpatient COVID-19 hospitalizations costs, regardless of ICD-10 procedure codes (DRG payment), in a Covid-19 support military hospital were analyzed. From August 2020 through June 2021, 241 patientswere hospitalized. Our national protocol for the treatment of Covid-19 infection was applied. The main COVID-19 manifestations were: 69% respiratory (18% with severe pneumonia, 2.9% with pulmonary embolism, diagnosed by angio-computed tomography), 3.3% cardiac, 28% digestive, and 33% psychiatric (most common anxiety) manifestations. According to COVID-19 severity, most of the patients had moderate (104 patients – 43%) and severe (50 patients - 21%) forms. Seven patients with severe form died because of multiple comorbidities, and 30 patients were transferred in hospitals with COVID-19 intensive care units.Only two patients have had procalcitonin>10 ng/mL (high probability of severe sepsis or septic shock), and 1 patient had moderate risk for septic shock (0.5 - 2 ng/mL). The average estimated costs were about 3000€/patient, without significantly differences depending on disease severity. Equipment costs were 2 times higher than for drugs and 4 times than for laboratory tests. In a Covid-19 support military hospital that took care for predominantly moderate forms of COVID-19, the costs for equipment were much higher than that for treatment. Therefore, new criteria for hospitalization of these forms of COVID-19 deserve to be analyzed to avoid useless costs.

Keywords: Covid-19, costs, hospital stay, military hospital

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

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

Keywords: Acanthaster plancii, atherosclerosis, luciferase assay, PCSK9

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Authors: Muhtasim Shafi Kader, Fizar Ahmed, Annesha Acharjee

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Machine learning and data mining are crucial in health care, as well as medical information and detection. Machine learning approaches are now being utilized to improve awareness of a variety of critical health issues, including diabetes detection, neuron cell tumor diagnosis, COVID 19 identification, and so on. Parkinson’s disease is basically a disease for our senior citizens in Bangladesh. Parkinson's Disease indications often seem progressive and get worst with time. People got affected trouble walking and communicating with the condition advances. Patients can also have psychological and social vagaries, nap problems, hopelessness, reminiscence loss, and weariness. Parkinson's disease can happen in both men and women. Though men are affected by the illness at a proportion that is around partial of them are women. In this research, we have to get out the accurate ML algorithm to find out the disease with a predictable dataset and the model of the following machine learning classifiers. Therefore, nine ML classifiers are secondhand to portion study to use machine learning approaches like as follows, Naive Bayes, Adaptive Boosting, Bagging Classifier, Decision Tree Classifier, Random Forest classifier, XBG Classifier, K Nearest Neighbor Classifier, Support Vector Machine Classifier, and Gradient Boosting Classifier are used.

Keywords: naive bayes, adaptive boosting, bagging classifier, decision tree classifier, random forest classifier, XBG classifier, k nearest neighbor classifier, support vector classifier, gradient boosting classifier

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Authors: Nazmul Haque, Syeda Tasnuva Maria

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Sheehan's Syndrome (SS), also known as postpartum hypopituitarism, is a rare but potentially serious condition resulting from ischemic necrosis of the pituitary gland, often occurring during or after childbirth. This syndrome is characterized by hypopituitarism, leading to deficiencies in various hormones produced by the pituitary gland. The primary cause is typically severe postpartum hemorrhage, leading to inadequate blood supply and subsequent necrosis of the pituitary tissue. This chronic hypopituitarism sometimes plays the role of premature atherosclerosis, which may lead to cardiovascular disease. This abstract provides a comprehensive overview of Sheehan's Syndrome with ischaemic heart disease, encompassing its pathophysiology, clinical manifestations, and current management strategies. The disorder presents a wide spectrum of symptoms, including chest pain, fatigue, amenorrhea, lactation failure, hypothyroidism, and adrenal insufficiency. Timely diagnosis is crucial, as delayed recognition can lead to complications and long-term health consequences. We herein report a patient complaining of chronic fatigue symptoms, aggressiveness, chest pain, and breathlessness with repeated LOC that were diagnosed with SS with IHD. The patient was treated with antiplatelet, antianginal, steroids, and hormone replacement with marked improvement in his overall condition.

Keywords: ischaemic heart disease, Sheehan's syndrome, post-partum haemorrhage, pituitary gland

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Authors: Sara Alzahrani, Samia Bokari, Patan Khan, Muneera Alshareef, Rania Safwat, Mohammed Galal, Hamdi Alqadi, Ameerah Alzahrani, Rehab Alboraie

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Introduction & Background: Diabetes in COVID-19 patients is individual risk factor and documented in worldwide studies to contribute to disease severity, increased length of stay and higher mortality. Aggressive management of blood sugars and acute diabetic complications reduce the length of stay and mortality. Methods: Randomly selected 200 patients admitted with diabetes and COVID-19 studied. The unified treatment protocol applied for all patients and blood sugars monitored closely and optimized .Data collected on bimonthly basis and analyzed. Patients’ characteristics taken from data extraction tool (Oasis) of hospital. Median values for length of stay and post discharge FBS and RBS were calculated via Microsoft Excel tool. Mortality rates were calculated by percentages. The results monitored in the post discharge clinic was 130 mg/dl and 170 mg/dl respectively. The results compared with the standard international studies. Discussion: Diabetes in COVID-19 patients posed great challenge as increased severity and mortalities reported compared to non-diabetic. Taking a pre-emptive strategy to combat this problem by aggressively manage diabetes help in reducing length of stay and morbidity. The length of stay in studded population was 3 days as compared to 13 days in a major international study. Financial saving come from rapid turnover of beds. The mortality was 2.5 % compared to reported 7.3% in a major study, reflecting the implications of aggressive management of diabetes. Regular follow-up and support by running post-discharge clinic definitely help reducing readmissions and acute complications of uncontrolled diabetes. Conclusion: Aggressive management of diabetes in COVID-19 patients by tailored treatment protocols and dedicated teams will help to decrease the morbidity and mortality.

Keywords: diabetes, covid-19, management, mortality

Procedia PDF Downloads 159

Authors: Kelsi Hagerty, Ami Rosen, Aaliyah Heyward, Nadia Ali, Emily Brown, Erin Demo, Yue Guan, Modele Ogunniyi, Brianna McDaniels, Alanna Morris, Kunal Bhatt

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Hereditary transthyretin amyloidosis (hATTR) is a progressive, multi-systemic, and life-threatening disease caused by a disruption in the TTR protein that delivers thyroxine and retinol to the liver. This disruption causes the protein to misfold into amyloid fibrils, leading to the accumulation of the amyloid fibrils in the heart, nerves, and GI tract. Over 130 variants in the TTR gene are known to cause hATTR. The Val122Ile variant is the most common in the United States and is seen almost exclusively in people of African descent. TTR variants are inherited in an autosomal dominant fashion and have incomplete penetrance and variable expressivity. Individuals with hATTR may exhibit symptoms from as early as 30 years to as late as 80 years of age. hATTR is characterized by a wide range of clinical symptoms such as cardiomyopathy, neuropathy, carpal tunnel syndrome, and GI complications. Without treatment, hATTR leads to progressive disease and can ultimately lead to heart failure. hATTR disproportionately affects individuals of African descent; the estimated prevalence of hATTR among Black individuals in the US is 3.4%. Unfortunately, hATTR is often underdiagnosed and misdiagnosed because many symptoms of the disease overlap with other cardiac conditions. Due to the progressive nature of the disease, multi-systemic manifestations that can lead to a shortened lifespan, and the availability of free genetic testing and promising FDA-approved therapies that enhance treatability, early identification of individuals with a pathogenic hATTR variant is important, as this can significantly impact medical management for patients and their relatives. Furthermore, recent literature suggests that TTR genetic testing should be performed in all patients with suspicion of TTR-related cardiomyopathy, regardless of age, and that follow-up with genetic counseling services is recommended. Relatives of patients with hATTR benefit from genetic testing because testing can identify carriers early and allow relatives to receive regular screening and management. Despite the striking prevalence of hATTR among Black individuals, hATTR remains underdiagnosed in this patient population, and germline genetic testing for hATTR in Black individuals seems to be underrepresented, though the reasons for this have not yet been brought to light. Historically, Black patients experience a number of barriers to seeking healthcare that has been hypothesized to perpetuate the underdiagnosis of hATTR, such as lack of access and mistrust of healthcare professionals. Prior research has described a myriad of factors that shape an individual’s decision about whether to pursue presymptomatic genetic testing for a familial pathogenic variant, such as family closeness and communication, family dynamics, and a desire to inform other family members about potential health risks. This study explores these factors through 10 in-depth interviews with patients with hATTR about what factors may be contributing to the underdiagnosis of hATTR in the Black population. Participants were selected from the Emory University Amyloidosis clinic based on having a molecular diagnosis of hATTR. Interviews were recorded and transcribed verbatim, then coded using MAXQDA software. Thematic analysis was completed to draw commonalities between participants. Upon preliminary analysis, several themes have emerged. Barriers identified include i) Misdiagnosis and a prolonged diagnostic odyssey, ii) Family communication and dynamics surrounding health issues, iii) Perceptions of healthcare and one’s own health risks, and iv) The need for more intimate provider-patient relationships and communication. Overall, this study gleaned valuable insight from members of the Black community about possible factors contributing to the underdiagnosis of hATTR, as well as potential solutions to go about resolving this issue.

Keywords: cardiac amyloidosis, heart failure, TTR, genetic testing

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Authors: Nirmal Kumar Verma, Pallavi Jha

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Terahertz (THz) radiation generation by propagation of two-color laser pulses in plasma is an active area of research due to its potential applications in various areas, including security screening, material characterization and spectroscopic techniques. Due to non ionizing nature and the ability to penetrate several millimeters, THz radiation is suitable for diagnosis of cancerous cells. Traditional THz emitters like optically active crystals when irradiated with high power laser radiation, are subject to material breakdown and hence low conversion efficiencies. This problem is not encountered in laser - plasma based THz radiation sources. The present paper is devoted to the simulation study of the enhanced THz radiation generation by propagation of two-color, linearly polarized laser pulses through magnetized plasma. The two laser pulses orthogonally polarized are co-propagating along the same direction. The direction of the external magnetic field is such that one of the two laser pulses propagates in the ordinary mode, while the other pulse propagates in the extraordinary mode through homogeneous plasma. A transverse electromagnetic wave with frequency in the THz range is generated due to the presence of the static magnetic field. It is observed that larger amplitude terahertz can be generated by mixing of ordinary and extraordinary modes of two-color laser pulses as compared with a single laser pulse propagating in the extraordinary mode.

Keywords: two-color laser pulses, terahertz radiation, magnetized plasma, ordinary and extraordinary mode

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Authors: Zainab Dahrouch, Beatrix Petrovičová, Claudia Triolo, Fabiola Pantò, Angela Malara, Salvatore Patanè, Maria Allegrini, Saveria Santangelo

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Synthetic dyes dispersed in water cause environmental damage and have harmful effects on human health. Methylene blue (MB) is broadly used as a dye in the textile, pharmaceutical, printing, cosmetics, leather, and food industries. The complete removal of MB is difficult due to the presence of aromatic rings in its structure. The present study is focused on electrospun nanofibers (NFs) with engineered architecture and surface to be used as catalysts for the photodegradation of MB. Ti and/or Zn oxide NFs are produced by electrospinning precursor solutions with different Ti: Zn molar ratios (from 0:1 to 1:0). Subsequent calcination and cooling steps are operated at fast rates to generate porous NFs with capture centers to reduce the recombination rate of the photogenerated charges. The comparative evaluation of the NFs as photocatalysts for the removal of MB from an aqueous solution with a dye concentration of 15 µM under UV irradiation shows that the binary (wurtzite ZnO and anatase TiO₂) oxides exhibit higher catalytic activity compared to ternary (ZnTiO₃ and Zn₂TiO₄) oxides. The higher band gap and lower crystallinity of the ternary oxides are responsible for their lower photocatalytic activity. It has been found that the optimal load for the wurtzite ZnO is 0.66 mg mL⁻¹, obtaining a degradation rate of 7.94.10⁻² min⁻¹. The optimal load for anatase TiO₂ is lower (0.33 mg mL⁻¹) and the corresponding rate constant (1.12×10⁻¹ min⁻¹) is higher. This finding (higher activity with lower load) is of crucial importance for the scaling up of the process on an industrial scale. Indeed, the anatase NFs outperform even the commonly used P25-TiO₂ benchmark. Besides, they can be reused twice without any regeneration treatment, with 5.2% and 18.7% activity decrease after second and third use, respectively. Thanks to the scalability of the electrospinning technique, this laboratory-scale study provides a perspective towards the sustainable large-scale manufacture of photocatalysts for the treatment of industry effluents.

Keywords: anatase, capture centers, methylene blue dye, nanofibers, photodegradation, zinc oxide

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Authors: Reza Sadeghi

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Carbon dioxide treatment is one of the new methods for storage pest control. It can be used to replace chemical approaches for postharvest. Hazelnut has a considerable share in the annual exports of Iran. In the present study, hazelnut was studied after being exposed to different CO2 pressures (0.1-0.5bar) within 24 hours. Changes in organoleptic properties (colour, firmness, aroma, crispness, and overall acceptability) during fumigation were studied. The results showed that the sensory evaluation showed that carbon dioxide had no effect on the qualitative characteristics of hazelnut.

Keywords: carbon dioxide, hazelnut, qualitative characteristics, organoleptic

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Authors: Santos Maza, Enzo Aldoradin, Carlos Pariona, Eliud Arpi, Maria Rosales

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The objective of this study was to investigate the effect of flaying then bleeding anchovy (Engraulis ringens) immersed within a sodium citrate solution. Anchovy is a pelagic fish that readily deteriorates due to its high content of polyunsaturated fatty acids. As such, within the Peruvian food industry, the shelf life of frozen anchovy is explicitly 6 months, this short duration imparts a barrier to use for direct consumption human. Thus, almost all capture of anchovy by the fishing industry is eventually used in the production of fishmeal. We offer this an alternative to its typical production process in order to increase shelf life. In the present study, 100 kg of anchovies were captured and immediately mixed with ice on ship, maintaining a high quality sensory metric (e.g., with color blue in back) while still arriving for processing less than 2 h after capture. Anchovies with fat content of 3% were immediately flayed (i.e., reducing subcutaneous fat), beheaded, gutted and bled (i.e., removing hemoglobin) by immersion in water (Control) or in a solution of 2.5% sodium citrate (treatment), then subsequently frozen at -30 °C for 8 h in 2 kg batches. Subsequent glazing and storage at -25 °C for 14 months completed the experiments parameters. The peroxide value (PV), acidity (A), fatty acid profile (FAP), thiobarbituric acid reactive substances (TBARS), heme iron (HI), pH and sensory attributes of the samples were evaluated monthly. The results of the PV, TBARS, A, pH and sensory analyses displayed significant differences (p<0.05) between treatment and control sample; where the sodium citrate treated samples showed increased preservation features. Specifically, at the beginning of the study, flayed, beheaded, gutted and bled anchovies displayed low content of fat (1.5%) with moderate amount of PV, A and TBARS, and were not rejected by sensory analysis. HI values and FAP displayed varying behavior, however, results of HI did not reveal a decreasing trend. This result is indicative of the fact that levels of iron were maintained as HI and did not convert into no heme iron, which is known to be the primary catalyst of lipid oxidation in fish. According to the FAP results, the major quantity of fatty acid was of polyunsaturated fatty acid (PFA) followed by saturated fatty acid (SFA) and then monounsaturated fatty acid (MFA). According to sensory analysis, the shelf life of flayed, beheaded and gutted anchovy (control and treatment) was 14 months. This shelf life was reached at laboratory level because high quality anchovies were used and immediately flayed, beheaded, gutted, bled and frozen. Therefore, it is possible to maintain the shelf life of anchovies for a long time. Overall, this method displayed a large increase in shelf life relative to that commonly seen for anchovies in this industry. However, these results should be extrapolated at industrial scales to propose better processing conditions and improve the quality of anchovy for direct human consumption.

Keywords: citrate sodium solution, heme iron, polyunsaturated fatty acids, shelf life of frozen anchovy

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Authors: A. Zahra, G. de Cesare, D. Caputo, A. Nascetti

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PDMS (Polydimethylsiloxane) polymer is a suitable material for biological and MEMS (Microelectromechanical systems) designers, because of its biocompatibility, transparency and high resistance under plasma treatment. PDMS round channel is always been of great interest due to its ability to confine the liquid with membrane type micro valves. In this paper we are presenting a very simple way to form round shape microfluidic channel, which is based on reflow of positive photoresist AZ® 40 XT. With this method, it is possible to obtain channel of different height simply by varying the spin coating parameters of photoresist.

Keywords: lab-on-chip, PDMS, reflow, round microfluidic channel

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Authors: Mohammad Javaherian, Siamak Bashardoust Tajali, Monavvar Hadizadeh

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Objective: This systematic review study was conducted to evaluate the effects of Pulsed Electromagnetic (PEMF) and Static Magnetic Fields (SMG) on pain relief and functional improvement in patients with musculoskeletal Low Back Pain (LBP). Methods: Seven electronic databases were searched by two researchers independently to identify the published Randomized Controlled Trials (RCTs) on the efficacy of pulsed electromagnetic, static magnetic, and therapeutic nuclear magnetic fields. The identified databases for systematic search were Ovid Medline®, Ovid Cochrane RCTs and Reviews, PubMed, Web of Science, Cochrane Library, CINAHL, and EMBASE from 1968 to February 2016. The relevant keywords were selected by Mesh. After initial search and finding relevant manuscripts, all references in selected studies were searched to identify second hand possible manuscripts. The published RCTs in English would be included to the study if they reported changes on pain and/or functional disability following application of magnetic fields on chronic musculoskeletal low back pain. All studies with surgical patients, patients with pelvic pain, and combination of other treatment techniques such as acupuncture or diathermy were excluded. The identified studies were critically appraised and the data were extracted independently by two raters (M.J and S.B.T). Probable disagreements were resolved through discussion between raters. Results: In total, 1505 abstracts were found following the initial electronic search. The abstracts were reviewed to identify potentially relevant manuscripts. Seventeen possibly appropriate studies were retrieved in full-text of which 48 were excluded after reviewing their full-texts. Ten selected articles were categorized into three subgroups: PEMF (6 articles), SMF (3 articles), and therapeutic nuclear magnetic fields (tNMF) (1 article). Since one study evaluated tNMF, we had to exclude it. In the PEMF group, one study of acute LBP did not show significant positive results and the majority of the other five studies on Chronic Low Back Pain (CLBP) indicated its efficacy on pain relief and functional improvement, but one study with the lowest sessions (6 sessions during 2 weeks) did not report a significant difference between treatment and control groups. In the SMF subgroup, two articles reported near significant pain reduction without any functional improvement although more studies are needed. Conclusion: The PEMFs with a strength of 5 to 150 G or 0.1 to 0.3 G and a frequency of 5 to 64 Hz or sweep 7 to 7KHz can be considered as an effective modality in pain relief and functional improvement in patients with chronic low back pain, but there is not enough evidence to confirm their effectiveness in acute low back pain. To achieve the appropriate effectiveness, it is suggested to perform this treatment modality 20 minutes per day for at least 9 sessions. SMFs have not been reported to be substantially effective in decreasing pain or improving the function in chronic low back pain. More studies are necessary to achieve more reliable results.

Keywords: pulsed electromagnetic field, static magnetic field, magnetotherapy, low back pain

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Authors: Amelia J. McFarland, Andrew K. Davey, Shailendra Anoopkumar-Dukie

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Microglia are the resident macrophage population of the central nervous system (CNS), contributing to both innate and adaptive immune response, and brain homeostasis. Activation of microglia occurs in response to a multitude of pathogenic stimuli in their microenvironment; this induces morphological and functional changes, resulting in a state of acute neuroinflammation which facilitates injury resolution. Adequate microglial function is essential for the health of the neuroparenchyma, with microglial dysfunction implicated in numerous CNS pathologies. Given the critical role that these macrophage-derived cells play in CNS homeostasis, there is a high demand for microglial models suitable for use in neuroscience research. The isolation of primary human microglia, however, is both difficult and costly, with microglial activation an unwanted but inevitable result of the extraction process. Consequently, there is a need for the development of alternative experimental models which exhibit morphological, biochemical and functional characteristics of human microglia without the difficulties associated with primary cell lines. In this study, our aim was to evaluate whether THP-1 human peripheral blood monocytes would display microglial-like qualities following an induced differentiation, and, therefore, be suitable for use as surrogate microglia. To achieve this aim, THP-1 human peripheral blood monocytes from acute monocytic leukaemia were differentiated with a range of phorbol 12-myristate 13-acetate (PMA) concentrations (50-200 nM) using two different protocols: a 5-day continuous PMA exposure or a 3-day continuous PMA exposure followed by a 5-day rest in normal media. In each protocol and at each PMA concentration, microglial-like cell morphology was assessed through crystal violet staining and the presence of CD-14 microglial / macrophage cell surface marker. Lipopolysaccharide (LPS) from Escherichia coli (055: B5) was then added at a range of concentrations from 0-10 mcg/mL to activate the PMA-differentiated THP-1 cells. Functional microglial-like behavior was evaluated by quantifying the release of prostaglandin (PG)-E2 and pro-inflammatory cytokines interleukin (IL)-1β and tumour necrosis factor (TNF)-α using mediator-specific ELISAs. Furthermore, production of global reactive oxygen species (ROS) and nitric oxide (NO) were determined fluorometrically using dichlorodihydrofluorescein diacetate (DCFH-DA) and diaminofluorescein diacetate (DAF-2-DA) respectively. Following PMA-treatment, it was observed both differentiation protocols resulted in cells displaying distinct microglial morphology from 10 nM PMA. Activation of differentiated cells using LPS significantly augmented IL-1β, TNF-α and PGE2 release at all LPS concentrations under both differentiation protocols. Similarly, a significant increase in DCFH-DA and DAF-2-DA fluorescence was observed, indicative of increases in ROS and NO production. For all endpoints, the 5-day continuous PMA treatment protocol yielded significantly higher mediator levels than the 3-day treatment and 5-day rest protocol. Our data, therefore, suggests that the differentiation of THP-1 human monocyte cells with PMA yields a homogenous microglial-like population which, following stimulation with LPS, undergo activation to release a range of pro-inflammatory mediators associated with microglial activation. Thus, the use of PMA-differentiated THP-1 cells represents a suitable microglial model for in vitro research.

Keywords: differentiation, lipopolysaccharide, microglia, monocyte, neuroscience, THP-1

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Authors: Nastaran Hemmati, Farhad Nikkhahi, Amir Javadi, Sahar Eskandarion, Seyed Mahmuod Amin Marashi

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Neisseria meningitidis, Escherichia coli K, Streptococcus agalactiae, and Streptococcus pneumoniae cause 90% of bacterial meningitis. Almost all infected people die or have irreversible neurological complications. Therefore, it is essential to have a diagnostic kit with the ability to quickly detect these fatal infections. The project involved 212 patients from whom cerebrospinal fluid samples were obtained. After total genome extraction and performing multiplex quantitative polymerase chain reaction (qPCR), the presence or absence of each infectious factor was determined by comparing with standard strains. The specificity, sensitivity, positive predictive value, and negative predictive value calculated were 100%, 92.9%, 50%, and 100%, respectively. So, due to the high specificity and sensitivity of the designed primers, they can be used instead of bacterial culture that takes at least 24 to 48 hours. The remarkable benefit of this method is associated with the speed (up to 3 hours) at which the procedure could be completed. It is also worth noting that this method can reduce the personnel unintentional errors which may occur in the laboratory. On the other hand, as this method simultaneously identifies four common factors that cause bacterial meningitis, it could be used as an auxiliary method diagnostic technique in laboratories particularly in cases of emergency medicine.

Keywords: cerebrospinal fluid, meningitis, quantitative polymerase chain reaction, simultaneous detection, diagnosis testing

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Authors: Warnakulasuriya Arachichige Malisha Ann Rosary Fernando, Udalamatta Gamage Omila Chalanka Jinadasa, Bihini Pabasara Amandi Amarasinghe, Manul Thisuraka Mandalawatta, Uthpala Samarakoon, Manori Gamage

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The surge in sexually transmitted diseases (STDs) has become a critical public health crisis demanding urgent attention and action. Like many other nations, Sri Lanka is grappling with a significant increase in STDs due to a lack of education and awareness regarding their dangers. Presently, the available applications for tracking and managing STDs cover only a limited number of easily detectable infections, resulting in a significant gap in effectively controlling their spread. To address this gap and combat the rising STD rates, it is essential to leverage technology and data. Employing technology to enhance the tracking and management of STDs is vital to prevent their further propagation and to enable early intervention and treatment. This requires adopting a comprehensive approach that involves raising public awareness about the perils of STDs, improving access to affordable healthcare services for early detection and treatment, and utilizing advanced technology and data analysis. The proposed mobile application aims to cater to a broad range of users, including STD patients, recovered individuals, and those unaware of their STD status. By harnessing cutting-edge technologies like image detection, symptom-based identification, prevention methods, doctor and clinic recommendations, and virtual counselor chat, the application offers a holistic approach to STD management. In conclusion, the escalating STD rates in Sri Lanka and across the globe require immediate action. The integration of technology-driven solutions, along with comprehensive education and healthcare accessibility, is the key to curbing the spread of STDs and promoting better overall public health.

Keywords: STD, machine learning, NLP, artificial intelligence

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Authors: Tanya Anand, Arun Kandasamy, L. N. Suman

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Family based therapy for adolescent substance abuse has been studied to be effective in the West. Whereas, based on literature review, family therapy and interventions for adolescent substance abuse is still in its nascent stages in India. A multidimensional perspective to treatment has been indicated consistently in the Indian literature, but standardized therapy which addresses early substance abuse, from a social-ecological perspective has not been developed and studied for Indian population. While numerous researches have been conducted in India on the need of engaging the family in therapy for the purpose of symptom reduction, long-term maintenance of gains, and reducing family burnout, distress and dysfunction; a family based model in the Indian context has not been developed and tried, to the best of our knowledge. Hence, from the aim of building a model to treat adolescent substance abuse within the family context, experts in the area of mental health and deaddiction were interviewed to inform upon the clinical difficulties, challenges, uniqueness that Indian families present with. The integration of indigenous techniques that would be helpful in engaging families of young individuals with difficulties were also explored. Eight experts' who were interviewed, have 10-30 years of experience in working with families and substance users. An open-ended interview was conducted with the experts individually and audio-recorded. The interviews were then transcribed and subjected to qualitative analysis for building a framework and treatment guideline. Additionally, interviews with patients and their parents were conducted to elicit ‘felt needs’. The results of the analysis revealed culture-specific issues widely experienced within Indian families by adolescents and young adults, centering around the theme of Individuation versus collective identity and living. Substance abuse, in this framework, was found to be perceived as one of the maladaptive ways of the youth to disengage from the family and attempt at individuation and the responsibilities that are considered entitlements in the culture. On the other hand, interviews with family members revealed them to be engaging in inconsistent patterns of care and parenting. This was experienced and observed in terms of fostering interdependence within the family, sometimes within adverse socio-economic and societal conditions, where enacted and perceived stigma kept the individual and family members in a vicious loop of maladaptive coping patterns, dysfunctional family arrangements, and often leading to burnout with poor help seeking. The paper inform upon a framework that lays down the foundation for assessments, planning, case management and therapist competencies, required to address alcohol and drug issues in an Indian family context with such etiological factors at its heart. This paper will cover qualitative results of the interviews and present a model that may guide mental health professionals for treatment of adolescent substance use and family therapy.

Keywords: Indian families, family therapy, de-addiction, adolescent, youth, substance abuse, behavioral issues, felt needs, culture, etiology, model building, framework development, interviews

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Authors: Hanna Abbo, Siyasanga Noganta, Salam Titinchi

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The global lack of clean water for human sanitation and other purposes has become an emerging dilemma for human beings. The presence of organic pollutants in wastewater produced by textile industries, leather manufacturing and chemical industries is an alarming matter for a safe environment and human health. For the last decades, conventional methods have been applied for the purification of water but due to industrialization these methods fall short. Advanced oxidation processes and their reliable application in degradation of many contaminants have been reported as a potential method to reduce and/or alleviate this problem. Lately it has been assumed that incorporation of some metal nanoparticles such as magnetite nanoparticles as photocatalyst for Fenton reaction which could improve the degradation efficiency of contaminants. Core/shell nanoparticles, are extensively studied because of their wide applications in the biomedical, drug delivery, electronics fields and water treatment. The current study is centred on the synthesis of silver-doped Fe3O4/SiO2/TiO2 photocatalyst. Magnetically separable Fe3O4@SiO2@TiO2 composite with core–shell structure were synthesized by the deposition of uniform anatase TiO2 NPs on Fe3O4@SiO2 by using titanium butoxide (TBOT) as titanium source. Then, the silver is doped on SiO2 layer by hydrothermal method. Integration of magnetic nanoparticles was suggested to avoid the post separation difficulties associated with the powder form of the TiO2 catalyst, increase of the surface area and adsorption properties. The morphology, structure, composition, and magnetism of the resulting composites were characterized and their photocatalytic activities were also evaluated. The results demonstrate that TiO2 NPs were uniformly deposited on the Fe3O4@SiO2 surface. The silver nanoparticles were also uniformly distributed on the surface of TiO2 nanoparticles. The aim of this work is to study the suitability of photocatalysis for the treatment of aqueous streams containing organic pollutants such as methylene blue which is selected as a model compound to represent one of the pollutants existing in wastewaters. Various factors such as initial pollutant concentration, photocatalyst dose and wastewater matrix were studied for their effect on the photocatalytic degradation of the organic model pollutants using the as synthesized catalysts and compared with the commercial titanium dioxide (Aeroxide P25). Photocatalysis was found to be a potential purification method for the studied pollutant also in an industrial wastewater matrix with the removal percentages of over 81 % within 15 minutes. Methylene blue was removed most efficiently and its removal consumed the least of energy in terms of the specific applied energy. The magnetic Ag/SiO2/TiO2 composites show high photocatalytic performance and can be recycled three times by magnetic separation without major loss of activity, which meant that they can be used as efficient and conveniently renewable photocatalyst.

Keywords: Magnetite nanoparticles, Titanium, Photocatalyst, Organic pollutant, Water treatment

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Authors: Mehrnaz Mostafavi

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Lung cancer is one of the most harmful forms of cancer. The long-term survival rate of lung cancer patients treated by conventional modalities such as surgical resection, radiation, and chemotherapy remains far from satisfactory. Systemic drug delivery is rarely successful because only a limited amount of the chemotherapeutic drug targets lung tumor sites, even when administered at a high dose. Targeted delivery of drug molecules to organs or special sites is one of the most challenging research areas in pharmaceutical sciences. By developing colloidal delivery systems such as liposomes, micelles and nanoparticles a new frontier was opened for improving drug delivery. Nanoparticles with their special characteristics such as small particle size, large surface area and the capability of changing their surface properties have numerous advantages compared with other delivery systems. Targeted nanoparticle delivery to the lungs is an emerging area of interest.Multimodal or combination therapy represents a promising new method to fight disease. Therefore, a combination of different therapeutic strategies may be the best alternative to improve treatment outcomes for lung cancer. Photothermal therapy was proposed as a novel approach to treatment. In this work, photothermal therapy with gold nanoparticles and near infrared laser (NIR) irradiation was investigated.Four types of small (<100nm), NIR absorbing gold nanoparticles (nanospheres, nanorods) were synthesized using wet chemical methods and characterized by transmission electron microscopy, dynamic light scattering and UV-vis spectroscopy. Their synthesis and properties were evaluated, to determine their feasibility as a photothermal agent for clinical applications. In vitro cellular uptake studies of the nanoparticles into lung cancer cell lines was measured using light scattering microscopy.Small gold nanorods had good photothermal properties and the greatest cellular uptake, and were used in photothermal studies. Under 4W laser irradiation, an increase in temperature of 10°C and decrease in cell viability of up to 80% were obtained.

Keywords: photothermal, therapy, cancer, gold nanorods

Procedia PDF Downloads 233

Authors: Pamphile Ndagijimana, Xuejiao Liu, Zhiwei Li, Yin Wang

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The valorization of plastic wastes, as a mitigation strategy, is attracting the researchers’ attention since these wastes have raised serious environmental concerns. Plastic wastes have been reported to adsorb the organic pollutants in the water environment and to be the main vector of those pollutants in the aquatic environment, especially dyes, as a serious water pollution concern. Recycling technologies of plastic wastes such as landfills, incineration, and energy recovery have been adopted to manage those wastes before getting exposed to the environment. However, they are far from being widely accepted due to their related environmental pollution, lack of space for the landfill as well as high cost. Therefore, modification is necessary for green plastic adsorbent in water applications. Current routes for plastic modification into adsorbents are based on the combustion method, but they have weaknesses of air pollution as well as high cost. Thus, the green strategy for plastic modification into adsorbents is highly required. Furthermore, recent researchers recommended that if plastic wastes are combined with other solid carbon materials, they could promote their application in water treatment. Herein, we present new insight into using plastic waste-based materials as future green adsorbents. Magnetic plastic-reduced graphene oxide (MPrGO) composite was synthesized by cross-linking method and applied in removing methylene blue (MB) from an aqueous solution. Furthermore, the following advantages have been achieved: (i) The density of plastic and reduced graphene oxide were enhanced, (ii) no second pollution of black color in solution, (iii) small amount of graphene oxide (1%) was linked on 10g of plastic waste, and the composite presented the high removal efficiency, (iv) easy recovery of adsorbent from water. The low concentration of MB (10-30mg/L) was all removed by 0.3g of MPrGO. Different characterization techniques such as XRD, SEM, FTIR, BET, XPS, and Raman spectroscopy were performed, and the results confirmed a conjugation between plastic waste and graphene oxide. This MPrGO composite presented a good prospect for the valorization of plastic waste, and it is a promising composite material in water treatment.

Keywords: plastic waste, graphene oxide, dye, adsorption

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Authors: Eitan Yefenof

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Glucocorticoid (GC) hormones, e.g. Dexamethasone and Prednisone, are widely used in the therapy of leukemia and lymphoma owing to their apoptogenic effect on lymphoid cells. However, the emergence of GC resistant cells during therapy is a major cause for treatment failure, urging the need for novel strategies that maintain leukemia sensitivity to the pro-apoptotic activity of GCs. GCs act by binding to the GC receptor (GR), which, in its inactive state, is sequestered in the cytosol by a multi-subunit complex of heat shock proteins. Upon ligand binding, the complex dissociates, allowing GR activation and translocation to the nucleus, where it regulates transcription of multiple genes. We demonstrated that in addition to gene expression, GR also regulates microRNA (miR) expression. Deep-sequencing analysis revealed 14 miRs that are regulated in GC-sensitive but resistant leukemias upon treatment with GC. GC up-regulates miR-103, miR-15~16 and miR-30e/d, while down-regulates miR-17, mir-18a, miR-19a, miR-19b, miR-20a and miR-92a (members of the miR-17∼92a multi-cistron). Upon transfection, miR-103 confers GC apoptotic sensitivity to otherwise GC-resistant cell. Furthermore, knocking down miR-103 expression reduces the GC apoptotic response of sensitive cells. miR-103 abrogates c-Myc expression, an oncogenic transcription factor which is deregulated in many cancers. In addition, miR-103 up-regulates Bim, a pro-apoptotic protein crucial for GC-induced death. Activated glycogen synthase kinase 3 (GSK3) is also crucial for GC-induced apoptosis. GSK3 is active in GC-sensitive but not in GC-resistant cells. We found that GSK3 associates with the GR multi-subunit complex. Upon GC exposure, it dissociates from the GR and interacts with Bim to enable activation of the mitochondrial apoptosis pathway. miR-103 mediated c-Myc ablation is followed by down-regulation of the multi-cistron miR-17~92a, in particular miR-18a and miR-20a. miR-18a targets GR for degradation whereas miR-20a targets Bim degradation. Hence, miR-103 acts, in concert with Bim and GR, as a "tumor suppressor" that leads to reduced proliferation, cell-cycle arrest and cell death. We suggest that miR-103 can provide a diagnostic tool that predicts the sensitivity of leukemia to GC based therapy. Furthermore, exosomal delivery of miR-103 or up-regulation of the endogenous miR-103 could confer apoptotic sensitivity to resistant cells at the outset, thus becoming a useful therapeutic tool combined with GCs.

Keywords: apoptosis, leukemia, micro-RNA, steroids

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Authors: Sana Gul, Sheeba Murad, Aneela Javed

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Introduction: Human Papilloma Virus (HPV) is small DNA virus mostly infecting mucosa and cutaneous keratinocytes. So far, more than 200 Human papillomaviruses are known. HPV have been divided into high- and low-risk on the basis of their oncogenic potential. High risk HPV is considered to be the main etiological cause for cervical cancer. Objective: Current study was designed to screen the local cervical cancer patients from the twin cities of Pakistan for the occurance of high risk HPV. Methodology: A total of 67 formalin fixed paraffin-embedded samples of cervical cancer biopsies were obtained from the government hospitals in Islamabad and Rawalpindi. Cervical cancer biopsies were examined for the presence of HPV DNA. Polymerase chain reaction (PCR) was used for the amplification of a region in the HPV-L1 gene for the general detection of the Papilloma virus and for the genotype specific detection of high risk HPV 16 and 18 using the GP5/GP6 primers and genotype specific primers respectively. Results: HPV DNA was detected in 59 out of 67 samples analyzed. 30 samples showed the presence of HPV16 while 22 samples were positive for HPV 18 . HPV subtype could not be determined in 7 samples. Conclusion: Our results show a strong association between HPV infection and cervical cancer among women in twin cities of Pakistan. One way to minimize the disease burden in relation to HPV infection in Pakistani population is the use of prophylactic vaccines and routine screening. An early diagnosis of HPV infection will allow better health management to reduce the risk of developing cervical cancer.

Keywords: cervical cancer, Pakistan, human papillomavirus, HPV 16

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Authors: Simon B. N. Thompson

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Cortisol is important to our immune system, regulates our stress response, and is a factor in maintaining brain temperature. Saliva cortisol is a practical and useful non-invasive measurement that signifies the presence of the important hormone. Electrical activity in the jaw muscles typically rises when the muscles are moved during yawning and the electrical level is found to be correlated with the cortisol level. In two studies using identical paradigms, a total of 108 healthy subjects were exposed to yawning-provoking stimuli so that their cortisol levels and electrical nerve impulses from their jaw muscles was recorded. Electrical activity is highly correlated with cortisol levels in healthy people. The Hospital Anxiety and Depression Scale, Yawning Susceptibility Scale, General Health Questionnaire, demographic, health details were collected and exclusion criteria applied for voluntary recruitment: chronic fatigue, diabetes, fibromyalgia, heart condition, high blood pressure, hormone replacement therapy, multiple sclerosis, and stroke. Significant differences were found between the saliva cortisol samples for the yawners as compared with the non-yawners between rest and post-stimuli. Significant evidence supports the Thompson Cortisol Hypothesis that suggests rises in cortisol levels are associated with yawning. Ethics approval granted and professional code of conduct, confidentiality, and safety issues are approved therein.

Keywords: cortisol, diagnosis, neurological disease, thompson cortisol hypothesis, yawning

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Authors: Aoxue Yang, Weili Tian, Yonghe Wu, Haikun Liu

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Brain tumor stem cells (BTSCs) are resistant to therapy and give rise to recurrent tumors. These rare and elusive cells are likely to disseminate during cancer progression, and some may enter dormancy, remaining viable but not increasing. The identification of dormant BTSCs is thus necessary to design effective therapies for glioblastoma (GBM) patients. Little progress has been made in therapeutic treatment of glioblastoma in the last decade despite rapid progress in molecular understanding of brain tumors1. Here we show that the stress hormone glucocorticoid is essential for the maintenance of brain tumor stem cells (BTSCs), which are resistant to conventional therapy. The glucocorticoid receptor (GR) regulates metabolic plasticity and chemoresistance of the dormant BTSC via controlling expression of GPD1 (glycerol-3-phosphate dehydrogenase 1), which is an essential regulator of lipid metabolism in BTSCs. Genomic, lipidomic and cellular analysis confirm that GR/GPD1 regulation is essential for BTSCs metabolic plasticity and survival. We further demonstrate that the GR agonist dexamethasone (DEXA), which is commonly used to control edema in glioblastoma, abolishes the effect of chemotherapy drug temozolomide (TMZ) by upregulating GPD1 and thus promoting tumor cell dormancy in vivo, this provides a mechanistic explanation and thus settle the long-standing debate of usage of steroid in brain tumor patient edema control. Pharmacological inhibition of GR/GPD1 pathway disrupts metabolic plasticity of BTSCs and prolong animal survival, which is superior to standard chemotherapy. Patient case study shows that GR antagonist mifepristone blocks tumor progression and leads to symptomatic improvement. This study identifies an important mechanism regulating cancer stem cell dormancy and provides a new opportunity for glioblastoma treatment.

Keywords: cancer stem cell, dormancy, glioblastoma, glycerol-3-phosphate dehydrogenase 1, glucocorticoid receptor, dexamethasone, RNA-sequencing, phosphoglycerides.

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