Search results for: sewage treatment plant
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 10693

Search results for: sewage treatment plant

5743 Use of Fault Tree Analysis for Technical Assessment of Waste-to-Energy Plants

Authors: Ying-Chu Chen

Abstract:

Waste to energy (WTE) technology is becoming increasingly important throughout the world. There are 24 WTE plants in operation in Taiwan that might be ranked the top in density (number of MSW incinerators/area) in the world. Many problems exist in WTE plants, such as low-quality construction, leakage of pipelines, irregular feedings, and lack of maintenance. These problems should be identified and analyzed for effective implementation and efficient operation of WTE plants. This research applies a fault tree analysis (FTA) to identify failures and evaluate their effects on the operation of WTE plants from a technical point of view. Five subsystems of a WTE plant were defined, including loading system, incineration system, effluent disposal system, structural components, and control system. This research results proved that FTA is suitable for WTE evaluation and is an effective analysis tool for technical evaluation in the field of WTE technology.

Keywords: delphi method, fault tree approach, municipal solid waste, waste to energy, WTE

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5742 Delivery of Ginseng Extract Containing Phytosome Loaded Microsphere System: A Preclinical Approach for Treatment of Neuropathic Pain in Rodent Model

Authors: Nitin Kumar

Abstract:

Purpose: The current research work focuses mainly on evolving a delivery system for ginseng extract (GE), which in turn will ameliorate the neuroprotective potential by means of enhancing the ginsenoside (Rb1) bio-availability (BA). For more noteworthy enhancement in oral bioavailability (OBA) along with pharmacological properties, the drug carriers’ performance can be strengthened by utilizing phytosomes-loaded microspheres (PM) delivery system. Methods: For preparing the disparate phytosome complexes (F1, F2, and F3), an aqueous extract of ginseng roots (GR) along with phospholipids were reacted in disparate ratio. Considering the outcomes, F3 formulation (spray-dried) was chosen for preparing the phytosomes powder (PP), PM, and extract microspheres (EM). PM was made by means of loading of F3 into Gum Arabic (GA) in addition to maltodextrin polymer mixture, whereas EM was prepared by means of the addition of extract directly into the same polymer mixture. For investigating the neuroprotective effect (NPE) in addition to their pharmacokinetic (PK) properties, PP, PM, and EM formulations were assessed. Results: F3 formulation gave enhanced entrapment efficiency (EE) (i.e., 50.61%) along with good homogeneity of spherical shaped particle size (PS) (42.58 ± 1.4 nm) with least polydispersity index (PDI) (i.e., 0.193 ± 0.01). The sustained release (up to 24 h) of ginsenoside Rb1 (GRb1) is revealed by the dissolution study of PM. A significantly (p < 0.05) greater anti-oxidant (AO) potential of PM can well be perceived as of the diminution in the lipid peroxidase level in addition to the rise in the glutathione superoxide dismutase (SOD) in addition to catalase levels. It also showed a greater neuroprotective potential exhibiting significant (p < 0.05) augmentation in the nociceptive threshold together with the diminution in damage to nerves. A noteworthy enhancement in the relative BA (157.94%) of GRb1 through the PM formulation can well be seen in the PK studies. Conclusion: It is exhibited that the PM system is an optimistic and feasible strategy to enhance the delivery of GE for the effectual treatment of neuropathic pain.

Keywords: ginseng, neuropathic, phytosome, pain

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5741 Enhanced Phytoremediation Using Endophytic Microbes

Authors: Raymond Oriebe Anyasi, Harrison Atagana

Abstract:

The use of a plant in the detoxification of several toxin is been known to be enhanced by various microbial endophytes which have been reported to be contained in plants growing in any contaminated soil. Plants in their natural state are mostly colonized by endophytes which in the process forms symbiotic associations with the host plants. These benefits that the endophytes offer to the plants include amongst others to: Enhance plants growth through the production of various phytohormones; increase in the resistance of environmental stresses; produce important bioactive metabolites; help in the fixing of nitrogen in the plants organelles; help in the metal translocation and accumulation in plants; assist in the production of enzymes involves the degradation of organic contaminants. Therefore recognizing these natural processes of the microbes will enable the understanding of the effective mechanism for enhanced phytoremediation. The aim of this study was to survey the progressiveness in the study involving endophyte-assisted phytoremediation of contaminants; highlighting various pollutants, the plants used, the endophytes studied as well as the type of interaction between the plants and the microbes so as to proffer a better future prospect for the technology.

Keywords: phytoremediation, endophytes, microbes, pollution, environmental management, plants

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5740 Alcohol Septal Ablation in a 19-Year-Old with Hypertrophic Obstructive Cardiomyopathy Patient: A Case Report

Authors: Christine Ysabelle G. Roman, Pauline Torres

Abstract:

Background: Hypertrophic cardiomyopathy is a disease of marked heterogeneity. It is a genetically determined heart disease characterized by significant myocardium hypertrophy that results in diastolic dysfunction, left ventricular outflow tract obstruction, and an increased risk of arrhythmias. The primary treatment in patients with such conditions is negative inotropic drugs, such as beta-blockers, calcium channel antagonists, and disopyramide. However, for those who remain symptomatic and need septal reduction therapy, surgical septal myectomy or alcohol septal ablation are options. Case Summary: A 19 – year old female presented in the authors’ institution with easy fatigability. The consult was done a year prior, and 2D echocardiography was requested which showed concentric left ventricular hypertrophy, asymmetrically hypertrophied interventricular septum (IVS) with the largest diameter of 3.3cm & subaortic dynamic obstruction with a maximum gradient of 47 mmHg. A repeat echo a year later showed asymmetric septal hypertrophy (IVS measuring at 3cm) with the systolic anterior motion of anterior mitral valve leaflet and left ventricular outflow tract obstruction (peak gradient of 50mmHg). The patient then underwent alcohol septal ablation and was discharged stable after four days of admission. Conclusion: Hypertrophic obstructive cardiomyopathy, a cardiovascular genetic disease, results in various patterns of left ventricular hypertrophy and abnormality of mitral valve apparatus. The patient is managed medically initially. However, despite optimal drug therapy and significant left ventricular outflow tract obstruction, significant heart failure symptoms or syncope require invasive treatment.

Keywords: hypertrophic obstructive cardiomyopathy, left ventricular outflow tract obstruction, alcohol septal ablation, alcohol

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5739 Conservation Detection Dogs to Protect Europe's Native Biodiversity from Invasive Species

Authors: Helga Heylen

Abstract:

With dogs saving wildlife in New Zealand since 1890 and governments in Africa, Australia and Canada trusting them to give the best results, Conservation Dogs Ireland want to introduce more detection dogs to protect Europe's native wildlife. Conservation detection dogs are fast, portable and endlessly trainable. They are a cost-effective, highly sensitive and non-invasive way to detect protected and invasive species and wildlife disease. Conservation dogs find targets up to 40 times faster than any other method. They give results instantly, with near-perfect accuracy. They can search for multiple targets simultaneously, with no reduction in efficacy The European Red List indicates the decline in biodiversity has been most rapid in the past 50 years, and the risk of extinction never higher. Just two examples of major threats dogs are trained to tackle are: (I)Japanese Knotweed (Fallopia Japonica), not only a serious threat to ecosystems, crops, structures like bridges and roads - it can wipe out the entire value of a house. The property industry and homeowners are only just waking up to the full extent of the nightmare. When those working in construction on the roads move topsoil with a trace of Japanese Knotweed, it suffices to start a new colony. Japanese Knotweed grows up to 7cm a day. It can stay dormant and resprout after 20 years. In the UK, the cost of removing Japanese Knotweed from the London Olympic site in 2012 was around £70m (€83m). UK banks already no longer lend on a house that has Japanese Knotweed on-site. Legally, landowners are now obliged to excavate Japanese Knotweed and have it removed to a landfill. More and more, we see Japanese Knotweed grow where a new house has been constructed, and topsoil has been brought in. Conservation dogs are trained to detect small fragments of any part of the plant on sites and in topsoil. (II)Zebra mussels (Dreissena Polymorpha) are a threat to many waterways in the world. They colonize rivers, canals, docks, lakes, reservoirs, water pipes and cooling systems. They live up to 3 years and will release up to one million eggs each year. Zebra mussels attach to surfaces like rocks, anchors, boat hulls, intake pipes and boat engines. They cause changes in nutrient cycles, reduction of plankton and increased plant growth around lake edges, leading to the decline of Europe's native mussel and fish populations. There is no solution, only costly measures to keep it at bay. With many interconnected networks of waterways, they have spread uncontrollably. Conservation detection dogs detect the Zebra mussel from its early larvae stage, which is still invisible to the human eye. Detection dogs are more thorough and cost-effective than any other conservation method, and will greatly complement and speed up the work of biologists, surveyors, developers, ecologists and researchers.

Keywords: native biodiversity, conservation detection dogs, invasive species, Japanese Knotweed, zebra mussel

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5738 Genomic and Proteomic Variability in Glycine Max Genotypes in Response to Salt Stress

Authors: Faheema Khan

Abstract:

To investigate the ability of sensitive and tolerant genotype of Glycine max to adapt to a saline environment in a field, we examined the growth performance, water relation and activities of antioxidant enzymes in relation to photosynthetic rate, chlorophyll a fluorescence, photosynthetic pigment concentration, protein and proline in plants exposed to salt stress. Ten soybean genotypes (Pusa-20, Pusa-40, Pusa-37, Pusa-16, Pusa-24, Pusa-22, BRAGG, PK-416, PK-1042, and DS-9712) were selected and grown hydroponically. After 3 days of proper germination, the seedlings were transferred to Hoagland’s solution (Hoagland and Arnon 1950). The growth chamber was maintained at a photosynthetic photon flux density of 430 μmol m−2 s−1, 14 h of light, 10 h of dark and a relative humidity of 60%. The nutrient solution was bubbled with sterile air and changed on alternate days. Ten-day-old seedlings were given seven levels of salt in the form of NaCl viz., T1 = 0 mM NaCl, T2=25 mM NaCl, T3=50 mM NaCl, T4=75 mM NaCl, T5=100 mM NaCl, T6=125 mM NaCl, T7=150 mM NaCl. The investigation showed that genotype Pusa-24, PK-416 and Pusa-20 appeared to be the most salt-sensitive. genotypes as inferred from their significantly reduced length, fresh weight and dry weight in response to the NaCl exposure. Pusa-37 appeared to be the most tolerant genotype since no significant effect of NaCl treatment on growth was found. We observed a greater decline in the photosynthetic variables like photosynthetic rate, chlorophyll fluorescence and chlorophyll content, in salt-sensitive (Pusa-24) genotype than in salt-tolerant Pusa-37 under high salinity. Numerous primers were verified on ten soybean genotypes obtained from Operon technologies among which 30 RAPD primers shown high polymorphism and genetic variation. The Jaccard’s similarity coefficient values for each pairwise comparison between cultivars were calculated and similarity coefficient matrix was constructed. The closer varieties in the cluster behaved similar in their response to salinity tolerance. Intra-clustering within the two clusters precisely grouped the 10 genotypes in sub-cluster as expected from their physiological findings.Salt tolerant genotype Pusa-37, was further analysed by 2-Dimensional gel electrophoresis to analyse the differential expression of proteins at high salt stress. In the Present study, 173 protein spots were identified. Of these, 40 proteins responsive to salinity were either up- or down-regulated in Pusa-37. Proteomic analysis in salt-tolerant genotype (Pusa-37) led to the detection of proteins involved in a variety of biological processes, such as protein synthesis (12 %), redox regulation (19 %), primary and secondary metabolism (25 %), or disease- and defence-related processes (32 %). In conclusion, the soybean plants in our study responded to salt stress by changing their protein expression pattern. The photosynthetic, biochemical and molecular study showed that there is variability in salt tolerance behaviour in soybean genotypes. Pusa-24 is the salt-sensitive and Pusa-37 is the salt-tolerant genotype. Moreover this study gives new insights into the salt-stress response in soybean and demonstrates the power of genomic and proteomic approach in plant biology studies which finally could help us in identifying the possible regulatory switches (gene/s) controlling the salt tolerant genotype of the crop plants and their possible role in defence mechanism.

Keywords: glycine max, salt stress, RAPD, genomic and proteomic variability

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5737 Antımıcrobıal Actıvıty of Gırardınıa Heterophılla

Authors: P. S. BEDI* , Neavty Thakur, Balvınder Sıngh

Abstract:

In the present study an attempt has been made to prepare the crude extracts of leaves and stem of ‘Girardinia heterophylla’ by using various solvents like petroleum ether, ethanol and double distilled water. The samples were given the code NGLS 1, NGLS 2, NGLS 3, NGSS 1, NGSS 2 and NGSS 3 respectively. All the extracts were used to study their antimicrobial activity against gram positive bacteria eg. Bacillus subtilis, Gram negative bacteria eg. E. coli, K. pneumonia and antifungal activity against Aspergillus niger. The results of the antimicrobial activity showed that all the crude extracts of the plant posseses antibacterial activity. Maximum antibacterial activity was shown by NGLS 2, NGLS 3 and NGSS 3 against K. pneumonia. The growth of fungus A. niger was also inhibited by all the crude extracts. Maximum inhibition was shown by NGSS 2 followed by NGSS 1.

Keywords: Girardinia heterophylla, leaves and stem extracts, Antibacterial activity, antifungal activity.

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5736 Effects of Anti-FGL2 Monoclonal Antibody SPF89 on Vascular Inflammation

Authors: Ying Sun, Biao Cheng, Qing Lu, Xuefei Tao, Xiaoyu Lai, Cheng Guo, Dan Wang

Abstract:

Fibrinogen-like protein 2 (FGL2) has recently been identified to play an important role in inflammatory diseases such as atherosclerosis through a thrombin-dependent manner. Here, a murine monoclonal antibody was raised against the critical residue Ser(89) of FGL2, and the effects of the anti-FGL2 mAb (SPF89) were analyzed in human umbilical vein endothelial cells (HUVECs) and THP-1 cells. Firstly, it was proved that SPF89, which belongs to the IgG1 subtype with a KD value of 44.5 pM, could specifically show the expression levels of protein FGL2 in different cell lines of known target gene status. The lipopolysaccharide (LPS)-mediated endothelial cell proliferation was significantly inhibited with a decline of phosphorylation nuclear factor-κB (NF-κB) in a dose-dependent manner after SPF89 treatment. Furthermore, SPF89 reduced LPS-induced expression of adhesion molecules and inflammatory cytokines such as vascular cell adhesion molecule-1, tumor necrosis factor-α, Matrix metalloproteinase MMP-2, Integrin αvβ3, and interleukin-6 in HUVECs. In macrophage-like THP-1 cells, SPF89 effectively inhibited LPS and low-density lipoprotein-induced foam cell formation. However, these anti-inflammatory and anti-atherosclerotic effects of anti-FGL2 mAb in HUVECs and THP-1 cells were significantly reduced after treatment with an NF-κB inhibitor PDTC. All the above suggest, by efficiently inhibiting LPS-induced pro-inflammatory effects in vascular endothelial cells by attenuating NF-κB dependent pathway, the new anti-FGL2 mAb SPF89 could to be a potential therapeutic candidate for protecting the vascular endothelium against inflammatory diseases such as atherosclerosis. This work was supported by the Program of Sichuan Science and Technology Department (2017FZ0069) and Collaborative Innovation Program of Sichuan for Elderly Care and Health(YLZBZ1511).

Keywords: monoclonal antibody, fibrinogen like protein 2, inflammation, endothelial cells

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5735 Hybrid Molecules: A Promising Approach to Design Potent Antimicrobial and Anticancer Drugs

Authors: Blessing Atim Aderibigbe

Abstract:

A series of amine/ester-linked hybrid compounds containing pharmacophores, such as ursolic acid, oleanolic acid, ferrocene and bisphosphonates, were synthesized in an attempt to develop potent antibacterial and anticancer agents. Their structures were analyzed and confirmed using Nuclear Magnetic Resonance, Fourier Transform Infrared Spectroscopy, and mass spectroscopy. All the synthesized hybrid compounds were evaluated for their antibacterial activities against eleven selected bacterial strains using a serial dilution method. Some of the compounds displayed significant antibacterial activity against most of the bacterial and fungal strains. In addition, the in vitro cytotoxicity of these compounds was also performed against selected cancer cell lines. Some of the compounds were also found to be more active than their parent compounds, revealing the efficacy of designing hybrid molecules using plant-based bioactive agents.

Keywords: ursolic acid, hybrid drugs, oleanolic acid, bisphosphonates

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5734 Synthesis of Silver Nanoparticles by Different Types of Plants

Authors: Khamael Abualnaja, Hala M. Abo-Dief

Abstract:

Silver nanoparticles (AgNPs) are the subject of important recent interest, present in a large range of applications such as electronics, catalysis, chemistry, energy, and medicine. Metallic nanoparticles are traditionally synthesized by wet chemical techniques, where the chemicals used are quite often toxic and flammable. In this work, we describe an effective and environmental-friendly technique of green synthesis of silver nanoparticles. Silver nanoparticles (AgNPs) synthesized using silver nitrate solution and the extract of mint, basil, orange peel and Tangerines peel which used as reducing agents. Silver Nanoparticles were characterized using Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM) and UV–Vis absorption spectroscopy. SEM analysis showed the average particle size of mint, basil, orange peel, Tangerines peel are 30, 20, 12, 10 nm respectively. This is for the first time that any plant extract was used for the synthesis of nanoparticles.

Keywords: silver nanoparticles, green synthesis, scanning electron microscopy, plants

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5733 Computational Fluid Dynamics Study on Water Soot Blower Direction in Tangentially Fired Pulverized-Coal Boiler

Authors: Teewin Plangsrinont, Wasawat Nakkiew

Abstract:

In this study, computational fluid dynamics (CFD) was utilized to simulate and predict the path of water from water soot blower through an ambient flow field in 300-megawatt tangentially burned pulverized coal boiler that utilizes a water soot blower as a cleaning device. To predict the position of the impact of water on the opposite side of the water soot blower under identical conditions, the nozzle size and water flow rate were fixed in this investigation. The simulation findings demonstrated a high degree of accuracy in predicting the direction of water flow to the boiler's water wall tube, which was validated by comparison to experimental data. Results show maximum deviation value of the water jet trajectory is 10.2 percent.

Keywords: computational fluid dynamics, tangentially fired boiler, thermal power plant, water soot blower

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5732 Initiation of Paraptosis-Like PCD Pathway in Hepatocellular Carcinoma Cell Line by Hep88 mAb through the Binding of Mortalin (HSPA9) and Alpha-Enolase

Authors: Panadda Rojpibulstit, Suthathip Kittisenachai, Songchan Puthong, Sirikul Manochantr, Pornpen Gamnarai, Sasichai Kangsadalampai, Sittiruk Roytrakul

Abstract:

Hepatocellular carcinoma (HCC) is the most primary hepatic cancer worldwide. Nowadays a targeted therapy via monoclonal antibodies (mAbs) specific to tumor-associated antigen is continually developed in HCC treatment. In this regard, after establishing and consequently exploring Hep88 mAb’s tumoricidal effect on hepatocellular carcinoma cell line (HepG2 cell line), the Hep88 mAb’s specific Ag from both membrane and cytoplasmic fractions of HepG2 cell line was identified by 2-D gel electrophoresis and western blot analysis. After in-gel digestion and subsequent analysis by liquid chromatography-mass spectrometry (LC-MS), mortalin (HSPA9) and alpha-enolase were identified. The recombinant proteins specific to Hep88 mAb were cloned and expressed in E.coli BL21 (DE3). Moreover, alteration of HepG2 and Chang liver cell line after being induced by Hep88 mAb for 1-3 days was investigated using a transmission electron microscope. The result demonstrated that Hep88 mAb can bind to the recombinant mortalin (HSPA9) andalpha-enolase. In addition, gradual appearance of mitochondria vacuolization and endoplasmic reticulum dilatation were observed. Taken together, paraptosis-like programmed cell death (PCD) of HepG2 is induced by binding of mortalin (HSPA9) and alpha-enolase to Hep88 mAb. Mortalin depletion by formation of Hep88 mAb-mortalin (HSPA9) complex might initiate transcription-independent of p53-mediated apoptosis. Additionally, Hep88 mAb-alpha-enolase complex might initiate HepG2 cells energy exhaustion by glycolysis pathway obstruction. These results imply that Hep88 mAb might be a promising tool for development of an effective treatment of HCC in the next decade.

Keywords: Hepatocellular carcinoma, Monoclonal antibody, Paraptosis-like program cell death, Transmission electron microscopy, mortalin (HSPA9), alpha-enolase

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5731 Cucurbita pepo L. Attenuates Diabetic Neuropathy by Targeting Oxidative Stress in STZ-Nicotinamide Induced Diabetic Rats

Authors: Navpreet Kaur, Randhir Singh

Abstract:

Diabetic neuropathy is one of the most common microvascular complications of diabetes mellitus which affects more than 50% of diabetic patients. The present study targeted oxidative stress mediated nerve damage in diabetic rats using a hydro-alcohol extract of Cucurbita pepo L. (Family: Cucurbitaceae) and its potential in treatment of diabetic neuropathy. Diabetes neuropathy was induced in Wistar rats by injection of streptozotocin (65 mg/kg, i.p.) 15 min after Nicotinamide (230 mg/kg, i.p.) administration. Hydro-alcohol extract of C. pepo seeds was assessed by oral administration at 100, 200 and 400 mg/kg in STZ-nicotinamide induced diabetic rats. Thermal hyperalgesia (Eddy's hot plate and tail immersion), mechanical hyperalgesia (Randall-Selitto) and tactile allodynia (Von Frey hair tests) were evaluated in all groups of streptozotocin diabetic rats to assess the extent of neuropathy. Tissue (sciatic nerve) antioxidant enzymes (SOD, CAT, GSH and LPO) levels were measured along with the formation of AGEs in serum to assess the effect of hydro-alcohol extract of C. pepo in ameliorating oxidative stress. Diabetic rats exhibited significantly decreased tail-flick latency in the tail-immersion test and decreased paw withdrawal threshold in both Randall-Selitto and von-Frey hair test. A decrease in the nociceptive threshold was accompanied by significantly increased oxidative stress in sciatic nerve of diabetic rats. Treatment with the C. pepo hydro-alcohol extract significantly attenuated all the behavioral and biochemical alterations in a dose-dependent manner. C. pepo attenuated the diabetic condition and also reversed neuropathic pain through modulation of oxidative stress and thus it may find application as a possible therapeutic agent against diabetic neuropathy.

Keywords: advanced glycation end products, antioxidant enzymes, cucurbita pepo, hyperglycemia

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5730 Review and Analysis of Parkinson's Tremor Genesis Using Mathematical Model

Authors: Pawan Kumar Gupta, Sumana Ghosh

Abstract:

Parkinson's Disease (PD) is a long-term neurodegenerative movement disorder of the central nervous system with vast symptoms related to the motor system. The common symptoms of PD are tremor, rigidity, bradykinesia/akinesia, and postural instability, but the clinical symptom includes other motor and non‐motor issues. The motor symptoms of the disease are consequence of death of the neurons in a region of the midbrain known as substantia nigra pars compacta, leading to decreased level of a neurotransmitter known as dopamine. The cause of this neuron death is not clearly known but involves formation of Lewy bodies, an abnormal aggregation or clumping of the protein alpha-synuclein in the neurons. Unfortunately, there is no cure for PD, and the management of this disease is challenging. Therefore, it is critical for a patient to be diagnosed at early stages. A limited choice of drugs is available to improve the symptoms, but those become less and less effective over time. Apart from that, with rapid growth in the field of science and technology, other methods such as multi-area brain stimulation are used to treat patients. In order to develop advanced techniques and to support drug development for treating PD patients, an accurate mathematical model is needed to explain the underlying relationship of dopamine secretion in the brain with the hand tremors. There has been a lot of effort in the past few decades on modeling PD tremors and treatment effects from a computational point of view. These models can effectively save time as well as the cost of drug development for the pharmaceutical industry and be helpful for selecting appropriate treatment mechanisms among all possible options. In this review paper, an effort is made to investigate studies on PD modeling and analysis and to highlight some of the key advances in the field over the past centuries with discussion on the current challenges.

Keywords: Parkinson's disease, deep brain stimulation, tremor, modeling

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5729 The Transcutaneous Auricular Vagus Nerve Stimulation in Treatment of Depression and Anxiety Disorders in Recovery Patient with Feeding and Eating Disorders

Authors: Y. Melis, E. Apicella, E. Dozio, L. Mendolicchio

Abstract:

Introduction: Feeding and Eating Disorders (FED) represent the psychiatric pathology with the highest mortality rate and one of the major disorders with the highest psychiatric and clinical comorbidity. The vagus nerve represents one of the main components of the sympathetic and parasympathetic nervous system and is involved in important neurophysiological functions. In FED, there is a spectrum of symptoms which with TaVNS (Transcutaneous Auricular Vagus Nerve Stimulation) therapy, is possible to have a therapeutic efficacy. Materials and Methods: Sample subjects are composed of 15 female subjects aged > 18 ± 51. Admitted to a psychiatry community having been diagnosed according to DSM-5: anorexia nervosa (AN) (N= 9), bulimia nervosa (BN) (N= 5), binge eating disorder (BED) (N= 1). The protocol included 9 weeks of Ta-VNS stimulation at a frequency of 1.5-3.5 mA for 4 hours per day. The variables detected are the following: Heart Rate Variability (HRV), Hamilton Depression Rating Scale (HAMD-HDRS-17), Body Mass Index (BMI), Beck Anxiety Index (BAI). Results: Data analysis showed statistically significant differences between recording times (p > 0.05) in HAM-D (t0 = 18.28 ± 5.31; t4 = 9.14 ± 7.15), in BAI (t0 = 24.7 ± 10.99; t4 = 13.8 ± 7.0). The reported values show how during (T0-T4) the treatment there is a decay of the degree in the depressive state, in the state of anxiety, and an improvement in the value of BMI. In particular, the BMI in the AN-BN sub-sample had a minimum gain of 5% and a maximum of 11%. The analysis of HRV did not show a clear change among subjects, thus confirming the discordance of the activity of the sympathetic and parasympathetic nervous system in FED. Conclusions: Although the sample does not possess a relevant value to determine long-term efficacy of Ta-VNS or on a larger population, this study reports how the application of neuro-stimulation in FED may become a further approach therapeutic. Indeed, substantial improvements are highlighted in the results and confirmed hypotheses proposed by the study.

Keywords: feeding and eating disorders, neurostimulation, anxiety disorders, depression

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5728 Thermo-Mechanical Processing Scheme to Obtain Micro-Duplex Structure Favoring Superplasticity in an As-Cast and Homogenized Medium Alloyed Nickel Base Superalloy

Authors: K. Sahithya, I. Balasundar, Pritapant, T. Raghua

Abstract:

Ni-based superalloy with a nominal composition Ni-14% Cr-11% Co-5.8% Mo-2.4% Ti-2.4% Nb-2.8% Al-0.26 % Fe-0.032% Si-0.069% C (all in wt %) is used as turbine discs in a variety of aero engines. Like any other superalloy, the primary processing of the as-cast superalloy poses a major challenge due to its complex alloy chemistry. The challenge was circumvented by characterizing the different phases present in the material, optimizing the homogenization treatment, identifying a suitable thermomechanical processing window using dynamic materials modeling. The as-cast material was subjected to homogenization at 1200°C for a soaking period of 8 hours and quenched using different media. Water quenching (WQ) after homogenization resulted in very fine spherical γꞌ precipitates of sizes 30-50 nm, whereas furnace cooling (FC) after homogenization resulted in bimodal distribution of precipitates (primary gamma prime of size 300nm and secondary gamma prime of size 5-10 nm). MC type primary carbides that are stable till the melting point of the material were found in both WQ and FC samples. Deformation behaviour of both the materials below (1000-1100°C) and above gamma prime solvus (1100-1175°C) was evaluated by subjecting the material to series of compression tests at different constant true strain rates (0.0001/sec-1/sec). An in-detail examination of the precipitate dislocation interaction mechanisms carried out using TEM revealed precipitate shearing and Orowan looping as the mechanisms governing deformation in WQ and FC, respectively. Incoherent/semi coherent gamma prime precipitates in the case of FC material facilitates better workability of the material, whereas the coherent precipitates in WQ material contributed to higher resistance to deformation of the material. Both the materials exhibited discontinuous dynamic recrystallization (DDRX) above gamma prime solvus temperature. The recrystallization kinetics was slower in the case of WQ material. Very fine grain boundary carbides ( ≤ 300 nm) retarded the recrystallisation kinetics in WQ. Coarse carbides (1-5 µm) facilitate particle stimulated nucleation in FC material. The FC material was cogged (primary hot working) 1120˚C, 0.03/sec resulting in significant grain refinement, i.e., from 3000 μm to 100 μm. The primary processed material was subjected to intensive thermomechanical deformation subsequently by reducing the temperature by 50˚C in each processing step with intermittent heterogenization treatment at selected temperatures aimed at simultaneous coarsening of the gamma prime precipitates and refinement of the gamma matrix grains. The heterogeneous annealing treatment carried out, resulted in gamma grains of 10 μm and gamma prime precipitates of 1-2 μm. Further thermo mechanical processing of the material was carried out at 1025˚C to increase the homogeneity of the obtained micro-duplex structure.

Keywords: superalloys, dynamic material modeling, nickel alloys, dynamic recrystallization, superplasticity

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5727 Comparative Evaluation of a Dynamic Navigation System Versus a Three-Dimensional Microscope in Retrieving Separated Endodontic Files: An in Vitro Study

Authors: Mohammed H. Karim, Bestoon M. Faraj

Abstract:

Introduction: This study aimed to compare the effectiveness of a Dynamic Navigation System (DNS) and a three-dimensional microscope in retrieving broken rotary NiTi files when using trepan burs and the extractor system. Materials and Methods: Thirty maxillary first bicuspids with sixty separate roots were split into two comparable groups based on a comprehensive Cone-Beam Computed Tomography (CBCT) analysis of the root length and curvature. After standardized access opening, glide paths, and patency attainment with the K file (sizes 10 and 15), the teeth were arranged on 3D models (three per quadrant, six per model). Subsequently, controlled-memory heat-treated NiTi rotary files (#25/0.04) were notched 4 mm from the tips and fractured at the apical third of the roots. The C-FR1 Endo file removal system was employed under both guidance to retrieve the fragments, and the success rate, canal aberration, treatment time and volumetric changes were measured. The statistical analysis was performed using IBM SPSS software at a significance level of 0.05. Results: The microscope-guided group had a higher success rate than the DNS guidance, but the difference was insignificant (p > 0.05). In addition, the microscope-guided drills resulted in a substantially lower proportion of canal aberration, required less time to retrieve the fragments and caused minimal change in the root canal volume (p < 0.05). Conclusion: Although dynamically guided trephining with the extractor can retrieve separated instruments, it is inferior to three-dimensional microscope guidance regarding treatment time, procedural errors, and volume change.

Keywords: separated instruments retrieval, dynamic navigation system, 3D video microscope, trephine burs, extractor

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5726 Fabrication of Ligand Coated Lipid-Based Nanoparticles for Synergistic Treatment of Autoimmune Disease

Authors: Asiya Mahtab, Sushama Talegaonkar

Abstract:

The research is aimed at developing targeted lipid-based nanocarrier systems of chondroitin sulfate (CS) to deliver an antirheumatic drug to the inflammatory site in arthritic paw. Lipid-based nanoparticle (TEF-lipo) was prepared by using a thin-film hydration method. The coating of prepared drug-loaded nanoparticles was done by the ionic interaction mechanism. TEF-lipo and CS-coated lipid nanoparticle (CS-lipo) were characterized for mean droplet size, zeta potential, and surface morphology. TEF-lipo and CS-lipo were further subjected to in vitro cell line studies on RAW 264.7 murine macrophage, U937, and MG 63 cell lines. The pharmacodynamic study was performed to establish the effectiveness of the prepared lipid-based conventional and targeted nanoparticles in comparison to pure drugs. Droplet size and zeta potential of TEF-lipo were found to be 128. 92 ± 5.42 nm and +12.6 ± 1.2 mV. It was observed that after the coating of TEF-lipo with CS, particle size increased to 155.6± 2.12 nm and zeta potential changed to -10.2± 1.4mV. Transmission electron microscopic analysis revealed that the nanovesicles were uniformly dispersed and detached from each other. Formulations followed sustained release pattern up to 24 h. Results of cell line studies ind icated that CS-lipo formulation showed the highest cytotoxic potential, thereby proving its enhanced ability to kill the RAW 264.7 murine macrophage and U937 cells when compared with other formulations. It is clear from our in vivo pharmacodynamic results that targeted nanocarriers had a higher inhibitory effect on arthritis progression than nontargeted nanocarriers or free drugs. Results demonstrate that this approach will provide effective treatment for rheumatoid arthritis, and CS served as a potential prophylactic against the advancement of cartilage degeneration.

Keywords: adjuvant induced arthritis, chondroitin sulfate, rheumatoid arthritis, teriflunomide

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5725 The Effect of Mindfulness-Based Interventions for Individuals with Tourette Syndrome: A Scoping Review

Authors: Ilana Singer, Anastasia Lučić, Julie Leclerc

Abstract:

Introduction: Tics, characterized by repetitive, sudden, non-voluntary motor movements or vocalizations, are prevalent in chronic tic disorder (CT) and Tourette Syndrome (TS). These neurodevelopmental disorders often coexist with various psychiatric conditions, leading to challenges and reduced quality of life. While medication in conjunction with behavioral interventions, such as Habit Reversal Training (HRT), Exposure Response Prevention (ERP), and Comprehensive Behavioral Intervention for Tics (CBIT), has shown efficacy, a significant proportion of patients experience persistent tics. Thus, innovative treatment approaches are necessary to improve therapeutic outcomes, such as mindfulness-based approaches. Nonetheless, the effectiveness of mindfulness-based interventions in the context of CT and TS remains understudied. Objective: The objective of this scoping review is to provide an overview of the current state of research on mindfulness-based interventions for CT and TS, identify knowledge and evidence gaps, discuss the effectiveness of mindfulness-based interventions with other treatment options, and discuss implications for clinical practice and policy development. Method: Using guidelines from Peters (2020) and the PRISMA-ScR, a scoping review was conducted. Multiple electronic databases were searched from inception until June 2023, including MEDLINE, EMBASE, PsychInfo, Global Health, PubMed, Web of Science, and Érudit. Inclusion criteria were applied to select relevant studies, and data extraction was independently performed by two reviewers. Results: Five papers were included in the study. Firstly, we found that mindfulness interventions were found to be effective in reducing anxiety and depression while enhancing overall well-being in individuals with tics. Furthermore, the review highlighted the potential role of mindfulness in enhancing functional connectivity within the Default Mode Network (DMN) as a compensatory function in TS patients. This suggests that mindfulness interventions may complement and support traditional therapeutic approaches, particularly HRT, by positively influencing brain networks associated with tic regulation and control. Conclusion: This scoping review contributes to the understanding of the effectiveness of mindfulness-based interventions in managing CT and TS. By identifying research gaps, this review can guide future investigations and interventions to improve outcomes for individuals with CT or TS. Overall, these findings emphasize the potential benefits of incorporating mindfulness-based interventions as a smaller subset within comprehensive treatment strategies. However, it is essential to acknowledge the limitations of this scoping review, such as the exclusion of a pre-established protocol and the limited number of studies available for inclusion. Further research and clinical exploration are necessary to better understand the specific mechanisms and optimal integration of mindfulness-based interventions with existing behavioral interventions for this population.

Keywords: scoping reviews, Tourette Syndrome, tics, mindfulness-based, therapy, intervention

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5724 Kinetics of Sugar Losses in Hot Water Blanching of Water Yam (Dioscorea alata)

Authors: Ayobami Solomon Popoola

Abstract:

Yam is majorly a carbohydrate food grown in most parts of the world. It could be boiled, fried or roasted for consumption in a variety of ways. Blanching is an established heat pre-treatment given to fruits and vegetables prior to further processing such as dehydration, canning, freezing etc. Losses of soluble solids during blanching has been a great problem because a reasonable quantity of the water-soluble nutrients are inevitably leached into the blanching water. Without blanching, the high residual levels of reducing sugars after extended storage produce a dark, bitter-tasting product because of the Maillard reactions of reducing sugars at frying temperature. Measurement and prediction of such losses are necessary for economic efficiency in production and to establish the level of effluent treatment of the blanching water. This paper aims at resolving this problem by investigating the effects of cube size and temperature on the rate of diffusional losses of reducing sugars and total sugars during hot water blanching of water-yam. The study was carried out using four temperature levels (65, 70, 80 and 90 °C) and two cubes sizes (0.02 m³ and 0.03 m³) at 4 times intervals (5, 10, 15 and 20 mins) respectively. Obtained data were fitted into Fick’s non-steady equation from which diffusion coefficients (Da) were obtained. The Da values were subsequently fitted into Arrhenius plot to obtain activation energies (Ea-values) for diffusional losses. The diffusion co-efficient were independent of cube size and time but highly temperature dependent. The diffusion coefficients were ≥ 1.0 ×10⁻⁹ m²s⁻¹ for reducing sugars and ≥ 5.0 × 10⁻⁹ m²s⁻¹ for total sugars. The Ea values ranged between 68.2 to 73.9 KJmol⁻¹ and 7.2 to 14.30 KJmol⁻¹ for reducing sugars and total sugars losses respectively. Predictive equations for estimating amount of reducing sugars and total sugars with blanching time of water-yam at various temperatures were also presented. The equation could be valuable in process design and optimization. However, amount of other soluble solids that might have leached into the water along with reducing and total sugars during blanching was not investigated in the study.

Keywords: blanching, kinetics, sugar losses, water yam

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5723 [Keynote Talk]: Treatment Satisfaction and Safety of Sitagliptin versus Pioglitazone in Patients with Type 2 Diabetes Mellitus Inadequately Controlled on Metformin Monotherapy

Authors: Shahnaz Haque, Anand Shukla, Sunita Singh, Anil Kem

Abstract:

Introduction: Diabetes Mellitus is a chronic metabolic disease affecting millions worldwide. Metformin is the most commonly prescribed first line oral hypoglycemic drug for type 2 diabetes mellitus, but due to progressive worsening of blood glucose control during the natural history of type 2 diabetes, combination therapy usually becomes necessary. Objective: This study was designed to assess the treatment satisfaction between Sitagliptin versus Pioglitazone added to Metformin in patients with type 2 diabetes mellitus (T2DM). Methods: We conducted a prospective, open label, randomized, parallel group study in SIMS, Hapur, U.P. Eligible patients fulfilling inclusion criteria were randomized into two groups having 25 patients in each group using tab Sitagliptin 100mg, tab Pioglitazone 30mg added to ongoing tab Metformin (500mg) therapy for 16 weeks. The follow-up visits were on weeks 4,12 and 16. Result: 16 weeks later, addition of Sitagliptin 100mg compared to that of Pioglitazone 30 mg to ongoing Metformin therapy provided similar glycosylated hemoglobin (HbA1c) lowering efficacy in patients with T2DM with inadequate glycemic control on metformin monotherapy. Change in HbA1c in group1 was -0.656±0.21%(p<0.0001) whereas in group2 was -0.748±0.35%(p<0.0001). Hence decrease in HbA1c from baseline was more in group2. Both treatments were well tolerated with negligible risk of hypoglycaemia. Weight loss was observed with Sitagliptin in contrast to weight gain seen in Pioglitazone. Conclusion: In this study, Sitagliptin 100 mg along with metformin therapy in comparison to pioglitazone 30 mg plus metformin therapy was both effective, well-tolerated and improved glycemic control in both the groups. Addition of pioglitazone had cause oedema and weight gain to the patients whereas sitagliptin caused weight loss in its patients.

Keywords: sitagliptin, pioglitazone, metformin, type 2 diabetes mellitus

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5722 A Study on Removal of SO3 in Flue Gas Generated from Power Plant

Authors: E. Y. Jo, S. M. Park, I. S. Yeo, K. K. Kim, S. J. Park, Y. K. Kim, Y. D. Kim, C. G. Park

Abstract:

SO3 is created in small quantities during the combustion of fuel that contains sulfur, with the quantity produced a function of the boiler design, fuel sulfur content, excess air level, and the presence of oxidizing agents. Typically, about 1% of the fuel sulfur will be oxidized to SO3, but it can range from 0.5% to 1.5% depending on various factors. Combustion of fuels that contain oxidizing agents, such as certain types of fuel oil or petroleum coke, can result in even higher levels of oxidation. SO3 levels in the flue gas emitted by combustion are very high, which becomes a cause of machinery corrosion or a visible blue plume. Because of that, power plants firing petroleum residues need to installation of SO3 removal system. In this study, SO3 removal system using salt solution was developed and several salts solutions were tested for obtain optimal solution for SO3 removal system. Response surface methodology was used to optimize the operation parameters such as gas-liquid ratio, concentration of salts.

Keywords: flue gas desulfurization, petroleum cokes, Sulfur trioxide, SO3 removal

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5721 An Approach to Spatial Planning for Water Conservation: The Case of Kovada Sub-Watershed (Turkey)

Authors: Aybike Ayfer Karadağ

Abstract:

Today, the amount of water available is decreasing day by day due to global warming, environmental problems and population increase. To protect water resources, it is necessary to take a lot of measures from the global scale to the local scale. Some of these measures are related to spatial planning studies. In this study, the impact of water process analysis was assessed in the development of spatial planning for water conservation. The study was conducted in the Kovada sub-watershed (Isparta, Turkey). By means of water process analysis, the way to reach underground water of surface water in the study area is mapped. In this context, plant cover, soil and rock permeability were evaluated holistically with geographic information systems technologies. Then, on the map, water permeability is classified and this is spatially expressed. The findings show that the permeability of the water is different in the study case. As a result, the water permeability map needs to be included in the planning for water conservation planning.

Keywords: water, conservation, spatial planning, water process analysis

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5720 Effects of Web-Enabled Sculpture Package on Colleges of Education Students’ Psychomotor Ability in Fine Arts in South-West, Nigeria

Authors: Ibrahim A. Kareem, Sina O. Ayelaagbe

Abstract:

This study investigated the effects of web-enabled Sculpture package on Colleges of Education students’ psychomotor level in Fine Arts in South-west, Nigeria. The objectives of this study were to: (i) determine the effect of web-enabled Sculpture package on Fine Arts Students’ performance; (ii) find out the effect of ability levels on Fine Arts Students’ performance and (iii) ascertain the interaction effect of treatment and ability levels on Fine Arts Students’ performance. The study was quasi-experimental design. A total of 48 Fine Arts Students participated in the study. There were 26 students in experimental and 22 for the control. The respondents were purposively sampled from Adeyemi College of Education, Ondo and Federal College of Education (Special) Oyo. Sculpture Achievement Test, Sculpture Skill Test and Sculpture ‘on the Spot’ Skill Assessment Instrument were validated by experts while Pearson’s Product Moment Correlation (PPMC) statistics was used to analyse the instrument while the remaining two instruments were subjected to Cronbach alpha statistics. Data were analysed using t-test and ANCOVA were used to test the hypotheses at 0.05 level of significance. The findings of the study revealed that: (i) Fine Arts Students’ in the experimental group performed significantly better than the control group; (ii) there was a significant difference among high, medium and low ability levels mean scores of Fine Arts Students’ performance in Colleges of Education; (iii) there was no significant interaction effect of treatment and ability levels on the mean scores of Fine Arts Students’ performance in Colleges of Education and. The study concluded that Fine Arts Students exposed to web-enabled Sculpture package performed better than those taught using the conventional method. Based on the study it was recommended that lecturers in Colleges of Education should endeavour to adapt and utilise web-enabled Sculpture package for teaching sculpture.

Keywords: fine art, psychomotor, sculpture, web-enabled

Procedia PDF Downloads 127
5719 Comparison of Small Ruminants (Sheep) Production Efficiency of Nomadic and Transhumance Flocks in Malakand, Pakistan

Authors: Akbar Nawaz Khan, Abdul Ghaffar, Abdur Rehman, Muhammad Naeem Riaz, Sayed Muhammad Hassan Andrabi

Abstract:

The present study was conducted to compare sheep rearing in nomadic with transhumance system in term of production parameters. The following parameters which studied for comparison were household size, landholding area, flock size, body condition score, fecal egg count and live weight change in sheep under nomadic and transhumance systems of management in Malakand since October 2010 to March 2011. Further the effects of Body Condition Score (BCS) and Fecal Egg Count (FEC) on production were also examined. Two systems were checked for the purpose to check the efficiency of production. A total of eight flocks, four each from nomadic and transhumance system were selected for the study; each flock was divided into treatment and controlled groups to check the effect of treatment or de-wormers. A total of 160 animals were selected randomly (80 treated, 80 controlled). The adult ram average weight transhumance system was 55.58 kg while in nomadic that was 54.16 kg, weight change was positive, and the highest change was recorded in transhumance treated which was 13%. Fecal egg count was record low (75 EPG) in transhumance treated group while high (330 EPG) in nomadic controlled. Body condition score was recorded 3.6 for transhumance treated and 3.32 for nomadic treated. It is concluded from the present study that transhumance system performed significantly (p < 0.05) better in respect of live weight, BCS, FEC, family size, Landholding area, number of animals in a flock, offspring record, culling, and mortality. Mean values are 7.367 ± 0221, 0.900 ± 0.071, 63.167 ± 1.559, 55.600 ± 1.480, 8.300 ± 0.321 and 2.500 ± 0.158 respectively. De-wormer effect on FEC showed a significant reduction in egg load in mature sheep on both systems.

Keywords: small ruminant, sheep, nomadic, transhumance, Malakand, production efficiency

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5718 Electrolysis Ship for Green Hydrogen Production and Possible Applications

Authors: Julian David Hunt, Andreas Nascimento

Abstract:

Green hydrogen is the most environmental, renewable alternative to produce hydrogen. However, an important challenge to make hydrogen a competitive energy carrier is a constant supply of renewable energy, such as solar, wind and hydropower. Given that the electricity generation potential of these sources vary seasonally and interannually, this paper proposes installing an electrolysis hydrogen production plant in a ship and move the ship to the locations where electricity is cheap, or where the seasonal potential for renewable generation is high. An example of electrolysis ship application is to produce green hydrogen with hydropower from the North region of Brazil and then sail to the Northeast region of Brazil and generate hydrogen using excess electricity from offshore wind power. The electrolysis ship concept is interesting because it has the flexibility to produce green hydrogen using the cheapest renewable electricity available in the market.

Keywords: green hydrogen, electrolysis ship, renewable energies, seasonal variations

Procedia PDF Downloads 138
5717 Protective Effects of Coenzyme Q10 and N-Acetylcysteine on Myocardial Oxidative Stress, Inflammation, and Impaired Energy metabolism in Carbon Tetrachloride Intoxicated Rats

Authors: Nayira A. Abd Elbaky, Amal J. Fatani, Hazar Yaqub, Nouf M. Al-Rasheed, Naglaa El-Orabi, Mai Osman

Abstract:

The present work is aimed to evaluate the protective effect of N-acetyl cystiene (NAC), coenzyme Q10 (CoQ10), and their combination against carbon tetrachloride (CCl4)-induced cardiotoxicity in rats. CCl4 treatment significantly elevated the levels of cardiac oxidative stress bio markers including nitric oxide (NO) and malondialdehyde (MDA). A concomitant decrease in the level of reduced glutathione and the activity of membrane bound enzyme, calcium-adenosine triphosphatase were observed in the hearts of rats exposed to CCl4 compared to respective values in normal group. Quantitative analysis of myocardial energy metabolism revealed a significant decrease in the glucose content coupled with depletion in the activities of myocardial glycolytic enzymes as hexokinase (HK), phosphofructokinase (PFK) and lactate dehydrogenase (LDH) after CCl4 treatment. In addition, a significant elevation in myocardial hydroxyproline level was observed in CCl4 intoxicated rats indicating interstitial collagen accumulation. Pretreatment with either NAC, CoQ10 or their combination successively alleviated the alterations in myocardial oxidative stress and antioxidant markers, as well as effectively up-regulated the decrease in cardiac energetic biomarkers in CCl4 intoxicated rats. Moreover, these antioxidants markedly reduced myocardial hydroxyproline level versus that of CCl4-treated animals. In conclusion, the present results illustrated that the prophylactic use of the current antioxidant resulted in a remarkable cardioprotective effect against CCl4 induced myocardial damage, which suggest that they may candidates as prophylactic agents against different cardio-toxins.

Keywords: carbon tetrachloride, lipid peroxidation, antioxidant, energy metabolism, hydroxyproline

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5716 A Stepped Care mHealth-Based Approach for Obesity with Type 2 Diabetes in Clinical Health Psychology

Authors: Gianluca Castelnuovo, Giada Pietrabissa, Gian Mauro Manzoni, Margherita Novelli, Emanuele Maria Giusti, Roberto Cattivelli, Enrico Molinari

Abstract:

Diabesity could be defined as a new global epidemic of obesity and being overweight with many complications and chronic conditions. Such conditions include not only type 2 diabetes, but also cardiovascular diseases, hypertension, dyslipidemia, hypercholesterolemia, cancer, and various psychosocial and psychopathological disorders. The financial direct and indirect burden (considering also the clinical resources involved and the loss of productivity) is a real challenge in many Western health-care systems. Recently the Lancet journal defined diabetes as a 21st-century challenge. In order to promote patient compliance in diabesity treatment reducing costs, evidence-based interventions to improve weight-loss, maintain a healthy weight, and reduce related comorbidities combine different treatment approaches: dietetic, nutritional, physical, behavioral, psychological, and, in some situations, pharmacological and surgical. Moreover, new technologies can provide useful solutions in this multidisciplinary approach, above all in maintaining long-term compliance and adherence in order to ensure clinical efficacy. Psychological therapies with diet and exercise plans could better help patients in achieving weight loss outcomes, both inside hospitals and clinical centers and during out-patient follow-up sessions. In the management of chronic diseases clinical psychology play a key role due to the need of working on psychological conditions of patients, their families and their caregivers. mHealth approach could overcome limitations linked with the traditional, restricted and highly expensive in-patient treatment of many chronic pathologies: one of the best up-to-date application is the management of obesity with type 2 diabetes, where mHealth solutions can provide remote opportunities for enhancing weight reduction and reducing complications from clinical, organizational and economic perspectives. A stepped care mHealth-based approach is an interesting perspective in chronic care management of obesity with type 2 diabetes. One promising future direction could be treating obesity, considered as a chronic multifactorial disease, using a stepped-care approach: -mhealth or traditional based lifestyle psychoeducational and nutritional approach. -health professionals-driven multidisciplinary protocols tailored for each patient. -inpatient approach with the inclusion of drug therapies and other multidisciplinary treatments. -bariatric surgery with psychological and medical follow-up In the chronic care management of globesity mhealth solutions cannot substitute traditional approaches, but they can supplement some steps in clinical psychology and medicine both for obesity prevention and for weight loss management.

Keywords: clinical health psychology, mhealth, obesity, type 2 diabetes, stepped care, chronic care management

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5715 Challenges of Management of Subaortic Membrane in a Young Adult Patient: A Case Review and Literature Review

Authors: Talal Asif, Maya Kosinska, Lucas Georger, Krish Sardesai, Muhammad Shah Miran

Abstract:

This article presents a case review and literature review focused on the challenges of managing subaortic membranes (SAM) in young adult patients with mild aortic regurgitation (AR) or aortic stenosis (AS). The study aims to discuss the diagnosis of SAM, imaging studies used for assessment, management strategies in young patients, the risk of valvular damage, and the controversy surrounding prophylactic resection in mild AR. The management of SAM in adults poses challenges due to limited treatment options and potential complications, necessitating further investigation into the progression of AS and AR in asymptomatic SAM patients. The case presentation describes a 40-year-old male with muscular dystrophy who presented with symptoms and was diagnosed with SAM. Various imaging techniques, including CT chest, transthoracic echocardiogram (TTE), and transesophageal echocardiogram (TEE), were used to confirm the presence and severity of SAM. Based on the patient's clinical profile and the absence of surgical indications, medical therapy was initiated, and regular outpatient follow-up was recommended to monitor disease progression. The discussion highlights the challenges in diagnosing SAM, the importance of imaging studies, and the potential complications associated with SAM in young patients. The article also explores the management options for SAM, emphasizing surgical resection as the definitive treatment while acknowledging the limited success rates of alternative approaches. Close monitoring and prompt intervention for complications are crucial in the management of SAM. The concluding statement emphasizes the need for further research to explore alternative treatments for SAM in young patients.

Keywords: subaortic membrane, management, case report, literature review, aortic regurgitation, aortic stenosis, left ventricular outflow obstruction, guidelines, heart failure

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5714 Clinical Response of Nuberol Forte® (Paracetamol 650 MG+Orphenadrine 50 MG) For Pain Management with Musculoskeletal Conditions in Routine Pakistani Practice (NFORTE-EFFECT)

Authors: Shahid Noor, Kazim Najjad, Muhammad Nasir, Irshad Bhutto, Abdul Samad Memon, Khurram Anwar, Tehseen Riaz, Mian Muhammad Hanif, Nauman A. Mallik, Saeed Ahmed, Israr Ahmed, Ali Yasir

Abstract:

Background: Musculoskeletal pain is the most common complaint presented to the health practitioner. It is well known that untreated or under-treated pain can have a significant negative impact on an individual’s quality of life (QoL). Objectives: This study was conducted across 10 sites in six (6) major cities of Pakistan to evaluate the tolerability, safety, and the clinical response of Nuberol Forte® (Paracetamol 650 mg + Orphenadrine 50 mg) to musculoskeletal pain in routine Pakistani practice and its impact on improving the patient’s QoL. Design & Methods: This NFORT-EFFECT observational, prospective multicenter study was conducted in compliance with Good Clinical Practice guidelines and local regulatory requirements. The study sponsor was "The Searle Company Limited, Pakistan. To maintain the GCP compliances, the sponsor assigned the CRO for the site and data management. Ethical approval was obtained from an independent ethics committee. The IEC reviewed the progress of the study. Written informed consent was obtained from the study participants, and their confidentiality was maintained throughout the study. A total of 399 patients with known prescreened musculoskeletal conditions and pain who attended the study sites were recruited, as per the inclusion/exclusion criteria (clinicaltrials.gov ID# NCT04765787). The recruited patients were then prescribed Paracetamol (650 mg) and Orphenadrine (50 mg) combination (Nuberol Forte®) for 7 to 14 days as per the investigator's discretion based on the pain intensity. After the initial screening (visit 1), a follow-up visit was conducted after 1-2 weeks of the treatment (visit 2). Study Endpoints: The primary objective was to assess the pain management response of Nuberol Forte treatment and the overall safety of the drug. The Visual Analogue Scale (VAS) scale was used to measure pain severity. Secondary to pain, the patients' health-related quality of life (HRQoL) was also assessed using the Muscle, Joint Measure (MJM) scale. The safety was monitored on the first dose by the patients. These assessments were done on each study visit. Results: Out of 399 enrolled patients, 49.4% were males, and 50.6% were females with a mean age of 47.24 ± 14.20 years. Most patients were presented with Knee Osteoarthritis (OA), i.e., 148(38%), followed by backache 70(18.2%). A significant reduction in the mean pain score was observed after the treatment with the combination of Paracetamol and Orphenadrine (p<0.05). Furthermore, an overall improvement in the patient’s QoL was also observed. During the study, only ten patients reported mild adverse events (AEs). Conclusion: The combination of Paracetamol and Orphenadrine (Nuberol Forte®) exhibited effective pain management among patients with musculoskeletal conditions and also improved their QoL.

Keywords: musculoskeletal pain, orphenadrine/paracetamol combination, pain management, quality of life, Pakistani population

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