Search results for: clinical trial optimization

Authors: Berredjem Hajira, Benlaifa Meriem, Becheker Imene, Bardi Rafika, Djebar Med Reda

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Recent acquired or reactivation T.gondii infection is a serious complication in HIV patients. Classical serological diagnosis relies on the detection of anti-Toxoplasma immunoglobulin ; however, serology may be unreliable in HIV immunodeficient patients who fail to produce significant titers of specific antibodies. PCR assays allow a rapid diagnosis of Toxoplasma infection. In this study, we compared the value of the PCR for diagnosing active toxoplasmosis in cerebrospinal fluid and blood samples from HIV patients. Anti-Toxoplasma antibodies IgG and IgM titers were determined by ELISA. In parallel, nested PCR targeting B1 gene and conventional PCR-ELISA targeting P30 gene were used to detect T. gondii DNA in 25 blood samples and 12 cerebrospinal fluid samples from patients in whom toxoplasmic encephalitis was confirmed by clinical investigations. A total of 15 negative controls were used. Serology did not contribute to confirm toxoplasmic infection, as IgG and IgM titers decreased early. Only 8 out 25 blood samples and 5 out 12 cerebrospinal fluid samples PCRs yielded a positive result. 5 patients with confirmed toxoplasmosis had positive PCR results in either blood or cerebrospinal fluid samples. However, conventional nested B1 PCR gave best results than the P30 gene one for the detection of T.gondii DNA in both samples. All samples from control patients were negative. This study demonstrates the unusefulness of the serological tests and the high sensitivity and specificity of PCR in the diagnosis of toxoplasmic encephalitis in HIV patients.

Keywords: cerebrospinal fluid, HIV, Toxoplasmosis, PCR

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Authors: Patricia O. Carvalho, Marcia C. F. Messias, Salvador Sanchez Vinces, Caroline F. A. Gatinoni, Vitor P. Iordanu, Carlos A. R. Martinez

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Lipidomics methods are widely used in the identification and validation of disease-specific biomarkers and therapy response evaluation. The present study aimed to identify a panel of potential lipid biomarkers to evaluate response to neoadjuvant chemoradiotherapy in rectal adenocarcinoma (RAC). Liquid chromatography–mass spectrometry (LC-MS)-based untargeted lipidomic was used to profile human serum samples from patients with clinical stage T2 or T3 resectable RAC, after and before chemoradiotherapy treatment. A total of 28 blood plasma samples were collected from 14 patients with RAC who recruited at the São Francisco University Hospital (HUSF/USF). The study was approved by the ethics committee (CAAE 14958819.8.0000.5514). Univariate and multivariate statistical analyses were applied to explore dysregulated metabolic pathways using untargeted lipidic profiling and data mining approaches. A total of 36 statistically significant altered lipids were identified and the subsequent partial least-squares discriminant analysis model was both cross validated (R2, Q2) and permutated. Lisophosphatidyl-choline (LPC) plasmalogens containing palmitoleic and oleic acids, with high variable importance in projection score, showed a tendency to be lower after completion of chemoradiotherapy. Chemoradiotherapy seems to change plasmanyl-phospholipids levels, indicating that these lipids play an important role in the RAC pathogenesis.

Keywords: lipidomics, neoadjuvant chemoradiotherapy, plasmalogens, rectal adenocarcinoma

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Authors: Nawaf Al-Kharashi, Waseem Al-Talalwah, Shorok Al Dorazi, Roger Soames

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Superior gluteal artery is one of the largest branches of posterior division of the internal iliac artery. It passes between the lumbosacral and first sacral root to escape from the pelvic cavity through the grater sciatic foramen just above the piriformis. The current study includes 41 cadaver investigates the origin and branch of the superior gluteal artery and clarify the clinical significance. In present study, the superior gluteal artery arises from the posterior division of the internal iliac artery directly in 82.5% whereas it arises indirectly as from the sciatic artery in 15.9%. However, it is congenital absence in 1.6% which is compensated by sciatic artery. The sciatic nerve gains vascular supply from superior gluteal artery in two ways either during its course or giving lateral sacral artery in 27% and lumbar branches in 1.6%. It also supplies the adductors group and iliacus via giving obturator artery in 14.3% and in 1.6% respectively. The superior gluteal artery usually passes between lumbosacral trunk and first sacral root in 82.5% whereas it does not passes the sciatic roots as it arises behind them in 15.9%. With a variability of the superior gluteal artery origin, there is a variability of sciatic nerve roots supply. Further, the superior gluteal artery arising from sciatic artery behind the sciatic roots carries a high risk of intra-pelvic bleeding in case of posterior pelvic fracture. Prolonged ligation of the superior gluteal artery which gives lateral sacral artery may result in sciatic neuropathy. Therefore, surgeons have to be aware of the superior gluteal artery variation in origin, course and branches to reduce the iatrogenic faults.

Keywords: internal pudendal artery, inferior gluteal artery, superior gluteal artery, internal iliac artery. sciatic neuropathy, sciatic nerve

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Authors: Lucia Salvioni, Pietro Giorgio Lovaglio, Valerio Leoni, Miriam Colombo, Luisa Fiandra

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The involvement of plasmatic surfactant protein-D (SP-D) in pulmonary diseases has been long investigated, and over the last two years, more interest has been directed to determine its role as a marker of COVID-19. In this direction, several studies aimed to correlate pulmonary surfactant proteins with the clinical manifestations of the virus indicated SP-D as a prognostic biomarker of COVID-19 pneumonia severity. The present work has performed a retrospective study on a relatively large cohort of patients of Hospital Pio XI of Desio (Lombardia, Italy) with the aim to assess differences in the hematic SP-D concentrations among COVID-19 patients and healthy donors and the role of SP-D as a prognostic marker of severity and/or of mortality risk. The obtained results showed a significant difference in the mean of log SP-D levels between COVID-19 patients and healthy donors, so as between dead and survived patients. SP-D values were significantly higher for both hospitalized COVID-19 and dead patients, with threshold values of 150 and 250 ng/mL, respectively. SP-D levels at admission and increasing differences among follow-up and admission values resulted in the strongest significant risk factors of mortality. Therefore, this study demonstrated the role of SP-D as a predictive marker of SARS-CoV-2 infection and its outcome. A significant correlation of SP-D with patient mortality indicated that it is also a prognostic factor in terms of mortality, and its early detection should be considered to design adequate preventive treatments for COVID-19 patients.

Keywords: SARS-CoV-2 infection, COVID-19, surfactant protein-D (SP-D), mortality, biomarker

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Authors: Sumia Fatima, Tayyaba Idrees

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Cardiac Arrest and Heart Failures are an important causes of mortality in developed and developing countries and even a second spent without Cardiopulmonary Resuscitation (CPR) increases the risk of mortality. Youngs doctors are expected to partake in CPR from the first day and if they are not taught basic life support (BLS) skills during their studies. They have next to no opportunity to learn them in clinical settings. To determine the exact level of knowledge of Basic Life Support among medical students. To compare the degree of knowledge among 1st and 2nd year medical students of RMU (Rawalpindi Medical University), using self-structured questionnaires. A cross sectional, qualitative primary study was conducted in March 2020 in order to analyse theoretical and practical knowledge of Basic Life Support among Medical Students of 1st and 2nd year MBBS. Self-Structured Questionnaires were distributed among 300 students, 150 from 1st year and 150 from 2nd year. Data was analysed using SPSS v 22. Chi Square test was employed. The results showed that only 13 (4%) students had received formal BLS training.129 (42%) students had encountered accidents in real life but had not known how to react. Majority responded that Basic Life Support should be made part of medical college curriculum (189 students), 194 participants (64%) had moderate knowledge of both theoretical and practical aspects of BLS. 75-80% students of both 1st and 2nd year had only moderate knowledge, which must be improved for them to be better healthcare providers in future. It was also found that male students had more practical knowledge than females, but both had almost the same proficiency in theoretical knowledge. The study concluded that the level of knowledge of BLS among the students was not up to the mark, and there is a dire need to include BLS training in the medical colleges’ curriculum.

Keywords: basic cardiac life support, cardiac arrest, awareness, medical students

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Authors: D. S. Chakraborty, S. Ghosh, A. Hazra

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Objective: Medication errors are a reality in all settings where medicines are prescribed, dispensed and used. High Alert Medications (HAM) are those that bear a heightened risk of causing significant patient harm when used in error. We conducted a knowledge-attitude-practice survey, among residents working in a teaching hospital, to assess the ground situation with regard to the handling of HAM. Methods: We plan to approach 242 residents among the approximately 600 currently working in the hospital through purposive sampling. Residents in all disciplines (clinical, paraclinical and preclinical) are being targeted. A structured questionnaire that has been pretested on 5 volunteer residents is being used for data collection. The questionnaire is being administered to residents individually through face-to-face interview, by two raters, while they are on duty but not during rush hours. Results: Of the 156 residents approached so far, data from 140 have been analyzed, the rest having refused participation. Although background knowledge exists for the majority of respondents, awareness levels regarding HAM are moderate, and attitude is non-uniform. The number of respondents correctly able to identify most ( > 80%) HAM in three common settings– accident and emergency, obstetrics and intensive care unit are less than 70%. Several potential errors in practice have been identified. The study is ongoing. Conclusions: Situation requires corrective action. There is an urgent need for improving awareness regarding HAM for the sake of patient safety. The pharmacology department can take the lead in designing awareness campaign with support from the hospital administration.

Keywords: high alert medication, medication error, questionnaire, resident

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Authors: Mohammed Abdulhameed, Sagir M. Abdullahi

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In this paper, based on the applications of nanoparticle, the blood flow along with nanoparticles through stenosed artery is studied. The blood is acted by periodic body acceleration, an oscillating pressure gradient and an external magnetic field. The mathematical formulation is based on Caputo-Fabrizio fractional derivative without singular kernel. The model of ordinary blood, corresponding to time-derivatives of integer order, is obtained as a limiting case. Analytical solutions of the blood velocity and temperature distribution are obtained by means of the Hankel and Laplace transforms. Effects of the order of Caputo-Fabrizio time-fractional derivatives and three different nanoparticles i.e. Fe3O4, TiO4 and Cu are studied. The results highlights that, models with fractional derivatives bring significant differences compared to the ordinary model. It is observed that the addition of Fe3O4 nanoparticle reduced the resistance impedance of the blood flow and temperature distribution through bell shape stenosed arteries as compared to TiO4 and Cu nanoparticles. On entering in the stenosed area, blood temperature increases slightly, but, increases considerably and reaches its maximum value in the stenosis throat. The shears stress has variation from a constant in the area without stenosis and higher in the layers located far to the longitudinal axis of the artery. This fact can be an important for some clinical applications in therapeutic procedures.

Keywords: nanoparticles, blood flow, stenosed artery, mathematical models

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Authors: Intan Maisarah Abd Rahim, Herlina Abdul Rahim, Rashidah Ghazali

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Diabetes is a medical condition that can lead to various diseases such as stroke, heart disease, blindness and obesity. In clinical practice, the concern of the diabetic patients towards the blood glucose examination is rather alarming as some of the individual describing it as something painful with pinprick and pinch. As for some patient with high level of glucose level, pricking the fingers multiple times a day with the conventional glucose meter for close monitoring can be tiresome, time consuming and painful. With these concerns, several non-invasive techniques were used by researchers in measuring the glucose level in blood, including ultrasonic sensor implementation, multisensory systems, absorbance of transmittance, bio-impedance, voltage intensity, and thermography. This paper is discussing the application of the near-infrared (NIR) spectroscopy as a non-invasive method in measuring the glucose level and the implementation of the linear system identification model in predicting the output data for the NIR measurement. In this study, the wavelengths considered are at the 1450 nm and 1950 nm. Both of these wavelengths showed the most reliable information on the glucose presence in blood. Then, the linear Autoregressive Moving Average Exogenous model (ARMAX) model with both un-regularized and regularized methods was implemented in predicting the output result for the NIR measurement in order to investigate the practicality of the linear system in this study. However, the result showed only 50.11% accuracy obtained from the system which is far from the satisfying results that should be obtained.

Keywords: diabetes, glucose level, linear, near-infrared, non-invasive, prediction system

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Authors: Ana Pego

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Environmental technologies were developed for decades. Clean technologies emerged a few years ago. In these perspectives, the use of cleantech technologies has become very important due the fact of new era of environmental feats. As such, the market itself has become more competitive, more collaborative towards a better use of clean technologies. This paper shows the importance of clean technologies in offshore energy sector in Portuguese market, its localization and its impact on economy. Clean technologies are directly related with renewable cluster and concomitant with economic and social resource optimization criteria, geographic aspects, climate change and soil features. Cleantech is related with regional development, socio-technical transitions in organisations. There are an economical and social combinations which allow specialisation of regions in activities, higher employment, reduce of energy costs, local knowledge spillover and, business collaboration and competitiveness. The methodology used will be quantitative (IO matrix for Portugal 2013) and qualitative (questionnaires to stakeholders). The mix of both methodologies will confirm whether the use of technologies will allow a positive impact on economic and social variables used on this model. It is expected a positive impact on Portuguese economy both in investment and employment taking in account the localization of offshore renewable activities. This means that the importance of offshore renewable investment in Portugal has a few points which should be pointed out: the increase of specialised employment, localization of specific activities in territory, and increase of value added in certain regions. The conclusion will allow researchers and organisation to compare the Portuguese model to other European regions in order to a better use of natural and human resources.

Keywords: cleantech, economic impact, localisation, territory dynamics

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Authors: Yaiprae Chatree, Tawan Chaiwon, Rodjana Chunhabundit, Kritsana Piriyawatcharakon, Waralai Ratwiset, Sasiwimol Chaiya

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The world is facing a serious situation of aging society. Elderly may have many physical health problems due to degenerative diseases including Alzheimer’s disease. Riceberry rice relatively contain high levels of carbohydrate, vitamin E, -oryzanol, and also abundant of bioactive compound of anthocyanin. This study aimed to determine the inhibitory effect of Riceberry rice crude extract on acetylcholinesterase activity. The active compound was extracted by using 70% ethanol (v/v). The inhibitory effect of Riceberry rice on acetylcholinesterase was evaluated by using slightly modified method of Ellman’s method. The 120 seconds time interval of kinetics measurement showed that Riceberry rice extract at concentrations of 2.5-12.5 mg/ml presented the acetylcholinesterase inhibitory activity at the statistically significant difference at p  0.05 compared to control group over 60 -120 seconds. At the concentrations of 10 and 12.5 mg/ml of Riceberry rice extract expressed the high percentage of inhibitory activity of 50.86 and 71.22%, respectively. The half maximal inhibitory concentration (IC50) of acetylcholinesterase inhibitory activity of Riceberry rice extract; considered to the end point, was found at concentration of 9.34 mg/ml. The physostigmine (positive control); however, showed a higher inhibitory capacity than that of Riceberry rice extract. The inhibitory activity of the positive control group was around at 80.40 – 90.41%. In conclusion, the results of this study indicated that Riceberry rice extract possessed the inhibitory capacity of acetylcholinesterase activity. Moreover, at the concentrations of 12.5 mg/ml it showed the identical inhibitory effect with physostigmine group. The Riceberry rice extract might be able to alleviate the clinical manifestations of Alzheimer’s disease.

Keywords: acetylcholine, acetylcholinesterase, Alzheimer's disease, riceberry rice

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Authors: Lianxue Shi

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Urban waterfront rail transit stations exert a dual impact on both the waterfront and the transit station, resulting in a concentration of development elements in the surrounding space. In order to more effectively develop the space around the station, this study focuses on the perspective of the integration of station, city, and people. Taking Chongqing as an example, based on the Arc GIS platform, it explores the vitality of the site from the three dimensions of crowd activity heat, space facilities heat, and spatial accessibility. It conducts a comprehensive evaluation and interpretation of the vitality surrounding the waterfront rail transit station area in Chongqing. The study found that (1) the spatial vitality in the vicinity of waterfront rail transit stations is correlated with the waterfront's functional zoning and the intensity of development. Stations situated in waterfront residential and public spaces are more likely to experience a convergence of people, whereas those located in waterfront industrial areas exhibit lower levels of vitality. (2) Effective transportation accessibility plays a pivotal role in maintaining a steady flow of passengers and facilitating their movement. However, the three-dimensionality of urban space in mountainous regions is a notable challenge, leading to some stations experiencing limited accessibility. This underscores the importance of enhancing the optimization of walking space, particularly the access routes from the station to the waterfront area. (3) The density of spatial facilities around waterfront stations in old urban areas lags behind the population's needs, indicating a need to strengthen the allocation of relevant land and resources in these areas.

Keywords: rail transit station, waterfront, influence area, spatial vitality, urban vitality

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Authors: Katalin Gombos, Bence Gálik, Krisztina Ildikó Kalács, Krisztina Gödöny, Ákos Várnagy, József Bódis, Attila Gyenesei, Gábor L. Kovács

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Although non-invasive pre-implantation genetic testing for aneuploidy (NIPGT-A) is potentially appropriate to assess chromosomal ploidy of the embryo, practical application of it in a routine IVF center has not been started in the absence of a recommendation. We developed a comprehensive workflow for a clinically applicable strategy for NIPGT-A based on next-generation sequencing (NGS) technology. We performed MALBAC whole genome amplification and NGS on spent blastocyst culture media of Day 3 embryos fertilized with intra-cytoplasmic sperm injection (ICSI). Spent embryonic culture media of morphologically good quality score embryos were enrolled in further analysis with the blank culture media as background control. Chromosomal abnormalities were identified by an optimized bioinformatics pipeline applying a copy number variation (CNV) detecting algorithm. We demonstrate a comprehensive workflow covering both wet- and dry-lab procedures supporting a clinically applicable strategy for NIPGT-A. It can be carried out within 48 h which is critical for the same-cycle blastocyst transfer, but also suitable for “freeze all” and “elective frozen embryo” strategies. The described integrated approach of non-invasive evaluation of embryonic DNA content of the culture media can potentially supplement existing pre-implantation genetic screening methods.

Keywords: next generation sequencing, in vitro fertilization, embryo assessment, non-invasive pre-implantation genetic testing

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Authors: Maha Saliba Foster

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Speech perception has been recognized as a bi-sensory process involving the auditory and visual channels. Compared to the auditory modality, the contribution of the visual signal to speech perception is not very well understood. Studying how the visual modality affects speech recognition can have pedagogical implications in second language learning, as well as clinical application in speech therapy. The current investigation explores the potential effect of speech visual cues on the perception of Arabic emphatics (AEs). The corpus consists of 36 minimal pairs each containing two contrasting consonants, an AE versus a non-emphatic (NE). Movies of four Lebanese speakers were edited to allow perceivers to have partial view of facial regions: lips only, lips-cheeks, lips-chin, lips-cheeks-chin, lips-cheeks-chin-neck. In the absence of any auditory information and relying solely on visual speech, perceivers were above chance at correctly identifying AEs or NEs across vowel contexts; moreover, the models were able to predict the probability of perceivers’ accuracy in identifying some of the COIs produced by certain speakers; additionally, results showed an overlap between the measurements selected by the computer and those selected by human perceivers. The lack of significant face effect on the perception of AEs seems to point to the lips, present in all of the videos, as the most important and often sufficient facial feature for emphasis recognition. Future investigations will aim at refining the analyses of visual cues used by perceivers by using Principal Component Analysis and including time evolution of facial feature measurements.

Keywords: Arabic emphatics, machine learning, speech perception, visual speech perception

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Authors: Yen-Luan Chen

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Maintenance has a great impact on the capacity of production and on the quality of the products, and therefore, it deserves continuous improvement. Maintenance procedure done before a failure is called preventive maintenance (PM). Sequential PM, which specifies that a system should be maintained at a sequence of intervals with unequal lengths, is one of the commonly used PM policies. This article proposes a generalized sequential PM policy for a system subject to shocks with imperfect maintenance and random working time. The shocks arrive according to a non-homogeneous Poisson process (NHPP) with varied intensity function in each maintenance interval. As a shock occurs, the system suffers two types of failures with number-dependent probabilities: type-I (minor) failure, which is rectified by a minimal repair, and type-II (catastrophic) failure, which is removed by a corrective maintenance (CM). The imperfect maintenance is carried out to improve the system failure characteristic due to the altered shock process. The sequential preventive maintenance-last (PML) policy is defined as that the system is maintained before any CM occurs at a planned time Ti or at the completion of a working time in the i-th maintenance interval, whichever occurs last. At the N-th maintenance, the system is replaced rather than maintained. This article first takes up the sequential PML policy with random working time and imperfect maintenance in reliability engineering. The optimal preventive maintenance schedule that minimizes the mean cost rate of a replacement cycle is derived analytically and determined in terms of its existence and uniqueness. The proposed models provide a general framework for analyzing the maintenance policies in reliability theory.

Keywords: optimization, preventive maintenance, random working time, minimal repair, replacement, reliability

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Authors: Sonila Robo, Ilma Robo, Eduart Kapaj, Saimir Heta

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Background: Early birth is 37 weeks or less, pregnancy maturity! Clinically active presence, or positive culture of vaginal secretions, means excessive production of cytokines and prostaglandins also encountered in amniotic fluid. Bacterial vaginosis appears with their clinical outbreak in a combination of bacteria. Some of these bacteria are basic members in the creation of bacterial plaque. Objective: The purpose of this study is to find the link between the presence of specific bacteria in the mouth, bacterial vaginosis as one of the causes of premature birth, and the latter. Methods: The study was applied to 30 pregnant women in the burden pathology ward at Fier maternity, divided into two groups. The first group consisting of 20 women in the 2-month period, August-September. The number of women in the ward was 10 days maximum! All women were treated with cortisone and serum IV, magnesium sulphate, antibiotic prophylaxis! Results: 55% of women were under the age of 25 and 45% of women were over the age of 25. The age effect is mentioned for classifying the diseases that causes Actinomyces. Under the age of 25, a teenager and a 25-year-old are chronically ill. The final index was G2! All females were positive for the presence of salicylic acid in saliva and vaginal secretions. Conclusions:Premature birth is a complex process with some gynecological reasons, but in high percentage of cases there is coverage with the presence of infection by Actinomyces Actinomycetemcomitans in the oral cavity, which depending on the age causes two different types of periodontitis with special characteristics.

Keywords: early birth, periodontal status, bacterial vaginosis, actinomyces actinomycetemcomitans

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Authors: Bita Payami-Shabestari, Dariush Eslami

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The purpose of this paper is to develop a multi-product economic production quantity model under vendor management inventory policy and restrictions including limited warehouse space, budget, and number of orders, average shortage time and maximum permissible shortage. Since the “costs” cannot be predicted with certainty, it is assumed that data behave under uncertain environment. The problem is first formulated into the framework of a bi-objective of multi-product economic production quantity model. Then, the problem is solved with three multi-objective decision-making (MODM) methods. Then following this, three methods had been compared on information on the optimal value of the two objective functions and the central processing unit (CPU) time with the statistical analysis method and the multi-attribute decision-making (MADM). The results are compared with statistical analysis method and the MADM. The results of the study demonstrate that augmented-constraint in terms of optimal value of the two objective functions and the CPU time perform better than global criteria, and goal programming. Sensitivity analysis is done to illustrate the effect of parameter variations on the optimal solution. The contribution of this research is the use of random costs data in developing a multi-product economic production quantity model under vendor management inventory policy with several constraints.

Keywords: economic production quantity, random cost, supply chain management, vendor-managed inventory

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Authors: Irina S. Burashnikova, Dmitriy A. Sychev, Ruslan Y. Kazakov

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Сytochrome P450 CYP2D6 activity affects antipsychotic therapy safety. CYP2D6*4 polymorphism frequency varies among different ethnic groups. We studied CYP2D6*4 polymorphism frequency in Tatar and Russian schizophrenic patients and association of CYP2D6*4 polymorphism and extrapyramidal disorders (EPD) frequency in schizophrenic patients on haloperidol monotherapy in daily doses up to 20 mg. Results: Heterozygous CYP2D6*4 allele carrier frequency among Tatars was lower (23.8% vs 32.4% in Russians), but the differences did not reach statistical significance. CYP2D6*4 allele frequency among Tatars was also lower (11.9% vs 24.3% in Russians), but the difference was not quite significant (p=0.0592). Average daily haloperidol dose in the group without EPD was significantly higher than in the group with EPD (11.35±4.6 vs 13.87±3.3 mg, p=0.0252), but average daily haloperidol dose/weight ratios in the compared groups had no significant differences. Statistically significant association between EPD development and heterozygous CYP2D6*1/*4 genotype and CYP2D6*4 allele carrier frequency was revealed among all schizophrenic patients and among those of Tatar nationality. Further well designed pharmacogenetic studies in different Russian regions are needed to improve psychotropic therapy safety and to establish evidence-based indications for pharmacogenetic testing in clinical practice.

Keywords: antipsychotic, CYP2D6 polymorphism, ethnic differences of CYP2D6*4 allele frequency, extrapyramidal side effects/disorder, schizophrenia, pharmacogenetics, Russians, Tatars

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Authors: Osama M. Ahmed, Walaa G. Hozayen, Haidy Tamer Abo Sree

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Doxorubicin (DOX), an anthracycline antibiotic is a broad-spectrum antineoplastic agent, which is commonly used in the treatment of uterine, ovarian, breast and lung cancers, Hodgkin's disease and soft tissue sarcomas as well as in several other cancer types. The effect of doxorubicin (4 mg/kg b.w.week) without or with oral administration of ethanolic purslane (Portulaca oleracea) shoot (leaves and stems) extract (50 mg/kg b.w. day) or ethanolic purslane seeds extract (50 mg/kg b.w.day) co-treatments for 6 weeks was evaluated in adult male rats. Serum ALT, AST, ALP, GGT, total bilirubin, total protein, and albumin levels were assayed. Lipid peroxidation (indexed by MDA) and antioxidants like hepatic glutathine, glutathione transferase, peroxidase, SOD, and CAT were assessed. There was an increase in serum levels of ALT, AST, ALP, GGT and total bilirubin. In addition, hepatic glutathine, glutathione transferase, peroxidase, SOD, and CAT activities were decreased while lipid peroxidation in the liver was increased. Co-administration of ethanolic purslane and seed extracts successfully improved the adverse changes in the liver functions with an increase in antioxidants activities and reduction of lipid peroxidation. In conclusion, it can be supposed that dietary purslane extract supplementation may provide a cushion for a prolonged therapeutic option against DOX hepatopathy without harmful side effects. However, further clinical studies are required to assess the safety and efficacy of these extract in human beings.

Keywords: doxorubicin, purslane, hepatotoxicity, antioxidants

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Authors: Hyeonkyeong Yang, Minseok Son, Taekbeom Yoo, Woojin Park

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Human error is the most salient contributing factor to railway accidents. To reduce the frequency of human errors, many researchers and train designers have adopted ergonomic design principles for designing display-control layout in rail cab. There exist a number of approaches for designing the display control layout based on optimization methods. However, the ergonomically optimized layout design may not be the best design for train drivers, since the drivers have their own mental models based on their experiences. Consequently, the drivers may prefer the existing display-control layout design over the optimal design, and even show better driving performance using the existing design compared to that using the optimal design. Thus, in addition to ergonomic design principles, train drivers’ mental models also need to be considered for designing display-control layout in rail cab. This paper developed an ergonomic assessment system of display-control layout design, and an interactive layout design system that can generate design alternatives and calculate ergonomic assessment score in real-time. The design alternatives generated from the interactive layout design system may not include the optimal design from the ergonomics point of view. However, the system’s strength is that it considers train drivers’ mental models, which can help generate alternatives that are more friendly and easier to use for train drivers. Also, with the developed system, non-experts in ergonomics, such as train drivers, can refine the design alternatives and improve ergonomic assessment score in real-time.

Keywords: display-control layout design, interactive layout design system, mental model, train drivers

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Authors: Gaurav Kumar Sinha

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The oil refining industry, significant in its energy consumption and carbon emissions, faces increasing pressure to reduce its environmental footprint. This article explores the application of energy efficiency and sustainability analytics as crucial tools for reducing carbon emissions in oil refineries. Through a comprehensive review of current practices and technologies, this study highlights innovative analytical approaches that can significantly enhance energy efficiency. We focus on the integration of advanced data analytics, including machine learning and predictive modeling, to optimize process controls and energy use. These technologies are examined for their potential to not only lower energy consumption but also reduce greenhouse gas emissions. Additionally, the article discusses the implementation of sustainability analytics to monitor and improve environmental performance across various operational facets of oil refineries. We explore case studies where predictive analytics have successfully identified opportunities for reducing energy use and emissions, providing a template for industry-wide application. The challenges associated with deploying these analytics, such as data integration and the need for skilled personnel, are also addressed. The paper concludes with strategic recommendations for oil refineries aiming to enhance their sustainability practices through the adoption of targeted analytics. By implementing these measures, refineries can achieve significant reductions in carbon emissions, aligning with global environmental goals and regulatory requirements.

Keywords: energy efficiency, sustainability analytics, carbon emissions, oil refineries, data analytics, machine learning, predictive modeling, process optimization, greenhouse gas reduction, environmental performance

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Authors: Z. S. Haidar

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Millions of teeth are removed annually, and dental extraction is one of the most commonly performed surgical procedures globally. Whether due to caries, periodontal disease, or trauma, exodontia and the ensuing wound healing and bone remodeling processes of the resultant socket (hole in the jaw bone) usually result in serious deformities of the residual alveolar osseous ridge and surrounding soft tissues (reduced height/width). Such voluminous changes render the placement of a proper conventional bridge, denture, or even an implant-supported prosthesis extremely challenging. Further, most extractions continue to be performed with no regard for preventing the onset of alveolar osteitis (also known as dry socket, a painful and difficult-to-treat/-manage condition post-exodontia). Hence, such serious resorptive morphological changes often result in significant facial deformities and a negative impact on the overall Quality of Life (QoL) of patients (and oral health-related QoL); alarming, particularly for the geriatric with compromised healing and in light of the thriving longevity statistics. Despite advances in tissue/wound grafting, serious limitations continue to exist, including efficacy and clinical outcome predictability, cost, treatment time, expertise, and risk of immune reactions. For cases of dry socket, specifically, the commercially available and often-prescribed home remedies are highly-lacking. Indeed, most are not recommended for use anymore. Alveogyl is a fine example. Hence, there is a great market demand and need for alternative solutions. Herein, SockGEL/PLUG (patent pending), an innovative, all-natural, drug-free, and injectable thermo-responsive hydrogel, was designed, formulated, characterized, and evaluated as an osteogenic, angiogenic, anti-microbial, and pain-soothing suture-free intra-alveolar dressing, safe and efficacious for use in fresh extraction sockets, immediately post-exodontia. It is composed of FDA-approved, biocompatible and biodegradable polymers, self-assembled electro-statically to formulate a scaffolding matrix to (1) prevent the on-set of alveolar osteitis via securing the fibrin-clot in situ and protecting/sealing the socket from contamination/infection; and (2) endogenously promote/accelerate wound healing and bone remodeling to preserve the volume of the alveolus. The intrinsic properties of the SockGEL/PLUG hydrogel were evaluated physical-chemical-mechanically for safety (cell viability), viscosity, rheology, bio-distribution, and essentially, capacity to induce wound healing and osteogenesis (small defect, in vivo) without any signaling cues from exogenous cells, growth factors or drugs. The proposed animal model of cranial critical-sized and non-vascularized bone defects shall provide new and critical insights into the role and mechanism of the employed natural bio-polymer blend and gel product in endogenous reparative regeneration of soft tissues and bone morphogenesis. Alongside, the fine-tuning of our modified formulation method will further tackle appropriateness, reproducibility, scalability, ease, and speed in producing stable, biodegradable, and sterilizable thermo-sensitive matrices (3-dimensional interpenetrating yet porous polymeric network) suitable for the intra-socket application. Findings are anticipated to provide sufficient evidence to translate into pilot clinical trials and validate the innovation before engaging the market for feasibility, acceptance, and cost-effectiveness studies.

Keywords: hydrogel, nanotechnology, bioengineering, bone regeneration, nanogel, drug delivery

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Authors: Rongrong Liu, Li Wang, Hui Xu, Jianpei Fang, Sixi Liu, Xiaolin Yin, Junbin Liang, Gaohui Yan, Yaoyun Li, Yali Zhou, Xinyu Li, Yue Li, Lei Shi, Yongrong Lai, Junjiu Huang, Xinhua Zhang

Abstract:

Background: Beta-Thalassemia is caused by reduced (β+) or absent (β0) synthesis of the β-globin chains of hemoglobin. Transfusions and oral iron chelation therapy have improved the quality of life for patients with Transfusion-Dependent thalassemia (TDT). Recent advances in genome editing platforms of CRISPR-Cas9 have paved the way for induction of HbF by reactivating expression of γ-chain.Aims: We performed CRISPR-Cas9-mediated genome editing of hematopoietic stem cells to mutate HBG1/HBG2 promoter sequence, thereby representing a naturally occurring HPFH-liked mutation, producing RM-001. Here, we present an initial assessment of safety and efficacy of RM-001 in patients with TDT. Methods: Patients (6–35 y of age) with TDT receiving packed red blood cell (pRBC) transfusions of ≥100 mL/kg/y or ≥10 units/y in the previous 2 y were eligible. CD34+ cells were edited with CRISPR-Cas9 using a guide RNA specific for the binding site of BCL11A on the HBG1/2 promoter. Prior to RM-001 product infusion (day 0), patients received myeloablative conditioning with Busulfan from day-7 to day-4. Patients were monitored for AEs Hb expression.Results: Data cut as of 28 Feb 2024, 16 TDT patients have been treated with RM-001 and followed ≥3 months. 5 of these 16 patients had finished their 24 months follow up. Eleven patients have β0/β0 genotype and five patients have β0/β+ genotype. In addition to β-thalassemia, two patients had α- deletion with the genotype of --/αα. Efficacy:All patients received a single dose intravenous infusion of RM-001 cells. 5 of them had been followed 24 months or longer. All patients achieved transfusion-independent (TI, total Hb continued ≥ 9g/dL) (Figure1). Patients demonstrated sustained and clinically meaningful increases in HbF levels since 4 month post-RM-001 infusion (Figure.2). Total hemoglobin in all patients was stable at 10-12g/dL during the follow-up period. Safety:The adverse events observed after RM-001 infusion were consistent with those that are typical of Busulfan-based myeloablation. The allelic editing analysis at 6-month visit showed that the on-target allelic editing frequency in bone marrow cells was 73.44% (64.65% to 84.6%, n=13).Summary/Conclusion: This interim analysis, in which all the 19 patients age from 7.9 to 25yo met the success criteria for the trial with respect to transfusion independence, showed that autologous HBG1/2 promoter-modified CD34+ HSPCs gene therapy resulted in an adequate amount of HbF as early as 2 months after infusion led to near-normal hemoglobin levels, remained transfusion-free through the reported period without product related SAE. After RM-001 infusion, high levels of HbF proportion and on-target editing in bone marrow cells were maintained. Submitted on behalf of the RM-001 Investigators.

Keywords: thalassemian, genetherapy, CRISPR/Cas9, HbF

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Authors: Gordana Branković, Vesna Dragičević, Dejan Dodig, Desimir Knežević, Srbislav Denčić, Gordana Šurlan-Momirović

Abstract:

Phytic acid is a major pool in the flux of phosphorus through agroecosystems and represents a sum equivalent to > 50% of all phosphorus fertilizer used annually. Nutrition rich in phytic acid can substantially decrease micronutrients apsorption as calcium, zink, iron, manganese, copper due to phytate salts excretion by human and non-ruminant animals as poultry, swine and fish, having in common very scarce phytase activity, and consequently the ability to digest and utilize phytic acid, thus phytic acid derived phosphorus in animal waste contributes to water pollution. The tested accessions consisted of 15 genotypes of bread wheat (Triticum aestivum L. ssp. vulgare) and of 15 genotypes of durum wheat (Triticum durum Desf.). The trials were sown at the three test sites in Serbia: Rimski Šančevi (RS) (45º19´51´´N; 19º50´59´´E), Zemun Polje (ZP) (44º52´N; 20º19´E) and Padinska Skela (PS) (44º57´N 20º26´E) during two vegetation seasons 2010-2011 and 2011-2012. The experimental design was randomized complete block design with four replications. The elementary plot consisted of 3 internal rows of 0.6 m2 area (3 × 0.2 m × 1 m). Grains were grinded with Laboratory Mill 120 Perten (“Perten”, Sweden) (particles size < 500 μm) and flour was used for the analysis. Phytic acid grain content was determined spectrophotometrically with the Shimadzu UV-1601 spectrophotometer (Shimadzu Corporation, Japan). Objectives of this study were to determine: i) variability and stability of the phytic acid content among selected genotypes of bread and durum wheat, ii) predominant source of variation regarding genotype (G), environment (E) and genotype × environment interaction (GEI) from the multi-environment trial, iii) influence of climatic variables on the GEI for the phytic acid content. Based on the analysis of variance it had been determined that the variation of phytic acid content was predominantly influenced by environment in durum wheat, while the GEI prevailed for the variation of the phytic acid content in bread wheat. Phytic acid content expressed on the dry mass basis was in the range 14.21-17.86 mg g-1 with the average of 16.05 mg g-1 for bread wheat and 14.63-16.78 mg g-1 with the average of 15.91 mg g-1 for durum wheat. Average-environment coordination view of the genotype by environment (GGE) biplot was used for the selection of the most desirable genotypes for breeding for low phytic acid content in the sense of good stability and lower level of phytic acid content. The most desirable genotypes of bread and durum wheat for breeding for phytic acid were Apache and 37EDUYT /07 No. 7849. Models of climatic factors in the highest percentage (> 91%) were useful in interpreting GEI for phytic acid content, and included relative humidity in June, sunshine hours in April, mean temperature in April and winter moisture reserves for genotypes of bread wheat, as well as precipitation in June and April, maximum temperature in April and mean temperature in June for genotypes of durum wheat.

Keywords: genotype × environment interaction, phytic acid, stability, variability

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Authors: Bang Haeyong

Abstract:

Purpose: The objectives of this study were to determine the prevalence, incidence, and risk factors for postoperative fever after lumbar fusion. Methods: This study was a retrospective chart review of 291 patients who underwent lumbar fusion between March 2015 and February 2016 at the Asan Medical Center. Information was extracted from electronic medical records. Postoperative fever was measured at Tmax > 37.7 ℃ and Tmax > 38.3 ℃. The presence of postoperative fever, blood culture, urinary excretion, and/or chest x-ray were evaluated. Patients were evaluated for infection after lumbar fusion. Results: We found 222 patients (76.3%) had a postoperative temperature of 37.7 ℃, and 162 patients (55.7%) had a postoperative temperature of 38.3 ℃ or higher. The percentage of febrile patients trended down following the mean 1.8days (from the first postoperative day to seventh postoperative day). Infection rate was 9 patients (3.1%), respiratory virus (1.7%), urinary tract infection (0.3%), phlebitis (0.3%), and surgical site infection (1.4%). There was no correlation between Tmax > 37.7℃ or Tmax > 38.3℃, and timing of fever, positive blood or urine cultures, pneumonia, or surgical site infection. Risk factors for increased postoperative fever following surgery were confirmed to be delay of defecation (OR=1.37, p=.046), and shorten of remove drainage (OR=0.66, p=.037). Conclusions: The incidence of fever was 76.3% after lumbar fusion and the drainage time was faster in the case of fever. It was thought that the bleeding was absorbed at the operation site and fever occurred. The prevalence of febrile septicemia was higher in patients with long bowel movements before surgery than after surgery. Clinical symptoms should be considered because postoperative fever cannot be determined by fever alone because fever and infection are not significant.

Keywords: lumbar surgery, fever, postoperative, risk factor

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Authors: Marta Błażkiewicz-Mazurek, Adam Konefał

Abstract:

The project can be divided into three main parts: i. modeling the Cf-252 neutron source and conducting an experiment to verify the correctness of the obtained results, ii. design of the BNCT system infrastructure, iii. analysis of the results from the logical detector. Modeling of the Cf-252 source included designing the shape and size of the source as well as the energy and spatial distribution of emitted neutrons. Two options were considered: a point source and a cylindrical spatial source. The energy distribution corresponded to various spectra taken from specialized literature. Directionally isotropic neutron emission was simulated. The simulation results were compared with experimental values determined using the activation detector method using indium foils and cadmium shields. The relative fluence rate of thermal and resonance neutrons was compared in the chosen places in the vicinity of the source. The second part of the project related to the modeling of the BNCT infrastructure consisted of developing a simulation program taking into account all the essential components of this system. Materials with moderating, absorbing, and backscattering properties of neutrons were adopted into the project. Additionally, a gamma radiation filter was introduced into the beam output system. The analysis of the simulation results obtained using a logical detector located at the beam exit from the BNCT infrastructure included neutron energy and their spatial distribution. Optimization of the system involved changing the size and materials of the system to obtain a suitable collimated beam of thermal neutrons.

Keywords: BNCT, Monte Carlo, neutrons, simulation, modeling

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Authors: Souheila Zemmouchi

Abstract:

Introduction: Diabetes is currently the leading cause of end-stage chronic kidney disease and dialysis, so it adds additional complexity to the management of chronic hemodialysis patients. These patients are extremely fragile because of their multiple cardiovascular and metabolic comorbidities. Clear and complete description of the experience: the management of a diabetic on hemodialysis is particularly difficult due to frequent hypoglycaemia and significant inter and perdialyticglycemic variability that is difficult to predict. The aim of our study is to describe the clinical-biological profile and to assess the cardiovascular risk of diabetics undergoing chronic hemodialysis, and compare them with non-diabetic hemodialysis patients. Methods: This cross-sectional, descriptive, and analytical study was carried out between January 01 and December 31, 2018, involving 309 hemodialysis patients spread over 4 centersThe data were collected prospectively then compiled and analyzed by the SPSS Version 10 software The FRAMINGHAM RISK SCORE has been used to assess cardiovascular risk in all hemodialysis patients Results: The survey involved 309 hemodialysis patients, including 83 diabetics, for a prevalence of 27% The average age 53 ± 10.2 years. The sex ratio is 1.5. 50% of diabetic hemodialysis patients retained residual diuresis against 32% in non-diabetics. In the group of diabetics, we noted more hypertension (70% versus 38% non-diabetics P 0.004), more intradialytichypoglycemia (15% versus 3% non-diabetics P 0.007), initially, vascular exhaustion was found in 4 diabetics versus 2 non-diabetics. 70% of diabetics with anuria had postdialytichyperglycemia. The study found a statistically significant difference between the different levels of cardiovascular risk according to the diabetic status. Conclusion: There are many challenges in the management of diabetics on hemodialysis, both to optimize glycemic control according to an individualized target and to coordinate comprehensive and effective care.

Keywords: hemodialysis, diabetes, chronic renal failure, glycemic control

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Authors: Chih-I. Tsai, Yu-Chien. Lin

Abstract:

Through experiences of clinical practices, it is discovered that locations on the body at a level of four fingerbreadth above and below the joints are the points at which muscles connect to tendons, and since the muscles and tendons possess opposite characteristics, muscles are full of blood but lack qi, while tendons are full of qi but lack blood, these points on our body become easily blocked. It is proposed that through doing acupuncture or creating localized pressure to the areas four fingerbreadths above and below our joints, with an elastic bandage, we could help the energy, also known as qi, to flow smoothly in our body and further improve our health. Based on the Four Fingers Theory, we understand that human height is 22 four fingerbreadths. In addition, qi and blood travel through 24 meridians, 50 times each day, and they flow through 6 cun with every human breath. We can also understand the average number of human heartbeats is 75 times per minute. And the function of qi-blood circulation system in Traditional Chinese Medicine is the same as the blood circulation in Western Medical Science. Informed by Four Fingers Theory, this study further examined its applications in acupuncture practices. The research question is how Four Fingers Theory proves what has been mentioned in Nei Jing that there are 66 acupoints under a human’s elbow and knee. In responding to the research question, there are 66 acupoints under a human’s elbow and knee. Four Fingers Theory facilitated the creation of the acupuncture naming and teaching system. It is expected to serve as an approachable and effective way to deliver knowledge of acupuncture to the public worldwide.

Keywords: four fingers theory, meridians circulation, 66 acupoints under human elbow and knee, acupuncture

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Authors: H. Yousefnia, S. Zolghadri

Abstract:

An early diagnosis of bone metastases is very important for providing a profound decision on a subsequent therapy. A prerequisite for the clinical application of new diagnostic radiopharmaceutical is the measurement of organ radiation exposure dose from biodistribution data in animals. In this study, the dosimetric studies of a novel agent for SPECT-imaging of bone methastases, 111In-(4-{[(bis(phosphonomethyl))carbamoyl]methyl}-7,10-bis(carboxymethyl)-1,4,7,10-tetraazacyclododec-1-yl) acetic acid (111In-BPAMD) complex, have been estimated in human organs based on mice data. The radiolabeled complex was prepared with high radiochemical purity at the optimal conditions. Biodistribution studies of the complex were investigated in male Syrian mice at selected times after injection (2, 4, 24 and 48 h). The human absorbed dose estimation of the complex was performed based on mice data by the radiation absorbed dose assessment resource (RADAR) method. 111In-BPAMD complex was prepared with high radiochemical purity >95% (ITLC) and specific activities of 2.85 TBq/mmol. Total body effective absorbed dose for 111In-BPAMD was 0.205 mSv/MBq. This value is comparable to the other 111In clinically used complexes. The results show that the dose to critical organs the complex is well within the acceptable considered range for diagnostic nuclear medicine procedures. Generally, 111In-BPAMD has interesting characteristics and can be considered as a viable agent for SPECT-imaging of the bone metastases in the near future.

Keywords: In-111, BPAMD, absorbed dose, RADAR

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Authors: Umme Hani, Mohammed Rahmatulla, Mohammed Ghazwani, Ali Alqahtani, Yahya Alhamhoom

Abstract:

Background and introduction: Neratinib is a potent anticancer drug used for the treatment of breast cancer. It is poorly soluble at higher pH, which tends to minimize the therapeutic effects in the lower gastrointestinal tract (GIT) leading to poor bioavailability. An attempt has been made to prepare and develop a gastro-retentive system of Neratinib to improve the drug bioavailability in the GIT by enhancing the gastric retention time. Materials and methods: In the present study a three-factor at two-level (23) factorial design based optimization was used to inspect the effects of three independent variables (factors) such as sodium alginate (A), sodium bicarbonate (B) and sodium citrate (C) on the dependent variables like in vitro gelation, in vitro floating, water uptake and percentage drug release. Results: All the formulations showed pH in the range 6.7 ±0.25 to 7.4 ±0.24, percentage drug content was observed to be 96.3±0.27 to 99.5 ±0.28%, in vitro gelation observed as gelation immediate remains for an extended period. Percentage of water uptake was in the range between 9.01±0.15 to 31.01±0.25%, floating lag time was estimated form 7±0.39 to 57±0.36 sec. F4 and F5 showed floating even after 12hrs. All formulations showed a release of around 90% drug release within 12hr. It was observed that the selected independent variables affect the dependent variables. Conclusion: The developed system may be a promising and alternative approach to augment gastric retention of drugs and enhances the therapeutic efficacy of the drug.

Keywords: neratinib, 2³ factorial design, sodium alginate, floating, in situ gelling system

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Authors: Manjunath Attibele, Alsawafi Manal, Al Dughaishi Tamima

Abstract:

Introduction: The purpose of this study was to describe the clinical characteristics and types of mechanisms of injuries caused by Motor vehicle accidents (MVA) during pregnancy. To analyze the patterns of accidents during pregnancy and its adverse consequences on both maternal and fetal outcome. Methods: This was a retrospective cohort study on pregnant patients who met with MVAs The study period was from January 1, 2010, to December 31, 2019. All relevant data were retrieved from electronic patients’ records from the hospital information system and from the antenatal ward admission register Results: Out of 168 women who had motor vehicle accidents during the study period, of which, 39 (23.2%) women during pregnancy. Twenty-one (53.8%) women were over 30 years old. Thirty-five (89.7%) women were Omanis, and 27 (69.2%) were in their third trimester. Twenty-three (59%) of accidents happened at night, and 31 (79.5%) of them happened on a weekday. Twenty-two (56.4%) of women were driving themselves, and 24 (61.5%) of them were not using any seatbelt. Accident related abdominal & back pain was seen in 23(59%) women. Regarding the outcome of pregnancy, 23 (74.2%) had a normal vaginal delivery. The mean accident to delivery interval was 7 weeks. Thirty (96.7%) of involved newborns were relatively healthy. One woman (3.2%) had a ruptured uterusleading to fetal death (3.2%). Conclusion: This study showed that the incidence of motor vehicle accidents during pregnancy is around 23.2% . Majority had trauma-associated pain. One serious injury to a woman causing a ruptured uterus which lead to fetal death. Majority of involved newborns were relatively healthy. No reported maternal death.

Keywords: motor vehicle accidents, pregnancy, maternal outcome, fetal outcome

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