Search results for: stress monitoring

Authors: Sanjay Dhiraaj, Puneet Goyal, Aditya Kapoor, Gaurav Misra

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In electrocardiography, an ECG artefact is used to indicate something that is not heart-made. Although technological advancements have produced monitors with the potential of providing accurate information and reliable heart rate alarms, despite this, interference of the displayed electrocardiogram still occurs. These interferences can be from the various electrical gadgets present in the operating room or electrical signals from other parts of the body. Artefacts may also occur due to poor electrode contact with the body or due to machine malfunction. Knowing these artefacts is of utmost importance so as to avoid unnecessary and unwarranted diagnostic as well as interventional procedures. We report a case of ECG artefacts occurring due to patient warming blanket and its consequences. A 20-year-old male with a preoperative diagnosis of exstrophy epispadias complex was posted for surgery under epidural and general anaesthesia. Just after endotracheal intubation, we observed nonspecific ECG changes on the monitor. At a first glance, the monitor strip revealed broad QRs complexes suggesting a ventricular bigeminal rhythm. Closer analysis revealed these to be artefacts because although the complexes were looking broad on the first glance there was clear presence of normal sinus complexes which were immediately followed by 'broad complexes' or artefacts produced by some device or connection. These broad complexes were labeled as artefacts as they were originating in the absolute refractory period of the previous normal sinus beat. It would be physiologically impossible for the myocardium to depolarize so rapidly as to produce a second QRS complex. A search for the possible reason for the artefacts was made and after deepening the plane of anaesthesia, ruling out any possible electrolyte abnormalities, checking of ECG leads and its connections, changing monitors, checking all other monitoring connections, checking for proper grounding of anaesthesia machine and OT table, we found that after switching off the patient’s warming apparatus the rhythm returned to a normal sinus one and the 'broad complexes' or artefacts disappeared. As misdiagnosis of ECG artefacts may subject patients to unnecessary diagnostic and therapeutic interventions so a thorough knowledge of the patient and monitors allow for a quick interpretation and resolution of the problem.

Keywords: ECG artefacts, patient warming blanket, peri-operative arrhythmias, mobile messaging services

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Authors: Dong Xie, Jun Zhao, Yiming Weng

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One of the challenges in dental cement biomaterials is how to make a restorative with mechanical strengths and wear resistance that are comparable to contemporary dental resin composites. Currently none of the dental cement restoratives has been used in high stress-bearing sites due to their low mechanical strengths and poor wear-resistance. The objective of this study was to synthesize and characterize the poly(alkenoic acid)s with different molecular structures, use these polymers to formulate a dental cement restorative, and study the effect of molecular structures on reaction kinetics, viscosity, and mechanical strengths of the formed polymers and cement restoratives. In this study, poly(alkenoic acid)s with different molecular structures were synthesized. The purified polymers were formulated with commercial Fuji II LC glass fillers to form the experimental cement restoratives. The reaction kinetics was studied via 1HNMR spectroscopy. The formed restoratives were evaluated using compressive strength, diametral tensile strength, flexural strength, hardness and wear-resistance tests. Specimens were conditioned in distilled water at 37 oC for 24 h prior to testing. Fuji II LC restorative was used as control. The results show that the higher the arm number and initiator concentration, the faster the reaction was. It was also found that the higher the arm number and branching that the polymer had, the lower the viscosity of the polymer in water and the lower the mechanical strengths of the formed restorative. The experimental restoratives were 31-53% in compressive strength, 37-55% in compressive modulus, 80-126% in diametral tensile strength, 76-94% in flexural strength, 4-21% in fracture toughness and 53-96% in hardness higher than Fuji II LC. For wear test, the experimental restoratives were only 5.4-13% of abrasive and 6.4-12% of attritional wear depths of Fuji II LC in each wear cycle. The aging study also showed that all the experimental restoratives increased their strength continuously during 30 days, unlike Fuji II LC. It is concluded that polymer molecular structures have significant and positive impact on mechanical properties of dental cement restoratives.

Keywords: dental materials, polymers, strength, biomaterials

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Authors: Maria Manzoor, Iram Gul, Muhammad Arshad, Jean Kallerhoff

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The potential of fungal isolates to be used in phytoremediation of widespread lead contaminated soil has been evaluated in this study. Five different fungal isolates (Trichoderma harzianum, Penicillium simplicissimum, Aspergillus flavus, Aspergillus niger and Mucor spp.) were obtained and tested for their tolerance to increasing concentration of lead (Pb) i.e. 100, 200, 300, 400 and 500 mgL-1 on PDA and PDB culture experiment. All strains were tolerant up to 500 mgL-1 following sequence; A. flavus > A. niger > Mucor spp. > P. simplicissimum > T. harzianum. Further the isolates were then monitored for possible effect on Pb solubility/mobility through soil incubation experiments and characterized for essays including pathogenicity, germination and root elongation and plant growth promoting activities including IAA (indole acetic acid), phosphorus solubilization and gibberellic acid (GA3) production. Results revealed that fungal isolates have positive effect on Pb mobility in soil and plant biomass production. Pb solubility was significantly (P> 0.05) increased in soil upon application of Mucor spp. P. simplicissimum and T. harzianum. when compared to control. Among different strains three isolates (Mucor spp., P. simplicissimum and T. harzianum) were nonpathogenic because no inhibitory effect of fungus was observed to plant growth when exposed to these strains in root shoot elongation essay. Particularly T. harzianum and P. simplicissimum showed great ability to increase root length by 1.1 and 1.3 folds and shoot length by 1.47 and 1.5 folds respectively under Pb stress (500 mgL-1). Significantly high production of IAA was observed in A. niger (26.7 μg/ml), Phosphorus solubilization was observed in T. harzianum (9.15 μg/ml) and GA3 production was observed in P. simplicissimum (11.02 μg/ml). From results it is concluded that Mucor spp., P. simplicissimum and T. harzianum have potential to increase Pb mobility and improving plant growth under highy Pb contamination, therefore can be used in microbially assisted phytoremediation of Pb contaminated soil.

Keywords: Pb tolerant fungus, Pb mobility, plant growth promoting activities, indole acetic acid (IAA)

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Authors: Anshu Gupta, Charu Gupta

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Background: Punjab, a border state in India has achieved notoriety world over for its drug abuse problem. People right from school kids to elderly are hooked to drugs. This pattern of substance abuse is prevalent in both cities and villages alike. Excess of younger population in India has further aggravated the situation. It is feared that the benefits of India’s economic growth may well be negated by the rising substance abuse especially in this part of the country. It is quite evident that the pattern of substance abuse tends to change over time which is an impediment in the formulation of effective strategies to tackle this issue. Aim: Purpose of the study was to ascertain the change in the pattern of drug abuse for two consecutive years in the out patient department (OPD) population. Method: The study population comprised of all the patients reporting for deaddiction to the psychiatry outpatient department over a period of twelve months for two consecutive years. All the patients were evaluated by the International Classification of Diseases; 10 criteria for substance abuse/dependence. Results: A considerably high prevalence of substance abuse was present in the Indian population. In general, there was an increase in prevalence from first to the second year, especially among the female population. Increase in prevalence of substance abuse appeared to be more prominent among the younger age group of both the sexes. A significant increase in intravenous drug abuse was observed. Peer pressure and parental imitation were the major factors fueling substance abuse. Precipitation or fear of withdrawal symptoms was the major factor preventing abstinence. Substance abuse had a significant effect on the health and interpersonal relations of these patients. Summary/Conclusion: Drug abuse and addiction are on the rise throughout India. Changing cultural values, increasing economic stress and dwindling supportive bonds appear to be leading to initiation of substance abuse. Need of the hour is to formulate a comprehensive strategy to bring about an overall reduction in the use of drugs.

Keywords: deaddiction, peer pressure, parental imitation, substance abuse/dependance

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Authors: Hi̇lal Surat

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People who want to get rid of stress and intensive working tempo for a while head for recreation operations in order to get rest and have fun. Therefore, planning recreation operation makes contributions to social, physiological, economic and psychological development of an individual and the community in a way that the needs of people meet regularly and constantly. The rapid increase of world population rate makes necessary of benefit from natural or man-made resources in a multiple way. Dams and reservoirs which are built near urban area with the aim of electrical energy conversion and agricultural irrigation are considered as natural area providing various opportunities such as recreation operations. Dams have a great importance regarding to protection and improvement of water resources and coming into service of community. There should be a priority to protect these water resources, which are essential for nature and living organisms. It should be taken into consideration that these water resources are the most important input in the area and have high nature value to make sustainability of recreation effectiveness. The Deriner reservoir that has been built yet near the province of Artvin with natural and cultural properties is considered as an alternative option for meeting the needs of people for sportive and recreation activities and as a potential for planning of water-based recreation activities. Hence, in this study, activities that meet the expectations of people who get benefit from the area considering to natural, cultural and sportive recreation opportunities will be developed. In the first place, planning criteria for some sportive and water-based recreation operations will be defined in order to use the area for recreation and sportive activities and these criteria will be a base for a macro planning work within the holistic perspective of natural, cultural, and economical structure of the area. After this time, necessities of local people and evaluation of reservoir recreational potential will be determined, end then different socio-economic groups according to their in-come, age groups will be chosen and the questionnaire which has already prepared will be done these groups, as a result of these questionnaire recreational activities in water necessities will determine and we are going to develop different suggestion for this reservoir.

Keywords: dam, dam lakes, Deriner, recreation, water based activities

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Authors: Prerna Kalra, Surender Singh

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Cisplatin is the most common chemotherapeutic agent used in different solid tumors, but its main limiting factor is dose-dependent nephrotoxicity by generating reactive oxygen species, by stimulating inflammatory and apoptotic pathways. Additional adjuvant therapies to decrease the toxicity of this chemotherapeutic drug are essential. This study was designed to evaluate the protective role of Emblica officinalis Geartn (Indian gooseberry) against cisplatin induced nephrotoxicity. Emblica officinalis was orally administered to Wistar rats (n=6) for 10 days in 50, 100 and 200mg/kg body weight. On day 7, 8mg/kg of cisplatin was administered intra-peritoneally to rats in all groups. Serum creatinine, blood urea nitrogen and antioxidant levels were measured on day10. The renal damage was evaluated by histopathological and transmission electron microscopy. We found that 200mg/kg dose of Emblica officinalis significantly inhibited the elevation of biochemical parameters i.e. serum creatinine, blood urea nitrogen, oxidant stress marker (malondialdehyde) and increased the reduced levels of antioxidant marker (endogenous glutathione and superoxide dismutase). Cisplatin treated rats have shown acute tubular necrosis and infiltration of inflammatory cells in rat kidney which was reversed after treating the animals with Emblica officinalis in the treatment group. In ultrastructural changes cisplatin treated group showed the damaged mitochondria (M) with dissolved cristae and large number of lysosomes (L) and vacuole (V) formation in tubular epithelial cells. EOE administered group showed visible cristae formation and sign of autophagy vacuoles at a dose of 200mg/kg. Further in-silico studies revealed that ellagic acid is responsible for its nephroprotective effect. The above findings conclude that the Emblica officinalis may be used as an adjuvant therapy in cisplatin induced nephrotoxicity.

Keywords: antioxidant, cisplatin, Emblica officinalis, in silico, nephrotoxicity

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Authors: Mehrdad Shafiei Dizaji, Hoda Azari

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The research explores the pioneering integration of Physics-Informed Neural Networks (PINNs) into the domain of Ground-Penetrating Radar (GPR) data prediction, akin to advancements in medical imaging for tracking tumor progression in the human body. This research presents a detailed development framework for a specialized PINN model proficient at interpreting and forecasting GPR data, much like how medical imaging models predict tumor behavior. By harnessing the synergy between deep learning algorithms and the physical laws governing subsurface structures—or, in medical terms, human tissues—the model effectively embeds the physics of electromagnetic wave propagation into its architecture. This ensures that predictions not only align with fundamental physical principles but also mirror the precision needed in medical diagnostics for detecting and monitoring tumors. The suggested deep learning structure comprises three components: a CNN, a spatial feature channel attention (SFCA) mechanism, and ConvLSTM, along with temporal feature frame attention (TFFA) modules. The attention mechanism computes channel attention and temporal attention weights using self-adaptation, thereby fine-tuning the visual and temporal feature responses to extract the most pertinent and significant visual and temporal features. By integrating physics directly into the neural network, our model has shown enhanced accuracy in forecasting GPR data. This improvement is vital for conducting effective assessments of bridge deck conditions and other evaluations related to civil infrastructure. The use of Physics-Informed Neural Networks (PINNs) has demonstrated the potential to transform the field of Non-Destructive Evaluation (NDE) by enhancing the precision of infrastructure deterioration predictions. Moreover, it offers a deeper insight into the fundamental mechanisms of deterioration, viewed through the prism of physics-based models.

Keywords: physics-informed neural networks, deep learning, ground-penetrating radar (GPR), NDE, ConvLSTM, physics, data driven

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Authors: Sisira Edirippulige

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Background: Digital health education and training (DHET) is imperative for preparing current and future clinicians to work competently in digitally enabled environments. Despite rapid integration of digital health in modern health services, systematic education and training opportunities for health workers is still lacking. Objectives: This study aimed to investigate healthcare professionals’ perspectives and expectations regarding the knowledge, skills and competency needs in digital health for current and future healthcare workforce. Methods: A qualitative study design with semi-structured individual interviews was employed. A purposive sample method was adopted to collect relevant information from the health workers. Inductive thematic analysis was used to analyse data. Interviews were audio-recorded and transcribed verbatim. Consolidated Criteria for Reporting Qualitative Research (COREQ) was followed when we reported this study. Results: Two themes emerged while analysing the data: (1) what to teach in DHET and (2) how to teach DHET. Overall, healthcare professionals agreed that DHET is important for preparing current and future clinicians for working competently in digitally enabled environments. Knowledge relating to what is digital health, types of digital health, use of technology and human factors in digital health were considered as important to be taught in DHET. Skills relating to digital health consultations, clinical information system management and remote monitoring were considered important to be taught. Blended learning which combined e-learning and classroom-based teaching, simulation sessions and clinical rotations were suggested by healthcare professionals as optimal approaches to deliver the above-mentioned content. Conclusions: This study is the first of its kind to investigate health professionals’ perspectives and expectations relating to the knowledge, skills and competency needs in digital health for current and future healthcare workforce. Healthcare workers are keen to acquire relevant knowledge, skills and competencies related to digital health. Different modes of education delivery is of interest to fit in with busy schedule of health workers.

Keywords: digital health, telehealth, telemedicine, education, curriculum

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Authors: Evdokia K. Oikonomou, Nikolay Christov, Galder Cristobal, Graziana Messina, Giovani Marletta, Laurent Heux, Jean-Francois Berret

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Fabric softeners are aqueous formulations that contain ~10 wt. % double tailed cationic surfactants. Here, a formulation in which 50% surfactant was replaced with low quantities of natural guar polymers was developed. Thanks to the reduced surfactant quantity this product has less environmental impact while the guars presence was found to maintain the product’s performance. The objective of this work is to elucidate the effect of the guar polymers on the softener deposition and the adsorption mechanism on the cotton surface. The surfactants in these formulations are assembled into large distributed (0.1 – 1 µm) vesicles that are stable in the presence of guars and upon dilution. The effect of guars on the vesicles adsorption on cotton was first estimated by using cellulose nanocrystals (CNC) as a stand-in for cotton. The dispersion of CNC in water permits to follow the interaction between the vesicles, guars, and CNC in the bulk. It was found that guars enhance the deposition on CNC and that the vesicles are deposited intactly on the fibers driven by electrostatics. The mechanism of the vesicles/guars adsorption on cellulose fibers was identified by quartz crystal microbalance with dissipation monitoring. It was found that the guars increase the surfactant deposited quantity, in agreement with the results in the bulk. Also, the structure of the adsorbed surfactant on the fibers' surfaces (vesicle or bilayer) was influenced by the guars presence. Deposition studies on cotton fabrics were also conducted. Attenuated total reflection and scanning electron microscopy were used to study the effect of the polymers on this deposition. Finally, fluorescent microscopy was used to follow the adsorption of surfactant vesicles, labeled with a fluorescent dye, on cotton fabrics in water. It was found that, in the presence or not of polymers, the surfactant vesicles are adsorbed on fiber maintaining their vesicular structure in water (supported vesicular bilayer structure). The guars influence this process. However, upon drying the vesicles are transformed into bilayers and eventually wrap the fibers (supported lipid bilayer structure). This mechanism is proposed for the adsorption of vesicular conditioner on cotton fiber and can be affected by the presence of polymers.

Keywords: cellulose nanocrystals, cotton fibers, fabric softeners, guar polymers, surfactant vesicles

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Authors: Longlong Zhang, Xiaohua Zhu, Ping Zhao, Yu Wang

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The construction of mines, railways, highways, water conservancy projects, etc., have formed a large number of high steep slope wounds in China. Under the premise of slope stability and safety, the minimum cost, green and close to natural wound space repair, has become a new problem. Nowadays, in situ element testing and analysis, monitoring, field quantitative factor classification, and assignment evaluation will produce vast amounts of data. Data processing and analysis will inevitably differentiate the morphology, mineral composition, physicochemical properties between rock wounds, by which to dynamically match the appropriate techniques and materials for restoration. In the present research, based on the grid partition of the slope surface, tested the content of the combined oxide of rock mineral (SiO₂, CaO, MgO, Al₂O₃, Fe₃O₄, etc.), and classified and assigned values to the hardness and breakage of rock texture. The data of essential factors are interpolated and normalized in GIS, which formed the differential zoning map of slope space. According to the physical and chemical properties and spatial morphology of rocks in different zones, organic acids (plant waste fruit, fruit residue, etc.), natural mineral powder (zeolite, apatite, kaolin, etc.), water-retaining agent, and plant gum (melon powder) were mixed in different proportions to form rock aging agents. To spray the aging agent with different formulas on the slopes in different sections can affectively age the fresh rock wound, providing convenience for seed implantation, and reducing the transformation of heavy metals in the rocks. Through many practical engineering practices, a dynamic data platform of rock aging agent formula system is formed, which provides materials for the restoration of different slopes. It will also provide a guideline for the mixed-use of various natural materials to solve the complex, non-uniformity ecological restoration problem.

Keywords: data-driven, dynamic state, high steep slope, rock aging agent, wounds

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Authors: S. K. Gali

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Spentwash, An effluent of distillery is an environmental pollutant because of its high load of pollutants (pH: 2-4; BOD>40,000 mg/l, COD>100,000mg/l and TDS >70,000mg/l). But However, after subjecting it to primary treatment (bio-methanation), Its pollutant load gets drastically reduced (pH: 7.5-8.5, BOD<10,000 mg/l) and could be disposed off safely as a source of organic matter and plant nutrients for crop production. With the consent of State Pollution Control Board, the distilleries in Karnataka are taking up ‘one time controlled land application’ of bio-methanated spentwash in farmers’ fields. A monitoring study was undertaken in Belgaum district of Karnataka State with an objective of studying the effect of land application of bio-methanated spent wash of a distillery on soil properties and crop growth. The treated spentwash was applied uniformly to the fallow dry lands in different farmers’ fields during summer, 2012 at recommended rate (based on nitrogen requirement of crops). The application was made at least a fortnight before sowing/planting operations. The analysis of soils collected before land application of spentwash and after harvest of crops revealed that there was no adverse effect of applied spentwash on soil characteristics. A slight build up in soluble salts was observed but, however all the soils recorded EC of less than 2.0 dSm-1. An increase in soil organic carbon (SOC) and available nitrogen (N) by about 10 to 30 % was observed in the spentwash applied soils. The presence of good amount of biodegradable organics in the treated spentwash (BOD of 6550 mg/l) contributed for increase in SOC and N. A substantial build up in available potassium (K) status (50 to 200%) was observed due to spentwash application. This was attributed to the high K content in spentwash (6950 mg/l). The growth of crops in the spentwash applied fields was higher and farmers could get nearly 10 to 20 per cent higher yields, especially in sugarcane and corn. The analysis of ground water samples showed that the quality of water was not affected due to land application of treated spentwash. Apart from realizing higher crop yields, the farmers were able to save money on N and K fertilisers as the applied spentwash met the crop requirement. Hence, it could be concluded that the bio-methanated distillery spentwash can be gainfully utilized in crop production without polluting the environment.

Keywords: bio-methanation, pollutant, potassium status, soil organic carbon

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Authors: Ugwu O. C., Mamah R. O., Awudu W. S.

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This work is aimed at enhancing signal reception on a mobile radio network and minimizing outage probability in a mobile radio network using adaptive beamforming antenna arrays. In this research work, an empirical real-time drive measurement was done in a cellular network of Globalcom Nigeria Limited located at Ikeja, the headquarters of Lagos State, Nigeria, with reference base station number KJA 004. The empirical measurement includes Received Signal Strength and Bit Error Rate which were recorded for exact prediction of the signal strength of the network as at the time of carrying out this research work. The Received Signal Strength and Bit Error Rate were measured with a spectrum monitoring Van with the help of a Ray Tracer at an interval of 100 meters up to 700 meters from the transmitting base station. The distance and angular location measurements from the reference network were done with the help Global Positioning System (GPS). The other equipment used were transmitting equipment measurements software (Temsoftware), Laptops and log files, which showed received signal strength with distance from the base station. Results obtained were about 11% from the real-time experiment, which showed that mobile radio networks are prone to signal failure and can be minimized using an Adaptive Beamforming Antenna Array in terms of a significant reduction in Bit Error Rate, which implies improved performance of the mobile radio network. In addition, this work did not only include experiments done through empirical measurement but also enhanced mathematical models that were developed and implemented as a reference model for accurate prediction. The proposed signal models were based on the analysis of continuous time and discrete space, and some other assumptions. These developed (proposed) enhanced models were validated using MATLAB (version 7.6.3.35) program and compared with the conventional antenna for accuracy. These outage models were used to manage the blocked call experience in the mobile radio network. 20% improvement was obtained when the adaptive beamforming antenna arrays were implemented on the wireless mobile radio network.

Keywords: beamforming algorithm, adaptive beamforming, simulink, reception

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Authors: Masome Moeni, Roya Abedizadeh, Elham Aram, Hamid Sadeghi-Abandansari, Davood Sabour, Robert Menzel, Ali Hassanpour

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Mitochondria- targeting immunogenic cell death inducers (MT-ICD) have been designed to trigger intrinsic apoptosis signalling pathway in malignant cells and revive the antitumour immune system. MT-ICD inducers have considered to be non-specific, which can deteriorate the ability to initiate mitochondria-selective oxidative stress, causing high toxicity. Iron oxide nanoparticles (IONPs) can be an ideal candidate as vehicles for utilizing in immunotherapy due to their biocompatibility, modifiable surface chemistry, magnetic characteristics and multi-functional applications in single platform. These types of NPs can facilitate a real time imaging which can provide an effective strategy to analyse pharmacokinetic parameters of nano-formula, including blood circulation time, targeted and controlled release at tumour microenvironment. To our knowledge, the conjugation of IONPs with MT-ICD and oxaliplatin (a chemotherapeutic agent used for the treatment of colorectal cancer) for immunotherapy have not been investigated. Herein, IONPs were generated via co-precipitation reaction at high temperatures, followed by coating the colloidal suspension with tetraethyl orthosilicate and 3-aminopropyltriethoxysilane to optimize their bio-compatibility, preventing aggregation and maintaining stability at physiological pH, then functionalized with (3-carboxypropyl) triphenyl phosphonium bromide for mitochondrial delivery. Analytical results demonstrated the successful process of IONPs functionalization. In particular, the colloidal particles of doped IONPs exhibited an excellent stability and dispersibility. The resultant particles were also successfully loaded with the oxaliplatin for an active mitochondrial targeting in immunotherapy, resulting in well-maintained super-paramagnetic characteristics and stable structure of the functionalized IONPs with nanoscale particle sizes.

Keywords: Immunotherapy, mitochondria, cancer, iron oxide nanoparticle

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Authors: Jasper Jose Zanco

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Plants are affected by substances diluted below certain limits. In seeds subjected to ultra-high dilutions (UHD), according to phytohomeopathic methods, it is possible to reduce the concentrations to infinitesimal levels and the effects persist. This research aimed to test different potencies of UHD to modify the vigor of Eruca versicaria (L) Cav. seedlings. The research was carried out at the Plant Production Laboratory of UNISUL University in Santa Catarina, Brazil. Eight UHD treatments were tested, four drops for every 30 mL of distilled water: Control (70% alcohol - A70); Sulphur (S9), Acidum fluoridricum (A30), Calcarea carbonica (C200), Graphies naturalis (G200), Kali carbonicum (K100) Belladonna (B12), diluted and succussed in Hahnemannian centesimal standards. Succussion is a standard pharmaceutical method found in worldwide pharmaceuticals. The statistical design consisted of 50 seeds every 4 replicates per treatment, completely randomized, followed by ANOVA and Tukey's test. Succussion may integrate the high dilution of water treatments, even after successive dilutions, and the product of this process acts through physical-chemical and bioelectric stimuli, causing physiological responses at the cellular level, such as the activation of antioxidant systems, increased resistance to environmental stress or growth modulation. According to some researchers, these responses could be mediated by genetic expression changes or the plants' cellular signaling systems. The results showed significant differences between the control (A70) and the other treatments. Conductivity measurements were made in the seed germination water and impedance; the seedlings were measured for dry weight and total area. The highest conductivity occurred in the control treatment (27.8 μS/cm) and the lowest in K100 (21.3 μS/cm). After germination, on germitest paper, A70 was significantly different from G200 (<1%) and S9 (5%). Both homeopathies differed from the other treatments, with S9 obtaining the best germination (87.1%) and vigor index (IV=7.98) in relation to the other treatments. The control, A70, presented the lowest germination (63.9%) and vigor (IV=4.93).

Keywords: ultra high dilution, impedance, condutivity, eruca versicaria

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Authors: Yuechao Lei, Lei Zhang

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The interface shear between asphalt overlay and existing rigid airport pavements occurs due to differences in the mechanical properties of materials subjected to aircraft loading. Interlayer contact influences the mechanical characteristics of the asphalt overlay directly. However, the effective interlayer relative displacement obtained accurately using existing displacement sensors of the loading apparatus remains challenging. This study aims to utilize digital image correlation technology to enhance the accuracy of interfacial contact parameters by obtaining effective interlayer relative displacements. Composite structure specimens were prepared, and fixtures for interlayer shear tests were designed and fabricated. Subsequently, a digital image recognition scheme for required markers was designed and optimized. Effective interlayer relative displacement values were obtained through image recognition and calculation of surface markers on specimens. Finite element simulations validated the mechanical response of composite specimens with interlayer shearing. Results indicated that an optimized marking approach using the wall mending agent for surface application and color coding enhanced the image recognition quality of marking points on the specimen surface. Further image extraction provided effective interlayer relative displacement values during interlayer shear, thereby improving the accuracy of interface contact parameters. For composite structure specimens utilizing Styrene-Butadiene-Styrene (SBS) modified asphalt as the tack coat, the corresponding maximum interlayer shear stress strength was 0.6 MPa, and fracture energy was 2917 J/m2. This research provides valuable insights for investigating the impact of interlayer contact in composite pavement structures on the mechanical characteristics of asphalt overlay.

Keywords: interlayer contact, effective relative displacement, digital image correlation technology, composite pavement structure, asphalt overlay

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Authors: Hala Alioua, Alberic Tellier

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This paper is designed to spotlight the research on corporate strategic planning, by emphasizing the role of middle manager of SBU’s and related issues such as the context of vision change. Previous research on strategic vision has been focused principally at the SME, with relatively limited consideration given to the role of middle managers SBU’s in the context of change. This project of research has been done by using a single case study. We formulated through our immersion for 2.5 years on the ground and by a qualitative method and abduction approach. This entity that we analyze is a subsidiary of multinational companies headquartered in Germany, specialized in manufacturing automotive equipment. The "Delta Company" is a French manufacturing plant that has undergone numerous changes over the past three years. The two major strategic changes that have a significant impact on the Delta plant are the strengths of its core business through « lead plant strategy» in 2011 and the implementation of a new strategic vision in 2014. These consecutive changes impact the purpose of the mission of the middle managers. The plant managers ask the following questions: How the middle managers make sense of the corporate strategic planning imposed by the parent company? How they appropriate the new vision and decline it into actions on the ground? We chose the individual interview technique through open-ended questions as the source of data collection. We first of all carried out an exploratory approach by interviewing 8 members of the Management committee’s decision and 19 heads of services. The first findings and results show that exist a divergence of opinion and interpretations of the corporate strategic planning among organization members and there are difficulties to make sense and interpretations of the signals of the environment. The lead plant strategy enables new projects which insure the workload of Delta Company. Nevertheless, it creates a tension and stress among the middle managers because its provoke lack of resources to the detriment of their main jobs as manufacturer plant. The middle managers does not have a clear vision and they are wondering if the new strategic vision means more autonomy and less support from the group.

Keywords: change, middle managers, vision, sensemaking

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Authors: Qianhui Li, Christoph H. Bruecker

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Atherosclerotic plaques are typically found where flow separation and variations of shear stress occur. Although helical flow patterns and flow separations have been recorded in the aorta, their relation has not been clearly clarified and especially in the condition of artificial heart valve prostheses. Therefore, an experimental study is performed to investigate the hemodynamic performance of different mechanical heart valves (MHVs), i.e. the SJM Regent bileaflet mechanical heart valve (BMHV) and the Lapeyre-Triflo FURTIVA trileaflet mechanical heart valve (TMHV), in a transparent model of the human aorta under a physiological pulsatile right-hand helical flow condition. A typical systolic flow profile is applied in the pulse-duplicator to generate a physiological pulsatile flow which thereafter flows past an axial turbine blade structure to imitate the right-hand helical flow induced in the left ventricle. High-speed particle image velocimetry (PIV) measurements are used to map the flow evolution. A circular open orifice nozzle inserted in the valve plane as the reference configuration initially replaces the valve under investigation to understand the hemodynamic effects of the entered helical flow structure on the flow evolution in the aortic arch. Flow field analysis of the open orifice nozzle configuration illuminates the helical flow effectively delays the flow separation at the inner radius wall of the aortic arch. The comparison of the flow evolution for different MHVs shows that the BMHV works like a flow straightener which re-configures the helical flow pattern into three parallel jets (two side-orifice jets and the central orifice jet) while the TMHV preserves the helical flow structure and therefore prevent the flow separation at the inner radius wall of the aortic arch. Therefore the TMHV is of better hemodynamic performance and reduces the pressure loss.

Keywords: flow separation, helical aortic flow, mechanical heart valve, particle image velocimetry

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Authors: Heewon Jeong, Seongpyo Kim, Joon Ha Kim

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Over the last few tens of years, the coastal regions of Korea have experienced red tide algal blooms, which are harmful and toxic to both humans and marine organisms due to their potential threat. It was accelerated owing to eutrophication by human activities, certain oceanic processes, and climate change. Previous studies have tried to monitoring and predicting the algae concentration of the ocean with the bio-optical algorithms applied to color images of the satellite. However, the accurate estimation of algal blooms remains problems to challenges because of the complexity of coastal waters. Therefore, this study suggests a new method to identify the concentration of red tide algal bloom from images of geostationary ocean color imager (GOCI) which are representing the water environment of the sea in Korea. The method employed GOCI images, which took the water leaving radiances centered at 443nm, 490nm and 660nm respectively, as well as observed weather data (i.e., humidity, temperature and atmospheric pressure) for the database to apply optical characteristics of algae and train deep learning algorithm. Convolution neural network (CNN) was used to extract the significant features from the images. And then artificial neural network (ANN) was used to estimate the concentration of algae from the extracted features. For training of the deep learning model, backpropagation learning strategy is developed. The established methods were tested and compared with the performances of GOCI data processing system (GDPS), which is based on standard image processing algorithms and optical algorithms. The model had better performance to estimate algae concentration than the GDPS which is impossible to estimate greater than 5mg/m³. Thus, deep learning model trained successfully to assess algae concentration in spite of the complexity of water environment. Furthermore, the results of this system and methodology can be used to improve the performances of remote sensing. Acknowledgement: This work was supported by the 'Climate Technology Development and Application' research project (#K07731) through a grant provided by GIST in 2017.

Keywords: deep learning, algae concentration, remote sensing, satellite

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Authors: Priyanka Devi, Mohammad Muzzaffar Khan, G. Kalyan Kumar

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Liquefaction of saturated soils due to dynamic loading is an important and interesting area in the field of geotechnical earthquake engineering. When the soil liquefies, the structures built on it develops uneven settlements thereby producing cracks in the structure and weakening the foundation. The 1964 Alaskan Good Friday earthquake, the 1989 San Francisco earthquake and 2011 Tōhoku earthquake are some of the examples of liquefaction occurred due to an earthquake. To mitigate the effect of liquefaction, several methods such use of stone columns, increasing the vertical stress, compaction and removal of liquefiable soil are practiced. Grouting is one of those methods used to increase the strength of the foundation and develop resistance to liquefaction of soil without affecting the superstructure. In the present study, an attempt has been made to investigate the undrained cyclic behavior of locally available soil, stabilized by cement to mitigate the seismically induced soil liquefaction. The specimens of 75mm diameter and 150mm height were reconstituted in the laboratory using water sedimentation technique. A series of strain-controlled cyclic triaxial tests were performed on saturated soil samples followed by consolidation. The effects of amplitude, confining pressure and relative density on the dynamic behavior of sand was studied for soil samples with varying cement content. The results obtained from the present study on loose specimens and medium dense specimens indicate that (i) the higher the relative density, the more will be the liquefaction resistance, (ii) with increase of effective confining pressure, a decrease in developing of excess pore water pressure during cyclic loading was observed and (iii) sand specimens treated with cement showed reduced excess pore pressures and increased liquefaction resistance suggesting it as one of the mitigation methods.

Keywords: cyclic triaxial test, liquefaction, soil-cement stabilization, pore pressure ratio

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Authors: Mohit Wadhawan, Sushma Rathaur

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Lymphatic filariasis, also called elephantiasis is a tropical disease afflicting over 120 million people in 81 countries worldwide. Existing anti filarial drugs are effective against the larval stages of filarial parasites which call for an urgent need of drugs which are macrofilaricidal. Identification of molecular targets crucial for survival of filarial parasites is a prerequisite for drug designing. Prolyl oligopeptidase (POP) is one such crucial enzyme involved in the maturation and degradation of neuropeptides and peptide hormones. We have identified this peptidase in the bovine filarial parasite, Setaria cervi. Effect of inhibition of POP on the proteome profile of filarial parasite has been discussed in this study. Filarial parasites were exposed to Z-pro-prolinal (ZPP), a specific POP inhibitor for 8 h and the motility and viability of the parasites was observed. It significantly reduced the motility and viability of the parasites. To study the proteome profile, the cytosolic, endoplasmic reticulum (ER) and mitochondrial extracts of the adult female parasites were subjected to 2-dimensional electrophoresis. As analyzed by the PD-Quest software, the ZPP caused the alteration in the different subcellular proteins, and the significantly altered proteins were identified using MALDI-MS/MS spectrometry. The major proteins identified were found to play important role in diverse biological functions like signaling, redox regulation, energy metabolism, stress response, and cytoskeleton formation. Moreover, we found upregulation in the calcium binding proteins such as calreticulin, calponin, and calpain-6 suggesting that POP inhibition regulates calcium release. This relates to earlier reports that POP plays non-catalytic role in inositol 1,4,5-trisphosphate (IP3) signaling inducing release of calcium from ER. Taken together, the data demonstrated that inhibition of prolyl oligopeptidase alter the overall proteome signifying its role in survival of the filarial parasites. Thus this study provides a basis for the use of POP as a chemotherapeutic target for the treatment of lymphatic filariasis.

Keywords: lymphatic filariasis, setaria cervi, prolyl oligopeptidase, proteomics

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Authors: Carolyn Cameron

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Stop Food Waste Australia is working with the industry to co-design sector action plans to prevent and reduce food waste across the supply chain. We are a public-private partnership, funded in 2021 by the Australian national government under the 2017 National Food Waste Strategy. Our partnership has representatives from all levels of government, industry associations from farm to fork, and food rescue groups. Like many countries, Australia has adopted the Sustainable Development Goal (SDG) target of 12.3 to halve food waste by 2030. A seminal 2021 study, the National Food Waste Feasibility Report, developed a robust national baseline, illustrating hotspots in commodities and across the supply chain. This research found that the consumption stages – households, food service, and institutions - account for over half of all food waste, and 22% of food produced never leaves the farm gate. Importantly the study found it is feasible for Australia to meet SDG 12.3, but it will require unprecedented action by governments, industry, and the community. Sector Action Plans (Plan) are one of the four main initiatives of Stop Food Waste Australia, including a voluntary commitment, a coordinated food waste communications hub, and robust monitoring and reporting framework. These plans provide a systems-based approach to reducing food loss and waste while realising multiple benefits for supply chain partners and other collaborators. Each plan is being co-designed with the key stakeholders most able to directly control or influence the root cause(s) of food waste hotspots and to take action to reduce or eliminate food waste in their value chain.  The initiatives in the Plans are fit-for-purpose, reflecting current knowledge and recognising priorities may refocus over time. To date, sector action plans have been developed with the Food Rescue, Cold Chain, Bread and Bakery, and Dairy Sectors. Work is currently underway on Meat and Horticulture, and we are also developing supply-chain stage plans for food services and institutions. The study will provide an overview of Australia’s food waste baseline and challenges, the important role of sector action plans in reducing food waste, and case studies of implementation outcomes.

Keywords: co-design, horticulture, sector action plans, voluntary

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Authors: Toumi Farah, Charallah Salima

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In the Algerian Sahara, goat farming is predominant, and it’s associated with other types of breeding, particularly camel and sheep; it also constitutes a significant proportion of breeding exclusively goat. This Saharan goat is a small ruminant with a black dress with white’s spots, hanging ears, and a coat more or less long. It is known for its hardiness and resistance to adverse conditions of arid zones and its perfect ecophysiological adaptation to harsh environmental conditions. However, pregnancy alterations, particularly abortion, degrade its productivity and cause economic losses, having both direct and indirect effects on animal production, like the costs of veterinary interventions and the reconstitution of livestock. The purpose of this work is to study the histological aspect of the liver of goats’ aborted living under nomadic herds in the region of Béni-Abbès (30° 7' N, 2° 10 'O). The organs were collected in physiological serum, rinsed, and then fixed with formaldehyde (37°, diluted at 10%). After that, these samples were processed for a topographic study. The morphometric study of the liver was performed by using an image analysis and processing software "Image J"; the various measurements obtained are intended to specify the supposed stage of development according to the body weight. The histological structure of the liver shows that the hepatic parenchyma consists of vascular conjunctive spaces surrounded by Glisson’s capsule. The sinusoids and hepatic portal vein are full of red blood cells, representing sinusoidal congestion and a thrombosed vein. At high magnification, the blood vessels show the presence of vascular thrombosis and haemorrhage in some areas of the hepatic parenchyma. Morphometric analysis shows that the number of liver parenchymal cells and the diameter of liver vessels vary according to the stage of development. The results obtained will provide details of the anatomical and cellular elements that can be used in the diagnosis of early or late abortion and late embryonic death. It would be interesting to find, by immunohistochemistry, some inflammatory markers useful for monitoring the progress of pregnancy and bioindicators of fetomaternal distress.

Keywords: aborting goat, arid zone, liver, histopathology

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Authors: Md. Alauddin, Md. Ruhul Amin, Md. Omar Faruque, Muhammad Ali Siddiquee, Zakir Hossain Howlader, Mohammad Asaduzzaman

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Diabetes and hypertension are the major lifestyle related diseases. The α-amylase and angiotensin converting enzymes (ACE) are the key enzymes that regulate diabetes and hypertension. The aim was to develop a drug for the treatment of diabetes and hypertension. The Rice Bran (RB) sample (Oryza sativa; BRRI-Dhan-84) was collected from the Bangladesh Rice Research Institute (BRRI), and rice bran proteins were isolated and hydrolyzed by hydrolyzing enzyme alcalase and trypsin. In vivo experiment suggested that rice bran bioactives has an effect on regulating the expression of several key gluconeogenesis and lipogenesis-regulating genes, such as glucose-6-phosphatase, phosphoenolpyruvate carboxykinase, and fatty acid synthase. The above genes have a connection of regulating the glucose level, lipids profile as well as act as an anti-inflammatory agent. A molecular docking, bioinformatics and in vitro experiments were performed. We found rice bran protein hydrolysates significantly (<0.05) influence the peptide concentration in the case of trypsin, alcalase, and (trypsin + alcalase) digestion. The in vitro analysis found that protein hydrolysate significantly (<0.05) reduced diabetic and hypertension as well as oxidative stress. A molecular docking study showed that the YY and IP peptide have a significantly strong binding affinity to the active site of the ACE enzyme and α-amylase with -7.8Kcal/mol and -6.2Kcal/mol, respectively. The Molecular dynamics (MD) simulation and Swiss ADME data analysis showed that less toxicity risk, good physicochemical properties, pharmacokinetics, and drug-likeness with drug scores 0.45 and 0.55 of YY and IP peptides, respectively. Thus, rice bran bioactive could be a good candidate for the treatment of diabetes and hypertension.

Keywords: anti-hypertensive and anti-hyperglycemic, anti-oxidative, bioinformatics, in vitro study, rice bran proteins and peptides

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Authors: Małgorzata Tomczyńska, Joanna Saluk-Bijak

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Background: Graves’ disease is a frequent organ-specific autoimmune thyroid disease, which characterized by the presence of different kind autoantibodies, that, in most cases, act as agonists of the thyrotropin receptor, leading to hyperthyroidism. Role of platelets and lymphocytes can be modulated in the pathophysiology of thyroid autoimmune diseases. Interference in the physiology of platelets can lead to enhanced activity of these cells. Activated platelets can bind to circulating lymphocytes and to affect lymphocyte adhesion. Platelets and lymphocytes can regulate mutual functions. Therefore, the activation of T lymphocytes, as well as blood platelets, is associated with the development of inflammation and oxidative stress within the target tissue. The present study was performed to investigate a platelet-lymphocyte relation by assessing the degree of their mutual aggregation in whole blood of patients with Graves’ disease. Also, the purpose of this study was to examine the impact of platelet interaction on lymphocyte migration capacity. Methods: 30 patients with Graves’ disease were recruited in the study. The matched 30 healthy subjects were served as the control group. Immunophenotyping of lymphocytes was carried out by flow cytometry method. A CytoSelect™ Cell Migration Assay Kit was used to evaluate lymphocyte migration and adhesion to blood platelets. Visual assessment of lymphocyte-platelet aggregate morphology was done using confocal microscope after magnetic cell isolation by Miltenyi Biotec. Results: The migration and functional responses of lymphocytes to blood platelets were greater in the group of Graves’ disease patients compared with healthy controls. The group of Graves’ disease patients exhibited a reduced T lymphocyte and a higher B cell count compared with controls. Based on microscopic analysis, more platelet-lymphocyte aggregates were found in patients than in control. Conclusions: Studies have shown that in Graves' disease, lymphocytes show increased platelet affinity, more strongly migrating toward them, and forming mutual cellular conglomerates. This may be due to the increased activation of blood platelets in this disease.

Keywords: blood platelets, cell migration, Graves’ disease, lymphocytes, lymphocyte-platelet aggregates

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Authors: Alexandra P. Alexandropoulou, Andreas Fousteris, Eleni Didaskalou, Dimitrios A. Georgakellos

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As urbanization is becoming a major stress factor not only for the urban environment but also for the wellbeing of city dwellers, incorporating the issues of urban health in strategic city planning and policy-making has never been more relevant. The impact of urbanization can vary from low to severe and relates to all non-communicable diseases caused by the different functions of cities. Air pollution, noise pollution, water and soil pollution, availability of open green spaces, and urban heat island are the major factors that can compromise citizens' health. Urban health describes the effects of the social environment, the physical environment, and the availability and accessibility to health and social services. To assess the quality of urban wellbeing, all urban characteristics that might have an effect on citizens' health must be considered, evaluated, and introduced in integrated local planning. A series of indices and indicators can be used to better describe these effects and set the target values in policy making. Local strategic planning is one of the most valuable development tools a local city administration can possess; thus, it has become mandatory under Greek law for all municipalities. It involves a two-stage procedure; the first aims to collect, analyse and evaluate data on the current situation of the city (administrative data, population data, environmental data, social data, swot analysis), while the second aims to introduce a policy vision described and supported by distinct (nevertheless integrated) actions, plans and measures to be implemented with the aim of city development and citizen wellbeing. In this procedure, the element of health is often neglected or under-evaluated. A relative survey was conducted among all Greek local authorities in order to shed light on the current situation. Evidence shows that the rate of incorporation of health in strategic planning is lacking behind. The survey also highlights key hindrances and concerns raised by local officials and suggests a path for the way forward.

Keywords: urban health, strategic planning, local authorities, integrated development

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Authors: Yori Gidron, Laura Caton, Irit Ben-Aharon

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Background: Many patients and even certain clinicians attribute cancer development to psychosocial factors. Yet, empirical data supports more the prognostic role, rather than the etiological role, of psychosocial factors in cancer. Part of the inconsistency may result from not considering possible moderating factors in the etiological role of psychosocial factors. One important candidate moderating factor is the vagal nerve, whose activity is indexed by heart-rate variability (HRV). The vagal nerve may prevent cancer since it reduces inflammation on the one hand, and since it increases anti-tumor immunity on the other hand. This study examined the moderating role of the vagus in the relation between life threatening events (LTE) and cancer development. Method: We re-analyzed data from the Lifelines Dutch longitudinal cohort study of over 150,000 people. The present study included 82,751 adults, who initially were cancer-free. We extracted information on background factors (e.g., age, gender, fat consumption), whether they ever experienced LTE, HRV and cancer diagnosis as reported by patients in annual clinic visits. HRV was derived from brief ECGs. Results: Of the full sample, 1011 people developed cancer during a follow-up. In the full sample, LTE significantly predicted cancer development (R.R = 1.063 p < .01) and HRV significantly predicted a reduced risk of cancer development (R.R = .506 p <.001). Importantly, LTE significantly predicted cancer only when HRV was low (R.R = 1.056, 95% CI: 1.007 - 1.108, p < .05) but not when HRV was high (R.R = 1.014; 95% CI: 0.916 - 1.122, p > 0.05), independent of confounders. Conclusions: To the best of our knowledge, this is the first study showing in a large sample that LTE predict cancer development, and that this occurs only when vagal nerve activity (HRV) is relatively low. These results could result from lack of vagal modulation of inflammation and also from lack of vagal modulation of stress responses. Results are in line with the cancer-protective role of the vagus. HRV needs to be routinely monitored in the population and future intervention trials need to examine whether vagal nerve activation can prevent cancer in people with LTE and with other cancer risk factors.

Keywords: cancer development, life-events, moderation, vagal nerve

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Authors: Anupam Sibal

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Apollo Quality Program(AQP) was launched across the Apollo Group of Hospitals to address the four patient safety areas; Safety during Clinical Handovers, Medication Safety, Surgical Safety and the six International Patient Safety Goals(IPSGs) of JCI. A measurable, online, quality dashboard covering 20 process and outcome parameters was devised for monthly monitoring. The expected outcomes were also defined and categorized into green, yellow and red ranges. An audit methodology was also devised to check the processes for the measurable dashboard. Documented clinical handovers were introduced for the first time at many locations for in-house patient transfer, nursing-handover, and physician-handover. Prototype forms using the SBAR format were made. Patient-identifiers, read-back for verbal orders, safety of high-alert medications, site marking and time-outs and falls risk-assessment were introduced for all hospitals irrespective of accreditation status. Measurement of Surgical-Site-Infection (SSI) for 30 days postoperatively, was done. All hospitals now tracked the time of administration of antimicrobial prophylaxis before surgery. Situations with high risk of retention of foreign body were delineated and precautionary measures instituted. Audit of medications prescribed in the discharge summaries was made uniform. Formularies, prescription-audits and other means for reduction of medication errors were implemented. There is a marked increase in the compliance to processes and patient safety outcomes. Compliance to read-back for verbal orders rose from 86.83% in April’11 to 96.95% in June’15, to policy for high alert medications from 87.83% to 98.82%, to use of measures to prevent wrong-site, wrong-patient, wrong procedure surgery from 85.75% to 97.66%, to hand-washing from 69.18% to 92.54%, to antimicrobial prophylaxis within one hour before incision from 79.43% to 93.46%. Percentage of patients excluded from SSI calculation due to lack of follow-up for the requisite time frame decreased from 21.25% to 10.25%. The average AQP scores for all Apollo Hospitals improved from 62 in April’11 to 87.7 in Jun’15.

Keywords: clinical handovers, international patient safety goals, medication safety, surgical safety

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Authors: Željka Rogač, Dejan Stevanović, Sara Bečanović, Ljubica Božić, Aleksandar Dimitrijević, Dragana Bogićević, Dimitrije Nikolić

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Children with epilepsy face changes in cognitive functioning, the appearance of symptoms of psychopathology and a decline in their quality of life. Factors related to epileptic seizures and the side effects of AEDs are considered to be potential causes of these changes.These changes can be prevented by prompt action, replacement of AEDs, psychological and psychiatric treatment, and social support. However, a review of literature has not yielded a conclusion as to when it is best to react, i.e., when changes in the functioning of children with newly-diagnosed epilepsy appears. The primary goal of this study was to investigate the impact of the most commonly used AEDs on cognitive status, behavior, anxiety and depression, as well as quality of life of children with newly-diagnosed epilepsy, during the first six months of treatment. This is a non-interventional, prospective study involving six-month monitoring of cognitive status, internalizing and externalizing symptoms, as well as quality of life of children with newly-diagnosed epilepsy, and the impact of antiepileptic drugs on these domains. Children with new-onset epilepsy and their parents, immediately after the introduction of antiepileptic drugs as well as six months later, filled out appropriate questionnaires (RCADS, NCBRF, CHEQOL-25, KIDSCREEN-10, AEP). At the same time, a psychologist performed the psychological testing of the child (REVISK). At the very beginning of REVISK treatment, a reduced VIQ was established, while after six months there was a significant decrease in IQ, VIQ and especially PIQ, under the influence of primary cognitive potentials and the development of depressive symptoms. All scores of the RCADS and NCBFR questionnaires were significantly elevated after six months while internalizing and externalizing symptoms affected each other. The development of depressive symptoms was significantly influenced by AED. The scores of the CHEQOL25 and KIDSCREEN10 questionnaires were significantly reduced, influenced by the adverse effects of AED and quality of life at the start of treatment. Side effects of AEDs, were significantly associated with depressive symptoms and reduced quality of life and did not significantly affect cognitive decline, anxiety, ADHD, and behavioral disorders during the first six months.

Keywords: epilepsy, children, AEDs, cognition, behavior, ADHD, anxiety, depression, QOL

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Authors: Shashwat, Sandra G. L. Persiani, Yew Wah Wong, Pramod S. Kamath, Avinash H. Anantharam, Hui Ling Aw, Yann Grynberg

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Achieving zero-energy targets in existing buildings is known to be a difficult task, hence targets are addressed at new buildings almost exclusively. Although these ultra-efficient case-studies remain essential to develop future technologies and drive the concepts of Zero-energy, the immediate need to cut the consumption of the existing building stock remains unaddressed. This work aims to present a reliable and straightforward methodology for assessing the potential of energy-efficient upgrading in existing buildings. Public Singaporean school buildings, characterized by low energy use intensity and large roof areas, were identified as potential objects for conversion to highly-efficient buildings with a positive energy balance. A first study phase included the development of a detailed energy model for two case studies (a primary and a secondary school), based on the architectural drawings provided, site-visits and calibrated using measured end-use power consumption of different spaces. The energy model was used to demonstrate compliances or predict energy consumption of proposed changes in the two buildings. As complete energy monitoring is difficult and substantially time-consuming, short-term energy data was collected in the schools by taking spot measurements of power, voltage, and current for all the blocks of school. The figures revealed that the bulk of the consumption is attributed in decreasing order of magnitude to air-conditioning, plug loads, and lighting. In a second study-phase, a number of energy-efficient technologies and strategies were evaluated through energy-modeling to identify the alternatives giving the highest energy saving potential, achieving a reduction in energy use intensity down to 19.71 kWh/m²/y and 28.46 kWh/m²/y for the primary and the secondary schools respectively. This exercise of field evaluation and computer simulation of energy saving potential aims at a preliminary assessment of the positive-energy feasibility enabling future implementation of the technologies on the buildings studied, in anticipation of a broader and more widespread adoption in Singaporean schools.

Keywords: energy simulation, school building, tropical climate, zero energy buildings, positive energy

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Authors: Aneena Suresh, C. S. Sidharth

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Drug related problems (DRPs) are common in chronic kidney disease (CKD) patients and end stage patients undergoing hemodialysis. To treat the co-morbid conditions of the patients, more complex therapeutic regimen is required, and it leads to development of DRPs. So, this calls for frequent monitoring of the patients. Due to the busy work schedules, physicians are unable to deliver optimal care to these patients. Addition of a clinical pharmacist in the team will improve the standard of care offered to CKD patients by minimizing DRPs. In India, the role of clinical pharmacists in the improving the health outcomes in CKD patients is poorly recognized. Therefore, this study is conducted to put an insight on the role of clinical pharmacist in improving Drug Related Problems in patients with chronic kidney disease, thereby helping them to achieve desired therapeutic outcomes in the patients. A prospective interventional study was conducted for a year in a 620 bedded tertiary care hospital in India. Data was collected using an unstructured questionnaire, medication charts, etc. DRPs were categorized using Hepler and Strand classification. Relationships between the age, weight, GFR, average no of medication taken, average no of comorbidities, and average length of hospital days with the DRPs were identified using Mann Whitney U test. The study population primarily constituted of patients above the age of 50 years with a mean age of 59.91±13.59. Our study showed that 25% of the population presented with DRPs. On an average, CKD patients are prescribed at least 8 medications for the treatment in our study. This explains the high incidence of drug interactions in patients suffering from CKD (45.65%). The least common DRPs in our study were found to be sub therapeutic dose (2%) and adverse drug reactions (2%). Out of this, 60 % of the DRPs were addressed successfully. In our study, there is an association between the DRPs with the average number of medications prescribed, the average number of comorbidities, and the length of the hospital days with p value of 0.022, 0.004, and 0.000, respectively. In the current study, 86% of the proposed interventions were accepted, and 41 % were implemented by the physician, and only 14% were rejected. Hence, it is evident that clinical pharmacist interventions will contribute significantly to diminish the DRPs in CKD patients, thereby decreasing the economic burden of healthcare costs and improving patient’s quality of life.

Keywords: chronic kidney disease, clinical pharmacist, drug related problem, intervention

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