Search results for: acute lung injury (ALI)

Authors: T. Suleiman, C. Mchugh, H. Ranu

Abstract:

Background; Asthma continues to be associated with poor patient outcomes, including mortality. An audit of the management of acute asthma admissions in our hospital in 2020 found poor compliance with National Asthma and COPD Audit Project (NACAP) standards which set out to improve inpatient asthma care. Clinical nurse specialists have been shown to improve patient care across a range of specialties. In September 2021, an asthma Nurse Specialist (ANS) was employed in our hospital. Aim; To re-audit management of acute asthma admissions using NACAP standards and assess for quality improvement post-employment of an ANS. Methodology; NACAP standards are wide-reaching; therefore, we focused on ‘specific elements of good practice’ in addition to the provision of inhaled corticosteroids (ICS) on discharge. Medical notes were retrospectively requested from the hospital coding department and selected as per NACAP inclusion criteria. Data collection and entry into the NACAP database were carried out. As this was a clinical audit, ethics approval was not required. Results; Cycle 1 (pre-ANS) and 2 (post-ANS) of the audit included 20 and 32 patients, respectively, with comparable baseline demographics. No patients had a discharge bundle completed on discharge in cycle 1 vs. 84% of cases in cycle 2. Regarding specific components of the bundle, 25% of patients in cycle 1 had their inhaler technique checked vs. 91% in cycle 2. Furthermore, 80% of patients had maintenance medications reviewed in cycle 1 vs. 97% in cycle 2. Medication adherence was addressed in 20% of cases in cycle 1 vs. 88% of cases in cycle 2. Personalized asthma action plans were not issued or reviewed in any cases in cycle 1 as compared with 84% of cases in cycle 2. Triggers were discussed in 30% of cases in cycle 1 vs. 88% of cases in cycle 2. Tobacco dependence was addressed in 44% of cases in cycle 1 vs. 100% of cases in cycle 2. No patients in cycle 1 had community follow-up requested within 2 days vs. 81% of the patients in cycle 2. Similarly, 20% of the patients in cycle 1 vs. 88% of the patients in cycle 2 had a 4-week asthma clinic follow-up requested. 75% of patients in cycle 1 were the recipient of ICS on discharge compared with 94% of patients in cycle 2. Conclusion; Our quality improvement project demonstrates the utility of an ANS in improving performance in the management of acute asthma admissions, evidenced here through concordance with NACAP standards. Asthma is a complex condition with biological, psychological, and sociological components; therefore, ANS is a suitable intervention to improve concordance with guidelines. ANS likely impacted performance directly, for example, by checking inhaler technique, and indirectly as a safety net ensuring doctors included ICS on discharge.

Keywords: asthma, nurse specialist, clinical audit, quality improvement

Procedia PDF Downloads 363

Authors: Dong Zhan

Abstract:

China sports science is the core periodical of scientific research in the field of sports in China at present. It is the first academic periodical ranked in China. The author has studied the characteristics and trends of articles on sports medicine and physical fitness published in the journal since it founded. Now, the articles on sports medicine and physical fitness published in the Journal of Sports Science from 2013 to 2017 are reviewed. The results show that 1) The characteristics of previous sports medicine articles showed that there were more articles on the basis of sports medicine than that on the application. The research on animal experiments was far more than that on the human body. Moreover, the trend was getting worse and worse as time goes on. But in the past five years, there had been a marked improvement. The basic/application has been improved from 2.1/1 to 1.3/1. This shows that sports medicine researchers have been paid more attention to the application research in sports medicine. 2) There are few articles on sports injury, because the state put the sports injury specialty into the medical colleges, and the research scope of sports research institutes does not include sports injury. It cannot meet the need for the development of sports medicine, and it should change sooner or later. 3) In the past, researchers’ effort was on athletes' physical health, not on ordinary people. Now, there is a great change, they not only research on the sportsmen’s health but also research on the health of the ordinary people. 4) Researchers mainly studied on the young people’s physical fitness in the past; now, it has been greatly improved. Researchers study on the physical health of the elderly, especially those over the age of 60. Numbers of paper researching on the young were much more than those on the old. In the past 10 years, the ratio of number of paper researching on the young to the old people was (young/old) 16.6/1, while in the past 5 years, this ratio was 6.3/1. However, this is not enough. China has a large population and needs to focus on promoting the health of the people. Conclusion: It is important to pay more attention to the application research on sports medicine and on the physical fitness, and it is also important to make a research on physical health of the elderly.

Keywords: sports medicine, people's health, the young, the old

Procedia PDF Downloads 135

Authors: Yoshitaka Ooya, Daishuke Furuya, Manabu Nemoto

Abstract:

Some countries such as Canada and Australia have mandatory bicycle helmet laws for all citizens and age groups. As of 2008 Japan has also adopted a helmet law but it is restricted to people 13 years old and under. People over 13 years of age are not required to wear helmets in Japan. Currently, the rate that people 0-13 years old actually wear helmets is low. In 2013 a number of patients came to Saitama University Hospital International Medical Center for treatment due to bicycle-related trauma. The total number of patients was 89 (55 male and 34 female). The average age of the patients was 40.9 years old (eldest; 83 y/o, median; 40 y/o, youngest; 1 y/o with a standard deviation ± 2.8). 54 of these patients (61%) experienced head trauma as well as some experiencing multiple injuries associated with their accident. 13 patients were wearing helmets, 50 patients were not wearing helmets and it is unknown if the remaining 26 patients were wearing helmets. This information was acquired from the patient`s medical charts. Only one patient who was wearing a helmet had a severe head injury, and this patient also experienced other multiple injuries. 17 patients who were not wearing helmets had severe head injuries and out of the 17, two had multiple injuries. The mechanism for injury varied. 12 patients were injured in an accident with a vehicle, only one of which was wearing a helmet. This patient also had multiple injuries. Of the other 11 patients, two had multiple injuries. The remaining patient`s injuries were caused by other accidents (3; fell over while riding, 2; crashed into an inanimate object, 1; collided with a motorcycle). The ladder of which had a severe head injury. All of these patients had light energy accidents and were all over 13 years of age. In Japan it is not mandatory for people over the age of 13 years to wear a bicycle helmet. Research shows that light energy accidents were mostly present in people over the age of 13, to which the law does not require the wearing of helmets. It is important that all people in all age groups be required to wear helmets when operating a bicycle to reduce the rate of light energy severe head injuries.

Keywords: bicycle helmet, head trauma, hospital, traumatic situation

Procedia PDF Downloads 344

Authors: Y. Landkocz, P. Gosset, A. Héliot, C. Corbière, C. Vendeville, V. Keravec, S. Billet, A. Verdin, C. Monteil, D. Préterre, J-P. Morin, F. Sichel, T. Douki, P. J. Martin

Abstract:

Air Pollution produced by automobile traffic is one of the main sources of pollutants in urban atmosphere and is largely due to exhausts of the diesel engine powered vehicles. The International Agency for Research on Cancer, which is part of the World Health Organization, classified in 2012 diesel engine exhaust as carcinogenic to humans (Group 1), based on sufficient evidence that exposure is associated with an increased risk for lung cancer. Amongst the strategies aimed at limiting exhausts in order to take into consideration the health impact of automobile pollution, filtration of the emissions and use of biofuels are developed, but their toxicological impact is largely unknown. Diesel exhausts are indeed complex mixtures of toxic substances difficult to study from a toxicological point of view, due to both the necessary characterization of the pollutants, sampling difficulties, potential synergy between the compounds and the wide variety of biological effects. Here, we studied the potential indirect genotoxicity of emission of Diesel engines through on-line exposure of rats in inhalation chambers to a subchronic high but realistic dose. Following exposure to standard gasoil +/- rapeseed methyl ester either upstream or downstream of a particle filter or control treatment, rats have been sacrificed and their lungs collected. The following indirect genotoxic parameters have been measured: (i) telomerase activity and telomeres length associated with rTERT and rTERC gene expression by RT-qPCR on frozen lungs, (ii) γH2AX quantification, representing double-strand DNA breaks, by immunohistochemistry on formalin fixed-paraffin embedded (FFPE) lung samples. These preliminary results will be then associated with global cellular response analyzed by pan-genomic microarrays, monitoring of oxidative stress and the quantification of primary DNA lesions in order to identify biological markers associated with a potential pro-carcinogenic response of diesel or biodiesel, with or without filters, in a relevant system of in vivo exposition.

Keywords: diesel exhaust exposed rats, γH2AX, indirect genotoxicity, lung carcinogenicity, telomerase activity, telomeres length

Procedia PDF Downloads 376

Authors: Hayley Lawrence, Nabi Shah, Sarah Dyer

Abstract:

Aims: Lumbar punctures are a common bedside procedure performed in acute medicine. Published guidance exists on the standardised documentation of invasive procedures in order to reduce the risk of complications. The audit aim was to assess current standards of documentation in accordance with both the GMC and the National Standards for Invasive Procedures guidelines. A second cycle was conducted after introducing a standardised sticker created using current guidelines. This would assess whether the sticker improved documentation, aiming for 100% standard in each step of the procedure. Methods: An initial prospective audit of current practice was conducted over a 3-month period. Patients were identified by their presenting complaints and by colleagues assessing acute medical patients. Initial findings were presented locally, and a further prospective audit was conducted following the implementation of a standardised sticker. Results: 19 lumbar punctures were included in the first cycle and 13 procedures in the second. Pre-procedure documentation was collected for each cycle, whereby documentation of ‘Indication’ improved from 5.3% to 84.6%, ‘Consent’ from 84.2% to 100%, ‘Coagulopathy’ from 0% to 61.5%, ‘Drug Chart checked’ from 0% to 100%, ‘Position of patient’ from 26.3% to 100% and use of ‘Aseptic Technique’ from 83.3% to 100% from the first to the second cycle respectively. ‘Level of Doctor’ and ‘Supervision’ decreased from 53% to 31% and 53% to 46%, respectively, in the second cycle. Documentation of the procedure itself also demonstrated improvements, with ‘Level of Insertion’ 15.8% to 100%, ‘Name of Antiseptic Used’ 11.1% to 69.2%, ‘Local Anaesthetic Used’ 26.3% to 53.8%, ‘Needle Gauge’ 42.1% to 76.9%, ‘Number of Attempts’ 78.9% to 100% and ‘Traumatic/Atraumatic’ procedure 26.3% to 92.3%, respectively. A similar number of opening pressures were documented in each cycle at 57.9% and 53.8%, respectively, but its documentation was deemed ‘Not Applicable’ in a higher number of patients in the second cycle. Post-procedure documentation improved, with ‘Number of Samples obtained’ increasing from 52.6% to 92.3% and documentation of ‘Immediate Complications’ increasing from 78.9% to 100%. ‘Dressing Applied’ was poorly documented in the first cycle at 16.7%. This was not included on the standardised sticker, resulting in 0% documentation in the second cycle. Documentation of Clinicians’ Name and Bleep reduced from 63.2% to 15.4%, but when the name only was analysed, this increased to 84.6%. Conclusions: Standardised stickers for lumbar punctures do improve documentation and hence should result in improved patient safety. There is still room for improvement to reach 100% standard in each area, especially with respect to the clinician’s name and contact details being documented. Final adjustments will be made to the sticker before being included in a lumbar puncture kit, which will be made readily available in the acute medical wards. Future audits could be extended to include other common bedside procedures performed in acute medicine to ensure documentation of all these procedures reaches 100% standard.

Keywords: invasive procedure, lumbar puncture, medical record keeping, procedure checklist, procedure documentation, standardised documentation

Procedia PDF Downloads 73

Authors: Atena Sadat Hosseini, Mohammadhossein Habibi

Abstract:

Acute myeloid leukemia (AML) is the most typically diagnosed leukemia. In older adults, AML imposes a dismal outcome. AML originates with a dominant mutation, then adds collaborative, transformative mutations leading to myeloid transformation and clinical/biological heterogeneity. Several chemotherapeutic drugs are used for this cancer. These drugs are naturally associated with several side effects, and finding a more accurate molecular mechanism of these drugs can have a significant impact on the selection and better candidate of drugs for treatment. In this study, we evaluated bortezomibin myeloma cells using bioinformatics analysis and evaluation of RNA-Seq data. Then investigated the molecular pathways proteins- proteins interactions associated with this chemotherapy drug. A total of 658upregulated genes and 548 downregulated genes were sorted.AUF1 (hnRNP D0) binds and destabilizes mRNA, degradation of GLI2 by the proteasome, the role of GTSE1 in G2/M progression after G2 checkpoint, TCF dependent signaling in response to WNT demonstrated in upregulated genes. Besides insulin resistance, AKT phosphorylates targets in the nucleus, cytosine methylation, Longevity regulating pathway, and Signal Transduction of S1P Receptor were related to low expression genes. With respect to this results, HIST2H2AA3, RP11-96O20.4, ZED9, PRDX1, and DOK2, according to node degrees and betweenness elements candidates from upregulated genes. in the opposite side, PYURF, NRSN1, FGF23, UPK3BL, and STAG3 were a prominent role in downregulated genes. Sum up, Using in silico analysis in the present study, we conducted a precise study ofbortezomib molecular mechanisms in myeloma cells. so that we could take further evaluation to discovermolecular cancer therapy. Naturally, more additional experimental and clinical procedures are needed in this survey.

Keywords: myeloma cells, acute myeloid leukemia, bioinformatics analysis, bortezomib

Procedia PDF Downloads 74

Authors: Alvin Han, Reema Shafi, Alishba Afaq, Jennifer Gommerman, Valeria Ramaglia, Shannon E. Dunn

Abstract:

Adolescents engaged in contact-sports can suffer from recurrent brain concussions with no loss of consciousness and no need for hospitalization, yet they face the possibility of long-term neurocognitive problems. Recent studies suggest that head concussive injuries during adolescence can also predispose individuals to multiple sclerosis (MS). The underlying mechanisms of how brain concussions predispose to MS is not understood. Here, we hypothesize that: (1) recurrent brain concussions prime microglial cells, the tissue resident myeloid cells of the brain, setting them up for exacerbated responses when exposed to additional challenges later in life; and (2) brain concussions lead to the sensitization of myelin-specific T cells in the peripheral lymphoid organs. Towards addressing these hypotheses, we implemented a mouse model of closed head injury that uses a weight-drop device. First, we calibrated the model in male 12 week-old mice and established that a weight drop from a 3 cm height induced mild neurological symptoms (mean neurological score of 1.6+0.4 at 1 hour post-injury) from which the mice fully recovered by 72 hours post-trauma. Then, we performed immunohistochemistry on the brain of concussed mice at 72 hours post-trauma. Despite mice having recovered from all neurological symptoms, immunostaining for leukocytes (CD45) and IBA-1 revealed no peripheral immune infiltration, but an increase in the intensity of IBA1+ staining compared to uninjured controls, suggesting that resident microglia had acquired a more active phenotype. This microglia activation was most apparent in the white matter tracts in the brain and in the olfactory bulb. Immunostaining for the microglia-specific homeostatic marker TMEM119, showed a reduction in TMEM119+ area in the brain of concussed mice compared to uninjured controls, confirming a loss of this homeostatic signal by microglia after injury. Future studies will test whether single or repetitive concussive injury can worsen or accelerate autoimmunity in male and female mice. Understanding these mechanisms will guide the development of timed and targeted therapies to prevent MS from getting started in people at risk.

Keywords: concussion, microglia, microglial priming, multiple sclerosis

Procedia PDF Downloads 82

Authors: Ana Claudia Muniz Rennó, Karina Nogueira

Abstract:

This study aimed to investigate the in vivo tissue response of the introduction of the bioactive mesh (BM) scaffolds using a model of tibial bone defect implants in rats. Although a previous in vivo study demonstrated a highly positive response of particulate bioactive materials in the morphological and biomechanical properties of the bone callus, the effects of material with superior bioactivity, present in form of meshes have not been studied yet. Eighty male Wistar rats with 3 mm tibial defects were used. Animals were divided into four groups: intact group (IG) – tibia without any injury; bone defect day zero (0dD) – bone defects, sacrificed immediately after injury; bone defect control group (CG) – bone defects without any filler and bone defect filled with BM scaffold. The animals of BM and CG groups were sacrificed 15, 30 and 45 days post-injury to compare the temporal-special effects of the scaffolds on bone healing. The histological analysis revealed an organized newly formed bone at 30 and 45 days post-surgery in the BM. Also, this group presented an increased COX-2 expression on days 15 and 30 post-surgery. Furthermore, the immunohistochemistry analysis revealed that, BM presented a positive immunoexpression of RUNX-2 during all periods evaluated. The biomechanical analysis revealed that at 15 day after surgery, no significant statistically difference was observed between BM and CG and both groups had significantly higher values of maximal load compared to 0dG and significantly lower values than IG. On days 30 and 45 post-surgery, BM presented statistically lower values of maximal load compared to the CG. Nevertheless, at the same periods, BM did not show statistically significant difference compared to the IG maximal load values (p > 0, 05). Our results revealed that the implantation of the BM scaffolds was effective in stimulating newly bone formation.

Keywords: bone, biomaterials, scaffolds, cartilage

Procedia PDF Downloads 324

Authors: Abdolrasoul Daneshjoo

Abstract:

The aim of this study was studying the effect of acute creatine supplementation on physiological variables of continuous and intermittent soccer activities of men soccer players. 32 soccer players from Tarbiat Moalem University aged (22/3+-1/6) volunteered for this research and were divided into two groups randomly. Both experimental and control groups after 6 days taking supplementation were tested. For measuring height and weight meter and balance were used. Questionnaire for health background, lactate electro, heart beat measuring polar electro, continuous and intermittent training program and time recorder were used for data collection. For data analysis descriptive statistical techniques, two-way ANOVA and F test were used. The result of this study showed increased significantly in heart rate in control group. For control group heart beat was (71/6 +- 3/5) and for experimental group it was (75/3 +- 4/9). No significant differences were observed in players weight after taking creatine.

Keywords: heartbeat, lactate Blood, creatine, soccer players of Tarbiat Moalem University

Procedia PDF Downloads 365

Authors: Matthew T. McCarthy, Sarah Janse, Natalie M. Pizzimenti, Anthony K. Savino, Brian Crosser, Sean C. Rose

Abstract:

Concussion is diagnosed clinically using a comprehensive history and exam, supported by ancillary testing. Frequently, symptom checklists are used as part of the evaluation of concussion. Existing symptom scales are based on a subjective Likert scale, without relation of symptoms to clinical or functional impairment. This is a retrospective review of 133 patients under age 30 seen in an outpatient neurology practice within 30 days of a probable or definite concussion. Each patient completed 2 symptom checklists at the initial visit – the SCAT-3 symptom evaluation (22 symptoms, 0-6 scale) and a scale based on the degree of clinical impairment for each symptom (22 symptoms, 0-3 scale related to functional impact of the symptom). Final clearance date was determined by the treating physician. 60.9% of patients were male with mean age 15.7 years (SD 2.3). Mean time from concussion to first visit was 6.9 days (SD 6.2), and 101 patients had definite concussions (75.9%), while 32 were diagnosed as probable (24.1%). 94 patients had a known clearance date (70.7%) with mean clearance time of 20.6 days (SD 18.6) and median clearance time of 19 days (95% CI 16-21). Mean total symptom score was 27.2 (SD 22.9) on the SCAT-3 and 14.7 (SD 11.9) for the functional impairment scale. Pearson’s correlation between the two scales was 0.98 (p < 0.001). After adjusting for patient and injury characteristics, an equivalent increase in score on each scale was associated with longer time to clearance (SCAT-3 hazard ratio 0.885, 95%CI 0.835-0.938, p < 0.001; functional impairment scale hazard ratio 0.851, 95%CI 0.802-0.902, p < 0.001). A concussion symptom scale based on degree of functional impairment correlates strongly with the SCAT-3 scale and demonstrates a similar association with time to clearance. By assessing the degree of impact on clinical functioning, this symptom scale reflects a more intuitive approach to rating symptoms and can be used in the management of concussion.

Keywords: checklist, concussion, neurology, scale, sports, symptoms

Procedia PDF Downloads 137

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

Abstract:

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

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

Procedia PDF Downloads 366

Authors: C. P. Mallapur, U. K. Hulihalli, D. N. Kambrekar

Abstract:

Maize (Zea mays L.) an important cereal crop in the world has diversified uses including human consumption, animal feed, and industrial uses. A major constraint in low productivity of maize in India is undoubtedly insect pests particularly two species of stem borers, Chilo partellus (Swinhoe) and Sesamia inferens (Walker). The stem borers cause varying level of yield losses in different agro-climate regions (25.7 to 80.4%) resulting in a huge economic loss to the farmers. Although these pests are rather difficult to manage, efforts have been made to combat the menace by using effective insecticides. However, efforts have been made in the present study to integrate various possible approaches for sustainable management of these borers. Two field experiments were conducted separately during 2016-17 at Main Agricultural Research Station, University of Agricultural Sciences, Dharwad, Karnataka, India. In the first experiment, six treatments were randomized in RBD. The insect eggs at pinhead stage (@ 40 eggs/plant) were stapled to the under surface of leaves covering 15-20 % of plants in each plot after 15 days of sowing. The second experiment was planned with nine treatments replicated thrice. The border crop with NB -21 grass was planted all around the plots in the specific treatments while, cowpea intercrop (@6:1-row proportion) was sown along with the main crop and later, the insecticidal spray with chlorantraniliprole and nimbecidine was taken upon need basis in the specific treatments. The results indicated that the leaf injury and dead heart incidence were relatively more in the treatments T₂ and T₄ wherein, no insect control measures were made after the insect release (58.30 & 40.0 % leaf injury and 33.42 and 25.74% dead heart). On the contrary, these treatments recorded higher stem tunneling (32.4 and 24.8%) and resulted in lower grain yield (17.49 and 26.79 q/ha) compared to 29.04, 32.68, 40.93 and 46.38 q/ha recorded in T₁, T₃, T₅ and T₆ treatments, respectively. A maximum yield loss of 28.89 percent was noticed in T₂ followed by 19.59 percent in T₄ where no sprays were imposed. The data on integrated management trial revealed the lowest stem borer damage (19.28% leaf injury and 1.21% dead heart) in T₅ (seed treatment with thiamethoxam 70FS @ 8ml/kg seed + cow intercrop along with nimbecidine 0.03EC @ 5.0 ml/l and chlorantraniliprole 18.5SC spray @ 0.2 ml/l). The next best treatment was T₆ (ST+ NB-21 borer with nimbecidine and chlorantraniliprole spray) with 21.3 and 1.99 percent leaf injury and dead heart incidence, respectively. These treatments resulted in highest grain yield (77.71 and 75.53 q/ha in T₅ and T₆, respectively) compared to the standard check, T₁ (ST+ chlorantraniliprole spray) wherein, 27.63 percent leaf injury and 3.68 percent dead heart were noticed with 60.14 q/ha grain yield. The stem borers can cause yield loss up to 25-30 percent in maize which can be well tackled by seed treatment with thiamethoxam 70FS @ 8ml/kg seed and sowing the crop along with cowpea as intercrop (6:1 row proportion) or NB-21 grass as border crop followed by application of nimbecidine 0.03EC @ 5.0 ml/l and chlorantraniliprole 18.5SC @ 0.2 ml/l on need basis.

Keywords: Maize stem borers, Chilo partellus, Sesamia inferens, crop loss, integrated management

Procedia PDF Downloads 157

Authors: Dyna Ann C. Sevilles, Noel J. Belonguel, Jarungchai Anton S. Vatanagul, Mary Jeanne O. Flordelis, Grace G. Anota

Abstract:

Guillain Barre syndrome is an acute inflammatory polyradiculoneuropathy causing progressive symmetrical weakness which can be debilitating to the patient. Early diagnosis is important especially in the acute phase when treatment favors good outcome and reduces the incidence of the need for mechanical ventilation. Electrodiagnostic studies aid in the evaluation of patients suspected with GBS. However, the characteristic electrical changes may not be evident until after several weeks. Thus, studies performed early in the course may give unclear results. The aim of this study is to associate the symptom onset of patients diagnosed with Guillain Barre syndrome with the EMG NCV results and determine the earliest time when there is evident findings supporting the diagnosis. This is a retrospective descriptive chart review study involving patients of >/= 18 years of age with GBS written on their charts in a Tertiaty hospital in Cebu City, Philippines from January 2000 to July 2014. Twenty patients showed electrodiagnostic findings suggestive of GBS. The mean day of illness when EMG NCV was carried out was 7 days. The earliest with suggestive findings was done on day 2 (10%) of illness. Moreover, the highest frequency with positive results was done on day 3 (20%) of illness. Based on the Dutch Guillain Barre Study group criteria, the most frequent variables noted were: prolonged distal motor latency in both median and ulnar nerves(65%) and both peroneal and tibial nerves (71%); and reduced CMAP in both median and ulnar nerves (65%) and both tibial and peroneal nerves (71%). The EMG NCV findings showed majority of demyelinating type (59%). Electrodiagnostic studies are helpful in aiding the physician in the diagnosis and treatment of the disease in the early stage. Based on this study, neurophysiologic evidence of GBS can be seen in as early as day 2 of clinical illness.

Keywords: Acute Inflammatory Demyelinating Polyneuropathy, electrophysiologic study, EMG NCV, Guillain Barre Syndrome

Procedia PDF Downloads 271

Authors: Muneesh Kumar, Rajesh Kumar, Sangeeta Devi

Abstract:

Heavy metals are a major problem because they are toxic and tend to accumulate in living organisms. This study was carried out with the aims of studying on histopathology of Zn(SO4) toxicity on gill and liver tissues of catfish (Clarias batrachus) within the period of 96 h. Totally, 140 fishes with mean weight 50±10 g were stocked in 12 aquariums with capacity of 200 L water and divided in to 3 trails including control, 4 ppm and 8 ppm of Zn with 3 replicates. Tissue samples were fixed by bouin’s solution and sectioned in 7 μm based on histological regular method and stained with Hematoxylin and Eosin (H&E) method for microscopic study within the period of 96 h. Results showed some damaged such as hyperplasia, telangiectasis and edema, necrosis of second filaments, jerky movement, aneurism, hyperemia and fusion of second filaments in gills; and cell atrophy, necrosis, fatty degeneration, hyperemia and bile stagnation at different treatments in comparison with control. Gill and liver tissue damages were severed with the increase of Zn concentration and days. Therefore, Zn had acute toxicity effects on gill and liver tissues in Catfish at 5 and 10 ppm concentrations.

Keywords: gill, liver, histopathology, zinc, Clarias batrachus

Procedia PDF Downloads 469

Authors: Ayesha Ali, Emilia Lindquist, Arif Jalal, Hannah Yusuf, Kayan Cheung, Rowan Eastabrook

Abstract:

It is currently estimated that over a third of deaths in children under five in Tanzania are caused by acute respiratory infections (ARIs). However, despite being one of the leading causes of morbidity and mortality across the developing world, its risk factors are poorly understood. Therefore, a systematic review of the literature published between 2015 and 2020 was conducted, focusing on risk factors for ARI in Tanzanian children under the age of five. 2015 Demographic and Health Survey (DHS) for Tanzania was analysed to supplement these findings with national data. 2224 papers were retrieved from two databases and were analysed by three independent reviewers. Thirteen papers were eligible for inclusion, covering a wide range of risk factors among which comorbidities (n=6), malnutrition (n=5), lack of parental education (n=4), poor socio-economic status (n=3), and delay in seeking healthcare (n=3) were the most cited risk factors. The risk factors with the highest reported risk ratios/odds ratios were lack of parental education (RR=11.5-14.5), followed by enrolment in school (RR=4.4), delay in seeking healthcare (RR=3.8) and cooking indoors (aOR =1.8-RR=5.5). The DHS data provided local context to these risk factors. For instance, the number of children experiencing symptoms of ARI in both urban and rural areas ranged between 4.5-5% in the two weeks prior to the survey. However, 79% of symptomatic children in Zanzibar received antibiotics for treatment compared to just 34% of those in the Southern Highlands. As demonstrated by both the systematic review and the DHS analysis, risk factors for ARI are predominantly socially determined, with Tanzania’s poorer rural children possessing the highest risk for ARI and more adverse health outcomes. Therefore, the burden of ARIs in Tanzanian children may be alleviated through the provision of appropriate treatment and parental education in rural areas.

Keywords: acute respiratory infection, child, health education, morbidity, mortality, pneumonia, Tanzania

Procedia PDF Downloads 175

Authors: Adel Edwar Waheeb Louka

Abstract:

Purpose AI-driven solutions are at the forefront of many pathology and medical imaging methods. Using algorithms designed to better the experience of medical professionals within their respective fields, the efficiency and accuracy of diagnosis can improve. In particular, X-rays are a fast and relatively inexpensive test that can diagnose diseases. In recent years, X-rays have not been widely used to detect and diagnose COVID-19. The under use of Xrays is mainly due to the low diagnostic accuracy and confounding with pneumonia, another respiratory disease. However, research in this field has expressed a possibility that artificial neural networks can successfully diagnose COVID-19 with high accuracy. Models and Data The dataset used is the COVID-19 Radiography Database. This dataset includes images and masks of chest X-rays under the labels of COVID-19, normal, and pneumonia. The classification model developed uses an autoencoder and a pre-trained convolutional neural network (DenseNet201) to provide transfer learning to the model. The model then uses a deep neural network to finalize the feature extraction and predict the diagnosis for the input image. This model was trained on 4035 images and validated on 807 separate images from the ones used for training. The images used to train the classification model include an important feature: the pictures are cropped beforehand to eliminate distractions when training the model. The image segmentation model uses an improved U-Net architecture. This model is used to extract the lung mask from the chest X-ray image. The model is trained on 8577 images and validated on a validation split of 20%. These models are calculated using the external dataset for validation. The models’ accuracy, precision, recall, f1-score, IOU, and loss are calculated. Results The classification model achieved an accuracy of 97.65% and a loss of 0.1234 when differentiating COVID19-infected, pneumonia-infected, and normal lung X-rays. The segmentation model achieved an accuracy of 97.31% and an IOU of 0.928. Conclusion The models proposed can detect COVID-19, pneumonia, and normal lungs with high accuracy and derive the lung mask from a chest X-ray with similarly high accuracy. The hope is for these models to elevate the experience of medical professionals and provide insight into the future of the methods used.

Keywords: artificial intelligence, convolutional neural networks, deeplearning, image processing, machine learningSarapin, intraarticular, chronic knee pain, osteoarthritisFNS, trauma, hip, neck femur fracture, minimally invasive surgery

Procedia PDF Downloads 44

Authors: Mitchell Stanton

Abstract:

Background: Endovascular management is well established as a mainstay treatment option for cerebral aneurysms. It is also well established that immediate post procedural imaging can be difficult to interpret due to the presence of contrast material. However, through the use of Dual-Energy computed tomography, it has become possible to differentiate contrast extravasation and intracranial haemorrhage. This case illustrates the importance of this technology following endovascular treatment of an unruptured cerebral aneurysm. Case Presentation: A 79-year-old female was found to have an unruptured large intracavernous ICA fusiform aneurysm on CT Brain Angiogram after presenting with acute ophthalmoplegia. This ophthalmoplegia was caused by mass effect from the aneurysm and subsequently the aneurysm was treated with an endovascular flow diverting stent. CT brain was performed post operatively due to a reduced level of consciousness and this showed diffuse subarachnoid hyperdensity of the left hemisphere. The use of Dual-Energy CT allowed accurate differentiation and illustrated diffuse contrast material extravasation, allowing patient to continue on dual-antiplatelets and therapeutic anticoagulation to reduce the risk of ischaemic injury post endovascular stent. Conclusion: Endovascular treatment options for management of intracranial aneurysms are constantly evolving. The use of Dual-Energy CT therefore has an integral role in accurately diagnosing any post-operative complications. Specifically, differentiating between subarachnoid haemorrhage and contrast extravasation is vital in these patients due to the significant consequences to their ongoing management in regards to continuation or cessation of antiplatelets or anticoagulation. With increasing access to this technology, its use should become standard practice in the post-operative investigation of these patients undergoing endovascular treatment.

Keywords: aneurysm, computed tomography, contrast extravasation, dual-energy CT, endovascular, subarachnoid haemorrhage

Procedia PDF Downloads 57

Authors: Muhammad Nauman Ahmad, Patrick Büker, Sofia Khalid, Leon Van Den Berg, Hamid Ullah Shah, Abdul Wahid, Lisa Emberson, Sally A. Power, Mike Ashmore

Abstract:

Although ozone is well-documented to affect crop yields in the densely populated Indo-Gangetic Plain, there is little knowledge of its effects around cities in more remote areas of South Asia. We surveyed crops around the city of Peshawar, Pakistan for visible injury, linking this to passive measurements of ozone concentrations. Foliar injury was found in the field on potato, onion and cotton when the mean monthly ozone concentration reached 35-55ppb. The symptoms on onion were reproduced in ozone fumigation experiments, which also showed that daytime ozone concentrations of 60ppb and above significantly reduce the growth of Pakistani varieties of both spinach (Beta vulgaris) and onion. Aphid infestation on spinach was also reduced at these elevated ozone concentrations. The ozone concentrations in Peshawar are comparable to those through many parts of northern south Asia, where ozone may therefore be a significant threat to sensitive vegetable crops in peri-urban regions.

Keywords: ozone, air pollution, vegetable crops, peshawar, south asia

Procedia PDF Downloads 717

Authors: Isha Ranadive, Sonam Patel, Suresh Balakrishnan

Abstract:

It has been observed that in lizards wound can be healed by either a scar free mechanism or by scarring. The animal model used to study both these healing processes was Northern House Gecko. In lizard, the tail when amputated heals by scar free mechanism which allows it to regenerate, the same is not seen when the limb is amputated. Proliferation, apoptosis, and angiogenesis are the main events which succeed an injury. We observed that proliferation of the cells beneath the wound epidermis was much higher in case of wound healing in tail. This could be because after the wound gets covered by the epithelium, it enters in to a cross-talk with the underlying mesenchyme to recruit a pool of blastemal cells which proliferate and later differentiate to form the lost part through epimorphic regeneration. This was substantiated by mRNA expression levels of various FGFs which facilitate the cross-talk and also by PCNA which is a marker for proliferation. Western blot result reaffirms the same notion. However, in case of the limb, the rate of apoptosis was more than proliferation as there are a lot of debris that needs to be removed. We came to this conclusion as we observed that p53 the apoptotic gene was highly upregulated in case of the scarred tissue. Further, we confirmed this result by checking the anti-apoptotic gene bcl2 and found it to be significantly down-regulated. As we noticed heightened proliferation in the case of scar-free wound healing in tail, angiogenesis was targeted for the study. This is because, when the cells are proliferating they require constant supply of blood and hence neo-vascularization is inevitable. It was observed that the marker of angiogenesis, VEGF, was expressed more during wound healing as compared to the resting stage of tail. Moreover, a high up-regulation was seen in KDR, a receptor of VEGF. Thus, this study reveals how proliferation, apoptosis, and angiogenesis play a key role in the scar-free as well as scarred wound healing.

Keywords: epimorphic regeneration, injury, northern house gecko, wound healing

Procedia PDF Downloads 229

Authors: Qian Mao, Xiaozan Wang, Jiarong Zhong, Xiaolin Zou

Abstract:

Introduction: As a result of the decline of students' physical health level and the increase of study pressure, students’ academic performance is not so good. Objective: This study aims to verify whether the Brain-Break intervention in the fourth-grade classroom of primary school can improve students' physical health and academic performance. Methods: According to the principle of no difference in pre-test data, students from two classes of grade four in Fuhai Road Primary School, Fushan district, Yantai city, Shandong province, were selected as experimental subjects, including 50 students in the experimental class (25 males and 25 females) and 50 students in the control class (24 males and 26 females). The content of the experiment was that the students were asked to perform a 4-minute Brain-Berak program designed by the researcher in the second class in the morning and the afternoon, and the intervention lasted for 12 weeks. In addition, the lung capacity, 50-meter run, sitting body forward bend, one-minute jumping rope and one-minute sit-ups stipulated in the national standards for physical fitness of students (revised in 2014) were selected as the indicators of physical health. The scores of Chinese, Mathematics, and English in the unified academic test of the municipal education bureau were selected as the indicators of academic performance. The independent-sample t-test was used to compare and analyze the data of each index between the two classes. The paired-sample t-test was used to compare and analyze the data of each index in the two classes. This paper presents only results with significant differences. Results: in terms of physical health, lung capacity (P=0.002, T= -2.254), one-minute rope skipping (P=0.000, T=3.043), and one-minute sit-ups (P=0.045, T=6.153) were significantly different between the experimental class and the control class. In terms of academic performance, there is a significant difference between the Chinese performance of the experimental class and the control class (P=0.009, T=4.833). Conclusion: Adding Brain-Berak intervention in the classroom can effectively improve the cardiorespiratory endurance (lung capacity), coordination (jumping rope), and abdominal strength (sit-ups) of fourth-grade students. At the same time, it can also effectively improve their Chinese performance. Therefore, it is suggested to promote micro-sports in the classroom of primary schools throughout the country so as to help students improve their physical health and academic performance.

Keywords: academic performance, brain break, fourth grade, physical health

Procedia PDF Downloads 89

Authors: Francesco Pantano, Marta Fogolari, Michele Iuliani, Sonia Simonetti, Silvia Cavaliere, Marco Russano, Fabrizio Citarella, Bruno Vincenzi, Silvia Angeletti, Giuseppe Tonini

Abstract:

Background: Although immune checkpoint inhibitors (ICIs) have changed the treatment paradigm of non–small cell lung cancer (NSCLC), these drugs fail to elicit durable responses in the majority of NSCLC patients. The gut microbiota, able to regulate immune responsiveness, is emerging as a promising, modifiable target to improve ICIs response rates. Since the oral microbiome has been demonstrated to be the primary source of bacterial microbiota in the lungs, we investigated its composition as a potential predictive biomarker to identify and select patients who could benefit from immunotherapy. Methods: Thirty-five patients with stage IV squamous and non-squamous cell NSCLC eligible for an anti-PD-1/PD-L1 as monotherapy were enrolled. Saliva samples were collected from patients prior to the start of treatment, bacterial DNA was extracted using the QIAamp® DNA Microbiome Kit (QIAGEN) and the 16S rRNA gene was sequenced on a MiSeq sequencing instrument (Illumina). Results: NSCLC patients were dichotomized as “Responders” (partial or complete response) and “Non-Responders” (progressive disease), after 12 weeks of treatment, based on RECIST criteria. A prevalence of the phylum Candidatus Saccharibacteria was found in the 10 responders compared to non-responders (abundance 5% vs 1% respectively; p-value = 1.46 x 10-7; False Discovery Rate (FDR) = 1.02 x 10-6). Moreover, a higher prevalence of Saccharibacteria Genera Incertae Sedis genus (belonging to the Candidatus Saccharibacteria phylum) was observed in "responders" (p-value = 6.01 x 10-7 and FDR = 2.46 x 10-5). Finally, the patients who benefit from immunotherapy showed a significant abundance of TM7 Phylum Sp Oral Clone FR058 strain, member of Saccharibacteria Genera Incertae Sedis genus (p-value = 6.13 x 10-7 and FDR=7.66 x 10-5). Conclusions: These preliminary results showed a significant association between oral microbiota and ICIs response in NSCLC patients. In particular, the higher prevalence of Candidatus Saccharibacteria phylum and TM7 Phylum Sp Oral Clone FR058 strain in responders suggests their potential immunomodulatory role. The study is still ongoing and updated data will be presented at the congress.

Keywords: oral microbiota, immune checkpoint inhibitors, non-small cell lung cancer, predictive biomarker

Procedia PDF Downloads 75

Authors: Arman Kishan, Mark Haft, Kiyanna Thomas, Duc Nguyen, Dawn Laporte

Abstract:

Objective: Patients receiving anticoagulation therapy frequently experience increased rates of postoperative complications. Presently, limited data exist regarding the outcomes of patients undergoing carpal tunnel release surgery (CTR) while on anticoagulation. Our objective is to examine and compare the occurrence of complications in patients on anticoagulation who underwent either endoscopic CTR (ECTR) or open CTR (OCTR) for CTS. Methods: The Trinet X database was utilized to retrospectively identify patients who underwent OCTR or ECTR while concurrently on anticoagulation. Demographic data, medical comorbidities, and complication rates were analyzed. We used multivariable analysis to identify differences in postoperative complications, including wound infection within 90 days, wound dehiscence within 90 days, and intraoperative median nerve injury between the two surgical methods in patients on anticoagulation. Results: A total of 10,919 carpal tunnel syndrome patients on anticoagulation were included in the study, with 9082 and 1837 undergoing OCTR and ECTR, respectively. Among patients on anticoagulation, those undergoing ECTR exhibited a significantly lower occurrence of 90-day wound infection (p < 0.001) and nerve injury (p < 0.001) compared to those who underwent OCTR. However, there was no statistically significant difference in the risk of 90-day wound dehiscence between the two groups (p = 0.323). Conclusion:  In prior studies, ECTR demonstrated reduced rates of postoperative complications compared to OCTR in the general population. Our study demonstrates that among patients on anticoagulation, those undergoing ECTR experienced a significantly lower incidence of 90-day wound infection and nerve injury, with risk reductions of 35% and 40%, respectively. These findings support using ECTR as a preferred surgical method for patients with CTS who are on anticoagulation therapy.

Keywords: endoscopic treatment of carpal tunnel syndrome, open treatment of carpal tunnel syndrome, postoperative complications in patients on anticoagulation, carpal tunnel syndrome

Procedia PDF Downloads 52

Authors: Keivan Jamshidi, Afshin Zahedi

Abstract:

Acrylamide (ACR) has been shown to cause neurotoxic effects in humans and neurotoxic, genotoxic, reproductive, and carcinogenic effects in laboratory animals. To investigate the nephrotoxic effect of Acrylamide (ACR), 50 adult male rats (Wistar, approximately 250 g) housed in polycarbonate boxes as 5 per each, and randomly assigned in 5 groups including 4 exposure groups as A, B, C, and D groups of rats (10 rats per exposure group., total) and were exposed to 0.5, 5, 50, 100 mg/kg ACR per day×11days i.p. respectively. The remaining 10 rats were housed in group (E) as control group. Control rats received daily i.p. injections of 0.9% saline (3ml/kg). On day 12, four rats, were randomly selected, perfused , dissected and proper samples were collected from their kidneys. Results of histopathological studies based on H&E technique did show no morphologic changes in kidneys of rats belong to groups A, B and E, while moderate to severe morphologic changes including glomerular hypercellularity, global pattern of proliferative glomerulonephritis, occupation of capsular space, tubular cell swelling and hyaline cast formation, were observed in different stained sections obtained from the kidneys of rats belong to group, C, and D. This finding, beside neurotoxic, reproductive and carcinogenic effects, seems to indicate for the first time another important aspect of toxic effect of ACR, i.e., acute nephrotoxicity.

Keywords: acrylamide, nephrotoxicity, glomerulonephritis, rats

Procedia PDF Downloads 601

Authors: Ayda Youssef, Mohammed Ali Khalaf, Tarek Rafaat

Abstract:

Background: Langerhans cell histiocytosis (LCH) is a rare multi-systemic disease that shows an abnormal proliferation of these kinds of cells associated with a granular infiltration that affects different structures of the human body, including the lung, liver, spleen, lymph nodes, brain, mucocutaneous, soft tissue (head and neck), and salivary glands. Evaluation of the extent of disease is one of the major predictors of patient outcome. Objectives: To recognize the pathogenesis of Langerhans cell histiocytosis (LCH), describe the radiologic criteria that are suggestive of LCH in different organs rather than the bones and to illustrate the appropriate differential diagnoses for LCH in each of the common extra-osseous sites. Material and methods: A retrospective study was done on 150 biopsy-proven LCH patients from 2007 to 2012. All patients underwent imaging studies, mostly US, CT, and MRI. These patients were reviewed to assess the extra-skeletal manifestations of LCH. Results: In 150 patients with biopsy-proven LCH, There were 33 patients with liver affection, 5 patients with splenic lesions, 55 patients with enlarged lymph nodes, 9 patient with CNS disease and 11 patients with lung involvement. Conclusions: Because of the frequent LCH children and evaluation of the extent of disease is one of the major predictors of patient outcome. Radiologist need to be familiar with its presentation in different organs and regions of body outside the commonest site of affection (bones). A high-index suspicion should be raised a biopsy is recommended in the presence of radiological suspicion. Chemotherapy is the preferred therapeutic modality.

Keywords: langerhans cell histiocytosis, extra-skeletal, pediatrics, radiology

Procedia PDF Downloads 424

Authors: N. A. Kazemi Sefat, M. M. Mohammadi, J. Hadjati, S. Talebi, M. Ajami, H. Daneshvar

Abstract:

Colorectal cancer metastases result in a significant number of cancer related deaths. Histone deacetylase (HDAC) inhibitors induce growth arrest and apoptosis in a variety of human cancer cells. Sodium butyrate (SB) is a short chain fatty acid, belongs to HDAC inhibitors which is released in the colonic lumen as a consequence of fiber fermentation. In this study, we are about to assess the effect of sodium butyrate on HCT116 human colorectal carcinoma cell line. The viability of cells was measured by microscopic morphologic study and MTT assay. After 48 hours, treatments more than 10 mM lead to cell injury in HCT116 by increasing cell granulation and decreasing cell adhesion (p>0.05). After 72 hours, treatments at 10 mM and more lead to significant cell injury (p<0.05). Our results may suggest that the gene expression which is contributed in cell proliferation and apoptosis has been changed under pressure of HDAC inhibition.

Keywords: colorectal cancer, sodium butyrate, cytotoxicity, MTT

Procedia PDF Downloads 342

Authors: Sarah E. Nelson, Casey Weiner, Alexander Sigmon, Jun Hua, Haris I. Sair, Jose I. Suarez, Robert D. Stevens

Abstract:

Graph-theoretical information from structural connectomes indicated significant connectivity changes and improved acute prognostication in a Random Forest (RF) model in aneurysmal subarachnoid hemorrhage (aSAH), which can lead to significant morbidity and mortality and has traditionally been fraught by poor methods to predict outcome. This study’s hypothesis was that structural connectivity changes occur in canonical brain networks of acute aSAH patients, and that these changes are associated with functional outcome at six months. In a prospective cohort of patients admitted to a single institution for management of acute aSAH, patients underwent diffusion tensor imaging (DTI) as part of a multimodal MRI scan. A weighted undirected structural connectome was created of each patient’s images using Constant Solid Angle (CSA) tractography, with 176 regions of interest (ROIs) defined by the Johns Hopkins Eve atlas. ROIs were sorted into four networks: Default Mode Network, Executive Control Network, Salience Network, and Whole Brain. The resulting nodes and edges were characterized using graph-theoretic features, including Node Strength (NS), Betweenness Centrality (BC), Network Degree (ND), and Connectedness (C). Clinical (including demographics and World Federation of Neurologic Surgeons scale) and graph features were used separately and in combination to train RF and Logistic Regression classifiers to predict two outcomes: dichotomized modified Rankin Score (mRS) at discharge and at six months after discharge (favorable outcome mRS 0-2, unfavorable outcome mRS 3-6). A total of 56 aSAH patients underwent DTI a median (IQR) of 7 (IQR=8.5) days after admission. The best performing model (RF) combining clinical and DTI graph features had a mean Area Under the Receiver Operator Characteristic Curve (AUROC) of 0.88 ± 0.00 and Area Under the Precision Recall Curve (AUPRC) of 0.95 ± 0.00 over 500 trials. The combined model performed better than the clinical model alone (AUROC 0.81 ± 0.01, AUPRC 0.91 ± 0.00). The highest-ranked graph features for prediction were NS, BC, and ND. These results indicate reorganization of the connectome early after aSAH. The performance of clinical prognostic models was increased significantly by the inclusion of DTI-derived graph connectivity metrics. This methodology could significantly improve prognostication of aSAH.

Keywords: connectomics, diffusion tensor imaging, graph theory, machine learning, subarachnoid hemorrhage

Procedia PDF Downloads 173

Authors: Bahar Tunctan, Sefika Pinar Kucukkavruk, Meryem Temiz-Resitoglu, Demet Sinem Guden, Ayse Nihal Sari, Seyhan Sahan-Firat

Abstract:

We hypothesized that rexinoids such as bexarotene, a selective retinoid X receptor α (RXRα) agonist, may be beneficial for preventing mortality due to inflammation associated with increased expression/activity of inducible nitric oxide synthase (iNOS) induced by lipopolysaccharide (LPS). Therefore, we investigated effects of bexarotene on the changes in circulating protein levels of iNOS (an index for systemic iNOS expression), myeloperoxidase (MPO) (an index for systemic inflammation), and lactate dehydrogenase (LDH) (an index for systemic tissue injury) in LPS-induced systemic inflammation model resulting in septic shock in rats. Rats were injected with saline (4 ml/kg; i.p.), LPS (10 mg/kg; i.p.), dimethylsulphoxide (4 ml/kg, 0.1%; s.c.) at time 0. Mean arterial blood pressure and heart rate were measured using a tail-cuff device. Bexarotene (0.03, 0.1, 0.3, and 1 mg/kg; s.c.) was administered to separate groups of rats 1 h after injection of saline or LPS. The rats were sacrificed 4 h after saline or LPS injection and blood was collected for measurement of serum iNOS, MPO, and LDH protein levels. Blood pressure decreased by 31 mmHg and heart rate increased by 63 bpm in the LPS-treated rats. Bexarotene at 0.3 and 1 mg/kg doses caused 20% mortality 4 h after LPS injection. In the LPS-treated rats, serum iNOS, MPO, and LDH protein levels were increased. Bexarotene only at 0.1 mg/kg dose prevented the LPS-induced hypotension and increased in iNOS, MPO, and LDH protein levels. These data are consistent with the view that a decrease in systemic iNOS levels contributes to the beneficial effect of bexarotene to prevent the hypotension associated with inflammation and tissue injury during rat endotoxemia. [This work was financially supported by The Scientific and Technological Research Council of Turkey (SBAG-109S121)].

Keywords: bexarotene, inflammation, iNOS, lipopolisaccharide, RXRa

Procedia PDF Downloads 296

Authors: Hongmei Wang, Ziyun Xiang, Ying liu, Li Yu, Dongsheng Yue

Abstract:

Intro: The COVID-19 (Corona Virus Disease 2019) has greatly changed the global economic, political and financial ecology. The mutation of the coronavirus in the UK in December 2020 has brought new panic to the world. Deep learning was performed on Chest Computed tomography (CT) of COVID-19 and Influenza and describes their characteristics. The predominant features of COVID-19 pneumonia was ground-glass opacification, followed by consolidation. Lesion density: most lesions appear as ground-glass shadows, and some lesions coexist with solid lesions. Lesion distribution: the focus is mainly on the dorsal side of the periphery of the lung, with the lower lobe of the lungs as the focus, and it is often close to the pleura. Other features it has are grid-like shadows in ground glass lesions, thickening signs of diseased vessels, air bronchi signs and halo signs. The severe disease involves whole bilateral lungs, showing white lung signs, air bronchograms can be seen, and there can be a small amount of pleural effusion in the bilateral chest cavity. At the same time, this year's flu season could be near its peak after surging throughout the United States for months. Chest CT for Influenza infection is characterized by focal ground glass shadows in the lungs, with or without patchy consolidation, and bronchiole air bronchograms are visible in the concentration. There are patchy ground-glass shadows, consolidation, air bronchus signs, mosaic lung perfusion, etc. The lesions are mostly fused, which is prominent near the hilar and two lungs. Grid-like shadows and small patchy ground-glass shadows are visible. Deep neural networks have great potential in image analysis and diagnosis that traditional machine learning algorithms do not. Method: Aiming at the two major infectious diseases COVID-19 and influenza, which are currently circulating in the world, the chest CT of patients with two infectious diseases is classified and diagnosed using deep learning algorithms. The residual network is proposed to solve the problem of network degradation when there are too many hidden layers in a deep neural network (DNN). The proposed deep residual system (ResNet) is a milestone in the history of the Convolutional neural network (CNN) images, which solves the problem of difficult training of deep CNN models. Many visual tasks can get excellent results through fine-tuning ResNet. The pre-trained convolutional neural network ResNet is introduced as a feature extractor, eliminating the need to design complex models and time-consuming training. Fastai is based on Pytorch, packaging best practices for in-depth learning strategies, and finding the best way to handle diagnoses issues. Based on the one-cycle approach of the Fastai algorithm, the classification diagnosis of lung CT for two infectious diseases is realized, and a higher recognition rate is obtained. Results: A deep learning model was developed to efficiently identify the differences between COVID-19 and influenza using chest CT.

Keywords: COVID-19, Fastai, influenza, transfer network

Procedia PDF Downloads 123

Authors: Magdalena Rusady Goey, Gordon Strathdee, Neil Perkins

Abstract:

Background: Acute lymphoblastic leukaemia (ALL) is the most frequent type of childhood malignancy, accounting for 25% of all cases. TWIST2, a basic helix-loop-helix transcription factor, has been implicated in ALL development. Prior studies found that TWIST2 undergoes epigenetic silencing in more than 50% cases of ALL through promoter hypermethylation and suggested that re-expression of TWIST2 may inhibit cell growth/survival of leukaemia cell lines. TWIST2 has also been implicated as a regulator of NF-kappaB activity, which is constitutively active in leukaemia. Here, we use a lentiviral transductions system to confirm the importance of TWIST2 in controlling leukaemia cell growth and to investigate whether this is achieved through altered regulation of NF-kappaB activity. Method: Re-expression of TWIST2 in leukaemia cell lines was achieved using lentiviral-based transduction. The lentiviral vector also expresses enhanced green fluorescent protein (eGFP), allowing transduced cells to be tracked using flow cytometry. Analysis of apoptosis and cell proliferation were done using annexinV and VPD450 staining, respectively. Result and Discussion: TWIST2-expressing cells were rapidly depleted from a mixed population in ALL cell lines (NALM6 and Reh), indicating that TWIST2 inhibited cell growth/survival of ALL cells. In contrast, myeloid cell lines (HL60 and K562) were comparatively insensitive to TWIST2 re-expression. Analysis of apoptosis and cell proliferation found no significant induction of apoptosis, but did find a rapid induction of proliferation arrest in TWIST2-expressing Reh and NALM6 cells. Initial experiment with NF-kappaB inhibitor demonstrated that inhibition of NF-kappaB has similar impact on cell proliferation in the ALL cell lines, suggesting that TWITST2 may induce cell proliferation arrest through inhibition of NF-kappaB. Conclusion: The results of this study suggest that epigenetic inactivation of TWIST2 in primary ALL leads to increased proliferation, potentially by altering the regulation of NF-kappaB.

Keywords: leukaemia, acute lymphoblastic leukaemia, NF-kappaB, TWIST2, lentivirus

Procedia PDF Downloads 330

Authors: R. Bužgová, R. Kozáková, M. Škutová, M. Bar, P. Ressner, P. Bártová

Abstract:

Introduction: Currently, there has been an increasing concern about the provision of palliative care in non-oncological patients in both professional literature and clinical practice. However, there is not much scientific information on how to provide neurological and palliative care together. The main objective of the project is to create and to verify a concept of neuro-palliative and rehabilitative care for patients with selected neurological diseases in an advanced stage of the disease and also to evaluate bio-psychosocial and spiritual needs of these patients and their caregivers related to the quality of life using created standardized tools. Methodology: Triangulation of research methods (qualitative and quantitative) will be used. A concept of care and assessment tools will be developed by analyzing interviews and focus groups. Qualitative data will be analyzed using grounded theory. The concept of care will be tested in the context of the intervention study. Using quantitative analysis, we will assess the effect of an intervention provided on the saturation of needs, quality of life, and quality of care. A research sample will be made up of the patients with selected neurological diseases (Parkinson´s syndrome, motor neuron disease, multiple sclerosis, Huntington’s disease), together with patients´ family members. Based on the results, educational materials and a certified course for health care professionals will be created. Findings: Based on qualitative data analysis, we will propose the concept of integrated care model combining neurological, rehabilitative and specialist palliative care for patients with selected neurological diseases in different settings of care and services. Patients´ needs related to quality of life will be described by newly created and validated measuring tools before the start of intervention (application of neuro-palliative and palliative approach) and then in the time interval. Conclusion: Based on the results, educational materials and a certified course for doctors and health care professionals will be created.

Keywords: multidisciplinary approach, neuropalliative care, research, quality of life

Procedia PDF Downloads 269