Search results for: clinical assessment

Authors: Noorulain Khalid, Unsaar Hayat, Muhammad Chaudhary, Christos Iosifidis, Felipe Dhawahir-Scala, Fiona Carley

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Dry eye disease (DED) is a common condition seen in the emergency eye department (EED) at Manchester Royal Eye Hospital (MREH). However, there is variability in the prescription of lubricating eye drops among different healthcare providers. The aim of this study was to develop an up-to-date, standardized algorithm for the prescription of lubricating eye drops in the EED at MREH based on international and national guidelines. The study also aimed to assess the impact of implementing the guideline on the rate of inappropriate lubricant prescriptions. Primarily, the impact was to be assessed in the form of the appropriateness of prescriptions for patients’ DED. The impact was secondary to be assessed through analysis of the cost to the hospital. Data from 845 patients who attended the EED over a 3-month period were analyzed, and 157 patients met the inclusion and exclusion criteria. After conducting a review of the literature and collaborating with the corneal team, an algorithm for the prescription of lubricants in the EED was developed. Three plan-do-study-act (PDSA) cycles were conducted, with interventions such as emails, posters, in-person reminders, and education for incoming trainees. The appropriateness of prescriptions was evaluated against the guidelines. Data were collected from patient records and analyzed using statistical methods. The appropriateness of prescriptions was assessed by comparing them to the guidelines and by clinical correlation with a specialized registrar. The study found a substantial improvement in the number of appropriate prescriptions, with an increase from 55% to 93% over the three PDSA cycles. There was additionally a 51% reduction in expenditure on lubricant prescriptions, resulting in cost savings for the hospital (approximate saving of £50/week). Theoretical importance: Appropriate prescription of lubricating eye drops improves disease management for patients and reduces costs for the hospital. The development and implementation of a standardized guideline facilitate the achievement of these goals. Conclusion: This study highlights the inconsistent management of DED in the EED and the potential lack of training in this area for healthcare providers. The implementation of a standardized, easy-to-follow guideline for lubricating eye drops can help to improve disease management while also resulting in cost savings for the hospital.

Keywords: lubrication, dry eye disease, guideline, prescription

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Authors: Hiba T. Allah ALtieb Gusm ALsied, Amna Beshir Medani Ahmed, Ikram Mohamed ELtayeb, Saad Mohamed Hussein Ayoub

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This study was carried out to determine the hepatoactivity and the antioxidant activity of Coiradrum sativum L. aerial part and fruit extracts against CCL4 induced acute liver damages in Wistar rats. The aerial parts and fruits part of the plant were extracted 96% ethanol with soxhlet apparatus. Hepatic injury was achieved by subcutaneous injection of 3 ml/kg of CCL4 diluted with olive oil with ratio 1:1. The extracts were mixed together 1:1 ratio and given in different doses 100,200,400 mg/kg/day for 5 days under CCL4 induction at 3rd day. The significance of differences between means by using T-test was compared among the groups. The mixture of the two extracts didn’t show any significant result in protecting liver injury (antagonistic effects), it shows high level of liver enzyme like alkaline phosphatase (ALP), glutamate oxaloacetate transaminase (SGOT) and glutamate pyruvate transaminase (SGPT). Serological studies further confirmed the results. The results obtained were compared with silymarin (70 mg/kg/day) orally, the standard drug for hepatoprotection which show recovery close to normalization almost like that of silymarin; therefore, further studies on this plant with different ratios especially in isolated tissue to spot more light on antagonistic effects of the two extracts. Antioxidant activity of the extracts was determined by the DPPH method. The results obtained show high anti-oxidant activity for fruits extract while slight or moderate antioxidant activity to aerial extracts.

Keywords: antioxidant, aerial part, Coriadrum sativum L., fruity, hepatoprotection, Silymarin, phytochemical screening

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Authors: Emanuela Zilli, Antonio Madia, Milvia Marchiori, Paola Anello, Chiara Cabbia, Emanuela Velo, Delia Campagnolo, Michele Scomazzon, Emanuela Salvatico, S. Tikvina, Antonio Miotti

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Hepatitis C is an inflammation of the liver caused by the hepatitis C virus (HCV). Antiviral medicines can cure more than 95% of cases of hepatitis C infection, but access to diagnosis and treatment remains low. The ULSS 6 Euganea – Health Trust has implemented a campaign to eradicate hepatitis C in the province of Padua (North-East of Italy), which can be subdivided into three areas: North (300.000 inhabitants), Centre (400.000) and South (300.000). In September 2021, the project was launched in the Northern area; a set of brochures was distributed in outpatient services, general practitioners’ clinics and offices, community pharmacy services, social health districts, and through social networks. The Hepatology Service contacted 460 patients selected by the Clinical Laboratory (positivity for HCV antibodies): 83 patients (18.0%) had been already cured of HCV infection, missing or deceased; 377 patients (82.0%) met the criteria to be eligible for HCV eradication therapy and were therefore included in a Day Service specific agenda and followed by a multidisciplinary team of healthcare professionals, with a dedicated telephone line. Haemato-chemical tests, general medical check-ups and ultrasound tests with fibroscan were performed. Patients were tested for Sars-CoV-2 positivity; those not yet vaccinated against Covid-19 were encouraged to complete the vaccination scheme. All 377 patients (100%) received HCV eradication therapy at the community pharmacy service; a detailed explanation of how to take their medication was provided. At the end of the first phase, Covid-19 vaccination rate was 100% (377/377), including patients already vaccinated and new-vaccinated. Check-up appointments were arranged after 2 or 3 months, according to the treatment plan. The awareness campaign and the organization of HCV eradication therapy service by ULSS 6 Euganea are proving to be effective; the project is now going to be applied to Central and Southern areas of the province (1.132 patients).

Keywords: public health, HCV-eradication, Covid-19 emergency, health communication strategies

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Authors: Franca De Sarno, Alfonso Maria Ponsiglione, Enza Torino

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Recent advances in diagnostic imaging technology have significantly contributed to a better understanding of specific changes associated with diseases progression. Among different imaging modalities, Magnetic Resonance Imaging (MRI) represents a noninvasive medical diagnostic technique, which shows low sensitivity and long acquisition time and it can discriminate between healthy and diseased tissues by providing 3D data. In order to improve the enhancement of MRI signals, some imaging exams require intravenous administration of contrast agents (CAs). Recently, emerging research reports a progressive deposition of these drugs, in particular, gadolinium-based contrast agents (GBCAs), in the body many years after multiple MRI scans. These discoveries confirm the need to have a biocompatible system able to boost a clinical relevant Gd-chelate. To this aim, several approaches based on engineered nanostructures have been proposed to overcome the common limitations of conventional CAs, such as the insufficient signal-to-noise ratios due to relaxivity and poor safety profile. In particular, nanocarriers, labeling or loading with CAs, capable of carrying high payloads of CAs have been developed. Currently, there’s no a comprehensive understanding of the thermodynamic contributions enable of boosting the efficacy of conventional CAs by using biopolymers matrix. Thus, considering the importance of MRI in diagnosing diseases, here it is reported a successful example of the next generation of these drugs where the commercial gadolinium chelate is incorporate into a biopolymer nanostructure, formed by cross-linked hyaluronic acid (HA), with improved relaxation properties. In addition, they are highlighted the basic principles ruling biopolymer-CA interactions in the perspective of their influence on the relaxometric properties of the CA by adopting a multidisciplinary experimental approach. On the basis of these discoveries, it is clear that the main point consists in increasing the rigidification of readily-available Gd-CAs within the biopolymer matrix by controlling the water dynamics, the physicochemical interactions, and the polymer conformations. In the end, the acquired knowledge about polymer-CA systems has been applied to develop of Gd-based HA nanoparticles with enhanced relaxometric properties.

Keywords: biopolymers, MRI, nanoparticles, contrast agent

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Authors: Rossana Taravella, Gilberto M. Cellura, Giuseppe Cirrincione, Salvatore Asciutto, Marco Caruso, Massimo Benedetto, Renato Ciofalo, Giuliana Pace, Salvatore Novo

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Objectives: This retrospective analysis sought to evaluate 1-month outcomes and therapy effectiveness of a population of patients treated with MitraClip therapy. We describe in this article the preliminary results of primary effectiveness endpoint. Background: Percutaneous Mitral Repair is being developed to treat severe mitral regurgitation (MR), with increasing real-world cases of functional MR (FMR). In the EVEREST (Endovascular Valve Edge-to-Edge Repair Study)II trial, the percutaneous device showed superior safety but less reduction in MR at 1year. 4-year outcomes from EVEREST II trial showed no difference in the prevalence of moderate-severe and severe MR or mortality at 4years between surgical mitral repair and percutaneous approach. Methods: We analysed retrospectively collected data from one center experience in Italy enrolled from January 2011 to December 2016. The study included 62 patients [mean age 74±11years, 43 men (69%)] with MR of at least grade3+. Most of the patients had functional MR, were in New York Heart Association (NYHA) functional class III or IV, with a large portion (78%) of mild-to-moderate Tricuspid Regurgitation (TR). One or more clips were implanted in 67 procedures (62 patients). Results and Conclusions: Severity of MR was reduced in all successfully treated patients,54(90%) were discharged with MR≤2+ (primary effectiveness endpoint). Clinical 1-month follow-up data showed an improvement in NYHA functional class (42 patients (70%) in NYHA class I-II). 60 of 62 (97 %) successfully treated patients were free from death and mitral valve surgery at 1-month follow-up. MitraClip therapy reduces functional MR with acute MR reduction to <2+ in the great majority of patients, with a large freedom from death, surgery or recurrent MR in a great portion of patients.

Keywords: MitraClip, mitral regurgitation, heart valves, catheter-based therapy

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Authors: Yasmin Sayed, Hala Hamdy, Hafez Bazaraa, Hanaa Rady, Sherif Elanwary

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Intravenous and inhaled magnesium sulfate (MgSO₄) had been recently used as an adjuvant therapy in cases suffering from the wheezy chest. Objective: We aimed to determine the possible change in the hemodynamic state in cases received intravenous or inhaled MgSO₄ in comparison to cases received standard treatment in critically ill infants and children with the wheezy chest. Methods: A randomized controlled trial comprised 81 patients suffering from wheezy chest divided into 3 groups. In addition to bronchodilators and systemic steroids, MgSO₄ was given by inhalation in group A, intravenously in group B, and group C didn't receive MgSO₄. The hemodynamic state was determined by assessment of blood pressure, heart rate, capillary refill time and the need for shock therapy or inotropic support just before and 24 hours after receiving treatment in 3 groups. Results: There was no significant difference in the hemodynamic state of the studied groups before and after treatment. Means of blood pressure were 102.2/63.2, 105.1/64.8 before and after inhaled MgSO₄; respectively. Means of blood pressure were 105.5/64.2, 104.1/64.9 before and after intravenous MgSO₄; respectively. Means of blood pressure were 107.4/62.8, 104.4/62.1 before and after standard treatment, respectively. There was a statistically insignificant reduction of the means of the heart rate in group A and group B after treatment rather than group C. There was no associated prolongation in capillary refill time and/or the need for inotropic support or shock therapy after treatment in the studied groups. Conclusion: MgSO₄ is a safe adjuvant therapy and not associated with significant alteration in the hemodynamic state in critically ill infants and children with the wheezy chest.

Keywords: critically ill infants and children, inhaled MgSO₄, intravenous MgSO₄, wheezy chest

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Authors: Renu Pattanshetty

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The aim of this narrative review is to highlight the impact of menopause on osteoporosis and weight gain. The review also aims to summarize physiotherapeutic strategies to combat the same.A thorough literature search was conducted using electronic databases like MEDline, PUBmed, Highwire Press, PUBmed Central for English language studies that included search terms like menopause, osteoporosis, obesity, weight gain, exercises, physical activity, physiotherapy strategies from the year 2000 till date. Out of 157 studies that included metanalyses, critical reviews and randomized clinical trials, a total of 84 were selected that met the inclusion criteria. Prevalence of obesity is increasing world - wide and is reaching epidemic proportions even in the menopausal women. Prevalence of abdominal obesity is almost double than that general obesity with rates in the US with 65.5% in women ages 40-59 years and 73.8 in women aged 60 years or more. Physical activities and exercises play a vital role in prevention and treatment of osteoporosis and weight gain related to menopause that aim to boost the general well-being and any symptoms brought about by natural body changes. Endurance exercises lasting about 30 minutes /day for 5 days/ week has shown to decrease weight and prevent weight gain. In addition, strength training with at least 8 exercises of 8-12 repetitions working for whole body and for large muscle groups has shown to result positive outcomes. Hot flashes can be combatted through yogic breathing and relaxation exercises. Prevention of fall strategies and resistance training are key to treat diagnosed cases of osteoporosis related to menopause. One to three sets with five to eight repetitions of four to six weight bearing exercises have shown positive results. Menopause marks an important time for women to evaluate their risk of obesity and osteoporosis. It is known fact that bone benefit from exercises are lost when training is stopped, hence, practicing bone smart habits and strict adherence to recommended physical activity programs are recommended which are enjoyable, safe and effective.

Keywords: menopause, osteoporosis, obesity, weight gain, exercises, physical activity, physiotherapy strategies

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Authors: Eric Gismondi, Aurelie Bigot-Clivot

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Endocrine disruptors (EDCs) are well known to disrupt the development and the reproduction of exposed organisms. Although this point has been studied in vertebrate models, the limited knowledge of the endocrine system of invertebrates makes the evaluation of EDCs effects difficult. However, invertebrates represent the major part of aquatic ecosystems, such as amphipods Gammaridea, which are crucial for their functioning (e.g., litter degradation, food resource). Moreover, gammarids are hosts of parasites such as vertically-transmitted microsporidia (microsporidia VT), which could be confounding factors in assessment of EDC effects. Indeed, some microsporidia VT could have endocrine effects by their own present in the host since it was observed for example, a feminization of juvenile males, which become phenotypic females. This work evaluated the impact of ethinylestradiol (EE₂, estrogenic), cyproterone acetate (CPA, anti-androgenic), 4-hydroxytamoxifen (4HT, anti-estrogenic) and 17α-methyltestosterone (17MT - androgenic), on the 20-hydroxyecdysone concentration (i.e. 20HE - molt process) and the vitellogenin gene expression (i.e. reproduction) in the freshwater amphipod Gammarus pulex, after a 96h laboratory exposure. In addition, the presence of microsporidia VT was verified in order to analyze the effect of this confounding factor. Results of this study shown that, although endocrine systems of invertebrates and vertebrates are different, EDCs proved in vertebrates could also affect biological functions hormonally controlled in invertebrates. Indeed, the molt process of crustaceans was disrupted in the first stage (i.e. 20-HE concentration) and therefore, could affect, at the long term, the population dynamic. In addition, it was observed that G. pulex was differently impacted according to the gender and parasitism, which underline the importance to take into account these confounding factors to better evaluate the EDCs impact on invertebrate populations.

Keywords: endocrine disruption, gammarus sp., molt, parasitism

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Authors: Thelma Palaoag, Melanie Basa, Jezreel Mark Panilo

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Checking short-answer questions and essays, whether it may be paper or electronic in form, is a tiring and tedious task for teachers. Evaluating a student’s output require wide array of domains. Scoring the work is often a critical task. Several attempts in the past few years to create an automated writing assessment software but only have received negative results from teachers and students alike due to unreliability in scoring, does not provide feedback and others. The study aims to create an application that will be able to check short-answer questions which incorporate information extraction. Information extraction is a subfield of Natural Language Processing (NLP) where a chunk of text (technically known as unstructured text) is being broken down to gather necessary bits of data and/or keywords (structured text) to be further analyzed or rather be utilized by query tools. The proposed system shall be able to extract keywords or phrases from the individual’s answers to match it into a corpora of words (as defined by the instructor), which shall be the basis of evaluation of the individual’s answer. The proposed system shall also enable the teacher to provide feedback and re-evaluate the output of the student for some writing elements in which the computer cannot fully evaluate such as creativity and logic. Teachers can formulate, design, and check short answer questions efficiently by defining keywords or phrases as parameters by assigning weights for checking answers. With the proposed system, teacher’s time in checking and evaluating students output shall be lessened, thus, making the teacher more productive and easier.

Keywords: information extraction, short-answer question, natural language processing, application

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Authors: Ahmed R. Z. Baghdadi, Ibrahim M. I. Hamoda,  Mona H. Gamal Eldein, Ibrahim Magdy Elnaggar

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Background: High-velocity low amplitude thrust (HVLAT) manipulation and low-velocity low amplitude (LVLA) mobilization are an effective treatment for low back pain (LBP). Purpose: This study compared the effects of HVLAT versus LVLA on pain, functional deficits and segmental mobility in treatment of chronic mechanical LBP. Methods: Ninety patients suffering from chronic mechanical LBP are classified to three groups; Thirty patients treated by HVLAT (group I), thirty patients treated by LVLA (group II) and thirty patients as control group (group III) participated in the study. The mean age was 28.00±2.92, 27.83±2.28 and 28.07±3.05 years and BMI 27.98±2.60, 28.80±2.40 and 28.70±2.53 kg/m2 for group I, II and III respectively. The Visual Analogue Scale (VAS), the Oswestry low back pain disability questionnaire and modified schoper test were used for assessment. Assessments were conducted two weeks before and after treatment with the control group being assessed at the same time intervals. The treatment program group one was two weeks single session per week, and for group II two sessions per week for two weeks. Results: The One-way ANOVA revealed that group I had significantly lower pain scores and Oswestry score compared with group II two weeks after treatment. Moreover, the mobility in modified schoper increased significantly and the pain scores and Oswestry scores decreased significantly after treatment in group I and II compared with control group. Interpretation/Conclusion: HVLAT is preferable to LVLA mobilization, possibly due to a beneficial neurophysiological effect by Stimulating mechanically sensitive neurons in the lumbar facet joint capsule.

Keywords: low back pain, manipulation, mobilization, low velocity

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Authors: Mardiana Madjid, Nurpudji Astuti Taslim, Suryani As'ad, Haerani Rasyid, Agussalim Bukhari

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The high level of Urine Urea Nitrogen (UUN) indicates hypercatabolism occurs in hospitalized patients. High levels of Total Lymphocyte Count (TLC) indicates the immune system condition, adequate wound healing, and limit complication. Adequate dietary intake affects to decrease of hypercatabolism status in treated patient’s hospitals. Nitrogen Balance (NB) is simply the difference between nitrogen (N₂) intake and output. If more N₂ intake than output, then positive NB or anabolic will occur. This study aims to evaluate the effect of dietary intake in influencing balance nitrogen and total lymphocyte count. Method: A total of 43 patients admitted to a Wahidin Sudirohusodo Hospital between 2018 and 2019 for 10 days' treats are included. The inclusion criteria were patients who were treated for 10 days and receives food from the hospital orally. Patients did not experience gastrointestinal disorders such as vomiting and diarrhea and experience impair kidney function and liver function and expressed approval to participate in this study. During hospitalization, food intake, UUN, albumin serum, balance nitrogen, and TLC was assessed twice on day 1 and day 10. There is no Physician Clinical Nutritional intervention to correct food intake. UUN is 24 hours of urine collected on the second day after admission and the tenth day. Statistical analysis uses SPSS 24 with observational cohort methods. Result: The Forty-three participants completed the follow-up (27 men and 18 women). The age of fewer than 4 years is 22 people, 45 to 60 years is 16 people, and over 60 years is 4 people. The result of the study on day 1 obtained SGA score A, SGA score B, SGA score C are 8, 32, 3 until day 10 are 8, 31, 4, respectively. According to 24h dietary recalls, the energy intake during observation was from 522.5 ± 400.4 to 1011.9 ± 545.1 kcal/day P < 0.05, protein intake from 20.07 ± 17.2 to 40.3 ± 27.3 g/day P < 0.05, carbohydrates from 92.5 ± 71.6 to 184.8 ± 87.4 g/day, and fat from 5.5 ± 3.86 to 13.9 ± 13.9 g/day. The UUN during the observation was from 6.6 ± 7.3 to 5.5 ± 3.9 g/day, TLC decreased from 1622.9 ± 897.2 to 1319.9 ± 636.3/mm³ value target 1800/mm³, albumin serum from 3.07 ± 0.76 to 2.9 ± 0.57 g/day, and BN from -7.5 ± 7.2 to -3.1 ± 4.86. Conclusion: The high level of UUN needs to correct adequate dietary intake to improve NB and TLC status on hospitalized patients.

Keywords: adequate dietary intake, balance nitrogen, total lymphocyte count, urine urea nitrogen

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Authors: Xue Li, Hui Xu

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Mild cognitive impairment (MCI) is a clinical stage that occurs between normal aging and dementia. Although MCI increases the risk of developing dementia, individuals with MCI may maintain stable cognitive function and even recover to a typical cognitive state. An intervention to prevent or delay the progression to dementia in individuals with MCI may involve promoting social engagement. Social participation is the engagement in socially relevant social exchanges and meaningful activities. Older adults with MCI may encounter restricted cognitive abilities, mood changes, and behavioral difficulties during social participation, influencing their willingness to engage. Therefore, this study aims to employ qualitative research methods to gain an in-depth comprehension of the authentic social participation experiences of older adults with mild cognitive impairment, which will establish a foundation for designing appropriate intervention programs. A phenomenological research was conducted. The study participants were selected using the purposive sampling method in combination with the maximum differentiation sampling strategy. Face-to-face semistructured interviews were conducted among 12 elderly individuals suffering from mild cognitive impairment in a community in Zhengzhou City from May to July 2023. Colaizzi 7-step method was used to analyze the data and extract the theme. The real experience of social participation in older adults with mild cognitive impairment can be summarized into 3 themes: (1) a single social relationship but a strong desire to participate, (2) a dual experience of social participation with both positive and negative aspects, (3) multiple barriers to social participation, including impaired memory capacity, heavy family responsibilities and lack of infrastructure. The study found that elderly individuals with mild cognitive impairment and one social interaction display an increased desire to engage in society. To improve social participation levels and reduce cognitive function decline, healthcare providers should work with relevant government agencies and the community to create a comprehensive social participation system. It is important for healthcare providers to note the social participation status of the elderly with mild cognitive impairment.

Keywords: mild cognitive impairment, the elderly, social participation, qualitative research

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Authors: Amir Abbas Fatemi, Zahra Tabrizian, Kabir Sadeghi

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To find the location and severity of damage that occurs in a structure, characteristics changes in dynamic and static can be used. The non-destructive techniques are more common, economic, and reliable to detect the global or local damages in structures. This paper presents a non-destructive method in structural damage detection and assessment using GA and static data. Thus, a set of static forces is applied to some of degrees of freedom and the static responses (displacements) are measured at another set of DOFs. An analytical model of the truss structure is developed based on the available specification and the properties derived from static data. The damages in structure produce changes to its stiffness so this method used to determine damage based on change in the structural stiffness parameter. Changes in the static response which structural damage caused choose to produce some simultaneous equations. Genetic Algorithms are powerful tools for solving large optimization problems. Optimization is considered to minimize objective function involve difference between the static load vector of damaged and healthy structure. Several scenarios defined for damage detection (single scenario and multiple scenarios). The static damage identification methods have many advantages, but some difficulties still exist. So it is important to achieve the best damage identification and if the best result is obtained it means that the method is Reliable. This strategy is applied to a plane truss. This method is used for a plane truss. Numerical results demonstrate the ability of this method in detecting damage in given structures. Also figures show damage detections in multiple damage scenarios have really efficient answer. Even existence of noise in the measurements doesn’t reduce the accuracy of damage detections method in these structures.

Keywords: damage detection, finite element method, static data, non-destructive, genetic algorithm

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Authors: Abdul-Dahiru El-Yuguda, Saka Saheed Baba, Tawa Monilade Adisa, Mustapha Bala Abubakar

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Background: Chikungunya (CHIK) virus, a previously anecdotally described arbovirus, is now assuming a worldwide public health burden. The CHIK virus infection is characterized by potentially life threatening and debilitating arthritis in addition to the high fever, arthralgia, myalgia, headache and rash. Method: Three hundred and seventy (370) serum samples were collected from outpatients with febrile illness attending University of Maiduguri Teaching Hospital, Nigeria, and was used to detect for Chikungunya (CHIK) virus IgG and IgM antibodies using the Enzyme Linked Immunosorbent Assays (ELISAs). Result: Out of the 370 sera tested, 39 (10.5%) were positive for presence of CHIK virus antibodies. A total of 24 (6.5%) tested positive for CHIK virus IgM only while none (0.0%) was positive for presence of CHIK virus IgG only and 15 (4.1%) of the serum samples were positive for both IgG and IgM antibodies. A significant difference (p<0.0001) was observed in the distribution of CHIK virus antibodies in relation to gender. The males had prevalence of 8.5% IgM antibodies as against 4.6% observed in females. On the other hand 4.6% of the females were positive for concurrent CHIK virus IgG and IgM antibodies when compared to a prevalence of 3.4% observed in males. Only the age groups ≤ 60 years and the undisclosed age group were positive for presence of CHIK virus IgG and/or IgM antibodies. No significant difference (p>0.05) was observed in the seasonal prevalence of CHIK virus antibodies among the study subjects Analysis of the prevalence of CHIK virus antibodies in relation to clinical presentation (as observed by Clinicians) of the patients revealed that headache and fever were the most frequently encountered ailments. Conclusion: The CHIK virus IgM and concurrent IgM and IgG antibody prevalence rates of 6.5% and 4.1% observed in this study indicates a current infection and the lack of IgG antibody alone observed shows that the infection is not endemic but sporadic. Recommendation: Further studies should be carried to establish the seasonal prevalence of CHIK virus infection vis-à-vis vector dynamics in the study area. A comprehensive study need to be carried out on the molecular characterization of the CHIK virus circulating in Nigeria with a view to developing CHIK virus vaccine.

Keywords: Chikungunya virus, IgM and IgG antibodies, febrile patients, enzyme linked immunosorbent assay

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Authors: Sujata Mukherjee, Arunavo Mukherjee

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Water covers 70 per cent of our planet; however, freshwater is incredibly rare, and scarce has been listed as the highest impact global risk. The problems related to freshwater scarcity multiplies with the human population having more than doubled coupled with climate change, changing water cycles leading to droughts and floods and a rise in water pollution. Businesses, governments, and local communities are constrained by water scarcity and are facing growing challenges to their growth and sustainability. Water foot printing as an indicator for water use was introduced in 2002. Business water footprint measures the total water consumed to produce the goods and services it provides. It is a combination of the water that goes into the production and manufacturing of a product or service and the water used throughout the supply chain, as well as during the use of the product. A case study approach was applied describing the efforts of Tata Steel. It is based on a series of semi-structured in-depth interviews with top executives of the company as well as observation and content analysis of internal and external documents about the company’s efforts in sustainable water management. Tata Steel draws water required for industrial use from surface water sources, primarily perennial rivers and streams, internal reservoirs and water from municipal sources. The focus of the present study was to explore Tata Steel’s engagement in sustainable water management focusing on water foot printing accounting as a tool to account for water use in the steel supply chain at its Jamshedpur plant. The findings enabled the researchers to conclude that no sources of water are adversely affected by the company’s production of steel at Jamshedpur.

Keywords: sustainability, corporate responsibility water management, risk management, business engagement

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Authors: Yahia Massinissa, Henhouda Affaf, Yahia Mouloud

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The aim of this study was to investigate the toxicity; analgesic and anti-pyretic properties of standardized HA methanolic extract (HAMeOH) in vivo. The acute toxicity study was performed on rats while adopting the OECD-420 Guidelines (fixed dose procedure). Assessment of analgesic activity was performed in rats with two analgesic models. One was acetic acid induced writhing response and the other formalin-induced paw licking. The anti-pyretic effect was tested by brewer’s yeast induced fever in rats. For the acute toxicity test, the higher dose administration of 2000 mg/kg bw. of Hyoscyamus albus did not produce any toxic signs or deaths in rats. There were no significant differences (p>0.05) in the body and organ weights between control and treated groups. The (LD50) of Hyoscyamus albus was higher than 2000 g/kg bw. In subacute toxicity study, no mortality and toxic signs were observed with the doses of 100 and 200 mg/kg bw. of extracts of for 28 consecutive days. These analgesic experimental results indicated that HAMeOH (100 mg/kg and 200 mg/kg) decreased the acetic acid-induced writhing responses and HAMeOH (100 mg/kg and 200 mg/kg) decreased the licking time in the second phase of the formalin test. Moreover, in the model of yeast induced elevation of the body temperature HAMeOH showed dose-dependent lowering of the body temperature up to 3h at both the doses these results obtained, were comparable to that of paracetamol. The present findings indicate that the leaves of Hyoscyamus albus L. possess potent analgesic and antipyretic activity.

Keywords: Hyoscyamus albus, methanolic extract, toxicity, analgesic activity, antipyretic activity, formalin test

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Authors: Yu Yoshihara, Chika Tada, Moe Takada, Nyam-Osor Purevdorj, Khorolmaa Chimedtseren, Yutaka Nakai

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Water pollution from animal waste and its influence on grazing animals is a current concern regarding Mongolian grazing lands. We allocated 32 free-grazing lambs to four groups and provided each with water from a different source (upper stream, lower stream, well, and pond) for 49 days. We recorded the amount of water consumed by the lambs, as well as their body weight, behavior, white blood cell count, acute phase (haptoglobin) protein level, and fecal condition. We measured the chemical and biological qualities of the four types of water, and we detected enteropathogenic and enterohemorrhagic Escherichia coli in fecal samples by using a genetic approach. Pond water contained high levels of nitrogen and minerals, and well water contained high levels of bacteria. The odor concentration index decreased in order from pond water to upper stream, lower stream, and well. On day 15 of the experiment, the following parameters were the highest in lambs drinking water from the following sources: water intake (pond or lower stream), body weight gain (pond), WBC count (lower stream), haptoglobin concentration (well), and enteropathogenic E. coli infection rate (lower stream). Lambs that drank well water spent more time lying down and less time grazing than the others, and lambs that drank pond water spent more time standing and less time lying down. Lambs given upper or lower stream water exhibited more severe diarrhea on day 15 of the experiment than before the experiment. Mongolian sheep seemed to adapt to chemically contaminated water: their productivity benefited the most from pond water, likely owing to its rich mineral content. Lambs that drank lower stream water showed increases in enteropathogenic E. coli infection, clinical diarrhea, and WBC count. Lambs that drank well water, which was bacteriologically contaminated, had increased serum acute phase protein levels and poor physical condition; they were thus at increased risk of negative health and production effects.

Keywords: DNA, Escherichia coli, fecal sample, lower stream, well water

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Authors: Nayera E. Hassan, Salah Mostafa, Hamed Elkhayat, Kalled Hassan Sewidan, Sahar A. El-Masry, Manal Mouhamed Ali, Mones M. Abu Shady

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Pubertal growth is influenced by many factors including environmental and nutritional factors. Objective: To assess impact of nutritional status on pubertal staging, ovarian and uterine volumes among school girls. Method: Study was cross sectional and carried out on 1000 healthy school girls, aged 8-18 years selected randomly. They were categorized according to their ages into three groups: 8-12 years, 13-15 years and 16-18 years ±6 months, then according to their body mass index percentile to normal weight: (≥15-<85.), overweight (≥85-<95) and obese (≥95). All girls were subjected for physical, anthropometric (weight, height, body mass index), nutritional markers WAZ (weight/age Z score), HAZ (height/age Z score) and BMI-Z (body mass index Z score), pubertal assessment (Tanner stage) and pelvic transabdominal sonography (uterine and ovarian volumes). Results: Highly significant differences in ovarian and uterine volumes and nutritional markers (WAZ, HAZ and BMI-Z score) were detected among different grades of puberty in the two age groups (8-12 years, 13-15 years) coming in advance of obese girls (with increase of BMI); except HAZ in the second age group. Girls aged 16-18 years reached to final volume for the uterus and ovary with insignificant differences. Pubertal stage, ovarian and uterine sizes were highly significantly correlated with nutritional markers. Mean ages of onset: of puberty, menarche and complete puberty were, 11.65 + 1.84, 14.79 + 1.75 and 15.02 + 1.68 years respectively. Conclusion: Nutritional status has a crucial role in determining pubertal stage, ovarian and uterine volumes among Egyptian girls during the pubertal process.

Keywords: pubertal stage, nutritional markers, girls, ovarian and uterine volumes

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Authors: Felix Oromena Egara, Moeketsi Mosia

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The study aimed to evaluate the impact of blended learning on mathematics retention among secondary school students. Conducted in the Isoko North Local Government Area of Delta State, Nigeria, the research involved 1,235 senior class one (SS 1) students. Employing a non-equivalent control group pre-test-post-test quasi-experimental design, a sample of 70 students was selected from two secondary schools with ICT facilities through purposive sampling. Random allocation of students into experimental and control groups was achieved through balloting within each selected school. The investigation included three assessment points: pre-Mathematics Achievement Test (MAT), post-MAT, and post-post-MAT (retention), administered systematically by the researchers. Data collection utilized the established MAT instrument, which demonstrated a high reliability score of 0.86. Statistical analysis was conducted using the Statistical Package for Social Sciences (SPSS) version 28, with mean and standard deviation addressing study questions and analysis of covariance scrutinizing hypotheses at a significance level of .05. Results revealed significantly greater improvements in mathematics retention scores among students exposed to blended learning compared to those instructed through conventional methods. Moreover, noticeable differences in mean retention scores were observed, with male students in the blended learning group exhibiting notably higher performance. Based on these findings, recommendations were made, advocating for mathematics educators to integrate blended learning, particularly in geometry teaching, to enhance students’ retention of mathematical concepts.

Keywords: blended learning, flipped classroom model, secondary school students, station rotation model

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Authors: Richa Sinha, Mohammad Irfan Javed, Sanjay Singh

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Introduction: Good antimicrobial prescribing reduces length of stay in hospital, risk of adverse events, antimicrobial resistance, and unnecessary hospital expenditure. The aim of this prospective audit was to identify any problems with antimicrobial prescribing including documentation of the relevant aspects as well as appropriateness of antibiotics use. The audit was conducted on the surgical wards in a teaching hospital in the UK. Methods: Standards included the indication, duration, choice, and prescription of antibiotic should be in line with current Regional Guidelines and should be clearly documented on the prescription chart. There should be an entry in each patients’ medical record of the diagnosis and indication for each acute antibiotic prescription issued. All prescriptions should clearly document the route, frequency and dose of antibiotic. Data collection was done for 2 weeks in the month of March 2014. A proforma including all the questions above was completed for all the patients. The results were analysed using Excel. Results: 35 patients in total were selected for the audit. 85.7% of patients had indication of antibiotic documented on the prescription chart and 68.5% of patients had indication documented in the notes. The antibiotic used was in line with hospital guidelines in 45.7% of patients, however, in a further 28.5% of patients the reason for the antibiotic prescription was microbiology approved. Therefore, in total 74.2% of patients had been prescribed appropriate antibiotics. The duration of antibiotic was documented in 68.6% of patients and the antibiotic was reviewed in 37.1% of patients. The dose, frequency and route was documented clearly in 100% of patients. Conclusion: Overall, prescribing can be improved on the surgical wards in this hospital. Only 37.1% of patients had clear documentation of a review of antibiotics. It may be that antibiotics have been reviewed but this should be clearly highlighted on the prescription chart or the notes. Failure to review antibiotics can lead to poor patient care and antimicrobial resistance and therefore it is important to address this. It is also important to address the appropriateness of antibiotics as inappropriate antibiotic prescription can lead to failure of treatment as well as antimicrobial resistance. The good points from the audit was that all patients had clear documentation of dose, route and frequency which is extremely important in the administration of antibiotics. Recommendations from this audit included to emphasize good antimicrobial prescribing at induction (twice yearly), an antimicrobial handbook for junior doctors, and re-audit in 6 months time.

Keywords: prescribing, antimicrobial, indication, duration

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Authors: Timmis W., Simms M., Thomas C.

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This case discusses the management of two floors of mouth (FOM) Squamous Cell Carcinomas (SCC) not identified upon initial biopsy. A 51 year-old male presented with right FOM erythroleukoplakia. Relevant medical history included alcoholic dependence syndrome and alcoholic liver disease. Relevant drug therapy encompassed acamprosate, folic acid, hydroxocobalamin and thiamine. The patient had a 55.5 pack-year smoking history and alcohol dependence from age 14, drinking 16 units/day. FOM incisional biopsy and histopathological analysis diagnosed Carcinoma in situ. Treatment involved wide local excision. Specimen analysis revealed two separate foci of pT1 moderately differentiated SCCs. Carcinoma staging scans revealed no pathological lymphadenopathy, no local invasion or metastasis. SCCs had been excised in completion with narrow margins. MDT discussion concluded that in view of the field changes it would be difficult to identify specific areas needing further excision, although techniques such as Lugol’s Iodine were considered. Further surgical resection, surgical neck management and sentinel lymph node biopsy was offered. The patient declined intervention, primary management involved close monitoring alongside alcohol and smoking cessation referral. Narrow excisional margins can increase carcinoma recurrence risk. Biopsy failed to identify SCCs, despite sampling an area of clinical concern. For gross field change multiple incisional biopsies should be considered to increase chance of accurate diagnosis and appropriate treatment. Coupling of tobacco and alcohol has a synergistic effect, exponentially increasing the relative risk of oral carcinoma development. Tobacco and alcoholic control is fundamental in reducing treatment‑related side effects, recurrence risk and second primary cancer development.

Keywords: alcohol dependence, biopsy, oral carcinoma, tobacco

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Authors: Maha Azzam, Mahmoud Gabr, Mahmoud Zakaria, Ayman Refaie, Amani Ismail, Sherry Khater, Sylvia Ashamallah, Mohamed Ghoniem

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Evidence was provided that human bone marrow-derived mesenhymal stem cells (HBM-MSCs) could be differentiated to form insulin-producing cells (IPCs). Transplantation of these cells was able to cure chemically-induced diabetes in nude mice. The efficacy of these cells to control diabetes in large animals was carried out to evaluate the sufficient number of cells needed/Kg body weight and to determine the functional longevity in vivo. Materials/Methods: Ten male mongrel dogs weighing 15-20 Kg were used in this study. Diabetes was chemically-induced in 7 dogs by a mixture of alloxan and streptozotocin. Three non-diabetic served as normal controls. Differentiated HBM-MSCs (5 million/Kg) were encapsulated in theracyte capsules and transplanted beneath the rectus sheath. Each dog received 2 capsules. One dog died 4 days postoperative from inhalation pneumonia. The remaining 6 dogs were followed up for 6-18 months. Results: Four dogs became normoglycemic within 6-8 weeks with normal glucose tolerance curves providing evidence that the transplanted cells were glucose-sensitive and insulin-responsive. In the remaining 2 dogs, fasting blood glucose was reduced but did not reach euglycemic levels. The sera of all transplanted dogs contained human insulin and c-peptide but negligible levels of canine insulin. When the HBM-MSCs loaded capsules were removed, rapid return of diabetic state was noted. The harvested capsules were examined by immunofluorescence. IPCs were seen and co-expression of with c-peptide was confirmed. Furthermore, all the pancreatic endocrine genes were expressed by the transplanted cells. Conclusions: This study provided evidence that theracyte capsules could protect the xenogenic HBM-MSCs from the host immune response. This is an important issue when clinical stem cell therapy is considered for definitive treatment for T1DM.

Keywords: diabetes, mesenchymal stem cells, dogs, Insulin-producing cells

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Authors: Kuo-Wei Hsu, Jen-Chih, Chao, Pei-Chen, Wu

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With the rapid development of global economy, the increasing population, the highly industrialization, greenhouse gas emission and the ozone layer damage, the Global Warming happens. Facing the impact of global warming, the issue of “green transportation” began to be valued and promoted in each city. Taichung has been elected as the model of low-carbon city in Taiwan. To comply with international trends and the government policy, we tried to promote the energy saving and carbon reduction to create a “low-carbon Taichung with green life and eco-friendly economy”. To cooperate with the “green transportation” project, Taichung has promoted a number of public transports constructions and traffic policy in recent years like BRT, MRT, etc. The elevated railway is one of those important constructions. Cooperating with the green transport policy, elevated railway could help to achieve the carbon reduction for this low-carbon city. The current studies of the carbon emissions associated with railways and roads are focusing on the assessment on paving material, institutional policy and economic benefit. Except for changing the mode of transportation, elevated railways/roads also create space under the bridge. However, there is no research about the carbon emissions of the space underneath the elevated section up until now. This study investigated the effect of railway track elevation project in Taichung based on the carbon emissions and the factors that affect carbon emissions by research related theory and literature analysis. This study concluded that : railway track elevation increased the public transit, the bike lanes, the green areas and walking spaces. In the other hand it reduced the traffic congestions, the use of motorcycles as well as automobiles for carbon emissions.

Keywords: low-carbon city, green transportation, carbon emissions, Taichung, Taiwan

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Authors: Shaik Asha Begum, S. Joshna Rani, Shaik Abdul Rahaman

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INTRODUCTION: Breast cancer is a disease that creates in breast cells. "KAP" study estimates the Knowledge, Attitude, and Practices of a local area. More than 1.5 million ladies (25% of all ladies with malignancy) are determined to have bosom disease consistently all through the world. Understanding the degrees of Knowledge, Attitude and Practice will empower a more effective cycle of mindfulness creation as it will permit the program to be custom-made all the more properly to the necessities of the local area. OBJECTIVES: The objective of this study is to assess the knowledge on signs and symptoms, risk factors, provide awareness on the practicing of the early detection techniques of breast cancer and provide knowledge on the overall breast cancer including preventive techniques. METHODOLOGY: This is an expressive cross-sectional investigation. This investigation of KAP was done in the Nirmala Educational Institutions from January to April 2021. A total of 300 participants are included from women students in pharmacy graduates & lecturers, and also from graduates other than the pharmacy. The examiners are taken from the BCAM (Breast Cancer Awareness Measure), tool compartment (Version 2). RESULT: According to the findings of the study, the majority of the participants were not well informed about breast cancer. A lump in the breast was the most commonly mentioned sign of breast cancer, followed by pain in the breast or nipple. The percentage of knowledge related to the breast cancer risk factors was also very less. The correct answers for breast cancer risk factors were radiation exposure (58.20 percent), a positive family history (47.6 percent), obesity (46.9 percent), a lack of physical activity (43.6 percent), and smoking (43.2 percent). Breast cancer screening, on the other hand, was uncommon (only 30 and 11.3 percent practiced clinical breast examination and mammography respectively). CONCLUSION: In this study, the knowledge on the signs and symptoms, risk factors of breast cancer - pharmacy graduates have more knowledge than the non-pharmacy graduates but in the preventive techniques and early detective tools of breast cancer -had poor knowledge in the pharmacy and non-pharmacy graduate. After the awareness program, pharmacy and non-pharmacy graduates got supportive knowledge on the preventive techniques and also practiced the early detective techniques of breast cancer.

Keywords: breast cancer, mammography, KAP study, early detection

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Authors: Lucas Kurth de Azambuja, Loise Silveira da Silva, Gean Vitor Salmoria, Darlan Dallacosta, Carlos Rodrigo de Mello Roesler

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This work provides a physicochemical and thermal characterization assessment of three different hyaluronic acid (HA)-based injections used for rejuvenation skin treatments. The three products analyzed are manufactured by the same manufacturer and commercialized for application on different skin levels. According to the manufacturer, all three HA-based injections are crosslinked and have a concentration of 23 mg/mL of HA, and 0.3% of lidocaine. Samples were characterized by Fourier-transformed infrared (FTIR), differential scanning calorimetry (DSC), thermogravimetric analysis (TGA), and scanning electron microscope (SEM) techniques. FTIR analysis resulted in a similar spectrum when comparing the different products. DSC analysis demonstrated that the fusion points differ in each product, with a higher fusion temperature observed in specimen A, which is used for subcutaneous applications, when compared with B and C, which are used for the middle dermis and deep dermis, respectively. TGA data demonstrated a considerable mass loss at 100°C, which means that the product has more than 50% of water in its composition. TGA analysis also showed that Specimen A had a lower mass loss at 100°C when compared to Specimen C. A mass loss of around 220°C was observed on all samples, characterizing the presence of hyaluronic acid. SEM images displayed a similar structure on all samples analyzed, with a thicker layer for Specimen A when compared with B and C. This series of analyses demonstrated that, as expected, the physicochemical and thermal properties of the products differ according to their application. Furthermore, to better characterize the crosslinking degree of each product and their mechanical properties, a set of different techniques should be applied in parallel to correlate the results and, thereby, relate injection application with material properties.

Keywords: hyaluronic acid, characterization, soft-tissue fillers, injectable gels

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Authors: Kimberly Joyce A. Roguis, Mica Lorraine L. Fernando, Alan Vito B. Macadangdang, Jennina Mari C. Mijares, Maria Carinnes A. Gonzalez

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The paper showcases the vulnerability of the tourism industry especially the inevitable occurrence of natural disasters, implicating the necessity for post-disaster analysis on tourist attractions. This study discusses the aftermath of the super typhoon ‘Yolanda’ incident in the locality of Coron Island, Palawan, assessing its general effect on the community and its tourism livelihood through the analysis of responses from key role-players in the tourism industry of the area gathered through semi-structured interviews and direct observation. The local government’s instigation of recovery programs to their locality has been a pivotal factor in reviving the vitality of their tourism industry and the involvement of the community has been the determining condition that shifted the industry towards revival a year after the incidence. The study illuminates the disaster mitigation processes in the local tourism livelihood perspective, predominantly the diving industry. It did not suffer physical damage to a great extent but was affected because of the public imagery the disaster brought upon. Collaboration between the local government and the community is the highlight of the research for they maneuvered recovery revealing that cooperation between these two parties bridged the correlation of recovery to tourism development. The disaster paved way to a stance towards promoting progressive tourism outlooks, raising awareness among the public and private sectors and re-assessment of the tourism vitality in their locality. The mayhem and destruction proved to be a liberating creative process to give way to progression and was deemed to be of high significance in the over-all tourism system process despite its impediments in the case of the tourism industry in Coron, Palawan.

Keywords: disaster recovery, tourism development, diving, Palawan

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Authors: Vaikunthan Rajaratnam

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Intro: Motor imagery (MI) and mental practice (MP) can be an alternative to acquire mastery of surgical skills. One component of using this technique is the use of a mental script. The aim of this study was to design and develop a mental script for basic micro suturing training for skill acquisition using a low-fidelity rubber glove model and to describe the detailed methodology for this process. Methods: This study was based on a design and development research framework. The mental script was developed with 5 expert surgeons performing a cognitive walkthrough of the repair of a vertical opening in a rubber glove model using 8/0 nylon. This was followed by a hierarchal task analysis. A draft script was created, and face and content validity assessed with a checking-back process. The final script was validated with the recruitment of 28 participants, assessed using the Mental Imagery Questionnaire (MIQ). Results: The creation of the mental script is detailed in the full text. After assessment by the expert panel, the mental script had good face and content validity. The average overall MIQ score was 5.2 ± 1.1, demonstrating the validity of generating mental imagery from the mental script developed in this study for micro suturing in the rubber glove model. Conclusion: The methodological approach described in this study is based on an instructional design framework to teach surgical skills. This MP model is inexpensive and easily accessible, addressing the challenge of reduced opportunities to practice surgical skills. However, while motor skills are important, other non-technical expertise required by the surgeon is not addressed with this model. Thus, this model should act a surgical training augment, but not replace it.

Keywords: mental script, motor imagery, cognitive walkthrough, verbal protocol analysis, hierarchical task analysis

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Authors: Masoud Ghahvechi Pour

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Risk management is a systematic and regular process of identifying, analyzing and responding to risks throughout the project's life cycle in order to achieve the optimal level of elimination, reduction or control of risk. The purpose of project risk management is to increase the probability and effect of positive events and reduce the probability and effect of unpleasant events on the project. Risk management is one of the most fundamental parts of project management, so that unmanaged or untransmitted risks can be one of the primary factors of failure in a project. Effective risk management does not apply to risk regression, which is apparently the cheapest option of the activity. However, the main problem with this option is the economic sensitivity, because what is potentially profitable is by definition risky, and what does not pose a risk is economically interesting and does not bring tangible benefits. Therefore, in relation to the implemented project, effective risk management is finding a "middle ground" in its management, which includes, on the one hand, protection against risk from a negative direction by means of accurate identification and classification of risk, which leads to analysis And it becomes a comprehensive analysis. On the other hand, management using all mathematical and analytical tools should be based on checking the maximum benefits of these decisions. Detailed analysis, taking into account all aspects of the company, including stakeholder analysis, will allow us to add what will become tangible benefits for our project in the future to effective risk management. Identifying the risk of the project is based on the theory that which type of risk may affect the project, and also refers to specific parameters and estimating the probability of their occurrence in the project. These conditions can be divided into three groups: certainty, uncertainty, and risk, which in turn support three types of investment: risk preference, risk neutrality, specific risk deviation, and its measurement. The result of risk identification and project analysis is a list of events that indicate the cause and probability of an event, and a final assessment of its impact on the environment.

Keywords: risk, management, knowledge, risk management

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Authors: Mohammed Muharram

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The Blue Humanities aims to deepen our understanding of the oceans through the integration of arts and sciences, emphasizing their cultural, historical, and ecological significance. This study explores the role of visual arts within this interdisciplinary framework, focusing on the underwater sculptures of Jason deCaires Taylor as a case study. The research employs a multidisciplinary approach, combining art history, environmental science, and cultural studies to explore the significance of Taylor's underwater installations. Methodologies include analysis of the artistic elements and themes in Taylor's work, assessment of the ecological impact of the sculptures on marine environments, and examination of the cultural narratives they evoke. Key findings highlight how Taylor's sculptures serve as artificial reefs, promoting marine biodiversity while simultaneously raising awareness about ocean conservation. The artworks act as powerful symbols, merging environmental activism with artistic expression and transforming underwater spaces into immersive art galleries that challenge traditional notions of viewing art. By bridging the gap between visual arts and environmental science, this study demonstrates how Taylor's sculptures contribute to the Blue Humanities by fostering a deeper, more holistic appreciation of the marine world. The research advocates for the continued integration of artistic perspectives into marine conservation efforts, emphasizing the role of visual arts in shaping public perceptions and promoting ecological sustainability. In conclusion, this study underscores the transformative potential of visual arts within the Blue Humanities, exemplified by Jason deCaires Taylor's underwater sculptures, which inspire both aesthetic appreciation and environmental consciousness.

Keywords: blue humanities, visual art, underwater sculptures, Jason deCaires Taylor

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Authors: Khemakhem Nahed, Hammami Fatma, Trabelsi Houaida, Neji Sourour, Sellami Hayet, Makni Fattouma, Turki Hamida, Ayadi Ali

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Dermatophytoses are considered a public health problem and represent 10% of dermatological consultations in our region. Their epidemiology is influenced by various factors, such as lifestyle, human migration patterns, changes in the environment and the host relationship. The understanding of epidemiology has a major impact on their prevention and treatment. The aim of the study is to determine the prevalence pattern of aetiological agents and to describe the clinical characteristics of dermatophytoses between 1999 and 2019. Out of 65 059 subjects suspected to have superficial mycoses, 36 220 (55.67%) were affected with dermatophytoses. The mean age was 40.1 years (range: 10 days to 99 years). The sex ratio was 0.8. Our patients were from urban regions in 80.9% of cases. The most common type of infection was onychomycosis (42.64%), followed by tinea pedis (20.8%), intertrigo (18.3%), tinea corporis (8.48%) and tinea capitis (7.87%). The most isolated dermatophyte was Trichophyton rubrum (76.5%), followed by T. mentagrophytes complex (6.3%), Microsporum canis (5.8%), T. violaceum (5.3%), T. verrucosum (0.83%) and Epidermophyton floccosum (0.3%). Zoophilic agents have become more prevalent and their frequency has been increased from 6.46% in 1999 to 13% in 2019. It is interesting to note that M. canis has been on the rise since 2010 and it was the first etiological agent of tinea capitis (48%), while infections caused by T. violaceum continued to decrease from 1999 (16.2%) to 2019 (4.7%). Other dermatophytes have been rarely isolated: T. tonsurans (9 cases), T. schoenleinii (3 cases), T. soudanense (2 cases), M. fulvum (1 case), M. audouinii (1 case) and M. ferrugineum (2 cases).T. mentagrophytes var. quinckeanum was isolated from an inflammatory tinea capitis lesion in an a-3-year-old girl. T. mentagrophytes var. erinacei was isolated from the first case of tinea manuum, in-a-10-year-old girl. The same fungus was isolated from the hair and scales of the hedgehog. Our study showed significant changes in the dermatophytes spectrum in our region. The prevalence of zoophilic species increased in recent years due to people's behavioral changes with the adoption of pets and animal husbandry in urban settings. Molecular methods are often crucial that help us to refine the identification strains of dermatophytes and to identify their origin of the contamination.

Keywords: dermatophytoses, PCR-sequencing, spectrum, Sfax, Tunisia

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