Search results for: chronic disease management
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 13578

Search results for: chronic disease management

12918 Trigonella foenum-graecum Seeds Extract as Therapeutic Candidate for Treatment of Alzheimer's Disease

Authors: Mai M. Farid, Ximeng Yang, Tomoharu Kuboyama, Yuna Inada, Chihiro Tohda

Abstract:

Intro: Trigonella foenum-graecum (Fenugreek), from Fabaceae family is a well-known plant traditionally used as food and medicine. Many pharmacological effects of Trigonella foenum- graecum seeds extract (TF extract) were evaluated such as anti-diabetic, anti-tumor and anti-dementia effects using in vivo models. Regarding the anti-dementia effects of TF extract, diabetic rats, aluminum chloride-induced amnesia rats and scopolamine-injected mice were used previously for evaluation, which are not well established as Alzheimer’s disease models. In addition, those previous studies, active constituents in TF extract for memory function were not identified. Method: This study aimed to clarify the effect of TF extract on Alzheimer’s disease model, 5XFAD mouse that overexpresses mutated APP and PS1 genes and determine the major active constituent in the brain after oral intake of TF extract. Results: Trigonelline was detected in the cerebral cortex of 5XFAD mice after 24 hours of oral administration of TF extract by LC-MS/MS. Oral administration of TF extract for 17 days improved object location memory in 5XFAD mice. Conclusion: These results suggest that TF extract and its active constituents could be an expected therapeutic candidate for Alzheimer’s disease.

Keywords: Alzheimer's disease, LC-MS/MS, memory recovery, Trigonella foenum-graecum Seeds, 5XFAD mice

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12917 Chronic Fatigue Syndrome/Myalgic Encephalomyelitis in Younger Children: A Qualitative Analysis of Families’ Experiences of the Condition and Perspective on Treatment

Authors: Amberly Brigden, Ali Heawood, Emma C. Anderson, Richard Morris, Esther Crawley

Abstract:

Background: Paediatric chronic fatigue syndrome (CFS)/myalgic encephalomyelitis (ME) is characterised by persistent, disabling fatigue. Health services see patients below the age of 12. This age group experience high levels of disability, with low levels of school attendance, high levels of fatigue, anxiety, functional disability and pain. CFS/ME interventions have been developed for adolescents, but the developmental needs of younger children suggest treatment should be tailored to this age group. Little is known about how intervention should be delivered to this age group, and further work is needed to explore this. Qualitative research aids patient-centered design of health intervention. Methods: Five to 11-year-olds and their parents were recruited from a specialist CFS/ME service. Semi-structured interviews explored the families’ experience of the condition and perspectives on treatment. Interactive and arts-based methods were used. Interviews were audio-recorded, transcribed and analysed thematically. Qualitative Results: 14 parents and 7 children were interviewed. Early analysis of the interviews revealed the importance of the social-ecological setting of the child, which led to themes being developed in the context of Systems Theory. Theme one relates to the level of the child, theme two the family system, theme three the organisational and societal systems, and theme four cuts-across all levels. Theme1: The child’s capacity to describe, understand and manage their condition. Younger children struggled to describe their internal experiences, such as physical symptoms. Parents felt younger children did not understand some concepts of CFS/ME and did not have the capabilities to monitor and self-regulate their behaviour, as required by treatment. A spectrum of abilities was described; older children (10-11-year-olds) were more involved in clinical sessions and had more responsibility for self-management. Theme2: Parents’ responsibility for managing their child’s condition. Parents took responsibility for regulating their child’s behaviour in accordance with the treatment programme. They structured their child’s environment, gave direct instructions to their child, and communicated the needs of their child to others involved in care. Parents wanted their child to experience a 'normal' childhood and took steps to shield their child from medicalization, including diagnostic labels and clinical discussions. Theme3: Parental isolation and the role of organisational and societal systems. Parents felt unsupported in their role of managing the condition and felt negative responses from primary care health services and schools were underpinned by a lack of awareness and knowledge about CFS/ME in younger children. This sometimes led to a protracted time to diagnosis. Parents felt that schools have the potential important role in managing the child’s condition. Theme4: Complexity and uncertainty. Many parents valued specialist treatment (which included activity management, physiotherapy, sleep management, dietary advice, medical management and psychological support), but felt it needed to account for the complexity of the condition in younger children. Some parents expressed uncertainty about the diagnosis and the treatment programme. Conclusions: Interventions for younger children need to consider the 'systems' (family, organisational and societal) involved in the child’s care. Future research will include interviews with clinicians and schools supporting younger children with CFS/ME.

Keywords: chronic fatigue syndrome (CFS)/myalgic encephalomyelitis (ME), pediatric, qualitative, treatment

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12916 Use of a Novel Intermittent Compression Shoe in Reducing Lower Limb Venous Stasis

Authors: Hansraj Riteesh Bookun, Cassandra Monique Hidajat

Abstract:

This pilot study investigated the efficacy of a newly designed shoe which will act as an intermittent pneumatic compression device to augment venous flow in the lower limb. The aim was to assess the degree with which a wearable intermittent compression device can increase the venous flow in the popliteal vein. Background: Deep venous thrombosis and chronic venous insufficiency are relatively common problems with significant morbidity and mortality. While mechanical and chemical thromboprophylaxis measures are in place in hospital environments (in the form of TED stockings, intermittent pneumatic compression devices, analgesia, antiplatelet and anticoagulant agents), there are limited options in a community setting. Additionally, many individuals are poorly tolerant of graduated compression stockings due to the difficulty in putting them on, their constant tightness and increased associated discomfort in warm weather. These factors may hinder the management of their chronic venous insufficiency. Method: The device is lightweight, easy to wear and comfortable, with a self-contained power source. It features a Bluetooth transmitter and can be controlled with a smartphone. It is externally almost indistinguishable from a normal shoe. During activation, two bladders are inflated -one overlying the metatarsal heads and the second at the pedal arch. The resulting cyclical increase in pressure squeezes blood into the deep venous system. This will decrease periods of stasis and potentially reduce the risk of deep venous thrombosis. The shoe was fitted to 2 healthy participants and the peak systolic velocity of flow in the popliteal vein was measured during and prior to intermittent compression phases. Assessments of total flow volume were also performed. All haemodynamic assessments were performed with ultrasound by a licensed sonographer. Results: Mean peak systolic velocity of 3.5 cm/s with standard deviation of 1.3 cm/s were obtained. There was a three fold increase in mean peak systolic velocity and five fold increase in total flow volume. Conclusion: The device augments venous flow in the leg significantly. This may contribute to lowered thromboembolic risk during periods of prolonged travel or immobility. This device may also serve as an adjunct in the treatment of chronic venous insufficiency. The study will be replicated on a larger scale in a multi—centre trial.

Keywords: venous, intermittent compression, shoe, wearable device

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12915 Parents of Kids with Type 1 Diabetes Sleep with Open Eyes

Authors: Samereh Abdoli, Amit Vora, Anusha Vora

Abstract:

Aim: To qualitatively investigate diabetes burnout in parents of children with Type 1 Diabetes (T1D) who shared their experiences through YouTube videos in order to inform future interventions and improve diabetes practice. Methods: A qualitative descriptive approach was used to explore YouTube videos. Of the 568 videos that were identified, only 9 videos met the inclusion criteria of the study. Results: After the videos were transcribed and analyzed using qualitative content analysis, it was revealed that parents shared common concerns and experiences and they translated into three main themes: I do not ever get a break, I am exhausted, I can’t burn out, and I just need a break Conclusion: All in all, the literature revealed that there are negative psychosocial outcomes associated with caring for a child with T1D, but there is a lack of information on diabetes burnout and how parents’ well-being are affected. Reports of self-neglect and sleep deprivation only confirm the need for intervention for parents of children with T1D. The hope with this study is that burnout can be recognized early on and appropriate interventions put in place to help parents cope with the stressors of caring for a child with a chronic disease.

Keywords: Diabetes burnout, type 1 diabetes, qualitative research, parents

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12914 Imaging Features of Hepatobiliary Histiocytosis

Authors: Ayda Youssef, Tarek Rafaat, Iman zaky

Abstract:

Purpose: Langerhans’ cell histiocytosis (LCH) is not uncommon pathology that implies aberrant proliferation of a specific dendritic (Langerhans) cell. These atypical but mature cells of monoclonal origin can infiltrate many sites of the body and may occur as localized lesions or as widespread systemic disease. Liver is one of the uncommon sites of affection. The twofold objective of this study is to illustrate the radiological presentation of this disease, and to compare these results with previously reported series. Methods and Materials: Between 2007 and 2012, 150 patients with biopsy-proven LCH were treated in our hospital, a paediatric cancer tertiary care center. A retrospective review of radiographic images and reports was performed. There were 33 patients with liver affection are stratified. All patients underwent imaging studies, mostly US and CT. A chart review was performed to obtain demographic, clinical and radiological data. They were analyzed and compared to other published series. Results: Retrospective assessment of 150 patients with LCH was performed, among them 33 patients were identified who had liver involvement. All these patients developed multisystemic disease; They were 12 females and 21 males with (n= 32), seven of them had marked hepatomegaly. Diffuse hypodense liver parenchyma was encountered in five cases, the periportal location has a certain predilection in cases of focal affection where three cases has a hypodense periportal soft tissue sheets, one of them associated with dilated biliary radicals, only one case has multiple focal lesions unrelated to portal tracts. On follow up of the patients, two cases show abnormal morphology of liver with bossy outline. Conclusion: LCH is a not infrequent disease. A high-index suspicion should be raised in the context of diagnosis of liver affection. A biopsy is recommended in the presence of radiological suspicion. Chemotherapy is the preferred therapeutic modality. Liver histiocytosis are not disease specific features but should be interpreted in conjunction with the clinical history and the results of biopsy. Clinical Relevance/Application: Radiologist should be aware of different patterns of hepatobiliary histiocytosis, Thus early diagnosis and proper management of patient can be conducted.

Keywords: langerhans’ cell histiocytosis, liver, medical and health sciences, radiology

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12913 The Impact of City Mobility on Propagation of Infectious Diseases: Mathematical Modelling Approach

Authors: Asrat M.Belachew, Tiago Pereira, Institute of Mathematics, Computer Sciences, Avenida Trabalhador São Carlense, 400, São Carlos, 13566-590, Brazil

Abstract:

Infectious diseases are among the most prominent threats to human beings. They cause morbidity and mortality to an individual and collapse the social, economic, and political systems of the whole world collectively. Mathematical models are fundamental tools and provide a comprehensive understanding of how infectious diseases spread and designing the control strategy to mitigate infectious diseases from the host population. Modeling the spread of infectious diseases using a compartmental model of inhomogeneous populations is good in terms of complexity. However, in the real world, there is a situation that accounts for heterogeneity, such as ages, locations, and contact patterns of the population which are ignored in a homogeneous setting. In this work, we study how classical an SEIR infectious disease spreading of the compartmental model can be extended by incorporating the mobility of population between heterogeneous cities during an outbreak of infectious disease. We have formulated an SEIR multi-cities epidemic spreading model using a system of 4k ordinary differential equations to describe the disease transmission dynamics in k-cities during the day and night. We have shownthat the model is epidemiologically (i.e., variables have biological interpretation) and mathematically (i.e., a unique bounded solution exists all the time) well-posed. We constructed the next-generation matrix (NGM) for the model and calculated the basic reproduction number R0for SEIR-epidemic spreading model with cities mobility. R0of the disease depends on the spectral radius mobility operator, and it is a threshold between asymptotic stability of the disease-free equilibrium and disease persistence. Using the eigenvalue perturbation theorem, we showed that sending a fraction of the population between cities decreases the reproduction number of diseases in interconnected cities. As a result, disease transmissiondecreases in the population.

Keywords: SEIR-model, mathematical model, city mobility, epidemic spreading

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12912 Relevance Of Cognitive Rehabilitation Amongst Children Having Chronic Illnesses – A Theoretical Analysis

Authors: Pulari C. Milu Maria Anto

Abstract:

Background: Cognitive Rehabilitation/Retraining has been variously used in the research literature to represent non-pharmacological interventions that target the cognitive impairments with the goal of ameliorating cognitive function and functional behaviors to optimize the quality of life. Along with adult’s cognitive impairments, the need to address acquired cognitive impairments (due to any chronic illnesses like CHD - congenital heart diseases or ALL - Acute Lymphoblastic Leukemia) among child populations is inevitable. Also, it has to be emphasized as same we consider the cognitive impairments seen in the children having neurodevelopmental disorders. Methods: All published brain image studies (Hermann, B. et al,2002, Khalil, A. et al., 2004, Follin, C. et al, 2016, etc.) and studies emphasizing cognitive impairments in attention, memory, and/or executive function and behavioral aspects (Henkin, Y. et al,2007, Bellinger, D. C., & Newburger, J. W. (2010), Cheung, Y. T., et al,2016, that could be identified were reviewed. Based on a systematic review of the literature from (2000 -2021) different brain imaging studies, increased risk of neuropsychological and psychosocial impairments are briefly described. Clinical and research gap in the area is discussed. Results:30 papers, both Indian studies and foreign publications (Sage journals, Delhi psychiatry journal, Wiley Online Library, APA PsyNet, Springer, Elsevier, Developmental medicine, and child neurology), were identified. Conclusions: In India, a very limited number of brain imaging studies and neuropsychological studies have done by indicating the cognitive deficits of a child having or undergone chronic illness. None of the studies have emphasized the relevance nor the need of implementingCR among such children, even though its high time to address but still not established yet. The review of the current evidence is to bring out an insight among rehabilitation professionals in establishing a child specific CR and to publish new findings regarding the implementation of CR among such children. Also, this study will be an awareness on considering cognitive aspects of a child having acquired cognitive deficit (due to chronic illness), especially during their critical developmental period.

Keywords: cognitive rehabilitation, neuropsychological impairments, congenital heart diseases, acute lymphoblastic leukemia, epilepsy, and neuroplasticity

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12911 A Computer-Aided System for Detection and Classification of Liver Cirrhosis

Authors: Abdel Hadi N. Ebraheim, Eman Azomi, Nefisa A. Fahmy

Abstract:

This paper designs and implements a computer-aided system (CAS) to help detect and diagnose liver cirrhosis in patients with Chronic Hepatitis C. Our system reduces the required features (tests) the patient is asked to do to tests to their minimal best most informative subset of tests, with a diagnostic accuracy above 99%, and hence saving both time and costs. We use the Support Vector Machine (SVM) with cross-validation, a Multilayer Perceptron Neural Network (MLP), and a Generalized Regression Neural Network (GRNN) that employs a base of radial functions for functional approximation, as classifiers. Our system is tested on 199 subjects, of them 99 Chronic Hepatitis C.The subjects were selected from among the outpatient clinic in National Herpetology and Tropical Medicine Research Institute (NHTMRI).

Keywords: liver cirrhosis, artificial neural network, support vector machine, multi-layer perceptron, classification, accuracy

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12910 Characterization of Bacteriophage for Biocontrol of Pseudomonas syringae, Causative Agent of Canker in Prunus spp.

Authors: Mojgan Rabiey, Shyamali Roy, Billy Quilty, Ryan Creeth, George Sundin, Robert W. Jackson

Abstract:

Bacterial canker is a major disease of Prunus species such as cherry (Prunus avium). It is caused by Pseudomonas syringae species including P. syringae pv. syringae (Pss) and P. syringae pv. morsprunorum race 1 (Psm1) and race 2 (Psm2). Concerns over the environmental impact of, and developing resistance to, copper controls call for alternative approaches to disease management. One method of control could be achieved using naturally occurring bacteriophage (phage) infective to the bacterial pathogens. Phages were isolated from soil, leaf, and bark of cherry trees in five locations in the South East of England. The phages were assessed for their host range against strains of Pss, Psm1, and Psm2. The phages exhibited a differential ability to infect and lyse different Pss and Psm isolates as well as some other P. syringae pathovars. However, the phages were unable to infect beneficial bacteria such as Pseudomonas fluorescens. A subset of 18 of these phages were further characterised genetically (Random Amplification of Polymorphic DNA-PCR fingerprinting and sequencing) and using electron microscopy. The phages are tentatively identified as belonging to the order Caudovirales and the families Myoviridae, Podoviridae, and Siphoviridae, with genetic material being dsDNA. Future research will fully sequence the phage genomes. The efficacy of the phage, both individually and in cocktails, to reduce disease progression in vivo will be investigated to understand the potential for practical use of these phages as biocontrol agents.

Keywords: bacteriophage, pseudomonas, bacterial cancker, biological control

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12909 Evaluation of Insulin Sensitizing Effects of Different Fractions from Total Alcoholic Extract of Moringa oleifera Lam. Bark in Dexamethasone-Induced Insulin Resistant Rats

Authors: Hasanpasha N. Sholapur, Basanagouda M.Patil

Abstract:

Alcoholic extract of the bark of Moringa oleifera Lam. (MO), (Moringaceae), has been evaluated experimentally in the past for its insulin sensitizing potentials. In order to explore the possibility of the class of phytochemical(s) responsible for this experimental claim, the alcoholic extract was fractionated into non-polar [petroleum ether (PEF)], moderately non-polar [ethyl acetate (EAF)] and polar [aqueous (AQF)] fractions. All the fractions and pioglitazone (PIO) as standard (10mg/kg were p.o., once daily for 11 d) were investigated for their chronic effect on fasting plasma glucose, triglycerides, total cholesterol, insulin, oral glucose tolerance and acute effect on oral glucose tolerance in dexamethasone-induced (1 mg/kg s.c., once daily for 11 d) chronic model and acute model (1 mg/kg i.p., for 4 h) respectively for insulin resistance (IR) in rats. Among all the fractions tested, chronic treatment with EAF (140 mg/kg) and PIO (10 mg/kg) prevented dexamethasone-induced IR, indicated by prevention of hypertriglyceridemia, hyperinsulinemia and oral glucose intolerance, whereas treatment with AQF (95 mg/kg) prevented hepatic IR but not peripheral IR. In acute study single dose treatment with EAF (140 mg/kg) and PIO (10 mg/kg) prevented dexamethasone-induced oral glucose intolerance, fraction PEF did not show any effect on these parameters in both the models. The present study indicates that the triterpenoidal and the phenolic class of phytochemicals detected in EAF of alcoholic extract of MO bark may be responsible for the prevention of dexamethasone-induced insulin resistance in rats.

Keywords: Moringa oleifera, insulin resistance, dexamethasone, serum triglyceride, insulin, oral glucose tolerance test

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12908 Elevated Celiac Antibodies and Abnormal Duodenal Biopsies Associated with IBD Markers: Possible Role of Altered Gut Permeability and Inflammation in Gluten Related Disorders

Authors: Manav Sabharwal, Ruda Rai Md, Candace Parker, James Ridley

Abstract:

Wheat is one of the most commonly consumed grains worldwide, which contains gluten. Nowadays, gluten intake is considered to be a trigger for GRDs, including Celiac disease (CD), a common genetic disease affecting 1% of the US population, non-celiac gluten sensitivity (NCGS) and wheat allergy. NCGS is being recognized as an acquired gluten-sensitive enteropathy that is prevalent across age, ethnic and geographic groups. The cause of this entity is not fully understood, and recent studies suggest that it is more common in participants with irritable bowel syndrome (IBS), with iron deficiency anemia, symptoms of fatigue, and has considerable overlap in symptoms with IBS and Crohn’s disease. However, these studies were lacking in availability of complete serologies, imaging tests and/or pan-endoscopy. We performed a prospective study of 745 adult patients who presented to an outpatient clinic for evaluation of chronic upper gastro-intestinal symptoms and subsequently underwent an upper endoscopic (EGD) examination as standard of care. Evaluation comprised of comprehensive celiac antibody panel, inflammatory bowel disease (IBD) serologic markers, duodenal biopsies and Small Bowel Video Capsule Endoscopy (VCE), when available. At least 6 biopsy specimens were obtained from the duodenum and proximal jejunum during EGD, and CD3+ Intraepithelial lymphocytes (IELs) and villous architecture were evaluated by a single experienced pathologist, and VCE was performed by a single experienced gastroenterologist. Of the 745 patients undergoing EGD, 12% (93/745) patients showed elevated CD3+ IELs in the duodenal biopsies. 52% (387/745) completed a comprehensive CD panel and 7.2% (28/387) were positive for at least 1 CD antibody (Tissue transglutaminase (tTG), being the most common antibody in 65% (18/28)). Of these patients, 18% (5/28) showed increased duodenal CD3+ IELs, but 0% showed villous blunting or distortion to meet criteria for CD. Surprisingly, 43% (12/28) were positive for at 1 IBD serology (ASCA, ANCA or expanded IBD panel (LabCorp)). Of these 28 patients, 29% (8/28) underwent a SB VCE, of which 100 % (8/8) showed significant jejuno-ileal mucosal lesions diagnostic for IBD. Findings of abnormal CD antibodies (7.2%, 28/387) and increased CD3+ IELs on duodenal biopsy (12%, 93/745) were observed frequently in patients with UGI symptoms undergoing EGD in an outpatient clinic. None met criteria for CD, and a high proportion (43%, 12/28) showed evidence of overlap with IBD. This suggests a potential causal link of acquired GRDs to underlying inflammation and gut mucosal barrier disruption. Further studies to investigate a role for abnormal antigen presentation of dietary gluten to gut associated lymphoid tissue as a cause are justified. This may explain a high prevalence of GRDs in the population and correlation with IBS, IBD and other gut inflammatory disorders.

Keywords: celiac, gluten sensitive enteropathy, lymphocitic enteritis, IBS, IBD

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12907 A Validated High-Performance Liquid Chromatography-UV Method for Determination of Malondialdehyde-Application to Study in Chronic Ciprofloxacin Treated Rats

Authors: Anil P. Dewani, Ravindra L. Bakal, Anil V. Chandewar

Abstract:

Present work demonstrates the applicability of high-performance liquid chromatography (HPLC) with UV detection for the determination of malondialdehyde as malondialdehyde-thiobarbituric acid complex (MDA-TBA) in-vivo in rats. The HPLC-UV method for MDA-TBA was achieved by isocratic mode on a reverse-phase C18 column (250mm×4.6mm) at a flow rate of 1.0mLmin−1 followed by UV detection at 278 nm. The chromatographic conditions were optimized by varying the concentration and pH followed by changes in percentage of organic phase optimal mobile phase consisted of mixture of water (0.2% Triethylamine pH adjusted to 2.3 by ortho-phosphoric acid) and acetonitrile in ratio (80:20 % v/v). The retention time of MDA-TBA complex was 3.7 min. The developed method was sensitive as limit of detection and quantification (LOD and LOQ) for MDA-TBA complex were (standard deviation and slope of calibration curve) 110 ng/ml and 363 ng/ml respectively. The method was linear for MDA spiked in plasma and subjected to derivatization at concentrations ranging from 100 to 1000 ng/ml. The precision of developed method measured in terms of relative standard deviations for intra-day and inter-day studies was 1.6–5.0% and 1.9–3.6% respectively. The HPLC method was applied for monitoring MDA levels in rats subjected to chronic treatment of ciprofloxacin (CFL) (5mg/kg/day) for 21 days. Results were compared by findings in control group rats. Mean peak areas of both study groups was subjected for statistical treatment to unpaired student t-test to find p-values. The p value was < 0.001 indicating significant results and suggesting increased MDA levels in rats subjected to chronic treatment of CFL of 21 days.

Keywords: MDA, TBA, ciprofloxacin, HPLC-UV

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12906 Use of External Sensory Stimuli in the Treatment of Parkinson Disease: Literature Review

Authors: Hadi O. Tohme

Abstract:

This study is a review on the effectiveness of new physiotherapy techniques with external sensory stimulus compared to standard physiotherapy in the daily activities of patients with Parkinson's disease. Twenty studies from 1996 to 2015 were analyzed and discussed in this review, using the rehabilitation strategy with external sensory stimulus evaluating walking, freezing episodes, balance, transfers, and daily activities of parkinsonian patients. The study highlights the effectiveness of the variety of rehabilitation with cueing strategy used in the treatment of Parkinson's disease. Based on the literature review completed, there is a need for more specific trials with better treatment strategies to support the most appropriate choice of physiotherapy intervention using external sensory stimulus to the type and frequency of this stimulus. In addition, no trials examined the long-term benefits of the physiotherapy intervention with the external sensory stimulus. In order to determine if, or how long the improvements due to the external sensory stimulus physiotherapy intervention can last, long-term follow-up should be performed.

Keywords: cueing strategy, external sensory stimulus, parkinson disease, rehabilitation for parkinson, sensory attention focused exercises, sensory strategy reeducation

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12905 Prevalence of Mycobacterium Tuberculosis Infection and Rifampicin Resistance among Presumptive Tuberculosis Cases Visiting Tuberculosis Clinic of Adare General Hospital, Southern Ethiopia

Authors: Degineh Belachew Andarge, Tariku Lambiyo Anticho, Getamesay Mulatu Jara, Musa Mohammed Ali

Abstract:

Introduction: Tuberculosis (TB) is a communicable chronic disease causedby Mycobacterium tuberculosis (MTB). About one-third of the world’s population is latently infected with MTB. TB is among the top 10 causes of mortality throughout the globe from a single pathogen. Objective: The aim of this study was to determine the prevalence of tuberculosis,rifampicin-resistant/multidrug-resistant Mycobacterium tuberculosis, and associated factors among presumptive tuberculosis cases attending the tuberculosis clinic of Adare General Hospital located in Hawassa city. Methods: A hospital-based cross-sectional study was conducted among 321 tuberculosis suspected patients from April toJuly 2018. Socio-demographic, environmental, and behavioral data were collected using a structured questionnaire. Sputumspecimens were analyzed using GeneXpert. Data entry was made using Epi info version 7 and analyzed by SPSS version 20. Logistic regression models were used to determine the risk factors. A p-value less than 0.05 was taken as a cut point. Results: In this study, the prevalence of Mycobacterium tuberculosis was 98 (30.5%) with 95% confidence interval (25.5–35.8), and the prevalence of rifampicin-resistant/multidrug-resistantMycobacterium tuberculosis among the 98 Mycobacteriumtuberculosis confirmed cases was 4 (4.1%). The prevalence of rifampicin-resistant/multidrug-resistant Mycobacterium tuberculosisamong the tuberculosis suspected patients was 1.24%. Participants who had a history of treatment with anti-tuberculosisdrugs were more likely to develop rifampicin-resistant/multidrug-resistant Mycobacterium tuberculosis. Conclusions: This study identified relatively high rifampicin-resistant/multidrug-resistant Mycobacterium tuberculosis amongtuberculosis suspected patients in the study area. Early detection of drug-resistant Mycobacterium tuberculosis should be givenenough attention to strengthen the management of tuberculosis cases and improve direct observation therapy short-course and eventually minimize the spread of rifampicin-resistant tuberculosis strain in the community.

Keywords: rifampicin resistance, mycobacterium tuberculosis, risk factors, prevalence of TB

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12904 Sustainable Biostimulant and Bioprotective Compound for the Control of Fungal Diseases in Agricultural Crops

Authors: Geisa Lima Mesquita Zambrosi, Maisa Ciampi Guillardi, Flávia Rodrigues Patrício, Oliveiro Guerreiro Filho

Abstract:

Certified agricultural products are important components of the food industry. However, certifiers have been expanding the list of restricted or prohibited pesticides, limiting the options of products for phytosanitary control of plant diseases, but without offering alternatives to the farmers. Soybean and coffee leaf rust, brown eye spots, and Phoma leaf spots are the main fungal diseases that pose a serious threat to soybean and coffee cultivation worldwide. In conventional farming systems, these diseases are controlled by using synthetic fungicides, which, in addition to intensifying the occurrence of fungal resistance, are highly toxic to the environment, farmers, and consumers. In organic, agroecological, or regenerative farming systems, product options for plant protection are limited, being available only copper-based compounds, and biodefensivesornon-standard homemade products. Therefore, there is a growing demand for effective bioprotectors with low environmental impact for adoption in more sustainable agricultural systems. Then, to contribute to covering such a gap, we have developed a compound based on plant extracts and metallic elements for foliar application. This product has both biostimulant and bioprotective action, which promotes sustainable disease control, increases productivity as well as reduces damage to the environment. The product's components have complementary mechanisms that promote protection against the disease by directly acting on the pathogens and activating the plant's natural defense system. The protective ability of the product against three coffee diseases (coffee leaf rust, brown eye spot, and Phoma leaf spot) and against soybean rust disease was evaluated, in addition to its ability to promote plant growth. Our goal is to offer an effective alternative to control the main coffee fungal diseases and soybean fungal diseases, with a biostimulant effect and low toxicity. The proposed product can also be part of the integrated management of coffee and soybean diseases in conventional farming associated with chemical and biological pesticides, offering the market a sustainable coffee and soybean with high added value and low residue content. Experiments were carried out under controlled conditions to evaluate the effectiveness of the product in controlling rust, phoma, and cercosporiosis in comparison to control-inoculated plants that did not receive the product. The in vitro and in vivo effects of the product on the pathogen were evaluated using light microscopy and scanning electron microscopy, respectively. The fungistatic action of the product was demonstrated by a reduction of 85% and 95% in spore germination and disease symptoms severity on the leaves of coffee plants, respectively. The formulation had both a protective effect, acting to prevent infection by coffee leaf rust, and a curative effect, reducing the rust symptoms after its establishment.

Keywords: plant disease, natural fungicide, plant health, sustainability, alternative disease management

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12903 Prediction of Alzheimer's Disease Based on Blood Biomarkers and Machine Learning Algorithms

Authors: Man-Yun Liu, Emily Chia-Yu Su

Abstract:

Alzheimer's disease (AD) is the public health crisis of the 21st century. AD is a degenerative brain disease and the most common cause of dementia, a costly disease on the healthcare system. Unfortunately, the cause of AD is poorly understood, furthermore; the treatments of AD so far can only alleviate symptoms rather cure or stop the progress of the disease. Currently, there are several ways to diagnose AD; medical imaging can be used to distinguish between AD, other dementias, and early onset AD, and cerebrospinal fluid (CSF). Compared with other diagnostic tools, blood (plasma) test has advantages as an approach to population-based disease screening because it is simpler, less invasive also cost effective. In our study, we used blood biomarkers dataset of The Alzheimer’s disease Neuroimaging Initiative (ADNI) which was funded by National Institutes of Health (NIH) to do data analysis and develop a prediction model. We used independent analysis of datasets to identify plasma protein biomarkers predicting early onset AD. Firstly, to compare the basic demographic statistics between the cohorts, we used SAS Enterprise Guide to do data preprocessing and statistical analysis. Secondly, we used logistic regression, neural network, decision tree to validate biomarkers by SAS Enterprise Miner. This study generated data from ADNI, contained 146 blood biomarkers from 566 participants. Participants include cognitive normal (healthy), mild cognitive impairment (MCI), and patient suffered Alzheimer’s disease (AD). Participants’ samples were separated into two groups, healthy and MCI, healthy and AD, respectively. We used the two groups to compare important biomarkers of AD and MCI. In preprocessing, we used a t-test to filter 41/47 features between the two groups (healthy and AD, healthy and MCI) before using machine learning algorithms. Then we have built model with 4 machine learning methods, the best AUC of two groups separately are 0.991/0.709. We want to stress the importance that the simple, less invasive, common blood (plasma) test may also early diagnose AD. As our opinion, the result will provide evidence that blood-based biomarkers might be an alternative diagnostics tool before further examination with CSF and medical imaging. A comprehensive study on the differences in blood-based biomarkers between AD patients and healthy subjects is warranted. Early detection of AD progression will allow physicians the opportunity for early intervention and treatment.

Keywords: Alzheimer's disease, blood-based biomarkers, diagnostics, early detection, machine learning

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12902 Malnutrition of the Cancer Patients under Chemotherapy and Influence of Learned Food Aversions

Authors: Hafsa Chergui

Abstract:

Malnutrition is a very common problem for hospitalized patients in general but it happens most to those who have a chronic disease such as cancer. Learned food aversions are defined as aversions which form toward foods after their ingestion has been temporally paired with illness (nausea or emesis). Learned food aversion may exert a negative impact on nutritional status and quality of life. The present review evaluates the literature derived both from laboratory animals and humans. Also, a questionnaire has been filled by patients under chemotherapy to assess the level of food aversions. This study evaluated the current research for avoiding the formation of aversions to dietary items in 200 cancer patients treated with chemotherapy. A scapegoat food or beverage can be used just before treatment to reduce the incidence of treatment-related aversions to foods in the individual s usual diet. The goal of this work is to inform the nurses and dieticians because they play a vital role in the daily assessment of the patients' nutritional status. Being aware of all the causes of malnutrition may help to suggest solutions to improve the health condition of the patient and avoid severe malnutrition.

Keywords: chemotherapy, oncology, food aversion, taste aversion

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12901 Rhizosphere Microbiome Involvement in the Natural Suppression of Soybean Cyst Nematode in Disease Suppressive Soil

Authors: M. Imran Hamid, Muzammil Hussain, Yunpeng Wu, Meichun Xiang, Xingzhong Liu

Abstract:

The rhizosphere microbiome elucidate multiple functioning in the soil suppressiveness against plant pathogens. Soybean rhizosphere microbial communities may involve in the natural suppression of soybean cyst nematode (SCN) populations in disease suppressive soils. To explore these ecological mechanisms of microbes, a long term monoculture suppressive soil were taken into account for further investigation to test the disease suppressive ability by using different treatments. The designed treatments are as, i) suppressive soil (S), ii) conducive soil (C), iii) conducive soil mixed with 10% (w/w) suppressive soil (CS), iv) suppressive soil treated at 80°C for 1 hr (S80), and v) suppressive soil treated with formalin (SF). By using an ultra-high-throughput sequencing approach, we identified the key bacterial and fungal taxa involved in SCN suppression. The Phylum-level investigation of bacteria revealed that Actinobacteria, Bacteroidetes, and Proteobacteria in the rhizosphere soil of soybean seedlings were more abundant in the suppressive soil than in the conducive soil. The phylum-level analysis of fungi in rhizosphere soil indicated that relative abundance of Ascomycota was higher in suppressive soil than in the conducive soil, where Basidiomycota was more abundant. Transferring suppressive soil to conducive soil increased the population of Ascomycota in the conducive soil by lowering the populations of Basidiomycota. The genera, such as, Pochonia, Purpureocillium, Fusarium, Stachybotrys that have been well documented as bio-control agents of plant nematodes were far more in the disease suppressive soils. Our results suggested that the plants engage a subset of functional microbial groups in the rhizosphere for initial defense upon nematode attack and protect the plant roots later on by nematodes to response for suppression of SCN in disease-suppressive soils.

Keywords: disease suppressive soil, high-throughput sequencing, rhizosphere microbiome, soybean cyst nematode

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12900 Assessing the Impact of Physical Inactivity on Dialysis Adequacy and Functional Health in Peritoneal Dialysis Patients

Authors: Mohammad Ali Tabibi, Farzad Nazemi, Nasrin Salimian

Abstract:

Background: Peritoneal dialysis (PD) is a prevalent renal replacement therapy for patients with end-stage renal disease. Despite its benefits, PD patients often experience reduced physical activity and physical function, which can negatively impact dialysis adequacy and overall health outcomes. Despite the known benefits of maintaining physical activity in chronic disease management, the specific interplay between physical inactivity, physical function, and dialysis adequacy in PD patients remains underexplored. Understanding this relationship is essential for developing targeted interventions to enhance patient care and outcomes in this vulnerable population. This study aims to assess the impact of physical inactivity on dialysis adequacy and functional health in PD patients. Methods: This cross-sectional study included 135 peritoneal dialysis patients from multiple dialysis centers. Physical inactivity was measured using the International Physical Activity Questionnaire (IPAQ), while physical function was assessed using the Short Physical Performance Battery (SPPB). Dialysis adequacy was evaluated using the Kt/V ratio. Additional variables such as demographic data, comorbidities, and laboratory parameters were collected to control for potential confounders. Statistical analyses were performed to determine the relationships between physical inactivity, physical function, and dialysis adequacy. Results: The study cohort comprised 70 males and 65 females with a mean age of 55.4 ± 13.2 years. A significant proportion of the patients (65%) were categorized as physically inactive based on IPAQ scores. Inactive patients demonstrated significantly lower SPPB scores (mean 6.2 ± 2.1) compared to their more active counterparts (mean 8.5 ± 1.8, p < 0.001). Dialysis adequacy, as measured by Kt/V, was found to be suboptimal (Kt/V < 1.7) in 48% of the patients. There was a significant positive correlation between physical function scores and Kt/V values (r = 0.45, p < 0.01), indicating that better physical function is associated with higher dialysis adequacy. Also, there was a significant negative correlation between physical inactivity and physical function (r = -0.55, p < 0.01). Additionally, physically inactive patients had lower Kt/V ratios compared to their active counterparts (1.3 ± 0.3 vs. 1.8 ± 0.4, p < 0.05). Multivariate regression analysis revealed that physical inactivity was an independent predictor of reduced dialysis adequacy (β = -0.32, p < 0.01) and poorer physical function (β = -0.41, p < 0.01) after adjusting for age, sex, comorbidities, and dialysis vintage. Conclusion: This study underscores the critical role of physical activity and physical function in maintaining adequate dialysis in peritoneal dialysis patients. These findings highlight the need for targeted interventions to promote physical activity in this population to improve their overall health outcomes. Future research should focus on developing and evaluating exercise programs tailored for PD patients to enhance their physical function and dialysis adequacy. The findings suggest that interventions aimed at increasing physical activity and improving physical function may enhance dialysis adequacy and overall health outcomes in this population. Further research is warranted to explore the mechanisms underlying these associations and to develop targeted strategies for enhancing patient care.

Keywords: inactivity, physical function, peritoneal dialysis, dialysis adequacy

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12899 Sudden Death and Chronic Disseminated Intravascular Coagulation (DIC): Two Case Reports

Authors: Saker Lilia, Youcef Mellouki, Lakhdar Sellami, Yacine Zerairia, Abdelhaid Zetili, Fatma Guahria, Fateh Kaious, Nesrine Belkhodja, Abdelhamid Mira

Abstract:

Background: Sudden death is regarded as a suspicious demise necessitating autopsy, as stipulated by legal authorities. Chronic disseminated intravascular coagulation (DIC) is an acquired clinical and biological syndrome characterized by a severe and fatal prognosis, stemming from systemic, uncontrolled, diffuse coagulation activation. Irrespective of their origins, DIC is associated with a diverse spectrum of manifestations, encompassing minor biological coagulation alterations to profoundly severe conditions wherein hemorrhagic complications may take precedence. Simultaneously, microthrombi contribute to the development of multi-organ failures. Objective This study seeks to evaluate the role of autopsy in determining the causes of death. Materials and Methods: We present two instances of sudden death involving females who underwent autopsy at the Forensic Medicine Department of the University Hospital of Annaba, Algeria. These autopsies were performed at the request of the prosecutor, aiming to determine the causes of death and illuminate the exact circumstances surrounding it. Methods Utilized: Analysis of the initial information report; Findings from postmortem examinations; Histological assessments and toxicological analyses. Results: The presence of DIC was noted, affecting nearly all veins with distinct etiologies. Conclusion: For the establishment of a meaningful diagnosis: • Thorough understanding of the subject matter is imperative; • Precise alignment with medicolegal data is essential.

Keywords: chronic disseminated intravascular coagulation, sudden death, autopsy, causes of death

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12898 The Cost of Non-Communicable Diseases in the European Union: A Projection towards the Future

Authors: Desiree Vandenberghe, Johan Albrecht

Abstract:

Non-communicable diseases (NCDs) are responsible for the vast majority of deaths in the European Union (EU) and represent a large share of total health care spending. A future increase in this health and financial burden is likely to be driven by population ageing, lifestyle changes and technological advances in medicine. Without adequate prevention measures, this burden can severely threaten population health and economic development. To tackle this challenge, a correct assessment of the current burden of NCDs is required, as well as a projection of potential increases of this burden. The contribution of this paper is to offer perspective on the evolution of the NCD burden towards the future and to give an indication of the potential of prevention policy. A Non-Homogenous, Semi-Markov model for the EU was constructed, which allowed for a projection of the cost burden for the four main NCDs (cancer, cardiovascular disease, chronic respiratory disease and diabetes mellitus) towards 2030 and 2050. This simulation is done based on multiple baseline scenarios that vary in demand and supply factors such as health status, population structure, and technological advances. Finally, in order to assess the potential of preventive measures to curb the cost explosion of NCDs, a simulation is executed which includes increased efforts for preventive health care measures. According to the Markov model, by 2030 and 2050, total costs (direct and indirect costs) in the EU could increase by 30.1% and 44.1% respectively, compared to 2015 levels. An ambitious prevention policy framework for NCDs will be required if the EU wants to meet this challenge of rising costs. To conclude, significant cost increases due to Non-Communicable Diseases are likely to occur due to demographic and lifestyle changes. Nevertheless, an ambitious prevention program throughout the EU can aid in making this cost burden manageable for future generations.

Keywords: non-communicable diseases, preventive health care, health policy, Markov model, scenario analysis

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12897 Combined Use of FMRI and Voxel-Based Morphometry in Assessment of Memory Impairment in Alzheimer's Disease Patients

Authors: A. V. Sokolov, S. V. Vorobyev, A. Yu. Efimtcev, V. Yu. Lobzin, I. A. Lupanov, O. A. Cherdakov, V. A. Fokin

Abstract:

Alzheimer’s disease (AD) is the most common form of dementia. Different brain regions are involved to the pathological process of AD. The purpose of this study was to evaluate brain activation by visual memory task in patients with Alzheimer's disease and determine correlation between memory impairment and atrophy of memory specific brain regions of frontal and medial temporal lobes. To investigate the organization of memory and localize cortical areas activated by visual memory task we used functional magnetic resonance imaging and to evaluate brain atrophy of patients with Alzheimer's disease we used voxel-based morphometry. FMRI was performed on 1.5 T MR-scanner Siemens Magnetom Symphony with BOLD (Blood Oxygenation Level Dependent) technique, based on distinctions of magnetic properties of hemoglobin. For test stimuli we used series of 12 not related images for "Baseline" and 12 images with 6 presented before for "Active". Stimuli were presented 3 times with reduction of repeated images to 4 and 2. Patients with Alzheimer's disease showed less activation in hippocampal formation (HF) region and parahippocampal gyrus then healthy persons of control group (p<0.05). The study also showed reduced activation in posterior cingulate cortex (p<0.001). Voxel-based morphometry showed significant atrophy of grey matter in Alzheimer’s disease patients, especially of both temporal lobes (fusiform and parahippocampal gyri); frontal lobes (posterior cingulate and superior frontal gyri). The study showed correlation between memory impairment and atrophy of memory specific brain regions of frontal and medial temporal lobes. Thus, reduced activation in hippocampal formation and parahippocampal gyri, in posterior cingulate gyrus in patients with Alzheimer's disease correlates to significant atrophy of these regions, detected by voxel-based morphometry, and to deterioration of specific cognitive functions.

Keywords: Alzheimer’s disease, functional MRI, voxel-based morphometry

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12896 SVM-RBN Model with Attentive Feature Culling Method for Early Detection of Fruit Plant Diseases

Authors: Piyush Sharma, Devi Prasad Sharma, Sulabh Bansal

Abstract:

Diseases are fairly common in fruits and vegetables because of the changing climatic and environmental circumstances. Crop diseases, which are frequently difficult to control, interfere with the growth and output of the crops. Accurate disease detection and timely disease control measures are required to guarantee high production standards and good quality. In India, apples are a common crop that may be afflicted by a variety of diseases on the fruit, stem, and leaves. It is fungi, bacteria, and viruses that trigger the early symptoms of leaf diseases. In order to assist farmers and take the appropriate action, it is important to develop an automated system that can be used to detect the type of illnesses. Machine learning-based image processing can be used to: this research suggested a system that can automatically identify diseases in apple fruit and apple plants. Hence, this research utilizes the hybrid SVM-RBN model. As a consequence, the model may produce results that are more effective in terms of accuracy, precision, recall, and F1 Score, with respective values of 96%, 99%, 94%, and 93%.

Keywords: fruit plant disease, crop disease, machine learning, image processing, SVM-RBN

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12895 Pain Intensity, Functional Disability and Physical Activity among Elderly Individuals with Chronic Mechanical Low Back Pain

Authors: Adesola Odole, Nse Odunaiya, Samuel Adewale

Abstract:

Chronic Mechanical Low Back Pain (CMLBP) is prevalent in the aging population; some studies have documented the association among pain intensity, functional disability and physical activity in the general population but very few studies in the elderly. This study was designed to investigate the association among pain intensity, functional disability and physical activity of elderly individuals with CMLBP in the University College Hospital (UCH), Ibadan, Nigeria and also to determine the difference in physical activity, pain intensity and functional disability between males and females. A total of 96 participants diagnosed with CMLBP participated in this cross-sectional survey. They were conveniently sampled from selected units in the UCH, Ibadan, Nigeria. Data on sex, marital status, occupation and duration of onset of pain of participants were obtained from the participants. The Physical Activity Scale for the Elderly, Visual Analogue Scale and Oswestry Disability Questionnaire were used to measure the physical activity, pain intensity and functional disability of the participants respectively. Data was analysed using Spearman correlation, independent t-test; and α was set at 0.05. Participants (25 males, 71 females) were aged 69.64±7.43 years. The majority (76.0%) of the participants were married, and over half (55.2%) were retirees. Participants’ mean pain intensity score was 5.21±2.03 and mean duration of onset of low back pain was 63.63 ± 90.01 months. The majority (67.6%) of the participants reported severe to crippled functional disability. Their mean functional disability was 46.91 ± 13.99. Participants’ mean physical activity score was 97.47 ± 82.55. There was significant association between physical activity and pain intensity (r = -0.21, p = 0.04). There was significant association between physical activity and functional disability (r = -0.47, p = 0.00). Male (87.26 ± 79.94) and female (101.07 ± 83.71) participants did not differ significantly in physical activity (t = 0.00, p = 0.48). In addition, male (5.48 ± 2.06) and female (5.11 ± 2.02) participants’ pain intensity were comparable (t = 0.26, p = 0.44). There was also no significant difference in functional disability (t = 0.05, p = 0.07) between male (42.56 ±13.85) and female (48.45 ± 13.81) participants. It can be concluded from this study that majority of the elderly individuals with chronic mechanical low back pain had a severe to crippled functional disability. Those who reported increased physical activity had reduced pain intensity and functional disability. Male and female elderly individuals with chronic mechanical low back pain are comparable in their pain intensity, functional disability, and physical activity. Elderly individuals with CMLBP should be educated on the importance of participating in physical activity which could reduce their pain symptoms and improve functional disability.

Keywords: elderly, functional disability, mechanical low back pain, pain intensity, physical activity

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12894 An Optimal Control Model for the Dynamics of Visceral Leishmaniasis

Authors: Ibrahim M. Elmojtaba, Rayan M. Altayeb

Abstract:

Visceral leishmaniasis (VL) is a vector-borne disease caused by the protozoa parasite of the genus leishmania. The transmission of the parasite to humans and animals occurs via the bite of adult female sandflies previously infected by biting and sucking blood of an infectious humans or animals. In this paper we use a previously proposed model, and then applied two optimal controls, namely treatment and vaccination to that model to investigate optimal strategies for controlling the spread of the disease using treatment and vaccination as the system control variables. The possible impact of using combinations of the two controls, either one at a time or two at a time on the spread of the disease is also examined. Our results provide a framework for vaccination and treatment strategies to reduce susceptible and infection individuals of VL in five years.

Keywords: visceral leishmaniasis, treatment, vaccination, optimal control, numerical simulation

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12893 An Unusual Case of Wrist Pain: Idiopathic Avascular Necrosis of the Scaphoid, Preiser’s Disease

Authors: Adae Amoako, Daniel Montero, Peter Murray, George Pujalte

Abstract:

We present a case of a 42-year-old, right-handed Caucasian male who presented to a medical orthopedics clinic with left wrist pain. The patient indicated that the pain started two months prior to the visit. He could only remember helping a friend move furniture prior to the onset of pain. Examination of the left wrist showed limited extension compared to the right. There was clicking with flexion and extension of the wrist on the dorsal aspect. Mild tenderness was noticed over the distal radioulnar joint. There was ulnar and radial deviation on provocation. Initial 4-view x-rays of the left wrist showed mild radiocarpal and scapho-trapezium-trapezoid (ST-T) osteoarthritis, with subchondral cysts seen in the lunate and scaphoid, with no obvious fractures. The patient was initially put in a wrist brace and diclofenac topical gel was prescribed for pain control, as a patient could not take non-steroidal anti-inflammatory drugs (NSAIDs) due to gastritis. Despite diclofenac topical gel use and bracing, symptoms remained, and a steroid injection with 1 mL of lidocaine with 10 mg of triamcinolone acetonide was performed under fluoroscopy. He obtained some relief but after 3 months, the injection had to be repeated. On 2-month follow up after the initial evaluation, symptoms persisted. Magnetic resonance imaging (MRI) was obtained which showed an abnormal T1 hypodense signal involving the proximal pole of the scaphoid and articular collapse proximally of the scaphoid, with marked irregularity of the overlying cartilage, suggesting a remote injury, findings consistent with avascular necrosis of the proximal pole of the scaphoid. A month after that, the patient had the left proximal pole of the scaphoid debrided and an intercompartmental supraretinacular artery vascularized. Pedicle bone graft reconstruction of the proximal pole of the left scaphoid was done. A non-vascularized autograft from the left radius was also applied. He was put in a thumb spica cast with the interphalangeal joint free for 6 weeks. On 6-week follow-up after surgery, the patient was healing well and could make a composite fist with his left hand. The diagnosis of Preiser’s disease is primarily based on radiological findings. Due to the fact that necrosis happens over a period of time, most AVNs are diagnosed at the late stages of the disease. There appear to be no specific guidelines on the management AVN of the scaphoid. In the past, immobilization and arthroscopic debridement had been used. Radial osteotomy has also been tried. Vascularized bone grafts have also been used to treat Preiser’s disease. In our patient, we used three of these treatment modalities, starting with conservative management with topical NSAIDS and immobilization, then debridement with vascularized bone grafts.

Keywords: wrist pain, avascular necrosis of the scaphoid, Preiser’s disease, vascularized bone grafts

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12892 Effectiveness of a Pasifika Women’s Diabetes Wellness Program (PWDWP) – Co-design With, by and for MāOri and Pasifika Women Living in Queensland

Authors: Heena Akbar, Winnie Niumata, Danielle Gallegos

Abstract:

Type 2 diabetes is a significant public health problem for Māori and Pasifika communities in Queensland, who are experiencing a higher burden of morbidity and mortality from the condition. Despite this higher burden, there are few initiatives that are culturally tailored to improve prevention and management. Modification of personal behaviors through women’s wellness programs aimed at early intervention has been shown to reduce the risk of developing complications in established type 2 diabetes and may reduce hospitalization rates from preventable complications related to this disease. The 24-week Pasifika Women’s Diabetes Wellness Program (PWDWP) was culturally co-designed and co-developed with Māori and Pasifika women with type 2 diabetes through a community-academia partnership in Queensland. Underpinned by Social Cognitive Theory and the Indigenous Pacific Health frameworks to include family culture & spirituality and integrating a collectivist and whānau (family) centered approach to self-care, the program takes into consideration the cultural shame associated with acknowledging the disease and tailors the interventions using talanoa (storytelling or conversation in a relational context) as the key strategy to come to a shared meaning for behavior change. The pilot trial is a 12-week intervention followed by a 12-week follow-up period conducted with 50 women with type 2 diabetes, 25 women who will receive the intervention and 25 women who will receive usual care. The pilot program provides in-person and virtual access to culturally supported prevention and self-management of Māori and Pasifika women with type 2 diabetes with the aim to improve healthy lifestyles and reduce late hospital presentations from diabetes-related complications for better diabetes-related outcomes. This study will test and evaluate the effectiveness of the PWDWP pilot trial in partnership with Māori & Pasifika community organizations and key stakeholders for improved glycated hemoglobin (HbA1c) levels associated with poor management of type 2 diabetes.

Keywords: culturally co-designed intervention, Indigenous methodology, Māori and Pasifika communities, type 2 diabetes self-management

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12891 Finding the Longest Common Subsequence in Normal DNA and Disease Affected Human DNA Using Self Organizing Map

Authors: G. Tamilpavai, C. Vishnuppriya

Abstract:

Bioinformatics is an active research area which combines biological matter as well as computer science research. The longest common subsequence (LCSS) is one of the major challenges in various bioinformatics applications. The computation of the LCSS plays a vital role in biomedicine and also it is an essential task in DNA sequence analysis in genetics. It includes wide range of disease diagnosing steps. The objective of this proposed system is to find the longest common subsequence which presents in a normal and various disease affected human DNA sequence using Self Organizing Map (SOM) and LCSS. The human DNA sequence is collected from National Center for Biotechnology Information (NCBI) database. Initially, the human DNA sequence is separated as k-mer using k-mer separation rule. Mean and median values are calculated from each separated k-mer. These calculated values are fed as input to the Self Organizing Map for the purpose of clustering. Then obtained clusters are given to the Longest Common Sub Sequence (LCSS) algorithm for finding common subsequence which presents in every clusters. It returns nx(n-1)/2 subsequence for each cluster where n is number of k-mer in a specific cluster. Experimental outcomes of this proposed system produce the possible number of longest common subsequence of normal and disease affected DNA data. Thus the proposed system will be a good initiative aid for finding disease causing sequence. Finally, performance analysis is carried out for different DNA sequences. The obtained values show that the retrieval of LCSS is done in a shorter time than the existing system.

Keywords: clustering, k-mers, longest common subsequence, SOM

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12890 Identification of Hub Genes in the Development of Atherosclerosis

Authors: Jie Lin, Yiwen Pan, Li Zhang, Zhangyong Xia

Abstract:

Atherosclerosis is a chronic inflammatory disease characterized by the accumulation of lipids, immune cells, and extracellular matrix in the arterial walls. This pathological process can lead to the formation of plaques that can obstruct blood flow and trigger various cardiovascular diseases such as heart attack and stroke. The underlying molecular mechanisms still remain unclear, although many studies revealed the dysfunction of endothelial cells, recruitment and activation of monocytes and macrophages, and the production of pro-inflammatory cytokines and chemokines in atherosclerosis. This study aimed to identify hub genes involved in the progression of atherosclerosis and to analyze their biological function in silico, thereby enhancing our understanding of the disease’s molecular mechanisms. Through the analysis of microarray data, we examined the gene expression in media and neo-intima from plaques, as well as distant macroscopically intact tissue, across a cohort of 32 hypertensive patients. Initially, 112 differentially expressed genes (DEGs) were identified. Subsequent immune infiltration analysis indicated a predominant presence of 27 immune cell types in the atherosclerosis group, particularly noting an increase in monocytes and macrophages. In the Weighted gene co-expression network analysis (WGCNA), 10 modules with a minimum of 30 genes were defined as key modules, with blue, dark, Oliver green and sky-blue modules being the most significant. These modules corresponded respectively to monocyte, activated B cell, and activated CD4 T cell gene patterns, revealing a strong morphological-genetic correlation. From these three gene patterns (modules morphology), a total of 2509 key genes (Gene Significance >0.2, module membership>0.8) were extracted. Six hub genes (CD36, DPP4, HMOX1, PLA2G7, PLN2, and ACADL) were then identified by intersecting 2509 key genes, 102 DEGs with lipid-related genes from the Genecard database. The bio-functional analysis of six hub genes was estimated by a robust classifier with an area under the curve (AUC) of 0.873 in the ROC plot, indicating excellent efficacy in differentiating between the disease and control group. Moreover, PCA visualization demonstrated clear separation between the groups based on these six hub genes, suggesting their potential utility as classification features in predictive models. Protein-protein interaction (PPI) analysis highlighted DPP4 as the most interconnected gene. Within the constructed key gene-drug network, 462 drugs were predicted, with ursodeoxycholic acid (UDCA) being identified as a potential therapeutic agent for modulating DPP4 expression. In summary, our study identified critical hub genes implicated in the progression of atherosclerosis through comprehensive bioinformatic analyses. These findings not only advance our understanding of the disease but also pave the way for applying similar analytical frameworks and predictive models to other diseases, thereby broadening the potential for clinical applications and therapeutic discoveries.

Keywords: atherosclerosis, hub genes, drug prediction, bioinformatics

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12889 Transarterial Chemoembolization (TACE) in Hepatocellular Carcinoma (HCC)

Authors: Ilirian Laçi, Alketa Spahiu

Abstract:

Modality of treatment in hepatocellular carcinoma (HCC) patients depends on the stage of the disease. The Barcelona Clinic Liver Cancer Classification (BCLC) is the preferred staging system. There are many patients initially present with intermediate-stage disease. For these patients, transarterial chemoembolization (TACE) is the treatment of choice. The differences in individual factors that are not captured by the BCLC framework, such as the tumor growth pattern, degree of hypervascularity, and vascular supply, complicate further evaluation of these patients. Because of these differences, not all patients benefit equally from TACE. Several tools have been devised to aid the decision-making process, which have shown promising initial results but have failed external evaluation and have not been translated to the clinic aspects. Criteria for treatment decisions in daily clinical practice are needed in all stages of the disease.

Keywords: hepatocellular carcinoma, transarterial chemoembolization, TACE, liver

Procedia PDF Downloads 98