Search results for: micro and macrovascular complications
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2832

Search results for: micro and macrovascular complications

2172 Implementation of Enhanced Recovery after Surgery (ERAS) Protocols in Laparoscopic Sleeve Gastrectomy (LSG); A Systematic Review and Meta-analysis

Authors: Misbah Nizamani, Saira Malik

Abstract:

Introduction: Bariatric surgery is the most effective treatment for patients suffering from morbid obesity. Laparoscopic sleeve gastrectomy (LSG) accounts for over 50% of total bariatric procedures. The aim of our meta-analysis is to investigate the effectiveness and safety of Enhanced Recovery After Surgery (ERAS) protocols for patients undergoing laparoscopic sleeve gastrectomy. Method: To gather data, we searched PubMed, Google Scholar, ScienceDirect, and Cochrane Central. Eligible studies were randomized controlled trials and cohort studies involving adult patients (≥18 years) undergoing bariatric surgeries, i.e., Laparoscopic sleeve gastrectomy. Outcome measures included LOS, postoperative narcotic usage, postoperative pain score, postoperative nausea and vomiting, postoperative complications and mortality, emergency department visits and readmission rates. RevMan version 5.4 was used to analyze outcomes. Results: Three RCTs and three cohorts with 1522 patients were included in this study. ERAS group and control group were compared for eight outcomes. LOS was reduced significantly in the intervention group (p=0.00001), readmission rates had borderline differences (p=0.35) and higher postoperative complications in the control group, but the result was non-significant (p=0.68), whereas postoperative pain score was significantly reduced (p=0.005). Total MME requirements became significant after performing sensitivity analysis (p= 0.0004). Postoperative mortality could not be analyzed on account of invalid data showing 0% mortality in two cohort studies. Conclusion: This systemic review indicated the effectiveness of the application of ERAS protocols in LSG in reducing the length of stay, post-operative pain and total MME requirements postoperatively, indicating the feasibility and assurance of its application.

Keywords: eras protocol, sleeve gastrectomy, bariatric surgery, enhanced recovery after surgery

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2171 Social Justice-Focused Mental Health Practice: An Integrative Model for Clinical Social Work

Authors: Hye-Kyung Kang

Abstract:

Social justice is a central principle of the social work profession and education. However, scholars have long questioned the profession’s commitment to putting social justice values into practice. Clinical social work has been particularly criticized for its lack of attention to social justice and for failing to address the concerns of the oppressed. One prominent criticism of clinical social work is that it often relies on individual intervention and fails to take on system-level changes or advocacy. This concern evokes the historical macro-micro tension of the social work profession where micro (e.g., mental health counseling) and macro (e.g., policy advocacy) practices are conceptualized as separate domains, creating a false binary for social workers. One contributor to this false binary seems to be that most clinical practice models do not prepare social work students and practitioners to make a clear link between clinical practice and social justice. This paper presents a model of clinical social work practice that clearly recognizes the essential and necessary connection between social justice, advocacy, and clinical practice throughout the clinical process: engagement, assessment, intervention, and evaluation. Contemporary relational theories, critical social work frameworks, and anti-oppressive practice approaches are integrated to build a clinical social work practice model that addresses the urgent need for mental health practice that not only helps and heals the person but also challenges societal oppressions and aims to change them. The application of the model is presented through case vignettes.

Keywords: social justice, clinical social work, clinical social work model, integrative model

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2170 Computer Simulation to Investigate Magnetic and Wave-Absorbing Properties of Iron Nanoparticles

Authors: Chuan-Wen Liu, Min-Hsien Liu, Chung-Chieh Tai, Bing-Cheng Kuo, Cheng-Lung Chen, Huazhen Shen

Abstract:

A recent surge in research on magnetic radar absorbing materials (RAMs) has presented researchers with new opportunities and challenges. This study was performed to gain a better understanding of the wave-absorbing phenomenon of magnetic RAMs. First, we hypothesized that the absorbing phenomenon is dependent on the particle shape. Using the Material Studio program and the micro-dot magnetic dipoles (MDMD) method, we obtained results from magnetic RAMs to support this hypothesis. The total MDMD energy of disk-like iron particles was greater than that of spherical iron particles. In addition, the particulate aggregation phenomenon decreases the wave-absorbance, according to both experiments and computational data. To conclude, this study may be of importance in terms of explaining the wave- absorbing characteristic of magnetic RAMs. Combining molecular dynamics simulation results and the theory of magnetization of magnetic dots, we investigated the magnetic properties of iron materials with different particle shapes and degrees of aggregation under external magnetic fields. The MDMD of the materials under magnetic fields of various strengths were simulated. Our results suggested that disk-like iron particles had a better magnetization than spherical iron particles. This result could be correlated with the magnetic wave- absorbing property of iron material.

Keywords: wave-absorbing property, magnetic material, micro-dot magnetic dipole, particulate aggregation

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2169 Encapsulated Rennin Enzyme in Nano and Micro Tubular Cellulose/Starch Gel Composite for Milk Coagulation

Authors: Eleftheria Barouni, Theano Petsi, Argyro Bekatorou, Dionysos Kolliopoulos, Dimitrios Vasileiou, Panayiotis Panas, Maria Kanellaki, Athanasios A. Koutinas

Abstract:

The aim of the present work was the production and use of a composite filter (TC/starch), containing rennin enzyme, in continuous system and in successive fermentation batches (SFB) for milk coagulation in order to compare the operational stability of both systems and cheese production cost. Tubular cellulose (TC) was produced after removal of lignin from lignocellulosic biomass using several procedures, e.g. alkaline treatment [1] and starch gel was added for the reduction of TC tubes dimensions to micro- and nano- range[2]. Four immobilized biocatalysts were prepared using different ways of the enzyme entrapment. 1) TC/ rennin (rennin entrapped in the tubes of TC), 2) TC/SG-rennin (rennin entrapped in the tubes of the composite), 3) TC-SG/rennin (rennin entrapped into the layer of starch gel) and 4) TC/rennin- SG/rennin (rennin is entrapped both in the tubes of the TC and into the layer of starch gel). Firstly these immobilized biocatalysts were examined in ten SFB regarding the coagulation time and their activity All the above immobilized biocatalysts remained active and the coagulation time was ranged from 90 to 480, 120-480, 330-510, and 270-540 min for (1), (2), (3), and (4) respectively. The quality of the cheese was examined through the determination of volatile compounds by SPME GC/MS analysis. These results encouraged us to study a continuous coagulation system of milk. Even though the (1) immobilized biocatalyst gave lower coagulation time, we used the (2) immobilized biocatalyst in the continuous system. The results were promising.

Keywords: tubular cellulose, starch gel, composite biocatalyst, Rennin, milk coagulation

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2168 Comparative Efficacy of Prolene and Polyester Mesh for the Repair of Abdominal Wall Defect in Pigeons (Columba livia)

Authors: Muhammad Naveed Ali, Hamad Bin Rashid, Muhammad Arif Khan, Abdul Basit, Hafiz Muhammad Arshad

Abstract:

Abdominal defects are very common in pigeons. A new technique is known as intraabdominal mesh transplant that give better protection for herniorrhaphy. The aim of this study was to determine the performance of hernia mesh. In this study, an efficacy of two synthetic hernia mesh implants viz. conventional Prolene and a lightweight mesh monofilament polyester were assessed for the abdominal wall repair in pigeons. Twenty four healthy pigeons were selected and randomly distributed into three groups, A, B and C (n=8). In all groups, experimental laparotomy was performed; thereafter, abdominal muscles and peritoneum were sutured together, while, a 2 x 2 cm defect was created in the abdominal muscles. For onlay hernioplasty, the hernia mesh (Prolene mesh: group A; Polyester mesh: group B) was implanted over the external oblique muscles of the abdomen. In group C (control), the mesh was not implanted; instead, the laparotomy incision was closed after a herniorrhaphy. Post-operative pain wound healing, adhesion formation, histopathological findings and formation of hematoma, abscess and seroma were assessed as short-term complications. Post-operatively, pain at surgical site was significantly less (P < 0.001) in group B (Polyester mesh); wound healing was also significantly better and rapid in group B (P < 0.05) than in group A (Prolene mesh). Group B (Polyester mesh) also depicted less than 25% adhesions when assessed on the basis of a Quantitative Modified Diamond scale; a Qualitative Adhesion Tenacity scale also depicted either no adhesions or flimsy adhesions (n=2) in group B (Polyester mesh), in contrast to group A (Prolene), which manifested greater adhesion formation and presence of dense adhesions requiring blunt dissection. There were observed hematoma, seroma and abscess formations in birds treated by Prolene mesh only. Conclusively, the polyester mesh proved superior to the Prolene mesh regarding lesser adhesion, better in wound healing, and no short-term follow-up complications.

Keywords: adhesion, mesh, polyester, prolene

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2167 Diagnosis of Choledocholithiasis with Endosonography

Authors: A. Kachmazova, A. Shadiev, Y. Teterin, P. Yartcev

Abstract:

Introduction: Biliary calculi disease (LCS) still occupies the leading position among urgent diseases of the abdominal cavity, manifesting itself from asymptomatic course to life-threatening states. Nowadays arsenal of diagnostic methods for choledocholithiasis is quite wide: ultrasound, hepatobiliscintigraphy (HBSG), magnetic resonance imaging (MRI), endoscopic retrograde cholangiography (ERCP). Among them, transabdominal ultrasound (TA ultrasound) is the most accessible and routine diagnostic method. Nowadays ERCG is the "gold" standard in diagnosis and one-stage treatment of biliary tract obstruction. However, transpapillary techniques are accompanied by serious postoperative complications (postmanipulative pancreatitis (3-5%), endoscopic papillosphincterotomy bleeding (2%), cholangitis (1%)), the lethality being 0.4%. GBSG and MRI are also quite informative methods in the diagnosis of choledocholithiasis. Small size of concrements, their localization in intrapancreatic and retroduodenal part of common bile duct significantly reduces informativity of all diagnostic methods described above, that demands additional studying of this problem. Materials and Methods: 890 patients with the diagnosis of cholelithiasis (calculous cholecystitis) were admitted to the Sklifosovsky Scientific Research Institute of Hospital Medicine in the period from August, 2020 to June, 2021. Of them 115 people with mechanical jaundice caused by concrements in bile ducts. Results: Final EUS diagnosis was made in all patients (100,0%). In all patients in whom choledocholithiasis diagnosis was revealed or confirmed after EUS, ERCP was performed urgently (within two days from the moment of its detection) as the X-ray operation room was provided; it confirmed the presence of concrements. All stones were removed by lithoextraction using Dormia basket. The postoperative period in these patients had no complications. Conclusions: EUS is the most informative and safe diagnostic method, which allows to detect choledocholithiasis in patients with discrepancies between clinical-laboratory and instrumental methods of diagnosis in shortest time, that in its turn will help to decide promptly on the further tactics of patient treatment. We consider it reasonable to include EUS in the diagnostic algorithm for choledocholithiasis. Disclosure: Nothing to disclose.

Keywords: endoscopic ultrasonography, choledocholithiasis, common bile duct, concrement, ERCP

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2166 Clinical Validation of an Automated Natural Language Processing Algorithm for Finding COVID-19 Symptoms and Complications in Patient Notes

Authors: Karolina Wieczorek, Sophie Wiliams

Abstract:

Introduction: Patient data is often collected in Electronic Health Record Systems (EHR) for purposes such as providing care as well as reporting data. This information can be re-used to validate data models in clinical trials or in epidemiological studies. Manual validation of automated tools is vital to pick up errors in processing and to provide confidence in the output. Mentioning a disease in a discharge letter does not necessarily mean that a patient suffers from this disease. Many of them discuss a diagnostic process, different tests, or discuss whether a patient has a certain disease. The COVID-19 dataset in this study used natural language processing (NLP), an automated algorithm which extracts information related to COVID-19 symptoms, complications, and medications prescribed within the hospital. Free-text patient clinical patient notes are rich sources of information which contain patient data not captured in a structured form, hence the use of named entity recognition (NER) to capture additional information. Methods: Patient data (discharge summary letters) were exported and screened by an algorithm to pick up relevant terms related to COVID-19. Manual validation of automated tools is vital to pick up errors in processing and to provide confidence in the output. A list of 124 Systematized Nomenclature of Medicine (SNOMED) Clinical Terms has been provided in Excel with corresponding IDs. Two independent medical student researchers were provided with a dictionary of SNOMED list of terms to refer to when screening the notes. They worked on two separate datasets called "A” and "B”, respectively. Notes were screened to check if the correct term had been picked-up by the algorithm to ensure that negated terms were not picked up. Results: Its implementation in the hospital began on March 31, 2020, and the first EHR-derived extract was generated for use in an audit study on June 04, 2020. The dataset has contributed to large, priority clinical trials (including International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC) by bulk upload to REDcap research databases) and local research and audit studies. Successful sharing of EHR-extracted datasets requires communicating the provenance and quality, including completeness and accuracy of this data. The results of the validation of the algorithm were the following: precision (0.907), recall (0.416), and F-score test (0.570). Percentage enhancement with NLP extracted terms compared to regular data extraction alone was low (0.3%) for relatively well-documented data such as previous medical history but higher (16.6%, 29.53%, 30.3%, 45.1%) for complications, presenting illness, chronic procedures, acute procedures respectively. Conclusions: This automated NLP algorithm is shown to be useful in facilitating patient data analysis and has the potential to be used in more large-scale clinical trials to assess potential study exclusion criteria for participants in the development of vaccines.

Keywords: automated, algorithm, NLP, COVID-19

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2165 Efficacy of In-Situ Surgical vs. Needle Revision on Late Failed Trabeculectomy Blebs

Authors: Xie Xiaobin, Zhang Yan, Shi Yipeng, Sun Wenying, Chen Shuang, Cai Zhipeng, Zhang Hong, Zhang Lixia, Xie Like

Abstract:

Objective: The objective of this research is to compare the efficacy of the late in-situ surgical revision augmented with continuous infusion and needle revision on failed trabeculectomy blebs. Methods From December 2018 to December 2021, a prospective randomized controlled trial was performed on 44 glaucoma patients with failed bleb ≥ 6months with medically uncontrolled in Eye Hospital, China Academy of Chinese Medical Sciences. They were randomly divided into two groups. 22 eyes of 22 patients underwent the late in-situ surgical revision with continuous anterior chamber infusion in the study group, and 22 of 22 patients were treated with needle revision in the control group. Main outcome measures include preoperative and postoperative intraocular pressure (IOP), the number of anti-glaucoma medicines, the operation success rate, and the postoperative complications. Results The postoperative IOP values decreased significantly from the baseline in both groups (both P<0.05). IOP was significantly lower in the study group than in the control group at one week, 1, and 3 months postoperatively (all P<0.05). IOP reductions in the study group were substantially more prominent than in the control group at all postoperative time points (all P<0.05). The complete success rate in the study group was significantly higher than in the control group (71.4% vs. 33.3%, P<0.05), while the complete failure rate was significantly lower in the study group (0% vs. 28.5%, P<0.05). According to Cox’s proportional hazards regression analysis, high IOP at baseline was independently associated with increased risks of complete failure (adjusted hazard ratio=1.141, 95% confidence interval=1.021-1.276, P<0.05). There was no significant difference in the incidence of postoperative complications between the two groups (P>0.05). Conclusion: Both in-situ surgical and needle revision have acceptable success rates and safety for the late failed trabeculectomy blebs, while the former is likely to have a higher level of efficacy over the latter. Needle revision may be insufficient for eyes with low target IOP.

Keywords: glaucoma, trabeculectomy blebs, in-situ surgical revision, needle revision

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2164 Multi-Objective Optimization and Effect of Surface Conditions on Fatigue Performance of Burnished Components Made of AISI 52100 Steel

Authors: Ouahiba Taamallah, Tarek Litim

Abstract:

The study deals with the burnishing effect of AISI 52100 steel and parameters influence (Py, i and f on surface integrity. The results show that the optimal effects are closely related to the treatment parameters. With a 92% improvement in roughness, SB can be defined as a finishing operation within the machining range. Due to 85% gain in consolidation rate, this treatment constitutes an efficient process for work-hardening of material. In addition, a statistical study based on regression and Taguchi's design has made it possible to develop mathematical models to predict output responses according to the studied burnishing parameters. Response Surface Methodology RSM showed a simultaneous influence of the burnishing parameters and to observe the optimal parameters of the treatment. ANOVA Analysis of results led to validate the prediction model with a determination coefficient R2=94.60% and R2=93.41% for surface roughness and micro-hardness, respectively. Furthermore, a multi-objective optimization allowed to identify a regime characterized by P=20 Kgf, i=5 passes and f=0.08 mm.rev-1, which favors minimum surface roughness and a maximum of micro-hardness. The result was validated by a composite desirability D_i=1 for both surface roughness and microhardness, respectively. Applying optimal parameters, burnishing showed its beneficial effects in fatigue resistance, especially for imposed loading in the low cycle fatigue of the material where the lifespan increased by 90%.

Keywords: AISI 52100 steel, burnishing, Taguchi, fatigue

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2163 Opto-Thermal Frequency Modulation of Phase Change Micro-Electro-Mechanical Systems

Authors: Syed A. Bukhari, Ankur Goswmai, Dale Hume, Thomas Thundat

Abstract:

Here we demonstrate mechanical detection of photo-induced Insulator to metal transition (MIT) in ultra-thin vanadium dioxide (VO₂) micro strings by using < 100 µW of optical power. Highly focused laser beam heated the string locally resulting in through plane and along axial heat diffusion. Localized temperature increase can cause temperature rise > 60 ºC. The heated region of VO₂ can transform from insulating (monoclinic) to conducting (rutile) phase leading to lattice compressions and stiffness increase in the resonator. The mechanical frequency of the resonator can be tuned by changing optical power and wavelength. The first mode resonance frequency was tuned in three different ways. A decrease in frequency below a critical optical power, a large increase between 50-120 µW followed by a large decrease in frequency for optical powers greater than 120 µW. The dynamic mechanical response was studied as a function of incident optical power and gas pressure. The resonance frequency and amplitude of vibration were found to be decreased with increasing laser power from 25-38 µW and increased by1-2 % when the laser power was further increased to 52 µW. The transition in films was induced and detected by a single pump and probe source and by employing external optical sources of different wavelengths. This trend in dynamic parameters of the strings can be co-related with reversible Insulator to metal transition in VO₂ films which creates change in density of the material and hence the overall stiffness of the strings leading to changes in string dynamics. The increase in frequency at a particular optical power manifests a transition to a more ordered metallic phase which tensile stress onto the string. The decrease in frequency at higher optical powers can be correlated with poor phonon thermal conductivity of VO₂ in conducting phase. Poor thermal conductivity of VO₂ can force in-plane penetration of heat causing the underneath SiN supporting VO₂ which can result as a decrease in resonance frequency. This noninvasive, non-contact laser-based excitation and detection of Insulator to metal transition using micro strings resonators at room temperature and with laser power in few µWs is important for low power electronics, and optical switching applications.

Keywords: thermal conductivity, vanadium dioxide, MEMS, frequency tuning

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2162 Miniaturizing the Volumetric Titration of Free Nitric Acid in U(vi) Solutions: On the Lookout for a More Sustainable Process Radioanalytical Chemistry through Titration-On-A-Chip

Authors: Jose Neri, Fabrice Canto, Alastair Magnaldo, Laurent Guillerme, Vincent Dugas

Abstract:

A miniaturized and automated approach for the volumetric titration of free nitric acid in U(VI) solutions is presented. Free acidity measurement refers to the acidity quantification in solutions containing hydrolysable heavy metal ions such as U(VI), U(IV) or Pu(IV) without taking into account the acidity contribution from the hydrolysis of such metal ions. It is, in fact, an operation having an essential role for the control of the nuclear fuel recycling process. The main objective behind the technical optimization of the actual ‘beaker’ method was to reduce the amount of radioactive substance to be handled by the laboratory personnel, to ease the instrumentation adjustability within a glove-box environment and to allow a high-throughput analysis for conducting more cost-effective operations. The measurement technique is based on the concept of the Taylor-Aris dispersion in order to create inside of a 200 μm x 5cm circular cylindrical micro-channel a linear concentration gradient in less than a second. The proposed analytical methodology relies on the actinide complexation using pH 5.6 sodium oxalate solution and subsequent alkalimetric titration of nitric acid with sodium hydroxide. The titration process is followed with a CCD camera for fluorescence detection; the neutralization boundary can be visualized in a detection range of 500nm- 600nm thanks to the addition of a pH sensitive fluorophore. The operating principle of the developed device allows the active generation of linear concentration gradients using a single cylindrical micro channel. This feature simplifies the fabrication and ease of use of the micro device, as it does not need a complex micro channel network or passive mixers to generate the chemical gradient. Moreover, since the linear gradient is determined by the liquid reagents input pressure, its generation can be fully achieved in faster intervals than one second, being a more timely-efficient gradient generation process compared to other source-sink passive diffusion devices. The resulting linear gradient generator device was therefore adapted to perform for the first time, a volumetric titration on a chip where the amount of reagents used is fixed to the total volume of the micro channel, avoiding an important waste generation like in other flow-based titration techniques. The associated analytical method is automated and its linearity has been proven for the free acidity determination of U(VI) samples containing up to 0.5M of actinide ion and nitric acid in a concentration range of 0.5M to 3M. In addition to automation, the developed analytical methodology and technique greatly improves the standard off-line oxalate complexation and alkalimetric titration method by reducing a thousand fold the required sample volume, forty times the nuclear waste per analysis as well as the analysis time by eight-fold. The developed device represents, therefore, a great step towards an easy-to-handle nuclear-related application, which in the short term could be used to improve laboratory safety as much as to reduce the environmental impact of the radioanalytical chain.

Keywords: free acidity, lab-on-a-chip, linear concentration gradient, Taylor-Aris dispersion, volumetric titration

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2161 Emergence of Fluoroquinolone Resistance in Pigs, Nigeria

Authors: Igbakura I. Luga, Alex A. Adikwu

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A comparison of resistance to quinolones was carried out on isolates of Shiga toxin-producing Escherichia coliO157:H7 from cattle and mecA and nuc genes harbouring Staphylococcus aureus from pigs. The isolates were separately tested in the first and current decades of the 21st century. The objective was to demonstrate the dissemination of resistance to this frontline class of antibiotic by bacteria from food animals and bring to the limelight the spread of antibiotic resistance in Nigeria. A total of 10 isolates of the E. coli O157:H7 and 9 of mecA and nuc genes harbouring S. aureus were obtained following isolation, biochemical testing, and serological identification using the Remel Wellcolex E. coli O157:H7 test. Shiga toxin-production screening in the E. coli O157:H7 using the verotoxin E. coli reverse passive latex agglutination (VTEC-RPLA) test; and molecular identification of the mecA and nuc genes in S. aureus. Detection of the mecA and nuc genes were carried out using the protocol by the Danish Technical University (DTU) using the following primers mecA-1:5'-GGGATCATAGCGTCATTATTC-3', mecA-2: 5'-AACGATTGTGACACGATAGCC-3', nuc-1: 5'-TCAGCAAATGCATCACAAACAG-3', nuc-2: 5'-CGTAAATGCACTTGCTTCAGG-3' for the mecA and nuc genes, respectively. The nuc genes confirm the S. aureus isolates and the mecA genes as being methicillin-resistant and so pathogenic to man. The fluoroquinolones used in the antibiotic resistance testing were norfloxacin (10 µg) and ciprofloxacin (5 µg) in the E. coli O157:H7 isolates and ciprofloxacin (5 µg) in the S. aureus isolates. Susceptibility was tested using the disk diffusion method on Muller-Hinton agar. Fluoroquinolone resistance was not detected from isolates of E. coli O157:H7 from cattle. However, 44% (4/9) of the S. aureus were resistant to ciprofloxacin. Resistance of up to 44% in isolates of mecA and nuc genes harbouring S. aureus is a compelling evidence for the rapid spread of antibiotic resistance from bacteria in food animals from Nigeria. Ciprofloxacin is the drug of choice for the treatment of Typhoid fever, therefore widespread resistance to it in pathogenic bacteria is of great public health significance. The study concludes that antibiotic resistance in bacteria from food animals is on the increase in Nigeria. The National Food and Drug Administration and Control (NAFDAC) agency in Nigeria should implement the World Health Organization (WHO) global action plan on antimicrobial resistance. A good starting point can be coordinating the WHO, Office of International Epizootics (OIE), Food and Agricultural Organization (FAO) tripartite draft antimicrobial resistance monitoring and evaluation (M&E) framework in Nigeria.

Keywords: Fluoroquinolone, Nigeria, resistance, Staphylococcus aureus

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2160 Systematic and Meta-Analysis of Navigation in Oral and Maxillofacial Trauma and Impact of Machine Learning and AI in Management

Authors: Shohreh Ghasemi

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Introduction: Managing oral and maxillofacial trauma is a multifaceted challenge, as it can have life-threatening consequences and significant functional and aesthetic impact. Navigation techniques have been introduced to improve surgical precision to meet this challenge. A machine learning algorithm was also developed to support clinical decision-making regarding treating oral and maxillofacial trauma. Given these advances, this systematic meta-analysis aims to assess the efficacy of navigational techniques in treating oral and maxillofacial trauma and explore the impact of machine learning on their management. Methods: A detailed and comprehensive analysis of studies published between January 2010 and September 2021 was conducted through a systematic meta-analysis. This included performing a thorough search of Web of Science, Embase, and PubMed databases to identify studies evaluating the efficacy of navigational techniques and the impact of machine learning in managing oral and maxillofacial trauma. Studies that did not meet established entry criteria were excluded. In addition, the overall quality of studies included was evaluated using Cochrane risk of bias tool and the Newcastle-Ottawa scale. Results: Total of 12 studies, including 869 patients with oral and maxillofacial trauma, met the inclusion criteria. An analysis of studies revealed that navigation techniques effectively improve surgical accuracy and minimize the risk of complications. Additionally, machine learning algorithms have proven effective in predicting treatment outcomes and identifying patients at high risk for complications. Conclusion: The introduction of navigational technology has great potential to improve surgical precision in oral and maxillofacial trauma treatment. Furthermore, developing machine learning algorithms offers opportunities to improve clinical decision-making and patient outcomes. Still, further studies are necessary to corroborate these results and establish the optimal use of these technologies in managing oral and maxillofacial trauma

Keywords: trauma, machine learning, navigation, maxillofacial, management

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2159 Methylglyoxal Induced Glycoxidation of Human Low Density Lipoprotein: A Biophysical Perspective and Its Role in Diabetes and Periodontitis

Authors: Minhal Abidi, Moinuddin

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Diabetes mellitus (DM) induced metabolic abnormalities causes oxidative stress which leads to the pathogenesis of complications associated with diabetes like retinopathy, nephropathy periodontitis etc. Combination of glycation and oxidation 'glycoxidation' occurs when oxidative reactions affect the early state of glycation products. Low density lipoprotein (LDL) is prone to glycoxidative attack by sugars and methylglyoxal (MGO) being a strong glycating agent may have severe impact on its structure and consequent role in diabetes. Pro-inflammatory cytokines like IL1β and TNFα produced by the action of gram negative bacteria in periodontits (PD) can in turn lead to insulin resistance. This work discusses modifications to LDL as a result of glycoxidation. The changes in the protein molecule have been characterized by various physicochemical techniques and the immunogenicity of the modified molecules was also evaluated as they presented neo-epitopes. Binding of antibodies present in diabetes patients to the native and glycated LDL has been evaluated. Role of modified epitopes in the generation of antibodies in diabetes and periodontitis has been discussed. The structural perturbations induced in LDL were analyzed by UV–Vis, fluorescence, circular dichroism and FTIR spectroscopy, molecular docking studies, thermal denaturation studies, Thioflavin T assay, isothermal titration calorimetry, comet assay. MALDI-TOF, ketoamine moieties, carbonyl content and HMF content were also quantitated in native and glycated LDL. IL1β and TNFα levels were also measured in the type 2 DM and PD patients. We report increased carbonyl content, ketoamine moieties and HMF content in glycated LDL as compared to native analogue. The results substantiate that in hyperglycemic state MGO modification of LDL causes structural perturbations making the protein antigenic which could obstruct normal physiological functions and might contribute in the development of secondary complications in diabetic patients like periodontitis.

Keywords: advanced glycation end products, diabetes mellitus, glycation, glycoxidation, low density lipoprotein, periodontitis

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2158 Characterization, Replication and Testing of Designed Micro-Textures, Inspired by the Brill Fish, Scophthalmus rhombus, for the Development of Bioinspired Antifouling Materials

Authors: Chloe Richards, Adrian Delgado Ollero, Yan Delaure, Fiona Regan

Abstract:

Growing concern about the natural environment has accelerated the search for non-toxic, but at the same time, economically reasonable, antifouling materials. Bioinspired surfaces, due to their nano and micro topographical antifouling capabilities, provide a hopeful approach to the design of novel antifouling surfaces. Biological organisms are known to have highly evolved and complex topographies, demonstrating antifouling potential, i.e. shark skin. Previous studies have examined the antifouling ability of topographic patterns, textures and roughness scales found on natural organisms. One of the mechanisms used to explain the adhesion of cells to a substrate is called attachment point theory. Here, the fouling organism experiences increased attachment where there are multiple attachment points and reduced attachment, where the number of attachment points are decreased. In this study, an attempt to characterize the microtopography of the common brill fish, Scophthalmus rhombus, was undertaken. Scophthalmus rhombus is a small flatfish of the family Scophthalmidae, inhabiting regions from Norway to the Mediterranean and the Black Sea. They reside in shallow sandy and muddy coastal areas at depths of around 70 – 80 meters. Six engineered surfaces (inspired by the Brill fish scale) produced by a 2-photon polymerization (2PP) process were evaluated for their potential as an antifouling solution for incorporation onto tidal energy blades. The micro-textures were analyzed for their AF potential under both static and dynamic laboratory conditions using two laboratory grown diatom species, Amphora coffeaeformis and Nitzschia ovalis. The incorporation of a surface topography was observed to cause a disruption in the growth of A. coffeaeformis and N. ovalis cells on the surface in comparison to control surfaces. This work has demonstrated the importance of understanding cell-surface interaction, in particular, topography for the design of novel antifouling technology. The study concluded that biofouling can be controlled by physical modification, and has contributed significant knowledge to the use of a successful novel bioinspired AF technology, based on Brill, for the first time.

Keywords: attachment point theory, biofouling, Scophthalmus rhombus, topography

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2157 Reducing the Length of Stay and Mortality in COVID-19 Patients with Diabetes

Authors: Sara Alzahrani, Samia Bokari, Patan Khan, Muneera Alshareef, Rania Safwat, Mohammed Galal, Hamdi Alqadi, Ameerah Alzahrani, Rehab Alboraie

Abstract:

Introduction & Background: Diabetes in COVID-19 patients is individual risk factor and documented in worldwide studies to contribute to disease severity, increased length of stay and higher mortality. Aggressive management of blood sugars and acute diabetic complications reduce the length of stay and mortality. Methods: Randomly selected 200 patients admitted with diabetes and COVID-19 studied. The unified treatment protocol applied for all patients and blood sugars monitored closely and optimized .Data collected on bimonthly basis and analyzed. Patients’ characteristics taken from data extraction tool (Oasis) of hospital. Median values for length of stay and post discharge FBS and RBS were calculated via Microsoft Excel tool. Mortality rates were calculated by percentages. The results monitored in the post discharge clinic was 130 mg/dl and 170 mg/dl respectively. The results compared with the standard international studies. Discussion: Diabetes in COVID-19 patients posed great challenge as increased severity and mortalities reported compared to non-diabetic. Taking a pre-emptive strategy to combat this problem by aggressively manage diabetes help in reducing length of stay and morbidity. The length of stay in studded population was 3 days as compared to 13 days in a major international study. Financial saving come from rapid turnover of beds. The mortality was 2.5 % compared to reported 7.3% in a major study, reflecting the implications of aggressive management of diabetes. Regular follow-up and support by running post-discharge clinic definitely help reducing readmissions and acute complications of uncontrolled diabetes. Conclusion: Aggressive management of diabetes in COVID-19 patients by tailored treatment protocols and dedicated teams will help to decrease the morbidity and mortality.

Keywords: diabetes, covid-19, management, mortality

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2156 The High Precision of Magnetic Detection with Microwave Modulation in Solid Spin Assembly of NV Centres in Diamond

Authors: Zongmin Ma, Shaowen Zhang, Yueping Fu, Jun Tang, Yunbo Shi, Jun Liu

Abstract:

Solid-state quantum sensors are attracting wide interest because of their high sensitivity at room temperature. In particular, spin properties of nitrogen–vacancy (NV) color centres in diamond make them outstanding sensors of magnetic fields, electric fields and temperature under ambient conditions. Much of the work on NV magnetic sensing has been done so as to achieve the smallest volume, high sensitivity of NV ensemble-based magnetometry using micro-cavity, light-trapping diamond waveguide (LTDW), nano-cantilevers combined with MEMS (Micro-Electronic-Mechanical System) techniques. Recently, frequency-modulated microwaves with continuous optical excitation method have been proposed to achieve high sensitivity of 6 μT/√Hz using individual NV centres at nanoscale. In this research, we built-up an experiment to measure static magnetic field through continuous wave optical excitation with frequency-modulated microwaves method under continuous illumination with green pump light at 532 nm, and bulk diamond sample with a high density of NV centers (1 ppm). The output of the confocal microscopy was collected by an objective (NA = 0.7) and detected by a high sensitivity photodetector. We design uniform and efficient excitation of the micro strip antenna, which is coupled well with the spin ensembles at 2.87 GHz for zero-field splitting of the NV centers. Output of the PD signal was sent to an LIA (Lock-In Amplifier) modulated signal, generated by the microwave source by IQ mixer. The detected signal is received by the photodetector, and the reference signal enters the lock-in amplifier to realize the open-loop detection of the NV atomic magnetometer. We can plot ODMR spectra under continuous-wave (CW) microwave. Due to the high sensitivity of the lock-in amplifier, the minimum detectable value of the voltage can be measured, and the minimum detectable frequency can be made by the minimum and slope of the voltage. The magnetic field sensitivity can be derived from η = δB√T corresponds to a 10 nT minimum detectable shift in the magnetic field. Further, frequency analysis of the noise in the system indicates that at 10Hz the sensitivity less than 10 nT/√Hz.

Keywords: nitrogen-vacancy (NV) centers, frequency-modulated microwaves, magnetic field sensitivity, noise density

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2155 Dietary Magnesium, Lipids, and Hypertension: New Insights and Unsolved Mysteries

Authors: Elena Pello, Martin Bobak, Yuri Nikitin

Abstract:

In current issue we evaluated integration of magnesium with lipids; the attractive findings were obtained in men and women; the crucial ties of magnesium with total cholesterol in hypertensive men, with total cholesterol in concordance with low-density lipoprotein cholesterol in hypertensive women were disclosed; unanswered questions were trapped, difficulties were surmounted, and magnesium deficiency perseverance in pathogenesis of cardiovascular disease development was expressed; nutrients as well as risk factors may contribute to cardiovascular complications.

Keywords: dietary, magnesium, hypertension, lipids

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2154 Reconstruction of Complex Post Oncologic Maxillectomy Defects

Authors: Vinay Kant Shankhdhar

Abstract:

Purpose: Maxillary defects are three dimensional and require complex bone and soft tissue reconstruction. Maxillary reconstruction using fibula osteocutaneous flaps in situation requiring orbital floor, orbital wall, palatal defects, and external skin, all at the same time require special planning and multiple osteotomies. We tried to improvise our reconstruction using multiple osteotomies and skin paddle designs for fibula and Flexor Hallucis Longus Muscle. This study aims at discussing the planning and outcome in complex maxillary reconstructions using fibula flaps and soft tissue flaps with or without bone grafts. Material and Methods: From 2011 to 2017 a total of 129 Free fibula flaps were done, 67 required two or more struts, 164 Anterolateral Thigh Flaps, 11 Deep Inferior Epigastric Artery perforator flaps and 3 vertical rectus abdominis muscle flaps with iliac crest bone graft. The age range was 2 to 70 years. The reconstruction was evaluated based on the post-operative rehabilitation including orbital support (prevention of diplopia), oral diet, speech and cosmetic appearance. Results: The follow- up is from 5 years to 1 year. In this series, we observed that the common complications were the de-vascularisation of most distal segment of osteotomised fibula and native skin necrosis. Commonest area of breakdown is the medial canthal region. Plate exposure occurs most commonly at the pyriform sinus. There was extrusion of one non-vascularized bone graft. All these complications were noticed post-radiotherapy. Conclusions: The use of free fibula osteocutaneous flap gives very good results when only alveolar reconstruction is required. The reconstruction of orbital floor with extensive skin loss with post operative radiotherapy has maximum complication rate in long term follow up. A soft tissue flap with non vascularized bone graft may be the best option in such cases.

Keywords: maxilla reconstruction, fibula maxilla, post cancer maxillary reconstruction

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2153 Microfluidic Construction of Responsive Photonic Microcapsules for Microsensors

Authors: Lingling Shui, Shuting Xie

Abstract:

As alternatives to electronic devices, optically active structures from responsive nanomaterials offer great opportunity buildup smart functional sensors. Hereby, we report on droplet microfluidics enabled construction and application of photonic microcapsules (PMCs) for colorimetric temperature microsensors, enabling miniaturization for injectable local micro-area sensing and integration for large-area sensing. Monodispersed PMCs are produced by in-situ photopolymerization of hydrogel shells of cholesteric liquid crystal (CLC)-in-water-in-oil double emulsion droplets prepared using microfluidic devices, with controllable physical structures and chemical compositions. Constructed PMCs exhibit thermal responsive structural color according to the selective Bragg reflection of CLC’s periodical helical structures within the microdroplet’s spherical confinement. Constructed PMCs with tunable size and composition have been successfully applied for monitoring the living cell extracellular temperature via co-incubation with cell suspension, and for detecting human body temperature via a flexible device from assembled PMCs. These PMCs could be flexibly applied in either micro-environment or large-area surface, enabling wide applications for precision temperature monitoring biological activities (e.g. cells or organs), optoelectronic devices working conditions (e.g. temperature indicators under extreme conditions), and etc.

Keywords: droplet, microfluidics, assembly, soft materials, microsensor

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2152 The Impact of Total Parenteral Nutrition on Pediatric Stem Cell Transplantation and Its Complications

Authors: R. Alramyan, S. Alsalamah, R. Alrashed, R. Alakel, F. Altheyeb, M. Alessa

Abstract:

Background: Nutritional support with total parenteral nutrition (TPN) is usually commenced with hematopoietic stem cell transplantation (HSCT) patients. However, it has its benefits and risks. Complications related to central venous catheter such as infections, and metabolic disturbances, including abnormal liver function, is usually of concern in such patients. Methods: A retrospective charts review of all pediatric patients who underwent HSCT between the period 2015-2018 in a tertiary hospital in Riyadh, Saudi Arabia. Patients' demographics, types of conditioning, type of nutrition, and patients' outcomes were collected. Statistical analysis was conducted using SPSS version 22. Frequencies and percentages were used to describe categorical variables. Mean, and standard deviation were used for continuous variables. A P value of less than 0.05 was considered as statically significant. Results: a total of 162 HSCTs were identified during the period mentioned. Indication of allogenic transplant included hemoglobinopathy in 50 patients (31%), acute lymphoblastic leukemia in 21 patients (13%). TPN was used in 96 patients (59.30%) for a median of 14 days, nasogastric tube feeding (NGT) in 16 (9.90%) patients for a median of 11 days, and 71 of patients (43.80%) were able to tolerate oral feeding. Out of the 96 patients (59.30%) who were dependent on TPN, 64 patients (66.7%) had severe mucositis in comparison to 17 patients (25.8%) who were either on NGT or tolerated oral intake. (P-value= 0.00). Sinusoidal obstruction syndrome (SOS) was seen in 14 patients (14.6%) who were receiving TPN compared to none in non-TPN patients (P=value 0.001). Moreover, majority of patients who had SOS received myeloablative conditioning therapy for non-malignant disease (hemoglobinopathy). However, there were no statistically significant differences in Graft-vs-Host Disease (both acute and chronic), bacteremia, and patient outcome between both groups. Conclusions: Nutritional support using TPN is used in majority of patients, especially post-myeloablative conditioning associated with severe mucositis. TPN was associated with VOD, especially in hemoglobinopathy patients who received myeloablative therapy. This may emphasize on use of preventative measures such as fluid restriction, use of diuretics, or defibrotide in high-risk patients.

Keywords: hematopoeitic stem cell transplant, HSCT, stem cell transplant, sinusoidal obstruction syndrome, total parenteral nutrition

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2151 Experimental and Theoretical Investigation of Slow Reversible Deformation of Concrete in Surface-Active Media

Authors: Nika Botchorishvili, Olgha Giorgishvili

Abstract:

Many-year investigations of the nature of damping creep of rigid bodies and materials led to the discovery of the fundamental character of this phenomenon. It occurs only when a rigid body comes in contact with a surface-active medium (liquid or gaseous), which brings about a decrease of the free surface energy of a rigid body as a result of adsorption, chemo-sorption or wetting. The reversibility of the process consists of a gradual disappearance of creep deformation when the action of a surface-active medium stops. To clarify the essence of processes, a physical model is constructed by using Griffith’s scheme and the well-known representation formulas of deformation origination and failure processes. The total creep deformation is caused by the formation and opening of microcracks throughout the material volume under the action of load. This supposedly happens in macroscopically homogeneous silicate and organic glasses, while in polycrystals (tuff, gypsum, steel) contacting with a surface-active medium micro crack are formed mainly on the grain boundaries. The creep of rubber is due to its swelling activated by stress. Acknowledgment: All experiments are financially supported by Shota Rustaveli National Science Foundation of Georgia. Study of Properties of Concretes (Both Ordinary and Compacted) Made of Local Building Materials and Containing Admixtures, and Their Further Introduction in Construction Operations and Road Building. DP2016_26. 22.12.2016.

Keywords: process reversibility, surface-active medium, Rebinder’s effect, micro crack, creep

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2150 Analysis of the Evolution of Techniques and Review in Cleft Surgery

Authors: Tomaz Oliveira, Rui Medeiros, André Lacerda

Abstract:

Introduction: Cleft lip and/or palate are the most frequent forms of congenital craniofacial anomalies, affecting mainly the middle third of the face and manifesting by functional and aesthetic changes. Bilateral cleft lip represents a reconstructive surgical challenge, not only for the labial component but also for the associated nasal deformation. Recently, the paradigm of the approach to this pathology has changed, placing the focus on muscle reconstruction and anatomical repositioning of the nasal cartilages in order to obtain the best aesthetic and functional results. The aim of this study is to carry out a systematic review of the surgical approach to bilateral cleft lip, retrospectively analyzing the case series of Plastic Surgery Service at Hospital Santa Maria (Lisbon, Portugal) regarding this pathology, the global assessment of the characteristics of the operated patients and the study of the different surgical approaches and their complications in the last 20 years. Methods: The present work demonstrates a retrospective and descriptive study of patients who underwent at least one reconstructive surgery for cleft lip and/or palate, in the CPRE service of the HSM, in the period between January 1 of 1997 and December 31 of 2017, in which the data relating to 361 individuals were analyzed who, after applying the exclusion criteria, constituted a sample of 212 participants. The variables analyzed were the year of the first surgery, gender, age, type of orofacial cleft, surgical approach, and its complications. Results: There was a higher overall prevalence in males, with cleft lip and cleft palate occurring in greater proportion in males, with the cleft palate being more common in females. The most frequently recorded malformation was cleft lip and palate, which is complete in most cases. Regarding laterality, alterations with a unilateral labial component were the most commonly observed, with the left lip being described as the most affected. It was found that the vast majority of patients underwent primary intervention up to 12 months of age. The surgical techniques used in the approach to this pathology showed an important chronological variation over the years. Discussion: Cleft lip and/or palate is a medical condition associated with high aesthetic and functional morbidity, which requires early treatment in order to optimize the long-term outcome. The existence of a nasolabial component and its respective surgical correction plays a central role in the treatment of this pathology. The high rates of post-surgical complications and unconvincing aesthetic results have motivated an evolution of the surgical technique, increasingly evident in recent years, allowing today to achieve satisfactory aesthetic results, even in bilateral cleft lip with high deformation complexity. The introduction of techniques that favor nasolabial reconstruction based on anatomical principles has been producing increasingly convincing results. The analyzed sample shows that most of the results obtained in this study are, in general, compatible with the results published in the literature. Conclusion: This work showed that the existence of small variations in the surgical technique can bring significant improvements in the functional and aesthetic results in the treatment of bilateral cleft lip.

Keywords: cleft lip, palate lip, congenital abnormalities, cranofacial malformations

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2149 Non-Methane Hydrocarbons Emission during the Photocopying Process

Authors: Kiurski S. Jelena, Aksentijević M. Snežana, Kecić S. Vesna, Oros B. Ivana

Abstract:

The prosperity of electronic equipment in photocopying environment not only has improved work efficiency, but also has changed indoor air quality. Considering the number of photocopying employed, indoor air quality might be worse than in general office environments. Determining the contribution from any type of equipment to indoor air pollution is a complex matter. Non-methane hydrocarbons are known to have an important role of air quality due to their high reactivity. The presence of hazardous pollutants in indoor air has been detected in one photocopying shop in Novi Sad, Serbia. Air samples were collected and analyzed for five days, during 8-hr working time in three-time intervals, whereas three different sampling points were determined. Using multiple linear regression model and software package STATISTICA 10 the concentrations of occupational hazards and micro-climates parameters were mutually correlated. Based on the obtained multiple coefficients of determination (0.3751, 0.2389, and 0.1975), a weak positive correlation between the observed variables was determined. Small values of parameter F indicated that there was no statistically significant difference between the concentration levels of non-methane hydrocarbons and micro-climates parameters. The results showed that variable could be presented by the general regression model: y = b0 + b1xi1+ b2xi2. Obtained regression equations allow to measure the quantitative agreement between the variation of variables and thus obtain more accurate knowledge of their mutual relations.

Keywords: non-methane hydrocarbons, photocopying process, multiple regression analysis, indoor air quality, pollutant emission

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2148 A Qualitative Study on Job Selection of Diverse Job Seekers from the Perspective of Spatial Environment Behavior

Authors: Mi Yuan

Abstract:

Employment issues have become increasingly severe in contemporary society, with job seekers' criteria for work environments becoming more complex. However, most studies lack an analysis from the perspective of employment spatial environment. This study employs qualitative research methods such as interviews and thematic analysis, focusing on spatial environment behavior research. By analyzing the behaviors and preferences of key employment groups in China (college graduates, migrant workers, and reemployed laid-off workers) from the perspectives of physical and socio-cultural environments, this study identifies the consistencies and differences in personal viewpoints during job selection and their impact on employment decisions. The findings indicate that college graduates tend to emphasize the macro spatial environment, while migrant workers and reemployed laid-off workers are more concerned with micro spatial environment factors. Additionally, college graduates have higher requirements for the diversity of space types and the distinction between public and private spaces. Furthermore, aside from salary considerations, key employment groups generally place less importance on the socio-cultural environment compared to the physical environment. This study aims to highlight the significance of spatial environment in job selection decisions from the perspective of diverse job seekers, providing insights for policy-making and corporate recruitment strategies.

Keywords: job-seeking populations, spatial environment behavior, micro, macro, qualitative research, physical environment, socio-cultural environment

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2147 A Review of Evidence on the Use of Digital Healthcare Interventions to Provide Follow-Up Care for Coeliac Disease Patients

Authors: R. Cooper, M. Kurien

Abstract:

Background: Coeliac Disease affects around 1 in 100 people. Untreated, it can result in serious morbidity such as malabsorption and cancers. The only treatment is to adhere to a gluten free diet (GFD). International guidelines recommend that people with the coeliac disease receive follow-up healthcare annually to detect complications early and support their adherence to a GFD. However, there is a finite amount of healthcare in the UK, and as such, not all patients receive follow-up care as recommended by the guidelines. Furthermore, there is an increasing number of patients being diagnosed with coeliac disease. Given the potential severe morbidity that non-adherence to a GFD could result in, alongside reports that the rate of non- GFD adherence could be as high as 91%, it is imperative that action is taken. One potential solution to this would be to provide follow-up care digitally through utilising technology. This abstract reports on a rapid review undertaken to explore the existing evidence in this area. Methods: In June 2020, 11 bibliographic databases were searched to find any pertinent studies. The inclusion criteria required the study to be written in the English language and report on the use of digital healthcare interventions for people with Coeliac Disease. Results: A small amount of evidence (n=8) was found which met our inclusion criteria and pertained to the provision of CD follow-up digitally. These studies focussed either on educating and supporting patients to adhere to a GFD or providing consultation remotely with a focus on detecting complications early. These studies showed that there is potential for digital healthcare interventions to positively impact people with coeliac disease. However, it is suggested that the effectiveness of these interventions may depend on local circumstances, individual knowledge of CD and general attitudes. Conclusion: The above studies suggest that providing follow-up care digitally may offer a potential solution; however, the evidence about how this should be done and in what circumstances this will work for individuals is scarce. In the light of the COVID-19 pandemic, the introduction of digital healthcare interventions appears to be highly topical, and as such, this review may benefit from being refreshed in the future.

Keywords: coeliac disease, follow-up, gluten free diet, digital healthcare interventions

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2146 Clinical Cases of Rare Types of 'Maturity Onset Diabetes of the Young' Diabetes

Authors: Alla Ovsyannikova, Oksana Rymar, Elena Shakhtshneider, Mikhail Voevoda

Abstract:

In Siberia endocrinologists increasingly noted young patients with the course of diabetes mellitus differing from 1 and 2 types. Therefore we did a molecular genetic study for this group of patients to verify the monogenic forms of diabetes mellitus in them and researched the characteristics of this pathology. When confirming the monogenic form of diabetes, we performed a correction therapy for many patients (transfer from insulin to tablets), prevented specific complications, examined relatives and diagnosed their diabetes at the preclinical stage, revealed phenotypic characteristics of the pathology which led to the high significance of this work. Materials and Methods: We observed 5 patients (4 families). We diagnosed MODY (Maturity Onset Diabetes of the Young) during the molecular genetic testing (direct automatic sequencing). All patients had a full clinical examination, blood samples for biochemical research, determination of C-peptide and TSH, antibodies to b-cells, microalbuminuria, abdominal ultrasound, heart and thyroid ultrasound, examination of ophthalmologist. Results: We diagnosed 3 rare types of MODY: two women had MODY8, one man – MODY6 and man and his mother - MODY12. Patients with types 8 and 12 had clinical features. Age of onset hyperglycemia ranged from 26 to 34 years. In a patient with MODY6 fasting hyperglycemia was detected during a routine examination. Clinical symptoms, complications were not diagnosed. The patient observes a diet. In the first patient MODY8 was detected during first pregnancy, she had itchy skin and mostly postprandial hyperglycemia. Upon examination we determined glycated hemoglobin 7.5%, retinopathy, non-proliferative stage, peripheral neuropathy. She uses a basic bolus insulin therapy. The second patient with MODY8 also had clinical manifestations of hyperglycemia (pruritus, thirst), postprandial hyperglycemia and diabetic nephropathy, a stage of microalbuminuria. The patient was diagnosed autoimmune thyroiditis. She used inhibitors of DPP-4. The patient with MODY12 had an aggressive course. In the detection of hyperglycemia he had complaints of visual impairment, intense headaches, leg cramps. The patient had a history of childhood convulsive seizures of non-epileptic genesis, without organic pathology, which themselves were stopped at the age of 12 years. When we diagnosed diabetes a patient was 28 years, he had hypertriglyceridemia, atherosclerotic plaque in the carotid artery, proliferative retinopathy (lacerocoagulation). Diabetes and early myocardial infarction were observed in three cases in family. We prescribe therapy with sulfonylureas and SGLT-2 inhibitors with a positive effect. At the patient's mother diabetes began at a later age (30 years) and a less aggressive course was observed. She also has hypertriglyceridemia and uses oral hypoglycemic drugs. Conclusions: 1) When young patients with hyperglycemia have extrapancreatic pathologies and diabetic complications with a short duration of diabetes we can assume they have one of type of MODY diabetes. 2) In patients with monogenic forms of diabetes mellitus, the clinical manifestations of hyperglycemia in each succeeding generation are revealed at an earlier age. Research had increased our knowledge of the monogenic forms of diabetes. The reported study was supported by RSCF, research project No. 14-15-00496-P.

Keywords: diabetes mellitus, MODY diabetes, monogenic forms, young patients

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2145 Micro Plasma an Emerging Technology to Eradicate Pesticides from Food Surface

Authors: Muhammad Saiful Islam Khan, Yun Ji Kim

Abstract:

Organophosphorus pesticides (OPPs) have been widely used to replace more persistent organochlorine pesticides because OPPs are more soluble in water and decompose rapidly in aquatic systems. Extensive uses of OPPs in modern agriculture are the major cause of the contamination of surface water. Regardless of the advantages gained by the application of pesticides in modern agriculture, they are a threat to the public health environment. With the aim of reducing possible health threats, several physical and chemical treatment processes have been studied to eliminate biological and chemical poisons from food stuff. In the present study, a micro-plasma device was used to reduce pesticides from the surface of food stuff. Pesticide free food items chosen in this study were perilla leaf, tomato, broccoli and blueberry. To evaluate the removal efficiency of pesticides, different washing methods were followed such as soaking with water, washing with bubbling water, washing with plasma-treated water and washing with chlorine water. 2 mL of 2000 ppm pesticide samples, namely, diazinone and chlorpyrifos were individuality inoculated on food surface and was air dried for 2 hours before treated with plasma. Plasma treated water was used in two different manners one is plasma treated water with bubbling the other one is aerosolized plasma treated water. The removal efficiency of pesticides from food surface was studied using HPLC. Washing with plasma treated water, aerosolized plasma treated water and chlorine water shows minimum 72% to maximum 87 % reduction for 4 min treatment irrespective to the types of food items and the types of pesticides sample, in case of soaking and bubbling the reduction is 8% to 48%. Washing with plasma treated water, aerosolized plasma treated water and chlorine water shows somewhat similar reduction ability which is significantly higher comparing to the soaking and bubbling washing system. The temperature effect of the washing systems was also evaluated; three different temperatures were set for the experiment, such as 22°C, 10°C and 4°C. Decreasing temperature from 22°C to 10°C shows a higher reduction in the case of washing with plasma and aerosolized plasma treated water, whereas an opposite trend was observed for the washing with chlorine water. Further temperature reduction from 10°C to 4°C does not show any significant reduction of pesticides, except for the washing with chlorine water. Chlorine water treatment shows lesser pesticide reduction with the decrease in temperature. The color changes of the treated sample were measured immediately and after one week to evaluate if there is any effect of washing with plasma treated water and with chlorine water. No significant color changes were observed for either of the washing systems, except for broccoli washing with chlorine water.

Keywords: chlorpyrifos, diazinone, pesticides, micro plasma

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2144 Tribological Response of Self-Mated Zircaloy-4 under Varying Conditions

Authors: Bharat Kumar, Deepak Kumar, Vijay Chaudhry

Abstract:

Zirconium alloys are widely used for the core components of a pressurized heavy water reactor (PHWR) or Canada deuterium (CANDU) reactor due to their low neutron absorption cross-section and excellent mechanical properties. The components made of Zirconium alloys are subjected to flow-induced vibrations, resulting in fretting wear at the interface of; pressure tubes and bearing pads, pressure tubes and calandria tubes, and calandria tubes and Liquid injection shutdown system (LISS) nozzles. There is a need to explore the tribological response under such conditions. Present work simulates the contact between calandria tube and LISS nozzle of PHWR/CANDU reactor as cylinder-on-cylinder contact configuration. Reciprocating tribo-tests were conducted on Zircaloy-4 (Zr-4) under the self-mated condition at varying amplitude, frequency, and sliding time. To understand the active wear mechanism, worn surfaces were analyzed using Scanning Electron Microscopy (SEM) and Energy Dispersive Spectroscopy (EDS). The change in amplitude severely affects the wear than other factors. The wear mechanism transits from adhesion to abrasion with increasing test amplitude. The dominant wear mechanisms are micro-cutting and micro-plowing followed by delamination in some areas. However, the coefficient of friction has indifferent behaviors.

Keywords: zircaloy-4, tribology, calandria tube, LISS nozzle, PHWR

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2143 A Study on Micro-Renewal of Mountainous Urban Communities Based on Child-Friendliness

Authors: Zipei Yin

Abstract:

Community space is the main place for children's daily outdoor activities. The mountain community space has the typical characteristics of a closed natural environment, a scattered population layout with height differences, and a relatively independent group structure. This has resulted in special limitations on children's outdoor activities in terms of safety, accessibility, and appropriateness, which urgently makes it necessary to explore how to construct children's activity spaces in mountainous societies under the special limitations. This study investigated the activity spaces for children aged 3-11 years old in typical old communities in Chongqing and evaluated them based on the dimensions of spatial characteristics, environmental safety, and connectivity to summarise three typical patterns of children's outdoor activity spaces in old communities in mountainous cities. Then, under the framework of the appeal of the child-friendly urban environment, taking advantage of the characteristics of the old community in mountain cities compared with the plain urban community, such as complex social form, diversified functional positioning, and good foundation of autonomy, this paper explores the micro-renewal path and strategy of the compound utilization of community public space from the two levels of design and governance, so as to further promote the research and practice of the healthy development of mountain urban community environment.

Keywords: child-friendly, healthy community, community public space, mountainous urban community, community renewal

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