Search results for: recurrence interval

Authors: S. Hannah Elizabeth, A. Panneerselvam

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Objective: The main objective was to evaluate the degradative properties of Bacillus cereus sp TUHP2 isolated from TNT-Polluted soils in the Vellore District, Tamil Nadu, India. Methods: Among the 3 bacterial genera isolated from different soil samples, one potent TNT degrading strain Bacillus cereus sp TUHP2 was identified. The morphological, physiological and the biochemical properties of the strain Bacillus cereus sp TUHP2 was confirmed by conventional methods and genotypic characterization was carried out using 16S r-DNA partial gene amplification and sequencing. The broken down by products of DNT in the extract was determined by Gas Chromatogram- Mass spectrometry (GC-MS). Supernatant samples from the broth studied at 24 h interval were analyzed by HPLC analysis and the effect on various nutritional and environmental factors were analysed and optimized for the isolate. Results: Out of three isolates one strain TUHP2 were found to have potent efficiency to degrade TNT and revealed the genus Bacillus. 16S rDNA gene sequence analysis showed highest homology (98%) with Bacillus cereus and was assigned as Bacillus cereus sp TUHP2. Based on the energy of the predicted models, the secondary structure predicted by MFE showed the more stable structure with a minimum energy. Products of TNT Transformation showed colour change in the medium during cultivation. TNT derivates such as 2HADNT and 4HADNT were detected by HPLC chromatogram and 2ADNT, 4ADNT by GC/MS analysis. Conclusion: Hence this study presents the clear evidence for the biodegradation process of TNT by strain Bacillus cereus sp TUHP2.

Keywords: bioremediation, biodegradation, biotransformation, sequencing

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Authors: Cecilia Amponsem-Boateng, Timothy Bonney Oppongx, Weidong Zhang, Jonathan Boakye Yiadom, Lianke Wang, Kwabena Acheampong, Godfrey Opolot

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In Ghana, the management of hypertension in primary health care is a cost-effective way of addressing premature deaths from vascular disorders that include hypertension. There is little or no evidence of large-scale studies on the prevalence, risk, and knowledge/awareness of hypertension in students aged 12–22 years in Ghana. In a cross-sectional study, blood pressure, anthropometric indices, and knowledge/awareness assessment of students at second-cycle schools were recorded from 2018 to 2020 in three regions of Ghana. Multistage cluster sampling was used in selecting regions and the schools. Prevalence of prehypertension and hypertension was categorized by the Joint National Committee 7, where appropriate, chi-square, scatter plots, and correlations were used in showing associations. A total of 3165 students comprising 1776 (56.1%) females and 1389 (43.9%) males participated in this study within three regions of Ghana. The minimum age was 12 years and the maximum age was 22 years. The mean age was 17.21 with standard deviation (SD: 1.59) years. A 95% confidence interval was set for estimations and a P value < 0.05 was set as significant. The prevalence rate of overall hypertension was 19.91% and elevated (prehypertension) was 26.07%. Risk indicators such as weight, BMI, waist circumference, physical activity, and form of the diet were positively correlated with hypertension. Among Ghanaian students currently in second-cycle educational institutions, 19.91% were hypertensive and 26.07% were prehypertensive. This may indicate a probable high prevalence of hypertension in the future adult population if measures are not taken to curb the associated risks.

Keywords: hypertension, second-cycle schools, Ghana, youth

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Authors: Martins Onyekwelu Onuorah, Jnr Dahiru Usman

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Introduction: In the realm of public health, the threat posed by Monkeypox continues to elicit concern, prompting rigorous studies to understand its dynamics and devise effective containment strategies. Particularly significant is its recurrence in variable populations, such as the observed outbreak in Nigeria in 2022. In light of this, our study undertakes a meticulous analysis, employing a data-driven approach to explore, validate, and propose optimized intervention strategies tailored to the distinct dynamics of Monkeypox within varying demographic structures. Utilizing a deterministic mathematical model, we delved into the intricate dynamics of Monkeypox, with a particular focus on a variable population context. Our qualitative analysis provided insights into the disease-free equilibrium, revealing its stability when R0 is less than one and discounting the possibility of backward bifurcation, as substantiated by the presence of a single stable endemic equilibrium. The model was rigorously validated using real-time data from the Nigerian 2022 recorded cases for Epi weeks 1 – 52. Transitioning from qualitative to quantitative, we augmented our deterministic model with optimal control, introducing three time-dependent interventions to scrutinize their efficacy and influence on the epidemic's trajectory. Numerical simulations unveiled a pronounced impact of the interventions, offering a data-supported blueprint for informed decision-making in containing the disease. A comprehensive cost-effectiveness analysis employing the Infection Averted Ratio (IAR), Average Cost-Effectiveness Ratio (ACER), and Incremental Cost-Effectiveness Ratio (ICER) facilitated a balanced evaluation of the interventions’ economic and health impacts. In essence, our study epitomizes a holistic approach to understanding and mitigating Monkeypox, intertwining rigorous mathematical modeling, empirical validation, and economic evaluation. The insights derived not only bolster our comprehension of Monkeypox's intricate dynamics but also unveil optimized, cost-effective interventions. This integration of methodologies and findings underscores a pivotal stride towards aligning public health imperatives with economic sustainability, marking a significant contribution to global efforts in combating infectious diseases.

Keywords: monkeypox, equilibrium states, stability, bifurcation, optimal control, cost-effectiveness

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Authors: Mustapha Saidu, Bilyaminu Mohammed

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The study was conducted in Udubo Grazing Reserve between July 2019 and October 2019 to assess forage utilization for pasture-based livestock production in reserve. The grazing land was cross-divided into grids, where 15 coordinates were selected as the sample points. Grids of one-kilometer interval were made. The grids were systematically selected 1 grid after 7 grids. 1 × 1-meter quadrat was made at the coordinate of the selected grids for measurement, estimation, and sample collection. The results of the study indicated that Zornia glochidiatah has the highest percent of species composition (42%), while Mitracarpus hirtus has the lowest percent (0.1%). Urochloa mosambicensis has 48 percent of height removed and 27 percent used by weight, Zornia glochidiata 60 percent of height removed and 57 percent used by weight, Alysicapus veginalis has 55 percent of height removed, and 40 percent used by weight, and Cenchrus biflorus has 40 percent of height removed and 28 percent used by weight. The target is 50 percent utilization of forage by weight during a grazing period as well as at the end of the grazing season. The study found that Orochloa mosambicensis, Alysicarpus veginalis, and Cenchrus biflorus had lower percent by weight which is normal, while Zornia glochidiata had a higher percent by weight which is an indication of danger. The study recommends that the identification of key plant species in pasture and rangeland is critical to implementing a successful grazing management plan. There should be collective action and promotion of historically generated grazing knowledge through public and private advocacies.

Keywords: forage, grazing reserve, live stock, pasture, plant species

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Authors: Shreesh Sinha, Alexander B. Barker, Megan Parkin, Emma Wilson, Rachael L. Murray

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Background and Objectives: Exposure to HFSS imagery is associated with the consumption of foods high in fat, sugar or salt (HFSS), and subsequently obesity, among young people. We report and compare the results of two content analyses, one of two popular terrestrial children's television channels in the UK and the other of a selection of children's programmes available on video-on-demand (VOD) streaming sites. Methods: Content analysis of three days' worth of programmes (including advertisements) on two popular children's television channels broadcast on UK television (CBeebies and Milkshake) as well as a sample of 40 highest-rated children's programmes available on the VOD platforms, Netflix and Amazon Prime, using 1-minute interval coding. Results: HFSS content was seen in 181 broadcasts (36%) and in 417 intervals (13%) on terrestrial television, 'Milkshake' had a significantly higher proportion of programmes/adverts which contained HFSS content than 'CBeebies'. In VOD platforms, HFSS content was seen in 82 episodes (72% of the total number of episodes), across 459 intervals (19% of the total number of intervals), with no significant difference in the proportion of programmes containing HFSS content between Netflix and Amazon Prime. Conclusions: This study demonstrates that HFSS content is common in both popular UK children's television channels and children's programmes on VOD services. Since previous research has shown that HFSS content in the media has an effect on HFSS consumption, children's television programmes broadcast either on TV or VOD services are likely to have an effect on HFSS consumption in children, and legislative opportunities to prevent this exposure are being missed.

Keywords: public health, junk food, children's TV, HFSS

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Authors: Firjeeth C. Paramba, Vamanjore A. Naushad, Nishan K. Purayil, Osama H. Mohammed, Prem Chandra

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Background: Fever is a common problem in adults visiting the emergency department. Extensive studies have been done in children comparing the efficacy of various antipyretics. However, studies on the efficacy of antipyretic drugs in adults are very scarce. To the best of our knowledge, no controlled trial has been carried out comparing the antipyretic efficacy of paracetamol (oral and intravenous) and intramuscular diclofenac in adults. Methods: In this parallel-group, open-label trial, participants aged 14–75 years presenting with fever who had a temperature of more than 38.5°C were enrolled and treated. Participants were randomly allocated to receive treatment with 1,000 mg oral paracetamol (n=145), 1,000 mg intravenous paracetamol (n=139), or 75 mg intramuscular diclofenac (n=150). The primary outcome was degree of reduction in mean oral temperature at 90 minutes. The efficacy of diclofenac versus oral and intravenous paracetamol was assessed by superiority comparison. Analysis was done using intention to treat principles. Results: After 90 minutes, all three groups showed a significant reduction in mean temperature, with intramuscular diclofenac showing the greatest reduction (−1.44 ± 0.43, 95% confidence interval [CI] −1.4 to −2.5) and oral paracetamol the least (−1.08 ± 0.51, 95% CI −0.99 to −2.2). After 120 minutes, there was a significant difference observed in the mean change from baseline temperature between the three treatment groups (P, 0.0001). Significant changes in temperature were observed in favor of intramuscular diclofenac over oral and intravenous paracetamol at each time point from 60 minutes through 120 minutes inclusive. Conclusion: Both intramuscular diclofenac and intravenous paracetamol showed superior antipyretic activity than oral paracetamol. However, in view of its ease of administration, intramuscular diclofenac can be used as a first-choice antipyretic in febrile adults in the emergency department.

Keywords: antipyretic, intramuscular, intravenous, paracetamol, diclofenac, emergency department

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Authors: Moussa Majed, Omar Yaser

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The main objective of this experiment was to study the impact of Probiotic compound on the specific immunity as the case study of infectious bursal disease. Total of 8000 one-day old Ross 108 broiler were randomly divided into two experimental groups; control group (4500 birds) and experimental group (3500 birds). Birds in two groups were reared under similar environmental conditions. Birds in control group received basal diets without probiotic whereas the birds in experimental one were fed basal diets supplemented with a commercial probiotic mixture) probiotic lacting k, which contains bacteria cells beyond to lactobacillus, Streptococcus and bifidobacterium genus that are isolated from gut microflora in healthy chickens(. The commercial probiotic were used according to the manufacturer instruction. 400 blood samples for each group were collected from wing vein every 5-7 days as interval period till 42 days old. Indirect Enzyme-Linked Immunosorbent Assay (ELISA) test was performed to detect the level of infectious bursal disease virus (IBDV) antibodies. The results clearly showed that the mean of immune titers was significantly (p= 0.03) higher in trail group than control one. The coefficient of variance percentages were 55% and 39% for control and trial groups respectively, this illustrates that homogeneity of immunity titers in the trail group was much better comparing with control group. The values of geometric means of titers in the control group and trial group were reported 3820 and 8133, respectively. The crude mortality rate in the experimental group was two times lower comparing with control group (14% and 28% respectively, p = 0.005

Keywords: probiotic, broiler chicken, infectious bursal disease, immunity, ELISA test

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Authors: Luristya Nur Mahfut, Nada Mawarda Rilek, Ameiga Cautsarina Putri, Mujaroh Khotimah

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The use of bioetanol from lignocellulosic material has begone to be developed. In Indonesia the most abundant lignocellulosic material is stem of palm which contain 32.22% of cellulose. Indonesia produces approximatelly 300.375.000 tons of stem of palm each year. To produce bioetanol from lignocellulosic material, the first process is pretreatment. But, until now the method of lignocellulosic pretretament is uneffective. This is related to the particle size and the method of pretreatment of less than optimal so that led to an overhaul of the lignin insufficient, consequently increased levels of cellulose was not significant resulting in low yield of bioetanol. To solve the problem, this research was implemented by using the process of pretreatment method ultasonifikasi in order to produce higher pulp with nano-sized particles that will obtain higher of yield ethanol from stem of palm. Research methods used in this research is the RAK that is composed of one factor which is the frequency ultrasonic waves with three varians, they are 30 kHz, 40 kHz, 50 kHz, and use constant variable is concentration of NaOH. The analysis conducted in this research is the influence of the frequency of the wave to increase levels of cellulose and change size on the scale of nanometers on pretreatment process by using the PSA methods (Particle Size Analyzer), and a Cheason. For the analysis of the results, data, and best treatment using ANOVA and test BNT with confidence interval 5%. The best treatment was obtained by combination X3 (frequency of sonication 50 kHz) and lignin (19,6%) cellulose (59,49%) and hemicellulose (11,8%) with particle size 385,2nm (18,8%).

Keywords: bioethanol, pretreatment, stem of palm, cellulosa

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Authors: Esra Yuce, Isil D. S. Yamaner, Murude Yazan

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Aims and objective: Antiresorptive agents including bisphosphonates and denosumab as strong suppressors of osteoclasts are the most commonly used antiresorptive medications for the treatment of osteoporosis which counteract the negative quantitative alteration of trabecular and cortical bone by inhibition of bone turnover. Oral bisphosphonate therapy for the treatment of osteopenia, osteoporosis or Paget's disease is associated with the low-grade risk of osteonecrosis of the jaw, while higher-grade risk is associated with receiving intravenous bisphosphonates therapy in the treatment of multiple myeloma and bone metastases. On the other hand, there has been a remarkable increase in incidences of antiresorptive related osteonecrosis of the jaw (ARONJ) in oral bisphosphonate users. This clinical presentation will evaluate the healing outcomes via piezoelectric bone surgery under the irrigation of PVP-I solution irrigation in patients received bisphosphonate therapy. Material-Method: The study involved 8 female and 5 male patients that have been treated for ARONJ. Among 13 necrotic sites, 9 were in the mandible and 4 were in the maxilla. All of these 13 patients treated with surgical debridement via piezoelectric bone surgery under irrigation by solution with 3% PVP-I concentration in combination with long-term antibiotic therapy and 5 also underwent removal of mobile segments of bony sequestrum. All removable prosthesis in 8 patients were relined with soft liners during the healing periods in order to eliminate chronic minor traumas. Results: All patients were on oral bisphosphonate therapy for at least 2 years and 5 of which had received intravenous bisphosphonates up to 1 year before therapy with oral bisphosphonates was started. According to the AAOMS staging system, four cases were stage II, eight cases were stage I, and one case was stage III. The majority of lesions were identified at sites of dental prostheses (38%) and dental extractions (62%). All patients diagnosed with ARONJ stage I had used unadjusted removable prostheses. No recurrence of the symptoms was observed during the present follow-up (9–37 months). Conclusion: Despite their confirmed effectiveness, the prevention and treatment of osteonecrosis of the jaw secondary to oral bisphosphonate therapy remain major medical challenges. Treatment with piezoelectric bone surgery with irrigation of povidone-iodine solution was effective for management of bisphosphonate-related osteonecrosis of the jaw. Taking precautions for patients treated with oral bisphosphonates, especially also denture users, may allow for a reduction in the rate of developing osteonecrosis of the maxillofacial region.

Keywords: antiresorptive drug related osteonecrosis, bisphosphonate therapy, piezoelectric bone surgery, povidone iodine

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Authors: Aziz Rezapour, Abdosaleh Jafari, Marziye Hadian, Elaheh Mazaheri

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Introduction: Cardiac rehabilitation is an accurate educational and sporting program designed to help heart patients to increase their physical activities and reduce the risk factors that make their health worse and help to a healthier lifestyle so that they can return to their families and society with a better spirit. The aim of this study was to examine the cost-effectiveness and cost-utility of cardiac rehabilitation programs for patients with cardiovascular diseases. Methods: In the present review study, published articles related to cost-effectiveness and cost-utility of cardiac rehabilitation programs for patients with cardiovascular diseases within the time interval between 2004 and 2019 were searched using electronic databases. The methodological quality of the structure of articles was examined by Drummond’s standard checklist. Results: The results of reviewing studies showed that most of the studies related to the economic evaluation of cardiac rehabilitation programs in patients with cardiovascular disease were flawed in Drummond’s criteria, and only one study adhered to Drummond’s criteria. The results of the present study indicated use of cardiac rehabilitation programs in patients with cardiovascular disease was cost-effective. Conclusion: The results of this review study showed that although the results of the studies were different in terms of a number of aspects, such as the study perspective, the time horizons, and the costs of rehabilitation programs, they achieved a similar conclusion, they concluded that the use of cardiac rehabilitation programs in patients with cardiovascular diseases, leading to higher quality-adjusted life years (QALYs) and lower costs.

Keywords: economic evaluation, systematic review, cardiac rehabilitation, Drummond’s checklist

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Authors: Oum Elkhir Mahmoudi, Nebiha Ben Haj Ali

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Micropaleontological, sedimentological and statistical studies were carried out on the late Paleocene-early Eocene succession of Sra Ouertaine and Dyr El Kef in Northern open phosphatic Basin of Tunisia. Based on the abundance and stratigraphic distribution of planktic foraminiferal species, five planktic zones have been recognized from the base to the top of the phosphatic layers. The El Acarinina sibaiyaensis Zone, the E2 Pseudohastigerina wilcoxensis Zone, the E3 Morozovella marginodentata Zone, the E4 Morozovella formosa Zones and the E5 Morozovella subbotinae Zone. The placement of Paleocene-Eocene boundary (PETM) is just below the base of the phosphatic interval. The ETM-2 event may be detectable in the analyzed biotic record of Sra Ouertaine. Based on benthic assemblages, abundances, cluster and multivariate statistical analyses, two biofacies were recognized for each section. The recognized ecozones are typical of warm and shallow water inner neritic setting (dominance of epifaunal fauna Anomalinoides, Dentalina and Cibicidoides associated with Frondicularia phosphatica, Trochamminoides globigeriniformis and Eponides elevatus). The paleoenvironment is eutrophic (presence of several bolivinitids and verneuilinids). For the Dyr El Kef section and P5 and E2 of Sra Ouertaine section, our records indicate that paleoenvironment is influenced by coastal upwelling without oxygen-deficiency, the paleodepth is estimated to be around 50 m. The paleoecosystem is diversified and balanced with a general tendency to stressed condition. While the upper part of Sra Ouertaine section is more eutrophic, influenced by coastal upwelling with oxygen-deficiency, the paleodepth is estimated to be less than 50 m and the ecosystem is unsettled.

Keywords: Tunisia, Sra ouertaine Dyr el kef, early Eocene, foraminifera, chronostratigraphy, paleoecology, paleoenvironment

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Authors: Susmiati, Ingrid S. Surono, Jamsari, Nur Indrawati Lipoeto

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There are two contradicting opinions on the relationship between fat mass obesity associated (FTO) rs 9939609 variants and obesity on various ethnics and races. The first opinion agrees that there is an association between the two variables, yet another one disagree. Minangkabau ethnic had a different dietary pattern with other ethnics in Indonesia. They had higher fat and low fiber intakes compared to the other ethnics groups. There is little research in genetic factors that influence eating behavior (food preference or food selection). The objective of this study was to investigate the association between FTO rs 9939609 variants with obesity and eating behavior in adolescent girls of Minangkabau Ethnic. The research design was case control study. A total of 275 adolescent girls aged 12-15 years old (130 obese and 145 normal) were randomly chosen from four districts at West Sumatera (Padang, Padang Pariaman, Padang Panjang and Tanah Datar). Genetic variants of FTO rs 9939609 were analyzed with Tetra-primer Amplification Refractory Mutation System-Polimerase Chain Reaction (AMRS PCR), eating behavior were gathered using eating habits questionnaire, and Body Mass Index (BMI) was calculated according to BMI Z-score (WHO). The result showed that genetic variants of FTO rs 9939609 (TT, TA and AA genotype) had associated with obesity (p = 0,013), whereas subject with An Allele was significantly associated with obesity (odds ratio 1,62 [95% confidential interval, 1,00-2,60]). Subjects with An Allele carrier reported a higher consumption of fried food (p < 0.05) as compared to TT genotypes carriers. There is no association between genetic variants and meal frequency, fruit and fiber intakes p > 0.05. The genetic variants of FTO rs 9939609 are associated with obesity and eating behavior in adolescent of Minangkabau Ethics.

Keywords: FTO rs9939609, obesity, eating behavior, adolescents

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Authors: K. Shafiei, A. Pirestani, G. Ghalamkari, S. Safavipour

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Use of GnRH or its agonists to increase conception rates should be based on an understanding of GnRH-induced biological effects on the reproductive-endocrine system. This effect may occur through GnRH-stimulated LH surge stimulating production of progesterone by corpus luteum.the aim of this study was to compare the effects on reproductive efficiency of a luteolytic dose of a synthetic prostaglandin Cloprostenol Sodium versus ainjectable progesterone and Luliberin- A on Follicle estrogen and progesterone levels.In this study, we used45 head of holstein dairy heifersin the three treatments, with 15 replicates per treatment were performed in random groups. all the heifers before the projects is began in two steps injection 3 mL CloprostenolSodium with an interval of 11 days been synchronized and 10 days later, second injection of prostaglandin was conducted after that we started below protocol:Control group (daily sodium chloride serum injection 1 cc), Group B: Day Zero, intramuscular injection of 15 mg Luliberin- A + every other day injection of 3 cc progesterone + day 7, injection of Cloprostenol Sodium+ day 9, injection of 15 mg Luliberin- A.Group C: similar to Grop B + daily injection of progesterone after that blood samples was collected and centrifuged.plasma were analysed by ELISA.the analysis of this study uses SPSS data software package and compared between the mean and LS Means LSD test at 5% significance level was used.The results of this study shows that maximum of progesterone plasma levels were in the control gruop (P ≥ 0.05).Therefore, daily injection of progesterone inhibit the growth CL. the most estrogen levels in plasma were in Group C (P ≥ 0.05) thus it can be concluded, rise in endogenous estrogen concentrations normally stimulates the preovulatory LH release in heifers.

Keywords: Luliberin- A, Cloprostenol Sodium, estrogen, progesterone, dairy heifers

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Authors: P. N. Guru, C. S. Patil

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The experiment was conducted during Kharif 2016 at Hingoni, Ahmednagar (dist.), Maharashtra (India) to evaluate the novel molecules of acaricides against mites in polyhouse capsicum. The study was planned with randomized block design (RBD) and included nine treatments replicated thrice with 30 m² each plot size. The crop (var. Bachata) was raised according to the standard package of practices except plant protection measures. The molecules viz., spiromesifen 22.9SC (95 gm a.i. ha⁻¹), fenpyroximate 5EC (15 gm a.i. ha⁻¹), hexythiazox 5.45EC (15 gm a.i. ha⁻¹), diafenthiuron 50WP (300 gm a.i. ha⁻¹), chlorfenapyr 10SC (75 gm a.i. ha⁻¹) were compared with a standard acaricide, dicofol 18.5EC (500 gm a.i. ha⁻¹) and biopesticides like Verticillium lecanii (2 g/l), Metarhizium anisopliae (2 g/l) and Neem oil 10,000ppm (2ml/l). In total three sprays were given after 30, 50 and 70 days after transplanting (DAT) at an interval of 20 days. The insecticidal solutions were prepared in water by diluting required concentration of chemical and applied using knapsack sprayer with hollow cone nozzle @ 500L of solution per hectare. The mites were counted per 4 cm² in three leaves from randomly selected five plants in each plot at 1 day before treatment (precount) and 1, 3, 5, 7, 10 and 15 days after treatment. The results revealed that fenpyroximate 5EC found best by recording significantly least mite population (2.72/4 cm² leaf area) followed by hexythiazox 5.45EC and spiromesifen 22.9SC (3.78 and 3.82 per 4 cm² leaf area, respectively) and followed by remaining treatments chlorfenapyr 10SC (4.13/4 cm² leaf area), diafenthiuron 50WP (4.32/4 cm² leaf area), and dicofol 18.5EC (4.48/4 cm² leaf area). Among the biopesticides tested Neem oil and Verticillium lecanii were found to be superior to Metarhizium anisopliae. Overall, newer molecules like fenpyroximate, hexythiazox, spiromesifen, diafenthiuron, and Chlorfenapyr can be used for the effective management of mites under polyhouse capsicum.

Keywords: acaricides, capsicum, mites, spiromesifen

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Authors: Ying Li, Rui Hu, Shizhen Chen, Xin Zhou, Yunhuang Yang

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Prostate cancer is one of the leading causes of cancer-related death among men. Prostate-specific antigen (PSA), a specific product of prostatic epithelial cells, is an important indicator of prostate cancer. Though PSA is not a specific serum biomarker for the screening of prostate cancer, it is recognized as an indicator for prostate cancer recurrence and response to therapy for patient’s post-prostatectomy. Since radical prostatectomy eliminates the source of PSA production, serum PSA levels fall below 50 pg/mL, and may be below the detection limit of clinical immunoassays (current clinical immunoassay lower limit of detection is around 10 pg/mL). Many clinical studies have shown that intervention at low PSA levels was able to improve patient outcomes significantly. Therefore, ultra-sensitive and precise assays that can accurately quantify extremely low levels of PSA (below 1-10 pg/mL) will facilitate the assessment of patients for the possibility of early adjuvant or salvage treatment. Currently, the commercially available ultra-sensitive ELISA kit (not used clinically) can only reach a detection limit of 3-10 pg/mL. Other platforms developed by different research groups could achieve a detection limit as low as 0.33 pg/mL, but they relied on sophisticated instruments to get the final readout. Herein we report a microfluidic platform for point-of-care (POC) detection of PSA with a detection limit of 0.5 pg/mL and without the assistance of any equipment. This platform is based on a previously reported volumetric-bar-chart chip (V-Chip), which applies platinum nanoparticles (PtNPs) as the ELISA probe to convert the biomarker concentration to the volume of oxygen gas that further pushes the red ink to form a visualized bar-chart. The length of each bar is used to quantify the biomarker concentration of each sample. We devised a long reading channel V-Chip (LV-Chip) in this work to achieve a wide detection window. In addition, LV-Chip employed a unique enzyme-free ELISA probe that enriched PtNPs significantly and owned 500-fold enhanced catalytic ability over that of previous V-Chip, resulting in a significantly improved detection limit. LV-Chip is able to complete a PSA assay for five samples in 20 min. The device was applied to detect PSA in 50 patient serum samples, and the on-chip results demonstrated good correlation with conventional immunoassay. In addition, the PSA levels in finger-prick whole blood samples from healthy volunteers were successfully measured on the device. This completely stand-alone LV-Chip platform enables convenient POC testing for patient follow-up in the physician’s office and is also useful in resource-constrained settings.

Keywords: point-of-care detection, microfluidics, PSA, ultra-sensitive

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Authors: Iyanujesu Adereti, Tajudeen Basiru, Ayodamola Olanipekun

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Background: Substance abuse among adolescents is of public health concern globally. Despite being the most abused by adolescents, there are limited studies on the prevalence of alcohol use and cigarette smoking among adolescents in Mauritius. Objectives: To determine the prevalence of cigarette smoking, alcohol use and associated correlates among school-going adolescents in Mauritius. Methodology: Data obtained from 2017 WHO Global School-based Student Health Survey (GSHS) survey of 3,012 school-going adolescents in Mauritius was analyzed using STATA. Descriptive statistics were used to obtain prevalence. Bivariate and multivariate logistic regression analysis was used to evaluate predictors of cigarette smoking and alcohol use. Results: Prevalence of alcohol consumption and cigarette smoking were 26.0% and 17.1%, respectively. Smoking and alcohol use was more prevalent among males, younger adolescents, and those in higher school grades (p-value <.000). In multivariable logistic regression, male gender was associated with a higher risk of cigarette smoking (adjusted Odds Ratio (aOR) [95%Confidence Interval (CI)]= 1.51[1.06-2.14]) but lower risk of alcohol use (aOR[95%CI]= 0.69[0.53-0.90]) while older age (mid and late adolescence) and parental smoking were found to be associated with increased risk of alcohol use (aOR[95%CI]= 1.94[1.34-2.99] and 1.36[1.05-1.78] respectively). Marijuana use, truancy, being in a fight and suicide ideation were associated with increased odds of alcohol use (aOR[95%CI]= 3.82[3.39-6.09]; 2.15[1.62-2.87]; 1.83[1.34-2.49] and 1.93[1.38-2.69] respectively) and cigarette smoking (aOR[95%CI]= 17.28[10.4 - 28.51]; 1.73[1.21-2. 49]; 1.67[1.14-2.45] and 2.17[1.43-3.28] respectively) while involvement in sexual activity was associated with reduced risk of alcohol use (aOR[95%CI]= 0.50[0.37-0.68]) and cigarette smoking (aOR[95%CI]= 0.47[0.33-0.69]). Parental support and parental monitoring were uniquely associated with lower risk of cigarette smoking (aOR[95%CI]= 0.69[0.47-0.99] and 0.62[0.43-0.91] respectively). Conclusion: The high prevalence of alcohol use and cigarette smoking in this study shows the need for the government of Mauritius to enhance policies that will help address this issue putting into accounts the various risk and protective factors.

Keywords: adolescent health, alcohol use, cigarette smoking, global school-based student health survey

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Authors: Lāsma Cielava, Daina Jonkus, Līga Paura

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The age of first calving (AFC) is one of the most important factors that have a significant impact on cow productivity in different lactations and its whole life. A belated AFC leads to reduced reproductive performance and it is one of the main reasons for reduced longevity. Cows that calved in time period from 2001-2007 and in this time finished at least four lactations were included in the database. Data were obtained from 68841 crossbred Holstein Black and White (HM), crossbred Latvian Brown (LB), and Latvian Brown genetic resources (LBGR) cows. Cows were distributed in four groups depending on age at first calving. The longest lifespan was conducted for LBGR cows, but they were also characterized with lowest lifetime milk yield and life day milk yield. HM breed cows had the shortest lifespan, but in the lifespan of 2862.2 days was obtained in average 37916.4 kg milk accordingly 13.2 kg milk in one life day. HM breed cows were also characterized with longer calving intervals (CI) in first four lactations, but LBGR cows had the shortest CI in the study group. Age at first calving significantly affected the length of CI in different lactations (p<0.05). HM cows that first time calved >30 months old in the fourth lactation had the longest CI in all study groups (421.4 days). The LBGR cows were characterized with the shortest CI, but there was slight increase in second and third lactation. Age at first calving had a significant impact on cows’ age in each calving time. In the analysis, cow group was conducted that cows with age at first calving <24 months or in average 580.5 days at the time of fifth calving were 2156.7 days (5.9 years) old, but cows with age at first calving >30 months (932.6 days) at the time of fifth calving were 2560.9 days (7.3 years) old.

Keywords: age at first calving, calving interval, longevity, milk yield

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Authors: Ouafa Amira, Jiangshe Zhang

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Clustering is an unsupervised machine learning technique; its aim is to extract the data structures, in which similar data objects are grouped in the same cluster, whereas dissimilar objects are grouped in different clusters. Clustering methods are widely utilized in different fields, such as: image processing, computer vision , and pattern recognition, etc. Fuzzy c-means clustering (fcm) is one of the most well known fuzzy clustering methods. It is based on solving an optimization problem, in which a minimization of a given cost function has been studied. This minimization aims to decrease the dissimilarity inside clusters, where the dissimilarity here is measured by the distances between data objects and cluster centers. The degree of belonging of a data point in a cluster is measured by a membership function which is included in the interval [0, 1]. In fcm clustering, the membership degree is constrained with the condition that the sum of a data object’s memberships in all clusters must be equal to one. This constraint can cause several problems, specially when our data objects are included in a noisy space. Regularization approach took a part in fuzzy c-means clustering technique. This process introduces an additional information in order to solve an ill-posed optimization problem. In this study, we focus on regularization by relative entropy approach, where in our optimization problem we aim to minimize the dissimilarity inside clusters. Finding an appropriate membership degree to each data object is our objective, because an appropriate membership degree leads to an accurate clustering result. Our clustering results in synthetic data sets, gaussian based data sets, and real world data sets show that our proposed model achieves a good accuracy.

Keywords: clustering, fuzzy c-means, regularization, relative entropy

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Authors: Saqib Saleem Abdullah, Saima Masood, Hafsa Zaneb, Shela Gul Bokhari, Muti Ur Rehman, Jamil Akbar

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A 5- weeks feeding trial was carried out to determine the effectiveness of Bacterial Phytase (Phyzyme®) in broilers, at different dietary levels of Phosphorous. 140 d-old broilers (Hubbard) were randomly divided into 4 groups (n=4). Birds were fed corn-based basal diet or the same diet supplemented with 3 different levels of non Phytate Phosphorous (NPP) (0.45 %, 0.30 % and 0.15 %). Furthermore, the diets were supplemented with bacterial Phytase. Birds were fed ad libitum and kept under thermo neutral conditions. The parameters studied were; body weight gain (BWG), tibial bone characteristics (TBC), serum Calcium (Ca), Phosphorus (P) and Alkaline Phosphatase (AP) levels and tibia ash percentage (TAP). BWG of the broilers was calculated at weekly interval and remaining parameters were calculated after slaughtering the birds at 35thday. Results suggested that Phytase supplementation at 0.30% NPP (Non Phytate Phosphorus + Bacterial Phytase) increased (P < 0.05) the BWG, bone length, bone weight, tibiotarsal index, medullary canal diameter and diaphysis diameter however, rubosticity index was reduced to minimum (P < 0.05) at this dietary level of phosphorous when compared with other groups. Maximum (P < 0.05) rubosticity index was observed in control group with 0% Phytase. Furthermore, Phytase addition at 0.30 % NPP also improved (P < 0.05) Ca, P and AP levels in the blood. Phytase supplementation at lower phosphorus level (0.30%NPP) improved BWG and TBC including bone density and bone quality in broilers hence it can be concluded that addition of Phytase at 0.30% NPP may prove beneficial for bone and overall performance in broilers.

Keywords: diaphysis diameter, phytase, rubosticity index, tibia

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Authors: Vignesh Ratnaraj, Jaewon Chang

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Background: Frailty is associated with poorer outcomes in cardiac surgery, but the heterogeneity in frailty assessment tools makes it difficult to ascertain its true impact in cardiac surgery. Slow gait speed is a simple, validated, and reliable marker of frailty. We performed a systematic review and meta-analysis to examine the effect of slow gait speed on postoperative cardiac surgical patients. Methods: PubMED, MEDLINE, and EMBASE databases were searched from January 2000 to August 2021 for studies comparing slow gait speed and “normal” gait speed. The primary outcome was in-hospital mortality. Secondary outcomes were composite mortality and major morbidity, AKI, stroke, deep sternal wound infection, prolonged ventilation, discharge to a healthcare facility, and ICU length of stay. Results: There were seven eligible studies with 36,697 patients. Slow gait speed was associated with an increased likelihood of in-hospital mortality (risk ratio [RR]: 2.32; 95% confidence interval [CI]: 1.87–2.87). Additionally, they were more likely to suffer from composite mortality and major morbidity (RR: 1.52; 95% CI: 1.38–1.66), AKI (RR: 2.81; 95% CI: 1.44–5.49), deep sternal wound infection (RR: 1.77; 95% CI: 1.59–1.98), prolonged ventilation >24 h (RR: 1.97; 95% CI: 1.48–2.63), reoperation (RR: 1.38; 95% CI: 1.05–1.82), institutional discharge (RR: 2.08; 95% CI: 1.61–2.69), and longer ICU length of stay (MD: 21.69; 95% CI: 17.32–26.05). Conclusion: Slow gait speed is associated with poorer outcomes in cardiac surgery. Frail patients are twofold more likely to die during hospital admission than non-frail counterparts and are at an increased risk of developing various perioperative complications.

Keywords: cardiac surgery, gait speed, recovery, frailty

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Authors: Alexander B. Barker, Megan Parkin, Shreesh Sinha, Emma Wilson, Rachael L. Murray

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Objectives: Exposure to HFSS imagery is associated with consumption of foods high in fat, sugar, or salt (HFSS), and subsequently obesity, among young people. We report and compare the results of two content analyses, one of two popular terrestrial children’s television channels in the UK and the other of a selection of children’s programs available on video-on-demand (VOD) streaming sites. Design: Content analysis of three days’ worth of programs (including advertisements) on two popular children’s television channels broadcast on UK television (CBeebies and Milkshake) as well as a sample of 40 highest-rated children’s programs available on the VOD platforms, Netflix and Amazon Prime, using 1-minute interval coding. Setting: United Kingdom, Participants: None. Results: HFSS content was seen in 181 broadcasts (36%) and in 417 intervals (13%) on terrestrial television, ‘Milkshake’ had a significantly higher proportion of programs/adverts which contained HFSS content than ‘CBeebies’. In VOD platforms, HFSS content was seen in 82 episodes (72% of the total number of episodes), across 459 intervals (19% of the total number of intervals), with no significant difference in the proportion of programs containing HFSS content between Netflix and Amazon Prime. Conclusions: This study demonstrates that HFSS content is common in both popular UK children’s television channels and children's programs on VOD services. Since previous research has shown that HFSS content in the media has an effect on HFSS consumption, children’s television programs broadcast either on TV or VOD services are likely having an effect on HFSS consumption in children and legislative opportunities to prevent this exposure are being missed.

Keywords: public health, epidemiology, obesity, content analysis

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Authors: L. Vafaei, McDominic Eze

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The performance of thermal energy in homes and buildings is a significant factor in terms of energy efficiency of a building. In a large sense, the performance of thermal energy is dependent on many factors of which the amount of thermal insulation is at one end a considerable factor, as likewise the essence of mass and the wall thickness and also the thermal resistance of wall material. This study is aimed at illustrating the different wall system in Turkish Republic of North Cyprus (TRNC), acknowledge the problem and suggest a solution through comparing the effect of thermal radiation two model rooms- L1 (Ytong wall) and L2 (heat insulated wall using stone wool) set up for experimentation. The model room has four face walls. The study consists of two stage, the first test is to access the effect of solar radiation for south facing wall and the second stage is to test the thermal performance of Ytong and heat insulated wall, the effects of climatic condition during winter. The heat insulated wall contains material hollow brick, stone wool, and gypsum while the Ytong wall contains cement concrete, for the outer surface and the inner surface and Ytong stone. The total heat of the wall was determined, 7T-Type thermocouple was used with a data logger system to record the data, temperature change recorded at an interval of 10 minutes. The result obtained was that Ytong wall save more energy than the heat insulated wall at night while heat insulated wall saves energy during the day when intensity is at maximum.

Keywords: heat insulation, hollow bricks, south facing, Ytong bricks wall

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Authors: Vivian Correa

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Hypothesis There are typical patterns - phenotypes - of sleep behaviors by age and biological sex groups of parasomnia patients where wearable devices could avoid injuries. Materials and methods We analyzed public video records on sleep-related behaviors likely representing parasomnias, looking for phenotypes in different groups. We searched public internet databases using the keywords “sleepwalking”, “sleep eating,” “sleep sex”, and “aggression in sleep” in six languages. Poor-quality vide-records and those showing apparently faked sleep behaviors were excluded. We classified the videos into estimated sex and age (children, adults, elderly) groups; scored the activity types by a self-made scoring scale; and applied binary logistic regression for analyzing the association between sleep behaviors versus the groups by STATA package providing 95% confidence interval and the probability of statistical significance. Results 224 videos (102 women) were analyzed. The odds of sleepwalking and related dangerous behaviors were lower in the elderly than in adults (P<0.025). Females performed complex risky behaviors during sleepwalking more often than males (P<0.012). Elderly people presented emotional behaviors less frequently than adults (P<0.004), and females showed them twice often as males. Elderly males had 40-fold odds compared to adults and children to perform aggressive movements and 70-fold odds of complex movements in the bed compared to adults. Conclusion Unlike other groups, the high chances of adults being sleepwalkers and elderly males performing intense and violent movements in bed showed us the importance of developing wearable parasomnia devices to prevent injuries.

Keywords: parasomnia, wearable devices, sleepwalking, RBD

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Authors: Iulianna Taritsa, Kuldeep Neote, Eric Fossel

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Lysosome-induced immunogenic cell death (LIICD) is a powerful mechanism of targeting cancer cells that kills circulating malignant cells and primes the host’s immune cells against future remission. Current immunotherapies for cancer are limited in preventing recurrence – a gap that can be bridged by training the immune system to recognize cancer neoantigens. Lysosomal leakage can be induced therapeutically to traffic antigens from dying cells to dendritic cells, which can later present those tumorigenic antigens to T cells. Previous research has shown that oxidative agents administered in the tumor microenvironment can initiate LIICD. We generated a fusion protein between an oxidative agent known as xanthine oxidase (XO) and a mini-antibody specific for EGFR/HER2-sensitive breast tumor cells. The anti-EGFR single domain antibody fragment is uniquely sourced from llama, which is functional without the presence of a light chain. These llama micro-antibodies have been shown to be better able to penetrate tissues and have improved physicochemical stability as compared to traditional monoclonal antibodies. We demonstrate that the fusion protein created is stable and can induce early markers of immunogenic cell death in an in vitro human breast cancer cell line (SkBr3). Specifically, we measured overall cell death, as well as surface-expressed calreticulin, extracellular ATP release, and HMGB1 production. These markers are consensus indicators of ICD. Flow cytometry, luminescence assays, and ELISA were used respectively to quantify biomarker levels between treated versus untreated cells. We also included a positive control group of SkBr3 cells dosed with doxorubicin (a known inducer of LIICD) and a negative control dosed with cisplatin (a known inducer of cell death, but not of the immunogenic variety). We looked at each marker at various time points after cancer cells were treated with the XO/antibody fusion protein, doxorubicin, and cisplatin. Upregulated biomarkers after treatment with the fusion protein indicate an immunogenic response. We thus show the potential for this fusion protein to induce an anticancer effect paired with an adaptive immune response against EGFR/HER2+ cells. Our research in human cell lines here provides evidence for the success of the same therapeutic method for patients and serves as the gateway to developing a new treatment approach against breast cancer.

Keywords: apoptosis, breast cancer, immunogenic cell death, lysosome

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Authors: Giovana Privatte Maciera, Jair Izaías Kappann

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Introduction: The violence against woman is a complex phenomenon that accompanies the woman throughout her life and is a result of a social, cultural, political and religious construction, based on the differences among the genders. Those differences are felt, mainly, because of the patriarchal system that is still present which just naturalize and legitimate the asymmetry of power. As consequence of the women’s lasting historical and collective effort for a legislation against the impunity of violence against women in the national scenery, it was ordained, in 2006, a law known as Maria da Penha. The law was created as a protective measure for women that were victims of violence and consequently for the punishment of the aggressor. Methodology: Analysis of police inquiries is established by the Police Station of Defense of the Woman of Assis city, by formal authorization of the justice, in the period of 2013 to 2015. For the evaluating of the results will be used the content analysis and the theoretical referential of Psychoanalysis. Results and Discussion: The final analysis of the inquiries demonstrated that the violence against women is reproduced by the society and the aggressor, in most cases it is a member of their own family, mainly the current or former-spouse. The most common kinds of aggression were: the threat bodily harm, and the physical violence, that normally happens accompanied by psychological violence, being the most painful for the victims. The biggest part of the aggressors was white, older than the victim, worker and had primary school. But, unlike the expected, the minority of the aggressors were users of alcohol and/or drugs and possessed children in common with the victim. There is a contrast among the number of victims who already admitted have suffered some type of violence earlier by the same aggressor and the number of victims who has registered the occurrence before. The aggressors often use the discourse of denial in their testimony or try to justify their act like the blame was of the victim. It is believed in the interaction of several factors that can influence the aggressor to commit the abuse, including psychological, personal and sociocultural factors. One hypothesis is that the aggressor has a violence history in the family origin. After the aggressor being judged, condemned or not, usually there is no rehabilitation plan or supervision that enable his change. Conclusions: It has noticed the importance of studying the aggressor’s characteristics and the reasons that took him to commit such violence, making possible the implementation of an appropriate treatment to prevent and reduce the aggressions, as well the creation of programs and actions that enable communication and understanding concerning the theme. This is because the recurrence is still high, since the punitive system is not enough and the law is still ineffective and inefficient in certain aspects and in its own functioning. It is perceived a compulsion in repeat so much for the victims as for the aggressors, because they end involving, almost always, in disturbed and violent relationships, with the relation of subordination-dominance as characteristic.

Keywords: aggressors' profile, gender equality, Maria da Penha law, violence against women

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Authors: Tzu-Hao Li, Yen-Ying Kung, Chang-Youh Tsai

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Oral dryness is a common chief complaint among patients with Sjőgren syndrome (SS), which is a disorder currently known as autoantibodies production; however, to author’s best knowledge, there has been no satisfying pharmacy to relieve the associated symptoms. Hence the effectiveness of other non-pharmacological interventions such as acupuncture should be accessed. We conducted a meta-analysis of randomized clinical trials (RCTs) which evaluated the effectiveness of xerostomia in SS. PubMed, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), Chongqing Weipu Database (CQVIP), China Academic Journals Full-text Database, AiritiLibrary, Chinese Electronic Periodicals Service (CEPS), China National Knowledge Infrastructure (CNKI) Database were searches through May 12, 2018 to select studies. Data for evaluation of subjective and objective xerostomia was extracted and was assessed with random-effects meta-analysis. After searching, a total of 541 references were yielded and five RCTs were included, covering 340 patients dry mouth resulted from SS, among whom 169 patients received acupuncture and 171 patients were control group. Acupuncture group was associated with higher subjective response rate (odds ratio 3.036, 95% confidence interval [CI] 1.828 – 5.042, P < 0.001) and increased salivary flow rate (weighted mean difference [WMD] 3.066, 95% CI 2.969 – 3.164, P < 0.001), as an objective marker. In addition, two studies examined IgG levels, which were lower in the acupuncture group (WMD -166.857, 95% CI -233.138 - -100.576, P < 0.001). Therefore, in the present meta-analysis, acupuncture improves both subjective and objective markers of dry mouth with autoantibodies reduction in patients with SS and is considered as an option of non-pharmacological treatment for SS.

Keywords: acupuncture, meta-analysis, Sjogren syndrome, xerostomia

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Authors: Raphael M. Ritti-Dias, Marilia A. Correia, Wagner J. R. Domingues, Aline C. Palmeira, Paulo Longano, Nelson Wolosker, Lauro C. Vianna, Gabriel G. Cucato

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Patients with peripheral arterial disease (PAD) have a high prevalence of hypertension, which contributes to a high risk of acute cardiovascular events and cardiovascular mortality. Strategies to reduce cardiovascular risk of these patients are needed. Meta-analysis studies have shown that isometric handgrip training promotes reductions in clinical blood pressure in normotensive, pre-hypertensive and hypertensive individuals. However, the effect of this exercise training on other cardiovascular function indicators in PAD patients remains unknown. Thus, the aim of this study was to analyze the effects of isometric handgrip training on blood pressure in patients with PAD. In this clinical trial, 28 patients were randomly allocated into two groups: isometric handgrip training (HG) and control (CG). The HG conducted the unilateral handgrip training three days per week (four sets of two minutes, with 30% of maximum voluntary contraction with an interval of four minutes between sets). CG was encouraged to increase their physical activity levels. At baseline and after eight weeks blood pressure and heart rate were obtained. ANOVA two-way for repeated measures with the group (GH and GC) and time (pre- and post-intervention) as factors was performed. After 8 weeks of training there were no significant changes in systolic blood pressure (HG pre 141 ± 24.0 mmHg vs. HG post 142 ± 22.0 mmHg; CG pre 140 ± 22.1 mmHg vs. CG post 146 ± 16.2 mmHg; P=0.18), diastolic blood pressure (HG pre 74 ± 10.4 mmHg vs. HG post 74 ± 11.9 mmHg; CG pre 72 ± 6.9 mmHg vs. CG post 74 ± 8.0 mmHg; P=0.22) and heart rate (HG pre 61 ± 10.5 bpm vs. HG post 62 ± 8.0 bpm; CG pre 64 ± 11.8 bpm vs. CG post 65 ± 13.6 bpm; P=0.81). In conclusion, our preliminary data indicate that isometric handgrip training did not modify blood pressure and heart rate in patients with PAD.

Keywords: blood pressure, exercise, isometric, peripheral artery disease

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Authors: Anneke Van Biljon

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Background: Exercise is a primary form of preventing and improving cardiometabolic disease risk factors; however specific exercise variables and their associated health benefits in children are inconclusive. A preliminary study revealed that different exercise variables may improve particular cardiometabolic health benefits. Objectives: This study further investigated the specific cardiometabolic health benefits associated with three isocaloric exercise interventions set at different intensities. Methods: Hundred-and-twenty (n = 120) participants between the ages of 10 – 14 years old were assigned to four different study groups 1. High intensity interval training (HIIT) at > 80% MHR 2. Moderate intensity continuous training (MICT) at 65% – 70% MHR 3. Alternative intensities (ALT) of HIIT and MICT 4. Control group. Exercise interventions were designed to generate isocaloric workloads of ~154.77 kcal per session, three times per week for five weeks. The one-way ANOVA test established comparisons between group means. Post hoc tests were calculated to determine specific group differences. Results: Although, all exercise groups improved cardiometabolic health, the MICT group showed greater improvements in fasting glucose (-9.30%), whereas cardiorespiratory fitness increased most by 31.33% (p = 0.000) within the HIIT group. Finally, ALT group recorded overall superior and additional cardiometabolic health benefits compared with both MICT and HIIT groups. Conclusion: The findings of this study indicate that superior benefits may be elicited when combining and alternating MICT and HIIT. These results provide specific exercise recommendations for achieving optimal and substantial cardiometabolic health benefits in children which will contribute towards achieving the health-related Sustainable Development Goals for 2030.

Keywords: cardiometabolic disease risk factors, exercise, pediatrics, interventions

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Authors: Anit S. Malhotra, Ajay Duseja, Neelam Chadha

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Endothelial dysfunction is a precursor to atherosclerosis, and flow-mediated dilatation (FMD) in the brachial artery is the commonest method to evaluate endothelial function in humans. Non-alcoholic fatty liver disease (NAFLD) is one of the most common liver disorders encountered in clinical practice. An earlier meta-analysis had quantitatively assessed the degree of endothelial dysfunction using FMD. However, the largest study investigating the relation of FMD with NAFLD was published after that meta-analysis. In addition, that meta-analysis did not include some studies, including one from our centre. Therefore, an updating the previous meta-analysis was considered important. We searched PubMed, Cochrane Library, Embase, Scopus, SCI, Google Scholar, conference proceedings, and references of included studies till June 2017 to identify observational studies evaluating endothelial function using FMD in patients with non-alcoholic fatty liver disease. Data was analyzed using MedCalc. Fourteen studies were found eligible for inclusion in the meta-analysis. Patients with NAFLD had lower brachial artery FMD as compared to controls, standardized mean difference (random effects model) being –1.279%; 95% confidence interval (CI), –1.478 to –0.914. The effect size became smaller after addition of the recent study with the largest sample size was included compared with the earlier meta-analysis. In conclusion, patients with NAFLD had low FMD values indicating that they are at a higher risk of cardiovascular disease although our results suggest the effect size is not as large as reported previously.

Keywords: endothelial dysfunction, flow-mediated dilatation, meta-analysis, non-alcoholic fatty liver disease

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Authors: Ravshan A. Ibadov, Sardor Kh. Ibragimov

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Objective. The aim of the study was to optimize the protocol of cardiopulmonary resuscitation (CPR) after cardiovascular surgical interventions. Methods. The experience of CPR conducted on patients after cardiovascular surgical interventions in the Department of Intensive Care and Resuscitation (DIR) of the Republican Specialized Scientific-Practical Medical Center of Surgery named after Academician V. Vakhidov is presented. The key to the new approach is the rapid elimination of reversible causes of cardiac arrest, followed by either defibrillation or electrical cardioversion (depending on the situation) before external heart compression, which may damage sternotomy. Careful use of adrenaline is emphasized due to the potential recurrence of hypertension, and timely resternotomy (within 5 minutes) is performed to ensure optimal cerebral perfusion through direct massage. Out of 32 patients, cardiac arrest in the form of asystole was observed in 16 (50%), with hypoxemia as the cause, while the remaining 16 (50%) experienced ventricular fibrillation caused by arrhythmogenic reactions. The age of the patients ranged from 6 to 60 years. All patients were evaluated before the operation using the ASA and EuroSCORE scales, falling into the moderate-risk group (3-5 points). CPR was conducted for cardiac activity restoration according to the American Heart Association and European Resuscitation Council guidelines (Ley SJ. Standards for Resuscitation After Cardiac Surgery. Critical Care Nurse. 2015;35(2):30-38). The duration of CPR ranged from 8 to 50 minutes. The ARASNE II scale was used to assess the severity of patients' conditions after CPR, and the Glasgow Coma Scale was employed to evaluate patients' consciousness after the restoration of cardiac activity and sedation withdrawal. Results. In all patients, immediate chest compressions of the necessary depth (4-5 cm) at a frequency of 100-120 compressions per minute were initiated upon detection of cardiac arrest. Regardless of the type of cardiac arrest, defibrillation with a manual defibrillator was performed 3-5 minutes later, and adrenaline was administered in doses ranging from 100 to 300 mcg. Persistent ventricular fibrillation was also treated with antiarrhythmic therapy (amiodarone, lidocaine). If necessary, infusion of inotropes and vasopressors was used, and for the prevention of brain edema and the restoration of adequate neurostatus within 1-3 days, sedation, a magnesium-lidocaine mixture, mechanical intranasal cooling of the brain stem, and neuroprotective drugs were employed. A coordinated effort by the resuscitation team and proper role allocation within the team were essential for effective cardiopulmonary resuscitation (CPR). All these measures contributed to the improvement of CPR outcomes. Conclusion. Successful CPR following cardiac surgical interventions involves interdisciplinary collaboration. The application of an optimized CPR standard leads to a reduction in mortality rates and favorable neurological outcomes.

Keywords: cardiac surgery, cardiac arrest, resuscitation, critically ill patients

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