Search results for: clinical samples
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 9365

Search results for: clinical samples

1085 Kinematical Analysis of Tai Chi Chuan Players during Gait and Balance Test and Implication in Rehabilitation Exercise

Authors: Bijad Alqahtani, Graham Arnold, Weijie Wang

Abstract:

Background—Tai Chi Chuan (TCC) is a type of traditional Chinese martial art and is considered a benefiting physical fitness. Advanced techniques of motion analysis have been routinely used in the clinical assessment. However, so far, little research has been done on the biomechanical assessment of TCC players in terms of gait and balance using motion analysis. Objectives—The aim of this study was to investigate whether TCC improves the lower limb conditions and balance ability using the state of the art motion analysis technologies, i.e. motion capture system, electromyography and force platform. Methods—Twenty TCC (9 male, 11 female) with age between (42-77) years old and weight (56.2-119 Kg), and eighteen Non-TCC participants (7 male, 11 female), weight (50-110 Kg) with age (43- 78) years old at the matched age as a control group were recruited in this study. Their gait and balance were collected using Vicon Nexus® to obtain the gait parameters, and kinematic parameters of hip, knee, and ankle joints in three planes of both limbs. Participants stood on force platforms to perform a single leg balance test. Then, they were asked to walk along a 10 m walkway at their comfortable speed. Participants performed 5 trials of single-leg balance for the dominant side. Also, the participants performed 3 trials of four square step balance and 10 trials of walking. From the recorded trials, three good ones were analyzed using the Vicon Plug-in-Gait model to obtain gait parameters, e.g. walking speed, cadence, stride length, and joint parameters, e.g. joint angle, force, moments, etc. Result— The temporal-spatial variables of TCC subjects were compared with the Non-TCC subjects, it was found that there was a significant difference (p < 0.05) between the groups. Moreover, it was observed that participants of TCC have significant differences in ankle, hip, and knee joints’ kinematics in the sagittal, coronal, and transverse planes such as ankle angle (19.90±19.54 deg) for TCC while (15.34±6.50 deg) for Non-TCC, and knee angle (14.96±6.40 deg) for TCC while (17.63±5.79 deg) for Non-TCC in the transverse plane. Also, the result showed that there was a significant difference between groups in the single-leg balance test, e.g. maintaining single leg stance time in the TCC participants showed longer duration (20.85±10.53 s) in compared to Non-TCC people group (13.39±8.78 s). While the result showed that there was no significant difference between groups in the four square step balance. Conclusion—Our result showed that there are significant differences between Tai Chi Chuan and Non-Tai Chi Chuan participants in the various aspects of gait analysis and balance test, as a consequence of these findings some of biomechanical parameters such as joints kinematics, gait parameters and single leg stance balance test, the Tai Chi Chuan could improve the lower limb conditions and could reduce a risk of fall for the elderly with ageing.

Keywords: gait analysis, kinematics, single leg stance, Tai Chi Chuan

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1084 Modulation of the Interphase in a Glass Epoxy System: Influence of the Sizing Chemistry on Adhesion and Interfacial Properties

Authors: S. Assengone Otogo Be, A. Fahs, L. Belec, T. A. Nguyen Tien, G. Louarn, J-F. Chailan

Abstract:

Glass fiber-reinforced composite materials have gradually developed in all sectors ranging from consumer products to aerospace applications. However, the weak point is most often the fiber/matrix interface, which can reduce the durability of the composite material. To solve this problem, it is essential to control the interphase and improve our understanding of the adhesion mechanism at the fibre/matrix interface. The interphase properties depend on the nature of the sizing applied on the surface of the glass fibers during their manufacture in order to protect them, facilitate their handling, and ensure fibre/matrix adhesion. The sizing composition, and in particular the nature of the coupling agent and the film-former affects the mechanical properties and the durability of composites. The aim of our study is, therefore, to develop and study composite materials with simplified sizing systems in order to understand how the main constituents modify the mechanical properties and the durability of composites from the nanometric to the macroscopic scale. Two model systems were elaborated: an epoxy matrix reinforced with simplified-sized glass fibres and an epoxy coating applied on glass substrates treated with the same sizings as fibres. For the sizing composition, two configurations were chosen. The first configuration possesses a chemical reactivity to link the glass and the matrix, and the second sizing contains non-reactive agents. The chemistry of the sized glass substrates and fibers was analyzed by FT-IR and XPS spectroscopies. The surface morphology was characterized by SEM and AFM microscopies. The observation of the surface samples reveals the presence of sizings which morphology depends on their chemistry. The evaluation of adhesion of coated substrates and composite materials show good interfacial properties for the reactive configuration. However, the non-reactive configuration exhibits an adhesive rupture at the interface of glass/epoxy for both systems. The interfaces and interphases between the matrix and the substrates are characterized at different scales. Correlations are made between the initial properties of the sizings and the mechanical performances of the model composites.

Keywords: adhesion, interface, interphase, materials composite, simplified sizing systems, surface properties

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1083 An Endophyte of Amphipterygium adstringens as Producer of Cytotoxic Compounds

Authors: Karol Rodriguez-Peña, Martha L. Macias-Rubalcava, Leticia Rocha-Zavaleta, Sergio Sanchez

Abstract:

A bioassay-guided study for anti-cancer compounds from endophytes of the Mexican medicinal plant Amphipteryygium adstringens resulted in the isolation of a streptomycete capable of producing a group of compounds with high cytotoxic activity. Microorganisms from surface sterilized samples of various sections of the plant were isolated and all the actinomycetes found were evaluated for their potential to produce compounds with cytotoxic activity against cancer cell lines MCF7 (breast cancer) and HeLa (cervical cancer) as well as the non-tumoural cell line HaCaT (keratinocyte). The most active microorganism was picked for further evaluation. The identification of the microorganism was carried out by 16S rDNA gene sequencing, finding the closest proximity to Streptomyces scabrisporus, but with the additional characteristic that the strain isolated in this study was capable of producing colorful compounds never described for this species. Crude extracts of dichloromethane and ethyl acetate showed IC50 values of 0.29 and 0.96 μg/mL for MCF7, 0.51 and 1.98 μg/mL for HeLa and 0.96 and 2.7 μg/mL for HaCaT. Scaling the fermentation to 10 L in a bioreactor generated 1 g of total crude extract, which was fractionated by silica gel open column to yield 14 fractions. Nine of the fractions showed cytotoxic activity. Fraction 4 was chosen for subsequent purification because of its high activity against cancerous cell lines, lower activity against keratinocytes. HPLC-UV-MS/ESI was used for the evaluation of this fraction, finding at least 10 different compounds with high values of m/z (≈588). Purification of the compounds was carried out by preparative thin-layer chromatography. The prevalent compound was Steffimycin B, a molecule known for its antibiotic and cytotoxic activities and also for its low solubility in aqueous solutions. Along with steffimycin B, another five compounds belonging to the steffimycin family were isolated and at this moment their structures are being elucidated, some of which display better solubility in water: an attractive property for the pharmaceutical industry. As a conclusion to this study, the isolation of endophytes resulted in the discovery of a strain capable of producing compounds with high cytotoxic activity that need to be studied for their possible utilization.

Keywords: amphipterygium adstringens, cytotoxicity, streptomyces scabrisporus, steffimycin

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1082 Exploring an Exome Target Capture Method for Cross-Species Population Genetic Studies

Authors: Benjamin A. Ha, Marco Morselli, Xinhui Paige Zhang, Elizabeth A. C. Heath-Heckman, Jonathan B. Puritz, David K. Jacobs

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Next-generation sequencing has enhanced the ability to acquire massive amounts of sequence data to address classic population genetic questions for non-model organisms. Targeted approaches allow for cost effective or more precise analyses of relevant sequences; although, many such techniques require a known genome and it can be costly to purchase probes from a company. This is challenging for non-model organisms with no published genome and can be expensive for large population genetic studies. Expressed exome capture sequencing (EecSeq) synthesizes probes in the lab from expressed mRNA, which is used to capture and sequence the coding regions of genomic DNA from a pooled suite of samples. A normalization step produces probes to recover transcripts from a wide range of expression levels. This approach offers low cost recovery of a broad range of genes in the genome. This research project expands on EecSeq to investigate if mRNA from one taxon may be used to capture relevant sequences from a series of increasingly less closely related taxa. For this purpose, we propose to use the endangered Northern Tidewater goby, Eucyclogobius newberryi, a non-model organism that inhabits California coastal lagoons. mRNA will be extracted from E. newberryi to create probes and capture exomes from eight other taxa, including the more at-risk Southern Tidewater goby, E. kristinae, and more divergent species. Captured exomes will be sequenced, analyzed bioinformatically and phylogenetically, then compared to previously generated phylogenies across this group of gobies. This will provide an assessment of the utility of the technique in cross-species studies and for analyzing low genetic variation within species as is the case for E. kristinae. This method has potential applications to provide economical ways to expand population genetic and evolutionary biology studies for non-model organisms.

Keywords: coastal lagoons, endangered species, non-model organism, target capture method

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1081 Comparison of Effect of Group Counseling with Cognitive Therapy Approach and Interactive Lectures on Anxiety during Pregnancy in Primiparas: A Clinical Trial

Authors: Zohre Shahhosseini, Mehdi Pourasghar, AliReza Khalilian, Fariba Salehi

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Objective: The prevalence of anxiety during pregnancy, particularly in developing countries, and its adverse effects on mother and baby, can make pregnancy unpleasant for pregnant women. The effect of anxiety during pregnancy on birth outcomes and children can be a justification for screening of anxious pregnant women in periodic pregnancy care and helping them. In this study, researchers have investigated effects and comparison of group counseling (Cognitive therapy) and interactive lectures on anxiety during pregnancy of primiparas. Methods: The population studied in this semi-experimental trail was nulliparous pregnant women with backgrounds in health care centers in Sari city .They were studied during a period of 3 months from early March to end May 2016. Sample size in this study was 91 patients, who were randomly assigned to three groups: group counseling, interactive lecture, and control group. Demographic questionnaire and Speilberger State –Trait Anxiety Inventory (SPAI) was completed for all three groups after obtaining letter of consent and completing the initial checklist. Then interventions included 4 sessions for group counseling and 4 sessions for interactive lecture which were implemented in two sessions a week. 4 weeks after interventions, Speilberger State – Trait Anxiety Inventory (SPAI), completed by both group counseling and interactive lectures groups again. In control group, the second questionnaire was also completed 4 weeks after completing the initial questionnaire. Data analysis was performed using spss software version 18. At first, the Kalmogorov-Smiranov test was carried out and then chi square tests, Independent t-test, paired t-test, ANOVA test, and Dunnett's post hoc test were applied. Results: Findings show that group counseling and interactive lecture with reducing state and trait anxiety in significant level of P=0/000 contribute to reduction of anxiety in nulliparous pregnant mothers. However, in this study, group counseling was more effective than an interactive lecture in reducing participants' anxiety, but this difference was not significant (P≥0/05). Conclusions: According to the results of this study, it is suggested that by screening of psychological - mental problems of pregnant women in periodic care during pregnancy be considered by revised prenatal care plans and creation of counseling and training units at health centers. Besides owing to the fact that both interactive lecture and group counseling method were effective in reducing anxiety, these methods should be used proportionate to situations and facilities.

Keywords: anxiety, group counseling, cognitive therapy, interactive lecture, nulliparous

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1080 Epidemiology of Hepatitis B and Hepatitis C Viruses Among Pregnant Women at Queen Elizabeth Central Hospital, Malawi

Authors: Charles Bijjah Nkhata, Memory Nekati Mvula, Milton Masautso Kalongonda, Martha Masamba, Isaac Thom Shawa

Abstract:

Viral Hepatitis is a serious public health concern globally with deaths estimated at 1.4 million annually due to liver fibrosis, cirrhosis, and hepatocellular carcinoma. Hepatitis B and C are the most common viruses that cause liver damage. However, the majority of infected individuals are unaware of their serostatus. Viral Hepatitis has contributed to maternal and neonatal morbidity and mortality. There is no updated data on the Epidemiology of hepatitis B and C among pregnant mothers in Malawi. To assess the epidemiology of Hepatitis B and C viruses among pregnant women at Queen Elizabeth Central Hospital. Specific Objectives • To determine sero-prevalence of HBsAg and Anti-HCV in pregnant women at QECH. • To investigate risk factors associated with HBV and HCV infection in pregnant women. • To determine the distribution of HBsAg and Anti-HCV infection among pregnant women of different age group. A descriptive cross-sectional study was conducted among pregnant women at QECH in last quarter of 2021. Of the 114 pregnant women, 96 participants were consented and enrolled using a convenient sampling technique. 12 participants were dropped due to various reasons; therefore 84 completed the study. A semi-structured questionnaire was used to collect socio-demographic and behavior characteristics to assess the risk of exposure. Serum was processed from venous blood samples and tested for HBsAg and Anti-HCV markers utilizing Rapid screening assays for screening and Enzyme Linked Immunosorbent Assay for confirmatory. A total of 84 pregnant consenting pregnant women participated in the study, with 1.2% (n=1/84) testing positive for HBsAg and nobody had detectable anti-HCV antibodies. There was no significant link between HBV and HCV in any of the socio-demographic data or putative risk variables. The findings indicate a viral hepatitis prevalence lower than the set range by the WHO. This suggests that HBV and HCV are rare in pregnant women at QECH. Nevertheless, accessible screening for all pregnant women should be provided. The prevention of MTCT is key for reduction and prevention of the global burden of chronic viral Hepatitis.

Keywords: viral hepatitis, hepatitis B, hepatitis C, pregnancy, malawi, liver disease, mother to child transmission

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1079 Contribution to the Hydrogeochemical Investigations on the Wajid Aquifer System, Southwestern Part of Saudi Arabia

Authors: Mohamed Ahmed, Ezat Korany, Abdelaziz Al Basam, Osama Kasem

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The arid climate, low rate of precipitations and population reflect the increasing of groundwater uses as the main source of water in Saudi Arabia. The Wajid Aquifer System represents a regional groundwater aquifer system along the edge of the crystalline Arabian Shield near the southwestern tip of the Arabian Peninsula. The aquifer extends across the border of Saudi Arabia and Yemen from the Asir –Yemen Highlands to the Rub al Khali Depression and possibly to the Gulf coast (at the southwestern tip). The present work is representing a hydrogeochemical investigation on the Wajid Aquifer System. The studied area is being classified into three zones. The 1st zone is West of Wadi Ad Dawasir (Northern part of the studied area), the 2nd is Najran-Asir Zone (southern part of the studied area), and the 3rd zone is the intermediate -central zone (occupying the central area between the last two zones). The groundwater samples were collected and chemically analyzed for physicochemical properties such as pH, electrical conductivity, total hardness (TH), alkalinity (pH), total dissolved solids (TDS), major ions (Ca2+, Mg2+, Na+, K+, HCO3-, SO42- and Cl-), and trace elements. Some parameters such as sodium adsorption ratio (SAR), soluble sodium percentage (Na%), potential salinity, residual sodium carbonate, Kelly's ratio, permeability index and Gibbs ratio, hydrochemical coefficients, hydrochemical formula, ion dominance, salt combinations and water types were also calculated in order to evaluate the quality of the groundwater resources in the selected areas for different purposes. The distribution of the chemical constituents and their interrelationships are illustrated by different hydrochemical graphs. Groundwater depths and the depth to water were measured to study the effect of discharge on both the water level and the salinity of the studied groundwater wells. A detailed comparison between the three studied zones according to the variations shown by the chemical and field investigations are discussed in detailed within the work.

Keywords: Najran-Asir, Wadi Ad Dawasir, Wajid Aquifer System, effect of discharge

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1078 Preoperative Anxiety Evaluation: Comparing the Visual Facial Anxiety Scale/Yumul Faces Anxiety Scale, Numerical Verbal Rating Scale, Categorization Scale, and the State-Trait Anxiety Inventory

Authors: Roya Yumul, Chse, Ofelia Loani Elvir Lazo, David Chernobylsky, Omar Durra

Abstract:

Background: Preoperative anxiety has been shown to be caused by the fear associated with surgical and anesthetic complications; however, the current gold standard for assessing patient anxiety, the STAI, is problematic to use in the preoperative setting given the duration and concentration required to complete the 40-item extensive questionnaire. Our primary aim in the study is to investigate the correlation of the Visual Facial Anxiety Scale (VFAS) and Numerical Verbal Rating Scale (NVRS) to State-Trait Anxiety Inventory (STAI) to determine the optimal anxiety scale to use in the perioperative setting. Methods: A clinical study of patients undergoing various surgeries was conducted utilizing each of the preoperative anxiety scales. Inclusion criteria included patients undergoing elective surgeries, while exclusion criteria included patients with anesthesia contraindications, inability to comprehend instructions, impaired judgement, substance abuse history, and those pregnant or lactating. 293 patients were analyzed in terms of demographics, anxiety scale survey results, and anesthesia data via Spearman Coefficients, Chi-Squared Analysis, and Fischer’s exact test utilized for comparison analysis. Results: Statistical analysis showed that VFAS had a higher correlation to STAI than NVRS (rs=0.66, p<0.0001 vs. rs=0.64, p<0.0001). The combined VFAS-Categorization Scores showed the highest correlation with the gold standard (rs=0.72, p<0.0001). Subgroup analysis showed similar results. STAI evaluation time (247.7 ± 54.81 sec) far exceeds VFAS (7.29 ± 1.61 sec), NVRS (7.23 ± 1.60 sec), and Categorization scales (7.29 ± 1.99 sec). Patients preferred VFAS (54.4%), Categorization (11.6%), and NVRS (8.8%). Anesthesiologists preferred VFAS (63.9%), NVRS (22.1%), and Categorization Scales (14.0%). Of note, the top five causes of preoperative anxiety were determined to be waiting (56.5%), pain (42.5%), family concerns (40.5%), no information about surgery (40.1%), or anesthesia (31.6%). Conclusions: Combined VFAS-Categorization Score (VCS) demonstrates the highest correlation to the gold standard, STAI. Both VFAS and Categorization tests also take significantly less time than STAI, which is critical in the preoperative setting. Among both patients and anesthesiologists, VFAS was the most preferred scale. This forms the basis of the Yumul FACES Anxiety Scale, designed for quick quantization and assessment in the preoperative setting while maintaining a high correlation to the golden standard. Additional studies using the formulated Yumul FACES Anxiety Scale are merited.

Keywords: numerical verbal anxiety scale, preoperative anxiety, state-trait anxiety inventory, visual facial anxiety scale

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1077 The Interventricular Septum as a Site for Implantation of Electrocardiac Devices - Clinical Implications of Topography and Variation in Position

Authors: Marcin Jakiel, Maria Kurek, Karolina Gutkowska, Sylwia Sanakiewicz, Dominika Stolarczyk, Jakub Batko, Rafał Jakiel, Mateusz K. Hołda

Abstract:

Proper imaging of the interventricular septum during endocavital lead implantation is essential for successful procedure. The interventricular septum is located oblique to the 3 main body planes and forms angles of 44.56° ± 7.81°, 45.44° ± 7.81°, 62.49° (IQR 58.84° - 68.39°) with the sagittal, frontal and transverse planes, respectively. The optimal left anterior oblique (LAO) projection is to have the septum aligned along the radiation beam and will be obtained for an angle of 53.24° ± 9,08°, while the best visualization of the septal surface in the right anterior oblique (RAO) projection is obtained by using an angle of 45.44° ± 7.81°. In addition, the RAO angle (p=0.003) and the septal slope to the transverse plane (p=0.002) are larger in the male group, but the LAO angle (p=0.003) and the dihedral angle that the septum forms with the sagittal plane (p=0.003) are smaller, compared to the female group. Analyzing the optimal RAO angle in cross-sections lying at the level of the connections of the septum with the free wall of the right ventricle from the front and back, we obtain slightly smaller angle values, i.e. 41.11° ± 8.51° and 43.94° ± 7.22°, respectively. As the septum is directed leftward in the apical region, the optimal RAO angle for this area decreases (16.49° ± 7,07°) and does not show significant differences between the male and female groups (p=0.23). Within the right ventricular apex, there is a cavity formed by the apical segment of the interventricular septum and the free wall of the right ventricle with a depth of 12.35mm (IQR 11.07mm - 13.51mm). The length of the septum measured in longitudinal section, containing 4 heart cavities, is 73.03mm ± 8.06mm. With the left ventricular septal wall formed by the interventricular septum in the apical region at a length of 10.06mm (IQR 8.86 - 11.07mm) already lies outside the right ventricle. Both mentioned lengths are significantly larger in the male group (p<0.001). For proper imaging of the septum from the right ventricular side, an oblique position of the visualization devices is necessary. Correct determination of the RAO and LAO angle during the procedure allows to improve the procedure performed, and possible modification of the visual field when moving in the anterior, posterior and apical directions of the septum will avoid complications. Overlooking the change in the direction of the interventricular septum in the apical region and a significant decrease in the RAO angle can result in implantation of the lead into the free wall of the right ventricle with less effective pacing and even complications such as wall perforation and cardiac tamponade. The demonstrated gender differences can also be helpful in setting the right projections. A necessary addition to the analysis will be a description of the area of the ventricular septum, which we are currently working on using autopsy material.

Keywords: anatomical variability, angle, electrocardiological procedure, intervetricular septum

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1076 Open Joint Surgery for Temporomandibular Joint Internal Derangement: Wilkes Stages III-V

Authors: T. N. Goh, M. Hashmi, O. Hussain

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Temporomandibular joint (TMJ) dysfunction (TMD) is a condition that may affect patients via restricted mouth opening, significant pain during normal functioning, and/or reproducible joint noise. TMD includes myofascial pain, TMJ functional derangements (internal derangement, dislocation), and TMJ degenerative/inflammatory joint disease. Internal derangement (ID) is the most common cause of TMD-related clicking and locking. These patients are managed in a stepwise approach, from patient education (homecare advice and analgesia), splint therapy, physiotherapy, botulinum toxin treatment, to arthrocentesis. Arthrotomy is offered when the aforementioned treatment options fail to alleviate symptoms and improve quality of life. The aim of this prospective study was to review the outcomes of jaw joint open surgery in TMD patients. Patients who presented from 2015-2022 at the Oral and Maxillofacial Surgery Department in the Doncaster NHS Foundation Trust, UK, with a Wilkes classification of III -V were included. These patients underwent either i) discopexy with bone-anchoring suture (9); ii) intrapositional temporalis flap (ITF) with bone-anchoring suture (3); iii) eminoplasty and discopexy with suturing to the capsule (3); iii) discectomy + ITF with bone-anchoring suture (1); iv) discoplasty + bone-anchoring suture (1); v) ITF (1). Maximum incisal opening (MIO) was assessed pre-operatively and at each follow-up. Pain score, determined via the visual analogue scale (VAS, with 0 being no pain and 10 being the worst pain), was also recorded. A total of 18 eligible patients were identified with a mean age of 45 (range 22 - 79), of which 16 were female. The patients were scored by Wilkes Classification as III (14), IV (1), or V (4). Twelve patients had anterior disc displacement without reduction (66%) and six had degenerative/arthritic changes (33%) to the TMJ. The open joint procedure resulted in an increase in MIO and reduction in pain VAS and for the majority of patients, across all Wilkes Classifications. Pre-procedural MIO was 22.9 ± 7.4 mm and VAS was 7.8 ± 1.5. At three months post-procedure there was an increase in MIO to 34.4 ± 10.4 mm (p < 0.01) and a decrease in the VAS to 1.5 ± 2.9 (p < 0.01). Three patients were lost to follow-up prior to six months. Six were discharged at six month review and five patients were discharged at 12 months review as they were asymptomatic with good mouth opening. Four patients are still attending for annual botulinum toxin treatment. Two patients (Wilkes III and V) subsequently underwent TMJ replacement (11%). One of these patients (Wilkes III) had improvement initially to MIO of 40 mm, but subsequently relapsed to less than 20 mm due to lack of compliance with jaw rehabilitation device post-operatively. Clinical improvements in 89% of patients within the study group were found, with a return to near normal MIO range and reduced pain score. Intraoperatively, the operator found bone-anchoring suture used for discopexy/discoplasty more secure than the soft tissue anchoring suturing technique.

Keywords: bone anchoring suture, open temporomandibular joint surgery, temporomandibular joint, temporomandibular joint dysfunction

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1075 Effect of Elevated Temperatures on Trans Fat Content and Oxidative Parameters of Groundnut Oil

Authors: Akanksha Jain, Santosh J. Passi, William Selvamurthy, Archna Singh

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Heating/frying at elevated temperatures cause numerous physiochemical reactions including oxidative deterioration and trans fatty acid (TFA) formation; however Indian data on these parameters are scanty. The present study was designed to assess the effect of constant heating/frying on formation of TFAs and oxidative stability in groundnut oil. 750 mL of the oil was heated in a large iron karahi (utensil similar to a wok) and freshly cut potato strips were fried constantly at varying temperatures (160ºC, 180ºC, 200ºC, 220ºC, 230ºC). In each case, the oil sample was drawn after one hour and stored at –20ºC until analysed. While TFA was estimated using gas chromatography with flame ionisation detector (AOCS official method Ce 1h–05), other chemical parameters were assessed by AOCS official methods. Oil samples subjected to heating/frying at varying temperatures demonstrated a significant increase in TFAs (p < 0.01) and saturated fatty acids (p < 0.01) while there was a corresponding decrease in cis-unsaturated fatty acids (p < 0.01). Frying process demonstrated greater TFA formation (mean TFA at 160ºC being 0.11±0.01g/100g; at 230ºC it being 2.33±0.05g/100g) as compared to heating alone (mean TFA at 160ºC being 0.07g±0.01/100g; at 230ºC it being 0.47±0.02g/100g), indicating that there was a significant difference in the generation of TFAs during the two thermal treatments (heating vs. frying; p=0.05). With increasing temperatures, acid value, p-anisidine value and total oxidation (TOTOX) value registered a significant increase (p < 0.01); however, peroxide value was found to be inconsistent. Thus, the formation of TFA and various oxidative parameters (except peroxide value) is directly influenced by the temperature of heating/frying. Since TFA formation and poor oxidative stability of oils can pose serious health concerns, food safety agencies/organizations need to devise appropriate policies, stringent food laws/standards and impose necessary safety regulations to curb oil abuse during the process of heating and frying. There is a dire need to raise consumer awareness regarding deleterious health effects of TFA and oxidative deterioration of oils at elevated temperatures employed during heating/frying procedures.

Keywords: cis-unsaturated fatty acid, oxidative stability, saturated fatty acid, trans fatty acid

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1074 Studies on the Effect of Bio-Methanated Distillery Spentwash on Soil Properties and Crop Yields

Authors: S. K. Gali

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Spentwash, An effluent of distillery is an environmental pollutant because of its high load of pollutants (pH: 2-4; BOD>40,000 mg/l, COD>100,000mg/l and TDS >70,000mg/l). But However, after subjecting it to primary treatment (bio-methanation), Its pollutant load gets drastically reduced (pH: 7.5-8.5, BOD<10,000 mg/l) and could be disposed off safely as a source of organic matter and plant nutrients for crop production. With the consent of State Pollution Control Board, the distilleries in Karnataka are taking up ‘one time controlled land application’ of bio-methanated spentwash in farmers’ fields. A monitoring study was undertaken in Belgaum district of Karnataka State with an objective of studying the effect of land application of bio-methanated spent wash of a distillery on soil properties and crop growth. The treated spentwash was applied uniformly to the fallow dry lands in different farmers’ fields during summer, 2012 at recommended rate (based on nitrogen requirement of crops). The application was made at least a fortnight before sowing/planting operations. The analysis of soils collected before land application of spentwash and after harvest of crops revealed that there was no adverse effect of applied spentwash on soil characteristics. A slight build up in soluble salts was observed but, however all the soils recorded EC of less than 2.0 dSm-1. An increase in soil organic carbon (SOC) and available nitrogen (N) by about 10 to 30 % was observed in the spentwash applied soils. The presence of good amount of biodegradable organics in the treated spentwash (BOD of 6550 mg/l) contributed for increase in SOC and N. A substantial build up in available potassium (K) status (50 to 200%) was observed due to spentwash application. This was attributed to the high K content in spentwash (6950 mg/l). The growth of crops in the spentwash applied fields was higher and farmers could get nearly 10 to 20 per cent higher yields, especially in sugarcane and corn. The analysis of ground water samples showed that the quality of water was not affected due to land application of treated spentwash. Apart from realizing higher crop yields, the farmers were able to save money on N and K fertilisers as the applied spentwash met the crop requirement. Hence, it could be concluded that the bio-methanated distillery spentwash can be gainfully utilized in crop production without polluting the environment.

Keywords: bio-methanation, pollutant, potassium status, soil organic carbon

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1073 Anatomical and Histological Analysis of Salpinx and Ovary in Anatolian Wild Goat (Capra aegagrus aegagrus)

Authors: Gulseren Kirbas, Mushap Kuru, Buket Bakir, Ebru Karadag Sari

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Capra (mountain goat) is a genus comprising nine species. The domestic goat (C. aegagrus hircus) is a subspecies of the wild goat that is domesticated. This study aimed to determine the anatomical structure of the salpinx and ovary of the Anatolian wild goat (C. aegagrus aegagrus). Animals that were taken to the Kafkas University Wildlife Rescue and Rehabilitation Center, Kars, Turkey, because of various reasons, such as traffic accidents and firearm injuries, were used in this study. The salpinges and ovaries of four wild goats of similar ages, which could not be rescued by the Center despite all interventions, were dissected. Measurements were taken from the right-left salpinx and ovary using digital calipers. The weights of each ovary and salpinx were measured using a precision scale (min: 0.0001 g − max: 220 g, code: XB220A; Precisa, Swiss). The histological structure of the tissues was examined after weighing the organs. The tissue samples were fixed in 10% formaldehyde for 24 h. Then a routine procedure was applied, and the tissues were embedded in paraffin. Mallory’s modified triple staining was used to demonstrate the general structure of the salpinx. The salpinx was found to consist of three different regions (infundibulum, ampulla, and isthmus). These regions consisted of tunica mucosa, tunica muscularis, and tunica serosa. The prismatic epithelial cells were observed in the lamina epithelialis of tunica mucosa in every region, but the prismatic fimbrae cells occurred most in the infundibulum. The ampulla was distinguished by its many mucosal folds. It was the longest region of the salpinx and was joined to the isthmus via the ampullary–isthmus junction. Isthmus was the caudal end of the salpinx joined to the uterus and had the thickest tunica muscularis compared with the other regions. The mean length of the ovary was 13.22 ± 1.27 mm, width was 8.46 ± 0.88 mm, the thickness was 5.67 ± 0.79 mm, and weight was 0.59 ± 0.17 g. The average length of the salpinx was 58.11 ± 14.02 mm, width was 0.80 ± 0.22 mm, the thickness was 0.41 ± 0.01 mm, and weight was 0.30 ± 0.08 g. In conclusion, the Anatolian wild goat, which is included in wildlife diversity in Turkey, has been disappearing due to illegal and uncontrolled hunting as well as traffic accidents in recent years. These findings are believed to contribute to the literature.

Keywords: Anatolian wild goat, anatomy, ovary, salpinx

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1072 A Vaccination Program to Control an Outbreak of Acute Hepatitis A among MSM in Taiwan, 2016

Authors: Ying-Jung Hsieh, Angela S. Huang, Chu-Ming Chiu, Yu-Min Chou, Chin-Hui Yang

Abstract:

Background and Objectives: Hepatitis A is primarily acquired by the fecal-oral route through person-to-person contact or ingestion of contaminated food or water. During 2010 to 2014, an average of 83 cases of locally-acquired disease was reported to Taiwan’s notifiable disease system. Taiwan Centers for Disease Control (TCDC) identified an outbreak of acute hepatitis A which began in June 2015. Of the 126 cases reported in 2015, 103 (82%) cases were reported during June–December and 95 cases (92%) of them were male. The average age of all male cases was 31 years (median, 29 years; range, 15–76 years). Among the 95 male cases, 49 (52%) were also infected with HIV, and all reported to have had sex with other men. To control this outbreak, TCDC launched a free hepatitis A vaccination program in January 2016 for close contacts of confirmed hepatitis A cases, including family members, sexual partners, and household contacts. Effect of the vaccination program was evaluated. Methods: All cases of hepatitis A reported to the National Notifiable Disease Surveillance System were included. A case of hepatitis A was defined as a locally-acquired disease in a person who had acute clinical symptoms include fever, malaise, loss of appetite, nausea or abdominal discomfort compatible with hepatitis, and tested positive for anti-HAV IgM during June 2015 to June 2016 in Taiwan. The rate of case accumulation was calculated using a simple regression model. Results: During January–June 2016, there were 466 cases of hepatitis A reported; of the 243 (52%) who were also infected with HIV, 232 (95%) had a history of having sex with men. Of the 346 cases that were followed up, 259 (75%) provided information on contacts but only 14 (5%) of them provided the name of their sexual partners. Among the 602 contacts reported, 349 (58%) were family members, 14 (2%) were sexual partners, and 239 (40%) were other household contacts. Among the 602 contacts eligible for free hepatitis A vaccination, 440 (73%) received the vaccine. There were 87 (25%) cases that refused to disclose their close contacts. The average case accumulation rate during January–June 2016 was 21.7 cases per month, which was 6.8 times compared to the average case accumulation rate during June–December 2015 of 3.2 cases per month. Conclusions: Despite vaccination program aimed to provide free hepatitis A vaccine to close contacts of hepatitis A patients, the outbreak continued and even gained momentum in transmission. Refusal by hepatitis A patients to provide names of their close contacts and rejection of contacts to take the hepatitis A vaccine may have contributed to the poor effect of the program. Targeted vaccination efforts of all MSM may be needed to control the outbreak among this population in the short term. In the long term, universal vaccination program is needed to prevent the infection of hepatitis A.

Keywords: hepatitis A, HIV, men who have sex with men, vaccination

Procedia PDF Downloads 245
1071 Kawasaki Disease in a Two Months Kuwaiti Girl: A Case Report ‎and Literature Review.‎

Authors: Hanan Bin Nakhi, Asaad M. Albadrawi, Maged Al Shahat, ‎Entesar Mandani

Abstract:

Background:‎ Kawasaki disease (KD) is one of the most common vasculitis of childhood. ‎It is considered the leading cause of acquired heart disease in children. The ‎peak age of occurrence is 6 to 24 months, with 80% of affected children being ‎less than 5 years old. There are only a few reports of KD in infants younger ‎than 6 months. Infants had a higher incidence of atypical KD and of coronary ‎artery complications. This case report from Kuwait will reinforce considering ‎atypical KD in case of sepsis like condition with negative cultures and ‎unresponding to systemic antibiotics. Early diagnosis allows early treatment ‎with intravenous immune globulin (IVIG) and so decreases the incidence of ‎cardiac aneurysm.‎ Case Report:‎ A 2 month old female infant, product of full term normal delivery to ‎consanguineous parents, presented with fever and poor feeding. She was ‎admitted and treated as urinary tract infection as her urine routine revealed ‎pyurea. The baby continued to have persistent fever and hypoactivity inspite ‎of using intravenous antibiotics. Latter, she developed non purulent ‎conjunctivitis, skin mottling, oedema of the face / lower limb and was treated ‎in intensive care unit as a case of septic shock. In spite of her partial general ‎improvement, she continued to look unwell, hypoactive and had persistent ‎fever. Septic work up, metabolic, and immunologic screen were negative. KD ‎was suspected when the baby developed polymorphic erythematous rash and ‎noticed to have peeling of skin at perianal area and periangular area of the ‎fingers of the hand and feet. IVIG was given in dose of 2 gm/kg/day in single ‎dose and aspirin 100 mg/kg/day in four divided doses. The girl showed marked ‎clinical improvement. The fever subsided dramatically and the level acute ‎phase reactant markedly decreased but the platelets count increased to ‎‎1600000/mm3. Echo cardiography showed mild dilatation of mid right ‎coronary artery. Aspirin was continued in a dose of 5 mg/kg/d till repeating ‎cardiac echo. ‎Conclusion:‎ A high index of suspicion of KD must be maintained in young infants with ‎prolonged unexplained fever. Accepted criteria should be less restrictive to ‎allow early diagnosis of a typical KD in infants less than 6 months of age. ‎Timely appropriate treatment with IVIG is essential to avoid severe coronary ‎sequels.‎

Keywords: Kawasaki disease, atypical Kawasaki disease, infantile Kawasaki disease, hypo activity‎ ‎

Procedia PDF Downloads 305
1070 Nephroprotective Effect of Asparagus falcatus Leaf Extract on Adriamycin Induced Nephrotoxicity in Wistar Rats: A Dose Response Study

Authors: A. M. S. S. Amarasiri, A. P. Attanayake, K. A. P. W. Jayatilaka, L. K. B. Mudduwa

Abstract:

Adriamycin (ADR) is an effective anthracyclin antitumor drug, but its clinical use is limited due to renal toxicity. The leaves of Asparagus falcatus (Family: Liliaceae) have been used in the management of renal diseases since antiquity. In the present investigation, the aqueous leaf extract of A. falcatus was evaluated for acute nephroprotective activity in ADR induced nephrotoxic rats. Nephrotoxicity was induced in healthy male Wistar rats by intraperitoneal administration of ADR 20 mg/kg. The lyophilized powder of the aqueous refluxed (4h) leaf extract of A. falcatus was administered orally at three selected doses; 200, 400 and 600 mg/kg for three consecutive days. Fosinopril sodium (0.09 mg/kg) was used as the standard drug. Administration of the plant extract and the standard drug was commenced 24 hours after the induction of nephrotoxicity to rats. The nephroprotective effect was determined by selected biochemical parameters and by the assessment of histopathology on H and E stained kidney sections. The results were compared to a group of control rats with ADR induced nephrotoxicity. A group of rats administered with the equivalent volume of normal saline served as the healthy control. Administration of ADR 20 mg/kg produced a significant increase in the concentrations of serum creatinine (61%) and urine protein (73%) followed by a significant decrease in serum total protein (21%) and albumin (44%) of the plant extract treated animals compared to the healthy control group (p < 0.05). The aqueous extract of Asparagus falcatus at the three doses; 200, 400 and 600 mg/kg and the standard drug were found to decrease the elevation of concentrations of serum creatinine (33%, 51%, 54% and 42%) and urine protein (8%, 63%, 80% and 86%) respectively. The serum concentrations of total protein (12%, 17%, 29% and 12%) and albumin (3%, 17%, 17% and 16%) were significantly increased compared to the nephrotoxic control group respectively. Assessment of histopathology on H and E stained kidney sections demonstrated that ADR induced renal injury, as evidenced by loss of brush border, cytoplasmic vacuolization, pyknosis in renal tubular epithelial cells, haemorrhages, glomerular congestion and presence of hyaline casts. Treatment with the plant extract and the standard drug resulted in attenuation of the morphological destruction in rats. The results of the present study revealed that the aqueous leaf extract of A. falcatus possesses significant nephroprotective activity against adriamycin induced acute nephrotoxicity. The improved kidney functions were supported with the results of selected biochemical parameters and histological changes observed on H and E stained sections of the kidney tissues in Wistar rats.

Keywords: adriamycin induced nephrotoxicity, asparagus falcatus, biochemical assessment, histopathological assessment, nephroprotective activity

Procedia PDF Downloads 149
1069 Detection and Molecular Identification of Bacteria Forming Polyhydroxyalkanoate and Polyhydroxybutyrate Isolated from Soil in Saudi Arabia

Authors: Ali Bahkali, Rayan Yousef Booq, Mohammad Khiyami

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Soil samples were collected from five different regions in the Kingdom of Saudi Arabia. Microbiological methods included dilution methods and pour plates to isolate and purify bacteria soil. The ability of isolates to develop biopolymer was investigated on petri dishes containing elements and substance concentrations stimulating developing biopolymer. Fluorescent stains, Nile red and Nile blue were used to stain the bacterial cells developing biopolymers. In addition, Sudan black was used to detect biopolymers in bacterial cells. The isolates which developed biopolymers were identified based on their gene sequence of 1 6sRNA and their ability to grow and synthesize PHAs on mineral medium supplemented with 1% dates molasses as the only carbon source under nitrogen limitation. During the study 293 bacterial isolates were isolated and detected. Through the initial survey on the petri dishes, 84 isolates showed the ability to develop biopolymers. These bacterial colonies developed a pink color due to accumulation of the biopolymers in the cells. Twenty-three isolates were able to grow on dates molasses, three strains of which showed the ability to accumulate biopolymers. These strains included Bacillus sp., Ralstonia sp. and Microbacterium sp. They were detected by Nile blue A stain with fluorescence microscopy (OLYMPUS IX 51). Among the isolated strains Ralstonia sp. was selected after its ability to grow on molasses dates in the presence of a limited nitrogen source was detected. The optimum conditions for formation of biopolymers by isolated strains were investigated. Conditions studied included, best incubation duration (2 days), temperature (30°C) and pH (7-8). The maximum PHB production was raised by 1% (v1v) when using concentrations of dates molasses 1, 2, 3, 4 and 5% in MSM. The best inoculated with 1% old inoculum (1= OD). The ideal extraction method of PHA and PHB proved to be 0.4% sodium hypochlorite solution, producing a quantity of polymer 98.79% of the cell's dry weight. The maximum PHB production was 1.79 g/L recorded by Ralstonia sp. after 48 h, while it was 1.40 g/L produced by R.eutropha ATCC 17697 after 48 h.

Keywords: bacteria forming polyhydroxyalkanoate, detection, molecular, Saudi Arabia

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1068 Identification and Antibiotic Resistance Rates of Acinetobacter baumannii Strains Isolated from the Respiratory Tract Samples, Obtained from the Different Intensive Care Units

Authors: Recep Kesli, Gulşah Asik, Cengiz Demir, Onur Turkyilmaz

Abstract:

Objective: Acinetobacter baumannii (A. baumannii) can cause health-care associated infections, such as bacteremia, urinary tract and wound infections, endocarditis, meningitis, and pneumonia, particularly in intensive care unit patients. In this study, we aimed to evaluate A. baumannii production in sputum and bronchoalveolar lavage and susceptibilities for antibiotics in a 24 months period. Methods: Between October 2013 and September 2015, Acinetobacter baumannii isolated from respiratory tract speciments were evaluated retrospectively. The strains were isolated from the different intensive care units patients. A. baumannii strains were identified by both the conventional methods and aoutomated identification system -VITEK 2 (bio-Merieux, Marcy l’etoile, France). Antibiotic resistance testing was performed by Kirby-Bauer disc diffusion method according to CLSI criteria. Results: All the ninety isolates included in the study were from respiratory tract specimens. While of all the isolated 90 Acinetobacter baumannii strains were found to be resistant (100%), against ceftriaxone, ceftazidime, ciprofloxacin and piperacillin/ tazobactam, resistance rates against other tested antibiotics found as follows; meropenem 77, 86%, imipenem 75, 83%, trimethoprim-sulfamethoxazole (TMP-STX) 69, 76,6%, gentamicin 51, 56,6% and amikacin 48, 53,3%. Colistin was found as the most effective antibiotic against Acinetobacter baumannii, and there were not found any resistant (0%) strain against colistin. Conclusion: This study demonstrated that the no resistance was found in Acinetobacter baumannii against to colistin. High rates of resistance to carbapenems (imipenem and meropenem) and other tested antibiotics (ceftiaxone, ceftazidime, ciprofloxacine, piperacilline-tazobactam, TMP-STX gentamicin and amikacin) also have remarkable resistance rates. There was a significant relationship between demographic features of patients such as age, undergoing mechanical ventilation, length of hospital stay with resistance rates. High resistance rates against antibiotics require implementation of the infection control program and rational use of antibiotics. In the present study, while there were not found colistin resistance, panresistance were found against to ceftriaxone, ceftazidime, ciprofloxacin and piperacillin/ tazobactam.

Keywords: acinetobacter baumannii, antibiotic resistance, multi drug resistance, intensive care unit

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1067 Measuring Elemental Sulfur in Late Manually-Treated Grape Juice in Relation to Polyfunctional Mercaptan Formation in Sauvignon Blanc Wines

Authors: Bahareh Sarmadi, Paul A. Kilmartin, Leandro D. Araújo, Brandt P. Bastow

Abstract:

Aim: Sauvignon blanc is the most substantial variety cultivated in almost 62% of all producing vineyards of New Zealand. The popularity of New Zealand Sauvignon blanc is due to its unique taste. It is the most famous wine characterized by its aroma profile derived from mercaptans. 3-mercaptohexan-1-ol (3MH) and 3-mercaptohexyl acetate (3MHA) are two of the most important volatile mercaptans found in Sauvignon blanc wines. “Viticultural” and “Enological” factors such as machine-harvesting, the most common harvesting practice used in New Zealand, can be among the reasons for this distinct flavor. Elemental sulfur is commonly sprayed in the fields to protect berries against powdery mildew. Although it is not the only source of sulfur, this practice creates a source of elemental sulfur that can be transferred into the must and eventually into wines. Despite the clear effects of residual elemental sulfur present in the must on the quality and aroma of the final wines, its measurement before harvest or fermentation is not a regular practice in the wineries. This can be due to the lack of accessible and applicable methods for the equipment at most commercial wineries. This study aims to establish a relationship between the number and frequency of elemental sulfur applications and the concentration of polyfunctional mercaptans in the final wines. Methods: An apparatus was designed to reduce elemental sulfur to sulfide, then an ion-selective electrode to measure sulfide concentration. During harvest 2022, we explored a wider range of residual elemental sulfur levels than what typically applies in the vineyards. This has been done through later manual elemental sulfur applications in the vineyard. Additional sulfur applications were made 20, 10 and 5 days prior to harvesting the treated grapes, covering long and short pre-harvest intervals (PHI). The grapes were processed into juice and fermented into wine; then, they were analyzed to find the correlation between polyfunctional mercaptans concentrations in the wines and residual elemental sulfur in the juice samples. Results: The research showed that higher 3MH/3MHA was formed when elemental sulfur was applied more frequent in the vineyards and supported the proposed pathway in which elemental sulfur is a source of 3MH formation in wines.

Keywords: sauvignon blanc, elemental sulfur, polyfunctional mercaptans, varietal thiols

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1066 Management Problems in a Patient With Long-term Undiagnosed Permanent Hypoparathyroidism

Authors: Babarina Maria, Andropova Margarita

Abstract:

Introduction: Hypoparathyroidism (HypoPT) is a rare endocrine disorder with an estimated prevalence of 0.25 per 1000 individuals. The most common cause of HypoPT is the loss of active parathyroid tissue following thyroid or parathyroid surgery. Sometimes permanent postoperative HypoPT occures, manifested by hypocalcemia in combination with low levels of PTH during 6 months or more after surgery. Cognitive impairments in patients with hypocalcemia due to chronic HypoPT are observed, and this can lead to problems and challenges in everyday living: memory loss and impaired concentration, that may be the cause of poor compliance. Clinical case: Patient K., 66 years old, underwent thyroidectomy in 2013 (at the age of 55) because of papillary thyroid cancer T1NxMx, histopathology findings confirmed the diagnosis. 5 years after the surgery, she was followed up on an outpatient basis, TSH levelsonly were monitored, and the dose of levothyroxine was adjusted. In 2018 due to, increasing complaints include tingling and cramps in the arms and legs, memory loss, sleep disorder, fatigue, anxiety, hair loss, muscle pain, tachycardia, positive Chvostek, and Trousseau signs were diagnosed during examination, also in blood analyses: total Ca 1.86 mmol/l (2.15-2.55), Ca++ 0.96 mmol/l (1.12-1.3), P 1.55 mmol/l (0.74-1.52), Mg 0.79 mmol/l (0.66-1.07) - chronic postoperative HypoPT was diagnosed. Therapy was initiated: alfacalcidol 0.5 mcg per day, calcium carbonate 2000 mg per day, cholecalciferol 1000 IU per day, magnesium orotate 3000 mg per day. During the case follow-up, hypocalcemia, hyperphosphatemia persisted, hypercalciuria15.7 mmol/day (2.5-6.5) was diagnosed. Dietary recommendations were given because of the high content of phosphorus rich foods, and therapy was adjusted: the dose of alfacalcidol was increased to 2.5 mcg per day, and the dose of calcium carbonate was reduced to 1500 mg per day. As part of the screening for complications of hypoPT, data for cataracts, Fahr syndrome, nephrocalcinosis, and kidney stone disease were not obtained. However, HypoPT compensation was not achieved, and therefore hydrochlorothiazide 25 mg was initiated, the dose of alfacalcidol was increased to 3 mcg per day, calcium carbonate to 3000 mg per day, magnesium orotate and cholecalciferol were continued at the same doses. Therapeutic goals were achieved: calcium phosphate product <4.4 mmol2/l2, there were no episodes of hypercalcemia, twenty-four-hour urinary calcium excretion was significantly reduced. Conclusion: Timely prescription, careful explanation of drugs usage rules, and monitoring and maintaining blood and urine parameters within the target contribute to the prevention of HypoPT complications development and life-threatening events.

Keywords: hypoparathyroidism, hypocalcemia, hyperphosphatemia, hypercalciuria

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1065 Flammability and Smoke Toxicity of Rainscreen Façades

Authors: Gabrielle Peck, Ryan Hayes

Abstract:

Four façade systems were tested using a reduced height BS 8414-2 (5 m) test rig. An L-shaped masonry test wall was clad with three types of insulation and an aluminum composite panel with a non-combustible filling (meeting Euroclass A2). A large (3 MW) wooden crib was ignited in a recess at the base of the L, and the fire was allowed to burn for 30 minutes. Air velocity measurements and gas samples were taken from the main ventilation duct and also a small additional ventilation duct, like those in an apartment bathroom or kitchen. This provided a direct route of travel for smoke from the building façade to a theoretical room using a similar design to many high-rise buildings where the vent is connected to (approximately) 30 m³ rooms. The times to incapacitation and lethality of the effluent were calculated for both the main exhaust vent and for a vent connected to a theoretical 30 m³ room. The rainscreen façade systems tested were the common combinations seen in many tower blocks across the UK. Three tests using ACM A2 with Stonewool, Phenolic foam, and Polyisocyanurate (PIR) foam. A fourth test was conducted with PIR and ACM-PE (polyethylene core). Measurements in the main exhaust duct were representative of the effluent from the burning wood crib. FEDs showed incapacitation could occur up to 30 times quicker with combustible insulation than non-combustible insulation, with lethal gas concentrations accumulating up to 2.7 times faster than other combinations. The PE-cored ACM/PIR combination produced a ferocious fire, resulting in the termination of the test after 13.5 minutes for safety reasons. Occupants of the theoretical room in the PIR/ACM A2 test reached a FED of 1 after 22 minutes; for PF/ACM A2, this took 25 minutes, and for stone wool, a lethal dose measurement of 0.6 was reached at the end of the 30-minute test. In conclusion, when measuring smoke toxicity in the exhaust duct, there is little difference between smoke toxicity measurements between façade systems. Toxicity measured in the main exhaust is largely a result of the wood crib used to ignite the façade system. The addition of a vent allowed smoke toxicity to be quantified in the cavity of the façade, providing a realistic way of measuring the toxicity of smoke that could enter an apartment from a façade fire.

Keywords: smoke toxicity, large-scale testing, BS8414, FED

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1064 Validating the Cerebral Palsy Quality of Life for Children (CPQOL-Child) Questionnaire for Use in Sri Lanka

Authors: Shyamani Hettiarachchi, Gopi Kitnasamy

Abstract:

Background: The potentially high level of physical need and dependency experienced by children with cerebral palsy could affect the quality of life (QOL) of the child, the caregiver and his/her family. Poor QOL in children with cerebral palsy is associated with the parent-child relationship, limited opportunities for social participation, limited access to healthcare services, psychological well-being and the child's physical functioning. Given that children experiencing disabilities have little access to remedial support with an inequitable service across districts in Sri Lanka, and given the impact of culture and societal stigma, there may be differing viewpoints across respondents. Objectives: The aim of this study was to evaluate the psychometric properties of the Tamil version of the Cerebral Palsy Quality of Life for Children (CPQOL-Child) Questionnaire. Design: An instrument development and validation study. Methods: Forward and backward translations of the CPQOL-Child were undertaken by a team comprised of a physiotherapist, speech and language therapist and two linguists for the primary caregiver form and the child self-report form. As part of a pilot phase, the Tamil version of the CPQOL was completed by 45 primary caregivers with children with cerebral palsy and 15 children with cerebral palsy (GMFCS level 3-4). In addition, the primary caregivers commented on the process of filling in the questionnaire. The psychometric properties of test-retest reliability, internal consistency and construct validity were undertaken. Results: The test-retest reliability and internal consistency were high. A significant association (p < 0.001) was found between limited motor skills and poor QOL. The Cronbach's alpha for the whole questionnaire was at 0.95.Similarities and divergences were found between the two groups of respondents. The child respondents identified limited motor skills as associated with physical well-being and autonomy. Akin to this, the primary caregivers associated the severity of motor function with limitations of physical well-being and autonomy. The trend observed was that QOL was not related to the level of impairment but connected to environmental factors by the child respondents. In addition to this, the main concern among primary caregivers about the child's future and on the child's lack of independence was not fully captured by the QOL questionnaire employed. Conclusions: Although the initial results of the CPQOL questionnaire show high test-retest reliability and internal consistency of the instrument, it does not fully reflect the socio-cultural realities and primary concerns of the caregivers. The current findings highlight the need to take child and caregiver perceptions of QOL into account in clinical practice and research. It strongly indicates the need for culture-specific measures of QOL.

Keywords: cerebral palsy, CPQOL, culture, quality of life

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1063 A Systematic Review of Chronic Neurologic Complications of COVID-19; A Potential Risk Factor for Narcolepsy, Parkinson's Disease, and Multiple Sclerosis.

Authors: Sulemana Saibu, Moses Ikpeme

Abstract:

Background: The severity of the COVID-19 pandemic, brought on by the SARS-CoV-2 coronavirus, has been unprecedented since the 1918 influenza pandemic. SARS-CoV-2 cases of CNS and peripheral nervous system disease, including neurodegenerative disorders and chronic immune-mediated diseases, may be anticipated based on knowledge of past coronaviruses, particularly those that caused the severe acute respiratory syndrome and Middle East respiratory syndrome outbreaks. Although respiratory symptoms are the most common clinical presentation, neurological symptoms are becoming increasingly recognized, raising concerns about their potential role in causing Parkinson's disease, Multiple sclerosis, and Narcolepsy. This systematic review aims to summarize the current evidence by exploring the association between COVID-19 infection and how it may overlap with etiological mechanisms resulting in Narcolepsy, Parkinson's disease, and Multiple sclerosis. Methods: A systematic search was conducted using electronic databases ((PubMed/MedLine, Embase, PsycINFO, ScieLO, Web of Science, ProQuest (Biotechnology, Virology, and AIDS), Scopus, and CINAHL)) to identify studies published between January 2020 and December 2022 that investigated the association between COVID-19 and Parkinson's disease, multiple sclerosis, and Narcolepsy. Per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, the review was performed and reported. Study quality was assessed using the Critical Appraisal Skills Programme Checklist and the Joanna Briggs Institute Critical appraisal tools. Results: A total of 21 studies out of 1025 met the inclusion criteria, including 8 studies reporting Parkinson's disease, 11 on multiple sclerosis, and 2 on Narcolepsy. In COVID-19 individuals compared to the general population, Narcolepsy, Parkinson's disease, and multiple sclerosis were shown to have a higher incidence. The findings imply that COVID-19 may worsen the signs or induce multiple sclerosis and Parkinson's disease and may raise the risk of developing Narcolepsy. Further research is required to confirm these connections because the available data is insufficient. Conclusion: According to the existing data, COVID-19 may raise the risk of Narcolepsy and have a causative relationship with Parkinson's disease, multiple sclerosis, and other diseases. More study is required to confirm these correlations and pinpoint probable mechanisms behind these interactions. Clinicians should be aware of how COVID-19 may affect various neurological illnesses and should treat patients who are affected accordingly.

Keywords: COVID-19, parkinson’s disease, multiple sclerosis, narcolepsy, neurological disorders, sars-cov-2, neurodegenerative disorders, chronic immune-mediated diseases

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1062 Possibilities and Limits for the Development of Care in Primary Health Care in Brazil

Authors: Ivonete Teresinha Schulter Buss Heidemann, Michelle Kuntz Durand, Aline Megumi Arakawa-Belaunde, Sandra Mara Corrêa, Leandro Martins Costa Do Araujo, Kamila Soares Maciel

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Primary Health Care is defined as the level of a system of services that enables the achievement of answers to health needs. This level of care produces services and actions of attention to the person in the life cycle and in their health conditions or diseases. Primary Health Care refers to a conception of care model and organization of the health system that in Brazil seeks to reorganize the principles of the Unified Health System. This system is based on the principle of health as a citizen's right and duty of the State. Primary health care has family health as a priority strategy for its organization according to the precepts of the Unified Health System, structured in the logic of new sectoral practices, associating clinical work and health promotion. Thus, this study seeks to know the possibilities and limits of the care developed by professionals working in Primary Health Care. It was conducted by a qualitative approach of the participant action type, based on Paulo Freire's Research Itinerary, which corresponds to three moments: Thematic Investigation; Encoding and Decoding; and, Critical Unveiling. The themes were investigated in a health unit with the development of a culture circle with 20 professionals, from a municipality in southern Brazil, in the first half of 2021. The participants revealed as possibilities the involvement, bonding and strengthening of the interpersonal relationships of the professionals who work in the context of primary care. Promoting welcoming in primary care has favoured care and teamwork, as well as improved access. They also highlighted that care planning, the use of technologies in the process of communication and the orientation of the population enhances the levels of problem-solving capacity and the organization of services. As limits, the lack of professional recognition and the scarce material and human resources were revealed, conditions that generate tensions for health care. The reduction in the number of professionals and the low salary are pointed out as elements that boost the motivation of the health team for the development of the work. The participants revealed that due to COVID-19, the flow of care had as a priority the pandemic situation, which affected health care in primary care, and prevention and health promotion actions were canceled. The study demonstrated that empowerment and professional involvement are fundamental to promoting comprehensive and problem-solving care. However, limits of the teams are observed when exercising their activities, these are related to the lack of human and material resources, and the expansion of public health policies is urgent.

Keywords: health promotion, primary health care, health professionals, welcoming.

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1061 PWM Harmonic Injection and Frequency-Modulated Triangular Carrier to Improve the Lives of the Transformers

Authors: Mario J. Meco-Gutierrez, Francisco Perez-Hidalgo, Juan R. Heredia-Larrubia, Antonio Ruiz-Gonzalez, Francisco Vargas-Merino

Abstract:

More and more applications power inverters connected to transformers, for example, the connection facilities to the power grid renewable generation. It is well known that the quality of signal power inverters it is not a pure sine. The harmonic content produced negative effects, one of which is the heating of electrical machines and therefore, affects the life of the machines. The decrease of life of transformers can be calculated by Arrhenius or Montsinger equation. Analyzing this expression any (long-term) decrease of a transformer temperature for 6º C - 7º C means doubles its life-expectancy. Methodologies: This work presents the technique of pulse width modulation (PWM) with an injection of harmonic and triangular frequency carrier modulated in frequency. This technique is used to improve the quality of the output voltage signal of the power inverters controlled PWM. The proposed technique increases in the fundamental term and a significant reduction in low order harmonics with the same commutations per time that control sine PWM. To achieve this, the modulating wave is compared to a triangular carrier with variable frequency over the period of the modulator. Therefore, it is, advantageous for the modulating signal to have a large amount of sinusoidal “information” in the areas of greater sampling. A triangular signal with a frequency that varies over the modulator’s period is used as a carrier, for obtaining more samples in the area with the greatest slope. A power inverter controlled by PWM proposed technique is connected to a transformer. Results: In order to verify the derived thermal parameters under different operation conditions, another ambient and loading scenario is involved for a further verification, which was sampled from the same power transformer. Temperatures of different parts of the transformer will be exposed for each PWM control technique analyzed. An assessment of the temperature be done with different techniques PWM control and hence the life of the transformer is calculated for each technique. Conclusion: This paper analyzes such as transformer heating produced by this technique and compared with other forms of PWM control. In it can be seen as a reduction the harmonic content produces less heat transformer and therefore, an increase in the life of the transformer.

Keywords: heating, power-inverter, PWM, transformer

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1060 Ground Water Pollution Investigation around Çorum Stream Basin in Turkey

Authors: Halil Bas, Unal Demiray, Sukru Dursun

Abstract:

Water and ground water pollution at the most of the countries is important problem. Investigation of water pollution source must be carried out to save fresh water. Because fresh water sources are very limited and recent sources are not enough for increasing population of world. In this study, investigation was carried out on pollution factors effecting the quality of the groundwater in Çorum Stream Basin in Turkey. Effect of geological structure of the region and the interaction between the stream and groundwater was researched. For the investigation, stream and groundwater sampling were performed at rainy and dry seasons to see if there is a change on quality parameters. The results were evaluated by the computer programs and then graphics, distribution maps were prepared. Thus, degree of the quality and pollution were tried to understand. According to analysis results, because the results of streams and the ground waters are not so close to each other we can say that there is no interaction between the stream and the groundwater. As the irrigation water, the stream waters are generally in the range between C3S1 region and the ground waters are generally in the range between C3S1 and C4S2 regions according to US Salinity Laboratory Diagram. According to Wilcox diagram stream waters are generally good-permissible and ground waters are generally good permissible, doubtful to unsuitable and unsuitable type. Especially ground waters are doubtful to unsuitable and unsuitable types in dry season. It may be assumed that as the result of relative increase in concentration of salt minerals. Especially samples from groundwater wells bored close to gypsium bearing units have high hardness, electrical conductivity and salinity values. Thus for drinking and irrigation these waters are determined as unsuitable. As a result of these studies, it is understood that the groundwater especially was effected by the lithological contamination rather than the anthropogenic or the other types of pollution. Because the alluvium is covered by the silt and clay lithology it is not affected by the anthropogenic and the other foreign factors. The results of solid waste disposal site leachate indicate that this site would have a risk potential for pollution in the future. Although the parameters did not exceed the maximum dangerous values it does not mean that they will not be dangerous in the future, and this case must be taken into account.

Keywords: Çorum, environment, groundwater, hydrogeology, geology, pollution, quality, stream

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1059 Histological and Morphometric Studies of the Liver of Goats Aborted

Authors: Toumi Farah, Charallah Salima

Abstract:

In the Algerian Sahara, goat farming is predominant, and it’s associated with other types of breeding, particularly camel and sheep; it also constitutes a significant proportion of breeding exclusively goat. This Saharan goat is a small ruminant with a black dress with white’s spots, hanging ears, and a coat more or less long. It is known for its hardiness and resistance to adverse conditions of arid zones and its perfect ecophysiological adaptation to harsh environmental conditions. However, pregnancy alterations, particularly abortion, degrade its productivity and cause economic losses, having both direct and indirect effects on animal production, like the costs of veterinary interventions and the reconstitution of livestock. The purpose of this work is to study the histological aspect of the liver of goats’ aborted living under nomadic herds in the region of Béni-Abbès (30° 7' N, 2° 10 'O). The organs were collected in physiological serum, rinsed, and then fixed with formaldehyde (37°, diluted at 10%). After that, these samples were processed for a topographic study. The morphometric study of the liver was performed by using an image analysis and processing software "Image J"; the various measurements obtained are intended to specify the supposed stage of development according to the body weight. The histological structure of the liver shows that the hepatic parenchyma consists of vascular conjunctive spaces surrounded by Glisson’s capsule. The sinusoids and hepatic portal vein are full of red blood cells, representing sinusoidal congestion and a thrombosed vein. At high magnification, the blood vessels show the presence of vascular thrombosis and haemorrhage in some areas of the hepatic parenchyma. Morphometric analysis shows that the number of liver parenchymal cells and the diameter of liver vessels vary according to the stage of development. The results obtained will provide details of the anatomical and cellular elements that can be used in the diagnosis of early or late abortion and late embryonic death. It would be interesting to find, by immunohistochemistry, some inflammatory markers useful for monitoring the progress of pregnancy and bioindicators of fetomaternal distress.

Keywords: aborting goat, arid zone, liver, histopathology

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1058 Uterine Torsion: A Rare Differential Diagnosis for Acute Abdominal Pain in Pregnancy

Authors: Tin Yee Ling, Kavita Maravar, Ruzica Ardalic

Abstract:

Background: Uterine torsion (UT) in pregnancy of more than 45-degree along the longitudinal axis is a rare occurrence, and the aetiology remains unclear. Case: A 34-year-old G2P1 woman with a history of one previous caesarean section presented at 36+2 weeks with sudden onset lower abdominal pain, syncopal episode, and tender abdomen on examination. She was otherwise haemodynamically stable. Cardiotocography showed a pathological trace with initial prolonged bradycardia followed by a subsequent tachycardia with reduced variability. An initial diagnosis of uterine dehiscence was made, given the history and clinical presentation. She underwent an emergency caesarean section which revealed a 180-degree UT along the longitudinal axis, with oedematous left round ligament lying transverse anterior to the uterus and a segment of large bowel inferior to the round ligament. Detorsion of uterus was performed prior to delivery of the foetus, and anterior uterine wall was intact with no signs of rupture. There were no anatomical uterine abnormalities found other than stretched left ovarian and round ligaments, which were repaired. Delivery was otherwise uneventful, and she was discharged on day 2 postpartum. Discussion: UT is rare as the number of reported cases is within the few hundreds worldwide. Generally, the uterus is supported in place by uterine ligaments, which limit the mobility of the structure. The causes of UT are unknown, but risk factors such as uterine abnormalities, increased uterine ligaments’ flexibility in pregnancy, and foetal malposition has been identified. UT causes occlusion of uterine vessels, which can lead to ischaemic injury of the placenta causing premature separation of the placenta, preterm labour, and foetal morbidity and mortality if delivery is delayed. Diagnosing UT clinically is difficult as most women present with symptoms similar to placenta abruption or uterine rupture (abdominal pain, vaginal bleeding, shock), and one-third are asymptomatic. The management of UT involves surgical detorsion of the uterus and delivery of foetus via caesarean section. Extra vigilance should be taken to identify the anatomy of the uterus experiencing torsion prior to hysterotomy. There have been a few cases reported with hysterotomy on posterior uterine wall for delivery of foetus as it may be difficult to identify and reverse a gravid UT when foetal well-being is at stake. Conclusion: UT should be considered a differential diagnosis of acute abdominal pain in pregnancy. It is crucial that the torsion is addressed immediately as it is associated with maternal and foetal morbidity and mortality.

Keywords: uterine torsion, pregnancy complication, abdominal pain, torted uterus

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1057 Evaluation of Natural Gums: Gum Tragacanth, Xanthan Gum, Guar Gum and Gum Acacia as Potential Hemostatic Agents

Authors: Himanshu Kushwah, Nidhi Sandal, Meenakshi K. Chauhan, Gaurav Mittal

Abstract:

Excessive bleeding is the primary factor of avoidable death in both civilian trauma centers as well as the military battlefield. Hundreds of Indian troops die every year due to blood loss caused by combat-related injuries. These deaths are avoidable and can be prevented to a large extent by making available a suitable hemostatic dressing in an emergency medical kit. In this study, natural gums were evaluated as potential hemostatic agents in combination with calcium gluconate. The study compares the hemostatic activity of Gum Tragacanth (GT), Guar Gum (GG), Xanthan Gum (XG) and Gum Acacia (GA) by carrying out different in-vitro and in-vivo studies. In-vitro studies were performed using the Lee-White method and Eustrek method, which includes the visual and microscopic analysis of blood clotting. MTT assay was also performed using human lymphocytes to check the cytotoxicity of the gums. The in-vivo studies were performed in Sprague Dawley rats using tail bleeding assay to evaluate the hemostatic efficacy of the gums and compared with a commercially available hemostatic sponge, Surgispon. Erythrocyte agglutination test was also performed to check the interaction between blood cells and the natural gums. Other parameters like blood loss, adherence strength of the developed hemostatic dressing material incorporating these gums, re-bleeding, and survival of the animals were also studied. The data obtained from the MTT assay showed that Guar gum, Gum Tragacanth, and Gum Acacia were not significantly cytotoxic, but substantial cytotoxicity was observed in Xanthan gum samples at high concentrations. Also, Xanthan gum took the least time with its minimum concentration to achieve hemostasis, (approximately 50 seconds at 3mg concentration). Gum Tragacanth also showed efficient hemostasis at a concentration of 35mg at the same time, but the other two gums tested were not able to clot the blood in significantly less time. A sponge dressing made of Tragacanth gum was found to be more efficient in achieving hemostasis and showed better practical applicability among all the gums studied and also when compared to the commercially available product, Surgispon, thus making it a potentially better alternative.

Keywords: cytotoxicity, hemostasis, natural gums, sponge

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1056 Evidence-Triggers for Care of Patients with Cleft Lip and Palate in Srinagarind Hospital: The Tawanchai Center and Out-Patients Surgical Room

Authors: Suteera Pradubwong, Pattama Surit, Sumalee Pongpagatip, Tharinee Pethchara, Bowornsilp Chowchuen

Abstract:

Background: Cleft lip and palate (CLP) is a congenital anomaly of the lip and palate that is caused by several factors. It was found in approximately one per 500 to 550 live births depending on nationality and socioeconomic status. The Tawanchai Center and out-patients surgical room of Srinagarind Hospital are responsible for providing care to patients with CLP (starting from birth to adolescent) and their caregivers. From the observations and interviews with nurses working in these units, they reported that both patients and their caregivers confronted many problems which affected their physical and mental health. Based on the Soukup’s model (2000), the researchers used evidence triggers from clinical practice (practice triggers) and related literature (knowledge triggers) to investigate the problems. Objective: The purpose of this study was to investigate the problems of care for patients with CLP in the Tawanchai Center and out-patient surgical room of Srinagarind Hospital. Material and Method: The descriptive method was used in this study. For practice triggers, the researchers obtained the data from medical records of ten patients with CLP and from interviewing two patients with CLP, eight caregivers, two nurses, and two assistant workers. Instruments for the interview consisted of a demographic data form and a semi-structured questionnaire. For knowledge triggers, the researchers used a literature search. The data from both practice and knowledge triggers were collected between February and May 2016. The quantitative data were analyzed through frequency and percentage distributions, and the qualitative data were analyzed through a content analysis. Results: The problems of care gained from practice and knowledge triggers were consistent and were identified as holistic issues, including 1) insufficient feeding, 2) risks of respiratory tract infections and physical disorders, 3) psychological problems, such as anxiety, stress, and distress, 4) socioeconomic problems, such as stigmatization, isolation, and loss of income, 5)spiritual problems, such as low self-esteem and low quality of life, 6) school absence and learning limitation, 7) lack of knowledge about CLP and its treatments, 8) misunderstanding towards roles among the multidisciplinary team, 9) no available services, and 10) shortage of healthcare professionals, especially speech-language pathologists (SLPs). Conclusion: From evidence-triggers, the problems of care affect the patients and their caregivers holistically. Integrated long-term care by the multidisciplinary team is needed for children with CLP starting from birth to adolescent. Nurses should provide effective care to these patients and their caregivers by using a holistic approach and working collaboratively with other healthcare providers in the multidisciplinary team.

Keywords: evidence-triggers, cleft lip, cleft palate, problems of care

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